The Program Review and Investigations Committee met on Thursday, November 13, 2008, at 10:00 AM, in Room 131 of the Capitol Annex. Representative Reginald Meeks, Chair, called the meeting to order, and the secretary called the roll.
Present were:
Members: Senator Ernie Harris, Co-Chair; Representative Reginald Meeks, Co-Chair; Senators Vernie McGaha, Joey Pendleton, Dan Seum, Brandon Smith, and Katie Stine; Representatives Dwight D. Butler, Leslie Combs, Rick G. Nelson, Ruth Ann Palumbo, Rick Rand, and Ken Upchurch.
Guests: LaDonna Thompson, Commissioner; Jim van Nort, Assistant Director, Division of Mental Health; Department of Corrections. Van Ingram, Acting Executive Director; Heather Wainscott, Branch Manager; Office of Drug Control Policy. Amy Andrews, Kentucky Agency for Substance Abuse Policy Coordinator.
LRC Staff: Greg Hager, Committee Staff Administrator; Rick Graycarek; Jim Guinn; Christopher Hall; Colleen Kennedy; Van Knowles; Jean Ann Myatt; Rkia Rhrib; Tara Rose; Cindy Upton; Stella Mountain, Committee Assistant.
Upon motion made by Senator Pendleton and seconded by Senator Harris, the minutes of the October 9, 2008 meeting were approved by voice vote, without objection.
Representative Meeks asked that representatives from the Department of Corrections give a follow-up response to the report on felony reentry, which was approved at the October meeting. A request had been made by the committee that someone from the department explain why KRS197.420 (6) did not seem to be met.
Commissioner LaDonna Thompson described the reentry program. She agreed that tracking of recidivism could be improved.
Jim van Nort presented results from three studies of participants in the Sex Offender Treatment Program compared to a control group. The first study was conducted in 1997, the second in 2002, and the third in 2003. The second and third studies were follow-ups of the participants in 1997. For each study, recidivism rates were lower for those who participated in the treatment program.
Senator Harris said that according to KRS197.420 (6), “The department shall establish a system of data collection and program evaluation so as to allow study of participating sexual offenders and their offenses and to measure the impact of the program on recidivism.” He noted that a system had been established but he was concerned about how often they do evaluation and how often they report recidivism. He suggested that reporting should be done yearly to the General Assembly, likely to the Judiciary Committee.
Commissioner Thompson said that when their new electronic system is implemented, they will be able to report annually.
Representative Palumbo asked about the ‘Non-Sexual Violent Reoffenses’ to which Mr. van Nort referred.
Mr. van Nort said a ‘non-sexual violent’ reoffense is defined as the sex offender committing a new violent crime that is not a sex offense.
Representative Palumbo said it would be important to know what the sex offender’s second crime was.
Senator Stine said that it appeared that the same 259 people were studied since 1997. She asked whether the behavior of other offenders coming into the system is also examined.
Mr. van Nort said this type of research is to start with a group and then follow them over time.
Senator Stine asked whether they only have one treatment methodology that they are studying.
Mr. van Nort said yes, it is the same sex offender treatment program that is in place and is consistent across all institutions.
Senator Stine asked whether Kentucky is doing any analysis to examine what other states might be doing that might be more effective.
Mr. van Nort said that he keeps up with the research.
Senator Stine asked whether these other methodologies would be applied to a different category or different group of individuals, or would it be the same group.
Mr. van Nort said the treatment components themselves are the same. He said that current program is effective and consistent with national trends and what national research shows to be effective.
Senator Stine asked whether Mr. van Nort is comfortable that what is done in Kentucky is as effective as or more so than what other states are doing.
Mr. van Nort replied that Kentucky’s program is very effective.
Senator Smith said that from the data provided, it seems as if the treatment is effective in dealing with sexual offences, but not as effective for other offenses. He asked if that would be something to look at and address in the recovery process.
Mr. van Nort agreed.
Senator Harris said that he and Co-Chair Meeks had three recommendations so far for studies to initiate: 1) Medicaid information systems; 2) the Highly Skilled Educators Program; and 3) procedures of the Kentucky High School Athletic Association.
