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Study: More Medicaid Needed for Incarcerated Individuals with Substance Abuse Disorders

Andrew J Schappert — Wed, 22 May 2024 16:31:54 +0000

Study: More Medicaid Needed for Incarcerated Individuals with Substance Abuse Disorders Andrew J Schappert Wed, 05/22/2024 - 12:31

A new study examining how state Medicaid programs are helping people with substance use disorders (SUD) uncovered the need to expand the programmatic features to assist individuals who are transitioning in and out of the criminal justice system.

Faye Taxman: ‘There is a clear need for more states to adopt such initiatives, particularly given the high risk of overdose deaths in this population.’

The study, “State Medicaid Initiatives Targeting Substance Use Disorder in Criminal Legal Settings, 2021,” was published in the American Journal of Public Health and was cowritten by Faye Taxman, director of the Advancement for Correctional Excellence (ACE!) at the Schar School of Policy and Government at ��AV.

In 2021, a survey was sent to all 50 U.S. states and Washington, D.C. The survey asked if they had any special programs for individuals with SUD in the criminal justice system, including jails, prisons, and community corrections. An impressive 90 percent of those contacted responded to the survey.

The survey found that most states did not have specific Medicaid programs targeting people with SUD in the criminal justice system.

However, 18 states and Washington, D.C., introduced at least one type of Medicaid initiative. The most common efforts involved providing medication to treat opioid addiction before release and helping individuals sign up for Medicaid.

Another frequent initiative involved making it easier for individuals to keep their Medicaid by suspending rather than canceling their benefits when they are incarcerated. The least common initiative involved coordinating care for individuals with SUD.

“There is a clear need for more states to adopt such initiatives, particularly given the high risk of overdose deaths in this population,” said Taxman. “This has implications for new policies that states can apply for in terms of [Social Security Act] Section 1115 waivers to enhance Medicaid funding for those in the criminal legal system.”

The full text of the study is available on the American Journal of Public Health website.

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Taxman, ACE!, Probing St. Louis’s Troubled Jail

Andrew J Schappert — Wed, 31 Aug 2022 16:42:23 +0000

Taxman, ACE!, Probing St. Louis’s Troubled Jail Andrew J Schappert Wed, 08/31/2022 - 12:42

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Schar School of Policy and Government’s Faye S. Taxman, founding director of the Center for Advancing Correctional Excellence (ACE!), is helping administrators at St. Louis County Justice Center in St. Louis, Missouri, develop new racial equity policies and programming to improve the jail’s culture and reduce its population.

The 18-month, first-of-its-kind study, funded by a $300,000 grant from the MacArthur Foundation, will focus on rampant racism and mistreatment of inmates.

If successful, those new practices and policies could be adapted by criminal justice systems across the country.

The study team includes researchers from ACE!, the University of Missouri-St. Louis, and justice system partnerships.

—Buzz McClain

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Study: To Reduce Jail Populations, Increase Mental Health Services in Communities

Andrew J Schappert — Thu, 25 Aug 2022 19:21:05 +0000

Study: To Reduce Jail Populations, Increase Mental Health Services in Communities Andrew J Schappert Thu, 08/25/2022 - 15:21

Faye Taxman: ‘This study is important because it illustrates the interconnection between mental health services in the community and the size of the jail population…’

A new study by Schar School of Policy and Government researchers concludes that U.S. jails are de facto mental health institutions, with nearly 10 times as many individuals with serious mental illness in prisons and jails than in state psychiatric hospitals.

The study also found that access to affordable healthcare services and behavioral health treatment in the community changes how the jail is used and reduces the size of the jail population.

“This study is important because it illustrates the interconnection between mental health services in the community and the size of the jail population—that is, if counties invest in expanding local health services, then they can reduce how they use their local jail,” said Faye S. Taxman, founding director of the Center for Advancing Correctional Excellence (ACE!) at ��AV and the principal investigator of the study.

The data is relevant “to policy makers at federal, state, and local government agencies in terms of reducing the unnecessary use of local jails,” she said. “It also illustrates a connection that the number of services in the community is important to improve outcomes.”

Researchers included Niloofar Ramezani, a biostatistician at Mason’s College of Engineering and Computing, and collaborators from Michigan State University and the University of Central Florida. Working with $3.6 million in funding from the National Institute of Mental Health, the researchers studied the size of jail populations in 3,100 U.S. counties to explore factors contributing to the over-use of incarceration in county jails in the face of increased mental health challenges within those communities.

