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  1. Impaired Driving Task Force Meeting Jeff BathkeProgram Administratorjeff.bathke@state.sd.us February 10, 2011

  2. Contact Information Department of Human Services Division of Alcohol and Drug Abuse www.state.sd.us/dhs/dada Department of Corrections http://doc.sd.gov

  3. Agenda • History of the Department of Corrections • Division of Drug and Alcohol Abuse • Correctional Substance Abuse Programs • Intensive Methamphetamine Treatment Program • Other community activities • Questions

  4. NATIONAL STATISTICS Study looked at 1980 to 2008. The US incarcerates a higher share of population than any other country. 2.3 million inmates incarcerated. (2/3 prison, 1/3 jail. 753 per 100,000 US residents were incarcerated. (SD is 412) One out of every 48 working age men are incarcerated (2.1%) Non-Violent offenders make up 60% of the population. Non-violent drug offenders make up 25% of the population. Violent crime is only up 3% Population increased 33%, but incarceration increased 350%. • Source: The High Budgetary Cost of Incarceration, Center for Economic and Policy Research, 2010. 4

  5. DOC STATISTICS • 1982 • 715 male and 30 females in prison=745 • Adults (July 31, 2010) • 3,133 males and 394 females=3,527 • 2,770 on parole • All time high was on May 15, 2006 at 3,586. • More community based programs are keeping people out of prison. • July 2010 Parole Board=Released 106 inmates • July 2010 Parole Board=Violated 63 inmates • Last 5 years increase of 155 inmates (4% over 5 years) • Adolescents (July 31, 2010) • 440 in Custody • 138 in DOC facility • 302 in Private Care • 371 on Aftercare • 811 total under Juvenile Supervision

  6. DOC STATISTICS • Time Served • 95% of inmates will be released • Average time served is 19 months for males/14 for females • 2 on death row (Moeller, Rhines) (Piper-new trial) • 181 lifers (8 females) • July 11, 2007 Elijah Page was executed • 91% have a drug abuse or dependence diagnosis • 61% of all female admissions to prison are a result of a DUI or Drug Offense. • 48% of male admissions to prison are a result of a DUI or Drug Offense. • Crime Breakdown: • 41% are violent offenders • 13% are DUI offenses • 26% Non-Violent, other than DUI • 18% are for drug crimes • 2% are Federal/Out of State Inmates

  7. Correction’s Volume & Costs 1 in 31 are under correctional supervision nationally 1 in 40 are under correctional supervision in South Dakota 40% increase in prison population over the last decade 140% increase in parole population in the last decade Parole population would be 600+ higher without the early final discharge program State DOC budget has more than doubled in the last decade, to $106, 212,920. • Source: http://doc.sd.gov/about/publications/documents/DOCAnnualReportFY2010.pdf 7

  8. Offenders Under Correctional SupervisionMidwest Totals Per 100,000 U.S. Residents *As of 08/2009 **As of 12/31/2008-imprisonment rates of sentenced prisoners under jurisdiction of state and fed correctional authorities ***As of 12/31/2008 Source: U.S. Department of Justice Supervision Rates Source: http://bjs.ojp.usdoj.gov/ Crime Rates Source: http://bjsdata.ojp.usdoj.gov/dataonline/Search/Crime/State/OneYearofData.cfm 8

  9. 15 Year Population Trend

  10. Population Trendsby Drug Admission 10

  11. SD Women’s Prison – Pierre Campus Average Daily Count FY 1999-2011

  12. State’s Response • Community Based Programs • Adult Corrections Workgroup • Statewide Meth Task Force • Methamphetamine Specific Treatment for Male Inmates • Intensive Outpatient • Started Spring of 2005 • Development of Intensive Meth Treatment program at SDWP in 2006

