 Good evening. I'm Ellen Peary. I'm the County Supervisor for the Second District, which includes Aptos and I want to Welcome you and thank you for coming out this evening. We're hoping to have a really good conversation about drugs drug addiction incarceration and alternatives to incarceration First, let me thank thank Aptos High School for allowing us to be here this evening in their beautiful new performing arts center Also, I want to thank community TV of Santa Cruz for taping us and showing us in the future tonight's forum is Hosted by smart on crime Santa Cruz County and Cosponsored by more than 35 local organizations and entities from chambers of commerce To nonprofits to local media Smart on crime is a group that is a partnership between scholars professionals in the justice system Government leaders and community members who are interested in more effective criminal justice practices and policies The Santa Cruz County Board of Supervisors has a long-standing commitment to alternatives to incarceration We have a jail overcrowding task force We have a model widely respected Pre-trial program and we have support for programs that get people out of jail and hopefully keep them out of jail With recent changes in state law with the state budget crisis and with the federal courts Ordering California to reduce its prison population We have an opportunity to improve our local criminal justice system Reduce the number of people who cycle in and out of jail and hopefully make our community safer So the format for this evening is that we will have a four speakers up here They will each have a talk for you 10 to 15 minutes. I think We'll have a question-and-answer period at the end and the way we're doing the question and answer is that in the The materials that you got when you came in including your program There are some cards little three by five cards. So if you just want to write out questions We will have people circulating to pick up so if you have a question just wave your card in there and somebody will come Get it and then when the speakers have completed that Supervisor John Leopold will be coming up and he will be moderating the question-and-answer period Also in your packets on the top is a questionnaire and we would very much appreciate it if at the end of the program You filled out that questionnaire and returned it to us It's part of a community Engagement effort to really find out what people think about the criminal justice system and look for ideas of ways to improve it If you've already filled one of those out at a past forum, you don't need to do that again So let me start by introducing our first speaker and that is our sheriff Phil Wohack Sheriff Wohack is the chief law enforcement officer for the county and is responsible for all aspects of public safety Including including operation of the county jail system So let me give it to Phil and remember those cards Thank You Ellen Good evening As Ellen mentioned my name is Phil Wohack. I'm the county sheriff and a number of the different responsibilities that I hold as your elected sheriff include Managing the county jail system If you don't know about our county jail system, we have two different Holding facilities for adult inmates in Santa Cruz County One is it the Water Street facility adjacent to the courthouse in Santa Cruz and the second facility is in Watsonville adjacent to the county landfill and it's the roundtree lane men's corrections facility our correction system was designed in the 1970s to hold upwards of 700 adult inmates in our facility and over time and in the recent years we've brought down The authorized number of beds that we can hold inmates in our facility to roughly 450 my numbers are a little off because I don't run the jail system on a regular basis the chief of corrections and our Warden is with me here today chief Jim Hart and he runs the entire corrections system When we get to the question and answer period if you have any questions about the jail system I'll either answer them for you or ask chief Hart to address them So as Miss Perry mentioned when she introduced the program tonight. We're here to talk really about crime and punishment What has changed in California and in Santa Cruz County with regard to crime? criminal prosecution and punishment of offenders in in California So we have a fairly large group here tonight if I could just get a show of hands of who knows what assembly bill 109 or prison realignment is Okay, virtually everybody here So I'm not going to spend a lot of time on on assembly bill 109 But I will tell you that it is a state law in California that changed where a person serves their criminal sentence After conviction in the state of California prior to October 1st last year if you were convicted of a felony That had more than one year in jail You would serve that sentence in a state prison system If you were convicted and sentenced to less than a year in jail You would serve that time in our local county jail system the change in California law brought a Shift of prison population from the jail systems to local communities This is this didn't happen overnight and there's a member number of Folks in this room members of our panel and members of our audience that worked on This transition and and brought about this change in California Mainly because the California prison system was was significantly overcrowded. It was Essentially ruled cruel and unusual punishment to be sent to state prison in California and California was mandated to reduce its prison system population over time and that brought about Assembly bill 109 or the prison realignment So shifting the population of state prison inmates to county jails Was no easy task Last year when assembly bill 109 went into effect on October 1st Our county jail system was at about a hundred and twenty-five percent of capacity So every day we had about 50 inmates more than we had beds living in our jail system And on October 1st, we knew that folks sentenced to state prison the year prior For nonviolent non-sex and non-serious crimes Would wind up being sentenced in Santa Cruz County Jail So we had what I affectionately call an inventory control problem We knew we were going to be taking in more folks than we had room for So we had to make some very quick and very Challenging decisions and we had to reach out to people like yourselves and the community and really engage you in a Artful discussion about what is Punishment versus a crime and where we house people and when what do we really believe? County jail is there to serve I can tell you that as as the sheriff and as the person who runs the jail system We believe that our correction system has three responsibilities. The first is public safety We have to incarcerate people to keep them from reoffending or causing pain Or suffering to the general public. So we lock people up to keep the community safe The second is accountability another word for accountability is punishment Okay, you are sentenced to a jail or prison sentence to serve a length of time To pay your debt to society What prison rent realignment did is change that middle piece that that punishment or accountability piece And we had to accept the fact that punishment was not going to be served Prior to assembly bill 109 in the same way as after now We're very fortunate to live in Santa Cruz County because that was not a hard Pill to swallow in Santa Cruz County. We already had a significant number of Programs in place to deal with an overcrowded jail system and to deal with Punishment and corrections at the community level and by that I mean that we had a very Progressive judicial panel the bench in Santa Cruz County that sentenced people to To jail systems were very creative in their sentences and in in their corrective model We had a very progressive and he's seated here in the audience Probation chief chief Scott McDonald who worked with us on keeping our jail population down and holding offenders accountable in the community so we didn't have a As big a challenge as other communities But we did have a very big challenge on our hands as assembly bill 109 came into place Now I mentioned there were three pieces that that corrections is responsible for number one was public safety number two was accountability or punishment the third Was something that I don't think we did a very good job of and I don't know that anybody really has figured this out because Anybody in here who's a parent is sitting next to someone who's a parent. How do we correct behavior? Okay, we do it individually and we do it based on the offender And so when my child does something wrong I try and correct that behavior in the best way I know how with our human interaction In Santa Cruz County and in many jail systems We failed in the corrective behavior department and what what my staff has done is we've embraced Assembly Bill 109 and prison realignment to try and bring a corrections model to our Correction system we call it corrections as opposed to detention in the 80s and 90s our our Jail system was called detention Well detention is nothing more than putting a person in a timeout and doing nothing to correct the behavior that put them there under Sheriff Mark Tracy in the 90s our Detention Bureau was was changed to corrections and we tried to apply as many programs as possible in the correction system to Reduce offenders reoffense after leaving and we did that by providing different programs in The facility Now when I say we embraced Assembly Bill 109 we tried to use The state allocation that came and the legal responsibility that came from the state to work on our corrections model After Assembly Bill went on a 109 went into effect each individual County formed what is called the community corrections Partnership and our probation chief is the chair just like all 58 counties in in California The probation chief is the chair of that partnership And that partnership is responsible for building a corrections model for each individual community that fits that community