Implementation Plan

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As Nebraska attempts to address the MA crisis which it is currently facing, both practitioners and clients will require tools to ensure progress. Some of these tools will be MA-specific; others will be more system specific. The state must develop solutions which address the long term challenge of recovery. The practice of recycling MA addicted offenders through the justice system until they are incarcerated must stop. The following implementation plan will provide guidance to state and private agencies seeking to address the MA crisis within Nebraska.

Voucher Fund

Treatment and Recovery Services

There is no single point in the justice or social services process where policy makers can fix funding decisions or capacity expansion. Instead, every agency and justice provider possesses some lever which can be used to press methamphetamine addicts to seek help or maintain the recovery process. Therefore, it is necessary to initiate assessment/treatment at all stages of the justice/social service process. The state must capitalize on addict’s contact with any stage of the justice/social service process by making voucher funds available at all stages of the justice/social service process. Use of vouchers can fund substance abuse capacity expansion within those stages of the justice/social service system with the potential to impact addiction.

Whether it is the police, HHSS case-workers investigating abuse/neglect allegations, judges making sentencing decisions, parole officers supervising offenders’ re-entry programs, or any of the other justice and social service providers executing their official duties, each of these contacts with an addict is one more opportunity to steer offenders to treatment. When these efforts are successful, additional barriers have been erected to keep the methamphetamine user from pushing on to more expensive, intensive systems of punishment.

To promote the conversion of all justice and social service system points into portals for engaging treatment, voucher funds must be available. Flexible funding for assessments and treatment services are the best way to transform these possibilities into genuine opportunities.

Although it is tempting to allocate limited resources to one class of addicts, such as felony offenders, voucher funds must be made available to addicts at all levels of the criminal justice and social service systems. Only about 500 MA using offenders were sentenced to prison in 2005. Given the number of arrestees who tested positive for MA in 2003, it is estimated that approximately 19,000 offenders would have probably tested positive for MA if every arrestee had been subjected to a drug test. This means that 97% of all of Nebraska’s offenders who use MA were not sent to prison in 2005. Limiting voucher funds to felony offenders would preclude many MA users within Nebraska from accessing voucher funds to receive treatment.

Policy makers may debate what priority, if any should be given to the distribution of voucher funds. For example, since the children of HHSS clients are facing the devastating loss of their parents, should these parents receive greater priority for voucher resources than

Probation clients who face prison if they violate the terms of their supervision or re-offend? If carefully designed and implemented, the voucher program could eliminate the need for the Legislature to somehow anticipate which agency will require what levels of funding on an annual basis, by simply distributing funds on a first come, first served basis until the support is

exhausted.

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This type of funding strategy also holds offenders more accountable for their progress in recovery. Consider the example of a newly convicted methamphetamine user. As part of the PSI process, Probation requests the person to complete a substance abuse evaluation. When the offender demonstrates they lack the $75 to $155 for the evaluation, a voucher can issue for the assessment. If the offender continues to follow-through with the treatment paid for by the voucher program, they should remain eligible to receive voucher funds in support of their recovery progress. If the user resists treatment, then voucher funds would not be issued and the user is left to the legal consequences that may result. Similarly, parents involved with HHSS for whom methamphetamine treatment is required, would be motivated to incrementally pursue recovery one step at a time in order to capitalize on the chain of funding support as they seek reunification and the restoration of their family.

Urinalysis

Nebraska must fund urinalysis at all stages of the justice/social service process and collect the results in a centralized database. One way for the social service and justice systems to monitor the sincerity of a methamphetamine user’s efforts to take advantage of these treatment opportunities is the regular use of urinalysis tests. Funding or a State-sponsored testing program need to be created so that the financial impact to state and local agencies for testing is not a disincentive for it to be used as often as necessary. If these agencies are to bear increasing responsibility for intercepting and diverting methamphetamine users from higher levels of justice involvement, they must have all the tools they need to achieve success.

Day Reporting Centers

When examining the barriers to providing effective MA treatment, several common constraints emerged. Treatment providers and justice professionals both reported that access to treatment services was problematic in many communities. Lack of transportation prevents many MA users from accessing treatment or and complying with conditions of probation. Lack of transportation is felt most acutely by substance abuse offenders who lose their driving privileges as a result of their substance abuse problems. In parts of the state where treatment services are scattered across large geographic areas and public transportation is non-existent, a lack of driver’s license becomes more than an inconvenience. It becomes a seemingly insurmountable hurdle to accessing treatment and services. The user is reliant on friends and family for

transportation to attend treatment and meet with probation officers. In situations where friendships and familial relationships are strained, these arrangements are perilous and inconsistent at best.

Services are often located far from one another. If a user needs to meet with his probation officer, attend drug treatment and apply for a job, he must travel to three separate locations, sometimes, in separate communities. These competing obligations further strain users’

tenuous resources, undermining their ability to effectively address their addiction problems.