  13. PREVENTION AND TREATMENT SYSTEM IN SOUTH DAKOTA FY 2010 data on the Division: • 58 accredited facilities • 10 agencies provide Gambling Treatment Services • Some level of treatment services provided to 14,839 clients • 74% male, 26% female • 1,566 (11%) were adolescents • 7,344 (49%) were Caucasian, 6,572 (44%) were Native American • 68% are court ordered to treatment • Primary drugs of choice by clients served are alcohol, cannabis and other. Other would include: inhalants, hallucinogens, sedatives, PCP, over the counter medication, nicotine, caffeine or other drugs. • InFY2008 South Dakota had 11,029 DUI arrests. 3,174 of these were 2nd or more. • InFY2009 South Dakota had 10,147 DUI arrests. 2,815 of these were 2nd or more. • InFY2010 South Dakota had 9,246 DUI arrests. 2,574 of these were 2nd or more. • In FY2010, 171 pregnant women entered treatment services. 109 of the 171 entered a Pregnant/parenting residential program. • In FY2010, 26 pregnant adolescents entered treatment services. • In FY2010, 13% of clients served had a meth dependence or abuse diagnosis. • Approximately 600 Certified Chemical Dependency Counselors in SD

  14. Correctional Substance Abuse Programs • Comprehensive alcohol and drug treatment system is operational in all Adult and Adolescent Correctional Facilities. • Starting in 1989 in one prison, with 3 staff and a budget of $150,000 • 5 Adolescent programs in 2 locations • 9 Adult programs in 5 locations • FY10 Adolescents: 357 Assessments & 252 treatment completions. • FY10 Adults: 2,363 Assessments & 1,402 treatment completions.

  15. Institution Based Staff1,043.5 • DOC Staff=901.5 • Mental Health=15 FTE + 5 Contract Staff • Department of Health=76 FTE • CD-East Region-SD State Pen and Minnehaha County Work Release Center: • 12 Staff (10 Counselors, 1 Secretary, 1 Supervisor) • CD-South Region-Mike Durfee State Prison & Yankton Minimum Unit: • 15 Staff (13 Counselors, 1 Secretary, 1 Supervisor) • CD-Central Region-SDWP: • 9 Staff (8 Counselors, 1 Supervisor) • CD-West Region-STAR Academy (3 boys and 2 girls programs) • 8 Staff (5 Counselors, 1 Secretary, 1 Release Coordinator, 1 Supervisor) • CD-Parole • 1 Parole Transition Coordinator

  16. Services Provided • Assessment • Primary Intensive Outpatient Treatment • Relapse Specific Intensive Outpatient Treatment • Treatment within Community Transition Program (CTP) • Co-Occurring Diagnosis Treatment • Native American Specific Treatment • Methamphetamine Specific Treatment (Male and IMT) • Aftercare and Individual Sessions • Discharge Planning and Referral

  17. Substance Dependence and Abuse Diagnosis • In FY2010, 91% of female inmates were assessed as having a substance dependence or abuse diagnosis: • 87% dependence, 4% abuse • Alcohol, Amphetamine, Cannabis • In FY2010, 91% of male inmates were assessed as having a substance dependence or abuse diagnosis: • 84% dependence, 7% abuse • Alcohol, Cannabis, Amphetamine

  18. CorrectionsPrimarySubstance Abuse %-Males

  19. CorrectionsPrimarySubstance Abuse %-Females Note: This is onlyPrimarySubstance Abuse %, the overall % is on next slide.

  20. Meth Diagnosis Adult Inmate PopulationAssessment at Prison Admission

  21. Primary Intensive Outpatient Treatment • Provided to regular inmates and Community Transition Program (CTP) inmates • 5-8 Weeks of group and individual Counseling • 9-15 hours per week, depending on location; plus individual counseling • Disease Concept of Addiction • 12 step education • Research Based Corrective Thinking Program by TruThought • Evidence Based Interactive journals from the Change Company • Focus on periods of success • Role play • Spirituality/Belief Systems • Relationships • Relapse Prevention/Recovery Planning • Treatment within Community Transition Program (CTP) • 3 week program • Parolee vs. Inmate • Same Curriculum as Primary IOP

  22. Native American Specific Treatment • Provided to regular inmates and Community Transition Program (CTP) inmates • 6-8 week group/individual counseling • 9-15 hours per week, depending on location • Started at the request of Native inmates • Disease Concept of Addiction • Medicine Wheel and the 12 Steps • Nationally recognized Red Road Approach to Wellness and Healing (Medicine Wheel, Inc.) • Nationally recognized Red Road to Wellbriety from White Bison Inc. • Cultural Education • Spirituality (Ceremonies, Songs) • Talking Circles • Relapse Prevention and Recovery Planning • Returning to live on the Reservation • Life off the Reservation • Focus on periods of success • Role play

