program evaluation form NersuryProgram

Ohio Department of Rehabilitation and Correction

Office of Policy and Offender Reentry Bureau of Planning and Evaluation

Evaluation of the Achieving Baby Care Success

Nursery Program

Bob Taft Terry Collins Governor Director

Office of Policy and Offender Reentry Edward E. Rhine, Ph.D.

Deputy Director

Bureau of Planning and Evaluation Evalyn C. Parks

Bureau Chief

Tina L. Mawhorr, Ph.D. Principal Author Kelly Ward Principal Researcher

September 2006

TABLE OF CONTENTS

ABSTRACT....................................................................................................................................I

EXECUTIVE SUMMARY ......................................................................................................... II

INTRODUCTION......................................................................................................................... 1 PURPOSE OF THE STUDY AND ORGANIZATION OF THE REPORT .................................................... 1 OPTIONS AVAILABLE TO ALL PREGNANT WOMEN IN DRC ......................................................... 1 HISTORY OF THE ABCS NURSERY PROGRAM .............................................................................. 2

METHODOLOGY ....................................................................................................................... 2

PROCESS EVALUATION RESULTS....................................................................................... 3 ELIGIBILTY CRITERIA ........................................................................................................... 3 ADMISSION TO THE ABCS NURSERY PROGRAM .......................................................................... 3 ABCS NURSERY PROGRAM ELIGIBILITY CRITERIA ..................................................................... 3 ASSESSMENT OF THE APPLICATION OF ELIGIBILITY CRITERIA ..................................................... 7

PROPORTIONAL REPRESENTATION OF PREGNANT INMATES ................................ 8

PROGRAMMING ...................................................................................................................... 12 GENERAL OBSERVATIONS REGARDING PROGRAM DATA AND PROGRAM IMPLEMENTATION..... 12 PROGRAM MANUAL SPECIFIED COURSES .................................................................................. 13 OTHER PROGRAMMING OFFERED BY ABCS .............................................................................. 15

DISCUSSION .............................................................................................................................. 17 ABILITY TO PROVIDE FOR CHILDREN UPON RELEASE................................................................ 18 CUSTODY OF PREVIOUS CHILDREN ............................................................................................ 18 FAMILY INSTABILITY ................................................................................................................. 19 SIGNIFICANT OTHER FELONY CONVICTION ............................................................................... 19 PARENTING SKILLS .................................................................................................................... 20

CONCLUSIONS AND RECOMMENDATIONS.................................................................... 24

BIBLIOGRAPHY ....................................................................................................................... 31

APPENDIX A:............................................................................................................................. 32

APPENDIX B: ............................................................................................................................. 33

APPENDIX C:............................................................................................................................. 34

APPENDIX D:............................................................................................................................. 36

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ABSTRACT

In 2001, the Ohio Department of Rehabilitation and Correction (DRC) opened the Achieving Baby Care Success (ABCS) program at the Ohio Reformatory for Women in Marysville, Ohio. This paper provides a description of the DRC’s Achieving Baby Care Success program and a description of all pregnant women incarcerated with the Department who had due dates between May 11. 2001 and December 31, 2004. This paper will also provide the results of a process evaluation of the nursery program and provide recommendations to improve program integrity in preparation for an outcomes evaluation.

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EXECUTIVE SUMMARY The report on the process evaluation of the Achieving Baby Care Success (ABCS) nursery program presents the results of the first systematic examination of the implementation of this program at the Ohio Reformatory for Women. In addition to the findings, the report also provides a number of recommendations for program administrators to increase the integrity of the program. The study focuses on the program from its inception in 2001 through the end of 2004. During this period, seventy women participated in the ABCS nursery program. Eligibility The study assessed the extent to which the participants of the program met the eligibility criteria as established by statute, departmental administrative rules, and program rules. Overall, the group of individuals involved in making the decisions about eligibility and ineligibility did a very good job of adhering to the criteria. The decisions are most often characterized by consensus of the six individuals/agency representatives making those decisions. Over 95 percent of the decisions as to whether an inmate was determined to be eligible were unanimous. In only three cases of women determined to be eligible for the program did background characteristics conflict with the established criteria. An assessment of the extent to which all pregnant inmates who were interested in participating in the ABCS nursery program were proportionately represented in the group of women who were identified as being eligible was conducted. Of particular concern was the fact that the results showed that non-white women were underrepresented in the group of women determined to be eligible. Analysis revealed that the reason non-white women were more likely to have been considered ineligible was that non-white women were more likely than white women to be excluded because of specific eligibility criteria (current or past conviction of a violent offense, offenses of child neglect and child endangerment, or previous contact with the Ohio Department of Job and Family Services). Given that the primary goal of the eligibility criteria is to ensure a safe environment for the inmate mothers and their newborns, this disparity of impact on non-white inmates may be unavoidable. Nevertheless, program administrators may want to examine the eligibility criteria to determine if there are any efforts that can be made to reduce the disparate impact on non-white pregnant female inmates in terms of their opportunity to participate in the nursery program. Program Design The report also reviewed the ABCS program design and content. Perhaps the most critical weakness identified in the examination of the nursery program design was the lack of a clear purpose statement in the program manual. The program manual does provide a general and vague discussion of the “program philosophy.” However, this information primarily relates to the importance to the baby of bonding with the mother, rather than the impact or effect that bond might have on the mother. Based on this discussion in the manual, an individual attempting to identify the purpose of the program might conclude that the program is primarily designed to benefit the child, since there are no clear statements as to what the purpose of the program is for

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inmate mothers or how participation might affect their subsequent behavior, such as their future involvement in crime (even though there is a program brochure touting the effectiveness of the program in reducing recidivism among the female offenders). This examination concludes that an explicit, clear set of program objectives cannot be identified from the program documentation.

The major significance of this finding can be found in the implications for researchers’ ability to conduct an outcome evaluation on the effectiveness of the program. Essentially, if program objectives cannot be identified, then they cannot be measured. If they cannot be measured, there can be no outcome evaluation of the program. An additional complication of not having clear program goals and objectives is the problems encountered in collecting program participation information. The nursery files were complete with respect to inmate mother and infant information. However, no central repository of information regarding the hours offenders spent in programming (whether it be parenting education or other programming) existed. The inaccessibility of information made it very difficult to determine the real extent to which women were being exposed to programming. We also know little about how these courses might fulfill a need or purpose for the offenders in relation to the overall program objectives or goals. Without a clear statement of purpose and goal-driven program design, we cannot identify what changes or strengths the program intends to build among participants so that we can identify the outcomes (e.g., stronger bonds between mother and child, reduced likelihood of recidivism) that should be expected and why (e.g., decreased desire to use drugs, increased motivation to develop job skills in order to remain in the community and raise the child). Based on the assessment of the ABCS nursery program as it is currently documented and implemented, there is clearly a need for the department to expend additional energy and effort in analyzing the problem to be addressed by the program, setting program goals and objectives, and designing the program before considering the possibility of conducting an impact (outcome) evaluation. Enhancing the Program Design The data collected for this project provide a wealth of information to help guide the department on establishing the kind of programming that would be most beneficial to the inmate mothers. The first step in developing better programming is to understand the target population. The women who participated in the first several years of the nursery program tended to be relatively young, single, unemployed and likely to have limited job skills, be poorly educated, and have a history of drug and/or alcohol use. In addition to these social disadvantages, many of these women already had custody of at least one of their other children, presenting additional strain on the women when they are released from prison with their newborn babies. The participants are also likely to be facing considerable strain in their family lives: they have responsibility for other children, they have had children by more than one father, and substantial proportions of the women’s families have been involved with the criminal justice system. These women are clearly in need of social, emotional, financial, and childcare support for their families and from the fathers of their children. Additionally, some of the struggles that these women have previously had with raising their children is reflected in the fact that a considerable proportion of women who participated in the ABCS program had previous contact with the Department of Job and Family Services. These

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previous problems, coupled with data on some of the incidents in the nursery program for which the inmate mothers received conduct reports, indicate that some of the women need instruction in some very fundamental childcare and child rearing practices. It is clear from the profiles of the ABCS program participants, that these women have significant social problems with which they need help far beyond those addressed through parenting education courses. Determining the type of programming that is most likely to assist these women in being able to properly raise their children and support their families once they are released from prison is further complicated by the short length of time that these women actually spend in the program. The data show that the average length of stay in prison is about eight months and the length of stay in the ABCS nursery program is less than four months.

All of the above factors must be taken into consideration when developing a structured, meaningful nursery program. It may be that there is no rationale or program purpose statement that can be developed under these circumstances that would lead one to expect that participating in the nursery program should reduce recidivism given the short duration that women are in the program. It may be that all there is time to do is provide fundamental, educational child care courses (such as the SIDS, Infant CPR, and Breast Feeding courses) in order to benefit the child. In this event, program developers should not expect that this ‘programming’ would have any impact on the likelihood that these women will recidivate. It is important to remember that this is not the first child for the overwhelming majority of these women. In this scenario, the program goals may simply be to provide the mothers with the parenting skills to properly care for her infant. Measuring the success of this type of program outcome would be dependent upon the department’s ability to track the woman and her child over time in the community.

Summary of Recommendations The following briefly summarizes the major recommendations contained in this report: 1. Review the ABCS nursery program eligibility criteria in order to determine whether or not

there are any efforts that can be made to improve the proportional representation of non- white pregnant female inmates in the pool of individuals eligible to participate.

2. Develop a clear purpose statement for the program and set clear program goals and objectives. This exercise will help to inform the development of a structured, goal-driven program that will permit meaningful program evaluation.

3. Develop a more structured, goal-driven program using information collected for the present study in conjunction with principles of effective programming.

4. Develop systematic data collection and monitoring system in anticipation of subsequent evaluations.

5. Plan for outcome measures based on new program design.

Over the past decade, a considerable body of literature has developed to help guide practitioners in the development and maintenance of correctional programs that are characterized by high levels of program integrity that maximize the benefits of rehabilitative efforts. Although not a formal test, this study endeavored to examine the overall implementation of the DRC ABCS nursery program in an effort to determine the extent to which the program is being delivered in a manner consistent with some of these principles of effective programming. The purpose of the study has been to use the results to provide guidance to program administrators in strengthening the integrity of the program.

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INTRODUCTION

Research has demonstrated significant and substantial relationships between program

characteristics and program effectiveness (Lowencamp et al., 2006). Over the past decade, a considerable body of literature has developed to help guide practitioners in the development and maintenance of correctional programs that are characterized by high levels of program integrity which maximize the benefits of rehabilitative efforts (see particularly the Correctional Services of Canada 2000 Compendium). Although not a formal test, this study has endeavored to examine the overall implementation of the DRC Achieving Baby Care Success nursery program in an effort to determine the extent to which the program is being delivered in a manner consistent with some of these principles of effective programming. By considering the data collected for this assessment using the effective correctional programming literature as a framework, it is hoped that the results of this study will provide guidance to program administrators in strengthening the integrity of the program.

Purpose of the Study and Organization of the Report

The purpose of this paper is to provide a description of the ABCS nursery program and report the results of the first process evaluation since the inception of the program in 2001. This evaluation will primarily assess the extent to which the program is being delivered as intended. A process evaluation is an important first step in determining the extent to which the quality of the implementation of the program is sufficient to warrant an outcome evaluation. The importance lies in the fact that conducting an outcome evaluation of a program which has not been properly implemented will not provide an accurate assessment of the effectiveness of the intended intervention.

This report will present information regarding options available to all pregnant women who are incarcerated in a DRC correctional facility, a description of the development of the nursery program, methodology of the study, a detailed description of eligibility criteria and extent to which program adheres to them, and a review of the levels of programming women obtained while in the program in comparison to that specified in the program manual. The paper concludes with recommendations for the department and program administrators. Options Available to All Pregnant Women in DRC

All female inmates who enter the DRC are received at the Ohio Reformatory for Women (ORW) before being assigned to one of the four institutions that house females. Inmates receive medical, mental health, substance abuse, and education evaluations in addition to a risk and needs assessment before they are given a security classification ranging from the lowest (Level 1) to the highest level (Level 4) of supervision. During the medical evaluation, all women are given a pregnancy test. Pregnant women who are classified at Level 1 or Level 2 are transferred to the Franklin Pre-Release Center (FPRC) while those who are classified at Level 3 or Level 4 security will remain at ORW. Between November 1, 2000 and December 1, 2004 11,242 women entered the Ohio Department of Rehabilitation and Correction (DRC). Of those women, 504 (4.5%) were pregnant.

