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NC TASC Effective Case Management for Improved Offender & System Outcomes September 30, 2004 Annapolis, Maryland. Structured Sentencing Act. Truthful & consistent sentencing that projects resource needs Established 3 forms of punishment Established statutory continuum of sanctions

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slide1

NC TASC Effective Case Management for Improved Offender & System OutcomesSeptember 30, 2004Annapolis, Maryland

slide2

Structured Sentencing Act

  • Truthful & consistent sentencing that projects resource needs
    • Established 3 forms of punishment
    • Established statutory continuum of sanctions
    • Eliminated discretionary parole
    • Established model for matching sentences & resources
  • SSA-related Expansions
    • Largest Expansion of probation resources in 60 year history - 900+ positions
    • Enhanced TASC Expansion - 1.8 mil established 13 new programs
type of punishment imposed
Typeof PunishmentImposed

Felonies

In 1993, Average Sentence served - 16 Months

Under SSA, Average Sentence served - 34 Months

* SOURCE: NC Sentencing and Policy Advisory Commission

** SOURCE: 1993 Pre-Structured Sentencing Data

nc problem statement
NC Problem Statement
  • Use of criminal justice & treatment resources
  • Complex clients: challenging behavioral health needs & serious consequences of failure
  • Recidivism & relapse are common
  • Unmanaged cases, uncharted outcomes
  • Service availability & effectiveness
  • Prison pop  offenders entering community in increasing numbers  multiple unsuccessful tx & prison admissions
  • Budget shortfalls & no expansions

Need options to improve access to & retention in treatment, while preserving public safety

evolving solution
Evolving Solution

Our Common Goal: Safely manage high-risk, high-need offenders in the community

  • Treatment System Needs:
    • Less reliance on institutions
    • Better resource utilization & management
    • Increased community capacity
    • Effective treatment, interventions & case management
  • Justice System Needs:
    • Effective & available care
    • Regular communication
    • Offender & treatment accountability
slide6

OFFENDER

MANAGEMENT

MODEL

OMM

ONE OFFENDER - ONE CASE PLAN - ONE TEAM

DHHS

DOC

TASC

DCC

Balances Intervention Opportunities provided thru DMHDDSAS & Controlled Supervision provided thru DCC

slide7

NC Offender Management Model

Target Population

I Punishment, C Punishments at-risk for Revocation, Post-Releasees who completed a prison tx program

Standard TASC Screening & Assessment

Individual Case Planning

by Probation & TASC

Control, Care & Service Management

Team staffings with shared decision-making between Probation & TASC

slide8

North Carolina Criminal Justice Planning Flow Chart

Arrest

Pre-Trial

Hearing

Pre-Sentence

Hearing

Trial/

Sentencing

Div of Prisons/

Post-Release

Div of Community

Corrections

Referred to Other

Services

NC Offender Management Model (OMM)

Clinical Assessment

CBI

Employment

Mental Health

Services

Individualized

Case Plan

Education/

Voc Training

Transportation

Substance

Abuse Svcs

Housing/Food/

Clothing

Medical Services

EXIT MODEL

Continuous Case Management and Case Staffing

Figure 1. NC Criminal Justice Flow Chart

slide9

NC Continuum of Sanctions, Supervision & Care

Split Sentence

Community Detention

Drug Court

Enhanced Intensive

Intensive

Residential Tx

House Arrest

Day Reporting Center

Enhanced Traditional Probation

Contempt of Court (all supervision & tx levels)

Cost & Intensity

Cost & Intensity

Cost & Intensity

Level 1 Care Management w/ Tx Level 6 & Aftercare Services

  • Intermediate
  • I Punishment
  • Post-Release
  • C Failures
  • Sex Offenders
  • Domestic Violence
  • High Risk/High Need DWIs

No Tx

Therapeutic Community

Residential Tx

Intensive Outpatient Tx

Level 1, 2 or 3 Care Management w/ Tx Level 4 or 5

Level 1 or 2 Care Management w/ Tx Level 3

Level 1 Care Management w/ Tx Level 2

  • Community
  • C Punishment
  • Unsupervised Failures
  • Low Risk/Low Need DWIs
  • PSIs & Targeting for Courts

