03/19/2001 01:10 PM House JUD
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+ teleconferenced
= bill was previously heard/scheduled
ALASKA STATE LEGISLATURE
HOUSE JUDICIARY STANDING COMMITTEE
March 19, 2001
1:10 p.m.
MEMBERS PRESENT
Representative Norman Rokeberg, Chair
Representative Jeannette James
Representative John Coghill
Representative Kevin Meyer
Representative Ethan Berkowitz
MEMBERS ABSENT
Representative Scott Ogan, Vice Chair
Representative Albert Kookesh
COMMITTEE CALENDAR
HOUSE BILL NO. 32
"An Act relating to the forfeiture of property used to possess
or distribute child pornography, to commit indecent viewing or
photography, to commit a sex offense, or to solicit the
commission of, attempt to commit, or conspire to commit
possession or distribution of child pornography, indecent
viewing or photography, or a sexual offense."
- MOVED CSHB 32(JUD) OUT OF COMMITTEE
HOUSE BILL NO. 4
"An Act relating to offenses involving operating a motor
vehicle, aircraft, or watercraft while under the influence of an
alcoholic beverage or controlled substance; relating to implied
consent to take a chemical test; relating to registration of
motor vehicles; relating to presumptions arising from the amount
of alcohol in a person's breath or blood; and providing for an
effective date."
- HEARD AND HELD
HOUSE BILL NO. 97
"An Act relating to court approval of the purchase of structured
settlements."
- BILL HEARING POSTPONED
PREVIOUS ACTION
BILL: HB 32
SHORT TITLE:SEX CRIME AND PORNOGRAPHY FORFEITURES
SPONSOR(S): REPRESENTATIVE(S)HAYES
Jrn-Date Jrn-Page Action
01/08/01 0032 (H) PREFILE RELEASED 1/5/01
01/08/01 0032 (H) READ THE FIRST TIME -
REFERRALS
01/08/01 0032 (H) JUD, FIN
02/09/01 0286 (H) COSPONSOR(S): MCGUIRE, GUESS
02/14/01 0327 (H) COSPONSOR(S): MURKOWSKI
02/21/01 (H) JUD AT 1:00 PM CAPITOL 120
02/21/01 (H) Heard & Held
02/21/01 (H) MINUTE(JUD)
03/09/01 (H) JUD AT 1:00 PM CAPITOL 120
03/09/01 (H) Heard & Held
MINUTE(JUD)
03/19/01 (H) JUD AT 1:00 PM CAPITOL 120
BILL: HB 4
SHORT TITLE:OMNIBUS DRUNK DRIVING AMENDMENTS
SPONSOR(S): REPRESENTATIVE(S)ROKEBERG
Jrn-Date Jrn-Page Action
01/08/01 0024 (H) PREFILE RELEASED 12/29/00
01/08/01 0024 (H) READ THE FIRST TIME -
REFERRALS
01/08/01 0024 (H) TRA, JUD, FIN
02/22/01 (H) TRA AT 1:00 PM CAPITOL 17
02/22/01 (H) Heard & Held
MINUTE(TRA)
02/27/01 (H) TRA AT 1:00 PM CAPITOL 17
02/27/01 (H) Moved CSHB 4(TRA) Out of
Committee
MINUTE(TRA)
02/28/01 (H) JUD AT 1:00 PM CAPITOL 120
02/28/01 (H) Heard & Held
MINUTE(JUD)
02/28/01 0470 (H) TRA RPT CS(TRA) NT 1DNP 2NR
2AM
02/28/01 0471 (H) DNP: SCALZI, NR: KAPSNER,
KOOKESH;
02/28/01 0471 (H) AM: MASEK, KOHRING
02/28/01 0471 (H) FN1: (ADM); FN2: (ADM)
02/28/01 0471 (H) FN3: (COR); FN4: (CRT)
02/28/01 0471 (H) FN5: (HSS); FN6: (HSS)
02/28/01 0472 (H) FN7: (HSS); FN8: (HSS)
02/28/01 0472 (H) FN9: (LAW); FN10: (DPS)
02/28/01 0472 (H) REFERRED TO JUDICIARY
03/09/01 (H) JUD AT 1:00 PM CAPITOL 120
03/09/01 (H) Heard & Held
MINUTE(JUD)
03/12/01 (H) JUD AT 2:30 PM CAPITOL 120
03/12/01 (H) Heard & Held
03/12/01 (H) MINUTE(JUD)
03/14/01 (H) JUD AT 2:15 PM CAPITOL 120
03/14/01 (H) Scheduled But Not Heard
03/16/01 (H) JUD AT 1:00 PM CAPITOL 120
03/16/01 (H) Heard & Held
MINUTE(JUD)
03/19/01 (H) JUD AT 1:00 PM CAPITOL 120
WITNESS REGISTER
REPRESENTATIVE JOE HAYES
Alaska State Legislature
Capitol Building, Room 426
Juneau, Alaska 99801
POSITION STATEMENT: Sponsor of HB 32.
ERNIE TURNER, Director
Central Office
Division of Alcoholism & Drug Abuse (DADA)
Department of Health & Social Services (DHSS)
PO Box 110607
Juneau, Alaska 99811-0607
POSITION STATEMENT: Provided information regarding the
treatment element of HB 4 and answered questions.
LOREN JONES
CMH/API Replacement Project Director
Division of Mental Health & Developmental Disabilities
Department of Health & Social Services
PO Box 110620
Juneau, Alaska 99811-0620
POSITION STATEMENT: Provided additional information regarding
the treatment element of HB 4 and answered questions.
RON TAYLOR, Coordinator
Alcohol Safety Action Program (ASAP)
Division of Alcoholism and Drug Abuse (DADA)
Department of Health & Social Services (DHSS)
303 K Street
Anchorage, Alaska 99501
POSITION STATEMENT: Provided additional information regarding
the ASAP portion of the treatment element of HB 4, and answered
questions.
SARAH WILLIAMS, Coordinator
Substance Abuse Program
Inmate Programs
Division of Institutions
Department of Corrections (DOC)
4500 Diplomacy Drive, Suite 109
Anchorage, Alaska 99508
POSITION STATEMENT: During discussion of HB 4, provided
information regarding the DOC's treatment programs, and answered
questions.
CANDACE BROWER, Program Coordinator/Legislative Liaison
Office of the Commissioner
Department of Corrections
431 North Franklin, Suite 203
Juneau, Alaska 99801
POSITION STATEMENT: Provided information regarding the DOC's
fiscal note as it relates to the treatment element of HB 4, and
answered questions.
DENITA SOLITAIRE, Substance Abuse Counselor
Akeela House, Inc.
PO BOX 201412
Anchorage, Alaska 99520
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of the treatment element.
SHEILA SANFORD, Meeting the Challenge
320 South Bragaw
Anchorage, Alaska 99508
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of the treatment element.
ODIS ADAMS
5800 Lake Otis Parkway, Number 360
Anchorage, Alaska 99507
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of the treatment element.
RUDOLF NEWMAN, Meeting the Challenge
3252 Carriage Drive
Anchorage, Alaska 99507
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of the treatment element.
LEONA HAWKENSON (ph) CROW, Meeting the Challenge
PO Box 8567
Kodiak, Alaska 99615
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of treatment for DWI offenders.
KATHERINE FRIDAY
PO Box 980
Craig, Alaska 99921
POSITION STATEMENT: During discussion of HB 4, spoke on the
issue of treatment availability in rural areas for substance
abuse.
CLARA M. PETERS
PO Box 65087
Nulato, Alaska 99765
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of the treatment element.
BRIAN MASSEY
PO Box 2324
Sitka, Alaska 99835
POSITION STATEMENT: During discussion of HB 4, shared personal
experience and spoke in support of substance abuse treatment.
ACTION NARRATIVE
TAPE 01-35, SIDE A
Number 0001
CHAIR NORMAN ROKEBERG called the House Judiciary Standing
Committee meeting to order at 1:10 p.m. Representatives
Rokeberg, Coghill, Meyer, and Berkowitz were present at the call
to order. Representative James arrived as the meeting was in
progress.
HB 32 - SEX CRIME AND PORNOGRAPHY FORFEITURES
Number 0033
CHAIR ROKEBERG announced that the first order of business would
be HOUSE BILL NO. 32, "An Act relating to the forfeiture of
property used to possess or distribute child pornography, to
commit indecent viewing or photography, to commit a sex offense,
or to solicit the commission of, attempt to commit, or conspire
to commit possession or distribution of child pornography,
indecent viewing or photography, or a sexual offense."
Number 0069
REPRESENTATIVE JOE HAYES, Alaska State Legislature, sponsor,
requested that the committee consider the proposed committee
substitute (CS) for HB 32, version 22-LS0270\C, Luckhaupt,
3/7/01. He added that this Version C gives a narrow definition
of forfeiture, and a definition of property that addresses
computer and electronic equipment.
Number 0133
REPRESENTATIVE COGHILL made a motion to adopt the proposed
committee substitute (CS) for HB 32, version 22-LS0270\C,
Luckhaupt, 3/7/01, as a work draft. There being no objection,
Version C was before the committee.
Number 0175
REPRESENTATIVE COGHILL moved to report the CS for HB 32, version
22-LS0270\C, Luckhaupt, 3/7/01, out of committee with individual
recommendations and the accompanying zero fiscal notes.
Number 0200
REPRESENTATIVE BERKOWITZ objected for the purpose of discussion.
He asked why HB 32 had been referred to the House Finance
Committee if it had zero fiscal notes.
Number 0214
CHAIR ROKEBERG responded that he did not know, and suggested
that the sponsor request a waiver from the House Finance
Committee. Chair Rokeberg noted that the objection was removed.
There being no further objection, CSHB 32(JUD) was reported from
the House Judiciary Standing Committee.
HB 4 - OMNIBUS DRUNK DRIVING AMENDMENTS
Number 0231
CHAIR ROKEBERG announced that the next order of business would
be HOUSE BILL NO. 4, "An Act relating to offenses involving
operating a motor vehicle, aircraft, or watercraft while under
the influence of an alcoholic beverage or controlled substance;
relating to implied consent to take a chemical test; relating to
registration of motor vehicles; relating to presumptions arising
from the amount of alcohol in a person's breath or blood; and
providing for an effective date." He noted that the focus for
this meeting would be on the treatment element of HB 4. [Before
the committee was CSHB 4(TRA).]
