Policy Recommendations on Substance Abuse
Based on practitioners’ clear need for assistance in coordinating, making available, and providing effective substance abuse services to criminal justice clients, the Texas Criminal Justice Coalition makes the following recommendations to the Texas Legislature and organizations that engage in substance abuse treatment or address substance abuse issues.
(1) Texas Should Tackle the Problem of Drug Abuse Head On and Strengthen the Recidivism Prevention Infrastructure.
Texas must halt the wasteful expenditure of millions of dollars each year on the incarceration and re-incarceration of non-violent drug users. Instead, the State must promote medical and public health responses to drug abusers, who would be better managed through rehabilitation programs. Texas should improve and make more widely available tailored, coordinated, and effective community-based substance abuse treatment programs.
a. A treatment diversion program should be implemented for drug offenders, rather than sending them to prison.
Individuals who suffer from substance abuse addiction and who convicted for drug possession offenses should be diverted by judges to treatment programs instead of incarcerated. Judicial discretion should 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. Equip Texas’ probation departments with the necessary resources to improve departmental culture and assist those suffering with drug addiction.
Departmental culture is key to a probationer’s success. A factor that contributes to the success of probationers is how they view their relationship with their probation officer. In other words, if probation officers believe that probationers can change their behavior and begin to make positives decisions in their lives to refrain from drug use, then their interaction is much more positive – which in turn produces better results.
It is imperative that probation departments are given the necessary tools to identify, recruit, and retain highly qualified probation officers, especially those with an understanding of substance abuse and mental health problems. This means that departments must be given resources to implement strategies that will improve the morale and job satisfaction of probation officers as they implement supervision policies.
Also, the State should expand the ability of probation departments to (1) offer early identification of all probationers who suffer from drug addiction/abuse, and (2) promptly place them in a treatment program. Probationers should be allowed access to a continuum of alcohol, drug, and other related treatment and rehabilitative services.
By equipping probation departments to better assist probationers in receiving immediate treatment, holding a job, and supporting their families, the flow to prisons can stop. Since most probationers who re-offend do so in the first two years – and the majority of those re-offend within the first eight months – probation officers’ caseloads should be reduced to allow them to more closely monitor probationers’ progress during this critical period. Furthermore, treatment program backlogs for probationers should be addressed and other programs should be put in place to help them overcome addiction, better secure housing and jobs, and ensure that the terms of their probation are achievable.
c. The current treatment infrastructure should be strengthened while service accountability is maintained.
A large percentage of individuals incarcerated in Texas prisons have a history of substance abuse problems. For those already within prison walls, a transition plan should be developed to include how each offender will most successfully re-integrate into society. For drug 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 the severity of addiction, and a tailor-made, individualized plan should be created to respond to his or her substance abuse problems (or other issues).
d. The allocation of funds for the treatment of substance abuse addiction and mental health illnesses should be increased.
Prisons have taken the place of mental health and substance abuse treatment centers. Although federal and state funding for treatment programs outside prison walls began a drastic decline in 2003, the 80th state Legislature began to address the devastating effects of under-funded programs in Texas by providing funds for alternatives to incarceration. Now and in the future, the State should invest in strengthening the treatment infrastructure to decrease criminal activity derived from substance abuse addiction, in turn preventing costly and ineffective prison construction and maintenance.
First and foremost, funding must be increased in efforts to reduce or eliminate current obstacles facing treatment providers and their clients. Enough funding should be allocated so that agencies and programs – especially in historically underserved areas (such as rural areas) – can attract and hire qualified professionals in the field, retain current, experienced practitioners, provide these practitioners with continuing education and other necessities, conduct program evaluations, and minimize the waiting periods and statutory barriers faced by criminal justice clients seeking treatment.