The motion by Senator Harris to initiate these three studies, seconded by Senator Stine, was approved by roll call vote.
Representative Meeks re-emphasized that it is not too late if any member has topic suggestions, and that more topics could be selected at the December meeting.
Van Knowles presented the report A Review of the Kentucky Agency for Substance Abuse Policy and the Office of Drug Control Policy.
Mr. Knowles said that staff had been instructed to review Kentucky-ASAP. Because the Office of Drug Control Policy (ODCP) is now jointly responsible with and oversees KY-ASAP, both agencies were included in this review. The study’s primary focus was program coordination, policy development, and strategic planning related to prevention and treatment of substance use and abuse. ODCP consists of ODCP and its KY-ASAP branch; the KY-ASAP state board; and the network of 75 local boards covering 113 counties; all reporting to the governor and General Assembly and interacting with numerous other agencies and organizations. Mr. Knowles gave a brief history of the agency.
Program Review staff identified five fundamental principles that should guide Kentucky’s response to alcohol, tobacco, and other drugs. 1) Efforts to fight substance use and abuse must be ongoing and constantly refined. 2) Because substance issues involve many, if not all, agencies, the state’s response needs to be planned and coordinated. 3) Policies and programs related to substance use and abuse are applied at the local level and should be guided by local observations and experience. 4) Research-based prevention and treatment approaches should be used when possible. 5) As noted in statute, tobacco is a gateway drug “that leads to later and escalated drug and alcohol abuse”.
Mr. Knowles said the report contains six major conclusions. 1) Alcohol, tobacco, and other drugs cause or contribute to problems and costs associated with physical and mental illness, crime, social welfare, unemployment, lost productivity, and other social issues. 2) Kentucky’s prevention, treatment, and enforcement efforts are scattered over numerous agencies and have insufficient funds. A planned and coordinated approach is needed urgently to make the most efficient and effective use of limited resources. 3) Local wisdom is of vital importance in helping to set policy and to guide prevention, treatment and enforcement. Kentucky’s local board infrastructure of volunteers may be unique and is worth sustaining and supporting. 4) Many of the ways that ODCP and KY-ASAP have not fulfilled their statutory duties can be attributed to changes inherent in creating a new agency, to turnover in agency staff and leadership, and to inadequate numbers of staff. 5) During its first four years, KY-ASAP established 54 local boards covering 98 counties, created a statewide strategic plan, established good working relationships with many agencies, and was progressing towards more accountability of substance abuse programs and their administering agencies. 6) Since 2004, ODCP and its KY-ASAP branch have not progressed toward a comprehensive formalized system for planning and coordinating Kentucky’s policies and services. However, the agency has performed well in several areas.
He said that ODCP has worked with other agencies to support several legislative initiatives and has assisted with projects such as Recovery Kentucky and the Strategic Prevention Framework. The local board system now covers 113 counties.
The Office of Drug Control Policy currently has 4 full-time personnel and is unable to carry out all statutory responsibilities with current staff. Recommendation 2.1 is that ODCP report on how it plans to prioritize its tasks and indicate what could be accomplished with different levels of staffing and resources.
He said that turnover and reorganization have been significant challenges for ODCP and KY-ASAP. However, the agency has not maintained adequate procedures and records of its activities to ensure continuity. The agency also has not taken advantage of available tools to increase its efficiency in the complex tasks of strategic planning and coordination of state programs and services. Recommendation 2.2 is that the agency maintain written procedures and records adequate to ensure continuity in leadership and staff and employ automated tools to manage its tasks.
Mr. Knowles said after the General Assembly confirmed the transition from KY-ASAP to ODCP, the definition of KY-ASAP was ambiguous and ODCP and KY-ASAP were jointly responsible for 20 distinct tasks, creating overlap in statute and practice. Recommendation 2.3 is that the General Assembly consider amending the statute to clarify what KY-ASAP is, to define its relationship with ODCP, and to distinguish their duties.