The study’s conclusions point to increasing mental health services—particularly in counties with smaller populations, reduced numbers of high school graduates, and fewer treatment services—to reduce prison and jail populations.

There is hope on the horizon, Taxman pointed out.

“The new Bipartisan Infrastructure Bill has funds for mental health services,” she said. “If used, that funding can help to reduce the over 11 million Americans who are processed by local jails each year.”

The complete study is here.

Probing St. Louis’s Troubled Jail

Taxman and ACE! are helping administrators at St. Louis County Justice Center in St. Louis, Missouri, develop new racial equity policies and programming to improve the jail’s culture and reduce its population. The 18-month, first-of-its-kind study, funded by a $300,000 grant from the MacArthur Foundation, will focus on rampant racism and mistreatment of inmates.

If successful, those new practices and policies could be adapted by criminal justice systems across the country.

The study team includes researchers from ACE!, the University of Missouri-St. Louis, and justice system partnerships.

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Reforming Criminal Justice

Andrew J Schappert — Fri, 03 Dec 2021 14:31:53 +0000

Reforming Criminal Justice Andrew J Schappert Fri, 12/03/2021 - 09:31

Screenshot by Buzz McClain/Schar School of Policy and Government

Nearly 100 viewers with an interest in criminal justice reform in the commonwealth tuned into an early December webinar on the subject, moderated by Bonnie Stabile of the Schar School’s Gender and Policy Center (GAP), and featuring Faye Taxman, director of the Center for Advancing Correctional Excellence (ACE!). Guests addressing the equity, effectiveness, and economics of incarceration included keynote speaker Jennifer Carroll Foy, former Virginia delegate and gubernatorial candidate; Bonnie Hoffman, director of public defense reform and training at the National Association of Criminal Defense Lawyers; Claire Guthrie Gastañga, former director of the American Civil Liberties Union of Virginia; and Edward Ungvarsky, criminal defense lawyer.
—Buzz McClain

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Three New Studies Funded by JCOIN’s Rapid Innovation Grant Program

Andrew J Schappert — Wed, 06 Oct 2021 15:13:48 +0000

Three New Studies Funded by JCOIN’s Rapid Innovation Grant Program Andrew J Schappert Wed, 10/06/2021 - 11:13

The nation’s correctional facilities are uniquely vulnerable to the novel coronavirus. Since the pandemic was declared a public health emergency in February 2020, prison populations have been decimated across the country as COVID-19 finds few barriers behind bars.

In response to the spread of COVID-19 among justice-involved populations suffering from addictions, the Justice Community Opioid Innovation Network (JCOIN) created the JCOIN Rapid Innovation Grant program (J-RIG), a rapid funding mechanism to support research grants to study newly emerging policies, practices, and interventions that address prevention and treatment of addiction in justice settings.

Three projects recently have been approved for J-RIG funding:

Reducing Stigma among Individuals with Addiction and Staff in the Criminal Justice System: A Pilot Feasibility Trial. This project addresses the serious negative consequences of stigma in the criminal justice system by combining cutting-edge research in stigma intervention with implementation science to address stigma associated with addiction, medications for opioid use disorder (MOUD), and criminal involvement in the CJ system. PI: Kelly E Moore, assistant professor, clinical psychology, East Tennessee State University.
Improving low-threshold naloxone-on-release from incarceration. The primary purpose of this study is to determine whether providing high-volume, low-threshold, naloxone-on-release is effective at placing naloxone in the hands of jail releasees most likely to experience or witness an overdose. Two secondary aims are to determine facilitators and barriers to releasees obtaining additional doses of naloxone after release in the community and to explore how releasees take naloxone and associated training back to the community. PI: Peter J Davidson, associate professor, University of California-San Diego.
Decreasing Relapse and Recidivism: The Evaluation of a Novel Continuity of Care Model for Offenders with Substance Use Disorder (SUD). This project has two aims: to assess the effectiveness of a new SUD treatment program for short-term detainees in promoting detainee recovering and its impact on recidivism. The evaluation will improve our understanding of best practices for assisting detainees with SUD in re-entering their home communities successfully. PI: Valerie G Hardcastle, executive director, Institute for Health Innovation, Northern Kentucky University.

The first two J-RIG-funded projects began their work in 2020:

A Statewide Evaluation of the Implementation of Medications for Opioid Use Disorder in Vermont Correctional Facilities and the Impact of COVID-19.
PI: Elias Klemperer, assistant professor, Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont Larner College of Medicine.