The ORW parenting coordinator/case manager reviews files of pregnant inmates and discusses options available to incarcerated women for addressing the pregnancy and physical

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custody of the child after birth. These options include adoption, placing the baby with family or friends, elective termination of the pregnancy1, or participating in the ABCS nursery program.

The Department also offers a prenatal program at Franklin Pre-Release Center (FPRC) to all incarcerated women who elected to continue their pregnancies, regardless of whether they will be involved in the ABCS nursery program. The prenatal classes for the time period examined in the present study were provided by Wilmington College and Community Connection for Ohio Offenders, Inc.2 The prenatal program involves the provision of information and instruction in areas such as prenatal nutrition and behavioral health issues that may affect the fetus, the process of childbirth, postpartum experiences, and birth control, among others. (For further details of the prenatal classes, see Appendix A.)

Women who intend to maintain custody of their children are offered additional parenting classes (also discussed in Appendix A). The women who are eligible and are accepted into the ABCS nursery program are provided additional parenting education and services beyond those they receive in the prenatal service programs.

History of the ABCS Nursery Program

In 1999, DRC formed a committee to examine the feasibility of creating a nursery for inmate mothers and their newborns. Committee members reviewed the literature and visited other prison nurseries in New York, Nebraska, and Washington, to identify best practices upon which to model the Ohio program. Presentations were made to the Ohio legislature and House Bill 661 was passed. This bill, which permitted DRC to establish a twenty-bed prison nursery at the Ohio Reformatory for Women was signed into law by Governor Taft on December 14, 2000 and became effective on March 14, 2001. The first participant in the Achieving Baby Care Success (ABCS) program was accepted in May of 2001 with the official grand opening of the program taking place in June of that same year. The program is overseen by a twenty-four member advisory board which meets quarterly. Members of the board include DRC employees, as well as individuals representing outside agencies including the Union County Department of Jobs and Family Services, Ohio State Medical Center, Catholic Social Services, Columbus Urban League, and the Altrusa Club. There is also a local (Marysville) pharmacist who served as a board member.

METHODOLOGY

Secondary data regarding social and criminal background information and program participation data were collected on all pregnant women (n=504) who entered DRC and gave birth or were due to give birth between May 11, 2001 and December 31, 2004. Appendix B provides a summary of the data used in this study. This information will be used to conduct a process evaluation in order to determine the extent to which the ABCS Nursery Program is being implemented as designed.

One concern expressed by the DRC administration was the apparent lack of participation in the nursery program. The nursery unit can accommodate twenty women and their newborns,

1 This option is limited to inmates who are less than 16 weeks pregnant. The gestational stage is determined by an ultrasound examination. State and local funds may not be used for this procedure. If termination of the pregnancy is elected, the inmate is referred to an outside agency. The outside agency incurs the cost of the procedure while the institution provides for the follow-up medical care of the inmate.

2 After 2005, DRC personnel took over the services offered by Wilmington College and Community Connections. Because the scope of this study is prior to 2005, services offered by the two vendors will be the only ones mentioned in this paper.

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yet there were only seventy total participants within the three years and eight months examined for this study. Today, the numbers of women enrolled in the program continues to be less than initially anticipated. This process evaluation will determine not only how well the Department is adhering to the eligibility requirements (as established by statute and departmental administrative rules) and the extent to which women are receiving the intended programming but will also assist DRC in determining the reasons for the lower-than-expected levels of program utilization. For example, is the low level of program enrollment due to a high number of eligible women who choose not to participate, or are the eligibility criteria responsible for excluding the majority of pregnant inmates from participating? Understanding why there are so few women participating in the program will enable the department to determine whether any modifications to the program or eligibility criteria could be made in order to increase enrollment.

PROCESS EVALUATION RESULTS ELIGIBILTY CRITERIA Admission to the ABCS Nursery Program

The admission process involves the review of the offender’s criminal history and social history background in order to determine the eligibility of the offender for the ABCS program. There are six separate individuals and organizations consulted when making the admission decision. They include: the ABCS program administrator (ORW), a representative from the Ohio Department of Jobs and Family Services (ODJFS), a representative from DRC mental health services, a representative from DRC medical services, a Unit Management Administrator (ORW), the Deputy Warden of Operations (ORW), and the Warden (ORW). Unanimity among these parties is not required. The Warden takes into consideration the recommendations of all parties and makes the final decision. (For a detailed description of the admission process, see Appendix C.)

ABCS Nursery Program Eligibility Criteria

The eligibility criteria for the ABCS program are set forth by the Ohio Revised Code (ORC), DRC Administrative Regulations (AR) and ABCS program rules. The first nine eligibility criteria are established by the ORC 5120.651 and DRC AR 5120:9-57 (C) and are presented below:

1. She is pregnant at the time she is delivered into the custody of the Department of Rehabilitation and Correction.

2. She gives birth while in the custody of DRC. 3. She is 18 years old at the birth of her child - In the state of Ohio,

juveniles may be sentenced as adults. If a juvenile were to be admitted to a DRC correctional facility while pregnant and give birth to that baby prior to her eighteenth birthday she would not be eligible for the ABCS program (DRC AR 5120:9-57 (C)). This eligibility criterion is based on Ohio law requiring the living units of minors incarcerated in adult correctional facilities to be segregated from the living units of adult offenders. Since individuals participating in the nursery program are all housed in one dorm, the housing of juvenile mothers with adult mothers in the ABCS program would violate this legislative mandate.

4. She has never been convicted of a violent crime or any type of child abuse or child endangering.

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5. She is subject to a sentence of imprisonment of not more than eighteen months.

6. She must have a security status of Level 1 or Level 2. 7. She and her child meet established medical and mental health criteria

– this criterion primarily involves ensuring that the mothers have no medical or mental health impairment that would prevent them from being able to provide proper care to their infants while in the program (e.g., no conditions that would require a lengthy hospital stay that would separate them from their babies) (See Appendix D for further discussion of mental health criteria.).

8. She is the legal custodian of the child - In order to be sensitive to the rights of the father of the inmate’s baby, the DRC seeks the father’s expressed consent to allow the infant be placed with the mother in the nursery program. Prior to being considered for the ABCS program, the potential participant mails a standardized form to the father of her unborn child. If the father objects to the infant’s participation in the prison nursery program, the inmate is not admitted to the program.

9. No one else has been granted custody or shared parenting privileges. The ABCS program rules identify additional issues which affect the determination of eligibility for the ABCS program. They include:

10. She must be in prison at least thirty days prior to having her baby in order to complete all necessary paperwork and screenings (Thirty-Day Rule) - Inmates who are due to have their babies within thirty days of their arrival to prison may not be eligible to enter the ABCS program. The length of time needed for those providing recommendations to review the inmates’ files and to obtain the documentation and the approvals from all interested parties may exceed thirty day.

11. She must not have any outstanding warrants or detainers - Offenders who have outstanding warrants or detainers are often released from DRC into the immediate custody of another state or federal jurisdiction to face additional charges or serve additional time elsewhere. Given the uncertainty of these mothers’ situations after they are released from ORW, they are not eligible to participate in the ABCS program.

12. She must not have had extensive contact with the Ohio Department of Jobs and Family Services (ODJFS) – Women who have had previous contact with the ODJFS are not automatically excluded from participating in the nursery program. The committee including a representative from the ODJFS, reviews each individual case in order to make the most appropriate decision.

Although not established by statute, administrative rules, or the program manual, a final

eligibility requirement was identified through the review of the inmates’ program files. Women were considered ineligible for the program if the sentence they were serving was for the conviction of a first, second, or third degree felony. The final criterion is:

13. She must not have been convicted of a first (F1), second (F2), or third (F3) degree felony offense.

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Chart A (p. 6) displays results of the admissions process for all 504 pregnant women due to give birth between May 11, 2001 and December 31, 2004. The chart presents the number of women determined to be ineligible for the ABCS nursery program by eligibility criterion.3 Seventeen (3.4%) of the women were not considered because they chose to pursue adoptions for their babies (five women) or to terminate their pregnancies (twelve women). An additional seven women did not participate in the program, but no reason for their non-participation could be identified.

Of the remaining 480 who were considered candidates for the program, nursery program records indicate that fourteen women (2.8%) were no longer eligible for the program due to the fact that they had miscarried (criterion #1). An additional sixty-one women were considered to be ineligible because they had had their babies while not in the custody of DRC (criterion #2): either they had their babies while they were in the custody of a municipal court (0.4%, n = 2) or they were being released from prison well in advance of their due dates (11.7%, n=59). No women who entered prison were under the age of eighteen at the time their babies was due (criterion #3). A large number of women were determined to be ineligible for program participation for failure to meet to criterion #4. These women had either been convicted of a violent offense (n=149, 29.6%) or a child abuse or child endangerment offense (n=24, 4.8%). Nineteen women (4.8%) were ineligible as a result of being sentenced to a term of more than eighteen months. Six (3.8%) of the women were assigned a security classification higher than Level 2 (criterion #6). Medical and mental health concerns were factors contributing to the ineligibility of four (0.8%) women (criterion #7). In only one case did custody issues (criteria #8 and #9) preclude a woman from participating in the program. In this case, the father of the child was pursuing custody of the baby. There were an additional fifteen (3.0%) women who were due to have their babies before the application process could be completed (criterion #10). Being wanted in other jurisdictions (criterion #11) prevented eight (1.6%) women from being admitted to the program. There were seventy (13.9%) pregnant inmates who were not considered for enrollment in the nursery program due to ODJFS objections (criterion #12). Finally, nine (1.8%) were excluded because they were serving sentences for conviction of a third degree felony (F3).

Overall, there were 100 of the 504 pregnant inmates who were determined to eligible to participate in the ABCS nursery program. Seventy of these women (13.9% of all pregnant inmates) actually enrolled. Seven of the 100 eligible inmates declined to participate and an additional twenty-three women were released, primarily through judicial release, before their babies were born. Summary – The examination of the application of the eligibility criteria to the 504 pregnant female inmates due to give birth between May 11, 2001 and December 31, 2006 indicates that the majority of female offenders were determined to be ineligible due to their past behavior or issues related to timing. Past behavior leading to ineligibility included having criminal histories involving violent offenses (n=149) and crimes involving children (child neglect and child endangering, n=24). Having prior contact with ODJFS (n=70) was also a behavior that caused many women to be deemed ineligible for participation in the ABCS program. Women who were released before they gave birth (n=59) and women who gave birth before the application process could be completed (the Thirty-Day Rule, n=15) comprised a significant number of women who did not participate in the program due to logistic concerns rather than the result of past behavior.

3 Some women failed to meet more than one eligibility criterion. For ease of interpretation, Chart A is based on the criterion considered to be the primary reason and/or the most problematic background characteristic, as subjectively determined by the principal researcher.

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Chart A: Number of Women Ineligible for ABCS Program by Eligibility Criteria

504 Pregnant Inmates

May 11, 2001 – Dec. 31, 2004

Not Considered for Eligibility: Adoption (n=5) Terminated Pregnancy (n=12) Ineligible for Unknown Reason (n=7)

1. No Longer Pregnant: Miscarriage (n=14)

2. Not In DRC Custody at Time of Birth: Gave Birth While Out to Court (n=2)

Released Before Birth (n=59)

4. Conviction for Violent Offense, Child Abuse/Endangerment: Current Sentence for Violent Crime (n=133) Previous Conviction for Violent Crime (n=16) Child Abuse/Endangerment (n=24)

5. Sentence Length Over 18 Months: (n=19)

7. Medical or Mental Health Concerns: Medical (n=2) Mental Health (n=2)

8. & 9. Custody Issue (n=1)

10. 30-Day Rule (n=15)

11. Warrant/Detainers (n=8)

12. ODJFS (n=70)

3. Not 18 Years of Age at Birth: (n=0)

6. Not Minimum or Medium Security Classification: (n=6)

100 Women Eligible for ABCS Nursery Program

Declined to Participate (n=7) Out of Prison before Birth (n=23)

13. Current Offense F3 (n=9) (no F1, F2)

70 ABCS NURSERY PROGRAM PARTICIPANTS

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Assessment of the Application of Eligibility Criteria

Process -- The process of screening pregnant inmates in order to identify appropriate participants appears to be one characterized by a high degree of consensus. In an overwhelming majority of cases (94.3%), all six individuals/organizations consulted agreed on whether the should be admitted to the nursery program. There was disagreement in only four instances. In the first case, representatives of the ORW nursery unit, in conjunction with those from the ODJFS, objected to an inmate participating in the program based on the fact that this woman had previously given birth to two other children, both of whom were born drug addicted. However, representatives from DRC Medical, Mental Health, Unit Management Administrator (UMA), and the Deputy Warden and Warden found no contemporary reason for denying the woman admission to the nursery program. As a result, the Warden decided to allow the woman to participate in the nursery program citing that the offender had in fact been reunified with one of her children prior to her incarceration.

