Improving In-Prison Rehabilitation Programs

Improving In-Prison Rehabilitation Programs MAC TAYLOR LEGISLATIVE ANALYST DECEMBER 6, 2017 analysis full gutter AN LAO REPORT LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT Executive Summary In-Prison Rehabilitation Programs Intended to Reduce Recidivism. The California Department of Corrections and Rehabilitation (CDCR) offers inmates various rehabilitation programs while they are in prison, including education and substance use disorder treatment programs. The primary goal of these programs is to reduce recidivism—the number of inmates who reoffend after they are released from prison. Key Principles for Rehabilitation Programs to Reduce Recidivism. Research shows that a rehabilitation program generally is effective at reducing recidivism if it possesses three key principles. First, the program should be “evidence based”—meaning it is modeled after a program shown to reduce recidivism and actually operates in the same manner as the proven program. Second, the program should be evaluated for cost-effectiveness. Third, the program should focus on the highest-risk and highest-need inmates, as this has the greatest potential to reduce recidivism. CDCR In-Prison Rehabilitation Programs Have Several Shortcomings. Based on our review of CDCR’s in-prison rehabilitation programs, we conclude that they have several shortcomings. This is because CDCR (1) often falls short in adhering to the above three key principles for reducing recidivism, (2) does not effectively use all of its rehabilitation program slots despite waitlists for such programs, and (3) has a flawed approach to measuring program performance, which makes it difficult to determine whether existing program resources are being used effectively. LAO Recommendations. In order to address the above shortcomings, we recommend several steps to improve CDCR’s in-prison rehabilitation programs. Specifically, we recommend the Legislature: • Require Programs Be Evidence Based. We recommend directing CDCR to provide a report detailing whether each rehabilitation program is research based. The Legislature could make the provision of this information a condition for receiving ongoing state funding for the program. Programs should also be regularly evaluated to ensure they are implemented in the same manner as the modeled program. These steps would help ensure that the programs have the potential to reduce recidivism. • Measure Actual Cost-Effectiveness of Rehabilitation Programs. We recommend having independent researchers evaluate the cost-effectiveness of rehabilitation programs. Such an evaluation could track the programs that inmates participate in and whether inmates that complete these programs are less likely to recidivate. • More Effectively Target Programs to Highest-Risk and Highest-Need Inmates. We recommend establishing a review committee to select the assessment tools most effective at determining which inmates are the highest-risk to recidivate and have the highest-need for rehabilitation programs to address those needs. We also recommend that the Legislature direct CDCR to prioritize the enrollment of its highest-risk and highest-need inmates in its programs. • Improve Efficient Use of Existing Rehabilitation Resources. We recommend that the Legislature direct CDCR to conduct an assessment of all existing CDCR facilities to determine the level of resources required to meet all the rehabilitative needs for the highest-risk and highest-need offenders. We also recommend the Legislature consider incorporating actual inmate attendance www.lao.ca.gov 1 analysis full gutter AN LAO REPORT into rehabilitation program funding decisions in order to help limit the number of program slots that are not used efficiently. • Improve Performance Measures to Conduct Regular Oversight. We recommend directing CDCR to improve its rehabilitation program performance measures in order to enable regular program oversight, such as by requiring the reporting of certain performance measures—including the percentage of inmates with unmet needs nearing release. 2 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT INTRODUCTION California state prisons house nearly can reduce the number of offenders who recidivate (or 130,000 inmates. Each year, these prisons release tens reoffend) and that the resulting savings can more than of thousands of offenders into the community after offset their costs. serving their sentences. While incarcerated in prison, In this report, we (1) provide background information offenders often participate in various rehabilitation on the state’s in-prison rehabilitation programs programs that seek to improve the likelihood that (including their intended goals), (2) outline key program offenders will lead a productive, crime-free life upon principles for maximizing reductions in recidivism, release from prison by addressing the underlying (3) identify key shortcomings in the state’s rehabilitation factors that led to their criminal activity. These programs programs, and (4) make recommendations to improve include education and substance use disorder how the state provides in-prison rehabilitation treatment. When such programs are well-designed and programs. implemented effectively, various studies show that they OVERVIEW OF STATE’S IN-PRISON REHABILITATION PROGRAMS Rehabilitation programs are generally offered to release (CDCR’s definition of recidivism). The primary offenders who are incarcerated in either state prison or goal of rehabilitation programs is to reduce the level of county jail, as well as those who are supervised in the recidivism. (Please see the nearby box for information community by state parole agents or county probation on the different ways recidivism can be measured.) officers. Below, we provide a general overview of the In order to help achieve this goal, CDCR attempts to rehabilitation programs provided in state prisons and identify and address the various factors that may have managed by the California Department of Corrections led to an offender’s original criminal activity. Research and Rehabilitation (CDCR)—the primary focus of this has shown that eight factors are particularly significant report. in influencing future criminal activity. For example, criminal thinking—meaning attitudes, values, or beliefs Primary Goal Is to Reduce Recidivism that can lead to an individual committing a criminal Many California inmates reoffend after they are offense—is a significant factor. The eight different released from prison. Specifically, of the 36,000 inmates factors are summarized in Figure 1 (see next page). released in 2012-13, 16,500 (or 46 percent) were Research shows that rehabilitation programs can convicted of a subsequent crime within three years of be designed to address these factors. For example, Measuring Recidivism Rates Recidivism—the number of inmates that reoffend after release—can be measured in different ways. For example, the California Department of Corrections and Rehabilitation (CDCR) currently measures recidivism based on the number of inmates who are convicted of a subsequent crime within three years of their release from state prison. Alternatively, some organizations measure recidivism as the total number of offenders who return to prison. However, this calculation does not include offenders who were returned to jail. While there is no universally agreed upon method for measuring recidivism, various measures can help agencies understand the extent to which offenders remain involved with the criminal justice system following their release. www.lao.ca.gov 3 analysis full gutter AN LAO REPORT Figure 1 Eight Significant Criminal Risk Factors 9 Antisocial Behavior. Inability to avoid criminal activity when placed in high-risk situations. 