Design & Principles

LEAD acknowledges that many systems, including the social service, child welfare, banking, housing, and health systems, have long been deeply fraught with racial injustice. LEAD seeks to shift discriminatory systems and decision-making through changes in policies, practices, beliefs, and investments, not only in the criminal legal system but in adjacent systems that have too often failed to provide sufficient or any assistance to people for whom only the criminal legal system has regularly responded.

No single organization or person owns LEAD. Stakeholders may have differing reasons for approaching the table and may have varied faith in its capacity to foster meaningful change, and partner involvement and commitment may ebb and flow accordingly. But maintaining a threshold level of commitment from all necessary partners is one of the primary duties of project management. Project managersThe Project Manager (PM) is responsible for coordinating all aspects of the LEAD initiative and managing its day-to-day … More must identify the organizational interests and needs of each partner and work to ensure that LEAD contributes to improving each partner’s situation and addresses each partner’s legitimate needs. Stakeholders committing to share responsibility for both achievements and difficulties is one of the key tenets of a LEAD project.

Changing complex systems requires patience and commitment. There are real public safety, order, and health issues that affect our communities and that demand action. Any effective transformation of past approaches must grapple with the legitimate need of all people for safety and security. LEAD was constructed in recognition that systems outside the criminal legal apparatus have frequently failed to provide the kinds of care, support, and investment that could effectively prevent crime and disorder.

It is not enough to divert individuals from the criminal legal system into other processes that defeat, reject, and fail them – LEAD is committed to helping communities build a pathway to recovery that is geared to the specific needs of people who too often have been either consigned to enforcement systems or abandoned without resources.

Building consensus for a better approach requires questioning long-standing articles of faith about how communities tackle common problems, making room for the insights generated by many diverse points of view. That’s what the LEAD framework provides.

LEAD guides communities to do what will successfully reduce harm, foster stabilization and recovery, reduce crime, and improve safety. Succinctly put, “Do what works and doesn’t make it harder for people to stabilize and recover.” All operational partners are asked to make decisions within their authority and discretion that are most likely to actually foster behavior change, based on individual circumstances and information available to them as a result of their participation in LEAD.

LEAD recognizes relationships – in and of themselves – as a core resource and a primary method for change; this is as true for stakeholder partners as for LEAD participants. All relationships are important in LEAD, including participants with case managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More, case managers with police and prosecutors, project managersThe Project Manager (PM) is responsible for coordinating all aspects of the LEAD initiative and managing its day-to-day … More with neighborhood leaders and public officials, and policy-makers with one another. It is not unusual to hear partners invoke the maxim that “relationships are the resource.”

LEAD emphasizes participant-driven goals and intrinsic motivation over compulsory- or compliance-based expectations and systems. This evidence-based approach, using motivational interviewingMotivational Interviewing (MI) is a foundational technique for LEAD. An evidence-based approach to supporting positive b… More and trauma recovery techniques, is both ethical and pragmatic. It recognizes that recovery is non-linear, that trust, safety and confidence-building are among the greatest resources relevant to recovery that we can foster.

Whether it’s the distressing evidence of human suffering on our streets, the disruptions and fear caused by public disorder, or the harm and setbacks caused by entanglement in the criminal legal system: LEAD recognizes that it’s in everyone’s interest to do far more to address the human needs that cause problematic behavior. This is actually a core principle of the harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More movement:

Harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More does not attempt to minimize or ignore the real and tragic harm and danger that can be associated with illicit drug use.¹National Harm ReductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More Coalition, “Principles of Harm Reduction”

As a health and safety strategy, LEAD takes all forms of harm seriously – both individual and systemic. This includes harm people can cause themselves, their families, and the community through disruptive or unlawful conduct that can stem from unmet behavioral health needs, substance use disorder, poverty, and living unsheltered.

