Community Integration: Treatment, Supervision, and Community Safety

1
Community IntegrationTreatment, Supervision,
and Community Safety

• RWJ Cross-System Financing Project
• Chicago, IL
• October 1314, 2006

2
Georgias State Team

• Marta Daniell, Program Manager, State Board of
  Pardons and Parole (SBPP)
• Wendy Tiegreen, Director of Provider Network
  Development, Division of Mental Health,
  Developmental Disabilities, and Addictive
  Diseases (MHDDAD), DHR
• Neil Kaltenecker, Director, Office of Addictive
  Diseases, MHDDAD, DHR

3
Context

• Georgias Adult Offender Population
• FY 2005
• 24,276 State Parolees
• 50, 921 State Inmates
• 133,165 State Probationers
• 5,080 Probation Facilities
• 6,079 County-Sentenced
• 262,041 MM Probationers
• 21,630 In Jail Awaiting Trial

4
Context

• 1,478 paroled or reprieved with a Special
  Condition for MH counseling
• 6,656 parolees newly enrolled in ASAM Level 1
  substance abuse treatment (2,933, or 44,
  completed)
• 81,972 random drug screens for parolees (15
  positive)

5
Context

• Approximately 75 of offenders enter prison
  with a drug-related history
• Less than 1 of prison beds are designated for
  residential substance abuse treatment (RSAT)

6
The State Benefit Package-Services

• Core Services
• Diagnostic Assessment
• Community Support Individual
• Physician Assessment
• Nursing Assessment
• Individual Counseling
• Family Counseling/Training
• Group Counseling/Training
• Medication Administration
• Crisis Intervention

7
The State Benefit Package-Services

• Specialty SA Services
• Crisis Stabilization Program
• Ambulatory Detox
• SA Residential
• SA Day Treatment
• Consumer/Family Supports

8
Context

• Governors Commission for a New Georgia
• Develop an effective intervention program for the
  MH/AD needs of the adult offender population
• Lack of effective treatment leads to high
  recidivism rates (as high as 40) for discharged
  offenders

9
Context

• Recent history of addiction services not being
  available for parolees upon release
• Grant-in-Aid Funding for Adult MH/SA
• Housing Needs vs. Residential Treatment

10
Goal
Treatment contracted through MHDDAD Treatment contracted through SBPP
Single System for Community Integration for CJ
Populations
11

1. Grant-in-Aid funding process through FY07
2. Few new state dollars
3. Priority services for those being released from
   institutions and those in CJ system.
4. Defining targeted treatment levels (ASAM 2.1 and
   above)
5. Statewide Crisis and Access Line (July 1, 2006)

12

1. ASAM Level 1 statewide, including assessment
2. 60-bed SA residential treatment for parolees (5
   month length of stay)
3. Parole Reporting Center w/ emphasis on SA
   treatment in largest county in Georgia
   (Metro-Atlanta)
4. Drug testing
5. Refer to OAD community providers for
   higher-levels of SA treatment

13
Cross System Support and Contribution
OAD
OAD/SBPP
SBPP
ASAM Level 2.1 and above Training Co-occurring MH/AD treatment Assessment ASAM Level 1 Recovery Supports (DOL, DTAE, Cog. Skills training)
14
Accomplishments so far

• Series of meetings with staff from Pardons and
  Parole and Office of Addictive Diseases
• Data of releases w/ Special Condition of SA
  treatment, revoked with a positive drug test
• Number of consumers being served in Core and
  Specialty services
• Input from community SA provider
• Input/feedback from SBPP field staff

15
NIDA - Principles of Drug Abuse Treatment for
CJ Populations

1. Drug addiction is a brain disease that
   affects behavior.
2. Recovery from drug addiction requires effective
   treatment, followed by management of the problem
   over time.
3. Treatment must last long enough to produce stable
   behavioral changes.
4. Assessment is the first step in treatment.
5. Tailoring services to fit the needs of the
   individual is an important part of effective drug
   abuse treatment for criminal justice populations.

16
NIDA - Principles of Drug Abuse Treatment for
CJ Populations

1. Drug use during treatment should be carefully
   monitored.
2. Treatment should target factors that are
   associated with criminal behavior.
3. Criminal justice supervision should incorporate
   treatment planning for drug abusing offenders,
   and treatment providers should be aware of
   correctional supervision requirements.
4. Continuity of care is essential for drug abusers
   re-entering the community.
5. A balance of rewards and sanctions encourages
   pro-social behavior and treatment participation.

17
NIDA - Principles of Drug Abuse Treatment for
CJ Populations

• Offenders with co-occurring drug abuse and mental
  health problems often require an integrated
  treatment approach.
• Medications are an important part of treatment
  for many drug abusing offenders.
• Treatment planning for drug abusing offenders who
  are living in or re-entering the community should
  include strategies to prevent and treat serious,
  chronic medical conditions, such as HIV/AIDS,
  hepatitis B and C, and tuberculosis.

18
Demonstration Project
19
Things to do

• Identify potential funding
• Select pilot sites based on
• Urban, suburban, and rural locations
• Quality of provider agencies
• Supportive field staff
• Develop Timeline for implementation

20
Considerations

• Major Shift in OAD Purchasing Practices
• Developing an MH/SA Adult Services Purchasing
  Plan
• Parole Board Support

21
Implementation

• Project Manager
• RFQC
• Training
• Evaluation Plan
• On-going Adjustments

22
Ultimate Success

• Positive Outcomes
• Integrated delivery system for Parolees
• Transfer to Adult Probation and Juvenile
  Correctional Systems
• Approach Legislature w/ budget request based on
  need