MINNESOTA SEX OFFENDER PROGRAM ANNUAL PERFORMANCE REPORT 2012

January 2013 Minnesota Sex Offender Program 444 Lafayette Road North Saint Paul, MN 55155-0992

Table of Contents
Executive Summary ........................................................................................................................................... 3 Background...4 Section I Section II Section III Section IV Section V Section VI Appendix 1 Program Overview, Strategic Mission, Goals, Objectives and Outcomes of Minnesota Sex Offender Program ....................................................................................... 5 Treatment Model and Progression..................................................................................... 13 MSOP Department of Corrections Site ............................................................................ 19 Program-Wide Per Diem and Fiscal Summary ................................................................ 20 Annual Statistics .................................................................................................................... 22 MSOP Evaluation Report Required Under Section 246B.03 ........................................ 31 MSOP Outside Evaluation Report .................................................................................... 32

Executive Summary
For the Minnesota Sex Offender Program (MSOP), the past year has been one filled with significant challenges, opportunities, accomplishments, and changes. Our ever-evolving program continues to progress in the provision of comprehensive, evidence-based sex offender treatment within safe and therapeutic living environments. Noteworthy program highlights for 2012 include the retirement of Executive Director, Dennis Benson early in the year. Nancy Johnston, a long-term employee with MSOP, was appointed as the new Executive Director and is now serving in that leadership capacity. Since that time, organizational re-structuring at the executive level has been implemented, thus enhancing overall service delivery and operational oversight. The second provisional discharge in the history of the program occurred in 2012. A well-attended Community Notification meeting took place prior to the client moving into the Golden Valley community. After several months at a halfway house residential setting, he moved to a permanent apartment residence where he currently lives. With solid treatment planning, close supervision and monitoring, and collaborative clinical and security efforts, this client has been experiencing successful reintegration in the community. Construction completion at our Moose Lake facility took place this past year and the new 120,000 square foot Support Building became operational. This two-year project resulted in a necessary infrastructure providing additional space for programming, vocational opportunities, treatment groups, maintenance, and dining. In St. Peter, construction was completed for the 15-bed expansion within Community Preparation Services. Renovation of the Shantz Building, also at the St. Peter facility, began in 2012. The completion of the project in 2014 will provide an additional 72 beds to the program. During 2012, MSOP implemented the use of the Area Monitoring System (AMS) across our program. By placing AMS bracelets on our clients, we have been able to put an open movement concept into practice. Utilization of AMS technology enhances the quality of life and overall treatment environment due to increased freedom of movement for our clients. In addition, this highly effective tracking system provides additional security measures regarding client location and accountability. MSOP departments and disciplines have been instrumental in the ongoing revision and new development of critical internal policy that guides our program into the future, assuring continuity and consistency. Exciting changes occurred this year within staff development for MSOP in overall structure, content, and training requirements. The Treatment Theory Manual was updated and the Clinicians Guide was developed at the end of 2012, along with establishing a new 90-module curriculum for clients. Building and maintaining a strength-based approach to sex offender treatment, and incorporating a strong motivational philosophy, are key components in our quest for continued quality programming. During 2012, a Class Action Lawsuit was brought forward by several clients in the program. Treatment progression and conditions of confinement are the two areas that are being addressed through mediation with a Federal Magistrate. In addition, a Task Force was ordered by the federal
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court to thoroughly review and make recommendations regarding both the civil commitment process in Minnesota as well as the development of less restrictive alternatives to civil commitment. The Department of Human Services (DHS) Commissioner appointed the Task Force members in early fall of 2012 and that group convened and has begun their challenging work. The first set of recommendations were submitted to the Commissioner of DHS in December, 2012, outlining the details of less restrictive alternative residential settings and a Request for Information was published. To address treatment progression issues, the federal court ordered a five-member evaluation team consisting of experts within the field of sex offender treatment to evaluate internal MSOP processes that measure client progress through treatment phases. This team will visit the program in February and audit client charts. Their recommendations to the Commissioner will then be made in April, 2013. Although this lawsuit has drawn media attention, brought about MSOP employee concern, and will be a time-consuming process, it also provides an excellent opportunity for our state to thoroughly examine our civil commitment system and, in the end, may prompt positive and needed change for Minnesota.

Background
M.S. 246B.035 requires the electronic submission of an annual performance report to the chairs and ranking minority members of the legislative committees and divisions with jurisdiction over funding for the Minnesota Sex Offender Program (MSOP) by January 15th of each year. The statute stipulates the report must include information on the following: 1. description of the program, including strategic mission, goals, objectives and outcomes; 2. program-wide per diem; 3. annual statistics; and 4. the sex offender program evaluation report required under section 246B.03. MSOP is one program, operating across two campuses. Admissions and the majority of primary treatment occur in Moose Lake. After clients demonstrate meaningful change and progress through the first two phases of treatment, they are considered for transfer to the St. Peter campus. The St. Peter campus has two missions: reintegration and programming for alternative clients. Clients in phase III progress through privileges that allow opportunities to demonstrate their abilities to use new coping skills and risk management techniques in settings with less structure. St. Peter also provides the Alternative Program for clients with impaired executive functioning due to learning disabilities, developmental disabilities, head injury or trauma, and other neuropsychological issues. These clients do all three phases of programming on the St Peter campus.

