Police, Treatment, and Community Collaborative (w/Jac Charlier & Leslie Balonick) – C4 Recovery Solutions Podcast Episode 4

Episode 4: Police, Treatment, and Community Collaborative

In this episode, Jac Charlier explains the aims of PTACC (Police, Treatment, and Community Collaborative) as we work towards mending the relationship between communities and law enforcement. Joined by Leslie Balonick, the panel discussion highlights PTACC’s successes and the work that still needs to be done.


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Jack O’Donnell Welcome to the fourth episode of the C4 Recovery Solutions podcast. I am your host, Jack O’Donnell. Some of you might know me as the CEO of C4 Recovery Foundation. As many of you know, C4 is dedicated to improving access to high-quality, ethical treatment services for behavioral health and social wellness. We are fierce advocates for the often overlooked individuals and underserved populations within our society. Through innovation and forward-thinking, C4 has developed service delivery systems for addiction and recovery programmes throughout the US and throughout the world in some of the most challenging environments.

Each week on this podcast, we will hear stories from people who have benefited directly from programmes C4 developed, those who assisted C4 in the process, and especially those still involved in the implementation of the programmes today.

On today’s episode, we are discussing the Police Treatment and Community Collaborative, otherwise known as PTACC. C4 is a founding partner of PTACC, the national voice of the field of deflection, calling the first meeting to discuss forming a national collaborative effort to promote deflection and pre-arrest diversion. The meeting was held at C4’s West Coast Symposium on addictive disorders. One of the other founding partners of PTACC, along with Civil Citation Network, add care justice services, and the International Association of Chiefs of Police, is treatment alternatives for safe communities centre for health and justice, otherwise known as TASC.

This is where Jac Charlier comes in, executive director of TASC, who also serves as the executive director of PTACC. And now, here is his story.

Jac Charlier PTACC is the Police Treatment and Community Collaborative. Our work at PTACC, as the national voice of the field says, everything we’re going to do is going to be in community and stay in community. And our mission is to widen opportunities available to communities when their residents have encounters with or are encountered by law enforcement or EMS and addressing their underlying behavioral health issues, such as substance use disorder and mental health.

Diversion is centred in the justice system. It is controlled by justice system processes. Deflection is controlled, if you will, ‘cause it’s not really about control, but the community, the residents, how they want things to unfold, community-based treatment. That’s the centring of it. Whereas diversion is centred in prosecutors, judges, parole, probation, jails, prisons, and wardens.

Prior to the very tragic events yet not new events of the murder of George Floyd, reframing says, Who do we want responding? There are times we’re going to want law enforcement responses, but reframing says also, What if we don’t want law enforcement? What if we want somebody like EMS? What if we want EMS plus behavioral health? We call that corresponder deflection. And what if we want no first responders and we want community responders? So, reframing is asking a question of Who should be responding? When should we be responding? and Where should we be responding? And the final part of that is the ultimate aim of PTACC, of course, is to ensure that as early as possible prior to any emergency, prior to any crisis, that people are able to access to treatment, housing, and services they need in community, preferably without having to encounter any first responders whatsoever.

When it comes to the United States criminal justice system, for the most part in racial inequity, it goes like this: If you are Black, you’re more likely to be arrested, you’re more likely ultimately then to be charged, and more likely ultimately to be convicted and go to jail or prison than if you are white. Also, along that same lines, if you are poor versus if you’re not poor—so, lower income versus higher income—the same applies. And if you put the race and equity of being black plus poverty and overlay them on each other, it’s a cruel, cruel set of things that unfold then within the US justice system as far as arrest, charging, conviction, and incarceration, whether jail, prison, or community supervision.

When we look in the United States, at jails and prisons, the percentages of people who have substance use disorders, so, we see that those percentages are fifty-six to sixty-eight percent of the justice population in the United States. When we look at the general US population, we’re looking at about nine percent. So, the justice system has lots and lots of people for whom the number one driver is substance use disorder.

Deflection, we like to say, is the handle on the front door of the justice system. In the United States, the justice system overall—parole, probation, jails, prisons—is approximately five-point-nine million people right now. The majority of those people are on probation and parole, probation being the dominant justice supervision in United States. And then, the next ones obviously are prisons. That’s five-point-nine million. About nine to twelve million churn through the jails every year. In other words, they go in and they come out within about seventy-hours hours, and they’re not counted in that five-point-nine million. The number of law enforcement contexts in the United States is sixty-point-five million.

