Innovative court program helps people navigate addiction services
'It’s not like anything we’ve ever done before'
CAPE COD DEFENSE attorney Susan Wenzel had a client with mental health and substance use issues who needed help handling both problems and had no health insurance. His criminal case was still in progress, so he had no access to court-ordered therapy.
Wenzel called Rick Palingo, a recovery support navigator who works in Barnstable area courts. “He’s like a magic wand almost,” Wenzel said. “He can find anything, he knows everything.” She says Palingo told her client where to go to enroll in MassHealth, then had a list of inpatient and outpatient programs that could meet her client’s needs.
Palingo is part of Project NORTH, which stands for Navigation, Outreach, Recovery, Treatment, and Hope. It is an innovative Trial Court program funded by a three-year, $6 million grant from the US Department of Justice, which connects court-involved individuals with people who can help them navigate the recovery process. The program also provides concrete support – a free ride from court to a service, and up to six months rent in a sober home. Navigators work for health care agencies, not the court, so they are bound by medical confidentiality laws.
“Often criminal clients are skeptical because they think it’s tied to the system. Judges are watching, probation is watching. But it’s not that way,” Wenzel said. “It’s a nice resource for people to have who don’t want to feel like they’re tied into Big Brother.”
Huge numbers of people who contact the criminal justice system struggle with substance use disorders, which can be a contributing factor to criminal behavior. Yet the criminal justice system is not set up to treat these individuals, and it can be hard for people to find help on their own.
Marisa Hebble, a public health professional, was hired by the Trial Court six years ago to research where people with substance use disorders fall through the cracks in services, to see if there are ways to intervene earlier and prevent them from ending up in the justice system. Hebble said she found a need everywhere in the mental health system for “timely access to treatment and support that meets someone where they are.” Hebble developed the idea for Project NORTH as a way for people who end up in crisis to find a “turbo warm handoff,” with someone easily accessible who can connect them with the services they need when they need them. Navigators hand the person off to treatment, then follow up with them after 24 hours, a week, and 30 days.
“It’s not like anything we’ve ever done before,” Hebble said.
Navigators can help someone enroll in health insurance; connect them with a clinical organization to provide evaluation, treatment, or recovery support; provide short-term coordination of care; or help someone get naloxone or overdose prevention services. They can also connect people to employment and housing services. Project NORTH will pay for transportation from court to the service provider. It will also pay up to six months’ rent in a certified sober home.
The program is voluntary and open to anyone who contacts the court system or their families. This includes people involved in custody battles or juvenile court cases, tenants facing eviction, and crime perpetrators or victims. One person might seek a 12-step meeting, while another needs a treatment facility for a teenager. Setting up the program involved reaching out to court staff, judges, attorneys, and others to make sure it is publicized.
Judy Bazinet, who runs Project NORTH, said often someone is told by a judge that they need to address their substance use problems, but it can be daunting to figure out how. “They don’t know where to begin,” she said. “If there’s someone there they can talk to at that moment who can help direct them, that’s overcoming one of the biggest barriers.” Bazinet said District Court receives the most services because that’s where the most need is.
“It used to be we would wait until people had long histories, whether long substance use histories or criminal histories, before we would offer help,” Bazinet said. “Now we’re intervening at the earliest level.”
According to the program, as of June 30, navigators had made 730 “brief contacts” with people, done comprehensive intakes with 320 people, and referred 156 clients to services, of whom 100 were reached for follow-up between April and June. Bazinet said in September that the project has paid rent for just 20 people in sober living homes and referred “a few people” for transportation.
Andy Rock, an addiction/resource coordinator at Clinical and Support Options, a Springfield-based nonprofit mental health agency, is Project NORTH’s navigator in Pittsfield, and his experience provides some insight into the challenges in getting the program running.
Rock works in the Pittsfield community justice center, which provides supervision and services to court-involved individuals. When someone stops by Rock’s office, they might have a simple question: Is there an Alcoholics Anonymous meeting nearby today? Does he know someone who can help them navigate their recovery? Or they might need a referral to detox or a sober home.
Between the time he started the job in March and September 1, Rock spoke to nearly 350 people, of whom 39 went through the intake process, which involves an in-depth conversation about their needs. But he only helped one person pay rent in a sober home. The reason is the program requires that a program be certified by a statewide sober housing group and agree to Project NORTH’s payment rate of $200 a week. Only two homes in Berkshire County are certified and neither has signed a contract agreeing to the rate. Almost no one has taken advantage of the transportation benefit, which Rock said is likely because that service is often used to get to a sober home.
Rock said he is in discussions with the Berkshire County homes and he hopes to make sober home assistance more accessible to area residents. But for now, it can be hard to place Berkshire County residents, who may be tied to the region due to family or job obligations, in a certified sober home elsewhere in the state. “I have to weigh with people do you want me to get you support and services here or have a change of scenery that’s one and a half hours away at least,” Rock said.
Bill Berneburg, president of the board of the Massachusetts Alliance for Sober Housing (MASH), which certifies sober homes, said he anticipates demand for the sober home money will increase soon. Even before Project NORTH started, his organization participated in a grant program run through the Probation and Parole departments, which offers 56 days of sober home rent for people on probation or parole. In August, MASH billed that program $90,000. Berneburg said Project NORTH just started offering its six-month grant July 1, so as more clients use up their 56 days on the probation or parole grants, they will switch to Project NORTH funding.
Berneburg, who operates sober homes in Brockton and Taunton, said the grants can be a game-changer for individuals in recovery who are involved in the court system and have little money. “If we take the burden of rent off the individual month by month, it frees them up to work on recovery and enables them to get into the community and hopefully working,” he said. Berneburg said before the grants existed, only 20 to 30 percent of men on probation would make it through two months in a home without relapsing and returning to court. An average of 60 percent of those who accept grants stay in the home, because the financial freedom lets them focus on recovery and goals like finding work or reuniting with children.
Several attorneys said Project NORTH helps avoid the administrative hassles involved in finding treatment.
Guy Larock, a Bristol County attorney and supervisor of the bar advocate program, said the private attorneys contracted with the public defender’s office to represent indigent defendants are often working solo with few institutional resources to connect clients to services. Lawyers can file a motion for a judge to approve funding for a social worker, or they can seek approval from the Probation Department. Either method requires time and red tape. “Just the idea of being able to bring a client in and not have to deal with the Probation Department to get someone services… it’s a very good thing for us,” Larock said.Thomas Grimmer, a lawyer who practices in Barnstable District Court, said before Project NORTH, the main recourse attorneys had to help clients with substance use problems was to send them to drug court, but that involved a weeks-long process. By the time clients get to him, they are often depressed and ready to change. “This is an added facility we have that they can get a coach right away, they can get treatment right away, they can get beds right away,” Grimmer said.
The program is “almost heaven sent,” said Grimmer. “It’s an option for them, it’s a road to recovery, and I’m not seeing people that were referred to Project NORTH return as habitual clients. It may not be the magic wand they need, but it sure helps, it sure gives them guidance. They think they have nothing. Now all of a sudden, they have people who care about them.”