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Section I
Program Overview, Strategic Mission, Goals, Objectives, and Outcomes
Description of the Program: The Minnesota Sex Offender Program provides comprehensive sexoffender-specific treatment to individuals (clients) who have been civilly committed by the courts. MSOP operates treatment facilities in Moose Lake and Saint Peter. Clients are committed as Sexual Psychopathic Personalities (SPP) or as Sexually Dangerous Persons (SDP) or as both SPP and SDP, only after a court has concluded that the individual meets the legal criteria for commitment. Such commitments are for an indeterminate time and, in most cases, follow an individuals completion of a period of incarceration.1 With the exception of clients in the MSOP Alternative Program, clients begin treatment at the Moose Lake facility.2 After successfully progressing through the majority of their treatment there, clients are transferred to the St. Peter facility to complete treatment and begin working toward reintegration. All clients participating in treatment develop skills through active participation in group therapy. Clients are provided opportunities to demonstrate meaningful change through their participation in rehabilitative services such as education classes, therapeutic recreational activities, and vocational opportunities. MSOP staff observe and monitor clients in treatment groups as well as in all aspects of daily living to determine and provide feedback on how clients are applying new knowledge and prosocial skills. Strategic Mission: MSOPs mission is to promote public safety by providing comprehensive treatment and reintegration opportunities for civilly committed sexual abusers. Priorities: MSOP is committed to creating a safe and respectful environment for clients and staff. Respect is defined as transparent and proactive communication, accountability, and recognition of the individualized needs of clients. Inherent in respect is the belief that all people are capable of making meaningful change if they possess the motivation and tools to do so. MSOP executive leadership has established strategic goals geared toward clarifying the treatment model, fostering cohesiveness and consistency in staff implementation of programming, and identifying areas in which efficiencies could be increased. These strategic goals are organized under the five themes of: Therapeutic Environment: Establish MSOP as a world class, research-based treatment program that is client focused and has a clear progression across the continuum of care. Program Integrity: Create a values-based environment. Learning Organization: Establish a dynamic culture of learning in all levels of our worldclass organization, which recognizes the many faces of learning.

As discussed in section III, MSOP provides staffing for sex-offender-specific treatment to Department of Corrections inmates who are identified as likely to be referred for civil commitment upon their release from incarceration. 2 Clients with low cognitive skills are placed in the MSOP Alternative Program and complete all phases of their treatment at St. Peter.
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Staff Development: Develop and maintain a confident, healthy and professional team. Responsibility to the Public: Partner with community stakeholders to enhance, develop, and effectively manage a world-class sexual offender treatment program.

2012 Strategic Goals:

Goals 1. Therapeutic Environment: 2012 Outcomes

Increase collaboration between clinical and operations staff.

The focus on increasing collaborative opportunities has been quite successful. Face-to-face consultations between clinical and operations are now routine and expected. Community meetings are interdisciplinary and opportunities for joint learning and networking such as Lunch & Learns are now a part of the program environment. In addition to the frequency of interactions, qualitatively, staff report there is less defensiveness and more conversation across disciplines. In 2013, this goal will be expanded to increasing similar collaborations with Security Counselor Leads. The most noticeable accomplishment in this area was the completion of the infrastructure building at the Moose Lake facility. Completion of this project obviously provided sorely needed space for clinical programming In addition, matrix cards were distributed to all clients based on their placement in treatment. These tools serve as external cues for clients in modifying their behavior but also assist staff in working more effectively with clients based upon their individual needs. The MSOP Assistant Executive Clinical Director and the Moose Lake Clinical Director increased their unit rounds to increase their accessibility to staff and clients alike.

Develop visible presence of treatment at both sites.

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Goals

2012 Outcomes There were significant advances made in this area during the last year. All psycho-educational modules (approximately 90) were revised and updated consistent with advances in the clinical literature. To increase consistency in service delivery, all clinicians have been trained on the new modules and MSOP continues to work toward standardization of the components. The Program Theory Manual was also updated with inclusions of new practice developments within the field of sex offender treatment. A Clinicians Guide was also developed to assist staff in accurately and consistently implementing clinical services across the program. Additional training and professional development for early-career clinicians has been established via routine professional development mentoring groups with more seasoned staff. The Moose Lake Support building was opened in August. The remodel of the Main Building in Moose Lake is scheduled to be completed in mid-February 2013. Both of these projects were critical to the delivery of secure clinical services and to increased efficiency in operations (e.g., centralized dining). The Green Acres expansion was completed and licensed in the first quarter of 2012. Ten clients currently reside in this residence (capacity 23). Construction on the Shantz Building began in December 2012. Phase I and Phase II of this projected are currently on track for completion in June 2013 and March 2014, respectively. Staff from Clinical, Security and the Office of Special Investigation (OSI) attend daily multi-disciplinary meetings and all serve on the community outings review team. OSI and the Clinical staff also collaborate on the administration of polygraphs. The average number of person crimes in 2011 was 168 and that dropped to 152 in 2012.

Improve quality of service delivery consistent with research and current practice.