So, when you think about reducing the scale and scope of the justice system, you can be in that space of five-point-nine million, you can be in the space of the nine to twelve million, which is diversion which must happen. Or you can be in a space where deflection operates of stopping, first of all, the entry by being the hand on the front door of that sixty-point-five million people that are out there that law enforcement is having contact with, that are making the decision of Should someone go in or should they not go in? Should they have contact or should they not? Deflection sits right there at that point and says, We need to increase the number of people who are in unity, not in the justice system.

Deflection saves money at the local level. If we are using more community-based services, which are cheaper than emergency room, cheaper than jail, and cheaper than jail treatment services and behavioral health services and medical services. If we can stop that flow, which deflection does, we will see that more and more sides are saying, “We are saving money.” And I have no problem saying or addressing the issue of mass incarceration. Reducing the size of the justice system has long been a bipartisan issue. I know the popular political rhetoric around it. But as a practical matter, both red states and blue states, at the local level and at the county level, where the rubber meets the road, they absolutely have been working at reducing jail populations, reducing arrests. There’s no doubt about that.

PTACC as the national voice of the field is about closing the front door of the justice system. Why? Because the justice system has two challenges to it as it exists in the United States right now. One, it’s a revolving door. We see rates of recidivism that are indicative of people not getting the services and the treatment they need. So, their needs not being met, which is right to the second point, which is that when we look at the data from the United States, generally in the US justice system, while we have fifty-six to sixty-eight percent of people who are in jail or prison, having a substance use disorder, somewhere along the continuum, what we see is about eleven percent nationally, we’ll actually get access to it. And if we stop you from going in the first place and can safely keep people in community, people get better, not just on their own, going through a treatment programme. Addressing addiction and mental health is absolutely a bipartisan issue.

Jack O’Donnell As Jac touched on, both he and the centre for health and justice specialise in practical solutions that bring together justice system partners, behavioral health, service providers, and community leaders in common aims of creating safer, healthier communities. The focus is on crime reduction for communities and well-being of people. PTACC is an alliance of national and now-international practitioners of law enforcement, behavioral health, community advocacy, research, and public policy. It is PTACC’s mission to strategically widen community behavioral health and social service options available to law enforcement diversion.

PTACC was founded with a purpose: to provide vision leadership, advocacy, and education to facilitate the growth and development of deflection in all of its forms, including pre-arrest and corresponding deflection across the United States. In just five short years, PTACC has become the national voice and knowledge leader in deflection. Now more than ever, PTACC seeks to reframe the relationship between police, treatment, and community. More than just limited to practice and programmes, this is a foundational understanding of a growing movement and field. What began with the first in-person meeting has now blossomed into an organization with forty-seven national partners. Unprecedented in its breadth and scope, this organization reaches from justice to community. From recovery to research and from behavioral health to advocacy and policy. This is the bedrock of deflection, seeing through the lens of PTACC.

For today’s panel, we are joined by Jack Charlier and vice-president of PTACC, Leslie Balonick.

So, Leslie, we’re going to start with you. You have worked directly with individuals who would most benefit from deflection. Tell us a little bit about the population.

Leslie Balonick I like to describe it like this: You look at your prison population in any state, and you look at the ZIP codes that they’re returning to. And then, you look at the jails and look at the ZIP codes that they’re returning to. And you look at your overdoses on the street and see where those ZIP codes are. It’s the same population. They’re hanging out in their community. They’re getting high. There’s always drama in their life. And, usually, we will intervene when there is a crisis. So, we don’t want the [crisises] to happen, but the [crisises] can be the point where someone can intervene or you’ve got their attention. You don’t have to wait ‘til someone gets incarcerated in a prison to finally get their attention. And that’s critical.

Now, in terms of the population, you have, you know … The majority are men, although there is a growing population of women out there that are getting involved in deflection or getting involved in the criminal justice system. With all of the reform going on for mass incarceration and prison reform and re-entry reform, you’ve got some really good models for reentry coming out of prison. But the issue becomes: Are the communities intact and is there a support system within the community to sustain that recovery?

Jack O’Donnell You know, sometimes, we do just look at it as men. But it’s widening. There’s a huge swath of people, human lives, that are touched by this from. As you mentioned, women, children. Right down the line, all of these people are affected when somebody goes off to jail instead of gets adequate treatment. Is that true?

