1. AB109, ACP and Centerforce: Opportunities and Challenges Carol F. Burton, LMSW Julie Lifshay, PhD Centerforce January 26, 2012 Centerforce Information, Education and Advocacy for individuals, families and communities impacted by incarceration

2. Why should you care?? 1 in 32 adults in the United States is under some form of correctional supervision (jail, prison, probation, parole). (BJS, 2003) 1 in 32 adults in the United States is under some form of correctional supervision (jail, prison, probation, parole). (BJS, 2003) That translates into approximately 7 million children. (BJS, 2003) That translates into approximately 7 million children. (BJS, 2003)

3. Under 1 year: 2% 1-4 years old: 20% 5-9 years old: 36% 10-14 years old: 28% 15-17 years old: 14% (Families Left Behind: The Hidden Costs of Incarceration and Reentry, The Urban Institute, 2003)

4. Minority Children are Disproportionately Affected In State Prison-42% of fathers are African In State Prison-42% of fathers are African American and African American children are seven and a half times more likely to have a parent in prison than white children

5. Percentage of incarcerated parents who NEVER had a visit from their child (BJS, 2000):  54% of mothers  57% of fathers

6. Fathers by Age

7. Children of Prisoners: Understanding the Risks and the Impact Incarceration is rarely the only risk factor for a child with a parent in prison or jail. Most have an “accumulation of risk”, multiple risk factors that occur in their families and communities. The children’s response will vary according to age. Older children are likely to act out—sexual misconduct, truancy, and substance abuse. Younger children are at greatest risk because they have not developed the coping skills to deal with trauma.

8. California’s Alternative Custody Program Largest women’s prison in the world Largest women’s prison in the world Chowchilla houses 7,000 women Chowchilla houses 7,000 women ¾ of women are mothers ¾ of women are mothers © Centerforce 2012 8

9. ACP Female, pregnant or parents who immediately prior to incarceration were primary caregivers Female, pregnant or parents who immediately prior to incarceration were primary caregivers –Residential Home –Residential Treatment –Transitional Care facility –Monitoring through technology © Centerforce 2012 9

10. 10 ALTERNATIVE CUSTODY PROGRAM FEMALE DEMOGRAPHIC ELIGIBILITY DATA - Per CSRA Score County(s) ELIGIBLE PER OISB**79% * Los Angeles 1,584 1,251 Orange 389 307 Riverside 285 225 San Bernardino 554 438 San Diego & Imperial 318 251 Northern California 177 140 Butte, Colusa, Del Norte, Glenn, Lake, Mendocino, Humboldt, Lassen, Modoc, Plumas, Shasta, Sierra, Siskiyou, Tehama, Trinity Southern Coastal 213 168 Monterey, San Benito, San Luis Obispo, Santa Cruz, Santa Barbara, Ventura Bay Area 402 318 Alameda, Contra Costa, San Francisco, San Mateo, Santa Clara, Marin, Napa, Sonoma Mid-Central 310 245 Alpine, Calaveras, Mariposa, Merced, Mono, San Joaquin, Stanislaus, Tuolumne Central Valley 551 435 Fresno, Inyo, Kern, Kings, Madera, Tulare Sacramento-Central 354 280 Amador, El Dorado, Nevada, Sacramento, Placer, Solano, Sutter, Yolo, Yuba TOTAL5,1374,058 Demographic information as of February 2011 * Random Sampling File Review Indicated Actual Eligibility to be 79% of OIS Pool ** Time period used was 0-24 months remaining in custody

11. © Centerforce 2012 11 NUMBER OF FEMALE INMATES BY COUNTY – Top 10 Counties *as of 3/17/2011 (OISB) County# of Inmates Los Angeles3,170 San Bernardino830 San Diego766 Riverside668 Orange County488 Sacramento427 Kern325 Fresno281 Santa Clara261 San Joaquin201 Total7444

12. AB109 Created three populations of offenders Created three populations of offenders –Post Release Community Supervision (PRCS) –3-NONS –State Parole Violators Community Corrections Partnerships (CCP) Community Corrections Partnerships (CCP) © Centerforce 2012 12

13. Challenges

14. Things to Consider Parenting and Relationship education for custodial and non custodial parents Parenting and Relationship education for custodial and non custodial parents Contact visits and other forms of communication with children and their incarcerated parent Contact visits and other forms of communication with children and their incarcerated parent Programs that help parents (including non custodial parents reunite) Programs that help parents (including non custodial parents reunite) © Centerforce 2012 14

15. Things to Consider Parents convicted of a felony are not eligible for TANF, Public Housing and have difficulty finding employment Parents convicted of a felony are not eligible for TANF, Public Housing and have difficulty finding employment PRCS offenders are not eligible for services offered to paroles PRCS offenders are not eligible for services offered to paroles © Centerforce 2012 15

