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Performance Audit Report - IA DOC Substance Abuse Programs, IA DMPAP, 2007

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Does Prison Substance Abuse
Treatment Reduce Recidivism?

Performance Audit Report
Iowa Department of Corrections
Licensed Substance Abuse Programs
May 25, 2007

Iowa Department of Management
Performance Audit Program

Iowa Department of Management
Performance Audit Program
State Capitol Building
1007 East Grand
Des Moines, IA 50319
Scott J. Vander Hart, Performance Auditor
515/281-6536
515/242-5897 FAX
Scott.VanderHart@iowa.gov

The Iowa Legislature has given the Iowa Department of
Management (IDOM) authority to implement a system of
periodic performance audits in consultation with the
Legislative Services Agency, Auditor of State and executive
branch agencies.
The performance audit is a key component of the Iowa
Accountable Government Act. Its purpose is to evaluate
agency performance, including program effectiveness, based
on performance measures, targets and supporting data.
In response, IDOM has created the consultative Performance
Audit Program designed to improve state agencies ability to
achieve and demonstrate key results by offering relevant and
practical solutions to performance challenges.

DOC Licensed Substance Abuse Programs

Page 1

Executive Summary

Report Highlights:
Þ 59.6% of offenders with

substance abuse needs are
released without treatment.

Þ 12.1% of offenders treated for

substance abuse problems are
convicted of new offenses
within 12 months of release.

Þ Substance abuse treatment
reduces new conviction
recidivism by 2.4%.

Þ Less than 50% of substance

abuse interventions reduce
both new conviction and total
recidivism.

Þ Programs had little effect on

prison population, operational
cost savings, and overall crime
reduction.

Þ Mental health issues,

community support, and
implementation of evidencebased practices can
significantly influence
outcomes.

Inside this Report:
Background

2

% of Offenders Released
without Treatment

9

Program effectiveness at
preventing recidivism

11

Consequences of programs
results

20

Issues significantly
influencing program results

23

Conclusions and
Recommendations

42

Department of Corrections
Response

56

Appendices

57

The Iowa Department of Corrections faces a growing prison
population expected to quickly exceed current capacities.
Additionally, nine out of every ten offenders have a history
of alcohol or drug problems often both. Research
suggests that alcohol and drugs lead to criminal behavior,
which lead offenders right back to prison creating a
vicious circle and placing a financial and societal burden on
the state. However, research also shows that substance
abuse treatment can minimize criminal behavior, and offers
a way to shut the revolving prison door.
Substance abuse programming attempts to change
offender thinking patterns and behavior in order to facilitate
re-entry back into the community, lessen substance abuse
relapse and reduce recidivism. Yet nearly 60% of offenders
with identified needs are not treated, and many lacking
treatment are high risk. Additionally, the percentage of
offenders returning to prison varies significantly from
program to program and some programs can not show
they have reduced recidivism when compared to offender
groups with substance abuse problems and receiving no
treatment at all. All of which minimize the effect substance
abuse programming has in curbing prison population
growth and reducing crime.
The Department of Corrections intends to reduce recidivism
through evaluation of program fidelity and implementation
of evidence-based practices. Many of the programs are
already structured to accommodate continuous
improvement centered on desired outcomes. Population
characteristics and the type and level of community support
can also significantly influence recidivism. All of which call
for the department to:
Þ Enhance community support and other re-entry

initiatives to reinforce desired behaviors in the
community where offenders face situations that can
lead to relapse and criminal behavior; and

Þ Develop planning, evaluation and service delivery

approaches that support integrated substance abuse
programming across the prison and correctional system,
and enable internal benchmarking of best practices.

DOC Licensed Substance Abuse Programs

Page 2

Background
The National Institute on Drug Abuse
and continued use persists regardless
(NIDA), one of the federal
of medical, psychological, and social
government s lead agencies for
consequences. Methamphetamine,
substance abuse research, describes
Marijuana and Cocaine were identified
drug addiction as a complex illness,
as the three most prominent drugs
characterized by compulsive, at
used/abused by offenders in Iowa s
times, uncontrollable drug
prison system (Prell Substance
Overtime, an
craving, seeking and use
Abuse 5). Short-term effects
individual s
Drug Abuse Treatment 9).
of such drug use include:
ability
to
choose
In 2004, 83% of state
impaired motor function and
not to take drugs
prisoners had used illegal
judgment, and bizarre, erratic
diminishes,
and
drugs, and 53% met the
and violent behavior in high
continued use
DSM-IV1 criteria for drug
doses (such as with cocaine).
persists
dependence or abuse
Long-term effects include:
regardless
of
(Mumola and Karberg 1).
addiction, mood disturbances,
medical,
The Department of
irritability, aggressive and
psychological,
Corrections (DOC) findings
violent behavior, paranoia,
and social
are similar. 90% of
hallucinations, and healthconsequences.
offenders within the prison
related problems (NIDA
system have a history of
Cocaine 4-5, Marijuana 5,
alcohol or drug problems, and roughly
Methamphetamine 5).
60% have had problems with both
drugs and alcohol (Prell Substance
Aggressive and violent behaviors and
Abuse 5). The statistics make
other drug effects can lead to criminal
Drugs/Alcohol the top priority need of
offenses. Illegal drug use was found to
offenders within prison (DOC Strategic
increase the odds of committing any
Plan 19).
crime sixfold (NIJ Adult Patterns ).
According to Mumola and Karberg,
nearly a third of state prisoners
Alcohol and Drug Use and
nationally were under the influence of
Abuse Can Lead to Criminal
illegal substances at the time of their
Behavior
offense, and over half had taken drugs
Drug use can lead to addiction,
within the month of their offense (2).
negative behaviors, and many health
There is also an association between
related problems. Even experimental
drug use and re-occurring crime. 21%
use can quickly grow into an addiction
more state prisoners dependent on or
depending on individual vulnerabilities.
abusing drugs also had at least three
Over time, an individual s ability to
prior sentences to probation or
choose not to take drugs diminishes,
incarceration when compared to other
inmates (Mumola and Karberg, 1).
1

Criteria specified in the Diagnostic and
Statistical Manual of Mental Disorders, fourth
edition (DSM-IV).

DOC Licensed Substance Abuse Programs

Page 3

Recent meta-analyses of treatment
program evaluations generally support
the use of substance abuse
Substance abuse is a recognized
programming as a means to reduce
dynamic risk factor2, altering the need
drug use and criminal behavior. A
can increase the likelihood of changing
meta-analysis conducted by
the criminal behavior and closing the
Prendergast et al. concluded that
revolving prison door (National
treatment programs, as practiced in
Institute of Corrections 5; Bonta Riskthe United States, are effective at
Needs 23). Long-term use of drugs
reducing drug use and crime (66).3
can temporarily and permanently alter
The average effect sizes for drug use
brain anatomy and chemistry. The
and crime were both positive
alterations persists long after drug use
indicating on average, clients who
(months to years) making it extremely
participated in treatment had better
difficult for addicts to quit on their own
outcomes than did those who received
(NIDA Drug Abuse Treatment 14;
no treatment or those who received
Treatment for Criminal Justice
minimal treatment (61).4 Effect sizes
Populations 1). This makes drug
were translated to reflect a 15% higher
addicts high risk for relapse even after
success rate on drug use outcomes,
prolonged periods of
and a 6% higher success rate
abstinence, suggesting the
evaluations
on crime outcomes for
need for treatment even
generally support treatment groups (63).5
with longer prison
the use of
Prendergast s study helped
sentences.
substance abuse
dismiss claims that drug
programming as
treatment was not effective,
DOC intends to impact and
a means to
and refocus on the question of
reduce recidivism of
reduce drug use
how can treatment be
offenders through evidenceand criminal
improved, and better address
based programming
behavior.
the needs of clients.
Strategic Plan 5,
Performance Plan 1, SelfAn analysis by Mitchell, Wilson, and
Assessment 15, 19, 38). According
MacKenzie focused more closely on
to NIDA, substance abuse treatment
the subject of this audit
has the potential to support this effort.
They state, Treatment offers the best
3
alternative for interrupting the drug
Meta-analysis conducted on 78 drug treatment
abuse/criminal justice cycle
studies conducted between 1965 and 1996.
However, only 25 of the studies had crime
Treatment for Criminal Justice
outcome information. The analysis compared
Populations 13).

Treatment Can Reduce Criminal
Behavior

2

Dynamic or changeable risk factors are also
known as criminogenic needs and serve as
predictors to criminal behavior.

those who received drug treatment to those who
received minimal or no treatment. 59% of the
studies assigned participants randomly or quasirandomly.
4
Effect size is an index that measures the
magnitude of a treatment effect.
5
Binomial effect size display (BESD) equivalent
was used to determine the success rates.

DOC Licensed Substance Abuse Programs

Page 4

further support the use of substance
incarceration-based substance abuse
abuse programs within correctional
treatment programs. They conclude
settings. They concluded that inmates
that incarceration-based programs are
receiving in-prison residential
modestly effective in reducing
treatment were less likely to be rerecidivism .6 In the study, the general
arrested than untreated inmates
recidivism odds-ratio favored the
within the first six months after release
treatment group over the comparison
(329).9
group in 83% of the 65 evaluations
having at least one measure for postrelease offending.7 The general
Prison Programming
recidivism rate is translated to be 7%
The DOC attempts to address
lower for treatment groups.
Programs are
this problem through the
Far fewer of the
intended
to
provision of substance abuse
independent evaluations
change
offender
programming to offenders
reviewed in this study
thinking patterns
through 15 licensed programs
assessed post-release drug
and
behaviors
in
in eight institutions.10 In SFY
use. The meta-analysis
order to reduce
2006, the licensed substance
results for drug use
recidivism.
abuse programs collectively
outcomes were not found to
had the capacity to serve 2,014
be statistically significant
offenders. In SFY 2007, the
(12, 17).8 In a study of
DOC budgeted $3.1 million for the
substance abuse programs within the
delivery of licensed substance abuse
federal prison system, Pelissier et al.
programs ( Budget Details 2).
6

The meta-analysis was based on 53 unique
studies reporting the results of 66 independent
evaluations with interventions conducted
between 1980 and 2004. Two-thirds of the
studies were post-1996. The scope was the
review was experimental and quasi-experimental
evaluations of incarceration-based drug
treatment programs for juveniles and adults that
utilized a comparison group (no or minimal
treatment).
7
General recidivism included re-arrests, reconvictions, and re-incarcerations.
8
The odds-ratio compared the odds of an event
occurring in comparison group to the odds of it
occurring in the treatment group. The mean
odds-ratio for the general recidivism was 1.37,
re-arrests 1.40, re-convictions 1.43, and reincarcerations 1.22. An odds ratio of 1 implies
that the event is equally likely in both groups.
Results greater than one indicates that the
recidivism event is more likely to happen in
comparison group, values less than one would
make it less likely to occur. All were found to be
statistically significant.

Although the substance abuse
programs were often developed
independently at the institutional-level,
they all share a common purpose.
Most employees, managers and
stakeholders believe that the
programs are intended to change
offender thinking patterns and
behavior in order to facilitate re-entry
back into the community, lessen
substance abuse relapse, and reduce
recidivism (Performance Audit
9

Male and female treatment subjects were drawn
from 20 different prisons of medium, low and
minimum security levels. Comparison subjects
were drawn from over 30 prisons. Both groups
were limited to those released to supervision.
10
Programs conform to the licensure standards
outlined in 641 Iowa Administrative Code
Chapter 156.

DOC Licensed Substance Abuse Programs

Manager Interviews, Employee Survey,
and Stakeholder Survey). However,
how the programs fulfill this purpose
differs:
Þ the level of treatment varies among

the licensed programs, four are
inpatient residential programs, one
is an intensive outpatient program,
and the remaining programs are
outpatient;

Þ the minimum program duration

generally ranges from 12 to 40
weeks (however, one program is
significantly longer spanning an
18 month period);
Þ the hours per week spent in or

intensity of program activities vary
among programs, and in many
cases are dependent on individual
case plans; and

Page 5

Many other factors can affect their
ability to do so, and as time passes the
programs degree of influence
diminishes. Figure 1 reflects the
relationships among program activities
and desirable results, as well as
factors that can influence results.
Patient with
Substance Abuse
Need

Staff and Program
Resources

Intake &
Orientation

Assessment &
Treatment Plan
Development

Factors Internal to
System that Influence
Results:
- Level of Resources
- Level of Service &
Matching Treatment
- Clinical Oversight
- Staff Abilities
- Staff Engagement
- Climate
-Therapeutic
Relationships
- Practices Used
- Dosage
- Offender Retention
-Treatment Timing

Substance
Abuse
Programming
System

However, the programs do share some
common ground with 11 of the 15
programs using curriculums
specifically incorporating cognitive and
cognitive-behavioral therapies. One
program also uses a gender specific
curriculum designed to help women
recover from substance abuse. Two
programs curriculums are eclectic
drawing from a variety of sources.
Although the programs are attempting
to lessen substance abuse relapse
and criminal behavior, it is important
to note they can not control the results
but can only hope to influence them.

Readiness

Addiction
Severity

Mental Health

Age

Criminal History

Þ the number of offenders per staff

person also varies significantly
from six offenders for every staff
person to 40.

Motivation

Implements
Treatment Plan/
Programming

Monitors Progress

Successful
Treatment
Completion

Improved
Awareness/
Enhanced skills

Other
Interventions

Factors External
to System that
Influence Results

Post-Release
Supervision

Employment

Programs
Desired
Outcomes

Lessen Relapse

Social
Environment

Family Support
Reduced Criminal
Behavior
Continuing Care

Figure 1: General Logic Model for the DOC s
Substance Abuse Programs.

DOC Licensed Substance Abuse Programs

Page 6

Audit Scope, Objectives and Methodology
The performance audit focused on the
licensed substance abuse programs
available to offenders in prison.
Substance abuse programs were
selected, since substance abuse is the
top criminogenic need among
offenders within Iowa s prison
system.11 The use of evidence-based
practices is also a key strategy
embraced by DOC to reduce offender
recidivism, which can influence the
means for which treatment is
delivered. The offender population
was set using offenders released
between October 1, 2004 and
December 31, 2005. The timeframe
was limited because of availability of
substance abuse intervention data in
Iowa Corrections Offender Network
(ICON).
The follow-up period to capture
recidivism information was one year.
Two recidivism measures were used:
new conviction resulting in prison or
community supervision; and new
conviction or return to prison for any
reason (i.e. total recidivism rate). Exit
or release was based on release from
prison due to end of sentence or
entrance into community supervision.
The performance audit s purpose,
developed as part of Iowa s
Accountable Government Act, is to
evaluate agency performance,
including program effectiveness,
based on performance measures,
11

Criminogenic needs are attributes of an
offender that when changed can reduce the
probability of criminal behavior.

targets and supporting. In accordance
with the program s legislative purpose,
the following objectives were
established to evaluate the
effectiveness of licensed substance
abuse programs within DOC:
Objective 1: What percentage of
offenders with a history of substance
abuse is released without treatment?
Objective 2: Are the DOC s licensed
substance abuse programs effective at
preventing offenders from being
reconvicted for new offenses and
returned to the correctional system?
What are the consequences of the
programs being effective or ineffective
and why?
1) Condition What are the
recidivism rates for offenders
successfully completing licensed
substance abuse programs 12
months following release from
prison?
2) Criteria How do the 12 month
recidivism rates of offenders
successfully completing the
substance abuse program compare
to:
a) offenders from the same
institution with a history of
substance abuse, but received
no treatment;
b) offenders who started the same
program, but did not
successfully complete it; and
c) offenders from the same
institution without a history of
substance abuse?

DOC Licensed Substance Abuse Programs

3) Effect How does this impact
corrections population growth and
operational costs?
4) Causes
a) Do the following variables
significantly influence
recidivism rates:
i) Co-occurring mental health
problems,
ii) Length of time between
treatment and release,
iii) LSI-R score, and
iv) Participation in community
aftercare?
b) How does program
management, structure and
staffing influence recidivism
rates?
Substance abuse needs were
identified by LSI-R, Iowa Risk, Custody
Classifications, or Jesness
Assessments. Treatment groups
institution and location were defined
by location where treatment was
concluded, which may differ from an
offender s release location.
Comparison groups institution and
location were based on offenders
location at time of release for
offenders comprising these groups.
Comparisons were made by reviewing
the difference in recidivism rates
between the treatment group and the
comparison groups at the same
institution or location. The recidivism
rates from the comparison group were
subtracted from the recidivism rate of
the treatment group to determine the
difference. Negative values reflect
positive results the expectation is
that treatment groups will have a lower
recidivism rate.

Page 7

Causes were reviewed primarily by
controlling for the specific variable of
interest to see if a pattern emerges in
recidivism rates. Where patterns
emerged at the department-wide and
institutional levels, population
characteristics were reviewed at the
program level if possible. Differences
in population characteristics between
treatment group and comparison
group were examined specifically for
co-occurring mental health problems,
LSI-R scores, and offender
demographics. Length of time
between treatment and release, and
participation in community aftercare
were reviewed for each treatment
group at the institution and program
level where possible.
The review of program management,
structure and staffing was limited
since many offenders received
treatment two to three years ago.
Observations made during the audit,
may not be representative to how the
program operated at the time
offenders in the data set were treated.
Additionally, previous evidence-based
program assessments were conducted
roughly two years prior to the offenders
receiving treatment, and they were
limited to five of the 15 programs.
These evaluations are also limited to a
specific point in time, and may not
adequately reflect how the offenders in
this data set were treated.
The variables were compared to
differences in recidivism rates for each
program to identify those which appear
to affect the difference. The data
collection methodology for the
performance audit is provided in
Appendix A. The data was

DOC Licensed Substance Abuse Programs

supplemented with policy and
procedure manual reviews, manager
interviews and employee and
stakeholder surveys.

