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Keeping Kids and Parents Parents Together, a Healthier Approach to Sentencing in Tennessee, 2018

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Keeping Kids and
Parents Together
A Healthier Approach to Sentencing
in Tennessee

February 2018

Executive Summary
It carries on throughout their life that their mother or father had to go away for a while.
If there was an alternative to incarceration in place it would keep the family bond
instead of the family being destroyed from separation.
– Lisa, formerly incarcerated mother
More than 800,000 parents are incarcerated across the US — a
common practice that tears families apart, hurts children, and
harms the health of entire communities. In this report, we evaluate
the health and equity impacts of Tennessee House Bill 0825 and
Senate Bill 0919. If passed, these bills would expand the ability to set
community-based sentences for parents.

Community-based sentencing is a healthier and
fiscally responsible alternative.
The benefits of allowing incarcerated parents to stay with or have
more contact with their children are tremendous. Parents are more
likely to succeed at treatment for substance use disorders and less
likely to return to prison. By staying connected with their parents,
children have the opportunity to experience healthy development
and attachment, which contributes to good mental health and fewer
behavioral issues. Community-based sentencing also decreases costs
to prisons and jails and keeps parents connected to the workforce.

Youth of color are more likely to experience their
parent getting locked up.
As a result of the racial inequities in the criminal legal system in the
US, Black children are nine times more likely and Latino/a children
are three times more likely than White children to have a parent in
prison. Kids with incarcerated parents are at risk of facing a variety
of physical, mental, and behavioral health issues throughout the rest
of their lives as a direct result of separation from their parent due to
incarceration. In fact, this type of child-parent separation is classified
as a specific type of trauma: an adverse childhood experience (ACE).
Across Tennessee, about 19,198 children are separated from a parent
due to incarceration.


Reducing the harm from
incarcerating parents
is doable in Tennessee.
In 2016, about 3,733
parents who are currently
incarcerated would have
been eligible for this
alternative sentencing in
Tennessee — potentially
keeping them together
with their kids while still
being held accountable for
their actions.

In Tennessee, about 1 of
every 10 children has had
an incarcerated parent.

Mothers and grandmothers bear the burden at home.
When a father is incarcerated, his children’s mother remains as the primary caregiver 90% of the time.
When a mother is incarcerated, her children are often displaced from their homes and frequently
placed in the care of their grandmother. In both of these situations, mothers and grandmothers face
the additional financial burden and emotional toll of a single parent home.

Incarceration is harmful to individual and
community health.
Prison and jail environments are not conducive to family visits. In
addition, most mothers and fathers in state and federal prisons are
held over 100 miles from their homes, creating significant barriers
for kids to visit their parents. Incarcerated parents who aren’t able to
maintain a connection with their children are more likely to experience
depression, anxiety, and hopelessness, be re-incarcerated, and lose
parental rights. In communities targeted by mass incarceration, the
loss of working adults and parents to jails and prisons fuels the cycle
of poverty without reducing crime or increasing public safety.

Almost 9 out of 10 women
who are incarcerated have
extensive histories of
emotional, physical, and
sexual abuse. They should
be supported and have
access to treatment —
not punished.

Alternative sentencing holds parents accountable and keeps
families together.
Research shows that community-based sentencing creates a supportive environment where parents
can heal and be held accountable for the consequences of their conviction — while staying with or
near their kids. These sentencing alternatives can also properly address substance use, mental health
issues, and homelessness, instead of criminalizing behaviors that merit public health interventions.
These community-based alternatives do not have to be residential, but they do have to be funded
external to the criminal legal system. This report highlights Tennessee programs that could serve
parents sentenced to community alternatives under this proposed legislation.

Visit to read the full report and view references.

- ii -

Authored By
Kim Gilhuly, MPH
Lee Taylor-Penn, MPA/MPH
In partnership with Alexandra Chambers and Dawn Harrington, Free Hearts

Suggested Citation
Human Impact Partners and Free Hearts. February 2018. Keeping Kids and Parents Together: A
Healthier Approach to Sentencing in Tennessee. Oakland, CA.

Contact Information
Kim Gilhuly
Human Impact Partners
510-452-9442, ext. 114

With support from: Healthy and Free Tennessee
Graphic Design: Little Red Cozette (Cozette Lehman)

The work in this report was made possible by the generous funding of the Kresge Foundation.

- iii -

Table of Contents
Executive Summary............................................................................................................................... i
Acknowledgments............................................................................................................................... iii
Introduction.......................................................................................................................................... 1
What are Tennessee House Bill 0825 and Senate Bill 0910?...........................................................1
Incarceration is a Determinant of Health.......................................................................................2
About this Report..........................................................................................................................2
Who is Affected by Incarceration in Tennessee?................................................................................... 3
Scope of Parents and Children Affected by Incarceration in Tennessee.........................................3
The Role of Trauma and Other Health Issues..................................................................................5
The Role of Disinvestment in Education, Employment, and Housing..............................................7
Community-Based Sentencing Is a Common Sense Alternative........................................................... 9
Community-Based Sentencing is Healthier for Children................................................................9
Community-Based Sentencing is Healthier for Parents............................................................... 10
Community-Based Sentencing is Fiscally Responsible................................................................ 12
Incarcerating Parents is Harmful........................................................................................................ 14
Having an Incarcerated Parent is a Traumatic Event and is Hazardous to Health......................... 14
Separation from One's Children is Harmful to Parents Too........................................................... 18
Families and Communities Suffer When Parents Are Incarcerated.............................................. 19
House Bill 0825 and Senate Bill 0919 Are a Healthier Approach to Sentencing Parents in Tennessee....21
Recommendations for Implementation....................................................................................... 21
References.......................................................................................................................................... 23

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You lock me up, you lock my child up, you cause dysfunction in the family, you cause
so much dysfunction. This [incarcerating parents] leads to dysfunction in [my child’s]
future, and then you got what you want. They want to deprive us, that’s how I feel.
– Aniya, who was separated from two children while incarcerated
Ensuring a safe, stable, and nurturing environment for children is a priority most of us can agree with.
However, when it comes to protecting kids and their family ties, our criminal legal system ignores the
harm of incarcerating parents for low-level convictions. More than 800,000 parents1 are incarcerated
across the US — a common practice tearing families apart, hurting children, and harming the health
of entire communities.
This report evaluates the health and equity impacts of Tennessee House Bill 0825 and Senate Bill 0919.
If passed, these bills would expand the ability to set community-based sentences rather than prisonor jail-based sentences for people who are parents. In 2016, about 3,733 parents who are currently
incarcerated would have been eligible for this alternative sentencing in Tennessee — potentially
keeping them together with their kids while still being held accountable for their actions.a 2 3 4 5

What are Tennessee House Bill 0825 and Senate
Bill 0910?
Tennessee House Bill 0825 and Senate Bill 0910 would expand the
ability to use community-based alternatives to sentence parents and
other primary caregivers of dependent children, so they can care for
their families while being accountable for the consequences of their
The bill defines “primary caregivers” as those who have assumed
responsibility for a dependent child under the age of 18. This includes
those who have responsibility for the housing, health, financial support,
education, family ties, or safety of that child. Legislative bill sponsors
specified eligibility for alternative sentencing to primary caregivers who
face “non-violent” convictions such as drug and property offenses.

