^County of Santa Clara
Office of the County Executive

&

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is

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CE03 041602

Prepared by: Sally Logothetti
Program Manager II

Reviewed by: Peter Kutras Jr.
Assistant County
Executive
DATE:

April 16, 2002

TO:

Board of Supervisors

FROM:

Richard Wittenberg
County Executive
SUBJECT:

Six Month Status Report for the Proposition 36 Program

RECOMMgNDEP ACTION

Accept the-Status-Report-on the first-six months ofth©-Proposition~36 programv-FISCAL IMPLICATIONS

There are no fiscal implications associated with acceptance ofthe report.
CONTRACT HISTORY
None.

Board of Supervisors: DonaJd F. Gage, Blanca Alvarado, Pete McHu^,James T. Beall Jr., Liz Kniss
County Executive: Richard Wittenberg

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REASONS FOR RECOMMENDATION

The attached status report provides information on the first six months of operation of the
Substance Abuse and Crime Prevention Act(SACPA,or Proposition 36)program. As is
indicated in the Executive Summary,the report documents significant successes achieved in
rolling out the implementation.

The status report was reviewed by the Proposition 36 Steering Committe on March 14th, and
by the Public Safety and Justice Committee on April 4th. Upon approval by the Board,
Administration will release the information to the community.
BACKGROUND

On July 1, 2001,the new Proposition 36 program began operation in Santa Clara County. The
program was developed through a highly collaborative process between the criminal justice
and treatment systems. Santa Clara County has been a leader in providing treatment and court
supervision to drug offenders through its Drug Treatment Court. This successful model
provided a foundation for developing the SACPA program that builds effective collaborations
among the various stakeholders.
The Office of the County Executive was designated as Lead Agency for implementation of the
new program. An extensive planning process received active support firom many players,
including the District Attorney, the Public Defender, the Probation Department, and the
Department of Alcohol and Drug Services. The Presiding Judge of the Superior Court has
been very supportive of the Proposition 36 program, and is committed to the drug court model
in the nine courtrooms which are hearing Proposition 36 cases
CONSEQUENCES OF NEGATIVE ACTION

'Iflhe fepdfi is nofreleased Tf wiirbeliifficuirtb'pfovide fimeryaM'acbufate ihfofmatioh'
regarding the implementation ofProposition 36 in Santa Clara County.
S.TEPS FOLLOWING APPROVAL

Administration will release the Status Report to the media and the public.
attachments

Board of Supervisors: Donald F. Gage, Blanca Alvarado, Pete McHugh, James T. Beall Jr., Liz Kniss
County Executive: Richard Wittenberg

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DRAFT

SANTA CLARA COUNTY

PROPOSITION 36- THE SUBSTANCE
ABUSE AND CRIME PREVENTION
ACT OF 2000

STATUS REPORT
JULY - DECEMBER 2001

Prepared by the Proposition 36 Steering Committee

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

1

t

C)
• Six Month Status Report Draft(Miscellaneous)

Board of SupcrvisorB: DonaJd F. Qago, Blanca Alvarado, Pete McHugh, Janies T. Beall Jr., Liz Kniss
CounQ' Executive: Richard Wittenberg

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This report is dedicated to the memory of Alice E. Foster, Deputy County
Executive, whose patience, guidance and vision led us in the initial
implementation of Proposition 36.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

2

Executive Summary
The Substance Abuse and Crime Reduction Act- SACPA,or Proposition 36 - became
effective July 1, 2001. Implementation of this new law, which requires a high degree of
coordination between the treatment and criminal justice systems, has been accomplished
in Santa Clara County through extensive planning and activity by the Courts, the criminal
justice system,the Department of Alcohol and Drug Services, and community treatment
and service providers.
Initial client contact indicates that a significant percentage of the SACPA clients are
chronic drug users with serious criminal histories. The level oftreatment required, as well
as supervision, reflects this.

Our implementation team has developed a number ofinnovative methods for providing
effective services. Provision of a sufficient amount of treatment capacity, and a sufficient
range oftreatment options, has been a high priority since the beginning ofthe planning
process. While the maximum number ofresidential treatment beds available is not as

much as we want, the treatment team has increased the number of transition housing
available to accormnodate clients needing a structured living environment while in
treatment. In addition a new modality-intensive outpatient- has been developed to
incorporate case management and more treatment time into the schedules of clients who
have this level of need.

Another implementation achievement is the establishment of an assessment center at
which both supervision and treatment staff can interview clients. The proximity of staff to
each other, and to the court at which many ofthe cases are heard, promotes client success
through early motivation and easy access to services.

Other early successes included procedure adjustments and streamlining once clients
began to appear in court. These procedural changes helped get assessment information
into the courtroom quickly, allowing clients to move through adjudication and into the
treatment system.

W'e have chairenges before usi Like most counties, we are stil^ seeking improvements in
how we deal with the many clients who are dually diagnosed, and whose mental health
needs must be addressed in order for them to be successful in drug treatment.

