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Getting it Right the First Time: Applying Research to Reduce Recidivism Presentation by: Karen McGovern, RN, BScN, LLB Manager, Hearings Program College.

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Presentation on theme: "Getting it Right the First Time: Applying Research to Reduce Recidivism Presentation by: Karen McGovern, RN, BScN, LLB Manager, Hearings Program College."— Presentation transcript:

1 Getting it Right the First Time: Applying Research to Reduce Recidivism Presentation by: Karen McGovern, RN, BScN, LLB Manager, Hearings Program College of Nurses of Ontario

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3 This session will: Explore issues of recidivism in regulatory discipline based on a retrospective study of CNO Discipline cases completed in the last five years; Consider study findings in the context of current research regarding criminal recidivism; Identify possible future directions for regulators

4 College of Nurses of Ontario Retrospective Audit of Discipline Cases from 1998 - 2003

5 The Complaints Process Investigations & Hearings Department receives letter of complaint Member notified of complaint Complaint investigated Member responds to complaint Case report forwarded to Complaint Committee Complaints Committee makes a decision about the complaint Option: Case referred to Discipline Committee Option: Case referred to Executive Committee for purposes of incapacity Option: Committee may: Take no action Remind member Give advice to member Issue written caution Issue oral caution Refer to Quality Assurance Frivolous and Vexatious Complainant and member can request review by Health Professions Board

6 For the purposes of the audit: A recidivist is a licensee/member who has a prior Discipline finding Does not include prior complaints or reports where no action was taken or where screening committee took remedial approach (e.g. letter of caution, reminder)

7 Summary of Recidivism in Relation to Disciplined Members Year Total cases with discipline outcomes Number with prior discipline action Recidivism Rate 19982015% 19992614% 20004225% 20013426% 20024025% Total1628Average= 5%

8 Findings – Rate of Recidivism Eight cases out of a total of 162 cases = 5% Criminal recidivism rate: - in U.S. = 39-53% - in Canada = 16.1%

9 Recidivism – Disciplined Members with Prior Discipline Action Case Reference DateDispositionNature of Conduct Case A28/10/02Suspension/reprimandFailing to comply with discipline order 10/11/98Suspension/condition/ reprimand Falsifying a record 14/06/93Suspension/condition/ reprimand Verbal abuse 01/01/80Revoke (member reinstated 26/01/81) Poor interpersonal communication Case B12/06/02Suspension/condition/ reprimand Misappropriating property 11/11/98Suspension/condition/ reprimand Collecting pay under false pretences

10 Recidivism – Disciplined Members with Prior Discipline Action Case Reference DateDispositionNature of Conduct Case C01/11/01RevocationFailure to comply with discipline order 26/06/00Suspension/condition /reprimand Failure to comply with College undertaking/providing false info to employer/public/colleagues 19/03/98Letter of concern and Meeting with Member Poor interpersonal communication/ administered unauthorized treatments 25/03/97Undertaking signedMental health issues Case D 22/08/01 Suspension/condition reprimand Verbal & emotional abuse 23/01/91WithdrawnNo info on file 01/05/78RevocationReinstated 18/12/81

11 Recidivism – Disciplined Members with Prior Discipline Action Case Reference DateDispositionNature of Conduct Case E22/02/00Suspension/condition/reprimandTheft of medications 11/09/90Suspension/condition/reprimandConviction for theft under $1000 22/03/82Letter of cautionTheft Case F21/11/00ReprimandBreach of confidentiality 17/09/90Condition/reprimandUnsatisfactory nursing practice Case G03/11/99Suspension/condition/reprimandBoundary violation 03/04/98Suspension/condition/reprimandConflict of interest 20/09/88Take no actionUnsatisfactory nursing practice Case H20/05/98Suspension/condition/reprimandProvided false information to employer/public/ colleague 11/09/95Suspension/condition/reprimandVerbal abuse 14/04/83ReprimandConviction for shoplifting

12 Findings – nature of misconduct All recidivists were disciplined at some point for matters involving conduct / moral turpitude There were no recidivists who were disciplined for practise/standards issues alone In six of the eight cases, the licensee/member’s subsequent discipline finding was in relation to conduct, not practice

13 Findings –matters similar to previous discipline Half of cases involved matters similar in nature to the prior discipline. In these four cases, the subsequent discipline finding was in relation to conduct e.g. abusive behaviour, theft/fraud/governance issues

14 Trends Conduct / moral turpitude, not practice, is the basis for the majority of cases in which licensees/ members commit repeated misconduct. Recidivists have problems with acting morally and ethically, rather than problems in respect of their practice

15 Making the connection between regulatory and criminal recidivism Moral turpitude basis for behaviour Similar aims and methods used in addressing conduct Sentencing principles of public protection; deterrence, specific and general; and rehabilitation

16 Criminal Recidivism Research Since mid-1970’s, trend away from rehabilitation and towards punishment as best method to reduce recidivism – “get tough on crime” Belief that harsher punishment will deter re-offending

17 Solicitor General, Canada (2002) Findings showed that harsher criminal justice sanctions had no deterrent effect on recidivism; in fact, punishment produced a 3% increase in recidivism. Consistent across gender, age and ethnicity Imprisonment v. community sanctions produced a higher recidivist rate. Longer jail sentences were associated with higher recidivism rates

18 Implications Policies to reduce recidivism based on “getting tough on crime” have no empirical basis Imprisonment and other criminal justice sanctions should be used for aims other than reducing re-offending Alternative approaches to punishment need to be explored and strengthened

19 Alternatives to punishment Community service Restitution Monitoring/supervising/mentoring Restorative justice options

20 Restorative justice Process whereby parties with a stake in a specific offence resolve collectively how to deal with the aftermath of the offence and its implications for the future Requires that offender admits responsibility for the offence and is based upon volunteer participation

21 Types Victim offender mediation Family or community group conferencing Peacemaking or Sentencing circles

22 Benefits Like Alternate Dispute Resolution, involves the victim and stakeholders in the outcome, increasing satisfaction in the process Solicitor General study (1998) showed a reduction in recidivism when Restorative Justice was used compared to usual justice sanctions: 5.3% compared to 16.1%

23 Applications to the Regulatory Arena? Restitution Mediated resolutions after findings of misconduct are made Sentencing circles involving the client, employer, public, the regulator

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