HOUSE TASK FORCE ON ALCOHOL AND ALCOHOL ABUSE Ketchikan, Alaska September 23, 1993 1:30 p.m. MEMBERS PRESENT Representative Brian Porter, Chairman Representative Eldon Mulder Representative Joe Sitton (via Teleconference) MEMBERS ABSENT Representative Jim Nordlund Representative Richard Foster OTHER LEGISLATORS PRESENT Senator Robin Taylor Representative Bill Williams COMMITTEE CALENDAR Public testimony on alcohol abuse. WITNESS REGISTER LOREN JONES, Director Division of Alcoholism and Drug Abuse Department of Health and Social Services P.O. Box 110607 Juneau, AK 99811-0607 GLENN HACKNEY Former State Senator 1136 Sunset Drive Fairbanks, AK 99709 KATHY BLAUSER Ketchikan Youth Services 1621 Tongass #103 Ketchikan, AK 99901 ANITA HALL Alaskans for Drug Free Youth 2417 Tongass, #114 Ketchikan, AK 99901 TOM COYNE P.O. Box 5283 Ketchikan, AK 99901 GAY MEDINA P.O. Box 8 Craig, AK 99921 JIM ELKINS 312 Front St. Ketchikan, AK 99901 CURT LEDFORD Health Alliance 514 Lake St., Ste. E Sitka, AK 99835 KRISANNE RICE Health Alliance 514 Lake St., Ste. E Sitka, AK 99835 DICK HINDMAN P.O. Box 1066 Petersburg, AK 99833 SONNY ANDERSON P.O. Box 83 Craig, AK 99921 JEANNE BOOK 3050 Fifth Ave. Ketchikan, AK 99901 DAVID FISHER P.O. Box 805 Craig, AK 99921 TOM STOCK P.O. Box 1108 Wrangell, AK 99929 CECELIA BIRD P.O. Box 5404 Ketchikan, AK 99901 BARBARA CRAVER National Council on Alcoholism 4th Street Juneau, AK 99801 GREG PEASE 5597 Aiser St. Juneau, AK 99801 (As transcribed by PARALEGAL PLUS, Total Law Office Support Agency, 733 West Fourth Ave., Suite 200, Anchorage, AK 99501) LEGISLATIVE TELECONFERENCE H. TASK FORCE ON ALCOHOL & ALCOHOL ABUSE REGIONAL MEETING KETCHIKAN, ALASKA PUBLIC HEARING ON ALCOHOL ABUSE MEMBERS PRESENT REPRESENTATIVE BRIAN PORTER REPRESENTATIVE JOE SITTON REPRESENTATIVE ELDON MULDER REPRESENTATIVE TOM BRICE TAPE I - SIDE A PROCEEDINGS CHAIRMAN PORTER: We have officially banged the gavel and we'll commence the meeting. I would like to welcome you here and we appreciate being able to be in Ketchikan. This is the second meeting this week. Two days ago we were in Nome. The Alcohol Task Force appointed by the speaker of the House, Ramona Barnes. On the Task Force are myself Representative Brian Porter from Anchorage, Representative Eldon Mulder from Anchorage, Representative Jim Nordlund is as we speak in Valdez addressing the problems of the needs of Harbor View and will be joining us teleconference-wise tomorrow if we do have this meeting going until tomorrow. Representative Joe Sitton is on the Task Force and is joining us teleconference-wise from Fairbanks, and Representative Richard Foster was with us in Nome and was unable to come down here. We have, as I mentioned, been appointed by the Speaker of the House to look on a statewide basis at a statewide policy, statewide expenditures in the areas of apprehensive alcohol abuse. We don't have a fixed agenda in terms of having predetermined notions that we're here to prove. We really are trying to be objective in terms of looking at what is going on listening to what perceived needs are. We would like to pay particular attention to any programs or approaches that appear to be working in this specific area or state so that we could document it and carry it to other areas of the state. I think we do have two things that we must recognize. One that the state has -- has had for some time. Most of the experience of members of the Task Force and continues to have substantial problems in the area of alcohol abuse. The other thing that we must realize is that the resources the state has to address these problems have diminished and probably will continue to diminish over the next several years. With this in mind it would appear that we should find out what is the most expedite, what is the most efficient, what is the most productive way to address the problem and get at it. With that in mind we are holding these hearings to address the problems and try to find what information is available. We will be in Fairbanks on October 4th, return and have another meeting in Anchorage, December 1st. Then we'll compiled the data that we have acquired these four meetings and continue in Juneau during the session to try to formulate a report hopefully with some good ideas on directions to proceed. On the teleconference today we have Anchorage, Fairbanks, Juneau, Petersburg, Sitka, Wrangell and Craig and have people in some of those sites that wish to testify. I would like to begin by recognizing the Director of the Division of Alcohol and Drug Abuse of the state who is Loren Jones who is in Fairbanks and I'd like to ask him to give us a general executive summary of what's going on within the state right now, program wise, budget wise, and his knowledge of this particular region. And then we'll go through rotating through the sites to receive testimony along with people here in Ketchikan. So, Loren if you're available, please come forward and address the Task Force. MR. LOREN JONES: Thank you much, Representative Porter. Can you hear me? CHAIRMAN PORTER: Sure can. MR. JONES: Thank you. It seems like we did this just the other day in Nome, but interesting, I'm now in Fairbanks and you're in Ketchikan and we're able to continue this discussion. As I pointed out in Nome, I won't take the time to review all the issues that we reviewed there. That is part of the record. However, for those who are in Southeast and in Anchorage, just to summarize some of the issues, the Division of Alcohol and Drug Abuse is statutorily responsible for issues related to alcohol, alcohol abuse, alcoholism, intoxicated persons, drug abusers and inhalant abusers. This Task Force as entitled is somewhat charged from the legislature to look at alcohol and alcohol abuse and I will keep in mind that the division's mandate is much broader and our resources that are available are used in all of those areas. In terms of budgetary resources, as part of the packet for the committee members, you were given the history of our budget from FY83 through FY94 and while -- if you look at the total dollars it has increased. That increase has not kept up with inflation. And in fact, we are not about 2-1/2 million dollars below our level that we were at in FY92. In the last two years we have had a decrease in the resources available to us and we've had to try to make some of that up with additional categorical federal funds, but have not always been successful. One other issue that I will again reiterate is that we have three major funding sources for the state effort. That which we give out to the local programs. First of all is our federal receipts. We have the alcohol and drug abuse block grant, which is roughly 2 million dollars a year. Although that did decline in this previous year. In addition, we have state general fund dollars. State general fund dollars is the largest component in our budget. The alcohol and drug abuse grant component is only $900,000.00 of the 17-1/2 or 18 million dollars available. The rest of those funds come from the general fund, Mental Health Trust Income Account. Within our other components we do have a small community action. (indiscernible) component that is general funds, and our alcohol safety action component, which has around a million dollars is general funds. But the majority of our administrative budget and the majority of our alcohol and drug abuse grant budget does come from the Mental Health Trust. That does pose some problems for us in that the federal block grant is very specific while it's a block grant in some requirements. We are required and we may only use 5% for administrative purposes, which we do. We must spend 20% of the block grant on prevention. We just spend 20% of the block grant on services to women. That definition is basically targeted to women with children and/or pregnant women. And in addition, we must spend 35% on alcohol abuse services and 35% on drug abuse services. If you add up all those percentages, they are more than 100%. We are allowed to double count in categories. Women services can be alcohol and/or drugs. Prevention services may be alcohol and/or drugs. So, there are some limitations and some requirements that a certain amount of those funds be spent on services outside of strictly alcohol and alcohol abuse. In addition, because of the way in which the issue was brought before the Court in the Mental Health Trust Settlement, the beneficiary group of the Mental Health Trust is defined as chronic alcoholic with psychosis. That is a fairly narrow definition in legal terms that has no clinical definition. There is no definition in the psychiatric manual called the DSM3R. There is nothing in the International Code of Diseases, the ICD9 Codes, the Medicaid -- it is a legal term. As such, the Mental Health Trust Board, acting as trustees, feel that only 25 to 30% of our clients fit that definition and that should be the level of funding received from the Mental Health Trust. The legislature has appropriated for alcohol and drug abuse services almost 86 to 90% of my grant budget from trust. So, we have tried to be honest to the Trust as best we can and therefore have not funded drug only programs like methadone maintenance funds out of Mental Health Trust. We have not funded prevention out of Mental Health Trust. We have tried to avoid funding of youth services out of the Trust, but that's not always been possible, because some of the youth services, young person services, might be for those that are even considered adults. 18 to 21. So, within those perimeters we must serve the means of alcohol, other drug abuse and inhalant abusers within that framework of funding restrictions with a definition of chronic alcoholics with psychosis, the federal requirements and what amounts to a limiting and declining base of general fund dollars that allows us the flexibility between all the rules attached to the other funding sources. So, I think it's important to, as you describe at the end of your work and for your report to the legislature that in deciding what direction we should take or recommending to us or putting in statute certain requirements, you keep in mind the sort of restrictions we have on federal funding and the restrictions based on whatever the settlement for the Mental Health Trust would be. In addition, we face many growing demands for services, the population of the state is growing. There are increasing issues with inhalant abuse that is demanding of our resources that without additional funds will take away for some of our responses to alcohol and alcohol abuse. There is growing desire for us to be more active with the Department of Corrections and a desire to be more active in prevention activities in school and out of school. To target services to pregnant women. To duly diagnose those who have a mental illness and a substance abuse, alcohol or drug abuse problem. And how that manifest itself, those individuals require a lot of services relatively expensive services. There are always those pressures. And I think as you listen to the testimony in Nome and you listen to the testimony over this afternoon and tomorrow you will hear, again, from the providers in Southeast how some of those issues are putting pressure on their limited resources and on the resources of their local community to help contribute either in-kind services, actual cash, providing the ability and support to these programs of the impact of diminished revenues at the local level and how that is a double impact when you talk about services. Again, I would remind you that the Division, except for the Anchorage Alcohol Safety Action Program, does not provide any direct services. All of the funds that we receive in our grant lines are distributed to local non-profits, (indiscernible) organizations, cities, boroughs to provide those services. This administration has taken the position that they would like to privatize as much of government services this division has since it's inception in 1972 always provided funds to public non-profits to municipalities to cities. We have never provided any direct services from the state. We do not have the equivalent of an API. We do not have counselors on staff. We do not have social workers. We have privatized. We are doing it as cost-efficient as