The Primary Caregiver
legislation was crafted by
women who are currently
and formerly incarcerated
who were motivated
because of the harms
they experienced due
to separation from their
children by imprisonment.

What are community-based sentencing alternatives?
Community-based sentencing alternatives allow for community rehabilitation, accountability, and
parent-child unity. Examples of community-based sentencing options identified in this bill include:

Drug and alcohol treatment
Physical and sexual abuse counseling
Family and individual counseling
Behavioral Health Intervention

Tennessee has about 3,700 parents currently incarcerated in state prisons and county jails who would be eligible to benefit
from community-based sentencing alternatives. The bill is not retroactive and these parents are currently incarcerated will
not be eligible for alternate sentencing as a result of passing the bill.



Domestic violence education and prevention
Anger management
Financial literacy
Parenting classes

Vocational and educational services
Job training and placement
Affordable and safe housing assistance
Family case management

Incarceration is a Determinant of Health
Although health care and individual behaviors undoubtedly influence health and well-being, more
than 50% of our health is actually determined by social and environmental conditions — social
determinants of health. These are shaped by environmental, economic, and social policies, which can
either help build healthier communities or harm them.6 7
Being incarcerated can affect an individual's health in profound ways, and social policies that lead to
mass incarceration can impact the health of entire groups.8 The policies leading to mass incarceration
have profoundly affected health and impact large proportions of people of color contributing to racial
health inequities. In Tennessee, the health of Black, Brown, and low-income rural White communities
are all disproportionately impacted by incarceration.9

About This Report
This report represents a partnership between Free Hearts and Human Impact Partners (HIP). Free
Hearts is an organization lead by formerly incarcerated women that provides support, education, and
advocacy for families impacted by incarceration, with the ultimate goals of keeping families together.
HIP’s Health Instead of Punishment Program increases the consideration of health in public decisions
about criminal legal system policy and practices. The research in this report includes peer-reviewed
literature, government reports and data, grey literature, and interviews with people who are either
parents who were incarcerated or children of incarcerated parents. These data sources synthesize the
health and equity impacts of offering community-based alternatives to incarcerating parents.

Notes about language in this report
We use the term “parent” to signify a primary caregiver: a person who has assumed responsibility

for a dependent child’s housing, health, financial support, education, family ties, or safety.
We use the following terms: “people in prison,” “incarcerated individuals/people,” and “system-

involved individuals or people” rather than “prisoner” or “offender.” We also use “formerly
incarcerated individuals/people” instead of “convict.” Our intent is to avoid defining people
permanently by past experiences or behaviors.

Highlighting alternatives to incarceration
Throughout the report we describe several alternative programs to incarceration that are working well in
Tennessee and across the United States. We identified them as examples that may work and be of value.


Who is Affected by Incarceration
in Tennessee?
There are approximately 3,733 parents currently incarcerated in state
prisons and county jails in Tennessee who would have been eligible
for community-based alternatives had they been sentenced under
this law.b
It’s important to note that the relatively low number of people
potentially impacted makes this bill manageable. Tennessee’s
nonprofit infrastructure may help set the stage for the state to lead
the way in implementing this humane and common-sense policy.
According to the National Center for Charitable Statistics, there were
about 28,000 nonprofits registered in Tennessee in 2013. About 3,000
of them are “safety net” organizations providing housing, health and
human services, and crisis intervention.10

Scope of Parents and Children Affected by
Incarceration in Tennessee

Tennessee is starting to
make smart choices on
incarceration policies.
In 2016 the Tennessee
legislature voted to
defeat a law that jailed
pregnant women and new
mothers that used drugs
during pregnancy. This
vote reflects a thoughtful
consideration of the role
of health in legislative
decision-making and is
step forward for respecting
basic human rights.12

Tennessee incarcerates thousands of parents
Approximately 80% of incarcerated women are mothers,11 and are the primary caregivers of children
prior to their arrest.12 Incarcerated mothers have an average of 2.4 dependent children each.13 Some
women are pregnant when incarcerated — a survey of jailed and imprisoned mothers found that 9%
of respondents gave birth while incarcerated.14
The number of fathers in prisons and jails is much higher, which reflects the far greater number of
imprisoned men in general. Fathers in prison report having an average of 2.1 children1 however, only
2% of incarcerated fathers are single fathers living alone with their child.15

1 out of 10 kids in Tennessee has had an incarcerated parent
Across Tennessee, about 19,198 children have a parent in prison or
jail.c A 2016 study by The Annie E. Casey Foundation, found that 10%
of children and teens, or 144,000 youth, living in Tennessee had ever
experienced having a parent in prison or jail at some time in their young
lives. Tennessee has the third highest prevalence rate of incarcerated
parents, along with five other states.16

Black children are nine
times more likely and
Latino/a children are three
times more likely than
White children to have a
parent in prison.1 19

Nationally, more than one in five of children with a parent in prison is
under five years old,11 and 2.3% of US resident children under age 18
had a parent in prison.


This estimate is compiled using numbers of people incarcerated in prisons and jails in Tennessee, the types of crimes people
are incarcerated for that would be eligible under this bill, the proportion male and female, and the proportion of women and
men who tend to be primary caregivers. This estimate is somewhat conservative; comprehensive jail data from across the
state in Tennessee was not publicly available
This estimate comes from the same calculations described above for numbers of primary caregivers.