Number 0270
ERNIE TURNER, Director, Central Office, Division of Alcoholism &
Drug Abuse (DADA), Department of Health & Social Services
(DHSS), explained that his slide presentation was titled
"Understanding Alcoholism and the Treatment of Alcoholism -- An
Overview." He prefaced his presentation with some personal
background information. He said he is a chronic recovering
alcoholic, and that he had spent many years on the streets as a
very hopeless alcoholic. He added that in the 1960s he was a
"guinea pig" in a research center at the University of
Washington, which only took hopeless alcoholics; the center did
not accept anyone who was expected to survive his/her
alcoholism. The center subjected him to a variety of tests,
which he noted he somehow survived. He recounted that he tried
various methods of recovery such as psychiatry and drug therapy
(including prescribed LSD - lysergic acid diethylamide), and
that he also tried seeking help through the church. He also
recounted that he made many trips to jail because at the time he
was drinking, alcoholism was considered a crime, not a disease;
there were no detoxification facilities, simply the "drunk
tank."
MR. TURNER added that during that time he made many trips to the
hospital; that he suffered internal bleeding; and that he has
had surgery to remove portions of his intestines and stomach,
and to repair his esophagus. His alcoholism physically wore him
out, he said, and for a long period of time suicide ideation was
a constant companion. However, suicide was a mortal sin
according to the way he was raised; he also had three children,
and he said that he did not want them to live the rest of their
lives knowing that their father had committed suicide. He said
that one day in court he told the judge that he was "at the
bottom of the barrel" and had no way out. The judge
consequently sentenced him to 120 days of treatment, which
consisted mostly, at the time, of work therapy. Participants
were given jobs involving four hours of work a day for the
county; participants also spent four hours every day in therapy
at "school."
Number 0530
MR. TURNER explained that it was during this 120-day treatment
that he learned that he did not "cause" his alcoholism. He
learned, instead, that it was a "no-fault" disease, which had
been activated by his initial experimental use of alcohol, and
had progressed to the point of nearly causing his death. He
noted that he had attended this treatment program in 1970, and
that nine months later he made the decision to devote the rest
of his life to the field [of alcoholism]. He then went back to
school for two years at the University of Utah, School of Social
Work, and completed a project at the Western Region
Alcoholism/Training Center. He also graduated from Lesley
College in Cambridge, Massachusetts, with a degree in substance
abuse management.
MR. TURNER said that he has worked in both the public and
private sectors. He worked for four years at Lakeside-Milam
Recovery Centers in the state of Washington, which at that time
had approximately 160 beds. The center averaged about 20
referrals a month from all over Alaska, including
Representatives, Senators, aides, and business people; many of
those referrals were from the Juneau area. He added that they
averaged seven adolescent referrals a month from Alaska,
approximately five of which were from Juneau. He reported that
they treated people from all over the world, and that he learned
what it was like to treat affluent alcoholics - people who were
millionaires and/or had a lot of resources at their disposal
such as good insurance. He added that they treated doctors,
ministers, college professors, bankers, and other people from
all walks of life.
MR. TURNER said that in 1988 he read a series of articles from
the Anchorage Daily News entitled "People in Peril," which
detailed the destruction in rural communities from alcoholism
such as the high homicide and suicide rates, and it was at that
point that he made the decision to return to Alaska. He
explained that he was born in the village of Shageluk, and was
therefore familiar with village-style drinking because that was
where he started drinking at age 16. He noted that he did not
get into recovery until age 40.
Number 0761
MR. TURNER, moving on to his slide presentation, said that it
was a brief overview. [This slide presentation was made
available in the form of handouts and placed in members'
packets.] He said that the clinical definition used for
alcoholism is that it is a disease of the brain with genetic and
environmental factors, which influences development and
manifestations, and that the disease is often progressive and
fatal. He added that the most recent research - via a web
search - indicates that the "reward" pathway in the brain may be
even more important to the craving associated with addiction
compared to the reward itself. Further, scientists have learned
a great deal about the biochemical, cellular, and molecular
basis of addiction, and have said it is clear that it is a
disease of the brain, rather than simply a weakness of the will
or a moral problem. He went on to say that [alcoholism] is
characterized by impaired control over drinking; preoccupation
with alcohol, even when not drinking; use of alcohol despite all
of the negative consequences; and distortions in thinking, most
notably the denial factor.
MR. TURNER suggested that by looking at the disease of
alcoholism as a root - something that is buried underground that
can't be seen - all of the problems associated with alcoholism
become clearer. He said that the disease affects the family
first. Family problems such as child abuse, spousal abuse, and
neglect begin to occur. Also FAS and FAE (Fetal Alcohol
Syndrome and Fetal Alcohol Effects) situations crop up. School
dropout rates increase as well due to alcohol and drug use.
Drinking affects a person's job in terms of absenteeism and poor
work performance. There is also a tremendous cost to the legal
system, the court system, and the prison system. He
acknowledged the financial burdens of people with the disease,
as well as the physical symptoms such as an increase in
accidents. He added that about 53 percent of the fatal
accidents that occur in Alaska are alcohol-related. In
addition, people with the disease suffer emotional and mental
anguish and despair, and their value systems and morals
[deteriorate]. Mr. Turner said he believed that when a person's
spirit dies, his/her thoughts begin to turn to suicide.
Number 0968
MR. TURNER said that the amount of money spent treating the
symptoms compared to the amount of money spent on the treatment
of alcoholism is more than ten to one. He mentioned a national
study that said ".04 percent" of the total cost of alcoholism
and drug addiction goes into prevention of the problem.
Referring to a slide in his presentation, he said it all adds
up: the costs of alcoholism to society are extremely high. His
slide listed the percentages of suicides; child abuse; domestic
violence; sexual assaults; fatal automobile crashes; fatal
fires; and homicides that are alcohol-related. He noted that in
fiscal year 2000, the Alaska Court System (ACS or "the courts")
data reflected approximately 5,300 arrests for DWI (driving
while intoxicated). He added that DWI seems to get an awful lot
of attention, yet it is seen as one of the symptoms of the
disease (of alcoholism), not the disease itself. Many of those
who get DWIs may get assessed as being dependent on alcohol and
are in need of treatment, but many more are not alcoholic. They
are people who have been to a wedding or to a funeral or to some
other occasion where they had too many drinks and then attempted
to drive home, which is simply a sign of really poor judgment.
MR. TURNER reported that the rate of alcoholism in Alaska is one
of the highest of any state; the results of a 1998 Gallup poll
showed that 41,108 adult Alaskan residents are dependent on
alcohol, and that about 17,294 are what are known as "alcohol
abusers."
Number 1110
CHAIR ROKEBERG sought comments on why Alaska's statistics were
double the national average.
MR. TURNER said that there were a lot of theories. He
acknowledged that there are races [of people] for which the rate
of alcoholism is much greater than in other races. To
illustrate, he said that in the Jewish and Italian races it is a
very low rate, and in the American Indian/Alaskan Native races,
it is extremely high, and he added that Alaska is about 17
percent Alaskan Native. He also said that Alaska is a frontier
state, and as such, has a history of drinking as the norm. He
said that he was unaware whether any research has been done
within Alaska to determine the reasons for the high numbers.
CHAIR ROKEBERG inquired whether the aforementioned statistics
had been applicable over a number of years.
MR. TURNER replied that those numbers had held pretty steady.
On the point of responding to the problem of alcoholism, he said
that there are four main responses, but over the years it has
been found that there is only one response that really works,
and that is treatment. With the response of locking people up,
they eventually get out [of jail], and if they haven't gone
through treatment, they go back into society and begin causing
problems again. He explained that the treatment process starts
from the time the patient gets into referral, and continues on
with screening, assessment, placement, treatment, [continuing
care, and follow-up monitoring].
MR. TURNER explained that there are many ways in which people
enter into the treatment system. Most people enter at the
urging of others, some at the urging of the court/judge, but
very few are self-referred. He noted that some people will come
in to a treatment facility and say they are self-referred but it
is later found out that they are "self-referred" by a spouse or
some other family member. He acknowledged that there are some
who say patients can only be successful when treatment is
entered into without coercion. He pointed out, however, that
coercion is the basic reason why people get into treatment to
begin with - coercion through their bosses, family members,
friends, or the court system.
Number 1278
REPRESENTATIVE BERKOWITZ asked how success was being defined
with regard to treatment.
MR. TURNER asked to defer that question until later, when he
would answer in detail. On the topic of screening, he said that
it is an initial review of a person's symptoms to determine
whether drinking or drug use is out of bounds. He added that
screening is used to rapidly distinguish between those who need
education and those who need treatment. He noted that there are
different forms of screening, and for the purposes of this slide
presentation he used CAGE - Concern, Anger, Guilt, and Eye-
opener - but he also noted that another form was SASSI - Subtle
Alcohol Substance Screening Inventory - which is technical in
nature and requires training to administer. With CAGE, which is
a tool that has been used for many years, four questions are
asked: "Is someone concerned about your drinking? Do you get
angry when someone wants to talk to you about drinking? Do you
feel guilty the morning after? Do you need an eye-opener upon
awakening?" If a person answers yes to one of those questions,
then he/she proceeds to the assessment stage of the treatment
process because there is an indication that there is a problem.
If a person answers yes to two of those questions, then there is
an indication that he/she needs treatment. Three questions
answered in the affirmative reflect the late stages [of
alcoholism], and if the answer is yes to all four questions,
then there is an indication that the disease has progressed to
the chronic stage.
MR. TURNER next described assessment as gathering and evaluating
information to diagnose substance abuse disorders, and then
developing a treatment plan that addresses the specific problems
identified in the assessment. The assessment may include
questioning what the person drinks; the frequency of drinking;
the amount which is drunk; if it is a court-referred DWI case,
looking at the blood alcohol concentration (BAC); looking at how
the drinking affects the person's schooling, job, and family;
getting information about other arrests; looking into the
person's financial situation; and determining the presence of
any physical, emotional, mental, or spiritual disorders. All of
this information is used to determine the severity of the
disease and then determining, according to a scale, what the
best placement would be.
MR. TURNER then described placement as putting patients in the
setting where they can receive the most effective treatment. He
explained that in Alaska, the American Society of Addiction
Medicine, Patient Placement Criteria, Second Edition (ASAM PPC-
2), is used to determine whether outpatient or inpatient
treatment, and short-term or long-term treatment would provide
the best possible chance for a person to respond and get well.
He also explained that treatment can take many forms, depending
on the patient. It can include detoxification; drug-assisted
therapy, such as Naltrexone; longer-term care; or treatment for
mental illness in dually diagnosed clients.
