that have t>een found to contribute to effective drug abuse treatment.
Including ( 1 ) coordinating criminal justice and treatment efforts,
(2) providing incentives to enter treatment, (3) matching offenders with
the most appropriate treatment, and (4) monitoring with drug testing. Drug
abuse experts we spoke with were unaware of any other program that
combined all of these necessary elements in one program.
Coordinates Criminal
Justice and Treatment
A common theme among some of the research literature was the need for
a more coordinated effort between the cnminai justice and treatment
GA(MHSr>-M-41 Tr«at»*at AII#nudvM Prt>cr*»
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systems. For example, a National Institute of Corrections report stated
that linkages are needed to ensure effective communication and
coordination among criminal justice agencies and between these agencies
and treatment providers.' The report concluded that to a£fect an offender's
criminal behavior and drug abuse it is imperative that the two systems
work together. ,
Several sources cited tasc as an effective mechanism to coordinate
criminal justice and treatment efforts. For example, according to the
Director of the Center for Substance Abuse Treatment (csat) within the
Department of Health aiKl Human Services, diversion to treatment requires
TASC or a TASC-Iike mechanism to ensure coordinated case management. A
study of three Wiscoi\sin tasc programs concluded that a nuuor program
strength was its ability to increase commuiucation among criminal justice
agoides and between these agencies and treaunent providers. In addition,
the 1992 National Drug Control Strategy stated that tasc effectively links
crimitud justice and treatment and provides reliable offender management
Provides Incentive to Enter
Community-Based
Treatment
Research indicates that offenders may be more likely to enter and stay in
treatment when faced with possible criminal sanctions, tasc uses the
influence of legal sanctions to encourage drug- abusing offenders to enter
and stay in treatment According to offenders we spoke with, the potential
prison time they faced was a nuyor reason for acceptii\g and remaining in
treatment For example, one offender said she faced 15 years to life if she
did not successfully complete the year-long treatment program.
Matches Offenders With
the Most Appropriate
Treatment
Matching offenders with the most appropriate drug treatment contributes
to more effective treatment According to an ota report matched patients
had higher motivation and stayed in treatment longer than those
mismatched.* Matched patients also experienced less substance abuse 6
months after treatment
Local criminal justice oflBcials told us that tasc enhances the criminal
justice system's ability to assess needs and match offenders with the
appropriate treatment For example, a New York dty probation oCBcial
said that her probation ofBcers are not skilled at matching offenders with
Intervening with Subamice-Abusing Ottenien: A FmneworV for Action , National Institute of
Correctionj (June 1991), pp. 61-52.
TTw EffecDventsa of Dnig Abuae Treannent Imphcationa for Conoolling AIDS/HIV Infection , OIBct
of Technology Asaessment, BacVground paper m (Sept. 1990), p. 90.
Pages
GMVGGD-n^l TreUBcat Alteiautre* PragraB
197
the most appropriate treatment Consequently, she relies on tasc case
managers to perform this function. She also told us that tasc can place
offenders quickly. The New York area tasc programs have formal
agreements with 300 community-based treatment providers.
Monitoring With Drug
Testing Holds Offenders
Accountable
One objective of the National Drug Control Strategy is to hold users
accountable for their behavior. Monitoring offender behavior to ensure
compliance with criminal justice requirements is one way of ensuring user
accountability. Several studies have cited the inability of the criminal
justice system to adequately supervise offenders in the community, such
as those on probation, which decreases user accountability.
Drug testing may ensure that offenders are held accountable and has been
shown to contribute to reducii\g offender drug use For example, research
indicates that drug testing combined with supervision was more effective
at reducing drug use than supervision alone, tasc programs we visited
monitored and reported on offender compliance to criminal justice
ofBcials. For example, programs reported the results from random drug
tests suid whether offenders attended counseling and treatment sessions
and remained drug- and crime-free.
Criminal justice officials believe tasc monitoring and reporting functions
increase the probability that offenders will be held accountable. For
example, two judges told us that before tasc, they had no way of knowing
if defendants complied with court orders to seek drug treatment TTiey
now receive periodic reports on an offender's progress. An assistant
district attorney told us that tasc notifies his office if any changes occur in
the offender's case to enable appropriate action to be takert Probation
officials we spoke with welcomed tasc's enhanced supervision because
probation officers' high caseloads prevent adequate supervision of all
probationers.
