powerpoint presentationdhhr.wv.gov/bhhf/documents/2013 ibhc presentations...title: powerpoint...
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WEST VIRGINIA INTEGRATED BEHAVIORAL HEALTH CONFERENCE
Risk Need Responsivity: Who, What, How of Offending Behavior
Jennifer Pealer, Ph.D.
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Presentation Overview
• Justice Reinvestment in West Virginia
– What is Justice Reinvestment?
– Findings from Justice Reinvestment analysis
– Justice Reinvestment Policy Framework
• Risk, Need, Responsivity
– Relevance to Justice Reinvestment Framework
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JUSTICE REINVESTMENT IN WEST VIRGINIA
What is Justice Reinvestment?
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Council of State Governments Justice Center • National non-profit, non-partisan membership association
of state government officials • Engages members of all three branches of state
government • Justice Center provides practical, nonpartisan advice
informed by the best available evidence
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The Two Phases of Justice Reinvestment
Justice Reinvestment
a data-driven approach to reduce corrections spending and reinvest savings in strategies that can decrease recidivism and increase public safety.
Bipartisan, inter-branch, bicameral structure
1
Analyze Data & Develop
Policy Options
2
Adopt New Policies
3
Measure Performance
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CSG Justice Reinvestment States
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Governor Tomblin Signs SB 371
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JUSTICE REINVESTMENT IN WEST VIRGINIA
Findings from Justice Reinvestment Analysis
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• 152,000 West Virginians over the age of eighteen have a substance use problem ~ which is 1 in 10 adults
• Number of overdose deaths increased 5.5 times (largest increase of any state) between 1999 and 2004
• Leads the nation in methadone-related deaths per capita and has the fastest growing rate of methadone overdoses in the nation
• West Virginians are more likely to die from drug overdoses than residents of any other state
Source: http://www.dhhr.wv.gov/bhhf/sections/programs/ProgramsPartnerships/AlcoholismandDrugAbuse/Pages/SBIRT.aspx
West Virginia Chamber of Commerce, Drug-free Workplace Act, 2011
West Virginia Department of Health & Human Resources, Comprehensive Substance Abuse Strategic Plan, 2011
Behavioral Health Statistics in West Virginia
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Unique Challenges for West Virginia Treatment challenges: behavioral health, particularly community-based substance use treatment, disconnected from criminal justice Convoluted terrain causing a dispersed population and huge transportation challenges Structural challenges: five state criminal justice agencies and four local programs, with two layers of judicial authority affecting CJ resources, and connected only between circuit courts and probation
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GACSA Regional Task Force Needs Assessments Show Demand for Levels of Service by Region REGION 4
SBIRT Sites: 3 Detox Beds: 6-8 New Intensive Outpatient Programs: 1 Expanded Intensive Outpatient Programs: 1 Short-Term Res. TX: 16-20 beds Fellowship Homes: 2 Recovery Coaches: 26
REGION 6 SBIRT Sites: 3 Detox Beds: 6-8 New Intensive Outpatient Programs: 2 Short-Term Res. TX Beds: 8-10 Long-Term Res. TX Beds: 10-16 Fellowship Homes: 3 Recovery Coaches: 22
REGION 5 SBIRT Sites: 2 Detox Beds: 12-16 Expanded Intensive Outpatient Programs: 1 Short-Term Res. TX Beds: 8-10 Fellowship Homes: 3 Recovery Coaches: 20
Source: http://wvsubstancefree.org/resources.php (Region Profiles 1-6)
http://terzettocreative.com/clients/advisorycouncil/docs/Section2_Definitions-Needs-Assessment.pdf
z
Hardy Tucker
Marion
Lewis
Monongalia
Ohio
Wetzel
Boone
Logan
Prescription Drug Overdose Rates
(2006-2010 Combined))
Rate per 100k people
0-15
16-30
31-45
REGION 2 SBIRT Sites: 2 Detox Beds: 12-16 Long-Term Res. TX Beds: 16-20 Fellowship Homes: 3 Recovery Coaches: 16
46-90
REGION 3 SBIRT Sites: 2 Detox Beds: 6-8 Short-Term Res. TX Beds: 8-10 Fellowship Homes: 2 Recovery Coaches: 16
REGION 1 SBIRT sites: 2 Detox Beds: 6-8 Crisis Stabilization Units: 1 New Intensive Outpatient Programs: 1 Short-Term Res. TX Beds: 8-10 Fellowship Homes: 3 Recovery Coaches: 10
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Drug Offenses and Substance Abuse are Contributing to Prison Population Growth
• 22% of new commitments are for drug offenses
• 62% of probation revocations to prison had a substance score indicating abuse or addiction
• Prison stock population drug offenders up 32%
• Alcohol and drug use cited in 78% of technical parole revocations and 65% of revocations for new crimes
• Arrests for drug offenses are up 6%
Source: WV DOC commitments and stock population datasets, WV parole revocations dataset, WVSP arrest data
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CSG Justice Center Finding: Substance Use is Major Driver for Prison Growth
DOC Commitments by Offense Type 2007-2011
400
600
800
1,000
1,200
1,400
1,600
2007 2008 2009 2010 2011
Other – Up 12%
Violent – Down 1%
Drug – Up 11%
Property – Up 11%
589
1,368
616
751
Source: WV DOC commitments dataset
Stakeholder outreach suggested that many property offenses were also related to substance use.