Number 1498
REPRESENTATIVE MEYER asked for more information regarding
detoxification coupled with the use of the drug Librium. He
asked whether, in such instances, these are people who are
chronic alcoholics, and if so, would going without Librium be
dangerous for them.
MR. TURNER, in response, confirmed that most such instances do
involve the chronic alcoholic. He also acknowledged that
sometimes if a person withdraws suddenly from a substance,
his/her state of anxiety increases to the point of perhaps
causing seizures or delirium tremens (DTs), and because Librium
keeps patients slightly sedated, it consequently prevents that
stage from occurring. He added that the DTs can involve severe
hallucinations, which can, in some instances, be controlled by
the person experiencing them. He also said that any drug
similar to Librium, when used to sedate a person, could prevent
the DTs. He reported that about one in sixteen dies from the
DTs and about one in twelve dies from alcohol-induced seizures.
REPRESENTATIVE MEYER commented that if the experience of going
through the DTs is so unpleasant, he could understand why a
person would avoid treatment just to avoid the experience of the
DTs.
MR. TURNER responded that unpleasant as that experience is, a
person eventually has to go through it because a constant level
of intoxication cannot be maintained indefinitely; the person
either dies or has to withdraw at least occasionally.
REPRESENTATIVE BERKOWITZ asked how the DTs become fatal.
Number 1663
MR. TURNER explained that if a person is withdrawing from a
substance by himself/herself without any assistance, and he/she
begins to hallucinate, fatal accidents can occur; he also noted
that there are some instances of heart failure associated with
the DTs, although heart failure is more common in alcohol-
induced seizures. Returning to the issue of treatment, he said
it could also include education about the disease (he said that
in his own case when he learned that he suffered from a disease
that could be brought into remission, he had hope for the first
time); confrontation to break through denial; referral to
support groups; relapse-prevention-skills development; and
recovery-life-skills development.
CHAIR ROKEBERG asked whether, in the rural parts of the state
where perhaps there is not an existing Alcoholics Anonymous (AA)
chapter or similar group, [the DADA] works to establish any non-
state-funded support groups.
MR. TURNER said that the DADA does not establish any such
groups; instead, it informs people where informational material
can be obtained. He added that the focus of the DADA is in
establishing a continuum of care - referred to as "aftercare."
Also, if people in a community are interested in forming a 12-
step group or a cultural group, the DADA can assist them in
locating startup informational materials or refer them on to
other groups that can offer assistance. He noted that the
Natives for Sobriety is one such cultural support group, and
that there are various similar groups throughout the state.
MR. TURNER explained that it is the therapist's job to focus on
the disease of alcoholism - to break through the denial
barriers. However, much of the therapist's time is taken up
working with the family because the family needs to be involved
and understand that there is a plan for recovery, as well as
working with teachers or employers. Furthermore, much time is
spent in the legal system, since therapists can be subpoenaed to
appear in court on behalf of the patient many times. He added
that one of the biggest complaints [the DADA] receives from
treatment centers is the amount of time therapists are required
to spend in responding to subpoenas. With regard to patients'
financial situations, he also explained that therapists assist
patients in finding housing and jobs. Therapists must also
coordinate with physicians, psychologists, psychiatrists,
churches, and ministers. Thus a lot of a therapist's time is
spent working with the symptoms of a patient's disease, rather
than the disease itself.
Number 1882
MR. TURNER, on the topic of continuing care, said that a New
Standards study done between 1994-1998 showed that participation
in continuing care is the best predictor of treatment outcomes
at the one-year follow-up session. Referring to a chart in his
slide presentation, he said that a person who attends a support
group after treatment is more likely to be sober after a year of
treatment compared to a person who does not attend a support
group.
CHAIR ROKEBERG, referring to the chart, asked what the
difference was between the aftercare given to residential-
treatment recipients and the aftercare given to outpatient-
treatment recipients.
MR. TURNER responded that the percentages for the outpatient-
treatment recipients looked better because they had been
assessed as not having as severe a problem. He added that the
earlier the disease is caught, the better the results. If a
patient is suffering from the later chronic stages of the
disease, such as with those assessed as needing inpatient
treatment, then the results go down because a person's ability
to respond is not as good. Thus, he confirmed for
Representative Berkowitz, in looking at the chart, a person
should not misconstrue that outpatient treatment is more
effective; simply, patients assessed as needing outpatient
treatment, as opposed to inpatient treatment, are affected by
the disease to a lesser extent and therefore respond better to
the treatment they are given. Mr. Turner also went on to
explain that there are various types of inpatient [treatment],
and that there are very long-term inpatient facilities for the
more chronic alcoholic and drug addict in addition to short-term
inpatient facilities for those less affected by the disease. He
added that ASAM PPC-2 is used to move patients to the next phase
of treatment - from inpatient to outpatient and then on to
continuing care.
MR. TURNER then posed the question: "Does treatment work?" He
answered, "Yes, it works, and I'm a living example that it
works." He went on to say that a recent study of Alaskan
treatment outcomes shows 56 percent of outpatients and 42
percent of inpatients abstained from alcohol for a year after
treatment. He remarked, however, that abstention is not the
only measure of success. He went on to say this study also
shows treatment has benefits that significantly reduce the costs
of alcoholism to the state. Directing attention to the slide
showing columns that reflected behavior-pattern percentages
during the year prior to treatment and the year after treatment
for both inpatient (residential) and outpatient-treatment
recipients, he commented that the results were easy to see. He
referred to a study done in Oregon, which showed that for every
dollar spent on treatment, there was a savings of $5.60 to that
state. He also noted that California had spent $30 million
doing a similar study, which showed that for every dollar spent
on treatment, there was a savings of $7 to the state in alcohol-
related costs.
Number 2038
REPRESENTATIVE MEYER, referring to Mr. Turner's statement that
treatment works and that it worked for him, surmised that it
worked for Mr. Turner because really he wanted help. He
offered, by way of contrast, that what was being proposed with
HB 4 was offering a choice to DWI offenders to either go to
treatment or go to jail. He said he wondered, given those two
choices, whether the success rate would be as high for those
offenders opting for treatment - whether offenders in that
situation would really want the treatment.
MR. TURNER recounted that he had worked for a number of years in
the state of Washington, which has a two-year deferred
prosecution program whereby all DWI offenders are given the
choice between prison and treatment. In comparing the two-year
deferred clients with the self-referred clients, there was a
much better success rate with the two-year deferred clients
because those clients attended the program for the full two
years, whereas the self-referred clients often dropped out of
treatment after 30-40 days. A person who refers himself/herself
to treatment can also refer himself/herself out of treatment, he
added, but the two-year deferred clients had to finish the two
years of treatment or face going to prison. He commented that
his daughter is an example of the success of the two-year
deferred prosecution program; eight years ago she got a DWI and
opted for the two-year deferred prosecution program and has
remained sober ever since.
CHAIR ROKEBERG clarified that HB 4 has mandatory treatment at
every aspect of it, including during incarceration, with the
exceptions of the Alcohol Safety Action Program (ASAP) provision
wherein only the educational necessity assessment is required,
and the diversion program for .08-.10 BAC levels.
Number 2158
MR. TURNER continued by posing the question: "Who has a better
success rate, people who buy their own treatment or people whose
treatment is paid for by the state?" He then said that some
studies show that private-pay treatment facilities have a higher
success rate. He added that again, as in comparing differences
between inpatient and outpatient [treatment], those people who
go to private facilities and who still have jobs and insurance
and thus retain the ability to pay for treatment are, therefore,
not as debilitated as people that are in need of public
treatment centers. Also, too, if the disease is caught at the
earlier stages of its progression, there is a greater chance of
success.
MR. TURNER clarified that the state does not provide treatment.
The DADA is a "grant in aid" program, and because this is so, no
employee of the state provides alcohol treatment; all of the
treatment centers are privatized.
MR. TURNER then posed the question: "Who pays for treatment in
programs that receive public funds?" He explained that the
state actually pays for less than half the treatment costs in
programs that receive public funds. Treatment programs are held
to a rigorous review, through private audits, of their sources
of revenue and of expenditures for treatment services to ensure
that "double-dipping" does not occur. He stated that treatment
is not free. He acknowledged that people can be more committed
to something if they put their own resources into it, but they
have to have resources to put there, and alcoholism is a disease
that robs people of their resources.
MR. TURNER next posed the question: "What is the cost of
treatment?" He explained that the cost per day varies depending
on the treatment center and type of treatment provided, for
example, $71/day at Nugens [Ranch] compared to $345/day in a
hospital-based setting where doctors, psychiatrists, and
psychologists are available.
MR. TURNER posed another question: "How can we improve
treatment outcomes?" Develop more capacity so that systems can
provide timely service, he offered; when a person is ready, that
is the time to get him/her into treatment, but very often that
is not possible because of waiting lists that are sometimes six
months long. In six months, a person is not as ready as when
he/she is first contacted. He said that there is also a need to
look into providing more specialized treatment to women, youth,
and patients with co-occurring disorders such as mental illness.
He said he knew there were a lot of people "dropping through the
cracks," and he opined that a "no wrong door" approach needed to
be developed so that whether a person is in a mental health
program or an alcohol program, he/she still gets the treatment
needed. He remarked that there was a need to stabilize,
restore, and extend the ASAP.
Number 2314
REPRESENTATIVE BERKOWITZ asked for an outline of the current
standing of the ASAP as well as an indication of Mr. Turner's
vision of the ASAP's future.
MR. TURNER remarked briefly that testimony prepared for later in
the meeting will show an increase in ASAP referrals without any
corresponding increase in funding, which has, in fact, decreased
to the point of mandating the closure of [six] facilities
(Cordova, Valdez, Sitka, [Barrow, Nome, and Seward]). At Chair
Rokeberg's urging, however, he offered to return to this issue
later.
MR. TURNER then referred to his slide presentation and an
additional handout that showed the number of beds available
through programs that receive grant funds, where those beds are
located, and where the funds come from for those beds. He added
that 84 percent of the DADA beds for adults (which total 376
beds) are funded by the general fund (GF), 11 percent by the
SAMHSA (Substance Abuse & Mental Health Services Administration)
Federal Block Grant, 3 percent by the Mental Health Trust
Authority Authorized Receipts (MHTAAR), and 2 percent by
interagency receipts from other agencies. In regard to [DADA
beds] for women (which total 81 beds), he said that 40 percent
are funded by the SAMHSA Federal Block Grant, 31 percent by
interagency receipts from other agencies, and 29 percent by the
[GF]. [Tape changed with approximately 2.5 minutes blank at the
end of Side A.]