We also face serious budget issues as the SACPA program continues. Although we will
be able to fund our desired level of services and treatment in the next fiscal year, we
anticipate significant reduction in Fiscal Year 2004. We will continue to seek solutions to
these problems as we move towards completion of our first full year of operation.

Overview of the Legislation
In November 2000, the voters of California passed Proposition 36, the Substance Abuse
and Crime Prevention Act 2000(SACPA). SACPA made significant changes in the

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

3

processing of drug cases by the criminal justice and substance abuse treatment systems.
In brief, SACPA changes state law to require treatment rather than incarceration for
persons convicted of non-violent drug possession and use offenses. Qualifying offenders
who were on probation or parole as of July 1, 2001 are also eligible for treatment.

The intent of the program is to enhance public safety by reducing drug-related crime, as
well as to preserve jail and prison space for serious and violent offenders. The underlying
premise is that substance abuse treatment is a cost effective method for improving both
health and public safety. Criminal offenders who are drug dependent, and who receive
drug treatment, are less likely either to commit new crimes or to continue using drugs.
This in turn provides them the opportunity to lead more stable and productive lives. In
addition, SACPA is intended to promote savings oftax dollars by reducing incarceration
costs.

SACPA established funding through Fiscal Year 2006 to support county drug treatment
and supervision operations. For the six months prior to July 1®', counties received a
portion of$60 million in startup funds. Each annual allocation will be a share of$120
million. Allocations are based on a formula, which considers population, arrest data, and
treatment caseload data for each county.
Santa Clara County received $2.49 million for Fiscal Year 2001, and $4.96 million for
Fiscal Year 2002.

Planning: Service Coordination and Collaboration
Santa Clara County adopted a collaborative policy development approach to SACPA
implementation. The County Executive’s Office was designated as Lead Agency to
provide a focus on the balance between treatment and criminal justice needs.
A high level of administrative participation was ensured through the Board of
Supervisors’ appointment of a multi-disciplinary_.steering coguBittee. Planning efforts
occur under the leadership and direction of the Proposition 36 Steering Committee, which
has met regularly since the passage of the Proposition 36 legislation. Initial meetings
were devoted to development ofclient population estimates, implementation strategies,
and budget recommendations. Since approval ofthe implementation plan, the Committee
continues to provide policy guidance and support for program activities.
The Court Working Group is comprised of participants from the Court, the Department of
Alcohol and Drug Services, and the Probation Department. This group met weekly during
the first six months ofimplementation, and continues to meet on a bimonthly basis. The
group has resolved critical implementation issues such as changes in treatment capacity
needs, improvements to the assessment and reporting process, and how to structure rapid
reassessment for clients needing treatment modifications.

Further collaborative efforts have been maintained through an Evaluation Team. The ETeam includes analysts, programmers, and subject matter experts who oversee data
Santa Clara County SACPA Status Report July I 2001 - December 31 200!

4

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collection and evaluation. During initial planning efforts, the E-Team developed an
evaluation protocol, performed a process analys;is, identified gaps in data collection, and'
began planning evaluation efforts in conjimction with consultants from the Northwest
Professional Consortium. Staff from the Criminal Justice Information Control(CJIC)
unit, which manages the interagency criminal justice data system, are critical to this
effort.

The Operations Working Group is a small and informal group that provides department
staff with a forum for brainstorming and problem solving. Members meet monthly as
needed on a variety of operational issues.
Santa Clara County has a successful model for providing treatment and court supervision
to drug offenders tlirough its Drug Treatment Court. This model, which relied upon the
building of effective collaborations between the various stakeholders, provided a
foundation for the development of a collaborative SACPA process. Due to the
tremendous efforts put forward by the Courts,the Department of Alcohol and Drug
Services(DADS),the Probation Department, CJIC,the Office ofthe District Attorney,
the Public Defender, the General Services Agency, and many others, our local program
began operation on time and is moving effectively through early phases of activity.

Program Implementation
[side bar]Santa Clara County’s core objectives in implementing the SACPA program
included:

• Establishment ofa meaningful collaboration between the criminaljustice system,
the Health and Hospital System, the Social Services Agency, and community
treatment and service providers
• Adoption ofthe Administrative Office ofthe Court Workgroup’s Drug Court
model with designatedjudges and calendarsfor review ofclient progress and
monitoring treatment and probation compliance
• Use ofa non-adversarial approach in which prosecution and defense counsel
—promote publie-safety-while supporting-partieipants-success in treatmentf
• Provision ofassessmentsfocused on each individual’s needs;
• Provision ofan integrated court, probation and treatment system to supervise and
manage substance abusing defendants under court supervision, and designed to
permit defendants to move between treatment and supervision levels as they
progress orfail in treatment;
• Development ofan evaluation process, which identifies critical participant
information, provides outcome measuresfor both participants and
implementation impacts, and assists in ongoing planning and adjustment to the
program.