DOC Commitments by Offense Type (2007 – 2011)
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CSG Justice Center Finding: Revocations for Substance Use Are Another Significant Driver
1,425 1,704
386
490 389
597
76
165
329
368
0
500
1,000
1,500
2,000
2,500
3,000
3,500
2005 2011
Prison Commitments by Type, 2005 and 2011
New Regular Commitments +20%
Parole Revocations +27%
Other +12%
Probation Revocations +53%
Community Corrections / Home Confinement Revocations +117% 2,605
3,324
62% of probation revocations to had a substance use score indicating abuse or addiction
78% of revocations for technical revocations & 65% of revocations for new crimes involved possession or use of drugs/alcohol
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Long Wait Times Affect Many with All Levels of Substance Abuse or Mental Health Need
Probation Parole DRC
Outpatient programs 23% 8% 21%
Intensive outpatient programs 39% 23% 31%
Residential treatment 83% 67% 77%
What percentage of clients with needs experience wait times of more than a month for the following substance abuse services?
Probation Parole DRC
Outpatient programs 30% 11% 14%
Assertive community treatment/ Intensive case management
36% 21% 15%
Residential treatment 63% 58% 42%
What percentage of clients with needs experience wait times of more than a month for the following mental health services?
Source: CSG Justice Center qualitative field research
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Barriers to Treatment Within Community Supervision Go Beyond Wait Times
Probation Parole DRC
Transportation 66% 64% 64%
Cost 75% 58% 71%
Services aren’t available in community 74% 64% 50%
Other (Lack of space, wait time, no insurance, lack of desire to attend)
22% 25% 29%
Probation Parole DRC
Transportation 64% 56% 64%
Cost 84% 69% 71%
Services aren’t available in community 62% 53% 64%
What barriers limit client access to mental health treatment?
What barriers limit client access to substance abuse treatment?
Source: CSG Justice Center qualitative field research
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Few Substance Abuse Services are Provided for Those on Community Supervision
DRC Probation Drug Court DOC Parole
Funding for services
$986,088 $0 $1,137,838 $872,000 $0
Capacity to provide services
Unknown None 430 ALADRUE:
944 RSAT: 427
None
Estimated demand for services – Total
108 1,449 263 2,431 492
Outpatient 43 580 105 973 197
Intensive Outpatient
43 580 105 973 197
Residential with step down
22 290 53 486 98
Source: D.A. Andrews & James Bonta, “ColorPlpt Profile Form for Men,” The Level of Service Inventory - Revised: U.S. Norms, 2003
Steven Belenkoa & Jordon Peugh“Estimating Drug Treatment Needs Among State Prison Inmates.” Drug and Alcohol Dependence 77, no. 3 (2005): 269–281.
Conversation with Alexa Eggleston and Fred Osher, November, 2012
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JUSTICE REINVESTMENT IN WEST VIRGINIA
Justice Reinvestment Policy Framework
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Challenge Objective
Substance use is pervasive and contributes to the growing prison population. Additionally, treatment resources are not targeted where they could have the biggest impact – in the community.
Reduce Substance Use: • Invest in community-based treatment for people on
supervision with substance use needs • Establish partnerships and resources across systems • Ensure effective substance use treatment within DOC
Max outs have increased because of sentencing and parole inefficiencies. Additionally, many people who are revoked from community supervision spend long periods in prison, at a great cost to taxpayers.
Improve Accountability: • Ensure that releases from prison are supervised • Respond to violations with swift, certain, and cost-
effective sanctions • Streamline correctional system processes to reduce
delays in parole eligibility and other inefficiencies
Revocations have increased because community supervision agencies have not incorporated the principles of the Risk-Needs-Responsivity model.
Strengthen Community Supervision: • Adopt a statewide risk/needs assessment and focus
supervision resources on high risk offenders • Maximize potential of DRCs to reduce recidivism • Ensure implementation of evidence-based practices
Objectives of the Justice Reinvestment Policy Framework
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Reduce Substance Use By Reinvesting in Community-based Treatment
3(A): Invest in community-based treatment for people with substance use needs
• Create a treatment supervision sentencing option for judges to impose supervised probation with dedicated state treatment resources to people convicted of felony offenses who have a high likelihood of reoffending and who have moderate to high substance use treatment needs.
