TASC, Partners Launch Supportive Release Center by Cook County Jail

(Chicago) – In collaboration with the University of Chicago Health Lab, the Cook County Sheriff’s Office, and Heartland Health Outreach, on July 26, 2017, Treatment Alternatives for Safe Communities (TASC) announced the launch of the Supportive Release Center (SRC), an innovative new program that provides short-term, critical services to people with high needs as they are released from the Cook County Jail.

SRC Ribbon Cutting

Supportive Release Center Ribbon Cutting, July 26, 2017. Left to right: Pamela F. Rodriguez, TASC; Dr. David Meltzer, University of Chicago Harris School of Public Policy; Cook County Sheriff Tom Dart; Dr. Daniel Diermeier, University of Chicago; Ed Stellon, Heartland Health Outreach; Dr. Harold Pollack, University of Chicago Urban Labs.

The SRC offers a brief overnight stay and linkages to community-based services for individuals who are struggling with mental illness, substance use disorders, or homelessness.

The facility, owned and administered by TASC, is located just blocks away from the Cook County Jail. It offers a “softer landing” for vulnerable persons who are being released from the jail, with the goal of reducing re-arrests, future incarceration, adverse health outcomes, and future incidents of homelessness.

SRC Exterior

 

SRC Interior with Staff

At the Cook County Jail—the largest single site jail in the United States—staff estimate that at least 30 percent of the daily population is living with some form of mental illness. An April 2016 survey study conducted by the UChicago Health Lab found that over 70 percent of respondents being released from Cook County Jail indicated some form of mental illness, substance use disorder, or other acute need, including feeling unsafe leaving the jail or an immediate need for medical care. More than one in three of those leaving the jail with indications of mental illness and substance use disorders were re-arrested within just five months of release. With approximately 70,000 individuals passing through the jail each year, the need to better serve individuals as they transition out of the jail has become a pressing public health concern.

“We know that people released from jail often don’t have a safe place to go, especially if they are facing addiction, mental illness, or homelessness,” said TASC President Pam Rodriguez. “The SRC represents a collective effort of partners in the nonprofit sector, academia, government—and supported by private donors—to create a better path to health and safety.”

The Cook County Sheriff’s Office provides assistance in assessing and recruiting people for the center as they are leaving the jail. Participation in the SRC is voluntary, and interested participants are transported to the SRC by TASC staff, where they receive light food, clothing, and access to showers. TASC staff at the SRC conduct needs assessments and facilitate linkages to services in the community, including substance use treatment, mental health services, supportive housing, job training programs, and legal aid resources.

Participants also have access to an advanced practice nurse (APN) on-site, to provide immediate medical care and any necessary prescription medications. For those individuals who are identified as being homeless, Heartland Alliance Health is offering longer-term, more intensive case management services. The University of Chicago Health Lab is evaluating the project.

SRC partners group

SRC partners gather to celebrate the center’s launch.

The SRC was the winner of the Health Lab’s 2015 Innovation Challenge, which sought to identify and evaluate the most promising solutions to pressing challenges in public health.

Along with the University of Chicago Health Lab, numerous foundations and donors have contributed to the development of the SRC, including: Blue Cross Blue Shield of Illinois, The Chicago Community Trust, Crown Family Philanthropies, Michael Reese Health Trust, Margot and Thomas Pritzker Family Foundation, Reynolds Family Foundation, The Siragusa Family Foundation, and SixDegrees.org.

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SAMHSA Awards Funding to Cook County Drug Treatment Courts, including TASC Case Management

(Chicago) – TASC now plays a supporting role in all Cook County Drug Treatment Court programs, thanks to a new federal grant awarded to three suburban drug court programs.

The Substance Abuse and Mental Health Services Administration (SAMHSA), an agency within the U.S. Department of Health and Human Services, awarded $324,811 to the Circuit Court of Cook County Drug Treatment Court programs in the Markham, Maywood, and Bridgeview courthouses. These programs follow the original such program operating in the Criminal Court Building at 26th Street and California Avenue in Chicago.

Defendants enter the drug courts voluntarily, and all participants have been charged with nonviolent offenses.

