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Program For Mentally-Impaired Inmates Eyed For Cuts

They are “severely functionally impaired.” And they are among the highest-dollar offenders under watch at the Department of Corrections.

The cost to house these troubled, often aggressive convicts in community placements outside prison walls has vexed budget writers for years. The price tag for a single offender can exceed $500,000 annually. And while the six-figure expenditures are relatively rare, they have become budget-busters at an Agency of Human Services beset by fiscal pressures elsewhere.

Recently, however, Human Services Secretary Doug Racine neutralized the problem by instituting a moratorium on the high-cost placements that had previously been deemed a necessary component of the rehabilitative process.

“I think we can provide better services for that population while they’re in the (correctional) facilities,” he said. “And I think we can make better connections with service providers when they leave the facilities.”

Racine said the decision isn’t merely clinical. “With $500,000, I can buy a lot of child care subsidies for a lot of low-income families,” he said last week.

But critics of the policy change say the decision will only exacerbate the public safety risks posed by people who fail sometimes even to understand the wrongness of their criminal behavior.

The intensive intervention that had been accorded these high-need individuals, according to Robert Appel, former head of the Vermont Human Rights Commission, is admittedly expensive.

“But the alternative is simply releasing people after they’ve spent a considerable amount of time in an institution where their primary mental health needs are not being met,” said Appel, now a private-practice lawyer who continues to advocate for the severely functionally impaired or SFI population.

“You put someone back out in the community with untreated needs, and the likely result is a return to prison, probably after some injury to the public.”

The SFI designation — created by the Legislature as a means of classifying special-needs inmates suffering from everything from traumatic brain injury to acute mental illness — accords modified treatment standards for a population that tends to be at a higher risk either of victimizing others, or falling prey themselves.

At any given time, they account for about 5 percent of the state’s approximately 2,200-person prison population. And it’s a smaller subset of the SFI population — 10 to 20 people, as inmate loads ebb and flow — around which the controversy centers.

Vermont’s progressive corrections policies rely on “intermediate sanctions” — supervised community release — to assimilate convicts back into society.

High-needs SFI offenders, however, are a group for whom conventional transitional placements have proven difficult. Addressing their clinical and security needs has in some cases required multiple round-the-clock employees for a single offender, not to mention the overhead for the residential homes in which the convict and his stewards are housed.

“I had contracts coming across my desk for $200,000 and $300,000, and there’s no place in the budget for this population,” Racine said.

After his agency was forced to request a $2.5 million budget adjustment late last year solely for unanticipated SFI-related costs, Racine decided enough was enough.

“So what we have done as an agency is said we are not going to provide that,” he said. “If somebody is coming out of corrections with an SFI designation, or not, and reaches their minimum, and the only way services can be provided in the community is if we have to have two-on-one or three-on-one supervision, then we’re saying if there’s that much of risk, they should stay in Corrections.”

Julie Tessler, executive director of the Vermont Council of Developmental and Mental Health Services, said the agency’s financial decision won’t be without cost.

The transitional services are administered to SFI inmates after they’ve served their minimum jail terms but before they’ve hit their maximums. The threat of return to jail, Tessler said, is often the only leverage for good behavior and participation in treatment programs.

Once they’re in the high-intensity placements, she said, offenders often make tremendous strides they wouldn’t have otherwise. And she said they almost always consent to continued high-level treatment even after they’ve maxed out, and are no longer under the judicial imperative to do so.

Tessler said the kinds of treatment and supports provided in those high-intensity settings is unlike anything the Department of Corrections could hope to administer inside a prison.

“So if you let someone max out, and they pose an ongoing threat to public safety, and are unwilling to participate in treatment, then there’s nothing anybody can do, and it means there’s a potential for someone being hurt,” she said.

“A number of these people have histories of violence, of sex offenses — some people it’s both,” Tessler said. “It’s not just about the safety of the person, it’s about the safety of Vermonters they may be around.”

Corrections Commissioner Andy Pallito said he hasn’t seen any empirical evidence to suggest that offenders who receive high-level transitional treatment enjoy better outcomes than those who max out inside prison.

He also said he’s not convinced that members of the high-needs SFI population always merit the “high risk” tag that’s been attached to them.

Pallito said these are offenders of sound enough mind to have been deemed mentally competent to stand trial for whatever crimes they were convicted of. If they can’t maintain the behavioral standards needed to participate in more conventional transitional settings, he said, then why should taxpayers foot the hundreds of thousands of dollars for specialized round-the-clock oversight?

Pallito said if they are high risk inmates, then the department ought to treat them as it does other offenders in that category — keep them in jail.

“If they were at high risk, we wouldn’t make a decision to release someone on furlough,” he said. “We would have made a decision to keep them in jail.”

Appel, Tessler and others say a study, commissioned by the Legislature last year, proves that conventional correctional settings aren’t suitable environments for many SFI offenders.

A survey of slightly more than half of the SFI population, conducted by the recently departed director of the Vermont State Hospital, found that at least 14 belonged in a secure psychiatric hospital.

Lawmakers are poised to pass another study bill this year, this one establishing a legislative committee to further examine the SFI dilemma this summer.

If lawmakers do try to legislate policy from the Statehouse, then Racine said the solution needs to honor the complexity of the problem, and the severity of its financial impacts.

“If you want to change policy, then be explicit about it, define it,” he said. “And if you want to spend more money, then you need to find that money somewhere in the budget.”

The Vermont Statehouse is often called the people’s house. I am your eyes and ears there. I keep a close eye on how legislation could affect your life; I also regularly speak to the people who write that legislation.
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