It also includes the harmful failure of many systems to meet the legitimate needs of many people – quality education, housing, health care, financial resources and physical safety – and recognizes the setbacks and tragedies experienced by so many who were unnecessarily pulled into a punitive system when meaningful support would have been the best response to their situation.

Harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More education and training are essential to ensure that LEAD stakeholders understand the efficacy, research base, logic, and value of harm reduction-based interventions to support behavior change for individuals with complex needs and high barriers. Case managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More and supervisors should be well-versed in the logic and practical skill set required to operate effectively in a harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More program.

In working with people, harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More refers to a philosophy and practice of meeting people where they are, without preconditions, and working with them on concerns that matter to them, building over time, as they are able, to reduce behavior that is risky for them, and actions that are problematic for others. Harm reduction is a change strategy that is strength-based, trauma-informed, and highly pragmatic; it is based on connection and non-judgmental care, but it is not indifferent to the problematic situations individuals face.

LEAD’s harm reduction case managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More supports participants to build resources and strength to tackle behaviors that undermine their own goals or pose problems for others This is a core tenet of the LEAD model.

Harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More is commonly considered a direct-service methodology, a way to deliver care to individuals. But it can be viewed through a wider lens, as well. The LEAD model provides local stakeholders with the opportunity to reduce systemic harms by collectively shifting both policies and practices:

• At the policy level, stakeholders work to reduce harm by ending overuse of the criminal legal system for challenges that can be better addressed as issues of public health. This includes cultivating shared commitments to build voluntary, non-punitive diversion pathways to community-based responses and care.
• In day-to-day practice, LEAD replaces the office- or clinic-based care model with street-based, low-barrier, non-contingent intensive case managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More for the people LEAD is intended to reach. Case managersLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More are a “golden thread” that stays with participants no matter what, and helps navigate hostile systems, recruit needed resources, and buttress participant confidence and strength to tackle important goals. Demonstrating the efficacy of this approach can catalyze systemic shifts in how care strategies are designed. The reduction in harm is both for individuals, who receive more effective care and support, and for communities who enjoy reduced disorder and problematic behavior.

By shifting systemic policies and practices and making space for a new kind of low-barrier, street-based direct services and case coordination, the LEAD model fosters systemic harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More.

LEAD acknowledges that many systems, including the social service, child welfare, banking, housing, and health systems, have long been deeply fraught with racial injustice. LEAD seeks to shift discriminatory policies, systems, and decision-making through changes in policies, practices, beliefs, and investments, not only in the criminal legal system, but in adjacent systems which have too often failed to provide sufficient or any assistance to people for whom only the criminal legal system has regularly responded.

• Capture and Review Racial Data
  Sites should establish mechanisms to capture and review race data throughout the LEAD continuum, including diversion-eligible arrests, rates of arrest diversionsArrest diversions give law enforcement officers the option of referring people to LEAD at the point of arrest (either pr… More, social contact referralsSocial contact referrals give law enforcement officers the opportunity to refer people whose law violations may be relat… More, and community referralsCommunity referrals provide community partners with the opportunity to refer people who are known to chronically engage … More, enrollment, retention, and service provision. Sites should assess the relationship of various operational choices on racial disparity, adjust policies and procedures to reduce disparities if any are discerned, and provide transparent insight to partners regarding any barriers they encounter in the effort to ensure that this intervention reduces, and does not exacerbate, racial inequities.
• Consult Experts, Advocates and Agencies
  LEAD sites are encouraged to work with civil rights, racial justice, and harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More advocates and agencies to ensure that a commitment to reducing racial disparities and equity is at the forefront of collective intention. These partners should be at the governing table and should consult regularly on technical design questions.

It is important to safeguard LEAD against what is known as “net-wideningNet-widening is the phenomenon in which a society or community increases the array of behaviors (and thus people) subjec… More,” in which policies and practices explicitly intended to reduce criminal legal involvement paradoxically increase the circle of people brought into contact with it.