Treatment providers and probations reported that a great deal of their time is taken up driving to appointments or transporting clients. This “windshield time” robs professionals of time when they could be meeting with clients or providing services. Given the overall lack of treatment capacity in Nebraska, the time that licensed professionals can spend providing services should be maximized.

One way Nebraska can address these problems is to establish at least one reporting center in every Probation District or Mental Health Region across the State. Staffed by probation

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officers, parole officers, LADACS, psychologists/mental health providers, and social

workers/community support specialists, these centers would become a hub for all the substance abuse services, supervision, and drug and alcohol testing which will sustain methamphetamine recovery over time. The supervisory powers of probation and parole officers can compensate for less than ideal levels of direct treatment. The centers’ physical space will become a venue through which intensive outpatient, individualized counseling, group counseling, and relapse crisis response can be administered and ease the transportation and logistical challenges methamphetamine users face during recovery. The availability of multiple counseling group options and recovery support services will allow offenders to continue their pursuit of sobriety even after they have been discharged from drug courts, probation, or parole.

Day/night reporting centers also provide policy makers with one more way to lure treatment professionals into practice. Free or subsidized office space with telephone,

photocopying, and computer networking and internet services comes at a relatively modest cost to the State, but can be a lucrative benefit to contract and private treatment providers delivering services to the offender and HHS populations. To the extent that cities and counties desire the placement of reporting centers in their locations, local government should be able to partner with the State in bearing some of the costs associated with the buildings in which the reporting centers are housed. Alternatively, private/commercial agencies may be willing to provide probation and parole officers space and support in order to secure convenient access to offender populations for their staff counselors and psychologists who are delivering treatment services.

Because of limited funding it is tempting to establishing reporting centers that are open for limited hours or offer minimal services. A review of the literature found the success of DRCs was conditioned on providing a wide range of services. The literature review revealed that the following components comprise successful DRCs (Craddock 2001, Martin 2003, Roy 2004, Marion, 2002, Kim, 2005, Parent 1990, Parent 1995). To create reporting centers that lack these basic requirements undermines the effectiveness of the day reporting center model.

History of Day Reporting Centers

DRCs were first used in Britain during the 1970’s. DRCs were first introduced in the United States in the late 1980’s to address overcrowded prisons and high incarceration costs.

DRCs are intermediate sanctions that operate as a community-based corrections alternative to incarceration for criminal offenders. Primary goals included reducing costs of incarceration, jail/prison overcrowding, and recidivism (Parent 1990; Marion 2002; Martin 2003; Roy 2004).

Although all the programs varied in design and purpose, the first DRCs in the United States were largely operated by private organizations many of which focused on providing surveillance services rather than treatment services. By the mid 1990’s, however, the number of publicly run DRCs had increased and their focus shifted from surveillance alone to a combination of

surveillance and treatment services.

Research shows that the number of DRCs within the United States continues to grow.

DRC programs are located in various regions throughout the country. DRCs operate in rural and urban settings and provide a vast array of services. Research to determine the most effective type of DRC has been challenging because each program serves a specific population, has specific goals and emphasize different resources and services. In spite of this diversity in structure and procedure, a number of specific services are offered in most, if not all effective DRCs. By building on these common features, Nebraska can begin to develop DRCs to positively impact treatment and justice needs within the state.

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Hours of Operation

All DRCs are open at least five days a week, with some operating six to seven days per week. The DRCs surveyed were open for an average of eight to ten hours a day. Hours of operation varied with some providing early morning hours and others offering evening hours.

Structured Surveillance

All of the DRCs relied on some type of structured surveillance to monitor offenders’

activities, behaviors and compliance with DRC rules and requirements.¹⁷ The number of weekly DRC contacts with the offender far exceeds the norm for community supervision (Parent 1990).

Each DRC has a unique method for handling surveillance. Methods include a combination of graduated phases, personal contact, phone contact, itineraries and curfews. Another important element of surveillance, drug testing will be discussed below.

Graduated Phases DRCs often divide surveillance into phases which decrease in frequency and intensity of

contact as offenders progress through the program. Advancement to the next phase serves as an incentive for offenders to comply with DRC requirements. The majority of programs are divided into three phases. There is no research suggesting how long each phase should last. Some DRCs move offenders to the next phase after a specified amount of time, such as six weeks, has passed. Other DRCs move offenders to the next phase upon completion of specified program requirements, such as drug treatment or maintaining employment. Some DRCs give their staff discretion regarding progression to the next phase.

The length of the phases and the length of the whole DRC program must be carefully determined. Research indicates that termination from DRCs increases as the length of stay increases. This is attributable to the fact that the longer an offender is in the program, the greater his chance of violating the DRC’s strict rules and requirements. However, a recent evaluation of the Douglas County Day Reporting Center suggests that structured control and intensive

programming lessens this effect (Kim 2005). Research also shows that the longer an offender is involved with a DRC the more services he can access. Therefore, the length of stay must be structured so the offender can maximize exposure to provided services without being terminated from the program for rule violations.

