Rada Moss,
Enterprise Foundation/Reentry partnership (PREP) Program
"What we see with Omar's experience is that relapse is real. 80 or 85 percent of our clients have substance abuse-related issues, and they have to effectively deal with them."
Maryland Department of Public Safety and Correctional Services — Partnerships for Reentry Programming (PREP) is a Department of Corrections-wide program to serve 90 percent of inmates being released.
Introduction
Enterprise Foundation/Reentry partnership (PREP) Program
"What we see with Omar's experience is that relapse is real. 80 or 85 percent of our clients have substance abuse-related issues, and they have to effectively deal with them."
Maryland Department of Public Safety and Correctional Services -- Partnerships for Reentry Programming (PREP) is a Department of Corrections-wide program to serve 90 percent of inmates being released.
Tuerk House
"Many of them do have criminal histories, and drug abuse is a big part of that. Quite often that's a real cause of their crimes. Many of our clients will come in and they've got 15 to 20 years of being actively involved in the drug lifestyle."
Tuerk House is the only 28-day residential drug treatment facility in Baltimore City. With a 70-bed capacity, the program includes an onsite detoxification and outpatient service.
Rada Moss, Enterprise Foundation/REP Program
POV: What kinds of things does the Maryland Reentry Project do with prisoners and ex-prisoners to help them transition to life after prison?
Based on their needs assessment, we have an idea of what their needs are in terms of substance abuse treatment, housing, education, employment, health and mental health, so that we can devise the case plan accordingly. Our whole intent and goal is to ensure that they have the services that they need to be connected to the community, so that they don't return to prison. We don't provide any direct services other than case management. We have a community network of service providers that provide those services for us. And so when we say that we're a partnership, we mean that in every sense of the word. We have nine to twelve community partners that we contract with to provide services, and we have a working partnership with the Division of Correction. We have an assigned agent from parole and probation that works exclusively with our clients. We work with the police department, the health department, so it's a systemic and community partnership. And it's a voluntary program. It's not mandated, and it's a two-year commitment from the time of their release.
POV: What's distinctive about REP? How does this program differ from other transitional programs for ex-prisoners?
Moss: I think what's distinctive is the fact that we are definitely community-based, but we also have a strong link with corrections. That being said, we're also decentralized, so there's not a one-stop hub that we have. We work from three organizational centers in the communities that we serve so that we can have easy access to our clients and they can have easy access to us. The staff is also critical. We want people who have a blend of perspective and expertise, and I invest a lot in training them to be professionals. So I think that the staff are the ones that move the wheel. And I think the intensity and depth of services that we provide access to -- through contracts, not just relationships, though we have those, too -- allows us to keep our clients on track and prevent recidivism. So it's a really tight, strategic, very inclusive approach that has made us successful.
POV: What's the advantage of having contracts with service providers rather than informal relationships, as many other community agencies do?
Moss: We've been very careful about what services we wanted to contract with, because we've really studied what the needs are, and we've recognized that we can't do everything. So we have contracts with service providers that provide transitional housing and that provide substance abuse treatment. But we've really taken a look at what are the biggest barriers to someone's transition, and that's what we've targeted and are paying for.
POV: In the film, Omar finds himself in violation of his parole for failing to inform his parole officer that he'd used drugs, although he informed one of his REP counselors. What are the distinctive roles of REP case managers and state parole officers? How are all these different agencies coordinating their efforts?
Moss: We don't consider our clients as reporting to us, we consider them as having a relationship and partnering with us to aid in their transition back. We make it very clear from the beginning that we're not parole officers, because we need to establish a trusting relationship with them. We don't want them thinking that we're going to be on their back and watching them. That may be what we do in one sense, but in a very different approach than a parole officer. There aren't necessarily consequences other than us saying, "We're going to have to let you go, because you're not benefiting yourself and there's somebody else that we could help." Other than that there are not real consequences for not complying with us, like there is with a parole agent.
At the same time, we make clear that the parole agent who works with us is not meant to be lenient on our clients. The fact that she works exclusively with us is meant to make it easier for us to contact a single person within a large agency. We hope that we're helpful to the parole agency, sometimes in finding a client, in getting him to tell her the truth about what his condition is so she can better help him. But our stance and relationship is purely one of an advocate and a friend, mentor, guide, coach, not one of an agent.