[different side bar]The County is currently implementing public education activities to
assist the community in better understanding the requirements ofthe law. An

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

5

informational brochure is plannedfor distribution through the courts, the District
Attorney’s Office and the Department ofDrug and Alcohol Services. In addition, an
article will be published in the County’s Alliances community newsletter that is
distributed to local business organizations, community centers and Countyfacilities with
high public traffic. Finally, information is under developmentfor posting on County web
sites.

Program Components
Assessment: A joint client assessment process conducted by Probation and Department
of Alcohol and Drug Services staff began July 1, 2001, with staff temporarily located at
the Adult Probation office. The close proximity of staff facilitates a high degree of
interaction and communication and promotes prompt attention to client needs.
[side hdix\Since November 2001, the SACPA -Prop 36 Assessment Center has been
located across the streetfrom the Terraine Court Facility, in which the largest number of
SACPA cases are heard. The Center houses staffproviding assessments, case
management, and supervision services. The easy access to andfrom the Court was
deemed criticalfor motivation and accountability ofclients. It is also highly effectivefor
ease ofcase management and reassessment leading to treatment plan modification.
Five probation officers conduct interviews with participants at the Assessment Center,
and prepare reports to the Court outlining the defendant’s substance abuse history,
criminal background, and future risk to offend, as well as observed social, psychological
and vocational needs. This information is shared with DADS so they have current and
accurate information necessary to assess the client’s treatment needs. The probation
officer also makes a recommendation to the Court as to the supervision level the client
requires.
Six stafffrom the Department of Alcohol and Drug Services work closely with Probation
and the Courts to assess participant treatment needs. Ofthe six staff in the Assessment
Center, only two are funded through the SACPA program; the remaining four are
previously existing positions which were reassigned to meet the SACPA assessment

need. Assessments take into account the client’s current drug and alcohol use and history,
and motivation for treatment. In addition, assessors review housing, mental health,
vocational, educational, medical status, and dental and other ancillary needs. The
referring party, the Courts or the Board ofPrison Terms, receives a report recommending
treatment placement. If a participant’s level oftreatment requires modification,
assessment staff provide updated information to the Court by means of the Treatment
Status Report(TSR).
Both DADS and Probation assessment staff travel to the jails daily to perform
assessments on clients in custody. It is a goal of the program to provide assessment
results on in-custody clients to the Court within seven working days. This rapid
turnaround helps to achieve a rapid release of the client to treatment.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

6

V)

Supervision: Once SACPA clients have been sentenced and referred to treatment, the

Probation Department works closely with the Courts and DADS in providing supervision.
Clients are placed in one offour levels of probation supervision, each distinguished by
different standards of contact between the client and probation officer.

Face-to-face client contact occurs most frequently for clients in the Drug Treatment Court
Unit(DTC), which concentrates on the most seriously addicted. Staff in this intensive
supervision unit have caseloads of60 clients per officer. These clients are tested at least
weekly, and the DTC team prepares and closely monitors individualized treatment plans.
Four probation officers in the newly created Recovery Services Unit(RSU)maintain
intensive supervision caseloads, each containing 100 SACPA clients. These officers are
located at the Assessment Center, and see clients who require a high level of contact due
to the seriousness of their criminal history and/or their level of addiction. Both DTC and
RSU officers are assisted by community workers who help maintain the level of direct
contact with the client at home and work.

General Supervision officers see their clients an average of once per month; clients in the
Administrative Monitoring Unit are seen less frequently, but monitored for treatment
program progress reports and testing results.
All probation officers provide information regarding their supervision to the Court
through progress reports at scheduled review hearings.
Drug Testing: Although SACPA funds cannot be used for testing, counties are now
receiving funds through the passage of Senate Bill 223 (Burton). This funding is available
for drug testing costs associated with Proposition 36 implementation. Drug testing is one
tool available to the treatment and supervision team to assess the client’s progress, or lack
of progress, in treatment. When there are relapses, it is the intent of the team to respond
immediately and effectively, and make a determination as to whether a more structured
treatment and/or supervision environment is necessary. In support ofthis programmatic
intent, the Probation Department monitors progress through engagement of clients in a
drug testing regimen. Probation staff act as a liaison to the Court and DADS,sharing test
results via^both informal communications and scheduled progress reviewsrSometreatment providers also test their clients and report the results to the Court.

Orientation: All clients are referred to orientation sessions prior to beginning treatment.
Sessions are conducted in the afternoons, evenings and on Saturdays at two sites. At the
centrally located site, child supervision is provided for parents attending orientation. It is
a goal of Santa Clara County’s program to have all clients attend orientation to review the
law and the benefits of participating in and completing treatment, and allow the clients to
consider their own drug use and behavior. Explanations and handouts are also provided
regarding support services available in the comfnunity.