TAPE 01-35, SIDE B
Number 2393
[There are approximately 2.5 minutes blank at the beginning of
Side B.]
MR. TURNER said that [the DADA beds] for youth (which total 32
beds) are 100 percent funded by the GF.
CHAIR ROKEBERG asked Mr. Turner to provide this information to
the committee in a short memo, and pointed out that at some
future juncture the committee would be taking up the issue of
waiting lists, either via HB 4 or some other legislation, and
thus a good understanding of this information was crucial.
MR. TURNER continued by saying that there are more people
requesting services than the system can serve. He reported that
statewide there were 223 people waiting to receive inpatient
treatment (although that number changes from month to month),
and 81 people were waiting for outpatient treatment.
CHAIR ROKEBERG interjected, requesting clarification regarding
capacity because he had heard others mention that only 10 beds
in Fairbanks and 14 beds in Anchorage were available.
REPRESENTATIVE BERKOWITZ noted that 10 and 14 reflected the
number of beds designated for "detox" in Fairbanks and
Anchorage. He also noted that the numbers given by Mr. Turner
reflecting available DADA beds included beds designated as detox
beds, treatment beds, and dual-diagnosis beds.
MR. TURNER followed up by confirming that there are only 14
detox beds available at Clitheroe Center ("Clitheroe"), which is
located in Anchorage, and that a lot of clients who are
designated as needing those detox beds are flown in from other
parts of the state. He also confirmed that while there are
other beds available at privately funded facilities (such as
"Charter North"), and, while the Ernie Turner Center did have
privately funded beds, the chart he provided only reflected
facilities that received public funds. He added that he himself
had built the Ernie Turner Center, and that he had built it
overcapacity with the hope that he could get additional public
funds in order to fill it up. However, since he has not gotten
the additional funding, he has opted, instead, to have those
extra beds made available for private-pay clientele; while this
has helped, the facility is still not filled to capacity.
CHAIR ROKEBERG asked for suggestions on how to cut the waiting
list. He said he had concern that if the courts, under HB 4,
begin meting out additional treatment time as conditions of
punishment and/or release, the treatment beds would not be
available for, in some cases, up to 60 days.
Number 2116
MR. TURNER suggested deferring that question to Loren Jones, who
would speak later. He then continued with his slide
presentation by saying, on the topic of specialized treatment,
that a 1998 Gallup poll of Alaskan households revealed that two
out of every five Alaskans who wanted alcohol treatment but had
not received it in the past year were women of childbearing age.
He added that those women were at risk of giving birth to a
child with FAS or FAE.
MR. TURNER also said that another group in need of specialized
treatment are youths. He referred to a chart reflecting minor
consuming/possessing violations, and noted that these offenses
were increasing. He said that while there is some belief that
adolescents may not be addicted to alcohol, his experience in
treating adolescents has shown him that this is a fallacy; he
has known some adolescents who, at 14 and 15 years of age, were
just as addicted as many chronic alcoholics. He added that in
hindsight, he has no doubt that he was an alcoholic at age 16.
He remarked that there is a three-to six-month waiting list for
youth residential treatment, and that publicly funded youth
residential treatment programs are only available in Anchorage,
Fairbanks, and Sitka, while outpatient treatment for youths is
only available in Wasilla, Anchorage, Juneau, and Fairbanks.
MR. TURNER, returning to the point of the Alcohol Safety Action
Program (ASAP), said that although it is not a treatment
program, the ASAP refers offenders for assessment and monitors
offenders referred by the courts to ensure that they complete
required treatment. He added that ASAP is a very successful
program for monitoring treatment. He reported that a University
of Alaska Anchorage (UAA) survey found that monitoring the
treatment of Alaskans convicted of drunken driving and other
drug- and alcohol-related crimes significantly reduced their
tendency to repeat their crimes. He advised that the ASAP needs
more resources in order to do the job effectively; from 1988 to
1995 the ASAP experienced an 87 percent increase in its caseload
and a "zero" increase in funding.
MR. TURNER added that in the past three fiscal years, while
funding for treatment (not including prevention) has dropped,
the need for treatment has increased. He noted that there was a
$500,000 fund source change from the "GF to FAS," and that a
$529,000 Center for Substance Abuse Treatment (CSAT) grant,
which was for rural treatment in the Hooper Bay area, has
expired, although a portion of that grant was carried forward
into 2001 along with $125,000 from another expired grant. He
pointed out that as federal grants expire, which happens after
three to five years, the amount of treatment available in the
state is significantly reduced.
Number 1902
LOREN JONES, CMH/API Replacement Project Director, Division of
Mental Health & Developmental Disabilities, Department of Health
& Social Services, noted that he was formerly the director of
the DADA, and said that the preliminary numbers he arrived at
regarding the waiting list were approximately $4 million, some
of which is capital money and some operating money.
CHAIR ROKEBERG asked Mr. Jones if he meant that beds were
available if there was funding for them.
MR. JONES responded that in looking at the specific facilities
and programs that had waiting lists, specifically waiting lists
for women and children or for family treatment, it was found
that the current facilities are at physical capacity and thus
those programs cannot be expanded. Therefore, [the state] would
need to find other facilities in order to expand specific
programs, and that takes time. It takes both time and money to
remodel a facility in order to pass local zoning requirements,
and building and fire codes, he added. He noted that the only
facility that had room to expand was the Ernie Turner Center,
but because it is set up as a coed program, it would not do as a
women-and-children-only program. Again, he added, all other
women-and-children programs, such as at the Alaska Woman's
Resource Center, the Salvation Army and the Fairbanks Native
Association, are at capacity. Hence, to add additional
treatment beds to those residential facilities that are already
at capacity would require those facilities to procure other
physical locations.
CHAIR ROKEBERG remarked that that information was very
distressing. He then said the assumption is that because it is
privatized, the private sector - either through for-profit
companies or nonprofits - will step up to do that in the urban
areas. He asked if that is correct.
Number 1782
MR. JONES said that was not necessarily the case. Most of the
nonprofits that the DADA deals with can usually - through the
grant payment, operating funds, or revenues - cover rent if they
can rent a facility. But generally the cost they cannot cover
upfront is the initial remodeling cost to turn a facility that
was used for some other purpose into an appropriate treatment
center - especially if it is for women and children's treatment.
He added that every woman that enters treatment usually brings
one or two children with her; therefore, an onsite daycare
center must be developed at the facility, and the rooms for
clientele must be larger because zoning requirements stipulate
that an almost equal square-footage be given to each child
(depending on the age of the child) as is given to the mother.
Facilities suitable for this kind of conversion are hard to
find, he also added, and most nonprofits don't have the capital
available to undertake such a conversion.
CHAIR ROKEBERG said he inferred that Mr. Jones's testimony is
that it is a combination of capital requirements - grubstake
grants, so to speak - that would initially provide the
facilities, coupled with per-diem head-costs.
MR. JONES said that was correct.
MR. TURNER added that some facilities - including the facility
in Nome, which has since closed down - have reduced their
capacity to 16 beds because of Medicaid requirements; Medicaid
will only cover 16 beds due to the IMD (institution for mental
disease) exclusion.
MR. JONES elaborated by saying that under the federal Medicaid
rules, an IMD is a facility that treats adults from the ages of
21 through 64, generally for a mental illness. And further, the
Health Care Financing Administration (HCFA), which operates the
federal Medicaid program, has determined that any facility
greater than 16 beds that treats adults for mental diseases is
an IMD, and Medicaid cannot pay for the care of those persons,
even if they are Medicaid-eligible, in an IMD. As an example,
he said that Alaska Psychiatric Institution (API) is an IMD and
as such does not receive any Medicaid payment for adults treated
at that facility; Medicaid only pays for youths treated at API.
Under this ruling, residential substance abuse treatment
programs are considered to be mental institutions; consequently,
as an example, the Salvation Army is not permitted to bill
Medicaid for treatment to any person who is on Medicaid because
the Salvation Army has 54 beds. For this reason, most of the
newer programs that have come online are limiting themselves to
16 beds so that they fall under the IMD exclusion and thus
retain the ability to bill Medicaid for treatment provided to
Medicaid-eligible recipients.
Number 1588
REPRESENTATIVE COGHILL raised the question of future labor
problems brought about by mandated treatment. He asked what the
forecast was for having an adequate pool of qualified people who
could work in treatment centers.
MR. TURNER said he had the opportunity last year to visit many
treatment programs throughout the state, and he acknowledged
that retention of treatment staff is a basic problem. Some of
the programs are paying a starting salary of $10.50/hour for a
counselor, and as soon as this counselor is trained, he/she
moves on to either the social services field or the mental
health field, which pays more, and then that counselor is lost
to the alcoholism field. Treatment programs just don't have the
funds to bring salaries up in order to retain personnel.
Another problem he acknowledged was a lack of training money.
There is one contract for doing training for the state, and
there is not enough money in that contract to hire the staff who
could provide statewide training.
REPRESENTATIVE COGHILL asked if there was any way, within the
grants that provide funding for staff, to create an incentive
for staff to build careers within the field of alcoholism
treatment.
MR. TURNER mentioned that there were some nonprofits that do
have a career ladder, and have a retirement program. However,
very few of them do, he added.
CHAIR ROKEBERG, on the topic of mandating offenders to pay for
their court-ordered treatment, asked Mr. Turner what rate of
success the DADA had in collecting money for treatment.
Number 1436
MR. TURNER explained that [the DADA] did not make collections.
In response to further questions, he said that any funds paid by
an individual for his/her treatment costs are put back into the
program to help pay for the overall costs, but it was up to the
individual organizations to make their own collections. He
noted that individual programs are only required to come up with
a 10 percent match of funds provided by the DADA. He added,
however, that the funds the DADA provides, plus that match, are
not enough to pay for the treatment facility; programs generally
have to raise additional funds. For example, when he was the
director of the Alaska North Addictions Recovery Center (now
known as the Ernie Turner Center), that organization received a
$340,000 grant from the state, but the total cost to operate
that facility was $1.5 million. Consequently, through other
sources, the program had to come up with enough money to operate
the facility. Some funds (about $260,000) came from the Indian
Health Service (IHS), but the rest were collected as fees for
services. He noted that fees for services were based on a
sliding scale and the minimum a client had to come up with was
10 percent. In cases covered by insurance, the insurance
company paid anywhere from 50 percent to 100 percent, depending
on the type of coverage an individual had.
MR. JONES added that when programs submit their annual budgets
to the DADA through the grant process, they are to identify all
of their other sources of income, such as insurance payments.