9 Antisocial Personality. Displays impulsive, exploitative, aggressive, or manipulative behavior. 9 Criminal Thinking. Attitudes, values, and beliefs that can lead to crime. 9 Antisocial Relationships. Association with other criminal actors and isolation from noncriminal actors. 9 Family and Marital Status. Poor relationships with family and/or spouse. 9 School and Work Status. Low performance, involvement, and satisfaction with school and/or work. 9 Leisure and Recreational Activities. Low involvement or satisfaction with activities that are not associated with criminal involvement. 9 Substance Use. Problems with alcohol and/or other drugs. substance use disorder treatment programs can help State Funds Various reduce or eliminate the criminal risk resulting from an In-Prison Rehabilitation Programs offender’s problems with alcohol and/or other drugs. As discussed in greater detail later in this report, Various Fiscal Benefits From Reducing upon admission to prison, CDCR assesses inmates’ Recidivism. If rehabilitation programs are successful at rehabilitative needs and assigns them to programs. reducing recidivism, they not only can reduce crime but The state funds six categories of in-prison rehabilitation also can result in both direct and indirect fiscal benefits programs within CDCR. (As discussed in the to the state. Direct fiscal benefits include reduced nearby box, there are also various nonstate funded incarceration costs—as offenders will not return to rehabilitation programs offered at prisons.) These prison—as well as reduced crime victim assistance programs can be operated by CDCR employees, other costs. Indirect benefits could include reduced costs for governmental employees, private entities, or nonprofits. public assistance, as some offenders may receive job These categories are: training that leads to employment, thereby reducing the level of public assistance needed. If rehabilitation • Academic Education. Academic education programs are operated effectively, these benefits can programs include adult basic education, General exceed the costs of providing the programs and result Education Development (GED) certification, the in net fiscal benefits to the state. high school diploma program, and various college Other Program Goals. In addition to reducing programs. State law requires inmates with low recidivism, rehabilitation programs can also serve literacy scores to attend adult basic education other related goals, such as making it easier to safely programs. manage the inmate population, improving overall • Career Technical Education (CTE). CTE inmate wellbeing, and improving inmate educational programs provide job training for various career attainment. These secondary goals can also result sectors, including masonry, carpentry, and auto in direct and indirect fiscal benefits. For example, an repair. easier-to-manage inmate population could result in • Cognitive Behavioral Therapy (CBT). CBT fewer inmates needing to be housed in higher security programs are designed to help offenders change units, which could minimize the need and costs for the patterns of behavior that led to criminal additional security staff. activity. Specifically, these programs provide various forms of therapy to address rehabilitative 4 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT needs—such as criminal thinking and anger CDCR Operates management—that, if left unaddressed, can 114,000 Rehabilitation Program Slots increase the likelihood of recidivism. Each year, CDCR is generally budgeted for a specific • Employment Preparation. Employment number of slots in its rehabilitation programs. Slots are preparation programs provide employment skills, generally defined as the number of inmates who could such as job readiness and job search techniques, be enrolled for the full duration of the program in any for inmates up to six months prior to their release given year. For example, a six-month long CBT program in order to aid their transition back into society. with 20 students equals 40 slots. The 2017-18 budget • Substance Use Disorder Treatment (SUDT). provides funding to support a total of 114,000 program SUDT programs focus on helping inmates treat slots. (This does not include Arts-in-Corrections or their substance use disorders, avoid relapse, Innovative Programming Grant programs, which are and successfully reintegrate into society. Unlike not budgeted based on slots.) The number of slots for other rehabilitation programs which inmates budgeted for in the current year is more than twice generally attend on a voluntary basis, CDCR the number of slots budgeted for in 2015-16. This requires certain inmates who are caught using increase is primarily due to additional funding provided alcohol or illegal substances while in prison to in 2016-17 to offer rehabilitation programs at all attend SUDT programs. institutions rather than at only certain institutions. As • Arts-in-Corrections. Arts-in-Corrections shown in Figure 2 (see next page), nearly half of the programs focus on providing inmates with arts program slots in 2017-18 are for education-related programs ranging from theatre to creative writing. purposes. • Innovative Programming Grants. Innovative The total number of inmates served in all programs programming grants provide limited-term funding over the course of the year does not match the number to support various volunteer-run programs—such of slots provided for a couple reasons. First, as we as prison gardening programs and mentorship discuss in greater detail later, not all rehabilitation projects—at certain prisons. program slots are utilized due to various factors, including a lack of teachers or programs being locked Nonstate-Funded Rehabilitation Programs In addition to the state-funded rehabilitation programs, the California Department of Corrections and Rehabilitation (CDCR) allows certain nonstate entities and the California Prison Industry Authority (CalPIA) to offer rehabilitation programs at prisons. Programs Led by Inmates or Outside Organizations. Inmates and outside organizations can operate rehabilitation programs with CDCR approval. These programs are generally referred to as Inmate Leisure Time Activity Groups (ILTAGs). Specifically, ILTAGs are groups initiated by inmates and volunteers that provide various rehabilitation opportunities—such as self-help support, creative writing, or peer mentorship. These programs allow inmates to be engaged in activities outside state-funded rehabilitation programs and/or work assignments. (Work assignments allow inmates to earn wages for jobs they perform within prisons, such as janitorial work or cooking meals.) Some of the programs require inmates to complete a specific rehabilitative curriculum, such as a one-year long violence prevention and life skills program. Other programs have a less clearly defined curriculum, such as the various self-help support groups in prisons. CalPIA. CalPIA is a semi-autonomous state agency that provides work assignments and vocational training (similar to certain Career Technical Education rehabilitation programs) to inmates. It is funded primarily through the sale of the goods and services produced by the program. State law