  23. Co-Occurring Diagnosis Treatment • Provided to regular inmates and Community Transition Program (CTP) inmates • 10 week group/individual counseling • 10 hours per week, plus weekly individual counseling • Co-facilitated by CD Counselor and MH Therapist • Disease Concept of Addiction and Mental Illness • Mental Health Education-specific to client’s diagnosis & med management • 12 step education • Research Based Co-Occurring Disorders Series (Hazelden) • Spirituality/Belief Systems • Relapse Prevention/ Recovery Planning • Returning to live in society while taking medication, as prescribed • Focus on periods of success • Role play

  24. Intensive Methamphetamine Treatment • 2006 outgrew SDWP • 400 female inmates in March, 2006 • 413 on February 1, 2011 • Increase in female incarcerations for possession of methamphetamine • Opened H Unit • Capacity for 100, at 96 now.

  25. METH MOUTH • SD State Penitentiary-1 Week in 2008 • 41 intakes • 16 with meth teeth issues • 5 with severe meth mouth • 20 YOA male-29 teeth, 13 extracted • Symptomatic-Now feel the pain • Teeth grinding • Dry mouth Increases acidic nature of meth • Mt. Dew • Poor hygiene • “Constitutional Obligation of basic care” • Good appearance at interviews • Healthy inmate is a stable inmate

  26. 2010 HIV/AIDS in SD • 609 cases since 1985 (up 34 in 2006, and 25 in 2007, 34 in 2008 & 21 in 2009) • 372 current cases (71% male/29% female) • 20 year average was 25 cases per year • Blacks-22% of cases, but <1% of population • Native-16% of cases, but 9% of the population • White-58% of cases • Hispanic/Other-4% of cases • 18% linked to drug use • DOC-5 females & 7 males in June 2007 were HIV positive Source: DOH and 2007 Corrections Compendium Survey

  27. Intensive Meth Treatment (IMT Program) • IMT: 4 phase, 15 month program for female inmates and parolees – started August 2006 • Joint effort of Departments of Health, Human Services and Corrections • FY11 Request: FTE • $ 700,005 DOC 9.0 • $ 922,388 DHS 6.0 • $ 54,092 DOH 1.0 • $1,676,485 Total 16.0

  28. IMT ParticipantsAugust 21, 2006 – February 2011 361 participants involved in the program. 79% have completed or are currently involved in the program: • 88 are currently in one of the 4 phases • 12 in Phase 1 • 22 in Phase 2 • 20 in Phase 3 • 34 in Phase 4 • 199 completed the program • 74 listed as program failures or removed due to non disciplinary reasons • Disciplinary • Absconded/walked away from parole/halfway house in phase 3 or 4 • Violated parole or halfway house rules in phase 3 • Failed due to substance use in phase 3 or 4 • Committed new felonies while in phase 3 or 4 • 91 Inmates entered the program in FY10

  29. Intensive Methamphetamine Treatment Program • Phase 1. Identification & Assessment • 60-90 days • SDWP/H Unit • Assessed at Intake • Methamphetamine Abuse or Dependence diagnosis • Must be able to reside in a Minimum Unit • Must have enough time on sentence to complete • Individual Counseling and preparation. • Early recovery skills-MATRIX Model

  30. Intensive Meth Treatment Program (IMT) Phase 2 • Phase 2. Intensive Prison Based Treatment • 90 days, 465 total hours • 19 hours per week Chemical Dependency Treatment (group and individual sessions) • 8.75 hours per week of group meetings • 8 hours per week of Mental Health Treatment/Individual and Education • Treatment Community design; almost 50 hours of CD treatment services, life skills, academic work, mental health, family/relationships and case management and case planning per week. • H Unit. 40 IMT beds on one floor of barracks and up to 60 offenders in phase 1 or other stage of recovery housed on other floor. • Living, meals, programming, visits in old DCI building (separate from main building of SDWP) • Provided to regular inmates and Community Transition Program (CTP) inmates

