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How more lives could be saved from heroin in York County

Written by Ed Mahon and Brandie Kessler/York Daily Record | Mar 27, 2017 6:12 PM
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"I couldn't believe it. Really. I was in shock. I thought for sure I was not going to get a job," said Emily Bielawa, seen here working the register at Brew Cumberland's Best in New Cumberland. The 26-year-old mother of one was required by her participation in drug court to find a job and has been with the coffee shop for nine months. (Photo: Jason Plotkin, York Daily Record)

(York) -- In a York County courtroom, a judge asked Emily Bielawa how things were going.

Smoothly, she said.

"I'm getting used to life without drugs," the 26-year-old mother added.

That life seems drastically different from when she struggled to go more than a few hours without heroin, and when, as a waitress, she would forge tip amounts to pay for the drug. In early March, she was approaching one year clean. She credits that recovery at least in part to a drug treatment court.

"I could be dead," Bielawa said. "The heroin that they have out now ... people are dying left and right."

As part of the program, people facing criminal charges can avoid prison time and have criminal charges dismissed or reduced in exchange for undergoing increased supervision outside of jail. The goal is to address mental health and substance issues that lead to them committing crimes. To graduate, they have to meet many requirements, including attend court sessions regularly, work at least 30 hours a week, comply with random drug tests, pay fines and weekly fees, and attend recommended counseling.

Some state lawmakers, including Democratic Gov. Tom Wolf and a Republican state representative from Luzerne County, are pushing for the expansion of drug courts as a key tool in fighting the heroin and opioid epidemic that claimed more than 100 lives in York County in 2016.

But there's at least one big hurdle: Money. County courts need judges to handle cases and meet with offenders. The courts need attorneys, probation officers and other staff members. Salaries, benefits and other costs could total hundreds of thousand of dollars or a few million dollars, depending on how many people the program accepts.

In York County, it's common for the court system to close off admission to its adult drug court and similar programs, also known as problem-solving or treatment courts. At least one person who died in a heroin-related overdose in 2014 was rejected from drug court months earlier because the program was full.

The county's adult treatment courts are capped at about 365 people total at any one time, which includes 150 in drug court and 150 in DUI court. All the adult treatment courts in York County - not just drug court - help people with heroin and other addictions, and Common Pleas Judge John S. Kennedy said the county has never had trouble filling the programs.

Last year, lawmakers approved a $1 million increase to help the Administrative Office of Pennsylvania Courts expand problem-solving courts statewide. And the governor's budget proposes expanding them further.

Pretty much all the costs for local treatment courts falls under the York County budget, and county commissioners are looking into expansion options. But Kennedy thinks the state should significantly increase its share of funding by closing state prisons, and if it did, York County's treatment courts could help 10 times as many people.

During a treatment court graduation ceremony in December, Kennedy referred to the limits. Looking out at the crowd of treatment graduates and their families, he talked about how he had reviewed the treatment court graduation applications the previous weekend.

"I almost want to cry because we don't have the funding to provide this opportunity to more people," Kennedy told the crowd.

'It works'

York County has more types of problem-solving courts than most counties in Pennsylvania. It has adult drug, DUI, mental health and veterans courts, plus similar programs for juvenile offenders.

Problem-solving courts are designed for tough cases, ones where the people are considered high risk and high need.

Some of those people don't finish the program or relapse after completing the program. York County's adult drug court graduation rate is 44 percent, while its DUI court graduation rate is higher, according to a recent treatment courts report.

Kennedy has gone to funerals for people he knew through a problem-solving court.

"We work with these folks. We 'treat' them," he said. When they die, "we feel a loss," he said.

Still, there are many successes. Kennedy and other backers of problem-solving courts point to research that shows people who complete the programs are less likely to commit crimes in the future.

Susan Byrnes, York County's president commissioner, told the York Daily Record editorial board in January that she has talked with Kennedy and the two other county commissioners about expanding them. In March, she said she did not have a set number in mind for how many more people she wants to add to the programs. But she said she was working on setting up a meeting with court officials and others to pursue expansion. She wants the program to be open to anyone that qualifies.

"I just know that it works," Byrnes said.