Page 8

DOC Licensed Substance Abuse Programs

Page 9

What percentage of offenders with a history of
substance abuse is released without treatment?
Lack of treatment resources was one
of the most pressing issues noted by
managers, stakeholder and employees
alike. Budget and staffing reductions
and available treatment space limit
DOC s ability to provide substance
abuse treatment to many of the
offenders in need (Performance Audit
Employee Survey, Stakeholder
Survey; Howard and Phillips; Dick and
Comp; Dursky et al.; Bagby; Austin and
Kelly). Of those released from prison

between October 1, 2004 and
December 31, 2005, slightly less than
60% of the offenders with substance
abuse needs had not received
substance abuse treatment, as shown
in Figure 2. North Central Correctional
Facility had the largest percentage of
offenders with substance abuse needs
released without treatment at 85.4%
and Clarinda Correctional Facility the
fewest at 36.6%, as shown in Table 1.

Percent of Offenders with Substance Abuse Need Released without Treatment

Group
SA Need/No Prison
Treatment
SA Need/Successful
Prison Treatment
SA Need/Unsuccessful
Prison Treatment
SA Need/Prison Treatment
- Other

59.6%

Figure 2: Percent of Offenders with Substance Abuse Need Released without Substance Abuse
Treatment.

DOC Licensed Substance Abuse Programs

Page 10

% of Offenders with Substance Abuse Needs Released without Treatment by Institution
SA Need
/No Prison
Treatment

SA Need
/Successful
Prison
Treatment

SA Need /
Unsuccessful
Prison
Treatment

SA Need
/Prison
Treatment Other

Total

Anamosa State Penitentiary

53.2%

39.1%

4.7%

3.0%

100.0%

Clarinda Correctional Facility

36.6%

52.5%

9.1%

1.8%

100.0%

Fort Dodge Correctional Facility

60.4%

34.5%

3.5%

1.6%

100.0%

Iowa Correctional Institution for Women

56.7%

36.8%

4.7%

1.8%

100.0%

Iowa Medical & Classification Center

81.3%

13.5%

3.1%

2.1%

100.0%

Iowa State Penitentiary

82.4%

13.7%

1.1%

2.8%

100.0%

Mount Pleasant Correctional Facility

43.8%

51.5%

1.2%

3.4%

100.0%

North Central Correctional Facility

85.4%

13.1%

.9%

.7%

100.0%

Newton Correctional Facility

64.0%

33.1%

1.6%

1.3%

100.0%

Total

59.6%

35.1%

3.3%

2.0%

100.0%

Institution

Table 1: Percentage of Offenders with Substance Abuse Needs Released without Treatment by
Institution.

DOC Licensed Substance Abuse Programs

Page 11

Are the DOC s licensed substance abuse programs
effective at preventing offenders from being reconvicted
for new offenses and returned to the correctional
system?
The DOC s licensed substance abuse programs have a new conviction recidivism rate
of 12.1% and total recidivism rate of 26.6% at twelve months following release for
the time period reviewed. Overall, these programs slightly reduce new conviction
recidivism department-wide, but do not effect the total recidivism rate. As the data is
disaggregated to the institution and intervention level, it demonstrates not all
institutions performance is the same, and that not all interventions (i.e. substance
abuse programs) are equally effective at reducing recidivism.
Key findings:
Þ 12.1% of offenders released after successful completion of substance abuse treatment
Þ
Þ
Þ
Þ

are convicted for new offenses within 12 months; 26.6% return for either new offenses
or technical violations.
New conviction recidivism rates range from 3.4% to 21.1% for substance abuse
programs; total recidivism rates range from 7.1% to 41.7%.
Department-wide substance abuse treatment slightly lowers new conviction recidivism by
2.4%, but not total recidivism.
Substance abuse treatment lowers new conviction and total recidivism in three out of
eight institutions Newton Correctional Facility (NCF) and Iowa State Penitentiary (ISP)
have the best overall performance.
In eight out of 17 substance abuse interventions, substance abuse treatment lowers
both new conviction and total recidivism. PSD and IFI at the Newton Correctional Facility
stand out among the group.

12.1% of offenders with successful substance abuse treatment are
convicted for new offenses within 12 months of release, and 26.6%
return for either new offenses or technical violations.
As shown in figure 3, the new
conviction recidivism rate for offenders
successfully completing treatment was
12.1% 12 months following release
from prison. Among institutions, new
conviction recidivism rates ranged
from 5.1% (Iowa State Penitentiary) to
16.2% (Anamosa State Penitentiary).
The total recidivism rate for this
population was 26.6% departmentwide. Fort Dodge Correctional Facility

had the highest total recidivism rate at
38.7% and Iowa State Penitentiary the
lowest at 15.4%. New conviction
recidivism rates for programs, as
shown in figure 4, ranged from 3.4%
(PSD at Newton Correctional Facility)
and 21.1% (Violator s Program at
ICIW). Total recidivism rates ranged
from a low of 7.1% (STAR) to 41.7%
(TC at Anamosa State Penitentiary).

DOC Licensed Substance Abuse Programs

Page 12

Recidivism Rates at 12 Months for Offenders Successfully Completing Substance Abuse
Treatment - Department-wide and by Institution
45.0%
40.0%

38.7%

37.2%

35.0%
29.4%

30.0%
26.6%
25.0%

16.2%
15.0%

21.1%

19.7%

20.0%

19.2%
16.7%

15.4%

15.1%
13.5%

12.1%

11.6%

11.2%

11.5%

10.0%
5.9%

5.1%

5.0%
0.0%
Departmentwide

Anamosa
State
Penitentiary

Clarinda
Correctional
Facility

Fort Dodge
Correctional
Facility

Iowa
Correctional
Institution for
Women

New Conviction Recidivism

Iowa State
Penitentiary

Mount
Pleasant
Correctional
Facility

Newton
Correctional
Facility

North Central
Correctional
Facility

Total Recidivism

Figure 3: New conviction and total recidivism rates of offenders successfully completing substance
abuse treatment 12 months subsequent to release both department-wide and by institution. Data for
figure provided in Table 2 and Appendix B.

Recidivism Rates at 12 Months for Offenders Successfully Completing Substance Abuse
Treatment by Program
45.0%
40.0%
35.0%
30.0%
25.0%
20.0%
15.0%
10.0%
5.0%

New Conviction Recidivism

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tie
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0.0%

Total Recidivism

Figure 4: New conviction and total recidivism rates of offenders successfully completing substance
abuse treatment 12 months subsequent to release by program. Data for figure provided in Appendix
C.

DOC Licensed Substance Abuse Programs

Page 13

Department-wide substance abuse treatment slightly lowers new
conviction recidivism, but not total recidivism.
needs and no treatment within prison.
Within the prison system, new
Although fewer offenders with
conviction recidivism rates were 0.3%
successful substance abuse program
lower for offenders successfully
completion were reconvicted
completing substance
Substance abuse
for new offenses, more
abuse treatment programs
treatment
returned to the correctional
compared to offenders with
reduces new
system due to technical
substance abuse needs
conviction
violations. Collectively, DOC s
receiving no treatment in
recidivism for
substance abuse programs did
prison. The difference in
those with
not demonstrate success for
new conviction recidivism
substance abuse
either new convictions or total
rates associates
need by 2.4%
recidivism rates or when
Department-wide successful
department-wide.
compared to offenders
substance abuse treatment
released with no substance abuse
with a 2.4% reduction in recidivism for
needs. See Table 2 for additional
new convictions12. However, the total
information.
recidivism rate for offenders
successfully completing substance
abuse treatment is 0.5% higher than
those offenders with substance abuse
Recidivism Rates by Comparison Group

Did Not
Recidivate

Comparison Group
No SA Need
SA Need/No Prison Treatment
SA Need/Successful Prison Treatment
SA Need/Unsuccessful Prison Treatment
SA Need/Prison Treatment - Other
Total

General Population

Count

% change = ((12.4%-12.1%)/12.4%) X 100

Total
184

%

78.2%

11.2%

10.7%

21.8%

Count

1893

314

321

635

%

74.9%

12.4%

12.7%

25.1%

Count

1095

180

216

396

%

73.4%

12.1%

14.5%

26.6%

Count
%
Count
%

95

22

24

46

67.4%

15.6%

17.0%

32.6%

63

9

11

20

75.9%

10.8%

13.3%

24.1%

Count

3805

619

662

1281

%

74.8%

12.2%

13.0%

25.2%

Table 2: Recidivism Rates by Comparison Group.

12

659

Recidivism Rates
New
Technical
Convictions
Violations
94
90

DOC Licensed Substance Abuse Programs

Page 14

In three out of eight institutions, substance abuse treatment lowers new
conviction and total recidivism.
NCF and ISP were the only institutions
to show success for both new
conviction and total recidivism when
compared to the substance abuse
need/no prison treatment and no
substance abuse need comparison
groups. North Central Correctional
Facility (NCCF) also reflected
improvement relative to new
conviction and total recidivism, but
only when compared to the substance
abuse need/no prison treatment
group.

offenders from the same institution
with no substance abuse needs, see
Figure 6. Iowa Correctional Institution
for Women (ICIW), Anamosa State
Penitentiary (ASP), and Mount
Pleasant Correctional Facility (MPCF)
had higher rates of new conviction
recidivism for offenders successfully
completing substance abuse
treatment compared to offenders with
no substance abuse need and those
with substance abuse need/no
treatment.

The review of total recidivism rates
Five of the eight institutions with
reflected similar results. Five
licensed substance abuse
of eight institutions with
programs had 0.5 to 7.9%
Only NCF and ISP
licensed substance abuse
lower new conviction
have lower new
programs have lower total
recidivism rates for offenders
conviction and
recidivism rates for offenders
successfully completing
total recidivism
successfully completing
substance abuse treatment
rates among those
successfully
substance abuse treatment
compared to offenders within
completing
compared to offenders from
the same institution with
treatment
same institution with
substance abuse needs, but
regardless
of
substance abuse needs.
no treatment within prison.
comparison group
NCF, NCCF, ISP, ICIW and
As a result, within the NCF,
evaluated.
MPCF had total recidivism
ISP, Fort Dodge Correctional
rates ranging 1.2 to 12.4%
Facility (FDCF), NCCF, and
lower for offenders with
Clarinda Correctional Facility
successful substance abuse treatment
(CCF), substance abuse treatment can
than those with a substance abuse
be associated with a 3.4 to 57.2%
need and no treatment, as shown in
reduction in new conviction recidivism
Figure 7. Within the five institutions,
depending on the institution. Figure 5
successful substance abuse treatment
provides additional information. Three
can be associated with a 5.4 to 42.6%
of the five institutions (NCF, ISP, and
reduction in total recidivism depending
NCCF) also demonstrated lower
on the institution. Additionally, ISP,
recidivism rates for offenders
NCF, and NCCF had lower total
successfully completing substance
recidivism rates than offenders from
abuse treatment compared to

DOC Licensed Substance Abuse Programs

Page 15

abuse treatment compared to either
offenders with no substance abuse
need or those with a substance abuse
need/no treatment.

the same institution with no substance
abuse needs, as shown in Figure 8.
CCF, ASP, and FDCF had higher total
recidivism rates for offenders
successfully completing substance

New Conviction Recidivism Rate - Difference Between Successful Treatment and Substance
Abuse Need/No Treatment by Institution
-10.0%

-8.0%

-6.0%

-4.0%

-2.0%

0.0%

2.0%

4.0%

6.0%

Newton Correctional Facility

Iowa State Penitentiary

Fort Dodge Correctional Facility

North Central Correctional Facility

Clarinda Correctional Facility

Iowa Correctional Institution for
Women

Anamosa State Penitentiary

Mount Pleasant Correctional Facility

Figure 5: Reflects the difference between new conviction recidivism rates for offenders successfully completing
substance abuse treatment and offenders with substance abuse needs without prison treatment by institution.
Negative values correspond to positive results. Figure based on data provided in Appendix B.

DOC Licensed Substance Abuse Programs

Page 16

New Conviction Recidivism Rate - Difference Between Successful Treatment and No
Substance Abuse Need by Institution
-10.0%

-8.0%

-6.0%

-4.0%

-2.0%

0.0%

2.0%

4.0%

6.0%

8.0%

Newton Correctional Facility

Iowa State Penitentiary

Fort Dodge Correctional Facility

Clarinda Correctional Facility

Iowa Correctional Institution for
Women

North Central Correctional Facility

Mount Pleasant Correctional Facility

Anamosa State Penitentiary

Figure 6: Reflects the difference between new conviction recidivism rates for offenders successfully completing
substance abuse treatment and offenders with no substance abuse need by institution. Negative values
correspond to positive results. Figure based on data provided in Appendix B.

Total Recidivism Rate - Difference Between Successful Treatment and Substance Abuse
Need/No Treatment by Institution
-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

Newton Correctional Facility

North Central Correctional Facility

Iowa State Penitentiary

Iowa Correctional Institution for
Women

Mount Pleasant Correctional Facility

Clarinda Correctional Facility

Anamosa State Penitentiary

Fort Dodge Correctional Facility

Figure 7: Reflects the difference between total recidivism rates for offenders successfully completing substance
abuse treatment and offenders with substance abuse needs and no prison substance abuse treatment by
institution. Negative values correspond to positive results. Figure based on data provided in Appendix B.

DOC Licensed Substance Abuse Programs

Page 17

Total Recidivism Rate - Difference Between Successful Treatment and No Substance Abuse
Need by Institution
-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%

Iowa State Penitentiary

Newton Correctional Facility

North Central Correctional Facility

Iowa Correctional Institution for
Women

Fort Dodge Correctional Facility

Mount Pleasant Correctional Facility

Clarinda Correctional Facility

Anamosa State Penitentiary

Figure 8: Reflects the difference between total recidivism rates for offenders successfully completing substance
abuse treatment and offenders with no substance abuse need by institution. Negative values correspond to
positive results. Figure based on data provided in Appendix B.

In eight out of 17 substance abuse interventions, treatment lowers both
new conviction and total recidivism.
Only eight of the 17 substance abuse
interventions reduced both new
conviction and total recidivism rates,
which include:
Þ PCD (NCF),
Þ IFI (NCF),
Þ Project TEA (ISP
Þ
Þ
Þ
Þ

John Bennett
Unit only),
Luster Heights SAP (ASP
Luster Heights),
STAR (ICIW),
SAT/Criminality (NCF
Correctional Release Center),
Journey (NCCF), and

Þ TOW (CCF

Lodge only).13

12 out of 17 substance abuse
interventions had 1.1 to 14.0% lower
new conviction recidivism rates for
offenders successfully completing
substance abuse treatment compared
to offenders at the same location with
a substance abuse need, but receiving
no treatment as shown in Figure 9.
Successful completion in substance
13

TOW and Project TEA were reviewed at more
than one location accounting for 17
interventions compared to the 15 licensed
programs previously noted. Project TEA at FM1
was excluded from the analysis for small
population size only one offender was released
during timeframe reviewed.

DOC Licensed Substance Abuse Programs

Page 18

substance abuse need, but no
treatment as shown in Figure 10.
Successful substance abuse
treatment, within the ten interventions,
was associated with an 8.4 to 50.5%
decrease in total recidivism rates.
Four programs stand out among the
programs provided by DOC PCD and
IFI at NCF, STAR at ICIW, and the
Luster Heights Substance Abuse
Program at ASP.

abuse treatment was associated with
a 1.1 to 80.2% reduction (depending
on intervention) in new conviction
recidivism. Three programs stand out
PCD and IFI at NCF, and Project TEA
at the John Bennett Unit within ISP.
However, substance abuse
interventions were slightly less
successful with total recidivism. Ten
out of 17 substance abuse
interventions had 2.0 to 17.4% lower
total recidivism rates for offenders
successfully completing substance
abuse programs compared to
offenders at the same location with a

ALTA at ASP, and WINGS and Violator s
Program Regular at ICIW did not
reduce either measure of recidivism.

New Conviction Recidivism Rate - Difference Between Successful Treatment and Substance
Abuse Need/No Treatment by Intervention
-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%
PCD
IFI
Project TEA @ JBU
Luster Heights SAP
STAR
New Frontiers
Violator's Program - Regular @ CRC
SAT/Criminality
Journey
TOW @ CCF
TC
TOW @ CCFL
Project TEA @ FM3
WINGS
SAP @ MPCF
ALTA
Violator's Program-Regular @ ICIW

Figure 9: Reflects the difference between new conviction recidivism rates for offenders successfully completing
substance abuse treatment and offenders with substance abuse needs and no prison substance abuse treatment
by intervention. Negative values correspond to positive results. Figure based on data provided in Appendix C.

DOC Licensed Substance Abuse Programs

Page 19

Total Recidivism Rate - Difference Between Successful Treatment and Substance Abuse
Need/No Treatment by Intervention
-20.0%

-15.0%

-10.0%

-5.0%

0.0%

5.0%

10.0%

15.0%

20.0%
IFI
STAR
PCD
Luster Heights SAP
Project TEA @ FM3
SAT/Criminality
Project TEA @ JBU
Journey
SAP @ MPCF
TOW @ CCFL
WINGS
Violator's Program - Regular @ CRC
TOW @ CCF
ALTA
New Frontiers
TC
Violator's Program-Regular @ ICIW

Figure 10: Reflects the difference between total recidivism rates for offenders successfully completing substance
abuse treatment and offenders with substance abuse needs and no prison substance abuse treatment by
intervention. Negative values correspond to positive results. Figure based on data provided in Appendix C.

DOC Licensed Substance Abuse Programs

Page 20

What are the consequences of the programs results?
There are a number of consequences associated with recidivism reductions, such as:
Þ Reductions in the incarcerated offender population or at least a reduction in the

projected growth

which is stressing the existing prison infrastructure;

Þ Cost savings associated with keeping offenders out of the prison system and/or

correctional system; and

Þ Societal benefits from reduced crime.

Key findings:
Þ The substance abuse programs overall did very little to curb the growing prison

population during the14-month review period.

Þ Cost savings is not produced Department-wide, but institutions like NCF highlight

potential with over $134,000 in saved operational costs one year following offender
release.
Þ Across the department, substance abuse treatment prevented less than five new
offenses from occurring during the 14 month review period.

