Legislature(2019 - 2020)ADAMS ROOM 519
04/24/2019 09:00 AM House FINANCE
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| Audio | Topic |
|---|---|
| Start | |
| HB14 | |
| Presentation: Sentencing Programs by Court System | |
| Presentation: Prison Programs by Dept. of Corrections | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| + | TELECONFERENCED | ||
| += | HB 14 | TELECONFERENCED | |
HOUSE BILL NO. 14
"An Act relating to assault in the first degree;
relating to sex offenses; relating to the definition
of 'dangerous instrument'; and providing for an
aggravating factor at sentencing for strangulation
that results in unconsciousness."
9:00:33 AM
Co-Chair Wilson began with to FN 1 from the Department of
Health and Social Services, Division of Juvenile Justice,
OMB Component Number 2134.
MATT DAVIDSON, SOCIAL SERVICES PROGRAM OFFICER, DIVISION OF
JUVENILE JUSTICE, DEPARTMENT OF HEALTH AND SOCIAL SERVICES
(via teleconference), reviewed the department's zero fiscal
note. He explained that the provisions of the bill related
to changes to criminal offenses applied to juvenile
offenders; however, the number of cases would be very low
and would not have a fiscal or programmatic impact on the
division.
Co-Chair Wilson asked if the division had statistics
showing the number of juveniles who had been convicted of
crimes included in HB 14.
Mr. Davidson replied that he did not have the statistics on
hand related to the number of assaults in the categories
impacted by the bill. He had learned in conversations with
probation staff handling juvenile cases that strangulation
type cases were very unusual with juveniles. He would
follow up with the requested information.
Co-Chair Wilson moved to FN 3 from the Department of Public
Safety (DPS), Alaska State Trooper Detachments, OMB
Component Number 2325.
KELLY HOWELL, SPECIAL ASSISTANT, DEPARTMENT OF PUBLIC
SAFETY, reviewed the department's zero fiscal note. The
changes proposed by HB 14 may slightly alter the way state
troopers conduct investigations and documentation but would
have no fiscal impact.
Co-Chair Wilson assumed DPS did not anticipate a
significant increase in arrests due to the bill.
Ms. Howell replied that she did not know whether the bill
would result in more arrests, but she believed that would
be positive. She hoped the legislation would help in
prosecutions and investigations. She elaborated that work
that would result from the bill was work the troopers were
already doing. The bill would provide troopers with
additional tools for investigations and provide more
information to the Department of Law (DOL) for improved
prosecutions.
9:03:51 AM
Co-Chair Wilson turned to FN 2 from the Department of Law,
Criminal Justice Litigation, OMB Component Number 2202.
ROBERT HENDERSON, DEPUTY ATTORNEY GENERAL, CRIMINAL
DIVISION, DEPARTMENT OF LAW (via teleconference), reviewed
the department's zero fiscal note. The changes made in the
bill elevated the criminal conduct and changed some of the
legal definitions. He explained the department was already
prosecuting the cases and the bill would mean prosecuting
them at a higher level. The department did not anticipate a
fiscal impact.
Co-Chair Wilson asked for verification that the department
did not anticipate new convictions; cases that were already
being prosecuted would be prosecuted at a higher level.
Mr. Henderson answered in the affirmative.
9:04:58 AM
Co-Chair Wilson moved to FN 5 from the Department of
Administration, Public Defender Agency, OMB Component
Number 1631.
BETH GOLDSTEIN, INTERIM PUBLIC DEFENDER, PUBLIC DEFENDER
AGENCY, DEPARTMENT OF ADMINISTRATION (via teleconference),
addressed the agency's indeterminate fiscal note. The
agency did not know how many additional cases the change in
law would create. She explained that the agency anticipated
some potential higher costs associated with the aggravator,
based on the more complex litigation with potential experts
or the need for additional transcripts at sentencing.
Co-Chair Wilson asked if the agency had any current
statistics showing the number of people who were being
arrested. She remarked that the bill would tighten things
up.
Ms. Goldstein answered that she did not have statistics on
how many more [arrests there would be]. She offered to
share numbers on average case costs for experts and
transcripts.
Co-Chair Wilson agreed the information would be helpful,
but she thought it would be even more helpful to know
whether 10 or 100 people had fallen into the category in
the past couple of years. She thought it did not make sense
the agency's note was indeterminate while notes from other
departments showed zero fiscal impact. She explained that
without statistics it was difficult for the committee to
know whether the note should be zeroed out or show a fiscal
impact.