When the annual audits are done through the state's "single
honor" process, it is to double-check whether programs could
have raised the revenue needed to operate their programs, and to
verify that what was stated in the grant discussions matches
what the "single audit" shows. He added that all grantees are
required under the state's single audit provisions to have an
audit each year on their use of funds so that the state can
guarantee that the funds raised by the grantees do actually go
back into the program.
MR. JONES noted some of the problems the DADA's programs have in
terms of collecting fees. If a person were to assign his/her
permanent fund dividend (PFD), the DADA is the last on the list
of many. And if a person does not apply for a PFD, then that
source is unavailable altogether. Small claims court is
sometimes utilized, although it is not a very productive way in
which to collect a fee that is owed, he observed. He added that
75 percent of all people who come to publicly funded treatment
programs have an annual income of less than $10,000. Therefore,
a program might get $5 as payment from a low-income individual
for a group session, whereas if an insurance company were
covering the cost, it would pay $25-$35 for that same group
session. He said that [programs] do try and collect some fees,
but it is oftentimes a very difficult process to get a
meaningful return in terms of actual dollars.
Number 1200
CHAIR ROKEBERG asked if the DADA made per-diem contractual
arrangements with the providers, or just grants.
MR. JONES responded that the process of funding is through a
grant process. The potential provider is asked to describe,
based on the request for funding, what services it intends to
provide and how much it anticipates that service costing, not
only for a certain number of people, but also to achieve certain
outcomes related to the client's job, and related to his/her
legal issues stemming from drug/alcohol use. In most of those
cases, it is found - by listing how much treatment providers
want from the state versus what they are going to collect from
fees, services-in-kind, donations, third-party/first-party
payees, and municipalities - that the state is paying roughly
half of the treatment costs. He explained that the DADA does
not, at this time, do a per-diem rate for the cost of the care.
He added that that was because in the past, the mechanism has
always been the grant-in-aid process. [The DADA] has looked at
doing per-diem contracts so that the full cost of a bed could be
determined in terms of, if the capacity of a bed were purchased,
how much it would cost on an annual basis. That concept has
never been fully developed, he noted; there has not been a lot
of desire generated over the years to move from a grant process
to a per-diem process.
CHAIR ROKEBERG commented that there have been complaints that
the state is being subsidized for some of the treatment programs
this year because the costs are higher than the state grants.
MR. JONES addressed that point by saying that about six years
ago, the legislature transferred from the Department of
Corrections (DOC) to the DADA approximately $630,000 to pay for
residential treatment in the communities. In the DADA's budget
there is a separate component called Corrections that has those
dollars in it. The agreement the DADA had with the DOC was to
try to purchase as many beds as the DADA could, based on the
DOC's historical information. The money available in that
component for the number of beds that the DOC really wanted in
the community is approximately $49/day. He noted that $49/day
is approximately half, or less, of the full cost of the care
provided. Thus, he acknowledged, the DADA's grant is picking up
the difference. If additional funds could be made available
through appropriation, he added, then there would be more
capacity in programs because they would not have to use some of
the grant funds to cover costs. He noted that this is a
situation that has developed over time but which has never been
addressed in a budgetary fashion.
CHAIR ROKEBERG asked Mr. Jones to provide the committee with a
memo outlining that issue in that it might have influence on the
House Finance Committee. He acknowledged that when providers
aren't being paid for their basic costs, it acts as a
disincentive to provide more beds.
REPRESENTATIVE COGHILL thanked Mr. Turner for sharing his
personal experiences. He asked, with regard to the ASAP,
whether all treatment programs are working with the same
philosophy, and also, how a distinction is made at the time of
referral in determining which type of treatment would be more
appropriate.
Number 0873
RON TAYLOR, Coordinator, Alcohol Safety Action Program (ASAP),
Division of Alcoholism and Drug Abuse (DADA), Department of
Health & Social Services (DHSS), explained that the Anchorage
office of ASAP is not only responsible for the monitoring and
oversight of defendants who are referred from the court on
misdemeanor probation, but is also the central office for the
entire Alaska ASAP system; his job entails arranging for
technical assistance and training, and ensuring that all of the
ASAP offices operate on a standardized basis. He noted that
this is a problem when there is approximately an 87 percent
increase in caseload but no increase in funding. He added that
the caseload is continuing to increase, and that the ASAP has
recently closed six of its programs. Back in the mid-'80s the
ASAP had 22 programs, and now it has 11 programs - a decrease by
half. He noted that the ASAP is anticipating reinstating six
programs in the rural areas that are really "hurting" for some
type of monitoring service.
MR. TAYLOR said the six programs that have recently been cut
back are Cordova, Valdez, Sitka, Seward, Nome, and Barrow. On
another point, he said that there is no misdemeanor probation
whatsoever in Alaska; ASAP is the closest thing to misdemeanor
probation, but the ASAP does not do supervision, only the
monitoring of alcohol/drug-related requirements. In the past,
the ASAP monitored community work service (CWS), weapons
awareness, parenting classes, and domestic violence
intervention, but it became so burdensome to an already taxed
staff that the ASAP has had to decline those duties. The ASAP
has only four probation officers in the Anchorage office who
each have a caseload of anywhere from 800-1,100 cases a year.
The ASAP also has grantee offices that are staffed with anywhere
from one person to (in the biggest grantee office, in Fairbanks)
three persons, and there is tremendous cost in terms of cases.
He noted that the ASAP's case management fee is only $100,
which, when compared with other states, is probably the very
lowest. Other states are charging anywhere from $300-$500 for
case management fees, and are also making it a requirement that
the fee be collected before signoff services are provided for
Division of Motor Vehicles (DMV) purposes, or for condition-of-
probation purposes.
MR. TAYLOR said that if he were to make any "pitch" to the
committee, it would be to point out that the committee has an
opportunity [with HB 4] to make a real difference. There is an
opportunity in the ASAP to begin helping treatment programs and
prevention programs to become more efficient and more effective
by collecting data from ASAP clients who come through programs.
This is a "captured population," and if the ASAP is able to do
its job and do it effectively, it can pay some very handsome
results for the state in the next couple of years.
Number 0538
MR. TAYLOR, when queried about raising the case management fee,
said that it was possible that the money might filter back down
to the ASAP if the ASAP also made payment of those fees a
requirement before signoff services were provided for (DMV)
purposes or for condition-of-probation purposes. He added that
the current case management fee generates approximately $140,000
a year in revenue, and if the fee were doubled, that might pay
for two more probation officers; however, he cautioned that the
increase would only affect the Anchorage office, and the ASAP
does have grantee offices to consider when seeking sources of
additional funds. On the point of whether the market would bear
an increase in case management fees, he said it would depend on
how that increase was pursued. One method would be to pursue
the increase as a collections matter. Another is to make
payment mandatory before signoff services are provided for (DMV)
purposes or for condition-of-probation purposes. And yet a
third method would be to have the increased case management fee
in lieu of, or to help offset, the court fine. He added that
for those individuals who cannot afford the case management fee,
the DHSS could, via regulation, exercise a waiver.
MR. TAYLOR, in response to Representative Berkowitz, confirmed
that the Anchorage ASAP office had never monitored community
work service (CWS), though in the outlying areas the other ASAP
offices were monitoring CWS but have since stopped. He also
noted that ASAP did not monitor any anger management or domestic
violence (DV) programs; the only similarity the ASAP has to a DV
program is a grant of $50,000 that the ASAP has through AWAIC
(Abused Women's Aid in Crisis) to monitor DV. He reiterated for
Representative Berkowitz that the ASAP had four probation
officers in Anchorage with a caseload ranging from 800-1,100 per
probation officer. He also confirmed that, unfortunately, there
were no national standards for an ideal caseload.
Number 0353
CHAIR ROKEBERG referred to a handout provided by Mr. Turner,
which said that 75 percent of first-time DWI offenders assigned
to the ASAP office and 52 percent of the non-DWI offenders did
not receive a new criminal/traffic offense within three years of
the original ASAP referral. Chair Rokeberg asked Mr. Taylor
what non-DWI offenders were, and how they came to the ASAP.
MR. TAYLOR explained that those non-DWI offenders were referred
by the district court through cases such as domestic violence
assaults, shoplifting, larceny, and any type of alcohol/drug-
related cases.
REPRESENTATIVE BERKOWITZ suggested that it would be appropriate
for the committee to observe the district court in order to see
how it functions.
CHAIR ROKEBERG said that was not a bad idea and that he had, in
fact, visited Judge Froehlich's court a couple of weeks ago. He
then asked Mr. Taylor if the ASAP dealt with any youthful
offenders.
MR. TAYLOR responded that the only program serving youthful
offenders currently is the Fairbanks ASAP office, which is
helping out with a pilot program dealing with minor-consuming
offenders. However, it is not being funded via ASAP/DADA; it is
something the grantee is doing on its own. He added that it is
proving to be a very successful program, and was started in
September of 1999.
MR. TURNER added that he would get the committee the most recent
figures on the results of this pilot program.
CHAIR ROKEBERG called an at-ease from 2:36 p.m. to 2:39 p.m.
[Tape changed with approximately 1.5 minutes blank at the end of
Side B.]
TAPE 01-36, SIDE A
Number 0001
SARAH WILLIAMS, Coordinator, Substance Abuse Program, Inmate
Programs, Division of Institutions, Department of Corrections
(DOC), said the handouts she has provided would be helpful in
outlining what services the DOC provides with regard to
substance abuse treatment. She said there is a $200,000
increment needed for the next fiscal year just to keep afloat
the services already provided across the state. This does not
involve any new programs; without these funds, the DOC will have
to cut some of the [substance abuse] programs out. She noted
that the $200,000 increment was not funded in the House budget,
nor has the DOC's [substance abuse] program received an increase
in eight to nine years. She stressed that the DOC desperately
needs those funds, without which the DOC will have to cut its
[substance abuse] programs, which she offered was not what the
committee wanted to see. She added that the DOC has a lot of
people who are DWI offenders in [substance abuse] programs. For
example, she said that at the [Pt. MacKenzie Farm Program's]
intensive outpatient program, 50 percent of the participants in
that program are felony DWI offenders.
