# Presentation: 744830

## Homeless Policy Academies National Learning MeetingOctober 7 & 8, 2004Discharge Policies

**Karia Lee Basta**Missouri Department of Mental Health
**Rita McElhany**Missouri Department of Health and Senior Services

## The Transition from Prison to Community Initiative

**Organizational**
**Development**

**TPCI**
**Model**

**Collaboration**

**Learning**
**Organizations**

**The Transition from Prison ****to Community Initiative**

**Notes:**
TPCI is based on three foundations:
The TPCI Model
Collaboration among partnering agencies
Organizational development within partnering agencies

We’ll talk about each of these three foundations and about  “Learning Organizations”

## Missouri’s Transition from Prison to Community Initiative

- 	“Demonstrated, through quantitative data, that people accessing the services of Department of Corrections (DOC) have similar needs and characteristics as those being served by the State’s other human service agencies.”

## Missouri’s TPCI Process

- Missouri is using an innovative model developed by Abt Associates and National Institute of Corrections (NIC)
- This has been a powerful springboard for intra-departmental and inter-departmental collaboration to improve reentry practices
- Partnering agencies are finding smarter ways to work together on common goals

## Recidivism in Missouri

- During FY02, DOC received 16,578 admissions to prison
- 14,884 offenders released back to their communities across the state
- 1 in 3 Missouri Prison admissions was a returning parole violator

## Implementation in Missouri

- _Leadership_

- _Initiators_
- DOC
- Parole
- Supervision

- Governor

- _Policy Team_
- Governor’s Policy Advisor
- Commissioners of
- Corrections
- Parole
- Mental Health
- Education
- Employment
- Economic Development
- Health
- Court Administration

- Human Services Agencies

## Implementation in Missouri

- _Structure_

- Policy Team

- Steering Committee

- Staff from Partner Agencies
- Data and analysis
- Visioning
- Identify Problems
- Set Priorities
- Establish Implementation Work Groups

- Implementation Work Group

- Implementation Work Group

- Implementation Work Group

- Implementation Work Group

- Implementation Work Group

- Implementation Work Group

## Selected Recommendations

**	****Establish a Transition Accountability Plan (TAP) and Pre-Release Planning Process **
- 	A  means to achieve continuity across agencies and over time as offenders move through
- Institutional phase
- Release phase
- Community phase
- Discharge and aftercare phase

## Principles of TAP

- 	Develop TAP soon after an offender is admitted to prison
- 	Measure offenders’ static and dynamic risk factors
- 	Define programs to reduce offender’s dynamic risks
- 	Identify partners to implement and monitor TAPS for individual offenders as they move through each phase
- 	 - 	Define each agency’s role during each phase
- 	 -	Change responsibility for monitoring TAP as offender       	moves from prison, to community supervision, to aftercare

## Advantages of TAP

- 	Allows administrators of each partnering agency to accurately measure and reallocate resources needed to alter offenders’ dynamic risk factors
- 	Identifies responsibilities of offenders, correctional agencies, and system partners for
- 	 - creating
- 	 - modifying
- 	 - implementing TAP
- 	Promotes a continuum in interventions, services and information sharing over time and across and between agencies

## Re-Entry Phase

- Admission
- to
- Prison

- Assessment
- and
- Classification

- Behavior
- and
- Programming

- Release
- Preparation

- Release
- Revocation

- Supervision
- and
- Services

- Discharge

- Aftercare

- Law
- Abiding
- Citizen

**Re-Entry Phase**

- Develop a reentry component to TAP for each offender to cover the period
- - Six months before release
- - Six months after release
- Focus on critical reentry issues
- - Housing
- - Employment
- - Conditions and restrictions
- - Access to programs, services, supports
- - Continuity
- - Compatibility

## Additional 

- Establish a presumptive release date as early as possible
- Establish transitional housing units
- Establish inter-departmental plan for internal and external communication

**Additional **
**Selected Recommendations**

## Selected Recommendations (cont.) – Employment -

- 	Employability screening and rehabilitation plan for each offender
- 	- Improve Keyboarding and Computer Skills
- 	Establish linkage to the Division of Workforce Development and Workforce Investment Boards prior to release
- 	Provide identification cards to offenders upon release from prison
- 	Develop a targeted educational effort for prospective employers

