Our Goal at Tennessee Opiate Initiative is to correctly evaluate and assess each addict entering into our Judicial Systems into the Level of Addiction that best serves the addicts needs. We propose that upon entry, the addict will be evaluated by the Criminal Justice Liaison or the Forensic Social Worker by completing an ASI assessment, ASAM and Bio Psychosocial on the individual. This process will correctly evaluate the addict as a whole, focusing on criminal history, family structure and support, housing, drug and alcohol history, trauma and life changing events, and employment history.
Once evaluated, a point system will be created to place the addict in the correct level of addiction, where the CJL, FSW, District Attorney and the Judge will have the necessary tools to place the addict into the correct level of treatment. Currently, we see that a level 3 addict is being placed into a 30 day program or a Halfway House, only to set them up for failure. They are non-functioning and need more intensive programing and accountability to see long-lasting sobriety. However, a level 2 addict will flourish in a Drug Court, and a level 1 would be successful in a Halfway House. Having the correct level of addict in the correct level of treatment, the success rate of each Rehabilitation Center would skyrocket, and as a whole, the epidemic would be combated to better produce productive citizens in Society.
Generally, this plan is a variation of previous plans and is designed for housing facilities, municipal drug courts, or 501 nonprofit facilities that qualify for a state license status. It is also designed for religious nonprofits who choose to fund their operations through philanthropy. The purpose of the program would be to rapidly generate enough housing and facilities throughout the state that have solid programs designed to break the cycle of addiction with nonfunctioning addicts. This program is not designed for participation by halfway houses or housing that does not focus on internal programs to break the cycle of addictive behavior through full accountability. This program will only be used and be made available to institutions who are well organized and who hold the addict 100% accountable for their behavior. All applicants for the 80/10/10 program would need to submit the following:
1. Plans for the build along with appraisal, endorsement letter from planning and zoning, along with an endorsement letter from the county mayor or the city/county council.
2. A business plan to show how they will be able to financially sustain the program once the building is built to include some of the previously mentioned organizational requirements for successful operation.
3. Proof that at least 10% of the cost to build the facility can be raised by private sector or 20% for direct funding without state participation. Proof that the 10% that has been raised by private or municipal funding has been matched by a 10% grant from the state of Tennessee.
4. A comprehensive plan for the liquidation of the real property at some future date in the event that property will need to be disposed of if the operations of the program are discontinued or they lose their state certification.
State of Tennessee gives 10% matching fund to counties/cities or non-profit 501(c)3 institutions who raise 10% of the needed 20% down payment. Recipients must have approved standard operating procedure manuals and table of organizations and personnel that will enable them to run these facilities. All business plans must be approved by drug commissioner for state of Tennessee. There are two separate processes to check in to each facility:
Court ordered- Persons who have committed a crime and is awaiting sentence
Voluntary Persons who need and want help but have committed no recent crime
Land acquisition- $200,000.00 60 beds facility
Meeting facilities, Counseling rooms, Cafeteria and offices- $1,380,000.00
Total Cost $1,580,000.00 Need 20% down to finance
Total cost- $1,580,000.00 Down payment- $316,000.00 Amount financed- $1,264,000.00
Loans presently available through U.S.D.A. for a 60 bed facility:
Rate- 3.8% Term- 40 years
Same monthly payment to U.S.D.A. for Tennessee corrections- $29,110.60 per month for a 60 bed facility
Daily Housing Costs For Addicts
Tenn. Dept. of Corrections- $76.00 per day
Drug court Nashville- $56.00 per day
True Purpose Ministries $17.00 per day
Public/private partnership $17.00 per day
50% people in prison are non-violent drug offenders with addiction problems.
Construction Costs for Facilities
Cost of prison bed- $120,000.00
Cost of drug court bed- $40,000.00
Cost of public/private partnership bed under 3/16 and 80/10/10 programs- $26,000.00
Additional Facts from Tennessee Dept. of Health
· 12,630 admitted for drug treatment in 2017
· Only 17% had a prescription for opioids
· 800 meth labs in operation
· Heroin is now laced with fentanyl which is a synthetic opioid
· Oxycodone pills in appearance are now being sold but they contain fentanyl manufactured by illegal labs, and these pills are being distributed throughout Tennessee.
Cost to build facilities to handle 13,000 addicts
There are approximately 320,000 addicts in the state of Tennessee but presently only 13,000 are being court ordered or choose to stop their addiction. Ultimately almost every addict ends up in the court system and many end up in the prison system. The cost to build the facilities to house these individuals is extreme. Below would be an example of what it would cost the state of Tennessee to add 13,000 beds through the prison system, the drug courts, or through public/private partnerships.
Prison beds (tax dollars)- $1,560,000,000.00
Drug court beds (tax dollars)- $520,000,000.00
Public/private partnerships- $338,000,000.00
Note: Many of our state prison overcrowded facilities could have significant reduction by the removal of non-violent addicts to county jails and then non-violent addicts in county jails to public/private partnerships.
1. Evaluate and Assess each addict in correct level of addiction.
2. Provide per diem for State Licensed, approved Level 3 Programs.
3. Immediately complete and offer the 80/10/10 program to 501(c)3 nonprofits and municipal drug courts.
4. Use state per diem monies for year-long programs for outpatient and inpatient treatment in state licensed facilities instead of paying jails for incarceration.
5. Redesign the state license status to be in line with municipal drug courts and successful 501(c)3 nonprofit programs that offer a complete program to participating addicts.
6. Complete the design of the “addict facilitation” process to lessen the per diem cost to the state of Tennessee.
7. Reform the present status quo and use of insurance payments for those who have insurance coverage and wish to enter a treatment facility. The current efforts by Governor Haslam as identified in the executive summary titled “Prescription for Success” and administrated by Department of Mental Health and Substance Abuse Services was an excellent start to address the problems that Tennessee faces with opioid addiction. This effort pulled together many departments and “shot-gunned” out an all-inclusive effort to try to address this problem. It is time to zero in on some of the areas within this executive summary that have proven successes and enhance new efforts to promote those with a solid track record of success. Despite this initial effort which was an excellent starting point, the problem in Tennessee has continued to grow and get much worse. Obviously, the present plan needs some reevaluation and a more surgical approach towards addressing Tennessee’s opioid crisis if it is to be successful.