need Now I'm proud to be up here today and talking to you about this model because I think that Santa Cruz County has been The most successful County in the state number one because we had those prior systems in place as I mentioned a minute ago but we also have People that work together in this justice system on a regular basis and do so efficiently I'm pointing my finger at the other 57 counties in the state of California when I make that statement because a lot of Counties don't have that collaboration and that Cooperation with their own government systems let alone the community and groups like yourselves here I'm going to shift Gears just a second and I want to tell you what we did in response to Assembly Bill 109 As soon as the law went into effect We knew that we were going to get a segment of state prisoners coming to our jail system effective October 1st we anticipated that that number would be in the 70 per year range And we knew that those inmates would stay with us for a significant length of time Above and beyond what our previous population did now prior to October 1st The average length of stay in Santa Cruz County jail for an inmate was 32 days So you would have an offense you would go through the court system You would get convicted and you would be sentenced and of all the people that were sentenced to Santa Cruz County jail Prior to October 1st of last year the average length of stay was 32 days We after October 1st began to receive long sentences the longest being eight years now A person has been sentenced to county jail And so you can imagine that that math problem is going to grow In future years and the average length of stay is probably going to eclipse a hundred days this year And it will probably be in the neighborhood of 200 to 250 days next year for all of our inmate population That brought about some challenges number one with bed space number two with care in custody and number three in the types Of programs that we were going to offer to our inmate population So I mentioned chief Hart who's in the audience today. He and I got together before that October 1st date We worked Collaboratively with the smart on crime series with the probation chief and with a number of members of the community corrections partnership And we came up with a program that we implemented on on December for October 1st Of last year the first piece that we put into place was a custody alternatives program So we built a program that gave alternatives to incarceration a program that didn't require you to just go to jail Spend time in jail and then leave either on probation or having served your sentence We looked at the offense that a person was in custody for and we essentially built a model where low-level offenders misdemeanor offenders who were in custody for theft related crimes Drug abuse type crimes crimes that didn't present a risk to the community in a safety aspect we built a Electronic monitoring system and we moved that population into that custody alternatives program Now to date we've had over a hundred people participate in that electronic monitoring program and on any given day As of today we have in excess of 40 people on that program Now this time last year those people were in our custody in our clothing Sleeping in our beds, and they were taking up the space that we needed for our Prison realignment inmates so we built that program to number one to To build capacity in the jail system But number two to create what we know has to grow into our future Correction system, and that's an incentive-based incarceration system We believe that every inmate that comes into custody in Santa Cruz County Must be given an opportunity to succeed both in custody and to break a cycle Whatever that cycle is that put them into custody in our system when they're returned back to the community So the custody alternatives program is essentially a carrot. It's a carrot for each and every inmate If they work in the system to better themselves in the system They can earn the ability to do a portion of their custody outside of our jail facility on a monitoring program under direct supervision It's not something that's automatically granted to someone and I use this analogy When my son was young he's old now or older, but when he was young and I asked him to clean his room He did an okay job But when his girlfriend was coming over and he did it on his own He did a much better job because it was his idea not mine And so our incentive-based incarceration system is built on that model if an inmate comes into custody and they work through the program and we give them the Opportunities to succeed and they earn their way out. They do significantly better on the outside now we just started this program nine months ago and as of today the numbers of of AB 109 or 1170 h inmates in our custody are 60 We have had 60 people sentenced to County Jail that last year would have gone to state prison And we're only two-thirds of the way through the the year So we know when we hit October of next of this year We will most likely eclipse the 70 mark that we thought we were gonna get in the first year So our job is really to create a system number one that creates capacity for that group and number two puts together a correction system in our Incarceration model that helps people build their way out of the system Now as of today We've built the electronic monitoring system the custody alternative system We've also added a significant amount of capacity in a work-release program And by this time next year, we believe that we will have just as many folks in custody alternatives as we do in custody So if Santa Cruz County grows to a 500 inmate population We will probably have that number of people a half of that number of people out of custody I'm gonna stop there because I'm getting the the time sign and I'm gonna save some of the Statistical information that I have for you with regard to the jail system for the question-and-answer period So I'm gonna invite a supervisor period up and to introduce our next speaker Dr. Craig Reinerman Thank you Thank You sheriff warwick Craig Reinerman is our next speaker. He's a professor of sociology and legal studies at UCSC Dr. Reinerman has authored many books and articles on drug use law and policy He's a consultant to the World Health Organization on substance abuse Please welcome. Dr. Reinerman Thank you very much. Thank you for coming Thanks to Susan Green and her colleagues for organizing this At times like these We are reminded of the the horrors of crime lives are lost and Families torn apart and the fabric of the community ripped and at times like these we're up to want to respond with fear and even vengeance and I like to begin tonight by suggesting that those are not really good foundations for public policy and My particular angle is Has to do with drug abuse and we all know that drug abuse and addiction are bound up with crime or at least a significant portion of crime Important pieces of the puzzle but the relation between drug abuse and crime is always more complicated than we usually imagine and Less directly causal and more contingent So I want to show to begin with introduce you to a few Measures of the sort of national effort. We've been engaged in On the drug war, I guess I point this back there. Yeah I'm gonna fly through a few of these graphs there. They're I'm happy to answer questions about them afterwards, but basically this just shows that the The drug czar's budget the federal government went from about two billion dollars when Ronald Reagan came into office to over 23 or four billion it Crunkated there at the end by the time President Bush the second left office. That's a over a tenfold increase and One of the results is that the percentage of total federal prisoners and as a very parallel curve of the state level in most states percentage of total prison population sentence for drug offenses Similarly skyrocketed up beginning in the 1980s With some harsh new laws that were passed to to do something about crack cocaine they called for mandatory minimum sentences long sentences and It came to pass by 2006 that drug offenses were the largest single category of offense according to the Bureau of Justice Statistics and Justice Department More than violent crime certainly and more even than property crime And Indeed just to put it in a little bit of comparative framework There are more people in prison in the United States for drug offenses Then there are in all of the European Union countries combined for all offenses combined We're pretty tough on our drug offenders in this country And they have much higher population another hundred million people beyond US population that has put us at the top of a list that We really shouldn't be proud to be at the top of and that is the incarceration rate how many people per hundred thousand population are incarcerated and This figure is now with 751 on this graph. We're at the very top And it's now up to 753 or 4 at this point And that is just again to put it in comparative perspective That is somewhere between five and twelve times more than all of the other modern industrialized democracies that we normally compare ourselves to Canada Australia and England Ireland France Germany and so on Five or ten times as many people incarcerated and again the largest single reason for that is the drug war When Ronald Reagan came into office in 1981, there were about 50,000 drug offenders in America's prisons And last year or 2010 the last year for which we have data It was 500,000 That's a tenfold increase so This raises a question Was this people talk a lot about crime waves well what we've had is a an imprisonment wave and During most of this time that will last 15 years crime in most categories has been declining And so the question is well did this imprisonment wave Was that sparked by some massive increase? in in drug use and all the indicators suggest there are lots of ups and downs but but basically the answer to that is no This is a graph based on