16. 16 Health Issues Facing People who are Incarcerated © Centerforce 2012

17. 17 There are many… Rates of HIV are approximately 5X higher than in general population Rates of HIV are approximately 5X higher than in general population –~ A quarter [1/4] of PLWHIV/AIDS in the US pass through a correctional facility each year Rates of Hep C in CA prisons: Rates of Hep C in CA prisons: –40% of men; 50% of women upon entry are HCV+ (1999) Tuberculosis Tuberculosis –Up to 25% of prisoners in the US have latent tuberculosis infection (LTBI)

18. © Centerforce 2012 18 There are many… 43% (prisons) and 39% (jails) reported a chronic medical condition** (2009, 2006) 43% (prisons) and 39% (jails) reported a chronic medical condition** (2009, 2006) –Statistically higher rates of asthma, hypertension, arthritis** DOJ estimates that ~50% of U.S. inmates have mental health problems DOJ estimates that ~50% of U.S. inmates have mental health problems >50% have history of substance abuse and addiction* >50% have history of substance abuse and addiction* A significant number of prisoners continue to use drugs, including injection drugs, during incarceration A significant number of prisoners continue to use drugs, including injection drugs, during incarceration

19. © Centerforce 2012 19 The Cycle

20. © Centerforce 2012 20 The Cycle Cycling between home and incarcerated settings means that Cycling between home and incarcerated settings means that –The care delivered by Correctional Health Services has important implications for the overall care of formerly incarcerated people in the community –Effective community re-entry support is vital for continuity primary care post-release –Re-entry/transitional and community health programs serving this community must communicate effectively to successfully support client needs

21. © Centerforce 2012 21 Incarceration Experience Significantly different from the “free” community Significantly different from the “free” community –Loss of Autonomy Autonomy Privacy Privacy Possessions Possessions Ordinary, loving & sexual relationships Ordinary, loving & sexual relationships Safety/Security Safety/Security Power Power Very stressful Very stressful Health Care Health Care

22. © Centerforce 2012 22 Re-entry Experience Experiences range from abrupt to drawn-out Experiences range from abrupt to drawn-out Stressful (positive and negative) Stressful (positive and negative) –Individual, relationships, family (including children) –Competing priorities All ex-prisoners on probation must comply with probation conditions which may include securing stable housing or employment All ex-prisoners on probation must comply with probation conditions which may include securing stable housing or employment Health care needs often not addressed Health care needs often not addressed

23. © Centerforce 2012 23 Re-entry Experience HIV positive prisoners are released with 7 to 30 days of AVT medications and in that timeframe must HIV positive prisoners are released with 7 to 30 days of AVT medications and in that timeframe must –Meet basic subsistence needs (e.g. housing, clothing, food, transportation) –Secure or re-establish primary care – for care and medications primary care – for care and medications reimbursement sources (ADAP, Medi-Cal, VA etc) reimbursement sources (ADAP, Medi-Cal, VA etc) –Resist use of or relapse into use of alcohol/illegal substances The first month post-release is a critical period for HIV+ ex-prisoners who need strong support systems to support continuity of care and access to basic needs. The first month post-release is a critical period for HIV+ ex-prisoners who need strong support systems to support continuity of care and access to basic needs.

24. © Centerforce 2012 24 Re-entry Experience Without access to treatment and care post-release, many health improvements achieved during incarceration may be lost. Without access to treatment and care post-release, many health improvements achieved during incarceration may be lost. The overall instability that exists in the lives of many ex-prisoners hampers their ability to attend to their health care needs. The overall instability that exists in the lives of many ex-prisoners hampers their ability to attend to their health care needs. –Most former prisoners return to the community with co- occurring housing and substance abuse related problems. –Complicating their access to health care are fragmented health care and correctional systems.

25. © Centerforce 2012 25 Re-entry Experience Strong predictors of post-release primary care utilization & not recidivating include –housing stability –housing comfort –no alcohol use

26. © Centerforce 2012 26 Responses Discharge planning Discharge planning Continuity of Care Programs Continuity of Care Programs Transitional Services Transitional Services Re-entry Case Management Re-entry Case Management Transitional Services Continuity Of Care Programs Discharge Planning Re-entry Case Management

27. © Centerforce 2012 27 Re-entry Case Management Discharge planning, transitional services, and continuity of care programs are essential for the vast majority of releasing ex-prisoners returning home. Discharge planning, transitional services, and continuity of care programs are essential for the vast majority of releasing ex-prisoners returning home. Case management may be particularly useful in helping high-risk clients engage in health-seeking behaviors (e.g. accessing primary care and substance abuse treatment services) Case management may be particularly useful in helping high-risk clients engage in health-seeking behaviors (e.g. accessing primary care and substance abuse treatment services)

28. Questions? Comments? © Centerforce 2012 28

29. Centerforce www.centerforce.org