Findings pose several important implications for future Proposition 36 program planning and research. First, it appears that offenders may be targeted for employment services based on several factors including current employment status, income sources, recent work history, severity of family/social problems, and desire for such services; yet, processes for matching services to need are little understood. People who did not receive employment services mostly got services for Medi-Cal and SSI benefits. Yet, employment services may be of benefit to individuals who do not express an explicit desire for help getting or keeping a job. Employed users have been shown to make further employment gains after substance abuse treatment.33
For many, being employed is not just about generating a source of income (wages improved after Prop 36 treatment among both groups, but still remained generally low) but is more importantly instrumental in perceived quality of life34
and in cultivating positive social support systems and mechanisms for improving self-esteem.5
Offenders who enter the Prop 36 program and are not in the labor force or are already employed (and perhaps underemployed) may benefit from efforts targeting employability and education/skills training as it may be possible to capitalize on the Prop 36 experience as a “teachable moment” to encourage these offenders to obtain work or improve their work situation. More information is needed to better understand how decisions are made regarding who receives employment services and whether better matching of services to need improves outcomes.
Second, two thirds of Prop 36 offenders are not working at intake, but about an equal proportion of offenders are assigned to outpatient care, a treatment setting in which, as the data in this paper shows, offenders are less likely to receive employment services. “Reserving” ancillary services or specialized care, like employment services, for more severe offenders who are in greater need makes immediate fiscal sense but the long-term impacts must also be considered. Provision of vocational services within addiction treatment has been associated with an increased probability of abstinence that can have cost-effective implications.36
Prop 36 offenders are in their prime income earning years, and more of them need to be encouraged to work and reconnected to the labor market. However, health services research indicates that drug treatment providers continue to struggle to link clients to ancillary services at a level that is commensurate with client needs.37
Incentive programs intended to move individuals from welfare to greater self-sufficiency through work39
and programs intended to enhance the employability of individuals with chronic and severe substance use disorders40
present some interesting lessons learned and stimulate conjectures whether similar models might be effective with the Prop 36 population.
Third, the greater likelihood of positive employment outcomes among Hispanic groups may be explained, in part, due to better access and motivation for work because of cultural and family obligations, and Hispanics may also exhibit a greater willingness than other racial/ethnic groups to perform unskilled work. A recent large study of substance abuse treatment outcomes in California found that although Hispanics reported more employment difficulties than Whites at treatment intake, receipt of employment services and outcomes were similar for the two groups.41
Additionally, analysis showed that family/social problems were more severe at intake among the group that received employment services, that severity of family/social problems was related to receipt of employment services, and that family/social problems remained more severe among this group at follow-up. More research is needed to understand the roles culture, family, and social relationships play in impacting Prop 36 services utilization and outcomes. Similarly, county context must also be considered. It was found that county of residence was related to the likelihood of later employment and county-level variation in unemployment rates among the general population may, to some extent, help to explain this finding. In 2006, county unemployment rates in California ranged from 3.4% to 15.3%, with 22 counties having an unemployment rate below the statewide rate of 4.9%, and the remaining 36 counties reporting an unemployment rate above the statewide rate.42
Another study found that high unemployment rates were one of several contextual factors that increased the likelihood that recovering ex-offenders would recidivate during their first year in the community.43
Additional information is needed to better understand contextual factors like these that affect employment.
Fourth, conflicts offenders face when trying to get or keep a job and also meet the criteria of Prop 36 may make it especially difficult to do both well. Since the inception of Prop 36 in 2001, a consistent percentage of offenders, about 30%, actually complete treatment every year under the program.44
Added to this, many appear to enter treatment with a job and leave treatment on welfare or other types of public assistance.45
These data are especially troubling given that a study of a similar population of persons utilizing publicly funded mental health services reported that employment rates declined after the receipt of public support.46
While it is understandable that treatment for drug use remains the focus of substance abuse treatment, employment has been associated with improved functioning after treatment in multiple domains. Anecdotally, some Prop 36 county stakeholders have expressed interest in making employment a part of the criteria for completing treatment and/or the Prop 36 program while other stakeholders have considered making employment outcomes an element of results-based funding criteria,45
a strategy that has been tried with some success with persons with severe mental illness.47
These and other strategies that may positively impact both treatment completion rates as well as employment outcomes deserve further exploration.
Finally, vocational and employment training can positively impact client outcomes,48
particularly when services are well-matched to need50
or are a key component of a case management approach.51
However, there is no generally accepted vocational rehabilitation or employment assistance model for use with criminal offenders,8
particularly for those who are also substance abusers whose use histories present significant employer concerns. Also, being unemployed can stand for a host of other deficits, many of which cannot be adequately addressed by the minimal amount of vocational assistance that is typically provided in community substance abuse treatment programs. Yet, clearly, one area for improvement in Prop 36 programming is that of record expungement. While in some counties, approximately 80% of eligible offenders reportedly have their Prop 36 felony conviction expunged, in other areas less than half actually do so,55
an oversight that can have lasting consequences for offenders and their ability to generate legitimate sources of income in the future. Considering policy options to assist more eligible Prop 36 offenders to have their conviction expunged would have a real impact on future employability (see Raphael 200759
for related discussion) and may be of most benefit to individuals without a prior criminal record or those who express explicit desires to remain or become employed.
The present study has several limitations. This study captured a relatively small proportion of the larger statewide population of Proposition 36 offenders, and findings may vary with analysis of a wider spectrum of this group. The “received employment services” grouping is self-reported at 3 months post-assessment and may have been affected by misrepresentation or recall errors. Also, services that may have been received immediately after the 3-month follow-up interview were not documented, and so the potential influence of subsequent or additional treatment on outcomes could not be analyzed. Furthermore, whether clients received services from a trained vocational rehabilitation counselor was not assessed, and validated measures of motivation for work or work readiness were not employed in this study. Instead, motivation for employment services was measured by an individual item (“wants employment services”) and although this measure was associated with receipt of services as expected, stronger measures may have revealed undetected components of motivation or readiness that could impact associations between receipt of services and outcomes. Finally, county variation in Proposition 36 program practices regarding provision of services remains unexamined. Despite these limitations, some useful findings have resulted from the unique design of this study. The study instruments are based on standardized instruments that have been widely used in previous studies among similar populations, and new aspects of the Proposition 36 program were documented.