“For nonviolent defendants who are driven by drug addiction, the court exercises compassion in the pursuit of justice. Treatment, not punishment, is the best option to pursue,” Chief Judge Timothy C. Evans said.

“Many times, these individuals would rather receive a short-term jail sentence so that they can start using again upon release. Instead, we offer a long-term effective treatment plan that can help end their suffering and the suffering of their families and friends. This grant funding will allow us to enhance our existing services and help defendants find a future of sobriety.”

The three suburban courts will now work with case managers from TASC, who will provide clinical assessments of all defendants entering the drug courts. The case managers will determine what level of treatment is needed and whether it will require out-patient or in-patient services. The TASC case managers are also trained to help defendants enroll in Medicaid and also re-enroll as required every year. The coverage under Medicaid can pay for the drug court defendant’s treatment.

Read more.

TASC Opposes the Gutting of Medicaid

(Chicago) – TASC stands in opposition to the proposed massive cuts to Medicaid under the U.S. Senate’s draft Better Care Reconciliation Act of 2017, which would repeal and replace the Affordable Care Act. We share this opposition with our partners—including the National Association of Addiction Treatment Providers (NAATP), the Illinois Association for Behavioral Health, and the National Council—along with a majority of Americans.

Under the Senate’s proposed bill, the expansion of Medicaid that occurred under the ACA would be reversed, with phase-out beginning in 2021. By making Medicaid expansion much more expensive for states, they will be more likely to end their expansion programs. 

Under the Affordable Care Act, Illinois was among the majority of states that expanded Medicaid, which provides federally funded health insurance for low-income people. By attacking this key provision, both the U.S. House’s American Health Care Act (AHCA) and the Senate’s version of the bill topple the cornerstone upon which significant aspects of Illinois’ interconnected public health and public safety strategies rely.

Additionally, both the House and Senate versions give states the ability to modify or eliminate the ten essential benefit requirements, no longer safeguarding addiction treatment as an essential covered benefit—even as the opioid crisis has caused overdose deaths to skyrocket.

More than three million Illinoisans—almost one-quarter of the state’s population—are enrolled in Medicaid coverage. By diminishing Medicaid coverage, and throwing costs back on the state, the proposed legislation will further burden Illinois’ state budget, already drowning in record deficits. As an example, in behavioral health services alone, the State would have to replace an estimated $80 million per year in federal Medicaid resources to pay for community-based substance use and mental health services that would support alternatives to incarceration and reentry initiatives.

The Henry J. Kaiser Family Foundation, a leading non-partisan source for health policy analysis, reports that, “The majority of the public – regardless of partisanship – hold favorable views of Medicaid, the government health insurance and long-term care program for low-income adults and children.” Three fourths have a favorable view, and 67 percent say the program is working well for most low-income people in their state.

Drew Altman, the foundations’s president and chief executive wrote, “And you cannot cut over $800 billion from Medicaid without adversely affecting health services for the poor.”

 

Addiction Policy Forum Spotlight on Innovation: Moms and Babies Program at Decatur Correctional Center

(Chicago) – The national Addiction Policy Forum (APF) has published a spotlight feature and video on the Moms and Babies program at the Decatur Correctional Center. This innovative prison nursery and community reentry program is a partnership between the Illinois Department of Corrections, TASC, and a team of partners who work together to provide both in-prison and community-based reentry services for mothers and their babies.

The Moms and Babies program allows incarcerated mothers to keep their newborn infants with them for a specified amount of time, and supports women in developing and nurturing bonds with their babies through a supportive living environment, including parenting classes and clinical programs.

Following release from prison, TASC provides ongoing case management, home visits, and linkages to services in the community. Using a combination of pre-release services and post-release case management, the program builds solid foundations for strong family structures to continue upon release.

In addition to services in Illinois, TASC, through its Center for Health and Justice, offers consulting and training to jurisdictions across the country. For example, working with partners in Montgomery County, Maryland, TASC helped develop the STEER (Stop, Triage, Engage, Educate, Rehabilitate) program, which was previously featured by APF. STEER is a pre-booking law enforcement that links people to drug treatment instead of entry into the justice system.

TASC is a partner in the Addiction Policy Forum, a diverse group of organizations, policymakers, and stakeholders committed to working together to elevate awareness around addiction and to improve national policy through a comprehensive response that includes prevention, treatment, recovery, and criminal justice reform.