we feel we can and have tried to keep that system the best we can. If you look at the mental health system in terms of their committing no health center grants, the amount they have available for grants is twice the amount that we have available for alcohol and drug abuse grants. And so our programs have attempted to provide the best care to obtain the best possible outcomes for their clients with resources that have always been under what they felt was truly necessary. That's sort of a quick executive summary of some of the pressures that we're under and I'm sure that you will hear more from those persons who testify and those persons who have other concerns and other issues and potentially, hopefully, some quality suggestions for the Task Force on how we can best address this problem and improve on the system that I feel is very, very good given the resources available. I would like to take just a few minutes as I did in Nome listening to where the teleconferencing is and knowing that probably legislators around Anchorage -- I will talk about those services are available within Southeast Alaska from basically Yakutat South. I will start there in Ketchikan. There are two funded providers in the Ketchikan area. The City of Ketchikan is funded to provide alcohol and drug abuse treatment services, both outpatient and residential. They also do the alcohol safety action program. They have a small withdrawal management unit, a small detox unit and they are also funded by the Department of Corrections to provide services within the jail. In addition, you have Ketchikan Youth Services, which is a primary prevention youth alternative project. They are also funded to do some aftercare for youth who have gone outside the Ketchikan community for treatment and provide that support when they come back in the community. The school system also has some active projects that are funded through drug free schools. In addition, the Ketchikan Families In Action program and also the headquarters of the Alaskans For Drug Free Youth are located there in Ketchikan. They do receive some support for one specific project from the Department of Education. But otherwise they do not receive any support from the division there -- a grass root agency that has units throughout Southeast and other parts of the state. Their Executive Director, Linda Adams, is on our advisory board and she is here in Fairbanks at the Advisory Board meeting, but I understand she has some of her volunteers and board members that will testify. On Prince of Wales Island we have a program funded, the communities organized for health options or COHO. C-O-H-O. They are a combined joint program with the Division of Mental Health. They also provide mental health services and they basically are responsible for all the services on Prince of Wales Island. They are headquartered in Craig, but they serve an island, I believe, with a population of around 7,000 people and they'll correct me if I'm wrong, but about eight or nine communities there on Prince of Wales Island. In Petersburg, we have the Petersburg Council. They are an outpatient treatment program and also do youth services in schools. In Wrangell we have the Council on Alcoholism, it's an outpatient program. And in addition one of our cast and one of community action against substance grants is with the Wrangell Police Department there which has a DARE program in the schools. I understand the Police Chief has written to the Task Force with some suggestions and he may or may not be on the line today. In Sitka we have the Sitka Council on Alcoholism, which is an outpatient program in Sitka and also has a 16 bed halfway house located there in Sitka. They also have the Sitka Team Program, which is a youth alternative, youth prevention program. And Sitka also serves as the headquarters for the Southeast Alaska Regional Health Corporation. And they have two programs. One that serves the communities of Yakutat, Haines, Skagway, Hoonah and Hydaburg and other rural communities with family service workers located in some communities and (indiscernible) to others. In addition, they operate the Raven's Way Youth Treatment Program there. It is a co-funded program between the Indian Health Service and ours treat adolescents. That is an adventure based program where they spend one month in a sort of traditional treatment program and the next month on a wilderness experience that is on another island located there. So, SEARCH does have some responsibilities throughout the region and then is also headquartered. And then using corporate funds they also operate a residential treatment program out (indiscernible) hospital that is not funded by the state, but funded within their corporate resources. And then in Juneau we have the City and Borough of Juneau which provides the outpatient, some of the prevention effort, residential treatment, detox, community service patrol. They subcontract with the (indiscernible) Human Services for halfway house and transitional care or negotiating for some long term care from that agency. And also the youth outpatient programs by using the other resources of some of the private sector programs in Juneau and one of our prevention projects. In addition, the National Council on Alcoholism in Juneau affiliate is one of our regional prevention projects. They are also the site of a clearing house, have computer access to a federal data basis and federal information. And they are also the headquarters for our counselor training program, which serves all of the programs within southeast. In addition, in Juneau we do have a couple of private programs that are outpatient programs that are not funded by the division. But those services are not found elsewhere. So, Southeast has a fairly extensive network. It is mature in the sense that the agencies have operated for a long time. They have a good working relationship among each other and they better than I can explain some of the other issues facing them. But, there are services in those communities. And so, with that, maybe I will stop and if there are any questions I do have a board meeting going on here in Fairbanks for the next couple of days. I will stick around here until probably about 3 o'clock to listen. I may stop by in the morning. Other than that, I do have staff in Juneau, they are listening and taking notes. So, if there's anything, questions you need answered during the course of the teleconference, make sure that they're known and the staff in Juneau can take some notes and I will get that information to you as soon as we can. So, with that, Mr. Chairman, Representative Porter, I will stop and if there's any questions.... CHAIRMAN PORTER: Thank you very much. Here I see none. If there are any specific that come up it's mentioned that we'll either catch you before you leave or get some of your staff. I think what I would like to do now is ask Representative Sitton... I have on the print out indication that he would like to say something. I don't know if that's true or not. Representative Sitton? REPRESENTATIVE SITTON: Thank you, Mr. Chairman. No, not really. I've certainly regret not being able to attend the Nome meeting. You know we had a pretty big public health conference going on here right before then. But, Fairbanks is on the line here and Fairbanks is very concerned about these problems. And we have former Senator Glen Hackney here. I'm very pleased to see him here and he might want to talk to you some. CHAIRMAN PORTER: Well, thank you very much. Before I ask Senator Hackney if he would like to, I would also like to recognize our host here in Ketchikan. Senator Robin Taylor and Representative Bill Williams are with us at the table. We welcome their participation and thank them for being here. Senator Hackney. SENATOR HACKNEY: Yeah. Thank you very much, Mr. Chairman. This is kind of deja vous all over again for me. It was, I believe, 1978 when the task force very similar to what you have convened operated during the off legislative season. We held hearings all over the state. And some of the people who were involved in that was (indiscernible) from Juneau, Frank Ferguson, Mike Collata (ph), myself and then there were several others who were on that task force. And we concluded at that time that Alaska did indeed have a problem with alcohol. About the only thing that really came out of that hearing was an increase in the tax on products of alcohol. We had suggested that there be a very substantial increase. What came out of it, you're well aware of the legislative process, was a much more modest increase. However, something good did come out of that hearing and I'm hopeful that something is going to come out of your hearing here. Now, I'm testifying today more or less as a representative of Mothers Against Drunk Driving. We have noticed in late months here in Fairbanks an increase in incidents involving alcohol and underage drivers. Now, I'm talking about kids under the age of 21. There's been a great increase in serious crashes around this area in that age group. Now, as Director Jones pointed out the problem that they recognize in consumption of alcohol. There's a figure that I've used many times in making presentations for man. In the year 1985 there were 16,850,000 gallons of alcoholic beverages that were brought into this state. Now, that came in under bond. These are figures from the Department of Revenue. Those are figures that cover beer, wine, including coolards and hard liquor. And it's very easy for your staff to check those numbers. There are three things that I'd like to see the legislature do. You have before you a bill that was introduced at the behest of Mothers Against Drunk Driving which proposes to reduce the presumed blood alcohol content for being considered drunk from .10 to .08. That came within an eyelash of passing a couple of years ago. It died in the Senate (indiscernible) Committee in the very waning days of the legislative session. It could have come out very easy. But, it didn't, and I realize there were some things within the legislature that made that happen. But we'd like to see you reinstate that bill and we would like to see you pass it this time. There are two other things that we would like to see you do, and that is to make parents more responsible financially when their kids are involved in under-age drinking incidents. We'd also like to see offenders pay a greater cost of their incarceration or whatever action is taken in connection with the -- whatever incident -- drunken incident they may have been involved in. Call it pay for play if you'd like to. It really isn't play anymore. Drunk driving is a serious offense. I don't need to tell any of you that. The Anchorage area and the Fairbanks area attest to the number of people who have been killed in incidents involving alcohol. We'd like to see you raise that. It seems that one thing that gets people's attention is when their pocketbook is hit. I'd like to commit to your staff's attention the local events column of the Daily News Miner here in Fairbanks where they list incidents, court cases here in the Fairbanks area. And I would call your attention to the number of cases that involve drinking and driving. It's staggering. It really is. Now, a couple of years ago the City of Fairbanks, again at the request of MADD, passed a bill and ordinance allowing billing of offenders where alcohol was involved within the city limits if, for instance, the police car was involved in responding to an accident, a fire engine was involved, an ambulance was involved. The City of Fairbanks can now bill offenders. This is something that you might want to consider on the state level, also. I'm past my five minutes. I appreciate what you are doing in conducting this exercise around the state and we certainly hope that something will come out of it and I thank you very much. CHAIRMAN PORTER: Thank you, Senator. I have to tell on myself. I knew that as soon as one of you finished I would have a bite of my sandwich in my mouth and I do. I'll try to.... Senator, in brief response, your points are very well taken. With my background, I agree that DWI is a serious problem. To that end the .08 bill in the House passed through the committee that I am chairman of, the Judiciary