ab109, acp and centerforce: opportunities and challenges carol f. burton, lmsw julie lifshay, phd...

AB109, ACP and AB109, ACP and Centerforce:Centerforce:Opportunities and Opportunities and ChallengesChallenges

Carol F. Burton, LMSWCarol F. Burton, LMSWJulie Lifshay, PhDJulie Lifshay, PhDCenterforceCenterforceJanuary 26, 2012January 26, 2012

CenterforceCenterforceInformation, Education and Advocacy for

individuals, families and communities impacted by incarceration

Why should you care??Why should you care??

• 1 in 321 in 32 adults in the adults in the United States is under United States is under some form of some form of correctional supervision correctional supervision (jail, prison, probation, (jail, prison, probation, parole).parole). (BJS, 2003)(BJS, 2003)

• That translates into That translates into approximately approximately 7 million7 million children.children. (BJS, 2003)(BJS, 2003)

• 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)

Minority Children are Minority Children are Disproportionately Disproportionately AffectedAffected In State In State Prison-42% of fathers are African Prison-42% of fathers are African

American and African American children are American and African American children are seven and a half times more likely to have a seven and a half times more likely to have a parent in prison than white childrenparent in prison than white children

Percentage of incarcerated parents Percentage of incarcerated parents who who NEVERNEVER had a visit from their had a visit from their child child (BJS, 2000):(BJS, 2000):

54% of mothers54% of mothers 57% of fathers57% of fathers

Fathers by AgeFathers by Age

0

10

20

30

40

50

60

70

80

<24 25-34 35-44 45-54 55+

State Prison

Federal Prison

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.

California’s Alternative California’s Alternative Custody ProgramCustody Program Largest women’s prison in the Largest women’s prison in the

worldworld Chowchilla houses 7,000 womenChowchilla houses 7,000 women ¾ of women are mothers¾ of women are mothers

© Centerforce 2012© Centerforce 201288

ACPACP

Female, pregnant or parents who Female, pregnant or parents who immediately prior to incarceration immediately prior to incarceration were primary caregiverswere primary caregivers– Residential HomeResidential Home– Residential TreatmentResidential Treatment– Transitional Care facilityTransitional Care facility– Monitoring through technologyMonitoring through technology



ALTERNATIVE CUSTODY PROGRAM FEMALE DEMOGRAPHIC ELIGIBILITY DATA - Per CSRA Score

County(s) ELIGIBLE PER OISB** 79% *Los Angeles 1,584 1,251Orange 389 307Riverside 285 225San Bernardino 554 438San Diego & Imperial 318 251Northern California

177 140Butte, Colusa, Del Norte, Glenn, Lake, Mendocino,

Humboldt, Lassen, Modoc, Plumas, Shasta, Sierra, Siskiyou, Tehama, Trinity

Southern Coastal

213 168Monterey, San Benito, San Luis Obispo, Santa Cruz,

Santa Barbara, Ventura

Bay Area

402 318Alameda, Contra Costa, San Francisco, San Mateo, Santa Clara, Marin, Napa, Sonoma

Mid-Central

310 245Alpine, Calaveras, Mariposa, Merced, Mono, San Joaquin, Stanislaus, Tuolumne

Central Valley551 435

Fresno, Inyo, Kern, Kings, Madera, Tulare

Sacramento-Central

354 280Amador, El Dorado, Nevada, Sacramento, Placer, Solano, Sutter, Yolo, Yuba

TOTAL 5,137 4,058

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


NUMBER OF FEMALE INMATES BY COUNTY – Top 10 Counties*as of 3/17/2011 (OISB)

County # of Inmates

Los Angeles 3,170

San Bernardino 830

San Diego 766

Riverside 668

Orange County 488

Sacramento 427

Kern 325

Fresno 281

Santa Clara 261

San Joaquin 201

Total 7444

AB109AB109

Created three populations of Created three populations of offendersoffenders– Post Release Community Post Release Community

Supervision (PRCS)Supervision (PRCS)– 3-NONS3-NONS– State Parole ViolatorsState Parole Violators

Community Corrections Community Corrections Partnerships (CCP)Partnerships (CCP)


ChallengesChallenges

Things to ConsiderThings to Consider

Parenting and Relationship education Parenting and Relationship education for custodial and non custodial for custodial and non custodial parentsparents

Contact visits and other forms of Contact visits and other forms of communication with children and communication with children and their incarcerated parenttheir incarcerated parent

Programs that help parents (including Programs that help parents (including non custodial parents reunite)non custodial parents reunite)


Things to ConsiderThings to Consider

Parents convicted of a felony are Parents convicted of a felony are not eligible for TANF, Public not eligible for TANF, Public Housing and have difficulty Housing and have difficulty finding employmentfinding employment

PRCS offenders are not eligible for PRCS offenders are not eligible for services offered to parolesservices offered to paroles


1616

Health Issues Facing Health Issues Facing People who are People who are IncarceratedIncarcerated



There are many…There are many…

Rates of Rates of HIVHIV are approximately 5X higher are approximately 5X higher than in general populationthan in general population– ~ A quarter [1/4] of PLWHIV/AIDS in the US pass ~ A quarter [1/4] of PLWHIV/AIDS in the US pass

through a correctional facility each yearthrough a correctional facility each year

