agenda

WASHINGTON STATECOMMUNITY PROTECTIONPROGRAM (CPP)

WASPC ConferenceOctober 8, 2014

Moderator: Chris ColemanPanelists: Marci Arthur

Lori Gianetto BareSara 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 - CP Identification15.02 - CP Program Services15.03 - CP Employment Program 15.04 - CP Residential Services15.05 - 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

DDA Sex Offender-Kidnapping Registration Rate

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 of- expression, body language, tone, pitch, volume, articulation

ADDITIONAL CHALLENGESMore concrete styles of thinking

Less ability to abstract and reflectDifficulty generalizing concepts

Difficulty with analogiesMore limited vocabulary

More limited life experienceShort attention spansSuperficial compliance

Trouble understanding cause and effectDifficulty relating to others

Response to abuse

CLINICAL ASSESSMENT OF SEXUAL RISKHistory of sexual behavior

Sexual knowledgeIndividual or solitary sexual behavior

Sexual experiencesSexual arousal and interest

Personal history of victimization/exploitationExposure to pornography

Witnessed sexual behaviorUnderstanding of appropriate versus

inappropriate sexual behavior

OTHER RISK FACTORS TO CONSIDER

IN ASSESSMENT

Family HistoryCriminal History

Drug and Alcohol HistoryMental Health

Medical/Physical HealthEducation/Vocation/Employment History

Social SkillsSupport Systems

Current Environment and Living Situation

TREATMENT INTERVENTIONSHealthy Sexuality

Legal Versus Illegal Sexual BehaviorSexual Arousal and Fantasy Management

BoundariesCycles of Behavior and Patterns

Emotion Expression and RegulationSocial Skills / Relationship Development

Responsibility and AccountabilityIndependent Living Skills

Anger Management

Healthy Choices / Increase Positive Behavior and Decrease Negative

BehaviorConsequential Thinking

Thinking ErrorsRelapse 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 OBSTACLESSex 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


• 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


• 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, [email protected]

• Chris Coleman, [email protected]

• Lori Gianetto Bare, [email protected]

• Sara Straus-King, [email protected]

agenda

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