Solutions
I. Create and make available tailored, coordinated, and effective community-based substance abuse treatment programs.
Texas must tackle the problem of drug abuse head on. We must halt the wasteful expenditure of millions of dollars each year on the incarceration and re-incarceration of non-violent drug users, who would be better managed through rehabilitation programs. We must also promote medical and public health responses to drug abusers and reject the policy of incarceration for non-violent defendants charged with drug possession or drug use. The state should ensure that drug testing is used as a treatment tool, with relapse understood to be a part of the process of recovery and not an occasion for punishment. In order to do so, the following should be accomplished:
a. Implement a treatment diversion program for drug offenders who do not commit violent or sex-related crimes.
Individuals convicted up to three times for drug-possession offenses should be diverted by judges to treatment programs for substance abuse instead of incarceration. Judicial discretion may be exercised to redirect such offenders directly to incarceration if they commit a violent or sex-related crime, or if a preponderance of evidence indicates that they represent a threat to public safety or are not amenable to successful rehabilitation.
b. Strengthen the current treatment infrastructure while maintaining service accountability.
Approximately 80% of those incarcerated in Texas prisons have a history of substance abuse problems. [i] For those already within prison walls, a transition plan should be developed to include how each offender will most successfully reintegrate into society. For offenders who will be entering the system, front-end changes need to be made. Specifically, during each offender’s intake process, his or her history should be assessed to determine severity and evaluated to create an individualized plan best suited to respond to his or her substance abuse problems (or other issues).
c. Increase the allocation of funds for the treatment of substance abuse addiction and mental health illnesses.
Texas has substituted prisons for treatment centers. Meanwhile, federal and state funding for treatment programs outside prison walls has been declining since 2003 and is now insufficient to provide adequate services. Texas should utilize the $8.2 billion surplus in the state budget and divert the $711.5 million that was to go towards new prison construction to fund new treatment programs – in turn helping to offset over-incarceration costs presently being shouldered by Texas taxpayers. Since every dollar spent on treatment yields $7 in future savings, $711.5 million allocated for treatment will translate to $4.98 billion in savings.
Texas must also help to sustain existing treatment programs. Currently, there are 433 certified programs in Texas that deal with the broad range of substance abuse needs; only 10% serve criminal justice clients. Generally, these latter treatment providers have a limited amount of outpatient program availability. More problematic, they often choose to treat the clients who will pay higher rates because they must support their own program survival (as their funding comes from fees). These treatment providers often accept (1) federal clients who pay treatment fees of $60/65 per day (or more), or (2) clients who fall under the Department of Health and Human Services who pay treatment fees of $46 per day; they are less likely to serve probationers and parolees with judge-ordered drug treatment requirements or Substance Abuse Felony Punishment (SAFP) clients who must receive outpatient aftercare because there is no financial incentive: providers only receive $33 per day in treatment fees for these clients.
Increasing this bracket’s fee amount to at least $46 per day will increase the likelihood of providers contracting with probation and parole departments (as well as the Department of Criminal Justice in general) to fulfill current treatment needs.
d. Increase the number of qualified treatment professionals that focus on criminal justice clients.
Through incentives, Texas must recruit, train, and retain quality professionals in the field of substance abuse treatment. The average salary of a drug treatment counselor ($30,000) is not competitive enough to attract an adequate amount of qualified professionals. The state should adopt a loan forgiveness program for those entering the difficult field of substance abuse treatment. In addition, individuals who have already paid their student loans and who are considered well performing employees within this profession should be eligible to receive merit bonus incentives over the long term.
e. Increase funding for Transitional Treatment Centers as well as outpatient and aftercare programs, and ensure that Substance Abuse Felony Punishment (SAFP) facilities use evidence-based, effective treatment practices while following the necessary 3-pronged approach.
Of individuals with substance abuse problems, 85% can be treated in community-based programs, but 15% will require programs like SAFP. All SAFP facilities must utilize a 3-pronged approach to be effective. First, substance abusers must stay in SAFP for 9 months instead of the current 6-month stay. Second, after SAFP, individuals need to be admitted to a Transitional Treatment Center for 90 days. Finally, individuals must spend 9-10 months in an outpatient program. As has been demonstrated in past attempts to use SAFP to address drug addiction for those who cannot be treated in community-based programs, recidivism rates do not decrease without implementation of all three of these components.
f. All funding made available for community-based chemical dependency and mental health treatment, intervention, prevention and support services must be provided to the Department of State Health Services (DSHS), Texas Correctional Office on Offenders with Medial or Mental Impairments (TCOOMMI), TDCJ Community Justice Assistance Division (CJAD), and the Parole Division.
Services using this funding must be provided by DSHS licensed facilities and licensed professionals to ensure effective and quality services.
The amount of funding allocated to each one of these designated state agencies shall be determined by two main factors: (1) the number of clients that can be treated through the agency’s existing infrastructure and (2) the performance measures that each entity adopts.
Furthermore, service rates paid for criminal justice clients must equal the Department of State Health Services and traditional Texas Medicaid rates in order to be competitive for the most effective and high quality services. Privately operated inpatient treatment programs that only treat criminal justice clients are not required to meet DSHS rules concerning the specifications of their physical facilities, such as minimum square footage requirements, although they must comply with DSHS rules relating to the treatment provided.
Probation and parole departments may utilize these funds to create and run treatment programs within their respective agencies for the purposes outlined above, provided that they meet relevant standards for treatment equal to those mandated for contractual providers who comply with DSHS regulations.
Outpatient drug treatment for criminal justice clients administered by probation departments and private contractors must comply with DSHS rules regarding treatment.
All agencies receiving these funds must give highest priority to criminal justice clients and their families when using the aforementioned funds.