the national household survey on drug use and these are for people 12 years old and older And it goes from 1982 on out to 2006 the blue line I'm sorry the key didn't print there to show you this but The blue line is marijuana and that was declining through most of this period It took an uptick in the early 2000s and then leveled off again Cocaine is the green line and that's been down and then pretty stable and heroin never very big As remained pretty stable all along so no evidence whatsoever that this massive increase in the number of people Incarcerated in America for drug offenses was driven by any increase in drug use This is a in effect a policy choice that we have made Does all this imprisonment? Eliminate or even substantially reduce our most serious drug problems again. I'm sad to say that it didn't One of the indicators that's very often used by the Drug Enforcement Administration the drugs are his office is The price and purity the idea being that if we can Interdict a lot of supplies and arrest a lot of drug smugglers and Ideally you would you would arrest and imprison kingpins They're pretty rare rarely caught The price would go up and that would mean it would be more difficult to use fewer people would start using fewer people Would get in trouble and so forth But as you can see the price has declined fairly steadily from 1980 through 1999 while the purity on the other hand which makes it easier to abuse easier to get in trouble Has gone up from used to be down to next to nothing just under 4% Now up tenfold So for all of the money that we've spent many billion some people estimate 50 billion dollars a year spent on the on the Drug war most of it for police in prisons For all of this expenditure of taxpayer dollars What are we getting for that? We're not getting an increase in price that puts these drugs out of reach and we're not getting a decline in in in purity that would discourage use Next slide here This is a these are DEA figures by the way and they they they shoved in It was six dollars to get high in 1970 it was it was only one and a half percent pure Cost about four dollars for a unit That's now down to 80 cents to use their figures and the purity is back up to 38 percent This is another slide for that was first one was for heroin this is for cocaine the blue line being the Let's see. I'm having a hard time reading this from here Purity You can see that the price per gram has been sort of headed up and the purity Has been headed down the same problem the opposite of what you would hope for for all the expenditure of the tax dollars So if we can't and I infer from this I want to suggest to you that We can't incarcerate our way out of our drug problems We've been trying this for the better part of the 20th century and so far in the 21st century And there are ups and downs in the drug use indicators But there's there's no real drop-off in drug problem indicators in the rate of addiction a number of people who are getting arrested Getting into various kinds of trouble Lots of people are lining up for for treatment, but much treatment Goes need for treatment goes unmet So what can we do and so I want to start with just a few characteristics Based on surveys of people who were in County Jail 60% have less than high school education Half of them are or have been homeless 20% have been diagnosed as having a mental illness And it's certainly the case that many more go undiagnosed So that's a very conservative estimate 50% were booked on alcohol related offenses doesn't mean that's the only thing that they did the only charge but alcohol is involved in in a huge proportion and 66% were repeat offenders and I think thanks to some of the programs the sheriff has implemented and probation department is implemented That's much lower than the the statewide average But still 66% two out of three repeat offenders is is pretty high So anything we can do to reduce that rate of recidivism is going to be in the longer term good for the safety of our community So what these figures suggest to me is there's an awful lot of unmet basic human needs out there That are part and parcel of the context of drug abuse addiction and the kinds of offenses that are related to it This is a Kind of broader measure if you situate a lot of Western countries the the index of drug abuse is on the vertical axis here from low to high and Income inequality goes from low to high out on the horizontal axis and as you can see there's a Trendline that shoots through the middle where the higher the inequality the higher the the drug use Now we are not the top because Australia has that honor We're right up there even with the UK and New Zealand, but you can tell the the shape of the line that the slope of that line Suggests a very strong relationship between income inequality And drug use so that's another sort of a broader comparative angle on the underlying sources of our drug problems So I want to borrow here from the logic of drug courts drug courts are We're started by Judges who were really quite fed up with the Revolving door they kept seeing the same faces over and over again People would come in for petty crime And underneath it all basically was an addiction problem. And so these judges got together and basically said Let's in effect sentence them to treatment and So drug court movement was born and there are drug courts have lots of fans out there But the logic was if we want to do something about added crime We have to deal with the underlying addiction and I think that logic can be extended so that if we want to deal with the addiction We have to pay attention to the underlying pain and trauma and unmet basic human needs That underlies so much of addiction now. This is strongly correlated with inequality and poverty and all the problems and troubles that go with that It's not reducible to that because we all know people who are middle-class or even affluent Who get themselves in serious trouble with alcohol or other drugs? So it's it's an equal opportunity form of trouble but basically If if it follows from that the treatment and social services aren't going to eliminate these problems, but they can reduce drug abuse addiction and the Collateral damage that they cause in some significant way so Treatment is the a crucial part you'll hear more about this from Jang in a minute Treatment is essential part of the solution Treatment I should say right off is is not going to be the answer in all cases It's not the case that everyone who gets arrested for a drug offense is an addict Some of them are just using these drugs They don't have the what what many people consider to be the disease of addiction They broke the law But Treatment is not the answer for for everyone, but it's certainly helpful for people who are the most deeply involved with drugs to the point where they can't stop even though they Experience difficulties in their lives that have to do with their health or their family or their jobs Most people require more than one attempt to to succeed If 35 to 45 percent depending on the type of treatment and the type of client How long they've been addicted and so forth older people tend to Get out at a certain point. Whereas that's more difficult move if you're a little bit younger But somewhere between 35 and 45 percent of the people who complete treatment Succeed and that is defined as staying clean away from drugs for a period of a year or two depending on on the study Most people require more than one attempt I was reminded of the the old line I think it's from Mark Twain, but I'm I'm not sure sounds like him About quitting smoking Quitting smoking is easy. I've done it a hundred times. He said Well, if that's true about cigarettes It's also true about other drugs heroin cocaine methamphetamine and so forth We need all kinds of different treatment programs There are some that are just sort of emergency right now your you suffer from alcohol poisoning or overdoses. I mean you need detoxification more long-term Programs like in residential programs sometimes called therapeutic communities. We have several good ones in this community Drug substitution therapies have the highest rate of success for opiate addicts. That's to say methadone and well butrin and Then 12 step groups that probably help more than any other form of treatment Started by alcoholics anonymous But now encompassing every other substance and as well as shopping and work and all kinds of other sex All kinds of other behaviors that people can go overboard with We need all of those things and we have all of those things, but we just don't have them in the in the insufficient quantities This is a slide we got kind of counterintuitive because you may remember back in the 80s when the National Crack Asteroid was upon us This drug was said to be the most addictive substance Ever known to man. That was the phrase repeated everywhere even in the best newspapers well If you look carefully at the figures from the National Surveys It turns out that over 80% of the people who had ever in their lives tried crack hadn't done so in the past year A lot of people say wait a minute. I don't want to go there. This is a scary Drug you can't do this regularly and have a life and the people who have a life Want to preserve the life? and they Knock it off. They straighten up. They quit they get clean Sometimes it's with a lot of difficulty sometimes with a little difficulty sometimes with treatment sometimes not But it's possible even with a drug that is said to be the most addictive ever Meanwhile This graph this is again from the National Institute on Drug Abuse is a kind of measure of unmet need the Without going into any of the details the the we're talking about Millions here to 23 million at that last bar And we have for illicit drugs and for alcohol and for both But the the key thing to notice about this graph is that the light colored blue Is these are all people who in the by their definition require treatment. They need to treatment The dark blue portion of the bars are the