NDOC 2061 Google

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Dec 6, 2023

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Nevada Department of Corrections Instructions to complete form DOC 2061 Proposal for an Evidence-Based Correctional Program/Class Section 1 - Name of proposed correctional program/class ("intervention") This is the official program/class name as it will be listed in the approved merit credit programs/classes roster (e.g., Thinking for a Change). Section 1.a) Date proposal submitted This is the date the proposer emails the form to the Program Review Committee at the following address: ndocprogramreviewcommittee@doc.nv.gov Section 2 - Proposer's Information This is the proposer's contact information. The "proposer" is the person who fills out the form and answers any questions regarding the proposal. Section 3 - Proposer's Program Area Choose only one area. If the proposer's area is not listed on the form, check the "other" box and specify the area. Section 4- Which criminal-producing risk factor(s) does this intervention address? Check all the boxes that apply. However, the proposer only needs to identify one risk factor to meet this criterion. If the proposed intervention does not address at least one of the risk factors, the intervention does not qualify as an evidence- based practice for offenders. At the same time, the intervention may meet the criteria for an optional program or activity (see AR 801 ). Section 5.a) - Is the intervention listed on Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence- Based Programs and Practices? (See: www .nrepp.samhsa.gov/) Note: The intervention does not need to be listed on the registry in order to be considered an evidence-based practice. Section 5. b) - Does the National Institute of Corrections (NIC) recognize the intervention as an evidence-based practice? (See: http://nicic.gov/) Note: The intervention does not need to be recognized by NIC in order to be considered an evidence-based practice. I of 4 DOC 2061-I / Instrnctions (11/13)
Section 6 - What criminal-risk area(s) does the intervention target? Check only the area(s) that apply as listed in the curriculum or manual. Note: If a particular risk area is not specifically identified in the curriculum, do not check the box (e.g., a person's mental health may improve as a result of participating in Thinking for a Change, but the program is not specifically designed to target that area.) Section 7 - Briefly, list the primary intervention goals per the curriculum or manual. Refer to the curriculum or manual for this section. The goals are usually found in the beginning of the document. List only the goals that are identified in the ---------"'-1JFFie1Jl1Jm-0r-manua<-.---------------------------- Section 8.a) - What performance indictors(s) will be used to determine whether the intervention is having the desired effect on the inmates? Check only the boxes that specifically relate to the intervention goals that were identified in Section 7, above. Section 8.b) - For each performance indicator checked, identify an objective instrument, such as a pre- and post test that will be used to evaluate the inmates' targeted behavior. --·· -If none of tnelistea-inaicators relatefotne p~r-o~po~s~e~a~p-r-o-g-ra~m~7class, cnecl<the- --- -- "other" box and specify the indicator(s) that will be used for evaluation. Section 8.c) - For each performance indicator checked, attach a performance indicator instrument(s) Attach a copy of each instrument, as listed in 8.b). Section 9 - How will the facilitator's supervisor evaluate whether the facilitator is maintaining fidelity to the practice? If none of the listed methods apply, check the "other" box and specify the method that will be used. Section 10 - How will inmates be prioritized for this intervention? Check at least one box. If none of the listed methods apply, check the "other" box and specify the method that will be used. Section 11.a) - Is this intervention a treatment program? A "treatment program" is defined as an intervention that is specifically for inmates who have been assessed by a qualified clinician and who meet the diagnostic criteria for a condition that is classified in the Diagnostic and Statistical Manual of Mental Disorders - Fifth Edition. The diagnosis needs to relate to the specific intervention as listed in section 7, above. Note: The intervention does not need to be a treatment program to qualify as an evidence-based practice. 2of4 DOC 2061-1 I Instructions (l 1/13)_revised 4-8-2020
