NYAPRS Note: Peer support has been proven to be an effective way to support people dealing with substance use challenges by helping them stay connected to services and improve recovery outcomes. While we have begun undertaking great efforts to expand peer support to many sectors, there is still much work to be done getting peers imbedded in non-traditional service areas, such as jails and prisons. To support the efforts of expanding peer support, the Biden-Harris Administration and the US Department of Health and Human Services (HHS) released the new National Model Standards for Substance Use, Mental Health, and Family Peer Worker Certifications. These standards will help states not only increase the peer workforce but also support their inclusion in more systems touching those with mental health and substance use challenges. There is still much work to be done at the state level, especially in New York. Peer support has been shown to improve the lives of people touched by the justice system and reduce recidivism for those in re-entry programs. NYAPRS is doing our part to advance peer support for justice involved people by sponsoring and participating in The NYC Justice Peer Initiative’s (JPI) upcoming conference Building the Justice Peer Community in New York: Pushing Policy & Progress Forward. Register for the event using this link. Click here to read HHS’ official announcement of the National Model Standards for Peer Support Certification. Read below to learn more about the hurdles New York peer support providers are currently facing when trying to offer services in state jails.
New York Mandates Peer Support in Jails, But Lets Sheriffs Keep Peers Out
Formerly incarcerated “peers” offer drug counseling to people in county jails — when they can get in.
By Spencer Norris | New York Focus | May 31, 2023
By her estimate, Victoria Metz hasn’t been called to the Putnam County jail in about three months. Her services are mandated there by New York state law. The law just doesn’t say how often she’s supposed to go.
Metz is a peer advocate — someone with prior lived experience helping other people going through the same thing — who supports incarcerated people facing substance use disorders. Research shows that if an incarcerated person with an opioid use disorder has a peer they can trust who will help them get medication, therapy, and housing on their way out, they’re less likely to end up back in jail or suffer an overdose.
Two years ago, New York passed a law requiring addiction recovery services, including peer support, in jails. The law could have guaranteed unfettered access to the jail system for peers and provided clear rules for how the services should operate.
That’s not what happened. While the 2021 law provided significant guidance for how to implement some services, it didn’t provide jails with any instructions for implementing peer support. The Office of Addiction Services and Supports, the state agency responsible for regulating recovery programs, was charged with signing off on jails’ plans for peer services. But a spokesperson confirmed that the agency does not provide any guidelines for how it should be done.
Without any supervision from the state, county jails are mostly calling their own shots on how to comply with the law. When peers do get access to jails, experts told New York Focus, it’s normally under very limited circumstances: a one-hour support group once a week, or a single meeting for reentry planning when incarcerated people are on their way out the door.
“It wasn’t like I had easy access,” Metz said of her work in Putnam County. “It wasn’t like I chose and could have just walked in.”
Sometimes peers can go months without getting in. According to Metz, she’s only able to get into the Putnam jail when an in-house social worker decides that they need her services. Outside regular visiting days, she said, she needs to be cleared by the sheriff’s office any time she wants to go work with someone incarcerated at the facility.
The Putnam County Sheriff’s Department’s website states that it allows professional visitation any day the jail isn’t in lockdown, but did not respond to requests for comment about Metz’s access.
Overall, recovery services have had limited success reaching incarcerated people, and the problem could persist for a while, according to Christopher Assini, policy director for the non-profit Friends of Recovery.
“I don’t think there’s any real urgency to solve these problems,” Assini said. “The frustrating part is when there is treatment available to individuals who are incarcerated, recidivism rates go down. We know that. There’s clear data on that. So you would think it would make sense to proactively try to mitigate that … but there isn’t urgency.”
On a Thursday afternoon about 140 miles north of Putnam, Ben Deeb estimated that he’d assembled reentry plans for 20 people at the Saratoga County jail since Tuesday. For everyone leaving the jail that week, he’d reached out to families, arranged shelter, and found clothing. He’d secured everything from bus passes to social security cards to fentanyl test trips. He set up appointments for mental health counseling, addiction medication, support groups, and meetings at a substance abuse recovery center called Healing Springs, where they could see the facility’s peer supervisor: Ben Deeb.