people who are getting treatment the light blue much larger Portion of the bars are the people who are need in need of treatment, but not getting it so it's a pretty gripping visual indicator of the The amount of additional treatment that's necessary again. This is national figure But there's no reason to suspect that there are too many communities out there that are have too much of it So it's probably true pretty much across the board that we have unmet need now I Guess I want to say something about some trends in drug policy the Failure really of the war on drugs of all these many years first declared by Richard Nixon in 1970 They've had their way be really with law With federal funding with state funding And our drug problems are still with us the problem problem indicators and use indicators go up and down a little bit, but They never really go away so We're not the first ones to have noticed that something different needs to be tried harm reduction policies like substitution therapy for methadone Which still outlawed in places like Russia and a lots of other countries This is slowly spread across the world Also needle exchange, which has done extraordinary work in reducing the spread of HIV AIDS and hepatitis C and a variety of other sort of user-friendly services Have spread to 75 countries some very conservative ones too in the past 25 years there have been various steps toward decriminalization in Switzerland and the Netherlands in most recently in Portugal and Pretty much all the indicators are their drug problems don't go away either But they're markedly less and the amount of additional damage caused by incarceration Is strikingly reduced So they're really had they have been better off and set a certain example that it's now Quite attractive to a number of other countries a Global drug commission report which came out last year called for Any number of things along these lines, but their basic core conclusion core finding was that we really need a shift of gaze We need to look at these things differently We need to move it away from criminal law and punishment Save the jail cells for people who are really a danger to the community violent criminal sexual offenders and the like and Get people to help they need to get out from under addiction problems So they want to shift the gaze away from criminal law and punishment to public health and social services so you may have read recently when President Obama was meeting with the The presidents of various Latin American countries There were several of them an increasing number all the time including the president of Mexico who were saying we really need to change the basic framework of drug policy in Much the same way the global commission recommended as a strategy for winding down The cartels we now have a huge army and billions of dollars in US tax support And and yet there's more and more violence and in northern Mexico very close to 50,000 people have died in the last five years Mostly battles between cartels over market territory, but we the United States are that market And We need we've also seen increasing pressure on UN drug control agencies. These are the people who In effect enforce the treaties that almost all nations on the globe have signed that say we're going to criminalize these drugs There's more and more people opposing that now And more and more whoops. I'm leaning on this the wrong way here And and more and more countries that are sort of lining up to say to the UN agencies We need to think differently. We need to move in the direction of public health not criminal law Now I Don't want to seem Naive or idealistic here None of these problems are going to be easy to solve. None of them are going to be solved with a Waving any kind of magic wand Whether that's legalization decriminalization More treatment or more of the same our drug problems are going to be here to stay we can only Do our best to reduce them to minimize the damage that they cause and so I Have to say that there are no really good drug policies. Nothing. That's ideal. That's going to make all this go away There are only less bad ones Drug policies that do less damage Prison one of the first on our first event We had a great presentation by my colleague Craig Haney Who's an expert on on prisons and the effects of incarceration and without oversimplifying his argument? Prison doesn't really socialize people to to bring out their best instincts if you're always Looking over your shoulder, you know, who's gonna knife you who's gonna beat you up This is not the sort of the attitude we want people walking around the streets in So prison will brutalize it will further marginalize people who are usually already marginalized And stigmatize them with a record a big hole in their resume. That's hard to explain when they go to apply for a job and if Effectively in most cases leaves people less able to live a drug-free crime-free life When they get out the opposite of what we would hope our public policy would achieve So instead of incarcerating drug offenders I Recommend that we try to divert as many as we can possibly divert into various other community alternatives that are based in treatment Except for those who are especially dangerous to public-safing to the community save the jail cells for them But most drug users can get help and they can turn their lives around and eventually do The only question is how much damage they're going to do in the meantime to themselves and their families in the community so more treatment and Treatment alone is not going to be enough if you read the I recently read a The latest issue of the Lancet medical journal had a review of a hundred studies About the effectiveness of drug treatment and one clear theme is that the treatments that work the best At the highest rate of success for the largest part of the population are those where you not only get drug treatment But you get other social services as part of the deal and Prevention I Don't know any teacher Even in a wonderful high school like this Who will say we have enough After-school activities. There's enough music for kids who want music There's enough sports for kids who want sports and there's otherwise meaningful roles for young people in the community that gives them Some sort of satisfaction some sort of connection to the rest of us that will insulate them against whatever temptations They run across we don't have anywhere near enough of that And if we want if we're serious about preventing drug problems in the front end, we have to do better there as well and Again the punchline in the the end of the argument really is that these sorts of alternatives Treatment and a variety of social services and prevention efforts are what it's going to make for less recidivism Less harm to the community in the long run And I'll stop there and take questions Later. Thank you Thank you, Dr. Reineman So if you've got questions write them out wave wave the car in the air and we will have somebody come along and pick those up our next speaker is Jane Nguyen who is our health services agency director? Miss Nguyen has experienced in many aspects of health services having worked in acute psychiatric care Children's health care public health mental health and behavioral health. Please join me in welcoming miss Nguyen Thank you, Supervisor Perry. Good evening everyone. How are you? Thank you. Thanks for being here. I wanted to Share with you that the focus of my conversation with you this evening is about my Perspective on drug abuse drug addiction as a serious public health problem It involves treatment of offenders with drug and alcohol addiction problems from the public health standpoint as Well as integrating public health and public safety So I really appreciated hearing from our sheriff from the professor and I look forward to hearing from one of our community members on her own experience with drug issues and incarceration So I wanted to see a show of hand here. How many of you in the audience? Know if someone have loved one's friends who actually have drug addiction problem with drug abuse issues Almost everyone in the rooms including myself How many of you have someone that you care for your friends your loved one who have addiction problems and ended up in jail prisons? Absolutely, I have a friend best friend of mine Die from drug addiction drug abuse actually committed suicide And I couldn't help the person so it's it's it is a problem It is a chronic problem It is a public health issue and as your public health director for this county. It is my responsibility To work with you to collaborate with you to support our criminal justice system to reform and to solve this problem So as you have heard from our sheriff about AB 109 It is very clear to us that this AB 109 is very complex very very complex And it is definitely a challenge for all local communities in California But I am very optimistic that Santa Cruz County and the local community here can really meet this challenge and Utilize it as a an opportunity In dealing with crime issues in our community We can really turn it around and use this as an opportunity to do the right thing Well, I want to share with you some data you heard about numbers and perspective earlier But I wanted to share with you from the public health standpoint about drug addiction drug problems According to the National Institutes of Health particularly the National Institute of Drug Abuse nationwide The number of adults involved in criminal justice system has increased from about 1.8 million in 1980 to 7.2 million in 2009 1.8 to 7.2 million The connection between drug abuse and crime is well known we all know that one half to two-thirds of inmates in jail in State and federal prisons meet standard diagnostic criteria for alcohol slash drug dependence or abuse Very high statistics very Permanent yet only seven to seventeen percent of these prisoners Receive treatment at jail or prisons for their substance abuse issue So most of the 650,000 inmates receiving back into the local