MS. WILLIAMS pointed out that included in the handouts she
provided was one addressing frequently asked questions about
substance abuse treatment in the DOC. She added that this
program is a bit "mysterious" because it occurs behind bars;
there are not many, aside from participating inmates, who have
seen the program. She said that she wanted to convey to the
committee why [the DOC] does treatment in certain types of
facilities, and what the whole point [of treatment] is. As an
example, she noted that some might ask why the DOC provides
treatment at all at the [Sixth Avenue Correctional Center], when
the turnaround at that institution is so fast; she answered that
treatment is provided because it is an opportunity to do some
intervention work with very high-risk people such as pregnant
women who have been drinking, or IV (intravenous) drug users
before they go back out on the street. She added that
unfortunately that program has been reduced to just five hours a
week, and the program at the [Mat-Su Pre-Trial Facility], which
is also another key intervention point, has been reduced to just
three hours a week.
Number 0315
MS. WILLIAMS said [the DOC] hates to see its services dwindle,
and that there is a great need for these programs. There are
over 70 people on the waiting list at [Spring Creek Correctional
Center], which is an outpatient treatment program. She added
that [the Spring Creek Correctional Center] is probably the
DOC's most extreme site in terms of a waiting list. She
acknowledged that the committee is concerned about those people
who refuse court-ordered treatment, but she offered that in her
experience, those cases are really quite the exception; the DOC
has people in all of its facilities wanting treatment.
REPRESENTATIVE BERKOWITZ noted that at [the Spring Creek
Correctional Center], most people are there for relatively long
periods of incarceration, and he asked whether everyone who is
there with court-ordered treatment gets that treatment before
leaving state custody.
MS. WILLIAMS replied affirmatively. She also commented that
sentences being served at [the Spring Creek Correctional Center]
are much shorter than they used to be, primarily due to having
800 people in Arizona; the DOC tries to send the more long-term
people there. Thus some people in [the Spring Creek
Correctional Center] may be doing six months to two years, but
the DOC prioritizes the waiting list on a person's length of
time at the facility. So, eventually, the DOC "gets to them"
and provides treatment. But, she added, it is good to provide
treatment early because they make much better inmates if they
are not engaging in alcohol/drug-seeking behavior and can
instead focus on education programs, chaplaincy programs, and
other programs.
REPRESENTATIVE BERKOWITZ asked, "So, it's cheaper to incarcerate
them if we treat them?"
MS. WILLIAMS responded that it is a lot easier, but that is not
the main reason [the DOC] provides treatment. [The DOC]
provides treatment so that people will be less of a risk to the
public when they are released, and almost all of them are
getting out, she added.
REPRESENTATIVE JAMES asked how much access there is in prison to
drugs and alcohol.
MS. WILLIAMS replied that there is access, and of course it is
not something [the DOC] condones or is in the least bit proud
of. [The DOC] is constantly working to decrease access, but
people are extremely resourceful, especially when they have
addictions. She added that she has seen things in [the DOC] she
never would have anticipated, for example, melting down stick-
deodorant for the alcohol content. And of course there are
always the situations in which visitors bring in contraband,
which is something the DOC tries very hard to minimize,
although, unfortunately, it does happen.
Number 0507
REPRESENTATIVE COGHILL, with regard to treatment, commented that
since the [prison] population is a fluid population, one of the
things that he has seen is somebody getting a certain degree of
a treatment program under his/her belt, and then getting moved
along. He asked whether that is something [the DOC] takes into
consideration, and how significant is [that problem].
MS. WILLIAMS responded that that situation does occur,
especially when [the DOC] is trying to manage a population that
is fluid, such as moving people to Arizona. What [the DOC] does
is transfer the treatment progress to the next stop, and this
involves a release of information and a movement of treatment
materials, client files, and so forth. She added that this is
disruptive to a program; it is not ideal, but the DOC does some
things to minimize the impact. Substance abuse education
programs have a minimum of ten required topics, and [the DOC]
keeps track of which topic somebody has had; that way, a person
who gets moved to another facility can pick right up in the
education cycle wherever he/she goes. She explained that [the
DOC] does not want to be pulling people in and out of programs,
but in managing this overcrowded population, it does happen.
Hence, [the DOC] provides treatment and education against all
odds.
REPRESENTATIVE COGHILL remarked that he has heard people
complain that just when they get started in a program, they get
moved and have to start all over again, which impedes their
progress and impedes their ability for probation discussions.
MS. WILLIAMS explained that [the DOC] keeps track of why someone
is terminated from a program, whether it is a transfer to
another facility or something beyond his/her control, so that a
break in treatment is not treated in a punitive manner. She
added that the two programs that [the DOC] never disturbs are
the residential substance abuse treatment programs and the 6-to-
12-month intensive programs at [Hiland Mountain Correctional
Center] and [Wildwood Correctional Center]. These are [the
DOC's] federally funded programs, and [the DOC] receives a 26
percent state match - thanks to the Mental Health Trust
Authority.
MS. WILLIAMS went on to say that the 6-to-12-month intensive
program for women at [Hiland Mountain Correctional Center] has
been up and running for two and a half years. At the two-year
juncture, [the DOC] did an outcome study (provided as a handout)
that shows a significant difference between the women who had
treatment and the comparison group of women who needed the
program but did not get it. To obtain this information, [the
DOC] combed through the Offender Based State Corrections
Information System (OBSCIS) records, which show prisoner
movement and re-offenses. [The DOC] discovered that among the
graduates of the Residential Substance Abuse Treatment (RSAT)
program, which is a therapeutic community for women, there was
only one new felony offense and one new misdemeanor offense
committed within six months of being back in the community,
compared with five new felony offenses and eleven new
misdemeanor offenses committed by the comparison group. When
[the DOC] is asked whether treatment works, [the DOC] interprets
the question as whether offenders come back through the system,
and [the DOC] saw significant differences between the two groups
of women - treated and untreated - who were part of the outcome
study.
Number 0790
MS. WILLIAMS noted that [the DOC] has just started a similar
men's program at the [Wildwood Correctional Center], and will
also do a two-year study in which [the DOC] anticipates dramatic
results as well. She added that the tricky part for [the DOC]
is arranging for continuing care in the community because the
federal dollars cannot be used outside the institution. That is
where [the DOC] will have to get very creative with its linkages
in the communities. She remarked that [the DOC] is currently
establishing a halfway house at Akeela House, Inc., just for
these RSAT graduates. This is so that when the RSAT graduates
arrive, they are not mixed in with confined misdemeanants; the
graduates will be with people who are serious about treatment,
and will be recognized for their accomplishments.
MS. WILLIAMS pointed out that included in the handouts are pages
describing both the women's RSAT program and the men's RSAT
program. She added that these two programs are among [the
DOC's] major accomplishments within recent months, and if ever
there is an opportunity to expand on this level of care, [the
DOC] would very much like to do it. For felony DWI cases, she
explained, probably 50 percent need intensive outpatient
treatment, and another 50 percent need a residential level of
care. Currently the men's RSAT program holds 42 people, 6 of
whom are felony DWI cases already, and the women's RSAT is a 48-
bed program. She added that there are DWI cases across the
state - some offenders are in programs and some are not. In
order for [the DOC] to prepare for an influx of DWI cases it
needs to "gear up" because DWI offenders do need treatment.
REPRESENTATIVE COGHILL commented that with many of the halfway
houses, some of the other issues dealing with incarceration
relate to trying to get offenders back into working society.
And with regard to treatment, he asked how [the DOC] was doing
with family unification and/or family treatment, which goes
beyond just the person in treatment.
Number 0966
MS. WILLIAMS responded that at the [Hiland Mountain Correctional
Center] women's community, there is a social worker - funded
through federal dollars and a state match - who just works on
permanency planning and custody issues for the women in the
program with children. She added that at least 70 percent or
more of these women have at least one child under the age of 19,
and in [the DOC's] program they are being prepared to make plans
for the custody of their children, or to plan on regaining
custody. The aforementioned social worker connects with the
Division of Family & Youth Services (DFYS) and the community
because oftentimes [society] says getting to be a parent again
is the reward for going through treatment, yet realistically,
without help from [the DOC], the women are not prepared. She
also explained that [the DOC] has a transition counselor funded
just by state dollars to work with the women; the counselor
actually goes into the community and visits the women while they
are in the halfway houses, and especially pending aftercare. If
there is a break between being in the treatment program in the
facility and then graduating out onto the street, and if those
women are on a waiting list for services, it is such a critical
time, and the transition counselor "tides them over."
MS. WILLIAMS said the relationship between the community and the
DOC is a symbiotic one; all of the folks in [the DOC's]
facilities need at least aftercare upon release. [The DOC] says
they may be "program complete" but they are not "treatment
complete"; they need that aftercare piece desperately. She
noted that the programs are only as good as the aftercare in the
community. A lot of the folks coming out of the therapeutic
communities are going to need aftercare support services, so
[the DOC] works hand-in-hand with the DADA; all of [the DOC's]
programs are contract agencies that are approved by the DADA.
REPRESENTATIVE JAMES commented that from what she has read and
heard from the folks who have had these sorts of problems,
sometimes the best treatment is to not go back into the same
community and to not have the same group of friends. She asked
how [the DOC] evaluates whether a person is strong enough to go
back to the same influences that he/she had before going to
treatment.
Number 1111
MS. WILLIAMS said that was a good question because for so many
people, when they enter treatment, that is their goal - to go
back home. Sometimes during the course of treatment, especially
an intensive program, people realize they can't go back. And
that is a very sad realization that they can't go back to their
village or their community. If [the DOC] can set up
transitional services, it does, and [the DOC] is making those
connections; at the men's RSAT program at [Wildwood Correctional
Center] there is a transition counselor built into that program
to contact the community and set up structure. If, however, the
person goes back and family and friends are drinking, it is such
a sad setup for failure; sometimes when a person has had all
this intensive treatment, Ms. Williams said she believes that
when that person relapses, it hits even harder because of the
guilt and the hopes that he/she had to stay clean. She
acknowledged that [the DOC] has to be constantly aware of those
transitional situations. She commented that about 80 percent of
people coming through [the DOC's] programs do go back into
Anchorage, where there are resources; it is the rural clients
that [the DOC] needs to take extra care with.
CHAIR ROKEBERG directed attention to the treatment element's
fiscal note, which is over $1 million. He asked whether,
currently, participation in the substance abuse programs is
voluntary.
MS. WILLIAMS replied that participation in [the DOC's] programs
is voluntary; however, there are repercussions for offenders if
they don't participate in treatment. "You may not receive the
furlough that you had hoped for if you don't earn it, [or] you
may have probation revoked while you're actually in the
institution; so there are some built-in incentives," she
explained. She noted that some people go to treatment because
once they get behind bars, they get bored. [The DOC] does not
care if people come to the program for the wrong reason. She
added that a lot of inmates get into the [Wildwood Correctional
Center's] program simply because they don't want to go to
Arizona, and then once they get in the program, they consider it
a privilege to be there. So, even if inmates enter the programs
for all the wrong reasons, [the DOC] takes advantage of it.