Treatment: Treatment services are offered by county and community-based providers
whose contracts are monitored by the Department of Alcohol and Drug Services.
Services are offered along a continuum of care, which addresses the level of need of each

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

7

participant.(See Appendix 3 for description oftreatment modalities.) All contract
providers are licensed or certified by the State Department of Alcohol and Drug
Programs. Providers are responsible for developing individualized treatment plans and
providing Treatment Status Reports and recommendations to the Court if clients need
their treatment plans modified.
Case Management: Through a collaborative effort between the County and our local
community based organizations, eight case managers provide assistance to SACPA
clients in reaching their recovery goals. Managers are assigned to those SACPA
participants whom the Court feels will not succeed without coordinated assistance and
monitoring. Assessors and treatment providers may also recommend clients for Case
Management services. The goal is that eventually each case manager will have a caseload

of40 clients, some short-term and some long-term, and will receive assignments based
on language and ethnic orientation. Case management services are offered in English,
Spanish, Vietnamese, Tagalog, German,Portuguese and various languages of Africa.
Case management services include help with making the initial connection with
orientation and treatment programs; monitoring of client participation in treatment and
compliance with conditions ofProbation; and support in accessing ancillary service needs
such as emergency housing, food, clothing, medication or medical services, and

transportation. The case managers work collaboratively with probation officers. County
treatment staff, and community treatment providers. Case manager submittals of TSRs
provide an additional source ofinformation to assist the judges in reviewing the clients’
progress in treatment programs and other services.
Other Services: A wide variety of services which are not classified as “treatmenf are
available to SACPA participants. These include transitional housing for clients who do

not have a safe, stable, and drug-free living environment, and psychiatric evaluations and
subsidized psychotropic medications for dual-diagnosed clients. The SACPA Job
Readiness Training Program is also available to clients having difficulty finding
employment.

All clients are assessed for their needs for other services which will support their success
in treatment-Referrals^for ancillary services eanbe mad&by assessment staffrprobation
officers,judges, and treatment providers. The Ancillary Services Coordinator reviews all
requests for assistance and provides referrals to agencies providing these specialized
services at low or no cost. The Coordinator has already developed an extensive inventory
of these services, including medical and dental, literacy, vocational, professional clothing
for job interviews, housing, mental health, tattoo removal, and educational.
The SACPA Process

SACPA applies to simple drug possession and use offenses, as defined by law. Potential
participants in the SACPA program are initially screened for eligibility by the District
Attorney or by the Board of Prison Terms if already on Parole.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

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VJ

Participants are seen in one of nine courtrooms in Santa Clara County. Two departments
in the North County (Palo Alto and Sunnyvale), and one department in South County see
SACPA clients; the remaining courtrooms are located in downtown San Jose, either in
the Hall of Justice or at the Terraine facility.

The SACPA process is illustrated in the following flow chart:

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

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1

SANTA CLAi<A COUNTY SACPA PROCESS FLOW

Parole

New Arrest/Citation

Violation

DA Determination of Prop.36 eligibility
Prop 36 Eligibility
Review &

Arraienment

Findings by Board
of Prison Terms

1
Traditional

Refuse

Sentencing*

treatment

<

Plead

Plead Not

Guilty

Giiiltv

>

i

Trial

Service of Treatment

i

1

Conviction

Order

No conviction

I

Y
End

Referral to County
Treatment Assessment

Assessnaent/Reassessment

I
>

Provider Treatment

Refuse
>

Sentencing

Treatment

Traditional

Orientation

BPT Acceptance of
Plan

90-day Parole Progress
Reviews

fipntpnrino*

Probation

Treatment/
>

Violation

Non

Drug

drug

Related

related

I

Review Hearings

2nd Parole

Successful

Violation

Completion

I

t
Treatment/

End

Non

Successful

Drug

Supervision

Related

Modification

drug

Completion

related

lst/2nd

DutofProp
>6 Program

Violation
End

I
3rd

OutofProp
36 Program

Revocation

hearing

Violation

T
Treatment/

Out of Prop
36 Program

* Traditional sentencing can include E>rug Treatment Court, jail or prison.

Supervision
Modification

ji

Participant and Process Data
During the first six months of operation, 1,541 persons were referred to treatment through
the SACPA process. A total of 51 persons - less than half of one percent - refused
treatment and received traditional sentencing.

Ofthe total referred, 1,424, or 92% came through the Court system, and the remaining
117, or 8% were referred by the Board ofPrison Terms. If current trends continue, a total
of 3082 clients, or nearly 260 per month, will have been referred by the end of our first
year of operation.
The following chart provides statistical information regarding clients referred to
treatment.

Number of Clients

Percent of total

18-25

291

20.4%

26-35

502

35.3%

36-55

617

43.3%

14

1.0%

1424

100.0%

1031

72.4%

393

27.6%

1424

100.0%

Caucasian

533

37.4%

African-American

125

8.8%

Hispairic/Other

677

47.5%

Asian

89

6.3%

Total

1424

100.0%

Over 55

Total

Gender

Male
Female
Total

Ethnicity

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

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Of the 1,424 clients referred by the Court to SACPA treatment, 752 had felony
convictions and 672 had misdemeanor convictions. (Figure 2).

