Researchers at the University of California at Los Angeles have found that California’s six-year-old treatment-instead-of-incarceration program needs at least $228.6 million to provide adequate services, improve treatment outcomes and increase taxpayer savings.

Treatment advocates welcomed the report, which was released on Friday, April 13, and encouraged legislators to reject the governor’s proposal to slash Prop. 36 funding to just $120 million, fully $109 million short of UCLA’s recommendation.

Margaret Dooley, Prop. 36 coordinator for the Drug Policy Alliance, said “Today’s report makes it clear that Prop. 36 has performed very well despite a serious shortage of funding. The governor and the legislature cannot afford to ignore this report’s clear warning: failing to adequately fund Prop. 36 jeopardizes treatment success and the fiscal savings this program has delivered to date.”

Dooley added, ”Prop. 36 needs at least $230 million, but the governor proposes just over half that much. Today’s report may be inconvenient and embarrassing for the governor, but he should heed its message. Starving Prop. 36 would actually cost California hundreds of millions of dollars, while fully funding it will save lives and money.”

UCLA researchers arrived at the recommended funding level by analyzing the costs of a series of improvements, including:

• More appropriate treatment placement (eg, residential placement for those severely addicted, $18.9 million);
• Providing a “minimum dose”, or 90 days, of treatment ($31.3 million);
• Expanding access to narcotic replacement therapies, such as methadone and buprenorphine ($3.7 million); and
• Enhancing probation supervision ($25 million).

Using counties’ Prop. 36 spending in FY 2005-06 ($149.7 million) as a baseline, the cost of these changes would require total Prop. 36 funding of $228.6 million.

This figure mirrors the funding recommendation of the County Alcohol and Drug Program Administrators’ Association of California, whose 2007 survey of program administrators found that Prop. 36 needs at least $230 million to “adequately address the treatment needs.”

In their report, the UCLA researchers point out that that the optimal funding figure for Prop. 36 is still higher. The report notes, “Many potential program enhancements are excluded here, for example, the cost of increasing length of stay in long-term residential treatment, providing ancillary services, or aftercare, all of which have been shown to improve drug treatment outcomes.”

Funding Shortfall Drags Down Positive Results

As revealed by the report, inadequate funding may already be having a negative impact on the program. Data show that 32.0% of year-three Prop. 36 participants went on to complete treatment. This is two percentage points lower than the completion rate in the program’s first two years: 34.4% and 34.3%, respectively.

Dave Fratello, co-author of Prop. 36, said, “The results of funding shortfalls in years past are beginning to show up in lower treatment completion rates for Prop. 36. Due to limited resources, Prop. 36 participants are often placed on long waiting lists or in an inappropriate, but cheaper, level of care. The result is predictable – fewer complete treatment.”

Fratello added, “It is remarkable that the state and counties give short shrift to the cheapest, highest-impact reform possible under Prop. 36. For just $3.7 million more per year, UCLA says most heroin and opiate-using clients could get narcotic replacement therapy – the gold standard treatment for this addiction. It is a tragedy that this treatment is so badly under-utilized.”

According to UCLA, a one-third completion rate is comparable to treatment outcomes of other groups, both those who enter treatment voluntarily and those otherwise ordered to treatment by criminal justice. According to the California Society of Addiction Medicine, it is also comparable to treatment compliance with other chronic conditions, including diabetes and hypertension.

No Significant Crime Impacts

UCLA found that implementation of Prop. 36 in 2001-04 did not result in any increases or decreases in crime rates in California. The report found that among those Prop. 36 participants who re-offended after treatment, their offenses were almost always drug-related, rather than more serious crimes. Controlling for "days on the street," UCLA found: "offenders in the [Prop. 36]-era group had fewer re-arrests during un-incarcerated time than offenders in the pre-[Prop. 36]-era group."

In other words, the effect of treatment was lasting across the tens of thousands of people with Prop. 36 experience. They were less likely to be arrested than people who had not had treatment before Prop. 36 was enacted. Unsurprisingly, drug arrests were lowest among those who completed treatment.

About the Prop. 36 Budget Figures

For five years (FY 2001-02 through FY 2005-06), Prop. 36 was guaranteed funding of $120 million per year from the state general fund. Counties actually spent $149 million to implement Prop. 36 in FY 2005-06, according to the UCLA report, which was possible because some counties had carried forward money from earlier years with fewer clients.

Last year was the first in which legislators set the Prop. 36 program's budget. The legislature approved $120 million for the main Prop. 36 fund, and $25 million in supplementary funds under the auspices of the Offender Treatment Program, which requires 1:9 county-matching.

Prop. 36 Savings

Analyses conducted by UCLA show that for every $1 invested in Prop. 36, the state saves $2.50. For program completers, every $1 invested leads to $4 in savings. UCLA put first year (2001-02) savings at $173 million. The Legislative Analyst’s Office has estimated that the state’s $120 million annual investment in Prop. 36 resulted in net savings of $205 million in 2002-03 and $297 million in 2004-05. Conservatively estimating $200 million in savings per year, total program savings in six years surpasses $1.2 billion.

Nearly six years into Prop. 36, the number of people incarcerated for drug possession has fallen by 32% (5,000 people). More than 1,000 Californians on parole complete treatment under Prop. 36 each year instead of going back to prison. By diverting so many into treatment, Prop. 36 rendered unnecessary the construction of a new men’s prison (saving an addition $500 million) and also resulted in the shuttering of a women’s prison. This brings total savings to $1.7 billion.

Prop. 36 Background

Prop. 36 was approved by 61 percent of voters in November 2000. A June 2004 poll by the Field Institute showed support for the law at 73 percent. Nearly 12,000 people have successfully completed substance treatment during each year of Prop. 36’s existence, putting the program on track to graduate 72,000 Californians in its first six years.

Read the UCLA report online.

Read commentary from Oliver H., a Prop 36 graduate.