CHAIR ROKEBERG asked what calculations were used to arrive at
the $1 million fiscal note.
Number 1299
CANDACE BROWER, Program Coordinator/Legislative Liaison, Office
of the Commissioner, Department of Corrections (DOC), explained
that according to her understanding, the treatment element in HB
4 applies to felony offenders. And while it is difficult to
anticipate in a generic fashion what an individual offender
might need in terms of treatment, she offered that the
prevailing belief is that a third-time DWI offender would, at a
minimum, require outpatient treatment in order to achieve a full
recovery, and his/her problem might even be severe enough to
require inpatient treatment.
MS. WILLIAMS added that at the [Wildwood Correctional Center],
the 6-to-12-month inpatient program costs approximately
$6,380/person, which she noted is very reasonable, and she
confirmed that that is in addition to the standard per-diem
hard-bed costs.
MS. BROWER also added that that $6,380/person was only for the
cost of [the DOC's] contract for 6 to 12 months. With regard to
calculating the fiscal note, she said her numbers for the first
year were 240 felony offenders, with an estimated 50 percent
needing intensive outpatient treatment at a cost of
$2,500/person and 50 percent needing residential treatment at a
cost of $6,380/person. She added that although her calculations
were simplistic, she did add in those people who were already in
ongoing treatment on a voluntary basis (minus those in the
[Wildwood Correctional Center's] program). She confirmed that
all of the RSAT-program beds at [the Wildwood Correctional
Center] were already full.
MS. WILLIAMS added that the RSAT-program at [the Wildwood
Correctional Center] did not involve adding any extra hard beds
to the DOC, those beds were available anyway; there were no
state employees hired for the program; and it is all contract
treatment. Thus, the dollars go directly towards the treatment
services; there is no extra overhead.
CHAIR ROKEBERG remarked "just a million bucks."
Number 1466
MS. BROWER countered by referring to Mr. Turner's testimony, and
asked the committee to calculate the potential savings incurred
by investing in treatment.
MS. WILLIAMS added that the treatment programs the felony-DWI
offenders will need, in general, are nothing new to [the DOC];
those offenders are already in [the DOC's] programs; they have
high-risk behaviors; and in so many aspects, the addiction
issues are the same as for those offenders who are there for
other reasons. She said she had asked the coordinator of the
[Wildwood Correctional Center's] RSAT program how many
participants were there for felony DWI, and the answer was six,
but the coordinator also stipulated that those offenders all
drive drunk - they all lead irresponsible lifestyles that do not
take into account victims' issues. Ms. Williams offered that
the whole host of topics that apply to treating DWI cases are
already being addressed by [the DOC's] substance abuse programs.
REPRESENTATIVE JAMES asked if the fiscal note reflected only the
change to a .08 BAC, or also reflected calculations for
mandatory treatment. She also asked if it addressed any of the
aforementioned shortages to the DOC's budget.
CHAIR ROKEBERG commented that the change to a .08 [BAC] should
not affect [the DOC's] fiscal note.
MS. BROWER added that it did not, except that [the DOC] was
anticipating a slight increase in felony offenders who have a
.08 [BAC]. She noted, however, that [the DOC] is also looking
at the increased "look-back" provision of HB 4, which would
entail having more offenders in [the DOC]. She added that the
provision mandating treatment also influences [the DOC's] fiscal
note, as do a number of other factors that [the DOC] anticipates
might bring in more offenders who will need to be accommodated.
And the number of offenders that [the DOC] will need to
accommodate will also be increasing considerably each year, she
warned. Ms. Brower said [the DOC] would like to provide people
with the treatment they truly need, but the way things are right
now, [the DOC] does not have the capacity, especially if,
through HB 4, treatment is going to be mandated.
Number 1630
MS. WILLIAMS added that the aforementioned $200,000 increment
would just keep [the DOC's] substance abuse treatment programs
afloat. Currently, all seven of the community treatment
providers that [the DOC] uses subsidize the DOC; it costs the
treatment providers to provide their services to [the DOC]. She
added that [the DOC] could not ask the community treatment
providers to do that anymore. She noted that the specific
details of both this increment and the Inmate Substance Abuse
Treatment (ISAT) programs were included in the handouts. She
said that [the DOC] has lost providers in recent years. In
answer to the question of why any organization still provides
treatment services if it costs providers to do so, she offered
that it is because people in this profession are very
passionate, they feel that the prison is actually a part of
their community, and they would like to provide the services if
they can. But, for example, Seward Life Action Council finally
had to quit; its board said it could not keep subsidizing [the
DOC] $7,000 a year in order to provide services. She noted that
this sort of thing has happened in several places across the
state.
MS. WILLIAMS explained that the $200,000 increment would simply
go towards adequately paying the existing providers so that [the
DOC] does not lose any more providers. Without that increment,
programs will have to be cut - which does not have anything to
do with the DWI package - and [the DOC] will then be going in
the opposite direction from what she said she believes the
legislature wants.
CHAIR ROKEBERG asked how many third-time, or more, DWI offenders
are not getting treatment, either on a voluntary or mandatory
basis.
MS. WILLIAMS said she did not have specific numbers, but she
added that she imagined that many are sneaking through because,
for example, at [the Pt. MacKenzie Farm Program] the people in
treatment have an average of seven DWIs; therefore, there are
probably a number of third- and fourth-time DWI offenders that
[the DOC] does not see.
Number 1808
CHAIR ROKEBERG expressed the concern that "this increment" is
going to be vulnerable as HB 4 progresses through the
legislative process. He asked if it would be possible to put
some sideboards or parameters [on the treatment requirements in
HB 4], which would still make sense from a treatment aspect, in
order to lower the fiscal note - perhaps either by making
treatment semi-voluntary or finding ways to more selectively
triage offenders who qualify for treatment.
MS. WILLIAMS responded that [the DOC] has an assessment
specialist position that (if all goes well) will start July 1,
and that this person can "red-flag" DWI offenders so that they
can be targeted for treatment; [the DOC] can make that a
priority.
CHAIR ROKEBERG noted that [the DOC's] current program is for all
types of offenders, while the current fiscal note [for CSHB
4(TRA)] only speaks to the DWI-offender portion of the treatment
programs - which, he said, was not necessarily a bad thing,
because by helping throw the net out there for these people, HB
4 affects domestic violence [problems], and it affects almost
every other aspect that affects our society. And if the
treatment elements are in place because of HB 4, it may not
solve all the problems, but it covers a lot of ground and makes
a major step forward. He requested that [the DOC
representatives] assist him in finding ways to lower the fiscal
note while maintaining the spirit of the legislation.
Number 2126
DENITA SOLITAIRE, Substance Abuse Counselor, Akeela House, Inc.,
noted that she has just accepted a position working at the Ernie
Turner Center. She relayed that she was incarcerated for
shoplifting, and that she was part of the RSAT program at
[Hiland Mountain Correctional Center]. At that time, she said,
she could not go back to her family environment, nor did she
have access to a halfway-house situation during that critical
time. She added that later she graduated from the program at
Akeela House and was able to move into the transitional housing.
She reported that she has since been "clean" for five years due
to that support. She mentioned that she has four kids who were
in state custody for four years. She remarked that [providing
treatment] is a worthwhile cause; whenever she hears of budget
cuts, domestic violence problems, and problems in the schools,
she considers substance abuse treatment to be the most important
part of the solution. Yes, it may cost money right now, she
argued, but in the long run, substance abuse treatment will curb
crime, substance abuse, and deterioration of the family system.
She urged the committee to continue funding treatment because it
does work.
Number 2170
SHEILA SANFORD, Meeting the Challenge, said that she, too, has
been a part of the [Hiland Mountain Correctional Center] RSAT
program, and was a successful graduate. She said that
afterwards, she participated in the Clitheroe Center's aftercare
program for six months. She recounted that previous to her
participation in the [Hiland Mountain Correctional Center] RSAT
program, she was a patient at the Reflections program at
[Clitheroe Center] for 42 days, but relapsed because she had
not, at that time, dealt with issues surrounding a sexual
assault that occurred against her. She said that after her
relapse, she was arrested for a felony offense, and was
subsequently placed in the RSAT program at [Hiland Mountain
Correctional Center].
MS. SANFORD reported that the RSAT program taught her very
effective life-building skills, not only with relationships, but
also with finances, and also how to change her thinking patterns
so that she could change her life for the better. Without that
program, she said, she did not think she would be where she is
today; because of the RSAT program, and because of the people
who took the time to care about her, and the people who put the
proper programs (such as STAR - Standing Together Against Rape)
in place, she is no longer incarcerated, out on the streets, or
facing death due to her addictions. She encouraged the
committee to provide the funding for treatment because it does
work. "If it worked for me, then it can work for anybody," she
stated.
Number 2314
ODIS ADAMS said that he has been in prison for 23 of the last 25
years; he has had 7 DWIs and 47 convictions. He remarked that
he has been through the system, and he knows what works and what
doesn't work. He noted that while people in jail can get
treatment, those on the street cannot; people on the street who
want treatment have to go to jail to get treatment. He said he
went to [the Clitheroe Center] and did the five-day detox, and
while there, he asked if he could "go upstairs" and was told
that there was not a bed available for him, that he would have
to "call back every Tuesday." He noted that for the addict on
the street, it was hard to get treatment because he/she
generally doesn't have any money, and if he/she does get a job,
he/she probably also owes court fines, the CSED (Child Support
Enforcement Division) for child support, or state restitution.
MR. ADAMS offered that if there were a treatment center
available where addicts could go to get treatment without having
to go to jail or API, it would be very beneficial and save the
state money in the long run. He suggested that the crime rate
would be reduced considerably if addicts who are out of jail
were given as much help as is given to addicts who are in jail.
He said that in addition, there is a need for treatment criteria
that offer complete help; treatment should address the needs of
the addict in other areas of his/her life so that the transition
from addiction to recovery could be successfully completed. He
suggested this treatment should consist of at least 12 months of
treatment followed by 12 months of aftercare, and include
transitional housing; assistance with food stamps; bus passes;
some medical coverage; financial advice; assistance with setting
up a payment plan for unpaid bills; and receiving the same help
that welfare clients receive at job service centers, such as
counseling, testing, resume writing, on-the-job training,
computer classes, and job placement. All of this additional
assistance would provide a tremendous boost to the addict as
he/she strives for recovery.