Complete construction projects: Moose Lake Support Building (2012) St. Peter Green Acres Expansion (2012) St. Peter Shantz Expansion (June 2013)

Increase clinical partnerships with clinical and security staff and work towards reducing the number of person crimes committed by clients within the MSOP.

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Goals 2. Program Integrity:

2012 Outcomes This has been a significant project in the last year. In the first quarter of the year, the clinical department began manually tracking clinical services provided to clients until the computerized system, Phoenix, was online in the third quarter. This system will enhance the ability to track services as well as extract research. The process of centralizing all program data with the research department has started and it is anticipated this will allow the program to develop and measure outcomes independent of the number of provisional releases. According to the Bureau of Criminal Apprehension (BCA), there are 60 MSOP clients who are not compliant with their registration requirement. This represents a 91% compliance rate. Of note, only two of these clients are at the St. Peter facility, which includes clients in the later phases of treatment. Now that the new curriculum and theory manual have been introduced to staff, it is anticipated this goal will show additional progress in the coming year. The Executive Clinical Director and Research & Program Evaluation Director have identified some potential tools to assess the change process within the program. As mentioned above, a new computer system for recording client participation in clinical services is online. It is anticipated this electronic recording system will advance research and internal program reviews. In 2012, the first training plan and accompanying materials were developed and delivered to the SRB. Providing current research within the sexual offense treatment and assessment field is critical for board members reviewing client petitions seeking provisional discharge. These training opportunities also keep the SRB abreast of changes in the program. An update meeting and training session now occur on a quarterly basis. This practice will continue into 2013.

Establish clear and accurate data collection and recording system to establish baseline clinical services provided in MSOP.

Demonstrate MSOP encourages law-abiding behavior and hold clients accountable for committing crimes within the program.

3. Learning Organization:

Research and implement tools which measure qualitative treatment experience of clients.

Develop and implement Special Review Board (SRB) member orientation and sustaining training.

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Goals

Increase MSOPs safety culture by updating training, improving communication; reducing staff injuries and creating backup staff for the MSOP Safety Director.

2012 Outcomes While there was initial progress with this goal over the last year (e.g., assessment of safety concerns at each facility), progress on this goal is stalled. In the first quarter, MSOP hired a Safety Director but he resigned from this position within the last quarter of the year. Safety continues to be a priority in MSOP so this position will be filled as soon as possible with the safety assessment process finishing up shortly thereafter. The number of recordable injuries, as well as Workers Compensation claims, ranged from 4 to 11 over the course of 4 quarters. These numbers, which serve as baseline data, will be compared against the quarterly data moving forward. The Deputy Director of the Office of Special Investigation attended the National Technical Investigators Conference in July to research this topic. While there is no single solution there are several products on the market that report they block cell phone signal within secure environments. OSI will research these products in terms of effectiveness and cost and will report back to MSOP executive staff in early 2013. This goal continues to be a strength for the program, which is significant given the number of new staff and the challenges of working with this complex client population. Externally, staff attended numerous conferences specific to research advancements, best practices, and clinical assessment tools for sex offender treatment. Staff has also been very involved in developing competency in continuous improvement. These techniques have been applied throughout the program to assess operational processes. In several cases, these evaluations have resulted in revised and more efficient program processes (e.g., incident reports). MSOP has also increased the use of internal experts to provide training within the program (e.g., sharing

MSOP will work towards the goal of 25% reduction in workplace injury incidents over the next three years by reducing the frequency and severity of employee injuries. This will be accomplished through regular review and follow-up of staff injuries utilizing Workers Compensation data and staff input.

Research options for combatting the use of cell phones by unauthorized persons within the MSOP.

4. Staff Development:

Provide training opportunities for staff to increase competencies in sex offender treatment and assessment.

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Goals

2012 Outcomes information from conferences, clinicians presenting their expertise on specific issues or populations). The Office of Special Investigation staff has utilized Century College, professional organizations, and other agencies to participate in quality training.

Provide opportunities for staff to increase their professionalism and competencies in conducting investigations, polygraphs, staff supervision, and surveillance in order to enhance public safety. 5. Responsibility to the Public:

There was a significant increase in positive and productive activity on this goal during the last year. Reintegration staff have developed a solid network of community relationships with nonprofits that advocate for reintegration resources for those with criminal backgrounds. Develop partnerships with community stakeholders and professionals who will be interacting with civillycommitted sexual offenders reintegrating in the community. Several appropriate housing resources have been identified and two half-way house contracts and one long-term housing contract are currently in place, even though there is only one client on provisional discharge. These efforts are actively supported through all levels of the program with on-site visits by the Reintegration Director, Executive Clinical Director and/or the Executive Director of MSOP. During the past year, MSOP developed a position for a Prevention Policy Director, who surveyed all of the current prevention efforts occurring within all administrations of the Department of Human Services. MSOP will remain actively engaged with sexual violence prevention partners in the community. However, in 2013, this position will be shifted to a more centralized role within DHS so the various prevention efforts within the agency can be coordinated and integrated rather than isolated or replicated. MSOP facilitated the first court-ordered discharge in several years. MSOP collaborated with the DOC Community Notification Unit, and half-way house staff for a successful community notification
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Position MSOP as a resource on sexual violence prevention and sexual offender treatment for outside stakeholders and partners.

