Since the Safe Alternatives to Segregation Initiative assessment process concluded, the five partner sites have continued the significant task of implementing strategies to reduce their use of restrictive housing, many of which stem from the recommendations of the Vera Institute of Justice. Here are highlights of the changes each agency reports it has made in recent years. Vera looks forward to seeing these agencies go even further in the coming years and achieve even greater reductions.

The Middlesex County Adult Correction Center (MCACC) reports enacting numerous reforms to reduce its reliance on restrictive housing while managing the constantly changing incarcerated population and addressing people’s diverse needs. These reforms include the following:

• Making conditions of confinement in the intake unit less restrictive. Unlike previous practice, new arrivals to the facility are no longer automatically held in conditions similar to those in restrictive housing while going through the intake process. Instead, they experience conditions much more like those of the general population; in particular, they are allowed out of their cells for approximately six hours each day.
• Restructuring disciplinary hearings. These hearings are now chaired by a senior psychiatric social worker from outside the facility, who is able to act as an impartial arbiter.
• Convening weekly interdisciplinary restrictive housing meetings. These regular meetings bring together senior facility staff, classification and intelligence staff, and mental health staff to discuss the status of people in restrictive housing and their individualized case plans, in order to ensure they can successfully transition to less-restrictive housing as soon as possible. 
• Creating specialized units as alternatives to restrictive housing. To more appropriately house specific populations that previously would often have been held in restrictive housing, MCACC created several specialized units where individuals are separate from the general population (GP), but have the same out-of-cell time as people in GP and are allowed congregate activity and some programming on the unit. These include a Maximum Control Unit (for people in custody due to murder charges, with high bail amounts), an Administrative Special Handling Unit (for individuals charged with offenses, such as a sex offense, that may put them at risk of harm in GP), and a Precautionary Supervision Unit (for other people requiring protective custody). 

MCACC has already seen positive outcomes from these changes:

• MCACC administrators report that their average daily population in restrictive housing decreased by about 50 percent, from roughly 50 to 60 people in 2015 to 25 people in early 2018. The facility saw a record low of 13 people in restrictive housing on April 27, 2018. The proportion of the total jail population that is in restrictive housing on an average day has decreased from around 6 percent to approximately 3 percent. 
• Reforms to the disciplinary process have led to a drastic reduction, by more than 50 percent, in the average length of stay in “disciplinary detention” (also known as punitive segregation or disciplinary segregation). MCACC reports that the average stay in this type of restrictive housing has dropped from about 12 days to just under five days. What’s more, the number of people sent to disciplinary detention has decreased by 41 percent.

Since 2015, the Nebraska Department of Correctional Services (NDCS) has dramatically changed how it uses restrictive housing: 

• In 2016, NDCS eliminated the use of disciplinary segregation as a punishment for rule violations, a rare step. Instead, restrictive housing is now used only to “manage risk” based on an assessment of the risk an individual poses to the safety of others or the security of the institution.^[]NDCS, “Administrative Regulation 210.01: Restrictive Housing” (effective July 1, 2016).
• Nebraska now has just two types of restrictive housing—immediate segregation and longer term restrictive housing (LTRH). 
  • Immediate segregation can be used in response to certain incidents of violence or threats; it provides time for NDCS to assess the risk someone poses to safety and security and whether the next step should be return to general population, placement in alternative housing, or referral for placement in LTRH. 
  • A high-level Central Office Multi-Disciplinary Review Team must approve every person who is assigned to LTRH, and it reviews everyone in such housing at least every 90 days to determine whether transfer to a less-restrictive setting is safely possible and ensure no one stays there longer than is necessary.