Committee, and is hopefully awaiting early hearing in the next committee in the House. This year Representative Mulder successfully passed through the legislature and interlogged a bill that did provide for required payment by the defendant. Jail costs that accrue based on a DWI since -- so some of those things are in the works are just beginning to see light of day. And I appreciate your testimony. Being totally arbitrary as chairmen are allowed to be, what I would like to do now, since we have several more people signed up here in Ketchikan than we apparently do throughout the network, I'd like to take a couple from here in Ketchikan as they appear on the list and then rotate through the rest of the teleconference sites. So, with that in mind, if I could ask Kathy Blauser to come forward. Beg your pardon? UNIDENTIFIED SPEAKER: (Indiscernible). CHAIRMAN PORTER: Oh, I'm sorry. Just observing. Okay. Anita Hall. Welcome. MS. ANITA HALL: Thank you, Mr. Chairman and Members of the Committee. My name is Anita Hall and I'm a prevention specialist and I'm here today representing the Ketchikan Affiliate for Alaskans for Drug Free Youth. We are an organization dedicated to alcohol and other drug abuse prevention through education. We are here to advocate for issues that further our objective. We will supply you with a written list of current bills and issues we would like to see addressed by the legislature and we would like you to understand our focus. Our primary concern is to ensure that our children never begin to abuse alcohol. We also know that the messages we send and with our adult behavior, including the laws we pass and the way that they are enforced, have a big impact on our young people. We would appreciate anything our legislative leaders can do to keep liquor out of the hands of our young people. Give local communities the tools to deal with their alcohol problems and keep our citizens safe from the violence that often is associated with abuse and use. We support bills allowing communities to tax alcohol, drug testing for bus drivers, increasing the penalty providing liquor to minors, strengthening the minor consuming laws and lowering blood alcohol limits and keg registration. We thank you for providing Alaskans with an opportunity to focus on the serious problems we have with the alcohol in our state and we very much appreciate your travelling around the state so concerned citizens can talk to you personally about the problems we face. We support the following pieces of legislation which are awaiting action in the '94 session. CSSB 42 - Local Sales Tax on alcoholic beverages. Local communities should be allowed to tax alcohol more to cover the increased cost of the community for it's use, such as increased law enforcement and health care. CSHB 2 - Drug testing for school bus drivers. School bus drivers need to be absolutely free from alcohol and other drugs while they are transporting our most precious cargo, kids. HB 28 - Penalty for providing alcohol to a minor. Adults who give or sell liquor to minors should be given severe penalties. We as adults are supposed to be the ones with better judgement. Young people should find it very difficult if not impossible to obtain liquor. HB 52 - Relating to tax on alcohol beverages. HB 53 - Increasing tax on alcohol beverages. We believe that users of alcohol should help pay the cost associated with the problems caused in our communities. HB 61 - Lower alcohol limit to 0.08 for OMVI's. Blood alcohol level should be lowered to ensure that no one is driving impaired. Bills we would like to have introduced into the next session are minors consuming. We need a change to the law because of recent court interpretations that impeded police when they need to take minors into custody. We understand that there is legislation already prefiled. Not a drop. We would like to see a .00 for minors. We believe that no level of alcohol is safe or acceptable for young people. Especially when driving. Use and lose. We would like to see a law mandating an administrative revocation of driver's license for alcohol violations by anyone under 21. We also believe that further offenses should cause a longer revocation. Beer keg registration - would require a person to have to provide ID when purchasing a keg of beer, sign a sworn statement that they will not supply the beer to minors, and state the address where the product will be consumed. The object of this is to enable the police to have another tool that alcohol is kept out of the hands of minors. Aggregate (indiscernible). The current law requires law enforcement agencies to process a marijuana plant into a dry manicured form before they can weigh it for prosecution. This is a time-consuming process and we believe our law enforcement dollars should be spent -- could be better spent. We would like to change the law to allow weighing the whole life plant for purposes of prosecution for these drug offenses. Tobacco vendors license. We would like to have the state law changed to allow local communities to license tobacco sales so that there is a better mechanism to ensure that they do not sell tobacco products to minors. This would give communities the clout they need to enforce these laws. I thank you, again, for allowing me to testify. Thank you. CHAIRMAN PORTER: Thank you very much. Are there any questions? Senator Taylor. SENATOR TAYLOR: No questions. I just wanted to state that my office already has refiled the bill that you were referring to. We changed the law concerning possession by consumption. It's been a problem in that the courts have failed to recognize that a young person having alcohol in their system may be (indiscernible) in possession. That is the consequence is we're having to change what "in possession" means (indiscernible) handle the situation. Hopefully, that bill will (indiscernible). CHAIRMAN PORTER: Thank you. If I could ask one more here in Ketchikan before we move on. Tom Coyne? MR. TOM COYNE: Good afternoon. My name is Tom Coyne. I've been a recovering addict for 37 years. I've been involved in alcoholism programs since I'm about 35. Now I'm speaking from observation locally. I was employed in a local program for 13 years. And I feel that if the state office runs everything in the state like they do in Ketchikan... It's just a self-perpetuating agency. In other words, they come in locally and just give the program to whoever will take it. They don't investigate anything. They just give it to the local agency to take it, which is the city. Now, they are 25 years behind the time. The state of Washington will not allow alcoholism programs to be affiliated in anyway with mental health programs. Now, here locally, the boss of the alcoholism program is a mental health agency. So, that's what I mean by a self-perpetuating agency. From Juneau. They're not too concerned with getting the best type of program. They aren't concerned with getting the alcoholism program away from mental health. They're increasing the funding so it'll never leave mental health and it'll be the same type of program that you'll find here. I assume, and like I say, when I was employed there, seven of the ten of the people that came into the alcoholism program were from the courts. From the courts. And you don't have to have a very good program to have people ciphered in from the courts because you already control -- as in Ketchikan -- you already control the referral agency which should be separate. But in Ketchikan it's part of the program. So, the only place that the referral agencies refer to are the self-perpetuating programs that the state has established here. So, you people have to have a good look at this program, because the state, when they come down and audit the program, they tell this program three or four weeks in advance we're coming down a certain date to audit you. Well, that isn't really an audit. They're going to get everything in order. So, actually in 20 years I don't think the local programs have been audited. Other than saying, hey, get your things we're coming down. So, you've got to look at this local programs and see what they're doing. See? If you want court programs you should establish separate court programs and then separate programs for voluntary or even involuntary people that have the problem. If you keep this type of system up that you have in Ketchikan under the guidance of the Mental Health, you're not really attacking the alcoholism program. You're just being a convenience for the court system and you're nothing but a jail annex when you're talking about treatment centers or halfway houses. You've got to take a good look at these programs and get them into the private hands. You know. And most of the city programs should be privatized, because Mental Health is going to hold on to this program for dear life, because that's part of their referral system. If you're not an alcoholic, when you're referred from the court to this program, they're going to make one of two things. They're either going to make you an alcoholic or a drug addict or they're going to make you a nut. So. There's no way a guy could get out. He's stuck. And it's supposed to be a program for the indigent? You don't take indigents to court. This program does. You don't take the permanent fund of indigents. This program does. So, that's what I mean by a self-perpetuating agency. Thank you. CHAIRMAN PORTER: Thank you, Tom. One of the things that this Task Force has in it's folder of existing information, and it came up in Nome and I'm sure will come up here, you indirectly mentioned was the method upon which programs are valued. Is the program self-perpetuating, does it measure how many people it touches or how many people, who as a result of the program have changed their negative drinking habits? I think those kinds of evaluations are going to be ones that the state will be looking in the future at rather than how many people have come through the door. That is one of the things that's already being worked. Okay. If I could, I'd like to go to Craig and ask if Gay Medina is available to testify? MS. GAY MEDINA: Yes, I am. I would like to thank you, Mr. Chairman, for the chance to testify. In some respects in answering Mr. Coyne, COHO is also a co-located mental health and substance program. Mental health is in no way our (indiscernible) and we are a separate and equal entity part of that agency. And we find it very helpful to work with mental health, particularly for those clients who are duly diagnosed. I would like to encourage the legislature to support the funding that we have. It certainly is not enough in terms of the numbers that we have to serve, nor is it enough in terms of the miles that we have to cover. As Loren mentioned, we have several communities on Prince of Wales. We have 2-1/2 counselors and this is not enough people or enough time to get to all the communities to offer treatment. As the funding is set up, I feel that COHO gets... that it is equitably distributed among the program and I have no problem with (indiscernible) doing on it. I think they have been very supportive of the program and I appreciate that. I would like to encourage the legislature to pass the legislation on the minor consumption, recognizing that any alcohol by consumption is illegal. And I would also like to encourage the legislature to look at the involuntary procedures. We are particularly hurt by this in Craig or on Prince of Wales because we have a superior court once a month. So, what we need is a system that is easier to do involuntary commitment. (Off record) (Tape Change) TAPE I - SIDE B (On record) CHAIRMAN PORTER: Let me do this. I'm told that my voice is fading in and out so I'll try to speak louder. We have someone here in Ketchikan that would like to testify now, as he's got an appointment. Could we ask Jim Elkins to come forward? MR. JIM ELKINS: Thank you, Mr. Chairman, it's a pleasure to speak today. I'm Jim Elkins and I'm representing (indiscernible) and we are part of the liquor (indiscernible) industry in the state of Alaska. And I would say to you, having been involved in the second generation, that the liquor industry has come a long way in helping and helping ourselves in how alcohol is consumed in the state of Alaska the last 20 