Leslie Balonick It’s definitely true. Let me give you some – some data on the women. Women are arrested on the street or are detained within a jail. There hasn’t even been a court date yet. It may be a bond hearing. And most of the women are single parents with multiple kids. I mean, we saw something like eighty percent of the women that are in jails and prisons are mothers. And so, they go into the county jail. And if they’re not bonded out, which is what happens, because they have no one to back them out—they’re the caretakers—if they’re in jail over a seventy-hour period, there’s a good chance the Child Welfare Department will intervene and there’s a possibility they could get their kids taken away just for being arrested on a charge that there’s no disposition.

Just recently, a study, a hundred and thirteen women were sitting in the – in the jails. So, there’s a tiny portion that get convicted. But in the meantime, women—and men, by the way—has a huge danger of losing their job, losing their children, and their whole life. Whatever they have pulled together. Stability in their foundation. That stay in jail disrupts that whole thing and jeopardises their stability.

At the same time with all of this reform, the – the male prison population is reducing. And there’s a nice, steady decline of reduction with the male. While the women’s are increasing at a three-fold rate and, at times, more. But they’re lost in the system. They’re basically lost in the system with very little support. And once they get into the system, I mean, I – I don’t… I can talk about the trauma and – and the exposure – the exposure to trauma and reinstituting previous trauma. We know that most of these women come with serious, serious histories of trauma and sex trafficking and theft and the whole range, the whole gamut. And so, that’s what we’re seeing.

Jack O’Donnell So, Jac, I want to ask a kind of a follow-up on what Leslie just said. You know, in terms of the people that wind up or could benefit the most from deflection, we’re not talking about violent individuals or, you know, or hardened criminals. We’re talking about low level drug offenses in most cases.

Jac Charlier Deflection’s best use is for people whose underlying drug use is the driver of the reason that they continue to have contact with, and in the case of what we’re talking about here, the justice system. As in, law enforcement. So, if we look at that population, that can include a wide range of people. And in much of deflection, they haven’t committed a crime. If the driver is drug use, and that presents an opportunity for someone without compromising public safety to be deflected, then that’s a good space for deflection. What we don’t want is people whose drug use are driving their contact with the justice system and then having criteria established to look at their past as if their past is coming into play right now.

So, that’s a little bit more nuanced, but it’s a better way to have a wider-cut an angle on who might be good for deflection. Certainly, if someone is charged with murder, sexual assault, arson, anything in that realm, and there’s a charge, they’re not going to be deflected. But most deflection cases in the United States actually don’t involve charges. So, we have to look at it differently. And that is what’s driving their repeated and ongoing contact with law enforcement. And that’s the better way to look at it than just what might be a potential charge that someone has. Because remember, most people won’t have charges. Therefore, we won’t be able to use that as a way to assess who should be deflected and who does not.

Jack O’Donnell You know, keeping people out of jail, getting them treatment, I mean, that… It sounds like so simple. But it’s a big task, actually.

So, Leslie, when you first got involved with PTACC, C4, and TASC—the whole group here—you know, it seems like a daunting proposition with eighteen thousand police forces across this country to spread this word. Were you optimistic from day one? You know, how do you think it’s going at this point for you guys? Was it difficult?

Leslie Balonick I remember being in the room while we were talking about this when C4 hosted the meeting. Jack Charlier invited me. I’ve known him from Illinois for many years. And I sat at the table. And I got so excited, because I was around same minded people as me. If something’s not working, let’s band together and create something that might work based on all that of our years of experience and our knowledge of the systems and opportunities that can happen within the justice system.

So, I’ve been optimistic the whole time. I mean, you could really track my careers. Give us a big problem with a vision. So, let’s move forward and – and make a change. Let’s not keep pouring dollars into doing something the same way we’ve done for year after year after year and expect different results. Let’s advocate for a new way to approach this problem.

To many of us, it’s new. But I remember, forty years ago, as an outreach worker in the city of Chicago, and we were out there meeting clients where they were at. That’s how I was trained in the field. You don’t wait for them to come to you all the time. You can’t wait. There’s lives at stake. So, it’s interesting to go full circle and see that a lot of the things that we did years and years ago in terms of outreach, in terms of meeting a client where it’s at, going into the community, going into their homes, working alongside law enforcement, so that they’re a friend, not their enemy. That’s been done, you know, for years.

