Call to Order and Roll Call
The 2nd meeting of the Interim Joint Committee on Judiciary was held on Friday, September 6, 2013, at the Kentucky National Guard’s Joint Forces Operation Center, London, Kentucky. Senator Whitney Westerfield, Co-Chair, called the meeting to order, and the attendance was noted.
Present were:
Members: Senator Whitney Westerfield, Co-Chair; Representative John Tilley, Co-Chair; Senators Sara Beth Gregory, Ray S. Jones II, Jerry Rhoads, and Robin Webb; Representatives Robert Benvenuti III, Kelly Flood, Joni L. Jenkins, Mary Lou Marzian, Reginald Meeks, Darryl T. Owens, Tom Riner, Kevin Sinnette, and Ken Upchurch.
Guests: Congressman Hal Rogers, Kentucky 5th Congressional District; Dan Smoot, President Operation UNITE; Chad Webb, UNITE Voucher Recipient, Pike County; Ronald Hatfield, J.D., Manager Health Information Solutions; Mark A. Fisher, M.S., State Opioid Treatment Administrator, Department of Behavioral Health & Intellectual Disabilities; Professor Robert Walker, M.S.W., L.C.S.W., UK Center on Drug and Alcohol Research; Van Ingram, Director, Kentucky Office of Drug Control Policy; Ed Monahan, Public Advocate, Kentucky Department of Public Advocacy; Dr. Henrietta Bada, Director of Kentucky Pediatric Research Institute, University of Kentucky; and Dr. Ruth Ann Shepherd, Director of Maternal and Child Health, Department of Public Health.
LRC Staff: Jon Grate, Matt Trebelhorn, Alice Lyon, Dallas Hurley, Nicole Straus, and Kathy Miller.
Congressman Hal Rogers
Senator Westerfield introduced Congressman Hal Rogers to Committee members and the audience. Congressman Rogers detailed the scope of the program Operation UNITE, an acronym for Unlawful Narcotics Investigations, Treatment and Education. Operation UNITE works to rid communities in 32 eastern Kentucky Counties of illegal drug use through undercover narcotics investigations, coordinating treatment for substance abusers, providing support to families and friends of substance abusers, and educating the public about the dangers of using drugs. UNITE’s goal is to educate and activate individuals by developing and empowering community coalitions to no longer accept or tolerate the drug culture.
Congressman Rogers highlighted some substance abuse programs of Operation UNITE. They included Chad’s Hope Treatment Center in Manchester, Ky., a treatment referral hotline of counselors offering information to callers, and a treatment voucher system that has assisted 3000 addicts. UNITE offers free counseling to children who have lost a parent to overdose. UNITE holds an annual summit, and the next national summit on prescription drugs will be in Atlanta. Congressman Rogers praised the results of House Bill 1 and noted the reduction in overdose deaths statewide. Of particular note were Clay and Floyd counties, which have experienced a 15 percent decline in deaths. He encouraged extending rehabilitation programs for addicts and to add treatment bed space. The Congressman believes treatment is the weak link in Kentucky’s substance abuse programs.
Representative Marzian asked about the budget effects of sequestration and how the money can be replaced. Senator Webb and Senator Jones congratulated UNITE on its 10 years of success.
Chairman Westerfield introduced Major General Edward W. Tonini, Adjutant General and Kentucky Commanding General of the Kentucky Army and Air National Guard. General Tonini described the Air Guard mission, marijuana eradication, and thanked the committee members and Congressman Rogers for their support.
Also present with Congressman Rogers were Mike Townsend and Don Ball of Recovery Kentucky, a network of housing and recovery centers. Each center uses a recovery program model that includes peer support, daily living skills classes, job responsibilities, and establishing new behaviors. Mr. Townsend elaborated on the call center and said the counselors are trained to take applications by phone for treatment vouchers. They distributed a pamphlet called “Your Road to Recovery.” Mr. Townsend stated that the success rate of treatment is not 100 percent, but participants are given tools to fight addiction that last a lifetime.
Operation UNITE
Dan Smoot, President Operation UNITE introduced his guest Chad Webb. Mr. Webb credited Congressman Rogers and UNITE for his life-saving treatment for addiction in 2005. Mr. Webb was offered treatment at Westcare, a residential substance abuse treatment facility in Eastern Kentucky, with a voucher from UNITE. Congressman Rogers and UNITE were instrumental in opening Westcare. Today he is a grateful recovered addict and father of 5.
Mr. Townsend said that Recovery Kentucky operates five men’s treatment centers and five women’s treatment centers, and four model centers. They offer an “opportunity, not a guarantee” of recovery.
Senator Webb congratulated Mr. Webb and thanked him for his presentation to the committee.