Section 11 .b) - If this is a treatment program, which discipline is addressed? Check only one box. Section 12 - Do the facilitators need a certain educational level in order to deliver this intervention? If the answer is "yes", identify the level. Example: Master's degree. Section 13 - Do the facilitators need to be licensed or certified in a particular field in order to deliver the intervention? If the answer is "yes", list the field and the credential. Example: Substance ------ --dause, Gertifie El-- A~GGRGl - aHEl--Qn , 1§1 - GGblA-sel01-c . ----------------- Section 14 - Can a volunteer facilitate the intervention? A volunteer is defined as someone other than a NDOC staff. The volunteer must meet any educational, licensure, or certification requirements as listed in sections 12 and 13 above. Reminder: Per AR 801, Correctional Programs/Classes/Activities, inmates are prohibited from teaching or facilitating any correctional program or classes that are approved for meritorious credits. Section 15.a) - Do the facilitators need to be trained by the developer of the intervention in order to deliver it? Some developers require the facilitators to be trained before they can deliver the intervention. Example, in order to facilitate the Cognitive Behavioral Interventions in Substance Abuse curriculum, the facilitator must first be trained by the developer. Training requirements can usually be found at the beginning of the source document or by contacting the developer. Section 15.b) - If the facilitators need to be trained by the developer, how will the training be obtained? If the facilitators must be trained by the developer, list the training funding source(s). Examples: general funds, grant, or donations. Section 16.a) - Does the intervention include facilitator and participant manuals? Check only one box. Section 16.b) If the intervention includes manuals, are they free of charge or otherwise available in the public domain? Check only one box. If the manuals are in the public domain but have restrictions, list the restrictions (e.g ., training by the developer). Section 16.c) - If the manuals are not available free of charge in the public domain, how will funding be obtained? If the materials are not free, list the funding source(s). Examples: general funds, grant or donations. 3 of 4 DOC 2061-I / Instructions ( 11 /l 3 )_revised 4-8-2020
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Section 17 - Which evidence-based practice (EBP) level are you requesting for this intervention? The levels range from Level 5, which is the gold standard of scientific rigor to Level 0, which has no scientific merit. To determine the level, refer to pages six and seven of DOC 2061. Attach copies of all supportive documents (e.g., journal articles). Note; If you have any questions, please send an email requesting assistance to: ndocprog ramreviewcomm ittee@doc.nv.gov - - - ---- -- -- ----------- - --- --- -- -- 4 of4 DOC 2061-1 / Instructions (11/13)_revised 4-8-2020
Nevada Department of Corrections Proposal for an Evidence-Based Correctional Program/Class (Please submit a completed DOC 2060 AND DOC 2061 via e-mail to: ndocprogramreviewcommittee@doc.nv.gov ). Prior to completing this form, please see DOC 2061-lnstructions 1. Name of proposed conectional program/class ("intervention"): a)Date proposal submitted: 2.Proposer's Infonnation: a) Name: b) Position: c) Phone: d) Email: 3.Proposer's Program Area 4. Which crime-producing risk factor(s) does this intervention address? D Case Work D Education D Mental Health D Re-Entry D Substance Abuse D Transitional Center D Vocation D Other (specify): Check all that apply, but you only need one: D Antisocial behavior D Antisocial personality D Criminal associates D Criminal thinking D Dysfunctional family D Leisure and recreation D Mental health issues D Substance abuse D Unemployment and education D None (If none, the intervention does not qualifv as an evidence- based practice for offenders)_ 5. a) Is the intervention listed on Substance Abuse and Mental Health Services Administration (SAMHSA's) National Registry of Evidence-Based Programs and Practices? (See: www.nrepp.samhsa.gov /) Page I of7 Yes No DOC 2061 (11/13) ---- ---
5. b) Does the National Institute of Corrections (NIC) recognize the intervention as an evidence-based practice? (See: http://nicic.gov/) 6. What criminal-risk area(s) does the intervention target? Yes No Unknown Check only the area(s) that apply, as listed in the curriculum or manual): D Anger/hostility/aggression D Antisocial peers D Co-occurring substance abuse and mental health issues - - ---+- - - - - - - - - - - - - --+-�EJ=i-e r i m i na l tliink i ng11::5el:!a v i or - - -- --- ------------- --· 7. Briefly, list the primary intervention goals, per the curriculum or manual. If more than six, attach on a separate page. 8. a) What performance indicator(s) will be used to Page2 of7 D Domestic violence D Family issues D Gang involvement D Interpersonal conflict D Lack of constructive use of leisure time D Lack of education D Lack of emotion regulation D Lack of healthy life skills D Lack of marketa_i)le job_skills D Lack of reliable re-entry plan D Lack of social skills D Lack of victim awareness/empathy D Mental health issues (including abuse history, trauma) D Negative attitude about work or school D Parenting issues D Risk of relapse D Self-control, self-management, problem solving D Sexual deviancy D Substance abuse D Unhealthy communications D Other (specify): I. 2. 3. 4, 5. 6. Check only the indicator(s) that specifically relate to the intervention goals (as identified in section 7 above): DOC 2061 (I 1/13)