In addition to these policy changes, NDCS reports that it has continued to make reforms:

• Providing programming and congregate activity to people in restrictive housing. This includes self-study coursework in collaboration with the University of Nebraska Omaha; risk-reducing programming that is provided outside of cells while people are restrained in programming chairs; and a peer support initiative that allows people in a prison’s general population to provide support to those who are in restrictive housing.
• Increasing staff training. The department now provides specialized training for staff assigned to work in restrictive housing; additional training for all new NDCS staff will begin in July 2018.
• Moving most people needing protective custody out of segregation. People who need protective custody are now generally housed in protective management units as an alternative to placement in restrictive housing. Such units provide programming, group recreation, at least four hours of out-of-cell time per day, and other privileges that make them more like general population housing.
• Creating a de-escalation room at the women’s facility. NDCS reports that they have created a de-escalation room at the Nebraska Correctional Center for Women. (For more about de-escalation rooms, see “Innovative programming in restrictive housing.”)
• Implementing an electronic data system. This will increase the department’s ability to monitor and track its use of restrictive housing.

Nebraska has begun seeing the positive results of its reforms:

• The average daily population in restrictive housing decreased by 11 percent, from 389 in fiscal year 2016 to 347 in fiscal year 2017.
• The number of people released from restrictive housing directly to the community has dropped significantly. In fiscal year 2014, 78 people who were released from NDCS custody were released directly from restrictive housing. This figure has decreased every year since then; 22 people were directly released in fiscal year 2017.
• Use of alternatives to restrictive housing placement. NDCS reports that in fiscal year 2017, facilities documented over 4,000 incidents that required an assessment of an incarcerated person’s risk and included the potential for placing them in immediate segregation. Of those, 1,750 incidents were resolved with “alternate placements,” which occur when staff move an incarcerated person to a new cell, housing unit, or other alternative rather than putting him or her in restrictive housing.

Over the past few years, the New York City Department of Correction (NYC DOC) has substantially reduced its use of punitive (disciplinary) segregation, using strategies such as the following:

• Reducing the number of disciplinary infractions for which punitive segregation is a sanction. Punitive segregation can now only be given in response to Grade I or Grade II infractions; Grade III infractions are not eligible.
  • Placement in “Punitive Segregation I” (PS I), which resembles typical restrictive housing with 23 hours in-cell per day, is limited to violent Grade I infractions. 
  • People who commit nonviolent Grade I infractions or Grade II infractions can be sanctioned to “Punitive Segregation II” (PS II), where they spend at least seven hours outside their cells per day.
• Limiting the amount of time people can spend in punitive segregation. No one can be placed in PS I or PS II for more than 30 consecutive days, and no one can serve more than 60 days total during a six-month period without specific approval from the Chief of Department, something that happens rarely, according to the DOC.
• Developing and promoting alternative ways to manage behavior.
  • The DOC employs incentive-based management systems to promote desired behavior. For example, in certain units, positive behavior is rewarded with new board games, movie nights, or similar incentives.
  • In addition, staff have been provided expanded training to prevent and resolve conflicts, focusing on de-escalation, conflict resolution, and working with special populations.
• Eliminating punitive segregation as a sanction for certain special populations, including people with serious mental illness (SMI), youth under age 18, young adults ages 18 to 21, and women. These changes were enacted in 2013, 2014, 2016, and as of 2018, respectively.

The department is creating “a more diverse portfolio of responses to negative behavior and units that integrate programmatic behavioral modification” as well as units with more clinical approaches.^[]NYC DOC, March 28, 2018, e-mail correspondence.

• Clinical Alternatives to Punitive Segregation (CAPS) units offer a clinically appropriate alternative to restrictive housing for people with serious mental illness who commit serious disciplinary infractions. These units, which were created after punitive segregation was abolished for this population, provide residents with in-patient levels of mental health care and therapeutic programming, including group programming. As of spring 2018, NYC DOC had three CAPS units.
• The Program to Accelerate Clinical Effectiveness (PACE) was developed to reduce violent behavior by individuals with serious mental illness. It aims to achieve this by providing preventive care in the form of enhanced mental health supports to individuals before they commit serious infractions. As of spring 2018, the department had established six PACE units.
• NYC DOC created additional alternative housing units to address various behavioral needs. These include Second Chance units, the Transitional Restorative Unit, the Secure Unit, and Enhanced Supervision Housing (ESH); such units seek to address the underlying causes of negative behavior and to incentivize positive behavior, and they provide “close supervision, targeted programming, and interdisciplinary teams to support individualized plans.”^[]NYC DOC, March 28, 2018, e-mail correspondence. For example, ESH units are “enhanced through evidence-based programming including dialectical behavior therapy, interactive journaling, tablet-assisted programming, anger management,” and programming led by “credible messenger[s].” People’s cases are reviewed every 30 days for progression to the next level or the jail’s general population.