communities each year Have not received needed treatment services as a rest or nurse as a public health nurse as a mental health nurse It is a concern of my big time hearing that kind of statistics So I wanted to share with you why I think drug abuse drug addiction is a serious public health problem for all of us number one it is costly and It impacts our society in on multiple levels directly or indirectly According to the National Institute for Mental Health into two for drug abuse substance abuse costs our nation more than 484 billion dollars per year Okay, remember this number for 84 billion dollars per year for substance abuse issue nationwide now if you compare the cost of all the chronic health problems such as diabetes it costs a 132 billion for diabetes 132 billion a year remember For 84 bin for substance abuse problems the cost for cancer It's a hundred seventy two billion dollars annually As you can see substance abuse Caught problems and the cost associated with that is tremendous foundation for our state and for our local community So the cost that I just mentioned includes the health care expenditures loss earnings at work Cost associated with crime and accidents. It is a public health issue Now, you know substance abuse individuals have a host of complicated health problems You know hepatitis B hepatitis C H HIV TB sexually transmitted diseases It is a public health problem Approximately half of the pediatric AIDS patients Result from injection drug use or sex with injection drug user by the child's mother It is a public health problem Driving under the influence Violence stress child abuse are some of the top social problems related to drug abuse Our adolescents are very vulnerable to drug abuse and Other risk-taking behaviors part of the adolescents growing up They take risk. They're very vulnerable people with mental illness are Particularly at risk for problems associated related to substance abuse Drug abuse affects us all affects us all homelessness Crime Education and the workplace. It is a public health problem So how do we solve these public health problems at our local community level? I think that's what you hear. We all here want to know. How do we do that? We all know it's a problem We know it's a chronic problem. How do we solve it? I think we have the golden opportunity of the AB 109 Implementation to tackle these problems I think that From reviewing the data that we got for the AB 109 non-violent non-sexual offenders Non-serious folks who coming back from our community. We know that before the enactment of the assembly view 109 We saw that 92% of the population that we sent to prison and now coming back to our community 92% of them have had had a drug and or alcohol offense or abuse history Very high So I think I have somewhat proven the case that it is a public health problem problem It is that among our Individuals incarcerated in jail coming back from prison has a high incidence of drug abuse drug addiction issues so I Think this is an opportunity for our community to work together and to do the right thing with AB 109 and That we know that it's left untreated. We heard from the professor Drugs abusing offenders can relapse to drug use and return to criminal behavior. We know that we've seen it You all raise your hands. You've seen it. You have people in jail, you know, and you care for and we know from looking at research evident based practices best practices that Providing treatment to the individuals with in criminal justice system will decrease future drug use and criminal behavior So I will discuss later At the end of my presentation My perspective on approaching drug abuse and addiction problems from the public health standpoint, but next I Want to provide you with some highlights a positive of the positive We have currently regarding the resources we have in our community in our county what we have currently to provide services for these individuals I think you like to know that right so I'm going to go over that very briefly and I have wonderful staff in the audience We have our behavior health director. We have our drug and alcohol program administrator. We have our Program manager that help us with jail medical services and the acute crisis system. They will be able to really talk with us During break time or answer any questions relating to those particular programs But I just wanted you to know that first I want to acknowledge that Yes, we do not have enough funding Yes, we do not have enough resources to provide services for everyone But we will not use that as an excuse To not be innovative to not work together and to not be collaborating to do the right thing So I want to make sure I say that and and we're not perfect and we have a lot of room for improvement So we have a full range of detoxification residential treatment. We have our patient We have day treatment. We have methadone maintenance services That are available for persons involved into the criminal in the criminal justice system So in 2010 11 fiscal year the county in partnership with our community based providers and Organization we serve approximately 800 adult clients who were involved with the criminal justice system Still we know that we are serving only a small fraction of Those who potentially need alcohol and drug treatment We need to do more We have a methadone clinic. We have those services located on 1000 Amaline Avenue and I have the phone number here if you like to talk to us about the program We're more than happy to provide you with more information And I can have staff talk with you about Qualification or criteria to enter those programs For perinatal substance abuse services We work with Janice perinatal and it's located on 516 Chestnut Avenue And we also have residential and outpatient treatment program propregnant and women with children We also operate by my center crews Community Counseling Center at Phoenix services. We have the primaries parcels program and We also have this program provide alcohol and drug treatment providing individual group and family counseling for pregnant women with young children We also have them provide vocational rehab job counseling with a primary emphasis on Latino population and migrant workers bilingual services are available in these locations I wanted to highlight some very good innovative programs that we have in our system That I think has been very effective The first one is the serial inebriate program. We call it SIP This program provides treatment instead of jail for people who have frequent arrest for public drunkeness The SIP program has achieved significant reductions in arrest jail days ambulance runs in hospital costs And we have more details of you interested after this Form we also have a drug court that provides treatment instead of jail prison for non violent drug offenders And we provide intensive outpatient treatment frequent drug testing and judicial supervision to assure both support and accountability for clients the drug court serve about 45 clients in fiscal year 2010 11 and With through the drug course we avoided about 10,000 16,000 jail and prison days At a saving of 1.2 million dollars for our taxpayers We also have a jail Mental health mental health team in the jail that provide mental health services in the jail And this team provides screening crisis intervention assessment and psychiatric services at the water street jail location And the staff in this team link the inmates under this program with a jail discharge planner To assist with recommendation to the court and assistant through the court process So people ask what is your relationship between mental health and substance abuse? Services the good news for our community here through the good leadership of our board of supervisors our CAO We have substance abuse services and mental health under one umbrella in other counties. That's not really the case So we have these two very Essential components of treatment services under the health services agency under my leadership And we have that and it's very effective in order to Maximize the economy of scale and able to mobilize services and to real to realize cost saving through best evidence base practices So I think that's one big plus. We need to acknowledge for our community here I've seen the sign tell me to stop But I would quickly say that You know for public health from the public health response to crime and substance abuse issue When you hear public health, you you know, it's about prevention. It's about population base You it's about prevention and I am all about prevention And I think that we need to look at ways Beyond just treating the symptoms and the signs. We need to look at how to prevent Look at the causes of drug addiction drug abuse Find out what the causes are and help with those causes from the get-go instead of waiting for the problems to occur and then treat it So we need to have An adequately funded continuum of substance abuse treatment services Which can serve as an alternative to incarceration for alcohol and drug offenders The probation chief mr. Scott McDonald our sheriff and myself we are strong Collaborators and I am very supportive of maximizing the use of treatment and a public health response rather than an incarceration response to drug use I think incarceration from my point of view should only be applied in cases where there is clear public harm Including property crimes However, we must also consider whether a drug problems Is the driver a property offending and if so again treatment needs to be a high priority response So in closing I sincerely appreciate your attention to this important matter it is a public health problem and Your support in joining me and the rest of the team Throughout the community to use the AB 109 implementation to tackle the serious public health problem. It is a multifax a problem and Would if we only use one tool Which is incarceration? We're doomed to fail Let us join hands and support the effort to be smart on crime That are associated with substance use disorders