years. It has changed greatly. You know, we have been -- we were instrumental in getting the six-pack bill passed. The happy hour bill we supported. Most of the DWI bills we have supported adamantly. We have tried for two years to get where a minor would lose his driver's license if he consumed any alcohol and even if he got consuming alcohol before he got a driver's license, he would be unable to get one. The legislature's been, you know, unwilling to pass that for some reason. We've had bills drawn up that we couldn't get introduced. But, I think that's a step in the right direction. I would strongly urge that the state never give up their power to hold the authority on taxation over liquor. You're the licensing agent, I think, going along with being the licensed agent, that is your responsibility. Now, not the local municipalities. We are strong supporters as an industry of local option having to do with wet and dry and hours. But, from an (indiscernible) standpoint, we think as a licensing agent the responsibility for taxation lies with the State of Alaska. Because it keeps continuity -- we think of taxation and keeping continuity within the State of Alaska. You wouldn't have a high tax here and somebody buying and (indiscernible) and shipping down here, for example. Which could exist if you didn't levy the same tax.... Another thing I would like to speak on, as the licensing agent for the State of Alaska, the legislature adopts all kinds of regulations. And I happen to be a member of the ABC Board, also, and we've just been holding public hearings on how to save the agency money and some at your direction. But, like a lot of bills that the legislature introduces they -- after a while, forget -- implement those regulations and the laws that you've written we need to have funding to do that. The ABC Board now enforcement division is at a lower status today than it was in prior pipeline. The last legislative audit said they should go eight to ten investigators, we've gone to four. You know, it's hard -- we see things in the industry we'd like to correct. We had a (indiscernible) convention and took testimony from CHAR (ph) members, things that they know is going on in the industry because not everybody cares what kind of industry we have out there, but a lot of us do. And I would encourage you if you want to stop minors being able to purchase alcohol we need to have investigators that can do the job. The state police don't have the time and the local people don't either, the local enforcement. The agency generates around 2. million dollars. Half of that goes back to the municipalities in the form of the rebate for the licensing fee. They need about 7 - 800,000 to run the agency and we got four. You know, that's at the level of six investigators. So, the quality of the industry that you have mandated is not being achieved by the industry partly because the enforcement you have, you know, there's bad apples in every case, you know. And if you don't have people out there to fine them and enforce them, it's not healthy. And I think -- the state needs to look at funding the agency closer to what it takes to operate it at a good level. I don't have any questions. I'm pleased to see you doing this and I can remember years ago when Glen was in the legislature we always enjoyed going head on head with him. He never voted with us, but he was a gentleman to do business with and I just want to say Hi, Glenn. CHAIRMAN PORTER: Question, Representative Mulder? REPRESENTATIVE MULDER: Thank you, Mr. Chairman. I appreciate you testifying, Jim. I know nationally there are a lot of programs going on through the alcohol industry in relation to educational programs within the schools and within the communities. Has the ABC Board looked at any of those programs and try to adopt some of them for Alaska or fine tune them to make them applicable up here? MR. ELKINS: There's a program, and I think it's still around and I'm not sure if Ketchikan has one, but there were a number of communities in the state, K-12, enough's enough, that the Alaska state (indiscernible) bought and put it's school districts around the state. That's been back probably 15 years ago. And if I remember right, in this district that was turned down. They would not accept it because it was from the liquor industry. And I could be wrong on that, but it goes back a while, but we had raffles all around the state because it was about an $8,000.00 program and you know, enough was enough. It was substance abuse. Too much, you know, as far as that goes, too much noise is too much. And so, yes, they have. REPRESENTATIVE MULDER: Well, I commend you on that and I think it's very important that as we've seen government attempting to gain control of it's purse strings that we've got to look at all avenues of cooperation. I mean, that comes not only from the health organizations and from those treating the alcoholics, but also from the liquor industry. You know, I think there -- as I've viewed my own community and we've worked with this problem in East Anchorage, I find that mostly, you know, you have a couple of bad apples, but mostly they're pretty good people and they're trying to clean up their industry and clean up their act and that's real important. And I find that as long as we maintain a healthy atmosphere it really promotes it and I would really encourage the ABC Board to look at new programs and new ways that are being worked in the Lower 48 and try and bring them into Alaska and adapt them. I would like to say one thing. Two more things. One, this year we have retired five licenses in this state. Now that's not very many. On the Attorney General's recommendation we just reinstated two of those at the last meeting. But, they were bad apple operators and bad license, had bad records and we just, you know, out of 1800 to do away with five in one year or now it ended up being three, but that was on the advice of the Attorney General that we reinstate two them. The Board is working and on the three we have -- all three have been to court and the court has upheld us on all of them, so we were right in that (indiscernible).... The other thing I wanted to say, I'm one of the original incorporators of the program in Ketchikan. And I think what Tom didn't say about the Ketchikan program was that Ketchikan used to have a model program and everybody in the state of Alaska used to come and look at it. And it was run basically -- I think it's 12 points -- the AA program, and we had a lot of success rates and there's people in this town today that haven't taken a drink that went through that program then. And I think an evaluation of programs throughout the state will save the state money and will get higher quality of programs, because court mandated alcohol treatment. The success rate is way down. And I don't care. You can talk to anybody that mandated programs -- you know, you've got to give people the tools to say, yes, I want to help myself and get in there and get the job done. Thank you. CHAIRMAN PORTER: Thank you. Okay. If we could go now to Sitka and see if Curt Ledford to testify? MR. CURT LEDFORD: No, I'm not ready at this time, but there is someone else here that is. CHAIRMAN PORTER: Well, why don't we have that person come forward and get his name and welcome and please testify. MS. KRISANNE RICE: Yes, this is Krisanne Rice and I'm the director of the Sitka Alliance for Health. We are one of the five CSAP's, Center for Substance Abuse Prevention, demonstration projects in the state. There's one in Sitka, Anchorage, Minto, St. Mary's and Nome, which covers the Bering Strait area. I just wanted to highlight a couple of different things. One, that there is a significant amount of money coming in through these partnership efforts. All of us are beginning pretty much our third year of our five-year program. The emphasis of these are to support local communities and local community initiatives in the area of substance abuse prevention. The emphasis is also on trying and there's no easy task. I'm sure you can all appreciate getting agencies not only within a local community but on a state and federal agency to truly work together by sharing resources and to improve their planning process. The other thing I'd like to mention is that there is one program which is beginning it's third year in Hoonah which was headed by Search. They received a funding from the Indian Health Services. It's called PACH, the Planned Approach to Community Health. This has received statewide and national recognition. The process is a community development process where a local community group organizes their community, specific health data regarding prevention is gathered, that group plans interventions, implements them and then they are evaluated. The state currently right now -- the health promotion branch, Search, the Alliance and CDC -- are looking at joining our resources to replicate this effort in six communities in Southeast. And then hopefully throughout the state. And finally, just to encourage people, the emphasis always seemed that agencies had to fix the problems associated with substance abuse, but really the responsibility needs to be shifted back towards communities and towards effective cooperative efforts among different sectors of the community which include schools, the media, education, religious communities, health and human service agencies, etc. Thank you. CHAIRMAN PORTER: Thank you very much, Chris Ann. Are you aware of any written description of the PACH program that we might be able to lay our hands on? MS. RICE: Yes, I can most certainly put you in contact with the person who's coordinating that. There's lots that have been put out about that. CHAIRMAN PORTER: That would be great. We'll be back in the office next week. If we could get a card or something with that, then we'll try to obtain it. Thank you, very much. If we go now go to Petersburg and ask if Dick Hindman is available? MR. DICK HINDMAN: Good afternoon. This is Dick Hindman, I'm the director of the Peters (indiscernible) and Alcoholism and other drug abuse. Can you hear me alright? CHAIRMAN PORTER: Just fine, Dick. MR. HINDMAN: Can you hear me? CHAIRMAN PORTER: Just fine. Can you hear me? MR. HINDMAN: That's right. I'm really happy to be able to testify, but before I get into what I really have to say let me talk a little bit about the program here in Petersburg. The Council on Alcoholism was established back in 1972. Original location was in a liquor warehouse with blankets separating the clients from the booze. So, we've made a lot of progress in location of the program. Then at times several changes have happened in Petersburg including the start up of a youth program funded primarily for prevention activities, and things have gone along quite well up until 1992. At that time, the end of fiscal 1992, the youth program was defunded because of lack of funds. And a lot of those prevention responsibilities were added to the Council on Alcoholism. In fiscal year 1982 we had a total of $138,000.00 state money coming into the community for alcohol and drug abuse. With the new funding of the youth program the total amount of money's coming into Petersburg was reduced to $120,000.00 for fiscal year '93 and for fiscal year '94 it's been reduced another 1,000 to about $119,000.00. I raised a lot of money locally to help with the program and I have a budget of about $165,000.00 for a community this size. Under my direction, and with the guidance of a board of directors, the Petersburg Council on Alcoholism has changed and grown from a community based drop in center where guys used to come in to detox and just kill time till they could get back on the streets to a state approved out patient treatment program providing after care services. We do prevention services and information and referral services. We presently have a staff of four full time employees. That's a large amount for a community this size. I have a full time adult counselor, a half time school based prevention specialist and an adolescent counselor and prevention specialist. We offer a 12-week out patient program. It includes a minimum of two therapy groups a week and one individual counselling session each week for each client. After that we offer 12-week after care or relapse prevention program for each client. After that we include a six-month follow up to keep track of our clients. When clients are not appropriate for out patient treatment we refer them to an in patient treatment program in the state, preferably, and if beds are not available we'll send them out of state. I could talk on and on about what we do. We have prevention activities going on in the school. Our school based prevention specialist teaches a "Here's Looking at You" curriculum in the elementary school. Our adolescent counselor teaches the ALERT project in the middle school and works with the natural helpers in health education classes in the high school. This last quarter or the first quarter of this fiscal year we have served 38 clients in our out patient program. 