Contact

Regardless of how the phases are structured all programs require offenders to have

regular, in-person contact with DRC staff. Two-thirds of DRCs surveyed by National Institute of Justice required offenders to check-in at the DRC 5 days a week (Parent 1995). One of the programs surveyed did not require the offenders to check-in daily if they were at work, school or had a court date. After checking in, offenders then participated in the services offered by the DRC such as treatment and employment services.

Contact also includes unannounced visits by DRC staff at the offender’s home or workplace. DRCs also used unannounced phone calls to monitor offenders’ activities. DRC staff call the offender at home or work verifying her compliance with DRC regulations.

Unannounced visits were not used as often as checking in at the DRCs.

17 Based upon goals and services provided, each DRC develops rules and regulations that govern the expected behavior of offenders utilizing the DRC.

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Itineraries

A commonly utilized method of surveillance is itineraries. When an offender checks in at the DRC, she is asked to complete a daily itinerary detailing her day’s activities. Itinerary completion forces offenders to plan their daily activities which provides structure and fosters accountability. DRC staff can reference the itineraries when planning unannounced contacts.

Curfews

Some DRCs mandate curfews requiring offenders to be at home after a certain time each evening. Curfews are enforced by calling the offender to verify his presence at home. This requires DRC to make phone contact during the times when the DRC is not in operation. This can be accomplished by employing a small staff to handle off-hour contacts or partnering with another organization or agency that already has staff working at times when unannounced telephone contact must be made.

Drug Testing

All of the successful DRCs included random drug testing to monitor compliance and provide accountability. The frequency of drug testing varied and many programs decreased the number of drug tests per month as offenders progressed to less intensive phases. On average DRCs administered drug tests five times per month in the most intensive phase.

Services

Every DRC is unique in the services that it offers. Some programs focus on substance abuse treatment while others emphasize literacy. No matter what specific services are provided, each DRC offers services intended to assist offenders in reintegrating into the community.

Services can act as control mechanisms providing structure to the offenders’ daily activities therefore positively affecting reintegration. Intensive programming not only provides structure, but helps the offender to establish social ties and life skills necessary to succeed once she leaves the DRC. Many services are provided by outside agencies with whom the DRC has contracted.

The services that are found in virtually all DRCs are highlighted below. It is these services that Nebraska must focus on developing first adding in additional services as resources permit.

SA Treatment

Virtually every DRC provided some type of substance abuse treatment. Some programs offered only support groups such as AA and NA while others provided treatment programs, individual counseling and group therapy. Providing treatment services is beneficial given that offenders who receive treatment as well as surveillance are less likely to recidivate. DRCs often contract with outside organizations to provide the services. Doing this allows the DRC to

provide a wider array of treatment services. DRCs throughout the country have attracted qualified organizations to provide services by supplying the organizations with free or low cost office space. Organizations are allowed to provide treatment services to non-offenders with the understanding that DRC clients will be given priority.

Because the DRCs in Nebraska will be dealing with MA users, many of whom are poly-drug users, it is important for the centers to provide the highest level of substance abuse

treatment possible. Best practices show that intensive outpatient treatment is effective in treating MA addiction. Since residential treatment is not necessary, it is possible to MA users to receive

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their actual treatment at the DRC. Follow-up resources including group meetings and relapse prevention can also be provided at the DRC.

Relapse Prevention

Although much of the research did not describe specific characteristics of substance abuse treatment provided by DRCs, an evaluation of the Douglas County Day Reporting Center found that there was a correlation between participation in relapse prevention classes and success in the program (Kim 2005). Instead of changing their antisocial personalities, relapse prevention classes teach offenders how to avoid the types of situations that induce them to commit crimes or begin using again. Relapse prevention classes at the Nebraska DRCs will equip offenders with the skills necessary to avoid potentially harmful situations enhancing their ability to remain drug free.

Directive Counseling

The Douglas County evaluation also highlighted the need for directive counseling (Kim 2005). The counselors need to actively participate in the counseling process helping the offender to recognize problems and formulate solutions. It is ineffective for the counselor to passively listen to the offenders’ problems without providing direction. Likewise, self-help groups are not effective treatment strategies as offenders need guidance in dealing with their substance abuse problems.

Employment

Research shows that employed offenders are less likely to recidivate than unemployed offenders (Kim 2005). Employment facilitates the offender’s reintegration into the community and heightens his likelihood of success. Not only does employment provide structure and accountability, it also provides resources to enable the offender cope with housing and financial issues. Therefore, it is not surprising that the vast majority, 98% in one study, of DRCs

nationwide provided some type of vocational services (Parent 1995).

Employment services are multi-faceted. At the very minimum, a DRC must provide instruction in job seeking skills and job placement assistance. Job seeking skills include

instruction in appropriate employee behavior as well as assisting offenders to identify or develop vocational skills. It is here that education and employment overlap. Education may be required before an offender is able to seek employment. DRCs must identify the types of education that

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