New York City reports that its reforms have already shown promising, measurable results:^[]NYC DOC, March 28, 2018, e-mail correspondence. For example, ESH units are “enhanced through evidence-based programming including dialectical behavior therapy, interactive journaling, tablet-assisted programming, anger management,” and programming led by “credible messenger[s].” People’s cases are reviewed every 30 days for progression to the next level or the jail’s general population.

• The average daily population in punitive segregation has been reduced by over 85 percent, from 671 people in 2009 to 95 individuals on March 7, 2018, according to the department. This brings the total segregation population in NYC DOC on any given day down to 1 percent (from 5 percent) of the total jail population.

• NYC DOC also reports that its efforts to address people’s needs through specialized housing units has contributed to better management of behavior and reduced violence. For example, the department noted that on average, use of force rates decreased while individuals were in CAPS, compared to prior to their entry. And the average rate of fights for incarcerated people in each of the department’s alternatives to segregation units was lower than their average rates of fights prior to placement in those units.

In 2016, the North Carolina Department of Public Safety (DPS) eliminated the use of highly restrictive housing (where people are confined to their cells for 22-24 hours per day) for anyone younger than 18. This is a population that Vera found was in this type of housing at a higher rate than people age 18 or above. DPS used multiple strategies to effect this change:

• Using alternative sanctions. Instead of disciplinary segregation, youth younger than 18 are given other sanctions, such as loss of canteen or other privileges.
• Providing alternate housing and more activities. Youth who need to be separated are placed in “modified housing” (MODH), which is more restrictive than general population but less so than restrictive housing. Young people in MODH have at least three hours out-of-cell time per day by policy, though they reportedly receive much more time outside their cells in practice. Youth come out in small groups for recreation and dayroom time and to go to the gym. In addition, a teacher provides classes on the unit to help prevent students from falling behind in their education.
• Increasing staff training. DPS staff who work with youth are now trained in motivational interviewing and crisis intervention.

North Carolina created Therapeutic Diversion Units (TDUs), a program to remove people with serious mental illness from long-term, highly restrictive housing and to divert them from being sent to such housing in the first place. TDUs are intended to serve as a therapeutic alternative to highly restrictive housing, using strategies including the following:

• Providing increased out-of-cell time and mental health programming and treatment. People in TDUs spend at least 20 hours outside their cells per week (10 hours of structured therapeutic activities and 10 of unstructured time), though DPS reports that it is often closer to 30 to 40 hours per week. Through a phased approach, people are gradually allowed out of their cells unrestrained, then in small groups, and eventually in larger groups. Evidence-based programming and individual and group therapy are provided.
• Increasing staffing levels. TDUs have more staff than a typical unit, and custody staff reportedly work side-by-side with mental health staff to foster the units’ therapeutic environment.

In addition, DPS has created a “step-down” program, the Rehabilitative Diversion Unit (RDU). It aims to help people safely transition out of restrictive housing and back into the general population using the following approach: 

• Moving incarcerated people from long-term restrictive housing to the RDU. 
• Transferring some people to the RDU soon after their placements in restrictive housing. This can help avoid keeping them in restrictive housing for longer periods of time.
• Providing programming and treatment to address mental illness and other factors.
• Allowing gradually increasing out-of-cell time, privileges, and group activity. 

North Carolina’s RDU and TDUs have already served hundreds of incarcerated people:

• 650 people were placed in the RDU program in its first two years.
  • 109 people in 2017, and an additional 64 people in January through March 2018, graduated from the RDU and were successfully reintegrated back into general population.
• DPS created TDUs at six facilities around the state, including a women’s prison and the youth facility, between 2016 and early 2018. 
• There were 417 admissions and 179 completions of the TDU program in the first 18 months TDUs existed.^[]The number of people admitted to TDUs may be somewhat smaller than this figure reflects, given that an individual could have been admitted to such a unit more than once. People who finished received an average of five months of treatment in a TDU.