House Bill 0825 and Senate Bill 0910 in the context of historical criminal
legal system policies
There are myriad policies and practices that have converged to create the criminal legal system that
operates today, which incarcerates many Volunteer State residents — particularly people of color and
those living in poverty. Many of those currently caught up in the criminal legal system are there due to
well-known public policies:17
The “War on Drugs” led to extreme and racialized sentencing laws.
Mandatory minimums and sentence enhancements that have served to incarcerate more people

for a longer amount of time.
Collateral consequences of criminal conviction make it extremely difficult for someone returning
from incarceration to succeed.
Mental health systems and social safety net programs have been dismantled.
Laws that criminalize people who have illnesses of addiction and mental health struggles, and
those who face homelessness.
Police engage in hyper-surveillance and arrest of communities of color and low-income communities.
Privatization of prisons and jails create economic incentives rewarding sentencing for minor
infractions and over-policing.
Prison and bail industries that seek profit over humane treatment.
Increased criminalization of the homeless, sex workers, undocumented immigrants, transgender
individuals, and others led to people arrested for behaviors arising in response to a decreased
social safety net and policies of marginalization.18

Tennessee disproportionately punishes parents of color and those who are poor
If you’re Black or Latino/a you are more likely to be criminalized and subsequently incarcerated.
Figure 1 shows disproportionate incarceration rates in Tennessee.

Figure 1. Incarceration Rates in Tennessee






Proportion of
TN General


Source: Tennessee Profile. 2010. Prison Policy Initiative.

The majority of incarcerated women live in poverty, are single, have lower rates of educational
attainment, and are disproportionately people of color.13


The incarceration of women in Tennessee has increased
While incarceration in Tennessee has increased by 7% over the past 7 years, women are being
incarcerated at a higher rate than men.3 According to the Tennessee Department of Correction, from 2010
to 2016, female admissions to jails increased by 37%,3 while female incarceration in prisons increased by
31%.19 The increases in prison and jail admissions of women is disheartening because women are, in the
majority, primary caregivers of their children.20

Mothers and grandmothers bear the burden when a parent is incarcerated
When fathers are locked up, their children’s mothers remain as primary caregivers 90% of the time.15
In this situation, kids often get to stay in their own home with a parent who was already taking care of
them — only 2% of incarcerated fathers were single fathers living alone with their child.15 As primary
caregivers, many mothers must also bear the financial burden: 54% of incarcerated fathers report
that they are the primary source of financial support for their children prior to incarceration.1

My children were with my sister and their granny, and it was very traumatic being
with your mom all these years and they had to go live with someone else. Very, very
emotional strain on everyone – and financially as well.
– Aniya, who was separated from two children while incarcerated
Children of incarcerated mothers are more likely to be displaced from their homes and placed with a
non-parent guardian.13 Mothers report that when they are incarcerated, 51% of the time grandmothers
care for children.11 On the low side, 17%21 of children live with their fathers, with other reports
showing as much as 28%.11 Other relatives and family friends take this role 20% and 4% of the time,
respectively. In 11% of cases, children go to a foster home or agency.11

The Role of Trauma and Other Health Issues
There is a long and complicated history that the United States has perpetuated to create our current
criminal legal system. That history includes hundreds of years of outright and institutional racism,
judgment and oppression of those in poverty, and reduction in equitable resources to ensure success
and health for all people. Overlaid with this is the decades-long use of policing, sentencing, and
incarceration as a tool to suppress Black communities and other people of color, leading to laws that
criminalize some of the health issues identified below.17
Because of this history of neglect and oppression, these parents are often coping with issues that
require support, which could mean treatment and time to heal from trauma, assistance getting
jobs, housing, and an education. Overwhelmingly, these parents can still be loving caregivers to their
children and should remain in that role despite the institutional obstacles they face.

The majority of people involved in the criminal legal system have experienced trauma
Between 77% and 90% of women who are incarcerated have extensive histories of emotional,
physical, and sexual abuse.22 Instead of treating this trauma appropriately, society’s common
response has been to respond by criminalizing the behaviors that can result from experiencing or
witnessing violence and neglect.


There is a vast research base looking at toxic stress in childhood and the lifelong problems it causes,
including a higher likelihood of incarceration. There is a relationship between being a survivor of crime
and abuse, and then being responsible for crime and abuse. A study documenting this phenomena
states, “Nearly everyone who commits violence has also survived it, and few have gotten formal
support to heal.”23

The majority of incarcerated women have experienced prior sexual abuse or sexual violence
The experience of sexual abuse or sexual violence is a common characteristic of women who are
imprisoned.24 25 One researcher found that 55% of a sample of 102 women in prison had been sexually
abused, which is double the rate in the general population.21 Another study found that 86% of women
in jails had experienced sexual violence in their lives, 77% had experienced partner violence, and 60%
had experienced caregiver violence.26

The criminalization of substance use disorder leads to incarceration
Substance use disorder is common among people housed in Tennessee prisons and jails. About
48% of people incarcerated in Tennessee have an identified, untreated substance abuse disorder.27
Additionally, about 70% of females in state prisons have a substance abuse disorder or mental
health issue.28
Most parents are incarcerated for “non-violent” reasons, such as drug-related behaviors. In fact,
people who committed drug and public-order crimes in prisons are more likely to have children
than those who committed violent crimes.1 Women in state prisons are more likely than men to
be incarcerated for a drug or property offense and less likely than men to be incarcerated for a
violent offense. The majority (60%) of women in state prisons have a history of drug dependence.11
In a sample of almost 500 women in jails across the country, 82% had experienced drug or alcohol
abuse or dependence.5
In Tennessee, one outcome of the opioid epidemic has been an increase of criminalization of women
for the illness of addiction, and longer periods of incarceration due to a lack of fundng for treatment
services for women, especially pregnant women and children.29 While judges and health officials
call for more treatment facilities as alternatives to incarceration, Governor Haslam’s recent budget
proposal includes adding hundreds of prison beds for treatment.30 Focusing funding on incarceration
instead of community treatment facilities further entrenches the criminalization of the illness of
addiction and the social and economic divide between those who can afford to access treatment
external to incarceration and those who cannot.

The criminalization of mental health issues leads to incarceration
People who have experienced trauma are more likely to have mental health issues. With laws that
criminalize behaviors of those suffering from mental illness, trauma, and other behavioral health
issues, more and more people who require health interventions are instead locked up in jail or
prison. Combined with de-institutionalization of state mental hospitals and the decimation of
systems to treat these issues, jails and prisons have wrongly become one of the few places that
people can access mental health treatment, and even so the treatment is woefully inadequate.31
According to the Treatment Advocacy Center, “[t]he three largest state prisons—at Henning,
Tiptonville, and Wartburg—each holds more seriously mentally ill prisoners than the largest state
psychiatric hospital.”32


While 12% of women in jails have severe psychiatric disorders, fewer than 25% of them receive
mental health services.11 In Tennessee, 29% of incarcerated persons have mental health issues, yet
only 2.5% receive mental health treatment.27 To decrease the number of people with mental health
issues being arrested and sent to prisons and jails, an increase in affordable and accessible mental
health services must be offered in the community.31 33

