washington state community protection program

WASHINGTON STATE
COMMUNITY PROTECTION
PROGRAM (CPP)
WASPC Conference
October 8, 2014
Moderator: Chris Coleman
Panelists: Marci Arthur
Lori Gianetto Bare
Sara Straus-King
AGENDA
• History of the program
• Myths
• Who are individuals with Community Protection
support needs?
• Definitions
• Developmental Disabilities Administration (DDA)
Policies
• Statistics
• Why it works
• Treatment Strategies
HISTORY
• A fire was set intentionally by a client enrolled
with DDA in 1996 resulting in the deaths of
two women
• The Legislature ordered DDA to identify clients
living in Adult Family Homes with histories of
dangerous behavior
• Efforts were expanded in 1997 to clients living
in supported living
HISTORY
•Task Force created in 1998
•Policies and Procedures written
•Training Curriculum developed
•Community Protection (CP) Providers
•RFQ (Request for Qualifications) for CP
Residential Providers
HISTORY
•CP Waiver Implemented 2004
• First in nation
• Participation is voluntary
•Chapter 71A.12.200-280 RCW written by
Legislature in 2006
•Chapter 388-831 WAC completed in October
2008
MYTHS
•You are considered for the CP Program if you
stole a pack of cigarettes
•Once you are in, you never get out!
•It’s just like prison
•People who live in it are terrible
Who are individuals with
CP support needs?
One of the following criteria must be met (Chapter 388-831-0030 WAC):
You have been charged with or convicted of a crime of sexual violence as defined in
Chapters 9A.44 RCW or 71.09 RCW ;
You have been charged with or convicted of a crime involving sexual acts directed
towards strangers or individuals with whom a relationship has been established or
promoted for the primary purpose of victimization, or persons of casual acquaintance
with whom no substantial personal relationship exists;
You have been charged with or convicted of one or more violent crimes as defined in
Chapter 9.94A.030(45) RCW;
You have not been charged with or convicted of a crime identified above, but you have
a history of violent, stalking, sexually violent, predatory and/or opportunistic behavior
which a qualified professional has determined demonstrates a likelihood to commit a
violent, sexually violent and/or predatory act; and
You constitute a current risk to others as determined by a qualified professional.
Charges or crimes that result in acquittal are excluded.
Who are individuals with
CP support needs? – simplified
•
•
•
•
An enrolled participant with DDA and
18 years old or older and
Has a history of sexual or violent crime and
Has been determined by risk assessment to be
a moderate to high risk to reoffend
Identification
•
•
•
•
•
•
File review
Individuals with CP Issues form competed
Regional CP committee review
Meeting with participant
Risk assessment
Referral to program
COMMUNITY PROTECTION
PROGRAM DEFINED
•Services to support people with CP support
needs
•Voluntary
•Opportunity for people to live successfully in
community & stay out of jail, prison, hospital
•Security Precautions
•Alarms on Doors/Windows
•Supervision while in community
DEFINITION - continued
•Specialized Environment
• Safe, structured environment
• Rules & Restrictions
• Expectations for personal responsibility
• Positive Behavior Support Plans
• Cross System Crisis Plans
DEFINITION - continued
•Treatment Team
• Group responsible for development,
implementation and monitoring of
participant’s supports and services
• Participant, Case/Resource Manager
(CRM), therapist, residential provider,
employment provider, mental health
representative, DOC rep., legal rep or
family member
DDA POLICIES
15.01
15.02
15.03
15.04
15.05
-
CP Identification
CP Program Services
CP Employment Program
CP Residential Services
CP Exit Criteria
Policy Manual
CP Policy 15.01 – Identification and
Eligibility
•Establishes guidelines for CRMs to follow when
identifying an individual as a person with CP
issues
•Procedures
•Complete Individual w/ CP Issues Form 10-258
•Send to CP Coordinator with additional
documentation as necessary
CP Policy 15.02 – Program Services
•Guidelines for CRMs to follow when offering and
authorizing services for people with CP issues.
•Services Offered:
• Community Protection Residential Program
(including therapy, employment, etc.)