Rates of Rates of Hep C Hep C in CA prisons:in CA prisons:– 40% of men; 50% of women upon entry are HCV+ 40% of men; 50% of women upon entry are HCV+

(1999)(1999)

TuberculosisTuberculosis– Up to 25% of prisoners in the US have latent Up to 25% of prisoners in the US have latent

tuberculosis infection (LTBI)tuberculosis infection (LTBI)


There are many…There are many…

43% (prisons) and 39% (jails) reported a chronic 43% (prisons) and 39% (jails) reported a chronic medical condition** (2009, 2006)medical condition** (2009, 2006)– Statistically higher rates of asthma, hypertension, Statistically higher rates of asthma, hypertension,

arthritis**arthritis**

DOJ estimates that ~50% of U.S. inmates have DOJ estimates that ~50% of U.S. inmates have mental health mental health problemsproblems

>50% have history of substance abuse and >50% have history of substance abuse and addiction*addiction*

A significant number of prisoners continue to A significant number of prisoners continue to use drugs, including injection drugs, during use drugs, including injection drugs, during incarcerationincarceration


The Cycle The Cycle


The CycleThe Cycle

Cycling between home and incarcerated Cycling between home and incarcerated

settings means that settings means that

– The care delivered by Correctional Health Services The care delivered by Correctional Health Services

has important implications for the overall care of has important implications for the overall care of

formerly incarcerated people in the community formerly incarcerated people in the community

– Effective community re-entry support is vital for Effective community re-entry support is vital for

continuity primary care post-releasecontinuity primary care post-release

– Re-entry/transitional and community health programs Re-entry/transitional and community health programs

serving this community must communicate effectively serving this community must communicate effectively

to successfully support client needs to successfully support client needs


Incarceration Incarceration ExperienceExperience Significantly different from the “free” Significantly different from the “free”

communitycommunity– Loss ofLoss of

AutonomyAutonomy Privacy Privacy Possessions Possessions Ordinary, loving & sexual relationshipsOrdinary, loving & sexual relationships Safety/Security Safety/Security Power Power

Very stressfulVery stressful

Health CareHealth Care


Re-entry ExperienceRe-entry Experience

Experiences range from abrupt to Experiences range from abrupt to drawn-outdrawn-out

Stressful (positive and negative)Stressful (positive and negative)– Individual, relationships, family (including Individual, relationships, family (including

children)children)– Competing prioritiesCompeting priorities

All ex-prisoners on probation must comply All ex-prisoners on probation must comply with probation conditions which may with probation conditions which may include securing stable housing or include securing stable housing or employment employment

Health care needs often not addressedHealth care needs often not addressed



HIV positive prisoners are released with 7 to HIV positive prisoners are released with 7 to 30 days of AVT medications and in that 30 days of AVT medications and in that timeframe musttimeframe must– Meet basic subsistence needs (e.g. housing, Meet basic subsistence needs (e.g. housing,

clothing, food, transportation)clothing, food, transportation)– Secure or re-establish Secure or re-establish

primary care – for care and medicationsprimary 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 Resist use of or relapse into use of alcohol/illegal substancessubstances

The first month post-release is a critical The first month post-release is a critical period for HIV+ ex-prisoners who need strong period for HIV+ ex-prisoners who need strong support systems to support continuity of care support systems to support continuity of care and access to basic needs.and access to basic needs.



Without access to treatment and care post-Without access to treatment and care post-release, many health improvements release, many health improvements achieved during incarceration may be lost.achieved during incarceration may be lost.

The overall instability that exists in the lives The overall instability that exists in the lives of many ex-prisoners hampers their ability to of many ex-prisoners hampers their ability to attend to their health care needs.attend to their health care needs.– Most former prisoners return to the community Most former prisoners return to the community

with co-occurring housing and substance abuse with co-occurring housing and substance abuse related problems. related problems.

– Complicating their access to health care are Complicating their access to health care are fragmented health care and correctional systems. fragmented health care and correctional systems.



Strong predictors of post-release Strong predictors of post-release primary care utilization & not primary care utilization & not recidivating includerecidivating include– housinghousing stability stability

– housinghousing comfort comfort

– no alcoholno alcohol use use


ResponsesResponses

Discharge Discharge planningplanning

Continuity of Continuity of Care ProgramsCare Programs

Transitional Transitional ServicesServices

Re-entry Case Re-entry Case ManagementManagement

Transitional Services

Continuity Of Care

Programs

Discharge Planning

Re-entry Case

Management


Re-entry Case Re-entry Case ManagementManagement

Discharge planning, transitional Discharge planning, transitional services, and continuity of care services, and continuity of care programs are essential for the vast programs are essential for the vast majority of releasing ex-prisoners majority of releasing ex-prisoners returning home.returning home.

Case management may be particularly Case management may be particularly useful in helping high-risk clients useful in helping high-risk clients engage in health-seeking behaviors engage in health-seeking behaviors (e.g. accessing primary care and (e.g. accessing primary care and substance abuse treatment services) substance abuse treatment services)

Questions?Questions?

Comments?Comments?


CenterforceCenterforce

www.centerforce.orgwww.centerforce.org

ab109, acp and centerforce: opportunities and challenges carol f. burton, lmsw julie lifshay, phd...

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