Chapter 5 -- Ancillary Services

Offenders with substance use disorders need certain basic services as they enter the community. These services are provided by a number of public systems that are generally not well coordinated, and because of the factors discussed throughout this TIP, offenders' abilities to access these services are limited. However, efforts at treatment are unlikely to succeed unless these basic needs are met. Foremost among these needs are

• Housing
• Employment
• Family support
• Peer support
• Transportation
• Education
• Primary health care

Many offenders lack more than one item on this list, and services must be prioritized for each individual. Safe housing is the paramount need for most inmates leaving custody, yet other needs can be almost as pressing for some. For example, transportation to secure housing may be needed, or planning for medication delivery might be crucial to avoid a health or psychological crisis.

Continued recovery requires that substance use disorder treatment remain a high priority during the transition period, but treatment will almost certainly be undermined in importance if any of the supportive components is lacking. Furthermore, public safety is at risk when offenders do not receive necessary supports because they are at greater risk of relapse and a return to criminal activity.

The complexity of accessing services creates many barriers for the offender. The offender must be vested with primary responsibility for meeting her needs, but the stresses of finding housing, employment, and perhaps child care, in addition to requirements for supervision and treatment, increase the potential for relapse. Treatment schedules may conflict with parole mandates, and job-seeking or work may compete for the time allocated for therapeutic needs. Coordination of these supports based on an individualized transition plan helps keep the client from being overwhelmed.

To ensure that each offender has basic needs met when returning to the community, an effective prerelease assessment is essential. The results of the assessment shape the transition plan, and the transition team has the responsibility to integrate service delivery as much as possible.

The difficulty of coordinating services is not the only roadblock to a successful transition. Some service providers do not consider released offenders their responsibility, particularly if they cannot be easily reimbursed for treatment. Once the offender is no longer within the custody of the criminal justice system, services previously available through that system may be unavailable. This adds to the challenge for case managers or others responsible for brokering care. Returning offenders must often contend with reluctantly given support and a lack of funding for health care and substance use disorder treatment services that were previously received in the correctional institution.

Certainly the offender retains primary responsibility for his own coordination of services, yet the overlap among services and service providers can be confusing and overwhelming. If no entity is required to provide assistance, service providers may "pass the buck," leaving the responsibility for the offender to some other system. Without integration of services, the offender has no access to other systems and is left without resources. This chapter presents the critical elements of a variety of social supports and suggests methods for obtaining services within each system. Relevant examples from model programs or approaches are highlighted throughout.