sdaapp jeff bathke, program administrator division of alcohol and drug abuse dada sd department of human services

1. 1 SDAAPP Jeff Bathke, Program Administrator Division of Alcohol and Drug Abuse (DADA) SD Department of Human Services October 5, 2009

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3. 3 Correctional Substance Abuse Programs Comprehensive alcohol and drug treatment system is operational in all Adult and Adolescent Correctional Facilities. Starting in 1989 in one prison, with 3 staff and a budget of $150,000 291 adolescents received treatment in FY09 1,529 adults completed treatment in FY09. Most important aspect: The Adult system has specialized programming in the following areas; Native American specific treatment, Co-occurring treatment programs, Methamphetamine specific, and regular treatment with an emphasis on relapse prevention.

4. 4 Institution Based Staff DOC Staff=901.5 Mental Health=15 FTE + 5 Contract Staff Department of Health=76 FTE CD-East Region-SD State Pen and Minnehaha County Work Release Center: 12 Staff (10 Counselors, 1 Secretary, 1 Supervisor) CD-South Region-Mike Durfee State Prison & Yankton Minimum Unit: 15 Staff (13 Counselors, 1 Secretary, 1 Supervisor) CD-Central Region-SDWP: 9 Staff (8 Counselors, 1 Supervisor) CD-West Region-STAR Academy 9 Staff (6 Counselors, 1 Secretary, 1 Release Coordinator, 1 Supervisor) CD-Parole 2 Parole Transition Coordinators One for Chemical Dependency, one for Mental Health

5. 5 Outcome Data One year post release Outcome Data: Adolescent Corrections � 36.9% success rate Adolescent Community-50.2% success rate Adult Corrections-41.8% success rate Adult Community-48.5% success rate Deterrents used include frequent drug screens, parole supervision/aftercare, and fear of return to Incarceration. �Success� defined: Clients complete the goals/objectives on their treatment plan. Once Paroled, clients are contacted one year post release and asked a series of questions; drug/alcohol use, employment, family functioning, housing, etc.

6. 6 Recidivism Rate 12 months after release = 29.9% 24 months after release = 39.3% 36 months after release = 44.8% Based 12 months from release, females returned at a 25.8% rate and males at 30.7%. Offenders ages 21-29 had the highest recidivism at 38.1%. Native American offenders recidivate at a rate of 42.4% while Caucasians at a rate of 23.1%. National Average is 67.5% of prisoners released were rearrested within 3 years (1994 latest study)

7. 7 Services Provided Assessment Primary Intensive Outpatient Treatment Treatment within Community Transition Program (CTP) Co-Occurring Diagnosis Treatment Native American Specific Treatment Methamphetamine Specific Treatment (Male and IMT) Aftercare and Individual Sessions Discharge Planning and Referral

8. 8 Corrections Primary Substance Dependence Male FY05 FY06 FY07 FY08 Alcohol 54 53 58 61 Cannabis 16 17 15 14 Meth 14 14 10 8 Other 8 4 3 3 Female FY05 FY06 FY07 FY08 Alcohol 45 37 45 49 Cannabis 5 7 5 8 Meth 30 37 29 26 Other 6 5 6 8 Male FY05 FY06 FY07 FY08 Alcohol 54 53 58 61 Cannabis 16 17 15 14 Meth 14 14 10 8 Other 8 4 3 3 Female FY05 FY06 FY07 FY08 Alcohol 45 37 45 49 Cannabis 5 7 5 8 Meth 30 37 29 26 Other 6 5 6 8

9. 9 Meth Diagnosis Adult Inmate Population

10. 10 FY02=10 FY03=22 FY04=25 FY05=26 FY06=22 FY07=11 FY08=14FY02=10 FY03=22 FY04=25 FY05=26 FY06=22 FY07=11 FY08=14

11. 11 Primary Intensive Outpatient Treatment Provided to regular inmates and Community Transition Program (CTP) inmates 891inmates completed in FY2009 5-6 Weeks of group and individual Counseling 9-15 hours per week, depending on location; plus individual counseling Disease Concept of Addiction 12 step education Research Based Corrective Thinking Program by TruThought Evidence Based Interactive journals from the Change Company Spirituality/Belief Systems Relationships Relapse Prevention/Recovery Planning

12. 12 Co-Occurring Diagnosis Treatment Provided to regular inmates and Community Transition Program (CTP) inmates 83 inmates completed in FY2009 10 week group/individual counseling 10 hours per week, plus weekly individual counseling Co-facilitated by CD Counselor and MH Therapist Disease Concept of Addiction and Mental Illness Mental Health Education (topics specific to client�s diagnosis and medication management) 12 step education Research Based Co-Occurring Disorders Series (Hazelden) Spirituality/Belief Systems Relapse Prevention/ Recovery Planning

