Tuesday, July 08, 2008

Shortage of aftercare beds threatens to continue TDCJ's drug treatment bottlenecks

Although the Texas Legislature (led by Sen. John Whitmire and Rep. Jerry Madden) spearheaded a massive expansion of treatment options and incarceration alternatives last year for prisoners and parolees, a shortage of Transitional Treatment Center (TTC) beds threatens to undermine Texas' expanded programs aimed at mitigating drug addiction.

While the Texas Department of Criminal Justice (TDCJ) has made progress, the majority of new treatment beds authorized by the Legislature have yet to come online according to information provided to Grits by Jason Clark, a TDCJ spokesperson. Here's the status of the various treatment beds authorized and funded last year (adapted from an email):
Intermediate Sanctions Facilities (ISF) -1400 beds allotted be legislature, 250 are under contract. The remaining 1150 are out on a RFP. The responses are due back July 14th for those beds that are available right now (fast track). The RFP for those beds that have to be constructed (slow track) are due back November 14th.

Substance Abuse Felony Punishment (SAFP) -1500 allotted
588 "fast track" beds are already under contract. The remaining 912 are out on RFP due back November 14th.

DWI-500 allotted
These beds are online (see the Longview News Journal coverage of the new facility)

In-Prison Therapeutic Community (IPTC) treatment slots-1000 allotted
These beds are online

Transitional Treatment Center (TTC) -1250 allotted
We have gone through with the first round of RFP and are now on the second round. The agency is working with existing vendors to vendors, CSCD's, and Department of State Health Services to increase available capacity.
So 2,338 of the beds are already online out of 5,650 total, or 41%. I was a little surprised at these numbers since TDCJ chief Brad Livingston told the Legislature this spring that most of the beds were already contracted.

Notably, the TTC beds are the only ones now on their second RFP. Though Clark wouldn't confirm it, I'm told by sources in local probation departments that's because no one submitted a proposal in response to the request. (We won't know until November whether that will be the case with other categories of beds not yet built.) All the treatment beds proposed (except possibly for TTC) will be operated by private contractors.

There's a fear among some local probation departments that by "working with ... CSCDs," the state means they hope to dump aftercare duties on county probation departments instead of contracting with vendors or providing the services themselves. Right now such services fall under the auspices of the TDCJ's parole division.

What's more, the TTC bed shortfall potentially thwarts larger treatment and re-entry goals because they're part of a three phase protocol designed for drug-addicted offenders - in fact, the same ones occupying the SAFP and IPTC beds, both of whom enter TTC facilities when their initial program is complete. From TDCJ's website:
The program consists of Phase I (Orientation), a comprehensive assessment and orientation of the Therapeutic Community; Phase II (Main Treatment), which includes education, skills training, offender lifestyle confrontation, family dynamics, and peer support groups; and Phase III (Re-Entry), the education of offenders in the development of social skills and the recognition of the triggers of relapse. Upon completion of the SAFPF program, offenders are placed in a community residential facility/Transitional Treatment Center for three months, followed by outpatient treatment for up to twelve additional months. The aftercare phase administers a diverse range of therapeutic, residential, outpatient, and resource programs. The Special Needs program provides educational components that address Axis I mental disorders as well as personality disorders, medication regimentation, and the interaction of disorders with substances of abuse.
TDCJ's website describes how the system is supposed to work in an ideal world:
Transitional Treatment Center (TTC) - is targeted for those releasees who have participated in the In-Prison Therapeutic Community (IPTC) or Substance Abuse Felony Punishment Facility (SAFP) programs. The TTC is the aftercare component of the treatment program for releasees from the IPTC and SAFP facilities, and lasts for three months. An additional twelve months of outpatient care follows. Specially trained parole officers supervise offenders.
These treatment beds as a package were the centerpiece of prison diversion legislation enacted in 2007 aimed at reducing or ending waiting lists for treatment programs required of certain offenders before release. But the various facilities were designed to be interdependent: If Texas expands SAFP and IPTC capacity but fails to increase the number of TTC beds, it invites bottlenecks and release delays that could continue to fill up scarce prison beds, disrupt rehabilitation and stymie re-entry efforts.

TDCJ deserves credit for getting 40% of the beds rolled out within a year after they were authorized, but those beds basically represent all the existing capacity they could easily sop up. Most additional beds will require new construction - or in the case of TTC beds, possibly a new delivery model - meaning it could easily be another couple of years before the treatment package authorized by the Texas Legislature in 2007 becomes fully available.


Don said...

When the lege appropriated this money, I predicted they would not be able to give it away. There has always been a shortage of TTC facilities since they were conceived, along with the SAFPF program. They can't hire staff, people don't want to jack with TDCJ's BS, and the programs that the clients come out of don't work. The concept is flawed. In the early 90's, Ann Richards got money appropriated for 12,500 SAFPF beds. First rattle out of the box, when Bush was elected, they trimmed that to 10,000, with the rest going for regular prison. Then they proceeded to cut the treatment beds over the years until they were down to almost none. Then along came the 07 lege and decided to put programs back in. But that means you have to build new facilities, or turn the regular prisons back into SAFPF or IPTC beds. Then you don't have enough regular prison beds to satisfy the "tuff on crime" conservatives. In my neck of the woods, even before the "expansion", nobody was spending 3 months in the TTC programs, due to lack of beds. The 40 something percent of the new beds that TDCJ is claiming "on line" are not staffed either, I'd be willing to bet. Does it strike anybody as odd that NOBODY wanted the money for the TTC's? It doesn't me. I wouldn't do it for all the tea in China. Chemical dependency is a brain disease which should fall under the category of public health, like diabetes and cancer. Criminal Justice, last time I checked, was not being asked to do anything about the cancer and diabetes problem, something about not being qualified.