86% of these clients have alcohol as a primary problem and about 78% are involved with the legal system. 62% are Caucasian, 47% are Alaska Native, and 11% are of Hispanic decent. And these statistics have been about the same during the past several years. We have recently completed an informal study of 327 prior clients. Okay? I've got some good news for you. 303 of these clients are still living, 24 of them are deceased. 192 live in Petersburg, 76 live in other parts of Alaska and 35 in other states. Out of these clients 172 were court referrals, 93 were self referrals and 38 were referred from other sources. The primary (indiscernible) for most of them was alcohol seconded by marijuana and then cocaine and almost all of them were polydrug addicted. Of these 303 people 98 now have 1 to 13 years of sobriety. 36 have from 1 to 11 months of sobriety. I think our system is working. I think that it's probably more evident in a smaller community than it might be in a larger community, but it does work. I believe that the current system, the competitive grant system that ADA monitors, is a fair and equitable way to run this business. I think you folks on the Task Force need to look at the level of funding provided for programs for ADA. Okay, instead of looking at ways to save money or decrease our funding we need to look at ways to increase. You know most of the folks in this field are pretty sincere and dedicated. Most of the folks in this field are certainly underpaid. But, if we are to continue to increase our services, if we need to provide further information, like outcome studies, then we need to look at other sources for funding. One of the ways I would urge you to look at this is for some additional taxes on alcohol. If you have any questions for me, I would be glad to answer them. CHAIRMAN PORTER: Dick, thank you very much. One question that comes to mind. You seem to have a good handle on your evaluation yourself of your own program in terms of where your graduates are and how they are doing. Is that difficult for you to do on those that are outside of Petersburg within the state or outside of the state? MR. HINDMAN: It is very time consuming and sometimes it's hard. The ones that we've been able to determine on out of state are those that we know personally and have kept in contact with personally. If you do an outcome study it's going to require a lot of time and a lot of money. CHAIRMAN PORTER: Right. Thank you very much. Representative Mulder? REPRESENTATIVE MULDER: Thank you, Mr. Chairman. Dick, you made a comment about the two recent years legislation looking over your shoulder, looking at how we can cut the budget of ADA, but I hastily remind you that the purpose of the committee isn't just to look at ways and means that we can cut the budget, but it's to provide some oversight. I think we'd be negligent in our responsibilities as legislators to evaluate programs. We not only fund them, but we also have to evaluate them. Try to judge what are we dong right, what are we dong wrong. And the only way we can really do that is to get out here in the communities and talk to you people, have you give us suggestions, tell us what you think is happening out there. What things are going right in your industry and your business and what things aren't. This is also the conclusion of the Ombudsman in the recent Ombudsman study that said there's too oversight of ADA in evaluation. So, we are attempting to provide some of that function. So, I wouldn't be as defensive as much as it is from our viewpoint we're trying to work with you to try to better understand the problems and to come to some solutions. We recognize the financial problems. CHAIRMAN PORTER: I'll just feel required to add that we're not looking for ways to cut the budget, but Prudhoe Bay productions is doing it for us. In any event, let's go on, and if I could return to Craig and ask if Sonny Anderson is available? MS. SONNY ANDERSON: Yes, I am. And thank you. I appreciate the opportunity to give some input. I have a couple of things. One, I think residential treatment is (indiscernible) point. And the problems that COHO has with that are, I think, typical throughout the state. And it's the inability to secure residential treatment due to long waiting lists. And by those long waiting lists sometimes the people on the islands do not receive the level of care that they need and it does lessen the outcome of what you would call hopefully a good outcome of a treatment program. And they say we're losing people out there. I think part of this has to do with the fact they are on a long waiting list. In Petersburg we do (indiscernible - ringing). Also, I think the prohibition on communities imposing the alcohol tax locally helps to reduce the ability of the communities to limit the alcohol consumption and the ability to respond to the costs to the community which is associated with alcohol and abuse. These costs include treatment in the prevention services. They also include police services, protection and maintenance and repair cost to the community and the other help in doing services (indiscernible) and this has a great impact on the health and well being of the total community. I would also like to comment on the fact that comments were made on the mental health agency being associated with substance abuse. I am certainly in support of the way that COHO works with our alcohol agency and entities. And I think this works very well as Gay (indiscernible) has already testified to and I really encourage that to continue. I also support the fact that I think the legislature should look at the fact that any alcohol consumption by teenagers is too much. And I really encourage the legislature to look at all these things that are being testified on today and I thank you for allowing me to testify. CHAIRMAN PORTER: Thank you very much, Sonny. I don't see any questions. So, if I could return here to Ketchikan and ask if Jean Book can come forward? MS. JEANNE BOOK: Representative Porter, Members of the Task Force and Senator Taylor. My name is Jeanne Book, I'm the Director of Gateway Center for Human Services here in Ketchikan. Gateway provides a variety of treatment services for adults who abuse alcohol and other drugs and for their families. I'll limit my remarks to four areas, although there are surely other areas of comment and you've already heard some of them. The first area is about the laws governing involuntary treatment for alcoholism. To be brief, they don't work. The process is cumbersome and basically it achieves no purpose once it's done. In many states the process for evaluation for involuntary treatment for alcoholism is (indiscernible) to the mental health statute. In two other states where I worked, that worked there very well. Currently the mental health statutes are misused for the assessment of people with alcohol problems. What happens then is, if indeed, they go through the process and you get the commitment they go off to API which has no alcohol treatment program. Psychiatric treatment facilities. So, true they're off the street for a few days, sometimes a very few, but they don't get the treatment they need and the resources at API are used inappropriately. So, there's a problem there. The statute also applies only to alcoholism, not to drug abuse and if revised should apply to both. I'd like to make it clear that I'm not anticipating or advocating that every person abuses alcohol or drugs be forced into treatment. I'm talking about the people who are killing themselves and are potentially killing other people and are the revolving door to hospitals and jails. And they just literally go around through that process, sometimes several times a month and we have nothing that we can do with them. The second thing that I want to comment on is closely related to the first and that is, if we had adequate commitment laws, we don't have any place to commit them to. There is no locked or secured facility for alcoholism treatment in the state. Once again, API's being used as maybe community respite care at best. And that is inappropriate. The third area has to do with the absence of appropriate treatment programs for women who have the disease of alcoholism. I would like for you to consider for a moment what it would be like if we had an array of services across the state that were designed for women and along came a man who needed treatment and we said, well, we have a treatment program here, though you be the only man in there you can go in there and it will be a fine treatment program. It isn't a fine treatment program. The needs of men and women in alcohol treatment are very different. And we don't have very many treatment programs for women. Here in Ketchikan we do have women in our residential program, frequently by court order. It's not appropriate to try to individualize it as much as possible, but it's just simply not recommended. The fourth thing I'd like to comment on is the Ombudsman report on grant funded programs. While it's quite true that there is very little hard evidence that programs are efficient or effective, the implication that this situation is in omission that can be easily fixed is quite erroneous. I worked for a number of years in the field of program evaluation and the measurement part is fairly easy. Deciding what to measure is a very difficult thing. What are the outcomes that are anticipated from alcohol programs. How do you measure those in terms of what goes in and all the other things that impact on a, for instance, one of the things that's often used down south for outcome measure is employment. Well, if you are in a community that has no employment that measure doesn't measure much. What you come out with is, well, this person went through treatment and they're not employed, therefore it's a bad program when in truth other factors are impinging upon that. We don't have any federal grants now so I don't keep up on that, but at one time required that 15% of the grant budget be used for evaluation. In fact, more years than I care to remember when I first started it was 5%. But, as you know, things change. 