The addicts are coming!

A tall, willowy blonde, with a model’s poise and figure, Dellena Hoyer-Johnson looks every bit the part of an urban career woman. Nothing in her mannerisms suggests that Hoyer-Johnson was once a drain on California taxpayers—to the tune of about $85,000 per year, by her own estimates—the result of 18 years spent cycling in and out of the court system on prostitution and other charges stemming from a once fierce heroin and crack cocaine addiction.

Clean and sober now for nearly 10 years, Hoyer-Johnson could be the poster girl for Proposition 36—the voter-approved drug reform law that requires treatment instead of jail time for non-violent, first- and second-time drug offenders. The law went into effect July 1.

“There’s an old line,” says Hoyer-Johnson. “ ‘Once a dope fiend, always a dope fiend.’ Well, that’s just not true anymore. Treatment works. I’m a living example.”

That type of success story is, in part, what fueled last year’s campaign on drug policy reform and caused 61 percent of voters to agree that continued criminalization of addiction wasn’t working. The measure has been lauded as an historic public policy shift in which tax dollars would be saved by treating addiction as a public health issue, rather than a criminal justice one, with reduced incarceration and hospitalization costs saving taxpayers millions of dollars each year.

“I’m absolutely impassioned in my belief that we are going to pay for untreated drug addiction,” said Trisha Stanionis, executive director of The Effort, a drug and alcohol treatment center on J Street and one of the longest-operating centers in the county. “The question is, where do we want to send the check?”

But there are some who question just where Sacramento County is choosing to spend its money and if that decision will subvert the intent of the voters.

Question of intent
A stack of clear dominos stood on Stanionis’ desk, each one representing a separate cost associated with untreated addiction: business losses, lost wages (and, by association, paid taxes), education, health-care costs, family destruction, child abuse and criminal justice costs. Treat the addict on the front end, Stanionis and others maintain, and you stop the dominos from toppling.

Established 30 years ago, The Effort is one of three treatment organizations contracted with Sacramento County to handle the influx of some 2,300 Proposition 36-diverted addicts expected to flood area programs in the next six months. County drug and alcohol specialists estimate that, by the second year of operation, its Proposition 36 clients will make up about 3,100 of the roughly 8,000 addicts treated countywide.

And while people like Stanionis and county alcohol and drug services administrator Toni Moore say they’re ready for the challenge, one drug-reform policy group is saying otherwise.

One week before counties were to implement Proposition 36, the Lindesmith Center Drug Policy Foundation graded Sacramento County and the 10 other big counties that together represent 75 percent of the state’s population.

Calling the county “dangerously unprepared” to meet the treatment needs of Proposition 36-diverted offenders, the Center heavily criticized Sacramento County for putting 46 percent of its $5.8 million allocation toward criminal justice costs, rather than treatment.

Specifically, said group spokeswoman Shayna Samuel, Sacramento County’s overall grade of “D” came as a result of its decision to funnel too much money toward fixing existing deficiencies in the Probation Department.

Although the law allows for counties to draw up plans and allocate money as they see fit, with no caps or benchmarks spelled out, the Center said that those counties who received an “A” grade did so by committing at least 83 percent of their resources to treatment and less than 17 percent to administration and court costs, including probation.

“The whole intention of Proposition 36 is for treatment,” Samuels said. “We recognize that money is needed to help other departments make the switch, but Proposition 36 money isn’t the only money available for probation and more money should be put into funding treatment options.”

Sacramento County scored an “A” when it came to providing a diversified level of treatment options to addicts.

The Center’s argument that the county is using Proposition 36 money to fill a void that should be funded by Sacramento County’s general fund would seem to be bolstered by the fact that the Probation Department has been severely understaffed and underfunded for years.

With more than 18,000 adults on probation—more than 13,000 of whom are convicted felons—and only 10 field probation officers to monitor them, fewer than 600 probationers actually receive visits from agents in the field. The remaining probation officers have caseloads that range from 300 to 2,000, according to Rex Sager, assistant chief deputy of field services.

The 14 officers and one supervising officer slated to be added to the department and paid for with Proposition 36 funds—35 percent of the county’s allocation, not 46 percent as the Center reported—will monitor diverted offenders only, according to David Spencer, supervising probation officer for the department’s Proposition 36 unit.

