From LEAD to Thrive

Santa Fe's Law Enforcement Assisted Diversion Program, commonly known by the acronym LEAD, is facing growing pains as it transitions from a pilot program partially funded through private dollars to a publicly-funded mainstay of Santa Fe's public safety services.

Upcoming changes include putting management of the program under the Santa Fe Fire Department's Mobile Integrated Health Office (MIHO) and changing the name from LEAD to Thrive. Police hope the new name and the larger partnership with emergency medical services will help build confidence in the program both among people receiving the services and among officers.

Former LEAD Program Manager Shelly Moeller says the transition is good news.

"These changes are going to improve the sustainability of the program because now it's really internal to the city. It also fits really nicely into the other work that the Mobile Integrated Health Office is doing," says Moeller. "They already provide intensive case management to people who have experienced an opioid overdose … and that's essentially what a LEAD case manager does as well."

But as the details get ironed out, LEAD hangs in limbo.

Police officers haven't made any new referrals in almost a year in anticipation of losing private funding this past July. Though LEAD has already secured both state and city funds for its continuation, that money can't be put into action and officers won't begin making new referrals until the transition to Fire Department leadership is complete—a goal tentatively pegged for the end of October.

The first five years of the program were partially funded by the Open Society Foundation, an organization that supports government accountability projects internationally, Moeller tells SFR. During this time the city paid for case management from the local organization The Life Link, says Moeller, but the long-term goal has always been to have the program fully transition to public funding.

The program received a one time appropriation of around $230,000 from the state Legislature for the coming year and is budgeted for another $250,000 in recurring funds from the city for the transition.

LEAD has demonstrated success in lowering the arrest and overdose rates of participants since it started but has diverted just 179 individuals since starting in 2014.

At a meeting of the Municipal Drug Strategy Task Force last week, Deputy Police Chief Ben Valdez and Lt. Michele Williams joined Andres Mercado, mobile integrated health officer for the Santa Fe Fire Department, to explain how the changes will help the program widen its scope.

LEAD began with a single police unit. Valdez and the handful of detectives who were part of the unit were the only officers trained to divert non-violent offenders with chronic substance abuse problems toward behavioral health services rather than toward the courts and the jail.

Now the Police Department is working to educate all of its officers to identify when an individual would be best served by diversion to behavioral health services. Valdez says this strategy should save police and the district attorney's office time and resources down the line by keeping some individuals out of the revolving doors of the system.

Police officers will refer individuals directly to the Fire Department, which will send in EMTs and manage the case from there, said Valdez, though he told SFR afterwards that the two departments are "still working on a protocol about what that will look like."

In terms of the name change, Williams said police received feedback from the DA that many potential participants held negative associations with the idea of "giving the cops a lead," assuming that LEAD was a confidential informant program.

By changing from LEAD to Thrive, the department hopes to create a clearer medical association with the program.

"Is the person staying alive to receive treatment? Can we get it to that point where they are thriving, they are not dying? Let's start with that," Williams said, noting that the clarification is as much for the benefit of the officers as for those they serve.

These changes come at a time when the city's governing body is considering a systemwide shift in its approach to substance use from criminalization to harm reduction and prevention. Behavioral healthcare needs are at the root of almost half of all 911 calls that police officers and EMT's respond to, and the departments are ill-equipped to meet those needs.

Yet, both departments have encountered internal resistance to these changes, partly because many police officers and firefighters have had a hard time embracing a role that sometimes looks more like that of a social worker than a crime-busting, flame-quenching hero.

"In years past you had a group of officers who were LEAD officers and they had all the institutional knowledge on how the program worked, and then you had some people in the organization that would say, 'Well you know what, just arrest them … Why are we doing this? It's not our job,'" Valdez said Wednesday, talking about the resistance he has encountered from officers who haven't always seen harm-reduction as part of their job description. "But I think that today it is our job. We are out there to protect and serve the community and so to do that service, that's where it comes in that we are serving the community by utilizing that kind of program."

Editor's note: An earlier version of this story switched the amounts of funding appropriated to LEAD by the city and the state. In addition, Shelly Moeller stepped down from the position of LEAD program manager in June.