He said that Recommendations 2.4 and 2.5 address the scope of the state board. Recommendation 2.4 is that the General Assembly consider whether the KY-ASAP state board should be responsible for oversight of ODCP or the KY-ASAP branch only and whether the board should oversee all agency funding. Recommendation 2.5 is that, in the meantime, ODCP grant the state board oversight of all its activities and employ the state board to assist with all its responsibilities.
Mr. Knowles presented several options for placement of ODCP. Recommendation 2.6 is that the governor consider placing ODCP and KY-ASAP in the Office of the Governor.
Mr. Knowles said there are strong opinions among some agencies and service providers that ODCP and KY-ASAP are redundant and unnecessary because of overlaps with entities at the state and local level. Recommendation 2.7 is that ODCP and KY-ASAP work with other entities to divide their responsibilities and actions and avoid duplication. If necessary, ODCP can recommend statutory changes to reduce duplication and improve coordination.
Mr. Knowles said ODCP was given explicit responsibility to coordinate and oversee all matters related to enforcement along with prevention and treatment, but in the 2007 statute no mention was made of enforcement. Recommendation 2.8 is that the General Assembly consider whether to include enforcement and criminal justice in the mandate of the agency, the local boards, and the state board.
Mr. Knowles mentioned issues regarding funding for local boards and other purposes. Recommendation 2.9 is that the agency determine the most effective means of applying KY-ASAP and other available funds in implementing its strategic plan. The agency should provide funds necessary to support the continuing operation of KY-ASAP local boards, and the agency should seek stable, long-term funding for successful projects funded by the boards.
He said that Chapter 3 describes the agency’s responsibilities in gathering and disseminating information, which includes gathering information from local communities and managing the KY-ASAP local boards.
Mr. Knowles discussed the responsibilities of local boards. Recommendation 3.1 is that KY-ASAP require local boards to fulfill their planning and reporting responsibilities, keep their plans up-to-date and submit the most recent versions to the agency, work toward reasonable evaluations of local programs, and ensure financial accountability for their funds.
Mr. Knowles said that during its first 4 years, KY-ASAP provided extensive support to local boards through field consultants and regional networks of boards. A formalized system collected feedback from local boards. Recommendation 3.2 is that KY-ASAP provide responsive training and support and consider reinstituting field consultants, regional networks, and a formal feedback process.
Mr. Knowles said that core indicators were recommended in 2002 for measuring alcohol, tobacco, and other drug use. A data warehouse, part of the Strategic Prevention Framework project, is in its early stages but does not address core indicators. He added that the Kentucky Incentives for Prevention survey of students is important for tracking youth substance use but it is not conducted in all school districts. ODCP and KY-ASAP should encourage all school districts to administer the survey.
Mr. Knowles said local boards reported that it can be difficult to ensure that all relevant community leaders are involved and fully engaged. Recommendation 4.1 is that KY-ASAP and ODCP take steps to encourage participation with local boards.
Mr. Knowles said ODCP is responsible for coordinating state and nongovernmental efforts against substance use and abuse. ODCP has assisted with coordination in significant ways but not in a systematic manner. Much interagency collaboration has happened without ODCP involvement. He said KY-ASAP originally and ODCP later had certain statutory tools to influence other state agencies, but both have avoided using these tools in order to maintain good relations with other agencies. Recommendation 4.2 is that the agency use a detailed action plan for coordination. The agency should use incentives and negotiation to the extent possible and should exercise its statutory authority prudently. The agency should include relevant nongovernmental organizations in its coordination plan.
Mr. Knowles said the statute gives ODCP and KY-ASAP additional coordination tasks, namely to coordinate media campaigns that focus primarily on tobacco, and school-based programs using a federal model to prevent tobacco use. ODCP has worked with the Partnership for a Drug-Free America on anti-drug media campaigns but has not focused on tobacco. Another task is to oversee a school-based tobacco use prevention initiative, but it appears that ODCP and the Kentucky Department of Education were not aware of the federal model on which it was based and it does not appear to be in use in Kentucky.