The Unmet Mental Health Need in Tennessee
In 2013, the Treatment Advocacy Center, a national nonprofit research organization, gave Tennessee
a “C” grade for how well the state does at diverting people with severe mental illness from the
criminal legal system. A more recent study noted that there has been a 9% reduction in the
availability of public psychiatric beds between 2010 to 2016, and subsequently it is 3 times more
likely that a person would be jailed rather than hospitalized for symptoms and behaviors associated
with untreated severe mental illness.34 32

The Role of Disinvestment in Education, Employment, and Housing
The greatest dangers to our communities are gentrification, under-invested public
schools coupled with an over-invested police force, lack of access to jobs and housing,
all of which perpetuate the crimes our families are being punished for. We are suffering
and it seems we are perpetually in a state of grief.
– Ayana, age 22, whose father was incarcerated for 17 years

Having a low level of education, due to many societal and interpersonal influences, is a risk factor for
incarceration. Nationally, about 21% of adults read below a 5th grade level.35 Just under half (44%)
of women in state prisons have neither graduated from high school nor received a GED.11 In spite of
this, only half of women’s jails and prisons offer post-secondary education.11 Educational attainment
directly impacts people’s earnings potential. One year of education, for example, leads to roughly an
8% increase in earnings.36 37 Educational attainment is associated with a lower likelihood of being

Structural obstacles to stable employment are also a risk factor for criminalization and incarceration.
People in prison have experienced low levels of employment. Like the gender gap in general society,
incarcerated women have high rates of unemployment — half of all incarcerated women did not work
at all in the month before being incarcerated, and 60% did not work full-time. Thirty-seven percent
had incomes below $600 per month. Among incarcerated men, 40% were not employed full-time
when they were arrested and 28% earned below $600 in the month before their arrest.11 Finding
employment can be even more challenging after being released from prison due to having a prior
felony conviction — thus, people formerly in prison are at a high risk of economic insecurity.39


A minimum wage earner in Tennessee would have to work 69 hours each week to afford a modest
1-bedroom rental (at Fair Market Rent). In Nashville, the most expensive area to live in Tennessee,
homelessness rose by nearly 10% in between 2015 and 2016.40 Based on the Point in Time Count in
Tennessee, about 2607 persons in families experienced homelessness on a single night in 2015.41
When people don’t have access to affordable and stable housing, they can end up criminalized for not
being able to maintain housing. For context, the National Law Center on Homelessness and Poverty
conducted a survey with 187 cities and found that:
More than 33% of cities have city-wide bans on camping in public
43% of cities prohibit sleeping in vehicles
53% of cities ban sitting or lying down in certain public places

Worse, once someone has been locked up in jail or prison, their odds of experiencing homelessness go
from 1 in 200 (for the general population) to 1 in 11 (for people recently released from prison).42

Neglect by institutions
People who become incarcerated — especially women — have often been neglected by the very
systems that are put in place to protect them.40 In a conference that brought together women who
had experienced incarceration themselves or of their families and women in public health, formerly
incarcerated women shared many experiences of reaching out for help — to a school counselor, a
school nurse, a clinic staff — and being ignored or neglected. This institutional neglect added to
family or community trauma ultimately led to decisions and behaviors that resulted in incarceration.41


Community-Based Sentencing Is a
Common Sense Alternative
Non-custodial, community-based sentencing options allowable under House Bill 0825 and Senate Bill
0919 are more effective and health-supportive than incarceration.

Community-Based Sentencing is Healthier for Children
Keeping parents and children together is better for children’s attachment and development
When children can stay with their parents throughout their infant, childhood, and adolescent years,
they have better bonding and attachment, development, and lifelong health outcomes.

For a child, your parents are the first example you get. And they are the reason why
your relationship with other people can be weak or strong. If there’s an alternative
solution that keeps the family together and still helps that person become better,
then you should want to take it. It’s not just about the person, it’s the whole system.
They’re raising somebody.
– Ashley, whose father was incarcerated for 10 years
Infants who spend quality time with their parents form stronger, more secure, and long-lasting
attachments.44 45 In turn, parental attachment impacts every aspect of childhood development.46
Infants seek bonds with their parents to gain protection and safety, and they also need attachment to
parents for their intellectual, social, and psychological development.46 15
Attachment to parents is essential for the health of older children as well: adolescents who are
securely attached to parents are less likely to engage in high risk behaviors, have fewer mental health
problems, and have better social skills and coping strategies as compared to those who do not have
secure attachments.46 For infants and older children alike, healthy attachment to parents gives
children the feeling of safety and stability that allows them to explore the world around them.46
Research demonstrates that allowing children to remain with their
mothers, even while they are in correctional control, is associated
Secure attachment47
Lower levels of anxiety and depression48
A higher likelihood of maintaining custody of children

following release49
Families are more bonded after the mother’s release4


Children whose mothers
are incarcerated are at
high risk of being placed in
foster care.
In a Bureau of Justice
Statistics study, mothers
in prison were five times
more likely than fathers in
prison to report that a child
was in foster care (11% vs.
2% respectively).1

Community-based sentencing keeps children with their families instead of foster care
When parents can maintain their caretaking roles, their children avoid placement in foster care. An
alternative sentencing program in the state of Washington prevented 44 children from going into the
foster care system. Eight children came out of foster care and were returned to their parents.48

Community-Based Sentencing is Healthier for Parents
Much of the research about the health impacts of parental incarceration is about children and
mothers — as such we report information about mothers in this section on parents, noting that there
is a research gap regarding impacts on fathers.
Sentencing programs for mothers in which children can cohabitate or stay overnight, or where
mothers just go during the daytime only, preserve and strengthen families.13 After completing
community-based programs, parents have successfully reduced substance use disorder, improved
parenting skills, and reduced recidivism. These benefits also extend to entire families. If our
corrections system truly seeks to correct behaviors and rehabilitate people while holding them
accountable for the consequences of their conviction, the most evidence-based method of achieving
this is to allow people to serve time in their communities.

