Recommendation 4: Texas should tackle the problem of drug abuse head on and establish a 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 create and make available tailored, coordinated, and effective community-based substance abuse treatment programs. Drug testing must be 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. A treatment diversion program should be implemented 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 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. The current treatment infrastructure should be strengthened while service accountability is maintained.
Approximately 80% 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).
c. The allocation of funds for the treatment of substance abuse addiction and mental health illnesses should be increased.
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. The State should utilize the surplus in the state budget and divert the millions of dollars that were 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.
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 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 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. Treatment providers are often 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. At the very least, 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.
d. The number of qualified treatment professionals that focus on criminal justice clients should be increased.
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. Funding for Transitional Treatment Centers, as well as out-patient and aftercare programs, should be increased, and Substance Abuse Felony Punishment (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 SAFP. All SAFP facilities must utilize a 3-pronged approach to be effective:
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Substance abusers must stay in a SAFP for 9 months instead of the current 6-month stay.
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After a stay in a SAFP, individuals need to be admitted to a Transitional Treatment Center for 90 days.
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Individuals must spend 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.