As the feds begin mobilizing toward criminal justice reform, we take a look at state-level efforts to promote diversion and reduce recidivism

 
Editor’s note: During the writing of this piece, Attorney General Eric Holder announced federal reforms to prevent mandatory minimums for nonviolent drug crimes, to broaden the criteria for reductions in sentence length, and to avoid prosecution for marijuana possession in states where it is legal.  
 
These are timely illustrations of action at the federal level to address problems in the criminal justice system and reasons to think about further reforms.
 
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Our last post on recovery and the criminal justice (CJ) system described some of the ways the system fails to effectively address substance use disorders (SUDs).  Recovery, as we wrote, is difficult for incarcerated people because of the effects of prisonization and the complexity of the transition from behind prison walls to the outside world.

And furthermore, access to treatment in jails and prisons is inadequate.  The numbers show that inmates are placed on long waiting lists or do not receive the treatment at all.

These are missed opportunities.

“Not treating a drug-abusing offender,” Redonna K. Chandler (et al, 2009) warns, “is a missed opportunity to simultaneously improve both public health and safety.”

Not providing effective treatment for inmates with SUDs is also a missed opportunity to save costs and prevent future crime.  Further, it’s a missed opportunity to engage with incarcerated individuals and promote connection with community–sometimes for the first time.

As Eddie Ellis from the Center for NuLeadership on Urban Solutions has pointed out, many incarcerated individuals—especially those with SUDs and co-occurring disorders—are people who are disenfranchised, who have slipped through the cracks and have never had connections to mainstream employment, healthcare, and education.

So we understand there’s a lot at stake.  How can we do better?

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Two types of solutions: Improving service provision and reforming policy

Solutions to substance-related problems among the criminal justice population are, as you might expect, not quick fixes.  However, experts in the field have been voicing pragmatic suggestions for years (compare CASA’s Behind Bars, 1998 with their Behind Bars II, 2010).   Now, as state and federal systems are looking more seriously at penal reform, these ideas are more relevant than ever.

Below are some of the most pressing recommendations for change in CASA’s 2010 report, Behind Bars II (emphasis added).

In the criminal justice system:

Use appropriately trained health care professionals to screen, assess and treat substance-involved offenders using comprehensive, evidence-based approaches tailored to the needs of offenders

Provide appropriate care for co-occurring physical and mental health problems; offer and encourage participation in literacy, education, job training and parenting programs; and, increase the availability of religious, spiritual, and mutual support services

• For inmates with substance use disorders, provide comprehensive pre-release planning to assure transition to a broad range of integrated reentry services

Expand the use of treatment-based alternatives to jail and prison–including drug courts and prosecutorial diversion programs–and post-release supervision for substance-involved offenders

In federal, state and local governments:

Require that addiction treatment be provided in criminal justice settings, that it be medically managed and that pharmacological treatments be available

Require the accreditation of prison- and jail-based treatment programs and providers

Expand federal grants to states and localities for integrated evidence-based and promising practices

These recommendations haven’t fallen entirely on deaf ears.  Particularly with economic shortfalls since 2009 at both state and federal levels, public attention has swiveled toward criminal justice reforms.  There are changes on the ground to point to.

For example, a number of states have explored models for jail diversion, modified penalties for drug offenses, scaled back mandatory minimums, and eliminated certain drug policy sentencing disparities. This year, South Dakota signed legislation for the expansion of drug courts, Hawaii formed a Veterans Treatment Court, and Georgia is working on legislation to divert juvenile offenders.

There also is recent progress at the federal level in reducing mandatory sentencing for nonviolent, low-level drug offenders.

There is a lot of work to do in the areas of treatment availability and quality.  Securing effective provision of Medication Assisted Treatment (MAT) is an area of significant need; we will treat this issue in a future post.

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Improving service provision: Sheridan Correctional Center in Illinois

CASA recommendations for improving treatment–SUD screening and assessment of treatment needs; individualized treatment plans; aftercare that provides community supervision; case management and integrated services; and monitoring of relapse episodes that provides sanctions and rewards–all point to the importance of treating the whole person.

According to Pamela Rodriguez, Executive Vice President for Treatment Alternatives for Safe Communities (TASC), a key to fostering recovery and reducing recidivism in inmates with SUDs lies in implementing Recovery-Oriented Systems of Care (ROSC) in the CJ system, both during and after incarceration.

ROSC is an intelligent, integrated system that is flexible enough take into account the life situations of individuals with SUDs, including a person’s need for medical and mental health care, housing, education, job placement, transportation, legal support, with sensitivity to cultural and gender differences.

Rodriguez has seen success firsthand with this model at the Sheridan Correctional Center in Illinois:

We noticed substantial improvement in not only our outcomes, but in the way we work together as a Recovery Oriented System, once all the providers—e.g., housing, treatment, community mentoring, parole—stopped simply focusing only on their specific service specialty (e.g., treatment placement, job placement, housing placement) and instead began to work together […].

Sheridan Correctional Center: Specifically designed to treat SUDs

Located 70 miles west of Chicago, Sheridan Correctional Center is an adult male medium-security prison that has been totally dedicated to substance abuse treatments since 2004.  Every inmate at Sheridan is there because he chose to be.