Overall, substance abuse programs did not curb the growing prison
population.
The offender population in prison is
expected to increase by over 31% in
the next ten years, causing inmate
capacity to be exceeded by 72% for
females and 52% for males (Stageberg
3). Readmissions to prison are one of
the factors influencing prison growth.
The 2,086 readmissions occurred in
state fiscal year 2006 and are
expected to increase 20.8% over the
next ten years (Stageberg 9). The
readmission growth makes treatment
interventions a key area of focus not

only for recidivism, but as a strategy to
help curb the prison inmate population
growth. Unfortunately, because the
total recidivism rate was not lowered
through DOC s substance abuse
programs (SA need/no treatment total
recidivism rate was 25.1% compared
to 26.6% for those successfully
completing treatment see table 2)
prison population growth should
continue to grow at the same rate
projected.

Cost savings was not produced Department-wide, but institutions
highlight potential savings.
It costs $23,367 annually to house an
offender in prison, and preventing one
offender from returning to prison from
parole or work release saves roughly
$5,400 in incarceration costs (DOC
Quick Facts 1; Prell Population

Growth 13).14 Although there was
cost savings of over $8 million
associated with offenders released
during the timeframe reviewed who
14

Annual costs estimated by taking the average
daily cost and multiplying it by 365.

DOC Licensed Substance Abuse Programs

Page 21

received treatment, cost savings were
not greater than what would have
been achieved if results were the
same as the substance abuse
need/no prison treatment group.
Additional information is provided in
table 3. However, ISP and NCF, where
the best performance related to total
recidivism was achieved, reflected cost
savings from offenders released to
community supervision of roughly
$12,800 and $134,600. Total cost
savings are likely to be much higher,

since savings only reflect DOC
operational costs not the costs
associated with the criminal justice
system or other societal costs
associated with crime. Return on
investment could not be calculated,
since recidivism rates were based on a
14 month release period. To calculate
return on investments, recidivism rates
would need to be established for the
treatment period, since offenders
could be released at different times.

Cost Savings Comparisons
Release to
Community
Supervision
1,334

Released from
Correctional
System
157

Annual Cost Reduction Per Offender
Remaining Out of Prison

$5,400

$23,367

% of Treatment Group Remaining Out
of Prison @ 12 months
Cost Savings

72.8%

79.0%

$5,243,400

$2,897,545

72.3%

82.0%

$5,211,610

$3,008,306

$8,219,916

$31,790

($110,761)

($78,971)

Total Released - Treatment Group

% of SA Need/No Treatment Group
Remaining Out of Prison @ 12 months
Cost Savings using SA Need/ No
Treatment Group Percentages
Difference

Total
1,491

$8,140,945

Table 3: Cost savings comparisons using release totals from the substance abuse need/successful
treatment group. Compared savings associated with non-recidivism rates of the treatment group
with those that would have been achieved if the rates were the same as those of the substance abuse
need/no treatment group. Savings for offenders remaining out of prison for less than one year was
not calculated. Cost savings were calculated by multiplying total released by % remaining out of
prison and by the annual cost reduction per offender.

DOC Licensed Substance Abuse Programs

Page 22

Across the department, substance abuse treatment prevented less than
five new offenses from occurring during 14 month review period.
Substance abuse treatment lowers
new conviction recidivism rates
which benefits society. However, the
benefit was relatively small.
Recidivism rates were 0.3% lower
among offenders receiving prison
substance abuse treatment compared
to those with a substance abuse need
and no prison treatment. This
amounts to slightly less than five new
offenses. However, because of
differing performance levels among
institutions some prevent more new
offenses. At NCF (where the best
performance related to new conviction

recidivism was achieved), 13 new
offenses were prevented.
If reconvicted, offenders completing
substance abuse treatment had fewer
property crimes as a percentage of
total new offenses compared to those
with substance abuse needs/no
treatment. However, other crime
types, including drug, were higher.
Data was not available to make a
comparison between initial convicting
crime and new offenses committed
which may reflect a greater societal
benefit if treatment lowers the severity
of the crimes committed.

New Offense Comparison

Convicting Crime Type
Drug
Other
Property
Public Order
Violent
Total

Count
%
Count
%
Count
%
Count
%
Count
%
Count

SA
Need/Successful
Prison
Treatment
33
18.3%
4
2.2%
41
22.8%
71
39.4%
31
17.2%
180

SA Need/No
Prison
Treatment
55
17.5%
4
1.3%
80
25.5%
124
39.5%
51
16.2%
314

%
100.0%
100.0%
Table 4: Comparison between treatment group and comparison group (substance abuse need/no
treatment) for those committing new offenses within 12 months of release. Percentages are expressed
as a percentage within the convicting crime type for all new offenses committed.

DOC Licensed Substance Abuse Programs

Page 23

What issues significantly influence program results?
Evaluating program effectiveness using outcomes is complicated. When changes to
outcomes occur, programs are often unable to explain why. The cumulative effect of
numerous events or situations influence results (in this case recidivism results) make
it challenging to understand what is truly causing observed changes. Many times,
changes simply cannot be attributed or attached to one particular cause, or the
program s contribution is relatively small in comparison to other factors and makes it
difficult to see how operational or strategic changes are impacting results, see figure
11.
Key findings:
Þ Both new conviction and total recidivism rates were higher among offenders with mental
Þ
Þ
Þ
Þ
Þ
Þ
Þ
Þ

Þ
Þ

health diagnosis highlighting the challenge to effectively treat individuals with multiple
needs.
Treatment should be made as close to an offender s release date, so new skills are
retained before offenders face high risk situations questionable data made this
variable difficult to evaluate.
Offenders with higher risks had higher recidivism rates.
Additional support in the community whether it is through supervision or continuing
substance abuse treatment lowers new conviction recidivism.
Older offenders were less likely to be reconvicted for new offenses, and incur technical
violations.
African Americans had higher new and total recidivism rates than Caucasians and other
minority groups highlighting socioeconomic conditions/issues within communities
African American offenders come from and return to.
DOC has yet to fully identify where evidence-based practices are being successfully
implemented.
DOC does not consistently measure addiction severity, and responsivity factors reducing
confidence that treatment approaches are best suited for individual offender
characteristics.
22.8% of offenders treated by the substance abuse program were classified in low to
low/moderate risk category whereas over 1,800 offenders with substance abuse
needs and classified with moderate to high risks, and received no treatment while in
prison. 500 of the higher risk individuals were released due to the end of their sentence
leaving no other opportunity to provide treatment while in the correctional system.
Consistent system-level measures are needed to enhance DOC s ability to manage for
results, and enable program comparisons.
More frequent recognition of quality work and ensuring adequate resources are
available could enhance employee engagement.

DOC Licensed Substance Abuse Programs

Page 24

Factors Affecting New Conviction Recidivism Among Offenders Released with Substance
Abuse Need
14.0%
12.0%

12.0%

10.0%
8.8%

9.1%

9.0%

8.0%
7.0%

7.4%

7.9%

5.6%

6.0%

4.7%
3.9%

4.0%

2.0%
0.3% 0.2%
0.0%
No Substance Abuse
Treatment

Mental Health
Diagnosis

High Risk
Classification

No Community
Supervision

Under 40 Years in Age

African American

New Conviction Recidivism Difference (Recidivism Rate of Group with Characteristic - Recidivism Rate of Group w/o Characteristic)
Group Difference (% of New Offense Group with Characteristic - % of Stay Out of Prison Group with Characteristic)

Figure 11: Factors affecting new conviction recidivism among offenders released with substance
abuse need. The first series (dark blue) reflects the difference in new conviction recidivism rates (e.g.
The new conviction recidivism rate for the group of offenders with a mental health diagnosis is 3.9%
higher than offenders without a mental health diagnosis). The second reflects population differences
in the percent of offenders exhibiting the characteristic between offenders reconvicted for new
offenses and offenders who have not returned to prison (e.g. The group of offenders returned to
prison for new convictions had 8.8% more individuals with mental health diagnoses than the group
of offenders who remained out of prison). Group differences by program are reflected in Appendix
D.

Both new conviction and total recidivism were higher among offenders
with mental health diagnosis.
DOC institutions and the Division of
Behavioral Health and Professional
Licensure at the Iowa Department of
Public Health identified offenders with
dual-diagnosis (i.e. substance abuse
need and mental health diagnosis) as
a key issue faced by substance abuse
programs (Hebron and LeBarge;
Durskey, et al.; Bagby; Austin and
Kelly). They were concerned about the
substance abuse curriculums abilities
to help those with both a substance

abuse and mental health need. This
population is challenging because of
the multiple issues they face. As such,
it was expected that offenders with
mental health diagnosis will be more
likely to recidivate, and as offenders
with dual-diagnoses increase as a
percentage of population served by the
substance abuse programs the new
conviction and total recidivism rates
would also increase.

DOC Licensed Substance Abuse Programs

Page 25

Department-wide, new conviction
recidivism was 3.8% and total
recidivism 7.4% higher among those
successfully completing substance
abuse treatment who have also been
diagnosed with a mental health
condition (other than substance
abuse) compared to those who have
not, see figure 12. When controlling
the population for mental health
diagnosis, new conviction recidivism
among those receiving substance
abuse treatment was 0.2% lower than
offenders with substance abuse need
and no treatment when neither
population had offenders with mental
health diagnosis.

Generally, offenders with both
substance abuse need and a mental
health diagnosis had higher recidivism
rates over those who just had
substance abuse needs at all
institutions. Offenders receiving
substance abuse treatment at ASP
and NCF were exceptions where
offenders who had mental health
diagnosis also had lower new
conviction recidivism rates. Those
offenders at NCF also had a lower total
recidivism rate. See Appendix E for
additional information.

Recidivism Rates by Comparison Group and Mental Health Diagnosis
SA Need/Successful Prison Treatment

SA Need/No Prison Treatment

35.0%
31.9%
29.6%

30.0%

25.0%

23.5%
22.2%

20.0%

14.7%

14.7%

15.0%

10.9%

10.7%
10.0%

5.0%

0.0%
No

Yes

No

Yes

Mental Health Diagnosis
New Conviction Recidivism

Total Recidivism

Figure 12: Department-wide recidivism rates by Comparison Group and Mental Health Diagnosis.
Mental health diagnosis does not include those with only a substance abuse disorder. Data
supporting figure provided in Appendix E.

DOC Licensed Substance Abuse Programs

Page 26

The amount of time between the conclusion of treatment and release
may influence recidivism, but data reliability made this difficult to
evaluate.
DOC attempts to time treatment with
an offender s target release date to
help improve offender outcomes
following release. The length of time
between when an offender receives
substance abuse treatment and when
they are released from prison is
believed to effect recidivism. The
longer the length of time; the harder it
becomes to retain the skills acquired
during treatment. This lessens the
offender s ability to apply the new
skills in the community environment
where they encounter high risk
situations that could lead to substance
abuse relapse and criminal behavior.
However, the reliability of treatment
end date was questionable impairing
the audit s ability to examine its
relationship to recidivism. Two issues

indicated questionable treatment end
date data:
Þ A small percentage of offenders

had treatment end dates that were
more recent than their release
date; and

Þ The Violator Programs at both CRC

and ICIW reflected more than 80%
of their treatment population
completing treatment more than a
year prior to release.
The offenders in the violator programs
are released once they have
successfully completed treatment,
therefore these programs should have
a very small percentage if any in
prison so long after treatment.

High risk offenders had higher recidivism rates.
Dynamic risk factors, including
in Iowa was significantly related to
criminogenic needs, serve as predictor
predicting future criminal activity (30).
of adult offender recidivism15. As
Offenders with higher risks are more
noted by Gendreu et al.,
likely to recidivate than those at
LSI-R, the instrument used
lower risk levels, and populations
New conviction
by DOC, produces
with higher percentage of
recidivism rates
correlations with
offenders within the high risk
are 17.3% higher
recidivism 62 75% of
category is believed to have
for offenders
time, and is better than
higher recidivism rates. Figures
classified high risk
compared to
other actuarial measures
13 and 14, show the recidivism
offenders in low
available (590).
rates progressively increase as
risk
category.
Lowenkamp and Betchel
the risk level of the offender
also noted that LSI-R use
population increases.
Department-wide new convictions
recidivism rates ranged from 3.1% of
15
Dynamic risk factors include: antisocial
those within the low risk category to
personality, attitudes and behavior, interpersonal
20.4% of those in the high risk
conflict, personal distress, social achievement,
and recent drug/alcohol abuse.

DOC Licensed Substance Abuse Programs

Page 27

offenders in the low/moderate risk
category. For total recidivism,
successful substance abuse treatment
only demonstrated lower recidivism
rates in the low and low/moderate risk
categories.

category among offenders successfully
completing substance abuse
treatment. Total recidivism ranged
from 6.3% to 39.8%. With new
convictions, substance abuse
treatment had the greatest benefit to

New Conviction Recidivism Rates by Comparison Group and LSI-R Category
25.0%

20.9%

20.4%

20.0%

16.5%

15.9%

15.0%

10.7%

11.1%

10.0%
7.9%
6.2%
5.0%

3.6%

3.1%

0.0%
Low

.

Low/Moderate

Moderate

SA Need/No Prison Treatment

Moderate/High

High

SA Need/Successful Treatment

Figure 13: New conviction recidivism rates by comparison group and LSI-R category. LSI-R data
was not available for all offenders, however the results presented in this figure were found to be
statistically significant. Data supporting figure provided in Appendix F.

DOC Licensed Substance Abuse Programs

Page 28

Total Recidivism Rates by Comparison Group and LSI-R Category
45.0%
39.8%

40.0%
34.7%

35.0%

35.1%

32.4%

30.0%
26.5%
24.0%

25.0%

20.0%

15.0%

15.8% 15.2%

14.3%

10.0%
6.3%
5.0%

0.0%
Low

Low/Moderate

Moderate

SA Need/No Prison Treatment

Moderate/High

High

SA Need/Successful Treatment

Figure 14: Total recidivism rates by comparison group and LSI-R Category. LSI-R data was not
available for all offenders, however the results presented in this figure were found to be statistically
significant. Data supporting figure provided in Appendix F.

Support within the community lowered new conviction recidivism; only
14.2% of offenders released to community supervision receive
additional programming to continue their treatment.
Stakeholders Survey). Studies have
Offenders face situations once
also demonstrated that individuals
released into the community that may
participating in both in-prison
result in relapse. These
Offenders
and post-release treatment in
situations are often relevant
receiving
the community have better
at re-entry making them more
community
drug use and recidivism
difficult to address in prisonsupervision had
outcomes, than in-prison
based treatment. The
new conviction
treatment alone (Klebe and
National Institute on Drug
recidivism rates
Keefe 30; Inciardi et al.,
Abuse has framed continuity
6.9 to 10% lower
Martin and Butzin 102;
of care as a principle of drug
than offenders
Wexler et al. 163).
abuse treatment, and
receiving no
suggests that treatment in
community
Transitional services following
prison can initiate the
supervision.
prison-based treatment are
process of therapeutic
critical, and treatment effect can be
change (4). Many stakeholders
greatly reduced or lost unless followed
agree, noting that there is a need for
by continuous aftercare in the
additional and expanded aftercare in
community (Simpson 110; Huebner
the community (Performance Audit

DOC Licensed Substance Abuse Programs

25). Pelissier et al. conclude that first
two months after release are crucial,
noting that the first priority of
probation officers and treatment
providers may need to be on
identifying how to avoid the high-risk
situations for drug use and on finding
alternative coping mechanisms to
resist the temptation to use drugs
(332). The Iowa Department of Public
Health staff agreed that the transition
to the community is full of challenges
and changes requiring
comprehensive discharge planning
(Austin and Kelly). However,
community treatment providers do not
always have comprehensive
knowledge on treatment provided
during incarceration (Performance
Audit Stakeholders Survey).
Impaired communication between
prison and the community could limit
community aftercare s effectiveness
when available.

Page 29

New conviction recidivism rates among
offenders receiving community
supervision were 6.9 to 10% lower
than offenders receiving no community
supervision. The difference was larger
among offenders who received
substance abuse treatment, as shown
in figure 15. Offenders who received
substance abuse programming in the
community also had lower new
conviction recidivism rates than
offenders who received prison
treatment alone, except for
inpatient/residential treatment, see
figure 16. Total recidivism did not
exhibit this pattern. Overall, only
14.2% of offenders released to
community supervision were enrolled
in programming to continue their
treatment (i.e., case management,
continuing care, and education).

New Conviction Recidivism by Comparison Group and Community Supervision
25.0%

SA Need/Successful Prison Treatment

SA Need/No Prison Treatment

21.0%
20.0%
17.5%

15.0%

11.0%

10.6%

10.0%

5.0%

0.0%
Community Supervison

No Community Supervision

Community Supervison

No Community Supervision

Figure 15: New conviction recidivism by comparison group and community supervision. Final
discharge release codes were used to identify offenders without community supervision. Data
supporting figure provided in Appendix G.

DOC Licensed Substance Abuse Programs

Page 30

Recidivism Rates for Offenders Successfully Completing Prison Treatment Grouped by
Additional Substance Abuse Programming Received in the Community
40.0%
34.8%

35.0%

33.3%
29.4%

30.0%
27.1%
25.0%
20.0%

20.0%

16.4%
15.0%
11.7%
10.0%

11.8%

11.1%
9.1%

8.3%

4.1%

5.0%

0.0%
None

Case Management

Continuing Care

New Conviction Recidivism

Education

Outpatient Treatment

Inpatient/Residential
Treatment

Total Recidivism

Figure 16: Recidivism rates for offenders successfully completing prison treatment grouped by
additional substance abuse treatment received in the community. Data was only available for those
offenders released to community supervision. Case management, continuing care and education are
perceived to be the interventions most likely associated with continuity of care. The results were
not statistically significant to suggest a similar finding for entire release population. Data supporting
figure provided in Appendix G.