and not use jail beds and Incarceration is the only way to help these individuals from the public health standpoint We need more prevention treatment and recovery programs and it will take the entire community to be part of the solution Thank you for being here tonight and help us think through the planning and solutions. Thanks Thank You miss win Next speaker is Martha Rock Montes You've heard Janice mentioned and Janice is a local drug treatment program Martha Brock Montes is a Janice alumni and employee Martha was born and raised in Santa Cruz County. I think you'll find her story very insightful Hi, everybody. Thank you for being here and please bear with me. I'm a little bit nervous Um, so my name is Martha. Like she said right now. I'm 34 year old mother of five kids and An alumni of Janice Peronato and I could say an ex addict or still an addict and I Working for Janice is a promotora working with them and trying to help other women like myself That find themselves pregnant with the disease and not knowing where to look for Services or where to go? So let me tell you a little bit about myself My disease started when I was 23 years old and At 23 I found myself Pretty broken up Just a depressed. I had just found out I was pregnant for the second time from a man a guy That I was with in a relationship for 11 years I Found out that he had been cheating on me and then just he's you know not a good man, but So I told them that I was pregnant and he said well have an abortion and by then I Was Working two jobs as when I was working at Emeline health services agency as a receptionist though And then I was working graveyard at Lipton T So I found myself very depressed just found out that and When he told me that I Just didn't want to wake up anymore. Just go to sleep not wake up and That's how I started my addiction My background is really I have a couple brothers and cousins family members that are Braggart eggs have the same disease and I would see my brother sleeping all day and I'm like well, you know, I want to be doing that I'm just didn't know how to ask for help how to reach out and And My family background my parents were there, but never there for us. They were really hard-working parents So we didn't have no communication with them and There's One night my brother had his thing out there He was passed out and I'm like well, I'm gonna try it It's been like a week that I haven't Slapped or anything and at the summer I wasn't even using so I didn't even know what you know That was I knew that what that was because of my family background and my family members But never had tried up So I did try it I got really really sick But after that like Tars later, I fell asleep and there was a really good Nap I could say I really good But when I did that my feelings started to go away My feelings started numbing so I'm like, oh, you know, I guess something in me is like This is helpful instead of going to ask for Mental health or a counselor or psychiatrist therapist. No Got the easiest thing that I had near and That's what Started my disease after that. I just couldn't Let it go next thing. I know three days later. I was already strung out And It was really really hard because I couldn't tell my brother that I was strung out and I was pregnant because that would have really broken his heart because he knew that I was Straight as could be never had used or drank or anything and So I didn't tell him I just kept on um Trying to get it by myself out in the streets and everything Next thing I know is like I have my daughter and I was I got clean after I I had my daughter. I got clean. I don't even remember how Just I guess by myself um And that ended just after I had her it I started using like three months after I had her because I started having those feelings That I didn't want to feel anymore And it's like all the time that I was using I didn't have any feelings. I didn't even feel I didn't even care um Care about anything I ended up asking my son's father to take him because to me it was too much I was pregnant working and I still had my son my son was like at that time he was like five years old so he was Very active And I just needed I guess my space because I didn't want to do it in front of him um After that I've been using for 11 years off and on In these 11 years, I've been incarcerated almost 15 times and all for the same reason I was a nonviolent never property damage never stole or Anything always using and possession. I only have one possession. Thank god and um All the other times that I got arrested like I said was for warrants failure to appear um When the first time I got arrested Yes, I did get um The first I don't remember what they're called but the first program They give you the first time that you get arrested I got that if they told me if you're good for a year Don't get in trouble or anything. We'll take it off your record Well, it wasn't not even like three months when I got arrested again for under the influence um And then they're like, okay. Well, you know, we're not gonna give you another program. You're just gonna do time And I'm like, okay. So I that time I only did um 90 days And They said you're gonna be on probation. You have to go to your probation officer say clean this over and Anytime you get stopped by a cop police officer, you're gonna have to you know, let them search you or whatever Well, I did um, I was doing that like for two weeks then I started using again and Just a repetitive cycle. I would just come out be out like do good for two three weeks and then again had a warrant From I could say from 2000 Like 2007 2010 Out of those years, it probably was out like six months all together and it really um It was really hard for my family not for me because I was using and I don't you know, I was just numbing up my feelings and I would call them every time I Be in jail call them and be like, oh, yeah, I'll change. I'll change And they'd always be by my side visiting me putting money on my books Like I said be good for two thirty weeks and again there I go um, and the reason that I kept Using it's an excuse for others and Probably an excuse for me, but not really like I had um Like I said, I have five kids out of those five kids. I only have my daughter with me and The reason I have my daughter with me is because I went into jenice pernado after In 2010 after I got released from jail but before then Two of my kids got abducted by their dad It's been six years already that I hadn't heard from them seen them known anything of them and then My older son is already 15 He's with his grandma here in Santa Cruz and then I got one They got adopted And for me, that's the only thing that was helping me deal with all those feelings that I was having was using and I knew that like when I'd get you know being jail I do three months four months and I would go to the meetings they'd give us there and I knew about the top steps. I knew about having a sponsor and But I just didn't want to use them because none of that was dealing with my feelings anyways, you know, like my feelings were still there and nothing other than I'm a heron and a meth addict. Sorry that's For me, that's what was numbing my feelings Until I found myself again I was four months pregnant. I got arrested They did a pregnancy test at jail. They said you're pregnant and And I told them I wanted to keep it Even though in my in my heart and my Like I knew that there was a slim chance of me keeping her with me Because I had just gotten my son adopted in 2009 and it's really The end of 2009 when I got arrested in November 2009. So Um, so I told them I wanted to keep her that I was gonna Go on with the pregnancy and I started seeing a doctor there If the doctor even told me, you know, there's a slim chance if you've been already in the cps system A very slim chance you'll be able to keep her So I was at Blaine Street I went to Blaine Street in December of 2010 When when I went to court for that time that last time My probation officer told judge told the judge that since I've always been getting arrested for the same The same charges. They were all warrants That they wanted they wanted me to do my time and finish my my charges already that You know, I guess I was just costing a lot of money for taxpayers. I didn't know and he told me You could if you're willing to do six months in jail Um Well, you know when you get out that that'll be your time and then you'll get out without probation For me, I was like I said I was pregnant. I'm like six months. Um That was Kind of a lot for me because I'm like I'm the chance of me having my daughter with me. It would have been going out um To a program at least to perinatal because I had just gone to perinatal when I had my son But that time I wasn't able to keep him foster care he went to foster care right away and I try to I try to work on my recovery and I was doing my program But the only thing that my partner I got bypassed And my partner was the one that had the services He relapsed and that's what ended our services Um by the time that I went into perinatal. I was already I got out February 14th And I had my daughter on March 10th That was the hardest thing for me because I didn't think I was gonna keep her and Thanks to the judge giving me the opportunity and And Brianna also helping me going to the program Um, I was able to keep my daughter Um Right now she's already 15 months old And she's my pride and joy and After being clean and sober for 18 months Um, I took it a day at a time and I always tell my because my sister she's my rock. She's my everything Um, I always tell her, you know, I just take it a day at a time and there's been times that I've been thinking about, you know, like What if what if But thank god I have my daughter and I'm here and I'm clean and sober and I'm just trying to help other women like myself. Thank you Thank you Well, I want to thank all the uh speakers Uh, we there's a lot of experience on this stage. Uh, a lot of research a lot of uh, uh, uh, real life Experience, uh