HealthyCal.org

A majority of California adults would be willing to pay higher taxes to preserve current levels of spending on health and social services, according to a new, independent poll released Tuesday.

The survey by the Public Policy Institute of California found that 57 percent of Californians would be willing to pay higher taxes to support the safety net, the same number who said they would support higher taxes to keep current spending levels for higher education. Even more — 72 percent — said they would pay higher taxes to support K-12 education. Just 13 percent support higher levies for the prison system.

The same poll found broad support for Gov. Jerry Brown’s proposal to raise income and sales taxes to help balance the budget.

While 74 percent said they support raising taxes on the wealthy and just 29 percent say they would back an increase in the sales tax, Brown’s proposal, which combines the two ideas, drew the support of 72 percent of all adults and 68 percent of likely voters. Another 31 percent of likely voters say they oppose the plan.

Voters were also opposed to the cuts Brown has proposed in his budget or suggested might be necessary if voters fail to pass the tax increase in November.

Only 24 percent of likely voters said they would support the cuts to schools that Brown has threatened to implement, the equivalent of cutting three weeks off the school year.

And 44 percent said they favored cuts to welfare, child care and Medi-Cal, which Brown says will be necessary even if the voters agree to raise taxes.

But Mark Baldasssare, president and CEO of the PPIC, said Brown might still have an uphill battle passing his plan because voters still believe that government can be cut further, and very few support raising the sales tax.

“The challenge the governor faces with his tax initiative is that one generally popular tax increase—raising personal income taxes on the wealthy—is paired with one generally unpopular one—raising the state sales tax,” Baldassare said.

To see the full poll, go here.

By Mary Flynn

Loren Jones was diagnosed with HIV 28 years ago. A relatively low viral load meant that for a long time, Jones, a 59-year-old African American woman, didn’t feel sick at all. “I ignored it completely,” she says of the first few years of her illness. “I was the kind of person who had always been very healthy. I don’t catch cold very much, even now. I basically tried to pretend it wasn’t there.”

It was only three years ago that Jones went on any sort of medication for the disease. The cost of her medication, a once-daily combination drug called Atripla, is approximately $22,000 a year, an impossible cost for someone like Jones who does not collect a paycheck.

While HIV/AIDS policy and funding have received more attention than usual in recent months, the state continues to reel from budget cuts prompted by sluggish tax revenue. These budget cuts, combined with ongoing efforts to reform healthcare could hurt already vulnerable patients, advocates say.

Ten California counties are rolling out healthcare reform in advance of 2014, when healthcare reform takes effect nationally. HIV/AIDS service providers want to make sure that the changes healthcare reform brings won’t further compromise care for any of California’s 190,000 people living with AIDS or HIV.

Advocates are especially worried about the shift away from wraparound services, like housing assistance, towards a more medical model of care. The end of federal funding dedicated specifically to low-income people with HIV/AIDS is also a concern. These changes are likely to hurt the low-income communities already hard hit by statewide cuts in HIV/AIDS prevention programs.

About $85 million dollars was cut from the California Office of AIDS budget in response to the budget crisis in fiscal year 2009-2010, according to a report from the UCSF AIDS Policy Research Center. That’s about half as much as the program’s budget in 2008-2009.

The reduction in funding resulted in devastating cuts to prevention efforts. Many community-based and support service organizations were forced to drastically reduce their services or close their doors altogether.

“These cuts have the impact of even further decreasing access to vulnerable communities,” said Dr. Ifeoma Udoh, Research Director at Pangea Global AIDS Foundation, an organization that supports HIV strategies primarily through research and evaluation.

In Alameda County, African Americans are most heavily impacted by HIV/AIDS, representing 43 percent of prevalent AIDS cases and half of HIV cases. The communities most vulnerable to the HIV epidemic include heterosexual girls and women, men who have sex with men (particularly African American and Latino men) and injection drug users.

“There’s also an economic issue,” said Tom Mosmiller, a Program Manager at Alameda County Office of AIDS Administration. “It’s moved from a middle-class disease of the white, gay, middle class male, to also a disease of low-income people of color.”