requires state agencies to purchase products and services offered by CalPIA whenever possible. www.lao.ca.gov 5 analysis full gutter AN LAO REPORT Inmate Risk and Figure 2 Rehabilitative Needs Nearly Half of CDCR Program Slots Are for Inform Program Education-Related Purposes 2017-18 Assignment Total: 114,019 Assessments Conducted to Determine Risk and Needs. At prisons with reception centers Cognitive Academic Behavioral Therapy Education (which receive inmates being admitted to CDCR) inmates are evaluated to determine which prison would be most appropriate for the inmate to serve his or her sentence. While at the reception center, CDCR staff generally determine the Employment criminal risk factors that increase Preparation each inmate’s risk to recidivate, as well as the specific rehabilitative Career Technical needs necessary to address those Substance Use Education risk factors. The department Disorder Treatment currently uses assessments to help determine which specific needs should be addressed and which down for security concerns. Second, the same inmate inmates should receive priority can be enrolled in multiple slots at the same time, when assigning inmates to rehabilitation programs. meaning the number of inmates actually served could Specifically, CDCR uses the following two assessments: be less than the number of slots. In addition, it is possible that the number of inmates served in a year is • California Static Risk Assessment (CSRA). greater than the number of slots. This is because some The CSRA uses an offender’s age, gender, and inmates leave programs before completing them. In past criminal history to identify his or her risk of 2015-16, almost half of inmates were released without recidivating. Based on their score, CSRA classifies receiving rehabilitation programs for which they have an assessed need, Figure 3 as we discuss later. Majority of CDCR Rehabilitation Spending on Education-Related Purposes In-Prison Rehabilitation Program Budget 2017-18 Amount The 2017-18 Budget Act included Program Budget (In Millions) Percent of Total $315 million in General Fund support (3 percent of CDCR’s total budget) for Academic Education $140.9 45% Career Technical Education 57.6 18 CDCR’s various in-prison rehabilitation CBT/SUDT 72.1 23 programs. As shown in Figure 3, Adminstration 21.3 7 most of the funding for these Innovative Programming Grants 8.5 3 programs is spent on academic and Arts-in-Corrections 8.0 3 career technical education. Employment Preparations 6.3 2 Totals $314.8 100% CBT = cognitive behavioral therapy and SUDT = substance use disorder treatment. 6 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT offenders into three categories—high, moderate, because research from other states has demonstrated and low risk. As of June 30, 2017, 98 percent of programs are most cost-effective if targeted at the inmate population received a risk assessment. highest-risk, highest-need offenders. CDCR defines its Of those who received an assessment, roughly highest-risk and highest-need inmates as those with half had a moderate or high risk of recidivating, (1) a moderate or high risk of recidivating (based on with the other half classified as low risk. CDCR their CSRA score) and (2) a moderate or high need for high-risk inmates have a 62 percent recidivism one or more rehabilitation programs (as identified by rate, moderate-risk inmates have a 44 percent COMPAS). A total of 44 percent of inmates met this recidivism rate, and low-risk inmates have a definition as of January 31, 2017. 21 percent recidivism rate. CDCR Assigns Inmate to Rehabilitation • Correctional Offender Management Profiling Programs. Once the inmate is transferred from the for Alternative Sanctions (COMPAS). When reception center to the institution where he or she will administering COMPAS, CDCR staff collect be housed, the inmate meets with a CDCR correctional inmates’ basic demographic data, criminal counselor to discuss the results of the risk and need histories, and responses to interview questions assessments and whether the inmate is interested that seek additional background information in particular rehabilitation programs. This is because (such as the inmate’s existing family relationships, inmate participation in rehabilitation programs is perceptions of peers and social environment, and generally optional with a couple of exceptions. For education and work history). COMPAS uses all example, inmates with a low literacy score or inmates of this information to identify an inmate’s criminal caught using illicit substances while in prison may be risk factors and assess whether the offender required to attend academic education or substance has a low, moderate, or high need for certain use disorder rehabilitation programs even if they are rehabilitation categories. As of June 30, 2017, low risk. After this initial discussion, the institution’s 92 percent of the inmate population received Unit Classification Committee (UCC), which consists a COMPAS needs assessment. As shown in of correctional counselors and representatives from Figure 4 CDCR reports that in 2016-17 the state-funded rehabilitation programs, meets to most frequently identified rehabilitative needs determine the inmate’s specific housing assignment were substance use disorder treatment, anger and rehabilitation program assignment. To make such management, and criminal thinking. decisions, the UCC typically considers various factors— including inmate risk, rehabilitative needs, and inmate As we discuss later in the report, research shows interest. An inmate in the highest-risk and highest-need that rehabilitation programs should be targeted towards category receives priority for rehabilitation program the highest-risk, highest-need offenders. This is slots when a space becomes available. If space is not immediately available, the inmate is placed on a Figure 4 waitlist. Given that many inmates have multiple needs, Top Five Rehabilitative Needs it is common for an inmate to be placed on multiple Identified by COMPAS waitlists. Priority is also generally given to inmates who will be released from prison earlier than others 2016-17 regardless of risk. Assessed Inmates With a Rehabilitative Need Moderate or High Need Current Oversight of Substance use disorder 66% CDCR Rehabilitation Programs treatment CDCR is responsible for implementing and Anger management 51 Criminal thinking 41 overseeing rehabilitation programs. In addition, state Employment services 38 law created the Office of the Inspector General (OIG)— Family support 22 an independent state agency to provide independent COMPAS = Correctional Offender Management Profiling for oversight over CDCR’s processes and procedures, Alternative Sanctions. including the operation of rehabilitation programs. www.lao.ca.gov 7 analysis full gutter AN LAO REPORT Most of OIG’s oversight of rehabilitation programs C-ROB regularly monitors whether programs are is conducted through the California Rehabilitation operating at capacity and identifies what factors (such Oversight Board (C-ROB), which consists of as teacher absences) prevent the programs from doing 11 members who are appointed by the Governor and so. The board does this by regularly collecting data, Legislature. The board is chaired by the Inspector visiting programs, and making recommendations to General and supported by four OIG staff members. address issues it identifies. KEY PRINCIPLES FOR REDUCING RECIDIVISM Research shows that in-prison and other