SACPA Conviction

□ Felony H Misdemeanor
Figure 2: SACPA clients based on most serious conviction.

Some early fi gures are available regarding client compliance with court requirements.
Out of 1,424 clients, 98 had at least one Failure to Appear bench warrant ordered after
sentencing. This represents about 7% of the total number of clients referred. (Figure 3).

Bench Warrants Ordered for SACPA Clients from July
1, 2001 to December 31, 2001
At least 1 bench
warrant ordered

98 (7%)

No bench warrant
ordered

1326 (93%)

ED At least 1 bench warrant ordered SNo bench warrant ordered

Figure 3: Bench Warrants ordered for SACPA clients after sentencing.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

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u

Out of 1,424 clients, 298 had at least one drug-related Violation ofProbation (VOP)charge. This represents 20% of the total clients referred. The breakdown by number
of violations(Figure 4)shows that one participant had already had three noncompliance situations within the first six months of the program. It is possible that a
non-compliance rate of20% is underrepresented simply because there are only six
months of data.

Drug-Related Violation of Probation of SACPA
Clients from July 1,2001 to December 31,2001
1200

1000
05

c
01

800

D
o

600 J

<u

6
3

400
251

Z
200

46
3%
1

0

1

No Violation of

First Violation of

Second Violation of

Third Violation of

Probation

Probation

Probation

Probation

Figure 4; Violations of Probation ordered for SACPA clients.

Supervision

Between July 1, 2001 and December 31,2001, the Probation Department completed
1,523 participant assessments; 46 % took place while clients were in custody.(Figure 5).
Of those assessed, the Court placed a total of 1,302 clients on formal supervision.(Others
‘5
rd Eritryof Judgemenf, had
may have'chosefianoflTefsentencing
their cases dismissed, or been placed on summary probation.) Figure 6 displays the array
of supervision levels to which clients were assigned. The percentage of probationers in
intensive supervision units(35%)will be watched as caseloads continue to grow over the
next several months.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

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(

)

Supervision Assessment Activities for SCAPA Clients from
July 1, 2001 to December 31,2001
900
—

800
c
V

700

S
Vi
Vi

600

V
Vi

<
o

^

r*p.-

500
400

^ 300
s
3

200

2
100
0

In- Custody Assessment

Oul-of-Custody Assessment

Figure 5: Supervision assessment activities for SACPA clients by the Probation Department.

SACPA Clients by Level of Supervision
Administrative

Drug Treatment

Monitoring

Court Unit

203(16%)

246(19%)

Recovery Service
Unit

General Supervision

205(16%)

648(49%)

D Administrative Monitoring

9General Supervision

□ Recovery Service Unit

□ Drug Treatment Court Unit

Figure 6; Level of Supervision of SACPA clients

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

13

Treatment

During the first six months, the Department of Alcohol and Drug Services completed
1,730 participant assessments. Ofthat total, 1,515(88%)resulted in referrals for
treatment. Referrals were performed for 1,360 clients. The number of assessments and
referrals are greater than the number of clients, as some clients are reassessed and re
referred as they progress through SACPA process. Some assessments did not result in
referrals; this may reflect that clients remained in custody on other charges after an
assessment was performed. 48 % of the assessments took place while clients were in
custody.(Figure 7). Of the clients confirmed to be in treatment, 59 clients(6%)were

referred by the Board ofPrison Terms; the remainder were referred through the Courts.

Treatment Assessment Activities for SACPA Clients from July
1, 2001 to December 31,2001
1000
Vi

C

900
800

2 700
(A

a>
Vi
Vi

:9Q5:

600

<

500

O

400
300

£
3

200

^ 100
0

In- Custody Assessment

Out-of-Custody Assessment

Figure 7: Treatment Assessment activity for SACPA clients

Ofthe 1,360 participants assessed for treatment,987(73%)were placed in a County
treatment facility or with a treatment provider under contract with DADS. Since
pro'cedtiTes'fOTtdentifying SACPA'clients were-ffewmd may not have beemconsistently
followed initially, this number is thought to be low. An additional 135 clients(10%)were
referred to treatment elsewhere (private or out-of-county).
Some of the characteristics of clients in treatment in Santa Clara County are shown
below.

Gender

Male

73%

Female

27%

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

14

{

m

m

Age
18-25

18%

26-35

35%

36-55

45%
1%

Over 55

Ethnicity
Caucasian
Afi*ican-American

Hispanic

36%
8%
48%

Asian

6%

Other

2%

Methamphetamine is the drug of choice for SACPA clients in Santa Clara County:
Primary Drug of Choice
Methamphetamine

53%

Cocaine

12%

Marijuana

10%

Heroin

6%

Other

19%

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

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I

Secondary Drug of Choice
Alcohol

28%

Manjuana/Hashish
Methamphetamine

17%

Cocaine

8%

Other secondary drugs
No Secondary drug use (one

7%

11%

29%

drug only)
Moreover, the large majority ofSACPA clients use multiple drugs:
Multiple Drug Use
One drug only
More than one drug

29%
71%

It was anticipated that the majority(86%)of the SACPA population would require
outpatient treatment, and that approximately 18% would require residential treatment.
After six months, it appears that the usage of residential treatment is higher than
estimated, while the usage of outpatient is somewhat lower(Figure 8).