Older offenders were less likely to be reconvicted for new offenses, and
incur technical violations.
Uggen and Massogila found a tight
linkage between an individual s
involvement in crime and adult status,
whether measured by behavioral
markers (such as marriage,
parenthood, full-time employment and
school completion) or respondents
own sense of themselves as adults
(32). This suggests that deviant
behavior and crime are inconsistent
with adult roles, and are held
incompatible when one views
themselves as an adult. As such,
larger percentages of older offenders
may perceive themselves as being

adults making them less likely to
recidivate. The data analyzed
reflected a steady decline for both new
conviction and total and new
conviction recidivism rates for older
offender populations. This pattern was
consistent for treatment and
substance abuse need/no treatment
comparison groups, as reflected in
figures 17 and 18. The high new
conviction recidivism rate within the
successful treatment group in the
Under 20 age group was likely
attributable to a small number of
offenders in this category.

DOC Licensed Substance Abuse Programs

Page 31

New Conviction Recidivism by Comparison Group & Age Category
45.0%

42.9%

40.0%

35.0%

30.0%

25.0%

20.0%
15.6%

14.8% 14.2%

15.0%

13.1%

12.2%
9.7%

10.0%

9.2%

5.0%

3.5%
1.5%

0.0%
Under 20

20 - 29

30 - 39

40 - 49

SA Need/No Prison Treatment

50 & Over

SA Need/Successful Treatment

Figure 17: New conviction recidivism rates by comparison group and age category. The population
within the Under 20 age category for those successfully completing treatment was very small only
included seven offenders. Data supporting figure provided in Appendix H.
Total Recidivism Rates by Comparision Group & Age Category
45.0%

42.9%

40.0%

35.0%
31.8%
29.3%

30.0%

26.9%

26.7%
25.1%

25.0%

20.7%
20.0%

19.9%
16.2%

15.0%

10.0%
4.6%

5.0%

0.0%
Under 20

20 - 29
SA Need/No Prison Treatment

30 - 39

40 - 49

50 & Over

SA Need/Successful Treatment

Figure 18: Total recidivism rates by comparison group and age category. The population within the
Under 20 age category for those successfully completing treatment was very small only included
seven offenders. Data supporting figure provided in Appendix H.

DOC Licensed Substance Abuse Programs

Page 32

African Americans had higher new and total recidivism rates than
Caucasians and other minority groups.
return to disadvantaged and
segregated urban communities that
are:

Recidivism studies have found certain
minority groups (e.g., African
Americans and Hispanics) to have
higher rates of re-arrest. Findings from
this audit are similar. African
Americans had new conviction
recidivism rates 4.7 to 4.8% than
Caucasians, see figure 19. Total
recidivism rates are 11.1 to 14.4%
higher, as shown in figure 20.
Reasons for higher recidivism rates
among African-Americans represent a
complex social phenomenon, and are
likely similar to factors contributing to
disparities in our state s prison
population. According to the
Governor s Task Force on
Overrepresentation of AfricanAmericans in Prison, the vast majority
of African-American inmates in Iowa

Þ often plagued by crime;
Þ have inadequate employment

opportunities; and

Þ have shrinking community

resources and support to address
poverty and unemployment, and
provide safe housing, reliable
transportation and adequate
childcare.
These offenders also often struggle
with weakened family structures, low
academic achievement, and have
limited access to substance abuse and
mental health treatment (12, 13, and
18).

New Conviction Recidivism Rates by Comparison Group and Race/Ethnicity
18.0%

16.0%

15.9%

16.0%
15.3%

14.0%

12.0%

11.2%

11.2%

10.0%
8.8%
8.0%

6.0%

4.0%

2.0%

0.0%
African American

Other Minority Groups
SA Need/No Prison Treatment

Caucasian

SA Need/Successful Prison Treatment

Figure 19: New conviction recidivism rates by comparison group and race/ethnicity. Other minority
groups include American Indian/Alaska Native, Asian/Pacific Islander, Hispanic, and unknown.
Individually, they represented such a small percentage of the total population reviewed. Data
supporting figure provided in Appendix I.

DOC Licensed Substance Abuse Programs

Page 33

Total Recidivism Rates by Comparison Group and Race/Ethnicity
40.0%

35.0%

37.9%
34.3%

29.0%

30.0%

25.0%

25.0%

22.2%

23.5%

20.0%

15.0%

10.0%

5.0%

0.0%
African American

Other Minority Groups
SA Need/No Prison Treatment

Caucasian

SA Need/Successful Prison Treatment

Figure 20: Total recidivism rates by comparison group and race/ethnicity. Other minority groups
include American Indian/Alaska Native, Asian/Pacific Islander, Hispanic, and unknown.
Individually, they represented such a small percentage of the total population reviewed. Data
supporting figure provided in Appendix I.

While evidence-based practices may improve effectiveness, their use
within substance abuse programs had not been fully evaluated.
Although, research has shown that
substance abuse programs can be
successful, it is important to recognize
that success varies depending on the
treatment approach utilized. NIDA
recognizes that not all drug abuse
treatment is equally effective ( Drug
Abuse Treatment 8). The general
assumption that any treatment
works should be avoided. This
assumption over-simplifies a complex
recovery process often requiring
sustained and repeated treatment
episodes (White 23). Results from
Mitchell, Wilson and MacKenzie s
meta-analysis also demonstrated
varying degrees of treatment
effectiveness depending on the type of
treatment provided (17).

Palmer highlights more effective
approaches at reducing recidivism, as
those with the strongest positive
results (e.g., the largest effect sizes or
recidivism reduction). Approaches
include: behavioral, cognitive
behavioral or cognitive, life skills or
skills oriented, multimodal, and family
intervention (147 148).
Interventions with the lowest
percentage of successful outcomes
include: diversion, group counseling or
therapy, and individual counseling or
therapy which often reflected mixed
results toward recidivism reduction;
and confrontation had the weakest (in

DOC Licensed Substance Abuse Programs

Page 34

fact, the most negative)
(Palmer, 135, 146).16
As mentioned previously, DOC
intends to reduce adult
offender recidivism through
evidence-based programming
Strategic Plan 5;
Performance Plan 1; SelfAssessment 15, 19, 38).
Figure 21 outlines the
principles embodied in DOC s
efforts. They also intend to
replicate and expand practices
that prove to be the most
effective through the
redirection of resources
(Bucklew, Prell Substance
Abuse 19).

Evidence-Based Principles for Effective Interventions
1.
2.
3.
4.
5.
6.
7.
8.

Figure 21: Evidence-Based Principles for Effective
Interventions developed by the National Institute of
Corrections and Crime & Justice Institute. The principles are
intended to help building learning organizations that reduce
recidivism through systemic integration of evidence-based
principles in collaboration with community and justice
partners.

DOC has partially evaluated the
conformance to evidence-based
principles (EBP) in the substance
abuse programs. In 2002, five
programs were assessed using the
Correctional Program Assessment
Inventory (CPAI). This assessment was
developed by Paul Gendreau and Don
Andrews in 1992. It is used to help
ascertain how closely a program meets
known principles of effective
correctional treatment (DOC CPAI ).
However, because of time and
resources to conduct such
assessments, DOC has moved towards
a self-assessment survey approach
which is scored by a team of
evaluators previously trained in the
CPAI process. Once completed, DOC
believes the scored survey will provide
a baseline for the status of EBP
16

Assess Actuarial Risk/Needs;
Enhance Intrinsic Motivation;
Target Intervention: Risk, Need, Responsivity, Dosage
and Treatment;
Skill Train with Directed Practice;
Increase Positive Reinforcement;
Engage Ongoing Support in Natural Communities;
Measure Relevant Processes/Practices; and
Provide Measurement Feedback.

The results were from an aggregate review of
9 meta-analysis and 23 literature reviews
(between 1975 and 1996).

interventions across Iowa s
correctional system (Bucklew). The
effort to conduct the survey is currently
underway. DOC intends to compare
the findings from the EBP survey to
those from this audit.
The challenge comes in identifying the
treatment approach that is most
effective. Substance abuse programs
often comprise multiple treatment
approaches (modalities) making it
challenging to understand which had
the greatest impact on post-treatment
drug use and recidivism. Harrison
identifies the research needs to
examine the effectiveness of various
treatment modalities, including the mix
of elements found in TCs and other
residential and outpatient treatment
programs. She continues by
highlighting the need to examine other
intervening variables (such as
individual involvement in treatment,
ethnicity, age, social support,
employment, and psychological status)

DOC Licensed Substance Abuse Programs

that play a role and may predict
treatment efficacy (478-479).
The Iowa Practice Improvement
Collaborative also note that although

Page 35

the term evidence-based practice is
commonly used, there is still no
consensus on what exactly constitutes
an evidence-based practice (4).

DOC assesses offender risk and needs at institutions, but does not
consistently measure addiction severity, and responsivity factors.
an inside job that is it happens
DOC utilizes LSI-R (Level of Service
within the offender. Responsivity
Inventory) as the main tool for
factors include offender characteristics
assessing actuarial risk/needs of
such as: motivation, personality
offenders. When properly
characteristics, cognitive and
administered, such assessments help
intellectual deficits, and demographic
identify the level of supervision and
variables which may or may not be
types of treatment required by
criminogenic needs, but can impact
offenders. However, Durrant states
treatment choices (Bonta
that the LSI-R assessments
Offenders
Offender Assessment 17;
are completed at offenders
cognitive and
Kennedy
20). Offenders
assigned institution not
verbal skills may
cognitive
and verbal skills may
reception, this limits
impair their ability
impair their ability to grasp
potential treatment
to grasp complex
complex ideas, and limit the
matches to those within the
ideas, and limit the
effectiveness of
effectiveness of some cognitiveinstitution assigned (2).
some cognitivebased programs. Additionally,
based programs.
responsivity factors are not
Institutions expressed the
always criminogenic need, but
need for a consistent statethat does not diminish their
wide assessment tool that
importance:
complements the LSI-R. LSI-R
identifies a substance abuse need but
Levels of anxiety are poor predictors
does not indicate the level of addiction
of
recidivism and decreases in anxiety
severity, or prevalence of mental
are not associated with reductions in
health issues (Howard and Phillips,
recidivism. Yet, the anxiety levels of
Nelson, and Bagby). Assessments to
offenders could impact on the choice
determine the required level of
of treatment. For example, an anger
management program may work well
substance abuse treatment were
in a group format consisting of
previously conducted during reception,
relatively non anxious individuals. For
but due to budget reductions the
clients who are extremely anxious in
service is no longer provided (Durrant
social situations however, the
2).
program would be more effective if
The LSI-R is also limited in assessing
offender responsivity (DOC, CPAI ).
Responsivity is critical because
substance abuse treatment is mainly

delivered on an individual basis
(Bonta, 17).

Such factors could have significant
implications regarding the

DOC Licensed Substance Abuse Programs

effectiveness of the program,
regardless of a program s therapeutic
integrity or competency of its staff.
Kennedy concludes, the need for a
systematic and comprehensive
assessment of responsivity and its
related constructs (i.e., motivation and
treatment readiness) is essential for
the successful planning,
implementation and delivery of
appropriate and effective treatment
programs (21). A similar argument
could be made for why systematic and
comprehensive assessments of
addiction severity and mental health
conditions are essential.
Consistent approaches for offender
responsivity assessments are not
evident from reviewing DOC policy and
procedure manuals. Some programs
make use of psychological/social
assessment questionnaires (DOC
ICIW - Treatment 4; ICIW Violator
Program 3; TOW 1). Newton notes
the use of Client Management

Page 36

Classification (CMC) and Jesness for
their violator program ( NCF Violator
Program 3). Most other programs, if
noted at all discuss making use of
various assessments when available;
or rely on classification notes, presentence investigations, and other less
structured approaches (DOC ASP 17;
NCF - PSD 3; MPCF 3).
Addiction severity assessments and
instruments used reflected little
consistency among substance abuse
programs. FDCF noted utilizing
Substance Abuse Subtle Screening
Inventory (SASSI), and Adult Substance
Use Survey (ASUS) (DOC New
Frontiers 24). NCCF also notes the
use of SASSI (DOC NCCF 4). Other
institutions policies make no
reference to any instruments, refer to
an evaluation conducted by MECCA, or
just reference the data collected
during the intake process at Iowa
Medical and Classification Center
(IMCC).

22.8% of offenders treated had low to low/moderate risks, while over
1,800 moderate to high risk offenders with substance abuse needs
received no treatment.
According to the National Institute of
Corrections and Crime and Justice
Institute, the risk principle calls for
programs to prioritize supervision and
treatment resources for higher risk
offenders (3). Their premise is that
prioritizing the higher risk offenders
places emphasis on harm-reduction
and public safety, since higher risk
offenders have a greater need for prosocial skills and thinking development
and are more likely to commit new
offenses (4). Bonta concurs stating
that research evidence suggests that

it is the higher risk client that can
benefit from treatment more so than
the lower risk offender ( Offender
Assessment 16).
22.8% of the offenders (321
offenders) released with substance
abuse treatment had low to
low/moderate risk levels with
Newton Correctional Facility having
50% of the offenders treated in the
two lower risk categories, and
Anamosa State Penitentiary the least
at 13.9% - see table 5. During the

DOC Licensed Substance Abuse Programs

Page 37

specific admission/selection criteria
related to risk level for entrance into
the program LSI-R scores 25 and
above for sentences 5 years and up is
a specific admission criterion for STAR
and WINGS (DOC ICIW - Treatment
3). NCF does as well for the violator
program, will accept males who
scored within the range of 24 to 40
(DOC NCF Violators Program 1).
FDCF, ASP and MPCF note referring to
LSI-R or LSI scores, but do not indicate
how an offenders risk level will impact
admission into the program (DOC
ASP 11-12; DOC MPCF 3; DOC
New Frontiers 15).

same timeframe, 994 moderate risk
offenders, 641 moderate/high risk
offenders, and 211 high risk offenders
in need of substance abuse treatment
did not receive any prior to their
release from prison. Of the higher risk
offenders receiving no prison
substance abuse treatment, 483 were
released due to the end of their prison
sentence offering no additional
opportunity for treatment.
Risk-based admissions/selection
criteria were not prevalent in
substance abuse treatment policy and
procedure documents. ICIW has

Percentage of Offenders Receiving Substance Abuse Treatment in Risk Categories by Institution
LSI-R Score Category
Institution

Low

Anamosa State
Penitentiary

Count

Clarinda Correctional
Facility

Count

Fort Dodge Correctional
Facility

Count

Iowa Correctional
Institution for Women

Count

Iowa State Penitentiary

%

%

%

%
Count
%

Mount Pleasant
Correctional Facility

Count

Newton Correctional
Facility

Count

North Central Correctional
Facility

Count

Total

%

%

%
Count
%

Low/Mod

Moderate

Total

Mod/High

High

Low

0

19

77

31

10

137

.0%

13.9%

56.2%

22.6%

7.3%

100.0%

1

47

160

97

39

344

.3%

13.7%

46.5%

28.2%

11.3%

100.0%

1

29

115

63

17

225

.4%

12.9%

51.1%

28.0%

7.6%

100.0%

6

57

69

36

14

182

3.3%

31.3%

37.9%

19.8%

7.7%

100.0%

2

6

24

5

1

38

5.3%

15.8%

63.2%

13.2%

2.6%

100.0%

3

47

121

73

19

263

1.1%

17.9%

46.0%

27.8%

7.2%

100.0%

19

77

61

34

1

192

9.9%

40.1%

31.8%

17.7%

.5%

100.0%

0

7

10

7

2

26

.0%

26.9%

38.5%

26.9%

7.7%

100.0%

32

289

637

346

103

1407

2.3%

20.5%

45.3%

24.6%

7.3%

100.0%

Table 5: Table highlights the number and percentage of offenders receiving substance abuse
treatment within each risk category by institution for those released between October 1, 2004 and
December 31, 2005.

DOC Licensed Substance Abuse Programs

Page 38

System-level measures are either inconsistent or do not exist across
programs limiting performance management capabilities new data
systems may offer solutions.
periodically (monthly, quarterly or at
Licensure standards for substance
the end of the treatment session).
abuse treatment programs in
Programs tend to look for patterns in
correctional facilities provide the
responses given for issues to address
framework for establishing consistent
and improvements to make. The data
system-level measures. 641 Iowa
is not compiled in such a way to see
Administrative Code Paragraph
changes over time, nor is there a
156.3(13) requires programs to
consistent approach used across
document the quality of inmate care
programs minimizing the data s
and use that information to
usefulness for program
detect trends and patterns
The data is not
compiled in such a
comparisons.
of performance. Iowa
way to see
Department of Public
changes over time,
FDCF, ASP, and NCCF
Health staff said this
nor is there a
discussed the use of pre and
requirement was initiated
consistent
post tests as ways to assess or
three years ago, and
approach used
measure learning that takes
progress has been made.
across programs
place as a result of the program
However, it is left to the
minimizing the
(Dick and Comp; Hebron and
individual programs to
data s usefulness
LaBarge; Johnson). Tests used
define the criteria they will
for program
are usually associated with the
look at (Austin and Kelly).
comparisons.
program s curriculum, and
The effort is a step in the
results are often kept in
right direction, but when the
offender files. No indication was
criteria are developed independently it
provided that the information is
hinders the ability for DOC to use the
aggregated to assess the programs
information collected for program
performance relative to offender
comparison purposes.
learning over time. One institution did
not believe the test they use to be the
Many of the programs attempt to learn
greatest, but did not have another
from offenders completing treatment
alternative available. NCF conducts
about the quality of their programs
pre and post tests using the criminal
through a survey or interview
sentiment scale, which measures
conducted when offenders exit the
changes in antisocial attitudes (Dursky
program. The survey or interview
et al.).17 This was the only approach
results serve as a gauge for offender
satisfaction and a mechanism to learn
what is working and what is not
17
The Criminal Sentiment Scale instrument
(Howard and Phillips; Dick and Comp;
measures
antisocial attitudes to determine
Nelson; Johnson; Dursky et al.; Bagby;
offender tolerance for the law and identification
Lawson et al.). The information
with criminal activities, and reflects tendencies
collected in this way is reviewed
to have antisocial attitudes.