correctional is designed to be similar to a proven program, rehabilitation programs that are effective at reducing but also actually operates in the same manner recidivism—whether they are education, substance use, to the proven program. For example, a college mental health, or other types of programs—generally correctional education program in California possess key principles that make them effective. would be considered to be implemented with These key principles are summarized in Figure 5 and fidelity if it was both designed and operated at all discussed in more detail below. state prisons in the same manner as the Indiana program described above. In contrast, a program Program Structure that is designed to be similar to the Indiana Should Be Evidence Based program but fails to actually operate in a similar manner on a day-to-day basis would be research According to research, “evidence based” programs based, but not implemented with fidelity. are most-likely to be effective at reducing recidivism. To be evidenced based, a program must be both of the Ensuring that the program is implemented with fidelity following: to a research-based model increases the likelihood that it could successfully reduce recidivism. • Research Based. Programs that are research The potential benefits of implementing based are designed to be similar to programs evidenced-based programs are illustrated by a series of that have undergone rigorous evaluations analyses carried out by the Washington State Institute showing that they reduce recidivism. For example, for Public Policy (WSIPP). WSIPP reviewed evaluation the Urban Institute determined that college studies of various types of in-prison and community correctional education programs in three states— rehabilitation programs and identified those that are Indiana, New Mexico, and Massachusetts— research based. It then estimated the potential fiscal successfully reduced recidivism. Adopting the benefits to state and local governments in Washington major features of the Indiana program would State if the programs were implemented with fidelity in mean that California’s program is research based. Washington. • Implemented With Fidelity. A research-based WSIPP determined that certain programs (such as program that is implemented with fidelity not only SUDT) had a significant amount of research showing that, if implemented with fidelity, they Figure 5 could potentially reduce recidivism enough to generate net fiscal benefits. Key Principles for Rehabilitation Programs to For example, as shown in Figure 6, Reduce Recidivism WSIPP estimated that in-prison 9 CTE programs could generate an Evidence Based average of $4,300 in net savings per 9 inmate in Washington. Given that Evaluated for Cost-Effectiveness California operates similar programs, 9 Focused on Highest-Risk and Highest-Need Inmates this suggests that California’s CTE 8 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT programs could also reduce recidivism and result in Programs Should Focus on net savings to the state. However, the magnitude of Highest-Risk and Highest-Need Inmates such net savings would differ depending on various Research has shown that targeting rehabilitation factors such as (1) how certain costs differ in California programs towards the highest-risk, highest-need compared to Washington (such as the cost of operating offenders has the greatest potential to reduce the prisons and rehabilitation programs) and (2) the recidivism rates. For example, a 2010 study of certain extent to which California was implementing CTE rehabilitation programs in Ohio found that high-risk programs with fidelity (such as whether inmates receive offenders who remained in programs over one year industry certification upon completion of the program). had an 8 percentage point lower recidivism rate than Programs Should Be high-risk inmates who did not participate or participated Evaluated for Cost-Effectiveness for less than one year. On the other hand, low-risk inmates who remained in programs for over one year While being evidence based increases the likelihood had a 7 percentage point higher recidivism rate than that a rehabilitation program will reduce recidivism, those who did not participate or participated for less the program itself still needs to be directly evaluated. than one year. Accordingly, by providing effective Such an evaluation is necessary to determine (1) the rehabilitation programs to its highest-risk, highest-need actual effect that the program has on recidivism inmates, CDCR could avoid the greatest number of and (2) if the effect is significant enough to justify its future crimes and provide the greatest fiscal benefit to continuation. Such a program evaluation is critical for state and local governments. two reasons. First, it is possible that an evidence-based program could Figure 6 reduce recidivism less (or even have no effect at all) in California, WSIPP Estimate of Potential Washington State even if it has reduced recidivism Savings From Various Rehabilitation Programsa elsewhere. For example, the program may have elements that Employment cannot effectively be recreated in Preparation the state for various reasons, such as significant differences between Academic Education California’s inmate population and the population of inmates that the CTE program was originally targeted at. Second, ensuring that programs are cost-effective helps ensure SUDT that the state is allocating its limited resources for rehabilitation CBT programs in a manner that has the maximum effect on recidivism. 2,000 4,000 6,000 8,000 10,000 $12,000 Accordingly, to the extent that the state is not allocating its resources Net Savings Per Inmate Participant to the most cost-effective programs, a Figure shows only the subset of rehabilitation programs assessed by WSIPP that are most similar to it is potentially allowing more crime state-funded CDCR rehabilitation programs. to occur than would otherwise be WSIPP = Washington State Institute for Public Policy; CTE = Career Technical Education; SUDT = Substance Use Disorder Treatment; CBT = Cognitive Behavioral Therapy; and the case. CDCR = California Department of Corrections and Rehabilitation. Source: Washington State Institute for Public Policy. www.lao.ca.gov 9 analysis full gutter AN LAO REPORT It is also important that the risk and need It is possible that assessments designed for inmate assessments used to classify inmates be validated populations from prior years may no longer accurately whenever there is a significant change in the inmate categorize the current population. For example, a population because the assessments were typically risk assessment that is not regularly validated could created using population information from prior years. inappropriately characterize high-risk inmates as low Validation is a process in which the assessment is risk, resulting in such inmates not receiving appropriate tested to ensure that it is correctly classifying inmates. rehabilitative services. STATE-FUNDED PROGRAMS HAVE SEVERAL SHORTCOMINGS As we discuss below, state-funded rehabilitation states that have been shown to reduce recidivism. programs have several shortcomings. This is because This suggests that these programs could potentially CDCR (1) often falls short in adhering to the key be successful at reducing recidivism in California as principles for reducing recidivism, (2) does not well. However, it is unclear whether Arts-in-Corrections effectively use all of its