As the Legislature’s tough-on-crime legislation House Bill 49 nears the finish line, legislators have pledged to turn their attention to tackling the substance abuse that underpins many of Alaska’s crimes… sometime over the next year.
Not everyone’s convinced they’ll follow through.
Rep. Tammie Wilson, the North Pole Republican who co-chairs the House Finance Committee, said she’s not willing to wait—having seen such promises fall by the wayside in the past—and is pushing ahead with expanding access to substance abuse treatment this year.
House Bill 49, which the House approved on Monday and ramps up sentencing for most crimes, is expected to increase Alaska’s prison population by more than 1,000 prisoners once it’s fully implemented and increase state spending by nearly $60 million every year. The growth in population would require the state to this year reopen the Palmer Correctional Center, which would reach capacity in another year.
Though she’s been supportive of House Bill 49, Wilson has been critical of the focus on prison time as the solution to Alaska’s crime problem. As the head overseer of the state’s capital budget she’s also in a unique and powerful position to do something about it.
“I don’t believe we can wait another year before we talk about the other portion of that and that is some kind of treatment,” she said. “What that looks like in the capital budget, whether we’re talking about new facilities, that is still being talked about. I don’t think we can wait a year just to see what happens with the new law that we have.”
Defining the problem
Anchorage Police Department Captain Sean Case agreed with the goal of expanding treatment, both for offenders in the system and people outside the criminal justice system. He said many of the arrests made by APD are either directly about drugs or are influenced by drugs.
“We’ve been dealing with this issue for decades and decades. Stricter penalties or legislation such as HB 49 alone are not going solve the problem,” he said. “If the underlying issue is some sort of addiction or mental health, then that particular problem needs to be addressed or we’re just going to see the same number trickle through.”
When asked where the most cost-effective place for the state to intervene with treatment, Case said before prison or, even better, before they’re arrested.
Case also warned the committee that while opioids have demanded much of the attention, there’s a rising resurgence of meth addiction that is quickly becoming an issue, too.
Philip Licht, the executive director of the Wasilla-based substance abuse treatment center Set Free Alaska, also told the committee about how treating drug addiction can help many offenders turn the corner and lead productive lives.
“If we don’t deal with the root causes of why they’re committing the crimes, it’s reasonable to expect they will continue to re-offend,” he said.
“That’s my belief as well,” Wilson replied.
Looking for solutions
With the capital budget still in the House Finance Committee, the legislation can be freely amended by the committee to add new funding to the budget. Wilson doesn’t have a crystal clear plan for that, but invited law enforcement and public health officials from around the state to testify about pending projects and other that could be put into place.
Officials from the Mat-Su Health Foundation were among the presenters.
Dr. Melissa Kimberling, the Mat-Su Health Foundation’s vice president of programs, said the programs are designed to take pressure off of emergency room treatment for people in crisis. She outlined how state grants could help the area establish increased substance abuse treatment as well as a crisis prevention center and hotline that could serve the state and coordinate care.
“When you have this, it can actually either prevent a crisis for people with behavioral health or substance use disorder needs and it can ameliorate the crisis, so make it a shorter crisis and not require hospitalization,” she said.
Much of the projects are reliant on a partially approved waiver from Medicaid that would allow the program to fund a wider array of substance abuse service to fill gaps in the existing system. The Mat-Su Health Foundation also recently completed a study of those games.
Kimberling said a state grant could help things get moving quickly.
“Are they shovel ready? No. Do we have the data and the analysis to show the need and the feasibility? Yes. Do we have healthy providers in Mat-Su that could step up to the plate and help deliver those services? Yes,” she said. “If there were capital funding, and if (the Department of Behavioral Health) put out something that was a competitive bid, we would be in a position to have some provider in Mat-Su step up and bid.”
Skepticism and opposition
While many members of the House Finance Committee engaged in the discussion with optimism about funding the treatment, not everyone was sold that it should be the state’s role to help with substance abuse treatment.
Anchorage made the pitch for capital support for a new in-patient treatment facility that could serve 250 more people annually with a range of services including treatment, withdrawal management and transitional housing. The municipality has an existing grant that will get the facility but would need new funding for construction. City officials also pointed out that Anchorage has become a focal point of many of the state’s mental health and substance abuse problems, meaning that its population is larger and often facing more severe problems than other areas of the state including its large homeless population.
Rep. Colleen Sullivan-Leonard, a minority Republican from Wasilla, said it should be up to the municipality and non-profits to foot the bill.
“I just know when you go through this process there’s all sorts of people involved whether it’s the Rasmuson Foundation or other non-profits that assist in this endeavor,” she said, requesting a list of potential backers of the project. “We know, too, at the state level we are at fiscal crisis. I think the reality of support from the state, I think, may be challenged. I’m hoping the municipality will come on board and take the brunt and support for this for their community.”
It’s interesting that Sullivan-Leonard referenced the Rasmuson Foundation. The foundation’s board recently penned an editorial outlining how the idea that the private sector can step in and fill the gap left behind by budget cuts is faulty.
“We have heard repeatedly from some supporting billion-plus budget cuts that ‘the private sector should step up and fill the gap.’ This isn’t possible. Total philanthropic giving in Alaska in 2018 added up to approximately $135 million. That’s a drop in the bucket compared to the severe cuts being proposed to our health care, education, transportation, housing and cultural infrastructure,” explained the board. “If philanthropy and private sector partnerships can’t fill the gap, what will happen if the governor’s cuts are passed as proposed? We believe that what’s left of a heavily diminished nonprofit sector will be overwhelmed by increased need.”
Gov. Michael J. Dunleavy’s record so far hasn’t been particularly supportive of drug treatment. Earlier this year, the administration rejected a $1 million federal grant to the Department of Corrections that would have helped fund prisoner re-entry. He’s also filed legislation, like Senate Bill 112, that would rework how Medicaid works with one of the changes being a proposed $12 million cut to community grants for substance abuse treatment.
It’s unclear how capital grants for substance abuse treatment would fair against the governor’s line item veto power.