Even as drug and alcohol overdoses rise amid the coronavirus pandemic, fewer Marylanders are undergoing court-ordered treatment because police, particularly in Baltimore, are arresting far fewer people for lower-level drug offenses.
The change in approach, brought about partly to lower jail and prison populations during the pandemic, has drug treatment centers across the state facing steep shortfalls of patients and money. At least one says it is in danger of closing, and more say they need access to money set aside in a state program that pays for treatment instead of incarceration.
Maryland’s courts have placed 233 people this year through Oct. 15 in what’s known as the “8-507” program, according to state Department of Health data. The statewide diversion program lets defendants charged or convicted with certain crimes enter treatment instead of, or alongside, incarceration.
That’s fewer than half the 519 total placements in 2019, with two months remaining in the year, even as fatal drug and alcohol overdoses are up statewide more than 9% from 2019.
In Baltimore, State’s Attorney Marilyn Mosby announced early in the pandemic that her prosecutors would no longer bring charges on most street drug offenses. Baltimore police statistics show that through Oct. 10 this year, officers made 446 arrests for misdemeanor drug offenses, down 76% from 1,884 in the same period last year. Lower-level crimes, especially drug possession offenses, are a major driver of clients into the program.
As some treatment providers face financial struggles, law enforcement agencies and treatment centers are debating whether enrollment in these programs should be fueled by low-level drug arrests.
State health officials say that they’ve begun to discuss the issue, after being contacted by treatment providers in recent weeks.
Declining drug arrests
For years, the law behind the diversion program has relied on a simple, and critics say untenable, formula: Police arrest people for low-level offenses, prosecutors haul them into court and judges send them to treatment centers. Most land in residential facilities for state-funded treatment that can run several months.
The state programs give defense attorneys and their clients, most charged with non-violent crimes, a chance to argue for treatment in lieu of, or concurrent with, jail. According to the state health department, five of the seven participating treatment providers run facilities in the city; there are also sites in Anne Arundel, Charles and Frederick counties.
But the appetite for filling treatment centers by arresting people with addiction problems is waning among some advocates and law enforcement officials.
In March, Mosby was among the most vocal leaders in the state calling for a sharp reduction in inmate populations. That was followed by her pronouncement that her office would not prosecute certain lower-level offenses, including drug possession, during the pandemic.
But fewer arrests meant fewer people were being evaluated for enrollment in court-ordered treatment.
It’s a reason Gaudenzia, a major treatment provider in the mid-Atlantic that participates in the diversion program, says it has seen a drastic drop in patients and is considering closing some facilities unless state officials approve additional funding for treatment facilities.
Gaudenzia has gone from serving 120 people a month in the program to about 30 in recent months, according to CEO Dale Klatzker.
In 2019, the state reimbursed treatment facilities roughly $85 to $200 a day per Medicaid-eligible patient, plus about $60 a day for room and board in residential programs.
Treatment time averages between five and six months, said Gaudenzia spokesman Kevin Shinkle.
Klatzker said the company has taken in $3.34 million less from the state diversion programcompared with last year.
To continue these services and keep staff employed, Klatzker asked the state health department to release money budgeted for the program to fill the gap.
“We only get paid if there’s someone in a bed,” Klatzker said. “Without people in the bed, we have to subsidize that revenue with whatever we can come up with.”
Health department spokesman Charlie Gischlar said earlier this month that providers raised the issue and the agency is evaluating it.
Gaudenzia isn’t the only provider facing shortfalls.
Benjamin Toney, executive director of ValleyBridge House in Baltimore’s Washington Hill neighborhood, said the center served about eight new clients a year, but has no state-referred patients right now.
ValleyBridge runs a six-month residential program that charges about $210 per patient per day, with room and board costs factored into the price, Toney said.
“We’re a small program and that’s a significant amount of revenue,” he said.
ValleyBridge is managing to stay open through donations and other non-program clients, Toney said, but counts on the court-ordered clientele and revenue.
Del. Luke Clippinger, the chairman of Maryland’s House Judiciary Committee, said he had not heard from Gaudenzia or other treatment providers about the lack of diversion program clients. But the Baltimore Democrat said he was “happy to hear from them” and wants to “ensure that treatment programs remain well-funded.”
The health department announced Wednesday the state would award $50 million in grants for local treatment and recovery programs to combat substance use disorder.
A Gaudenzia spokesperson said the company has applied for the relief, but the grant would be much lower than what the company is losing.
Maurice Mackall, 43, was placed at the ValleyBridge House treatment center earlier this year, after he successfully petitioned a judge to be entered into the program.
In 2016, he was sentenced in Charles County to 16 years in prison on a handful of illegal weapons and ammo possession charges and was allowed to enroll in treatment in January after he became eligible for parole, according to court records.
Mackall said he’d been using drugs like PCP and marijuana as well as drinking alcohol since he was a teenager. He admits to being in the room with a rifle, shotgun and ammunition illegally due to a previous felony conviction and said that he believes his addiction clouded his judgment.
He said treatment at ValleyBridge serves as a respite for those in recovery and helps them connect with each other and society. That contrasted with the smuggled drugs and gang fights he saw behind bars.
“I look at it as a peaceful place,” said Mackall, adding that patients had to turn in their cell phones and their movements around the facility were monitored. “I was never in harm’s way. [There were] no fights in the home. They kept a tight grip.”
He graduated from the program in July, and the terms of his sentence have been completed, he said, crediting ValleyBridge as instrumental in his recovery.
Drug policy and consent decree
While much of the reduction in diversion program clients can be linked back to the coronavirus, the drop in simple drug possession cases may continue.
Attitudes have changed, particularly in Baltimore where in recent years Mosby has advocated a more progressive approach to crime prevention. Baltimore police, under a federal consent decree for engaging in repeated stops of Black residents and other unconstitutional acts, now say they want to engage with the community and offer a more holistic approach to stopping drug abuse.
Neither Mosby nor Baltimore police said they want to see arrests return to their prior rates.
Zy Richardson, spokeswoman for Mosby’s office, said that, because the state diversion program requires an arrest, it creates “a problematic proposition during this health crisis.”
The office wrote that it would not support increasing participation in the program by prosecuting lower-level drug arrests “for the sake of funding or to meet a quota.”
“These programs should focus on crimes related to addiction: theft, burglary, etc., rather than simple possession,” Richardson wrote. “We are in active conversations with our diversion partners about the best way to do that.”
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Baltimore police spokeswoman Lindsey Eldridge wrote in a statement that the department “has made modification to some protocols in the interest of preserving public health and safety” and that tackling drug addiction would require multiple agencies to respond.
But Klatzker said something needs to be done in the short term to address the funding gap, if not the clientele gap as treatment centers face a crisis with rising fatal drug and alcohol overdoses.
At least one center owned by Gaudenzia could be in jeopardy, Klatzker said. He would not say which one, but noted Gaudenzia has two facilities in Baltimore City — one on Woodland Avenue and another on Park Heights Avenue — within about a mile of each other.
“In general, people believe this is good policy and that it’s money well spent,” Klatzker said. “We’re not looking for a handout. We’re looking for support from the state that can keep us whole. Right now, we’re bearing the burden.”
“We’re at risk of undoing really good public policy with this program,” he said. “We don’t want to criminalize people because of their illness.”