ONDCP BeUeves
TASC May Help
Achieve National
Drug Strategy
Objective
The Office of National Drug Control Policy (onix:p) Is the federal agency
responsible for developing and coordinating the implementation of the
nation's drug strategy. In its 1992 National Drug Control Strategy, ondcp
recommended that tasc be expanded and that programs should follow all
model elements. The strategy stated that tasc provides reliable offender
management A strategy objective is to support programs such as tasc that
increase the criminal justice system's capability to identify, refer, and
monitor offenders, onixp's 1991 strategy identified several "challenges"
r*m»
GAQ^GOI>-M.41 TrvaOMBI AJl«nulJv«« Procr«ai
198
B-2S208Z
that must be overcome, including the lack of incentives to seek treatment
and the inability to match offenders to the most appropriate treatment
program. Incentives and matching are part of the tasc model
To implement its recommendation to expand tasc, ondcp is relying on
bja's efforts, which provide information and technical assistance to state
and local governments. According to an ondcp official, ondcp is also
relying on state and local initiative to expand tasc. Although its goal is to
expand tasc to additional locations, ondcp has not targeted any particular
cities for tasc. Also, it has not discussed with relevant agencies the types
and amount of community-based treatment that may be necessary should
tasc be expanded, tasc officials told us that lack of adequate
commimity-based drug treatment was a m^or problem that hindered them
from placing offenders in the most appropriate treatment program. For
example, the Chicago tasc estimated that 26,000 offenders a year in Illinois
need immediate drug treatment, yet only about 25 percent receive needed
services.
Program Results Are
Encouraging but Not
Yet Conclusive
Available research suggests that tasc may help reduce offender drug use
and criminal behavior. According to experts we spoke with, tasc's
effectiveness is supported by the results from the Treatment Outcome
Prospective Study (tops).^ tops showed that tasc identified and referred
more individuals to treatment than would be expected from less formal
cipproaches. tops concluded that longer retention in treatment is
associated with reduced criminal behavior and showed that tasc offenders
stayed in treatment longer than non-TASC criminal justice offenders. The
authors concluded that these findings support efforts to continue and
expand programs such as tasc.
More recent data appears to support earlier findings that tasc offenders do
better than non-TASC offenders. For example, preliminary results from a
1992 study of 271 parolees in Colorado found that only 29 percent of the
TASC parolees returned to prison after 1 year, compared to 42 percent for a
comparable non-TASC group. In addition, at our request the New York tasc
program and a local treatment provider developed data on how long
offenders stayed in treatment. This data showed that 58 percent of the
TASC-managed offenders stayed in treatment 6 months or longer, compared
'The Treaonem Oulcome Prospective Study (Hubbani et al . Uiuveraity of North Carolina Press.
Chapel Hill. 1989) is the primary national study providilig infomiation on program effectiveness. TOPS
interviewed 1 1,750 cbenls who entered 41 treatment programs diinng 1979. 1380. and 1981 Chents
were followed up to 5 years after treatment Some of the chents studied were referred and managed by
TASC programs.
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GA(VGCI>-9S-61 Trcatneat AlteraaUvea Profram
199
to only 27 percent for all cbents. The treatment programy director
attributed this longer retention to the tasc program.
While TASC results are encouraging, we are unable to conclude that tasc is
effective at reducing offender drug use. The tasc programs we visited did
not measure how effective they were at reducing offender drug use.
Officials cited lack of funds and the difficulty of carrying out such
evaluations as reasons for not doing so.
F*rograms generally lacked data chat would allow for other measures of
effectiveness. For example, programs we visited provided data on the
percentage of offenders who successfully completed treatment However,
they lacked comparable data, such as the percentage of similar non-TASC
offenders who completed treatment The lack of data for measuring
effectiveness has been a consistent problem for evaluating tasc programs.
The inability to provide evaluation data can prevent programs &om
obtaining funds. For example, an Arizona criminal Justice official said his
state's tasc program is unlikely to receive state funds until it proves its
effectiveness at reducing drug abuse.