Ms. Goldstein understood the confusion and explained the
reason for the indeterminate note. She elucidated that
because the Public Defender Agency was a downstream agency,
she did not have any estimates - DOL had stated there was a
caseload increase. The agency could not determine how many
additional charges or cases would result from the
legislation. Additionally, the agency could not determine
the number of individuals who would be public defender
eligible.
Representative Carpenter asked if it would be appropriate
to review the estimated numbers in the Department of
Corrections' (DOC) fiscal note and extrapolate the
information out to determine the cost to the Public
Defender Agency and Office of Public Advocacy (OPA).
Co-Chair Wilson agreed it would be helpful to ask DOC where
its numbers had come from and whether it had some
statistics showing how the numbers had been derived.
Representative Carpenter pointed out that public advocacy
[Public Defender Agency] did not know what the increased
caseload would be [as a result of the bill]. He suggested
applying the projected number from another department's
fiscal note in the cases where departments did not have the
information; the information would give the committee
something to go off of.
Co-Chair Wilson agreed. She moved to DOC and asked to hear
how the department had arrived at its projections.
9:08:41 AM
SYLVAN ROBB, ADMINISTRATIVE SERVICES DIRECTOR, DEPARTMENT
OF CORRECTIONS, OFFICE OF MANAGEMENT AND BUDGET, addressed
the department's fiscal impact note, FN 6, OMB Component
Number 1381 for the Institution Director's Office. She
shared that Sections 1 and 4 of the legislation impacted
the department and would lead to an anticipated increase in
the prison population.
Co-Chair Wilson asked how the department had determined the
numbers in the fiscal note.
Ms. Robb answered that the data had been pulled from DOC's
offender tracking system, the Alaska Criminal Offender
Management System (ACOMS). Section 1 pertained to the crime
of causing someone to be unconscious with a dangerous
instrument, which the bill included under assault in the
first degree. Over the past five years, the department had
averaged 113 inmates incarcerated as the result of an
assault in the first degree conviction; the individuals had
an average stay of 1,611 days or 4.4 years. The department
projected an increase in the daily population beginning in
year two going forward. The increase in year two was
slightly lower than in subsequent years because the people
who would be charged and incarcerated would have been
charged with assault in the second degree under current
law; assault in the first degree carried a longer sentence
than an assault in the second degree conviction.
Co-Chair Wilson asked for verification that everyone
currently incarcerated for the crime would be incarcerated
for assault in the first degree. She thought all of the
individuals would fall underneath the bill with an
increased number of prison days. She asked if that was how
the department had determined the increase.
Ms. Robb clarified not everyone convicted of an assault in
the second degree charge would have the charge raised to an
assault in the first degree. The increase would occur only
in the case of strangulation with a dangerous instrument.
Starting in year three, the increase would result in an
extra 5.66 individuals incarcerated.
Co-Chair Wilson requested the statistics to understand the
numbers in the note. She was interested in seeing the
information broken out by year to learn if incarceration
for the crime had been increasing or decreasing.
9:11:45 AM
Ms. Robb responded that with the passage of the bill the
strangulation with a dangerous instrument would become a
crime. It was her understanding it was not a current
element of the crime. The department did not have precise
statistics; it was projecting based on a use of similar
crimes.
Representative Josephson stated that currently when a
person strangled someone (with a dangerous instrument -
typically the hands) and caused physical injury they were
into a felony already. He thought Ms. Robb was saying that
an increase would likely not exceed around 5 inmates. He
clarified that it was currently a crime to strangle
someone. He remarked that the bill primarily established
there would be no debate [about the charge] in
circumstances where there was unconsciousness; the crime
would be a Class A felony. He added that the bill also
dealt with the element regarding discharge of bodily
fluids. He did not believe the committee should be overly
concerned [with the potential increase] because the
individuals were already going to jail.
Co-Chair Wilson appreciated the remarks. She explained she
had been trying to follow up on Representative Carpenter's
suggestion about how to utilize the [DOC] numbers to gain
more clarity on impacts to OPA and the Public Defender
Agency. She reasoned there would not necessarily be more
people going through the prison system, but people going
through the system would have higher charges.
9:13:43 AM
Vice-Chair Ortiz addressed Representative Josephson's
point. He explained there was already the use of public
defenders and crimes similar to those outlined in the bill.
He reasoned there would not be an increased need for public
defender expenses. He thought a zero fiscal note made
sense.
Co-Chair Wilson pointed out that the notes were
indeterminate from OPA and Public Defender Agency.
