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UCLA’s Statewide Evaluation of Proposition 36

UCLA’s Statewide Evaluation of Proposition 36. Darren Urada, Ph.D. UCLA Integrated Substance Abuse Programs Association for Criminal Justice Research (California) October 16, 2008. Topics. What is Prop 36? Show rates Completion rates Arrests Cost Recommendations for Reducing No-Shows

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UCLA’s Statewide Evaluation of Proposition 36

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  1. UCLA’s Statewide Evaluation of Proposition 36 Darren Urada, Ph.D. UCLA Integrated Substance Abuse Programs Association for Criminal Justice Research (California) October 16, 2008

  2. Topics • What is Prop 36? • Show rates • Completion rates • Arrests • Cost • Recommendations for Reducing No-Shows • Employment • Narcotic Replacement Therapy • Incentives & Sanctions • Process Improvement

  3. What is Prop 36? • Passed by California Voters in November 2000 • Enacted into law as the Substance Abuse and Crime Prevention Act (SACPA) of 2000. • If an adult is convicted of a drug offense or commits a drug related parole violation and meets other eligibility criteria, the offender is given the option of receiving supervision with substance abuse treatment.

  4. Prop 36 Treatment Client Characteristics • Primary Drug: Meth 57.0%, cocaine/crack 13.1%, marijuana 12.5%, alcohol 8.2%, opiates 8.0%. • Sex: 73% male • Average age: 34.8 • Ethnicity: 43.9% non-Hispanic White, 35.9% Hispanic, 13.6% African-American. • First time in treatment: 50.4% • Probation: 86.8%, Parole: 13.2%

  5. Prop 36 Offender Pipeline2006-2007 Referred Assessed Placed in Treatment (Step 1) (Step 2) (Step 3) 85.6%82.8% 48,996 Yes 41,925 Yes 34,702 No 7,071 No 7,223 All categories may include people who “opted out” later Data Source: SACPA Reporting Information System, adjusted Overall Show Rate: 70.8%

  6. Prop 36 Treatment Clients by Modality(CADDS), 7/1/05 – 6/30/06(N = 40,358)

  7. Discharge Status by Referral Source(CADDS admissions 2004-2005) Note: Requirements may differ - Prop 36 completers spend about 30 days longer in tx.

  8. New Arrests During 42 Months After Offense Prop 36 Offenders, July 2001 – June 2002(N =17,519)

  9. New Arrests During 42 Months After Offense Prop 36 Year One vs Pre- Prop 36 Comparison Group

  10. Crime Trends 2001-2005 • Statewide, drug crime arrests rose more in California than nationally (21% vs 14%). • Statewide, property crime arrests rose more in California than nationally (6% vs 0%). • Statewide, violent crime arrests dropped more in California than nationally (12% vs 9%) Source: FBI Uniform Crime Reports, National Archive of Criminal Justice Data

  11. Cost Analysis by Treatment Status42 month follow-up Hawken, Longshore, Urada, Fan, & Anglin (2008)

  12. Cost Analysis:42 month followup Hawken, Longshore, Urada, Fan, & Anglin (2008)

  13. Recommendations

  14. Suggestions we hear most often Funding Funding Funding Funding Funding ! Funding

  15. “Classic” Recommendations for Reducing No-Shows • Co-locate assessment units in/near court • Assess in a single visit • Allow walk-in assessments • Incorporate procedures used in drug courts

  16. Employment: Focus Group Ideas Funding stability Lower cost suggestions: • “Felon-friendly” job lists • Tap into networks of alumni who can provide job search assistance, contacts • GED graduation ceremonies Higher Cost Suggestions: • Vocational education (regularly, weekly, evenings) • On-site “one-stop shopping” employment services, professional job counselor

  17. Narcotic Replacement Therapy • Methadone: still the “gold standard” to treat opiate addiction but there is exceptional resistance • Trainings needed, but valid concerns, barriers exist. • Suboxone (Buprenorphine + Naloxone) an alternative for areas without a methadone clinic.

  18. Sanctions & Incentives • Incentives work and are preferable to sanctions. • Literature: Testing and sanctions programs implemented with certainty and consistency have led to reduced drug use, recidivism. • Examples: DC Drug Court Experiment, HOPE • Literature: When sanctions were not delivered with certainty, the program failed • Example: Maryland’s Break-the-Cycle

  19. Treatment Provider Perceptions – would jail sanctions improve treatment completion? Source: UCLA 2007 Proposition 36 Treatment Provider Survey

  20. Process Improvement:Network for the Improvement of Addiction Treatment (NIATx) • Designed to help treatment providers improve their own programs • Goals: • Increase admissions • Reduce waiting times • Reduce no-shows • Increase client continuation in treatment

  21. Key Steps • Conduct a “walk-through” to understand the processes that facilitate or inhibit treatment goals from a client’s perspective. • Identify a measurable goal. • Establish a Change Team to select and test changes to address the problem. • Collect data before, during, after a change to see whether the change resulted in improvement. • Make adjustments to improve continuously and sustain changes.

  22. 2005-2006 LA County Pilot Project Change ExampleSouthern California Alcohol & Drug Programs, Inc. Normally assessor would call program and whoever answered phone scheduled intake. Change: When assessment center called, a Prop. 36 counselor would talk with the potential client on the phone. • Counselor introduced self • Told client about the program • Asked if client had any specific needs that should be addressed during treatment • Motivational interviewing-type strategies used

  23. Tracking Change Results

  24. Overall Results

  25. For more info UCLA Prop 36 Reports: http://www.uclaisap.org/Prop36/html/reports.html NIATx: http://www.NIATx.net Comments / Questions durada@ucla.edu

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