rehabilitation program slots, and the Innovative Programming Grant programs and (3) has a flawed approach to measuring program are research based. For example, California’s performance. Arts-in-Corrections program does not appear to be modeled after a similar program that has been shown CDCR’S IN-PRISON to reduce recidivism elsewhere. REHABILITATION PROGRAMS Unclear Whether Programs Are Implemented With Fidelity. Although most of CDCR’s state-funded FALL SHORT OF KEY PRINCIPLES rehabilitation programs appear to be research based, the department currently does not evaluate whether Based on our review of CDCR’s in-prison these programs are implemented with fidelity. Without rehabilitation programs, we conclude that the programs such an assessment, it is difficult to ensure that the often fall short in adhering to the three key principles programs are operating in a manner that maximizes needed to maximize recidivism reduction. Specifically, a reduction in recidivism. For example, it is unclear we find that (1) it is unclear whether some rehabilitation whether the anger management programs are programs are evidence based, (2) there is insufficient consistently employing the treatment techniques found evaluation of the cost-effectiveness of programs, and (3) CDCR is not always effectively targeting programs towards its Figure 7 highest-risk and highest-need inmates. Figure 7 provides a CDCR’s In-Prison Rehabilitation Programs summary of our findings, which we Fall Short of Key Principles discuss in more detail below. 9 Unclear Whether Some Programs Are Evidence Based Unclear Whether • Certain programs are not research based. Some Programs Are • Unclear whether programs are implemented with fidelity. Evidence Based 9 Limited Evaluation of Cost-Effectiveness Certain Programs Are Not 9 CDCR Not Effectively Targeting Highest-Risk, Highest-Need Research Based. Most of CDCR’s Inmates state-funded rehabilitation programs • Assessment tools may not accurately categorize population. appear to be research based as they • Low-risk/need inmates assigned to slots, while higher-risk/needs go are modeled after programs in other unmet. 10 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT to be effective elsewhere. This raises questions about programs are cost-effective, whether there are how effective the current programs are at reducing potential obstacles or challenges preventing them from recidivism. operating cost-effectively, and whether some are more cost-effective than others. As such, it is impossible for Limited Evaluation of Cost-Effectiveness the Legislature to assess which programs are the most The department has taken some steps to evaluate successful at reducing recidivism and to target funding the cost-effectiveness of its in-prison rehabilitation towards the most cost-effective programs that provide programs. For example, CDCR contracted with the the greatest benefit to the state. California State University at Chico in December CDCR Not Effectively Targeting 2010 to evaluate 19 CTE courses offered at certain Highest-Risk, Highest-Need Inmates prisons out of the 230 courses currently offered statewide. This study found that inmates who Assessment Tools May Not Accurately participated in the CTE programs were around Categorize Population. It is currently unclear whether 3 percentage points less likely to recidivate than those the risk and need assessments used by CDCR who did not. However, the study did not complete an accurately classify its current inmate population. assessment of cost-effectiveness. Although it is not While the CSRA is currently in the process of being an evaluation of cost-effectiveness, CDCR recently revalidated, the most recent validation of COMPAS began work with the Pew-MacArthur Results First was completed in 2010 using population data from Initiative to assess the potential cost-effectiveness of its 2006 to 2009. This means both assessments currently rehabilitation programs if implemented with fidelity to a being used do not take into account the significant proven model, similar to the WSIPP analyses mentioned changes in the inmate population that have occurred above. However, the assessment assumes that the in recent years—such as the 2011 realignment, which CDCR programs will have the same effect on recidivism shifted responsibility for tens of thousands of lower level as the programs implemented elsewhere. (Please offenders to county jail and probation departments. see the nearby box for a more detailed description (Please see the box on page 12 for additional of the Results First Initiative and the limitations of its information on the various policy changes that have evaluation.) impacted the state’s inmate population in recent Despite the above steps, the department generally years.) Thus, it is possible that these assessments lacks evaluations of the actual cost-effectiveness of may need to be modified to ensure that they continue most of its rehabilitation programs. This makes it difficult to accurately identify the rehabilitation needs of the for the department to determine which rehabilitation highest-risk and highest-need inmates. Moreover, Pew-MacArthur Results First Initiative Examination of Rehabilitation Programs The Pew-MacArthur Results First Initiative works with states and other governmental entities to identify cost-effective government programs, including those in criminal justice such as in-prison rehabilitation programs. The Results First Initiative will compare the California Department of Corrections and Rehabilitation (CDCR) rehabilitation programs—beginning with its substance use disorder programs— against an inventory of programs that have been evaluated elsewhere and shown to reduce recidivism. Results First uses the results of the evaluations to calculate the potential cost-effectiveness of CDCR programs. Specifically, it (1) assumes that CDCR’s programs will have the same effect on recidivism as the programs implemented elsewhere and (2) estimates the potential costs and benefits of a specific CDCR program based on how much it costs to operate the program and the California-specific costs associated with recidivism (such as how much it costs to operate prisons). However, this initiative will not specifically evaluate CDCR programs’ actual effects on recidivism. www.lao.ca.gov 11 analysis full gutter AN LAO REPORT CDCR does not currently have a policy requiring these program slots if a high-risk, high-need inmate is not assessments to be regularly revalidated to account for present at the institution to fill that slot. This is because significant changes in the inmate population that may the department does not want to leave a slot open until occur in the future. it can assign and transfer a high-risk, high-need inmate Low-Risk/Need Inmates Assigned to Slots, to the slot if there is a low-risk, low-need inmate who While Higher-Risk/Needs Go Unmet. As mentioned can fill the slot much sooner. previously, almost half (48 percent) of inmates were released from prison in 2015-16 without being enrolled INMATES DO NOT ALWAYS ATTEND and/or attending any rehabilitation programs that they REHABILITATION PROGRAMS had an assessed need for. While some of this could be due to limited resources, the problem of higher-risk, As mentioned previously, many inmates are on higher-need inmates being unable to address their waitlists for rehabilitation programs. Despite this, not all needs is compounded by the department not effectively programs are fully enrolled—meaning