Vice-Chair Ortiz asked if Co-Chair Wilson's concern was
about why there was an increase in one fiscal note and why
there was an indeterminate note.
Co-Chair Wilson clarified her concern related to
indeterminate fiscal notes from agencies. She stated that
DOL had a zero fiscal note, whereas, DOC had a fiscal
impact note based on holding current inmates longer, and
the state troopers submitted a zero note because they did
not anticipate picking up offenders they were not already
picking up. She questioned why the Public Defender Agency
and OPA would have indeterminate notes. She believed Vice-
Chair Ortiz had made her case that notes [from OPA and the
Public Defender Agency] should be zero.
9:15:27 AM
Co-Chair Wilson moved to indeterminate FN 4 from the
Department of Administration, Office of Public Advocacy,
OMB Component Number 43.
JAMES STINSON, DIRECTOR, OFFICE OF PUBLIC ADVOCACY,
DEPARTMENT OF ADMINISTRATION (via teleconference), believed
there was a bit lost in translation. He echoed comments
made by Ms. Goldstein. He explained that it was not
necessarily that more people would be arrested and charged
with "X" crime; however, anytime an aggravator was added,
which would require expert testimony, litigation related
expenses would increase (including post-conviction relief).
Co-Chair Wilson asked if it would increase the number of
OPA staff needed. She asked what the change meant in terms
of the agency's workload and needs.
Mr. Stinson replied that while it was difficult to predict,
if a new Class A felony was created that required a person
to go unconscious, it was important to acknowledge that in
a strangulation case sometimes there were no outward signs
of injury. He explained that a Class A felony charge
required serious physical injury. Typically, there were
signs of injury when the charge was made; however, someone
could be strangled to unconsciousness who did not have
petechiae, bloodshot eyes, or other external signs. He
explained that it meant DOL, the public defenders, and/or
OPA, would have to have a battle of the experts in many of
the cases. Whether or not an aggravator could be applied,
would be an issue for post-conviction relief. He could not
say exactly how much money that would cost, but he believed
Ms. Goldstein had some figures for how much those types of
things would cost. He could not identify how many of the
cases there would be, but there would undoubtedly be an
increase in litigation expenses any time a penalty was
increased.
Representative Carpenter surmised that if the committee
could get a cost per case, it could extrapolate out to the
DOC projected increase.
Co-Chair Wilson requested the cost of similar cases from
the Public Defender Agency and OPA. She believed the
committee had the other numbers it could use to get an idea
of the increase. She asked if aggravators would be brought
by DOL and defended against by the public defenders, which
would add to the cost. Alternatively, she wondered if it
was up to the public defenders to prove aggravators. She
was confused that there would be no cost increase for DOL,
but there would be an increase for OPA and the Public
Defender Agency.
9:18:41 AM
Mr. Stinson replied that ultimately the charging agency
dictated whether it would be seeking an aggravator. He
explained the issue could be significant in plea
negotiations. He noted that sometimes sentencing could be
bifurcated if a specific aggravator was argued after a jury
trial. He elaborated that it was difficult for the agency
to predict because OPA did not know whether prosecutors
would be seeking the new Class A felony every time there
was an allegation of unconsciousness. For example, if a
victim said they blacked out for a second, OPA could not
predict whether the prosecutor would go with the Class A
felony. Whereas, a person with external signs of
strangulation was a very serious case. The Department of
Law had a broad range of charging discretion when seeking
aggravators and whether or not to charge a case under "this
theory." The issue made it difficult for the public
defenders and OPA to predict.
Co-Chair Wilson looked forward to the information and
intended to discuss the specific fiscal notes at a later
time. She noted there was not a fiscal note from the Court
System; however, it would see the cases. She asked to hear
why the Court System had not submitted a fiscal note.
NANCY MEADE, GENERAL COUNSEL, ALASKA COURT SYSTEM, relayed
that she submitted a fiscal note when she saw a fiscal
impact and only submitted a zero note when requested by the
sponsor or a committee. The bill would result in very
little fiscal impact in the courts because the aggravators
would only come into play during a trial; very few cases
went to trial. She believed the situation addressed in the
bill would be quite rare; the circumstances that lead to
the bill showed the situation was somewhat unique. She did
not believe the Court System would need any additional
resources to handle any increased caseload that may result
from the legislation.
HB 14 was HEARD and HELD in committee for further
consideration.