Outpatient Treatment

Education & Urinalysis

Traditional Probation

Deferred Prosecution

Treatment Matching

Assessment

Screening

No Treatment

TASC

SANCTIONS

TREATMENT

SUPERVISION

objectives of omm
Objectives of OMM
  • Seamless system of care for the provision of services to offenders, improving access to treatment for justice clients
  • Clarify roles & responsibilities in providing control & treatment, eliminating duplication
  • Target limited resources to the right clients:
    • Combine efforts to guarantee effective utilization of limited resources with a team approach & shared decision-making
    • Emphasize quality over quantity
  • Develop coordinated information systems
  • Ensure staff are trained to implement the OMM
  • Reduce rates of revocation for technical & drug violations, while increasing accountability & community safety
  • Increase efficiency & improve client outcomes
philosophy principles processes policies protocols programs
Philosophy & PrinciplesProcesses & Policies & ProtocolsPrograms

Developing & Maintaining an Integrated Approach

slide13

ELEMENTS OF SUCCESSFUL COLLABORATION

  • Convergence of needs
  • Commitment - mutual respect, understanding & trust
  • Vision - shared mission; shared objectives & strategies
  • Willingness to re-think policies/procedures
  • Communication - communicate w/ & involve staff
  • Resources - commitment of financial & human
  • Regular meetings w/ diverse participation resulting in decisions (all key systems & the right people)
  • Clearly defined roles & responsibilities
  • Information & a common language
  • On-going oversight w/ regular feedback to an advisory group
  • Formal Service Agreements - protocols & MOUs
  • Formalized system for conflict resolution
challenges to successful collaboration
CHALLENGES TO SUCCESSFUL COLLABORATION
  • Separate Systems with Seemingly Disparate Goals
  • Competitive Markets
  • Lack of/Limited Communication
  • Duplicative Services
  • Revolving Door Treatment & Correctional Systems
  • Inadequate Funding
  • Limited Number of Service Providers
  • Limited Service Capacity, including Limited Effective Services in practice
  • Restricted Availability of certain Levels of Care & over abundance of other Levels of Care
  • Limited Specialized Services
  • Insufficient Aftercare & Transition Services
the bottom line
The Bottom Line
  • What do you want?
  • What do your partners want?
  • Identify resources to be shared
  • Establish regular venues for communication & problem-solving
slide16

What is TASC?

A program model & methodology that bridges two separate systems: justice & treatment.

The justice system’s legal sanctions reflect community concerns for public safety, while treatment emphasizes therapeutic relationships as a means for changing behavior.

tasc core services
TASC Core Services
  • Screening & Clinical Assessment
  • Service Determination & Referral
  • Care Planning, Coordination & Management
  • Reporting to Justice System
tasc care management model

Strategic Individualized Case Planning

Other

Services

Treatment

Referral

Other

Services

Monitoring

Reporting to Referral Source

TASC Care Management Model

Comprehensive Clinical Assessment

tasc person centered client flow
TASC Person-Centered Client Flow

Client referred out

No Services Needed

Services Refused

Non-TASC Services Needed

TASC Care Management

TASC

Eligibility Determination

Service Screening

High-Risk

High-Need

Client

Reporting,

Monitoring

Assessment

Person

Centered

Planning

Referral to

Services

Client

Identification

Low-Risk, Low-Need Client

Referral to intervention

Referral to other services

TASC reporting

tasc key concepts
TASC Key Concepts
  • Facilitates communication between systems
  • Based on clinical & support needs, not only medical necessity
  • Develops & maintains linkages with a variety of community resources
  • Incorporates justice system language & goals
  • Balances control & treatment
  • Active relationships - client, probation, treatment, community services
  • Utilizes the influence of legal sanctions to engage & retain offenders in treatment
  • Positive outcome-oriented for clients, as well as treatment & justice systems
tasc nationally
TASC Nationally
  • 1962 - Robinson v. California - addiction is an illness, not a crime
  • 1970s - Federal government develops model to interrupt drug-crime cycle - Treatment Alternatives to Street Crime
  • 1972 - first TASC program in Wilmington, Delaware
  • 2000 - Over 150 individual TASC programs in 32 states
national tasc critical elements
National TASC Critical Elements

1) Process to coordinate justice, treatment & other systems

2) Procedures for providing information & cross-training to justice, treatment & other systems