Put Public Safety at the forefront of all program policies and decisions.

Minnesota Sex Offender Program Annual Performance Report 2012

Goals

2012 Outcomes meeting. MSOP Reintegration Specialists provide intensive and integrated transition services for the provisionally discharged client. Within the program, MSOP has developed several systems of checks and balances to create safe opportunities for community reintegration. MSOP uses the Community Outings Review team to review all outing requests for therapeutic value and community safety. The Reintegration Steering Committee provides consultation on, and directs, policy needs and changes with regard to the Reintegration Program. MSOP staff have provided, and in many cases initiated, several tours and presentations to increase awareness about the commitment process, nature and effectiveness of treatment, and reintegration programming.

Promote transparency by conducting pro-active outreach to stakeholders in community to educate them on civil commitment, MSOP treatment and our reintegration programming.

During the past year there has also been a focus on meeting with county and state government officials and nonprofit housing providers to explore housing, employment, and social support resources for individuals with sex offense histories. MSOP is also partnering with other state agencies with similar needs in hopes of reduce replication or competition for scarce resources. Within the last year, it was established the SRB would meet four times a month to match the need of review hearings for submitted petitions. By midyear, all of the reviews were up to date.

Increase Special Review Board (SRB) capacity.

During the third quarter, MSOP identified the need for additional SRB members if the hearings were going to keep up with the demand. By the close of the year, the SRB had 15 members with nine vacancies. These vacancies will be posted in 2013 to increase members from 15 to 24 to conduct more hearings.

Implement "End of Confinement Review Committee" This committee is responsible for reviewing clients (ECRC) for program. provisionally discharging from the program who do not have a risk level for community notification, as
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Goals

2012 Outcomes required by statute. Most clients are reviewed and provided with such a level by the Department of Corrections (DOC). However, for clients who were not assigned a level (e.g., they were incarcerated before level assignment became law), this review must be completed by MSOP. During 2012, MSOP legal staff have been developing an ECRC policy, and MSOP staff have consulted with DOC staff as to how the current ECRC process works. It is anticipated the formal MSOP policy on ECRC will be in place in early 2013, well in advance of the need to implement such a committee as MSOP clients are approved by the court for Provisional Discharge. MSOPs Office of Special Investigation has conducted surveillance on 183 outings this year and logged 13 law enforcement contacts during the year. To increase the integration of the surveillance into the client overall progress assessment, the OSI and the Reintegration Directors meet on a weekly basis to discuss observations during community outings.

Increase partnership with Reintegration and law enforcement to enhance public safety by conducting covert surveillance operations on MSOP community outings.

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Treatment Model and Progression

Program Philosophy and Approach MSOP draws on several contemporary treatment models in its programming. These models include cognitive-behavioral therapy, group psychotherapy, and relapse prevention. In addition, programming is influenced by the professional psychological literature in the areas of risk/needs/responsivity and stages of change, with additional philosophical influence from the Good Lives model. Each clients treatment is guided by an individualized treatment plan that defines measurable goals. These goals are updated as the client progresses through treatment. Clients progress through three phases of treatment. In the initial treatment phase, clients address treatment-interfering behaviors and attitudes. Following this preparation, clients in the intermediate treatment phase focus on their patterns of abuse and on identifying and resolving the underlying issues in their offenses. Clients in the final treatment phase focus on maintaining the changes they have made and demonstrating their ability to consistently implement those changes and manage their risk. Comprehensive and Individualized Treatment MSOP provides a comprehensive treatment program. Clients acquire skills through active participation in group therapy and are provided opportunities to demonstrate meaningful change through participation in rehabilitative services including education classes, therapeutic recreational activities and vocational work programs. Clients are observed and monitored not only in treatment groups, but in all aspects of daily living. This observation and monitoring is crucial for assessing clients progress in making and maintaining meaningful personal change and in consistently applying treatment concepts, thereby decreasing their risk for re-offense. All clients follow Individualized Treatment Plans. The plan is developed with the client and the clients primary therapist, and is based on the results of a sexual offender assessment. The plans goals are written to address the clients individual risk factors for recidivism and specific treatment need areas. Treatment progress is reviewed on a quarterly basis, and plans are modified as needed. Treatment Design MSOP clients who choose to engage in treatment participate in a sexual offender assessment that sets the foundation for their individualized treatment plan. Clients are then placed in programming

