Modesto Bee Article

By Ken Carlson, Modesto Bee Staff Writer
last updated: April 24, 2009


First Step Perinatal Substance Abuse Treatment Program, which helps drug- addicted women who are pregnant or caring for infants, is on the county chopping block because of a $6.9 million funding shortfall for substance abuse services. (Debbie Noda / The Modesto Bee)

Carinna Fezi lost her first-born child to an adoption arranged by Child Protective Services because she couldn't stop using methamphetamine.

Since entering a residential treatment program seven months ago, she has stayed clean and is caring for her second daughter, Kina. But Stanislaus County budget cuts would eliminate the residential program June 30.

"I have been praying every night that whoever is doing the (county) budget can reconsider," said the 31-year-old Fezi. "They need to think about all the lives they can change and save with this program."

The First Step Perinatal Substance Abuse Treatment Program is one of the few residential programs in California for drug-addicted women who are pregnant or caring for infants. The 13 women live for six to nine months at the Stanislaus Recovery Center in Ceres, which provides a supportive environment to help them stay off drugs and become responsible mothers.

Proponents praise these early intervention programs for changing lives and lowering taxpayer costs for foster care, incarceration of drug-addicted women and special education for children with emotional problems.

But residential programs are expensive, making First Step a target as the county deals with a $6.9 million funding shortfall for mental health and substance abuse services.

County supervisors will consider the cuts to First Step and numerous other services during a May 19 public hearing. In other proposed cuts, the county would:

• No longer provide mental health assessments and referrals in Turlock, giving those duties to a crisis response team in Modesto
• No longer provide medication support at the Ceres Health Services Agency clinic, requiring those clients to travel to Modesto
• Shut down mental health services in Riverbank, Oakdale and Patterson
• Reduce mental health services in Juvenile Justice, Juvenile Hall and Juvenile Drug Court and Adult Drug Court
• Eliminate mental health services to 65 uninsured mothers and children in the Leaps & Bounds program
• Provide assessments and treatment for fewer seniors

In recent years, the county Department of Behavioral Health and Recovery Services has bled red ink because of reductions in state funding and the impact of the slumping economy on sales tax receipts.

It has closed outlying clinics, reduced staff and used fund balances to avoid making deeper cuts; now a big deficit looms in the 2009-10 budget.

The restructuring plan will further consolidate services in Modesto and Turlock and preserve state-mandated services for Medi-Cal beneficiaries, officials said.

Fears for outlying communities

Mental health advocates fear that people in outlying communities will be cut off from services that keep them from having a crisis or committing violent acts.

"It is going to have an impact, especially for those in Oakdale or Patterson where there is little public transportation on the corridors to Turlock or Modesto," said Chip Langman, who serves on the county Mental Health Board. "You are taking away services from the people who are the most vulnerable."

Denise Hunt, director of county Behavioral Health and Recovery Services, said the county will focus on maintaining assistance for people who need it the most, "but it is increasingly difficult to provide a full range of services."

Funding for drug and alcohol treatment services also is drying up. To stretch resources, the county has contracted with nonprofit organizations to run programs like First Step. The program is operated by Sierra Vista Child and Family Services and the Center for Human Services, whose overhead expenses are lower than the county's.

The restructuring will turn First Step into a lower-budget program, with the women living in "clean and sober" homes and going to an office for drug and alcohol and parental counseling. That will slash $750,000 from the program's $1.67 million annual budget and allow the program to serve more women.

But the program won't be the same.

"We will do what we can with the limited funding we have," said Judy Kindle, executive director of Sierra Vista. "Of course, it will impact the women who require the level of service of a residential treatment program."

First Step has 50 women at a time attending a day treatment program; the residential unit is for women who have failed to stay sober, have spent time in jails and need a 24-hour structured environment.

For women such as Fezi, the opportunity to care for their children in a residential center gives them incentive to stay with the program. The staff teaches the women to care for their babies, from preparing formula to dealing with a fussy child, and they receive daily counseling on the steps for breaking addiction.

When her first daughter was born with meth in her system more than two years ago, Child Protective Services gave Fezi the option of attending the program, and when she didn't, the child was put in a foster home.

Ready for a new direction

After 12 years of addiction, Fezi said she was ready to change her life when she got pregnant again. CPS allows her to take care of 9-month-old Kina at the center four days a week.

The program has taught her parenting skills and provided intensive drug and alcohol counseling. She also has received one-on-one counseling to help her deal with the emotions of losing her first child.

"I go through a lot of emotions over that, a lot of guilt, just a lot of pain," Fezi said. "The staff has taught me a healthy way to not feel like that. It's a more positive way of thinking."

Fezi will soon move to a clean and sober home and will be monitored as she takes care of Kina full time, then authorities will decide if she can keep her child.

Angelica Martinez stopped caring for her son, Michael, when he was 4 months old after she was jailed on a probation violation. She was released and started using drugs again.

Since entering the program in March, she is learning sign language to communicate with her 21-month-old son, who is deaf, and she is getting the proper prenatal care for a baby due next month. Martinez said other women in the program and the staff talked her into staying when she wanted to leave.

"If it wasn't for this program, I would be out there using and I wouldn't have my son, and my son wouldn't have a mom," she said. "I wish it would stay open because some of us who need more time here would get it."

Although the program is voluntary, many of the women are under legal orders requiring them to return to jail or give up their children if they leave the program.

First Step Director Kim Bull said 50 percent to 60 percent of women who complete the program are drug-free and taking care of their children a year after graduation. The staff teaches the women about the warning signs of relapse: isolation, spending time with drug-using friends or returning to boyfriends who are addicted.

Fezi said she's encouraged when graduates visit the center and talk about raising their children in a drug-free home.

Although the cuts still are subject to county board approval, Sierra Vista has conceded to changing the program and is close to securing a new location for First Step's outpatient treatment. It will try to work with the sober living centers to do more than offer board and care to the women.

"I understand it is expensive to run this program," Fezi said, "but if it's towards a positive change, something that is going to keep our community healthy and be good for the children, why not keep it open?"

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.