System Coordination Elements

organizational elements
Organizational Elements

3 & 4) Broad bases of support from justice & treatment systems, with institutionalized systems for effective communication

5) Organizational integrity

6) Policies & procedures for regular staff training

7) MIS with a program evaluation design

operational elements
Operational Elements

8) Clearly defined client eligibility

9)Client-centered case management

10) Screening procedures to identify justice system candidates

11) Assessment & referral procedures

12) Policies & procedures for monitoring drug & alcohol use through testing

13) Competency with diverse populations

slide25
For more information about TASC nationally, visit the National TASC website at

www.nationaltasc.org

slide26

In NC, TASC is administered by the Division of Mental Health, Developmental Disabilities & Substance Abuse Services, through private NPOs & public MH Centers.

NC TASC effectively & efficiently links treatment & justice goals of reduced drug use & criminal activity through processes that increase treatment access, engagement & retention.

tasc in north carolina
TASC in North Carolina
  • 1978 - First TASC Programs in NC
  • 1993 - 10 Programs in 20 Counties
  • 1994 - Enhanced TASC (SSA)
  • 1998 - 23 Programs in 43 Counties
  • 2002 - TASC services available in all 100 counties
  • 2003 - TASC Training Institute
goal for nc tasc
Goal for NC TASC

Equitable statewide access to a standard of TASC services in the most cost-effective, timely & organizationally efficient manner, consistent with the unified court & statewide probation systems

nc tasc tasks
NC TASC Tasks
  • Developed standard clinical care management procedures (TASC SOP) w/ TASC staff
  • Improved current aggregate data collection & analysis
  • Developed financing plan, based on I Punishment offender pop
  • Proposed regional management structure & statewide expansion plan
  • Issued RFA
nc tasc tasks30
NC TASC Tasks
  • Developed performance measures: process & outcome
  • Awarded 4 grants for infrastructure development & expansion
  • Identified training needs & contracted for NC TASC Training Institute
  • Implemented NC-TOPPS/TASC CJM - Performance Measures project
  • Developing NTASC Critical Elements audit protocols
  • Developing statewide MIS
expansion regionalized management
Expansion & Regionalized Management

Unified Statewide TASC System

Regional Coordinating Entity (RCE)

TASC Services

TASC Training Institute

TASC Service Expansion

implementing statewide offender care management
Implementing Statewide Offender Care Management
  • Committed, visionary leadership & identified key staff
  • Build support with community leaders, legislators & stakeholders
  • Design appropriate organizational structure & financing models
  • Financing plan for development, implementation & continuation
nc tasc training institute

NC TASC Training Institute

The mission of the TASC Training Institute is to improve the quality of services to the offender population through workforce development

TASC Clinical Series

TASC Continuing Education

On-line training

Drug Education Schools

Staff Certification

how is this done
How is this done?
  • 4 regional training coordinators & director review requests from the field to develop annual training plan
  • The Institute negotiates contracts with contractors to develop curricula, deliver TOTs, trainings, etc.
  • TASC Clinical Series is provided via TASC staff who’ve become TASC trainers
tasc clinical series
TASC Clinical Series

32 hours training for new staff:

  • Understanding TASC
  • Confidentiality
  • HIV/BRI/Infectious Disease (on-line)
  • Understanding Addiction
  • Criminal Justice
  • Clinical Skills - Care Planning & Management
tasc continuing education
TASC Continuing Education
  • American Society of Addiction Medicine
  • Motivational Interviewing & Enhancement
  • Mental Health Screening
  • Co-Occurring Disorders
  • Effective Interventions for

TASC Clients

  • The TASC Journey….

