What results is Seattle seeing from the LEAD program so far?
Earlier this month, the University of Washington released an evaluation of the impact LEAD had on recidivism rates. The results were significant. The evaluation found the LEAD participants had 34 to 58 percent lower odds of arrest compared to a control group that went through the “justice system as usual.”
Several of the Seattle LEAD partners (e.g., the Seattle Police Department, the King County Prosecutor, and the city council) were willing to support LEAD in the pilot phase, on the condition that we ensured a robust evaluation of whether the program worked as well or better than the system as usual in reducing recidivism among participants. Because of the evaluation, our local operational partners have renewed their commitment to this approach, and many are calling for its expansion throughout the city of Seattle and King County.
Similarly, dozens of jurisdictions around the country are considering moving toward a LEAD-style pre-booking diversion approach for crimes that originate in unmet public health needs. Many have been awaiting the evaluation results before making a final decision whether to move forward. These results have given new energy to planning efforts in those jurisdictions.
In piloting this program, Seattle had substantial foundation funding over the course of four years. As you know, the Open Society Foundations released a request for proposals for other jurisdictions to develop plans for pre-booking diversion programs of their own. But the scale of funding will be substantially smaller than what was granted to Seattle. With sustainability being critical, what would you recommend to jurisdictions that are attempting to follow your cues and develop LEAD programs of their own?
Three things make embarking on LEAD more feasible without a lot of grant money up front than it was when we started.
First, the Affordable Care Act and Medicaid expansion mean that many services and costs that otherwise would have to be funded by state and local governments are now covered by Medicaid. (Local jurisdictions should make sure they and their state is making the best possible use of this resource for the LEAD-eligible population.)
Second, this evaluation showing recidivism reductions should allow jurisdictions to be confident in planning that they will reduce their justice system costs by adopting this approach.
Finally, because LEAD has shown these significant improvements in recidivism, local jurisdictions may be willing to invest in this approach as a better strategy for improving public order and community health than the status quo offers. The city of Seattle, for example, funded expansion of LEAD beyond the pilot area in response to neighborhood demands to address issues posed by addiction, untreated mental illness, and homeless on their streets.
The news reports about this program and the evaluation have been largely positive. What do you think your greatest critics are saying now that the evaluation has been released?
Some have expressed skepticism about bringing an approach like this to scale. The success of LEAD depends in part on the strong working relationships case managers have established with law enforcement and prosecutors after years of bi-weekly meetings. Figuring out how to establish those working partnerships among a larger pool of case managers and officers will be challenging, but we have ideas about how it can be managed. Among them: greater use of technology and case manager attendance at officer roll calls.
Others are rightly concerned that this evaluation will cause a stampede to replicate LEAD without sufficient attention to the core principles that made it work in Seattle. On the social services side, those include a harm reduction framework, and adequate resources to provide intensive “guerrilla” case management (including street-based engagement), as well as to purchase services rather than referring participants to already over-subscribed wait lists. On the law enforcement side, those principles include buy-in from rank-and-file officers and from sergeants, and dedicated staff in prosecutors’ offices to coordinate what happens in cases involving LEAD participants beyond the initially diverted case.
Without these components, we would not expect comparable results. And the program requires a project manager with strong but arms-length relationships with all the operational partners.
What can we expect next from Seattle’s LEAD?
The next steps in the evaluation process are to look at the impact of the program on justice system utilization, and then to examine the program’s effect on the health and well-being of participants. On a policy level, we’ll spend the next several months engaging the question of how to take a pilot project like this to scale across the city of Seattle and King County, eventually involving all law enforcement officers and several times the number of participants now in the program. A data- and information-sharing system that can be easily accessed and added to by all the operational partners will be key.
We’ll also be considering whether to include additional nominally criminal behavior to the list of what qualifies someone for referral to LEAD. Presently, the individual must be suspected of drug or prostitution activity in the relevant neighborhood. Some people, however, have health needs unrelated to drugs or addiction that cause “public order” issues in the community. LEAD could expand to include such situations.
However, we will need to guard against “net widening,” an effect whereby the availability of the diversion option actually increases officers’ attention to someone ill or struggling who previously would not have been engaged by law enforcement.