Substance use disorder treatment is more effective if parents remain connected to children
Current or prior substance use disorder is a common though not universal issue for people in
prison.11 49 However, drug treatment services during incarceration are severely deficient and do not
match the needs of people incarcerated.11 50
Among women who participate in residential drug treatment, those who have their children with them
are far more likely to complete the program when compared to those who are separated from their
children.51 15 One study found that 88% of women who had their children with them at a residential drug
treatment program completed the program, while only 12% of those who were separated from their
children finished the program.51 This benefit can extend to the next generation: children of parents who
participate in family-based drug treatment are less likely to develop their own substance use disorders.52
More broadly speaking, drug and alcohol treatment is more effective when one’s family is involved. In
a study of factors that predict retention in and dropout from alcoholism treatment programs, clients
stayed in outpatient treatment longer when they had been assigned to couples or family interventions
compared to those receiving individual treatment.53

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Highlighting Alternatives to Incarceration
PATHways Beyond Birth
PATHways Beyond Birth is a nurse-driven 2-year program in Lexington, Kentucky for women who are
pregnant and opioid-addicted or have other substance use disorders. It is housed in a University of
Kentucky Healthcare clinic.
Women start with PATHways when they are pregnant and stay in the program for two years after
giving birth (PATHways Beyond Birth). Women receive prenatal medical visits and treatment for
opioid disorders. They receive training on maternal-fetal bonding, swaddling, breastfeeding, smoking
cessation, infant withdrawal, and other motherhood skills. They also participate in weekly group
sessions offering therapy, parenting education, and peer support, which are led by a nurse navigator.
PATHways is based on the latest science on opioid addiction and mother-infant bonding. Moms
receive medication-assisted therapy with buperenorphine, which helps opioid withdrawal, reduces
cravings, and helps people with severe addictions live a normal life. Medication-assisted therapy
is an evidence-based harm reduction treatment that is important for pregnant women, as quitting
suddenly can cause fetal distress and is a high risk for relapse for the moms. Another tenant of
PATHways is allowing moms to cuddle with their infants after birth, with regular visits from doctors
and nurses. In comparison, most babies born to drug dependent moms are taken away for observation
of withdrawal. However, 97% of PATHways babies who stay in rooms with their mothers do not need
treatment for withdrawal. Additionally, this practice shortens hospital stays, requires less morphine
for babies which suggests any withdrawal is less severe.
More than three-quarters of pregnant women in PATHways are not using illicit drugs by the time they
give birth. In studies, women in the PATHways program who attended more prenatal sessions had a
greater likelihood of being drug free; for every one session increase in attendance, a mom was 15%
less likely to relapse.
Importantly, PATHways Beyond Birth supports women who after delivering are at high risk of relapse,
non-treatment of infectious diseases, and not following up on certain well-baby care. Ninety-seven
percent of Beyond Birth participants have received long-acting birth control, 80% of women are
parenting or working to restore parenting, and nearly all are monitoring or treating their hepatitis
infections.54 55

Family-based alternatives to incarceration can improve parenting skills
Family-based drug treatment programs that also offer parenting classes and home-based case
management services are successful in reducing substance use and improving parenting skills.
Parenting classes for fathers are shown to improve relationships and attachment with their children,
as well as feelings of competence.56 57

Parents who stay connected to their children are less likely to return to jail or prison
Multiple studies show that parents who serve sentences while staying connected to their children

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recidivate less.15 58 46 59 13 60 As noted below, the Parent Sentencing Alternative in Washington has
a recidivism rate of 8% compared to the 29% for women in prison who are separated from their
children. According to Susan Leavell, Program Administrator of Parenting Sentencing Alternative in
Washington, “When offenders are successful parents, they stay out of prison. They stay engaged with
their kids. When parents are engaged with their kids we see healthy young adults.”

What I remember most was being taken away from the only person I had to call my
own, the only person I had to give me any amount of push in life.
– Aniya, who was separated from two children while incarcerated

Highlighting Alternatives to Incarceration
Parenting Sentencing Alternative
The Parenting Sentencing Alternative was enacted in Washington State in June 2010. This law
allows some convicted people who are parents of minor children the opportunity to avoid prison or
transfer from incarceration in order to parent their children. The Family and Offender Sentencing
Alternative (FOSA) portion of the law gives judges the option to impose 12 months of community
custody for eligible caregivers of children, rather than a prison sentence.
The FOSA program and the other component of the Washington law are driven by the philosophy
that keeping families together is best for children, and also draws upon the strengths of parents
and increases their capacity to heal and get their lives on track. In the last seven years, 470
participants have successfully finished the program. Of those that have completed the program,
only about 8% have returned to prison on a new felony. This is a much lower rate of returning to
prison than the state’s rate of 29%. Several children were averted from foster care during this time.
These successful programs have a far lower cost than the cost of prison. In Washington, it costs
about $31 per day to supervise a justice-involved person that serves time in their own community,
compared to about $91 per day for incarcerating them.61 62

Community-Based Sentencing is Fiscally Responsible
Community-based alternatives to incarceration are far more cost effective than incarcerating people
and cost taxpayers much less. The programs included in Washington’s sentencing alternative law,
described above, cost $31 per day to supervise someone in the community compared to a cost of
$91 per day for incarcerating that person.63 According to a presentation by the Dyer County Sheriff’s
Office, one day in a Dyer County jail costs the county $49, on average.64 A residential program for
incarcerated women in Los Angeles that includes drug treatment, housing assistance, mental health
services, employment assistance, and in-house residence for children costs between $16,500 and
$22,000 per year.65 The average cost to house someone in Tennessee Department of Correction
prisons is approximately $6000 higher, at $28,039 for one year. 66
Another fiscal benefit to keeping more parents in their communities, as long as they are still able to
be safe and loving caregivers, is keeping wage earners in the workforce. This would avoid some of the

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negative financial and health impacts to families and also to communities where large numbers of
wage earners disappear into incarceration.

Prisons and jails have a poor track record in prioritizing health
The criminal legal system has a spotty record of implementing programs that prioritize the health of
parents and families. Given the system’s historical value of punishment over rehabilitation, entrusting
implementation of this law to the Department of Corrections or county jails is not recommended. For
example, the California Department of Corrections and Rehabilitation implemented the California
Prisoner Mother Program that allowed children to live with mothers in prison. The implementation
showed a failure to meet children’s needs — from poor nutritional quality of food for the children,
limited access to medical care, to disturbing racial inequalities with better- funded programs.67 In
a similar vein, in 2015, an incarcerated woman at the Tennessee Prison for Women was accused of
faking labor pains before giving birth inside a cell without a qualified OB-GYN. Her infant son spent
5 days in intensive care due to a severe infection likely contracted from the non-sterile conditions of
the cell.68 Additionally, the Tennessee Department of Correction is currently involved in a class action
lawsuit due to a failure to provide treatment to incarcerated persons diagnosed with hepatitis C.
According to an investigation from The Tennessean, only 0.2% of incarcerated persons with hepatitis
C received treatment.69

