1.2: Treatment and Support Services

Make treatment and support services available to defendants and offenders to meet their assessed needs, to increase the likelihood of successful reintegration to the community, and to interrupt the cycle of substance abuse and crime.

Other Information:

CSOSA dedicates approximately 15 percent of its annual resources to activities in this area, including: - Assessment for, and placement in, appropriate substance abuse treatment, including detoxification, residential, transitional, and outpatient programming; - Monitoring and quality assurance of contracted treatment services; - Pre- and post-treatment drug testing; - Placement in court-ordered non-substance abuse treatment, including sex offender and domestic violence programming; - Operation of a system of Learning Labs, providing basic adult education, GED preparation, and vocational assistance. Long-term success in reducing recidivism among the defendant and offender population depends upon two key factors: 1) identifying and treating drug use and other social problems among this population; and 2) establishing swift and certain consequences for individuals under supervision who fail to comply with the conditions of their release. Unless both conditions are achieved, the cycle of drugs and crime cannot be interrupted. The supervision strategies CSOSA has put in place have proven effective in reducing drug-related crime. Sanctions-based treatment has proven to be an effective tool in changing behavior. Research performed by the Washington/ Baltimore High Intensity Drug Trafficking Area (HIDTA) project has found that the length of time in treatment contributes to reductions in arrests, drug use and technical violations. This study found that involvement in a drug treatment program with regular drug testing and immediate sanctions for violations resulted in a 70 percent reduction in recidivism 12 months following completion of the program. Since 1993, treatment services available for the criminal justice population have diminished dramatically. The number of detoxification beds available through the D.C. Addiction Prevention and Recovery Administration between 1993 and 1999 decreased from 105 to 50, a 52 percent reduction. During the same period, the number of residential treatment slots decreased by 60 percent from 379 to 153. The number of outpatient treatment slots fell 17 percent from 1,207 to 999. Further, individuals under supervision compete with the general public for limited treatment capacity. Because more than 70 percent of offenders under supervision report a drug problem, and because there is a proven nexus between drug abuse and crime, reducing substance abuse is one of CSOSA’s highest priorities. While drug testing has increased greatly, and while surveillance has a deterrent effect on the casual user, most offenders have more serious substance abuse problems. The agency has received substantial resources to make treatment available to an unprecedented number of defendants and offenders under supervision. Treatment placements increased dramatically between FY 1999 and FY 2002, and continued funding has enabled us to maintain approximately 1,100 treatment placements per year. CSOSA has developed contracts with a range of treatment providers for services ranging from hospital detox to outpatient treatment. In addition, CSOSA has developed in-house treatment expertise to provide clinical assessment and recommend the most appropriate placement. “Treatment” also encompasses court-ordered sex offender treatment, mental health assessment and referral, and domestic violence programs. Learning Labs CSOSA has established a range of support programs to help defendants and offenders address other problems in their lives. The CSOSA Learning Labs, located at the field offices, provide self-paced computer-assisted adult literacy and GED programming, English as a Second Language classes, and vocational placement assistance. Trained staff offer educational and vocational testing and help the offender/defendant to negotiate the stressful process of finding and maintaining employment. The Learning Labs represent an important collaboration between CSOSA, other government agencies, and neighborhood groups. The original Learning Lab at St. Luke Center was established in part with a grant from the Department of Justice’s Weed and Seed program, and a local minority-owned business, Empowerment Technology, equipped and networked the site for computer-based learning. Collaboration with Project Bridges, a consortium of churches in the District and Maryland organized to support and strengthen families, reinforced these opportunities by recruiting volunteer mentors. This type of active community involvement continues to be essential to the Learning Lab initiative. General Goal: - CSOSA will increase the proportion of offenders placed in residential substance abuse treatment who satisfactorily complete the program (from a baseline measurement established in FY 2003). While some benefit can be derived from any treatment experience—even if the offender does not complete the program—CSOSA has adopted this goal to ensure that the offender’s probability of completing treatment is among the criteria used in determining whether he or she should be placed. While CSOSA’s treatment resources have increased considerably, the demand for treatment continues to exceed availability. Therefore, placement in treatment should be at least partially contingent on the offender’s likelihood to complete the program and thereby derive maximum benefit from the treatment experience. This goal has been limited to residential treatment in order to take into account that relapse, which is most often experienced during the outpatient portion of the treatment continuum, is a necessary part of the treatment experience. An offender may fail to complete an outpatient placement several times, each time developing a better sense of his or her personal relapse cycle. Such cycles are fairly common and should not constitute a treatment failure. Similarly, some outpatient programs do not have a distinct termination, but are “maintenance” programs that help the offender transition from inpatient treatment to community-based support (such as a twelve-step or faith-based program). Means and Strategies. The achievement of this goal will depend on several factors. First, a