Services are integrated and coordinated at Sheridan, including evidence-based substance abuse treatment, academic and vocational classes, and other life skills/therapeutic offerings.  Close attention is paid to the reentry process, which is facilitated by a team that includes Sheridan, TASC (Rodriguez’s organization), and probation/parole services.

Rodriguez points to the case management function as the unifying force among different systems:

It was [the] independent case management thread that wove through and ultimately strengthened the various agencies and providers, both within the correctional institution and in the community.

The financial impact of programs like Sheridan seem promising.  Annually, Sheridan costs $10-20 million more than a regular prison in Illinois.  However, on average, offenders at Sheridan have been arrested 9-16 times.  The state reported that among graduates, there was a 40 percent drop in the number going back to jail, resulting in a $64 million reduction in incarceration costs in the first four years of its existence.

The Sheridan model is featured on a PBS Now episode, “Maximum Capacity,” which has interviews with current and former inmates and includes brief footage of intense overcrowding in California’s state prisons.

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Reforming policy: Federal reforms and California’s diversion experiment

It’s no news that prisons are overcrowded at both federal and state levels and that some incarcerated individuals, especially those with SUDs, would be better served by alternative placements in treatment facilities, counseling, or other services. Diversion from incarceration also saves the CJ system valuable resources and defrays “job productivity losses, and the separation from family and social support systems.” (Chandler et al, 2009).

2012 study on the benefits and costs of diversion from incarceration found that a diversion from incarceration of 10% of eligible individuals demonstrated societal net benefits of $8.5 billion over the group’s lifetime.  (Individuals were considered “eligible” if they were re-arrested for a nonviolent or drug offense, currently abusing drugs, had no history of incarceration for a violent offense, and had never before been diverted into treatment.)

The federal government is finally taking action.  Last month, the Department of Justice, in accordance with its Smart on Crime initiative, released a new policy regarding mandatory minimums for non-violent low-level drug offenses, a step that will reduce the number of incarcerations at the federal level.  Speaking in conjunction with the new policy, Attorney General Holder stated:

Long sentences for low-level, non-violent drug offenses do not promote public safety, deterrence, and rehabilitation.

However, these reforms only affect federal prisoners. In 2012, there were more than 1.5 million people in prison and, of those, only 200,000 were housed in federal prisons. Much of the work that matters in criminal justice reform will need to occur at the state level.

And here in the United States, of course, each state has different policies for its sentencing and correctional facilities.  These may or may not include ways to divert low-level drug offenders from unnecessary jail time.

California

As usual, California is serving as America’s “mini-me,” a sort of magnified microcosm of the rest of the country and, ultimately, a testing ground for new ways of doing things.  Severe problems in the state prison system have led to fairly radical reforms whose effects will have something to teach us all.

Overcrowding in California prisons in the last few years has become so extreme that prisoners have gone without beds, contracted deadly communicable diseases, and missed meals for days because of shortages.  These inhumane conditions have been cause for multiple federal investigations and, this summer, contributed to a widespread hunger strike among prisoners.

In light of the chaos and unmanageable expense associated with its penal system, California created a Public Safety Realignment policy in 2011, designed to divert new admissions of “nonserious, nonsex, nonviolent offenders” from state prisons to local jails.  Re-alignment began June 27 of this year.

Under realignment, each county receives funding for accommodating the diverted population with minimal guidance on how to use it.   Some are using the opportunity to invest in real reforms like rehabilitative services, sentencing alternatives and pre-sentencing assessments.  Many are simply building more jails.

Thus, California is plunging forward with prison reform because the status quo has become untenable.  It’s been called “the biggest penal experiment in modern history,” and will certainly generate local-level models that do promote recovery and reduce recidivism–as well as those that don’t.

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Opportunities Abound

Here’s some perspective: the United States incarcerates a larger percentage of our population than any other country in the world (Center for Economic Policy & Research, 2010).

However, often by sheer necessity, movement for change is afoot at the federal, state and local level.   And the numbers are moving.  In 2012, the prison population declined for the third year in a row.  It peaked at over 1.6 million in 2009–and had increased every  year between 1978 and 2009.  (Bureau of Justice Statistics, 2013)

Organizations like The Center for Health and Justice, which leads projects like the Justice Leadership Systems Change Initiative, are taking the right kind of steps to increase evidence-based approaches to addiction in the justice system.  IRETA, too, works with federal and state systems to construct more effective processes for dealing with substance use and addiction before, during and after incarceration.

This work is in its infanthood, though, and there’s plenty of room at the table for community organizations, treatment providers, and the probation and parole system.  We have a long way to go.

Next up in our series on recovery & and the CJ system: MAT for Prisoners and Orange Is the New Black

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Related Articles

What makes recovery difficult for the criminal justice population? (7/22/13)

Recommended Resources

Follow the conversation about federal drug policy on Twitter using the hashtag #drugpolicyreform

Read this fascinating article for more detail about California’s Realignment:  Will US Penal Reform Tip the Balance for Addictions?

Watch PBS Now featuring Sheridan Correctional Center: “Maximum Capacity”

Check out these organizations working to reform the justice system: The Center for Health and Justice, the U.S. Dept. of Justice, Bureau of Justice Assistance (BJA), The Center for Prisoner Health and Human RightsSAMHSA’s GAINS Center for Behavioral Health and Justice Transformation, the Drug Policy Institute (DPI) at the University of Florida, and the Illinois Consortium on Drug Policy (ICDP) at Roosevelt University