DEPARTMENT OF CORRECTIONS
2017-19 Biennial Budget
Issue Paper
Topic: DIN 5304 – OSCI Mental Illness Treatment & Diversion Units
Request
The Department of Corrections (DOC) requests $1,022,200 GPR and 16.85 GPR FTE in FY18 and
$1,214,300 GPR and 16.85 GPR FTE in FY19 to convert Housing Unit “W” at Oshkosh Correctional
Institution (OSCI) from 86 General Population beds to a Secured Residential Treatment Unit (SRTU) (75
inmate capacity) and a Diversion Unit (DU) (11 inmate capacity).
Problem Description
Inmates at OSCI and throughout the Division of Adult Institutions (DAI) with Mental Health Code MH-2A
and/or Intellectual Disability often end up in RH (See Appendix 1). Restrictive Housing (RH), previously
known as “segregation” in Wisconsin, is the placement of an inmate in a locked cell for 22 hours or more
per day. Inmates are placed in RH as punishment for violating prison rules. While inmates with an MH-2B
code are also categorized with Serious Mental Illness (SMI), the plan would be to place only inmates with
MH-2A or Intellectual Disability (ID) mental health codes in the SRTU/DU.
The effect of RH on inmates with SMI or ID varies from person to person, but the overall psychological
effects are negative. The effects may include one or more of the following:
increased depression or anxiety
Insomnia
paranoia

worsening of trauma-related symptoms
worsening of psychosis
emergence of self-harm behavior, suicide
attempts or aggression

Inmates with SMI in medium security institutions are often transferred to maximum security institutions as a
result of misconduct that stems from their mental illness. The level of mental health treatment in a medium
security general population (GP) setting is generally limited to intermittent appointments with psychologists
and psychiatrists, often spaced weeks or months apart. This is insufficient for many inmates with SMI, who
do best with more frequent and predictable programming.
Background
Mental Health professionals at DOC screen all inmates for the presence of serious mental illness (SMI) prior
to transfer to the Wisconsin Secure Program Facility (WSPF). A determination of SMI at any point makes
an inmate ineligible for transfer to WSPF.
Female inmates at the Taycheedah Correctional Institution (TCI) with serious mental health needs who are
in either Special Management Units (SMU) or restrictive housing are provided with at least ten hours per
week of structured, out-of-cell, therapeutic activities, also known as the “10/10 model”. Psychological staff

 are utilized for individual therapy and crises management, while other classifications such as Teachers or
Recreation Leaders are able to provide the staff necessary for other structured out-of-cell time.
Some states, such as Colorado, California, Ohio, Pennsylvania, and New York have eliminated the use of
RH for inmates with SMI and are instead using focused mental health treatment units. The Federal Bureau
of Prisons (BOP) also produced guidelines in July 2015 for RH, which included diverting inmates with SMI
to alternative forms of housing.
Reduced Use of Restrictive Housing
There has been a national trend to reduce the use of RH in prisons. In January 2016, the Federal BOP
implemented 50 Guiding Principles to reform solitary confinement use in its prisons, that has resulted in a
25% reduction in the use of solitary confinement. These reforms also included the diversion of inmates with
SMI to alternative forms of housing.
Colorado has dramatically reduced its solitary confinement population in the past few years from 1,505
inmates (6.8% of all inmates) in September 2011 to 141 inmates (0.8% of all inmates) at the start of FY15. 3
Many other states have also reformed their use of solitary confinement including: South Carolina, Illinois,
and Michigan.
DOC has implemented new administrative policies to reduce the use of RH. The Department’s Restrictive
Housing Committee began its work to review and revise RH policies and practices in 2014. This work is
ongoing, but concrete changes have already occurred.
DAI Policy 500.70.04 “Psychological Input to Security Decision” was effective as of 5/27/2015, and
requires written input from psychological staff for inmates in the disciplinary process who have been
diagnosed with SMI or ID or who have recently engaged in self-harm. DAI Policy 303.00.04 “Disciplinary
Guidelines” was re-written to: decrease the length of RH dispositions; encourage alternative sanctions; and
require monthly reviews of any discipline resulting in an RH placement longer than 120 days by the DAI
Administrator and the Secretary’s Office.
DOC’s efforts have reduced the number of inmates in RH from a five-year high of 1,362 inmates on 3/31/14
to 885 inmates as of 6/30/16.

