Legislature(2019 - 2020)ADAMS ROOM 519

04/24/2019 09:00 AM FINANCE

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Audio Topic
09:00:16 AM Start
09:00:33 AM HB14
09:21:36 AM Presentation: Sentencing Programs by Court System
09:41:06 AM Presentation: Prison Programs by Dept. of Corrections
10:02:58 AM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Presentations: TELECONFERENCED
- Prison Programs by Dept. of Corrections
- Sentencing Programs by Court System
+ Bills Previously Heard/Scheduled TELECONFERENCED
+= HB 14 ASSAULT; SEX OFFENSES; SENT. AGGRAVATOR TELECONFERENCED
Heard & Held
Fiscal Note Discussion
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