^PRESENTATION: SENTENCING PROGRAMS BY COURT SYSTEM
9:21:36 AM
NANCY MEADE, GENERAL COUNSEL, ALASKA COURT SYSTEM,
communicated she had been asked to talk about sentencing
programs, which she interpreted to mean the types of things
the court could do at sentencing that may have something to
do with treatment. She relayed that the court had the
ability to order, as part of a sentence, that a person go
through certain treatment or rehabilitative programs in the
institutions. Statute specified the court could order
someone to go through a treatment program if it was
available; it could not order a person to do something if
the option was unavailable; therefore, the wording was
often included in judgements. As a condition of probation,
the court routinely ordered people (usually with a felony
charge) to get assessed by an appropriate program, to
follow the instructions of the treatment provider, and to
work with their probation officer to ensure the treatment
requirement was fulfilled.
Ms. Meade highlighted the Alcohol Safety Action Plan (ASAP)
operated through the Department of Health and Social
Services (DHSS). The program was available as a condition
of probation to assess misdemeanants whose crime involved
drug or alcohol issues. She explained ASAP was frequently
ordered in misdemeanor cases as a condition of probation.
The information was the extent of what the court generally
did at sentencing.
Representative Josephson noted that the court also had the
Therapeutic Court and Veterans Court, which included
numerous treatment provisions.
Ms. Mead replied in the affirmative. The therapeutic courts
were available in six locations around the state. She
detailed that the prosecutor, defense attorney, and court
all had to agree that an individual could benefit by a
rigorous treatment program. The programs were very resource
intensive and lasted at least 18 months. She elaborated
that the programs included phase down provisions for the
first six months. For example, a person worked with a
probation officer and treatment providers through DHSS and
may see the judge once a week to answer questions related
to how their housing was going, how treatment was going,
how their children were doing, and other. She explained the
judge encouraged the individual throughout the program. She
reported the programs had good results for those who were
able to stick with them; the programs were intensive and
demanding.
Co-Chair Wilson asked who paid for the treatment cost.
Ms. Mead answered that the person was asked to contribute
to the cost, but the reality was that few participants
could afford the program cost. Generally, the state paid.
Co-Chair Wilson asked if the state received any
reimbursement from Medicaid.
Ms. Mead replied that the court's therapeutic court
coordinator was always working with Medicaid and insurance
companies trying to get reimbursement. There was a complex
system for trying to get the reimbursement for the
individuals in a program who were Medicaid eligible or may
have any other benefits.
9:25:55 AM
Representative Carpenter asked if the judge knew at the
time of assigning probation whether the treatment program
was available.
Ms. Mead answered they were now talking about general
judgements for felonies or misdemeanors. She explained that
the court could order treatment while incarcerated, if
available. The court could not tell the Department of
Corrections (DOC) which facility to put a person in, which
was a separation of powers problem. She elaborated that DOC
made its determination where to put someone (based on
population management issues); if the program was
available, the individual was required to do it. As a
probation condition when the court directed a person to get
assessed and get treatment (once the individual had been
released from prison), the court had no idea where a person
would go and did not confine them to a specific treatment.
She explained that if the treatment was not available in a
community the defendant chose to live, they would likely
not be able to live in that community and comply with their
probation. In other words, the defendant would have to go
where the treatment was located.
Representative Carpenter highlighted that an individual
could be directed to get treatment as a condition of
probation, without knowing or considering whether the
treatment would be available where the person would be
living.
Ms. Mead replied that at the time of sentencing a judge had
no idea where a person would be living after being released
from jail. The judge did not account for where a person
would be living.
Representative Carpenter asked for verification it would be
incumbent on the defendant to live where treatment was
available.
Ms. Mead answered it would generally be true. She added
that there may be treatment available remotely in certain
areas. How to comply with a court's order to get treatment,
depending on where a defendant wanted to live, was
something they would work out with their probation officer.
Representative Carpenter pointed to recidivism and
continued drug problem issues, which indicated to him there
was not adequate treatment available. He remarked that the
state was kicking people out on probation without any means
to achieve what they were directed to do. He thought it
seemed like a broken process.
Ms. Mead answered that as a probation condition, the court
could order a person to get treatment if available or get
treatment. Typically, the court ordered a person to get
treatment and the onus was on the defendant to find a means
of doing so with the assistance of the probation officer.
If it meant a person could not go back to a village because
treatment was unavailable, she believed the determination
had been made by the judge that the treatment was important
enough that the order would still be a condition of
probation.
Representative Carpenter provided a scenario where an
individual was ordered to attend drug treatment as a
probation condition, but treatment was not available. He
asked if the probation officer had the ability to revoke
probation and reincarcerate the individual if there was no
treatment available.