• MPC (with full disclosure)
CP Policy 15.03 – Employment
Services
• Agency Support Structure
– Security
– Integration
– Collaboration
• Administrative requirements, i.e. insurance, policies
• Staff training
– Staff must be trained in supporting persons with
community protection support needs prior to
working alone with participants
CP Policy 15.04 – Residential
Services
• Expectations
– Safeguards
– Integration
– Collaboration
– Staffing
• Household composition – mixing of households subject to approval
• Administrative requirements, i.e. certification, insurance, policies
• Staff training
– Staff must be trained in supporting persons with community
protection support needs prior to working alone with
participants
• Site Approvals
CP Policy 15.05 – Exit Criteria
•Four ways to leave CP
• Phase Out (Graduate)
• Be terminated (non-compliance)
• Voluntarily leave
• Be found not eligible for enrollment with
DDA through an Eligibility Review
Current Statewide Statistics
• 721 Individuals Identified as Community
Protection (3.4% of adult DDA enrolled
population)
• 435 Individuals residing in the Community
Protection Residential Program (39.7% of
those identified are not supported in the
residential program)
• 136 Additional Individuals Identified as
“Tracking Only”
• 40 graduations
Community Protection
Identification Response
Refused CPP,
53, 7%
Refused Risk
Assessment ,
13, 2%
Not Offered
CPP, 168, 22%
Accepted CPP,
533, 69%
DDA Sex Offender-Kidnapping
Registration Rate
Level III,
36, 28%
Level II,
38, 29%
Level I,
56, 43%
WHY IT’S WORKING
•Supports
•Opportunities to succeed
•Treatment Team
•Collaboration
•Training
TREATMENT STRATEGIES FOR
PERSONS WITH
DEVELOPMENTAL DISABILITIES
Sara Straus-King, M.A., C.S.O.T.P
WORKING WITH PERSONS WITH
DEVELOPMENTAL AND INTELLECTUAL
DISABILITIES BRINGS MANY UNIQUE
CHALLENGES
Cognitive Impairments
Social Delays
Self Regulation Skills Deficits
RESEARCH AND RESOURCES
While some resources exist regarding the
treatment of sexual offenders who have
disabilities (Blasingame, 2005; Haaven,
Little & Petre-Miller, 1990; Hansen & Kahn,
2005; Horton & Frugoli, 2001) there are
still a limited amount of interventions to
address clients with forensic challenges
STRATEGIES THAT WORK
One study of individuals with
developmental delays, psychiatric orders,
and severe behavioral problems has found
a strategy that works (Bird, Sperry &
Carreiro, 1998)
This treatment model includes:
• goal setting
• case management
• social skills teaching
• positive reinforcement
• crisis intervention
• competency based skills training
• medication monitoring
• data based outcome measurement
• community living arrangements
CRITICAL COMPONENT OF SEX
OFFENDER SPECIFIC TREATMENT
WITH DEVELOPMENTALLY
DELAYED CLIENTS
• Communication is highly essential and
key in successful treatment
• Understanding how communication is
impacted by disabilities
• Therapist style, skill level, and
understanding of impairments and
needs
• Effective: active listening, listening with
empathy, openness, awareness ofexpression, body language, tone, pitch,
volume, articulation
ADDITIONAL CHALLENGES
More concrete styles of thinking
Less ability to abstract and reflect
Difficulty generalizing concepts
Difficulty with analogies
More limited vocabulary
More limited life experience
Short attention spans
Superficial compliance
Trouble understanding cause and effect
Difficulty relating to others
Response to abuse
CLINICAL ASSESSMENT
OF SEXUAL RISK
History of sexual behavior
Sexual knowledge
Individual or solitary sexual behavior
Sexual experiences
Sexual arousal and interest
Personal history of victimization/exploitation
Exposure to pornography
Witnessed sexual behavior
Understanding of appropriate versus
inappropriate sexual behavior
OTHER RISK FACTORS TO
CONSIDER
IN ASSESSMENT
Family History
Criminal History
Drug and Alcohol History
Mental Health
Medical/Physical Health
Education/Vocation/Employment History
Social Skills
Support Systems
Current Environment and Living Situation
TREATMENT INTERVENTIONS
Healthy Sexuality
Legal Versus Illegal Sexual Behavior
Sexual Arousal and Fantasy Management
Boundaries
Cycles of Behavior and Patterns
Emotion Expression and Regulation
Social Skills / Relationship Development
Responsibility and Accountability
Independent Living Skills
Anger Management
Healthy Choices / Increase Positive
Behavior and Decrease Negative
Behavior
Consequential Thinking
Thinking Errors
Relapse Prevention (Avoid / Escape
Techniques, High Risk Situations)
Problem Solving
Responsibility and Accountability
Tailoring client treatment to fit their
risks, needs, and response to therapy
results in success in reaching goals and
having a better quality of life
OVERCOMING OBSTACLES
Sex offenders, including developmentally delayed
offenders, who are held accountable for their
behavior and receive appropriate intervention are
less likely to re-offend.
The criminal justice system serves a role in
ensuring community safety (identifying sex
offenders, holding them accountable, directing
them to treatment, and encouraging compliance).
OVERCOMING OBSTACLES
Therapist’s role is to assist client in reducing
risk by tailoring treatment to fit needs
(modifications, adaptations, flexibility,
support and creating opportunities).
RECOMMENDATIONS FOR LAW
ENFORCEMENT
Special training dealing with:
• Recognition of the indicators of
developmental delay
• Effective communication strategies for dealing
with developmentally delayed persons
RECOMMENDATIONS FOR LAW
ENFORCEMENT
• Accessibility of community resources that may
aid in investigations
• Informing developmentally delayed suspects
of their rights and determining if they
understand- a protocol should be developed
and followed in the event that an individual
does not understand their rights
RECOMMENDATIONS FOR LAW
ENFORCEMENT
• Collateral information on the individual’s
level of functioning and other pertinent
background information from various
sources should be available to
investigators with consent
Contact Information
• Marci Arthur, marci.arthur@dshs.wa.gov
• Chris Coleman, ncc22@comcast.net
• Lori Gianetto Bare, GianeLC@dshs.wa.gov
• Sara Straus-King, soundcounseling@frontier.com