NC TASC Bridging Systems for Effective Care Management of Persons with SA/MH Problems Involved in the Criminal Justice System North Carolina TASC 1

NC Problem Statement Limited Treatment Resources Complex Clients: challenging behavioral health needs serious consequences of failure Recidivism & Relapse are Common Need for CJ Specific EBP Need options to improve access to & retention in treatment, while preserving public safety North Carolina TASC 2

Balancing Control & Tx One Offender One Case Plan One Team Common Goal: Safely manage high-risk, high-need offenders in the community Balances Intervention Opportunities provided thru DMHDDSAS & Supervision provided thru DCC & AOC North Carolina TASC 3

DHHS-DPS-AOC MOA North Carolina TASC 4

NIC’s The Principles of Effective Interventions Assess Actuarial Risk/Needs Enhance Intrinsic Motivation Target Interventions Risk Principle Need Principle Responsivity Principle Dosage Treatment Principle Skill Train with Directed Practice Increase Positive Reinforcement Engage Ongoing Support in Natural Communities Measure Relevant Processes/Practices Provide Measurement Feedback Research supports several principles for effective offender interventions. NIC highlights 8 principles. Assess Actuarial Risk/Needs - Assessing offenders' risk & needs (focusing on dynamic & static risk factors & criminogenic needs) at the individual & aggregate levels is essential for implementing the principles Enhance Intrinsic Motivation - Research strongly suggests that "motivational interviewing" techniques, rather than persuasion tactics, effectively enhance motivation for initiating & maintaining behavior changes Target Interventions Risk Principle - Prioritize supervision & treatment resources for higher risk offenders Need Principle - Target interventions to criminogenic needs Responsivity Principle - Be responsive to temperament, learning style, motivation, gender, & culture when assigning to programs Dosage - Structure 40% to 70% of high-risk offenders' time for 3 to 9 months Treatment Principle - Integrate treatment into sentence/sanctions requirements Skill Train with Directed Practice - Provide evidence-based programming that emphasizes cognitive-behavior strategies & is delivered by well-trained staff Increase Positive Reinforcement - Apply 4 positive reinforcements for every 1 negative reinforcement for optimal behavior change results Engage Ongoing Support in Natural Communities - Realign & actively engage pro-social support for offenders in their communities for positive reinforcement of desired new behaviors Measure Relevant Processes/Practices - Accurate & detailed documentation of case information & staff performance, along with a formal & valid mechanism for measuring outcomes Provide Measurement Feedback - Providing feedback builds accountability & maintains integrity, ultimately improving outcomes 5

NIDA Principles for CJ Pops Treatment principles & research findings particularly relevant to the criminal justice community & treatment professionals working with persons with substance use disorders and criminal justice system involvement. Drug addiction is a brain disease that affects behavior. Recovery from drug addiction requires effective treatment, followed by management of the problem over time. Treatment must last long enough to produce stable behavioral changes. Assessment is the first step in treatment. Tailoring services to fit the needs of the individual is an important part of effective drug abuse treatment for criminal justice populations. Drug use during treatment should be carefully monitored. Treatment should target factors that are associated with criminal behavior. Criminal justice supervision should incorporate treatment planning for drug abusing offenders, & treatment providers should be aware of correctional supervision requirements. Continuity of care is essential for drug abusers re-entering the community. A balance of rewards & sanctions encourages prosocial behavior & treatment participation. Offenders with co-occurring drug abuse & mental health problems often require an integrated treatment approach. Medications are an important part of treatment for many drug abusing offenders. Treatment planning for drug abusing offenders who are living in or re-entering the community should include strategies to prevent & treat serious, chronic medical conditions, such as HIV/AIDS, hepatitis B & C, & tuberculosis. www.nida.nih.gov

What is TASC? A model that bridges two separate systems: justice & treatment Links treatment & justice goals of reduced drug use & criminal activity Uses processes that improve treatment access, engagement & retention North Carolina TASC 7

TASC Services Screening & Assessment Referral & Placement Care Planning, Coordination & Management Reporting Progress to Justice System North Carolina TASC 8

TASC Eligibility involvement in the CJS or DPS releasee who completed a prison substance abuse program voluntary consent to participate evidence of a history or potential substance abuse and/or mental health issue, including drug-related charges

TASC in NC 1978 First TASC Programs in NC 1993 10 Programs in 20 Counties 1994 Structured Sentencing Act 1998 23 Programs in 43 Counties 2000 SOP; DHHS-DOC MOA 2001 TASC Training Institute 2002 Services available in all 100 Counties 2005 AOC joined MOA 2007 15,000+ Persons Served 2014 20,000+ Persons Served (FY1314) North Carolina TASC 10

