How does a small county department tackle the overlapping national crises of substance abuse, untreated or undertreated mental illness and an overreliance on jails and prisons — seemingly intractable problems that are stumping communities across the nation?
One key step is getting people in a room.
While that’s only a start, it was the idea behind a two-day conference held recently in Tucson, which brought together national and local leaders to discuss how to navigate the line between crackdown and outreach, and how to divert people with mental illness and substance use disorders from jail and prison.
“The Pima County community is known nationally for our collaboration,” the county’s Justice Services Director Kate Vesely, told Arizona Luminaria. “But we know that there are still gaps and still work to be done, especially considering the impact of fentanyl usage and homelessness in the broader Tucson area.”
“As innovative as our community is, we know we need to evolve our processes, our policies and our philosophies to meet the changing needs of this new dynamic,” Vesley added.
The conference consisted of two long days of discussion, with some of the ideas put into practice almost immediately.
The Sequential Intercept Model Mapping Workshop was hosted by Policy Research Inc, Pima County Justice Services, other Pima County departments, the City of Tucson, and the MacArthur Foundation’s Safety and Justice Challenge.
Among those in attendance were locals from police, sheriff’s department, pretrial services, the county attorney’s office, Pima County’s Detainee and Crisis Systems, and various nonprofit organizations, including Community Medical Services, Hope Inc, Inside Out Network, and Goodwill’s Adult Reentry Program.
Vesely, one of the conference’s organizers, talked to Arizona Luminaria about the need to “step back and look at the larger network of these intercepts, a point at which each person going through the justice system will pass.”
The aim was “to look systemically not only at what we are addressing, but also what we might be missing,” she said. “We can easily see the areas where there is duplication, but also gaps.”
Desiree Voshefsky, community impact manager with Community Medical Services, described to Arizona Luminaria one of those gaps, explaining the consequences of releasing people from jail without giving them access to “bridge medications.”
When people are released from jail, Voshefsky said, their enrollment in Arizona Health Care Cost Containment System, or AHCCCS — the state’s Medicaid program — should be restored immediately. But that doesn’t always happen.
If people in the jail have been receiving Medication Assisted Treatment, or MAT — which typically constitutes receiving medication to help with opioid addiction — and then are released without being provided access to that medicine, they could go into withdrawal, or be tempted to find a dose of fentanyl or methamphetamines on the street.
Either option, Voshefsky said, can be dangerous.
“If you’re released on a Friday night, you’re not going to be able to get any meds until Monday,” Voshefsky said. “It can mean life or death. If you go into withdrawal you’re going to self-medicate.”
Despite these acknowledged shortcomings, the conference room had an air of earnest hope, which was repeatedly distilled to technical practicalities of navigating those insurance gaps, data sharing, emergency housing, or jail access for service providers.
Vesely explained that the work of streamlining these processes may not make headlines, but they are crucial for providing basic safety nets.
And while the conversation swung between the abstract and the practical, the urgent human costs were never out of sight.
In the field
A lot of the conference talk was put into action the next morning when a series of community organizations and the Tucson Police Department set up a services center off the Loop bike path on Tucson’s west side, just north of Speedway Boulevard.
The location was selected because of a nearby homeless encampment in the Santa Cruz River, which had been prompting multiple complaints about drug use from nearby residents.
Tucson Police set up a mobile command unit and lined part of the nearby park with yellow police tape. Though the setup may have looked like a crime scene, the ultimate goal, said Vesely, was to steer people away from jail.
In recent years, the Pima County jail has seen dozens of deaths of people detained there, with at least 12 people dying in the jail in 2022. The number of deaths has since plummeted, but at least three people have died so far in 2025, and critics and community members still see the facility as a dangerous place to spend any time.
Also present were representatives from Primavera Foundation, Old Pueblo Community Services, CODAC, Community Bridges, the City of Tucson, and the U.S. Department of Veterans Affairs.
Tucson Police Department’s Lieutenant Matt Brady told Arizona Luminaria that the goal that day was to achieve a “continuum of accountability, a continuum of care.”
By 8 a.m., the police had already cited multiple people who had been down in the wash. The intention was not to take them to jail, Brady explained, but to do an initial appearance — the first step in court proceedings — on the spot, and then hopefully direct them to community court rather than criminal court.
Community court is a voluntary program that people can enter if they are arrested or cited for certain low-level, non-violent offenses, like drinking in public or being in a park after hours.
Brady said he wanted to base the work on “innovation and compassion, not just enforcing criminal codes but funding people’s success.” That, he said, required “making adjustments to community needs.”
“Being unsheltered is not a crime,” Brady added.
Vesely noted that, by noon that same day, they had saved the city a significant amount in jail booking fees — fees that would have been racked up despite the fact that people would likely be released shortly thereafter, she said.
Each time Tucson Police books someone into the Pima County Jail, the city pays the county $495.
She calculated that the work amounted to saving taxpayers almost $7,500 in booking fees, and noted that they took 13 people directly to treatment facilities or housing.
Xavi Martinez, of Amphi Liberation Mutual Aid, told Arizona Luminaria the approach, even if resulting in short-term cost saving, is flawed.
“Emergency shelter options and limited resources are not options that provide a stable living or relief for anyone,” Martinez said.
“This recent TPD-led sweep of these encampments near the Loop are evidence of this, just like the recent efforts the public has recently seen with a number of sweeps at city parks and along washes. I don’t understand how a majority of our local officials fail to see how actively criminalizing people who are unsheltered comes at a cost beyond the booking fee expenses.”
“Help me get clothes and stuff”
Edwina, 52, sat slumped and half-asleep on a chair under a shade tent on the morning of the diversion operation. She wore high socks and short shorts. Bright blonde hair curled out from underneath her black hoodie.
Edwina didn’t want to share her last name because of her prior criminal history and fear of repercussions.
She said she was outside the Circle K an hour or so earlier, hadn’t slept the night before, and then, “the cops brought me in.” She said she wasn’t sure why, but it was “probably drugs.”
She said she planned to take it day-by-day, and just wanted to keep out of jail.
Todd Auge, a justice navigator with the county who works out of the Transition Center, told Edwina that Community Medical Services was on the way, which he described to her as “a dosing clinic,” saying they could help her with Suboxone or Methadone — common drugs used to treat opioid addiction.
Edwina listened, still slumped in her chair, nodding along, and then asked, “Could you help me get clothes and stuff?”
“We’re going to make sure we get you all those things,” Vesely told her. A few minutes later, Vesely came back and handed Edwina a pink baseball cap and a bag of other provisions.
Edwina offered a quiet thanks, and then asked if there was any food.
Filling those needs was relatively easy. There were more than a dozen people on scene, all willing to help.
But consistently providing mental health and addiction treatment services instead of sending people to jail?
That was, Vesely said, “A monumental challenge that will take years.”
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