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determine whether the intervention is having the desired effect? 8. b) As applicable, for each performance indicator you check, please identify an objective instrument, such as a pre-and post test, which will be used to evaluate the inmates' targeted behavior. Percentage of inmates who demonstrate a positive attitude about school and increased pro-social values, as evidenced by earning High School Equivalency (HSE). Percentage of inmates who demonstrate positive attitudes about school and pro-social values, as evidenced by earning High School Diplomas Percentage of inmates who demonstrate positive attitudes about work and pro-social values, as evidenced by earning Vocational 8. c) Attach performance Certificates ---1-indfoator-instmment(s),~. --- - •----------------·-·---------1--- Percentage of mentally ill inmates whose mental health conditions stabilize, as evidenced by compliance with prescribed psychiatric medications Percentage of mentally ill inmates who have better symptom management, as evidenced by a reduction in the number of psychiatric appointments ·-·-- -·· ... -- - ------- 1 ·--Percentage-of.inmates who increase their-problem-solving skills-and· Pago 3 of7 ameliorate their high risk situations, as evidenced by role playing increasingly difficult situations and completion of staff-approved relapse prevention plans Percentage of inmates who demonstrate an increase in prosocial attitudes; values; and motivation to change, as evidenced by negative urinalysis tests Percentage of inmate.s who demonstrate an increase in prosocial attitudes and values, as evidenced by successful completion of the program or class Percentage of inmates who demonstrate a reduction in criminal thinking, as evidenced by scores on standardized pre- post tests (Attach copy of performance indicator instrument) Percentage of inmates who demonstrate a decrease in anger; hostility; and aggression, as evidenced by scores on standardized pre- post tests (Attach copy of perfonnance indicator instrument) Percentage of inmates who demonstrate increased motivation for change, as evidenced by scores on standardized pre- post tests (Attach copy of performance indicator instrument} Percentage of inmates who demonstrate improved social functioning, as evidenced by scores on standardized pre- post tests DOC 2061 (1 !/l3)
9. How will the facilitator's supervisor evaluate whether the facilitator is maintaining fidelity to the practice? 10. How will inmates be prioritized for this intervention? 11.a) Is this intervention a treatment program? i 1 l.b) If this is a treatment program, which discipline is addressed? 12. Do the facilitators need a certain educational level in order to deliver this intervention? Page 4 of7 (Attach copy of performance indicator instrument) Percentage of inmates who increase prosocial peer associations and prosocial values, as evidenced by participation in volunteer-sponsored groups, organized peer-support meetings, and religious activities (e.g., (Veterans, Pups on Parole, Toast Masters, Alcoholics Anonymous and God Behind Bars). Percentage of inmates who improve parenting skills, as evidenced by role plays and scores on a standardized pre- post test (Attach copy of performance indicator instrument) Percentage of inmates who demonstrate improved pro-social attitudes and values, as evidenced by Parole Board approving re- entry plans Percentage of inmates who demonstrate positive attitudes about work and pro-social values, as evidenced by obtaining and maintaining employment · · Other-(specify): D Record/chart reviews D Inmate feedback on surveys/interviews D Group/class/session observation D Other (specify): D Risk and needs assessment D NOTIS Secondary Education Services Eligibility Report D Mental Health assessment D Release date eligibility D Sex offender assessment D Other (specify): 0Yes No D Co-occurring (a substance related disorder(s) with a mental health disorder(s)) D Mental health D Sex offender D Substance related disorder 0 Not Applicable D Yes (If yes, what level?): No DOC 2061 (11/13)