13. 13 Native American Specific Treatment Provided to regular inmates and Community Transition Program (CTP) inmates 182 inmates completed in FY2009 6 week group/individual counseling 9-15 hours per week, depending on location Started at the request of Native inmates Disease Concept of Addiction Medicine Wheel and the 12 Steps Nationally recognized Red Road Approach to Wellness and Healing (Medicine Wheel, Inc.) Nationally recognized Red Road to Wellbriety from White Bison Inc. Cultural Education Spirituality (Ceremonies, Songs) Relapse Prevention and Recovery Planning

14. 14 Methamphetamine Specific Treatment(Incarcerated Males) Provided to regular inmates and Community Transition Program (CTP) inmates 30 males completed in FY2009 7 weeks, 15 hours per week, 105 total hours Nationally recognized research based MATRIX model for methamphetamine addicts Group and individual counseling Started due to the rise in amphetamine addiction in South Dakota Cognitive Behavior Therapy (CBT) Rational Emotive Therapy (RET) to enhance the clients self esteem 12 step programs and Community Reinforcement Meth Effects (Physical & Psychological) Triggers/Relapse Support/Recovery Aftercare and Individual Sessions Discharge Planning and Referral

15. 15 Methamphetamine Specific Treatment(Incarcerated Females) Provided to regular inmates and Community Transition Program (CTP) inmates 15 month, 4 phase program 90 females completed in FY2009 169 of the 226 (75%) have completed or are still involved in the program 13 weeks, 387 total hours 18.5 hours per week Chemical Dependency Treatment 2 hours per week of group meetings with all inmates and staff 9.25 hours per week of MH/Education Nationally recognized research based MATRIX model for methamphetamine addicts Group, individual and family counseling Started due to the rise in amphetamine addiction Cognitive Behavior Therapy (CBT) Rational Emotive Therapy (RET) to enhance the clients self esteem Contingency Management (CM) which involves positive rewards for treatment progress 12 step programs and Community Reinforcement The research based Living In Balance Series (Danya International Corporation) is also used in the IMT program, which includes 33 sessions that focus on basic life skills. Aftercare and Individual Sessions Discharge Planning and Referral

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17. 17 Methamphetamine Specific TreatmentKeystone Treatment Center Provided as an alternative to incarceration, or as a parole plan. 12 month, 4 phase program 29 clients placed in FY2009 74 of the 129 (58%) have completed or are still involved in the program Nationally recognized research based MATRIX model for methamphetamine addicts Group, individual and family counseling Started due to the rise in amphetamine addiction

18. 18 Methamphetamine Specific TreatmentCity/County Alcohol & Drug Programs Can accept Amphetamine or Opiate Dependant clients 12 month, 4 phase program 18 clients placed in FY2009 71 of the 140 (50%) have completed or are still involved in the program Nationally recognized research based MATRIX model for methamphetamine addicts Group, individual and family counseling Started due to the rise in amphetamine addiction Full Meth Program Brochure is located at: http://dhs.sd.gov/ada/Treatment/documents/MethBrochure6-1-2009fordistribution.pdf

19. 19 Evaluation Assessments Data is collected at Intake and completion of Phase II, III, and IV Areas assessed in addition to substance use include: Mental Health Family Functioning Social Support Self-Efficacy (confidence & temptation to deal w/cravings)

20. 20 Assessments Used Center for Epidemiological Studies Depression Scale (CES-D) Interpersonal Support Evaluation List (ISEL) The Family Adaptation, Partnership, Growth, Affection, and Resolve (FAPGAR) University of Rhode Island Change Assessment Form (URICA) Methamphetamine Abstinence Self-Efficacy Scale (MASE) Exit Interview (End of Phase II and Program Completion only)

21. 21 IMT Report Over 90% of participants complete Phase II Over 70% of participants matriculating into Phase III remain active in Phase III or Phase IV 95% of participants reported some level of abuse in their background Participants report a reduction in mental health symptoms across phases of the program Participants report increases in family functioning across phases of the program Participants report a decrease in temptation to use methamphetamine in key situations and an increase in their confidence in their ability to not use methamphetamine in key situations Participants report an increase in their �readiness� to change along the stages of change continuum as the progress in the program Overall 97% of participants rate the overall program as �good� or �excellent� Participants report substantial progress on sixteen key concepts from entry into the program until completion on Phase II Full Report available from Mountain Plains Evaluation

22. 22 Population Trends 62% of all female admissions to prison are as a result of a DUI or Drug offense 50% of all male admissions to prison are as a result of a DUI or Drug offense

23. 23 Jeff Bathke, CCDC IIIProgram Administratorjeff.bathke@state.sd.us Division of Alcohol and Drug Abuse www.state.sd.us/dhs/dada