Low-income people need wraparound services, which help with finding a stable home, employment and transportation. The stability these services bring help people maintain their treatment regimen.

Loren Jones is well aware of the hardships of being both low income and HIV positive. In addition to her own experience, she volunteers much of her time working with AIDS advocacy and research groups.

She said that housing services were one of the first things to go. Jones lives in a studio apartment in Berkeley, affordable only through subsidized housing.

“When you have a disease where you need to have community, that’s a very frightening thing to not have a place to live,” she said.

Jones considers herself different from many low-income people. She attended Penn State, and later became a Licensed Vocational Nurse through Laney College. In addition to arming her with an extensive knowledge of the human body, she has some basic educational advantages.

“I don’t think that we are fully aware of how many people in our culture, especially low-income people, that don’t read really well,” she said, which is key to understanding one’s options for treatment or assistance.

“If you don’t know what’s on paper or you can’t go someplace and look up information and compare what you’re reading with what you’re being told, then you don’t really have much choice, and then you’re always at the mercy of whoever you’re talking to,” she said.

She has also said that the food resources have grown much tighter now. The resources are there, but their nutritional value is lacking – not helpful for the already-depleted immune systems of HIV/AIDS patients. For years she and many others made up the nutrition deficit by drinking supplemental shakes like Ensure, but the shakes are no longer provided.

Advocates are concerned that healthcare reform may not strengthen efforts to improve wraparound services so important to people like Jones, and may even weaken them.

For instance, the Obama administration unveiled the first National HIV/AIDS strategy in 2010, a “monumental document,” according to advocate Sonia Rastogi. “It was the first time the U.S. admitted to and created a plan around the domestic epidemic,” said Rastogi, a program coordinator for the Positive Women’s Network.

The strategy, however, tends to focus on those efforts that are quantifiable – results from new medicines, for example – creating a system that rewards a medical model with funding while wraparound services suffer.

“Support services and wraparound care are the first things to get cut and put on the table to see if they’re necessary for meeting certain types of goals,” Rastogi said.

She gave the example of an HIV community-based organization (CBO) seeking funding. To line up with the strategy’s goals and secure funding, the CBO would want to demonstrate that they are, for example, reducing incidents of HIV.

However, many community-based organizations focus on support groups or peer-to-peer supportive services. They do not necessarily know how to quantify the effect it may have on preventing HIV infection.

“They have to figure out how to quantify those things and that might be hard,” Rastogi said.

Similarly, because of HIPAA (the Health Insurance Portability and Accountability Act of 1996), if the CBO is not attached to a clinic or a healthcare provider, they cannot access information on a patient’s CD4 cell count and HIV viral load – indicators of the disease’s progression and the patient’s response to therapy.

“So basically a lot of CBO’s are having to figure out how to change the way that they do business,” Rastogi said.

Other potential problems, particularly issues with continuity and ease of care, suggest that healthcare reform may need to pay more attention to the needs of people with HIV/AIDS, advocates say.

California has in place the Low Income Health Program (LIHP), a new optional program for low-income patients that will bridge the gap between now and when major provisions of the Affordable Care Act will be in place in 2014.

“The program had been developed over the last few years and had overlooked the needs of people living with HIV and AIDS,” Tom Mossimiller explained.

For example, there is a medication dilemma. Right now, many patients like Loren Jones qualify for ADAP, the AIDS Drug Assistance Program, which assists uninsured and underinsured AIDS/HIV patients with access to their medications. Patients qualifying for ADAP can go to their neighborhood pharmacy to get their medications.

“The LIHP program doesn’t have any deals like that, or any arrangements worked out with commercial pharmacies,” Mosmiller said. LIHP patients only have access to their clinic’s pharmacies, so it raises the question of where HIV clients will go for their medications.

“Will they be prevented from going to the neighborhood pharmacy that they may have been going to the last 5 or 10 years? Will they have to go to a new pharmacy? The clinic’s pharmacy? Will there be a long wait? We’ve got some challenges we’ve got to figure out,” Mosmiller said.

Sonia Rastogi explains that under the Affordable Care Act, there’s more of an emphasis on getting uninsured or underinsured patients, including those with HIV, to Federally Qualified Health Centers for their healthcare.