Deeb is a peer working in the Saratoga County jail. He runs a recovery unit with 41 people, all on addiction medication, and handles reentry for the jail’s full population of 142. He’s a rare example of a peer with significant access to a county jail, where he has been praised for his work. He’s the only person there in his role — but the jail won’t hire him.
“In order to be effective in this role, lived experience is a needed prerequisite,” Deeb said. “The fact that I’ve done all of 10 years inside of prisons and jails” — with his final placement in Saratoga — “allows me to form that trust bond and be able to do my job effectively that the counselors and other folks can’t do with these individuals.”
It’s also why he can’t work directly for the sheriff’s office.
State law provides a special exemption to law enforcement agencies that allows them to legally discriminate against people with criminal backgrounds in hiring. According to Colonel Richard Emery, the corrections administrator for the Saratoga Sheriff’s Office, it’s their department policy not to hire people convicted of felonies. For Deeb, they used a workaround: The sheriff’s office bypassed its own policy by contracting with Deeb’s employer to put him in the jails as a peer.
For the 15 percent of people in jails with an opioid use disorder, the period immediately after release is a uniquely dangerous time, with a greatly elevated risk of overdosing because of lowered tolerance and risk factors like a lack of housing. It’s disturbingly commonplace to hear stories of families that lost loved ones to an overdose days after they regained their freedom.
Peer services can interrupt that pattern. A 2021 study showed that formerly incarcerated people with opioid use disorders who were placed in peer coaching programs had better health and behavioral outcomes. The model has also been applied to numerous other fields in prisons for decades, including HIV/AIDS education, suicide prevention, and sexual assault support.
The Saratoga Sheriff’s Office believes it’s working in Deeb’s recovery unit. A 2018 study of 68,000 state prisoners’ outcomes found that almost 80 percent of people with drug offenses were rearrested within four years of their release. While it’s a much smaller sample population than the study, the four-year recidivism rate for people in the jail’s addiction medication program is about 25 percent — less than a third of the national rate.
Deeb works from the jail multiple days a week. He hangs around the facility’s waiting room, meeting families of incarcerated people and building trust with folks in the recovery program. Deeb is “such an asset to this agency, it’s unbelievable,” Emery said. “You just couldn’t ask for anybody better, because the inmates can relate to him, they trust him.”
But Deeb’s work is rare, despite peers ready and waiting to fill similar roles in the state’s jails. Even when sheriffs and superintendents want peers in their facilities, layers of red tape can make it an infuriating process to get access.
Erin Wiggins spent a year trying to get into the Oneida County Jail and went through safety training three times. In the end, she switched jobs and never got work in the jail as a peer.
That’s a missed opportunity to save lives, she said.
“It helps, number one, save their life, having them linked up to all of their resources before they even step out of the facility,” Wiggins told New York Focus. “That’s like half the battle.”
Now, a bill is grinding its way through the New York legislature to declare substance use disorder treatment an essential service in New York’s jails. Its sponsor, Senator Pete Harckham, says it would prohibit jails from withholding recovery services: individualized treatment plans, group therapy, access to peers, discharge plans, and more.
But even if Harckham’s bill guaranteed that peer services couldn’t be suspended, other barriers to access would remain.
When it comes to peer services, “there is no legislation” on the table that would guarantee access to jails for peers with criminal records, said Assini, the policy director at Friends of Recovery. While peer services are mandated in jails, there are no guidelines for what they should look like, nor any legal protections against discrimination for peers based on their criminal record.
Emery said that he did not expect to see counties roll back the prohibitions on hiring people with criminal convictions.
“It’s a county policy, and I think you’re going to find that in any county, that there’s a policy that they will not hire a convicted felon,” he said. “They’re not gonna hire a felon, at least right now, not in this climate. It’s the way things are, it’s not gonna happen.”
When the 2021 law mandating peer support services passed, Deeb thought he was looking at a sea change, and that “everybody would bring somebody like me in.”
But “it’s just not happening,” he said.
“This is all I’ve focused on for the last five and a half years, and I don’t realistically see them voluntarily changing anything.”
New York Mandates Peer Services. Jails Lock Them Out. | New York Focus (nysfocus.com)