solid definition of treatment success must be developed. What really constitutes a successful completion—the vendor’s program structure or the benefit the offender derived from treatment? Second, CSOSA’s process of assessing and placing offenders in treatment must be structured to take both motivation and need into account. Third, offenders for whom treatment is a condition of release must be taken into account. The outcome of mandatory treatment may be different from that of voluntary treatment. CSOSA has significant work ahead in determining how, and by what criteria, to measure treatment success. General Goal: - CSOSA will reduce drug use among offenders who complete a residential treatment program, as measured by positive urine tests before and after treatment (from a baseline measurement established in FY 2004). CSOSA is just beginning to measure the effectiveness of treatment. The most reliable indicator of treatment effectiveness is drug test results. A baseline measurement of the level of negative tests post-completion should be available in FY 2004. This goal is confined to offenders who satisfactorily complete residential treatment due to the nature of outpatient treatment, as discussed above. It is too early to predict the level of reduction in positive drug tests that can be sustained. However, CSOSA is committed to measuring the effectiveness of treatment and continuing to make improvements in this area. Means and Strategies. Evaluation of treatment effectiveness is a high priority at CSOSA. Research and Evaluation staff are in the process of designing protocols to determine how both short-term and long-term treatment success should be measured. While evaluation design is a critical component of achieving this goal, the development and provision of adequate aftercare services are even more important for treatment success to be maintained over time. In the coming years, CSOSA intends to explore whether more treatment resources should be allocated to aftercare, or whether other options, including peer support, twelve-step programs, and faith-based groups, can be successfully implemented without decreasing the number of treatment placements. General Goal: - CSOSA will decrease the proportion of offenders under supervision who are revoked to incarceration for substance abuse violations (from a baseline measurement established in FY 2004). The most important measure of treatment success or failure is whether the offender returns to incarceration due to repeated substance abuse violations. In such cases, the combined elements of community supervision—surveillance, sanctions, and treatment—have proven ineffective in managing the offender’s substance abuse behavior. The offender’s substance abuse renders him or her unable to function in the community. There is often no choice but to return the offender to incarceration. CSOSA is committed to reducing the number of such cases. Effective assessment—particularly the type of programming that will be provided in the expanded Reentry and Sanctions Center—combined with treatment, supervision, sanctions, and outpatient support, should result in an increasing proportion of these high-risk offenders defeating their drug use. Means and Strategies. Full implementation of the Reentry and Sanctions Center is essential to achieving this goal. The Reentry and Sanctions Center will provide both a key pre-treatment assessment and a meaningful residential sanction for high-risk offenders. In addition, this goal also requires timely imposition of sanctions for the initial substance abuse violations, as well as timely referral for treatment. While some revocations for substance abuse violations are inevitable, these actions can be reduced through sanctions and treatment. General Goal: - CSOSA will increase the proportion of offenders who, after completing programming in CSOSA’s Learning Labs, achieve a significant increase in education level (from a baseline measurement established in FY 2004). Learning Lab programming is intended to produce meaningful increases in participants’ education levels. The majority of offenders under CSOSA supervision do not possess a high school diploma, and many function at a fifth grade level. Improving offenders’ education levels is a vital part of successful community reintegration. CSOSA is beginning to capture data on offenders’ functional level as part of the initial Learning Lab assessment. Comparable post-tests are also being initiated to measure the offender’s accomplishments. A baseline for achievement should be established by FY 2004. Means and Strategies. This goal will be achieved through continued implementation of the Learning Lab program and tracking of participants’ success. An enhancement to the case management system is under development to capture this information. Over the period covered by this plan, “significant increase” will be defined as a quantifiable increase in functioning according to a standardized literacy or educational achievement test. General Goal: - CSOSA will increase the proportion of offenders referred to Learning Labs who obtain employment through the Learning Lab (from a baseline measurement established in FY 2004). CSOSA is seeking to expand job opportunities available through the Learning Lab so that offenders can receive both assistance with the job application process and viable job leads. To achieve this goal, CSOSA will need to have both a range of jobs available and an effective process for placing offenders in those jobs. The Learning Lab network has been growing, putting staff and procedures in place and expanding the number of sites. Tracking of offenders placed in jobs through the Learning Labs began in FY 2002, and the SMART system will incorporate a Learning Lab module by the end of FY 2003. By the end of FY 2004, a baseline measurement of the rate of offender placement should be established. Means and Strategies. Achievement of this goal depends on continued success in developing employment resources through partnership with the public and private sectors. Such partnerships will result in increased employment opportunities for offenders under supervision. CSOSA is working with the D.C. Department of Employment Services and a number of potential employers to increase the number of placements that can be made through the Learning Labs.

Indicator(s):

Indicator:1

Content