Her concern is that “those community clinics most likely do not have an HIV specialist on board or an HIV care and treatment function in their infrastructure.”

For Kabir Hypolite, the Director of the Alameda County AIDS Office, continuity is also a big concern. Patients may have been receiving treatment from the same doctor for years, and developed a relationship with their healthcare providers. He said making sure those relationships remain intact is important.

“That’s really key for things like treatment adherence, which is key for controlling the HIV virus, both at the individual level and also in the community,” Hypolite said. “If your viral load is high, not only do you have a poor outcome, you’re also more infectious with intimate partners.”

If patients are forced to change their provider, or if it’s made inconvenient or lacks the support services – childcare, transportation vouchers, legal assistance – it could have a major impact on patient adherence to treatment.

In the past, the low-income gap has been resolved through the Ryan White Care Act, a large contributor to low-income AIDS and HIV patients since its inauguration in 1991. The Act, simply known as “Ryan White” is the single largest federally funded program for people living with HIV/AIDS and the only Act dedicated to a single disease. Sonia Rastogi calls it the “payer of last resort,” as it seeks funding to allow for lower income, uninsured and underinsured patients to have availability for treatment.

“I think one thing everybody is really worried about is what’s going to happen with Ryan White with respect to affordable healthcare,” Udoh said.

The act is supposed to sunset in 2014, as the new healthcare reform takes over. But HIV advocates and patients are worried: what happens if Ryan White goes away?

“Ryan White is specific, set-aside HIV dollars that are supposed to go specifically to HIV/AIDS, meaning setting up things like ADAP, which is a set aside pot of money that states can tap into to fund reduced costs for HIV meds,” Udoh said.

She said that she and other HIV workers are eager to have government clarification on how the new system will play out.

“I think an immediate lesson learned is that as we continue moving forward with healthcare reform, we need to make sure that HIV is immediately included at the earliest stages,” Mosmiller said.

By Daniel Weintraub

Gov. Jerry Brown is proposing the most far-reaching changes to welfare since former President Bill Clinton and Congress overhauled the program 15 years ago.

Brown wants to cut $1 billion from the program — nearly one-third of its general fund budget — by shortening the amount of time recipients can remain on aid and focusing the state’s cash assistance and child care subsidies on people who are moving from welfare to work.

His plan has won initial praise from the state’s independent budget analyst. But advocates for the poor say it would further marginalize the state’s already struggling underclass. And Democratic leaders in the Legislature have said they will delay any action on the proposal until after the governor’s March 1 deadline, in the hopes that state tax revenues will come in higher than Brown anticipates.

While a common perception of welfare is a program that supports poor, unproductive people, the program has morphed over the past decade into one that provides not just cash grants but job training and services to help people enter the workforce. And more than anything, it is a program that supports children. More than 1 million of the 1.4 million people helped by the program are children.

It is also a program which, while never a major part of the state budget, has shrunk dramatically over the past generation.

In the mid-1990s, when welfare was an entitlement with no work or education obligations and no time limit, more than 900,000 families were on aid in California. But in 1996 then-President Clinton and Congress agreed on a fundamental restructuring of the program. Aid would no longer be open-ended, and states were required to move a certain percentage of their cases from welfare to work.

These changes altered the mindset of the program from one of providing subsistence grants to one that became more of a bridge to employment. In California, recipients were given a five-year time limit (recently reduced to four years) and they got more access to education, job training and child care to help them move into the workforce.

Even the name of the program was changed to reflect the new attitude, from Aid to Families with Dependent Children to Temporary Assistance for Needy Families and, finally, to Cal-Works.

For a time, the changes in the rules and the philosophy seemed to work. They coincided with a late-1990s economy that was bolstered by the technology boom, and the number of welfare cases dropped in half, to 460,000 by 2007.

The cases that remained, however, were the toughest: people whose lack of education, job skills or experience made them very difficult to employ. As the economy slid into a recession, those people found it nearly impossible to find jobs, and they were joined on the rolls by more families headed by newly jobless parents.

The welfare caseload began to grow again. By next year, if nothing is done, about 600,000 families will be on welfare in California. The cost of the program will grow by half a billion dollars.