13. Do the facilitators need to be licensed or certified in a particular field in order to deliver this intervention? 14.Can a volunteer facilitate this intervention? (A volunteer is someone other than DOC staff) 15. a) Do the facilitators need to be trained by the developer in order to deliver this intervention? 15.b) If the facilitators need to be trained by the developer, how will the training be obtained? 16.a) Does this intervention include facilitator and -- ------·- -participant-manuals?---- ------- - 16. b) Are the manuals available free of charge in the public domain? 16.c) If the manuals are not available free of charge in the public domain, how will funding for the materials be obtained? 17. Which evidenced-based practice (EBP) level are you requesting for this intervention? (See this page below and on page 7) (Attach documentation that supports the practice level you are requesting) Page 5 of7 D Yes (If yes, list field and credential): No Yes No Yes LI No D Will be obtained by (list): D Not applicable Yes No --- ·---------------- . -- ·- D Yes, with no restrictions ---------- D Yes, with restrictions (list): No D Not applicable D Will be obtained by (list): D Not applicable Level 5 (EBP) Level 4 (EBP) Level 3 (EBP) - -- ------ ··----- - -- - - D Level 2 (Not EBP - Promising practice) D Level 1 (Not EBP � Anecdotal with public recognition) D Level O (Not EBP -Anecdotal only) DOC 2061 (11/13) ----------··· i
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Definitions for Evidence-Based Practice levels ~vidence-Based Practices: Program, practice, or intervention that is based on scientific research , nd has been shown to improve outcomes for offenders. ~on-refereed professional publication: Trade journals or magazines that use less rigorous tandards of screening prior to publication. 'eer-reviewed journal: Journal in which the articles it contains have been examined by people with redentials in the article's field of study before it was published. lefereed, professional journal: A professional or literary journal in which articles or papers are elected for publication by a panel ofreferees who are experts in the field. Evidence-Based Practice Levels LEVEL 5 - Evidence-Based Practice Experimental -- - ----- ----- - The intervention is based on a highly rigorous research design with a control group and random assignment. It has been studied in multiple places with multiple populations and has been generally shown to have high · credibility and generalizability. It has been determined the intervention generally has positive outcomes. Replication of the intervention has been documented in several refereed, professional journals. Attach articles from at least two refereed professional journals. LEVEL 4 - Evidence-Based Practice Quasi-Experimental The intervention is based on sound-theory and has some scientific rigor but no random assignment. The research design used multiple groups or multiple measurement points. A trained biostatistician has conducted a statistical review of many studies (meta-analysis) and determined the intervention generally has positive outcomes. The meta-analysis has been published in several refereed, professional journals. Attach articles from at least two refereed, professional journals. LEVEL 3 - Evidence-Based Practice Some aspects of research, some scientific merit: The intervention is based on sound-theory and multiple expe1is, usually individuals with doctorates and extensive research experience in the corrections or social services field, have reviewed the research and determined the designs met the standards of scientific rigor and the results were sufficiently positive. The practice has been modified or adapted for a population or setting that is different from the one in which it was formally developed and documented. A key indicator would be the research was published in a peer-reviewed journal. Attach a copy of an article that was published in a peer-reviewed journal, or Cite relevant published research (author, article title, name of journal, etc.) Page 6 of? DOC 2061 (11/13)
**************************************************************** THE THREE LEVELS BELOW ARE NOT EVIDENCE-BASED PRACTICES: LEVEL 2 - Not an Evidence-Based Practice Promising practice, but no scientific merit: The intervention is based on sound theory and has received some s01i of recognition from a group of expe1is in the conections or social services fields. The recognition should be in the fonn of acknowledgement in a non-refereed professional publication or trade journal. Attach a description of the intervention, including an identification of the theory -----~ •- Attach a copy of the ait 1cle(s), or Cite relevant published research (author, article title, name of journal, etc.). LEVEL 1 - Not an Evidence-Based Practice Anecdotal with public recognition; becoming a promising practice; no scientific merit: The intervention has not been sufficiently documented and replicated through scientifically sound research procedures. However, the intervention is building evidence through documentation of procedures and outcomes, and it fills a gap in the service system. It has also been recognized publicly and has received awards, honors, or mentions. Attach a copy of the award, honor, article, or other method of recognition. LEVEL O - Not an Evidence-Based Practice Anecdotal only, no scientific merit: The intervention is based solely on clinical opinion. Distribution: DOC 2060 as well as this DOC 2061 should be submitted via e-mail to: ndocprogramrc vicwcom mitt cc@doc.nv.gov Page 7 o f7 DO C 2061 (11/13)