In a second instance, a representative of ODJFS would neither approve nor disapprove a woman for program admission. The UMA and Deputy Warden rejected the inmate’s application on the basis that this individual had a past history with ODJFS and did not have custody of either of her two previous children. Because the others believed that this particular offender could benefit from being in the program and that ODJFS had not ruled either way, the Warden decided to provide this inmate with the opportunity to participate in the program and she was admitted.

A third woman was allowed to enter the program even though the Unit representative and Deputy Warden did not feel that she was an appropriate candidate for the program. The reason cited for her rejection was that she was alleged to have been operating a methamphetamine lab from her home prior to her incarceration. The Warden argued that the charge was only an allegation, not a conviction, and the inmate should not be punished for a crime that had not been proven. Information from ODJFS could not be located for this case.

Finally, the representative from DRC medical services would not recommend a woman for admission to the ABCS program due to concerns regarding potential medical problems with the baby. After the baby was born, there were no evident medical problems. The infant was cleared by doctors at the hospital, and the offender and her child were allowed to become program participants.

The effectiveness of these eligibility criteria is demonstrated by the fact that a high proportion of women are retained in the program until they are released from the prison and go home with their babies. Of the seventy women who entered the program, 81.4% lived in the nursery and participated in the program until their release. Of the thirteen women who were not retained in the program, two (2.9%) dropped out of the program voluntarily and eleven were removed. Of those eleven, seven were removed for violating program or institutional rules and regulations and four were removed for failing to attend to their infant.

Exceptions -- The principal researcher examined the files of all seventy women who participated in the nursery program to determine whether any eligibility criteria were overlooked, and whether there were any women participating in the program that perhaps should not have been. There were only three instances in which it could be argued that the women should not have been permitted to participate based on the eligibility criteria. Of all the women identified as eligible for program participation, only two (2.0%) had sentences greater than eighteen months. Both of these women were sentenced to twenty-four months in prison but were admitted to the program due to the fact that they had less than eighteen months remaining on their sentences after the babies had been born.

The third instance involved another woman who was serving a sentence for a violent felony offense. According to the presentence investigation report for this offender, her crime

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involved robbery (F4), and tampering with evidence (F3) for which she received a sentence of one year.4 While most of the eligibility criteria were fairly clear, the ARs did not differentiate between violent felony or misdemeanor convictions for criterion #4. As a result, this study examined the inmates’ previous convictions for both. If the ARs intended for women who had been convicted of any violent offense, felony or misdemeanor, there were an additional six nursery participants who had prior convictions for violent offenses: four were convicted of misdemeanor assault and two were found guilty of misdemeanor domestic violence. Given the care that appears to have been taken in ensuring that only women who met the established criteria were enrolled in the program, it seems likely that program administrators are interpreting the eligibility criterion as referring only to violent felony offenses. It is recommended, however, that program administers clarify this eligibility criterion. Summary - Overall, this assessment has found that the program administrators have adhered to the eligibility criteria in the overwhelming majority of the cases in the time period reflected in the study (assuming that criterion #4 refers only to convictions for violent offenses at the felony level). Over 95% of the cases reviewed were found to have met all of the eligibility criteria established by statute, departmental ARs, and program criteria.

PROPORTIONAL REPRESENTATION OF PREGNANT INMATES

Table 1 compares several demographic and criminal history variables among women who

were identified as meeting the eligibility criteria (eligible) and those who did not (ineligible) as compared to their representation in the pool of all pregnant women entering prison (total) who were interested in the nursery program as one potential option for placing the baby (n=480).5 This comparison is provided in order to determine whether any particular demographic is being disproportionately represented in the program. Overall, it appears that pregnant women entering prison are proportionately represented in the group of inmates considered to be eligible for the nursery program in terms of marital status, number of prior jail commitments, and the urban/rural nature of their county of commitment. That is, pregnant women entering prison tend to be single, have had no prior jail commitments, and are slightly more likely to have been sentenced by an urban court.

4 The details of the instant offense indicated that she drove a man to Speedway and he robbed it. She held the stolen money until they got home and then returned it to the male who had committed the robbery. She said that she did not know he was going to rob the store, and she helped him afterwards because she was “afraid of him because he had done domestic violence things to her in the past.” Her past criminal history includes only one misdemeanor for petit theft. 5 The women who chose adoption or termination of the pregnancy and the seven cases for which the women did not participate in the ABCS program is unknown were excluded from the pool. The assessment of proportional representation is dependent upon the proportions of characteristics in the pool of individuals who could actually participate. Women who have decided not to keep their babies are not candidates for the ABCS program and would not participate even if they met all of the criteria. The cases for which the reason for non-participation is not known were excluded given that we do not know whether they would have participated if they had met the eligibility criteria or if they had chosen one of the other placement options for their babies.

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Table 1: Demographic and Criminal History Variables of Pregnant Women Considered Eligible and Ineligible to Participate in the ABCS Nursery Program. ELIGIBLE INELIGIBLE TOTAL N % N % N % Race White 62 62.0% 184 48.4% 246 51.3% Non-White 38 38.0% 196 51.6% 234 48.8% Total 100 100.0% 380 100.0% 480 100.0% Age at Birth of Child 18 to 20 20 20.0% 47 12.4% 67 14.0% 21 to 23 40 40.0% 95 25.0% 135 28.1% 24 to 26 19 19.0% 83 21.8% 102 21.3% 27 to 29 7 7.0% 49 12.9% 56 11.7% 30 and over 14 14.0% 106 29.9% 120 25.0% Total 100 100.0% 380 100.0% 480 100.0% Average Age Modal Age

24.2 22

26.4 22

26.1 22

Marital Status Single 72 72.7% 288 76.4% 360 75.6% Married 12 12.1% 51 13.5% 63 13.2% Other (Widowed, Divorced, & Separated) 15 15.2% 38 10.1% 53 11.1% Total 99 100.0% 377 100.0% 476 100.0% (Missing) 1 3 4 County of Commitment Urban (Cuyahoga, Franklin, Hamilton, Lucas, Montgomery, and Summit)

53 53.0% 211 55.5% 264 55.0%

Rural 47 47.0% 169 44.5% 216 45.0% Total 100 100.0% 380 100.0% 480 100.0% Educational Attainment No Degree 53 53.0% 214 60.6% 267 58.9% High School Diploma 24 24.0% 73 20.7% 97 21.4% GED 18 18.0% 48 13.6% 66 14.6% Some College 4 4.0% 18 5.1% 22 4.9% College Degree 1 1.0% 0 0.0% 1 0.2% Total 100 100.0% 353 100.0% 453 100.0% (Missing) 0 27 27 Employment at Arrest Employed 35 42.2% 92 32.9% 127 35.0% Not Employed 48 57.8% 188 67.1% 236 65.0% Total 83 100.0% 280 100.0% 363 100.0% (Missing) 17 100 117 History of Alcohol/Drug Involvement Yes 62 62.0% 262 74.9% 324 72.2% No 38 38.0% 88 25.1% 126 28.0% Total 100 100.0% 350 100.0% 450 100.0% (Missing) 0 30 30 Number of Prior Felony Convictions Zero 73 73.0% 221 60.6% 294 63.1% One or More 27 27.0% 145 39.6% 172 36.9% Total 100 100.0% 366 100.0% 466 100.0% (Missing) 0 14 14 Number of Misdemeanor Convictions Zero 41 41.0% 112 32.8% 153 32.8% One or More 59 59.0% 255 69.5% 314 67.2% Total 100 100.0% 367 100.0% 467 100.0% (Missing) 0 13 13 Prior Jail Commitments Zero 60 60.0% 214 58.3% 274 58.7% One 19 19.0% 73 19.9% 92 19.7% Two or More 21 21.9% 80 21.8% 101 21.6% Total 100 100.0% 367 100.0% 467 100.0% (Missing) 0 13 13 Prior Prison Commitments Zero 85 85.0% 267 72.7% 352 75.4% One 9 9.0% 61 16.6% 70 15.0% Two or More 6 6.0% 39 10.6% 45 9.6% Total 100 100.0% 367 100.0% 467 100.0% (Missing) 0 13 13

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The differences in proportional representation among the group of women identified as eligible for program participation occur with respect to race, age at which they gave birth to the baby, education, employment, history of alcohol and drug abuse, number of prior misdemeanor and felony convictions, and prior prison commitments. First, the data indicate that white women were more likely to meet the eligibility requirements than were non-white women. White women represent 51.3% of the women who were pregnant when they entered prison and due to give birth between May 2001 and December 2004, yet they comprise 62.0% of the women who were considered to be eligible to participate in the ABCS program. White women were also more likely to decline to participate than non-white (57.1% vs. 42.9%) and more likely to be released before the birth of their child (69.6% vs. 30.4%). Of the 70 women who actually participated in the program, 60.0% were white.

A closer examination of characteristics of these women related to the eligibility criteria responsible for preventing the majority of women from being admitted to the program can help increase our understanding of the reasons for the disproportionate representation. Table 2 shows that one possible explanation for the disproportionate over-representation of white women in the nursery program is that non-white women were more likely than white women to have ever been convicted of a child abuse or child endangering offense (10.8% v. 5.4%, respectively), were more likely to have been convicted of a violent offense (38.5% vs. 30.1%), have had previous contact with ODJFS (74.4% vs. 52.7%), and were more likely to have been sentenced for being convicted of a first or second degree felony (22.2% vs. 12.2%). It appears that pregnant, non- white women entering prison are more likely than white women to be at risk of not being accepted into the nursery program due to having criminal histories and convictions involving more serious offenses and convictions for child neglect and child endangerment than pregnant white women. Also placing non-white women at a greater likelihood of being identified as ineligible is the fact that a greater proportion of them have had previous contact with ODJFS.

While the women eligible for the ABCS program are only slightly younger on average

than those identified as ineligible (25.7 vs. 26.2 years of age), Table 1 (p. 9) shows that a greater

Table 2: Comparison of White and Non-White Pregnant Inmates Under Consideration for Participation in the ABCS Nursery Program. WHITE NON-WHITE TOTAL N % N % N % Ever Convicted of Child Abuse/Child Endangering Yes 13 5.4% 25 10.8% 38 8.1% No 227 94.6% 206 89.2% 433 91.9% Total 240 100.0% 231 100.0% 471 100.0% (Missing) 6 3 9 Any Conviction for a Violent Offense Yes 72 30.1% 89 38.5% 161 34.3% No 167 69.9% 142 61.5% 309 65.7% Total 239 100.0% 231 100.0% 470 100.0% (Missing) 7 3 10 Previous Contact with ODJFS Yes 49 52.7% 58 74.4% 107 62.6% No 44 47.3% 20 25.6% 64 37.4% Total 93 100.0% 78 100.0% 171 100.0% (Missing) 20 17 37 Felony Level-Current Offense First, Second Degree 30 12.2% 52 22.2% 82 17.1% Third Degree 40 16.3% 39 16.7% 79 16.5% Fourth, Fifth Degree 176 71.5% 144 61.5% 320 66.7% Total 246 100.0% 234 100.0% 480 100.0% (Missing) 0 0 0

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proportion of eligible women are only twenty-three years of age or younger (60.0%), whereas only 37.4% of those who were ineligible were included in that age range. Also note that while 14.0% of the eligible women were thirty years of age or older, more than twice as many ineligible women (29.9%) were over thirty. It is important to note that age may have an impact on a number of the eligibility criteria simply because older women have had a longer time to have established a longer criminal history as well as longer exposure to the potential of having contact with ODJFS.