Highlighting Alternatives to Incarceration
Renewal House
Founded in 1996, Renewal House is the only Middle Tennessee agency offering a long-term family
residential recovery program that makes it possible for pregnant and parenting women to live with
their children while in treatment. The family residential program integrates addiction treatment,
mental health services, parenting, vocational and life skills education for the mothers and early
intervention and prevention services for the children. Over the years, Renewal House has expanded
its services to provide a licensed, gender-specific, intensive outpatient treatment program
accessible to low-income women and affordable rental housing in a drug-free environment for
women with at least six months in recovery and their children.
In 2013, Renewal House undertook an eight-month impact study to assess long-term client outcomes
following treatment. Researchers used standardized assessments to measure client strengths and
needs in the areas of substance abuse, physical health, mental health, employment, legal system
involvement, and family/social status. A total of 100 former clients completed the study. The analysis
provided strong evidence that after receiving treatment at Renewal House clients experienced
increases in their personal strengths, decreases in need, and improvements in life functioning.
Renewal House Chief Executive Officer Pamela Sessions stated, “It’s exciting that we can keep
families together. We see women every day who won’t come into treatment because they can’t keep
their children with them. If possible, it’s better to have moms and their children together. Having run
foster care programs for 12 years prior to leading Renewal House, I say this with confidence.”70
Find out more about Renewal House at

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Incarcerating Parents is Harmful
The …feeling like you lost a part of one of your major organs in your body. Feeling
like you lost somebody that you love so much, and you don’t know when you will see
them again. And you can’t control when you will see them. All the stuff builds up and
causes stress.
– Aniya, who was separated from two children while incarcerated

Having an Incarcerated Parent is a Traumatic Event and is Hazardous
to Health
Kids with incarcerated parents are at risk for a variety of health and social problems that could last
a lifetime. A growing body of research is revealing a link between adverse childhood experiences
(ACEs) and a greater chance of lifelong physical, mental, and behavioral health problems.71 Having an
incarcerated parent is classified as an ACE.72

Changes in caregiver and family structure can be a source of trauma for children
Most children of incarcerated mothers experience at least one change in caregiver while their mother
is incarcerated. Two thirds of these children have at least one change in caregiver, and 1 in 10 children
have two or more changes in caregiver.13 15 Separation from siblings is also traumatic.13
If children are separated from their primary caregivers in the first weeks and months of life,
reestablishing bonds at a later time becomes difficult. Such a “disorganized attachment relationship”
during infancy is the strongest predictor of hostile behaviors toward peers in preschool.15

I remember her just not being there at all, and feeling like, where is my mother? Why
is she not here? Does she want to go to jail? Does she not love me? It just made me
question myself.
– Brittany, whose mother was incarcerated

Parental incarceration can lead to physical health problems for kids
Having an incarcerated parent is associated with physical health problems such as migraines,
asthma, high cholesterol,73 74 HIV and AIDS,74 and rating one’s own health status as fair or poor.74
Recent evidence suggests that ACEs cause immediate physical consequences such as chromosome
damage and changes to the developing brain,75 and are risk factors for longer-term physical health
problems such as heart disease, cancer, chronic lung disease, skeletal fractures, liver disease, AIDS,
having one or more STD, and morbid obesity.27 69

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Adverse childhood experiences can also have intergenerational impacts
ACEs can also have inter-generational impacts. Having an ACE can be the reason why parents end
up being incarcerated in the first place,26 28 and unfortunately, incarcerated parents then pass an
ACE onto their children.42 41 Despite great adversity, research indicates that some interventions that
promote a supportive, responsive relationship between parent and child can reverse the intergenerational impacts of ACEs and toxic stress.76 70

Parental incarceration can contribute to mental health problems in kids
Children of incarcerated parents experience more mental health and “internalizing” problems. One
researcher reported that 70% of children of incarcerated mothers had emotional or psychological
problems13 such as depression,73 74 60 anxiety,74 emotional withdrawal,60 posttraumatic stress disorder
(PTSD),74 and feelings of guilt,13 embarrassment, and shame.60 15 Sometimes children feel so much
shame about their incarcerated parent that they socially isolate themselves from friends.13 Selfesteem issues are common as well.73 60 Young children of incarcerated mothers may be slower than
others to develop autonomy, independence, and a confident self-concept.13
Children tend to be traumatized by separation, and separation from an incarcerated parent can lead
to abandonment issues60 as well as an insecure attachment to the parent, which can put children at
risk for developmental delays60 and other mental health issues.46 In particular, infants and toddlers
face attachment problems when moved into and out of their mother’s care, and they may develop
insecure attachments to other caregivers as well.13 60

Parental incarceration is a driver of behavioral issues
“Internalizing” issues can go hand in hand with “externalizing” or behavioral issues such as anger,
aggression, hostility, substance use disorder, gang activity, lying, and stealing.13 73 ACEs are associated
with unhealthy behaviors such as smoking, drinking heavily,75 substance use disorder,24 and sexually
risky behaviors.24 75 ACEs increase the risk for depression, suicide, incarceration, poor educational and
employment outcomes,76 poverty,76 and involvement in violence.24 75 These behaviors in turn can lead to
higher chances for youth to be involved in the criminal legal system themselves.

She don’t want to listen to anything that I say or try to tell her not to do or give
her advice. She’s always angry, she’s a very angry child. And yeah, I think that [my
incarceration] has a lot to do with that.
– Desiree, formerly incarcerated woman with a daughter

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Highlighting Alternatives to Incarceration
Free Hearts
Free Hearts offers two evidence-based programs that could serve as an alternative to incarceration
for primary caregivers: Parenting Inside Out and Moving On.
Parenting Inside Out (PIO) is a cognitive-behavioral parenting skills training program designed for people
who are justice-involved through a six-year collaboration of scientists, policymakers, practitioners, and
people who have been incarcerated. The curriculum includes communication, cooperation, problem-solving,
monitoring, positive reinforcement, and non-violent discipline techniques. PIO promotes healthy child
adjustment, prevents child problem behaviors, builds resilience in kids, and helps parents refine social
skills and citizenship behaviors.
Parenting classes are the top prerequisite for families to reunite. In Nashville, there are few options; most
are hard to reach and charge a fee. Free Hearts is centrally located, offers the course free of charge, and
importantly the teacher is formerly incarcerated herself. Dawn Harrington, Executive Director of Free Hearts,
states that while women are mandated to take this course, participants report that they learned a lot, and
at home their children and families get something out of the skills, too; they have learned to listen and
communicate and find different ways to relate to each other.
A National Institutes of Mental Health-funded evaluation found that at one year after release, PIO
participants, when compared to a control group experienced reductions in self-reported criminal behavior
(95% reduction), self-reported substance abuse (66% reduction), and rearrest (women had a 48%
reduction; men had a 26% reduction). PIO is included on the Substance Abuse and Mental Health Services
Administration’s (SAMHSA) National Registry of Evidence-Based Programs and Practices.
Free Hearts evaluated their program and found that PIO participants had a 0% recidivism rate one-year
post-incarceration, a 28% decrease in parenting stress, and up to a 25% increase in tangible social support.
They also improved in problem solving, parenting, managing emotions, and in their relationships.
Moving On is a program for at-risk women, designed as an alternative to criminal activity by helping them
identify and mobilize personal and community resources. Moving On is made up of six modules that include
communications skills, healthy relationships, expressing emotions, and making connections and staying
Orbis Partners designed the Moving On curriculum to be gender-responsive, and was based on theory and
research with women. Relational theory, motivational interviewing, and cognitive behavioral intervention
influenced the curriculum.
Free Hearts’ evaluation showed that Moving On participants had a 0% recidivism rate one year postincarceration, which was 53% less than the population average of 47% recidivism. Participants also had a
23% decrease in PTSD symptoms and up to a 23% increase in social support.77 78 79