Mr. Knowles discussed the agency’s responsibility to guide Kentucky’s response to substance use and abuse. He outlined the foundations of a strategic plan and said that this report found that KY-ASAP had not completed the necessary tasks by the time ODCP was formed in 2004 and that ODCP has made little progress on these tasks since then. Recommendation 5.1 is that the agency develop and maintain a statewide needs assessment and a statewide map of prevention, treatment, and enforcement resources. Recommendation 5.2 is that the agency compile and maintain a description of Kentucky policies related to substance use and abuse and a description of recommended policies.
Mr. Knowles said the current strategic plan differs little from the 2002 plan and has several shortcomings. Recommendation 5.3 is that the agency develop and carry out a comprehensive strategic plan that meets strategic planning standards and that the agency perform implementation planning and develop written understandings with each relevant agency or organization. The plan should be part of a continuous improvement process.
KY-ASAP local strategic plans vary in their comprehensiveness and adherence to standards. Recommendation 5.4 is that local boards attempt to follow the same procedures and guidelines recommended for ODCP.
Mr. Knowles concluded by saying that ODCP and KY-ASAP are required by statute to certify during the budget process how each agency has cooperated with them and to make recommendations to the General Assembly and the governor. The agency also is required to report on the status of its own activities. None of the official reports produced under the statute have fully satisfied the needs of the General Assembly and the governor. Recommendation 5.5 is that the agency fulfill its annual reporting duties by making recommendations and providing adequate information to assess them. For its semiannual status reports, the agency should describe its performance on the strategic plan and on each of the agency’s statutory duties.
Senator Harris asked about the number of people who have worked for the agencies.
Mr. Knowles said there were 18 positions in the organization chart in 2004. Only 14 were filled at any given time and now there are 4.
Senator Harris said that he is concerned about the overlap with KY-ASAP and ODCP and the state board’s oversight role.
Representative Rand asked about the funding sources for these programs.
Mr. Knowles said the primary source of funds for KY-ASAP local boards, which is the largest expenditure, comes from the Tobacco Master Settlement Agreement. The funding has been just under $2 million per year recently.
Representative Rand asked whether the program’s primary focus was preventing tobacco use among young people.
Mr. Knowles said local boards are not limited to using it for tobacco or prevention; they can use it for treatment, tobacco cessation, for alcohol, other drugs, or other needs of their area.
Senator Seum asked whether “other drugs” that the report is focusing on are illegal drugs.
Mr. Knowles replied yes.
Representative Meeks asked Van Ingram, Acting Executive Director of the Office of Drug Control Policy, to respond to the report. Heather Wainscott and Amy Andrews joined him.
Mr. Ingram said ODCP concurs with Recommendation 2.1 and further recommends the General Assembly consider revising KRS 15A.342 (20) to consolidate reporting requirements to one combined annual report for KY-ASAP and ODCP.
Mr. Ingram said they concur with Recommendation 2.2. As funding and resources become available, the ODCP and KY-ASAP will attempt to implement the system suggested by the recommendation.
ODCP and KY-ASAP concur with Recommendation 2.3. However, with a small co-mingled staff, ODCP and KY-ASAP staff share the responsibility of statewide policy and coordination tasks.
In response to Recommendation 2.4, Mr. Ingram said KY-ASAP is responsible to the State Board as its advising entity. The ODCP receives oversight and funding from the Secretary of the Justice and Public Safety Cabinet and its executive staff.
Responding to Recommendation 2.5, Mr. Ingram said ODCP currently uses the State Board for program advice on issues related to KY-ASAP only. ODCP will seek advice and counsel of the state board on matters of public policy on substance abuse issues.
In response to Recommendation 2.6, Mr. Ingram said that ODCP has performed well and its mission has been served adequately in the Justice and Public Safety Cabinet, but that the recommendation may merit further study.
In response to Recommendation 2.7, he said that ODCP will continue to seek out situations where redundancies occur and strive to remove them, but few such conflicts have arisen over the past four years.
In response to Recommendation 2.8, Mr. Ingram said they agree that law enforcement representation on the state board would enhance the state board membership. ODCP has remained involved with law enforcement in that most agencies in the Commonwealth involved in proactive drug enforcement receive grant funding from the Justice and Public Safety Cabinet.