Section II

Primary Therapist Education Services Unit Staff

Health Services

Client

Sex Offender Treatment Staff

Vocational Services

Therapeutic Recreation

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based on their clinical profile. MSOP provides sex-offender-specific treatment to meet the needs of all clients. MSOP is one program at two facilities, one in Moose Lake and another in St. Peter. Each facility contributes to the mission of MSOP by specializing in different components of the treatment process. The Moose Lake facility houses individuals who have been petitioned for civil commitment but not yet committed, clients who refuse to participate in sex-offender-specific treatment, and clients participating in initial and primary stages of treatment. Individuals who have successfully demonstrated meaningful change and have progressed through treatment are transferred to St. Peter to begin the reintegration process. In addition to the components of reintegration, St. Peter is also the location of the Alternative Program for clients with compromised executive functioning and who therefore are not suited for conventional programming. These clients are in need of unique treatment approaches due to developmental disabilities, traumatic brain injuries, or severe learning disabilities. MSOP Treatment Units: Admissions: Clients newly admitted to MSOP and/or involved in the commitment proceedings but who have not been committed. Alternative Program: Clients with compromised executive functioning. Alternative clients may have cognitive impairments, traumatic brain injuries and/or profound learning disabilities. It is unlikely that these clients would be successful in a conventional cognitive behavioral treatment program and therefore they are in need of specialized programming. Assisted Living Unit (ALU): Clients who are medically compromised to the extent of requiring specialized care. Behavior Therapy Unit (BTU): Clients who demonstrate behaviors that are disruptive to the general population and/or affect the safety of the facility: criminal behavior, repetitive restrictions to maintain safety, threatening behavior (e.g., assaults on staff/peers, thefts, predatory type behaviors, etc.) are treated on this unit with the goal of returning clients to their units once the treatment-interfering behaviors have been resolved. Conventional Programming Unit (CPU): Clients who are motivated to participate in sexoffender-specific treatment and are meeting behavioral expectations. Corrective Thinking Unit (CTU): Clients who present with unique treatment needs including generally high levels of psychopathy and antisociality. Their traits often include: grandiosity, instrumental emotions, impulsivity, callousness, irresponsibility, conning and deception, belligerence, and lack of sustained effort in treatment. Mental Health Unit (MHU): Clients with significant mental health diagnoses including Axis I diagnoses that do not meet the requirements for a transfer to the Minnesota Security Hospital

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and/or significant personality disorders that result in persistent emotional instability and/or potential self-harm. Therapeutic Concepts Unit (TCU): A former unit for clients refusing to actively participate in sex-offender-specific treatment programming. During the third quarter of 2012, those clients were integrated into the other living units alongside clients who are participating in treatment to provide added encouragement and incentives for them to decide to enter into treatment participation. Young Adult Unit (YTU): Clients who are between the ages of 18 and 25 and do not meet criteria for the Alternative Program or CTU programming. Most of these men have not been incarcerated as an adult.

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Treatment Progression Clients progress through treatment by completing group module requirements, treatment assignments, risk management assessments, and by demonstrating they have changed their thinking and behaviors. Progress in treatment is assessed quarterly. Placement in treatment is determined by program matrix factors (See Appendix 1). These factors are reflective of the criminogenic needs of all sexual offenders. These treatment focused-areas are supported in the current professional literature and are indicators of risk for recidivism. On a quarterly basis, each client conducts a selfassessment and the results are compared to those the client's primary therapist and treatment team. Individual treatment plans are modified accordingly. Once clients have completed the majority of primary programming and have demonstrated meaningful change and successful risk management, they are assessed for and transferred to St. Peter to begin reintegration programming. MSOP Treatment Progression Model
Currently 15 Clients (2%)

Admissions Moose Lake

Currently Currently 541 489 Clients Clients (92%)

MH screening & Referral Assessment & Treatment Plan Intro to MSOP Treatment Readiness

Primary Treatment Moose Lake & St. Peter

Phases 1 & II I 2 Managing Behaviors Skills Acquisition Demonstrate Change Core / Psycho Ed Groups Recreational, Educ ., & Vocational Programming Phallometric and Polygraph Testing

Currently 22 27 Clients (4%)

MSOP Supervised Phase III Integration St. Peter (MSI) St. Peter
Maintain Change Maintain Change Maintenance Plan Development Phallometric and

Currently 10 clients (2%) 4 Clients (2%) (2%)

Community Preparation Services (CPS) (CPS) St. Peter St. Peter

Reside outside Secure Perimeter

Currently 1 client

Provisional Discharge
Halfway House Community -Based Housing

Polygraph Testing Incremental Privileges Community Based Programming GPS Monitoring Polygraph Testing

Discharge
Community -Based Housing

* This chart does not reflect the clients who do not agree to participate in treatment after leaving the Admissions Unit (as of 12/31/12, 90 clients).

Reintegration Reintegration is a transitional period designed to provide opportunities for clients to apply their acquired skills and to master increasing levels of privileges and responsibility while maintaining public safety. The focus of treatment during reintegration includes decompression from many

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years (often 15-20) of institutionalization. Clients are provided opportunities at a gradual pace to apply internalized treatment skills and behavioral changes. Reintegration Progression Model Phase III: Clients in Phase III are in the beginning of the transitional phase of treatment at MSOP and focus on solidifying skills for living safely in the community. After an adjustment period, clients progress and obtain increased privileges: accompanied on-campus, accompanied off-campus, and unaccompanied on-campus liberties. All Phase III clients with these privileges have Area Monitoring System (AMS) electronic monitoring bracelets.