3

Colorado’s Administrative Segregation Annual Report
https://drive.google.com/file/d/0B8WLSXAb0Mg8Wkw2T2FBelRzOTA/view

 Table 1. RH Population over Time

As a consequence of the new DAI policies, the number of SMI inmates in RH has also been reduced. There
were 155 (117 MH-2A) inmates with SMI as of 4/30/14; compared to 129 (99 MH-2A) inmates as of
4/30/15; and 91 (75 MH-2A) inmates as of 4/30/16 (See appendix 2). Additionally, there were 11 (9 MH2A) inmates in administrative confinement with SMI as of 4/30/14; compared to 9 (8 MH-2A) inmates as of
4/30/15; and 10 (8 MH-2A) inmates as of 4/30/16 (See appendix 3).
Analysis
Need for this program
There is a clear need for the SRTU/DU because DOC continues to place SMI inmates in RH despite
growing national trends away from this practice. DAI had 91 SMI (78 MH2A) male inmates in RH as of
4/30/16. As of 5/4/16 there were 1,390 male inmates with MH-2A or ID (including the 78 in RH) in all of
DAI (See Appendix 4). If the SRTU/DU is funded, DAI can transfer the medium-security SMI inmates who
are at highest risk for RH placement to OSCI to receive treatment in the SRTU/DU.
The SRTU/DU will provide 86 beds for SMI inmates to keep them from being placed in RH and may also
help keep SMI inmates from being moved from medium security institutions to maximum security
institutions because their mental illness prevents them from following the rules in a less restrictive medium
security setting.
Treatment
The SRTU/DU would only treat SMI inmates with MH-2A or ID mental health code. Inmates with an MH2B mental health code would not be prioritized for this unit and in general would not be placed there, due to
the possibility that MH-2B inmates could manipulate or victimize MH-2A inmates.

 The treatment that inmates with MH-2A or ID codes would receive in SRTU or DU is the “10/10 model”.
The women’s system has already implemented this model in their RH units. The level of treatment is less
than provided to inmates at DHS’ Wisconsin Resource Center (WRC), but still much more than currently
provided to male inmates in RH or GP.
This nationally recognized approach to treatment of inmates in RH includes 10 hours per week of out-ofcell, structured, and therapeutic programming. This would include any out-of-cell activity that is structured
and led by DOC staff. Examples might be individual appointments with psychologists or psychiatrists,
group therapy with psychologists, educational classes, a therapeutic work assignment, current events or
social skill groups, or any of our cognitive-based programming. Inmates also receive another 10 hours per
week of out-of-cell unstructured time. This would include any out-of-cell activities that are not structured or
led by DOC staff. Examples include dayroom time, meals, and recreation.
The SRTU and the DU will both provide 20 hours of out of cell (10/10 model) time. The SRTU will be for
long-term inmates, up to 18 months, who will be required to participate in programming that will consist of
incentive programs and individual treatment plans. Inmates will also have ongoing reviews by the treatment
team to determine when they can be released back to GP. The DU will be a short-term program of less than
30 days and consist of individual treatment plans along with 20 hours per week of out of cell time.
Staffing
Table 3 indicates the proposed staffing pattern for SRTU/DU. The Health staffing was based on the staffing
patterns currently utilized for female inmates.