Responding to Recommendation 2.9, Mr. Ingram said ODCP has no discretionary funds budgeted. ODCP has interpreted the main purpose of KY-ASAP funds as providing resources for local boards to help fund prevention, treatment and enforcement efforts at the community level.
Mr. Ingram said in its direction to local boards, KY-ASAP will reiterate the necessity of the items included in Recommendation 3.1. He noted that volunteers serve on the local boards and they do not want to place too many responsibilities on them.
In response to Recommendation 3.2, Mr. Ingram said KY-ASAP currently responds to all local boards’ needs and has provided training and support when asked. ODCP supports the concept of a system of field consultants but current resources do not allow for this.
He said ODCP and KY-ASAP concur with Recommendation 4.1, but current resources and staffing limit the ability to reach out to community leaders in the manner recommended. ODCP will continue to strive to improve its performance in this area.
In response to Recommendation 4.2, he said that ODCP has not found it necessary to use its statutory authority in order to coordinate and collaborate with other agencies.
Responding to Recommendation 5.1, he said that ODCP has consistently maintained maps of law enforcement activities and search for underserved areas. ODCP concurs that a prevention map would be useful.
He said that ODCP has discussed with the Long-Term Policy Research Center (LTPRC) the possibility of a yearlong study to help determine a 5- to 10-year legislative plan to address substance abuse. This recommendation is supported by the Justice and Public Safety Cabinet and has been recommended as a possible study topic for LTPRC.
In response to Recommendation 5.3, he said it is hoped that the partnership with LTPRC can occur to conduct a long-term study that will address this recommendation.
Responding to Recommendation 5.4, Mr. Ingram said each KY-ASAP local board is required to submit a needs assessment and a strategic plan before receiving initial funding. Although they are encouraged to update their local plans, it is complicated by the fact that local boards are almost entirely comprised of community volunteers.
He concluded by saying in response to Recommendation 5.5 that recommendations for policy, programming and funding at the state level are made to the executive staff of the Justice and Public Safety Cabinet. When funds existed to create reports to the General Assembly, they were created. They are going to work to fulfill their reporting requirements in the future.
Representative Rand asked whether it was correct that ODCP and KY-ASAP have been forced together, yet they have competing interests, the ODCP’s interest being primarily drug abuse, and KY-ASAP’s primarily smoking.
Mr. Ingram said ODCP staff have spent more time addressing illegal substances; the meth lab initiatives were done by KY-ASAP; and the state board focused more on tobacco cessation.
Representative Rand questioned how effective the local boards are because they are staffed primarily by volunteers.
Mr. Ingram said boards vary in their effectiveness from county to county and board to board. He said that if funding, at the least, gets decision makers in the local community together to talk about substance abuse issues, it is worth getting that kind of coordination. He said that for the amount of money, it is effective.
Representative Rand asked what is done to help local boards that are struggling.
Mr. Ingram said they have tried having strong boards mentor weaker boards, which seems to be helping.
Ms. Andrews said there is a strong group in western Kentucky where coordinators of boards come together once a month outside of their normal board meetings and network and see how they can work together. They are hoping to share this motivation with groups in other areas.
Senator Harris said he hopes that the agency will come with a legislative agenda regarding required reports. He agrees with placing money locally because that is where it can best be used. He said it is important to plan and look ahead to see what other problems are showing up in areas and could spread to other areas.
Mr. Ingram agreed. He said that prescription drugs will be epidemic in Kentucky and in the nation. They have regular dialogue with the Office of National Drug Control Policy on these kinds of issues and are looking for those trends and future problems.
Senator Harris asked whether they are going to come to the legislature in February with an agenda to help them do their job better.
Mr. Ingram replied yes.
Senator Harris said he appreciates the response from the agency and that they are willing to work with the General Assembly.
The report A Review of the Kentucky Agency for Substance Abuse Policy and the Office of Drug Control Policy was accepted by roll call vote upon motion made by Representative Rand and seconded by Senator Pendleton.
The next meeting is scheduled for December 11.
The meeting was adjourned at 11:35am.