[NYAPRS Enews] NY Civil Confinement Program Grows

[Briana Gilmore]

NYAPRS Note: The article below touches on the challenge of treating the behavioral health needs of persons under civil commitment for sexually-based offenses, particularly under budget pressures. NYAPRS will continue to watch this issue as other psychiatric inpatient units are downsized and the state ensures appropriate allocations and community transitions are being maintained.

Civil Confinement Program Designed for Most Dangerous Sex Offenders Grows
Democrat and Chronicle; Gary Craig, 9/2/2014

With plans for expanded housing, the state's program for civilly committed sex offenders has seen a spike in the number of newly confined offenders.
Meanwhile, the program's budget has swelled.
Now in its seventh year, the program, designed for those considered the most dangerous sex offenders, is experiencing some of the growth that critics predicted at the program's outset. Other states with decades of experience with similar programs had seen the budgets explode because of the costly psychiatric treatment for offenders and the fact that very few are released for years.
An examination of recent reports from state agencies, coupled with information provided by state officials, shows that:
* The Office of Mental Health, or OMH, budget for civil commitment has grown 45 percent in the past three years - from $44 million to $64 million.
* Between November 2012 and October 2013 - the months highlighted in a recently released OMH report - the number of state prisoners deemed eligible for the civil commitment program was more than twice that in recent years.
* While OMH psychologists had judged fewer than 4.5 percent of the eligible pool of inmates fitting for the civil commitment program in the previous four years, almost 7 percent were referred for the program in the year covered in the recent report.
Former Gov. Eliot Spitzer and the legislature created the program in 2007. Before their release from prison, sex offenders are evaluated by mental health specialists to determine whether they have a "mental abnormality" that makes them likely to commit new sex crimes.
Offenders deemed fit for the program then go through a legal process to decide whether they do indeed suffer from the mental abnormality and, if so, whether during subsequent treatment they should be confined in a mental health facility or free - with many restrictions - in the community.
The numbers of new sex offenders civilly confined each year may seem small - typically in the dozens - but they are costly. In recent years, mental health treatment at the state facilities has run as much as $175,000 a person - or about three times the cost per prison inmate.
The community treatment has ranged around $12,000 per offender.
The most recent OMH report shows that 105 offenders were recommended for civil confinement or community-based treatment during the 2012-13 year. If two-thirds of those were confined and another third treated in their communities - a percentage similar to what the program has experienced - the annual costs would be more than $12.5 million.
Those costs are only a portion of the program. Lawyers from the Attorney General's Office represent the state in the civil confinement proceedings. An office spokesman said the office does not have a breakdown of costs specifically for the program.
There are also the court costs in state and county courts, where the cases are heard.
OMH spokesman Ben Rosen said the increase in civil commitment referrals may well be nothing more than a standard fluctuation.
"From year to year, there is always variation in the rates of referral for civil management," he said in written responses to questions.
The state largely relies on two facilities - one at Marcy and another in Ogdensburg - for confinement. The 252-resident facility in Marcy is nearing capacity, based on current staffing. Another 28-bed unit is planned for the fall, Rosen said.
The expansion, as well as new programs in the prisons, account for part of the budget increase, he said.
Dr. John Bradford, a forensics psychiatrist from Canada with whom New York officials consulted when starting the program in 2007, said he thinks New York's program is much more therapy-based than some others.
"I think New York is balanced and they're doing a pretty good job," Bradford said.
A spike in confined offenders could be a sign that some of the psychologists are being overly aggressive in their initial evaluations when they try to determine who should be confined, Bradford said.
The current budget includes $2.5 million for expanded mental health treatment for sex offenders while in state prisons. Officials hope that the enhanced prison intervention may curb the number of inmates needing civil confinement upon release.
"OMH reviews the criminal history of all inmates incarcerated for a sex offense," Rosen said about the prison program. "This review includes factors such as the number and type of sex offense convictions in the individual's history, and those individuals with a significant likelihood of sexual offense recidivism."
The latest OMH report shows how unusual it is for confined offenders to be released. Those who are released typically transfer into the community program for continued oversight.
>From the program's first months in 2007 through October 2013, psychiatric examiners recommended 15 people for discharge out of 651 evaluated - or 2.3 percent.
Treatment includes a four-phase program with the final phase designed to "closely mimic the level of programming and responsibilities of living in the community," according to the OMH report.
Those who complete the fourth phase are typically prepared to move into a community program.
According to the latest report, only one of 315 confined sex offenders was in the fourth phase.
http://www.democratandchronicle.com/story/news/2014/09/01/civil-confinement-programs-numbers-grow/14942811/
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