Part of the pitch of these programs is that they save lives and save money, because it is more expensive to house people in jails and prisons.

For instance, a 2016 report for York County's treatment courts said the average cost to get someone through drug court is $11,954.

So the 46 graduates of the program in 2016 represented a cost of nearly $550,000. But the report said those 46 still saved taxpayers hundreds of thousands of dollars because the program was cheaper than sending them to jail or prison.

Caps

It's not clear how many people meet the criteria for York County's treatment courts. Information from the York County court system describes 146 referrals to drug court in 2016 and 86 people being admitted. But the caps prevent some people from applying or being considered for the program.

There is no waiting list to get into drug treatment court, Kennedy said. When the court is at capacity, it puts out a notice that it's not accepting any more applicants.

Mark Elliot, 32, figures he has spent about six years in York County Prison on various charges since he was 18. He has done pain pills, Ecstasy, cocaine, crack, meth and heroin. He applied for drug court in December 2015 and again in February 2016 and was rejected both times because the program was full, according to court documents.

Later in 2016, as he was running out of time to continue his cases, he was accepted into the program. Without treatment court, he faced years in state prison on multiple charges, including possession with intent to deliver. Elliot said the supervision in the program is more intense than any of the times he has been out of jail and under court supervision.

The York County drug court program is designed to last 12 to 18 months. If people follow the rules, they can get an incentive, such as applause at one of the court sessions, a gift card to a grocery store or a water bottle. If they don't, sanctions can include increased supervision and time in jail.

If someone finishes the program, felonies generally become misdemeanors and misdemeanors generally are dismissed.

Among other things, for at least the first few months, people in the program must attend weekly court sessions, go to treatment or support groups daily, and meet other obligations. Court appearances and some requirements lessen as you complete different phases of the program, but they don't stop.

"All the things that they make you do, in the beginning, were, you know, a pain. ...And I thought they were just a hassle," Elliot said. But he thinks that structure helped save his life.

Throughout the program, people have to call a phone number that tells them whether they will need to provide a urine sample that day.

Elliot talked about that with Judge Michael E. Bortner during a recent court appearance.

Elliot mentioned he was feeling under the weather, and Bortner, who now handles drug court, said it looked like Elliot was congested. The tone was casual, and Elliot talked about how he was staying away from most medications to avoid any types of false positives on drug tests. Hot tea, they both agreed, was a safe option.

Overall, Bortner was pleased with Elliot's report.

"Keep up the good work," Bortner told him.

The intense supervision that Elliot credits with helping save his life is also one of the hurdles to expanding.

"If we go over the caps, we cannot provide the quality of service that made York County treatment courts a nationally recognized program and a model of success," Michael Stough, a deputy director for York County probation services, said in an email.

For drug court and DUI court, the probation department generally has one probation officer for every 50 people in the program. To expand the number of people in treatment courts, the county would have to add probation officers, judges and case managers, Stough said.

Some magisterial district judges in York County have gone through treatment court training, so they could be available to serve as judges if programs expanded, Kennedy said.

The public defender's and district attorney's offices are both part of treatment court teams.

Tim Barker, an executive supervisor in the county district attorney's office, suggested now is a good time to revisit a strategic plan and what would be required for expansion for York County treatment courts.

Clasina Houtman, first assistant for the public defender's office, said in an email that research shows that a treatment court becomes less effective when the number of participants goes beyond 125 people to 150 people, so her office would support creating an additional drug court with its own team, including a judge.

If you expand a treatment court, you also have to consider whether there will be enough treatment services available in the community, according to P. Karen Blackburn, the Administrative Office of Pennsylvania Courts' problem-solving courts administrator.

State action

More than 100 problem-solving courts exist across Pennsylvania, and there were more than 7,000 participants in problem-solving courts from July 2015 to the end of June 2016, according to AOPC.

For this year's state budget, lawmakers approved an increase to help expand problem-solving courts through AOPC. That funding increased from $103,000 in 2015-16 to $1.1 million this year. For the governor's 2017-18 proposed budget, Wolf proposed continuing that funding amount.