15% is a lot of money when you look at the total grant program in Alaska. So, basically I would like to make four recommendations. One is revise the commitment statutes. Second is develop regional facilities for substance abusers who are so far into the disease that they're greatly disabled. And I emphasize regional facilities. You need to treat people as close to home and in their families as much as we possibly can. The third is recognize the need and plan for adequate treatment programs for women. And the fourth is to fund pilot evaluation programs to look at what works rather than collect a room full of data that is uninterpretable. Either because of the volume of the data. If you collect it on everybody who goes through the system or because the quality of the data is unreliable. Thank you for your time. CHAIRMAN PORTER: Thank you for your organized presentation. When you say program, or pilot evaluation, do you mean selective -- a program, or just a few programs? MS. BOOK: A program or a community, but something that's contained. Because a program in Ketchikan is different from a program in Nome. And if you use the same model you're assuming the same input in terms of the people who go through the program and they are very, very different. You get garbage when you come out. CHAIRMAN PORTER: Could you expand on the states that you worked in that had statutes that apparently worked superior to ours? What did they provide? Or what did they allow that we don't? MS. BOOK: California statute for alcohol and drug abuse is exactly parallel to the mental health statute for involuntary treatment and the Alaska statute, mental health statute is approximately parallel to the California statute. The same thing is true in Illinois. There are some minor variations. CHAIRMAN PORTER: What did that bring to your ability -- that we don't have here? MS. BOOK: Well, absent the resources, nothing. But, I don't think the resources really would be that big a problem if we had the ability to do it in the first place. We have people on the street who literally are in the hospital with serious life threatening physical conditions caused by alcohol that come back out and may come through our program for the detox part of it or something or other and are back out on the street. Again, life threatening situations. We don't have any legal way to force those people into treatment and, as I said, we don't have any secured facilities to send them to. But, we might be able to keep some of them in our program if the law were in place that would allow us to do that. CHAIRMAN PORTER: Thank you. Representative Mulder? REPRESENTATIVE MULDER: Thank you, Mr. Chairman. Your last point's a real interesting one, Jean, because it forces us, the legislators, to walk a tight rope. Because on one hand, you know, we're all fairly -- most people in this state are fairly conservative and they don't want government to be too big. They don't want big brother looking over their shoulder knowing too much and having too much ability or control over him. But, on the other hand you -- you know, you recognize the problem of a person out there in the community who is a danger not only to themselves, but to his neighbors. And we've all had experiences in one shape, form or another. So, any recommendations you can make along those lines about involuntary commitment would be appreciated. I'm not certain exactly where you're focused, but any suggestions or recommendations would be appreciated. The real question I had related to the success of court mandated treatment, has there ever been any evaluation done? Maybe somebody in Loren's shop listening by teleconference has any kind of summary -- the questions never been asked before and I think it's applicable. What kind of success rate do we have, if any, or has there been any evaluation in relation to court appointed or mandated treatment? MS. BOOK: I don't know of any specifically. I suspect that it has more to do with how far along the person is in the disease of alcoholism than it does whether they come from the court or someplace else. If someone, for instance, is sent to the program because they've been arrested for the first time while driving intoxicated, the chances of success are a whole lot better than somebody who's been through the court system a dozen times. So, it isn't the fact that they're court committed, it's where they are in the disease process. CHAIRMAN PORTER: Good point. Senator Taylor? I have one. You've mentioned the disease process a couple of times and we've had testimony, or I think we've had written testimony, that described our state's treatment generally is based on a disease model as opposed to some other model. Could you give us an executive summary of what a disease model treatment program is? And what the other one is? MS. BOOK: Well, the first part's easier. The disease model, whatever you call it, implies that there's a point with alcohol abuse where the alcohol takes over. A person no longer can exercise the choice whether or not to use that drug. Under the influence is the normal state of being and we all want to be at a normal state of being. And that in a nutshell, I expect my colleague to tell me that that wasn't a very scientific explanation, but that's..... Other treatment models -- there aren't any really well established ones. There was an argument for years about whether alcoholism was a psychiatric illness or, you know, a failure of will, so to speak. Well, I don't know that anybody accepts a failure of will anymore. There certainly are people who use alcohol to give relief to psychiatric problems, but that's not the majority of people we're talking about and even if that is the case, if they use alcohol long enough there's a chance they will be addicted. And there is an off shoot that says people that are addicted to alcohol can come back and drink moderately. I don't know. If you've ever been on a diet, you lose the weight and the first thing you know, well, I can have a piece of chocolate cake. Then I can have something else. And you know what happens? CHAIRMAN PORTER: I did that with smoking, yeah. MS. BOOK: Well, there isn't scientific evidence that I know of in the literature that works any other treatment program (indiscernible)... success rates not good in any treatment program. CHAIRMAN PORTER: Senator Taylor? SENATOR TAYLOR: Yes. Thank you, Mr. Chairman. Doctor, I would appreciate it if you would be willing to work with Joy Ambrose (ph) on my staff. She'll be back from vacation here in a couple of days. We'd be happy to sit down with you and start drafting some changes, because I too have been concerned a long time about the commitment laws. They are archaic and they do not work. And they take a horrible amount of energy and time. God Bless on behalf of the people who do go through it. Public Advocacy programs are the only ones really doing it and it's a very, very torturous process (indiscernible) and it really doesn't' have to be. I know there are more expedited procedures in other states and I would like...... MS. BOOK: I had talked to Loren Jones about this and it is something that I understand the alcohol advisory board is interested in as well. SENATOR TAYLOR: I just think their plate gets kind of full and I would be willing to do that. We may not get it accomplished this session, but at least we ought to get it off the ground and have it up for discussion this year in the Judiciary (indiscernible). The other thing I'd like your comments on and maybe you can't do that today, but if you can't get back to the committee at least get back to me on it, if you could. I know it sounds (indiscernible), but it's something that I found worked as a judge and that's (indiscernible). And everybody seems to run away from it like it's something fearful thing up there when we have people a threat to themselves or others and often times finding themselves in a life threatening situation. I usually used that as my criteria as a judge as to whether or not I would order it. But, if I found the individual had placed themselves in a life threatening situation I'd stick 90 days over their heads and give them (indiscernible) abuse treatment program for a year and you know, they were out of jail and they stayed sober and they held their job down and they didn't beat up on their wife or burn down a house for a whole year. The day after the program went off that's when they went out and did the same things again. MS. BOOK: Didn't know (indiscernible) prevented all of those things. SENATOR TAYLOR: If you keep them sober it does. But, the reason I'm asking is because I know now they have a time release antiabuse (ph) that can be inserted surgically and it's good for six months. The only reason we didn't do it before was because it was horribly time consuming and very difficult to monitor. You had to have this person show up off of a construction job every day at the alcohol center to take his pill. Yeah. It just takes forever, somebody's got to be babysitting them constantly, where this time release stuff is good for at least six months. I keep thinking of the fetal alcohol syndrome babies that wouldn't be in that problem right now if we'd have gone in with public health and said, lady, you've got a major problem here. Either get inserted with antiabuse or we're going to literally lock you up and make sure you get good prenatal care, because we ain't going to spend 2 million bucks on your kid. You know one lady (indiscernible) over a million. But, maybe you could respond back to that. A little now, if you can, and if you can't..... MS. BOOK: I can't, but I certainly will see if I can find the information. SENATOR TAYLOR: I would appreciate it. CHAIRMAN PORTER: Thank you. I'm sure glad Senator Taylor came in today. I was one I was thinking that we might have to take on and here he's going to do it. Now, if we could check back in with Craig and see if David Fisher is available? MR. DAVID FISHER: Yes, sir, I am. And I just have a couple of comments that I'd like to make. One of the things talked about is the success rate for (indiscernible) same success rate of those who have come in voluntarily and we've found that to be true with COHO and I think typically that's (indiscernible). The second thing that I would like to say is -- let me expand on chemical dependency treatment (indiscernible) -- money in the long run in terms of what it cost the legal system and (indiscernible)... Thirdly, it's been my experience that politicians seem to cut out a lot of (indiscernible)..... Alaska has a sincere problem with alcohol and drug abuse (indiscernible) important. I believe that those people who have the ability to make those decision (indiscernible).... CHAIRMAN PORTER: Okay. Thank you very much. Is Daryl Campbell still available? In Sitka? (Long pause) Looking for Daryl Campbell in Sitka. (Pause) Okay. I'm looking for Sitka. Are you on line? (Pause) Well, we'll give it another shot. I have an indication that there is a Tom Stock in Wrangell that would like to testify. Can you hear us, Tom? MR. TOM STOCK: Yes, I can. CHAIRMAN PORTER: Well, great. Let's hear from you. MR. STOCK: I don't have too much more to add to what's already been presented by Dick and some of the other treatment presenters in the other communities. I am in favor of change for minors in consumption. Someone brought up the idea of reducing the BAL to .08. That's not a bad idea. Mr. Elkins talked about his line of business and I think that should be considered, you know, since most of the people we do see are arrested for DWI, usually coming home from some establishment where they've definitely consumed more than the law allows. And just to throw this out there, in that line of business educating bartenders, bar owners, about consumption, about amount, perhaps an alcohol information course before they're hired. I don't know if that would change anything or not, but it would make them more aware, because eventually a client is going to get around to suing some business. There's one going on right now in this community blaming places that sell -- overstiffing drinks and letting them drink too much, knowing that he was fully intoxicated when he left their agency. That's just something that I would throw out there. (Phone ringing) CHAIRMAN PORTER: Okay. Tom, thank you. Just for your information and those listening. The alcohol server education course bill did pass this last -- this year. I think Senator Kelly sponsored the bill and it requires the course or the one similar to the one you're describing for alcohol servers be required to obtained within the first few months, I believe, of employment. And hopefully that will have the results that you indicate. Instead of as I recall -- having been a law enforcement, quote, good old days when drunken public was a crime, you do have to have other people who recognize the problems, or at least the symptoms and recognize when impairment or intoxication is approaching. Senator Taylor? SENATOR TAYLOR: Yeah, just one further note. As the gentleman had mentioned, one of the reasons Mr. Elkins was talking about was he sponsored that movement here in the community of Ketchikan some years ago. They've been involved with their (indiscernible) organization down here for a long time. He was then successful in getting the CHAR organization to sponsor it and bring the legislation forward. Senator Kelly introduced it and the organization very strongly supported it. (Off record) (Tape Change) TAPE II - SIDE A (On record) CHAIRMAN PORTER: I see Cecilia's back. (Laughter) If we could have Cecelia Bird come forward. Welcome. MS. CECELIA