Two features of the LEAD model guard against net-widening: (i) social contact referralsSocial contact referrals give law enforcement officers the opportunity to refer people whose law violations may be relat… More by law enforcementThe term “law enforcement” is used throughout this toolkit to describe police officers, sheriff’s deputies, and others… More and community referralsCommunity referrals provide community partners with the opportunity to refer people who are known to chronically engage … More, for use neither arrest nor calling 911 for police response is necessary and (ii) focusing approval of community referrals on those who are likely to otherwise be exposed to the criminal legal system in the absence of LEAD.

Often, harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More and recovery have been framed as distinct concepts. Revisions to the SAMHSAThe Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Healt… More working definition of recovery in recent years have unified these frameworks. Today, SAMHSA defines recovery²Defining Recovery, SAMHSA as “a process of change through that individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.”

Note that this holistic concept of recovery contains no predetermined objectives, thresholds, or requirements. This modern definition accepts that recovery is a non-linear journey that typically includes relapse and setbacks and which is individually defined; recovery may end in abstinence from psychoactive substances, but it also may not. This definition embraces concepts of harm reductionHarm reduction is a theory and practice that aims to reduce the level of harm (for oneself and for a larger community) t… More and gradual improvement of life prospects, rather than applying black and white litmus tests.

SAMHSA’s recovery framework recognizes four primary dimensions³The Four Dimensions of Recovery, SAMHSA:

• Health: Overcoming or managing one’s disease(s) or symptoms, and making informed, healthy choices that support physical and emotional well-being
• Home: Having a stable and safe place to live
• Purpose: Conducting meaningful daily activities, such as a job, school volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society
• Community: Having relationships and social networks that provide support, friendship, love and hope

Fully aligned with these precepts, LEAD’s harm reduction-based intensive case managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More is grounded in the evidence of what best supports people living with complex needs.

Consistent with its evidence-based approach, LEAD focuses on supporting people on this sometimes bumpy road. Thus, people do not “fail out” of LEAD. Once referred and enrolled, participants are not required to comply with a fixed schedule or timelines. Participants may be characterized as “active” or “inactive,” but they are not removed from LEAD for failure to achieve or sustain any specific goal.

However, the case managementLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More team can and should discharge individuals who are not benefitting from the program after an extended period of effort by the case managerLEAD-style case management is the heart and soul of LEAD’s effective, coordinated system of care, one that reorients e… More, either due to sustained lack of engagement or because there is no observable behavior change for an extended period. This is to ensure that valuable resources are allocated to individuals who can best benefit from them. Participants who are officially discharged may return, if circumstances change.

Of course, participants may also be discharged at the discretion of case management supervisors in the rare instances where they threaten or harm a staff member, or if the location or dynamics of program staffing makes continuation in the program inconsistent with the safety of other participants.

The Stages of Change theory is often mentioned in reference to supporting a desired behavior change with LEAD participants. But it should be mentioned that the LEAD recognizes that the Stages of Change theory is also relevant to the development of positive new behaviors among all of LEAD’s stakeholders, whether high-level decision-makers, direct-service staff, rank and file officers, reform advocates, or community members.

In LEAD, everybody is encouraged to continuously re-assess their assumptions, policies, and actions to reduce harm and make space for positive change. In a healthy LEAD ecosystem, it can be expected that the perspectives and approach of all partners will change over time due to the mutual learning everyone has the chance to experience.

Though “less punitive,” some forms of control can subject more people to criminal supervision

Net-wideningNet-widening is the phenomenon in which a society or community increases the array of behaviors (and thus people) subjec… More can occur when intended criminal legal reforms result in a larger number of people being subject to criminal legal supervision. For example, when probation or electronic monitoring are perceived as “less punitive” alternatives to jail, their use can end up increasing the overall number of people subject to carceral supervision and control. 

Thus, it is important that LEAD initiatives forge alternatives to the criminalization of people living with unmanaged behavioral illness without unintentionally deepening or broadening its criminal legal involvement.