In 2008, the Volunteers of America men's residential facility in Northeast Portland had a 71 percent success rate treating parolees and probationers considered to be of high and medium risk to commit new crimes. In 2010 the facility allowed in only high-risk men and its success rate dropped to 55 percent.
Greg Stone, program director the VOA center, worries that the success rate basically the percentage of men graduating the six-month program might drop further as more of the most difficult probationers and parolees gain Medicaid benefits and are sent to his facility for addiction treatment.
A residential treatment facility, Stone explains, develops a culture created by its clients, despite the best efforts of staff to control the environment. The VOA facility lost an advantage when it could no longer accept medium-risk addicts, according to Stone.
The people who had a little more incentive, who were a little higher functioning, could come in and stabilize your community, Stone says.
And the population of high-risk offenders that the VOA center treats increasingly is dominated by young opiate addicts, many hooked on heroin. Last year, 40 percent of the VOA facility's residents were heroin addicts, up from 8.7 percent 13 years ago. These men are less likely to cooperate and more likely to try and chip secretly use opiates while staying at the facility. And that, Stone says, makes it harder on all the clients.
It creates pure hell and chaos for you. You bring one guy in who brings (drugs) in and a lot of guys jump on board with him, Stone says.
Stone isn't going to get medium-risk offenders back into his client population. The county is primarily interested in lowering crime, and the most impact will occur if the most expensive treatment is reserved for addicted parolees and probationers most likely to re-offend, says Ginger Martin, deputy director for Multnomah County's Department of Community Justice.
Martin says medium- and low-risk offenders don't respond as well to the extended inpatient stays offered at the VOA center. Currently, Multnomah County does not pay for addiction treatment for low- and medium-risk offenders. Medicaid will pay starting in January, but Medicaid is unlikely to cover expensive inpatient treatment for those parolees and probationers when they could benefit from outpatient drug counseling.
Alternatively, Stone would like to see a different treatment model for the growing number of young heroin addicts on probation and parole a locked facility where it would be harder for the clients to bring in opiates from outside.
Martin says Multnomah County rented space in Washington County for such a facility about 15 years ago. High-risk probationers and parolees with serious addictions had to agree to live there for six months, and if they decided to leave they had to give 24-hour notice. The notice was key because often, clients who asked to be released had gotten past their crisis and changed their minds before the 24 hours were up.
It worked, people finished, Martin says, adding that there simply isn't county money for such a facility anymore. Ironically, Multnomah County currently has an empty facility that some have said could serve such a purpose the mothballed Wapato Jail.
On a second alternative, both Stone, Martin and others agree to an extent. If residential treatment centers are going to be increasingly dominated by high-risk heroin addicts, probation officers can help by removing the parolees and probationers who fail to cooperate.
High-risk offenders already have proven themselves more antisocial and more likely to break rules, Martin says. When an offender in treatment is found chipping, for instance, it is up to his parole officer to decide on a consequence. Typically parole and probation officers are reluctant to kick their clients out of treatment for one or two infractions, Martin says, because treatment at a facility like the men's residential center is their best hope for change.
Ideally, Martin says, parole and probation officers will respond quickly with a not overly severe sanction, such as a day or two in jail and then back to the treatment facility. Probation and parole officers, with already large caseloads, somehow are going to have to find a way to more closely monitor many of their high-risk offenders, Martin says, and that won't be easy.