Matthew T. Mangino
GateHouse News Service
December 27, 2013
The Pennsylvania Department of Corrections has entered into a first-of-its-kind incentive-based contract with a private vendor for providing mental health services in the state’s 26 correctional institutions.
The contract comes in the wake of an alarming federal investigation and the ever increasing demands on correctional facilities to treat inmates with mental illness.
Last summer, the U.S. Department of Justice (DOJ) announced the results of an investigation into the use of solitary confinement on prisoners with serious mental illness at a state correctional facility in Cresson, Pennsylvania.
The DOJ found that Cresson’s use of long-term and extreme forms of solitary confinement on prisoners with serious mental illness, many of whom also had intellectual disabilities, violated the Eighth Amendment ban against cruel and unusual punishment and the Americans with Disabilities Act.
A report by the Treatment Advocacy Center and the National Sheriffs’ Association, More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States, found that about 16 percent of inmates in jails and prisons nationwide have a serious mental illness. In Pennsylvania, 21 percent of state prison inmates receive mental health services, which equates to more than 10,000 individuals.
According to National Public Radio, more than 350,000 offenders with mental illness are confined in America’s prisons and jails. More Americans receive mental health treatment behind bars than in hospitals or treatment centers.
Once in prison, mentally ill inmates have a difficult time getting out. Prison rules are often violated by offenders who believe cellmates, guards and even family at home are out to harm them.
The mentally ill are often targeted by fellow inmates who are aggravated by the strange manifestations brought on by their illness. Mentally diseased inmates may have a problem concentrating in programming and therefore fail to complete required treatment programs.
Prison medical systems were not designed, nor equipped, to provide quality mental health services to prisoners in need. Seriously mentally ill inmates often face overworked or undermanned staff overwhelmed with the need to evaluate and implement treatment plans for an ever growing population of ill inmates. Often the result is a failure to reintegrate inmates back into the community.
Pennsylvania has an ambitious plan to deal with mental health treatment behind prison walls. Instead of just paying for services, Pennsylvania is demanding services that work.
"No longer are we issuing contracts for just a service,'' Corrections Secretary John Wetzel said. “From this point on, our contracts will focus on results. The new contract includes performance measures that will ensure taxpayers are getting what they pay for, including inmates who leave our system better than when they entered it.''
Pennsylvania has contracted with MHM Services of Virginia who will receive financial incentives to reduce the number of misconducts for mentally ill offenders; reduce the number of inmates recommitted to prison mental health units; and lower the number of recommitments to prison residential treatment units. MHM Services will also face sanctions for failure to achieve designated objectives.
In 2011, the Association of State Correctional Administrators surveyed corrections departments about their use of performance incentives. Out of 35 departments that responded to the survey, just three reported offering "incentives for positive contract performance" in any of their contracts.
"Performance-based contracting is an innovative and potentially powerful strategy to improve results in states and counties across the country," said Adam Gelb, director of the Public Safety Performance Project at The Pew Charitable Trusts, which helped develop the performance incentives.
Success will be determined by the bottom line. Corrections administrators across the country will be keeping an eye on Pennsylvania’s plan. If the contract boosts public safety and saves taxpayer dollars, incentive-based mental health treatment will be on every governor’s wish list.
Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly and George and the former district attorney for Lawrence County, Pa. You can read his blog at www.mattmangino.com and follow him on Twitter at @MatthewTMangino.
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