King County Melds EBP with Smart Technology Louisville, Ky 1 2 - - PowerPoint PPT Presentation

1

King County Melds EBP with Smart Technology

November 3, 2010

Louisville, Ky

2

3

META ANALYSIS

4

Criminal sanctions

• .07 (30 tests)

Inappropriate treatment

• .06 (38 tests)

Intensive probation/parole

• .07 (47 tests)

Unspecified treatment .13 (32 tests) Appropriate treatment .30 (54 tests)

5

Dynamic risk factors that have been clinically proven to be predictive of future criminal behavior.

6

(* Andrews & Bonta 1994, Simourd 1993: see nicic.org/pubs/2000/pps-uei-files/section3.pdf) Justice System Assessment & Training http://www.j-sat.com

0.18 0.22/0.48 0.10/0.14 .38 0.22/0.48 0.18

7

Reduction in recidivism Increase in Recidivism

Source: Gendreau P., French S.A., and A. Taylor (2002). What Works (What Doesn’t Work) Revised 2002 Invited Submission to the International Community Corrections Association Monograph Series Project

Target 1-3 non-criminogenic needs Target 2-4 criminogenic needs

8

Aspirin & reduced risk of death by heart attack

.02

9

Ibuprofen & reduced pain

.14

10

11

12

13

EIGHT GUIDING PRINCIPLES

• f

Evidence-Based Practice

14

• Risk
• Need
• Responsivity
• Treatment
• Program Integrity

15

Match level of services to level of risk

• Reserve resources for higher risk cases
• High risk cases require more intensive intervention
• Low risk cases require minimal or no intervention

IF IT AIN’T BROKE . . . . DON’T FIX IT

• r

16

9.1 34.3 58.9 10 20 30 40 50 60 70

Low Risk Medium Risk High Risk

Percent with New Arrest Low 0-14 Medium = 15-23 High = 24-33

Source: Latessa, 2009

17

Authors of Study O’Donnell et al, 1971 Baird et al, 1979 Andrews & Kiessling, 1980 Andrews & Friesen, 1987 Offender Risk Level Minimum Tx Intensive Tx Low Risk High Risk 16% 78% 22% 56% Low Risk High Risk 3% 37% 10% 18% 12% 58% 17% 31% 12% 92% 29% 25% % Recidivism: Tx by Risk Level Low Risk High Risk Low Risk High Risk

( 6%) ( 22%) ( 7%) ( 19%) ( 5%) ( 27%) ( 17%) ( 67%)

Impact on Recidivism

* Some studies combined intensive Tx with supervision or other services

= Up = Down

18

R e c i d i v i s m R a t e

19

Source: Latessa, 2009

20

• If you have100 High risk offenders about

60% will fail

• If you put them in well designed EBP for

sufficient duration you may reduce failure rate to 40%

• If you have 100 low risk offenders about

10% will fail

• If you put them in same program failure

rate will be 20%

Source: Latessa, 2009

21

Match Services (Interventions) to Criminogenic Needs

Prioritize treatment to highest scoring criminogenic needs; in the case of a tie treat the intrinsic need first, and/or acute needs first.

22

SCHOOL 4

Pro-social relations Stable/ Satisfying Employment School Retention/ Achievement

Big Six – Roadblock Wall to Pro-social Lifestyle

1 2 3 4 5 6

Anti-Social Attitudes Low Self-Control Callous Personality Anti-Social Companions Dysfunctional Family Relations

Low

Extrinsic

[ Least under offender’s control ]

Intrinsic

[ Most under offender’s control ]

The more you help offenders drive down criminogenic needs, the better are their chances of quitting crime

Substance Abuse

Source: Justice System Assessment & Training http://www.j-sat.com

23

24

• “Case management” defined as: “Prevention or intervention using case manager or

case team to develop service plan and arranges services.”

• Using a needs-assessment driven case/supervision plan to drive service referral you

become a case manager, and you’re arranging services for the offender, and thus doing precisely what was correlated with that 20 – 60% reduction.

*Lipsey, et al. 2009

25

• Journal of Offender Rehabilitation -- December 2008

26

Time Devoted to Discussions of Criminogenic Needs Time Spent Discussing Criminogenic Need Percent Recidivated 0 to 19 minutes 49% 20 to 39 minutes 36% More Than 40 Minutes 3%

27

Time Devoted to Discussing Conditions of Probation Time Spent Discussing Conditions of Probation Percent Recidivated 0 to 15 minutes 18.9 More than 15 minutes 42.3

Implementing the PRIME in King County

Reclaiming Futures: King County Robert Woods Johnson Foundation

• Early Identification
• Screening
• Assessment
• Treatment

The PRIME: What is it?