Anonymous said...

it is so ridiculous how even those supposedly progressive on criminal justice in Texas advocate for prison expansion

Gritsforbreakfast said...

"even those supposedly progressive on criminal justice in Texas advocate for prison expansion"

There's some truth to that, but also a sense in which it's unfair. In particular Texas had gutted its treatment programs and the parole board was refusing to let out drug and DWI offenders who'd not received treatment, making the prisons more crowded, because of long waiting lists to get into the programs. Expanding treatment beds actually lets those offenders get out much more quickly, or will when they're online.

Last session Texas faced projections it would need 17,000 new prison beds in five years. Instead, they added a much smaller number of mostly treatment and diversion beds that mitigated the entire need for more "hard" beds.

It's not a perfect solution, but given what they had to work with (and the fact that the Lt. Governor wanted to build more medium security units) IMO it was a positive and workable compromise.

All that said, given that the new treatment beds aren't all there yet, what's really kept the prison population down are changes in probation practices that reduced revocations in all the big counties except Bexar. Policy changes in the field impact the problem far more than new construction ever could.

Anonymous said...

the whole program is a joke. ask any offender who went to "aftercare"..more warehousing
with frequently unreachable expectations. they do it to get our and get on with life, they do it because the state says so. ask them, they'll tell you.

Anonymous said...

My spouse has worked in every phase of this program almost since its inception. Richard's vision of it was great, but the gutting of it under Bush cut its effectiveness; however, it is still more effective than no treatment at all.
TTC beds are short because the state pays $30/day for housing, feeding, transporting (to jobs), job search, and counseling each inmate. You cant even get a cheap hotel room for that, much less food and treatment, plus meet the regulations set forth by several agencies.
Right now at the SAFP they are going to start releasing inmates directly home, bypassing the TTCs because there are no beds, and there is starting to be a big backlog at the facilities.
But, you know, can't raise taxes, except to lock 'em up.

Anonymous said...

The SAFPF's were initially linked to the CSCD's across the state which provided offender (clients) for the program beds. Originally, the state ran two of the facilities and the vendors got the rest. Oddly enough, the State run facilities had better track records than most of the vendor run facilities. What was missing was the proposed aftercare where the "graduates" of the program would become part of the leadership in the community for others who had completed the program and wanted to follow through on their treatment and sobriety with like minded "graduates". Since that never materialized, most of the aftercare became AA and NA programs. While the SAFPF model incorporated many of the 12 step concepts, it also encouraged a strong sense of community among the "clients". When that same type of community was not in the freeworld upon their dischrged, the "aftercare" component of the program went away. The effect was recidivism for many who could not make it on their own. The aftercare component becomes critical as the programs are shortened in length so that more offenders are run through them. The clients from the CSCD's also tended to be more compliant than the parolees, because they could end up facing the judge again if they failed to participate in the program. Taking someone back to see the judge in the fourth month was often just the stimulation they needed to get serious or get revoked. Also, even in the 90's, recruitment of licensed chemical dependency counselors was very difficult, especially in rural areas of Texas. Over the years, the supply of those counselors has lessened dramatically. Staffing all the proposed treatment beds with licensed and experienced staff is almost impossible because it takes a special kind of CD counselor to work within a Therapeutic Community model. Many came and went, because the community model was so unusual.

Anonymous said...

to 9:06

and staffing with good people is only going to get worse. When the state decided to make LCDCs semi-professional and require some college (2 yrs), it was great. But they turned around and created a new license thru CJ that requires no college but will be enough to "counsel" people in TTCs and SAFP.

Anonymous said...

We have a friend with a well documented drug problem, who has been to prison twice in the past 5 years but who never received ANY counselling or treatment at all while there. He is now living on the streets in Waco waiting for a bed in a 90-day treatment centre.

Put the staff you have straight into the TDCJ units to work with the people who want to get and stay clean, and then you wont have to worry about opening new treatment facilities.

Anonymous said...

I received my degree in Substance Abuse counseling (a 2 year associates degree). The state requires an additional 2 years of internship, or 4000 hrs, for LCDC licensure. That's a four year investment. I know some LCDC's that are making $8.00 an hour. Many quit the profession for that reason.
Personally, I wish that I have never gone down that road. There's a reason LCDC's are as rare as hens teeth. They can't hang.
Rehabilitation and recovery for addiction is simply not our states priority list. Keeping our prison's at max capacity produces big money for the state... that why nothing changes.And..That's the bottom line.

Anonymous said...

There has been a shortage of LCDCs and other treatment professionals in Texas for quite a few years. TDCJ and TYC have long had problems filling vacancies in the programs existing prior to this initiative. The pay has been awful given the level of expertise it takes to deal with this population. The number of LCDCs has gone down steadily for a number of years. This is but another case of the legislature's failure to look at the larger picture - available resources (LCDCs and QCCs). If they had looked at the number of available professionals in the state, they would have known that it would be near impossible to implement these programs.

Anonymous said...

Aftercare programs

Aftercare programs are useful for complete cocaine recovery. Aftercare programs are very beneficial because it offers the client full recovery from cocaine addiction forever. They provide healthy, fresh and light diet in their recovery program to their patients.


Blakers903 said...

I have been searching for any kind of literature saying that you would have to pay for your continuum of aftercare groups. I have found NOTHING. There are some aftercare vendors that are charging $25 per group. 3 groups a week plus your one on one with your counselor that's totaling out to $325/mo. How are they expecting you to get back on your feet taking off work to attend these groups and pay all these fees? I feel like they aren't supposed to be charging you. If anyone could please send me a link of some literature that says you may be charged for continuum of aftercare it would be much appreciated! Bbaek13@gmail.com