TASC and Foster Cook: The Man Behind the Program

DSC 0111-275x200Mr. Foster Cook, on the faculty of the Department of Psychiatry since 1978 and the director of the Substance Abuse Programs, has provided the necessary leadership and vision to build a dynamic model of research, direct services, and social justice advocacy through the UAB Treatment Alternatives for Safer Communities (TASC).  His grandparents were missionaries to Korea in the early 1900’s and his family history of public service has imprinted well.

Mr. Cook’s attributes include a remarkable understanding of: salient political forces, the power of judges and law enforcement, the burden of not treating those with addiction caught up in the judicial system, and cost-effective evidence based treatment combined with a passionate commitment to advocacy for a disenfranchised population.  Starting in the mid to late 80’s, his aggressive solicitation of federal dollars brought resources into the local systems that have helped drive policy-topractice reforms.  Over the years, Mr. Cook has been awarded over 16 million dollars to fund such entities as: drug prevalence research, implementation of drug courts, and mental health courts, and expanded access to substance abuse treatment.  His vision, diligence, and leadership have created, preserved and sustained a system of care that saves money, but more importantly, saves lives.  He and TASC have never stopped working to help those who so desperately need assistance in the State of Alabama.

The UAB Treatment Alternatives for Safer Communities (TASC) originated through a federal grant proposal in The White House Special Action Office for Drug Abuse Prevention.  TASC was established as a case management program for felony offenders with serious substance abuse and addiction disorders.  In 1973, the Law Enforcement Assistance Administration (LEAA) and the National Institute in Drug Abuse funded 13 TASC sites, which included the UABTASC Program.  TASC was the first effort to bring together, through a formal partnership, the criminal justice system and the substance abuse treatment system.  It remains the oldest operational TASC Program in the country.

Mr. Foster Cook, the current director, helped implement the program, then housed in the Birmingham City jail, in 1973.  Mr. Bill Cox, a local parole official, was director until 1977.  At that time, federal funding had dissipated and local city and county funding was obtained for continuation of the program.  UAB Department of Psychiatry, then headed by Dr. Patrick Linton, provided the administrative infrastructure and support.  The partnership between UAB Psychiatry and TASC expanded in mission and scope under Mr. Cook’s leadership.  The UAB Methadone Clinic merged with TASC and the outpatient UAB Drug Abuse Program at Smolian Clinic in 1980.

In the early 90’s, the Jefferson County jail became dangerously overcrowded.  To alleviate these conditions, the county utilized UAB-TASC as a jail diversion/pre-trial program.  UAB-TASC also implemented one of the states earliest drug court programs; now the largest drug court in Alabama.  Presently, Jefferson County incorporates two Judicial Circuits-Birmingham and Bessemer.  Parallel programs, including pre-trial release and a drug court, were created in Bessemer to match services with the Birmingham Judicial Circuit.

In 1992, The National Institute of Drug Abuse selected 5 TASC programs for evaluation by the RAND Corporation and the UCLA Department of Neuropsychiatry.  UAB-TASC was one of the sites and the research team compared TASC program outcomes with criminal justice clients who did not receive TASC services.  UAB-TASC clients received significantly more services in every domain than the control group (jobs, drug treatment, HIV screening, mental health, urine screening) and responded with lowered re-arrest rates for high-risk felony offenders.

In 1996, UAB-TASC was one of three sites in the nation to be selected as a demonstration model for the Break-The-Cycle Project.  The White House office of National Drug Control Policy funded this unique effort to expand TASC core operational elements (early intervention, assessment, referral to appropriate community services and assertive case management) into a system wide continuum from arrest through final sentencing and adjudication.  The Urban Institute provided the outcome evaluation, which concluded that TASC supervision lowered recidivism dramatically (30%) compared to a control group.

Upon completion of this project, the local justice system retained the improvements that were implemented under Break-The-Cycle.  In 2001, TASC targeted those with severe mental illness who were incarcerated for longer periods of time and could not access the critical services necessary for management of their mental illness.  UAB-TASC collaborated with the National Alliance for the Mentally Ill (NAMI), county government and the courts to complement two mental health courts in Birmingham and Bessemer.  These courts are administered similar to the drug court model of intermediated sanction and incentives.  UAB-TASC has also served the juvenile offender population since the mid 1980’s.  The Adolescent Substance Abuse Program (ASAP) is contracted with the juvenile court system and provides urine screening and substance abuse treatment, prevention and monitoring for the court.

As can be readily observed, since 1973 UAB-TASC has evolved considerably, managing to combine the collective efforts of treatment providers, law enforcement, and the judiciary, to offer populations challenged by substance and drug dependence a breadth of services that have proven, overtime, to be profoundly effective.  Supported by federal funding, Mr. Cook implemented the core program elements and networks the have proven effective for over 35 years.