Adjustment Period (3 6 months)

Identification of clinical goals Maintenance Plan Development Sexual arousal / interest assessment

Privilege I Escorted On Campus Outings (3 4 months)

Three walks per week (3 hours each w/ pre and post -processing) Increase 2 -3 hours per week every 3 weeks (max @ 16 hours / week) Ankle bracelets track movement

Privilege II Escorted Off Campus Outings (6 9 months)

16 hours / week on campus outings. Develop community support network Family meetings

Privilege III Unescorted On Campus Outings Weekly community outings (6 - 9 months)

Weekly community outings On -campus walks with peer, then solo

Maintenance polygraphs

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Community Preparation Services (CPS): After Phase III, clients have demonstrated consistent application of newly acquired skills and management of community environmental triggers, a client is generally considered ready for transfer to CPS, which can only occur via the judicial appeal panel process. CPS clients have both AMS and GPS monitoring. CPS clients typically participate in oncampus vocational opportunities, and are allowed campus privileges and escorted community outings.

Stage 1: Orientation & Adjustment (3 6 months)

Weekly therapeutic off-campus group outings with two escorts GPS, other monitoring and testing tools used Unaccompanied oncampus walks (16 hrs / week) Begincommunity--based Begin communitybased services

Stage 2: Maintenance & Growth (6 12 months)

Off campus group & individual outings Advance to outings with one escort. Introduce passes for Expand community outings to include local outings of SO maintenance limited time and and CD support groups targeted purpose Continue GPS, other monitoring and testing

Stage 3: Prepare for Provisional Discharge (6 9 months)

Extend community Extend passesTwin outings to the to more locations and Cities area to meet longer times support people

Strengthen community support network Continue GPS, other monitoring and testing

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MSOP Treatment at the Department of Corrections

MSOP operates a collaborative, 50-bed, sex offender treatment program located at the Minnesota Correctional Facility in Moose Lake. Program participants are still serving their correctional sentences and have histories that indicate they are likely to be referred for civil commitment. Two outcomes may occur as the result of a client participating in this treatment prior to the end of their sentence in DOC: 1. 2. The client is viewed as having made such significant progress toward management of risk factors that the county does not petition for civil commitment. The county pursues commitment, and the client is civilly committed to MSOP and is able to begin treatment where he left off from the DOC site.

Section III

There have been 287 men who have been admitted to the MSOP-DOC program since 2001. As of January 1, 2013, there are currently 50 clients in the program. Of the 237 men who have been discharged from the program, 70 (29.5%) are still in DOC and 167 (70.5%) are not.

Commitment Status of Men Discharged from MSOP-DOC:

Of the 237 men discharged from the program: 117 (50%) were civilly committed, 11 (5%) were not referred to the county for review by the DOC (reside in the community or DOC), 40 (17%) the county did not pursue the commitment (reside in the community or DOC), 23 (10%) the petition was pursued by the county and dismissed by the courts (reside in the community or DOC), 12 (5%) DOC referred the petition to the county and it is pending, 31 (13%) have not yet been reviewed for referral by the DOC (reside in DOC not yet reviewed due to Scheduled Release Date) 3 (1%) are deceased
Dismissed 7% Not Forwarded 2% Not Yet Reviewed 18% Pending 7%

Disposition of MSOP-DOC Clients

Civilly Committed 50%

Did Not proceed 16%

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Section IV
Minnesota Sex Offender Program Fiscal Year 2012 & 2013 Per Diem
Description Direct Costs Clinical Healthcare and Medical Services Security CPS & Community Preparation Dietary Physical Plant & Warehouse Support Services Total Direct Costs Operating Per Diem Indirect Costs Statewide Indirect DHS Indirect Building Depreciation Bond Interest Capital Asset Depreciation Total Indirect Costs Total Costs Average Daily Client Count (ADC) Published Per Diem Rate FY2012 Annual $$ Per Diem FY2013 Annual $$ Per Diem

13,993,781 5,792,482 30,572,076 1,033,455 1,955,667 7,195,980 9,872,559 70,416,000

58.28 24.13 127.33 4.30 8.15 29.97 41.12 293.28 293

14,760,094 5,902,718 31,886,571 1,053,122 2,079,563 7,832,925 9,897,007 73,412,000

58.35 23.34 126.06 4.16 8.22 30.97 39.13 290.23 290

390,799 0 2,105,764 3,070,200 193,224 5,759,987 76,175,987 656

1.63 0 8.77 12.79 0.80 23.99 317.27

37,030 0 3,689,097 5,065,200 175,797 8,967,124 82,379,124 693

0.15 0.00 14.58 20.02 0.70 35.45 325.68

317

326

*Minnesota Management & Budget charges for services such as central purchasing, payment processing, electric fund transfers, and other services provided to all state agencies. *Allocated cost of agency central functions such as, but not limited to: financial operations, budgeting, telecommunications and media services, occupancy, compliance and internal audit, legislative coordination, and licensing.
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MSOP Per Diem While there are 21 civil commitment programs (20 state programs and one federal program) in the country, there is no uniform method for calculating the per diem cost of program operations. A survey conducted by MSOP Financial Services revealed that most programs do not include all costs associated with operating and maintaining a program. MSOP uses a comprehensive per diem calculation that includes all direct and indirect costs, including costs incurred by the state for bonding and construction of physical facilities. This all-inclusive per diem for fiscal year 2012 is $317 and for fiscal year 2013 is $326. The marginal per diem, which is the estimated additional costs for each new admission into MSOP, is currently $151.