One reason for that increase in costs will be the expiration of short-term changes adopted in each of the past two budgets. These changes reduced the amount of funding to counties to provide employment services and child care to families while exempting families with a child between the ages of 12 and 23 months, or two children under the age of six, from work requirements.

The Brown Administration says these changes have undermined the program by eroding its focus on work, leaving the state vulnerable to federal penalties levied on states that fail to shift enough families from welfare into the workforce.

In response, Brown has proposed what can only be described as a radical restructuring of the program.

His most dramatic proposal is to reduce the time limit from its current 48 months to just 24 months for people who fail to find unsubsidized employment. The adults would be kicked off aid and denied other services, but the families would continue to collect assistance for the children.

People who found jobs within their first two years on welfare but whose incomes still qualified them for aid would be allowed to remain in the program for a total of 48 months. And they would be allowed to keep more of what they earned. For the average family of three, the change would amount to an increase of $44 a month.

And while those families who remained on welfare with parents working would continue to be eligible for state-subsidized child care, many other families would lose this benefit. On one end, Brown would limit eligibility to just those parents who were meeting the state’s work requirement, leaving many low-income or penniless families out of child care altogether. On the other end of the scale, he would reduce the income eligibility threshold from 70 percent of the state’s median family income to about 62 percent, ending subsidized child care for families earning anything more than twice the federal poverty level. This would result in an estimated 62,000 children losing child care, out of about 296,000 who get it from the state today.

Brown wants the changes in welfare to take effect by October of this year. While the time limits on aid would apply retroactively, Brown proposes giving all recipients six months to find work before kicking them off the rolls. The counties would get $35 million in one-time funds from the state to help people ready themselves for work and find jobs.

But Brown acknowledges that few of the long-term cases would find work. His administration estimates that welfare cases would plummet next year from a projected 597,000 families to just 324,000, a reduction of 44 percent. Nearly 300,000 would be part of a new, separate program giving limited assistance, but few services, to the children in families headed by parents who could not, or refused, to work.

While Brown has proposed asking voters to raise taxes as part of his budget plan, the changes he suggests in welfare would take place with or without the tax increase. The state, he said, simply does not have enough money to do all the things it once did.

Welfare advocates and others say that the cuts will backfire, leaving more children in poverty and leading to social problems that will cost the state far more than the cuts would save in the long run. But Brown says he has no other choice than to propose changes that Democrats would have at one time would have considered cruel.

“We can’t spend what we don’t have,” he said when he released his budget proposal in early January. “It’s not nice. We don’t like it. But the economy and the tax statutes of California make only so much money available. We have to spend it and make tough choices.”

Has the birthplace of the digital revolution turned its back on older adults?

By Matt Perry

As the birthplace of the computer revolution, Silicon Valley vigorously celebrates innovation and youth culture. In the shadow of the digital age, however, older adults in Santa Clara county echo a similar concern: they are second-class citizens when it comes to financial support from government agencies and high-tech foundations.

During the same year that saw the death of Steve Jobs – the computer icon considered one of the greatest inventors of the past century – older adults last year experienced a succession of service cuts by Santa Clara County and the city of San Jose.

Representatives for older adults say that senior programs are cut at a greater percentage than other services.

“They’re highly marginalized, especially in Santa Clara County,” says Steve Schmoll, executive director for the Council on Aging Silicon Valley. “Most of the attention is focused on high-tech and younger people.”

In Santa Clara County, the heart of the Silicon Valley, the adult population 60 and over is expected to double in the next decade, creating further strains on social services and budgets.

Last spring, older adults rallied at meetings of the county’s Board of Supervisors and the San Jose City Council, demanding to retain critical services that included adult day health care, transportation to adult community centers, and senior nutrition programs. In a well-orchestrated effort by local nonprofits, seniors first addressed government officials, then pulled out a paper heart and ripped it in half.

“You’re tearing my heart in two,” each would say.

“Incredibly poignant,” recalled Lee Pullen, director of the Santa Clara County’s Department of Aging and Adult Services.