Correctional Officer
Nurse Clinician 2
Therapist*
Social WorkerCorrections*
Correctional Sergeant*
Psychologist - Licensed
Psychological
Associates*
Corrections Unit
Supervisor
Teacher (0.20 FTE)
Correctional Sergeant
Correctional Officer

Table 3. Staffing Pattern for SRTU/DU
AM
AM
PM
PM
NT
M-F
WKD
M-F
WKD
M-F
1
1
1
1
1
1
2

NT
WKD
1

New
FTE
5.25
1.00
2.00

1
1
1

1.00
1.00
1.00

5.60

5.60

1
0.20
1
2

1
2

1
2

1
2

1
2

1
2
16.85

*Positions will be split between AM and PM on weekdays and weekends
**Bold positions are positions being added. Non-bold positions are current positions that will be utilized for the SRTU/DU

 Psychological Associate: These positions will provide direct professional-level psychological services in a
group or individual setting to SMI inmates. These positions will report to one of the two existing
Psychologist Supervisor positions at OSCI.
Psychologist - Licensed: This position is needed to coordinate the day-to-day psychological responsibilities
of the SRTU/DU. The position will also provide some clinical supervision of the Psychological Associate
positions.
Therapist: These positions will provide structured recreational activities to inmates to get them out of their
cell and involved in appropriate physical activity. This is an important aspect of treatment as physical
activity has a positive effect on mental health.
Social Worker- Corrections: The position will provide case planning and re-entry preparation. Inmates
with SMI require more time and preparation for these services than other inmates.
Nurse Clinician 2: The position will be responsible for medication administration to inmates. Additionally,
it will serve as an on-site medical resource and liaison for the Health Services Unit (HSU). Inmates with
SMI have a higher than average medical needs and number of medications. If this position is not added,
Correctional Officers may be forced to pass out the large number of medications.
Correctional Sergeant: This position will provide programming and facilitation of structured and
unstructured program time. A current Correctional Sergeant post will also be utilized for this purpose.
Correctional Officer: These positions will be added to provide additional security as it converts from
General Population to all SMI inmates. Due to the inmates serious mental health needs, there is increased
security risk and an increased need for escorts by security staff to different locations for programming
throughout the institution.
DOC is requesting permanent FTE staff instead of LTE or contracted staff as LTE and contracted staff
typically have higher turnover. High turnover can result in programming not being provided because of
staff vacancies. Additionally, high turnover results in a less effective mental health treatment program, as
continuity is lost and new staff require start-up time, including training, to become familiar with the
program and the issues facing the inmates.
Return on Investment
SMI inmates in RH are more likely to threaten to commit or commit self-harm than other inmates. In CY15,
there were 80 different inmates with MH-2A codes in RH who had a total of 132 clinical observation
placements (suicide watch). Clinical observation placements require more staff time and possible staff
overtime as inmates are under close supervision.
Of these 132 placements, 56 were based on verbal threats and 76 were the result of some type of self-harm
behavior. Of the 76 incidents of self-harm behavior, 7 incidents were considered serious enough for off-site
care at a local emergency room. The creation of the OSCI SRTU/DU would improve inmates’ mental
health and lessen the clinical observation placements and self-harm incidents.

 This change would also likely result in a reduction of off-site visits to emergency rooms, a reduction of
overtime from transporting inmates to the emergency room, and a reduction of overtime as a result of less
clinical observation placements.
The SRTU/DU will work toward reducing recidivism of inmates with SMI by treating inmates mental health
needs. The DOC has had success in reducing recidivism by utilizing intensive treatment programs for
mentally ill inmates with the Opening Avenues to Reentry Success (OARS) program. The OARS program
treats people outside of prison who have a medium or high risk of recidivism.
Tracking Success of Program
If the SRTU/DU is implemented, OSCI will be able to track outcomes related to the SRTU/DU program.
Based on DOC’s prior experience with the Behavioral Health Unit (BHU) at Waupun Correctional
Institution, DOC anticipates reductions in conduct reports, uses of force, cell entries, observation placements
(suicide watch), self-harm attempts and ER visits.
Summary
GPR
TOTAL

FY 18
Funding
FTE
$1,022,200
16.85
$1,022,200
16.85

Prepared by: Jake Jokisch, Budget & Policy Analyst
240-5415

FY 19
Funding
FTE
$1,214,300
16.85
$1,214,300
16.85