many slots are prioritizing its limited resources for this population. For vacant because CDCR has not assigned an inmate to example, CDCR reported that around 9,000 low-risk fill them. Moreover, even in cases where inmates are inmates and 10,000 low-need inmates were assigned enrolled in programs, they often do not attend classes to rehabilitation programs in 2015-16. While some of every day the program is offered. For example, as these inmates may have been required to be enrolled shown in Figure 8, on average, inmates did not attend because of an SUDT or educational need, it is possible academic education slots in which they were enrolled that thousands of slots were used at various times for 26 percent of the time in 2016-17. inmates who were not classified as highest-risk and While some of the causes for the low attendance highest-need. According to CDCR, some low-risk, rate are outside of the department’s control (such as low-need inmates are assigned to empty rehabilitation when an inmate chooses not to attend an assigned Recent Policy Changes Impacting the Inmate Population In recent years, the Legislature and voters enacted various constitutional and statutory changes that significantly impacted the composition of the state’s inmate population. Some of the major changes include: • 2011 Realignment. The 2011 Realignment limited who could be sent to state prison. Specifically, it required that certain lower-level offenders serve their incarceration terms in county jail. Additionally, it required that counties, rather than the state, supervise certain lower-level offenders released from state prison. • Proposition 36 (2012). Proposition 36 reduced prison sentences for certain offenders subject to the state’s existing three-strikes law whose most recent offenses were nonserious, nonviolent felonies. It also allowed certain offenders serving life sentences to apply for reduced sentences. • Proposition 47 (2014). Proposition 47 reduced penalties for certain offenders convicted of nonserious and nonviolent property and drug crimes from felonies to misdemeanors. It also allowed certain offenders who had been previously convicted of such crimes to apply for reduced sentences. • Proposition 57 (2016). Proposition 57 expanded inmate eligibility for parole consideration, increased the state’s authority to reduce inmates’ sentences due to good behavior and/or the completion of rehabilitation programs, and mandated that judges determine whether youth be subject to adult sentences in criminal court. 12 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT rehabilitation program), there are Figure 8 some factors that are in fact within the CDCR In-Prison Rehabilitation Programs department’s control. For example, Not Fully Attended in 2016-17 some prisons reported difficulty recruiting and retaining sufficient Percent of Time Enrolled Slots teachers for some programs. If Programsa Not Attended inmates are not able to regularly Academic education 26% attend their rehabilitation programs, Career Technical Education 19 they are less likely to be released Substance use disorder treatment 19 with all their rehabilitative needs met, a Date did not report enrollment and utilization rates for cognitive behavioral therapy and which makes them more likely to employment preparation. recidivate. determining whether the level of resources provided and how such resources are used is appropriate. FLAWED PERFORMANCE Misleading Metrics. In addition, some existing MEASUREMENT performance measures are misleading. For example, until recently, the department classified an inmate’s Lack of Sufficient Performance Metrics. need for a particular rehabilitation program as having Currently, the department collects some rehabilitation been met if the inmate attended at least one day statistics—such as the number of hours offenders of class—greatly overestimating how effectively the attend programs and the number of offenders who department meets inmate needs. In order to address achieve certain educational benchmarks. While this concern, the department now considers a need this data provides some limited information on the as being met if an inmate has engaged in “meaningful programs, our review indicates that CDCR lacks key participation,” which it defines as the inmate being performance measures—such as participation rates enrolled in a program for at least 30 calendar days. for all state-funded rehabilitation programs, length of However, this definition is also problematic as participation before release, progress measurements, enrollment does not mean an offender fully attended and time needed to meet specified benchmarks—to and participated in the program over the 30-day period. assess the delivery of rehabilitative services. Such Additionally, it does not measure whether the inmate’s metrics could help illustrate (1) how effectively the needs were met. While 30 days of participation may be department uses state resources, (2) whether inmates sufficient to meet some inmates’ rehabilitative needs, complete programs consistent with their needs, and other inmates may need to complete a program’s entire (3) whether the department should change how it curriculum—or may need to take the program again. operates its programs. Without this information, it (We note that rehabilitation programs vary in length, is difficult for the Legislature to conduct adequate such as from three months for some CBT programs to oversight of CDCR’s rehabilitation programs, such as over a year for some CTE programs.) RECOMMENDATIONS TO MAXIMIZE RECIDIVISM REDUCTION FROM REHABILITATION PROGRAMS In this report, we reviewed California’s in-prison the programs. To address these shortcomings, we rehabilitation programs. Based on our review of the recommend several steps to improve the CDCR’s programs, as well as the key principles identified in-prison rehabilitation programs. Our specific in existing research as being important to reducing recommendations are summarized in Figure 9 (see recidivism, we identified several shortcomings with next page) and discussed in greater detail below. www.lao.ca.gov 13 analysis full gutter AN LAO REPORT be regularly evaluated to ensure they Figure 9 are implemented with fidelity to the LAO Recommendations to Improve research-based program that they CDCR’s In-Prison Rehabilitation Programs are modeled after. This will ensure that CDCR programs continually 9 Require Programs Be Evidence Based incorporate the best practices that 9 have been demonstrated to be Measure Actual Cost-Effectiveness of State-Funded Rehabilitation successful. Programs We believe that OIG is best 9 Direct CDCR to More Effectively Target Programs to Highest-Risk positioned to conduct these fidelity and Highest-Need Inmates assessments given their existing 9 role in independently monitoring and Improve Efficient Use of Existing Rehabilitation Resources evaluating various CDCR programs 9 and procedures. These evaluations Improve Performance Measures to Conduct Regular Oversight would require OIG staff to conduct more detailed examinations of Require Programs Be Evidence Based state-funded rehabilitation programs than are currently Only Fund Research-Based Programs. We conducted. Specifically, OIG would measure the recommend the Legislature direct CDCR to provide a extent to which each CDCR program implements the report detailing whether each state-funded rehabilitation best practices of the research-based program it is program is research based as a condition