Steps are being taken to address this problem, bja contracted with a
consulting firm to develop a management information system to help tasc
programs improve data collection and analysis, tasc officials are also
discussing what data m the proposed information system can be used to
uniformly measure tasc program effectiveness. In addition, bja added a
section on measuring and evaluating program effectiveneas in its new
program manual.
In September 1991. the nida contracted with the UCLA Drug Abuse
Research Group to conduct an evaluation of tasc effectiveneas. Results
are due in late 1994.
Barriers Limit TASC
Program Potential
Several barriers limit tasc program potential, including (1) inadequate
funding, (2) inconsistent implementation of the tasc program iiodel, and
(3) lack of impact because tasc programs serve a small portion of the
drug-using population and are not located in many areas that have m^Jor
drug problems.
rmat»
200
Inadequate Funding
TASC officials believe inadequate funding is the most significant obstacle to
program expansion. For example, the director of the New York tasc
program said his program operates in only three of the five New York
boroughs. He does not have the funds to expand services to the other two
boroughs even though criminal justice officials in those areas have
requested tasc.
Criminal Justice Block Grant
Funds Generally Not Used for
TASC
In addition, he does not have funds to expand existing programs to reach
more offenders. To relieve jail overcrowding, tasc's funding agency
requires that tasc accept only felons facing mandatory jail time unless they
complete drug treatment The program caimot accept other drug-abusing
offenders, such as those arrested for the first time or juveniles, although
both prosecutors and judges would like them accepted. Research shows
that early intervention with such offenders could increase the probability
of successful treatment ,
On the other hand, the Phoenix tasc program, which focuses on first-time
felons who are casual drug users, also has limitations. The Phoenix tasc
director said she does not have the additional funds to expand services to
offenders with multiple arrests or more serious addictions. Reductions in
funds may result in the closure of some offices and limit the number of
indigent offenders the program can accept
BJA encourages states to use federal criminal justice block grants for tasc
programs.' However, states have spent relatively little of the block grant
funds on tasc programs. According to data supplied by RAND, between
1987 and 1991, 13 states and 1 territory used about $5 million for tasc, less
than 1/2 of 1 percent of $1.2 billion funded duririg this 5-year period.' Four
states, Florida, Indiana, Iowa, and Missouri spent nearly two-thirds of the
approximate $5 million.
EUeven states with tasc programs have not used federal criminal justice
block grants for tasc for two primary reasons. First state officials said
that TASC programs were not a priority, and they use their funds for other
programs, such as drug task forces. Second, block grants are designed to
provide short-term seed money for new or itmovative projects, tasc
The AnS-Dmg Abuse Act of 1988 established the Edward Byme Memorial State and Local Law
Enforcement Assistance Program Under this program, BJA provides block grants to states for
programs that enhance drug control efforts and advance naoonal drug control pnondes. States decide
which programs in their states receive such funds. TASC programs are eligible for such grants under
several of the grant's 2 1 purposes.
^Part of a RAND study of how states have spent their crinunsl justice block grants.
Pa<e9
GA(VGGI>-98-«l Treatment Alternative* Program
201
B-262082
programs in their states were not developing new or expanditxg existing
services and were therefore ineligible.
In addition, there was a difference of opinion among officials on how to
fund TASC. For example, while ondcp and bja have suggested that states
use their criminal justice block grants for tasc, a nida report suggested
federal involvement through either direct funding or a specific block grant
for TASC programs.* In addition, two state officials told us that tasc
programs should be funded by health services grants instead of crimmal
justice grants. However, a csat official told us these grants are generally
reserved for programs that provide treatment and that tasc programs are
not a priority because they generally are not treatment providers.
A former bja official summed up the dilemma by stating that tasc's
greatest strength, to bndge criminal justice and treatment systems, is also
its greatest weakness. She believes that since tasc is part of neither
criminal justice noi treatment, neither system views tasc as its
responsibility to hmd.
However, csdcp and bja officials said the federal govenunent is limited in
what it can do under the criminal justice block grant program. It can only
suggest that certain programs be funded. It is up to state criminal justice
planiung agencies to allocate funds. These officials suggested tasc
directors lobby state and local criminal justice agencies for needed funds.
