Faced with extensive and rising supervision costs, the state is considering having some mentally impaired inmates spend more time behind bars.
Secretary of Human Services Doug Racine is proposing to keep prisoners who have a “serious functional impairment” (SFI) and who are considered a risk to public safety incarcerated until they’ve served their maximum sentence.
Racine floated the idea in front of the Senate Health and Welfare and Judiciary committees at a joint meeting today.
Currently, the Agency of Human Services (AHS) pays community service providers to supervise these people once they’ve fulfilled their minimum sentence and been released on furlough.
The people who end up in these situations are often on the cusp — but don’t quite qualify — for comprehensive AHS services upon their release. Some, for instance, have IQs just above the threshold of eligibility for receiving Developmental Services.
There is no formal diagnosis to determine whether or not a person poses a threat to public safety — it’s a judgment call that community providers make. When they make this call, it can, in extreme cases, set up arrangements where three people must supervise one individual, 24 hours a day, at huge costs to the state, Racine explained.
According to Racine, there is no statute that requires his agency to fund this level of oversight — AHS has simply acquiesced to concerns from community providers, who consider some of their clients a threat to public safety.
What has resulted, Racine said, is “essentially a confinement program.”
“How we could do that, I’m not really sure, quite frankly, because it raises a host of civil rights issues,” he added.
But Robert Appel, the outgoing executive director of the Human Rights Commission, said it makes more sense to keep people in the community. “I would say we are making progress, but I’m fearful, from what I’m hearing today, that we are retreating,” Appel said.
Appel argued that falling back on incarceration is “just poor public policy,” and the state should do more to divert mentally impaired people from prison in the first place by setting up more treatment courts.
For those who are incarcerated, Appel offered an alternative to Racine’s proposal. He suggested that lawmakers designate money from the state’s General Fund, which would otherwise be spent to keep these people in prison, and instead use it to support them once the Department of Corrections has cleared them for release. Under Appel’s plan, the money would be used to match individuals’ Medicaid grants.
The “serious functional impairment” (SFI) designation is particular to the correctional system. Vermont statute defines the term as a developmental disability, traumatic brain injury, or other serious mental impairment, as judged by a mental health professional. There are currently about 120 people in prison who are designated as SFI, and the majority have been convicted of violent crimes, often of a sexual nature, according to Dr. Delores Burroughs-Biron, the health services director for the Department of Corrections.
The Department of Mental Health, which is part of AHS, is currently spending $1.2 million to pay for supervision of just 12 people, according to the interim commissioner, Mary Moulton. Nine of these are people designated as SFI; three fall into the category of “complex community cases.” These are people who fit the same profile as inmates with SFI, but haven’t committed a crime. (After community providers began building up protective apparatuses around released inmates, they started extending the same services to people in the community who posed similar threats.)
The Department of Aging and Independent Living (DAIL), which also is part of AHS, is spending about $1.5 million on its caseload.
Racine said the cost of the program caused things to come to a head at AHS. The snapping point, Racine said, came when two requests landed on his desk last August— one asked for $600,000 for one individual; the other requested $800,000.
Racine said these cases have trickled in during past years, but they began “escalating” both in volume and cost last year.
“We cannot continue doing this,” Racine said. Unless the Legislature cries foul, AHS will terminate these arrangements after FY2014.
“If the only way that the designated agency is willing or able to provide services for that person is to provide three-on-one or two-on-one constant supervision, then that person will stay in Corrections until that person has served out his maximum [sentence]. And then when that person comes out, they are free to go.”
But community providers say it’s much easier to work with people with SFI if they are out on furlough because they have an incentive – fear of being sent back to jail – to be in treatment. Once they’ve carried out their maximum sentence, they have less of an incentive to comply with treatment programs.
“We can’t not meet people’s needs because they don’t fit into a silo,” said Julie Tessler, director of the Vermont Council of Developmental and Mental Health Services.
According to the Tessler, the closure of the Vermont State Hospital contributed to the upsurge of mentally impaired people who are considered a danger to their community.
“A lot of the people we are talking about would have been at VSH (Vermont State Hospital),” she said.
Tessler made the case that the void left by the Vermont State Hospital could be addressed by creating secure residential care units on the correctional facility grounds to improve care for inmates during their sentences.
Correction: Tessler said the residential care units should be on prison grounds — not in a correctional facility.