Jack O’Donnell So, Jac, you know, PTACC is the voice of deflection. And, you know, you’ve done a great job of getting PTACC up and running, quite frankly, as the executive director and you’ve really become the voice of PTACC. But tell me about the process. You know, do you actually get calls from police departments across the country to say, “Hey. We’ve heard about deflection, how do we set up a programme?” And if that’s the case, what does PTACC do for these police departments?

Jac Charlier Many of the calls we get are actually from policymakers, from county state level, and even federal policymakers, including elected officials and their staff, but policymakers who want to know: What is this new thing I’m hearing about called deflection?, who want to know: How do we partner police and law enforcement up with our local treatment and how do we get EMS partnered up, so that we have the right spaces filled with police when that’s correct and EMS when that’s correct? And none of them, no first responders. And that’s correct.

So, most of our calls are actually on a conceptual level down to then, yes, we will get calls from jurisdictions that say, “Can you come and help our city or our county set up a deflection initiative?” And in those cases, we generally then want to be in a position of being able to have the right grouping of people in the collaborative who have come together and said, “This is a field. We are experts in this field. Not a lot of people are working at it yet,” and figuring out what’s the right kind of grouping of people to respond to those requests. Because what sites are facing, Jack, they’ve heard about this. They’ve seen it once. They’ve maybe gone to a conference. But otherwise than that, they’re left to their own devices. And so, PTACC comes in and provides that expert technical assistance, networking, knowledge, and awareness of principles and practices that we already know have emerged from this very still emerging field.

Jack O’Donnell Deflection, in and of itself, it, you know, it seems like it’s an issue for big cities. But is it beyond that? Do you have deflection sites in rural communities?

Leslie Balonick In fact, in some of the rural communities that are used to dealing with minimal resources—not that it’s right—they come up with such creative ways. They roll up their sleeves. They get involved. They know these families. These are families that are arms-distance away. They know the grand- – they know the grandparents, the parents, the generations. And so, yes. We see it in rural. We’d like to see more, you know, in rural America. We’d like to see more in urban America.

Jack O’Donnell You know, you’ve talked about the support, like founding members of the International Association of Chiefs of Police. You know, traditionally, they don’t jump on board with some of this work. Why has police been so supportive of this effort?

Jac Charlier Based on a recent national survey, the progenitor, if you will, of the majority of deflection sites, we estimate about seventy-five percent of those eight hundred and fifty to a thousand sites were started by law enforcement, about fifteen percent by EMS and about ten percent by community organizations, which, by the way, is a great way to start deflection. We want more community-based sites.

But for law enforcement, I think there’s two very clear reasons. One is the opioid epidemic, which, I like to say, accelerated and catalyzed the growth of deflection. And that’s where we saw, like, the booming of it. Because law enforcement as the primary responders in cities and villages and towns across the United States, twenty-four/seven, especially rural areas, it is just law enforcement that’s out there. Big cities are spoiled in that you have fire and EMS twenty-four/seven. But that’s not common in rural and even smaller areas. You might have a volunteer fire force, but the ambulance could be a couple of hours away. So, law enforcement was faced with this conundrum of “We’re getting called to things that we know our tools and our trading and our equipment won’t allow us to make better to solve.” Policing is a very problem solution oriented profession. And so, that was one of the big drivers of law enforcement, saying, “We’ve got to do something different, because the tools we have aren’t suited to responding to this.”

I think the second reason to law enforcement has been involved, which really is external to them, is the realization that as they got involved in this, others started saying, “Boy, this… We can’t put this burden on law enforcement. We have got to figure out a different way to do it.” And that’s when also that we began to see that cities, counties, villages, townships started saying, What could we do differently than having the police do it?

You put those together, and you’ve got a rapid growth curve of relieving, the social burden that has been placed on law enforcement in many areas,, including substance use disorder and mental health.

Leslie Balonick I’d also like to add to that. Listening to other police chiefs that have gotten involved in deflection work in their communities, you – you hear them talk about this a-ha moment, especially during the opiate epidemic. You know, they’re going out on these overdose calls. They’re reviving folks. They’re seeing the same folks over and over again with multiple overdoses. Some are lucky enough not to pass away and some don’t make it. Okay. So, they’re – they’re frustrated. It’s like you don’t see the end. You know, you don’t see the end of the tunnel. And so, I’ve heard a lot of the police chiefs and – an law enforcement talk about the realization that whatever we were doing, trying to arrest our way out of the problem, does not work. It’s not working. And they were open to trying something different.