of receiving modeled after. We would note that there are existing ongoing state funding for the program. This requirement tools developed by researchers available to conduct could be satisfied by providing an inventory of these fidelity assessments. These tools would allow state-funded rehabilitation programs and the empirical OIG staff to measure how closely the program adheres evaluations done showing whether each program is to the best practices of the research-based model. effective. The Legislature could eliminate funding for For those rehabilitation programs that the OIG and a program if CDCR is unable to show that program is C-ROB determine are not following best practices, research based within a specified timeframe. This would we recommend the Legislature direct OIG to provide give CDCR time to identify or complete the necessary a corrective action plan to CDCR and the Legislature. evaluations. Limiting funding to research-based The Legislature could then monitor CDCR’s progress programs would help the Legislature ensure that towards fully implementing the plan and determine it maximizes the potential reduction in recidivism whether legislative action is necessary (such as shifting achieved from state-funded rehabilitation programs. funding to those programs shown to be evidence However, to the extent that the Legislature wants to based). This would help the Legislature ensure all fund new and innovative rehabilitation programs on a state-funded rehabilitation programs are likely to be pilot-basis to test whether they can reduce recidivism, effective at reducing recidivism. we recommend it make a temporary exception to the Measure Actual Cost-Effectiveness of above requirement that the programs must be research based to allow this research to occur. State-Funded Rehabilitation Programs Provide Regular Program Oversight to Ensure While being evidence based increases the likelihood Implementation Fidelity. As discussed previously, to that programs are effective at reducing recidivism, it is be evidenced based, a program must be implemented critical to measure the actual effect programs have on with fidelity in addition to being researched based. recidivism. Given that evaluating the cost-effectiveness Accordingly, in addition to requiring that state-funded of each rehabilitation program would likely prove rehabilitation programs be research based, we difficult and costly, we recommend the Legislature recommend that the Legislature ensure that such work with independent researchers to determine how programs are implemented with fidelity. Specifically, we to design a cost-effectiveness evaluation of CDCR recommend that state-funded rehabilitation programs programs. For example, such an evaluation could 14 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT be a longitudinal study that would follow cohorts of legislative priorities, we recommend that the committee inmates to document their risk and need levels, track include representatives from CDCR, research experts, the programs they participate in and complete, and and stakeholders experienced with reducing recidivism. measure the various impacts such programs have For example, the committee could consist of seven upon inmates’ lives and behavior after release (such as representatives—two from CDCR with rehabilitation whether an inmate recidivates and/or requires public program experience, one from probation (as probation assistance). We estimate that such a study could cost departments provide rehabilitation services in the a couple of millions of dollars annually for a number community to many inmates released from CDCR), two of years. These evaluations would allow the state to independent research experts, and two rehabilitation assess (1) the cost-effectiveness of its rehabilitation stakeholders (such as contract and/or nonprofit programs, (2) which programs are most effective at service providers). Such a makeup would balance the reducing recidivism, (3) whether further expansion of technical expertise of the academics with the practical such programs is appropriate, (4) whether existing experience of stakeholders and rehabilitation providers, programs need to be modified to improve their as well as CDCR’s knowledge of the inmate population. impact on inmate outcomes, and (5) whether other Appointments could be made by both the Legislature rehabilitative programs should be offered to address and the Governor to ensure that the interests of both gaps in existing programming. As such, the Legislature are represented. This collective knowledge could help would be better positioned to determine where limited the committee ensure that it selects tools that (1) can rehabilitation funding can best be utilized to achieve the effectively assess the inmate population and (2) can be greatest benefit to the state in terms of reduced crime implemented and used accurately. and costs. Prioritize Enrollment of Highest-Risk and Highest-Need Inmates. We recommend that the More Effectively Target Programs to Legislature direct CDCR to prioritize the enrollment of its Highest-Risk and Highest-Need Inmates highest-risk and highest-need inmates in state-funded rehabilitation programs. This would help ensure that Establish a Risk and Needs Assessment finite rehabilitation program funds are used to maximize Committee. In order to ensure that CDCR uses risk recidivism reduction. (We note that the inmates required and need assessments that appropriately categorize to attend basic education programs due to low literacy its inmate population, we recommend the Legislature scores or SUDT programs due to substance use rules establish a review committee to select the most violations could continue to attend, as these programs effective assessment tools and ensure that the selected have other goals in addition to recidivism reduction.) tools are independently validated on a regular basis. As discussed previously, rehabilitation programs are most In addition, CDCR should allocate slots to individuals effective when they are tailored to provide the treatment prison facilities based on the number of highest-risk needed to address identified inmate risks and needs. and highest-need inmates at each facility with unmet Thus, it is important to ensure that the tools used to needs, as well as the facility’s ability to support identify such risks and needs remain valid and accurate. rehabilitation programs. For example, the department This requires a regular and ongoing review of CDCR’s could consider shifting unused rehabilitation slots or risk and need assessments—particularly as the state’s allocating a greater number of new rehabilitation slots to inmate population continuously changes over time and an institution which fully utilizes its existing slots or has new assessment tools become available. Our proposed a greater number of the highest-risk and highest-need review committee would be similar to one currently inmates with unmet needs. This would help ensure that used by CDCR to oversee the use of an assessment program slots are used as frequently as possible to tool specific to sex offenders. Based on the costs of provide treatment to the highest-risk and highest-need operating that committee, we estimate that establishing inmates. To accomplish this, we recommend the and operating a risk and need assessment review Legislature direct the department to provide a plan for committee could cost around a million dollars annually. allocating slots in a manner that maximizes