Even though the women in the eligible and ineligible groups differ in proportional representation on some characteristics, they are similar in several important aspects: that is, the majority of eligible and ineligible women do not have a high school degree (58.9%), were unemployed at the time of their arrest (65.0%) and have a history of substance abuse (72.2%). Women who met the eligibility criteria were better off than ineligible women in the sense that eligible women were more likely to have earned their GED or had a high school degree compared to ineligible women (42.7% vs. 34.3%, respectively), more likely than ineligible women to have been employed at the time of their arrest (42.2% vs. 32.9%, respectively), and less likely to have a history of alcohol/drug abuse (62.0% vs. 74.9%). These apparent differences, however, do not neutralize the fact that the majority of all of these pregnant women are characterized as having serious social disadvantages that will only serve as impediments to their ability to provide for themselves and their children once they are released from prison.

Pregnant women considered for the ABCS program were also similar in the sense that the majority of the women considered for the ABCS program had prior misdemeanor convictions (67.2%), did not have prior felony convictions (63.1%), nor did the majority have prior prison commitments (75.4%). The differences between the eligible and ineligible again reflect an advantage for those identified as eligible. Eligible women were less likely to have prior convictions for misdemeanors (eligible = 59.0%; ineligible = 69.5%), prior felony convictions (eligible = 27.0%; ineligible = 39.6%), and prior prison commitments (eligible = 15.0%; ineligible = 27.2%). Given that a number of eligibility criteria reflect an offender’s criminal history, it is not surprising that women in the eligible group tend to be characterized by an under- representation of these variables.

Summary – Overall, the women identified as eligible for admission to the ABCS nursery program tend share a number of characteristics with those who were identified as ineligible. The two groups are proportionally represented in marital status, an urban/rural dichotomy of county of commitment, and prior jail commitments. There is, however, disproportional representation of all pregnant women considered for eligibility in terms of race, age, education, employment, history of alcohol/drug use, prior misdemeanor and felony convictions, and prior prison commitments. Non-white women are under-represented in the group of women identified as meeting all of the eligibility criteria. After examining the racial differences in several eligibility criteria, it appears that the primary reason that non-white women are more likely to be ineligible for program participation is that they tend to have criminal histories that reflect more serious offenses (more serious felony level) and violent offenses as well as convictions for child neglect or child endangering. Finally, non-white women were more likely to have had previous contact with ODJFS.

There were disproportionate representations of the characteristics of all pregnant women being considered for the ABCS program on a number of other characteristics. Without exception, the women in the eligible group were less likely to possess the negative attributes of those variables. Specifically, eligible women were disproportionately more (relatively) educated and more likely to be employed at the time of arrest. They were also less likely to have had any prior misdemeanor and felony convictions as well as no prior prison commitment.

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PROGRAMMING

General Observations Regarding Program Data and Program Implementation It should be noted at the outset that the results concerning the extent to which the program was delivered as intended (i.e., comparison of programming received vs. described in the program manual) should be interpreted with considerable caution. During the evaluation, it was very difficult to locate standardized and complete program data on the program participants. It is not entirely clear whether the apparent lack of participation in specific programming is ‘real’ or the result of poor data and record maintenance. In addition, the programs being offered to inmate mothers were not offered on a consistent basis during the time period under consideration. For example, one program identified in the program manual was never offered to the offenders (Developing the Inner-needs of a Child from Birth to Teen). Another program, the Prevent Child Abuse Ohio program, consisted of eight separate sessions. All eight sessions were offered to women from May 2001 through the year 2002. After that time, data suggest that only the first three sessions were ever offered to the program participants. At some point in time, the entire program was discontinued. While certainly common in correctional programming (see Feinman, 1986), the lack of consistency of standardized programming and continual program availability over time makes it very difficult to draw even the most tentative of conclusions about the effectiveness of a program. One concern raised by the lack of a standardized program curriculum raises questions about the extent to which the goals and objectives of the program are clear to program administrators and participants. For example, no statement of program purpose or program logic was found in the program documentation. The implications of this discovery on the ability of researchers to conduct a proper program outcome evaluation will be discussed later in this report.

Finally, during the review of the extent to which women in the nursery program participated in the courses offered, it became evident that the length of time the offenders were able to spend in the ABCS program was a major obstacle to the participants’ ability to complete a significant number of courses. For example, the average length of stay in prison for all ABCS participants was 8.09 months (mode = 5) and the average length of stay in the ABCS nursery program is only 3.87 months.

Table 3: Program Participant’s Length of Stay in Prison and Length of Stay in Program N % Length of Stay in Prison Zero to Six Months 32 45.7% Seven to Twelve Months 27 38.6% Thirteen to Eighteen Months 9 12.9% Nineteen to Twenty Four Months 2 2.8% Total 70 100.0% (Missing = 0) Average = 8.09 Length of Stay in ABC’S Program Less than one month 14 20.0% One Month 10 14.3% Two Months 12 17.1% Three Months 10 14.3% Four Months 2 2.9% Five Months 4 5.7% Six Months 4 5.7% Seven Months or More 14 20.0% Total 70 100.0% (Missing = 0) Average = 3.87

Table 3 shows that almost two-thirds of ABCS participants were enrolled in the nursery program for only three months or less. Given that inmates are considered to be on “maternity

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leave” during the six to eight weeks immediately after the birth of the baby, there is an extremely limited amount of time the new mothers are available to receive programming.

As would be expected, the effect that the short length of time an offender remains in prison after the birth of her baby on the ability of the women to complete programming is reflected in Table 4 below. While it appears that no ABCS program participant in the time period examined completed the minimum fifty hours of “parenting education” programming as specified in the program manual (discussed below), it is clear that women who are in the program longer are able to complete more hours of programming. For example, of the women who spent less than three months in the program, 84.8% received no more than sixteen hours of programming (39 out of 46 women). In contrast, only one (4.2%) of the women who spent four months or more completed sixteen hours or less of programming.

Table 4: Number of Class Hours by Time in Program

Time in Program

Less than One

Month One to Three

Months Four to Six Months Seven Months or

More

Total

Class Hours N % N % N % N % N % None 7 50.0% 7 21.9% 0 0.0% 0 0.0% 14 20.0% Two 6 42.9% 9 28.1% 0 0.0% 0 0.0% 15 21.4% Four to Ten 1 7.1% 6 18.7% 0 0.0% 1 7.1% 8 11.4% Eleven to Sixteen 0 0.0% 3 9.4% 0 0.0% 0 0.0% 3 4.3% Seventeen to Twenty Two 0 0.0% 6 18.7% 5 50.0% 2 14.3% 13 18.6% Twenty Three to Twenty Eight 0 0.0% 0 0.0% 3 30.0% 5 35.7% 8 11.4% Twenty Nine to Thirty Five 0 0.0% 1 3.1% 1 10.0% 4 28.6% 6 8.6% Thirty Six to Forty Five 0 0.0% 0 0.0% 1 10.0% 2 14.3% 3 4.3% Total 14 100.0% 32 100.0% 10 100.0% 14 100.0% 70 100.0% (Missing) 0 0 0 0

It is important for the reader to keep in mind the fact that this program review has raised a

number of questions regarding the implementation of the program. Concerns reflect issues regarding the quality of programming data, the lack of a structured program curriculum, the lack of a specified and documented program purpose statement, and the short amount of time the women were actually in the nursery program. These limitations require that any conclusions regarding the level of program participation drawn from this assessment be considered very tentative.

Program Manual Specified Courses The only requirement specified in the ABCS program manual is that all participants are to receive a minimum of fifty hours of parenting education. While there is no structured curriculum provided in the manual, there are number of courses that are listed by name. They include:

1.) Breastfeeding Awareness – 2 hours 2.) Sudden Infant Death Syndrome (SIDS) – 2 hours 3.) Infant CPR – 4 hours 4.) First Aid – 2 hours 5.) Poison Identification – 2 hours 6.) Car Seat Safety – 2 hours 7.) Developing the Inner-needs of a Child from Birth to Teen – 2 hours 5). GOALS - 12 hours 8.) Prevent Child Abuse Ohio – 40 hours 9.) Responsible Family Life Skills – 15 hours

Although not explicitly stated, the first three courses, Breastfeeding Awareness, SIDS, and Infant CPR may be considered “required” courses. The manual specifies that all women will

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receive these courses within a specified time-period. Given that the number of hours of courses #4 through #9 sum to more than fifty hours, it is assumed that they may be considered “electives.” That is, program participants are encouraged to elect to complete any combination of these courses in order to complete the minimum number of program hours required by the ABCS program. No underlying theory or guiding program model for which course selection and completion would benefit women the most, however, is offered. Table 5 provides information on the number of women who completed each of the courses available to the participants. The table shows that none of the courses were completed by all of the women who participated in the program. This is not surprising given that the sum of all the child/parenting programs available exceeds the minimum fifty-hour requirement and not all of these programs were offered consistently over time. What is surprising, however, is that the courses specified in the program manual implicitly considered mandatory (those specified by name and having specified time frames within which they are to be completed) also fail to show that all women completed these courses.

Table 5: Marital/Family Relations Core Courses Be Poison Smart Yes 27 38.6% No 43 61.4% Total 70 100.0% (Missing = 0) Breast Feeding Techniques Yes 20 28.6% No 50 71.4% Total 70 100.0% (Missing = 0) Car Seat Safety Yes 34 48.6% No 36 51.4% Total 70 100.0% (Missing = 0) CPR Yes 22 39.3% No 34 60.7% Total 56 100.0% (Missing = 0) Responsible Family Life Skills Yes 31 44.3% No 39 55.7% Total 70 100.0% (Missing = 0) Sudden Infant Death Syndrome Yes 30 42.9% No 40 57.1% Total 70 100.0% (Missing = 0) Prevent Child Abuse Ohio Yes 11 15.7% No 59 84.3% Total 70 100.0% (Missing = 0)

For example, the ABCS curriculum indicates that all women will receive the two-hour courses in SIDS and Breastfeeding Awareness within three days of admission into the program. Documentation could only be found to show that 42.9% of program participants completed SIDS training, (and only 72.4% of those individuals completed the course within the specified time frame). Only 28.6% of the women in the ABCS program completed the Breastfeeding Awareness course (whether or not all mothers completed the training for breastfeeding within the

15

first three days of the admission to the program is not known; the exact date training began or was completed was not available). Another course that was to be completed within a designated time frame was Infant CPR. All program participants were to complete this course within the first thirty days of entering the ABCS program. It should be noted that fourteen women left the program within the first thirty days. Given that the program did not have a full thirty days in which to ensure that these fourteen women received this course, they have been excluded from this analysis. The data available indicate that only 39.3% (n=22) of the women received Infant CPR instruction, however, it could not be determined whether the women completed the courses within the first thirty days of admission to the program due to missing information. The remaining programs presented in Table 5 reflect courses specified in the program manual which essentially function as “electives.” This means that program participants are not required to take all of the courses listed, but they must complete enough hours to fulfill the fifty minimum hours programming requirement. The table shows that the course most often completed by program participants was car seat safety, however, not even half of all women in the program participated in the training. Instruction on Poison Control was completed by only 38.6% of the ABCS participants and Responsible Family Life Skills (RFLS) training was completed by 44.3% of the women. Interestingly, while forty-nine of the women admitted to the program had prior contacts with ODJFS, only 15.7% (n=11) of all program participants attended at least one session sponsored by Prevent Child Abuse Ohio; only two of those participating actually had prior contact with ODJFS, the remaining nine did not.

Finally, even though the program manual mentions three courses, Developing the Inner- needs of a Child from Birth to Teen, First Aid, and GOALS, no documentation could be found in computer databases or paper files indicating that any ABCS program participant had been enrolled in or completed any of these courses; the first two of these courses were apparently never offered. Other Programming Offered by ABCS

In addition to the programming specified in the ABCS program manual, a number of other programs were identified in the files of program participants as having been offered to the nursery participants. One such program is called Baby’s First Story Time. Slightly less than one third (31.4%) of the women took this course. Women who participated in the ABCS program prior to 2003 (n=36) were also given the option of taking the 3M Library course of which 11.1% participated. The last program included in Table 6 is the lesson on Shaken Baby Syndrome which was developed in 2003, was completed by 17.6% of the women enrolled since that time (n=34).