The other thing that’s really critical is, remember, substance use disorders. They affect everyone, all everyone’s family. And as you go in and work with stakeholder teams, they’ve got personal experiences. Some of them just lost a family member from an overdose where years ago they wouldn’t talk about it. And now, they’re acknowledging that these problems don’t just happen to other people. They happen within their communities, and it’s happened to their neighbours and to their family members. So, I think it’s a combination of those things.

Jack O’Donnell We’ve talked about the deflection effort. And clearly, it’s almost grassroots. It’s at the local level that – that so much of this work is being done. But I think we all know that there’s a lot of major national issues—racial inequity, some of the policing reform issues that are coming up and so forth. One of the things that C4 has been so proud of over the years is our ability to convene and help solve problems. But what is PTACC doing in DC, at the federal level? Are we making any progress there? Are you seeing any – any – bearing any fruit for PTACC’s efforts in DC? What’s happening there?

Jac Charlier That question is like the other question we get asked: Where’s all the research on this, Jac? And I say it’s a very young field, right? We’re – we’re – we’re three to four years old. We’re like a toddler. We don’t have our high school diploma yet. The emergence in DC, thanks to the leadership of PTACC and our forty-seven organizational partners, we are seeing—for example, in what’s called CARA 3.0—the inclusion of language around deflection of pre-arrest diversion. And this is the first time federal legislation has ever used this languaging. Why? ‘Cause it didn’t exist before.

But thanks to the work of PTACC. And – and I do really want to call out the leadership here of C4, especially in this regard that I think very much leads in this space. It’s on a federal level of bringing this voice that PTACC speaks to. As well as when we look at the federal agencies and see language that they’ve adopted—like deflection, like pre-arrest diversion, like the five pathways—becoming the language that is being used in the field to describe this reframing of the relationship, to describe ways in which we want to go upstream from where we normally encounter people who have substance use disorder, and to describe pathways by which we can increase the scale and scope for people in community to get access to treatment, housing, and services. So, yes, lots of federal work going on. And PTACC is bringing that with its national partners.

Jack O’Donnell Our chairman likes to say the most meaningful piece of work that we’ve done in thirty years—and so, thirty-six years—it’s important work. In terms of bipartisan—I know you touched on it earlier—but I assume that CARA 3.0 has got support on both sides of the aisle.

Leslie Balonick Yes, there is support from both sides of the aisle. Like I said, the movement going on. We’re meeting PTACC national partners our policy strategy area, policy, and legislative strategy area. We’re meeting with the legislators, educating them about PTACC, educating them about legislation and funding and what’s in CARA 3.0 rather. And so, yes. That’s a long answer to your question, Jack. Yes, yes, yes, and yes.

Jack O’Donnell Our goal is simple: Deflection should be practiced in every town, city, and county. Whether police, EMS, or community responders, we want all of them to have the widest reach for those in need of treatment, housing, and services. There are eighteen thousand departments, and a thousand have programmes. Most of which have sprung up in the past five years. This is a very rapid pace of uptake for such a young field.

Given the current calls for police reform, PTACC and deflection are the perfect pathway for reshaping law enforcement, because PTACC advocates for a reframing of the relationship between police treatment and community. The vast majority of small time, non-violent drug offenders are minorities. Deflection will balance the playing field without defunding police and still allow them to do real law enforcement.

Listen, I wanna thank both of you today for taking the time to really spread the word about this great work. I know it’s something we’re very proud of at C4. Now, I come from a treatment background and I used to say the most beneficial thing every day is I know I save lives. PTACC is doing that. Deflection is doing that. And so, my hats off to both of you for the commitment that you’ve made, your organizations, and all the other founding partners of PTACC. Thanks very much for everything you guys do.

Jack O’Donnell Thank you for listening to this week’s episode of the C4 Recovery Solutions podcast, brought to you by C4 Recovery Foundation. For more information, please visit our website at c4recoveryfoundation.org or email us at contact@c4recovery.org. You can find both our email address and website in the show notes.

Be sure to rate, review, and subscribe on Apple Podcasts, Spotify, Stitcher, or wherever you like to listen. I’ll see you next time on the C4 Recovery Solutions podcast. Goodbye.