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Kids’ behaviors impact school success
These issues can play out in school where students can display issues such as absenteeism,
truancy, drop out,13 73 suspension, and expulsion.80 In a study of children of incarcerated mothers
and fathers, 70% of children of incarcerated mothers showed poor academic performance, and 50%
showed classroom behavior problems.13 A different study found a 34% dropout rate for children of
incarcerated parents compared to a 10% rate for their peers.13

Parental incarceration can lead to kids being placed in foster care
Having an incarcerated parent increases the chance of being placed in foster care.81 One estimation
is that at least 4.5% of foster children are in foster care because a parent is incarcerated.12 Parental
incarceration may also be associated with placement in foster care even when it is not the direct
cause: 20-30% of children in foster care have an incarcerated parent.12
Children of incarcerated parents in foster care as well as those who are cared for by relatives face
economic disadvantages, stigma, disruption of parent-child attachments, and unstable living
arrangements.12 In addition, once children are in foster care they have a reduced ability for visitation
and risk of loss of maternal custody.81
In general, foster care is associated with a higher risk for mental health and behavioral problems82
which may result from disruptions in attachment relationships.83 As adults, former foster youth have a
higher risk of multiple chronic health conditions84 such as hypertension, smoking, and asthma, as well
as increased self-reported fair or poor general health and lack of insurance.84 In a study examining
health outcomes in young adults who were in foster care as youth, all of these conditions were found
to be worse for former foster youth even as compared to adults who were economically insecure as
youth but not in foster care.84

Having an absent parent puts kids at higher risk for sexual abuse and victimization
Many studies have indicated that living without one’s mother or father at some point during
childhood is associated with higher vulnerability to sexual abuse than living with both parents.85 For
example, living apart from one’s mother caused an almost threefold higher risk of sexual abuse, and
separation from either parent for six months or longer before the age of 16 led to a higher likelihood
of being a victim of sexual abuse.85 Another study compared youth involved in the juvenile system
who had been arrested for sexual trafficking to those who were arrested for other offenses. All
youth had a high rate of having had a household member incarcerated, but approximately 85% of
youth who had been sexually trafficked had a person in their household incarcerated versus about
65% of other system-involved youth.86 The absence of a caregiver due to incarceration puts kids —
and girls in particular — at risk.

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Highlighting Alternatives to Incarceration
CEASE Domestic Violence and Sexual Assault
CEASE serves survivors of domestic violence and sexual assault in six counties in Central
Tennessee (Claiborne, Grainger, Hamblen, Hancock, Hawkins, and Union Counties).
CEASE provides a full range of services. They have: a 24 hour crisis hotline for people experiencing
domestic violence or sexual assault; two domestic violence shelters; counseling and support
services; healthy relationships workshops; court advocacy; Sexual Assault Response Team
services that respond to the hospital, provides counseling, and advocates for survivors; and a rapid
rehousing program.
The shelters in Hamblen and the other in Claiborne counties have a total of 26 beds. CEASE recently
expanded, opening offices in all 6 counties where people can access services, which has drastically
increased the need for their services. For example, one rural county that had 16 people in one
year on average saw an increase to 58 people in two months simply because the CEASE staff is
now present in an office in the county. The shelters provide food, transportation, counseling, and
anything that survivors need for 45 days, which can be extended if needed.
The CEASE Safe At Home program helps people with rapid rehousing if they are fleeing domestic
violence, knowing that 92% of homeless women have experienced domestic assault in their lives,
and 46% of people experiencing domestic violence stay because they have nowhere to go. Safe At
Home helps women find housing by providing the first two months of rent and utilities, and the first
three months of childcare.
Outreach Supervisor Sara Seale states that a large proportion of the people that CEASE serves are
justice-involved; some because of domestic violence-related situations, some because they are
drug-dependent, or other reasons.87 88
Visit the CEASE website at

Parental incarceration can change the course of kids’ lives
Children with an incarcerated parent tend to disproportionately face difficult issues as adults such
as lower incomes, higher rates of being uninsured, higher rates of homelessness, and feelings of
powerlessness.73 These children have a higher likelihood than children without an incarcerated parent
to be incarcerated themselves: a small sample of studies in the 1990s found that between 10% and
29% of incarcerated mothers reported that their children had been arrested or incarcerated.13

Separation from One’s Children is Harmful to Parents Too
Studies indicate that being responsible for one’s child keeps a parent away from crime. Conversely,
a mother’s lack of contact with children and constant fear of losing parental rights can lead to
engagement in more crime.4 Eighty-five percent of all arrests of mothers who have children in foster
care occurred after placement of the child rather than prior.4

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Most mothers and fathers in state and federal prisons are held over 100 miles from their homes.11
Because there are fewer prisons for women, women are often placed even farther from their families
than men.81 This distance, combined with the financial cost of visits for their children’s foster or
relative caregivers, hinder visits.81 89 In some cases, relative or foster caregivers for an incarcerated
parent’s children may also be unwilling to keep in touch with an incarcerated parent.81 As a result,
the majority of parents in prison are not able to see their children frequently, if at all.81 Over half
of incarcerated mothers have never had a visit from their children, and approximately one-third of
mothers in prison have never even spoken with her children by phone while incarcerated.11
Incarcerated fathers do not fare any better: one survey found that a third of incarcerated fathers had
not seen their children since entering prison, and more than half had not seen their children in the
prior six months.89
Even though jails are typically closer to home, because they usually house people serving shorter
sentences, they usually do not offer comprehensive visitation policies in which children and parents
can physically interact with one another.90