In addition, between May 2015 and April 2018, DPS reports the number of people in restrictive housing decreased by 27 percent, from 3,412 to 2,480:

• In April 2018, there were 800 fewer people in disciplinary segregation than in May of 2015 (574 people vs. 1,374 people), a decrease of almost 60 percent.
• During that same time, the population in other types of restrictive housing (called control housing and administrative segregation) decreased by 6.5 percent, or 132 people—from 2,038 to 1,906.

The Oregon Department of Corrections (ODOC) reports that in 2017 it took numerous steps to improve conditions of confinement and provide group programming in restrictive housing. These reforms include the following:

• Providing people in long-term restrictive housing with some opportunities for congregate activity and programming. ODOC is piloting an Administrative Segregation Intervention Program developed by the University of Cincinnati in its Intensive Management Unit (IMU), a form of high-security housing for people whose behavior is deemed to pose a significant threat to facility safety and security. The instructor-led, out-of-cell program uses cognitive behavioral therapy to address behaviors that led to a person’s placement in IMU, with the goal of preparing them for an eventual transition to less-restrictive housing.
• Providing programming in disciplinary segregation. The department has begun providing people in disciplinary segregation units at Eastern Oregon Correctional Institution with instructor-facilitated, out-of-cell programming as well as in-cell programming packets.

Oregon is working to improve the Behavioral Health Unit (BHU), an intensive behavioral management unit for people with serious mental illness. The director of ODOC has reported that the department has taken the following steps, among others:

• Employing more mental health staff. ODOC has more than doubled the number of qualified mental health professional positions assigned to the BHU, from four to nine full-time staff members.
• Increasing and improving the BMU’s physical space. Oregon is constructing a building that will provide additional rooms for therapy and group programs, creating another yard to increase outdoor recreation opportunities, and establishing a mindfulness room (similar to the state’s “Blue Room”)—all scheduled to be available in 2018. (For more about blue rooms, see “Innovative programming in restrictive housing.”)

The department is also pursuing systemwide strategies to decrease the number of people who enter restrictive housing, particularly for disciplinary reasons, and to shorten the time they spend there:

• Increasing staff training. In 2017, ODOC provided eight hours of training on gender identity and gender differences to all staff. In 2018, the department plans to offer all staff 26 hours of crisis intervention training (which covers mental health issues, crisis response, and communication skills).
• Encouraging positive behavior in general population. Oregon is assessing its incentive level process and adding more incentives to further encourage and reward positive behavior (and avoid negative behaviors that may lead to placement in restrictive housing).
• Creating additional “Blue Rooms.” One facility, Snake River Correctional Institution, currently has a Blue Room—a space where incarcerated people can watch videos of nature imagery in order to promote de-escalation and well-being. The department plans to create similar rooms in four more facilities.
• Reducing the amount of segregation given as sanctions for infractions. Oregon reports that disciplinary hearings officers now employ a more progressive approach to discipline, considering an infraction’s seriousness and the individual’s disciplinary history when deciding whether to recommend disciplinary segregation and the length of a segregation sanction to impose. They are also more frequently suspending segregation sanctions, allowing people to remain in general population and, if they remain infraction-free for a certain period of time, removing their disciplinary segregation sanction.
• Removing all “mandatory minimum” disciplinary segregation sanctions. This allows staff more discretion in sanctioning misconduct. They are now able to use alternative sanctions, instead of segregation, and there is no longer a minimum amount of time someone must be sent to segregation for certain infractions.
• Allowing people to earn time off their disciplinary segregation sanction. Staff now review incarcerated people in disciplinary segregation units weekly and recommend that some be released early, based on positive behavior and programming needs.

ODOC is seeing the results of its reform efforts. The department reports the following:

• The population in restrictive housing decreased from 8.8 percent to 7.7 percent of the total prison population in a one-year period, between the fourth quarter of 2016 and the fourth quarter of 2017. ODOC attributes this decline to multiple reforms, including the reduced use of disciplinary segregation and increased use of alternatives to restrictive housing.
• As of March 1, 2018, the system had 300 empty beds in its restrictive housing units. The department reports it is actively developing plans to repurpose some of these beds into general population units.