Teleservices in Judicially Led Diversion Programs: The Impact of COVID-19 on the Adoption of Remote Treatment and Recovery Services.
PI: Tara Kunkel, executive director, Rulo Strategies LLC.

“We’re excited about the continued quality of the proposals submitted for J-RIG funding and look forward to the findings from all five projects,” said University Professor Faye Taxman, who leads the JCOIN efforts.

Each of these projects has been funded for two years.

JCOIN and J-RIG are funded by the NIH HEAL Initiative and are administered by the Center for Advancing Correctional Excellence (ACE!) at ��AV’s Schar School of Policy and Government. The multi-university collaborative is led by University Professor Faye Taxman.

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Schar School’s ACE! Lands NIH Grant to Fund Diversity Mentoring

Andrew J Schappert — Mon, 04 Oct 2021 14:59:38 +0000

Schar School’s ACE! Lands NIH Grant to Fund Diversity Mentoring Andrew J Schappert Mon, 10/04/2021 - 10:59

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Faye Taxman: ‘We are proud to be at the forefront of helping develop the next generation of scientists…’

In an effort to increase minority presence among researchers studying solutions to the nation’s opioid crisis, particularly among populations in criminal justice settings, the National Institutes of Health’s Helping to End Addiction Long-Term (HEAL) Initiative has awarded the Schar School’s Center for Advancing Correctional Excellence (ACE!) a grant to sponsor a minority scholar in the coming year.

The grant is the only one awarded by HEAL and will support the Justice Community Opioid Innovation Network (JCOIN), which studies approaches to increase high-quality care for people with opioid misuse in justice settings.

“We are proud to be at the forefront of helping develop the next generation of scientists in the justice-health space,” said ACE! founding director, Schar School University Professor Faye Taxman, who also is principal investigator for JCOIN. “This grant allows us to mentor an affiliate scholar to continue and expand on the important work we have already accomplished over the last several years.”

The funding recognized the success of ACE! in the field of justice-health as well as understanding the wide disparities in those affected by opioid abuse among minority populations.

ABOUT THE SCHAR SCHOOL

The Schar School of Policy and Government is one of the 10 schools and colleges of ��AV, with approximately 2,000 students, 90 full-time faculty members, and 23 degree and certificate programs offered on Mason’s campuses in Fairfax and Arlington, Va. Among the degree programs are government and international affairs, public policy, public administration, political science, international security, and international commerce and policy. The Schar School prepares undergraduate and graduate students to be leaders and managers who solve problems and advance the public good in all sectors and levels of government—in the United States and throughout the world.

For more, contact Communications Manager Buzz McClain at bmcclai2@gmu.edu.

A dynamic education for an evolving world.

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National Institute of Justice Adopts New ‘Risk & Needs Assessment’ Guidelines Co-Authored by Faye Taxman

Andrew J Schappert — Thu, 12 Aug 2021 17:15:32 +0000

National Institute of Justice Adopts New ‘Risk & Needs Assessment’ Guidelines Co-Authored by Faye Taxman Andrew J Schappert Thu, 08/12/2021 - 13:15

ACE! director Faye Taxman

New guidelines that address the “core function in the criminal justice system” were published this summer by the U.S. Department of Justice’s Office of Justice Programs and the National Institute of Justice.

The guidelines were created by a team of corrections scholars, including the Schar School of Policy and Government’s Faye Taxman, a University Professor and director of the Center for Advancing Correctional Excellence (ACE!). Kristofer Bret Bucklen of the Pennsylvania Department of Corrections and Grant Duwe of the Minnesota Departments of Corrections, along with Taxman, drafted the “Guidelines for Post-Sentencing Risk Assessment,” a study that examines the “risk and needs assessment” (RNA) instruments used by those in corrections settings for post-sentencing decision-making.

“Risk and needs assessments serve a core function in the criminal justice system,” said Jennifer Scherer, the acting director of the National Institute of Justice in Washington, D.C. “The principles that are the focus of this paper—fairness, efficiency, effectiveness, and communication—reflect a critical need to develop and implement innovative risk assessments to improve the prediction of risk.

“Guided by these principles, the checklist developed by this expert team will assist criminal justice practitioners in producing data-driven risk and needs assessments.”

The new guidelines are important as the results of RNA examinations affect rehabilitation, probation, sentencing, pretrial detention, presentencing decisions, and supportive and therapeutic treatment for those in incarceration scenarios.

