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06/04/2019

Department of Corrections’ Evaluation Leads to Insight on Substance Use Disorder Treatment Program Success

Harrisburg, PA – Department of Corrections officials today announced results of an internal therapeutic communities (TCs) evaluation, specifically the effectiveness of the DOC's outpatient (OPT)* and substance use disorder (SUD) TCs, including recidivism and relapse outcomes and cost benefit analyses.

"Over the years, as is the case with all of our programs, we have made improvements to the policy and procedures that govern the operation of our SUD programs, including our TCs," DOC Secretary John Wetzel said. "This evaluation confirms our belief that slight modifications in inmate program placement could result in substantial taxpayer cost avoidance, while not having a negative impact on outcomes."

The report, released in June, titled "Therapeutic Communities (TC) Evaluation," found that there were no significant differences in recidivism or relapse outcomes between TC and OPT participants.

The evaluation recommended that, with slight modifications in current SUD policy, there is the potential for huge cost avoidance. These are:

  • A potential for approximately $5.8 million in savings if there are changes in the override process for placement in the TCs. The evaluation showed that many inmates who scored less than a six on Texas Christian University Drug Screen (TCU) ended up going to TC instead of OPT. This occurred due to the ability to increase an inmates TC score, through the override process.  
  • An additional potential savings of $2.3 million could be made if the DOC moved the TCU score up to seven as the cut-off for TC placement.

The report recommended future DOC evaluations continue to assess the impact of TCs and to ensure continuity of care directly after SUD treatment in prison, as well as upon release to community supervision.

A TC is a four-month, three-phase intensive treatment program, which is self-contained and semi-autonomous with shared responsibilities by staff and inmates. This program is developed to treat inmates who meet the diagnostic criteria for SUD dependence. The DOC has been using the TC model for several decades. TCs are designed as inpatient type of housing where all activities and programming takes place in a specific housing unit where the inmate resides during the course of the program.

Currently, TC admission criteria includes an inmate scoring six to nine on the Texas Christian University (TCU) drug screen instrument, which is administered to all inmates upon reception to the DOC. Inmates also may be considered on a case-by-case basis for placement in a TC for scoring between three to five on the TCU. Mental health issues found to be too severe for regular TC placement can be recommended for placement in either a co-occurring outpatient program or co-occurring TC. Inmates must be clear of any serious misconducts and may be removed from the TC for reasons of self-removal, misconduct, incomplete assignments, failed exams, being disruptive and attendance issues.

The primary goal of SUD treatment programs is to reduce incidents of relapse and recidivism, promote pro-social behavior, enable inmates to exhibit conduct in compliance with DOC rules and procedures and assist inmates in successful reintegration back into the community.

"We regularly evaluate ourselves to ensure our programs are working as expected and that we are not a drain on taxpayer resources," Wetzel said. "In fact, in January 2017, we made changes to the general population TC curriculum and the co-occurring disorders TC curriculum to provide evidence-based treatment. Also, in March 2017, we converted six TCs to opiate specific TCs. All of these changes, then and now, are examples of our agency using data to make sound program decisions."

The DOC will implement the recommended modifications this week.

The full report can be viewed on the Statistics page at cor.pa.gov.

MEDIA CONTACT: Susan McNaughton, 717-728-4025

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