GINGER LERNER-WREN COUNTY JUDGE SEVENTEENTH JUDICIAL CIRCUIT OF FLORIDA

Broward County Courthouse 201 S.E. 6th Street Fort Lauderdale, FL  33301 (954) 831-7240

 

 

     

September 3, 2009

 

Mayor Stacy Ritter

Broward County Commission

115 S. Andrews Avenue

Fort Lauderdale, Florida 

Via Electronic Mail

 

 

Re: Funding of Broward County Jail Treatment Programs

 

 

Dear Mayor Ritter,

 

Please accept this letter in accordance with Canon 3, Judicial Canons of Ethics submitted in the interest of the sound administration of justice.  I am writing with regards to the serious threat of closure of in jail treatment programs due to existing budgetary problems. 

 

I understand that it is the Sheriff’s inherent responsibility to establish priority regarding budget and not necessarily within the province of the County Commission regarding matters pertaining to the jail.  Yet I am writing to express my concern as to the potential closure of in jail substance abuse treatment and other rehabilitative programming as a great threat to community public health and potentially public safety. Therefore, I appeal to this body for its leadership.

 

As a former Commissioner of the President’s New Freedom Commission on Mental Health and Founding Judge of the nation’s first diversion court dedicated to persons with mental illness and substance abuse disorders, I believe the closure of in jail treatment programs could have serious negative public health and public safety consequences.

 

The evidence and authoritative research in the public health field as it relates to offenders in US jails and prisons, as published by the Department of Justice, Bureau of Statistics, has documented the continual almost explosive growth of prevalence of both mental illness and substance abuse in our jails and prisons.  The over representation of persons in the criminal justice system with co-occurring disorders (mental illness and substance abuse disorders) whether based in unresolved trauma or other psychiatric/neurological origins speaks to the need for additional programming for men and women offenders not less. These individuals who

 

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largely are unable to access scarce community based resources, (i.e. BARC) or do not have the financial means to pay for private rehabilitative programs or private hospitals. I believe it is imperative to view this issue on a public health level versus for example a more singular budgetary problem wherein the majority of the individuals at issue also are medically needy or at risk of further complicating serious and chronic medical conditions if substance abuse and addictive disorders are permitted to exacerbate and worsen.

 

From am logic model, one can envision when looking through a public health lens, the unintended and yet costly burden to our local hospital systems and emergency rooms. Chronic diseases, such as HIV Aids, diabetes, hypertension, seizure disorders predictably may worsen as overall quality of life deteriorates if offenders re- enter the community without benefit of treatment while in the jail system.

 

It should be noted and important to recognize that substance abuse disorders are defined in the Diagnostic Statistical Manuel, 4^th Edition (DSM IV) as an Axis I and therefore on the same diagnostic level as mental illness. I am unclear on the potential legal ramifications of discontinuing treatment and offer no legal implication accordingly, yet raise the issue to highlight the significance of substance abuse disorder as a legitimate and authentic medical issue in need of requisite clinical care and treatment.

 

From a criminal justice vantage point, failure to provide substance abuse treatment and related psycho social treatment in the jail system, more than likely will result in public safety risks as

Offenders will be more likely to recidivate and commit more crime to support existing drug and alcohol addiction an logically be ill–equipped to re-enter the community from a place of wellness and capacity to engage in society from an attitude of strength and ability to continue to recover and become productive with employment a future view yielding the capacity to care for themselves and their families.

 

It can be argued that the negative consequences and resulting costs to Broward County may be serious and cascading when viewed from a public health and public safety perspective.  On the flip side of the coin there are strong and sound public policy reasons for recognizing the essential nature of substance abuse treatment and rehabilitation ranging from reduction of crime for example, domestic violence, (wherein studies evidence the relationship between violence and use substances) to a whole range of alcohol or drug related crime, to enhanced recidivism in our jail.   

 

The concept to pay now or pay later is very real. The question from a public policy perspective seems to center around prevention and mitigation of further costs and expense to our health care system, both acute care hospital system and community based provider systems of care, criminal justice systems; and to our communities and families who suffer from potential victimization and loss.

 

I ask for your leadership in this matter, it has long been stated by health care policy makers that the jail is part of the community. In a time of extreme financial stress, unemployment and

 

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Medicaid reform that phrase rings even more true than ever that  the jail has become the rehabilitative center of last resort for so many in our community.

 

Thank you for your consideration. Your continued leadership and wisdom is greatly appreciated.

 

 

 

Sincerely,

 

GingerLener-Wren

 

Judge Ginger Lerner-Wren

 

 

 Cc: County Commissioners

       Broward County Defense Lawyers Association

       Sheriff Lamberti

        The Broward Public Defender’s Office

        The Broward State Attorney’s Office

        The Broward County Legislative Delegation