“Once someone has been convicted and sentenced for a crime, corrections agencies use risk and need assessment tools to identify how likely that person is to commit another crime or violate the rules of prison, jail, or community supervision,” said a review of the researchers work published separately by the National Institute of Justice. “Correctional authorities use RNA instruments to guide decisions about programming, support, and restrictions that are intended to enhance public safety and make better use of scarce resources.”

For her part, Taxman did her Rutgers University PhD dissertation on RNA, has been consistently studying RNA, and specializes in the design and implementation of RNA, as well as analyzing data to generate evidence or to examine the effectiveness of new systems and methods to reduce recidivism.

See Taxman’s RNR Simulation Tool at www.gmuace.org/tools to see how to apply RNA to target individuals to appropriate programs and services.

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New ACE! Study Shows Reforms in Correctional Settings Require Community Buy-In

Andrew J Schappert — Mon, 03 May 2021 17:19:46 +0000

New ACE! Study Shows Reforms in Correctional Settings Require Community Buy-In Andrew J Schappert Mon, 05/03/2021 - 13:19

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Faye Taxman, director of the Schar School’s Center for Advancing Correctional Excellence

Researchers commonly work with the criminal justice system to implement reforms, bringing with them the latest science and data pointing to why a certain practice will help improve outcomes. New research from the Center for Advancing Correctional Excellence (ACE!) shows that if community corrections agencies are to sustain evidence-based reforms, they need to view them as legitimate.

Researchers worked with eight federal community corrections agencies to implement Contingency Management, an evidence-based practice used to help people convicted of drug offenses set and achieve goals to end addiction, avoid repeat offenses, and increase pro-social behavior. Such evidence-based practices and reforms are frequently put in place across the criminal justice system.

“We’ve seen millions of dollars spent by institutions on evidence-based practices in community corrections settings, but there is very little research on if the reforms stick after researchers leave,” said Shannon Portillo, assistant vice chancellor for undergraduate programs and an associate professor of public affairs & administration at the University of Kansas. Portillo was an assistant professor at Mason’s Department of Criminology, Law and Society (CLS) when she began co-authoring the study.

Danielle Rudes, associate professor in ��AV’s Department of Criminology, Law and Society

“We followed up after our original study with community corrections agencies, and we found reform only sticks when staff viewed the reform as legitimate. It is not enough to show that reforms are effective or efficient. Workers must view them as legitimate and aligned with their organization’s goals.”

The study, co-written with ACE! co-founders Faye Taxman, a University Professor in the Schar School, and Danielle Rudes, an associate professor in CLS, was published in The British Journal of Criminology. It was funded by the National Institute on Drug Abuse.

The researchers returned to the eight community corrections sites five years after implementing Contingency Management. While all sites saw the reformed practices as legitimate enough to initially consider adoption, two sites never adopted them, four sites experimented with reform, and two sites continued to use the reform after the study was over. The research team evaluated the legitimacy of the reform on three levels: Pragmatic, or if staff recognized that the practice could fit with their site routines and operations; moral, or if it was viewed as the right thing to do to help their clients; and cognitive, or if they could understand how this reform was different from current practices and was a shift in behaviors that could fit their agency.

Shannon Portillo (Photo courtesy of KU Marketing and Communications)

Results showed that sites that sustained Contingency Management rated it moderately or strongly in all three areas but that it had to be viewed strongly in terms of cognitive legitimacy. Sites in which it was not sustained gave various reasons for scoring it lower; for example, one employee did not use the software provided to keep track of data, instead logging it manually and reporting it was additional work, resulting in a low score in pragmatic legitimacy. Leadership was key in implementing reforms but could not make others view them as legitimate simply by requiring staff to implement the new practice. In fact, leadership views of legitimacy, efficiency and effectiveness of the measure was not a key factor at all, compared to staff views of legitimacy.

“This shows it really had to be the workers who saw this change as worthwhile and saw how the reform was worth their time to change their behaviors and workplace practices,” Portillo said.

In some of the sites where the evidence-based practice was not sustained, workers and management discussed the reform, but they indicated they were not sure exactly what it meant or how they could find a way to make it fit in their operations, meaning it did not score well in cognitive or pragmatic legitimacy. Contingency Management works by helping individuals set goals for recovery, meeting requirements set in terms of their probation or by courts, and rewarding them with gift cards or points toward purchases when certain benchmarks are met.