  31. Intensive Meth Treatment Program (IMT) Phase 2 • Group, individual and family counseling (35.75+ per week) • Nationally recognized research based MATRIX model for methamphetamine addicts • Cognitive Behavior Therapy (CBT). Psychotherapy that emphasizes the important role of thinking in how we feel and what we do.  • Rational Emotive Therapy (RET) is an example of CBT used to enhance the clients self esteem dealing with emotional or behavioral problems • Motivational Interviewing (MI). A directive, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence. Compared with nondirective counseling, it is more focused and goal-directed. • Contingency Management (CM) which involves positive rewards for treatment progress • The research based Living In Balance Series (Danya International Corporation) is also used in the IMT program, which includes 33 sessions that focus on basic life skills. • 12 step programs and Community Reinforcement • Case Management • Transition to phase III-Learning to live in society

  32. Intensive Meth Treatment Program (IMT) Phase 2 • Variety of other treatment approaches in Phase II: • Relapse Prevention * Journaling • Associated diseases * Corrective Thinking, T4C • Sexual Abuse * Nutrition/Exercise • Self-esteem * Denial/Acceptance • Relapse to alcohol * Support/Recovery • Triggers/Relapse * Co-Occurring Issues • Moral Reconation Therapy • Employment & money management • Family Counseling/Relationships/Parenting • Medical, physical, & Psychiatric effects of amphetamines • Mentor/community involvement/building networks

  33. Phase II Daily Schedule(Sample) • Time Activity • 3:45 AM Count • 6:15 Count • 6:20-7:15 Clean up/ Breakfast • 7:15-8:15 Sick call/med pass/mental health/community chores • 8:15 - 9:00 Morning Community Meeting (Treatment Team Staffing) • 9:00 - 10:30 Programming Slots (11:40 count) • 10:30-10:45 Break (Staggered) • 10:45 - 12:15 PM Programming Slots • 12:15 - 1:00 Lunch • 1:00- 2:30 Programming Slots • 2:30-2:45 Break (Staggered) • 2:45-4:15 Programming Slots (med pass between 3:30 - 4:00) • 4:15-5:00 Open Programming (Treatment Team Staffing/4:45 Count) • 5:00-6:00 Evening meal • 6:00 - 9:00 Recreation/Employment/Community Groups/Count/AA/ Seminar • 9:00 - 10:00 Evening Community Meeting (9:30 Count) • 12:00 AM Count

  34. Intensive Meth Treatment Program (IMT) Phase 2 Weekly Schedule Phase II Weekly Schedule

  35. Intensive Meth Treatment Program (IMT) Phase 3 • Location: community halfway houses • Sioux Falls, Rapid City & Mitchell • Duration – 90 days • Offender will be either be paroled or minimum custody and work release eligible within 60 days of phase 3 placement. Do not have to be on parole to release to phase 3. • Offender is allowed employment after 2 weeks and will be employed or seeking employment. • Continuation of programming from institution, such as CD, MH, life skills, etc. • Heavy case management. • Random drug testing at least every 72 hours • Phone conferences with the HWH, DOC CM, CD Counselor, MH Counselor, and the client

  36. Intensive Meth Treatment Program (IMT) Phase 3 • Phase 3. Low Intensity Residential Treatment • 16 hours counseling per week for first 30 days • 5 hours CD specific counseling • 2 hours of corrective thinking • 2 hours of recovery support • 7 hours of individualized therapy • Release Planning • Parenting • Life Skills • Domestic Violence • Mental health counseling • Case Management • 5 hours specific CD counseling per week for last 60 days • Starting new option of early release for good behavior

  37. Intensive Meth Treatment Program (IMT) Phase 4 • Location: Community in their own residence • Duration: 180 days • 9,576 drug tests done on phase 3 and 4 participants • 656 tests with 5 positive in FY 07 • 4,078 tests with 23 positive in FY 08 • 4,842 tests with 13 positives in FY 09 • Aftercare Services • Phase 4a • 2 hours CD Aftercare per week • 1 hour of recovery support per week • 1 individual counseling session per month • Random drug testing at least every 72 hours • Phase 4b (self pay) • 1 hour CD Aftercare per week • 1 hour of recovery support per week • 1 individual counseling session per month, if needed • Random drug testing at least twice per month, if phase 4a is clean

  38. Evaluation Assessments • Data is collected at Intake and completion of Phase II, III, and IV • Areas assessed in addition to substance use include: • Mental Health • Family Functioning • Social Support • Self-Efficacy (confidence & temptation to deal w/cravings)