The final program offered to the women in the ABCS program is the Help Me Grow program (HMG). HMG is a statewide initiative that is provided in all women and their families (not only incarcerated women) in all eighty-eight counties. Expectant parents, newborns, infants and toddlers are provided with services that ensure that children develop at a proper rate so they will be ready to start school. All of the women who were in the ABCS nursery program longer than fourteen days were enrolled in HMG.6 The HMG Service Coordinator referred women who were in the program less than fourteen days to the HMG program in the counties to which they would be returning to live once released from prison.

6 A HMG specialist is assigned to the ABC'S nursery and visits at least once a week. During this time the mother discusses any concern she may have about her baby and receives suggestions on how to help her baby advance. When the inmate meets with the specialist for the first time, an Individualized Family Service Plan (IFSP) is written. The plan, which is reviewed every 120 days, will enable the specialist to identify services required by the mother and child while they are in prison and when they are released to the community.

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Table 6: Other Programs Offered N % Baby’s First Story Time Yes 22 31.4% No 48 68.6% Total 70 100.0% (Missing = 0) 3M Library Yes 4 11.1% No 32 88.9% Total 36 100.0% (Missing = 0) Shaken Baby Syndrome Yes 6 17.6% No 28 82.4% Total 34 100.0% (Missing = 0)

Mothers in the program can also join Parents Anonymous. This support group promotes

mutual support and leadership in order to help build and support strong and safe families. The goal of the program is to prevent child abuse and neglect through professionally facilitated peer- led support groups. Since this group was not offered until 2002 the women in the program prior to that date are not included in this portion of the analysis. About thirty-eight percent of women enrolled in the ABCS program during the time this program was offered (n=55) participated at least once in this group. Summary of Program Participation - While the above data indicate that women in the ABCS nursery program do not appear to be receiving the number of the programming hours specified in the manual, a number of potential reasons for this deficit have been identified in this process evaluation. First, it is important to bear in mind the limitations of the quality of the program participation data. During the data collection phase of the project, it became clear that there were no centralized databases that tracked the course/program completion for all of the ABCS participants. The principal researcher had to examine multiple paper files as well as make contact with individuals who were responsible for specific course offerings. This task was made even more difficult by the fact that there had been considerable turnover of non-ABCS program staff over the three year and eight month time period examined and as staff migrated to other jobs, they tended to take their program/course databases with them or the records were simply deleted. As a result, we cannot be entirely sure that the data portray an accurate representation of the course/programs attended and completed by the ABCS participants. There is considerable confidence, however, that if course/program participation documentation was available, it has been captured for the present study.

Despite the concerns regarding program data, there were various programmatic weaknesses identified by the process evaluation that may have affected the ability of women to complete more hours of programming and courses. A fundamental problem is the apparent lack of a clear and guiding set of purpose statements for the program. The program documentation included no statements identifying the purpose of the program. It also did not include a program logic model which specifies the process of change that is to occur as a result of the interventions implemented. These types of statements provide structure to the implementation of a program and provide a rationale for understanding why, after being exposed to the program, the participants would be likely to demonstrate the desired outcome.

The fact that there were programs/courses named in the program manual but never offered, some course that did not offer all sections or modules of their curriculum, and even

17

more that were offered for only a fraction of the period under examination is offered as evidence of this lack of understanding of the purpose and expected results of program participation. It is important to note that failure to have a standardized curriculum which is consistently offered over time creates a “program” upon which an outcome evaluation of the effectiveness of an intervention cannot be conducted.

For example, most programs in corrections maintain that one of the desired outcomes of the program is to reduce recidivism, the assumption being that the offender’s participation in the program has affected some change in the offender that reduces the likelihood that he/she will commit additional crimes upon being released from prison. The ability to conduct an evaluation focusing on this outcome assumes that program participation and completion can be measured. With the ABCS program, there is not a clear curriculum that is expected to be completed and the changes to be effected by the intervention are not identified. Any comparisons of recidivism between women who were enrolled in the nursery “program” as it currently exists and those who were not could not speak to the effectiveness of any active program intervention on the part of the department. If there were any differences in the recidivism rates between these two groups of women, it would have to be assumed that the differences were either due simply to the fact that some women were able to be with their newborns or that the differences were the result of unknown and unmeasured characteristics. It would be difficult to attribute differences to the former given that majority of the women in the program had previous children, yet they had become incarcerated none-the-less. An inspection of recidivism rates of these two groups of women under the current program implementation conditions would reveal little insight.

The final obstacle to providing meaningful programming revealed in this study is the very limited amount of time the women enrolled in the ABCS program were able to spend receiving programming and completing courses before they were released from prison. The average length of stay for all program participants was 3.87 months, with nearly two-thirds (65.7%) spending three month or less. In addition to providing a greater goal-driven program, a better planned and more structured curriculum would enable program administrators to take advantage of the limited period of time women are able to receive parenting education classes. We must recognize, however, that there is very little that can be accomplished in three months. In response to the discussion of a rehabilitation effort undertaken in 1975, Feinman notes that “It is unrealistic to believe that any program can change the values and life-styles of adult women in two months” (Feinman, 1986:45). If one of the goals of the ABCS program is to reduce recidivism among these women, it is interesting to think that more than thirty years later, we continue to try to create miracles in a very short period of time. This process evaluation provides us with an important insight to consider: we should not expect recidivism to be affected by this program as it is currently implemented.

DISCUSSION

This process evaluation has also afforded the Department an opportunity to achieve a

greater understanding of the life circumstances of women who have been accepted into the program. Only through this understanding will the most realistic and optimal programming be able to be developed. The difficulties confronting pregnant women who enter prison have been enumerated in the past. Some of the first textbooks on women in the criminal justice system provided an examination and consideration of the hardships facing this subgroup of the offender population (Feinman, 1986; Pollack-Byrne, 1990). The information collected during this process evaluation finds little to contradict these earlier profiles and obstacles to reintegration upon release among women who enter prison pregnant. The following discussion revolves around the

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difficulties facing these women upon leaving prison and the typical social circumstances to which they return that further impede their successful reintegration into the community.

Ability to Provide for Children Upon Release

Table 1 (p. 9) shows that the women in the nursery program tend to be young, single, lack a high school diploma, were unemployed at the time of their arrest, and had a history of substance abuse. This profile is consistent with findings from previous research reporting that while almost all of the women in prison who had children expected to live with them upon release, few were prepared to support them, given the fact that many were unemployed prior to incarceration, they lacked money and job skills, and they are often single (see Feinman, 1986:51, emphasis added).

The majority of the women in the nursery program had previous children (77.1%). Table 7 shows that over two thirds (68.6%) of those women had custody of at least one of their children prior to being incarcerated. Given that these women chose to participate in the ABCS nursery program, it can be assumed that they also had expected to live with children upon release from prison. It appears then, that given their educational attainment and employment history, female inmates continue to be similarly situated as the women offenders of previous decades. That is, they retain their desire to live with their children, yet they do not possess the attributes required to do so adequately.

Table 7: Custody of Inmate’s Previous Children Prior to Incarceration Custody of Previous Children

ABCS

Participants N % Had Custody of All Children 31 60.8% Had Custody of Some Children 4 7.8% Did Not Have Custody of Any Children Prior to Incarceration

16 31.4%

Total 51 100.0% (Missing) 2 *The women who had a child die is not included in this analysis, hence the total equaling 53 instead of 54.

Finding housing and securing employment sufficient to support themselves and their

children is a considerable challenge for these women (Pollock-Byrne, 1990: 69). Without significant social support, these women face an extraordinary obstacle to becoming contributing members of society. Pollack-Byrne (1990: 70) points out that if women try to live independently, housing may be a problem: “In many cities inexpensive housing close to employment does not exist. Women are forced to live in poverty-stricken areas and in apartment complexes that are havens for drug dealers and pimps. These locations only temp the woman to crime again, if only to get enough money to get her children to a safer neighborhood.” It is clear that these women will need considerable positive social support once they are released from prison. The information available regarding the ability of the families to provide this support is not encouraging.

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Family Instability A closer examination of the women’s own social and family histories reveals additional

difficulties. Previous assessments of female offenders’ family backgrounds have concluded; By all accounts, the lives of women prisoners before prison often involved economic distress, victimization, and self-abuse through the use of drugs and alcohol. Often, they have had a series of negative relationships with men, being either exploited or physically abused. Children come early, and the women typically have little in the way of skills and resources to take care of their children. The women’s families often have similar instabilities and economic problems and are not able to care for the women’s children either, although typically that is where children are placed (Pollack-Byrne, 1990:78). Some researchers have found that women in prison come from more disordered

backgrounds than men in prison do. A study by Crawford (1988) indicated that almost half of the women in the study had other family members incarcerated (48.4%) (see Pollock-Byrne, 1990:77-78). The data from the current study, although limited, seems to support this finding. Table 8 indicates whether the participant’s family or significant other has a criminal history involving a felony conviction. It is important to note that this information is self-reported by the inmate during her presentence investigation (PSI) interview, and caution is recommended in interpreting the data in this table. Additional caution is warranted given the large proportion of missing data for each variable.

“Family” is defined as parents, siblings, stepparents and stepsiblings. “Significant Other” is defined as the inmate’s husband, boyfriend, and/or father of one or more of their children including the father of their newborn. Table 8 shows that more than half (56.0%) of the women for whom information was available report that their significant other has a felony conviction while 33.3% stated that a member of their immediate family had been convicted of at least one felony.

Table 8: Family Criminal History ABC’S

Participants N %

Significant Other Felony Conviction Yes 14 56.0% No 11 44.0% Total 25 100.0% (Missing = 45) Immediate Family Felony Conviction Yes 13 33.3% No 26 66.7% Total 39 100.0% (Missing = 31)

The ABCS nursery program participants’ personal background information also hints at

personal lives that do not reflect stable, monogamous interpersonal relationships for a majority of these women. For example, Table 9 shows that over three quarters (77.1%) of the women in the program have had more than one child (including the newborn baby born while she was incarcerated). Of the women with more than one child, nearly 80% have children fathered by different men. Over one-third of these women (35.2%) have children fathered by three or more different men. It is important to note that this information is not presented in order to attach any moralistic judgment to the behavior of these women. It is simply presented to demonstrate that

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the personal lives of these women are complicated and that attempts to provide programming to build and strengthen family ties will have to navigate a great deal of complexity in order to do so with this particular group of women. The situation is further complicated if one refers back to Table 7 to note that nearly 40% of the women with previous children did not have custody of some (7.8%) or any (31.4%) of their children prior to incarceration.

Table 9: Family Background ABCS Participants

N % Number of Previous Children Zero 16 22.9% One 16 22.9% Two 25 35.7% Three 5 7.1% Four 5 7.1% Five 3 4.3% Total 70 100.0% Avg. # of Children Avg. #of Children Including Newborn

2.15 3.00

Number of Fathers for Women with Multiple Children (including newborn) One 11 20.4% Two 24 44.4% Three 14 25.9% Four 4 7.4% Five or More 1 1.9% Total 54 100.0% Avg. # of Fathers 2.26

Parenting Skills

Feinman (1986:52) refers to another serious problem facing pregnant women in prison. She notes that “many of these women need counseling and training in skills that will prepare them for motherhood and parenting. A large number have a history of beatings and sexual abuse as children and as adult women, and therefore have no positive mother-child or parent-child experiences or role models.” While the data collected for this study did not include information on the history of physical and sexual abuse of the program participants when they were children, the extent to which the women in the ABCS program may be struggling with parenting their children is revealed through their previous contacts with ODJFS and some of the behaviors they exhibited while in the program.

Contact with the Ohio Department of Jobs and Family Services -- Women who have had previous contact with ODJFS are not necessarily excluded from participating in the ABCS program. ODJFS representatives and other committee members evaluate each woman’s situation on a case-by-case basis. It is important to bear in mind that a women and/or her family may come in contact with ODJFS any time a third party reports an allegation of neglect or abuse to the agency. Neglect is defined as a failure to provide for a child’s basic needs. This can be physical (e.g., lack of housing), medical, educational, or emotional in nature. Physical abuse involves the infliction of harm upon the child that results in injury. Once a claim of neglect or abuse is made, case workers determine if the allegation is substantiated, indicated, or unsubstantiated. According to Ohio Administrative Code 5101:2-1-01 the definitions are as follows:

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1) Substantiated Report – in which there is an admission of child abuse or neglect by the person(s) responsible; an adjudication of child abuse or neglect; or other forms of confirmation deemed valid.

