OPENING DOORS: TRYING TO GET USERS TO SEEK TREATMENT, DRUG COUNSELORS TAKE
THEIR MESSAGE TO THE STREETS

Dellena Hoyer visited her old neighborhood recently, and the memories
were anything but fond.

"I used to cop dope around here," she said, walking down an Oak Park
street of houses with boarded windows and snarling dogs chained to
front porches. "Yep. I would drive around and see who had a bag."

More than a decade later, Hoyer was on a very different
mission.

In a neighborhood where illegal drugs are part of the landscape, she
and her team of outreach workers were knocking on doors, looking for
people on welfare who also are addicts, and offering help.

Under welfare reform, aid recipients must get jobs or lose their
benefits after two years. One of the biggest obstacles to people
getting off of welfare, workers suspect, is dependence on drugs and
alcohol. The system provides for free counseling and treatment for
CalWorks clients, but only a fraction of those who might benefit from
such programs are taking advantage of them.

Statewide last year, CalWorks spent only about 60 percent of funds
earmarked for substance abuse and mental health services, officials
said.

So, in an extraordinary endeavor, Sacramento County and more than a
dozen agencies that provide drug treatment as well as mental health
and domestic violence counseling are taking the message to the streets.

"If we're going to get people off of welfare, we have to remove the
roadblocks," said Trisha Stanionis, executive director of The Effort,
a Sacramento drug treatment agency. "This is our sales campaign for
programs that can help people succeed."

Each month, on four consecutive days, workers representing various
agencies visit impoverished neighborhoods with high welfare caseloads,
armed with information about drug treatment and other social services.
For most members of the outreach team, the territory is familiar.

"For a lot of these people, the idea of going to job training or going
to work is totally unrealistic," said Hoyer, 39, a former heroin
addict who now works for The Effort. "When you're putting something
into your body just to get through the day, having a job is the last
thing on your mind."

Hoyer should know.

A dozen years ago when her welfare check would run dry at the end of
the month, she would sell her body and commit other crimes to earn
money to feed her habit.

"I would buy drugs in Oak Park, Del Paso Heights, wherever I could get
them," Hoyer said. "I was shooting heroin and smoking cocaine and not
feeding my son. I thought I was gonna die an addict. I thought I was
doomed."

One day, she got evicted from an apartment complex in South Sacramento
and realized she had nowhere to go. She ended up on the doorstep of a
treatment program, and she has been clean ever since.

"For so long, I took and took and took from society," Hoyer said. "Now
I'm giving something back."

On a gray and drizzly morning at the end of February, Hoyer gathered
with other outreach workers in the parking lot of the Oak Park
community center, near Martin Luther King Boulevard and Eighth Avenue.
Sitting in a rickety motor home littered with informational pamphlets
in six languages, packets of condoms and tiny bottles of bleach to
distribute to addicts, they discussed their game plan.

Hurley Merical, who grew up and learned the drug trade in Oak Park,
would be the front man. "I know every drug house in this
neighborhood," boasted Merical, who now works for Harm Reduction
Services, a community service organization focusing on preventing
transmission of HIV. On this day, Merical would alert the
neighborhood's more-nefarious characters that the strangers walking
their streets were outreach workers, not cops, Child Protective
Services employees or gang rivals. Hoyer's team would canvass the
neighborhood in pairs, meet back at the trailer for lunch and then
head out again until late afternoon.

"OK, Let's go!" Hoyer said with the ebullience of someone who has been
given a second chance. The sun was beginning to peek through the
clouds. "It's a beautiful day!"

Dressed in jeans, glaringly white tennis shoes and a black rain
jacket, with a trio of earrings in each lobe, Hoyer bounded toward two
men standing in the parking lot. "Hey, we're doing some outreach here
today," she said as they stared at her blankly. "Did you know you can
get free detox and free drug treatment if you're on welfare? You can
get in right now. I had to wait two weeks to get into a program when I
decided to get clean. I could have killed myself or killed someone
else during that time. You know what I mean?"

After listening to her rapid-fire speech, the men accepted her
pamphlets, and one asked for her business card. Then they shuffled
away, and Hoyer and her partner Linda Cooper began canvassing the
neighborhood.

Each street seemed to have a distinct personality. Some featured neat
cottages with struggling gardens and blossoming fruit trees. On
others, nearly every front yard was littered with trash and empty
liquor bottles.

On the saddest streets, the workers saw signs of a thriving drug
culture. Cars creeping at a snail's pace up and down the roads. Homes
with busted windows. Shades drawn tightly, even as afternoon
approached. Dirty and disheveled children cowering inside darkened
living rooms.

"Hellloooooo?!" Hoyer sang after banging on the door of a ramshackle
house and getting no answer. "Anybody home?

"Drug addicts tend to get up later in the afternoon, like after 1
p.m," she shrugged, tucking a brochure into the mailbox. "We'll be
back."

Studies suggest about 29 percent of CalWorks clients could use mental
health counseling, and about 19 percent could benefit from drug and
alcohol treatment. But only about 3 percent of welfare recipients
statewide have been referred by their caseworkers for such services,
said Toni Moore, Sacramento County's alcohol and drug program
administrator. Sacramento's rate was higher, about 14 percent.

"People are reluctant to disclose substance abuse to their caseworkers
because of fear of their benefits being taken away or their children
being taken away," Moore said. They are more likely to make such
disclosures to people like Hoyer and her colleagues, who have an
intimate understanding of their fears, than a caseworker, said Moore.

So far, the approach seems to be working. "Success is very hard to
measure, but calls for services have gone up significantly in the past
year, and we believe that is associated with the outreach," Moore said.

Last month in Oak Park, Hoyer rang doorbells, stopped bicyclists and
approached people on the street, relentless in her determination and
undeterred by hard looks or apathetic responses.

"No one in this house is a drug user," declared one woman, her arms
folded tightly across her chest, blocking the front door as Hoyer and
Cooper approached.

"But do you know anyone who might be able to use these services? Pass
it on," Hoyer said, offering fliers with details and phone numbers.
The woman took the information, but not before threatening to unleash
her pit bull terrier on the workers. "My dog bites," she warned.

Others were more receptive. One CalWorks client caring for her elderly
mother and her young son told Hoyer that her stress level was "up to
here," waving her hand above her head. Hoyer told her she could get
free mental health counseling.

"This is like a miracle," she responded, smiling.

Earlier, Hoyer homed in on a woman whom Merical had identified as a
long-term, hard-core drug abuser. The woman looked tired and
downtrodden, in stark contrast to the bright yellow raincoat that hung
on her shoulders. She said her name was Ruby.

"Hear me out, OK?" Hoyer implored, staring into Ruby's eyes. "I've
been where you're at. You keep shooting dope, and you're gonna die.
But you don't have to. We have help."

Quietly, the woman confided that she feared authorities might take her
daughter away from her if she admitted to abusing drugs. "You're gonna
lose her anyway if you don't stop using," Hoyer counseled. "They can
give her temporary shelter while you're in treatment, OK? Call them.
No excuses."

As Hoyer spoke, the woman crumpled into Merical's arms and started to
sob. "I need help," she said. "My daughter has seen too much. I'm
gonna call for sure. Tomorrow morning."

It never happened.

"It's sad," Hoyer said two days after the street encounter. "I really
hoped she would call. If it doesn't happen soon, she's going to end up
dead.

"But I'll be looking for her out there. I'll be in her face again.
Maybe the next time she'll end up in recovery. Hey, if I did it,
anyone can."