Projected versus Actual Program Service usage for the First 6
months from July 1,2001 to December 31,2001
100%

81%
80%
N S

60%
40%

24%

18%
20%
0%

CXitpatient Service Usage

Residential Service Usage

□ Projected H Actual
Figure 8; Projected v. Actual Service Usage- 7/1/01 to 12/31/01

Substance abuse treatment clients can and do receive more than one form of treatment.

As an example, in the continuum of care system, a client may be first referred to a
residential program, then to outpatient treatment, and finally to aftercare education
following discharge. A client may also be referred to a transitional housing situation
while receiving outpatient treatment. Since the treatment system is structured to be
flexible to meet the needs of the client a wide variety of service combinations are
available. Figure 9 displays the number of clients who used a specific services and
combinations from July 1,2001 to December 31, 2001.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

16

/

I

Number

Service used

of Clients
9

Detox Only

26

Outpatient + Intensive Outpatient
Outpatient + Psycho-education*

24
638

Outpatient Only
Residential + Detox

4

Residential + Detox + Outpatient
Residential + Outpatient

3

51
2

Residential + Outpatient + Intensive Outpatient

131

Residential Only
Treatment +Transitional Housing

95

Other

4

Total

987

Figure 9: Services Used by Combination
Psychoeducation reporting incomplete

Clients that are placed in a THU are required to receive Standard Outpatient treatment, Intensive
Outpatient treatment, Methadone Maintenance Services at a County Clinic, or Heroin Detox in
combination with Outpatient treatment

SACPA clients tend to be chronic drug users who have been seen previously in the
treatment system (59% have prior treatment episodes). During the first 6 months of
implementation, changes were made to the treatment mix in order to accommodate
surfacing client needs. For example, lack of certified licensed bed space created a need
for additional transitional housing beds, and use of those beds in conjuction with a newly
implemented intensive outpatient modality.

Another example is the creation of a program which is responsive to the chronic nature of
the female population. The Women's Wellness Program accommodates women who have
mental health issues, and domestic violence and/or other abuse issues

SACPA services represent only a portion of Santa Clara County’s larger system of care.
As displayed in Figure 10,SACPA clients receive treatment services outside of those

funded by SACPA dollars. SACPA clients are placed in non-SACPA beds or slots if they
have specific needs such as mental health, geographical, environmental or language
capability outside of those provided through the SACPA treatment contracts. They can
also placed in an available slot in the larger system ofcare if a SACPA slot is not
immediately available. Some treatment wait lists occurred in SACPA during the first 6months due to the onset and saturation of clients in new services

Service

SACPA Clients

Currently Enrolled

SACPA

Opened To Date

in SACPA

Clients in the Adult

Slots/beds

System of Care

Modality

Slots/Beds

Outpatient

825

377

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

134

17

Residential

247

21

65

Transitional

100

47

2

Methadone

10

0

10

Perinatal

12

0

3

Psycho

81

66

0

702

702

NA

Housing

Education

Orientation

Figure 10: Client Placement in SACPA and non-SACPA

Mental Health Data

Of the 987 clients who have begun treatment through SACPA, 179, or 19%, have been
seen in the mental health system during the period July 1, 2001 to December 31, 2001. In
addition, 31 SACPA clients have accessed the psychiatric care available to SACPA
clients through the Department of Alcohol and Drug Services, and have had at least one
appointment scheduled. Additional data is under development in this area, but it appears
that there are a significant number ofSACPA clients whose mental health issues, if not
addressed, impair their progress in treatment.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

18

Jail Population

Figure 12 shows the average jail population for the first six months ofSACPA
implementation. Since July 2001, it has been steadily dropping from 4,101 to 3,799 with
no significant upturn. The population level of 3,799 for December,2001 is the lowest
since 1993. The drop in population is a continuation in a trend which has brought
population down from a high in the Fall of 1997 of over 4,800.
This six month drop is interesting in that the jail population generally tends to rise in the
Fall, and when there is a downturn in the economy. However, no direct correlation to
SACPA implementation can be ascertained as yet. There are many factors that contribute
to the size of the jail population, and additional study is needed to determine how much
impact SACPA has had on the recent drop.