2) Indicated Report - is a report in which there is circumstantial, or other isolated indicators of child abuse or neglect lacking confirmation: or a determination by the caseworker that the child has been abused or neglected based upon completion of an assessment/investigation.

3) Unsubstantiated Report - is a report in which the investigation determined no occurrence of child abuse or neglect occurred.

Table 10 illustrates that over one-third (36.8%) of the women who participated in the

program had had previous contact with ODJFS. It should also be noted, however, that ODJFS did not object to any of these women participating in the nursery program and 11% of the cases were determined to be unsubstantiated. While it is admittedly difficult to interpret the exact meaning of these data given that not all women who had contact were excluded from participating in the program, it may suggest that these women are living in social circumstances that are placing them at a high risk of coming into contact with a social service agency that is tasked with overseeing the welfare of dependent children (e.g., impoverished, little familial support to help care for the children, criminal associates).

Table 10: ABCS Program Participants’ Previous Contact with ODJFS N % Previous Contact with ODJFS Yes 25 36.8% No 43 63.2% Total 68 100.0% (Missing) 2 Number of Contacts Zero 43 67.2% One 6 9.4% Two 5 7.8% Three 6 9.4% Four 2 3.1% Five or More 2 3.1% Total 64 100.0% (Unknown number of contacts) 4 (Missing) 2 Average # of Contacts 2.24 Most Serious Type of Contact with ODJFS N/A-no contacts 43 67.2% Abuse Substantiated 1 1.6% Neglect Substantiated 6 9.4% Neglect Indicated 1 1.6% Open Case with ODJFS 1 1.6% Lost Custody of Children 1 1.6% Child Born Drug Addicted – Not Reunified 2 3.1% Child Born Drug Addicted - Reunified 2 3.1% Abuse Unsubstantiated 2 3.1% Neglect Unsubstantiated 5 7.8% Total 64 100.0% (Specifics Unknown) (Missing)

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Program Behaviors -- Women who participated in the ABCS program not only have to follow institutional rules but the program guidelines as well. Two out of three of the women received at least one incident report while they were in the program, with the average number being 1.99 per person. Given that these women were required to adhere to program rules as well as institutional

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rules, this numerical average does not seem to be of concern in and of itself. For example, Pollock-Byrne (1990:72) states that “one well documental difference between men and women is the greater rates at which women break rules.” She cites a study by Linquist (1980) in which he found that women committed on average 4.38 offenses in prison, compared to 2.61 offenses for males.

The types of rule violations the ABCS program participants committed can be divided into parenting violations, program behavioral violations, and institutional violations. Parenting violations include incidents that involve improper care of the infants and program behavioral violations primarily reflect the inmates’ failure to comply with rules specific to the program (e.g., smoking, refusing to attend courses). Institution violations involve infractions of the rules and regulations of the institution to which all offenders are required to adhere (e.g., no fighting, no arguing, no disrespecting officers). Table 11 indicates that the majority of the incidents were related to improper parenting. For example, the most frequently occurring violation related to parenting had to do with how and where the women put their babies to sleep. There were twenty- four incidents (involving twenty-one mothers) in which women put their babies on their stomachs to sleep, had their babies sleeping in bed with them, or had them sleeping in the stroller, carrier or swing. According to program rules, all babies must be put to sleep in their cribs and in a supine position with no pillows or toys. This is thought to reduce the incidence of Sudden Infant Death Syndrome and is endorsed by the American Medical Association. Also in this category, one woman would not let her baby sleep during the day so the baby would sleep at night.7

Table 11 also shows that there were fourteen incidents (involving twelve mothers) in which program participants were given a reprimand for feeding their babies food that was inappropriate for their age, preparing food incorrectly or feeding them in an improper manner. Incident reports were written when women were witnessed feeding infants Cheez Whiz® and putting Cream-Savers® candy in their bottles (“to make it taste better”), warming the babies’ bottles in the microwave,8 and propping up their babies’ bottles with a blanket instead of holding them. Women who committed the above violations were counseled and provided additional training on the proper ways of feeding an infant.

More serious violations occurred when the women were inattentive to the needs of the baby, cursed at the baby, or behaved in a manner that could potentially cause physical harm to the baby. The rules of the program stipulate that babies must not be left unattended. Women who have programming or educational classes are to either leave their babies in the nursery or with another inmate. The only time babies may be left alone for a brief period is when they are taking a nap in their crib. Even in this instance the mother must check on the baby every ten minutes. There were eight incidents (involving three mothers) in which a woman left her infant unattended. On five occasions (involving five mothers), the program participants’ behavior could have caused physical harm to the infant. The behavior can be characterized by

7 It should be noted that the violations of the program rule regarding sleeping may have occurred because of cultural practices, previous habits (since many women in the program had previous children), or ignorance rather than maliciousness on the part of the mother. Many women in non-western societies advocate that parents should sleep in the same bed as their newborn. Cosleeping supporters believe that this practice will encourage breastfeeding, make it easier for the mother and newborn to have in sync sleep cycles, help babies fall asleep more easily, and help parents bond with their babies. Although the U.S. Consumer Product Safety Commission and the American Academy of Pediatrics do not advocate this practice stating that it puts infants at risk of suffocation and strangulation, many women in the United States follow this custom. Another reason why women may have violated the ABCS rule on sleeping is that they may not have been aware of the importance of the rule since a majority 76.2% (n=21) did not receive Sudden Infant Death Syndrome (SIDS) training and seven were new mothers.

8 Warming bottles in a microwave oven is dangerous because “hot spots” are created and the baby could be easily burned. Bottles should be warmed in a cup of hot water, shaken and then given to the baby.

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unacceptably rough handling of the infants. For example, one woman was seen picking up her infant in a rough manner and another infant had bruises and scratches on his/her body. Of the five women who were given tickets for these offenses, four were removed from the program immediately after the incidents. Finally, the incidents included in the “other” category were written for cases involving a sunburned baby, storing inmate items in the baby’s cabinet or locker, and dressing the baby while pushing the stroller at the same time.

This analysis shows that the needs of some of these women are extraordinarily fundamental. There were thirty mothers who received incident reports for seventy-six parenting related violations. Basic knowledge - such as knowing the correct way to hold a baby, what foods are age-appropriate, and knowing a safe way to put their babies to sleep - appear to have been lacking among some of the program participants. More consistent offering of courses such as the SIDS course and other courses educating these women on the nutritional requirements of their infants would be beneficial to both mother and infant. Table 11: Program Behavior N % Number of Incidents per Inmate Zero 27 39.1% One 14 20.3% Two 9 13.0% Three 5 7.2% Four 3 4.3% Five 2 2.9% Six 3 4.3% Seven 2 2.9% Eight 1 1.4% Nine 2 2.9% Ten 1 1.4% Total 69 100.0% Average Number of Incidents = 1.99 (Missing = 1) Number of Incidents by Type Parenting Related –inappropriate sleep locations and feeding methods, cursing baby, being inattentive to baby and baby’s needs, other behaviors that could be dangerous to baby

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55.5% Program Behavioral Requirements – smoking, failure to clean program area, refusing to attend programming

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17.5%

Institution Violations – fighting, arguing, being out of place, disrespecting officers, other

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27.0%

Total 137 100.0% (Missing = 0)

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CONCLUSIONS AND RECOMMENDATIONS This report presents the results of the first systematic examination of the implementation of the DRC ABCS nursery program that was begun in May of 2001. This section of the report will summarize the findings and provide a number of recommendations for program administrators to increase the integrity of the program.

The first section of the report assessed the extent to which the participants in the program meet the eligibility criteria, as established by statute, departmental administrative rules, and program rules. Overall, the group of individuals involved in making the decisions as to which women would be eligible to participate in the nursery program and which women would not are doing a very good job at adhering to the eligibility criteria. The decisions are most often characterized by consensus of the six individuals/agency representatives making those decisions. Over 95% of the decisions as to whether an inmate was determined to be eligible were unanimous. In addition, the backgrounds of only three women who were declared eligible to participate in the program reflected characteristics that conflicted with the established criteria (one woman was convicted of a violent crime, and two women were serving sentences of longer than eighteen months).

An assessment of the extent to which all pregnant inmates who were interested in participating in the ABCS nursery program were proportionately represented in the group of women who were identified as meeting all of the eligibility criteria was conducted. Of particular concern is the fact that the results show that non-white women were under-represented in the women considered to be eligible. The eligibility criteria that were most responsible for eliminating candidates were examined by race. The data indicate that the reason non-white women were more likely to have been considered ineligible was that certain eligibility criteria excluded them at a higher rate than white inmates. Specifically, non-white women were more likely to have been convicted of a violent offense (current or past), offenses of child neglect and child endangerment, first and second degree felony offenses, and they were more likely to have had previous contact with ODJFS than white women. These were the criteria for which the greatest proportions of women were determined to be ineligible for program participation. About 50% of the 480 women were excluded for these characteristics alone (n=242, 50.4%).

Given that the primary goal of the eligibility criteria is to ensure a safe environment for the inmate-mothers and their newborns, this disparity of impact on non-white inmates may be unavoidable and constitute a ‘legitimate business reason.’ Nevertheless, program administrators may want to examine the eligibility criteria to determine if there are any efforts that can be made to reduce the disparate impact on non-white pregnant female inmates in terms of their opportunity to participate in the ABCS nursery program.

The second section of the report focused on reviewing the ABCS programming. Perhaps the most critical weakness identified in the examination of the ABCS nursery program design is the lack of a clear purpose statement in the program manual. The program manual does provide a general and vague discussion of the “Program Philosophy,” however, this information primarily relates to the importance to the baby of bonding with the mother, rather than the impact or effect that bond might have on the mother. Based on this discussion in the manual, an individual attempting to identify the purpose of the program might conclude that the program is primarily designed to benefit the child, since there are no clear statements as to what the purpose of the program is for the inmate mothers and how participation might affect their subsequent behavior, such as their future involvement in crime (even though there is a program brochure touting the effectiveness of the program in reducing recidivism among the female offenders). This examination concludes that an explicit, clear set of program objectives cannot be identified from the program documentation. The significance of this finding lies in the implications for

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researchers’ ability to conduct an outcome evaluation on the effectiveness of the program. Essentially, if program objectives cannot be identified, then they cannot be measured. If they cannot be measured, there can be no outcome evaluation of the program.

A set of clearly stated program objectives that can be measured is one of two main criteria that must be satisfied before conducting an outcomes or impact evaluation (Welsh, 2006). The second prerequisite is that “…the intervention should have been sufficiently well designed and sufficiently well implemented so that there is no question that its critical elements (activities) have been delivered to clients as planned” (Welsh, 2006:604-605). The review of the program manual did not provide researchers with a clear indication of actual program components and the expected effects that those components would have on those receiving the services. The manual specified that inmate-mothers were required to take a minimum of fifty hours of “parenting education” courses. While some courses were specifically named in the manual, there is no comprehensive model of programming designed to provide specific parenting courses that were designed to meet specific programmatic objectives. The information obtained regarding offender involvement in programs indicates that the female offenders were only able take whatever course was being offered during the time period they were in the program, and on some occasions, did not even have the opportunity to take the full complement of program offerings. In other words, the program does not appear to have been carefully designed and planned. This lack of structure and goal-driven programming is in part the result of the fact that there are no clear program goals and objectives upon which to design and structure the program.

An additional complication of not having clear program goals and objectives is the problems encountered in collecting program participation information. The nursery files were complete with respect to inmate mother and infant information, however, no central repository of information regarding the hours offenders spent in programming, whether it be parenting education or other programming, existed. This lack of organization makes it very difficult to determine the real extent to which women were being exposed to programming.