He would come to visit and they took the privilege of us touching away. He saw my
face and his face lit up and he took off running towards me. If you touch, they cut
the visit because they think you’re smuggling drugs through your child. They stopped
him, and his face just dropped. He was sad the entire visit and I just cried because I
couldn’t touch my baby
– Aniya, who was separated from two children while incarcerated
For parents who are incarcerated, having less frequent or no contact with their children is
devastating. For mothers, this lack of contact with children often leads to depression, guilt, distress,
decreased self-esteem, and a sense of tremendous loss.60 91
The threat of losing custody of children weighs heavily on parents who are incarcerated, and this
threat is particularly real for women. Incarcerated mothers whose children are in foster care while
they are in prison have to work very hard to maintain their parental rights.89 As a result, women in
prison are five times more likely than men to report having children removed from their immediate
families and placed in a foster home or other agency.11 One review study found that parental rights
were terminated in over 90% of cases in which the mother was incarcerated and 100% of cases in
which both parents were incarcerated.12

Families and Communities Suffer When Parents Are Incarcerated
As discussed previously, grandmothers are the most common caregivers for children of incarcerated
mothers, followed by other relatives.11 12 These family members who are willing to step in to raise these
children help provide stable environments and continuity of family relationships that the children
need. However, this responsibility can also cause financial hardships for the relative caregivers.13
This burden compounds existing financial burdens that the family is likely already facing because
the parent is no longer earning wages at her or his job. When fathers are incarcerated, a family’s
income drops by an average of 22%.80 When incarceration or other disruptions compromise a family’s
economic security, their housing security also suffers,92 and ability to afford other resources that are
vital to health such as healthcare and healthy food.

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In communities highly affected by mass incarceration, there are numerous absent parents
concentrated in one place. The absence of many adults who were formerly earning incomes can
impoverish entire communities.10 In addition, incarceration significantly reduces future opportunities
for employment and income potential, thereby making it hard for these communities to recover.93

Highlighting Alternatives to Incarceration
RISE (Responsibility. Initiative. Solution. Empowerment) is a Memphis-based nonprofit that
empowers people to become self-sufficient by building and sustaining human and financial assets.
They work to transform the financial well-being of low-income working people through four programs:
Save Up, Common Cents, Goal Card, and Silver Neighbors. RISE has been helping people for 17 years.
Save Up is a 6-month program to help people save for purchasing assets and for the future. Save Up
teaches budget creation, establishes a bank account, and helps get participants started on savings
habits. Through establishing a savings account that requires monthly deposits with matching by
RISE, participants have saved an average of $3,086 in six months. Evaluations find that after the
program, 92% still follow a budget, 92% have health insurance for all family members, 83% consider
themselves in a better financial position and 83% continue to save money. Save Up also partners
with other agencies to offer homebuyer workshops and microenterprise trainings.
Goal Card teaches public school students in grades 5 – 12 in zip codes 38126 and 38114 how to set
and achieve academic, financial and life goals. Goal Card provides structured academic mentoring,
support from adult volunteers, and students earn points for achievement which are redeemable for
school supplies, gift cards, and small electronic items. Students can choose to bank points for bigger
rewards. Goal Card students have a 90% graduation rate, outperform their peers in elementary and
middle school, and all graduating seniors have gone on to enroll in post-secondary institutions.
Common Cents is a workplace financial education program that teaches banking, budgeting,
debt management, spending strategies, and retirement planning. Classes are available to groups,
nonprofits, businesses, and church groups. Employers who provide their hourly workers this
financial literacy can increase productivity and decrease absenteeism.
Silver Neighbors is a program where trained volunteers go to senior centers, churches, and housing
developments to educate seniors about scams, fraud, Medicare, life insurance products, budgeting,
and benefits.
The 2015-2016 RISE Annual Report notes that people have saved up and purchased or improved
homes, computers, vehicles, and others have used their savings to begin micro-enterprises or pay
for tuition.94 95 96
Visit the RISE website at

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House Bill 0825 and Senate Bill
0919 Are a Healthier Approach to
Sentencing Parents in Tennessee
Tennessee doesn’t have to continue the harmful and inhumane practice of separating children from
their mothers and fathers. By encouraging judges to use their discretion to authorize alternatives
to incarceration that include treatment instead of prison or jail, Tennessee has the opportunity to
help parents heal and get the resources they need while staying connected to their loved ones, and
ultimately create youth who grow up to be successful and healthy.

Recommendations for Implementation
This report finds that House Bill 825 and Senate Bill 919 would have a positive health impact on
children, parents, and communities, especially those that are the hardest hit by incarceration. If the
bill passes, we recommend the following:
Prioritize health in the implementation of the Primary Caregivers law and its evaluation. The current

system ignores the healthy development of kids with incarcerated parents, the healthy healing of
parents who have trauma or substance use disorder issues, and the community health of those left
behind when large numbers of families are torn apart by punitive responses to behaviors that merit
public health intervention. Tennessee can raise the bar and prioritize the health of its residents and
communities by implementing this new legislation with health outcomes as a top priority. A public
health organization or university-based evaluator with a public health frame should partner with
Department of Corrections, county jails, and Probation researchers to monitor and evaluate process
and outcomes of implementation of this policy beyond the usual recidivism data points.
Involve those who have been directly impacted by parental incarceration in implementation and

evaluation decisions. Involving parents who have experienced incarceration and kids who have
experienced a close family member incarcerated can ensure programming considers the needs of
those most impacted.
Identify funding for implementation of the Primary Caregivers law and the programs that it

allows. While sentencing primary caregivers to alternatives to incarceration promises to save
money, the legislature and any implementing state agency must identify funds to ensure that
alternative programs can be successful, healthy, serve all races and ethnicities equitably, and have
the capacity to collect data for evaluation. Some effective alternatives already exist, although
they typically rely on private funding. The state should contribute to support these programs as
alternatives to incarceration for primary caregivers.
Allocate programming resources to community-based alternatives instead of growing the criminal

legal system. As this report identifies, there are model programs in Tennessee that could serve
as alternative sentencing options. Rather than operating programs through the Department
of Corrections our county jails, resources should be identified and allocated to community
organizations or health-based agencies.

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Educate defense attorneys, judges, and grassroots advocates about the new law. A convicted

person or their legal defense needs to initiate the process to be considered or an alternative
sentence to incarceration. So, it’s vital that advocates for defendants, including grassroots
organizations as well as legal advocates, are aware of this law.
Impose the least restrictive conditions possible. When judges are sentencing, they should impose

the least restrictive conditions on parents possible so they can stay connected with their children,
which in turn make them more likely to be successful.

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