MR. ADAMS said it has taken him a long time to get where he is
today, and he added that he received help from a lot of
different entities such as the DHSS, the Department of Revenue
(DOR), "Housing," and the Department of Labor & Workforce
Development (DLWD). In closing, he asked the committee to fund
treatment programs.
REPRESENTATIVE JAMES said she appreciated hearing Mr. Adams's
perspective. She asked whether there are any treatment
facilities that allow a person in recovery to stay after his/her
treatment is finished in order to facilitate that person's
efforts to stay sober as he/she reenters the workforce.
MR. ADAMS said none that he was aware of, although he
acknowledged that that sort of facility might have begun
operating recently. He added that if a person is in the DOC
system, there is the option of entering a halfway house after
coming out of a treatment center, but if a person is on the
street without a place to go, then that person just lives on the
street until he/she gets a chance to receive treatment. He
noted that there are a lot of addicts living on the street.
TAPE 01-36, SIDE B
Number 2491
MR. ADAMS suggested that the price of sending an addict to jail
for a year is three times what it would cost to send him/her to
treatment for a year. He reiterated that it is hard for an
addict [on the street] to get treatment without money, and he
noted that most addicts don't have money. Mr. Adams shared a
picture of his daughter with the committee, and said that his
daughter is very proud of him; she was ten years old when he
went to jail, and she is his reason for being here. He added
that he is now doing a lot of good things: he is working for
the Alaska Mental Health Trust Authority, he is participating in
his daughter's education, he is a student of Tae Kwon Do, and he
has taken a vacation with his daughter. He has never been able
to do these types of things before because he has been in jail
all his life, he explained. He has been out of jail for two
years, two months, and he said he is really enjoying his
sobriety and does not want to lose the life he has built for
himself since becoming sober. When he was on the street and
using [drugs], he added, he did not have anything to lose; he
couldn't get a job, and he owed $140,000 in child support
(currently only $11,000 with help from the DOR). Now, when he
works, he can pay his bills and still take care of his family.
Today he feels like a part of society; he has something to lose
and therefore he is not as reckless as he once was. He
concluded by saying he would like to see more treatment centers
so that others could also get a chance to turn their lives
around.
Number 2417
RUDOLF NEWMAN, Meeting the Challenge, said that during the years
he was drinking, he did not see his kids; he did not see them
grow, and he did not see them raised. That part of his life is
blank because of his alcohol abuse. Treatment was available to
him, but he did not participate fully until he made up his mind
to do so with the help of the court system and the DOC; "they"
scared him into participating fully. He recounts that he went
to jail May 30th for his third DWI conviction, and then
participated in Judge Wanamaker's wellness court, where he was
given the option of going to treatment or spending a year and a
half in jail. He chose treatment, and during treatment he was
given the opportunity to take Naltrexone for 120 days. He said
he took it every day, and that it took the craving [for alcohol]
away. He added that he has since been off of Naltrexone for
three months and has not experienced any side effects. He keeps
a supply of Naltrexone with him just in case the craving for
alcohol returns. He said he has recently obtained a job on the
Slope, but before starting it, he wanted to come before the
committee to speak in favor of treatment.
Number 2195
LEONA HAWKENSON (ph) CROW, Meeting the Challenge, said that she
works at the Kodiak Area Native Association. She also said that
she came to share her story and speak in support of treatment
for DWI offenders. She recounted that for her first DWI, in
addition to spending 30 days in jail, she was ordered to go to
the ASAP, but, due to a lack of understanding the consequences,
she failed to do so. Shortly thereafter, she received another
DWI, which, she said, would never have happened had she followed
through with her initial court-ordered treatment. She has since
received the treatment needed to turn her life around via a
women's treatment center (Dena A Coy, [Future Generations, run
by Southcentral Foundation]), which specializes in helping
pregnant women with substance abuse problems. She reported that
after treatment, she felt a lot better about who she is and
where she comes from, and that today she is living a healthy,
clean, and sober life. She then thanked the committee for
hearing her.
Number 2088
KATHERINE FRIDAY said she was from Craig, Alaska, on Prince of
Wales Island (POW). She said that there is definitely a problem
in the state of Alaska [with substance abuse]; she said she
would almost consider it a genetic epidemic that really needs to
be addressed. She also said she has noticed that there is a
divide between rural and urban communities with regard to
treatment availability. Rural communities don't have much in
the way of resources, she explained, and there are not a lot of
rehabilitation opportunities. She noted that in her area there
is Communities Organized for Health Options (COHO), but all it
can provide is information on rehabilitation facilities outside
the area; in addition, there is no funding for rehabilitation
available. Also, in her community, in order to get to a
facility that offers rehabilitation, a person has to first get
on a ferry and then a plane, and must buy his/her own tickets,
which can cost as much a $1,000.
MS. FRIDAY said that there should be more focus on providing
rehabilitation resources in the rural communities. For POW,
Ketchikan, and Metlakatla the only "rehab" facility that is
available is KAR House, which has only 15-20 beds for a
population of perhaps 30,000-35,000 people. She said she
wonders where people go once those 15-20 beds are filled. She
noted that she was lucky enough to be able to afford to go to
Seattle for rehabilitation, but a lot of people don't have the
finances it takes to get someplace where they can get the
treatment they need - it is simply out of reach. She said she
has looked at the problem, and she suggested that maybe what is
needed is an income-based rehabilitation program for the rural
communities so that it can become easier for people in those
communities to get help.
MS. FRIDAY, to illustrate, said that her mother (who is at a
critical stage) has had to go to COHO to get information on
where to go for rehabilitation; next, she will have to pick up
Medicaid papers from a different organization seven miles away.
She has no money; she has no insurance; she has no home; she has
nothing; she does not have a way to get the Medicaid paperwork;
and even if she did, by the time she gets the paperwork filled
out and sends it, she will be put on a waiting list (perhaps as
far down as number 12). Meanwhile, her mother is supposed to go
back into the community and simply wait to get help. That isn't
going to happen, Ms. Friday said; her mother is addicted to
alcohol, and even though she has been trying for ten years to
get into rehabilitation, she still drinks. Ms. Friday noted
that her family could not afford to send her mother to [a self-
pay rehabilitation center]. To finalize, she suggested focusing
more on the rural communities.
Number 1861
CLARA M. PETERS said she is from Nulato. She also said she is a
recovering alcoholic, and that she has been sober for 12 years.
She added that she comes from a village of about 400 people, and
that the village only has one alcohol and mental health
counselor - herself. She noted that she got into this field
because she was tired of seeing counselors come for a month,
leave, come back, and then leave again. She said she really
believes that people need to take responsibility and be
accountable for their actions. She explained that it took her a
year to understand the phrase: "In order to keep it, you have
to give it away." She reported that she was once so heavily
into drinking that nothing around her mattered, not even her
children. In retrospect, she does not know how she paid her
bills during that time, she said. She commented that because
she grew up in an environment where there was drinking in the
home, she learned that lifestyle, but no one explained to her
the consequences of that lifestyle such as addiction and bearing
children with FAS/FAE.
MS. PETERS says she advises the children in her village to not
start drinking because when children start drinking at a very
young age it accelerates the addiction process. She
acknowledged that it is hard for people to understand what it is
like to be caught up in an addiction unless they have been
through it themselves, but that is something she would not
recommend people do simply to gain an understanding of the
problems. She said she has watched people die due to alcohol
abuse because nothing matters to them but drinking. She said
she cannot say enough about the effectiveness of treatment -
treatment works - and she said it is a better alternative than
simply sitting in jail without treatment because when a person
is released from jail, he/she is back in society but nothing has
been done to change the drinking problem.
MS. PETERS explained that she participated in a 30-day treatment
program. Someone turned her in (she said she does not want to
know who did it, but she is grateful that someone did) and her
children were taken away from her. Once her children were
taken, everything of importance was taken away, and at that
point, her children became more important to her than "the
bottle." She said that she did not go to treatment just to get
her children back; she went because she knew she needed help but
did not know how to ask for it. She stated that she was really
grateful for that treatment, and that she is alive today because
of that treatment; without treatment, she predicted, she would
be buried six feet underground and would have lost the
opportunity to see her first grandson. On the issue of
treatment in rural areas, she said that coming from the small
village of Nulato, she can understand a person's reluctance to
have to go to a big city for treatment, and she advocated that
it is important to offer people hope in their own communities.
Number 1601
BRIAN MASSEY noted that he was born in the territory of Alaska,
that he is a lifelong resident of the state, and that he is a
recovering alcoholic. He said he was here today to say that
treatment works, and to help put a face on treatment dollars.
He cost the state a lot of money over the years while he was
drinking, he explained. He was responsible for getting judges
out of bed many times for search warrants, protective orders,
and other related items. He cost the jail system money, he
continued, by taking up space in its facilities. He cost the
health care system money by being there with alcohol-related
injuries, illnesses, and detoxifications. He cost the companies
that he worked for money via lost productivity and sick time.
He acknowledged that for all these reasons and more, he was a
drain on this state's resources and on his community. But, he
added, fortunately for him, in his community there was state-
funded substance abuse treatment.
MR. MASSEY noted that treatment did not work for him the first
time he participated, but it did the second time. What the
state got for its treatment dollars, he offered, was the
following: He is a better father and a healthy role model for
his children and their friends. He is not passing on his
substance abuse to his kids, and he is trying to lead by
example. He volunteers when asked by sitting on boards and
commissions. He has taught junior achievement, he coaches his
daughter's softball team, and he coaches his son's T-ball team.
He goes to work every day, and he is a productive member of his
community. In contrast to when he was drinking, he said that he
has not had the occasion to get a judge out of bed, nor has he
needed any jail space since he attained sobriety. In addition,
he has not ended up in the hospital for any alcohol-related
problems, he pays his bills, and he contributes to his
community, he said.
MR. MASSEY stated that treatment for substance abuse works; it
works at the state level, and it works in local communities.
Treatment dollars help produce productive, sober people. He
encouraged the committee to include treatment provisions in any
legislation that addresses drunk driving; whether people get
their treatment in jail or their communities does not matter as
long as they get it. Substance abuse is the 800-pound gorilla
that sits in Alaska's living room, he said, that most people
don't want to talk about. "Let's address this beast and get our
citizens the help they need to become productive and healthy
once more," he concluded.
[HB 4 was held over.]
ADJOURNMENT
Number 1459
There being no further business before the committee, the House
Judiciary Standing Committee meeting was adjourned at 3:50 p.m.
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