“It sounds simple, but this is a huge shift in mindset for the criminal justice system, because the system is so punishment-oriented. So, it was not always viewed as legitimate,” Portillo said.

Presenting such a fundamental change in operations shows that reform cannot be implemented or sustained without demonstrating to those tasked with carrying it out of its value. Demonstrating the efficacy or leadership simply telling workers it is something they have to do was not enough. While much effort and money have been invested in criminal justice reform, a deeper understanding of what reforms work as well as how to make them stick is vital to improving the criminal justice system and helping individuals successfully transition back to society.

“This is definitely an area that needs more research, as the federal government invests a lot, and individual organizations invest a lot of time and resources in reforms and evidence-based practices,” Portillo said. “We need to know more about how reform can be successful and how it is sustained for the long term.”

(Michael Krings is a public affairs officer at the University of Kansas. This story is adapted from KU with permission.)

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J-RIG Offers Rapid Response Research Grants for Studies of Addiction Treatment in Justice-Related Settings

Andrew J Schappert — Tue, 20 Apr 2021 17:25:16 +0000

J-RIG Offers Rapid Response Research Grants for Studies of Addiction Treatment in Justice-Related Settings Andrew J Schappert Tue, 04/20/2021 - 13:25

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You have a great idea for a new study related to the treatment of opioid addiction, but the thought of writing a proposal that might not be funded for months is daunting. Or, you would like to have some seed money to do a pilot study before facing the large grant application. JCOIN’s Rapid Innovation Grant program (J-RIG) is here for just such a dilemma.

J-RIG facilitates and, importantly, accelerates research on policies and practices affecting individuals in the criminal justice system. J-RIG provides researchers with quickly approved, small grants targeting new efforts to address prevention and treatment of addiction in justice, or justice-related, settings. Applicants may request up to $110,000 for a study of 6 months to 2 years.

J-RIG is the latest initiative funded through the Justice Community Opioid Innovation Network—JCOIN— a program within the National Institutes of Health’s Helping to End Addiction Long-Term (HEAL) Initiative, a collaborative effort to provide scientific solutions to the opioid crisis.

The goals of J-RIG, said JCOIN director Faye Taxman, “are to fund research that will create quick changes, leading to higher quality care. We see a desperate need to speed up the pace of change while maintaining scientific and academic excellence…We are seeking to support innovation and ideas that are often mired in bureaucracy and paperwork.” Decisions on funding are typically made in 90 days.

Two J-RIG grants have been approved and are underway.

In Vermont, researchers at the University of Vermont’s Larner College of Medicine are undertaking a statewide evaluation of how medications are used for opioid use disorder among those in the state’s correctional facilities, as well as studying the effects of COVID-19 on incarcerated populations. Assistant Professor Elias Klemperer at the university’s Vermont Center on Behavior and Health in the Department of Psychiatry is leading that program.
Washington, D.C.-based Rulo Strategies LLC, along with Wayne State University and the National Center for State Courts, is examining the effects of COVID-19 remote treatment teleservices in judicially led diversion programs. The national study will look at how courts use telehealth services. Rulo Strategies is led by Tara Kunkel.

While opioids are a key priority for J-RIG projects, applications may focus more broadly on other substance use issues, particularly substances associated with overdose and overdose mortality. Projects should have direct relevance to individuals who are justice-involved, but need not take place within justice settings. Those applying for grants may come from universities, nonprofit organizations, or private businesses.

J-RIG funding is available three times per year, with the call for proposals available January 5, March 20, and July 1. Typically, one project is funded in each funding cycle. Applications for the March 20 funding cycle are due May 6. Funding is open to those who work in research, policy, and practice settings. These studies will provide opportunities to learn about local initiatives, policy changes, or practice improvement efforts. For more information, contact jcpilot@gmu.edu.

At ��AV, the Coordination and Translation Center for JCOIN is managed by the 10-year-old Center for Advancing Correctional Excellence, ACE!, at Mason’s Schar School of Policy and Government. ACE! is led by Schar School professor Faye Taxman and Danielle Rudes, an associate professor in Mason’s Department of Criminology, Law, and Society.

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Study: More Medicaid Needed for Incarcerated Individuals with Substance Abuse Disorders

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Taxman, ACE!, Probing St. Louis’s Troubled Jail

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Study: To Reduce Jail Populations, Increase Mental Health Services in Communities

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Schar School’s ACE! Lands NIH Grant to Fund Diversity Mentoring

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