Blackburn said that money is going to help add new problem solving-courts not expand existing ones. She said if funding isn't guaranteed, a court system could hire a probation officer who would be laid off 12 months later.

"You don't want to set programs up to fail because of something like that," Blackburn said.

The funding has allowed the state to pilot a regional drug court in Forest, Elk and Jefferson counties, and expand elsewhere so 53 of 67 in Pennsylvania will have some type of problem-solving court, she said.

More:Drug-related deaths go up for 2016

There are other ideas for ways the state could help with problem-solving courts. For instance:

  • For the 2017-18 budget, Wolf proposed $3.4 million to expand specialty drug courts, including assistance to communities with existing drug courts, through the Pennsylvania Commission on Crime and Delinquency. That proposal was included under a section of the budget about combating the heroin and opioid epidemic, along with a $10 million proposal to expand access to naloxone, which is used to treat opioid overdoses. Statewide, there were more than 3,300 drug-related overdose deaths in Pennsylvania in 2015, according a report from the  Drug Enforcement Administration's Philadelphia Field Division. Heroin was the most frequently identified drug in those deaths. 
  • Earlier this year, state Rep. Aaron Kaufer introduced a package of opioid-related bills. One of them would allow counties to impose a fee up to $250 on anyone who is convicted under the Controlled Substance, Drugs, Device and Cosmetic Act. The money would go toward a special drug court fund in the county. Kaufer did not have estimates for how much funding that would provide.
  • Kennedy suggested the state could save enough money by closing prisons to give each county court system about $1 million for problem-solving courts. "We send so many people to the state prison system who could be walking across the stage with a transformed life," Kennedy said in December. In January, the Wolf administration announced it would close a state prison in Pittsburgh and save $81 million a year, but the administration did not suggest using that funding for the kind of large-scale increase Kennedy wants. That closure was done because of a decrease in the inmate population and to address an expected budget deficit.

'Beautiful thing'

Bielawa started illegally using painkillers several years ago, and she eventually moved onto cheaper heroin. She stole to pay for drugs.

"It was definitely something I am not proud of. I mean, when you already feel so small as ... an addict and so weak - it just, it made me so much smaller," Bielawa said. "I just thought I would never be able to change, really."

She was arrested on forgery and related charges in York County in 2015, applied for drug court and and was ordered into the program April 2016.

Her life is different now in big and small ways.

She's physically active in a way she wasn't while on drugs. The former high school point guard goes to the gym pretty much every other day. She likes to hike. Bielawa wakes up before 5 a.m. to work at a job she finds fulfilling - an early shift at a coffee shop - and she is planning to go back to college. She feels like a good mom now. She helps her 7-year-old daughter with her homework, goes on bike rides with her and puts her first.

"And ... to just wake up and be happy without the use of drugs - it's a beautiful thing," Bielawa said.

In early March, she completed the second phase of drug court. She is on pace to graduate from the program by the end of the year. It will be a big day for her, if it happens.

And for someone else struggling with addiction, her graduation would open up another spot in drug court.

Heroin-related overdose deaths

The York Daily Record/Sunday News reviewed 127 heroin-related overdose deaths in York County, based on a list provided by the coroner's office, from 2014 and 2015. The review found that several dozen of the people who died had at least one criminal charge in a common pleas court in Pennsylvania. The review found about 10 people who applied for a problem-solving court in their two most recent criminal cases in Pennsylvania. 

The listed included:

  • one person who was rejected in 2010 because she had a detainer in another county from a different case.
  • another person, who applied for the veterans treatment court and who faced an aggravated assault charge in 2012. Certain crimes involving violence are considered on a case-by-case basis. His rejection letters said that, among other things, the charges were not related to military service, and the nature of the offense was another reason to reject him.
  • and a man who applied for drug treatment court in September 2013 and was rejected because the program was at capacity. In November 2013, he pleaded guilty on charges of child endangerment and possession of drug paraphernalia. He was sentenced to probation. He died of a drug overdose in March 2014, according to coroner office records.

Another person was rejected twice in 2014. But then charges were reduced, and he was admitted into a treatment court. He died before completing the program.

 

This story is part of a partnership between WITF and the York Daily Record.

 

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