the number of the highest-risk and highest-need inmates whose While the specific makeup of the committee rehabilitative needs are fully met. Based on this plan, and number of members could vary depending on www.lao.ca.gov 15 analysis full gutter AN LAO REPORT the Legislature could determine whether legislative additional welding slots to those prisons that are able action—such as specifying how slots are to be to successfully recruit and retain instructors. During allocated—is necessary. the inmate assignment process, those inmates for which welding meets a rehabilitative need would then Improve Efficient Use of Existing be assigned to those prisons. This would help limit the Rehabilitation Resources number of slots that are not utilized due to instructor shortages. Conduct Assessment of Resources Needed to To incorporate attendance into funding, the Support Rehabilitation Programs. We recommend Legislature would need to decide the attendance rate that the Legislature direct CDCR to conduct an that would be required to receive full funding and the assessment of all existing CDCR facilities to determine level of funding provided per inmate in each of its what level of resources would be needed at each state-funded rehabilitation programs. Additionally, the institution to provide sufficient programs to allow all Legislature could consider whether to provide some offenders to be released with all needs met. The study level of funding stability to protect program service should also separately report the level of resources levels against fluctuations in attendance rates. For needed at each institution for the highest-risk and example, the Legislature could consider providing highest-need inmates to be released with all needs funding based on an average of multiple years instead met. This assessment would identify (1) the number of of attendance in a single year or could consider inmates with particular rehabilitation program needs providing the highest of two years of funding. Providing at each institution; (2) rehabilitation slots not currently funding in this manner would give the department being used; (3) current facility or staffing shortages greater incentive to thoughtfully decide how to allocate preventing full utilization of existing slots; (4) facility and and use its rehabilitation resources. staffing resources needed to support the programs needed by the population; and (5) the maximum Incorporating attendance would increase CDCR’s number of slots each prison can reasonably support incentive to get inmates to attend programs, but would given space, staffing, and time constraints. This not provide a strong incentive for CDCR to improve assessment would provide the Legislature and CDCR program quality. To the extent the Legislature wanted with more information to determine how to allocate its to make funding contingent on program quality, it existing rehabilitation resources effectively and prioritize could also fund programs based on various outcome the enrollment of the highest-risk and highest-need measures—such as the proportion of inmates who inmates. successfully complete programs. Consider Incorporating Actual Attendance Into Improve Performance Measures to Rehabilitation Program Funding. Currently, CDCR Conduct Regular Oversight receives funding for rehabilitation programs regardless of whether or not inmates attend programs. Instead We recommend the Legislature direct CDCR to of providing a base level of funding that is unaffected improve its performance measures in order to enable by actual attendance, we recommend the Legislature regular oversight of rehabilitation programs. For consider incorporating into rehabilitation program example, we recommend the Legislature require CDCR funding actual inmate attendance, similar to the to provide reliable information on (1) the percentage of Average Daily Attendance (ADA) methodology used in inmates in a given year who are enrolled in programs public K-12 schools and community colleges. CDCR that meet their needs; (2) the percentage of inmates would only receive its complete funding allocation if a released or nearing release with needs that are unmet; certain level of attendance is maintained. This would and (3) program waitlists—such as the number of provide the department with incentive to administer inmates on a waitlist, how long they have been on their programs effectively, such as limiting instances in the list, and their risk and needs. Requiring CDCR which classes are closed for reasons under the prison’s to collect and report such information would enable control or consolidating specific types of programs the Legislature, CDCR, and stakeholders to compare (and inmates who need such programs) at particular how effectively rehabilitation resources are used facilities. For example, CDCR could potentially allocate across various prisons and the extent to which further 16 LEGISLATIVE ANALYST’S OFFICE analysis full gutter AN LAO REPORT legislative or departmental action is required (such progress should also be measured at specified program as using this information to allocate slots to specific checkpoints, such as when an inmate advances from prisons). a basic class to a more advanced class. If a program We also recommend that the Legislature direct does not have such checkpoints, progress should be CDCR to improve its existing performance measures measured at an intermediate point, such as when the assessing whether an offender’s need has been met. offender attends and completes half of a program. If the Specifically, offenders’ needs should be considered program is not fully completed, the department should met when they complete programs, as it is unlikely that also consider using other ways to measure its effect— offenders who do not complete programs are actually such as an objective test or instructor observations to having their needs met. However, given that offenders determine whether the program actually addressed the may not complete programs for various reasons, inmate’s rehabilitative need. CONCLUSION In-prison rehabilitation programs play a key role highest-need inmates. In addition, CDCR does not in the state’s efforts to reduce recidivism. In order to currently have sufficient performance measures to maximize recidivism reduction, in-prison rehabilitation conduct regular oversight over these programs. As programs should be designed according to certain key such, we recommend the Legislature take various steps principles outlined in existing research, such as ensuring to improve CDCRs in-prison rehabilitation programs that programs are evidence based. However, we find to maximize recidivism reduction, which would in turn that CDCR’s programs do not consistently follow reduce the number of victims in the future and result in these key principles and that existing state resources state and local fiscal benefits. could be more effectively targeted at the highest-risk, www.lao.ca.gov 17 analysis full gutter AN LAO REPORT LAO PUBLICATIONS This report was prepared by Jonathan Peterson and Anita Lee, and reviewed by Drew Soderborg. The Legislative Analyst’s Office (LAO) is a nonpartisan office that provides fiscal and policy information and advice to the Legislature. To request publications call (916) 445-4656. This report and others, as well as an e-mail subscription service, are available on the LAO’s website at www.lao.ca.gov. The LAO is located at 925 L Street, Suite 1000, Sacramento, CA 95814. 18 LEGISLATIVE ANALYST’S OFFICE