A study released earlier this month by the Little Hoover Commission, an independent state advisory committee charged with examining California's public health and welfare systems, points a finger at San Diego County in a brief, yet eye-grabbing sidebar embedded within the 80-page report. The study, which examines the efficacy of the state's substance-abuse-treatment programs, targets San Diego County for making it tough to provide much-needed services to the area's share of the 2.3 million Californians addicted to drugs or alcohol.
Headlined “NIMBYism in San Diego”-the acronym stands for “not in my back yard”-the sidebar highlights the reality that county-contracted treatment facilities not only lack beds for voluntary residential treatment, but the 350 beds added with the implementation of Proposition 36 two years ago have also proven inadequate. Passed in November of 2000 by 61 percent of California voters, Prop. 36 allows first-time drug offenders with no other pending charges to seek treatment rather than jail time.
“San Diego County has been able to increase availability of alcohol and other drug abuse treatment services, but only to a limited degree due to NIMBYism,” the two-paragraph sidebar reports. “There are funds available to increase services, and there are several treatment providers willing to do it. However, the community response... has blocked development of these vitally needed programs.”
The adverse economic impact of substance abuse, the report points out-which covers treatment services, prevention programs and the criminal justice system-adds up to an estimated $32.7 billion annually. San Diego County is responsible for an estimated $3.9 billion of that total. It's an overwhelming amount of money for a problem that many people seem to believe doesn't affect their community. Of the above noted 2.3 million Californians in need of treatment, last year only 360,000-or 15 percent-actually received treatment. As several studies have pointed out, successful treatment saves the public $7 for every $1 spent.
For Linda Lloyd, Alliance Healthcare Foundation's vice president of programs and a vocal advocate of the need for expanded drug and alcohol treatment programs, the Little Hoover report's singling out of San Diego County recalled the case of El Cajon. Two years ago, the McAlister Institute, a private, nonprofit drug-and-alcohol treatment provider, tried to purchase a hospital in El Cajon with the intention of turning it into a residential treatment facility. “They had the funds,” Lloyd said, “but the NIMBYism was so terrible.”
McAlister had done its research and presented the community with information that showed how the facility would serve people in their community-the local need for residential treatment in that area was significant. The proposal received no political support, said Lloyd, and McAlister was denied the permit necessary to open the treatment center. “If it wasn't so sad, it would be kind of humorous,” McAlister Institute Deputy Director Mike Franz said of the overwhelming community-driven campaign to bar the facility.
On Monday, the eighth annual San Diego County Substance Abuse Summit, held in Mission Valley, opened with a community forum that included a panel organized to address NIMBYism. On the panel were Escondido mayor Lori Pfeiler, whose city is held up as a model for its progressive stance on treatment facilities; Chula Vista Assistant Planning Director Jim Sandoval; and parent Jim Miller, whose daughter is currently enrolled in residential treatment.
Sandoval's position is that growing cities like Chula Vista need to see residential drug-and-alcohol-treatment facilities as vital infrastructure rather than a blight on a community. Treatment facilities, he noted, are “akin to affordable housing that also has a stigma programmed in.” Community planners, then, need to be proactive and get facilities built in areas that are still developing, Sandoval said.
Miller, who works with parents of children in recovery, stressed the importance of locating adolescent treatment centers close to home-the Little Hoover Commission had also underscored the shortage of such facilities-and said it's not uncommon for desperate parents of addicted teens to plant drugs in the teen's backpack and call the school to request the backpack be searched. For some parents, especially those whose insurance won't cover treatment, it's the only way to get their child into a county-run juvenile drug-treatment program.
Deborah Parker, who co-directs the Solutions for Treatment Expansion Project (STEP), a county-funded program that advocates increased residential treatment programs locally, said the mention of San Diego County in the Little Hoover Commission report generated more than a few calls to her office, most of them concerned.
The commission mention, she noted, was spawned by the county's honesty-when Little Hoover was collecting its data, San Diego County admitted it had a severe shortage of slots in residential treatment programs. But, said Parker, the commission “didn't stress what we're doing about it.” And though San Diego County was singled out, she doesn't see it as too much of a negative. Clearly other counties will admit to being in the same position, she said, and San Diego is no different from most other counties in community perceptions of drug-and-alcohol treatment facilities, Parker noted. But what she'd like to see is less polarized battle and more collaborative effort between community residents, decision makers and the treatment providers. The first step in doing so is dispelling myths that surround treatment centers-something that's best done through the collection of hard data.
At the Monday afternoon session of the Substance Abuse Summit, Parker planned to give a PowerPoint presentation that focused attention on STEP program findings, compiled from more than two years of research. The impetus for the study was to show two things: treatment facilities don't increase crime in an area, nor do they cause a decrease in property values. As Parker's presentation notes:
* Property values around residential treatment facilities are rarely, if at all, affected. A survey of eight state-licensed facilities revealed that only in one instance did the treatment center appear to affect land values. For the most part, property values around such facilities were higher than expected.
* A study of crime data mapping revealed that crime rates are lower in the area immediately surrounding the treatment facility. And, as the study notes, “licensed treatment facilities tend to have a curative impact... even in high crime areas.”
But, as the study notes, there are still obstacles to treatment that may prove less pliable than public opinion:
* Private health care insurance rarely covers substance abuse treatment-a point emphasized at the summit's community forum by an audience member who painfully described how she's been unable to get her son the treatment he needs because of lack of insurance coverage. Many people in need of treatment don't qualify for county funded treatment because they have private health insurance.
* County funded treatment is, as STEP reports, right now “the only game in town”-during the past 10 years, private hospital treatment in San Diego County has plummeted from 15 programs to only two.