A New Approach

TREATMENT OBSTACLES SLOW PROGRESS

As Bay Area counties scramble to provide treatment for drug users
instead of jail, they're encountering two obstacles that are making
their jobs infinitely tougher: NIMBYism, or Not In My Back Yard, and
housing prices.

``One of the difficulties in providing treatment is building capacity,''
said Marye L. Thomas, director of health services for Alameda County.
``Especially in the residential community, you can't just flip a switch
and get more housing.

``There's quite a lot of NIMBYism. People just don't want treatment
houses in their neighborhoods,'' she said. ``If we have to increase
residential capacity substantially, it's going to take some time.''

Otherwise, the counties report good progress in implementing Proposition
36.

Santa Clara, with a well-established drug court program, is viewed as a
model by counties around the state. Here is a summary of how other
counties in the region are doing:

Alameda -- The county is considering innovative ways to expand its
treatment base, including appealing to faith-based organizations.

``There are six-bed, sober-living houses scattered throughout the
community, and they are an untapped resource,'' Thomas said. But they
also are not licensed to provide treatment, so that would require more
effort to make them eligible.

Alameda County has a caseload of 6,500 clients and anticipates
Proposition 36 will add between 2,500 and 3,200 a year.

Santa Cruz -- ``We expect to go to the board of supervisors with our
Proposition 36 plan in mid-May,'' said William F. Manov, administrator
of the county alcohol and drug program.

Manov said there are more than 1,900 people already in some form of drug
treatment, but the county expects the proposition to add 500 offenders a
year to that mix.

``Not all 500 will show up on July 1, but the question is how quickly
can we ramp up the treatment system. As we get into the particulars of
the proposition, the definition of who is eligible is more complicated
than it seems on the surface,'' he said.

There is little concern about licensing new programs, Manov said,
because the county expects to handle the new cases by expanding existing
treatment programs, which are already licensed.

San Francisco -- ``We have an extensive planning process with a San
Francisco flavor,'' said Phyllis Harding, director of the department of
public health.

That's probably not surprising in light of the fact that 72 percent of
the city's residents voted in favor of Proposition 36.

The planning process is particularly difficult in San Francisco because
of the diverse population and the unique kinds of addiction problems it
sees.

For example, Asian residents tend to smoke methamphetamines, while the
gay population tends to inject that drug.

``We need gender- and culturally appropriate programs. We have to serve
many people in their native languages,'' Harding said.

San Mateo -- Like many other counties, San Mateo is looking to expand
its present treatment facilities as the easiest way to comply with the
dictates of Proposition 36.

There are 25 providers now in business that have ``demonstrated a high
level of readiness to expand,'' said Yvonne Frazier, the county's drug
and alcohol services coordinator.

Officials have identified between 1,600 and 1,800 new treatment clients
a year that the system is likely to have to deal with, though that
number could come down. San Mateo currently has a caseload of about
6,000.