Inconsistent
Implementation of TASC
Program Model
Currently, there is no process to ensure that all tasc programs contain the
elements practitioners and experts deem essential to program success.
According to a tasc official, as many as 30 percent of the programs may
not follow the tasc model. For example, in order to maintam objectivity
the TASC model requires programs to be independent of criminal justice or
treatment agencies. According to data from tasc, many programs have
become affiliated with either a criminal justice or treatment agency to
obtain needed funding and therefore are not truly independent The nida
report concluded that tasc programs need more secure and consistent
funding to maintain their independence.
To encourage compliance with the tasc model, bja is sponsoring a
certificabon process for tasc programs. According to a tasc official,
certified programs will provide standard services, objectives, and
strategies to enhance the status and acceptance of tasc within criminal
TretliinntAltenMOYMtoStrmCrtrot. NMknnllMUtumwPnuAbimdgBl), p^38.
Pxe 10
GA£VGGI>-M-«I TraUBcat AluraadvM Pnicrma
202
justice and treatment communities. According to data from tasc, as many
as 73 percent of the programs are interested in tasc certification.
Limited Impact on
Offender Population
TASC programs we visited serve a small portion of the overall drug-abusing
population. For example, according to a justice ofBcial in Chicago, of the
13,000 drug offenders processed yearly in 1 county narcotics court, tasc
screened only 1,300 to determine if they were eligible for the program. The
3 New York City tasc programs we visited placed approximately 800
offenders in treatment in 1990. According to a Department of Justice
report, the average daily population for New York city jails is about 17,000,
many of whom are drug abusers. Department of Justice Drug Use
Forecasting data from January to March 1991 shows that 75 percent of the
males arrested in Manhattan tested positive for narcotics.^
Some areas with m^or drug problems, such as San Diego, Los Angeles,
Philadelphia, and Washington, D.C., do not have tasc programs. All of
these cities reported that from January to March 1991 more than
60 percent of their arrestees tested positive for narcotics. According to
tasc ofBcials, state and local ofBcials were either not interested in starting
TASC programs that would be independent of their criminal justice systems,
or they believed the significant funding necessary to implement tasc
would require diverting funds from ongoing drug control programs.
Conclusions
TASC appears to offer promise in helping reduce offender drug use because
(1) elements of the tasc model have been found to be effective and may
help meet drug strategy objectives, and (2) available research suggests
TASC-managed offenders appear to do better than non-TASC offenders.
While promising, program results on tasc's effectiveness at reducing
offender drug use and related criminal behavior are not yet conclusive
because program data are limited.
Federal efforts limited to providing information and technical assistance
about TASC may not be enough to achieve ondcp's goal of expanding tasc
No specific cities have been targeted and although federal officials have
encouraged states to use criminal justice block grant funds for tasc, these
funds are generally not used for tasc. Also, despite federal efforts to
expand this 20-year-old program, tasc is located in fewer states today than
10 years ago.
•Drug Use Forecasting (DUF) data, provided by the NaQoiul Institute of Justice, estimate through drug
testing the percentage of drug use among male arrestees for 24 target cities
Page 11
GACVGGD-93-«l Treatment Altematlvea Pro(raiii
203
Regardless of whether tasc is expanded, barriers, such as a lack of
agreement on how to fund tasc, are limiUng the program's potential and
need to be addressed. While some federal officials believe stales should
use the current criminal justice block grant program for tasc, a nida report
suggested more direct funding is necessary. Also, some state officials
believe tasc should be supported by health grants and not criminal justice
grants. Federal and state officials need to discuss the vanous funding
options available and reach agreement on how to fund tasc.
We believe Ondcp needs to take a more active role to help address these
issues. In its role as coordinator of national drug policy, osdcp is well
placed to act as a catalyst to expand promising programs like tasc and to
help address program barriers, tasc is a cross-cutting program embracing
elements of the cnminal justice and drug treatment systems and involving
federal, state, and local interaction, ondcp is the federal agency that cuts
across agency and functional lines to coordinate national drug policy.
Recommendation to
the Director, ONDCP
Consistent with ondcp's recommendation to expand tasc and its overall
responsibility to coordinate the implementation of the federal drug
strategy, we recommend that the Director of ondcp take several actions to
more strongly emphasize tasc. Specifically, the Director, in concert with
relevant federal and state officials, should (1) identify additional cities that
may benefit &t)m tasc programs, and (2) reach agreement on how tasc
should be funded.