North Carolina TASC Network Region 1 – Jennifer Saphara 609 Shipyard Blvd. Wilmington, NC 910-202-5125 Region 3 – Michael Gray 516 N. Trade St. Winston-Salem, NC 27101 336.714.7080 Region 2 – Andy Miller 412 West Russell Fayetteville, NC 28302 910.321.6796 Region 4 – Carlene Wood 370 N.Louisiana Ave, Ste. E-3 Asheville, NC 28806 828.210.0535 Region 3 Region 2 Region 1 23 Ashe Alleghany 23 1 Gates Surry 17 B Caswell 9 A 9 Vance 9 Warren Stokes 17 B Northampton 6 B Rockingham 17 A Person 9 Currituck 9 Granville 6 B Hertford Camden Region 4 24 Watauga 6 A Halifax Perquimans Wilkes 23 Yadkin 23 Forsyth 21 A-B-C- & D Alamance 15 A 6 B Bertie Pasquotank Mitchell 24 Avery 24 Guilford 18 A-B-C-D-E Orange 15 B Durham 14 A-B 9 Franklin 7 A Nash Chowan Alexander 22 Davie 22 7 B Edgecombe Yancey 24 Caldwell 25 A 2 Martin Madison 24 Wake 10 A-B-C-D 2 Washington Iredell 22 Davidson 22 2 Tyrrell Chatham 15 B Dare 1 Burke 25 A McDowell 29 Catawba 25 B Randolph 19 B Wilson 7 C Rowan 19 C 3 A Pitt 2 Beaufort Haywood 30 B Buncombe 28 8 A Greene Swain 30 A Lincoln 27 B Lee 11 Johnston 11 2 Hyde 30 A Graham Rutherford 29 19 B Montgomery 8 B Wayne Jackson 30 B Henderson 29 Polk 29 27 B Cleveland Cabarrus 19 A Harnett 11 27 A Gaston 26 A-B-C Mecklenburg Stanly 20 B Moore 20 A 8 A Lenoir Transylvania 29 3 B Craven 3 B Pamlico Cherokee 30 A Macon 30 A 4 A Jones Clay 30A 12 A-B-C Cumberland Union 20 B Anson 20 A Richmond 20 A Hoke 16 A Sampson 4 A Duplin 4 A 16 A Scotland 4 B Onslow 3B Carteret Robeson 16 B 13 Bladen Pender 5 TASC is organized into 4 regions which reflect the state’s 4 judicial divisions, consistent with the unified court & statewide probation systems New Hanover 5 13 Columbus TASC Training Institute Dale Willetts 613 Shipyard Blvd. Wilmington, NC 28412 910.202.5500 13 Brunswick North Carolina TASC 11

TASC Quality Points National TASC Critical Elements NC TASC Standard Operating Procedures Statewide Availability for Equity Regional Management for Economies of Scale Funding contingent on DHHS-DPS-AOC MOA compliance Local Memoranda of Agreement All staff registered, certified or licensed w/ NCSAPPB Addiction Severity Index (ASI-MV) / ASAM Criteria NC TASC Training Institute NC-TOPPS TASC CJM Measures To ensure accountability Audits DHHS-DOC MOU as model North Carolina TASC 12

Drugs & Crime 1 in 34 adults are under correctional supervision* *BJS Correctional Surveys, 2011 SA is disproportionately represented in correctional populations* 80% of parolees 80% of prison inmates 67% of probationers *Report of the Re-Entry Policy Council, CSG, 2005 59% of SA referrals from CJS

Drugs & Crime in NC 38,133 people in NC prisons* 30,506 need substance abuse services Note: 97% will be released 103,890 people on probation, parole or post-release in NC* 69,606 need substance abuse services * NCDOC Research & Planning, October 17, 2014 populations

The People TASC Serves 19,292 Admissions 76% Male 51% Non-White 31 Average Age 69% Never Married 32% No HS Diploma 41% Unemployed Avg age 31, Median 28, from 16 to 81 NCTOPPS TASC FY1314 Intake Data North Carolina TASC 15

Substance Use Diagnosis TASC Facts Substance Use Diagnosis 5 month Average Length of Stay $1.36 cost per day 50% increase in persons served over the last 7 years 20% increase in Successful Completions over the last 7 years 42% Dedendence / 37% Abuse / 21% None North Carolina TASC 16

TASC Benefits Increases Client Identification Improving treatment outreach & access Provides Independent Assessment of Need Improves Treatment Engagement orients clients to tx, reduces “no shows”; increasing tx staff productivity Improves Treatment Retention & Compliance improving tx outcomes Provides Support & Continuity during Tx & CJ Transitions

TASC Benefits Maintains clear Roles & Responsibilities Tx providers focus on client care Probation officers focus on supervision Balances Control & Treatment Improves Communication among Systems, appropriately managing client confidentiality Provides addt’l information for Treatment, Judicial & Correctional Decision-Making

Second Chance Reentry Program $600,000 - 2 years – funded by the Bureau of Justice Assistance Individuals involved incarcerated in NHC with Co- occurring disorders Priority population is women Providing: Assessment Treatment Residential Placement Case Management linkages NEW HANOVER COUNTY

FOR MORE INFORMATION DALE WILLETTS KAREN CHAPPLE NC TASC Training Institute of Coastal Horizons Center dwilletts@nctasc.com 910-202-5500 KAREN CHAPPLE Coastal Horizons Center – Wilmington Office kchapple@coastalhorizons.org 910-524-4800 North Carolina TASC