DRUG CENTERS FACE NEW BURDEN

PROP. 36 HEIGHTENS LICENSING CONCERNS

The state agency that will monitor the dramatic expansion of California's
drug treatment system under Proposition 36, the November ballot measure that
mandates treatment instead of jail for many non-violent drug offenders, has
only 25 inspectors for the state's 1,039 licensed treatment centers and was
without a director for two years.

With Proposition 36 estimated to direct 36,000 more people a year into a
treatment system that already has 5,000 people on waiting lists, Gov. Gray
Davis finally appointed a director for the agency, the Department of Alcohol
and Drug Programs, on Nov. 9, two days after the measure passed.

The new director, Kathryn Jett, who had been director of the attorney
general's Crime and Violence Prevention Center, has declined interviews
since her appointment. But she will be a speaker today at a conference in
Sacramento, organized by the ballot measure's supporters, to gather comments
on how to put it into effect.

While much concern about Proposition 36 has focused on the burden it will
place on county probation departments, which will supervise the drug
offenders, the number of treatment programs and centers also is likely to
grow substantially. But the Department of Alcohol and Drug Programs, which
licenses and certifies them, has received much less attention.

An examination of the state agency's responsibilities and resources suggests
the challenge California will face in regulating the added treatment
centers. That could be a particular concern for communities that host
residential treatment programs; under Proposition 36, all first- and
second-time non-violent drug offenders will enter the same system, even if
they have previous felony convictions.

Licensing system

The agency has an annual budget of $527 million, all but $29 million of
which it passes to the directors of alcohol and drug programs in the 58
counties, who use it to run their own treatment programs or contract with
providers.

The agency employs 25 program analysts who license, certify and respond to
complaints in the state's 663 residential alcohol and drug programs and 376
non-residential programs. According to a Rand Corp. study, 126,000 people
are enrolled in drug and alcohol treatment programs on an average day in
California. According to the agency, 80,469 of these positions are publicly
funded.

The analysts make one inspection during each two-year licensing period,
unless the agency receives a complaint from or about a program. The
inspections focus on health, safety and staffing issues. Are there enough
fire extinguishers? Is the kitchen sanitary? What is the ratio of staff to
clients?

In the last five years the agency has not revoked any licenses -- evidence,
the agency says, that it works closely with treatment centers ``to bring
them into substantial compliance.''

But others in the treatment field say the agency is too weak to enforce
standards, and that the infrequent inspections are easy to pass because they
are announced in advance.

``If your program is nothing more than a front, you can maintain it,'' said
Richard Johnson, director of Amicus House, a treatment program in San Jose.
``The state doesn't come around often enough to see through it.''

Bill Demers, president of the County Alcohol and Drug Program Administrators
of California, said, ``The ADP has been neglected for two years; a case
could be made forever. It needs greater authority and more manpower to
function at a level that will make a difference.''

While the agency certifies treatment facilities, a voluntary procedure
designed to show substance abusers and third-party payers that a program
meets minimal treatment standards, neither licensing nor certification
includes issuing a license to drug and alcohol counselors.

A bill that would license drug and alcohol counselors and require 315
college-level hours and 4,000 hours of clinically supervised field
experience will be introduced in the legislature in January.

``Right now, the license the ADP hands out to programs is so watered down,
it gives addicts, their families and the public a false sense of security,''
said Sherry Daley, Public Policy Coordinator for the California Association
of Alcoholism and Drug Abuse Counselors, the organization that is sponsoring
the legislation.

``If there are no standards for staff, how do you make sure a program has
some competency built into it?'' she said. ``How do you know if the
counselor sitting across the table has been clean for two weeks or knows
anything about pharmacology?''

Different programs

Halfway houses, or ``sober living environments,'' are for substance abusers
leaving a residential program, or inmates leaving jails or prison after
serving time on drug charges. They provide a clean, drug- and alcohol-free
environment where residents can go about rebuilding their lives. They are
exempt from licensing because, under state law, residents and the proprietor
maintain a tenant-landlord relationship.

But if a proprietor requires residents to submit to drug tests, attend
counseling, group therapy or Alcoholics Anonymous meetings -- and an unknown
number do, to qualify for the higher fees paid by drug courts and county
programs -- he is no longer running a halfway house. He is operating a
residential treatment program and must apply for a license.

Because halfway houses are not licensed, no one knows how many there are in
the state, how many are running residential treatment programs, or how good
those programs are. The unlicensed programs are able to operate because of
the demand for treatment.

``What happens is, County A doesn't have any space, so it sends someone who
needs long-term treatment to a program in County B,'' said David Byers, an
investigator in the Santa Clara County District Attorney's Office who
specializes in drug programs. ``But County A doesn't know they are actually
sending that someone to a sober living environment, because they never send
anyone down to County B to check out the program.''

This year, a bill that would require licenses for halfway houses that are
running treatment programs passed in the Assembly and the state Senate.
Davis did not sign it, saying it failed to include funding for the state
agency to add staff. The legislation will be introduced again next year.

The counties also share in enforcing standards. Their departments of alcohol
and drug services award contracts to treatment programs and monitor
conditions. If a program is substandard, the department can terminate the
contract. Or, it can notify the state, which will send a program analyst to
investigate.

In Santa Clara County, however, the district attorney has challenged the
effectiveness of the county department's oversight, and has established its
own program to certify treatment centers and to screen the people entering
them. It is the only county in the state, and perhaps the only one in the
country, to do so.