Transcript TASC Model - SteveApplegate.com

Treatment Alternatives
to Street Crime
The TASC Model
Elizabeth A. Peyton
Presentation at the 7th National Conference on Drugs and Crime
Orlando, Florida, October 2000
[email protected]
1
Understanding the Problem
The impact of substance
abuse on our justice & treatment
systems is astounding

High levels of substance
abuse in offender populations

2
Percent increase in state prison
admissions between 1980 & 1995
Drug Offenses
 1100%
Property Crime
 85%
 50%
Violent Crime
0%
200%
400%
600%
800%
1000% 1200%
Source: Corrections Program Office, U.S. Department of Justice
3
Only a small percentage of
inmates receive treatment
50
45
40
35
30
25
20
15
10
5
0
Need
Receive
Treatment Treatment
4
Offenders in the community are
substance involved &
Incarceration is expensive
 Costs
to incarcerate in state and federal
prisons and jails will exceed $41 Billion
in 2000 (Camp, 1999)
 Many
states spend more money on
prisons than on higher education (Justice
Policy Institute, 1999)
5
The use of illicit drugs &
alcohol is a central factor driving
correctional growth.

Treatment is effective as
reducing substance abuse &
related criminal activity.


Treatment is cost effective.
Providing adequate services to
justice populations is difficult.

6
Managed Care is Here
 In
most jurisdictions, the adoption of managed
care techniques has reduced access to services
 Lengths
of stay are shortened
 Thresholds
for admission to intensive treatment
have increased
 Referral
and admission procedures are more
complex, and may involve third-party
authorization
7
What is TASC?
A
program model and methodology to:
 Engage persons referred by the justice
system into substance abuse treatment and
other services
 Collaborate with both justice and treatment
to ensure that appropriate and adequate
services are available for justice clients
 The
13 Critical Elements define TASC
8
TASC Provides the
Infrastructure for
 managing
substance involved persons
throughout the justice process
 providing
support during transitions
 engaging
clients at all points in the
justice system
 integrating
services into justice
system processing
9
13 Critical Elements
Systems Coordination
Organizational
Operational
10
Systems
Coordination
Elements
11
Element 1
A Process to Coordinate Justice,
Treatment & other Systems

Develop collaborative approaches to integrate
treatment & justice to provide a seamless
continuum of treatment and accountability

Develop & expand treatment networks

Influence the policies, procedures & priorities
of the justice & treatment systems
 Ensure adequate & appropriate services for justice
clients
12
Element 2
Procedures for Providing Information
& Cross-Training to justice, treatment
& other systems

Continuously develop skills &
relationships

Keep policymakers & practitioners
current about status of & effective
strategies for managing substance
involved justice populations
13
Organizational
Elements
14
Element 3
A Broad Base of Support from the
Justice System with a Formal System
for Effective Communication
 Establish
& maintain a coordinated
effort & understanding for referrals
between TASC & justice system
components
15
Element 4
A Broad Base of Support by the
Treatment & Other Social
Services Community
 Establish
and maintain the
linkages & understanding to:
 Ensure
availability & quality of
treatment for justice clients
 Make client referrals
 Conduct tracking, monitoring &
case management activities
16
Element 5
Organizational Integrity

Ensure TASC program integrity and
organizational capability to carry
out the program mission

Ensure objectivity and autonomy
 Over-identification with either
system can limit TASC’s
credibility and functioning
17
Element 6
Policies and procedures for
regular staff training

Ensure that all staff understand the
TASC mission, philosophies &
procedures to ensure competency

TASC staff must be experts in all
participating systems

TASC staff must have skills to connect
with & manage clients

Clinical & non-clinical staff can be
effective
18
Element 7
A management information system
with a program evaluation design

Provide timely and accurate information
 for developing & managing program
services
 for determining & improving
operational effectiveness
 for policymakers & funding sources
 to meet public information needs
19
Important
Data Elements

Number of potential
clients identified &
referred; outcome of
referral; reasons for
exclusion;
demographics;
screening &/or
assessment information

Demographic &
socioeconomic
characteristics of all
admitted clients by
referral source

Client characteristics
including justice &
substance abuse
history & status;
screening &
assessment results;
drug screen results; &
mental health status
20
Important Data
Elements

Records of all
contacts & events
that occur at TASC,
treatment, other
services & the justice
system, along with
outcomes of those
events

Costs associated
with delivery of
client services

Performance
measures,
including process
& outcome
21
Operational
Elements
22
Element 8
Clearly Defined Client
Eligibility Criteria

Set clear standards for inclusion &
exclusion of individuals from TASC

Justice system involvement

Current &/or previous AOD
involvement

Informed voluntary consent
23
Element 9
Performing Client Centered
Case Management