Ms. Mead replied that a probation officer could file a
petition to revoke probation for failing to comply with any
probation conditions including treatment. She added it was
a collaborative process between the probation officer and
the defendant. The courts did not order a specific
treatment program because they did not know what was
available. For example, the court would not direct a person
to go to the Salvation Army's inpatient treatment program
for drug addicted individuals. Alternatively, courts
directed a person to get assessed and follow the
instructions. It was her understanding that the process was
fairly collaborative, and the person could work with the
assessor and probation officer to find an appropriate
program to address the person's specific needs.
9:31:07 AM
Representative Carpenter thought they recognized the pain
in the state's communities when individuals on probation or
a post incarceration plan reoffended and ended up back in
the system. He imagined that at some point in time the
individuals had been told to get treatment. He asked at
what point they were protecting the people. He asked where
the system was broken when people told to get treatment did
not get treatment and reoffended. He was not hearing the
departments point out where the fix was needed.
Ms. Mead clarified that the court had one role and it was
not a department. She explained that the judge's role was
to sentence the person appropriately to imprisonment and
probation. Treatment was often one of the conditions
imposed by a judge. After that, the court did not have a
role. She elaborated it was the individual's responsibility
to comply and find a program, working with the probation
officer, treatment providers in the community, and possibly
someone from DHSS. She elaborated that if a person did not
comply, they could have their probation revoked and be
returned to jail. There were a number of reasons a person
may not go to treatment, including motivation. The fact a
person could get a petition filed against them should
motivate a number of people; however, it may not. She did
not know how to address the question about the broken
system other than to say that people were complicated with
complicated problems.
Co-Chair Wilson thought the committee should hear from DHSS
about whether there were enough [treatment programs]
available for the number of individuals [needing
treatment].
9:33:08 AM
Representative Tilton asked about the six therapeutic
courts and wondered how the locations were selected. She
asked about the success rate of the programs and what
happened to an offender if the program was not successful.
Ms. Mead answered that how the court determined where a
therapeutic court would be located depended on a number of
factors, most notably where the resources were available. A
community had to have enough treatment, housing, and
employment in order to have a therapeutic court.
Additionally, the people in the system including the public
defender, prosecutor, judge, and DHSS personnel (a
probation officer), had to be ready to set up the system.
If everyone was ready and the population demanded it, a
therapeutic court would be set up. Generally, those who
graduated from therapeutic court recidivated approximately
one-third less than others. In that sense, the individuals
completing the program were considered successful. She
noted that a significant number of individuals did not
graduate from the program because it was demanding.
Representative Tilton asked what happened when individuals
did not successfully finish a program.
Ms. Mead answered that defendants entered a therapeutic
court under a plea agreement agreed upon by the defense and
prosecuting attorneys. The agreement specified the
individual would receive more favorable treatment if they
went through the therapeutic court; if they did not
graduate a jail sentence would be imposed.
9:35:46 AM
Representative Josephson asked if a defendant in
therapeutic court earn an SIS [suspended imposition of
sentence]. He asked what a person's record would show if
they completed the program.
Ms. Mead answered that each rule 11 agreement (plea
agreement) was different for individuals completing the
program. Sometimes the agreement dictated that a person
charged with a felony would see their charge reduced to a
misdemeanor if they successfully completed the program. She
elaborated that DUIs stuck with people - an individual
would still get a conviction for misdemeanor DUI. In cases
of drug offenses, it was possible the case would even be
dismissed. The outcome depended on a person's individual
record and the plea that was negotiated between the defense
counsel and prosecutor.
Representative Josephson asked if the rule 11 agreements
related to therapeutic courts were allowed to be crafted
liberally and creatively. He noted he was not objecting to
the concept.
Ms. Mead answered there were not constraints. She believed
the people in the system likely did not want constraints
because they were able to individualize the programs for
the participants. She highlighted that the number of
program participants was low - the therapeutic courts were
resource intensive due to the significant attention focused
on each participant. Many hours were spent on a
participant, which was the reason 18 months of therapy
could be so effective. Flexibility was key to having the
courts work.
Representative Tilton considered the cost effectiveness of
therapeutic courts. She asked about the cost difference
between going through a therapeutic court versus the
alternative.
Ms. Mead answered that she did not know if the Judicial
Council or others had tried to monetize the cost of
therapeutic courts per individual. She believed someone may
have or was in the process of doing so. She highlighted
that others had reported that despite the high costs,
because of the tremendous success rate for graduates, the
program was very positive and helpful to the criminal
justice system as a whole.
