SALT LAKE CITY — As lawmakers examine gaps in Utah’s criminal justice reform, those treating and supervising drug offenders say relapses are inevitable but more resources are needed to keep people on the right track.
“We’re dealing with people with chronic brain disorders who wound up in the criminal justice system,” said Mary Jo McMillen, executive director of Utah’s Recovery Community Organization. “(The Justice Reinvestment Initiative) was definitely the beginning of us saying, ‘we have to change this.”
The Utah law passed in 2015 as a recognition that those with low-level drug convictions need rehabilitation, not just time behind bars. The idea was to free up room in the Utah State Prison and redirect hefty costs of incarceration toward treatment and supervision.
But the full Medicaid expansion that Utah legislators had in mind when they wrote the law didn’t materialize for another five years. It meant that without as much money to expand treatment options and monitor whether they’re working, Utahns picked up new drug arrests more than in the past. That’s according to a legislative audit released in October.
“It’s not really a surprising outcome for those of us who have been involved with it since the very beginning,” said Christina Zidow, chief operating officer at Odyssey House, which runs treatment programs in Utah. “Everyone wants to do what works and have reductions in recidivism, clearly. But there has to to be the resources, because it’s not one of those things that just happens through magic.”
As state lawmakers on the Judiciary Interim Committee pored over a review of the program at its October meeting, one member of the panel didn’t hide his frustration.
Sen. Todd Weiler, R-Woods Cross, called the shortcomings “probably my biggest disappointment as a legislator.”
Weiler, a lawmaker of about nine years, noted the Legislature rejected plans to expand the state-federal program at the time it passed the reform and didn’t find a substitute.
He reiterated that the state drew plans for a new prison based on a smaller inmate population.
“If this doesn’t work, we’re going to be in real trouble as a state,” Weiler said.
Others point to bright spots despite the higher recidivism rate.
Utahns with substance abuse disorders were long ineligible for Medicaid, but that changed in 2016 when the state extended Medicaid coverage to those chronically homeless or in the justice system, noted Brent Kelsey, assistant director of the Utah Division of Substance Abuse and Mental Health.
“It really has been a game-changer,” he said.
The change allowed Salt Lake County, for example, to nearly quadruple its 150 beds in treatment facilities.
And 120,000 more low-income adults are eligible under full Medicaid expansion this year, which covers those up to 38% above the federal poverty level, or $17,608 for an individual.
Still other hurdles remain. There aren’t enough counselors and therapists to meet the need, and most rural communities lack residential treatment or detox centers.
“For the first time, we’re really trying to build out an effective behavioral health system,” Kelsey said. “And so we need people that are well-trained, and probably more people than we’ve ever needed.”
A housing crunch in southeastern Utah has left counselors there unable to afford a place of their own. Many work for about five years and then move somewhere more affordable, said Karen Dolan, CEO of Four Corners Behavioral Health, which does residential and outpatient treatment.
The shortage is so acute that three staff members live in program housing alongside clients. Dolan plans to tap into a state tuition reimbursement program for those in underserved areas.
In Price, hard-hit by the opioid epidemic, a new methadone clinic has helped people coming off drugs take early steps to get back to a normal life, but connecting to longer-term treatment remains a challenge, Dolan said.
In other parts of the state, jails effectively act as detox centers. And not every county does the sort of pretrial assessment that can help determine the level of treatment a person needs, so some judges don’t have information about a person’s needs.
The changes have redefined the job of officers with Adult Probation and Parole in the Utah Department of Corrections.
The department has long sought to reinforce good behavior and help a person address issues that may have led them to run up against the law.
But the changes meant probation officers began overseeing more people deemed a higher risk of reoffending — a group that requires more regular check-ins and reports — said Dan Blanchard, director of the division. Many of the agency’s 325 parole officers have been working overtime, he said.
“There’s an awful lot of opportunity to help to provide some of those avenues for change,” Blanchard said. “But it’s more work to get there with with those with those individuals.”
Todd Hilliker, a senior probation agent, said the agency continues to fine-tune its approach, which includes working with family members to hold a person accountable. The law accelerated a cultural shift toward agents seeing themselves not just as law enforcers but advocates.
When Hilliker’s son, Derek, began using heroin about five years ago, probation officers hadn’t begun using new tools to assess defendants and craft a plan to help them make long-term changes.
“My wife said, ‘Why aren’t there any tools that help? And I was like, ‘yeah, I don’t know, dear, this is what we’ve been dealing with,’” Hilliker recalled.
When his son succumbed to his addiction three years ago at age 29, Hilliker became so frustrated he nearly quit, he said. But he ultimately decided to spare other families the same tragic outcome.
“I want them to look at me and be happy that I’m the person that’s supervising their son or their daughter and trying to help,” he said. “I wish my son was here now, and I wished we could be supervising him now.”
The shift requires Hilliker and his colleagues to redefine success: someone may end up returning to jail, but other signals can indicate progress, like whether the person stayed out longer than last time or has begun to embrace treatment.
“We had to really recalibrate what we believe success was, or otherwise, you just burn out doing this job, you’d be frustrated all the time,” Hilliker said.