Monitoring prescription drugs
Ron L. Hatfield, J.D., Manager, Health Information Solutions, was introduced to the committee. Mr. Hatfield presented a PowerPoint, “Fighting Crime with Cutting-Edge Technology: Monitoring Prescription Drugs.” Mr. Hatfield described the PMP InterConnect, PMP AWARxE, and Drug Diversion Suite programs. PMP InterConnect facilitates the interstate sharing of Prescription Monitoring Program (PMP) data to authorized users. InterConnect links state PMPs, providing a more effective means of combating drug diversion, while maintaining state autonomy. PMP AWARxE is a joint undertaking between Appriss and the National Association of Boards of Pharmacy to provide a “next generation” of PMP software creating a simplified and integrated reporting system.
In response to a question from Representative Flood, Mr. Hatfield clarified that the new programs are in place to facilitate the uniformity of prescription monitoring from state to state.
Drug Assessment and Treatment Needs and Capacity Across the Commonwealth
State Opioid Treatment Administrator for the Department of Behavioral Health, Developmental and Intellectual Disabilities, Mark A. Fisher, M.S. was next to testify. He was joined by Professor Robert Walker, M.S.W., L.C.S.W., UK Center on Drug and Alcohol Research and Van Ingram, Director, Kentucky Office of Drug Control Policy. Mr. Fisher presented “Substance Abuse Treatment in Kentucky.” The presentation listed client and bed information for each of the 12 state treatment centers. This included the numbers of available beds for adolescents and adults and also the waiting period for treatment. Senator Westerfield was concerned by the lack of treatment availability for adolescents. In response, Mr. Walker said the major obstacle was that Kentucky is one of only seven states with no outpatient substance abuse treatment benefit through Medicaid. Funding is from state General funds, $8,929,000 for FY12, and federal Substance Abuse Prevention and Treatment block grant funds of $21,153,475.
Representatives Flood, Marzian and Benvenuti, and Senator Webb voiced concerns on the limited treatment options for substance addicted adolescents.
Mr. Walker said that adolescent treatment centers in Kentucky have 28 beds available for males and 12 for females. Of the 290,000 Kentuckians who meet the criteria for substance abuse/dependence, 15,390 are being treated. In response to questions from Senator Jones and Representatives Tilley and Jenkins, Mr. Walker stated that the Jefferson County Jail is the largest detoxification program in the state.
Mr. Walker then presented on “Availability and Access to Care.” He discussed barriers to access: a poorly publicized search engine on the DBHDID website, impaired mental process of addicts that affect treatment seeking, and speed of response from screening and appointment calls to treatment centers. Treatment access needs to be easy and rapid in order to have better effectiveness. He suggested that the Cabinet for Health and Family Services should be involved.
DPA Alternative Sentencing Social Worker Program
Professor Walker and Ed Monahan, Public Advocate, Kentucky Department of Public Advocacy testified. Mr. Monahan read written testimony from Judge Dan Kelly, 11th Judicial Circuit Judge, who was unable to attend the meeting, about the value of DPA social workers. Mr. Walker then presented “Alternative Sentencing Social Worker Program.” The program was recognized as one of the 25 most innovative government programs in the country by the Ash Center for Democratic Governance at the Harvard Kennedy School of Government. Mr. Monahan said from a public defender standpoint, “what is needed is a plan that delivers a more secure and lasting liberty interest for defendants BUT that also satisfies a public safety interest.” The DPA will facilitate client buy-in to diversion using motivational interviewing. A pilot study was conducted to examine the likely outcome of a social worker diversion program that showed that, for every $1.00 spent on social worker alternative sentencing services, there is a $4.47-$6.80 savings. Mr. Monahan asked that one social worker be placed in every Public Defenders office across the state. Senator Westerfield commented on advantage of having the program. Senator Webb made a statement on pretrial assessment. Senator Rhoads suggested that the committee examine means to continue criminal mediation programs as the Senior Status judge program comes to an end.
Drug Addicted and Dependent Babies
Dr. Henrietta Bada, Director of Kentucky Pediatric Research Institute, University of Kentucky and Dr. Ruth Ann Shepherd, Director of Maternal and Child Health, Department of Public Health, testified about National Abstinence Syndrome (NAS). During a PowerPoint presentation, the “Impact and Implications in Kentucky,” the doctors detailed the grave and complicated nature of maternal opiate use and NAS. Some of the issues covered were hospitalization, treatment, pre-natal care, post-discharge needs, and risk factors for child victims of abuse/neglect with the risk factor of substance abuse present in the home. Addicted mothers create an unsafe environment of toxic stress to their babies. Dr. Shepherd and Dr. Bada encouraged the committee to expand behavioral treatment to stabilize mothers, minimize risk, and mitigate bad outcomes.
Representative Benvenuti asked Dr. Bada and Dr. Shepherd if addicted mothers were typically unwed with criminal records. Dr. Shepherd said the study did not track this data.
The meeting was adjourned at 3:53 p.m.