“We’ve lost our promise to our seniors and we are whittling away at it every day.” says Patricia Gardner, executive director of the Silicon Valley Council of Nonprofits. “They’re having to make decisions between medication and food, or heating their apartment and food.”

In 2007, senior organizers created the Aging Services Collaborative, which combined non-profits and government entities “to get us all talking the same talk,” says Schmoll, who is also the collaborative’s co-chair.

To some in wealthy Santa Clara County, with 280,000 citizens over 60 – more than any other county in the Bay Area – older adults are often the detritus of society, hidden away and forgotten.

A Silicon Valley historian says that the Bay Area has always fostered a unique environment for youth culture.

Piero Scaruffi, a cultural historian and cognitive scientist who has lived in the Silicon Valley since 1983, links modern high-tech entrepreneurs to California’s legacy of pioneers including Gold Rush miners, Beat poets, student radicals, electronic hobbyists, and software hackers.

“Each of these were eccentric individualists who created an alternative leaderless community,” says Scaruffi. “It is as close as you can remain to being a teenager. Instead of being scolded by family and school, you get rewarded with money and honors.”

Where high-tech continues to flourish, older adult representatives say that local foundations financed by well-heeled technology firms largely ignore older adults.

The Silicon Valley Community Foundation dispenses grants for 40 area companies, including Cisco, Adobe, and eBay.

The foundation granted over $150 million in 2010, yet virtually none of these funds targeted seniors.

“Seniors are not a priority for that foundation,” says Lori Andersen, director of healthy aging for The Health Trust, a collaborative dedicated to making “Silicon Valley the healthiest region in America.”

Yet a foundation spokesperson says the organization doesn’t always get to decide where its funds will be distributed. Although the foundation acts as a conduit to the Valley community, often the corporations themselves decide where the funds will be spent.

The foundation gave just $500 in 2010 to three state Meals on Wheels programs – one of the only senior programs to receive direct funding. By contrast, it gave $160,000 to Media Matters, $325,000 to the Abortion Access Foundation, and millions to local education programs promoting math and science.

Microsoft’s director of citizenship at its Mountain View office says that corporate giving is tied to specific goals that “move the needle and have the most impact,” according to Sid Espinosa.

And in Silicon Valley the target areas are typically STEM: science, technology, engineering and math.

Espinosa, who is also the mayor of Palo Alto, says that Microsoft focuses on work force development and training programs.

“Part of that is making sure we remain competitive,” he says.

High-tech firms also have their own philanthropic programs. Yet older adults are absent from their core values when it comes to giving.

Google gave more than $100 million last year to various organizations, with an emphasis on four areas: education for girls, empowerment through technology, STEM, and human trafficking and slavery. Apple, Hewlett-Packard, and other tech giants were also a disappointment for those interested in the condition of older adults in the community.

“I think it’s only fair that those companies reinvest a little bit more in seniors,” says Schmoll.

Even the United Way has slashed funds targeted to seniors.

“Our data shows that corporate giving has dropped 50% or more in the last three years,” says Gardner, who was named “Woman of the Year” for the state’s 24th Assembly district last year.

“There’s going to be corporate apathy toward older adults because corporations operate on shareholder dividends,” says county supervisor Cortese, “They don’t have a heart. They don’t have a heart for what we do.”

Microsoft’s Espinosa disagrees.

“You get so many requests from wonderful and worthy causes,” he says, rattling off a list that includes breast cancer, veterans, food banks, adult literacy, special education, open space, the homeless, and AIDS. “And that list could continue.

“Is there a bias against seniors?” asks Espinosa. “I don’t think so.”

A national expert on aging agrees that some areas of the country focus on youth at the expense of aging, but adds that dwindling support for older adult services has more to do with fiscal reality than discrimination.

Majd Alwan, executive director of Leading Age, headquartered in Washington, D.C., says that foundation support for older adults often comes from faith-based organizations. And donors to these non-profit organizations have been hit hard by tough economic times.

Santa Clara County officials claim they are doing their best to address the needs of its eldest residents.

In November, the Board of Supervisors mandated that all county decisions – building closures, pedestrian walkways, or personnel changes — include an “impact on seniors.”

