The average wait for inpatient drug treatment in Salt Lake County has grown to four months, leaving some qualifying addicts and criminals in jail or on the street instead of under care.
And without increased funding or more discretion at the judicial level -- the waiting lists will probably continue to grow.
"We don't have the beds," said Patrick Fleming, the director of Salt Lake County's Division of Substance Abuse.
The courts, he says, are part of the problem.
Too often, judges use drug treatment programs as "community supervision," a move that clogs the system with people who could be just as successful with a less-intensive and less-costly option, Fleming said.
"We've become a criminal justice program," he said. The Division of Substance Abuse oversees the $23.4 million spent by substance abuse programs in the county.
Because of the court-mandated treatments, "we're squeezing out people who need help and can't get into treatment." Many of the people forced to wait have not committed a crime.
Currently, 60 percent of the people in Salt Lake County's publicly funded drug treatment programs have been ordered to undergo treatment by the court. Last year, about 8,000 people entered treatment in the county. Another 28,000 adults in the county are estimated to need drug or alcohol treatment.
Although Salt Lake County spends 55 percent of all the funding for substance abuse treatment in Utah, the county isn't alone when it comes to long waits for treatment beds.
In Utah County, men are waiting as many as eight weeks to get into a program, while the wait is about two weeks for women.
"It's always about people competing to get into treatment," said Richard Nance, the director of Utah County's Division of Substance Abuse.
But Fleming, his administrators and several other agencies are looking to change the way people access substance abuse treatment.
To start with, Fleming will be meeting with 3rd District presiding Judge Sandra Peuler to propose that prior to sentencing, judges initiate a substance abuse assessment, which would match services with a person and their addiction.
The same proposal was included in the Drug Offender Reform Act, a bill that failed to pass the Legislature earlier this year. The measure called for sweeping changes in the way the criminal justice system deals with drug addicts. Although the initial cost of the program was estimated at $17 million, Fleming argues the act would have saved millions by treating addicts rather than locking them up.
It costs about $28,000 to house a prisoner for one year. If that person has dependent children, another $30,000 is added for each child in foster care. In contrast, residential treatment costs $13,000 a year.
Fleming also wants to create space in treatment programs by creating a fee for service contract with providers. That option would pay providers by the number of people in treatment and, Fleming argues, would promote growth in in-patient treatment facilities.
Any such change, though, is more than a year away because new contracts for Salt Lake County's substance abuse programs won't open for bidding until July 2005.
In the meantime, programs are managing their waiting lists as best they can.
The Haven, which has run a residential substance abuse program for more than three decades, is currently running over capacity. There are 11 women in a program that is supposed to have a maximum of nine, said Dick Gillespie, the Haven's executive director.
Gillespie says they anticipated several releases -- that didn't happen -- while enrolling others at the same time.
"If we make a mistake, we have to cover," Gillespie said. "We kinda have to."
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