BIRD: Thanks for the opportunity. I work for the Alaska Native Health Center as a social service provider. I'm here to express my frustrations with our local substance abuse programs as they no longer offer involuntarily commitment as a service to the clinic. Our clinic utilizes the service. The service was deleted in January of '93 when I was away attending Seattle University. In June when I went back to work I questioned this move and proceeded to call appropriate agencies involved with involuntary commitments. The answer was, it was too much time and it was -- too much time was being spent and it was useless. Because we don't have quote, closed treatment programs in Alaska. Although I agree with this move I state strongly it was premature move. We would have like to have time to obtain our own attorney as right now we have five to six involuntaries that need to be committed but are having to suffer while we blunder around trying to get our own paperwork done so we can get our own attorney. I testify here because the attorney we are utilizing is the city attorney. So, I would like to testify on behalf of getting closed treatment programs in Alaska and Dr. Book did elaborate on that for you. And also, Representative Taylor, I have developed a great antiabuse protocol at Alaska Native Health Center which I use and utilize and I think it's a wonderful program and if anybody's interested they can come and see me and I'll show it to them. And I like that time released antiabuse. I think it's great. Thank you. CHAIRMAN PORTER: Thank you. Let me try one more time to see if there's anyone in Sitka. Sitka's off line? Those of you in Sitka, you're not hearing me? (Laughter). UNIDENTIFIED SPEAKER: Sitka is off line. CHAIRMAN PORTER: Okay. I understand that there are a couple of people in Juneau that would like to talk to the Task Force. Could I ask if Barbara Craver is available? MS. BARBARA CRAVER: I am. I'm here. Sounds like a marine radio. My name is Barbara Craver and I am here on behalf of the National Council and Alcoholism of Juneau. I'm the president of their board and have been a member of their board for approximately six years. My personal background is that I am an attorney licensed in Alaska for ten years and the past three years I have been employed by and still employed by the City and Borough of Juneau Law Department as assistant city attorney. Prior to that I was in private practice. So, I have some background in my profession dealing with some of the topics that I've been hearing here today. But, first if I could do my little spiel on behalf of NCAJ. The NCAJ, which is National Council of Alcoholism here in Juneau, a local non-profit agency here in Juneau that receives funding from a variety of sources including from the Department of Health and Social Services Division of Alcoholism and Drug Abuse in grant and aid process. NCAJ has been in business here in Juneau since August of 1965 and our mission is a prevention agency. It's to increase public awareness of all facets of alcohol and other drug abuse, alcoholism and other drug dependents, via programs of community information education intervention. No treatment at all. I am testifying today on behalf of NCAJ in order to share information on two public policy issues that the legislature might consider in view of your alcohol Task Force. And those are, we are asking for revisions in the statute regarding minor consuming and revisions in the statute regarding involuntary commitment. And these are two ends of the continuum. Minor consumers of the very beginning of age and involuntary commitment being (indiscernible) age and also continuum in the abuse of alcohol. And thus when all else is failed. Here in Juneau three years ago the Juneau Assembly established a minor consuming task force which worked on the issue of minor consuming for 10 months and then issued a report containing a series of recommendations including mandatory assessment and referral services for minor consuming offenders under the age of 18. And there already has been mandatory assessment and referral through the ASAP program for those 18 to 21. And it also included mandatory community service. The City and Borough of Juneau two years ago in part through state funds contracted with our agency, ACAJ, to provide the assessment referral in monitoring of community work service. 124 adolescents were screened and referred during the first two years. The majority of those successfully completed their education or treatment assignment and the ACAJ is in the process of doing follow up study and early results indicate a small recidivism rate. Regarding minor consuming, I'm sure that the committee has been informed that because of district court decisions herein Southeast Alaska the state law on minor consuming is not considered enforceable. I assume the committee is familiar with that? (Pause). May I assume the committee is familiar with that? UNIDENTIFIED SPEAKER: Yes. MS. CRAVER: Great. And the city and borough did take the step of creating their own minor consumer ordinance which was adopted by the Assembly on September 1st of '93 and should become effective October 1st, '93. That attempts to establish statutory grounds for officers to take minors in custody without having to actually to see them with a can of alcohol in their hand or actually drinking it. But that's not a good long term solution to have a patchwork number of municipal statutes and ordinances across the state trying to enforce this problem. And the MCAJ believes that the state law should be amended and I would say I personally, as an attorney who has to occasionally enforce these ordinances, also believe that it should be amended. And it is a statewide policy issue and thus would be suitable for that (indiscernible) statute. In regards to the involuntary commitment procedure one of the objectives of the Task Force apparently is to find ways to become more efficient. And as one of the assistant city attorneys here in Juneau for the past three years I work closely with the city agency, Juneau recovery unit that petitions for involuntary commitment of alcoholics. And I'm the attorney that has taken the cases to court. And apparently we are one of the few communities and programs in the state that regularly takes these commitments to the courts. So, I guess you would say that we are successful. We've even gotten orders after jury trials for persons to be committed and that's no easy feat. My comment though on the current statutory framework is that we currently, because of the way the statute is, potentially have to go through three separate jury trials in order to get someone committed to treatment for a total of 210 days. And most of the people that I have seen, the treatment professionals, they would benefit from two years or more of in patient treatment. And the cost to the system, the court system, not counting the costs to the city attorney's office is large. Jury trials are a big deal. They need to be set on very quickly. The court system is not familiar with them and I think that perhaps it would be valuable to do some research and gathering of evidence from other states to find out how they deal with this issue and what kind of statutes should they use. It seems to me that although the statute that we have now can be used they require fairly sophisticated users. Such as the city attorney who's done this several times. I know from my part the only reason I can do these cases is because the petitioner is Juneau Recovery Unit which is a sophisticated petitioner. The statute allows for a guardian, a relative, a parent of a person to come in, but I don't see how a lay person could actually put these papers through court. The courts themselves are not very familiar with the papers and they can provide no assistance. So, it takes a pretty specialized practitioner with experience to do the paperwork to get the case before the court and then I'm saying after you get the case before the court and say you have a jury trial and you're successful, the person is committed for 30 days. And that's not what a person who qualifies for involuntary commitment needs. These are chronic alcoholics. That 30 day program has failed consistently in the past. So, MCAJ says that their position is that it needs more research and it would be very helpful to re-evaluate this procedure and see if we can make some needed changes. And this population who needs these longer term care are utilizing increasing proportions of local and state resources and that changes in the law could increase the possibility for their success and treatment. My personal experience in prosecuting those cases is that it could be improved. And that's all I have unless there's any questions. CHAIRMAN PORTER: One comment. We've already identified you as a potential source for a little bit of assistance in taking a look at that commitment statute. Senator Taylor's people will probably be dropping a dime on you as they say in the profession. I really appreciate your testimony. I would like to ask one thing. It has been mentioned that if you go through this horrendous process and actually get a commitment, and you have, where do you commit them to? MS. CRAVER: We have -- Steve Hamilton is actually in the room listening, but the places I'm familiar with is we have -- we've tried places around the state. We've had Nugent's Ranch, have sent people to Nugent's Ranch. Sent people to Akeela House or attempted to send them there. And Greg Pease is in the room, also, and he says Craig Human Services is taking long term care of people now. I haven't done that particular place, yet. But we don't seem to have a problem down here in Juneau with the idea of a closed treatment program. What we do is if a person leaves the treatment program, at least if they leave jail in Juneau, we then file a motion for contempt of court, a motion to show cause why that person violated the court order and ask for a penalty of civil contempt which could be indefinitely. Basically they say the keys to the jailhouse are in your own hands. As soon as you're saying you're going to go treatment you can go. But until then you're going to stay in jail. So, we use any treatment program that our professionals think is available and we haven't had the problem with having to find a closed facility, yet. CHAIRMAN PORTER: Okay. Thank you very much. MS. CRAVER: Thank you. CHAIRMAN PORTER: We'll follow up by Senator Taylor. SENATOR TAYLOR: Yeah. Barbara, before you leave, thank you very much for taking the time to sit around today and give us your testimony. I really appreciate it. Jean Books is going to give us a little help down here through my staff, Joe Ambrose (ph) and we're going to start work on that commitment, expediting it a bit. And if you could help on that we would really appreciate it. And you'd also -- I've asked my secretary, Mary Hoyt, to send up to you a copy of the bill that we've already filed, prefiled so to speak. It hasn't been assigned a number, yet, it won't be read across the floor of the Senate until the first morning there in January when we meet. But, I'll send you a copy of that up. If you could review it also and give me some of your good thoughts on how we might improve this legislation on minor in possession by consumption. I'd appreciate that help, too. MS. CRAVER: Be happy to look at it. Thank you. SENATOR TAYLOR: Yeah. Thank you, very much. CHAIRMAN PORTER: Thanks again, Barbara. And you mentioned Greg. Is he available to testify? Greg Pease? MS. CRAVER: Yes. CHAIRMAN PORTER: Welcome, Greg. MR. GREG PEASE: Thank you. And thank you for giving me the opportunity to speak today. Can you all hear me? CHAIRMAN PORTER: Just fine. MR. PEASE: All right. I'm the executive director of (indiscernible) Human Services here in Juneau. We were on (indiscernible) Manor, which is the oldest halfway house and treatment program in the state of Alaska. Glacier Manor which is a CRC, funded through the Department of Corrections, also the oldest CRC community residential center with the department. We run the City Misdemeanor Center, predominantly misdemeanor cases, DWI offenders, which serve their sentence with us and work community work service while they serve their sentences as a sentencing