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HomeMy WebLinkAboutMINUTES - 06121990 - 1.61 i THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, !CALIFORNIA Adopted this Order on June 12, 1990, by the following vote: AYES: Supervisors Powers, Schroder, McPeak, Torlakson, Fanden NOES: None ABSENT: None ABSTAIN: None SUBJECT:, Grand Jury Report on Treatment Programs- The Board received a report dated May 29, ','1990 from the 1989-1990 Grand Jury with respect to Treatment Programs for Drug and Alcohol Abusers. IT IS . BY THE BOARD ORDERED that the aforementioned report is ACKNOWLEDGED and REFERRED to the County Administrator and the Internal Operations Committee. hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the CC' County Administrator Board of Supervisor on the date shown. Grand Jur ATTESTED: ��� Jury PHIL BA 6HELOR,Clerk of the Board Health Services of Su rvisors and County Administrator Internal Operations Committee (((.___: _r- Deputy i A REPORT BY THE 1989-90 CONTRA COSTA COUNTY GRAND 'JURY 1020 Ward Street Martinez, CA 94553 (415)646-2345RE CEIV D MpY 3 0 1990 1 CLERK PHIL SATCHrtog AR Of SUPFRYIS4E, CW N of REPORT ON TREATMENT PROGRAMS . FOR DRUG AND ALCOHOL ABUSERS i APPROVED BY THE GRAND JURY: DATE: DONALD G. HA OCR GRAND J Y FOREMAN ACCEPTED GR FI I' DATE NO SPELLBERG PRESIDING JUDGE 0 THE SUPERIOR COURT SECTION 933 (c) OF THE CALIFORNIA PENAL CODE - Sec. 933 Findings and recommendations; ,com- ment of governing bodies, elective officers, Worn., agency heads s ' k (c) No later than 90 days after the grand jury submits a final report on the operations of any public agency 'j yh°=subject to its reviewing authority, the governing body of 'µ .• the 'ublic agency shall comment to the presiding judge of the superior court on the findings and recommendations pertaining to matters under the control of the governing body, and every elective county officer or agency head for which the grand jury has responsibility pursuant' to Section 914.1 shall comment within 60 days to. the presiding judge of the superior court, with an information copy sent to the board of supervisors, on the findings and recommendations pertaining to matters under the control of that county officer or agency head and any agency or agencies which that officer or agency head supervises or controls. In any city and county, the mayor shall also comment on the findings and recommendations. All such comments and reports shall forthwith be submitted to the presiding judge of the superior court who impan- eled the grand jury. A copy of all responses to grand jury reports shall be placed on file with the clerk of the public agency and the office of the county clerk, or the mayor when applicable, and sha11 remain on file in those offices. One copy shall be placed on file with the applicable grand jury final report by, and in the control of the currently impaneled grand jury, where it shall be maintained for a minimum of five years. (Added by Stat..1961, c 1284, § L Amended by Stats 1963, d 674, § 1, .Stars.1974, c 393, § 6,• Stats 1974, c 1396, § 3; Stats 1977, c 107, § 6; Stars 1977, c 187, § 1; Stats 1980; c. 543, § 1; Stats 1981, c.. 203, § 1; Stara 1982, c- .1408, .1408, § 5, Stats:1985, c. 221,. § 1; Stats 1987, c 690, § 1; Stats 1988:. c 1297, § 5.) Former § 933, added. by Stats.1982, c. 1408. § 6; amended by stats.1985,C.2-11,§ 2,operative Jan. 1, 1989,was repealed by Stats.1987, c. 690, § 2. Former §. 933. added by Stau.1959, c. 501, § 2, was repealed by Stats.1959, C. lai .§ 3. REPORT ON TREATMENT PROGRAMS FOR DRUG AND ALCOHOL •ABUSERS SUMMARY. Contra Costa County, has a.. growing and serious problem with the illegal use and abuse 'of 'alcohol and other drugs. One aspect of coping with - the problem is the treatment: and rehabilitation of abusers. Treatment programs are offered in the County by, a variety of private organizations and` the County itself, but there is a growing waiting list for service. Expansion, coordination and oversight of the whole range of services are needed .if the need is to be met fully. J rl_ INTRODUCTION The Contra Costa County Community Drug and Alcohol Action Plan, developed over the past two years by County officials. and a wide variety of community groups, and submitted for endorsement by voters at the June 5, 1990 election, begins as follows: "Contra Costa County has a serious and growing problem with the illegal use and abuse of alcohol and other drugs. The problem involves all age groups, all ethnic and social groups, all economic levels of the community and all geo- graphic areas of the County. " Later in the .plan, the following declaration ismade: "If the community is serious about ° dealing with the drug problem, there must be available adequate, local, affordable treatment facilities to help people, including young people, plagued by drug abuse. " This report focuses on the treatment facility 'situation. in Contra Costa County. FINDINGS _1. Alcohol abuse and illegal drug abuse are both significant parts of the overall "drug problem" confronting the County and the nation. 2. The majority of , abusers are users of both alcohol and illegal drugs 3 . Treatment for both alcoholism and drug addiction are basically the same after the detoxification period. 4. There is no one accepted treatment formula, but most programs involve detoxification, physical rebuilding, psychological strengthening and aftercare. '. 5. The psychological strengthening phase usually includes some philosophical component, such as the Twelve Step approach developed by -Alcoholics Anonymous , 6. Aftercare involves altering the environment of the patient and continuing involvement in support groups. Full involvement of the patient's family is vital. 7. Addicted adolescents, pregnant women and' new mothers require programs geared to their interests', and problems. 8. Treatment will not be successful unless the individual wants to undergo it. Motivating an addict to undertake treatment requires a special skill; several attempts at treatment may often be undertaken by a patient before successful completion of the program. 9 . Successful completion of a treatment program does . not mean a complete return to pre-addiction normality. Constant awareness of the possibility of a relapse is critical. 