Click here to see all of the APF program spotlights from across the country.

Collateral Consequences of Convictions

(Chicago) – TASC submitted comments for the May 19 briefing of the U.S. Commission on Civil Rights on Collateral Consequences: The Crossroads of Punishment, Redemption, and the Effects on Communities.

The briefing focused on the barriers to successful community reentry for formerly incarcerated individuals. According to the Commission, “They may face numerous barriers to reentry, including denial of governmental assistance designed to assist with finding employment. These collateral consequences affect families of the formerly incarcerated in a multitude of ways. For decades, communities of color have been disproportionately represented in the rates of felony convictions, and therefore are hardest hit.”

These barriers are mirrored in Illinois, and are experienced by TASC clients, even decades after they have paid their debt to society and resumed a law-abiding life. Barred access to employment and housing opportunities also create added challenges for individuals who are also striving to overcome substance use and mental health disorders.

Below is a synopsis of TASC’s comments, offering observations from decades of experience working to support diversion to community-based behavioral health treatment for men and women involved in the justice system, as well as reentry support following release from incarceration:


[Barriers to reentry and disproportionate minority contact are among] the reasons that TASC actively pursues strategies and opportunities that reduce the number of people entering the justice system. We seek to divert people away at every intervention point, and we promote avenues to health and recovery in the community so individuals do not return to the system.

We worked with and drafted reports on behalf of the Illinois Disproportionate Justice Impact Study (DJIS) Commission and Illinois Racial and Ethnic Impact [REI] Research Task Force) to evaluate and address disparities in the justice system. We conducted several surveys of diversion programs across the country and in Illinois that prevent criminal convictions on record, offering observations and recommendations for improvement and expansion.

We seek ways to improve access to healthcare coverage for those who come in contact with the justice system. Recently we have collaborated with jurisdictions in exploring law enforcement diversion practices for drug-involved individuals, a need that has become even more visible and accentuated in the midst of the opioid crisis.

We recognize that there are many individuals in the justice system who are less likely to return to the system if they have access to behavioral health services, and we know that a criminal record acts as a barrier to recovery, restored citizenship, and community reintegration. Improving access to and connecting justice-involved populations to community-based services may help reduce the racial disparities that exist throughout the criminal justice system. It is good health policy. It is good justice policy. It is good public policy.

In our decades of work in these fields, we have made a number of observations about the state of safe, responsible criminal justice diversion that we hope will inform the Commission’s work.

  • The criminal justice system has become a de facto societal response to substance use and mental illness. Across the U.S., criminal justice systems are managing record numbers of people, with rates of substance use and mental health disorders that are much higher than those among the general public. More jurisdictions are focusing efforts to leverage resources toward management of these disorders in the community instead of the justice system, seeking to prevent taxpayer costs associated with incarceration and recidivism, as well as to support restored citizenship and second chances.
  • Numerous factors have led to broad-based calls for criminal justice reform. In recent years, a confluence of factors has created fertile ground for broad-based improvements to criminal justice policy and practice. These factors have included overburdened courts, crowded jails and prisons, strained government budgets, advances in the science of drug use intervention and recovery, shifting public attitudes about drug policy, awareness of the negative and residual impacts of justice involvement on families and communities, attention on the disparate burden of justice policies on racial/ethnic minority communities, and a preponderance of research on the effectiveness and cost efficiency of alternatives to incarceration.
  • Diversion policy should be focused on systems rather than programs. Modern justice policy is beginning to adopt public health strategies, focusing on broad-based, systemic intervention, and the application of the minimum but appropriate amount of supervision, sanctions, accountability, services, and resources to achieve the intended result.
  • Meaningful diversion can happen at any point before conviction. Initiatives can occur at points of contact with law enforcement, prosecutors and public defenders, pretrial services and probation, the judiciary, and even the jail. In cases where diversion before conviction isn’t an option, treatment-based alternatives to incarceration can prevent recidivism, taxpayer costs, and deleterious effects of confinement.
  • Evidence-based practices should inform decision-making. The most effective response to justice-involved individuals with substance use and mental health issues is a locally defined balance of supervision, accountability, and community treatment and support. What is deemed appropriate should be driven by the ever-expanding base of research and data regarding which intervention models best serve a given population at a given point of justice involvement. A risk-needs-responsivity (RNR) approach offers particular promise in this context. Considered a best practice for criminal justice populations, this approach assesses both the risk of recidivism as well as needs related to substance use, mental health, and other social and environmental conditions, and determines the appropriate type and dose of treatments and other services necessary to maximize justice and health outcomes.
  • Responses should be data-driven, which may mean changes in methods and resource allocation related to data collection. Justice, health, and community resources should be allocated to those programs that demonstrate the greatest capacity to reduce recidivism, protect public order and safety, promote public health, and promote equal and fair access to alternative options, while also mitigating the need for costly justice supervision. These determinations will be most successful if uniform data are collected and used—including measures related to the race/ethnicity of participants—and if programs take formal steps to develop standardized outcome measures (cost-, public safety-, and public health-based), and measure, analyze, monitor, and share results.
  • Arbitrary prohibitions on eligibility are counter-productive. Many jurisdictions still set limits on participation in diversion programs based on offense history or type, such as accepting only people with first-time or “low-level” offenses. Instead, jurisdictions can adopt strategies and interventions that focus on those individuals most likely to recidivate, and that consider factors other than just current charge and criminal history in determining an intervention plan (for example, through the use of individualized risk and needs assessments). The next generation of diversion programs should be able to determine and provide the appropriate level of services and justice supervision for each individual.
  • The field is continuing to evolve. The development of a common, shared language to discuss diversion and alternatives to incarceration is still in process. The need for clarity and specificity around the description of programs and models will be of increasing importance in the growing exchange of ideas, innovations, and best practices.