We also know little of how these courses, many of which were offered by outside vendors, fulfill a need or purpose for the offenders in relation to the overall program objectives or even goals. Without a clear statement of purpose and goal-driven program design, we cannot identify what changes or strengths the program intends to build among participants so that we can identify the outcomes (e.g., stronger bonds between mother and child, reduced likelihood of recidivism) that should be expected and why (e.g., decreased desire to use drugs, increased motivation to develop job skills in order to remain in the community to raise the child).

Based on the assessment of the ABCS nursery program as it is currently documented and implemented, there is clearly a need for the department to expend additional energy and effort in analyzing the problem to be addressed by the program, setting program goals and objectives, and designing the program before considering the possibility of conducting an impact (outcome) evaluation.

There is little doubt that the humanitarian ideals responsible for the inception of this program, as well as the desire to continue to allow female inmates who meet the eligibility criteria to keep their newborns with them in prison for a limited amount of time, are laudable. However, this assessment reveals that there are a number of steps the Department could take to improve the quality of the program and increase the ability of DRC to measure the impact that the program may have on the participants.

Better Program Planning and Development

A recent article by Welsh (2006) provides a brief synopsis of the Seven Stage Model of Program Planning and Development (Welsh and Harris, 2004) that may be helpful to program administrators. Welsh (2006) argues that a more comprehensive approach to program planning,

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development, and evaluation is needed. He provides a table outlining each of the seven stages of program planning that are accompanied by common planning deficits that occur at each stage. It is instructive to examine some of these stages in light of the findings presented above.

The first stage is “Analyzing the Problem.” The primary question that this stage addresses is “What need or problem is the program expected to address?” and involves collecting information about dimensions of the perceived problem, the history of the problem, the stakeholders affected by the problem, and potential causes of the problem (Welsh, 2006:609). It is interesting to note two of the five common deficits in correctional programming which occur at this stage of planning specified by Welsh reflect some of the deficiencies identified in our current program:

• No clear definition of the problem. • No theory guided the program. We don’t know how or why the expected change should

have occurred.

Stage 2 involves “Setting Goals and Objectives.” The description provided by Welsh defines goals as “broad aims of the program (e.g., reduce drug abuse)” and objectives as “explicit and measurable outcomes (e.g., fewer positive drug tests within a specific time period).” He notes that “we should be able to measure within-individual changes expected to mediate between treatment exposure and outcomes” (609). One of the common planning deficits at this stage includes:

• Goals and objectives were not clearly stated.

Stage 3 is called “Designing the Program.” In this stage, the program is specified in as much detail as possible: who does what to whom, in what order, and how much? It is described as the stage at which the “guts” of the program or policy, including its staff, its services, and its clients is specified. Three of the four common deficiencies at this stage reflect deficiencies identified in the ABCS nursery program in this study:

• No specific intervention approach was identified. • Program components and procedures were unclear. • Responsibilities of program staff were unclear.

The information collected for this project provides a considerable wealth of information to help guide the department in establishing what kind of programming should be offered to these women that will be most beneficial to them (Stage 1-3). For example, analyzing the problem involves understanding the target population. This study has shown that the women who participate in the program tend to be women in their early to mid-twenties (mode=22), who are single, unemployed and likely have limited job skills, given that the majority of these women (53%) do not graduate from high school, as well as a history of alcohol and drug use. These data paint a picture of a woman who is facing significant social disadvantages in being able to obtain employment simply to support herself. The fact that almost 70% of these women had custody of at least some of their previous children prior to incarceration will present an additional strain on these women when they are released from prison with their newborn babies.

The data collected also suggest that these women are likely to be facing considerable strain in their family life: over three-fourths of these women (n=54) had previous children, nearly 80% of whom (n=43) had children by different men and the data regarding the criminal histories of these women’s families or significant others indicates that significant proportions of these women’s families have felony convictions. These women are clearly in need of social, emotional, financial, and childcare support from their families and from the fathers of their

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children. It appears that even this aspect of life that Americans take for granted will not be available as a reliable source of support for many of these women.

A measure of the struggles that these women have had with raising their children is reflected in the fact that a considerable proportion of women (36.8%) who participated in the ABCS program had had previous contact with ODJFS. It is difficult to interpret the exact meaning of these data given that not all women who had contact were excluded from participating in the program. However, it may suggest that these women are living in social circumstances that are placing them at a high risk of coming into contact with a social service agency that is tasked with overseeing the welfare of dependent children (e.g., impoverished, little familial support to help care for the children, criminal associates). Some of the behaviors for which some women received incident reports related to childcare indicate that some of the women need instruction in some very fundamental childcare and child-rearing practices. This may reflect the assertion cited by Pollock-Byrne earlier that it is not likely that they had strong parenting role models in their past.

It is clear from this part of the ABCS program participants’ profiles that these women have significant social problems with which they need help far beyond those addressed by parenting education courses. Determining the type of programming that is most likely to assist these women in being able to properly raise their children and support their families once they are released from prison is further complicated by the short length of time that these women actually spend in the program; the data presented here indicating that the average length of stay in prison is about eight months and the length of stay in the nursery is not even half that (3.87 months).

All of these factors must be taken into consideration when developing a structured nursery program. It may be that there is no rationale or program purpose statement that can be developed under these circumstances that would lead one to expect that participating in the nursery program should lead to a reduction in recidivism given the short duration that women are in the program. It may be that all there is time to do is provide fundamental, educational childcare courses, such as SIDS, Infant CPR, and Breast Feeding in order to benefit the child. In this event, program developers should not expect that this “programming” will have any impact on the likelihood that these women will recidivate. It is important to remember after all, that this is not the first child for the overwhelming majority of these women. In this scenario, the program goals may simply be to provide the mothers with a reasonable degree of parenting skills to help her become more proficient in her ability to properly care for their infants. Given the short period of time that program participants are actually in the program, this would be a much more reasonable goal of the program that expecting the program to reduce recidivism. Allowing women to retain physical custody of their newborn children for the very short amount of time remaining on their sentence seems to be a goal that is quite compassionate and worthwhile in its own right.

Measuring the success of a program designed to improve the parenting skills of the inmate mothers would be dependent, in part, upon the Department’s ability to track the woman and her child over time, in the community. At the outset of this project, practitioners frequently requested that researchers track the women in the community in order to determine how the women who had participated in the ABCS nursery program were faring. They were under the assumption that the Department had the right to query other state agencies, such as ODJFS, for information on the women and children who had participated in the program. This raised ethical concerns and privacy rights issues for researchers during the planning stages of this study. More specifically, concerns arose over whether it would be ethical for the Department to personally contact past program participants in the community and ask them about their experiences with the program and/or to attempt to collect information on the custody status of their children from

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other state agencies as indicators of program impact and program success without prior knowledge and/or consent from the past participant.

At inception, no informed consent forms were developed for the program. Such a consent form may provide documentation that the mother of the child was aware that the Department would be following up with her and her child to see how they were doing at specified intervals. By signing the consent form, the mother agrees to allow representatives of the Department (or individuals contracted by the Department) to make contact with her for purposes of inquiring about the impact of the ABCS program on her and her child even though she was no longer under the jurisdiction of the DRC (either released from prison or successfully terminated from post-prison supervision). Without such explicit signed informed consent form for post- incarceration contact from program administrators or DRC research staff, the Bureau of Planning and Evaluation (BOPE) was concerned about unwanted and unanticipated invasions of the privacy of the ex-inmates. As a result, BOPE elected not to attempt to collect community follow- up information from the program participants included in the study (those participating from May 2001 to December 2004). Instead, it is recommended that the program administrators consult with DRC attorneys and researchers to develop an appropriate informed consent form for purposes of collecting follow-up information on program participants once they have retuned to the community, if warranted by the program design. In addition, avenues to obtaining ODJFS information on these women and their children for program evaluation purposes should be explored.

Based on the results of this study regarding the availability of program data, careful consideration should also be given to stages 5 and 6 of the Model of Program Planning and Development, after stages 1 through 3 are completed. Stage 5 is “Developing a Plan for Monitoring Program Implementation.” This stage involves conducting a process evaluation to determine the extent that the program design (Stage 3) is being carried out as planned. Again, three of the five common deficiencies have been identified in the current study:

• Information systems for monitoring were inadequate. • Monitoring instruments were unreliable. • Responsibilities for data collection, storage, or analysis were unclear.

The deficits in ABCS program identified in this study can be effectively addressed by

revisiting the stages presented above. Program administrators and developers will also need to consider addressing the issues specified in stage 6. Stage 6 involves the development of a plan for evaluating outcomes: “The goal of this stage is to develop a research design for measuring program outcome (a specified, intended change in the problem, as defined by objectives)…” (Welsh, 2006: 610). If departmental or contract researchers are able to use the information derived from completing stages 1-3 and 5, the ABCS nursery program will be a program that will truly be evaluable.

Although the above processes may seem tedious and daunting to practitioners, it is becoming more and more evident that “program integrity matters” (Lowencamp et al., 2006: 590). It is important to involve individuals familiar with the principles of effective programming. Researchers and practitioners most actively involved in the development and dissemination of the effective correctional programming literature recommend that correctional agencies make sure that competent researchers are involved in the whole process – program design, program delivery, program review, and process and outcome evaluations (e.g., Andrews, 2006; Welsh, 2006). Welsh (2006: 612) notes that correctional agencies “need to spend a greater amount of time in-house on program planning and development at the outset and continuously throughout the life of a program” and that the “potential payoff lies in better programs and better outcomes, and that is a reward worth striving for.”

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This assessment of the ABCS nursery program demonstrates that even after five years of operation, there is a significant amount of work to be done in terms of program development in order to successfully implement a program in a manner that permits a meaningful evaluation. There is little doubt that the ABCS nursery program is one of the most humanitarian programs in the department, and providing mothers of newborn infants the opportunity to care for them while they serve the final days or months of their sentences is perceived as a very worthwhile endeavor. This report provides a significant amount of information about the women in this program that should be used to improve upon the current effort. The data clearly show that the women participating in the ABCS nursery program do not have traditional nuclear family structures, and they face considerable obstacles in successfully supporting and raising their families once released from prison. The challenge for the Department and program administrators will be to revise the program to more systematically address some of the most pressing needs that these women will face upon release in the very short amount of time the participants have in the program.

As McGowan and Blumenthal (1978) noted, while it is unrealistic to expect the criminal justice system to strengthen family ties where none existed, the system has a “responsibility to prevent destruction of family life through ignorance or indifference and to help each woman who comes in the system to make the best plans for her children” (as cited in Feinman, 1986:50). Summary of Recommendations

1. Review the ABCS nursery program eligibility criteria in order to determine whether or not there are any efforts that can be made to improve the proportional representation of non-white pregnant female inmates in the pool of individuals eligible to participate.

2. Develop a clear purpose statement for the program and set clear program goals and objectives. This exercise will help to inform the development of a structured, goal-driven program that will permit meaningful program evaluation (Stages 1 and 2).

3. Develop a more structured, goal-driven program using information collected for the present study in conjunction with principles of effective programming (Stage 3).

4. Develop systematic data collection and monitoring systems in anticipation of subsequent evaluations (Stage 5).

5. Plan for outcome measures based on new program design (Stage 6). For example, if bonding between mother and child is identified as a program goal, identify measures of bonding that can be used to assess progress; if a program goal is to improve parenting skills and enable women to provide appropriate care for the child once in the community, work towards developing informed consent forms and memorandums of agreement with other social service agencies from whom information would be collected (e.g., ODJFS and ODH).

One final note of caution for program developers and administrators: Resist the

temptation to expect a reduction in recidivism among women who participate in the ABCS program if the duration and programming remain minimal in time and scope. The profiles of the women in the ABCS nursery program indicate that these women have considerable needs with respect to education, employment, addressing substance abuse issues, social support, as well as parenting skills. It is extremely difficult to conceive that a reduction of recidivism among this group of offenders could be attributed to a program of such brevity, even if the scope of services were expanded to include the other areas of need.

Over the past decade, a considerable body of literature has developed to help guide practitioners in the development and maintenance of correctional programs that are characterized by high

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levels of program integrity that maximize the benefits of rehabilitative efforts (see particularly the Correctional Services of Canada 2000 Compendium). This literature is accessible and we must do a better job of attending to the information and guidance that it provides. The ABCS Nursery Program is a program worthy of the additional care and effort required to increase the program utility for women if for no other reason that it is an exceptionally compassionate and decent manner in which to treat some of Ohio’s criminal offenders.

