California Dreaming?

A new study by researchers at UCLA provides some ammunition for supporters of a California law, passed in 2000, that mandates treatment instead of jail for non-violent offenders arrested on a drug-related crime, according to the New York Times.

The study found that the California Substance Abuse and Crime Prevention Act (SACPA) of 2000 provided $2.50 in benefits for every $1 invested by taxpayers, or a total of $1.5 billion over five years. Individuals who completed their court-mandated treatment program produced $4 in benefits for every $1 invested.

While these cost savings are impressive, it's not clear that the legislation is achieving the kinds of reductions in drug use and recidivism that its authors intended. For example, according to the report, only 34 percent of individuals who entered the program completed between 90 days and a year of drug treatment, an important step because treatment retention is an important indicator of long-term sobriety. Compare that to drug courts, which have about a 60 percent one-year treatment retention rate.

In addition, the report shows that conviction and arrest costs were higher for SACPA participants than a control group, driven largely by a small group of about 1,000 "high-impact" defendants who entered the program with five or more prior convictions.

Opinions differ about how to improve graduation rates and deal with high-impact defendants, who, according to the legislation, have the same right to treatment as a jail alternative as any other defendant. Some, following the drug court model, argue that the answer is to empower courts to mete out graduated sanctions and rewards to encourage compliance, or to modify the legislation to limit program entry to individuals with fewer than five convictions. It's clear, however, that any changes to the legislation will be resisted by its authors, who fear replacing a "treatment" model with a "punishment" model.

I'm interested in the California story, because it's an example of a very different model of institutionalization (and very different philosophy about the compatability of punishment and help) than Bronx Community Solutions. As a ballot initiative passed by 61 percent of the Calfornia electorate, SACPA can only be changed through additional legislation, which makes it tough to make mid-course corrections. It also imposed a host of new obligations on counties that may not be prepared to meet them.

On the other hand, SACPA has created profound statewide change in just a few years, helped by an annual influx of $120 million state dollars for drug treatment and other services. It's a tough trade-off: is it better to spread a new approach quickly, or move more slowly to make sure that it's being implemented effectively?


Mike Rempel, Research Director at the Center for Court Innovation said…
California's statewide treatment initiative for nonviolent drug offenders is indeed an intriguing test case for the institutionalization of problem-solving justice.

California has successfully implemented a treatment-based alternative-to-incarceration initiative on a truly massive scale: Over 30,00 felony level offenders mandated to treatment each year and resulting savings estimated to total $1.5 billion over all five years of implementation. Yet, does this intervention sacrifice too much clinical efficacy (e.g., measured in post-treatment drug use and re-offending rates) in its effort to reach large numbers? As the UCLA study makes clear, the initiative's efficacy falls short of drug courts, which operate on a smaller scale but have achieved exceptionally high retention rates and consistent recidivism reductions.

Back to the key findings: The UCLA study is convincing on its primary point: California's initiative saves money (or at least is cost-effective), mainly by diverting offenders away from jail on the initial criminal case. This good news however is tempered by the finding that the initiative leads to a slight increase in jail and prison sentences stemming from recidivist convictions off of future cases. Also, left unclear is whether the initiative leads to an increase in the underlying re-arrest or re-conviction rates (since not all new convictions will lead to new jail or prison sentences); or what new crimes were committed. And on a potentially positive note, as the study's authors point out, although the initiative produces more new jail and prison sentences in the short-term, this pattern may even out or even reverse itself over a longer period -- after more of those in the "comparison group" are released from their initial jail or prison sentence and hence are at risk to commit new crimes. So in sum, effects on "public safety" simply can't yet be determined.

Another point of concern relates to the initiative's 34% treatment completion rate: Is this too low?

Drug courts average a one-year retention rate of about 60% and a completion rate of about 50%. But on the other end of the spectrum, completion rates without any court mandate at all range from a paltry 10-30%, depending on the specific treatment program under consideration. So California's 34% figure does improve upon business-as-usual, even if it falls short of drug courts, which offer the benefits of intensive judicial monitoring during the treatment period and clear incentives and consequences for compliance and noncompliance.

I would view the research on California's initative as fundamentally positive, given the large numbers of offenders reached and the inevitability that at such scale, you can't duplicate the magnitude of positive outcomes achieved by drug courts. If California could somehow locate greater resources for intensive judicial oversight and case management, further improvements may be possible on the efficacy front.