Pubdate: Sun, 03 Dec 2000 Source: Los Angeles Times (CA) Copyright: 2000 Los Angeles Times Contact: Times Mirror Square, Los Angeles, CA 90053 Fax: (213) 237-7679 Website: http://www.latimes.com/ Forum: http://www.latimes.com/discuss/ Author: Carla Rivera Bookmark: Substance Abuse and Crime Prevention Act items http://www.mapinc.org/prop36.htm PROP. 36'S DIVERSION OF ADDICTS TO POSE HUGE CHALLENGES Probation officer Randall Gallegos has a sixth sense about the drug-addled ex-offenders he supervises, and all kinds of alarms were going off recently when a young woman and her two children sat down in front of him. She had tried to wriggle out of the appointment as best she could. The kids were withdrawn and wouldn't accept the candy he tried to offer. It was a sign of trouble at home and, just as he thought, 26-year-old Anita tested positive for methamphetamine use. She had completed drug rehab and been clean for four months before this relapse. But that, explained the veteran Los Angeles County officer, is the way of drug addiction. "People are prone to relapse three or four times before they get clean; we accept that," said Gallegos, 39, sitting in a small cubicle at the department's Rio Hondo office in Whittier. Addicts such as Anita are much on the mind of Gallegos these days because of Proposition 36, an unprecedented ballot measure passed by California voters last month that mandates treatment rather than jail for nonviolent drug offenders. The measure doesn't give addicts a free ride. Continued violations will send them to jail. The impact on Los Angeles County's law enforcement and drug treatment systems will be immense. Gallegos has a caseload of 200 probationers that may grow to as many as 500 by this time next year. The county's courts will be flooded with an estimated 20,000 new drug offenders each year who will be diverted into treatment programs--and those programs are expected to mushroom. The diversions will not begin until July 1, but county officials are already trying to sort out how many outpatient spots and residential beds will be needed to meet the demand. For probation officers such as Gallegos, Proposition 36 is both a dream come true and a nightmare. It upholds their belief in rehabilitation but takes away one of the immediate tools--the threat of jail time--that they believe makes treatment more effective. "We're going to lose some control," agreed Gallegos. "Some of these people need a lot of supervision, and they realize that themselves. I've had guys going off probation who are pleading with me: 'Mr. Gallegos, I don't want to go.' " He does not appear very nervous for a man who is a foot soldier in this latest effort to tackle one of society's oldest foes. Youthful and fit, he looks like the sympathetic older brother of many of the ex-offenders he supervises. But as he ponders what to do about Anita, his voice hints that he does not readily suffer the trash-talking, sympathy-grabbing spiels of addicts. Such as those who bring with them their small children in a play for pity. Or those who deny the accuracy of the narcotics tests. He has experienced plenty of both, he says. The urine sample provided by Anita--who served one day in jail on a one-year sentence for possession and sale of marijuana--showed an incredibly high toxicity level as well as evidence that she had tried to flush her system before the test. If she had been arrested after implementation of Proposition 36, she would not have served any jail time. "When she comes back in, if she admits she's been using, we can send her back to treatment," said Gallegos. But that was not to be. When Anita came back a week later, she was unyielding in her denial of drug use, said Gallegos. In a report he is writing to the judge who granted her probation, he will probably recommend that she serve the remaining 364 days of her jail term, with the last 120 days spent in a rehab facility "where she will have time to consider the consequences of her drug use." Gallegos said he expects to be deluged with cases like Anita's as Proposition 36 takes hold. New programs will have to be licensed by the state and approved by the county, a process that could take up to a year and leave many who qualify for treatment waiting for a space. And community resistance could delay construction of treatment facilities and expansion of existing ones, officials fear. Long-running opposition by neighbors and city planning commissions has stymied the enlargement of drug programs in Long Beach and San Pedro. Additionally, no one thinks that the funds allocated for Proposition 36--$120 million annually statewide, with Los Angeles County expected to reap about $40 million a year--are nearly enough to cover all the costs. County probation officials estimate that they will need to hire nearly 100 staff members to implement the measure. And there is