Santa Clara County SACPA Status Report July I 2001 - December 31 2001

19

KJ

Appendix A
Proposition 36 Steering Committee
Peter Kutras, Jr. Assistant County Executive, Chair

Maryann Barry, Director, Custody Health Services, Dept, of Correction
John Cavalli, Chief Probation Officer
Susan Chavez, Director, Office of Pretrial Services

Patrick Dwyer, President, Santa Clara County Police Chiefs Association
Robert Gamer, Director, Department of Alcohol and Dmg Services
Dr. Michael Goiman, School of Social Work, San Jose State University

Mel Johnson, Unit Supervisor, State Parole Office
George Kennedy, District Attorney

Nona Klippen, Assistant Public Defender
John Larson, Justice Services Program Manager, DADS

Will Lightboume, Director, Social Services Agency
Judge Stephen Manley, Superior Court
David Mann, Chief Assistant Public Defender

Kitty Mason, Catholic Charities, Provider Community Representative
Guadalupe Olivas, Director, Public Health Department
Nancy Pena, Director, Mental Health Department
Ann Ravel, County Counsel
Jim Rumble, Chief Counsel, Superior Court

Tim Ryan, Chief, Department of Correction
Gary Sanchez, Deputy ChiefProbation Officer, Adult Division
“Rar5TT-Sinunu7 AssistantDistrictAttomey
— - —
Susan Swain, Deputy County Counsel
Kiri Torre, Executive Officer, Superior Court
Jose Villareal, Public Defender

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

20

Appendix B
Evaluation Team

David Angel, Office of the District Attorney
Martha Beattie, Department of Alcohol and Drug Services
Terry Cain, Superior Court
Rich Ehman, Department of Correction
Bill James, Department of Correction
Sally Logothetti, Office of the County Executive
Wendy Maracchini, Criminal Justice Information Services
Ron Martz, Probation Department
Keith Nelson, San Jose State University
Quyen Nguyen, Office of the County Executive
Moe Pal, Information System Department
Jan Pfiffher, Probation Department
Katherine Puckett, Department of Alcohol and Drug Services
Deane Wiley, Department of Alcohol and Drug Services
Elaine Williams, Department of Correction
Martha Wilson, Superior Court

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

21

APPENDIX 3

Department of Alcohol and Drug Services
Continuum of Care
Treatment Levels

Psycho-education; for clients with no history of addiction or criminality. Clients attend
24 hours of psycho-education classes (mainly videos with lectures and discussion)
designed to raise consciousness about the dangers and warning signs of drug and alcohol
abuse and addiction. A “pre-treatment” model for clients who are either waiting to get
into outpatient programs, or who are still contemplating the need for treatment is being
implemented. This will allow all clients to begin services immediately after Orientation.

Outpatient: serves clients without a history of serious recent substance abuse and/or
criminality, who are willing to participate in treatment but need motivation and
monitoring. Clients attend group counseling and individual counseling as needed, 12
Step or other support meetings and undergo random urine testing. The goal ofthis
treatment is to move the client along the motivational continuum. For clients in pre
contemplation, the goal is to encourage consideration of whether they have a problem and
how they can avoid future problems with alcohol and drugs. For clients who recognize

their problems, treatment is aimed at helping them obtain and maintain recovery. Most
outpatient episodes last from 3 to 4 months.

Intensive Outpatient: for clients with a serious history of abuse/addiction and/or
criminal involvement. These clients are cased managed and will usually attend two

groups a week plus individual counseling, support meetings, and relapse prevention
groups. Ancillary services are provided as required. The treatment goal is to move clients
from low motivation levels to preparing for and taking steps to address their alcohoFdrug
abuse. Most treatment episodes last 4 to 6 months.

Outpatient/Intensive Outpatient Plus Transitional Housing: for clients with serious
aleohol/drug-problems whu are in unstable^or- unsafo living- environments.—Clients are
referred to Transitional Housing Units where they live in a clean and sober environment
for 2-3 months while they attend outpatient treatment and prepare to (re) enter the work
force. The treatment goal is to move clients through contemplation stage to action stages.
Residential: serves addicted clients who are currently using or unable to maintain

abstinence and present a danger to themselves or others. Despite experiencing serious
consequences or effects of drug use, these clients have marked difficulty with
understanding the relationship between their substance use and impaired level of
functioning. If they are currently using, they begin treatment in detox (3-7 days). If they
do not need detox, they begin treatment in a residential program. This treatment level
offers stabilization and motivation for 30-60 days with clients being discharged to

outpatient to continue treatment once stabilized. If appropriate, transitional housing may
also be recommended.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

22

(

Methadone and Peri-natal: Heroin addicts have the best outcomes when provided with
narcotic replacement therapy (i.e. methadone maintenance). Most pregnant and many
parenting women will also do better in our peri-natal programs(which also offer narcotic
replacement therapy) which provide intensive medical support, health and nutrition
support, child development assessments and parenting classes in addition to group and
individual counseling.

After Care Services: Aftercare education services are based on a psycho-ed model in
which clients are provided information about how to stay clean and sober, how to
develop a support system based on a 12 Step or other support network, and how to deal
with relapse triggers. This service is provided by one traditional program and by a
program based on health Realization concepts. This is not a treatment modality; clients
who relapse are re-assessed and referred to the appropriate level of treatment.

