Albany Uses Medicaid Funds to Assist Low-Level Drug Offenders

April 13, 2016

The criminal justice reform movement may have taken another step forward — thanks in part to the Affordable Care Act.

Officials in Albany, New York, this month launched a diversion program, Law Enforcement Assisted Diversion, or LEAD, which allows low-level drug offenders to bypass incarceration for treatment opportunities for addiction and mental illness.

“It was a long, hard road to get here, but no city has done more than Albany, from the mayor down,” said Gabriel Sayegh, co-founder of the Katal Center for Health, Equity and Justice, an advocacy group striving to reduce incarceration rates and promote drug war alternatives.

Individuals busted for minor drug crimes are now sent to case managers for counseling and services. And given many drug offenders are homeless, this assistance can come in the form of short-term housing and job training.

Here’s how it works: Instead of booking addicts, law enforcement officers contact LEAD representatives, who then speak with the users, presenting them with social services and resources that could make their lives easier.

Not only does this initiative aim to reduce low-level arrests, racial disparities and recidivism, it could also mend the relationship between the general public and police officers, who have been under intense scrutiny in recent years.

“This shows the community we’re willing to try different things,” Albany Police Chief Brendan Cox told the Associated Press. “This just makes all the sense in the world.”

Signed into law in 2010, the Affordable Care Act expanded Medicaid eligibility, allowing people with income up to 138 percent of the poverty line to qualify for coverage. The law also covers repeat drug offenders, including the homeless and mentally ill.

According to Sayegh, repeat drug offenders are “precisely the population Medicaid expansion was designed to cover.”

The city spent $150,000 to hire a project manager, case manager and outreach worker through the Albany Medical Center, which utilized Medicaid funds.

Albany is the third city in the nation to launch such a program, following Seattle and Santa Fe. Organizers studied Seattle’s approach while brainstorming their own.

Seattle Sees Success

The Emerald City was the first to launch the LEAD program.

LEAD was created as an innovative pilot program aimed to address low-level drug and prostitution crimes in the Seattle area. The initiative shifts addicts away from jails and into support services, greatly reducing recidivism rates for low-level drug offenders.

Many of its participants have taken full advantage of the opportunity.

“They know we’re out there struggling,” said Jerald Brooks, one of the original participants in LEAD. “Sooner or later, you start to do a little better.”

The organizers of LEAD had hoped the program would reduce low-level drug crimes, mitigating the number of individuals who frequent the criminal justice system.

The returns thus far are encouraging. In 2015, the University of Washington conducted a study indicating the program has greatly reduced the likelihood of new arrests for its participants.

Since the program’s initiation, there has been a 58 percent reduction in recidivism among participants, which encompasses the poor, homeless, low-level drug users and prostituted people. In response, Seattle is expanding its services.

The popularity of LEAD created a domino-effect of sorts. Dozens of cities nationwide have adopted similar programs, including Albany and Santa Fe. Atlanta, Baltimore and Fayetteville, North Carolina, are launching their own programs next year.

Drug Problem Among Homeless

A high percentage of homeless people turn to drugs. Studies indicate substance abuse is linked with homelessness, as many of the population pick up illicit substances to cope with their situation.

The 100,000 Homes Campaign — a movement of communities working to find permanent homes for 100,000 homeless individuals — conducted a survey of more than 30,100 homeless people across the nation. More than half of those surveyed were reported to have a substance abuse problem:

	Number	Percentage of Total
Substance Abuse	15,905	52.8
Substance Abuse Treatment	10,717	35.6
IV Drug Use	4,200	13.9
Drank Daily in past 30 days	4,635	15.4
Observed Substance Abuse	5,625	18.7
Total Number of Unique Substance Abuse Cases	17,888	59.4

Another study, by JAMA Internal Medicine, found overdose mortalities, mostly from opioids, to be the leading cause of death among the homeless population. Drug overdose claimed one-third of adults younger than 45, the study found.

More and more government officials are beginning to accept the notion of addiction as a disease. And with rising costs of incarceration, local, state and federal officials are looking to alternative methods to improve public health, reduce the costs of criminal justice and help addicts get the assistance they need.

So far, the LEAD program has proven to be a reliable alternative in Seattle. Albany hopes to see similar results in coming months.

“Going to jail is not the answer for a lot of people,” said Sam Wiggins, an Army vet and former addict who served time in prison for drug dealing and theft. “[The LEAD program] provides other options.”

Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

View Sources

• Baggett, T. et al. (2013). Mortality Among Homeless Adults in Boston. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleid=1556797#qundefined
• Collins, S. et al. (2015, March 27). LEAD Program Evaluation: Recidivism Report. Retrieved from http://static1.1.sqspcdn.com/static/f/1185392/26121870/1428513375150/LEAD_EVALUATION_4-7-15.pdf?token=gnJdC2hj4p%2BGAkbGvajjN06SJfY%3D
• Grondahl, P. (2016, March 31). Albany launches LEAD diversion program. Retrieved from http://www.timesunion.com/local/article/Albany-launches-LEAD-diversion-program-7219908.php
• Johnson, G. (2016, April 11). Low-Level Drug Offenders Find New Source of Addiction Help. Retrieved from http://abcnews.go.com/US/wireStory/low-level-drug-offenders-find-source-addiction-38300796
• Leadkingcounty.org (n.d.). About LEAD. Retrieved from http://leadkingcounty.org/about/
• National Coalition for the Homeless (2009, July). Substance Abuse and Homelessness. Retrieved from http://www.nationalhomeless.org/factsheets/addiction.pdf
• 100,000 Homes (n.d.). National QuickBase Data. Retrieved from http://100khomes.org/sites/default/files/National%20QB%20Data.pdf

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