Voters Open New Doors: Voter Initiatives in California Allow an Agency to Dramatically Expand Services
de Miranda, John, Behavioral Healthcare
Door to Hope was once a residential addiction treatment program that occupied a single facility in Salinas, California. Today it is a comprehensive human services agency that provides an array of related services such as dual diagnosis treatment for adolescents; screening, assessment, and intervention for drug-exposed infants; and substance use treatment for women involved in the criminal justice system. Most of this service expansion is the result of the agency's ability to take advantage of voter initiatives that expanded or reformed public policy and service delivery in the Golden State.
The voter initiative process historically has addressed taxes and financial bonds, but increasingly in recent years voters have used the initiative process to express their will on social issues, such as drug and justice policy reform, treatment of minority groups, and human services delivery.
Approximately half the states use voter referenda to allow citizens direct access to the legislative process. Sometimes known as citizens' initiatives, these measures usually qualify for the ballot through the collection of thousands of voter signatures.
Chris Shannon, Door to Hope's executive director since 2000, has creatively engineered the agency's expansion using opportunities afforded by three voter initiatives. "Our core residential services budget has not increased since 1999," she says, "but through Propositions 10, 36, and 63, we have grown the program by at least tenfold."
Approved by voters in 1998, Proposition 10 increased taxes on tobacco products and established the California Children and Families Program. Spearheaded by actor/activist Rob Reiner, Proposition 10 was designed to provide significant new revenue to support services to infants and children up to five years old. Each California county established a local "First 5" commission to determine needs and administer funds.
In 2001, Door to Hope received $315,000 from First 5 Monterey County for capital development of a new perinatal residential recovery program to serve Monterey County's Hispanic community.
Since 2003, Door to Hope has received more than $2 million to fund the Monterey County Screening Team for Assessment, Referral and Treatment (MCSTART). The program provides a comprehensive care model to identify, assess, refer, and treat children exposed to alcohol and other drugs in utero. The program closes a critical gap in the existing care system and complements and supplements existing efforts to address the needs of high-risk children and their families.
California's Substance Abuse and Crime Prevention Act of 2000 (Proposition 36) represented a tectonic shift in our society's approach to the addicted. Instead of incarceration, Proposition 36 offers nonviolent drug offenders the opportunity to enter treatment. The program has been controversial because of its emphasis on treatment rather than coercion and punishment. However, a recent evaluation found that for every $1 invested, Proposition 36 has saved the state $2.50, and that in the first four years of the program more than 140,000 offenders were diverted to treatment.
Beginning in 2002, Door to Hope used Proposition 36 funding to create the agency's first outpatient services, annually serving more than 180 men and women. …