that has helped inform this discussion. I appreciate the preparation and the hard work that everybody put in To speaking here this evening. My name is john leopold. I'm a county supervisor From the first district representing live oak. So Cal the summit area And uh, one of the founding members of the smart on crime santa cruz county In our forums, we try to provide lots of good information So people understand about some of the changes that are going on in our criminal justice system But we also provide an opportunity for you to ask questions Some of you have turned in some questions And if there are other people who want a turning question, we'll have people go through the audience one more time To pick up any uh, additional questions Uh, but I just want to start off and um, the first question here is for uh, professor reinerman Uh, professor reinerman, what will motivate addicts to finish therapy if we don't use incarceration And coerce continued participation Is this on? Yes This is among the most difficult questions anybody in the drug treatment field faces. Uh, as far as I can tell Uh, there are people who will say that, uh, that being incarcerated helped them This of course is what they are told when they're incarcerated And it may well be true, um for some But uh, I guess I'll just sort of reiterate what I said earlier that the Unless there's something Preferably before incarceration And some programs during incarceration and certainly after incarceration that deal with the underlying sources of trouble in someone's life Then incarceration alone is never going to get at it. It's going to cost a lot of money And you're going to be right back at square one More often than not So Jail may help some people. I don't want to deny that but in the in most cases. I don't think that's true It hasn't turned a lot of people around. I mean what turns people around Uh, the love of children the love of family the opportunity to have a decent job and a meaningful role in the community I had a leader of a Drug treatment program once say to me the the best cure for drug abuse I ever ran across was a good job Right Well, thank you Before the next question, I just want to remind people that on your way in you received a clipboard that had a lot of different Piece of information There are two pieces of information that I want to hope that you'll take uh, some time to fill out one is a survey Uh, this is part of the mandated This is part of the process we're using is the mandated community corrections partnership program Uh, that the county is seeking input from the community About how we should spend our limited, uh Correction dollars, uh that are coming to us as part of this prison realignment So far we've received several hundred, uh questionnaires and we'd like your Participation and filling out the questionnaires so you could share your ideas with us It's in the packet and at the end of the evening you just give it, uh To folks in baskets on the way out um The next question I have is for our sheriff Sheriff what are the current plans for academic and training programs for prisoners? Also, what about more space for these programs and where will we get the dollars to do these programs? Okay, three part question. I'll I'll start with what are the the programs in custody Right now in in our custody system. We have limited, uh Programs in comparison to what we should be able to offer to prepare people for a reentry into society But we do a very good job with the ones that we have we have GED high school education Learning program we have english as a second language program. We have overcoming Addiction or drug abuse training in custody We have anger management training in custody And we have a very limited regional occupation program in custody Training for outside we've had over the last three years significant cuts in our training program for regional occupation, but we do teach limited computer skills and and several other Occupation programs through the county office of education The future and what the future holds in that Is really unlimited. We have been Engaged with in conversation with the County office of education the Pajaro Valley school district and the santa crew school district to bring adult education into the custody system We're trying to leverage the the assembly bill 109 dollars that come in to the custody system and Partner it with adult education Dollars that are in our community education program. So that that's in in its infancy right now And in answering the first two questions. I missed the third Where will the dollars come from? The funding everybody wants to know where the dollars come from or where the dollars are printed the funding for these These programs in custody Right now come from two different sources inmates in custody are able to buy services and Extra needs in custody and the proceeds for that go to an inmate welfare fund a fund that The money can only be used to the benefit of inmates But it's a it's a very small pot of money in comparison to what's needed for future programs The second piece of funding that's coming in for these type of Opportunities in the custody system Is the assembly bill 109? Allocation that each county is getting based on its population its prison commitment rate and and a number of different Issues The community corrections partnership Divided the allocation for Santa Cruz county into thirds It was voted on unanimously that this allocation would be split with one third two corrections One third to probation and one third to treatment outside of the custody system So the treatment that's going to come in the in custody system Will be borne out of the one third of the community corrections partnership dollars that come to my office for incarceration and in custody treatment plans Thank you very much These are questions that that you all handed in that that i'm sharing with the the panel here The next one is maybe for our health director Jane Nguyen Does treatment work as well if it's co-orced or mandated uh mandated versus voluntary treatment? I think that's a very good question. You know I come in from um The mental health um substance abuse services background. I worked as a front line nurse working with uh individuals Who were brought in by law enforcement by ambulance on a 51 50 status? On legal hold that we could hold them against their will for Assessment and evaluation and treatment and um For my personal professional experience. I think co-orced treatment mandatory treatment my surf short-term Gratification what from the provider side of it, you know, we want to see people get better quickly But does it help people really sustain the long-term positive recovery effect of it? No I think it's better that we come from the public health standpoint again Is prevention is education through education to outreach To help the person with informed decision to receive treatment. I think it's better That we get voluntary treatment From the public health treatment perspective. It's better that way versus mandatory There'll be individuals who might need um immediate interventions for psychosis or for withdrawal Syndrome so that we can help them recover during that acute phase But after the acute phase we really need to get into the mode of helping the person understand better About the effect of getting treatment on a voluntary basis so that the person can continue on with their journey of recovery Thank you Maybe it's just a follow-up Professor Reinerman, are you aware of any studies that point to efficacy of mandated versus voluntary programs? I don't know that offhand no, but I would agree with what you just said that Again, unless you're going to deal with the underlying the sources of pain and trauma whatever in in the life of the person then you know, you may Prevent them from using drugs while they're incarcerated And if you force them into treatment The the downside is that they will not have made the personal commitment And it's a difficult struggle as we've heard tonight and and most people in the audience probably already know It's a long hard road And unless you are prepared to do it and committed to doing it Which means voluntary Then your likelihood of success goes down from there, right? Thank you Martha you had a very powerful story of your own personal journey And uh, I'm wondering if you could just Talk about what services would have helped you that were not available when you needed them Were there services that you wanted to get but but that weren't there at times counseling I Really helped me when I was at jenice perinatal was working with my counselor a lot of writing a lot of writing to get over Not to get over but try to eliminate or Lower the pain of not having my kids Just coming to to an idea I guess Um More than anything I would have I think I wouldn't have been using or been out there as much if I would have been getting help But uh when I really needed it by counselor or therapist like I said, um Working with my inner fillings Sure And that's getting to the underlying causes that the professor reinerman was talking about to deal with that Was a good way to deal with the addiction problem Yeah, right the reason I would use was to numb all those feelings and the pain Thank you Currently there's a bill in the state Legislature senate bill 1506 By senator leto that would reduce drug possession to mr. Miener offense I'm not sure About what the chances are passing but has uh the has the sheriff looked at What kind of cost savings that might be uh might be incurred if a bill like that gets passed I'm aware senator lentos bill. I do not know what um And we haven't examined the the potential Savings or or even the change in our custody model if that were to go into place We're just now bringing in data with regard to what assembly bill 109 has brought us in the last Uh nine months and um thanks to chief heart. I have some uh a snapshot of today's data and 97 of the people that assembly bill 109 have brought us are in custody for drug alcohol or a