A personal connection with Gov. Arnold Schwarzenegger's chief of staff led to Renee Zito's selection as California's drug and alcohol treatment czar. But more than a year into her tenure, Zito's aptitude is being questioned by substance abuse professionals and by an independent state watchdog agency.
Before she was tapped to run the California Department of Alcohol and Drug Programs, Zito was a top official at Marin Services for Women, a nonprofit treatment center in the San Francisco Bay Area, where she worked with the domestic partner of Susan Kennedy, Schwarzenegger's chief of staff. Kennedy's partner was promoted to Zito's job after she left.
The department that Zito was hired to run in February 2007 on Kennedy's recommendation has long been faulted for failing to police the drug programs it helps finance, and for doling out money without regard to which treatment methods work.
The administration said it hired Zito because it wanted a leader with experience in treatment programs. But a recent by the Little Hoover Commission, a state-funded, nonpartisan entity that evaluates state policy, said the department remains a "timid" and "weak" agency.
In unusually harsh terms, the report concluded that although Zito is passionate about improving the state's drug treatment efforts, her previous inexperience in state government or in running large organizations, along with her inability to answer questions in a meeting with the commissioners four months after she was hired, made them skeptical that she would be able to turn the department around.
A number of treatment providers, advocates and officials concurred.
"We hoped she would be a catalyst for change, but we haven't seen any movement," said Cathie Smith, a treatment activist who has been pressing for the state to better regulate substance abuse facilities since her son died in a car accident while in a drug program.
Some people with reservations about Zito nevertheless praised her as capable, innovative and appealingly blunt.
Zito has "a frankness that is actually a little refreshing," said Al Senella, chief operating officer of Tarzana Treatment Centers, which has 10 facilities in Los Angeles County. "She doesn't hold back."
But he added, "There still is concern about her ability to grasp the alcohol and drug programs."
Zito called the report's condemnation unfair, and noted that her experience includes running a hospital-based and a stand-alone treatment center, both in New York.
"I've worked in the field of addiction for over 30 years," she said in an interview. "That's why I'm here, not because of a friend. The state of California is lucky to have me because I truly bring a lot to the table."
Zito, 65, is paid $142,965 to run the agency, which has a staff of 335 and a $680-million budget.
The Little Hoover Commission said the department was one of the ineffectual parts of California's botched attempt to deal with addicts who are spread throughout the state's prisons, foster care system, mental health centers, healthcare clinics for the poor, and courts.
Taxpayers spend more than $1 billion each year on haphazard treatments that squander much of the money, the report found. Meanwhile, methamphetamine use has exploded, the prisons remain crammed with drug users and dealers, and substance abuse plays a major part in child maltreatment and traffic accidents.
A prime problem, treatment providers complain, is that California's programs addressing mental illnesses and drug abuse are run independently, although there is increasing clinical evidence that the two are deeply linked.
Robert Garner, who runs Santa Clara County's drug and alcohol programs, said Zito's department is showing little leadership, but he blamed it on Schwarzenegger. Many drug treatment advocates say the governor has not devoted enough money to treatment programs.
"I think they are willing to go as far as the governor will let them," Garner said of state officials. Referring to Zito, he said, "She is who she is, and we need to work with her and support her. I think the problem is the governor."
Lisa Page, a Schwarzenegger administration spokeswoman, said Zito was hired because her background and experience fit the ideal of who would best run the department.
The administration wanted "someone with a drug treatment background, a person who had spent years dealing with substance abuse clients," Page said. "Susan Kennedy recommended Renee Zito because of her more than 30 years' experience as a drug treatment provider."
Even Zito herself was initially daunted by her selection for the job, describing the call from the governor's office as "scary."
"It was like, my Lord, you know, that's a big department, and all that money, and all the rest of it," she told state senators at her confirmation hearing. "And then I just thought, well, I needed -- I like to take risks."
Santa Clara County Superior Court Judge Stephen Manley, who supervises drug courts, said Zito's predecessor took time to get up to speed before becoming effective.
"I think Renee Zito is becoming stronger every day," he said.
Zito said she was addressing many of the agency's shortcomings that were cited in the Little Hoover report. She said the department is working to devise clinical standards for all treatment programs based on medical evidence of what works best.
She also said she favors having the state take over responsibility for licensing drug treatment counselors, something that is now delegated to a number of private provider associations. A report by the Justin Foundation, a nonprofit established by Smith, the treatment activist, studied the 67 deaths in state-licensed treatment facilities from 2000 to 2006 and found that the state identified staff failures as part of the problem in 40% of cases.
"When a counselor breaks the rules, we should be the ones who hold them accountable," Zito said. She estimates that it would take about a year before the state could begin vetting counselors.
Zito is one of several people affiliated with Marin Services to go to work in state positions with five- and six-figure salaries since Kennedy went to work for Schwarzenegger. The state's labor commissioner is a former Marin Services' board member, and her domestic partner sits on the state board that hears collective bargaining disputes involving public-sector unions.
Kennedy's partner, Vicki Marti, is the longest-serving member of a board that negotiates Medi-Cal contracts with hospitals and insurers. Her appointment dates to Gov. Gray Davis' administration, in which Kennedy was Cabinet secretary.