31

PRIME Graphic

32

STEP 1 – Administer Assessment Tool, in This Case, GAIN SS Is Completed

33

STEP 2 - Information Entered for Scoring

34

STEP 3 - Software Provides Reminder: Release of Information Must Be Obtained

35

STEP 4 - Referrals Are Selected Based on the Scores in Drug and Mental Health

PENDING

36

STEP 5 - PRIME Selects Provider Based on Parameters Like Language Requirements, Type of Service and Location/Distance

Provider selection returned

37

STEP 6 - Appointment Time Is Selected

38

STEP 7 - Referral Is Accepted Immediately

39

STEP 8 - Provider Completes Diagnosis and Sends It Via PRIME back to Probation

40

What Happens When Johnny Fails to Attend?

 Provider notes the missed appointment and reschedules The Probation Officer is notified within seconds The Probation Officer can review the log from start to finish The youth is held accountable in real time with immediate responses from the provider and probation.

How does the PRIME fit with the Eight Guiding Principles of EBP?

42

EIGHT GUIDING PRINCIPLES

• f

Evidence-Based Practice

43

Access Actuarial Risk

The PRIME facilitates the appropriate and controlled sharing of assessment results. Better information leads to better results

44

Match level of services to level of risk

• Reserve resources for higher risk cases
• High risk cases require more intensive intervention
• Low risk cases require minimal or no intervention

44

IF IT AIN’T BROKE . . . . DON’T FIX IT

• r

RISK PRINCIPLE:

45

Enhanced Intrinsic Motivation

 The PRIME helps remove barriers to offender meeting with the provider. Many probation/parole agencies report that their clients fail, not because they fail to complete their treatment, but because they fail to show up for their treatment. On-the- spot appointment scheduling and confirmation can be just the motivation needed for successful engagement and follow through

46

Target Interventions

The PRIME targets the appropriate Provider treatment and interventions by matching the

• ffender’s prioritized needs – as determined

by the actuarial risk assessment – with the appropriate and available Provider services

47

Match Services (Interventions) to Criminogenic Needs

Prioritize treatment to highest scoring criminogenic needs; in the case of a tie treat the intrinsic need first

NEED PRINCIPLE:

48

Engage On-going Community Support

The PRIME facilitates access to services in the community for the

• ffender, and enhances

communication between the community service Providers and the Referring Agency

49

Measure Relevant Practices

 The PRIME aggregates

referral and Provider data, making it easier, e.g. to measure effectiveness of a Provider’s quality assurance program

50

Measurement Feedback

 The PRIME, as an integral part of the Assessments.com software system, provides a single repository of critical process and outcome information that can be easily managed, analyzed, measured and reported. In addition, the PRIME can be integrated with local MIS, creating a solid basis from which to make informed decisions about needed changes.

51

Reduce Recidivism

4th Gen Tool

Effective Interventions

Training-QA

Researched Standardize-QA

Low Risk Individual

Style/Skills

Motivational Interviewing

What brings

• ffenders in?

What keeps them

• ut?

ID Risk and Protective Factors Criminogenic Needs

Change in Infrastructure Judges/PA/DA Buy-In

Positive Outcomes

Management Buy-In

Staff Buy-In

Moderate/High Risk Individual

The PRIME: What are its benefits?

53

PRIME Benefits

• Real-time, proactive communication between

the Referring Agency and its servicer and treatment Providers, including appointment transactions, on-going case status reporting, and service outcomes.

54

PRIME Benefits

• Promotes accountability for offenders to show

up for their Provider treatment services.

55

Benefits cont.

• Improved communication and relationship

between the Referring Agency and Providers, with enhanced ease of managing Provider enrollment for the Referring Agency and easier access to needed information for both the Providers and the Referring Agency.

56

Benefits cont.

• Enhanced ability to populate Referring

Agencies case management plan via sharing of case notes generated through the PRIME.

57

Thank you!

Sean Hosman Susan Waild (801) 295-1385 Juvenile Probation Manager shosman@assessments.com 206-205-9427 Susan.Waild@metrokc.gov