May 7, 2013

Social worker program changes lives, but lacks funding

LAUREL COUNTY, Ky. — BARBOURVILLE — She was just trying to help. “Susan” flushed her husband’s pain pills down the toilet, hoping to make it easier for “James” to stay sober.

Instead, strung out and frustrated, he retaliated by assaulting her.

Susan (not her real name) didn’t suffer any serious injuries but she wasn’t taking any chances, either. She swore out a complaint and James (also not his actual name) found himself in front of Knox District Judge John Paul Chappell.

James, 27, a high school dropout, has been receiving a disability check since he was in school and can’t hold a job. Susan is a food service worker, making minimum wage, which along with James’ disability check, is all the income they have to support themselves and their two elementary school-aged children.

Susan wants James to come home, but only if he can stay off drugs. Facing jail time, James misses his children and desperately wants to go home so much that he’s willing to try to get clean.

If he goes to jail, it’ll cost the county about $11,000 a year and he won’t get help for his drug problem.

James’ and Susan’s best, maybe only, hope is Joanne Sizemore, a social worker for the Department of Public Advocacy.

Sizemore is one of only eight social workers statewide who are assigned to cases like James’ by the DPA, the public defenders’ office. She works out of the London DPA office and works with offenders in Laurel, Whitley, Knox, Clay and Leslie counties.

Clearly, she’s stretched pretty thin. Sometimes she is in court in one county when a client is before a judge in another.

The program works — it has an 80 percent success rate — at least where it’s available.

Wednesday, DPA’s social worker alternative sentencing program was recognized as one of the 25 most innovative government programs in the country by the Ash Center for Democratic Governance at the Harvard Kennedy School of Government.

The program saves the state and county governments thousands of dollars and it turns around lives lost in the dark despair of drug addiction.

Ed Monahan, the state’s Chief Public Advocate, estimates that every dollar spent on the program saves the state $3.25, or about $100,000 for each of the eight social workers.

Monahan wants social workers in each of DPA’s 31 offices, but there’s no money for that. In fact, he can’t afford to fill a vacancy in the Morehead field office, which once had a social worker and which handles about 6,000 cases a year in Rowan, Bath, Montgomery, Menifee, Morgan and Elliott counties.

Jay Barrett, the DPA directing attorney in the Morehead office, said the social worker once “helped clients move out of jail quicker, saving counties significant jail costs.” No more.

In Knox County, Sizemore arranges for James to receive outpatient drug abuse counseling at a hospital in Corbin, treatment he could never afford on his own.

The cost is covered by a voucher from Operation UNITE — Unlawful Narcotics Investigations, Treatment and Education — which operates in 32 eastern Kentucky counties to combat widespread drug abuse.

“You almost have to be rich to afford really good treatment,” Sizemore explained. “Even most insurance companies will only pay for detox, not long-term treatment. Most of my clients are essentially homeless.”

If James succeeds, everyone wins, said Knox County Assistant County Attorney Gilbert Holland.

“Over 90 percent of the people I deal with have an underlying drug issue,” Holland said. “We know good people do bad things when that happens. If Joanne can find them a facility to be in rehab, they’re getting rehabilitation plus they’re not in jail at the county’s expense.”

Chappell, the judge who assigned James to Sizemore, said the program makes sense for everyone. And it’s about more than saving money, he said.

“If we had more Joanne Sizemores, we could do so much more about drugs and other problems that plague the people on our court dockets,” Chappell said. “Having a social worker is leading to genuine reform in people’s lives. It’s how we should treat our fellow humans.”

James will receive intensive counseling three afternoons per week and will be drug screened each time. If he fails a drug screen, he’ll be discharged from the treatment program and he’ll be back in front of Chappell.

But the program usually works. Annual evaluations indicate an 80 percent success rate and only 18 percent recidivism or re-offending rate.

“We weren’t picked because we’re mediocre,” Monahan said.

Monahan hopes the national recognition will spur lawmakers to fund expansion of the program. He noted projected savings from changes in sentencing laws a couple of years ago have fallen about $20.5 million short of budgeted savings and this program is one of the few ways to close that gap.

He’s trying to make that case to lawmakers. When they see the results, they’re sold – except they don’t know where to find the money to pay for the expansion – even though it will ultimately save money.

“When I show them the studies and explain them, they get it. It’s straightforward, common sense,” Monahan said. “What I haven’t been able to get past is coming up with the money to expand it.”

Holland, the Knox County assistant county attorney, has also been trying to sell lawmakers on expanding the program.

“We need several more people doing what Joanne does,” Holland said. “We need to figure out a way to get more money to get more rehabilitation because we have a drug problem here.”

Tuesday, in Knox District Court, Sizemore watched as James agreed to the conditions of his treatment and alternative sentence.

As soon as he left the bench, a young woman and her mother appeared next before Chappell. Her case was also assigned to Sizemore. As the woman and her mother left the courtroom, the mother suddenly stopped and tearfully embraced Sizemore.

Sizemore and DPA don’t lack for clients. The question, Monahan said, is whether the state lacks the foresight to find the money to make a difference in those clients’ lives while save taxpayers money.

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