We are committed to continuing our work to connect people involved in or at risk for involvement in the justice system with community-based treatment and services for behavioral health conditions, to promote and support diversion and alternative options that prevent criminal convictions on record whenever appropriate and possible, and to advance policies and practices that reduce disproportionate minority contact with the justice system.

TASC Releases Survey of Prosecutorial Diversion in Illinois, Offering Recommendations to Guide Expansion and Improvement

(Chicago) – A new survey of Illinois state’s attorneys illustrates the scope and variety of prosecutorial diversion initiatives operating in jurisdictions across the state.

The intent of such programs often is to redirect individuals away from the criminal justice system and into community-based services, thereby preventing the unnecessary costs and harmful consequences—to the justice system, to communities, and to individuals and families—of repeated arrests, convictions, and incarcerations.

The report, No Entry: A Survey of Prosecutorial Diversion in Illinois, was produced by the Center for Health and Justice at TASC. It describes 54 programs operating in 37 Illinois counties, based on information submitted by prosecutors on diversion programs and options offered in their jurisdictions. The survey collected information on program authorization, oversight, target populations, goals, structure, services, outcomes, and evaluation.

“The survey highlights the work of state’s attorneys to meet local needs, and the needs of people coming through their systems, while also highlighting areas for improvement and growth,” said TASC President Pam Rodriguez.

“The current criminal justice system is clearly too expensive, and is proving to be an ineffective way to handle many offenders. In an effort to achieve an efficient and effective model, we must embrace initiatives that not only hold offenders accountable, but also appropriately impact their lives,” said Joseph Bruscato, Winnebago County state’s attorney and chairman of the Board of Governors for the Illinois State’s Attorneys Appellate Prosecutor’s Office. “Alternative justice programs can substantially reduce the likelihood that an individual will repeat their criminal behavior, and gives them the opportunity to be restored to useful citizenship.”

Joseph McMahon, Kane County state’s attorney and member of the same Board of Governors, notes support among criminal justice partners for programs like these. “Diversion programs receive widespread support in Kane County’s criminal courtrooms—from our office, from judges, and from defense attorneys—because they effectively address issues with people who need an alternative approach. I support and advocate for diversion programs and alternative courts because they hold people accountable yet provide an opportunity to move forward, they benefit the community, and they reduce long-term costs. They are the right thing to do.”

Preventing the Collateral Consequences of Convictions

With criminal justice reform efforts underway in jurisdictions across the country, diversion programs across the front end of the criminal justice system continuum not only help stem the vast numbers of people flowing into courts and correctional systems, but also may forestall the long-term collateral consequences of a conviction.