Texas must also do all that it can to sustain existing treatment programs that work. Currently, there are 435 certified programs in Texas that deal with the broad range of substance abuse needs; only 28.5% identified themselves as serving criminal justice clients.[1] Generally, these latter treatment providers have a limited amount of out-patient 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 whose rates for reimbursement for substance abuse treatment services are based on a competitive bidding process (note: the reimbursement rates vary based on the type of service provided and the area of the state solicited for services), or (2) clients who fall under the Department of Health and Human Services who pay treatment fees of $74 per day for intensive residential treatment, $41 per day for supportive residential treatment, $54 per hour for individual counseling, and $17 per hour for group counseling.[2]
Treatment providers are often less likely to serve probationers and parolees with judge-ordered drug treatment requirements (like Substance Abuse Felony Punishment (SAFP) clients) who must receive out-patient aftercare because there is little financial incentive: providers only receive an average of $43.44 per day to cover operation and treatment costs for SAFPs, $32.61 per day for supportive residential Transitional Treatment Centers (TTCs), $54.53 per day for relapse residential TTCs, and $32.62 per day for Halfway Houses.[3] Increasing these average per-day costs – while also keeping in mind relative cost of living standards throughout the state – 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.
e. The number of qualified treatment professionals that focus on criminal justice clients should be increased.
Through incentives, Texas must recruit, train, and retain quality substance abuse treatment professionals in the criminal justice field (e.g., within probation, in community-based treatment programs that serve criminal justice clients, at SAFPs, at TTCs, etc.). 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 reimbursement program for those entering the difficult field of substance abuse treatment and offer incremental reimbursements after employment periods have been completed by graduates.
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.
f. Funding for TTCs, as well as out-patient and aftercare programs, should be increased, and SAFP facilities should use evidence-based treatment practices while following a 3-pronged approach.
Of individuals with substance abuse problems, 85% can be treated in community-based programs, but 15% will require programs like SAFPs. All SAFP facilities must utilize a 3-pronged approach to be effective:
i. Substance abusers must stay in a SAFP for at least 9 months instead of the current 6-month stay.
ii. After a stay in a SAFP, individuals must be admitted to a Transitional Treatment Center for 90 days.
iii. Individuals must spend at least 9-10 months in an out-patient program.
As has been demonstrated in past attempts to use a 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.
Note: The State should ensure that SAFPs, TTCs, and out-patient programs have the resources to hire qualified professionals.
(2) Agencies Should be Encouraged to Coordinate and Share Information to Meet the State’s Public Safety Needs.
a. Texas should fund and expand the ability of probation, TDCJ institutional administrators, parole, health and human service departments, and the community-based service providers who contract with them to communicate and coordinate their resources.
Many criminal justice agencies do not communicate with each other, due in part to the absence of uniform datasets across agencies. Sharing information will help practitioners implement evidence-based practices by allowing them to match risk level and criminogenic needs to responsive interventions, which has been proven to increase the success of clients.
Ultimately, departments must be given incentives and provided with resources to share information, making their supervision strategies more effective and better assisting judges and treatment providers. Creating gateways of communication between departments will allow supervisors to coordinate efforts and provide a holistic service to increase the success rate of those under supervision.
In addition, agencies must be encouraged to share best practices. The Community Justice and Assistance Division at TDCJ should compile an annual report to be distributed to practitioners that assesses the successes and failures of all programs using evidence-based outcome measures. Post-completion program evaluations should include an examination of rates of recovery, employment, and educational attainment.
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The costs associated with a larger investment in substance abuse coordination, availability, and provision may be viewed as the greatest difficulty of actualizing survey respondents’ recommendations.
However, the social benefits to be gained by assisting those suffering with addiction outweigh the budgetary costs and will produce long-term savings. With a greater allocation of state funding towards substance abuse treatment, Texas will further its mission to improve public safety by producing more capable, law abiding, and productive citizens.
[1] Substance Abuse and Mental Health Services Administration; to view a full list, please go tohttp://findtreatment.samhsa.gov/ufds/locstates. To qualify to be on this list, a program must either be a private or public facility that is licensed, certified, or otherwise approved for inclusion by the State Department of State Health Services, or beadministered by the Department of Veterans Affairs, the Indian Health Service or the Department of Defense.
[2] Community Mental Health and Substance Abuse Programs Services Section, Texas Department of State Health Services. Please see Appendix E for Department of State Health Services reimbursement rates for substance abuse treatment services.
[3] These rates were provided by TDCJ in response to an open records request. Please see Appendix F for TDCJ’s full response to the open records request submitted by TCJC in regards to per diem rates for SAFPs, Halfway Houses, and TTCs.