Agency Views
We discussed our findings with okdcp and Department of Justice officials
who generally agreed with the information presented in our report and we
incorporated their comments where appropriate. An ondcp official told us
that given ondcp's recognition of tasc in two national drug strategies, it
would be appropriate for ondcp to more strongly emphasize tasc and try to
help address barriers facing the program. On the basis of our
recommendations, ondcp envisions sponsoring a series of meetings with
other relevant federal and state agencies to identify additional cities where
TASC may be appropriate and to discuss how federal funds should be used
to support TASC. According to an ondcp official, once agreement is reached.
ondcp would communicate this to the states.
Copies of this report will be sent to the House and Senate Appropriation
and Judiciary Committees; the Director, Office of National Driig Control
Pmc li
GA<yBCI>-t»4l
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B-ZSt082
Policy; the Attorney General; and the Secretary of Health and Human
Services. We will make copies available to other interested parties upon
request
Please contact me on (202) 566-0026 if you have any questions concerning
this report Other m^or contributors to this report are listed in appendix
IV.
Sincerely yours,
Harold A. Valentine
Associate Director, Administration
of Justice Issues
Pa<< 13
GA(VGGD-9S-<I Tre*tai«at AIUraatlTe* Pro(rmm
205
Contents
Letter
1
Appendix I
TASC Program Model
16
Appendix II
TASC Model Elements
17
Appendix in
Drug Abuse
Treatment Experts
18
Appendix IV '^
Major Contributors to
This Report
Abbreviations
BlA Bureau of Justice Assistance
CSAT Center for Substance Abuse Treatment
LEAA Law Enforcement Assistance Administration
NIDA National Institute on Drug Abuse
ONDCP Office of National Drug Control Policy
OTA Office of Technology Assessment
TASC Treatment Alternatives to Street Crime
TOPS Treatment Outcome Prospective Study
Paf( 14 GAiyGGD-M-«l Tnuwal AlwnuUvr* Procrmjs
206
Appendix I
TASC Program Model
Communrty
Based Drug
Abuse Treatment
^,,.,-4: J IndctfM TPMbnanI Phut
Pag«16
GAO/GOD-93-61 TreAtnent Altenudvea Progrun
207
Appendix 11
TASC Model Elements
1. Support from and effective communication with criminal justice
systems.
2. Support from and effective communication with treatment community.
3. Independent tasc unit
4. Staff training.
5. Program management and evaluation.
6. Specific offender eligibility criteria.
7. Procedures for identifying offenders.
8. Procedures for assessment, matching, and referral to most appropriate
treatment
9. Drug testing.
10. Monitoring and reporting to the criminal justice system.
rt4t 17 aManot>-l»-*l Tnuaai Alwrvuhro Pra^va
208
Appendix III
Drug Abuse Treatment Experts
Anglin, Douglas
Director
UCLA Drug Abuse Research Group
Flynn, Pat
Research Psychologist
Research Triangle Institute
Hepburn, John
Director
Arizona Institute for Criminal Justice
Hubbard, Robert
Senior Program Director for Alcohol and Drug Abuse Research
Research Triangle Institute
Inciardi, James
Director and Professor
Center for Drug and Alcohol Studies
University of Delaware
Leukefeld, Carl
Director of the Center of Alcohol and Drug Abuse
Professor of Psychology
University of Kentucky
Longshore, Douglas
Operations Manager, tasc Evaluation Project
UCLA Drug Abuse Research Group
McBride, Duane
Professor of Behavioral Sciences
Andrews University
ftS'lS GMi/GGD-9Z-» 1 Treatment Altenutlvc* Prognun
209
Appendix IV
Major Contributors to This Report
General Government *t** "^5"^ ^*'**^ '***^' Ad^nmistration of
. . „, , . Justice Issues
Division, Washington, Sam Caldrone, Assignment Manager
J) Q Barry J. Seltser, Senior Social Science Analyst
Teiri L White, Secretary
Los Angeles Regional ^ * ?^"^- ^^^^"^^^ ^^^''^'- Adnumsuation of