In June, the county held a Summit on Older Adult Mental Health Needs that was attended by 350 health officials. In mid-December, the county’s Mental Health Department delivered its final summit report to the board, which outlined a series of recommendations, including improved access to mental health services, and better collaboration between mental health providers.

The county has an annual operating budget of $4 billion, but county board of supervisors president David Cortese says it was forced to make $750 million in cuts – nearly 20% of its budget.

Representatives for the aging are not hopeful about the future.

“It’s just going to get worse in 2012,” says Andersen, who is also lead staff for the Aging Services Collaborative of Santa Clara County

Representatives for older adults say that because support from both sources has dwindled – government programs and high-tech foundations – the strategy for helping older adults has changed.

“We don’t see that leadership among the elected officials,” says Andersen, “so we’re going to have to build it from the ground up. That takes time.”

Matt Perry is a correspondent for the California Health Report at www.healthycal.org

By Callie Shanafelt, California Health Report

Henry Hernandez served half of his two years in the custody of the Department of Juvenile Justice at the Preston Youth Correctional Facility. The initial intake dorm he stayed in was overcrowded with more than 60 youth from rival gangs fighting everyday, he said. Fights of more than five guys at a time broke out almost every week. The guards would use pepper spray or gas bombs to get things under control.

“There would be so much tension,” Hernandez said.

Pictures of kids in cages at what was then called California Youth Authority facilities adorned the front pages of California newspapers in the early 2000s. Media stories in the first half of that decade charged the Youth Authority with a range of abuses, including unlicensed medical and mental health treatment, and extreme use of force and solitary confinement.

Reforms to the juvenile justice system then reduced the population of the Youth Authority, now called the Division of Juvenile Justice, by 88% over the past decade.

Today, DJJ handles less than one percent of the 225,000 youths arrested in California each year.

Almost all the youth left in DJJ, about 1,200 people, are serious violent juvenile offenders or serious sex offenders, according to DJJ reports.

Last Thursday Gov Brown suggested eliminating DJJ altogether in his proposed budget plan. If the Legislature passes the plan the responsibility for these youth would shift back to the counties.

But even if the budget doesn’t pass as proposed there is a possibility that DJJ will close, and these serious juvenile offenders will be sent to state prison with adults.

State legislators proposed closing DJJ in early 2011. The initial language of adult prison realignment forbade county courts from sending any more juvenile offenders to DJJ facilities. DJJ would have been shut down as current inmates left the system.

The provision didn’t make it into law, but DJJ may shut down anyway. If the state doesn’t have enough money to run DJJ as of Jan 1, 2012, it will begin charging counties the cost of housing youth offenders – $125,000 annually per inmate.

If the state begins to levy these hefty fees, counties may start charging more youth as adults, shifting incarceration costs back to the state by sending youth to adult prison.

Sending serious youth offenders to prison costs a third of what it takes to send them to DJJ, according to UC Berkeley law professor Barry Krisberg.

“We could have many more youth put in the prison system, and everything we know says that’s a bad idea,” Krisberg said.

DJJ is a difficult place, Hernandez said, but he credits the time he spent there between 2009 and 2011 with helping him turn his life around.

While inside, the 17-year-old Hernandez attended classes to get his high school diploma, but he said fights usually broke out in class. Eventually, he said, teachers gave up trying to teach.

Originally from Oakland, Hernandez joined the Soreño gang before ending up in DJJ.

“I wanted to be somebody in the hood,” said Hernandez.

That changed when he was in detention.

“While I was in there, I started seeing the gang that I used to belong to, they did me dirty,” said Hernandez. So he calmed down, he said, and stopped fighting.

Eventually, after three months of good behavior, Hernandez went to a fire camp where he was trained as a volunteer firefighter. He liked his time in the camp, where anyone caught or suspected of fighting was automatically sent back to a detention facility.

“Right there, you‘d see people from rival gangs talking, playing dominoes, sit down and have regular conversations,” Hernandez said. “I started to notice these people are just like me.”

State facilities have dramatically improved since 2005, Krisberg said, after a lawsuit prompted many reforms. They included providing treatment and rehabilitation services, reducing violence and the use of force, improving medical and mental health care, reducing the use of lock-ups and providing better education programs.

