Jail Based Substance Abuse Treatment Program Research
The Jail Based substance abuse treatment program is less than half of the cost of prison. The average daily cost for a client in the treatment program was $30.19 compared to $64.02, which is the daily rate to house an inmate in a state prison facility in Iowa. The majority of the jail based treatment clients who were interviewed tend to maintain abstinence, do not get arrested, and obtain full-time employment. Client abstinence increased by 82.4 percentage points from admission and maintained a 75.5% rate at the 12 month follow-up. A large percentage of clients were arrest free at Interview 1 lowering somewhat at Interview 2, but remained high at 80.2%. More clients were employed full-time at the 12 month interview.
The following cost analysis study of the Iowa Jail-Based Substance Abuse Treatment Program provides an economic perspective of the provision of substance abuse treatment and aftercare to incarcerated individuals in Polk, Woodbury, and Scott Counties. The analysis involved examining the costs of providing substance abuse treatment to incarcerated clients in county jails and continuing that treatment after release from jail followed by aftercare. The program, designed as a diversion to long prison sentences for drug-involved offenders, was initiated as a pilot in Polk County. The program was expanded to the other two counties and has proven a success through a follow-up evaluation that measures client abstinence, arrests and employment and several other outcomes. This analysis provides cost information on the aspects of treatment provision of the program compared to prison.
The Iowa Consortium for Substance Abuse Research and Evaluation Consortium) conducted a cost analysis of the clients admitted to the Jail-Based Substance Abuse Treatment Program. The costs of the Jail Treatment Program were compared to the costs related to incarceration in prison, if the program did not exist as a diversion opportunity to prison, and clients served prison terms versus the program. The Consortium examined the costs of treatment, jail time, and recidivism compared to the costs of time in prison. The purpose of this project was to determine differences in the cost of the program, which involves treatment, support, and aftercare services, versus the cost of a prison sentence.
Study Questions Three questions are addressed as a result of this analysis:
1) What was the total cost associated with in-jail and post-release community treatment?;
2) Was participation in the Jail-Based Substance Abuse Treatment Program more cost effective than not participating?;
3) What conclusions can policy makers draw from the cost information presented in this study? Program The Jail-Based Substance Abuse Treatment program was established to deliver substance abuse treatment services to clients during incarceration and after release from jail. To determine effectiveness of treatment services, clients are tracked for two follow-up interviews that occur approximately 6 and 12 months after admission to the treatment program. Three treatment agencies in Iowa are involved in this program: United Community Services, Inc. (UCS), a Des Moines-based agency delivering treatment to clients at the Polk County Jail; Center for Alcohol and Drug Services, Inc. (CADS), an agency located in Davenport, Iowa delivering treatment to clients at the Scott County Jail; and Jackson Recovery Centers based in Sioux City, Iowa delivering treatment to clients in Woodbury County Jail.
The sample for this project includes all clients admitted to the Jail-Based Substance Abuse Treatment Program between July 1, 2004 and June 30, 2005. During this period, 408 clients were admitted to the program: 181 in Polk County, 132 in Scott County, and 95 in Woodbury County. Two hundred ninety-seven (72.8%) of the clients were male and 111 (27.2%) were female. The clients ranged in age from 18 to 61 with a median age of 32 years. This group of clients spent an average of 77 days in the in-jail portion of treatment and 212 days in the treatment program from admission to discharge. Measures The data gathered related to costs of treatment and costs related to incarceration were based on documented actual costs of the Jail Treatment Program and from costs reported by the County Jails and the Iowa Department of Corrections that are based on actual costs. The costs related to the Jail Treatment Program involve time and resources for substance abuse treatment and time and costs of incarceration in the county jails. When clients are released from jail, treatment continues and evolves into aftercare programming. If clients recidivate during this time, costs related to the controlled environment in which they are placed were added program costs. To calculate the alternate consequences to the Jail Treatment Program, a total state cost related to incarceration in prison was obtained from the Iowa Department of Corrections.
Treatment Costs: Treatment costs were directly related to the actual costs of the Jail Treatment Program. Each treatment agency was awarded a contract by the State of Iowa to provide in-jail substance abuse treatment to eligible clients. Agencies were reimbursed monthly on actual expenses related to the program by the Iowa Department of Public Health. The costs of treatment include both administration support and direct treatment services. The reimbursement payments to each agency were examined for the period of July 2004 through June 2005. The daily cost of treatment was calculated by dividing the total reimbursed amount for the year examined by the total number of treatment days for all clients served under the Jail Treatment Program in the same time frame. The total program cost for the three agencies was $785,852.62. Five hundred ninety-five clients from the three counties spent 79,949 days in treatment (based on admission and discharge dates) from July 1, 2004 to June 30, 2005. The average cost of treatment per day was $9.83.
All clients in the Jail Treatment Program begin treatment in county jail facilities: the average length of stay in jail varies by site. The daily rate of jail incarceration was obtained from officials at each county jail. The rates varied by county: $85.52; $65.00; and $53.00. The 408 clients spent a total of 27,230 days in the in-jail portion of the treatment program. The total cost 3 for the 27,230 days based on the daily rates provided by each county was $2,054,342.32. To determine the average cost per day of the in-jail treatment time, this figure was divided by the number of clients (408) yielding an average cost of $5,035.15 per person per year. The average daily cost was determined by dividing the average cost for one year by the number of days in a year (365). The average cost per day of jail for each of the 408 clients from July 1, 2004 to June 30, 2005 was $13.79.
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