## Selected Recommendations (cont.)-Substance Abuse Treatment-

- 	Use standardized substance abuse screening and assessment
- 	Place emphasis on discharge planning referral for continuing outpatient treatment in the community prior to release
- 	Conduct formal mental health discharge and make direct linkage to community providers

## Discharge

- DOC jurisdictions will develop discharge policies that:
- 	Move offenders off supervision and into 		aftercare following a reasonable period of		successful adjustment
- 	Give offenders graduated sanctions to 		encourage compliance with release 			requirements
- 	Reduce “technical” violation rates by 			shortening the time at risk

## Aftercare

- Human services agencies will take the lead in implementing remaining portions of TAP
- Former offenders will take responsibility for identifying their future needs and for accessing available services
- Their skills and competencies will be developed and unreasonable legal barriers removed, so that they can participate in and contribute to the social, economic and civic lives of their communities
- Community groups (including neighborhood and faith-based organizations) and victims will be involved as required

## Achieving Stabilization 

- Achieving Stabilization
- and Maintaining Access to Health Care for HIV+ persons
- Leaving the Criminal Justice System

## A Positive Start!

- Transitional Case Management, a component of HIV Case Management, works with the institution’s medical and discharge planning staff to assist HIV+ persons leaving the correctional system in understanding their role in HIV prevention and maintaining the health status achieved while in Missouri’s correctional institutions

## Inside ConnectionsAnytime During Incarceration

- Transitional Case Managers (TMC) meet with offenders to provide:
- “HIV 101”-what HIV is and how to stay well
- HIV/STD prevention information
- Information about the Transitional Case Management program

## Transitional ConnectionsWithin 6 months of Release

- TCMs and inmates develop a plan to continue health care upon  release including:
- First medical visit
- Medication continuation
- Assessment of post release psycho-social needs
- Housing is health care!

## Outside Connections Post Release 

- Assistance with first medical appointment
- 90 days crisis case management
- Specialized funding for supportive services; **housing**, food, transportation, obtaining ID cards, etc. to facilitate ongoing engagement in health care, substance abuse or mental health treatment, entitlement applications, and work search

## Continuity

- 	TPCI and its recommendations have been renamed and are now the Missouri Re-Entry Initiative
- 	Key stakeholders have gone back to their agencies and begun the work of implementing and fine tuning the strategies necessary to make the recommendations reality
-  	Reality is offenders who transition from prison successfully

## TPCI Projected Impact on Recidivism

**	**

## Missouri’s Re-Entry Initiative is a “Change in Process”

**	**Organizational priorities
- 	Organizational practices
- 	Organizational culture
- 	Outcomes
- 	Change in the lives of offenders, their families, and communities

## Have questions?

- Contact person for Missouri is:
- Tom Clements
- Assistant Division Director
- Adult Institutions
- 573-522-1926
- tom.clements@doc.mo.gov

## Access To Recovery Grant

- 	Missouri was one of 14 states and one tribal organization to be awarded an Access to Recovery (ATR) grant by SAMHSA
- 	The Office of the Governor is the grant recipient and has designated the Department of Mental Health, Division of Alcohol and Drug Abuse, to administer the funds
- 	The total award is **$7.6 million** per year for each of the three grant years for a total of approximately $22.8 million

## ATR (cont.)

- 	The Division will be required to ensure that the following goals are met in administering the funds:
**	****Consumer Choice -** ensure genuine, free, and independent client choice for substance abuse clinical treatment and recovery supports
**	****Increased Capacity -** improve access and increase capacity for substance abuse treatment and recovery supports
**	****Faith-Based and Nontraditional Providers -** engage faith-based and nontraditional community providers in providing a broader spectrum of treatment services and recovery supports

## Evaluation

- 	An evaluation component must also be in place to track clients while they are engaged in treatment to ensure programs are demonstrating effective treatment that leads to recovery as measured by seven outcome domains:
- 		- Abstinence from drug and alcohol use
-  		- Employment/education
- 		- Criminal activity
- 		- Family and living conditions
- 		- Social supports of recovery
- 		- Access/capacity
- 		- Retention in treatment