POV: Are there rules to keep case managers from sharing information with the parole officer?
Moss: No, I'm not saying that at all. It's a case by case decision. And if it's something that our agent needs to know, whether it's detrimental or not to the client, if it's something that she needs to know, we would tell her. But if it's not going to affect the client's parole condition, then there's no need to tell her. We just need to get him on the right track to get him whole and healthy.
POV: Are the stories of Omar and Pete typical?
Moss: What we see with Omar's experience is that relapse is real. 80 or 85 percent of our clients have substance abuse-related issues, and they have to effectively deal with them. Having a job doesn't mean much if you're not able to keep it. At the same time, some of our most successful clients have been those who have relapsed. So relapse is not an uncommon or unfamiliar event for us to deal with. What is a little atypical about Omar's case is his steady decline, and his unwillingness to work with us to help him. We typically don't have that.
POV: How common are substance abuse problems among the inmates REP serves?
Moss: I think it varies, but I think substance abuse is the biggest issue. This is a subject of debate for people who do this work, but for me it trumps everything. I think lack of housing and homelessness is a huge barrier that has to be addressed immediately. So those two things, housing and treatment, and having access and resources to provide and find both, are the biggest problems.
POV: How effective is the Reentry Project? How does it compare to other programs for ex-offenders transitioning to life outside prison?
Moss: I don't know how it compares to others, but we have a recidivism rate that ranges from 11 to 18 percent over three years. That compares to about 52 percent, which is the statewide recidivism rate. So we've struck upon a model, serving a small number of men -- we've served about 400 men at this point -- that seems to work. It works, but it's a very intensive program, and it's steeped in partnerships, so there's not one organization or entity that's doing it alone.
POV: The Maryland Reentry Partnership is a pilot program, scheduled to last five years. Now that the five years of pilot funding are over, what's next for the program?
Moss: It was a five-year pilot which effectively ended June 30. But we're going to continue. That constant supply of federal funding just leveraged other funding. It's always been a constant fundraising effort.
POV: What kind of changes would you like to see in the support that's available to prisoners who've been released, either on the institutional level or in a broader cultural sense?
Moss: Institutionally, I think we're very fortunate. From five years ago, and even before that, we were very fortunate to have a state agency that embraced this and worked with us. And the community has also embraced us, they were the ones saying, "What took you so long? We've needed this support and this help." The only thing I think I'd like changed is for our society to be ready to receive this population as men, and to give them an opportunity to serve and to work and to be, and not to prejudge them so sharply before they're given a chance to showcase themselves. That stigma still exists, and there's not much we can do about that other than just to plug along.
POV: What are the best and worst things about the way the criminal justice system works in your experience? What are the biggest challenges in doing the work you do?
Moss: One of the biggest challenges is that there are very limited support services behind the fence [in prisons]. They've taken out higher education. And there's a huge need for treatment behind the fence. There's a lack of general support, in comparison to the way I have heard it was 30 years ago, when somebody could get a bachelor's degree or a master's degree or a GED [while in prison]. Those things aren't available anymore. And that's unfortunate because by the time somebody gets out, if they don't have that armor, that depletes them. The good news that I'm proud about is that there's a focus on wanting to improve things. There's a broader focus on reentry. There's recognition that these men are going to be released and that we're going to need to support them, and that the state Department of Corrections does have a responsibility there. Whereas the mindset before was that they were only responsible for incarcerating them. That paradigm has shifted, and they're gearing up to help prepare the men for release. So I think that's a wonderful movement here in Maryland.
Next: Interview with Dr. John Hickey »
Rada Moss is director of the Maryland Reentry Project, a community-based partnership serving ex-offenders reentering their communities in the city of Baltimore.
Dr. John Hickey, Tuerk House
POV: What kind of help does Tuerk House offer to people with substance abuse problems?
POV: How do the services provided at Tuerk House differ from those provided at other treatment facilities? What's distinctive about your approach?
Hickey: I think what's distinctive about it is that we have a state of the art detox program as part of the regular 28-day program, whereas at most places that's an extra cost. Our strength is in how focused and structured we are. The goal is to change how people think, and help them develop a value system. The other thing is that we also have an outpatient program, so a client can stay with us for the 28-day program and step down to an outpatient program. We also have two halfway houses for that purpose. The last piece that distinguishes us is our peer support program. That is set up so that people can stay involved with Tuerk House as long as they find it helps.