• Reinvest funding for people serving on probation and parole, who have a moderate to high likelihood of reoffending and a moderate to high need for substance use treatment in the community. Require these entities to partner with behavioral health providers to provide services.
• Support training, data collection, and other investments in the state treatment infrastructure to ensure treatment is delivered according to research-based approaches for providing substance use treatment to people under community-based supervision.
DRC Probation Drug Court DOC Parole
Current Funding for treatment
$986,088 $0 $1,137,838 $872,000 $0
Treatment Capacity
Unknown None 430 ALADRUE: 944
RSAT: 427 None
Policy Option Prioritize
treatment for high risk & need
Invest in treatment for high risk & need
Prioritize treatment for
high risk & need
Prioritize treatment for
high risk & need
Invest in treatment for high risk & need
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Reduce Substance Use By Connecting Community Corrections and Behavioral Health
3(B): Establish effective partnerships and resources across systems
• Require behavioral health providers to participate in community corrections boards. • Require DJCS to review the membership of all community corrections committees to close gaps in
the network of service providers. In addition, require DJCS to review the range of available services, sanctions, and programs that address criminogenic needs and develop programming beyond DRCs.
Supreme Court of Appeals
Administrative Office
of the Courts
Governor
Department of Military
Affairs & Public Safety
Judges
Division of
Corrections
Division of Justice &
Community Services
Parole
Board
Regional Jail
Authority
Probation
Services
Judges Judges Community Criminal
Justice Boards
Probation
Officers
Parole
Officers
Day Report
Centers
Community Corrections
Subcommittee
Proposal: Behavioral
Health Providers
Proposal: non-
DRC programs
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Key Provisions of Justice Reinvestment Framework • New treatment supervision sentencing option
– Substance abuse treatment and supervision in lieu of incarceration
– Can be imposed as condition of drug court, or a term or modification of probation
• Expands drug courts statewide by 2016
• Increases collaboration between criminal justice agencies and behavioral health agencies
• $3M in FY 2014 for community-based substance abuse treatment for criminal-justice involved population
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For more information on Justice Reinvestment in West Virginia
• Contact: Sarina Rosenberg, Program Associate, [email protected]
• Visit: csgjusticecenter.org
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RISK, NEED, AND RESPONSIVITY
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Principles of Effective Classification
RISK
WHO
Deliver more intense intervention to higher
risk offenders
NEED
WHAT
Target criminogenic needs to reduce risk
for recidivism
RESPONSIVITY
HOW
Use CBT approaches
Match mode/style of service to offender
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Risk Principle: Identify Major Risk Factors
Criminal thinking
Delinquent peers
Antisocial personality
Family criminality & psychological problems in the family origin
Low levels of academic & vocational achievement
Substance abuse
Lack of participation in prosocial leisure activities
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Risk Principle: Differentiate Placement by Risk Level
• Focus on the offenders most likely to re-offend
• Match services and supervision by risk level
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The Risk Principle in Action
Do not mix low and high risk offenders together in facilities or groups
Avoid placing lower risk offenders in more intensive (restrictive) services
• Disrupt protective factors
• Exposure to higher risk offenders
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Risk Principle: A Word on Dosage
•Less than 100 hours Low
•100 to 200 hours Moderate
•More than 200 hours High
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Principles of Effective Intervention
RISK
WHO
Deliver more intense intervention to higher
risk offenders
NEED
WHAT
Target criminogenic needs to reduce risk
for recidivism
RESPONSIVITY
HOW
Use CBT approaches
Match mode/style of service to offender
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Need Principle: What To Target
• Assess and target the needs/problems related to criminal behavior that can change – Antisocial attitudes, personality, peers
– Substance abuse
– Low academic/vocational achievement
– Family
• Criminogenic needs = dynamic risk factors
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Incorporating the Need Principle
• Community/Probation
– Make referrals to programs that target criminogenic needs using effective techniques
– Referrals should address the major criminogenic needs and not just employment, housing or mental health issues
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Principles of Effective Intervention
RISK
WHO
Deliver more intense intervention to higher
risk offenders
NEED
WHAT
Target criminogenic needs to reduce risk
for recidivism
RESPONSIVITY
HOW
Use CBT approaches
Match mode/style of service to offender
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Responsivity Principle
General
• Use of cognitive-behavioral strategies to decrease antisocial behavior and increase prosocial behaviors
Specific
• Refers to the learning/interaction styles of offenders which can affect their engagement in programming
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Responsivity Factors
• External Factors
– Program Characteristics
– Facilitator Characteristics
– Program Setting
• Internal Factors
– Motivation
– Mental health
– Maturity
– Transportation
– Cognitive deficiencies
– Demographics
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Summary:
Who
• Risk Principle
• Target higher risk offenders
What
• Need Principle
• Target criminogenic needs
How
• Responsivity Principle
• Match style to offender
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Contact Information
Jennifer Pealer, Ph.D.
Assistant Professor
East Tennessee State University