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Annual Statistics
Current Program Statistics As of December 31, 2012 Total MSOP Clients Clients by Location Moose Lake St. Peter Clients by Age 18-25 26-35 36-45 46-55 56-65 Over 65 Average Age Youngest Oldest Race American Indian/Alaskan Native Black/African American White Caucasian Other/Unknown 678 498 180 17 146 158 184 104 69 46 19 90 51 90 510 27 Education 0-8 Years 9-12 Years High School Degree GED High School degree and GED Some college or college degree Unknown 30 77 320* 207* 6 20* 18

Section V

Civilly Committed Offenders by County Hennepin 143 Ramsey 63 Olmsted 36 Dakota 26 Anoka 25 Beltrami 17 Other Counties 368 Metro Counties (7-County Area) Non-Metro Counties 280 398

* These numbers are more specific than in prior years due to a new computer data query option. In prior years, some of the high school graduates and GED recipients were included in a more general "12+" category.

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Population Statistics When civil commitment is pursued for an individual, upon expiration of a DOC sentence or a supervised release date, he or she is placed on a judicial hold while the petition is pending. Individuals on judicial holds have the option to remain in a DOC facility (210 days maximum) or to be admitted to MSOP. As of December 31, 2012, there were 20 individuals on hold status. It is a cost savings to the MSOP when individuals choose either to be held in a county jail or to remain in a DOC facility. Clients Pending Civil Commitment: Clients on judicial hold status in the MSOP Clients on judicial hold status in the DOC / jails Total on judicial hold status 9 11 20

Until May, 28, 2011, the civil commitment process in Minnesota had two phases after a county attorney filed a petition for commitment. During an initial hearing, the court determines if the individual meets the statutory criteria for civil commitment. If this burden is met, the individual is initially committed and transferred to MSOP (if the client is not already admitted). Sixty days after this hearing, per the former statute, MSOP was required to submit a report to the committing court indicating whether or not the clients status remained the same. Specifically, did the client still meet the statutory criteria for civil commitment? If the court determined there had not been significant change since the initial commitment, the clients indeterminate commitment was made final. Effective May 28, 2011, a change in Minnesota statutes eliminated the second phase of the civil commitment process for SPP/SDP commitments to MSOP and, thereby, the 60-day review of the commitment to MSOP. Clients Civilly Committed to the MSOP: Clients who have been initially and finally committed during 2012* Clients previously committed whose cases were reviewed and finalized for commitment during 2012 Total civil commitments to the MSOP during 2012 20 21 41

*Includes only those clients who needed just the initial commitment process due to the amended statute

Many clients who are civilly committed to the MSOP also still remain under DOC commitment on supervised release status (dually committed). If these clients engage in actions or criminal behaviors which result in the DOC revoking their supervised release status or result in a new conviction, the clients are returned to DOC to serve a portion or all of their criminal sentences (15 clients in 2012). However, even in DOC custody, these clients still remain under civil commitment and will return to the MSOP upon completion of their periods of incarceration. This is a pending cost liability for the program and its bed spaces. Civilly-Committed Clients Currently in Correctional Facilities: Clients who are under civil and DOC commitment in the MSOP Clients who are under civil commitment and in a DOC or federal prison Total number of dually committed clients as of December 31, 2012
Minnesota Sex Offender Program Annual Performance Report 2012

203 35 238

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Clinical Statistics
Treatment Participation All new admissions are assessed for individualized treatment needs. While on the admissions unit, clients are able to participate in groups geared toward adjustment issues and treatment readiness as well as rehabilitative programming. Of the clients eligible for sex offender-specific treatment, approximately 86% were participating at the end of 2012.

Percentage of Participation in Sex Offender-Specific Treatment, by Quarter, 2012*

*Clients in the Admissions/Assessment phase were not included in this chart.
100%

85%
80% 60% 40% 20% 0% 2012 1st Quarter

86%

86%

86%

525

540

560

573

2012 2nd Quarter Participating

2012 3rd Quarter

2012 4th Quarter

* This data does not include those clients who are on admission status or residing in DOC.

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Once the civil commitment process is finalized, and an individual has participated in the sex offender evaluation process, he or she has the opportunity to participate in sex offender-specific treatment. The chart below represents the treatment progression of clients over the past calendar year.

Treatment Progression

Minnesota Sex Offender Program 2012 Proportion of Participating Clients in Different Phases of Treatment Progress
70% 60% 50% 40% 30% 20% 10% 0% Admission Phase I Phase II 2012 2nd Quarter Phase III 2012 3rd Quarter CPS Provisional Discharge 2012 4th Quarter 4% 4% 3% 2% 4% 4% 4% 4% 2% 2% 2% 2% 0% 0% 0% 0% 36% 31% 28% 25% 65% 62% 60% 56%

2012 1st Quarter

* 1 Client was Provisionally Discharged in the 1st Quarter of 2012

* This data does not include those clients who are not participating in treatment.

As a result of initial and ongoing clinical assessments, clients are placed in treatment units appropriate to their individual treatment needs and abilities. The following chart illustrates the year-end distribution of clients across the treatment units. The MSOP population is diverse with 43% of the clients residing on units that provide specialty programming while 42% reside on units providing Conventional Treatment. The remaining 15% of the population resides on programming units that do not provide sex-offender specific treatment (ADM and TCU).