An Agency’s Response to Person

Centered Services

slide37
Training.nctasc.net
  • Provides on-line courses of didactic materials prior to clinical series
  • Research to Practice site
  • Continuous communication with users & Center’s staff
drug education school
Drug Education School
  • Intervention for First-time Offenders
  • 15 Hours of Standard Education
  • One Time Opportunity for Expungement for persons under 21 years of age
  • Self Supporting $150.00 Fee
  • Statutory Authority: G.S. 90-96
staff certification

Staff Certification

Legislation to be introduced in 2005 legislative session to create Certified Criminal Justice Addictions Credential

slide40

TASC Training Institute FY04

  • Delivered 4,199 hours of training to 315 TASC & 102 partner agency staff
  • Provided 100 stipends for the NTASC conference hosted in Raleigh, NC
  • Addt’l 2200+ hours were received thru NTASC Conference

All hours provided at no addt’l cost to participant or participant’s employing agency

slide41

NC TASC Training Institute Web Site

www.nctasc.net

Register for Classes

Read Important Announcements

View Your Total Training Hours

tasc quality points
TASC Quality Points
  • Statewide Availability for Equity
  • Regional Management for Economies of Scale
  • TASC Training Institute
  • TASC in MH Reform Legislation
  • MH Commission promulgated TASC Rules
  • NC TASC Standard Operating Procedures
  • National TASC Critical Elements
  • Local Memoranda of Agreement
  • TASC CJM Performance Measures
  • Funding contingent on DOC-DHHS MOU compliance
fy04 tasc statistics
FY04 TASC Statistics
  • Offenders served: 9845 (53% increase from FY99)
  • 70% Less than 36 years old (43% less than 26)
  • 83% Not married
  • 55% Did not complete high school
  • 34% Unemployed at admit (24% in FY01)
  • Primary Substance Used

•Marijuana 44% •Alcohol 28% •Cocaine 19%

  • Length of Stay

•0-3 months 24% •4-6 months 35%

•7-12 months 31% •More than 1 year 10%

tasc costs benefits
TASC Costs & Benefits
  • $1.79 per TASC client per day
  • FY96-97 sample TASC client pop*:
    • 85.9% had at least one previous arrests (mean # 2.6)
    • 61.3% were NOT re-arrested within 2 years

* NC Sentencing & Policy Advisory Commission - Submitted to the 2000 Session of the North Carolina General Assembly

dmhddsas reorganization

DMHDDSAS Reorganization

  • Best Practice & Community Innovations
  • Local Management Entity Systems Performance
  • Justice System Innovations
  • Prevention & Early Intervention
  • Single State Agency for Substance Abuse
  • Office of Employee Assistance Programs
  • State Methadone Authority
  • Quality Management

Community Policy Management Section

MH, DD & SA public policy leadership & oversight

collaboration w/ a wide base of customers, public & private partners

justice systems innovations team community policy management section

Justice Systems Innovations Team, Community Policy Management Section

Policy re: adults & children with mental health, developmental disabilities & substance abuse problems involved in criminal & juvenile justice systems

Multi-system coordination with state, county & local law enforcement, institutional & community corrections

Best practices, promising approaches & innovations related to supports, services & treatments for individuals & improved systems performance

slide47

Justice Systems Innovations

For Adults:

  • TASC develops & manages comprehensive protocols for offender management, according to DHHS-DOC MOU
    • Implementation of OMM, in partnership with DCC & other stakeholders
    • Implementation of “Going Home” initiative, according to DOC, DHHS, Department of Commerce & NC Community College System MOU
    • Treatment & case management for Drug Treatment Courts, in cooperation with AOC & DCC
  • Review & programming for DOC residential substance abuse programs & mental health services
  • Protocols for DWI
  • Drug Education School (GS90-96) diversion alternative
  • Jail-based & police partnership diversion programs
justice systems innovations

Justice Systems Innovations

For Children and Families:

Coordination with DJJDP for a continuum of services & care

RWJF Resources for Recovery & Co-occurring Academy projects

Evidence-based treatment in DJJDP Detention Centers & Youth Development Centers

Evidence-based protocols utilized in MAJORS program for juvenile offenders with substance abuse disorders

Evidence-based protocols for treatment & case management of individuals in juvenile courts, Youth & Family Treatment Court

mhddsa reform established
MHDDSA Reform established...

Adult Substance Abusing Criminal Justice Offender Target Population to ensure access to treatment for individuals with a SA diagnosis who present the greatest risk to public safety.

Eligibility includes:

  • DSM criteria for a substance-related disorder; and
  • Services approved by a TASC care manager; and
  • Voluntary consent to participate; and
  • Status as an Intermediate Punishment offender, a Department of Correction releasee who has completed an in-prison treatment program, or a Community Punishment violator at-risk for revocation
slide50

COMMUNITY CORRECTIONS: SOFT ON CRIME?