  39. Assessments Used • Center for Epidemiological Studies Depression Scale (CES-D) • Interpersonal Support Evaluation List (ISEL) • The Family Adaptation, Partnership, Growth, Affection, and Resolve (FAPGAR) • University of Rhode Island Change Assessment Form (URICA) • Methamphetamine Abstinence Self-Efficacy Scale (MASE) • Exit Interview (End of Phase II and Program Completion only)

  40. IMT Report • Over 90% of program participants completed Phase II of the program • Over 70% of program participants matriculating into Phase III remain active in the Phase III or are active in Phase IV • 95% of program participants reported some level of abuse in their background • 53% depressive symptoms – “at risk” for Mental Health concerns • 34% significant issues with family functioning • Participants report a reduction in mental health symptoms across phases of the program • Participants report increases in family functioning across phases of the program • Participants report a decrease in temptation to use methamphetamine in key situations and an increase in their confidence in their ability to not use methamphetamine in key situations • Participants report an increase in their “readiness” to change along the stages of change continuum as they progress in the program • Overall 97% of program participants rate the overall program as “good” or “excellent” • Program participants report substantial progress on sixteen key concepts from entry into the program until completion of Phase IV • Full Report available from Mountain Plains Evaluation

  41. 2010OUTCOMES • Outcome studies by Mountain Plains Research and Evaluation • Adult Corrections abstinence rate 36.6% • Adult Community Programs abstinence rate 49.1% • Adolescent Corrections abstinence rate 29.7% • Adolescent Community abstinence rate 43.8% • Deterrents used include frequent drug screens, parole supervision/aftercare, and fear of return to Incarceration. • “Success” is defined as Clients complete the goals/objectives on their treatment plan. Once released/Paroled, clients are contacted one year post release and asked a series of questions; drug/alcohol use, employment, family functioning, housing, etc.

  42. Recidivism Rate-DOC • 12 months after release = 29.9% • 24 months after release = 39.3% • 36 months after release = 44.8% • Based 12 months from release, females returned at a 25.8% rate and males at 30.7%. • Offenders ages 21-29 had the highest recidivism at 38.1%. • Native American offenders recidivate at a rate of 42.4% while Caucasians at a rate of 23.1%. • National Average is 67.5% of prisoners released were rearrested within 3 years (1994 latest study)

  43. South Dakota Recidivism Reduction Initiative Public safety - #1 Sound re-entry plans contribute to lower recidivism Preventing recidivism benefits the entire community Almost half of the state’s prison population are recidivists There are things that can be done to reduce recidivism Change offender thinking patterns and behaviors Improve the system to support successful re-entry Modify policies to reduce recidivism DOC goal – 50% reduction in 5 years Second Chance Act grant funds to assist with initiative 43

  44. Recidivism 2003-2009 Releases - All 44

  45. NO INMATE LEFT BEHIND

  46. COST EFFECTIVENESS • $9,177 in savings per client • $4 to $12 savings for every $1 spent • Reduced crime • Increased earnings • Decreased health care costs • Treatment/Prison costs • Social and Personal benefits Reference: Mountain Plains Research

  47. PAROLE REFERRALS FY04 725FY05 1,348FY06 1,273FY07 1,226FY08 1,546FY09 1,732FY10 1,673Total 9,523 • 176 (11%) did not receive treatment inside the prison • 392 inmates were referred to a Halfway house in FY10

  48. Current Halfway House Capacity

  49. What else are we doing? • Better release planning • Community Transition Program • Increased our Treatment Staff by 10 positions since 2002 • Methamphetamine Task Force • Additional funding for residential placements • Keystone Correctional Methamphetamine Program • City/County Methamphetamine Program • Legislation • Sioux Falls Case Management Project-MAS • West River Drug Court • “Meth makes you ugly” campaign • Extensive drug testing • Co-Occurring Initiative • Additional Parole Coordinator for MH Inmates/hard to place • 74% of inmates with a MH diagnosis also have substance abuse

  50. Random tests – 16,322 Random positive – 6 (.0003 %) Targeted tests - 11580 Targeted positive - 79 (.0068 %) Total tests – 27,902 Total positive – 85 (.003 %) Targeted Inmates that are suspected of some type of use. Minimum inmates returning from furlough All incoming female inmates. There are more targeted positives because many of those are inmates that came in hot and were still hot when tested. Random Computer generated list. Also includes CTP, which are not considered 'inmates'. Drug & Alcohol Tests Adult Corrections 50