California voters passed Proposition 36, the Substance Abuse and Crime Prevention Act, in November 2000. The law (now known as SACPA) went into effect on July 1, 2001. SACPA mandates that persons arrested for non-violent drug offenses be offered opportunities for treatment instead of serving jail time.
Before SACPA, a defendant convicted of PC 11550 (under the influence of an illegal drug) faced mandatory jail time of 90 days for a first offense and 180 days for a subsequent offense. (The Court had the option of allowing these defendants to serve this time in licensed residential substance-abuse treatment facilities.) Under SACPA, the same defendant would have an opportunity to participate in treatment and would face only 30 days of jail time after repeated failures in the program.
SACPA mandates that all clients be referred based on assessment. In Santa Clara County, the assessment is done either in jail or at the Assessment Center. In either case, the client receives a preliminary assessment of "Risk and Needs" from the Probation Department to determine the level of supervision required. There are three levels of supervision:
"Banked," the lowest level, is used for low-risk offenders and involves contact between the offender and the Probation Officer (P.O.) only if there is a problem such as another arrest or a positive drug test;
"General supervision," the middle range for medium-risk offenders, provides limited contact between P.O. and offender; and
"Intensive" is for high-risk offenders who need regular contact with their P.O.
DADS staff then assess clients to determine the appropriate placement in treatment. The assessment and placement process uses the Patient Placement Criteria developed by the American Society of Addiction Medicine (ASAM). Most clients attend an orientation session which provides them with both an overview of SACPA and an introduction to treatment and recovery, with special emphasis on the variety of services and support groups available in our community.
Most clients attend either Residential Treatment (if they have a serious problem with alcohol and/or other drugs and need the support of a structured, live-in environment to be stabilized) or Outpatient Treatment (if they are able to come to a clinic to work on their problems). Most clients referred to Residential Treatment are expected to move on to Outpatient Treatment, once their situations have stabilized. A few clients need Detoxification Services to rid their bodies of alcohol and other drugs before starting treatment. A few opiate addicts need Narcotic Replacement Therapy (methadone maintenance) to stay opiate free. Pregnant women are referred to Women's Treatment Services, which includes both methadone maintenance and drug-free tracks. There are other specialized services for dual-diagnosis clients (those who also have mental health problems), including clinically managed residential treatment, specialized outpatient treatment, and intensive case management. A range of culturally competent services is available in Spanish, Vietnamese, and other Asian languages. All clients are strongly encouraged to develop support networks (Twelve Step, Rational Recovery, church, or other spiritual groups) to help them maintain clean and sober lives.
SACPA offers case management to clients who are assessed to be at high risk for relapse or failure in treatment. Referrals can be made by DADS assessors, judges, P.O.s, and by treatment programs who deem the clients at risk to drop out of treatment. A case manager checks in with clients throughout their participation in treatment to ensure that they are receiving the services they need, to assist them with resolving issues which may be interfering with their participation in treatment, and to recommend modifications.
Ancillary services are those additional services which support clients to be successful in treatment. They include housing support, literacy training, vocational training, child care, transportation assistance, etc. Examples of ancillary services include bus passes to help clients get to treatment, vouchers to get dental work done, help with a security deposit on a new apartment, etc.
The most outstanding and unexpected development with SACPA has been the collaboration that has developed between the treatment and justice agencies. DADS and Probation share a brand-new Assessment Center where all out-of-custody assessments are conducted. This physical proximity has facilitated a sharing of pertinent information (as allowed by clients' signed consent) and better mutual understanding of the roles of each agency. In addition to DADS and Probation, the SACPA network includes the Courts, the District Attorney, the Public Defender, Pre-Trial Services, and the County Executive's Office (which is the lead agency in Santa Clara County).
DADS research staff continually track the flow of clients through the system and help identify weak links where clients are being lost. Their analysis of service-delivery data has guided plans for the expansion and reduction of various modalities-based on relative levels of usage and waiting lists. Due to the newness of the program, few clients have graduated thus far from SACPA services. However, as client numbers increase, the outcome data that is being collected will help evaluate clients' experiences in various modalities and specific programs.