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Programming Admissions (non-participants) Alternative Programming Assisted Living Unit Programming Behavioral Therapy Unit programming Community Preparation Services Conventional Programming Corrective Thinking Unit Programming Mental Health Unit Programming Young Adult Treatment Unit Programming Total
Note:

Location Moose Lake St. Peter Moose Lake Moose Lake St. Peter Moose Lake and St. Peter Moose Lake Moose Lake Moose Lake

Total Clients Percentage 15 2% 107 16% 21 3% 13 2% 10 1% 403 60% 66 10% 22 3% 21 3% 678 100%

There is no longer a unit designated for non-participants, who now reside on various units. Also, this is not a housing unit census, but rather a programming census. A program track can occur across various housing units.

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Reintegration Statistics
As of December 31st, the end of quarter four, ten clients were residing in Community Preparation Services (CPS) at the Green Acres facility. The construction for the new expansion project at CPS which began in October, 2011 was finished on schedule during the first quarter of 2012. This expansion of the Green Acres facility increased the CPS unit occupancy from eight to 23 beds. At year end, four clients were in CPS Stage 3, four clients were in Stage 2, and two clients were in Stage 1.

2012 Community Preparation Services Client Progression

12 10 8 6 4 Number of clients 2 0 Jan-Mar 2012 Stage One Apr-Jun 2012 Stage Two Jul-Sep 2012 Stage Three Oct-Dec 2012

Client Outings Staff accompanied the nine to ten CPS clients on 958 outings into the community in 2012, without incident. Clients participate in more than one activity on some of their outings.

2012 Total Number of Client Outings

300 200 100 0 Jan-Mar Apr-Jun Jul-Sep Oct-Dec

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Types of Outings

Jan-Mar 2012 Number of outings

Apr-Jun 2012* Total Hours

Jul-Sep 2012 Total Hours

Jul-Sep 2012 Number of outings

Oct-Dec 2012 Total Hours

Oct-Dec 2012 Number of Outings

Programming: AA 58 150 125.5 56 150 60 SO Maintenance 25 61 107 37 86 30 Treatment: SO Treatment 26 178 131 42 92 35 Reintegration: Banking 8 6 3.75 8 3 3 Recreation 20 167 197.25 38 88.75 20 Volunteer 26 91 148.25 49 204.5 58 Library 3 1 1 1 1.75 3 Prosocial activity 24 180.7 169.75 21 317.75 41 Mentoring 0 0 0 0 0 0 Other 9 18 53.75 21 51 21 * During the 2nd quarter, April June, 2012, the data measured changed from number of outings per quarter, to the total number of client hours per activity.

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Program Census Report

Unit Census

Minnesota Sex Offender Program 2012 4th Quarter Unit Census as of December 31st, 2012 Note: the "#/#" indicates ~ beds occupied/ unit capacity Total Program Bed Capacity: 740, Total Currently Occupied (based on census): 668 Beds Available: 72 (90% capacity)*
Complex 370 (93%) 30

Main

128 (81%)

30

Pexton

107 (92%)

Shantz 0

63 (95%) 3 50 100 150 200 250 300 350 400 450

* Green Acres has 23 licensed beds outside of the secure perimeter of which 10 are occupied.

Key Beds Occupied Beds Available

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Office of Special Investigation (OSI)

The Office of Special Investigations (OSI) provides the Minnesota Sex Offender Program (MSOP) with coordinated investigative services with the goal of aiding MSOP staff in providing a safe and secure treatment environment and to enhance public safety. In the event that illegal activities are suspected, OSI is responsible for conducting an investigation and providing information and reports to local law enforcement if it is believed a crime has occurred. Responsibilities of OSI include (but are not limited to) investigation of suspected criminal activity, coordinating information collection and dissemination on security threat groups and individuals, conducting covert surveillance on clients escorted into the community and those on provisional discharge, investigating circumstances that pose a threat to the security of the facility, and serving as the official liaison with local, state, and federal law enforcement agencies. In 2012, OSI completed 386 investigations focusing on client misconduct (there were 439 in 2011). Fifty-three of these cases were referred for criminal charges, with charges being filed in 39 cases (one from 2009, one from 2010, and ten from 2010). OSI also provides information to the Department of Corrections (DOC) regarding non-compliant clients who are on conditional release from the DOC. In 2012, 17 clients were returned to DOC for revocations of conditional release or new criminal convictions. The range for days spent in DOC by MSOP clients was 64 to 2093 days, with 302 being the average.

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Section VI
MSOP Evaluation Report Required Under Section 246B.03
In effort to maintain a treatment program that is grounded in current best practices, research, and contemporary theories, MSOP contracted with outside auditors to review the treatment program. This team consists of three professionals who are well respected, both nationally and internationally, in the area of sexual abuse treatment. Individually and as a group, they have consulted with similar programs throughout the world. They bring not only a perspective of current practices, but also years of professional experience. In 2012, they visited the Moose Lake facility. The focus of their consultation is the integrity of the clinical program design. The report generated as a result of this visit is contained within Appendix 1.

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Appendix 1

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