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BIBLIOGRAPHY

American Academy of Pediatrics (2005). Policy Statement. The Changing Concept of Sudden Infant Death Syndrome: Diagnostic Coding Shifts, Controversies Regarding the Sleeping Environment, and New Variables to Consider in Reducing Risk. Pediatrics, 116(5), 1245-1255. American Medical Association (n. d.) Policy H-245.977 Sudden Infant Death Syndrome. Retrieved from http://www.ama-assn.org/apps/pf_new/pf_online. September 18, 2006 Andrews, D.A. (2006). Enhancing Adherence to Risk-Need-Responsivity: Making Quality A Matter of Policy. Criminology & Public Policy, 5(3), 595-602. Correctional Service of Canada (2000). Compendium 2000. Retrieved from http://csc- scc.gc.ca/text/rsrch/compendium/2000, October 10, 2005. Crawford, J. (1988). Tabulation of a Nationwide Survey of Female Offenders. College Park, Md.: American Correctional Association. Feinman, C. (1986). Women in the Criminal Justice System (Second Edition). New York: Praeger. Henriques, Z.W. (1982). Imprisoned Mothers and Their Children: A Descriptive and Analytical Study. Lanham, Md.: University Press of America. Lindquist, C. (1980). Prison Discipline and the Female Offender. Journal of Offender Counseling, Services and Rehabilitation, 4(4), 305-319. Lowencamp, C.T., Latessa, E.J., Smith, P. (2006). Does Correctional Program Quality Really Matter? The Impact of Adhering to the Principles of Effective Intervention. Criminology & Public Policy, 5(3), 575-594. McGowan, B. and Blumenthal, K. (1978) Why Punish the Children? A Study of Children of Women Prisoners. Hackensack, N.J.: National Council on Crime and Delinquency. Pollack-Byrne, J.M. (1990) Women, Prison & Crime. CA.: Brooks/Cole Publishing Company. U.S. Consumer Product Safety Commission. (n. d.) CPSC Cautions Caregivers about Hidden Hazards of Babies on Adult Beds. Retrieved from: http://www.cpsc.gov/cpscpub/pubs/5091.pdf. September 18, 2006 Welsh, W.N. (2006). The Need for a Comprehensive Approach to Program Planning, Development, and Evaluation. Criminology & Public Policy, 5(3), 603-614. Welsh, W.N. and Harris, P.W. (2004). Criminal Justice Policy and Planning (2nd Edition). Cincinnati, Ohio: LexisNexis, Anderson Publishing.

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APPENDIX A: Description of Prenatal Classes Provided to All Pregnant Inmates

Prenatal Classes are divided into four workshops and two support groups. The first

prenatal workshop involves twelve two-hour sessions that help the mother-to-be understand the milestones associated with pregnancy, nutrition, prenatal bonding, and how smoking affects the unborn child. Character Development is the second workshop. Participants examine who they are and learn how to make better choices in life and learn responsible decision-making. Childbirth education classes are also offered in which the women learn basic Lamaze techniques, the stages of labor, hospital procedure, postpartum danger signs, birth control methods and receive information about sexually transmitted diseases. The final workshop in this series is an eight- week course entitled Women with Wings. Self-empowerment, drug and alcohol awareness, interpersonal skills, and job readiness are some of the topics discussed. The two support groups offered by Wilmington College include the New Life Support Group and Parents Anonymous. Both of these groups help the women learn how to deal with their thoughts, feelings, and emotions regarding childbirth and the postpartum experience.

A course in parenting is offered by Community Connections, Inc. Women learn different

styles of parenting including positive ways to discipline children, child development, self- esteem, communication skills, household safety, and money management skills. Pregnant women are also taught how to be good parents while they are incarcerated and how to cope with their children’s behavioral issues when they return home after being absent.

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APPENDIX B:

Summary of Secondary Data Sources Used in Study

Data Source Description Location Departmental Offender Tracking System database (DOTS)-

Electronic database – provides basic information for all inmates admitted to DRC

Accessed via Central Office Computer Terminal

Offender Supervision Portal (OSP)

Electronic database – provides community supervision adjustment information (parole/PRC)

Accessed via Central Office Computer Terminal

Training, Industries, and Education database (TIE)

Electronic database – provides inmate educational information

Accessed via Central Office Computer Terminal

OnBase database Electronic database – electronic repository for pre-sentence investigation reports (PSI)

Accessed via Central Office Computer Terminal

Reentry Program Oversite Committee database

Electronic database – electronic repository for departmental program description and documentation, including ABCS official program information

Accessed via Central Office Computer Terminal

Community Corrections Information System database (CCIS)

Electronic database – electronic repository for PSIs not yet scanned into the OnBase system.

Accessed via Central Office Computer Terminal

Inmate Records Microfiche Repository for older PSIs that have not yet been scanned into the OnBase system.

Records Office – Central Office

ABC’S Nursery Files Paper files – provides information on program participants as well as those who applied but were denied or were released from prison before the birth of their child.

Ohio Reformatory for Women (ORW)

Inmate Master Files Paper files of inmates – provides information about the current offense, programming, mental health, education, medical, substance abuse, disciplinary reports, correspondence, and detainers

ORW, FPRC, NePRC, Records storage facility in Grove City, Ohio

Program Files (Education, Responsible Family Life Skills Program, and Recovery Services files)

Paper files – provide information on inmate attendance and completion records for other programs in which ABCS participants had been enrolled

ORW and Central Office

Personal Communication with Staff

Correspondence and in person interviews with program staff in multiple programs at FPRC and ORW to reconcile program data found in DOTS, TIE and/or paper files

ORW, FPRC, Central Office

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APPENDIX C: The Admission Process

Once an inmate expresses interest in the ABCS program and an application is received,

the coordinator reviews the inmate’s presentence investigation (PSI), Bureau of Criminal Investigation (BCI) and Federal Bureau of Investigation Records (Rap Sheet) to determine if there is a history of violent crimes, crimes against children or a conviction of a sexually oriented offense. The Unit File and Master File are also studied to determine if the inmate has had any conduct reports during her incarceration. If these criteria are met, a tour is given of the ABCS housing unit and the coordinator conducts an interview with the inmate. Together the inmate and the coordinator complete the Social History Form (Form Ib) which includes the details of the inmate’s current offense, prior criminal history, and a detailed description of the inmate’s family, marital, medical, mental health, educational, work history. The inmate’s strengths and weaknesses in addition to her goals and achievements are also discussed. Also at this meeting, the inmate signs the Health and Safety Standards Agreement (Form V) and the Program Contract (Form VI). These forms comply with ORC 5120.652 (A) (1)-(3) in conjunction with DRC AR 5120-9-57 (D) (1)-(5) & (E) and state that each inmate must:

1.) Comply with any programs established by DRC such as A.) Child Development B.) Parenting Skills C.) Education D.) Domestic Violence Counseling E.) Job or Vocational Counseling F.) Alcohol and/or Drug Counseling

2.) Have her child(ren) participate in the Medicaid program or a health insurance program.

3.) Accept the normal risks of childrearing. 4.) Abide by any court decisions regarding the allocation of

parental rights and responsibility with respect to the child. 5.) Assign to DRC any rights to support from any other person,

excluding support assigned pursuant to section 5107.20 of the Revised Code and medical support assigned pursuant to section 5101.59 of the Revised Code.

6.) Specify with whom the child is to be placed, pending approval of ODJFS, in the event the inmate’s participation in the program is terminated for a reason other than release from imprisonment.

At this meeting, the inmate is required to sign a Release of Information (Form IIb) for

ODJFS. This release allows ODJFS to notify the program coordinator if the inmate has a history of child abuse, neglect, endangerment, or has an open case with their agency. Finally, the Father’s Agreement (Form IX) is sent to the father of the inmate’s child. He must agree that the infant is to be placed with the mother in the ABCS program and that he is allowed to visit but unable to remove the baby from ORW. This form must be notarized and returned within five working days of receipt.

While the coordinator is waiting to hear from ODJFS, the inmate is referred to mental

health services so that a clinical evaluation may be conducted. The psychologist at ORW administers the Personality Assessment Inventory (PAI) to the program candidate. This instrument provides information that assists the psychologist in determining if the inmate is able

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to care for the newborn and/or if she is a threat to herself or others. Women who are on the mental health caseload or who are mentally retarded will not automatically be excluded from the program if it is determined that they meet these two conditions.

In addition to mental health services clearing inmates for program participation, ORW

medical staff must also approve all candidates. As long as the inmate is able to care for herself and her baby and does not have a contagious disease that would pose a threat to other program participants or their children, she is cleared for participation. Medically disabled inmates are not excluded from being in the program as long as they meet the criteria and that their illnesses do not require lengthy hospitals stays.

If ODJFS has approved the inmate for participation in the program, then the advanced

screening process begins. The program unit manager reviews the application, program criteria, conduct reports, criminal history, medical evaluation and level of care, mental health evaluation, security instrument, and applicants social history and creates a packet that the unit team will review. If all is in order and all parties agree that the woman should be admitted to the program, the packet and their decision will go to the Unit Management Administrator and the Deputy Warden of Operations who will either concur with or dissent from the Unit Team’s recommendation. Finally, the packet is given to the Warden for final approval. If the inmate has been denied entrance to the program at any of the above levels, the Warden can override the decision.

Once the process is complete, the Acceptance Notification (Form VIII) letter is sent to all

inmates who applied for the program. This letter tells inmates that they are tentatively accepted to the program provided that they do not go to disciplinary control, have a positive drug test, or be in possession of drugs, alcohol or other dangerous contraband. Additionally, they are required to participate in the pre-natal program and must follow medical advice regarding their pregnancies. Additionally, the Emergency Contact Application (Form XXX) is sent to the inmate’s Plan B contact on her Baby Placement Plan. This person must agree to be able to pick up the infant within four hours if an emergency should arise or if the inmate is removed from the program. Additionally, if the individual is informed that the baby is to be returned to the mother at ORW, he or she is expected to do so within twenty-four hours of notification. Women who are not admitted to the program are sent a letter that lists the reason(s) for denial. Appeals of the decision can be made through the Unit Administrator.

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APPENDIX D:

Mental Health Eligibility Criteria

At intake, mental health personnel conduct a detailed screening where inmates are assigned to one of five levels of mental health classification based on their need of services. The classifications are as follows:

1. C1: Psychiatric Caseload (SMI) - the inmate is on the psychiatric caseload and meets criteria for SMI designation: a substantial disorder of thought or mood which significantly impairs judgment, behavior, capacity to recognize reality or cope with the ordinary demands of life within the prison environment and which is manifested by substantial pain or disability. Serious mental illness requires a mental health diagnosis, prognosis and treatment, as appropriate, by mental health staff.

2. C2: Psychiatric Caseload (non-SMI) - The inmate is on the psychiatric caseload but does not meet the criteria for SMI. Inmate is receiving mental health care and supportive services, which include medication prescription and monitoring, individual and group counseling and therapy, crisis intervention and behavior management.

3. C3: General Caseload - The inmate is receiving group or individual counseling, therapy and skill building services. He/she has a mental health diagnosis and treatment plan and is being treated by mental health staff other than the psychiatrist.

4. MR/DD caseload – Those individuals who meet the Diagnostic and Statistical Manual (4th Ed.) criteria for mental retardation or developmental disabilities.

5. N - No current mental health Women who are listed as C1 are excluded from participation in the program due to concern over their ability to take care of themselves or a newborn. According to the program manual, some C2 inmates could be approved for the ABCS program with a positive recommendation from their mental health treatment teams. Although this may be the case, no one at the C2 level was admitted to the ABCS program during the timeframe of this study. Information regarding the mental health of the program participants indicates that four out of ten had mental health issues and were either on the mental health caseload at ORW or reported past mental health treatment in the community or during a previous incarceration. These women, however, were classified at the C3 level and were not on any psychotropic medications. Level C3 only requires intermittent counseling. Women who were not eligible for the nursery program were more likely to have mental health issues than those in the program (57.1% vs. 40.0%). Despite this fact, only two women were excluded from the program for solely that reason.

Contact Information Kelly Ward

[email protected] (614) 752-1315

Web Page

www.drc.state.oh.us