DOC Licensed Substance Abuse Programs

Page 39

does not have good response rates,
identified that attempts to
and ISP reviews ICON for behavior
quantitatively measure behavioral
issues recorded by parole officers and
changes. However, the data produced
urinalysis results (Johnson; Lawson et
by the criminal sentiment scale test
al.).
was not mentioned when discussing
performance data periodically
DOC has begun to pilot test the Iowa
reviewed for management purposes
Service Management and Reporting
suggesting it may be collected at the
Tool (I-SMART) in two institutions which
individual level, but not aggregated to
promises to help with various research
assess program performance. ISP and
issues/questions, and will place all
ICIW noted that behavior change is not
individual record data in a database
specifically measured but is captured
enabling the aggregation of data
through discussions between the
(Lawson et al). According to the
offender and counselor.
The information is likely
promises to help Iowa Department of Public
Health, a key goal for I-SMART
kept in progress notes and
with various
is to advance the
not used for measuring
research
standardization and quality of
program effectiveness
issues/questions,
and will place all
treatment data to provide the
(Lawson et al; Bagby).
individual data in a
best available treatment
database enabling
information for managing and
Institutions also discussed
the
aggregation
of
monitoring system outcomes
following-up on offenders
data.
I-SMART ). It will allow
once they exit treatment
providers using the system to
programs. However, what
capture data related to intake,
they check and when they check
treatment services, discharge, and
varies. FDCF said an 18 month
follow-up tracking. However, another
recidivism check is conducted by
chief benefit is that it will enable the
counselors (Dick and Comp). MPCF
sharing of treatment information within
conducts follow-ups at 30, 60, and 90
the constraints of individual privacy
days, six months and one year
regulations, which is critical according
following treatment completion to
to stakeholders to enhance community
check on arrests, parole violations and
aftercare. Additionally, DOC s ICON
convictions (Nelson). ASP said that
system promises to offer a standard
recidivism data is collected every six
approach for gathering recidivism
months on the TC for grant reporting
data, as reflected in this performance
purposes, but was not collected for
audit, which will be beneficial for
ALTA and LH SAT (Hebron and
conducting future outcome
LeBarge). NCCF sends mailings to
evaluations.
offenders one year after treatment, but

DOC Licensed Substance Abuse Programs

Page 40

More frequent recognition of quality work and ensuring adequate
resources are available could enhance employee engagement.
Simpson describes the
The 12 Elements of Great Managing
therapeutic relationship
between offender and
To identify the elements of worker engagement, Gallup conducted
counselor as a major
many thousands of interviews in all kinds of organizations, at all
component to early
levels, in most industries, and in many countries. These 12 statements
the Gallup Q12 emerged from Gallup's pioneering research as
engagement of offenders in
those
that best predict employee and workgroup performance.
treatment programs. The
offender-counselor
1. I know what is expected of me at work.
relationship is commonly
2. I have the materials and equipment I need to do my work
considered to be at the very
right.
3. At work, I have the opportunity to do what I do best every
core of effective treatment
day.
(106). The relationship
4. In the last seven days, I have received recognition or praise
requires empathy, warmth
for doing good work.
and genuineness on behalf
5. My supervisor, or someone at work, seems to care about me
of the counselor. As part
as a person.
6. There is someone at work who encourages my development.
of the performance audit,
7. At work, my opinions seem to count.
employees were surveyed
8. The mission or purpose of my company makes me feel my
to identify and measure the
job is important.
elements of worker
9. My associates or fellow employees are committed to doing
engagement, utilizing
quality work.
10. I have a best friend at work.
questions developed by the
11. In the last six months, someone at work has talked to me
Gallop Organization, see
about my progress.
figure 22. Results have
12. This last year, I have had opportunities at work to learn and
shown a strong link
grow.
between high survey scores
and worker performance
Figure 22: The 12 elements of great managing. Copyright © 1992(Buckingham and Coffman 1999 The Gallup Organization, Princeton, NJ. All rights reserved.
31-41). A counselor more
highlight issues DOC management can
highly engaged (i.e. loyal and
focus on to help improve future program
productive) in their work arguably is
performance. Over 25% of the
more likely to develop the therapeutic
employees working in the substance
relationship required for effective
abuse program disagreed or were neutral
treatment than those who are
with five statements:
disengaged (i.e. unhappy and spreading
Þ I have the materials and equipment I
their discontent). As such, the survey
need to do my work right (36.4%).
results may serve as a proxy indicator
Þ At work, I have the opportunity to do
for the therapeutic relationship.
what I do best every day (27.2%).
Þ In the last seven days, I have
Although the survey data can not be
received recognition or praise for
related to recidivism results, it does
doing good work (45.5%).

DOC Licensed Substance Abuse Programs

Þ At work, my opinions seem to count

(30.9%).
Þ I have a best friend at work (34.5%).
Over 25% disagreed with receiving
recognition and praise in last seven days,
and 18.2% disagreed with having the
materials and equipment to do their job
right. The percentages were higher
among survey respondents.18 Survey
data is provided in Appendix J.

18

65% of DOC employees working in the
substance abuse programs responded to the
employee survey.

Page 41

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Page 42

Conclusions and Recommendations
DOC has begun to look for ways to improve their substance abuse treatment
programs, and is committed to reducing recidivism specifically with efforts to:
Þ evaluate the utilization of EBPs within interventions and programs;
Þ develop program corrective action plans to drive the implementation of EBPs; and
Þ redirect resources into promising or excellent strategies.

Even though connecting the implementation of evidence-based practices to
improvements in recidivism is not possible currently, research supports their use.
DOC should continually strive to evaluate, integrate and implement evidence-based
practices into their treatment offerings.
Many of the licensed substance abuse programs have also established quality
assurance programs to allow ongoing continual improvement, focused on making
small programmatic changes, which over time taken collectively have the
potential to greatly affect program results. While the quality assurance programs
offer a good start, DOC s efforts could be greatly enhanced with instruments to
monitor patient progress or aggregate patient records to provide measures of
motivation, engagement, and functioning and for these measures to be tracked
over time. Such measures have the benefit of demonstrating program effectiveness,
identifying problem areas and supporting focused improvement efforts. Approaching
measurement consistently across the prison system will provide the added benefit of
identifying unique programmatic problems from systemic problems prominent across
the entire prison-system.
DOC also has the need to fully understand dynamic population characteristics across
the system. The limited information presents challenges in knowing which type of
treatment in terms of intensity, duration, and modalities used are of greater need
Department-wide. Currently, the delivery of appropriate and effective treatment is
hindered by restricting programming to what is available at the institution where the
offender has been placed, which may not best fit the offender s needs. It also places
the burden of challenging offender populations, such as those with co-occurring
disorders (mental health and substance abuse need), on the institutions where
programming may not adequately address the problem.
While many strategies can be implemented within the prison-system, some issues
call for a broader approach. Recidivism rate changes associated with community
supervision, enrollment in community based substance abuse programming, and
environmental factors associated with higher recidivism rates among African
Americans suggest the need for enhanced social support systems and networks
within communities. More offenders need continuing support and care in the
community to maintain and further enhance treatment received while in prison.

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The following recommendations are offered for DOC s consideration:
Þ Enhance community support networks and release planning to positively reinforce

desired behaviors;

Þ Develop a consistent assessment protocol and standard intake process;
Þ Develop a system for monitoring program performance, setting targets and furthering the

use of evidence-based practices;

Þ Deliver substance abuse programming across the correctional system in an integrated

fashion; and
Þ Develop strategies to give substance abuse treatment staff positive recognition and
praise on a frequent basis.

All of the recommendations discussed below will require DOC to manage change.
Employees and stakeholders must understand the real costs, benefits and rationale.
A communication plan accompanying strategies the Department intends to move
forward with will be beneficial. The mantra regarding change management is to
communicate early and often.

Enhance community support networks and release planning to
positively reinforce desired behaviors.
Community aftercare is a critical element to NIDA. They have it listed as a principle
of drug abuse treatment for criminal justice populations Continuity of care is
essential for drug abusers re-entering the community ( Treatment for Criminal
Justice Populations 5). Community aftercare is also listed as an evidence based
principles for effective interventions, Engage ongoing support in natural
communities, see figure 21. Its importance is further supported by researchers in
the substance abuse field, Simpson states that nowhere is the importance of
transitional services treatment more evident than for correctional populations,
especially community re-entry programs that follow prison-based treatment (110).
Data presented in this audit suggests that community aftercare can reduce
recidivism. The following information presents a number of short-term and long-term
actions DOC can undertake to enhance community support networks and release
planning that will positively reinforce desired behaviors and reduce recidivism.
Short-term actions:
1. Review recidivism data geographically by region or county where offenders
are located following release to identify where additional support may be
required. Release location variable was not part of the data set reviewed as
part of this performance audit.
2. Review the discharge planning process to ensure substance abuse aftercare
requirements are incorporated and detailed in offenders discharge plans.

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3. Reinforce treatment received in prison by encouraging offenders
participation in self-help and peer support groups and religious activities after
release that will improve offenders bonds to pro-social community members
(National Institute of Corrections 6).
4. Enhance or expand interventions that increase offenders family contact and
educate family members how they can better support offenders recovery.
5. Evaluate the effectiveness of I-SMART pilot in conveying prison treatment
information to providers in the community, and mainstream the system to
other programs if success is demonstrated.
Long-term actions:
1. Develop partnerships with community-based organizations and substance
abuse providers to ensure services are available to offenders after their
release from prison.
2. Develop and pilot test a coordinated, supportive approach to community
supervision that emphasizes offenders pro-social goals in their conditions to
release and encourages positive responses to attainment of these goals (ReEntry Policy Council 5). See Step n Out behavioral management approach
outlined on www.cjdats.org. The goal of the approach is to enable community
supervision officials to become more of a change agent, and to rely less on
negative sanctions which lead to recidivism due to technical violations.
3. Enable local care providers to meet with offenders prior to their release and
to be involved in discharge planning. The Re-Entry Policy Council suggests
community-based providers are likely to be more familiar with the community
to which an individual will return after his or her incarceration than are
corrections staff (12).
In order to leverage departmental resources, DOC may want to explore ways to focus
such initiatives, the following are some examples:
Þ Build partnerships in communities where African Americans reside to help combat

prevalent socioeconomic issues.
Þ Build partnerships in communities where higher recidivism rates are evident.
Þ Enhance discharge planning for higher risk offenders, or with those mental health
diagnoses.

Develop a consistent assessment protocol and standard intake process.
The assessment process is arguably one of the most critical functions DOC conducts,
because with growing prison populations and declining resources where and how
services are provided become more and more critical with each admission. The
following four offender classification factors help with security decisions and guiding
treatment:

DOC Licensed Substance Abuse Programs

Þ
Þ
Þ
Þ

Page 45

Risk,
Need (criminogenic needs),
Responsivity, and
Professional discretion, which uses professional judgment to assess variables, deemed
important (Kennedy 19, Bonta Offender Assessment 16-17).

However, as Bonta notes, interview questions can vary from offender to offender, and
the range of error associated with measurement instruments available can make
assessing offenders challenging. He suggests a multi-method measurement of
theoretically relevant factors as a way to reduce error and increase the accuracy of
the assessment. This approach combines the use of a measurement instrument
(test) and a structured interview ( Offender Assessment 15-16). DOC utilizes the
validated LSI-R to assess risk and need (Lowenkamp and Bechtel). Classification
notes and pre-sentence investigation are also utilized by a number of substance
abuse programs as part of their intake phase, but were not reviewed as part of this
audit. However, the consistent use of instruments related to mental health, addiction
severity and responsivity is not apparent.
Short-term actions:
1. Review addiction severity instruments. According to a study of prisoner intake
systems, SASSI, the Texas Christian University Drug Dependency Screen
(TCUDDS) and the Addiction Severity Index (ASI) are common instruments
used nationally (Hardyman et al. 12).
2. Review mental health instruments. Millon Clinical Multiaxial Inventory (MCMI)
and Minnesota Multiphasic Personality Inventory (MMPI) were more common
instruments used to assess psychopathology and address compulsive
behaviors (Hardyman et al. 12).
3. Review responsivity instruments. Kennedy discusses CMC and the Jesness
Personality Inventory, as commonly used instruments for responsivity, but
highlights LSI Ontario Revision (OR) as the first risk assessment instrument
to incorporate a section on special responsivity considerations The
section measures motivation as a barrier, denial/minimization, interpersonal
anxiety, cultural issues, low intelligence and communication barriers (21).
Bonta highlights other valid and reliable measures for intelligence, anxiety,
and interpersonal maturity ( Offender Assessment 18).
4. Review existing interview methodologies used, and identify ways to establish
structured interviews that will help ensure consistency in administration.
5. Develop a standard comprehensive assessment protocol and intake process.
In the DOC executive meeting on December 18, 2006, it was noted that 1)
there is not a state-wide assessment, and 2) there is a need to make the
reception/intake process at IMCC more efficient. DOC may want to consider
utilizing a lean tool called Design for Lean Sigma, which is a methodology to

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Page 46

create a new service, product or process; is applicable to any high-value
project that needs a significant amount of new design; and places strong
emphasis on capturing and understanding the customer and organization
needs.
6. Train assessment staff on how the assessment and intake process will work
and how to use the instruments.
7. Develop training material so substance abuse counselors and other treatment
staff understand how the comprehensive assessment works and know how to
use the information from the assessment in developing individual treatment
plans.
Long-term actions:
1. Train substance abuse counselors and other treatment staff.
2. Validate any new measurement instruments used.
3. Conduct an assessment to identify gaps in treatment services offered within
the correctional system.
4. Establish treatment acceptance criteria for treatment offerings based on
information provided by the comprehensive assessment. The criteria should
be unique, so that it is appropriate for the specific intervention, yet standard
among similar interventions.
5. Redirect staffing resources, especially those with strong substance abuse
expertise to support the assessment function.

Develop a system for monitoring program performance, setting targets
and furthering the use of evidence-based practices.
System-level measures allow program comparisons, help programs tell their story,
track progress over time, and identify improvement opportunities. Measuring
relevant processes/practices and providing measurement feedback are also two
principles of for effective interventions (National Institute of Corrections and Crime &
Justice Institute 7). The litmus test for any measurement system is how it is used.
Managers need to define the specific purpose for the measurement system and
specific measures, and how it will be used as well as what it will be answering.
Measures should help agencies manage themselves better drive improvement,
measure progress towards achieving one s mission (or at least to know whether or
not they are doing a better job), and help answer key questions that stakeholders
have about the program.

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Short-term actions:
1. Continue efforts to assess the use of evidence-based practices to better
inventory what practices are used and where they are implemented. The Iowa
Consortium for Substance Abuse Research and Evaluation highlight that
numerous studies show positive outcomes in a variety of fields including
substance abuse treatment when programs accurately implement
evidence-based protocols (24). The integrity of program implementation is
just as important as understanding program results whether it is relapse or
recidivism.
2. Identify key aspects of the program that are the most important. The TCU
Treatment Model highlights six broad areas, which may establish common
aspects programs can look at: patient attributes, program attributes, early
engagement, early recovery, stabilized recovery, and post-treatment outcomes
(Simpson 103). DOC work on evidence-based practices provides a start on
what to look at.
3. Identify who will have questions about aspects of the substance abuse
program, and what questions they will have, and how the answers to those
questions would be used.
a. Internally, DOC has interest in knowing how well programs are
implementing evidence-based practices and how do offenders change
as a result of treatment, whereas policy makers are interested in
broader outcome related questions such as does the program keep
offenders from returning to prison? In these cases, the answers will
generally be used for driving improvements and allocating resources.
b. DOC may want to consider asking stakeholders what questions they
have about the substance abuse programs.
4. Prioritize questions to answer. Generally, resources are not available to
answer every possible question. Additionally, attempting to answer too many
questions through measurement can hinder DOC s ability to explain what the
data is telling you, which is just as important as the data itself.
a. When prioritizing, DOC should look for commonalities among questions
asked.
b. Most performance management efforts place focus on outcomes,
Iowa s Accountable Government Act is no different. DOC should
consider focusing on more immediate outcomes for the substance
abuse programs. Although reduced recidivism is key result, a lot of
variables influence it. Incremental offender change is a more
immediate outcome that can be directly attributable to the substance
abuse program it is also more immediate giving management an
opportunity to react, and make necessary changes.

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c. DOC must also have information that will help explain unusual or
unexpected outcomes. For instance, dosage is a key principle for
effective treatment so are offenders in therapeutic tasks 40% or
more of their time? Does a drop in offenders meeting the dosage
standard coincide with a reduction in the amount of change exhibited
by offenders?
5. Identify data needed to help answer your questions; and how and when it will
be collected.
a. Queries have been built to answer recidivism questions related to this
audit, which can be used.
b. I-SMART database piloted in two institutions may offer other
opportunities.
c. Samples may be sufficient treatment managers are already sampling
case files for quality assurance purposes, what other questions can
they answer during this exercise? If sampling is used, questions
asked, and how they are answered should be consistent across the
substance abuse programs.
d. DOC could continue to use the Q12 survey questions to measure
employee engagement, as a proxy for therapeutic relationships.
e. Some questions may need new data such as monitoring the change
in an offender s dynamic risk factors as a result of treatment, or
offender engagement during treatment.
f. Consider how DOC will need the data disaggregated considering
geographical or other demographic characteristics. In order to avoid a
central office orientation, it is important to include measures that are
relevant at the institution and program level as well.
g. Avoid unnecessary precision or confidence requirements that are of
little benefit and only make measurement more costly.
h. Collect and document data to support monitoring performance over
time and observing changes.
i.

Ensure what is measured and how frequently it is measured is
consistent over time and across programs.

6. Baseline and set targets and standards for action for every measure intended
to monitor performance. This helps establish what level of performance is
expected and provides a means to signal problems. It also allows substance
abuse programs to explore creative/innovative approaches for achieving
targets. Having targets and standards can help evaluate a program or
processes fidelity how close is the process or program implemented in the
way it was intended.