ABSOLUTELY NOT!

The Strategy Must:

  • Balance the public’s expectation for protection, control & accountability with resources necessary to control & treat high-risk/high-need offenders
  • Strive for a balance between Control & Treatment based on offender risk & needs
    • Manage risks by supervisory control
    • Manage needs through treatment collaboration
  • Prioritize resources based on offender risk & needs
  • Build partnerships with law enforcement, treatment

providers, schools, victims & the public

slide51

Effectiveness & Efficiency of Community Corrections

ACTIVE

  • 44% Recidivism
  • $63.00 Per Day
  • 21% Population

INTERMEDIATE PUNISHMENTS (Highest Risk Supervision)

  • 32% Recidivism
  • $10.00 Per Day
  • 24% Population

Crime & Punishment

U.S. prison, parole population sets record One in 32 Americans in jail or on parole in 2003

The Associated Press

July 26, 2004

WASHINGTON - A record 6.9 million adults were incarcerated or on probation or parole last year, nearly 131,000 more than in 2002, according to a Justice Department study.

Put another way, about 3.2 percent of the adult U.S. population, or 1 in 32 adults, were incarcerated or on probation or parole at the end of last year.

COMMUNITY PUNISHMENTS

(Traditional Probation/Parole Supervision)

  • 24% Recidivism
  • $2.00 Per Day
  • 42% Population
slide52

Why is Community Corrections Vital to the Criminal Justice System?

  • PUBLIC HEALTH
  • SOUND ECONOMICS
  • GOOD PUBLIC POLICY
  • PUBLIC SAFETY
  • THE RIGHT THING TO DO

Regardless of sentencing practices or laws, less than 1% of all incarcerated offenders will remain there for life.

Front end control & rational planning prior to release are essential for the 99% that remain in or return to our communities.

why is tasc care management vital to community corrections treatment
Why is TASC Care Management Vital to Community Corrections & Treatment?
  • Maintains clear roles & responsibilities
    • Probation officers focus on supervision & tx providers focus on client care
    • TASC actively supports & integrates both, providing a framework & structure for managing CJ clients
  • Engages clients at all points in CJ system
  • Improves communication among systems re: & with client
  • Advocates for & assists client in navigating multiple complex systems
slide54
Appropriately manages client confidentiality rules & law
  • Broadens range of sanctions available to CJ system & supports a system of graduated sanctions
  • Offers tx in lieu of or in combination with punishment
  • Provides added information to CJ system
  • Provides basis for judicial & correctional decision-making
slide55
Extends power of the court to influence drug-using behaviors
  • Reduces technical & drug violations
    • improving probation recidivism rates & positive impact on prison pop
  • Improves treatment outreach & access
  • Provides independent assessments & makes appropriate referrals
  • Improves treatment engagement
    • orients clients to tx, reduces “no shows”, increases tx staff productivity
slide56
Improves treatment retention & supports tx compliance
    • improving tx outcomes
  • Provides support & continuity during CJ & tx transitions
  • Facilitates access to addt’l services
  • Compensates for service availability
  • Utilizes resources more effectively
  • Arranges goals & objectives of CJ, tx & the client
tasc a task indeed

TASC … a Task Indeed

Damn, why am I here, I know I’m not an addict,

Yeah, I smoke a little weed, but it’s just a small habit;

I’m not alcoholic, I drink to ease the pain,

So what I popped a few pills, snorted lines of cocaine;

Hell no I’m not addicted, I could stop if I want,

But I don’t right now, I’m having too much fun;

They say I have a disease, I only use because I choose,

Drugs are harmless, what’s wrong with a blunt and a few booze;

Yeah I stole from a few people, but they had enough to share,

I knew that it was wrong, but drugs helped me not to care;

I feel a lot more stable being clean now but I don’t like it much,

I keep thinking about the past things I’ve done and people I’ve wrongly touched;

On the other hand, I’m relieved I can finally love again,

I can see much more clearly, I found who are my real friends;

I’ve regained trust from my family, they’re no longer ashamed,

Telling people I’ve changed, before they wouldn’t mention my name;

Matter of fact I like being drug free, I feel like I’m really alive,

And I owe all to God and Treatment Alternatives to Street Crime.

- Cumberland County, NC TASC Client