minor theft offense And so um that does correlate to to senator lentos bill, but I I don't know how that would change There would still be a custody Um Segment whether it be felony or or misdemeanor. I just believe the length of time would would be reduced Okay, thank you Director win, uh, if someone goes to a county health clinic seeking drug treatment What is available if they have no insurance and no money? Great question too. Um, thank you for asking the question I don't know of you aware of the latest and greatest program that we just implemented from the county called the low-income health program Um, the low-income health program was part of the health care reform movement that the state of california has implemented for Counties throughout the state to opt in if we so choose to do it And with that program now we if someone walked into the clinic who has no insurance Has no ability to pay for the services. They feel they need They could be Encouraged and staff will be there to help them fill out application for the low-income health program And that program actually has um the benefit package of providing Accenture mental health services and substance abuse services as the individual needs We also have we are obligated as a county to provide intelligent health care For those who are unable to pay But that program is limited. We are not able to provide Necessary substance abuse services for those individuals. So I think the good news is we do have the low-income health program And also we look forward to the passage of health care reform By the supreme court in august of this year. So let's keep our finger crossed. Okay, that's the health income health federal health reform to happen because when that happened We estimated that about 17,000 of our citizen residents here in in santa cruz county will be eligible for matic cal And then we are hoping for the parity Of substance abuse services mental health services and health services to happen as well So that people could be eligible and access Mental health substance abuse services and primary health care as well So that's a real benefit of uh of uh the the the health care reform act that was passed last year Let's keep our fingers crossed. Yeah, we'll wait to see what happened with the supreme court I want to say uh to everyone here that in the Packet of materials that you received there was a list of a number of programs in santa cruz county in which you can get involved It's something you're interested in there is a volunteer interest form which if you're interested in being contacted by any of these Organizations you can fill that out and hand that in at the end of the evening as well I hope you'll take a time to be part of the solution here in santa cruz county This next question is uh for professor reinerman It's widely understood that relapse is part of recovery But yet we send people back to jail for relapsing and treatment What effect does that have and does it work? Well, yeah risk of repeating myself If you send somebody back to jail Any progress they had made Is sort of stalled And whatever problems that they still faced and were still struggling with will remain until they get out Now there's some progress that may be made in in one of the programs that the sheriff described But but basically relapse is a predictable part of recovery Is this true for people who tried to quit smoking? Or tried to quit drinking? You know, you don't make it the first time or the first two or three times very often But people keep trying so In the alcohol field they they there's a Kind of shorthand where they talk about the four L's that help people get clean One of them is law But if you leave that aside, there's three more L's liver Meaning broadly your your health will say you got to cut this out now. That's partly insane Lover Your partner will say i've had enough of your drinking You got to straighten up or i'm out of here And livelihood The boss will say you don't come back from these three martini lunches and take a nap on your desperate two hours You're fired if you do that again So all of those other incentives that the community in one form or another can provide It seemed to me are likely to be more effective tools Then yanking somebody out for for a dirty urine and saying all the things you've managed to accomplish Aside from you know Caving into temptation at a certain point. All that gets washed away. That doesn't help the long run for recovery I kept on waiting for one of the L's to be leopold, but uh Martha uh Janice that got talked about this evening the the program and has both a residential on an outpatient counseling program From your point of view, how do you know when someone needs residential counseling? Versus outpatient or 12 step counseling. Do you have a perspective on that? Not really, but that's why there's um counselors where they could make their plan treatment um their treatment plan together But I would say like if you're In using like me for years and then years. I think you need Residential treatment. I don't think um day treatments can help a lot Thank you. Uh, director win any sense from your perspective about when and why we people choose these different services Yes, I think it really depends on the person's size and symptoms at the time and depends on the conditions in terms of acutia or chronic Most most the time the person will need a system of care approach Meaning a broad spectrum of everything that might be available to that person Including housing including opportunity to To gain employment to seek education It's important that the person has stability in terms of housing needs So that that person can have a peace of mind And have access to necessary services. So whether it's residential treatment, whether it's Therapy counseling most of the time it's a combination of almost everything to help the person through Okay, thank you. I just want to remind everyone again about the questionnaire that we gave you And the hopes you'll fill out we do have a facebook page if you look up smart on crime on facebook Um, we're going to be posting information from this forum as well as Information we receive from the survey in the coming weeks And we'd love for you to go to that facebook page You can like it if you if that's something you want to do, but it will also be providing information Um I guess this is a question for The sheriff has the county saved any money so far by sentencing low level offenders like drug users to electronic monitoring And have we had any failures? Well, the first answer is absolutely we've we've saved over 6000 bed days Since october 1st with electronic monitoring alone a bed day is a day where one of much like the seats in this audience Are unavailable because a person is occupying it And it can't be used for a high risk offender or someone who really needs to be in custody for public safety The electronic monitoring program Has been offender paid More than 90 of it offender paid So it hasn't been a cost of the county to run the program from that perspective the supervision behind the program Is is where the the assembly bill 109 funding has come into place And then lastly have there been failures? Yes, there have been but we've we have over a 94 success rate in the more than 100 people that have Participated in the electronic monitoring program to date I appreciate that information and maybe uh, you could just also address if uh With these programs that we're now trying to that we're doing the electronic monitoring Program Trying to work with people when they're in jail. Could we do that and build new jail bed? space with our With our funding from the state The funding from the state barely covers our existing programs building New jail beds in santa cruz county just would not be the answer. I mean, I agree with Dr. Reinerman with miss miss new in You can't arrest and incarcerate your way out of this problem Building a new jail today in today's construction cost is over $100,000 per bed So you do the math if we needed to add a 100 bed facility we would go through 20 times the annual funding For the entire ab 109 program just to build the facility Then there's the ongoing cost of staffing that facility so no adding Prison beds to santa cruz county isn't the answer and and I do believe the custody alternatives program managing our inmates and and bringing them to an incentive-based Education system while in custody and in partnering with health services other community-based organizations as they're released Is the answer and probably the most cost-effective way to run this program Thank you I want to thank all the speakers on the panel tonight for your work that you do day by day For for the stories that you told and the information that you shared It's very important for our community to understand. What are the drivers of incarceration in our county? What are the strategies that we can use to be more successful and reducing recidivism? And ultimately all these pieces together help to promote a good public safety. I appreciate everyone's participation here tonight We didn't get all the questions answered. We're going to try to share these With our panelists in the coming days and post them on the facebook page If you're interested in finding out about them, I want to encourage you to take the opportunity to volunteer And and share that interest form with us on the way out and I want to thank The organizers of today's event the smart on crime santa cruz county There was an organizing committee of people who work to get people to come here this evening Community tv for their work in filming tonight and apt us high for providing this beautiful facility We will This isn't an evolving part of county government. We'll be working on this I encourage you to stay informed and stay involved visit the facebook page at smart on crime santa cruz county Read the articles that are in the newspaper and and where you have questions choose to get involved We're a better community when that happens. Thank you for being here tonight