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

23

APPENDIX 4

Service Providers
Services

SACPA Slots

FY 02 Funding

Other Slots

Cost per Slot

Other

SACPA

SACPA

Other

mm

m'-'

39^75

Gardner-Proyecto Primavera
Health Realization

$

20,000

Aftercare Total $

59,375

Catholic Charities

$

100,000

Ancillary Total $

100,000
I’.','., r.w

n

?•■■■ :'

■'•a-'/

Catholic Charities

$

650,000

Case Manaeement Total $

650,000

;r^'

HB

Wiri

•

■ ■■

1

*

W".

'

^ .

t, f.

, ,._V„

Gardner-Blossoms

Day Treatment Total

$

61,604

4

$

61,604

4

$

35,249

i'ir

ARH-Mariposa Lodge

$

211,496

6

Horizon

$

203,132

10

$

414,628

16

Detox Total

ncadd'

$

50,000

Orientation Total $

50,000

msfS
$

25

89,618

AARS-Adult Services

$

CADS

$

85,370

CAPS

$

149,159

89

184,992

150,878

40

70

Catholic Charities-DD

$

341,732

105

Community Solutions

$

244,309

130

$

325,931

ESO-STEPS

$

125337

ESO-STEPS

$

89357

Family & Children Services

$

148,103

40

$

406315

168,000

Gardner-Proyecto Primavera
Gardner-Women's Wellness

$

124371

Indian Health Center

$

123,654

Path\vay

$

105,000

Outpatient Total $ 1,207,869

160

44

475,713

260

55
40
40

$

152,701

$ 2,836,909

a»,ass»

$

15,000

Gardner-Proyecto Primavera

$

35,000

West Valley Community College

$

100,000

Psycho-Ed Total ^

150,000

%r

psp*

2,155
3,255

$

2,089

1,879
1,987

$

2,234

$

3,366 $

2,539

$

14,590

$

3,055 S

1,830

$

3,107

$

3,091

60

$

3,000 $

2,545

404

1076

$

30,671 $

32,859

' f'Zr

275,617

3,729 $

35

¥■.

AACI

3,415

$

-38

1f:v

i|^cfoi%aucaa|^'Sl4tf!|il#3:

ARH-B. MclCeown

$

2,079
$

164

60

T~'5347438'—

Gardner-Blossoms

eSji?

3,585

25

$

55,562
ssWiSsfe,*

mR s»a R#sii
weimA

ffi'

AACI

Residcntiah

20,313
$

pits®

•?/!

^Stiiajiignl^

15,401

i'JSj

p

sill

$ 15,401
$

•i

1%

rhf. h.;

■a

,v-

I'fj,
7

iC

10

$

259,207

ARH-B. McKeown-DD

$

190,383

6

ARH-B. McKeown-DD-DTC

$

128,920

4

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

'ST ^;'A

$

39,374

25,921
31,731
$

32330

24

ARH-House on the Hill

$

398,421

15

$
21,306 $

15,137

22,373 $

16,214

ARH-Mariposa Lodge

$

170,449

$ 1,120,149

8

74

ARH-Treatment Options

$

44,746

$ 649,659

2

40

CAPS

$

108,291

88,173

4

4

$

27,073

22,043

4

25,164

CAPS DTC FFS

$

Horizon

$ 580,937

31

18,740

Pathway

$ 973,640

47

20,716

Residential Total $

599,103

100,656

26,561

$ 4,490,145

t:

SILU Total

$ 158,084

27

'£■
$

170,844

ARH-Women w/Children

1, .•

$

135,744

$

319,008

CADS

$

142,254

CADS

$

190,649

$

110,126 $

234,457
2

159,659

5,855
$

5,855
7

9,491 $

7,985

'v,-

=.,fcS,
s
.Z i
18

68,949

ARH-Women-Dependency Court

$
m

27

'
",4

ARH-Men's SLE

235

158,084

$

ARH

Tra nsitionarHSusffl^j^i^^

21

m

18

17

$

36

$

8,861

6

$

11,492

7,903 $

7,983

20

$

24

7,944

CAPS

$

52,995

7

7,571

Community Solutions

$

78,747

9

8,750

Crossroads

$

200,266

26

$

110,339

InnVision

$

88,696

LifeChoices

$

58,244

$

Rainbow

Rainbow-DTC

735,703
Transitional Housing Units Total $
m: mm
mf*}

9,855 $

$

9,707

$

9

$

7,703
$

13

105,704

85,016

Rainbow-DDTC

15

6

$

Pathway

9

7,356

$

8,131

9,984

9,446

499,199

50

$

93,559

10

$

9,356

54,346 $

95,172

$1,824,169

84

209

$

A

S

50,000

Vocational Total $

50,000

Northern California Service League

Santa Clara County SACPA Status Report July 1 2001 - December 31 2001

25

^ )

u
i