POV: Do many of the people served by Tuerk House have criminal histories other than drug abuse? Does Tuerk House approach those people differently? Do they face a distinct set of challenges?
Hickey: Many of them do have criminal histories, and drug abuse is a big part of that. Quite often that's a real cause of their crimes. Many of our clients will come in and they've got 15 to 20 years of being actively involved in the drug lifestyle. There's an individual treatment plan, where they have individual treatment during the week, where you can get into the housing issues. That's a big one for people coming out of the jails, and we often refer them to halfway houses, to longer-term treatment. But overall the program is the same for each person in terms of the group activity and the lectures and those kind of things. I'd also point out that over half of our patients at any one time are voluntary, in addition to the beds that are reserved for people referred on parole and probation. There are also a lot of people who are court-ordered to be here, as an alternative to incarceration.
POV: Is there a difference in the results for people who come voluntarily versus those who are court-ordered?
Hickey: Not really. The difference is between the people that show up for the initial appointment and those that don't. A lot of people from parole and probation don't show up, but once they get into the program, they seem to be as successful as anyone else. You have to have some level of motivation in order to come, because a lot of guys referred by the criminal justice system never even show up. The ones who come and get involved are at some level motivated. They've probably had enough of jails and prisons and all that. In general, the research says that coerced treatment works as well as anything else. And even the people that come in voluntarily are responding to pressure. Either their family's had it with them and they've got nowhere else to turn, or they've lost their job and they've lost their family; they've got nowhere else to go, and someone tells them about us. So there's a pressure on just about everyone that comes here.
POV: How successful is Tuerk House at helping its clients become drug-free? Is it common for them to return to their addictive behaviors?
Hickey: We've had about a 70 percent completion rate out of Tuerk House over the last ten years. The only really good follow-up data we have comes when we work with a partner or a program within the community. When we've done that, we see a success rate around 70 or even 80 percent. What we do know is that when clients go from us to another program, they usually do very well.
POV: How does Tuerk House prepare its clients for the return to their daily lives, and those times when they won't be surrounded by the resources and assistants available there?
Hickey: Discharge planning starts on day one. You have to find out, does the person have a drug-free environment to live in? And if they don't, you start talking to them about going to a halfway house, or some transitional housing, where they can be involved in treatment. We have a halfway house for 17 men, and a halfway house for 11 women, and there are others throughout the city. So you try not to send them back where they came from.
The hard part for people with a criminal record is getting a job. If you have a felony, that hurts. And we have relationships with places like Prisoner's Aid. The one thing I do know, from working with men and women that come out of prison, is that if they come here for the 28 days, and are in a program where they receive case management to get the help they need when they leave here, they're going to be very successful. So it's important to immerse them in an environment like Tuerk House where we really work on how you think about things, so you leave with a better attitude, and you really think about your own role in what happens. We really preach making "I" statements. What really works, is that combination of coming in to an environment like this when you leave the prison and then going into a case management system where someone's helping you deal with life until you're on your feet.
POV: What kind of resources are available for people once they've "graduated" from Tuerk House's program?
Hickey: Our rule is that no one leaves Tuerk House without a follow-up appointment, and if they're in a halfway house certified by the state, they can get their treatment there. Sometimes people go to transitional housing where it's not certified, they just go there to live, and there's usually support for Alcoholics Anonymous and Narcotics Anonymous. Those folks get another referral to an outpatient program, so they have a place to live, but they also have a place to keep their treatment going. We're kind of a hub where people from all over the city come and begin their recovery, and then we send them out to halfway houses and transitional housing all over town.
POV: Can Tuerk House meet the need in the local community for its services? What kind of additional community resources would help?
Hickey:There's a wait for our services. We usually have about 20 men or more who come to a support group two or three times a week while they're waiting for a bed to open. Usually it's about two weeks. For women there's less of a wait. But there's been a big increase in treatment in Baltimore over the last two years, although the increase has leveled off recently. There's a lot going on on the west side, but there's not a lot on the east side. The city needs more, but they've got a heck of a lot more than they had a few years ago. The state's put a lot of money in. So I give them credit for that.
John Hickey, Ph.D. is the executive director of Tuerk House.