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7. Assign individuals responsible for each performance measure identified.
8. Make the data visual utilizing graphical analysis of the data. This report
provides some examples, other techniques are run and control charts, which
are especially useful for time series data.
9. Use the data. Substance abuse programs have quality assurance teams or
committees, and most also have periodic employee/team meetings where
monitoring system data can be reviewed and corrective action plans devised.
With measures that are consistently measured over time and across
programs, the monitoring systems will support the inside out approach for
implementing the Principles of Evidence-Based Practices allowing for
comparisons across programs in search of best or at least better practices
to replicate in other areas of the department (National Institute of Corrections
and Crime & Justice Institute 12).
10.Share the data. The data, in some cases, was collected to answer
stakeholder questions let them see it. Some of the substance abuse
programs have advisory groups, which may serve as a good place to start.
Long-term actions:
1. Develop a system for external benchmarking of other incarceration-based
substance abuse programs/models supported by research. Although it is
good to look internally for utilization of evidence-based practices, external
review can provide new insights, and identify other practices or strategies that
would benefit DOC s substance abuse programs. It can also serve as a major
catalyst for change, and would allow DOC to build upon the work of others.
External benchmarking should only be considered after DOC s internal
monitoring and benchmarking methods are well developed.

Deliver substance abuse programming across the correctional system in
an integrated fashion.
As noted previously, most of the substance abuse programming offered by DOC was
developed at the institution level. Independent program development creates
treatment programs that are specific to the institution rather than supportive of a
comprehensive departmental system and may not adequately address service
gaps when looking at needs across the department. Also, the small percentage of
offenders receiving continuing substance abuse programming in the community,
suggests that many of DOC s treatment programs are stand alone where therapeutic
change is hopefully completed while the offender is incarcerated, rather than as part
of a treatment continuum spanning incarceration, work release and parole.
Approaching substance abuse programming in an integrated fashion promotes
consistent delivery of services, as well as, provides for the standardization of key
processes such as offender assessment and discharge planning. It would also
allow DOC to focus on advantages that incarceration-based treatment offers such

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Page 50

as time. As Inciardi et al. notes, there is the time and opportunity for focused and
comprehensive treatment, perhaps for the first time in a drug offender s career (91).
Short-term actions:
1. Work with Community Based Correction Districts to develop a multistage
treatment continuum model. Durrant notes that CBC facilities are an integral
and critical part of the correctional system (16). Exploring how the prisonbased and community-based substance abuse programs work together is a
natural extension to DOC s efforts to evaluate the use of evidence-based
practices and may offer opportunities to deliver services more cost
effectively. The multistage model used within the Delaware correctional
system since the mid-1990 has been the subject of many studies where
primary treatment is provided in the prison system, transitional treatment is
provided in a work release setting and aftercare is provided when the offender
enters parole or is placed under some other form of community supervision
(Inciardi et al. 91-92). This approach may also support utilizing prison
treatment resources for offenders with more severe addictions requiring more
intensive treatment. While others with less severe addictions could be treated
in the community rather than in prison.
2. Evaluate opportunities to create prison-wide centers that address specific
issues or needs. Focusing on a specific issue or problem typically allows for a
greater degree of specialization that is not possible or practical in all
situations. The co-occurrence of mental health and substance abuse needs
may be appropriate for such a center.

Develop strategies to give substance abuse treatment staff positive
recognition and praise on a frequent basis.
Evidence-based practices suggest that effective correctional programs are ones who
utilize rewards at a much higher rate than punishments as a way to change offender
behavior (DOC CPAI ). The same principle can be applied to employees in the form
of frequent recognition and praise that:
Þ Focus on positive interactions;
Þ Promote positive emotions that can profoundly influence employee productivity; and
Þ Enhance therapeutic relationships that are critical in substance abuse treatment.

This is especially critical in the field of substance abuse treatment, where relapse is
prevalent and often considered inevitable.

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Short-term actions:
1. Develop strategies to increase positive interactions occurring within work
teams. How Full is Your Bucket? by Tom Rath and Donald O. Clifton and
www.bucketbook.com offer some simple and practical suggestions on how
an organization can increase positive interactions.

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Department of Corrections Response

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Appendix A: Data Collection Methodology

1

2

3

4
5

6

7

Notes:
1.
The following releases were included: Release to work release (32),
Release to Iowa Parole (36), Release to Shock/Non-shock PB (38/39), Final
Discharge, End of Sentence (55), Final Discharge, Other (56), and Parole
w/immediate discharge (81). If ties used Minimum Release Date.
2.
The following admissions are included to track recidivism: New Court
Commitment (1), New Court Commitment after PB Rev (2), Parole
Revocation (11), Shock Probation Revocation (14), Admission from OWI
Facility (30), and Work Release Revocation (71). Data Captured: Offense
Dt, Crime Cd, Offense Description, and Convicting Crime Type/Sub Type.
3.
Recidivism Type: New Charges = Prison Status Charge Offense Date >
Release Date; Technical Violations = Prison Status Charge Offense Date <
Release Date. If ties (multiple charges) ranked by Most Serious (1) Offense
Class, (2) Offense Type and (3) Minimum Crime Cd Id.
4.
Need Identified by: LSI-R, Iowa Risk, Custody Classification, and Jesness
Assessments.
5.
LSI-R Score was from assessments conducted between the offender s first
supervision date and 90 days following release. Data Captured: Score,
Submitted Date, Category (Low 0-13; Low/Moderate 14-23; Moderate 2433; Moderate/High 34-40; High 41+)
6.
Community SA Intervention Data is not available for offenders released due
to end of sentence. The intervention captured is the first intervention after
release. Data Captured: Intervention, Start/End Date, and Intervention
Category.
7.
Institution Licensed Substance Abuse Interventions Data Captured: Region
Name, Intervention, Start/End Date, Closure Reason, and Closure Category
(Successful, Unsuccessful, Administrative, Intermediate Sanction).

DOC Licensed Substance Abuse Programs

Page 58

Appendix B: Non-Recidivism and Recidivism Rates by Comparison
Group and Institution.
Recidivism Rates
Did Not
Recidivate

No SA Need

Count
%

47
81.0%

New
Convictions
6
10.3%

SA Need/No Prison
Treatment

Count
%

114
71.7%

23
14.5%

22
13.8%

159
100.0%

SA Need/Successful
Prison Treatment

Count
%

93
62.8%

24
16.2%

31
20.9%

148
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

6
60.0%

2
20.0%

2
20.0%

10
100.0%

SA Need/Prison
Treatment - Other

Count
%

8
72.7%

2
18.2%

1
9.1%

11
100.0%

Total

Count
%

268
69.4%

57
14.8%

61
15.8%

386
100.0%

No SA Need

Count
%

52
76.5%

8
11.8%

8
11.8%

68
100.0%

SA Need/No Prison
Treatment

Count
%

156
75.0%

29
13.9%

23
11.1%

208
100.0%

SA Need/Successful
Prison Treatment

Count
%

257
70.6%

49
13.5%

58
15.9%

364
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

38
59.4%

12
18.8%

14
21.9%

64
100.0%

SA Need/Prison
Treatment - Other

Count
%

17
85.0%

1
5.0%

2
10.0%

20
100.0%

Total

Count
%

520
71.8%

99
13.7%

105
14.5%

724
100.0%

No SA Need

Count
%

58
65.2%

16
18.0%

15
16.9%

89
100.0%

SA Need/No Prison
Treatment

Count
%

262
71.4%

62
16.9%

43
11.7%

367
100.0%

SA Need/Successful
Prison Treatment

Count
%

146
61.3%

36
15.1%

56
23.5%

238
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

12
70.6%

3
17.6%

2
11.8%

17
100.0%

SA Need/Prison
Treatment - Other

Count
%

3
50.0%

1
16.7%

2
33.3%

6
100.0%

Count

481

118

118

717

%

67.1%

16.5%

16.5%

100.0%

Comparison Group

Fort Dodge Correctional Facility

Clarinda Correctional Facility

Anamosa State Penitentiary

Institution

Total

Technical
Violations
5
8.6%

Total
58
100.0%

DOC Licensed Substance Abuse Programs

Page 59

Recidivism Rates
Did Not
Recidivate

No SA Need

Count
%

98
83.8%

New
Convictions
10
8.5%

SA Need/No Prison
Treatment

Count
%

219
78.2%

28
10.0%

33
11.8%

280
100.0%

SA Need/Successful
Prison Treatment

Count
%

151
80.3%

21
11.2%

16
8.5%

188
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

22
81.5%

2
7.4%

3
11.1%

27
100.0%

SA Need/Prison
Treatment - Other

Count
%

10
76.9%

1
7.7%

2
15.4%

13
100.0%

Total

Count
%

500
80.0%

62
9.9%

63
10.1%

625
100.0%

No SA Need

Count
%

34
77.3%

8
18.2%

2
4.5%

44
100.0%

SA Need/No Prison
Treatment

Count
%

70
89.7%

6
7.7%

2
2.6%

78
100.0%

Total

Count
%

104
85.2%

14
11.5%

4
3.3%

122
100.0%

No SA Need

Count
%

86
75.4%

13
11.4%

15
13.2%

114
100.0%

SA Need/No Prison
Treatment

Count
%

231
78.6%

32
10.9%

31
10.5%

294
100.0%

SA Need/Successful
Prison Treatment

Count
%

33
84.6%

2
5.1%

4
10.3%

39
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

2
100.0%

0
.0%

0
.0%

2
100.0%

SA Need/Prison
Treatment - Other

Count
%

7
77.8%

1
11.1%

1
11.1%

9
100.0%

Comparison Group

Iowa State Penitentiary

Iowa Medical &
Classification
Center

Iowa Correctional Institution for
Women

Institution

Total

Technical
Violations
9
7.7%

Total
117
100.0%

Count

359

48

51

458

%

78.4%

10.5%

11.1%

100.0%

DOC Licensed Substance Abuse Programs

Page 60

Recidivism Rates
Did Not
Recidivate

No SA Need

Count
%

120
83.9%

New
Convictions
10
7.0%

SA Need/No Prison
Treatment

Count
%

199
77.7%

18
7.0%

39
15.2%

256
100.0%

SA Need/Successful
Prison Treatment

Count
%

225
78.9%

33
11.6%

27
9.5%

285
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

10
71.4%

3
21.4%

1
7.1%

14
100.0%

SA Need/Prison
Treatment - Other

Count
%

12
70.6%

2
11.8%

3
17.6%

17
100.0%

Total

Count
%

566
79.2%

66
9.2%

83
11.6%

715
100.0%

No SA Need

Count
%

96
77.4%

17
13.7%

11
8.9%

124
100.0%

SA Need/No Prison
Treatment

Count
%

359
70.8%

70
13.8%

78
15.4%

507
100.0%

SA Need/Successful
Prison Treatment

Count
%

169
83.3%

12
5.9%

22
10.8%

203
100.0%

SA Need/Unsuccessful
Prison Treatment

Count
%

5
71.4%

0
.0%

2
28.6%

7
100.0%

SA Need/Prison
Treatment - Other

Count
%

6
85.7%

1
14.3%

0
.0%

7
100.0%

Total

Count
%

635
74.9%

100
11.8%

113
13.3%

848
100.0%

No SA Need

Count
%

68
79.1%

6
7.0%

12
14.0%

86
100.0%

SA Need/No Prison
Treatment

Count
%

283
74.7%

46
12.1%

50
13.2%

379
100.0%

SA Need/Successful
Prison Treatment

Count
%

21
80.8%

3
11.5%

2
7.7%

26
100.0%

Total

Count
%

372
75.8%

55
11.2%

64
13.0%

491
100.0%

Comparison Group

North Central
Correctional Facility

Newton Correctional Facility

Mount Pleasant Correctional Facility

Institution

Technical
Violations
13
9.1%

Total
143
100.0%

DOC Licensed Substance Abuse Programs

Page 61

Appendix C: Non-Recidivism and Recidivism Rates by Comparison
Group and Location.
Did Not
Recidivate

Comparison Groups

Luster
Heights
SAP

LUH

Locationwide

TC

Anamosa State Penitentiary

Locationwide

19

Program

ALTA

Location

ASP

Institution

19

No SA Need

Recidivism Rates
New
Technical
Convictions Violations

Count

45

6

5

Total
56
100.0%

%

80.4%

10.7%

8.9%

SA Need/No Prison
Treatment

Count

93

18

20

131

%

71.0%

13.7%

15.3%

100.0%

SA Need/Successful
Prison Treatment

Count

51

15

14

80

%

63.8%

18.8%

17.5%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

1

0

0

1

%

100.0%

.0%

.0%

100.0%

SA Need/Prison
Treatment Other

Count

2

0

0

2

%

100.0%

.0%

.0%

100.0%

SA Need/Successful
Prison Treatment

Count

35

8

17

60

%

58.3%

13.3%

28.3%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

5

2

2

9

%

55.6%

22.2%

22.2%

100.0%

SA Need/Prison
Treatment Other

Count

3

2

1

6

%

50.0%

33.3%

16.7%

100.0%

No SA Need

Count

2

0

0

2

%

100.0%

.0%

.0%

100.0%

SA Need/No Prison
Treatment

Count

21

5

2

28

%

75.0%

17.9%

7.1%

100.0%

SA Need/Successful
Prison Treatment

Count

7

1

8

%

87.5%

12.5%

100.0%

SA Need/Prison
Treatment Other

Count

3

0

3

%

100.0%

.0%

100.0%

For those successfully completing treatment, the location was based on the location of the treatment,
except for TOW at CCF. Location for TOW was determined by release location within CCF. Location for
comparison groups were based on location of release.

