Combining Substance Abuse Treatment With Intermediate Sanctions for Adults in the Criminal Justice System
Treatment Improvement Protocol (TIP) Series 12

Appendix B -- Costing Issues

Calculating the cost of providing alcohol and other drug (AOD) abuse treatment services for offenders in intermediate sanctions programs is an important part of overall program planning and implementation. Data are necessary to determine the costs of various services, so that cost benefits may be analyzed and programs judged in an economic context.

Unfortunately, only a limited amount of data about costing were available in preparing this report, and the data showed a wide range of costs. Individual jurisdictions may find it beneficial to analyze in detail their own current costs in providing AOD abuse treatment services for criminal offenders, so that they can build a database that can be used for future decisionmaking about treatment options and planning treatment programming.

The data include costs for:

• Residential programs
• Outpatient programs
• Day reporting programs
• Detoxification
• Monitoring and drug testing (usually urinalysis).

In one large metropolitan area in the Midwest, residential services provided to 271 offenders over a 1-year period cost $1,400,149 or $5,167 per person. These ranged from $3,564 per person in a transition program to $7,302 per person in a halfway house.

In a second jurisdiction, a county in the Southwest, the estimated operating costs for community-based residential services for offenders were $55 to $95 per client per day, or an annual range of $20,075 to $34,675 per client. In this county, costs for residential detoxification were substantially higher, ranging from $115 to $130 per day.

Outpatient treatment programs cost considerably less. In the Midwestern metropolitan area, the cost for outpatient services for 61 clients totaled $31,602, or $518 per client annually. Day reporting programs cost $716,130 annually for 359 clients, or $1,995 per client. A community service program in this jurisdiction cost $66,667 for 186 clients, or $358 per client annually. In the county in the Southwest, outpatients costs were provided only for detoxification programs. These were $32 per day, at least one-third less than the cost of residential detoxification. However, even in the outpatient setting, detoxification services seem to be significantly more expensive than other types of outpatient services.

A study by Treatment Alternatives to Street Crime (TASC) in another large Midwestern city calculated a per diem client cost of $5.02 for outpatient services. For the purposes of comparison to the above statistics, this would total $1,832 per client per year, if services were provided every day of the year. TASC statistics were based on treatment of released offenders who were living in a facility similar to a halfway house and required assessment and case management services. Clients had an average length of stay of 111 days. The cost analysis did not include the costs of urinalysis.

The TASC cost analysis computed that labor costs -- i.e., the cost of the salary of the case manager, plus supervisory costs -- accounted for 65 percent of the total cost of the direct services provided. The remaining 35 percent included direct program expenses such as staff travel, supplies, equipment rental and maintenance, telephone, postage, and facility rental. In addition, 25 percent of the direct service total was budgeted for indirect costs. Thus, based on an average annual case manager salary of $20,000, plus $5,400 for fringe benefits, costs were:

• Labor: $25,400
• Supervision: $2,540
• Nonlabor costs: $9,779
• Indirect costs: $9,430.

TASC based its per client, per diem costs on a 40-client caseload, and 235 days of service in 1 year.

TASC also calculated per diem per client costs in other cities around the country. The lowest cost, $5, found was in a large Northeastern city. In a Southern city the per diem per client cost was $5.50. It was $7.50 in a Southwestern city, and it ranged from $5 to $10 in a State in the Northwest.