Dressed in jailhouse orange, with hands and feet shackled, Jimi Ray Haynes stood up in a Santa Cruz County courtroom and pleaded guilty to a felony weapons charge.
Haynes, 32, had spent the previous two weeks in jail detoxing from methamphetamine and heroin. The judge told Haynes he could serve part of his yearlong jail sentence in a drug treatment program rather than locked in county jail.
Eileen Jao, an assistant district attorney, quickly interjected: “It has to be residential, not outpatient,” she said. “It’s residential or jail.”
Jao wanted the terms to be crystal-clear. Because of a new county policy that took effect at the beginning of the year, treatment for low-income residents like Haynes, with drug-related criminal charges, must be decided by clinicians and providers—not the court. Judges can order whatever they want in terms of treatment, and prosecutors can block designated treatment they deem too risky, but essentially the type and length of treatment deemed appropriate is out of their hands.
When conflicts arise between what the court orders and the providers decide, felons can languish in jail with no treatment at all.
Court-ordered rehab is increasingly falling out of fashion in California as Santa Cruz and 18 other counties begin to treat addiction like any other health condition—with the Medicaid program relying on evidence-based practices and trained personnel to make decisions on care. That has upended the status quo for judges, attorneys, and defendants who often had agreed to residential treatment in lieu of jail—or at least to reduced sentences so inmates could get that treatment.
The California program appears to be unique in many respects, but other states—including Utah, Indiana, Kentucky, West Virginia, Virginia, Maryland, New Jersey and Massachusetts—also have sought federal permission to experiment with innovations in Medicaid-funded drug treatment.
[How treatment courts can reduce crime]
In California, “these changes are a tough pill to swallow for the criminal justice system,” said Gavin O’Neill, the drug-court manager for the Alameda County Superior Court, which implemented the policy in July. “In the past, some judges and attorneys have been able to use residential treatment as a sanction and long-term monitoring mechanism, as well as a chance to address the underlying drug problem,” said O’Neill. “That option has been shut down.”
Proponents say that evidence-based treatment will lead to better outcomes and that residential care should be reserved for those with the most severe addictions. Under Medi-Cal, it is limited to 90 …read more
Source:: The Atlantic – Health