DOC Licensed Substance Abuse Programs

Page 62

Did Not
Recidivate

Comparison Groups
Location

Program

Locationwide
New Frontiers

FDCF

Fort Dodge Correctional Facility

TOW

CCFL

Locationwide

TOW

Clarinda Correctional Facility

CCF

Locationwide

Institution

No SA Need

Count

39

Recidivism Rates
New
Technical
Convictions Violations
5
7

Total
51

%

76.5%

9.8%

13.7%

100.0%

SA Need/No Prison
Treatment

Count

118

24

16

158

%

74.7%

15.2%

10.1%

100.0%

SA Need/Successful
Prison Treatment

Count

186

40

47

273

%

68.1%

14.7%

17.2%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

29

12

10

51

%

56.9%

23.5%

19.6%

100.0%

SA Need/Prison
Treatment Other

Count

15

1

2

18

%

83.3%

5.6%

11.1%

100.0%

Count

13

3

1

17
100.0%

No SA Need

%

76.5%

17.6%

5.9%

SA Need/No Prison
Treatment

Count

38

5

7

50

%

76.0%

10.0%

14.0%

100.0%

SA Need/Successful
Prison Treatment

Count

71

9

11

91

%

78.0%

9.9%

12.1%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

9

0

4

13

%

69.2%

.0%

30.8%

100.0%

SA Need/Prison
Treatment Other

Count

2

0

0

2

%

100.0%

.0%

.0%

100.0%

No SA Need

Count

58

16

15

89

%

65.2%

18.0%

16.9%

100.0%

SA Need/No Prison
Treatment

Count

262

62

43

367

%

71.4%

16.9%

11.7%

100.0%

SA Need/Successful
Prison Treatment

Count

146

36

56

238

%

61.3%

15.1%

23.5%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

12

3

2

17

%

70.6%

17.6%

11.8%

100.0%

SA Need/Prison
Treatment Other

Count

3

1

2

6

%

50.0%

16.7%

33.3%

100.0%

DOC Licensed Substance Abuse Programs

Page 63

Did Not
Recidivate

Comparison Groups
Location

Program

STAR
Violator's
Program-Regular
@ ICIW
WINGS

ICIW

Iowa Correctional Institution for Women

Locationwide

Institution

No SA Need

Count

98

Recidivism Rates
New
Technical
Convictions Violations
10
9

Total
117

%

83.8%

8.5%

7.7%

100.0%

SA Need/No Prison
Treatment

Count

219

28

33

280

%

78.2%

10.0%

11.8%

100.0%

SA Need/Successful
Prison Treatment

Count

52

3

1

56

%

92.9%

5.4%

1.8%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

5

1

0

6

%

83.3%

16.7%

.0%

100.0%

SA Need/Prison
Treatment - Other

Count

3

1

1

5

%

60.0%

20.0%

20.0%

100.0%

SA Need/Successful
Prison Treatment

Count

12

4

3

19

%

63.2%

21.1%

15.8%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

6

0

0

6

%

100.0%

.0%

.0%

100.0%

SA Need/Prison
Treatment - Other

Count

0

0

1

1

%

.0%

.0%

100.0%

100.0%

SA Need/Successful
Prison Treatment

Count

87

14

12

113

%

77.0%

12.4%

10.6%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

11

1

3

15

%

73.3%

6.7%

20.0%

100.0%

SA Need/Prison
Treatment - Other

Count

7

0

0

7

%

100.0%

.0%

.0%

100.0%

DOC Licensed Substance Abuse Programs

Page 64

Did Not
Recidivate

Comparison Groups
Location

Program

Locationwide
Project TEA
Locationwide
SAP @ MPCF

MPCF

Mount Pleasant Correctional
Facility

JBU

Locationwide

Project
TEA

FM3

Iowa State Penitentiary

Project
TEA Class

FM1

Locationwide

Institution

No SA Need

Count

24

Recidivism Rates
New
Technical
Convictions Violations
3
5

Total
32

%

75.0%

9.4%

15.6%

100.0%

SA Need/No Prison
Treatment

Count

55

6

6

67

%

82.1%

9.0%

9.0%

100.0%

SA Need/Successful
Prison Treatment

Count

1

1

%

100.0%

100.0%

SA Need/Prison
Treatment - Other

Count

1

1

%

100.0%

Count

11

0

1

12

%

91.7%

.0%

8.3%

100.0%

SA Need/No Prison
Treatment

Count

62

4

8

74

%

83.8%

5.4%

10.8%

100.0%

SA Need/Successful
Prison Treatment

Count

13

1

14

%

92.9%

7.1%

100.0%

SA Need/Prison
Treatment - Other

Count

3

1

4

No SA Need

No SA Need

100.0%

%

75.0%

25.0%

Count

27

0

7

100.0%
34

%

79.4%

.0%

20.6%

100.0%

SA Need/No Prison
Treatment

Count

64

14

10

88

%

72.7%

15.9%

11.4%

100.0%

SA Need/Successful
Prison Treatment

Count

19

1

4

24

%

79.2%

4.2%

16.7%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

2

0

0

2

%

100.0%

.0%

.0%

100.0%

SA Need/Prison
Treatment - Other

Count

3

0

1

4

%

75.0%

.0%

25.0%

100.0%

No SA Need

Count

108

8

12

128

%

84.4%

6.3%

9.4%

100.0%

SA Need/No Prison
Treatment

Count

158

18

34

210

%

75.2%

8.6%

16.2%

100.0%

SA Need/Successful
Prison Treatment

Count

225

33

27

285

%

78.9%

11.6%

9.5%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

10

3

1

14

%

71.4%

21.4%

7.1%

100.0%

SA Need/Prison
Treatment - Other

Count

12

2

3

17

%

70.6%

11.8%

17.6%

100.0%

DOC Licensed Substance Abuse Programs

Page 65

Did Not
Recidivate

Comparison Groups
Location

Program

SAT/Criminality
IFI
Locationwide
Journey

NCCF

North Central
Correctional Facility

PCD

NCF

Locationwide

Newton Correctional Facility

Violator's Program
- Regular @ CRC

CRC

Locationwide

Institution

Recidivism Rates
New
Technical
Convictions Violations
8
3

Total
45

No SA Need

Count

34

%

75.6%

17.8%

6.7%

100.0%

SA Need/No Prison
Treatment

Count

160

17

26

203

%

78.8%

8.4%

12.8%

100.0%

SA Need/Successful
Prison Treatment

Count

72

6

5

83

%

86.7%

7.2%

6.0%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

1

0

1

2

%

50.0%

.0%

50.0%

100.0%

SA Need/Prison
Treatment - Other

Count

2

1

0

3

%

66.7%

33.3%

.0%

100.0%

SA Need/Successful
Prison Treatment

Count

11

1

3

15

%

73.3%

6.7%

20.0%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

2

0

1

3

%

66.7%

.0%

33.3%

100.0%

SA Need/Prison
Treatment - Other

Count

2

0

0

2
100.0%

No SA Need

%

100.0%

.0%

.0%

Count

62

9

8

79

%

78.5%

11.4%

10.1%

100.0%

SA Need/No Prison
Treatment

Count

199

53

52

304

%

65.5%

17.4%

17.1%

100.0%

SA Need/Successful
Prison Treatment

Count

63

4

9

76

%

82.9%

5.3%

11.8%

100.0%

SA Need/Prison
Treatment- Other

Count

1

0

0

1

%

100.0%

.0%

.0%

100.0%

SA Need/Successful
Prison Treatment

Count

23

1

5

29

%

79.3%

3.4%

17.2%

100.0%

SA Need/Unsuccessful
Prison Treatment

Count

2

0

0

2

%

100.0%

.0%

.0%

100.0%

SA Need/Prison
Treatment - Other

Count

1

0

0

1

%

100.0%

.0%

.0%

100.0%

No SA Need

Count

68

6

12

86

%

79.1%

7.0%

14.0%

100.0%

SA Need/No Prison
Treatment

Count

283

46

50

379

%

74.7%

12.1%

13.2%

100.0%

SA Need/Successful
Prison Treatment

Count
%

21
80.8%

3
11.5%

2
7.7%

26
100.0%

DOC Licensed Substance Abuse Programs

Page 66

New Conviction Recidivism
Difference

Difference in % Pop with
Mental Health Diagnosis

Difference in % Pop within
High LSI-R Risk Category

Difference in % Pop within
Low LSI-R Risk Category

Difference in % Pop with
African American
Race/Ethnicity

Difference in % Pop Over 40
Years Old

Program
ALTA
IFI
Journey
Luster Heights SAP
New Frontiers
PCD
Project TEA @ FM3
Project TEA @ JBU
SAP @ MPCF
SAT/Criminality
STAR
TC
TOW @ CCF
TOW @ CCFL
Violator's Program Regular @ CRC
Violator's ProgramRegular @ ICIW
WINGS

Total Recidivism Difference

Appendix D: Summary Comparisons by Program Substance Abuse
Treatment Program Compared to SA Need/No Prison Treatment
Group from Same Location.

7.2%
-17.4%
-6.1%
-12.5%
10.0%
-13.8%
-9.1%
-6.4%
-3.7%
-7.9%
-14.6%
12.7%
6.6%
-2.0%

5.0%
-12.2%
-0.6%
-5.4%
-1.8%
-14.0%
1.7%
-11.7%
3.0%
-1.1%
-4.6%
-0.4%
-0.5%
-0.1%

-11.4%
-19.7%
-6.1%
-17.9%
1.3%
-19.3%
15.9%
-3.5%
2.5%
-4.5%
-20.7%
-5.6%
-12.3%
0.5%

0.0%
-5.8%
-1.4%
-4.3%
-4.7%
-5.8%
-3.0%
-7.5%
2.7%
-4.8%
-13.5%
1.9%
-7.3%
-4.6%

0.0%
16.2%
-1.1%
0.0%
0.4%
4.7%
-1.5%
8.3%
-1.7%
-1.2%
6.7%
0.0%
-0.3%
0.0%

2.1%
-18.4%
5.2%
-3.6%
-2.0%
9.5%
-5.1%
-4.2%
4.3%
-1.0%
-7.9%
-2.9%
-7.5%
-14.4%

-8.7%
1.4%
-8.0%
16.1%
-0.7%
-4.8%
-11.2%
6.5%
-4.9%
-6.8%
11.4%
-0.8%
-1.2%
10.7%

5.5%

-1.7%

2.3%

2.9%

-5.3%

8.2%

-42.9%

15.1%

11.1%

11.9%

3.2%

-0.4%

-8.1%

-17.4%

1.2%

2.4%

7.2%

-3.3%

1.5%

2.6%

0.4%

Difference = SA Need/Successful Prison Treatment - SA Need/No Prison Treatment

DOC Licensed Substance Abuse Programs

Page 67

Appendix E: Mental Health Data.
Recidivism Rates by Comparison Group and Mental Health Diagnosis
Mental
Health
Diagnosis

Recidivism Rates
Comparison Group
SA Need/No Prison Treatment

No
SA Need/Successful Prison
Treatment
SA Need/No Prison Treatment
Yes

Did Not
Recidivate

SA Need/Successful Prison
Treatment

Count
%
Count
%
Count
%
Count
%

New
Convictions

Technical
Violations

Total

1165

164

169

333

77.8%

10.9%

11.3%

22.2%

710

99

119

218

76.5%

10.7%

12.8%

23.5%

694

145

147

292

70.4%

14.7%

14.9%

29.6%

372

80

94

174

68.1%

14.7%

17.2%

31.9%

Institution Recidivism Rates by Comparison Group and Mental Health Diagnosis

Clarinda Correctional
Facility

Anamosa State
Penitentiary

Institution

Mental
Health
Diagnosis

No

Yes

No

Yes

Recidivism Rates
Did Not
Recidivate

Comparison Group
SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

%
%
%
%
%
%
%
%

New
Convictions

Technical
Violations

Total

77

13

11

24

76.2%

12.9%

10.9%

23.8%

67

17

20

37

64.4%

16.3%

19.2%

35.5%

35

10

11

21

62.5%

17.9%

19.6%

37.5%

25

6

11

17

59.5%

14.3%

26.2%

40.5%

87

12

9

21

80.6%

11.1%

8.3%

19.4%

164

26

30

56

74.5%

11.8%

13.6%

25.4%

67

17

14

31

68.4%

17.3%

14.3%

31.6%

87

23

28

51

63.0%

16.7%

20.3%

37.0%

DOC Licensed Substance Abuse Programs

Mount Pleasant
Correctional Facility

Iowa State Penitentiary

Iowa Correctional
Institution for Women

Fort Dodge Correctional
Facility

Institution

Mental
Health
Diagnosis

No

Yes

No

Yes

No

Yes

No

Yes

Page 68

Recidivism Rates
Comparison Group
SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%

Did Not
Recidivate

New
Convictions

Technical
Violations

Total

178

33

27

60

74.8%

13.9%

11.3%

25.2%

104

22

29

51

67.1%

14.2%

18.7%

32.9%

77

27

16

43

64.2%

22.5%

13.3%

35.8%

41

14

26

40

50.6%

17.3%

32.1%

49.4%

85

8

10

18

82.5%

7.8%

9.7%

17.5%

62

3

6

9

87.3%

4.2%

8.5%

12.7%

131

20

22

42

75.7%

11.6%

12.7%

24.3%

87

18

10

28

75.7%

15.7%

8.7%

24.4%

143

19

15

34

80.8%

10.7%

8.5%

19.2%

21

1

1

2

91.3%

4.3%

4.3%

8.6%

83

13

16

29

74.1%

11.6%

14.3%

25.9%

11

1

3

4

73.3%

6.7%

20.0%

26.7%

116

9

20

29

80.0%

6.2%

13.8%

20.0%

150

18

17

35

81.1%

9.7%

9.2%

18.9%

83

9

19

28

74.8%

8.1%

17.1%

25.2%

73

15

10

25

74.5%

15.3%

10.2%

25.5%

DOC Licensed Substance Abuse Programs

North Central Correctional
Facility

Newton Correctional
Facility

Institution

Mental
Health
Diagnosis

No

Yes

No

Yes

Page 69

Recidivism Rates
Comparison Group
SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

%
%
%
%
%
%
%
%

Did Not
Recidivate

New
Convictions

Technical
Violations

Total

220

38

44

82

72.8%

12.6%

14.6%

27.2%

123

10

16

26

82.6%

6.7%

10.7%

17.4%

133

31

31

62

68.2%

15.9%

15.9%

31.8%

46

2

4

6

88.5%

3.8%

7.7%

11.5%

214

29

31

60

78.1%

10.6%

11.3%

21.9%

19

2

0

2

90.5%

9.5%

.0%

9.5%

63

15

18

33

65.6%

15.6%

18.8%

34.4%

2

1

2

3

40.0%

20.0%

40.0%

60.0%

DOC Licensed Substance Abuse Programs

Page 70

% of Offender Population with Mental Health Diagnosis by Program and Institution

Mental Health Diagnosis

Iowa Correctional
Institution for Women

Fort Dodge
Correctional
Facility

Clarinda Correctional
Facility

Anamosa State Penitentiary

Institution

Location

Comparison Group
SA Need/No
Treatment

ASP

ALTA
TC

LUH

SA Need/No
Treatment
Luster Heights SAP

CCF

SA Need/No
Treatment
TOW

CCFL

SA Need/No
Treatment
TOW
SA Need/No
Treatment

FDCF

%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count

New Frontiers
SA Need/No
Treatment
STAR
ICIW

Count

Violator's ProgramRegular @ ICIW
WINGS

%
Count
%
Count
%
Count
%
Count
%

No

Yes

Substance
Abuse
Disorder
Only

78

51

2

131

59.5%

38.9%

1.5%

100.0%

56

22

2

80

70.0%

27.5%

2.5%

100.0%

Total

40

20

60

66.7%

33.3%

100.0%

23

5

28

82.1%

17.9%

100.0%

8

8

100.0%

100.0%

78

79

1

158

49.4%

50.0%

.6%

100.0%

165

103

5

273

60.4%

37.7%

1.8%

100.0%

30

19

1

50

60.0%

38.0%

2.0%

100.0%

55

35

1

91

60.4%

38.5%

1.1%

100.0%

238

120

9

367

64.9%

32.7%

2.5%

100.0%

155

81

2

238

65.1%

34.0%

.8%

100.0%

103

173

4

280

36.8%

61.8%

1.4%

100.0%

32

23

1

56

57.1%

41.1%

1.8%

100.0%

5

14

26.3%

73.7%

34

78

1

113

30.1%

69.0%

.9%

100.0%

19
100.0%

DOC Licensed Substance Abuse Programs

Page 71

Mental Health Diagnosis

Institution

Location

Iowa State Penitentiary

FM1

Comparison Group
SA Need/No
Treatment
Project TEA - Class

FM3

SA Need/No
Treatment
Project TEA

JBU

SA Need/No
Treatment

Mount
Pleasant
Correctional
Facility

Project TEA
SA Need/No
Treatment
MPCF

Newton Correctional Facility

SA Need/No
Treatment

NCF

SAT/Criminality

Count
%
Count
%
Count
%
Count
%
Count
%
Count
%

%
Count
%
Count
%

Violator's Program Regular @ CRC

Count

SA Need/No
Treatment

Count

IFI
PCD

North Central
Correctional
Facility

%

Count
SAP @ MPCF

CRC

Count

SA Need/No
Treatment
NCCF

%
%
Count
%
Count
%
Count
%
Count

Journey

%

Substance
Abuse
Disorder
Only

Total

No

Yes

51

16

67

76.1%

23.9%

100.0%

1

1

100.0%

100.0%

51

20

3

74

68.9%

27.0%

4.1%

100.0%

8

6

14

57.1%

42.9%

100.0%

51

36

1

88

58.0%

40.9%

1.1%

100.0%

14

9

1

24

58.3%

37.5%

4.2%

100.0%

143

67

210

68.1%

31.9%

100.0%

185

98

2

285

64.9%

34.4%

.7%

100.0%

134

63

6

203

66.0%

31.0%

3.0%

100.0%

61

22

83

73.5%

26.5%

100.0%

10

5

15

66.7%

33.3%

100.0%

168

132

4

304

55.3%

43.4%

1.3%

100.0%

58

18

76

76.3%

23.7%

100.0%

20

7

2

29

69.0%

24.1%

6.9%

100.0%

274

96

9

379

72.3%

25.3%

2.4%

100.0%

21

5

26

80.8%

19.2%

100.0%

DOC Licensed Substance Abuse Programs

Page 72

Appendix F: LSI-R Category Data
Case Processing Summary
Cases
Valid
N
LSI-R Score
Category * Offender
Recidivism * Group

Missing
Percent

3649

90.8%

N

Total

Percent
370

N

9.2%

Percent

4019

100.0%

Recidivism Rates by Comparison Group and LSI-R Category

Group
SA Need/No Prison
Treatment

LSI-R
Category
Low
Low/Moderate
Moderate
Moderate/High
High

SA Need/Successful
Prison Treatment

Low
Low/Moderate
Moderate
Moderate/High
High

Did Not
Recidivate

Recidivism Rates
New
Technical
Conviction
Violation

Total

Count

24

1

3

4

%

85.7%

3.6%

10.7%

14.3%

Count

310

29

29

58

%

84.2%

7.9%

7.9%

15.8%

Count

755

106

133

239

%

76.0%

10.7%

13.4%

24.0%

Count

433

106

102

208

%

67.6%

16.5%

15.9%

32.4%

Count

137

44

30

74

%

64.9%

20.9%

14.2%

35.1%

Count

30

1

1

2

%

93.8%

3.1%

3.1%

6.2%

Count

245

18

26

44

%

84.8%

6.2%

9.0%

15.2%

Count

468

71

98

169

%

73.5%

11.1%

15.4%

26.5%

Count

226

55

65

120

%

65.3%

15.9%

18.8%

34.7%

Count

62

21

20

41

%

60.2%

20.4%

19.4%

39.8%

DOC Licensed Substance Abuse Programs

Page 73

Chi-Square Tests

Group
SA Need/No Prison
Treatment

Value
Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association

54.080(a)
54.866

8
8

.000
.000

30.760

1

.000

8

.000

N of Valid Cases
SA Need/Successful
Prison Treatment

Pearson Chi-Square

Asymp. Sig.
(2-sided)

df

2242
48.410(b)

Likelihood Ratio
51.273
8
.000
Linear-by-Linear
35.300
1
.000
Association
N of Valid Cases
1407
a 2 cells (13.3%) have expected count less than 5. The minimum expected count is 3.57.
b 2 cells (13.3%) have expected count less than 5. The minimum expected count is 3.78.

ASP

LSI-R Score Category

Comparison Group
SA Need/No
Treatment

Count

ALTA

Count

Low

%
%

TC

Count
%

LUH

Anamosa State Penitentiary

Institution

Location

% of Offender Population with Substance Abuse Need within Each Risk Category by Program and
Institution20

SA Need/No
Treatment

Count

Luster Heights SAP

Count

%
%

20

Low/
Moderate

Moderate

Moderate
/High

11

47

36

7

101

10.9%

46.5%

35.6%

6.9%

100.0%

Total

High

6

41

20

5

72

8.3%

56.9%

27.8%

6.9%

100.0%

13

29

10

5

57

22.8%

50.9%

17.5%

8.8%

100.0%

4

10

8

1

23

17.4%

43.5%

34.8%

4.3%

100.0%

7

1

8

87.5%

12.5%

100.0%

The approximation to the chi-square distribution breaks down if expected frequencies are too low. It will
normally be acceptable so long as no more than 10% of the events have expected frequencies below 5.
Unfortunately, that is not the case here. Because of the missing values, the distributions presented in the
table can not be related to the entire population.