But the improvements to the DJJ facilities have cost money. Even though the population has decreased sharply, the budget for these facilities is close to pre-reform levels, Krisberg said.

DJJ still needs improvement to meet the needs of high-risk youth, Krisberg added, but the closure of DJJ would be a mistake.

Alameda County Chief Probation Officer David Muhammad agrees. Ten years ago, as the head of The Mentoring Center in Oakland, Muhammad was one of the youth authority’s biggest critics.

“It is interesting to find myself on the other side now,” Muhammad said.

A lack of state revenue looks likely, Muhammad said, and will mean most counties stop sending their youth to DJJ as a result.

“Its underhanded, because you were going to do the opposite,” Muhammad said. “The state was going to pay counties for keeping youth.”

Henry Hernandez would have preferred to serve his time in a county facility, but he thinks his time at the DJJ fire camp helped him change his life.

“There was a big fire in somebody’s ranch. People passed by cheering and I felt good – like people are finally appreciating me,” Hernandez said. “It made me feel good about myself.”

He has now been out for nine months and has tested clean in all of his drug tests.

Hernandez has worked on changing his demeanor, too. He still has many visible gang tattoos, but has stopped wearing baggy clothes and shaving his head.

“If somebody who knew me from the past saw me,” Hernandez said, “they’d be like ‘woah’.”

Callie Shanafelt is a correspondent for the California Health Report at www.healthycal.org.

Youth prison population reduced by 88 percent in 10 years, with no increase in youth crime

By Callie Shanafelt, California Health Report

Michael Bryant has been in and out of Juvenile Hall in Santa Cruz since he was 13 years old, when he started drinking alcohol everyday. Now 17, Bryant is doing time in a treatment center after plea-bargaining on a charge of assault with a deadly weapon.

Some counties would have viewed this crime as a second strike and sent Bryant to a state facility. But Santa Cruz rarely sends youth to the state for supervision. In part, that’s because the county is a participant in the Juvenile Detention Alternatives Initiative, a program of the Annie E. Casey Foundation.

But like all California counties, Santa Cruz was also forced by state legislation to come up with new ways to keep youth out of detention facilities. For the past decade, county and state personnel have been “realigning” the juvenile justice system, in a process similar to the realignment of state prisons that started this October.

Bryant is relieved that he’s been diverted to treatment.

“Everyone that’s been says its pretty much getting you ready for prison,” he said of California Division of Juvenile Justice (DJJ).

Instead of preparing for a life in prison, Bryant is working on a life without alcohol. “I can’t put alcohol in my system if I don’t want to get locked up again,” Bryant said. He has an apartment and a job lined up for when he finishes his treatment program in three to five months.

California counties could learn from the decade-long juvenile realignment process as they struggle to incorporate adult inmates from state prisons into their county jails and reduce overall inmate populations following the passage of AB 109. The state reduced the juvenile population by 88% since 1996 – and did it with no increase in juvenile crime.

The number of youth in DJJ facilities peaked in 1996 at 10,112. The population had steadily risen since the 1970s. A recent study released by the Berkeley Center for Criminal Justice attributes the increase to factors including decreased state funding for local programs, which essentially made it cheaper for counties to send kids who break the law to state facilities.

Instead of building more facilities to deal with the increasing population, legislators passed SB 681, which created a sliding scale of costs for counties sending youth to state facilities. For less severe offenses, counties were charged 100% of the cost to incarcerate the youth ($2600 a month). For more severe offenders, counties paid the minimum rate of $150 a month. This created an incentive for counties to keep youth offenders local.

Legislators also passed AB 2312, which provided $33 million to support local juvenile justice programs. And The Juvenile Crime Enforcement and Accountability Challenge Grants gave nearly $50 million to local counties for programs and nearly $500 million to build county juvenile facilities.

“The dollars that came down didn’t have a lot of requirements on how the funding was used locally. I think that was appropriate,” said Santa Cruz Chief Probation Officer Scott McDonald.

Santa Cruz’s juvenile hall was old and overcrowded in the late 1990s, and community members were concerned with the disproportionate number of Latino youth in the system. Then Santa Cruz became a model site for the Juvenile Detention Alternatives Initiative, which aims to reduce youth incarceration by focusing on comprehensive social services.