9:38:59 AM
Representative Tilton extrapolated that the outcome for the
participant and public far outweighed the monetary cost of
the program.
Ms. Mead agreed; it was the reason the Court System tried
to set up therapeutic courts whenever possible. She
reported that often, legislators wanted the court to expand
the program. She relayed it was not easy to set up a new
court because it took a lot of personnel and the proper
community. The primary requirements were the appropriate
treatment availability in the community, housing, and
employment. For example, expansion in Juneau would likely
not work because treatment programs were generally full.
Co-Chair Wilson requested data related to the six existing
programs including available and filled slots, waitlists,
the number of graduates, and the success rate. She stated
that percentages were not always informative when the
number of participants was not known.
Ms. Mead would follow up with the information.
Representative Carpenter understood it was not the court's
responsibility if treatment was not available for
individuals on probation. He asked what options were
available to the probation officer if treatment was
unavailable.
Ms. Mead deferred to DOC to talk about how the probation
officers handled the condition of probation.
^PRESENTATION: PRISON PROGRAMS BY DEPT. OF CORRECTIONS
9:41:06 AM
Co-Chair Wilson asked to hear from DOC regarding its
programs. She asked which programs were working and which
were not, and why there were not more of the programs that
were working.
JEN WINKLEMAN, DIRECTOR, PROBATION, PAROLE, AND PRETRIAL,
DEPARTMENT OF CORRECTIONS, replied to a question by
Representative Carpenter regarding treatment in areas it
was not available. She detailed that probation officers
placed individuals on a waitlist in other areas or in the
petition to revoke probation (PTRP) process the probation
officer brought individuals in front of the court to
determine whether the person was resistant to getting
treatment or treatment was unavailable in the area. In the
latter case, the probation officer could then get
individuals on waitlists in other areas or look into
telemedicine possibilities. Some of the information was
included in the following presentation. She noted that a
colleague would get into the information a bit more
specifically regarding sex offender treatment.
LAURA BROOKS, DEPUTY DIRECTOR, HEALTH AND REHABILITATIVE
SERVICES, DEPARTMENT OF CORRECTIONS (via teleconference),
provided a PowerPoint presentation titled "Prison Programs"
dated April 24, 2019 (copy on file). She outlined her
intent to cover mental health programs, substance abuse
programs, and sex offender treatment. Her colleague would
cover education, vocational programs, and prosocial and
faith-based programs.
Ms. Brooks discussed how offenders gained access to the
programs [audio cut out]. She detailed that every offender
was screened at remand. At that point mental health needs
were determined, and referrals were made [audio cut out].
9:44:42 AM
AT EASE
9:45:56 AM
RECONVENED
Ms. Brooks resumed speaking about how inmates were referred
to programs. Individuals were screened at remand, where
mental health needs were identified, and referrals were
made. Referrals were also made for withdrawal monitoring;
individuals withdrawing from substances were referred to
medical for monitoring and then on to substance abuse
programing.
Ms. Brooks detailed that referrals were made for substance
abuse screening assessments at that point as well; much of
the referral process began when an inmate walked through
the door. Additionally, inmates went through an orientation
process that was specific to each facility. During the
process, individuals learned what particular programs were
available in their specific facility. Referrals were also
made at the initial classification hearing; pretrial
programming notices were given showing what was available
in a given facility. All inmates who were sentenced to 30
days or more were given the level of service inventory - a
tool used to determine what type of programs were best
suited to or most needed by a particular offender and
referrals were made to programs once identified. Throughout
the process inmates learned what programs were available at
each facility, which may also be supplemented by meetings
with institutional probation officers, mental health
clinicians, and so on. Throughout the system there were a
number of ways offenders could access individual programs.
9:48:09 AM
Ms. Brooks addressed psychiatric treatment services on
slide 3. She reported that by default, DOC was the state's
largest provider of mental health services in Alaska. She
detailed that about 65 percent of the offender population
had an identified mental health disability, which included
cognitive disorders, traumatic brain injuries, depression,
anxiety, bipolar disorder, and so on. She continued that
about 22 percent of the offender population experienced a
severe and persistent mental illness, which included
schizophrenia, bipolar disorder, and other debilitating
psychotic disorders.
Ms. Brooks turned to a list of on-site clinical services on
slide 4. A team of mental health professionals including
psychiatrists, nurse practitioners, clinicians, and
psychiatric nurses provided treatment services throughout
the DOC system. The department had to be prepared for
anything given that 65 percent of the prison population or
2,800 individuals had mental health disabilities.