CCF

Page 74

LSI-R Score Category

Comparison Group
SA Need/No
Treatment

Count

TOW

Count

Low/
Moderate

Low

%
%

CCFL

Clarinda Correctional
Facility

Institution

Location

DOC Licensed Substance Abuse Programs

SA Need/No
Treatment

Count

TOW

Count

FDCF
ICIW

Fort Dodge
Correctional
Facility
Iowa Correctional
Institution for Women

New Frontiers

Count

20

43

50

27

141

14.2%

30.5%

35.5%

19.1%

100.0%

1

33

115

75

30

254

.4%

13.0%

45.3%

29.5%

11.8%

100.0%

7

25

9

7

48

14.6%

52.1%

18.8%

14.6%

100.0%

SA Need/No
Treatment

Count

STAR

Count

%
%

Violator's ProgramRegular @ ICIW

Count

WINGS

Count
Count

Project TEA - Class

Count

22

9

90

24.4%

10.0%

100.0%

144

106

40

326

44.2%

32.5%

12.3%

100.0%

1

29

115

63

17

225

.4%

12.9%

51.1%

28.0%

7.6%

100.0%

1

40

115

62

34

252

.4%

15.9%

45.6%

24.6%

13.5%

100.0%

4

32

17

3

56

7.1%

57.1%

30.4%

5.4%

100.0%

4

4

7

3

18

22.2%

22.2%

38.9%

16.7%

100.0%

2

21

48

26

11

108

1.9%

19.4%

44.4%

24.1%

10.2%

100.0%

%

7

31

24

3

65

10.8%

47.7%

36.9%

4.6%

100.0%

1

FM3

%
SA Need/No
Treatment

Count

Project TEA

Count

%

SA Need/No
Treatment

Count

Project TEA

Count

100.0%

100.0%

11

40

13

2

67

1.5%

16.4%

59.7%

19.4%

3.0%

100.0%

%
%

1

1

%

JBU

Iowa State Penitentiary

FM1

%

45
50.0%

36

%

SA Need/No
Treatment

14
15.6%
11.0%

%
%

Total

High

1

%
Count

Moderate
/High

.7%

%

SA Need/No
Treatment

Moderate

3

9

1

13

23.1%

69.2%

7.7%

100.0%

10

41

17

9

77

13.0%

53.2%

22.1%

11.7%

100.0%

2

3

14

4

1

24

8.3%

12.5%

58.3%

16.7%

4.2%

100.0%

MPCF
CRC
NCF

Newton Correctional Facility

Mount
Pleasant
Correctional
Facility

Institution

Location

DOC Licensed Substance Abuse Programs

LSI-R Score Category

Comparison Group
SA Need/No
Treatment

Count

SAP @ MPCF

Count

%

SA Need/No
Treatment

Count

SAT/Criminality

Count

%
%

Violator's Program Regular @ CRC

Count

SA Need/No
Treatment

Count

IFI

Count

%
%
Count

SA Need/No
Treatment

Count

Journey

Count

%
%

Moderate

Moderate
/High

Total

High

5

39

85

42

8

179

2.8%

21.8%

47.5%

23.5%

4.5%

100.0%

3

47

121

73

19

263

1.1%

17.9%

46.0%

27.8%

7.2%

100.0%

10

62

75

32

9

188

5.3%

33.0%

39.9%

17.0%

4.8%

100.0%

3

30

26

15

74

4.1%

40.5%

35.1%

20.3%

100.0%

%

%

NCCF

Low/
Moderate

Low

%

PCD

North Central
Correctional
Facility

Page 75

6

6

1

13

46.2%

46.2%

7.7%

100.0%

6

48

114

91

16

275

2.2%

17.5%

41.5%

33.1%

5.8%

100.0%

14

43

15

4

76

18.4%

56.6%

19.7%

5.3%

100.0%

2

4

14

9

29

6.9%

13.8%

48.3%

31.0%

100.0%

4

56

159

100

32

351

1.1%

16.0%

45.3%

28.5%

9.1%

100.0%

7

10

7

2

26

26.9%

38.5%

26.9%

7.7%

100.0%

DOC Licensed Substance Abuse Programs

Page 76

Appendix G: Community Supervision Data.
Case Processing Summary
Cases
Valid
N
CBCIntCategory *
Offender Recidivism

Missing
Percent

1335

N

89.5%

Total

Percent
156

N

10.5%

1491

Recidivism Rates for Offenders Successfully Completing Substance Abuse Treatment
By Intervention in the Community

CBC Intervention Type
None
Case Management
Continuing Care
Education
Inpatient/Residential
Treatment
Outpatient Treatment

757

New
Conviction
122

Recidivism Rates
Technical
Violation
160

Total
282

72.9%

11.7%

15.4%

27.1%

Did Not
Recidivate
Count
%
Count
%
Count

8

1

3

4

66.7%

8.3%

25.0%

33.3%

86

12

34

46

%

65.2%

9.1%

25.8%

34.9%

Count
%

36
80.0%

5
11.1%

4
8.9%

9
20.0%

Count
%
Count
%

24

4

6

10

70.6%

11.8%

17.6%

29.4%

61

3

9

12

83.6%

4.1%

12.3%

16.4%

Chi-Square Tests

Pearson Chi-Square
Likelihood Ratio
Linear-by-Linear
Association
N of Valid Cases

Value
17.472(a)
17.602
.275

10
10

Asymp. Sig.
(2-sided)
.065
.062

1

.600

df

1335

a 4 cells (22.2%) have expected count less than 5. The minimum expected count is 1.32.

Percent
100.0%

DOC Licensed Substance Abuse Programs

Page 77

Recidivism Rates by Comparison Group and Supervision after Release

Supervision
After Release

No

Yes

Did Not
Recidivate

Group
SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

SA Need/No Prison
Treatment

Count

SA Need/Successful
Prison Treatment

Count

%
%
%
%

Recidivism Rates
New
Technical
Conviction
Violation
Total

543

116

3

119

82.0%

17.5%

.5%

18.0%

124

33

0

33

79.0%

21.0%

.0%

21.0%

1350

198

318

516

72.3%

10.6%

17.0%

27.6%

971

147

216

363

72.8%

11.0%

16.2%

27.2%

DOC Licensed Substance Abuse Programs

Page 78

Appendix H: Age Category Data.
Recidivism Rates by Age Category and Comparison Group

Comparison Group

Age
Category

Did Not
Recidivate
Count

Under 20

SA Need/Successful
Prison Treatment

20

29

30

39

40

49

%
Count
%
Count
%
Count
%
Count

50 & Over

%
Count

Under 20

SA Need/No Prison
Treatment

20

29

30

39

40

49

%
Count
%
Count
%
Count
%
Count

50 & Over

%

New
Conviction

Recidivism Rates
Technical
Violation

Total

4

3

0

3

57.1%

42.9%

.0%

49.2%

446

93

115

208

68.2%

14.2%

17.6%

31.8%

312

52

63

115

73.1%

12.2%

14.8%

26.9%

270

31

36

67

80.1%

9.2%

10.7%

19.9%

62

1

2

3

95.4%

1.5%

3.1%

4.6%

33

7

5

12

73.3%

15.6%

11.1%

26.7%

677

142

138

280

70.7%

14.8%

14.4%

29.3%

574

100

92

192

74.9%

13.1%

12.0%

25.1%

490

60

68

128

79.3%

9.7%

11.0%

20.7%

119

5

18

23

83.8%

3.5%

12.7%

16.2%

Age Groups by Location and Comparison Group

Institution

Location

Comparison Group
SA Need/No Treatment

ASP
Anamosa State
Penitentiary

Age at Release
Under
40 and
40
Older

ALTA
TC
SA Need/No Treatment

LUH
Luster Heights SAP

Total

Count

95

36

131

%

72.5%

27.5%

100.0%

Count

65

15

80

%

81.3%

18.8%

100.0%

Count

44

16

60

%

73.3%

26.7%

100.0%

Count

22

6

28

%

78.6%

21.4%

100.0%

Count

5

3

8

%

62.5%

37.5%

100.0%

DOC Licensed Substance Abuse Programs

Institution

Location

CCF
TOW
SA Need/No Treatment
CCFL
TOW

Fort Dodge
Correctional Facility

SA Need/No Treatment
FDCF
New Frontiers
SA Need/No Treatment

Iowa Correctional
Institution for
Women

STAR
ICIW

Violator's ProgramRegular @ ICIW
WINGS
SA Need/No Treatment

FM1
Project TEA - Class

Iowa State
Penitentiary

SA Need/No Treatment
FM3
Project TEA
SA Need/No Treatment
JBU
Project TEA

Mount Pleasant
Correctional Facility

Age at Release
Under
40 and
40
Older

Comparison Group
SA Need/No Treatment

Clarinda
Correctional Facility

Page 79

SA Need/No Treatment
MPCF
SAP @ MPCF

Total

Count

104

54

158

%

65.8%

34.2%

100.0%

Count

183

90

273

%

67.0%

33.0%

100.0%

Count

35

15

50

%

70.0%

30.0%

100.0%

Count

54

37

91

%

59.3%

40.7%

100.0%

Count

352

15

367

%

95.9%

4.1%

100.0%

Count

229

8

237

%

96.6%

3.4%

100.0%

Count

187

93

280

%

66.8%

33.2%

100.0%

Count

31

25

56

%

55.4%

44.6%

100.0%

Count

16

3

19

%

84.2%

15.8%

100.0%

Count

75

38

113

%

66.4%

33.6%

100.0%

Count

34

33

67

%

50.7%

49.3%

100.0%

Count

1

1

%

100.0%

100.0%

Count

34

40

74

%

45.9%

54.1%

100.0%

Count

8

6

14

%

57.1%

42.9%

100.0%

Count

46

42

88

%

52.3%

47.7%

100.0%

Count

11

13

24

%

45.8%

54.2%

100.0%

Count

140

70

210

%

66.7%

33.3%

100.0%

Count

204

81

285

%

71.6%

28.4%

100.0%

DOC Licensed Substance Abuse Programs

Institution

Location

SAT/Criminality
Violator's Program Regular @ CRC

Newton
Correctional Facility

SA Need/No Treatment
NCF

IFI
PCD

North Central
Correctional Facility

Age at Release
Under
40 and
40
Older

Comparison Group
SA Need/No Treatment

CRC

Page 80

SA Need/No Treatment
NCCF
Journey

Total

Count

116

87

203

%

57.1%

42.9%

100.0%

Count

53

30

83

%

63.9%

36.1%

100.0%

Count

15

15

%

100.0%

Count

216

88

100.0%
304

%

71.1%

28.9%

100.0%

Count

53

23

76

%

69.7%

30.3%

100.0%

Count

22

7

29

%

75.9%

24.1%

100.0%

Count

261

118

379

%

68.9%

31.1%

100.0%

Count

20

6

26

%

76.9%

23.1%

100.0%

DOC Licensed Substance Abuse Programs

Page 81

Appendix I: Race/Ethnicity Data.
Recidivism Rates by Race/Ethnicity and Comparison Group

Group

Race/Ethnicity
African American

SA Need/No Prison
Treatment

Other Minority

%
Count
%
Count

Caucasian

%

African American
SA Need/Successful
Prison Treatment

Count

Other Minority

Count
%
Count
%
Count

Caucasian

%

Did Not
Recidivate

New
Conviction

Recidivism Rates
Technical
Violation

Total

350

85

98

533

65.7%

15.9%

18.4%

100.0%

88

19

17

124

71.0%

15.3%

13.7%

100.0%

1455

210

206

1871

77.8%

11.2%

11.0%

100.0%

190

49

67

306

62.1%

16.0%

21.9%

100.0%

60

7

13

80

75.0%

8.8%

16.3%

100.0%

845

124

136

1105

76.5%

11.2%

12.3%

100.0%

African
American

Other
Minority

Caucasian

30

5

96

22.9%

3.8%

73.3%

Race/Ethnicity by Institution and Comparison Group
Institution

Location

Comparison Group
SA Need/No Prison
Treatment

ASP
Anamosa State
Penitentiary

ALTA
TC

LUH

SA Need/No Prison
Treatment
Luster Heights SAP

Count
%
Count
%
Count
%
Count
%
Count
%

20

2

58

25.0%

2.5%

72.5%

12

1

47

20.0%

1.7%

78.3%

1

1

26

3.6%

3.6%

92.9%
8
100.0%

DOC Licensed Substance Abuse Programs

Institution

Location

CCF

CCFL

SA Need/No Prison
Treatment

SA Need/No Prison
Treatment
TOW

Fort Dodge
Correctional Facility

FDCF

SA Need/No Prison
Treatment
New Frontiers
SA Need/No Prison
Treatment

Iowa Correctional
Institution for Women

STAR
ICIW

Violator's ProgramRegular @ ICIW
WINGS

FM1

SA Need/No Prison
Treatment
Project TEA - Class

Iowa State
Penitentiary

FM3

SA Need/No Prison
Treatment
Project TEA

JBU

SA Need/No Prison
Treatment
Project TEA

Mount Pleasant
Correctional Facility

MPCF

African
American

Comparison Group

TOW

Clarinda Correctional
Facility

Page 82

SA Need/No Prison
Treatment
SAP @ MPCF

Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%

Other
Minority

39

7

112

24.7%

4.4%

70.9%

47

24

202

17.2%

8.8%

74.0%

16

2

32

32.0%

4.0%

64.0%

16

5

70

17.6%

5.5%

76.9%

103

21

243

28.1%

5.7%

66.2%

62

16

160

26.1%

6.7%

67.2%

52

20

208

18.6%

7.1%

74.3%

6

2

48

10.7%

3.6%

85.7%

2

17

10.5%

89.5%

24

6

83

21.2%

5.3%

73.5%

13

2

52

19.4%

3.0%

77.6%

Count

1

%
Count
%
Count
%
Count
%
Count
%
Count
%
Count
%

Caucasian

100.0%
9

65

12.2%

87.8%

1

13

7.1%

92.9%

33

4

51

37.5%

4.5%

58.0%

8

3

13

33.3%

12.5%

54.2%

47

15

148

22.4%

7.1%

70.5%

76

16

193

26.7%

5.6%

67.7%

DOC Licensed Substance Abuse Programs

Institution

Location

Newton Correctional
Facility

NCF

SAT/Criminality

NCCF

Count
%
Count
%

Violator's Program Regular @ CRC

Count

SA Need/No Prison
Treatment

Count

IFI
PCD

North Central
Correctional Facility

African
American

Comparison Group
SA Need/No Prison
Treatment

CRC

Page 83

SA Need/No Prison
Treatment
Journey

%
%
Count
%
Count
%
Count
%
Count
%

Other
Minority

Caucasian

24

8

171

11.8%

3.9%

84.2%

9

1

73

10.8%

1.2%

88.0%

3

1

11

20.0%

6.7%

73.3%

76

12

216

25.0%

3.9%

71.1%

5

2

69

6.6%

2.6%

90.8%

10

1

18

34.5%

3.4%

62.1%

53

19

307

14.0%

5.0%

81.0%

5

21

19.2%

80.8%

DOC Licensed Substance Abuse Programs

Page 84

Appendix J: Q12 Results.
I know what is expected of me at work.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
3
2
20
11
36
19
55

Percent
5.5
3.6
36.4
20.0
65.5
34.5
100.0

Valid Percent
8.3
5.6
55.6
30.6
100.0

Cumulative
Percent
8.3
13.9
69.4
100.0

I have the materials and equipment I need to do my work right.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
10
10
11
5
36
19
55

Percent
18.2
18.2
20.0
9.1
65.5
34.5
100.0

Valid Percent
27.8
27.8
30.6
13.9
100.0

Cumulative
Percent
27.8
55.6
86.1
100.0

At work, I have the opportunity to do what I do best every day.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
8
7
14
7
36
19
55

Percent
14.5
12.7
25.5
12.7
65.5
34.5
100.0

Valid Percent
22.2
19.4
38.9
19.4
100.0

Cumulative
Percent
22.2
41.7
80.6
100.0

DOC Licensed Substance Abuse Programs

Page 85

In the last seven days, I have received recognition or praise for doing good work.

Valid

Missing
Total

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
3
11
11
7
4
36
19
55

Percent
5.5
20.0
20.0
12.7
7.3
65.5
34.5
100.0

Valid Percent
8.3
30.6
30.6
19.4
11.1
100.0

Cumulative
Percent
8.3
38.9
69.4
88.9
100.0

My supervisor, or someone at work, seems to care about me as a person.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
2
6
19
9
36
19
55

Percent
3.6
10.9
34.5
16.4
65.5
34.5
100.0

Valid Percent
5.6
16.7
52.8
25.0
100.0

Cumulative
Percent
5.6
22.2
75.0
100.0

There is someone at work who encourages my development.

Valid

Missing
Total

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
1
3
8
18
6
36
19
55

Percent
1.8
5.5
14.5
32.7
10.9
65.5
34.5
100.0

Valid Percent
2.8
8.3
22.2
50.0
16.7
100.0

Cumulative
Percent
2.8
11.1
33.3
83.3
100.0

DOC Licensed Substance Abuse Programs

Page 86

The mission or purpose of my company makes me feel my job is important.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
3
7
17
9
36
19
55

Percent
5.5
12.7
30.9
16.4
65.5
34.5
100.0

Valid Percent
8.3
19.4
47.2
25.0
100.0

Cumulative
Percent
8.3
27.8
75.0
100.0

My associates or fellow employees are committed to doing quality work.

Valid

Missing
Total

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
2
1
7
18
8
36
19
55

Percent
3.6
1.8
12.7
32.7
14.5
65.5
34.5
100.0

Valid Percent
5.6
2.8
19.4
50.0
22.2
100.0

Cumulative
Percent
5.6
8.3
27.8
77.8
100.0

At work, my opinions seem to count.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
7
10
13
6
36
19
55

Percent
12.7
18.2
23.6
10.9
65.5
34.5
100.0

Valid Percent
19.4
27.8
36.1
16.7
100.0

Cumulative
Percent
19.4
47.2
83.3
100.0

DOC Licensed Substance Abuse Programs

Page 87

I have a best friend at work.

Valid

Missing
Total

Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
2
5
12
12
5
36
19
55

Percent
3.6
9.1
21.8
21.8
9.1
65.5
34.5
100.0

Valid Percent
5.6
13.9
33.3
33.3
13.9
100.0

Cumulative
Percent
5.6
19.4
52.8
86.1
100.0

In the last six months, someone at work has talked to me about my progress.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
4
11
15
6
36
19
55

Percent
7.3
20.0
27.3
10.9
65.5
34.5
100.0

Valid Percent
11.1
30.6
41.7
16.7
100.0

Cumulative
Percent
11.1
41.7
83.3
100.0

This last year, I have had opportunities at work to learn and grow.

Valid

Missing
Total

Disagree
Neutral
Agree
Strongly Agree
Total
System

Frequency
2
8
16
10
36
19
55

Percent
3.6
14.5
29.1
18.2
65.5
34.5
100.0

Valid Percent
5.6
22.2
44.4
27.8
100.0

Cumulative
Percent
5.6
27.8
72.2
100.0

DOC Licensed Substance Abuse Programs

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DOC Licensed Substance Abuse Programs

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