Since then, the number of youth incarcerated in Santa Cruz County has dropped by 57% and the gap between incarceration rates of Latino and youth of other races has decreased.

The number of youth in DJJ facilities and camps was reduced to 8,000 by 2007. Legislators then passed the official juvenile realignment legislation, AB 81, which prohibited counties from sending non-violent offenders to state facilities. By that point, many counties, like Santa Cruz, had already stopped sending low-level offenders to DJJ.

Juvenile realignment also meant that non-violent offenders would be supervised by county probation instead of parole.

Probation Officer Ray Mizyed handles all of those juvenile cases for Alameda County. When the legislation first passed, it was so vague that Mizyed developed a new system for how to deal with these youth. For the first year he went to each of their hearings before a judge to make recommendations on their behalf – something that is usually done by a District Attorney.

Mizyed works well with the parole office in Oakland. “Not to knock them, I understand their caseloads are crazy, but they didn’t appear to be as hands on,” said Mizyed.

The parole office did, however, have vouchers for hotel rooms and could help with housing. Mizyed has to find creative ways to get his probationers services like healthcare, housing and work.

But he is able to give his cases more attention. “I would see my guys every week, you get to know them, see the family, it’s more effective,” Mizyed said.

Under juvenile realignment, county probation officers have also supervised people released from DJJ since Jan. 2011.

Nine months ago Henry Hernandez became one of Mizyed’s first probationers under this provision.

“He’s really hard on me sometimes, but the reason he does it is cause he doesn’t want me to violate” said Hernandez.

Hernandez served three years in DJJ after shooting someone from a rival gang in the arm.

“I’ve always had negative role models,” said Hernandez. He’s glad to be supervised by county probation where he can work with Mizyed.

“I need somebody to motivate me if I don’t have somebody motivating me to do good – what am I to do?” said Hernandez.

Barry Krisberg, one of the authors of the report A New Era in California Juvenile Justice, calls juvenile realignment a success.

The counties had time to prepare and were encouraged to be innovative in their programs, Krisberg said.

Boot camps and scared straight programs don’t work for juveniles, counties found. But programs like Reaffirming Young Sisters’ Excellence (RYSE), which specifically addressed the unique needs of girls in the juvenile justice system in Alameda, had strong results.

“That was probably one of our most successful programs,” said Alameda County Chief Probation Officer David Muhammad.

But the funding ran out, and the program ended a few years ago.

Alameda County also created the Community Probation program, which puts probation officers in community organizations serving youth. They once had 40 interns and 10 contracts with community based organizations. When Muhammad entered his position earlier this year there were no interns and only 3 contracts with community organizations because they’d lost much of their funding.

Now, Alameda County relies on programs like the Youth Offender Block Grant, created to give counties a lot of flexibility to come up with ways to keep youth out of DJJ. Alameda County uses these funds to provide more intensive supervision to high-risk youth.

All the programs of juvenile realignment have generally meant lower youth recidivism in Alameda County, Muhammad said.

Not all counties have had such success, according to Krisberg.

“Some of counties spent buckets of money on risk assessment, which wasn’t very effective,” said Krisberg.

Twenty-five to 30 percent of the youth in detention centers still don’t need to be there, Krisberg said.

“You don’t need to put kids in secure detention facilities because they missed a probation meeting or pissed off a judge in a hearing,” he said.

Krisberg suggests that counties take the money spent on incarcerating those youth and invest in proven community groups.

Counties can learn from juvenile realignment as they start adult realignment, Krisberg said.

There are differences in dealing with a much larger adult population and a much shorter timeframe, which is lamentable, Krisberg said.

But he also notes that the success of juvenile realignment could ease public safety concerns, because the youth crime rate has declined throughout juvenile realignment.

The youth in the system were the largest beneficiaries of realignment, Krisberg said.

“It took them out of terribly toxic environment and got them out of cages, got them out of prison cells. Got them back home into the community,” he said.

Callie Shanafelt is a correspondent for the California Health Report at www.healthycal.org.