The subject-matter hearing was held jointly by the state Senate Criminal Law Committee and the Special Committee on Public Safety, along with the House Judiciary-Criminal Committee, on February 13.

Brookes’ testimony, excerpted below, focused specifically on diversion policies, programs, and practices that create and support pathways to substance use treatment, with recommendations to expand their use.

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Diversion and alternative-to-incarceration programs offer a significant way to focus limited public resources where they will have a lasting and valuable impact. They offer opportunities for people to address substance use disorder and become healthy. They can ease the fiscal and procedural burden on courts and jails while providing a chance for people to earn restoration and engage actively with their families and communities. Sometimes these programs do this without resulting in a criminal conviction that has lifelong collateral consequences.

These programs have untapped potential, and importantly, are not novel in Illinois. They have a long record of utility and success. Policymakers have endorsed and codified an array of these options, many with treatment-related provisions. Further, Illinois has been advancing criminal justice policy and practice that treats substance use disorder as the public health issue it is. In 2018, for example, recent policy changes in Illinois around cannabis included increased funding for treatment. Also, the State authorized a federal 1115 Medicaid waiver to allow reimbursement for substance use case management provided to criminal justice clients. And in 2018, SB 3023 [the Community-Law Enforcement Partnership for Deflection and Substance Use Disorder Treatment Act] codified deflection—which is diversion at the very front end of the system—authorizing authorized local, collaborative, law enforcement–led programs that refer people to treatment rather than arrest, with funding appropriated to support implementation.

The criminal justice system relies on the State’s substance use treatment system to support these treatment-based approaches. And it, too, has been making great strides in scaling up treatment capacity, removing barriers to care, and incorporating evidence-based approaches. Policymakers have prohibited prior authorization requirements for substance use treatment and instituted parity requirements promoting equitable coverage for behavioral healthcare services. The State has invested tens of millions of dollars in federal opioid funds to expand availability and improve quality of treatment, including FDA-approved medications, and on overdose death prevention. And the Governor’s new Executive Order expands recovery and prevention services for individuals with opioid use disorder across the state, and includes a focus on populations experiencing disproportionately high rates of overdose deaths.

However, even with these advances, leaders and practitioners in the criminal justice system are well familiar with the fact that a majority of people who become involved experience problematic substance use.

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Highlighting the latter, an abundance of data and survey information highlighting the extremely high prevalence of substance use disorder among people who are arrested and incarcerated. National surveys continue to show that approximately two thirds of sentenced people in jail and over half in state prisons meet the diagnostic criteria for substance use disorder compared to just 5 percent in the general population. A survey of substance use among people arrested in Chicago found that over 80 percent tested positive for at least one illicit substance. And in Illinois, over 40 percent of admissions to the publicly funded substance use treatment system are referred by the criminal justice system.

Brookes cited several recommendations for expanding access to diversion and treatment alternatives, including (1) increased Medicaid enrollment assistance for eligible justice-involved individuals to facilitate timely referral to and engagement in treatment and other healthcare services; (2) promoting expansion of community-law enforcement deflection strategies in communities across the state; and (3) expanding opportunities for the justice system to divert misdemeanor cases, including via screening, assessment, and referral to treatment when indicated.

“Given the significant need for services among people involved at all stages of the system, everyone in contact with it—whether through an encounter with police, at diversion pre-trial or at sentencing, or during community reentry following release from prison—should be considered for assessment and referral to treatment,” said Brookes.

TASC Policy Director Laura Brookes (center) presents subject-matter testimony at the Feb. 13 Joint Hearing on the State of Criminal Justice in Illinois.