Maintain ongoing connection with each
client as he/she moves through various
justice processes & multiple programs

Communicate progress & changes
regularly to both justice & treatment

Provide the leverage, support & advocacy
to encourage treatment engagement &
retention

Intervene before behavior results in
treatment termination
24
Case Management

Ties everything together &
provides structure in and
between systems that aren’t
very systematically organized

The mortar that holds
everything together
25
Primary Functions of
TASC Case Management

Screening & assessment

Referral & linkage to services

Ensuring access to services

Monitoring progress through
client contact & chemical testing
26
Primary Functions of
TASC Case Management

Communicating with all relevant parties

Providing encouragement & support

Providing advocacy

Maintaining primary responsibility for
the client as he/she participates in
various justice & treatment programs &
interventions
27
TASC Case Management

Can be distinguished from
traditional case management by:




its level of assertiveness
its ongoing nature
its focus on long-term positive
outcomes resulting from multiple
interventions
its continual inter-agency & intersystem communication
28
Element 10
Screening Procedures for
Identification of TASC Clients
within the Justice System

Determine appropriateness &
suitability for treatment

Determine TASC eligibility

Begin building a plan for
treatment & supervision
29
Element 11
Documented Procedures for
Assessment & Referral

Provide a standardized assessment that
includes clinical, justice & other
information

Referral to an appropriate level of care
that is coordinated with justice
requirements

Development of a comprehensive case
management plan
30
Assessment and Referral Issues

Assessments should include, at a minimum:





Chemical dependency status
Justice involvement & justice history
Social history
Agreement to participate in TASC &
treatment - and understanding of
confidentiality rules
If treatment is not immediately available,
monitoring by TASC should be available for an
interim period
31
Element 12
Policies, Procedures & Protocols for
Monitoring Drug & Alcohol Use
through Chemical Testing

Reliably monitor & report client’s
use of or abstinence from alcohol
& other drugs to encourage
compliance & to facilitate the
therapeutic process
32
Element 13
Competency with Diverse
Populations

Ensure that TASC & treatment delivery
systems are sensitive to & provide
relevant services regardless of client race,
culture, religion, gender, age, ethnicity or
sexual orientation

Treatment engagement & success is
dependent on the ability programs &
counselors have to connect with the client
33
Effectiveness of TASC

TASC programming is effective in:






Identifying populations in great need of
treatment
Assessing the nature & extent of drug use
patterns & specific treatment needs
Referring to treatment
Serving as a linkage between justice &
treatment
Providing monitoring services
Retaining clients in treatment longer, with
better post-treatment success
34
Inciardi and McBride, 1991
Effectiveness of TASC

TASC clients remain in
treatment six to seven
weeks longer than
voluntary clients or other
criminal justice referrals
Hubbard et. al., 1989
35
Effectiveness of TASC

Involvement in TASC results in the
provision of significantly more substance
abuse & other services compared to nonTASC control groups

In study sites, TASC had the strongest
effect at reducing drug use & drug crimes
with the most problematic offenders
Turner and Longshore, 1998
36
Effectiveness of TASC

Hepburn, 1996
Clients diverted to TASC
through Maricopa County’s
Do Drugs Do Time program
had a 22% recidivism rate,
compared to 54% of
matched clients who didn’t
receive TASC services
37
Effectiveness of TASC

In 1998, New York City TASC
diverted almost 2,000 offenders from
prison & into treatment.

70% of participants have
successfully completed the program
since its inception in 1990.

Rearrest rates 12 months after
completion remained around 10% in
three separate studies.
38
EAC, 1999
Benefits of TASC

Provides the organizational infrastructure
to manage substance involved offenders in
a logical, organized & cost effective
fashion

Provides the organizational infrastructure
to support other programming, including
drug courts, re-entry management
programs, Breaking the Cycle, networks,
mental health courts, & other initiatives to
integrate treatment into justice processes
39
Benefits of TASC

Uses resources efficiently by
screening, assessing & placing justice
clients in the appropriate level of care
- and ensuring that transitional &
aftercare needs are met

Builds the capacity & capability of
treatment to serve justice populations
effectively through the development of
treatment networks
40
Benefits of TASC

Manages clients to make
sure they access & benefit
from treatment

Ensures that treatment
requirements are
coordinated with justice
processes
41
Benefits of TASC

Improves inter-system communication

Ensures that treatment is available to
coincide with or capitalize on the
“motivational opportunities” created by
justice processing

Augments available services through case
management, treatment readiness &
chemical testing - and by using justice
system leverage to encourage treatment
compliance
42
TASC:
Client & Systems
Management
43