Washington State is cutting its recidivism rates nearly in half among individuals with a disability or diagnosed severe mental illness who are incarcerated or involved in the criminal legal system, specifically those served by the state-funded Offender Reentry Community Safety (ORCS) Program. This legislatively mandated program was begun in 2000, notes Angie Sauer, M.S., LMHC, health services reentry administrator for the State Department of Corrections (DOC), who oversees the program.
The 20-year-old reentry program operates in conjunction with the Washington State Health Care Authority (HCA). HCA has a budget of roughly $1.8 million a year “to contract with community health agencies and providers for reentry care services above and beyond what we could consider the normal standard of care at the Medicaid level,” says Alex Stoker, M.A., LMHC, the HCA-side program administrator and Sauer’s counterpart. Together, Sauer, Stoker, and a committee of community providers run the effort.
Because Washington State expanded its Medicaid program under the Affordable Care Act, most of an individual’s health and behavioral health needs are met by Medicaid, Stoker explains. This includes trauma-informed and recovery-oriented services. The specialized services offered by the ORCS Program are provided by individuals with a history of working with people who are incarcerated, including several forensics teams. For example, Pierce County uses their various forensic teams, including a forensic assertive community treatment (or FACT) team, to provide intensive outpatient mental health services to clients, in addition to other needed reentry services.
Both Sauer and Stoker are clear on a couple of aspects of the program that have led to its success. The first is in-reach to the state’s prisons that allows an individual who meets program requirements to develop a care team that will work with him or her upon release. Individuals are eligible if they have a serious mental illness that impairs functioning and if they meet a certain level of potential dangerousness as determined by a DOC risk assessment. They may or may not have been convicted of a violent crime but have enough criminal history and a variety of crime types that puts them in a high-risk category, Sauer explains. The program also provides services to people with sex offense convictions, a population where services are difficult to come by.
The in-reach team includes DOC transition counselors and the community mental health providers who will work with the individual on their release. Pre-COVID, these sessions would occur at least two to three times in person before an individual’s release, but now much of this work is done by phone, which is not ideal, Stoker says. The development of a care team and release plan means the formerly incarcerated person is not at loose ends when they leave prison.
The second element that leads to an individual’s success is “ensuring that all clients have access to housing immediately upon release,” Stoker says. For most clients, this means they are moving into a transitional house where they have three to five roommates. The simple act of putting a roof over someone’s head can reduce recidivism rates at the 3-year mark by up to 50 percent, according to Stoker.
In addition to housing, the ORCS Program is authorized to pay for whatever a person needs to be successful in their recovery, as long as the program can afford it. Often, this includes basic household items like bedding, work clothes and tools, and access to food. But the 13 contracted community providers that serve 21 of the state’s 39 counties, and the representative payee who serves the more rural areas where a contracted provider is not available, are encouraged to be creative, Stoker points out.
For example, one program was housing a person with a previous conviction of a sex offense in a motel, which can become expensive. So, they helped him purchase an RV, Stoker says. Another program serving an individual who was fairly isolated found out he was musically inclined and purchased him a guitar so he could become more active in the local music scene, Sauer recalls.
ORCS is a 60-month program, and individuals are expected to be self-sufficient by the end of this time. According to Stoker, about 10 percent to 20 percent of the individuals they assist are able to return to work. The others are receiving Social Security disability payments, and for them, the goal may be stability—being housed, going to therapy, and following a medication regimen. “Recovery can look very different for different folks,” Stoker points out.
Stoker says the majority of the people with whom they work are men, though they do serve individuals from the state’s women’s prison. The ages range from 20 to 50 plus, and there is no one race represented more than another. Roughly 90 to 100 individuals are deemed eligible each year, and the program has served 1,137 persons in its 20-year history.
“Angie [Sauer] and I are both very passionate about this program and would like to see it expand,” Stoker says. There is currently a bill in the Washington State legislature considering its expansion. The numbers make a strong case for increasing access to the program.
For every $1 the program spends, it saves $1.90 in costs, according to an analysis done by the Washington State Institute for Public Policy (WSIPP). WSIPP also did “a huge analysis of all the different reentry programs, and this particular program has the best effect size for decreasing recidivism in comparison to other reentry programs in Washington State,” Sauer reports. The average 3-year recidivism rate for the past 20 years for the ORCS Program is roughly 17 percent, with a low of 5 percent in 2016 and a high of 26 percent in 2000 and 2001, the program’s first 2 years. In comparison, the overall 3-year recidivism rate for all people who are incarcerated in Washington State for 2016 was 33 percent.
Stoker’s pitch to get new community programs involved in the effort is the fact that they are already serving individuals released from prison, but many experience homelessness and become difficult to help. ORCS gives the programs the additional resources they need to help their clients succeed.
Finally, Stoker says the program returns some sense of humanity to the lives of the individuals it serves. When he used to run a program working with this group, he would take individuals to Goodwill to purchase $100 to $200 worth of clothing the week they were released from prison.
“That really matters when you’re released from prison and you have nothing, if somebody takes the time to help you find clothing that fits, that somebody helps you find clean socks and underwear,” Stoker explains. “Those little things add up to feeling like you’re not getting dehumanized by society. And I think that those little caring moments add up to the really resounding recidivism improvement that we see with this program,” he concludes.
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