But whether the county was looking for a way to boost its probation staff with its Proposition 36 windfall, Moore maintains she could not implement a successful Proposition 36 program without the additional officers.

“The [law] calls specifically for court-supervised treatment,” Moore said. “That’s what voters asked for. We think probation is a critical component to establishing a program with a strong accountability emphasis. How can you have meaningful supervision if every officer has 300 people to supervise?”

Moore and others also took exception to the Center’s contention that the majority of the county’s program is being controlled by the criminal justice system, rather than public health officials.

Not true, said Moore. In addition to offering addicts literacy training, job counseling and family counseling, Sacramento County added a public health and mental health component to its plan in an attempt to treat the “whole person,” not just a person’s addiction.

But she and others aren’t spending much time sweating the Lindesmith Center’s report card, saying they have too much work to do to be distracted by projections of doom before the program is two weeks old.

“At this stage, I think this level of criticism is not really helpful,” Moore said. “We’ve worked diligently to work within the financial constraints to offer quality treatment.”

New direction
Adequately financing this new policy direction is difficult, particularly because no one in the state knows exactly how many offenders will require intensive treatment and how many will be able to be successful with individual plans set up on an outpatient basis.

The Effort’s 40-bed residential facility in North Sacramento serves about 170 clients a year at a cost of about $800,000 annually. And its 18-bed detox facility, where addicts stay for an average of 10.5 days, serves about 400 clients per year, at a cost of about $620,000 annually.

Those involved, like Trisha Stanionis and Dellena Hoyer-Johnson, claim it’s money well spent, yet they say that after the first year of operation, Sacramento County and its 57 counterparts are going to be hurting for funding.

In fact, the $120 million earmarked for statewide implementation of Proposition 36 has been decried from the beginning as being woefully inadequate to meet the actual need of the population it is trying to serve. So underfunded, in fact, that other statewide ballot measures are underway to enhance funding. Call it reform in two parts.

How underfunded? No one seems to be able to put a figure on it. But drug treatment experts contend that assuming the bulk of addicts diverted as a result of Proposition 36 will again be able to kick long-term addiction without some sort of residential program is “unrealistic.”

As for Sacramento County, Moore said she’s confident she has enough funding to operate through the 2001-02 fiscal year, but she’s concerned what will happen when the annual price tag exceeds $7 million, as it’s expected to do in fiscal year 2002-03.

“That’s what bothers me,” Moore said last week. “We’re once again underfunding a need and implementing another program with inadequate resources to do the job we want to do in an already under-funded treatment system. Ultimately, what I want to see is treatment on demand for anyone who wants it. Unfortunately, I think we’re a long way from that.”

Moore’s frustration stems in large part, she says, from the success stories she sees everyday. People who were once a drain on the county’s criminal justice, welfare and health-care systems are now holding jobs, paying taxes, going to school and taking care of their children. These stories, Moore said, also make her excited about the challenges ahead.

“Obviously, I’d prefer adequate funding, but Proposition 36 is still a good move,” Moore said, “and the authors should be commended for getting public support for this. In a year’s time, we should be able to prove that it’s saving lives and saving tax dollars.”

It’s a theme that is echoed by both The Effort’s Stanionis and Hoyer-Johnson, who works as the agency’s community outreach coordinator.

“The fact is, even with the underfunding, this represents a major public policy shift and I, for one, believe we can make this work,” Stanionis said. “What’s more, I believe it will work because the people involved in putting this together in this county are committed to adapting and changing our plan as we see what works and what doesn’t. Nothing is set in stone, except for our commitment to seeing this succeed.”

To Hoyer-Johnson, Proposition 36 represents a chance for addicts to get their lives back without having to hit the bottom that she did—or take as long to get there. She also agrees, strongly, with the accountability feature of the measure, which allows jail time to be imposed if participants fail to meet probationary requirements.

“I was arrested 60 times a year, for roughly 18 years,” Hoyer-Johnson said. “But the denial I had around my disease was so fierce, I never got the connection. This kind of intervention is definitely needed. It will help a lot of people.”