10. Treatment programs in the County are offered by private for-profit organizations, private non-profit organiza- tions and by the County. 11. The Contra Costa County Health Services Department 1989-90 Resource Guide for drug and alcohol services lists more than 50 public and private organizations. providing services for abusers. Most specialize in the abuse area, but some are general counseling services equipped to treat abusers. 12. Some County programs are operated by the County and some are operated by .other organizations under contract with the County. 13. Most private for-profit programs are hospital-based, requiring approximately four-week residency and costing around $10,000. Many, are followed by an extended . period of weekly outpatient meetings_. r 14. Most private non-profit programs are outpatient, with patients involved from one to five days a week. A sliding fee scale is typical for these_ programs. 15. County programs consist of both residential "social model" and outpatient programs. Social model programs are group living and counseling programs. 16. A County residential program ' is .based on "a nine-month residency and costs the County about $45 per patient per day. In some cases, part of the cost is covered by direct payment to the County of welfare payments a patient is entitled to receive. . 17. County out-patient programs include both . methadone treatment centers for heroin addicts and counseling- support programs for other alcohol and drug abusers. 18. The County does not operate or contract 'for-..,_ an adolescent residential treatment facility in the County.: It does place a limited number of youth in private facilities outside the County, such as the Thunder Road facility in Oakland. -3_ 19. All County drug programs are monitored and evaluated through a process involving the State Department of Alcohol and Drug Programs, the County Drug Program Administration and the local Drug Abuse Advisory Board. 20. In fiscal year 1989, the County expended $7. 6 million on drug and alcchol treatment activities. Of this amount, $1.5 milion came from County funds, with federal and state allocations and user fees making up the remainder.- 21. There is no cent_-al registry of clients, of all the service providers, so there is no actual total of individuals receiving treatment at any one time or during the course of a year. 22. County-funded facilities treated nearly 8,700 people in 1989, which represents just over one percent of the County' s population. The total includes 3 ,000 detox patients, 707 res=dential recovery patients and about 5,000 outpatients. 23 . County officials report that the population being treated is getting younger and that waiting lists are getting longer, now extending to six months. in some instances. 24. The County pay scale for drug treatment facility counselors and. directors is quite low, resulting in frequent turnovers and vacancies. 25. Finding a site for new drug treatment facilities is most difficult because of people' s strong opposition to drug centers in their neighborhoods. CONCLUSIONS 1. Continuing evaluation of drug and alcohol treatment programs is essential if effectiveness is to be maintained. 2. Placement of a patient in a program promptly on request for treatment is advisable to prevent dissipation of motivation. 3 . Early placement of a patient into the appropriate type and style of treatment program is a critical element in successful treatment. 4. Contra Costa County does not have sufficient treatment slots to provide prompt placement of all applicants. -4- 5. The physical condition and staffing levels of County residential treatment facilities fall far below desired standards and detract from the effectiveness of the programs. 6 . Private for-profit treatment programs are priced beyond the reach of most people unless some insurance coverage is present. This leads to heavy reliance on County programs. 7. Drug and alcohol rehabilitation require services beyond those related directly to addiction. The provision of emplo=;anent and educational counseling, temporary financial support, housing assistance and health services is essential. 8. There is a critical need in the County for a youth residential facility, expanded facilities for pregnant women and additional treatment facilities for cocaine abusers. RECOMMENDATIONS The 1989-90 Contra Costa Grand Jury recommends that the Director o= the Health Services Department: 1. Take the lead in establishing a. coordinated reception process .that will accurately assess a potential patient' s needs and see that the patient is entered in the appropriate program, whether it is operated by the County, contracted for by the County or operated by a private non-profit organization. 2. Provide measures to maintain the motivation of people who request treatment but for whom no program openings are immediately available. 3 . Improve the physical conditions and staff compensation in County-operated facilities. 4. Establ-ish as the first priority for the use of any addit_onal funding the operation within the County of an. adolescent residential treatment facility, such as . the Thunder Road facility in Alameda County. 5. Establish as the second priority the opening of additional, conveniently located treatment facilities for pregnant abusers. 6. Develop and formulate an evaluation and monitoring plan for private treatmentfacilities comparable to the one in use for County facilities. This plan should also -5- provide for the maintenance of accurate statistics on the number and type of patients undergoing treatment _n the County. COMMENTS 1 . Count-v .personnel who staff the drug and alcohol abuse programs whom we encountered are skilled, experienced and deeply committed. 2. The Contra Costa County Community Drug and Alcohol Action Plan is a -great accomplishment and deserves the support and participation of every citizen. . Those Jn the community who are not directly affected by the abuse of alcohol and other drugs can and must serve as posit_ve role models. 3 . As the Action Plan points out, treatment is just one of several actions required to control the drug problem. The rehabilitation of ' one group of abusers while a new group is created results in no net gain for the community. Prevention of abuse through education, intervention and law enforcement goes hand-in-hand with . treatment in a comprehensive campaign. -6-