no money set aside for drug testing. The costs of testing 20,000 new probationers only four times a year--each test costing more than $8--could approach $1 million. Battle lines are being drawn over how the money will be divided. Indeed, overshadowing this daunting task is an already uneasy relationship between the treatment providers that mostly supported the measure and the law enforcement agencies that mostly opposed it. Some drug treatment executives are already grumbling that they have been shortchanged on the number of seats allotted to them on the county task force set up to implement Proposition 36. Albert M. Senella, chief operating officer of Tarzana Treatment Centers Inc. and president of the California Assn. of Alcohol and Drug Program Executives, fears that pressure from police, prosecutors and judges will divert Proposition 36 funds from treatment to law enforcement. He is also concerned that judges, rather than rehab experts, will decide on the kind of treatment addicts will receive. "Everybody wants a slice of the pie," he said. Michael Tynan, the supervising judge of drug courts for Los Angeles County, said it is unclear how judges will treat addicts in this interim period. "Many judges are concerned that we should not put people in custody who in six months' time would be given straight probation," Tynan said. "They will have to consider the ramifications of Proposition 36, even if subliminally, because all of a sudden the rules have changed." Defense lawyers will clamor to get drug cases heard before judges known to support the treatment provisions of Proposition 36, he suggested. And lawsuits over interpretation of the statute are liable to drag on for years. Probation officials and judges also worry about the quality of the treatment programs to which thousands of offenders will be diverted. That care does not come cheap. The cost of outpatient treatment of a drug court defendant can total about $4,000 a year, said Tynan. "We're talking quality treatment," he said. "Small group interaction is expensive to do right, and if we're not going to do it right, what's the purpose of doing it at all?" Senella said those involved in treatment are just as concerned. His group is encouraging the state to give provisional certifications to new programs while still requiring that all comply with licensing standards. "Nobody should allow the little private psychiatrist on the corner with three patients to step up and get a piece of the pie," he insisted. The county currently contracts with more than 300 programs providing both residential and outpatient treatment, said Lydia Becerra, a spokeswoman for the county Drug and Alcohol Administration, which disburses drug treatment funds. The agency also sends out auditors such as Michael Romo to monitor billing records and make sure patients are responding to treatment. Romo, 52, is a familiar face at the Tarzana Treatment Center, where he dropped by recently for a review of the facility's outpatient services. He had called the day before, but many visits are unannounced. His routine illustrates the work involved in ensuring that facilities are providing quality care, a task that will be multiplied in the post-Proposition 36 era. In his 15 years as an auditor, he has developed a friendly and easygoing manner, but not all treatment programs are happy to see him walk through he door, he says. He does not expect any problems at the Tarzana center, which treats thousands of patients with substance abuse and mental health services at several locations. In the main building, patients are being evaluated and tested. Some are in drug education classes, others in group therapy. Although Romo cannot sit in on individual psychiatric sessions because of patients' right to confidentiality, he frequently attends group lectures to evaluate their effectiveness. In a small conference room, Romo is handed a dozen patient files and charts. He makes sure that billings for group and individual sessions are backed up by treatment notations. Reading one chart, he is concerned that the progress notes that are supposed to be written up after counseling sessions seem rather thin. The case is that of a young pregnant girl, arrested for drug use and required to enter a yearlong treatment program as a condition of probation. "It may be that there's not been enough training to know that this is not adequate," he says. But as the treatment progresses, the notes begin to fill out. Tarzana evaluates its own staff, and the problem may have been corrected in-house, he says. Indeed, the most recent notes indicate that the young woman seems to be thriving under treatment. She's a young mother now, and all of her drug tests have been negative and she is back in school. Observes Romo: "She still has a way to go, but this is what we like to see." - --- MAP posted-by: Larry Stevens