Therefore, treatment options covered the spectrum from
immediate crisis intervention to prevent self-harm and
suicidality to group counseling and release planning. She
would provide more detail throughout the presentation.
9:49:19 AM
Ms. Brooks turned to a breakdown of psychiatric beds on
slide 4. The department had more than 300 dedicated
psychiatric beds. At full capacity the number of beds was
four times more than beds at the state hospital. She shared
that services were available to sentenced and unsentenced
inmates. The acute care units were 24-hour hospital level
psychiatric treatment units intended for people in crisis
who needed immediate stabilization. She detailed that a
person who was floridly psychotic or actively suicidal was
moved to the psychiatric unit whether they were sentenced
or unsentenced. The primary focus of the acute units was
medication management; the units were staffed 24-hours per
day with security and mental health staff.
Ms. Brooks continued that about 250 men went through the
acute psychiatric unit each year and about 200 women went
through the women's unit at the Hiland Mountain
Correctional Center. In the past, the average length of
stay had been about 20 to 30 days, but it had been
dramatically reduced because the demand was so high. The
units had become stabilization units instead of full
treatment units. Once individuals had been stabilized, most
were transferred to a subacute psychiatric unit. She
explained that treatment really expanded in the subacute
units; the units were highly structured with clinicians
providing group programming and one-on-one counseling and
support. A couple of years earlier, DOC had added a step-
down program for mentally ill offenders in segregation. The
program allowed a mentally ill offender who had been
necessarily housed in segregation to transition safely into
a treatment unit until they were determined to be stable
enough to mix with the population on the treatment unit.
The program allowed individuals to receive more one-on-one
care from mental health staff, which was more appropriate
intervention than segregation cells or housing may offer.
The waitlist for the men's acute unit could be anywhere
from 5 to 15 on any given day; the number was slightly less
in the women's unit.
9:51:34 AM
Ms. Brooks advanced to slide 5 and reviewed the
department's mental health programming. The programming on
slide 5 included programs offered in treatment units and to
the general population. The department tried to cover all
of the bases including anxiety, depression, adjusting to
incarceration, and exercise for mental health. She relayed
the department was always looking for new ways to provide
support and new evidence-based groups to offer. She
explained that evidence-based practice meant there was
current external research showing a program's efficacy with
the prison population. Over the past five to six years the
department had made a concerted effort prioritizing the
shift of its programs to evidence-based; nationally it had
been shown to be the most effective strategy with the
prison population.
Ms. Brooks discussed that crisis management was always key.
On any day there were six to eight individuals on suicide
watch in booking at the Anchorage Correctional Complex. She
detailed that clinical staff assessed each individual,
developed a safety plan, monitored the individuals (along
with security), and stepped them down off suicide watch
with a plan for ongoing monitoring and support. At that
point, individuals began to transfer to some of the other
available mental health programs. She added that the
programs were also available to individuals who did not
rise to that acuity level; anyone in general population may
need a group on coping with incarceration or stress
management. The department tried to provide the services;
availability depended on the resources at a facility. She
believed DOC had provided the committee with a list of
programs broken down by facility.
Ms. Brooks addressed success indicators. She shared that
measuring success in mental health programming was
challenging. She elaborated that DOC could not quantify the
number of suicides that had been avoided because of an
intervention or measure how much a person's psychotic
symptoms had lessened with treatment. The department had
learned from a research project done in collaboration with
the Alaska Mental Health Trust Authority (AMHTA) several
years earlier that offenders with mental illness were
significantly more likely to be convicted of felony crimes
than the rest of the DOC population (34.5 percent versus 21
percent respectively) and that mentally ill offenders
recidivate at nearly twice the rate of non-mentally ill
offenders. A large factor was a lack in community
resources. The department worked to stabilize individuals
while they were in custody, but they were often sent out to
minimal supports.
Ms. Brooks detailed that safe, sober housing was extremely
difficult to find even in Anchorage, but particularly in
smaller communities. She highlighted other transition needs
including case management support and access to medication.
The department worked to ensure individuals were signed up
to receive Medicaid whenever possible, but there were often
weeks-long delays in getting into see a psychiatrist in a
community. The department provided medications to
individuals upon release, but often the amount may not last
as long as the wait time to see a psychiatrist in the
community. She explained that the situation could impact an
individual's stability in the community. Often when an
individual's psychiatric stability was interrupted, it
resulted in the individual returning to DOC custody or to
the Alaska Psychiatric Institute.