With that understanding, and to be clear and consistent about what type of programs were included in the survey, the project adopted a definition of “diversion” that included only those programs and practices that divert individuals in a way that affords the opportunity to avoid a criminal conviction on public record.

“Policies and practices that divert people from arrest and detention are critically important,” said TASC Policy Director Laura Brookes. “The survey acknowledges that a criminal conviction—for either a misdemeanor or felony—sets off all kinds of collateral consequences that often severely hamper an individual’s ability to become and remain a productive member of the community.”

By facilitating early intervention, prosecutors’ diversion policies, practices, and programs can reduce court caseloads, prevent criminal records, and encourage quicker access to services that put men and women on the path to health, stability, and community participation.

Observations and Recommendations

In addition to highlighting program goals and collaboration, several observations emerged from the survey analysis.

For example, most programs responding to the survey limited participation eligibility based on the defendant’s charge or criminal history, and many were limited to first-time offenses. Most featured connections to clinical services, such as substance use and mental health interventions, with many accessing other supportive services as well.

A number of respondents reported either that evidence-based practices were not used or that they were not sure if they were used. In terms of program funding, a majority of programs surveyed relied on local budgets and/or participant fees. Additionally, responses indicated that while many programs reported outcomes, in most cases they did not rise to a statistical measure that can be analyzed or compared on level footing with other programs.

The report offers eight recommendations intended to guide criminal justice system practitioners and other stakeholders in the development, implementation, expansion, replication, and improvement of diversion programs. The recommendations are also intended to inform and motivate discussions and decisions made by policymakers and other decision-makers, as diversion programs continue to proliferate.

  1. Incorporate research findings and evidence-based practices into diversion programs.
  2. Apply resources to individuals and programs with potential to achieve the greatest impact.
  3. Incorporate community-based behavioral health and social services into diversion programs, as appropriate, especially substance use and mental health services.
  4. Leverage all available resources for community-based behavioral health and social services, and strongly advocate to protect and expand them.
  5. Adopt standardized program goals, outcome and performance measures, and terminology.
  6. Adopt standardized data collection and analysis models and mechanisms.
  7. Develop a web-based, searchable directory of diversion programs in Illinois.
  8. Develop opportunities for cross-system education, training, and technical assistance available to jurisdictions for the purpose of establishing, expanding, or improving prosecutorial diversion programs.

For further information on front-end diversion initiatives, please visit the Center for Health and Justice at TASC.

TASC Executive Vice President Chairing National Addiction Leadership Conference

(Chicago) – TASC Executive Vice President Peter Palanca will chair the 2017 National Addiction Leadership Conference, which will take place May 21-23 in Austin, Texas.

Hosted by the National Association of Addiction Treatment Providers (NAATP), this annual event is the premier conference for professionals in the addiction treatment field, featuring leadership roundtables, workshops, and networking events focused on the exchange ideas, research, public policy, clinical advancements, and best practices in addiction treatment.

In addition to serving as conference chair, Palanca also will moderate a panel discussion on bridging the public system/private system treatment divide.

Maureen McDonnell, TASC’s national director for healthcare initiatives, will join the panel to discuss the role of Medicaid in improving treatment access for people with substance use disorders.

The theme of this year’s conference is Developing a Unified Treatment Provider Platform.

“With overdoses killing 144 of our fellow citizens each day, our call is urgent. We have the opportunity to face new challenges as a united front,” said Palanca. “Our 2017 conference is built around the theme of unity, because patients and families need to be able to walk into a system that is interconnected and focused on their success.”

Palanca is executive vice president and chief operating officer of TASC (Treatment Alternatives for Safe Communities), which advocates for alternatives to incarceration and community reentry services for people with substance use and mental health disorders, and serves more than 18,000 individuals and families in Illinois each year. A national expert in addiction treatment services, Palanca is a board member of NAATP, co-chair of the National Association for Children of Alcoholics (NACoA), and past chair and current board member of the Illinois Association for Behavioral Health (IABH).

Click to learn more about the NAATP conference and to register.

TASC Executive Vice President Peter Palanca, 2017 National Addiction Leadership Conference Chair