9:55:16 AM
Ms. Brooks continued to address slide 5. She reported that
in FY 19 and beyond, DOC was looking at other ways to
measure success with the prison population. The department
had gone live with its electronic health record, which
would help produce important data that had not previously
been available. The department was also working with other
departments to share data because many mentally ill
offenders were seen elsewhere in the state system.
9:55:38 AM
Ms. Brooks addressed mental health reentry planning on
slide 6. She noted the process could be extremely difficult
for mentally ill offenders. Clinicians in DOC facilities
worked hard to develop a detailed release plan for
offenders. There were two release programs dedicated to
mentally ill offenders: the IDP+ Program and APIC (Assess,
Plan, Identify, Coordinate). She explained that clinicians
developed release plans for mentally ill felons who were
released on probation and parole.
Ms. Brooks elaborated that participation in the IDP+
Program was a part of an individual's parole conditions.
Clinicians continued to work with individuals released into
the community in collaboration with probation officers who
were trained to recognize and deal with unique needs of
mentally ill offenders. The program had proven very
successful; it had been in place for over 20 years and
resulted in a very limited recidivism rate for new crimes
for the population. The APIC program aimed to coordinate
services for mentally ill and cognitively disabled
offenders. The program provided funding through AMHTA to
try to ensure housing, medication, transportation, and that
other basic needs were met when individuals were released
and waiting for benefits and entitlements to kick in.
Ms. Brooks detailed that IDP+ served between 75 and 100
offenders per year and APIC served about 500 offenders in
2018. The programs had expanded considerably over the past
10 years in an effort to meet needs.
Ms. Brooks moved to slide 7 and discussed how DOC was
trying to address mental health needs throughout its
facilities to better improve overall outcomes. The
department recognized that security staff in particular
generally did not understand the needs of mentally ill
offenders; therefore, DOC had made a concerted effort to
bring training to security staff because they saw inmates
24-hours per day compared to mental health staff who
touched base with individuals briefly or met with them in
groups. The more information the department could bring to
security staff on how to deal with mentally ill offenders,
how to recognize signs and symptoms, and how to recognize
warning signs when a person was starting to deteriorate,
was critical. The department had started providing mental
health first aid and training to security, medical, and
mental health staff. Trauma informed care had also become
part of the department's curriculum. The department was
adding a crisis intervention team (CIT) model for
corrections in 2019. She believed everyone was familiar
with the CITs provided by law enforcement in communities. A
CIT training program specific to correctional workers had
been introduced and DOC would begin the program in August
2019. The first training session would include about 30
trainees who would take the program back to DOC facilities
and field probation offices.
9:59:16 AM
Ms. Brooks turned to slide 8 and discussed where mental
health needs continued to stress the system. She shared
that DOC's mental health clinicians had more than 17,000
contacts in custody with mentally ill offenders in 2018.
The number excluded the number of offenders seen in groups,
segregation wellness checks, or responses to offender
written requests. The figure included formal contacts where
a mental health clinician or psychiatrist spent time
assessing, monitoring, and supporting mentally ill
offenders.
Ms. Brooks shared that the department had to expand its
services due to an increase in need; the number of contacts
had risen 61 percent. The department had expanded subacute
services at the Goose Creek Correctional Center. She
believed the committee was well aware of the current
project to add treatment beds at the Hiland Mountain
Correctional Center. The department had also expanded its
transition cells for offenders with serious mental illness
transitioning out of segregation. Additionally, DOC was
looking at how it could expand bed space for men in the
system because of the waitlist of 5 to 15 [for subacute
psychiatric units]; the waitlist was hovering closer to 15.
Consequently, DOC was looking for ways to expand its
treatment capacity for men.
Ms. Brooks communicated that overall, offenders were
entering the correctional system with more acute needs than
ever before. The department saw an increase in individuals
with mental illness complicated by substance abuse. The
department had also seen an increase in the number of
individuals struggling with prescription drug addictions.
She highlighted the lack of continuity care in the
community [audio inaudible].
Co-Chair Wilson noted they would continue to hear from Ms.
Brooks the following day.
| Document Name | Date/Time | Subjects |
|---|---|---|
| DOC Programs 4.24.19.pdf |
HFIN 4/24/2019 9:00:00 AM |
HFIN Overview |
| HFIN - DOC programs-services.pdf |
HFIN 4/24/2019 9:00:00 AM |
HFIN |
| DOC Substance Use Disorder Treatment Services.pdf |
HFIN 4/24/2019 9:00:00 AM |
HFIN |