option in really giving something back to the community. We run the city and borough as of about the first of the month. Their long term program -- and you've been talking about the commitments, long term commitments, involuntary commitments this afternoon. We run the inmate substance abuse treatment program over at Lemon Creek Correctional Center. And I want to talk... in addition to being the executive director, I sit on the board for the Alaska Coalition on Housing and Homelessness, which is a statewide organization dealing with housing and with the homeless and this issue. I want to talk -- I want to make one brief comment about the need for increased treatment services and treatment options within the correctional system. Not only inside but outside of the institutions. I think that with the number of people that are incarcerated and serving time for -- especially alcohol related offenses that the Department of Corrections and the state really needs to increase the options that are available inside of our correctional system. Because we run residential programs, these next comments are going to be about the type of people within programs. A recent survey of residential recovery centers has pointed out that the majority of the participants in recovery home programs nationwide and including Alaska suffer from serious housing problems. There's a group that are in substantial danger of returning to a homeless status when they leave our programs. The data supports the understanding that without an adequate supply of housing, alcohol agencies continue to be exploited mostly for a provision of shelter. The studies re-enforce, and there are a number of them that concern progress accomplished in alcohol and other drug treatment programs will be undermined at the point of graduation for those lacking in secure and supportive living environment into which they can move. To meet the specific needs of the homeless individuals with alcohol and other drug problems, I believe policy makers must in the near and in the future integrate the work of alcohol and other drug treatment programs with that of housing developers and housing agencies. Like AHFC. Combined in doing departmental planning. Specific attention must be given to the post recovery and aftercare needs as well as capital funding needs. What the future holds in terms of services is going to have to be not simply the issue of bricks and mortar and where we put the buildings, but the issue of what kind of support services we're willing to fund. Many of you are HUD and national housing organizations now referring to even low income housing projects as in enhanced housing whereby you may even cite a satellite police precinct in a low income housing development as well as support of case workers in alcohol and other drug counselors. Whether homelessness is a cause or effect of alcohol or other drug related problems our response must acknowledge the complexity of the different factors and integrate services and approaches that will change the systems involved rather than focusing the majority of efforts on individual behavioral changes. Communities must be made aware of the fact that substance abuse problems and homelessness are interdependent. This abuse (indiscernible) barriers to housing and shelter and places an additional burden on low income people already having difficulties with housing. Conversely, the absence of housing increases the problems of abuse by leaving the abusers vulnerable to maltreatment, illness and criminal activity. I believe we need to combine what we know about treatment, what we know about housing and create a community partnership that supports recovery and self-sufficiency by providing alcohol and drug free living environments for any individual who needs that support to live independently. The models exist from Boston to Portland. The Federal Oxford Model revolving loan fund is in place in Alaska right now and warrants support and increased use by the Division of Alcohol and Drug Abuse. Comprehensive programs for the homeless start with aggressive, sometimes long term, outreach and intervention. They should provide short term detox, longer inpatient care, halfway house settings and long term alcohol and drug free residential settings. Addiction treatment programs that are modeled on the 28 day inpatient program assume a strong home environment after treatment. Treatment for more seriously impaired homeless people must be offered for longer periods of time and must be followed by aftercare and facilities that support sustained recovery. Such as halfway houses and long term sober living environments. Out patient treatment not only fails to provide sufficient structure, but also fails to address the most salient factor in relapse. That is, continuing to live in an environment that strongly encourages alcohol and drug abuse. According to the national coalition for the homeless report that was conducted recently, the single most significant impediment to recovery among homeless alcoholics and addicts was the absence of recovery housing. Alcohol and drug free residential settings are an essential step at the end of an active treatment program and must be incorporated into a long term recovery and aftercare process. These so called, and we can call them such, sober hotels prevent the revolving door syndrome whereby addicted homeless people return to neighborhoods or as we read in the Juneau paper recently down on the streets in Juneau and constantly complained about because they caused tourist flaws, so to speak in our community as such, they revolve through this syndrome. And when addicted homeless people return to their neighborhoods with permissive drinking and drug abusing cultures, the cycle of addictions and homelessness once again then repeats itself. So, basically, as someone who has worked in this program for six years and chaired the Juneau Municipal Mental Health and Social Service Advisory Board for about the same amount of time, I have seen people come back through the system. Not only through our recovery program system, but through the criminal justice system. And it's because they are once again forced in a number of respects to associate with, once again, abusing relatives, peer group, friends and become victimized and not offered a safe and sober place to live that we once again see them come back through the system. And so I'll end my comments on that note and ask if there are any questions. And once again, I want to applaud the efforts of the Task Force for your work and look forward to working with you at any time in the future. CHAIRMAN PORTER: Greg, thank you very much. Representative Mulder has a question. REPRESENTATIVE MULDER: All right, Greg. This year, as you know, we passed the HB 136, which is related to alternative sentencing for those convicted of DWI's. MR. PEASE: Bless your heart. REPRESENTATIVE MULDER: Well, it certainly should make a little more business for you. MR. PEASE: It's what we should have been doing a long time ago and I applaud the legislation. It makes a heck of lot more sense. Especially in the fact that a number of people that are incarcerated in a correctional facility are subsequently victimized by the perpetrators who live in the correctional facilities. And those people who can come out into the community now and spend their time at a CRC or halfway house and pay their fair share, it makes so much more sense as an alternative to have them, as I said, giving something back. There are a number of community work service programs that I hope that the judges and the judiciary of this state will look at alternatives sanctions as pointed out in the sentencing commissioner report, which make a lot more sense when looking at the criminal justice system and the over burdened court system in it's present form. REPRESENTATIVE MULDER: Well, I appreciate the -- I was just curious, has Public Safety operationalized the bill already? MR. PEASE: October 1st. REPRESENTATIVE MULDER: Has your facility been accredited? And if so, how many beds have been accredited? MR. PEASE: Accredited.... REPRESENTATIVE MULDER: Certified I mean. MR. PEASE: .....through the DOC? REPRESENTATIVE MULDER: Yes. MR. PEASE: We're already an accredited facility with the DOC. So, we probably will see -- we'll be bringing on four more beds October 1st and four more January 1st. REPRESENTATIVE MULDER: Well, I would sure consider it a personal favor, Greg, if you keep me posted in terms of the progress of the program and also the relative effectiveness of it. MR. PEASE: Oh, I will and I think that the other facilities up in the Anchorage area and Fairbanks are also going to be, you know, implementing that. And I see it as a real plus and you know only positive things coming from it. Right now we basically do the same thing in Juneau for the City and Borough of Juneau and have for the last two years. Juneau used to send all of it's DWI's to Lemon Creek Correctional Center where they spent their sentence. Now, we opened up, as I mentioned, a misdemeanor center and part of the design of that was to allow the city and borough to -- and the judges to remand them into our custody and they would serve their sentence immediately so you would have immediate punishment. And in addition to that, rather than sitting around and doing whatever they do in the institutions, they do all the paper recycling now in Juneau. The state paper, office paper. They pick it up, they sort it, and they get down to the docks and ship it out. This is in conjunction with one of the nonprofit organizations. It's a joint venture with the Flying Lion's Club here. But this can be expanded. I have even made proposals to Penwire (ph), if you're familiar with that. It's Pacific Northwest economic region incorporating the Canadian Providences of British Columbia and Alberta with Alaska, Washington, Oregon, Idaho and Montana to offer really a labor intensive industry, that of recycling to be handled just in this fashion, by having those individuals remanded into a program and the community work service system structured to take care of community problems. Like litter. We pick up 700 pounds of litter on the weekend here on the roadsides in Juneau with community work service people. We also do approximately, I think, last year alone around 30 to 50,000 hours of community work service not only with city agencies but other government agencies and nonprofit agencies for everything from snow removal to ADA wheelchair ramp construction. This has saved the city and borough in the last three years since the program began approximately $200,000.00 a year just in prisoner bed care daily costs per year, not to mention the costs of the community work service. So, it just took some foresight on that of the city police department and instantly we cut down on the wait list of people who were waiting to serve their sentence for driving under the influence. And so once again, I think that -- because we've been doing it for quite some time anyway -- that we're gong to see the same kind of results with the legislation that comes on line with public safety October 1st. Working in community corrections, I also serve as the chair of the international organization called IACRA, International Association of Community Residential Alternative Programs and nationwide we're seeing much more use of community work services as sanction reporting centers and a number of other sanctions that were talked about in this commission report and the Task Force that were held prior to the publishing of the final commission's report. CHAIRMAN PORTER: Okay, Greg, thank you very much for your testimony. I have no more indications of people available to testify or desirous of it. Let me go through our sites and make sure that that is correct? Is there anyone still available that wants to testify in Sitka? (No response) In Juneau? MS. CRAVER: No. CHAIRMAN PORTER: Could you give us you name and your testimony, please. MS. CRAVER: No. We have nobody here left to testify. Just observers. CHAIRMAN PORTER: Okay. Thank you. How about in Craig? (No response) And Fairbanks? (No response) Anchorage? (No response). Petersburg? (No response). Okay. We have concluded the reception of testimony for this afternoon. There is no one left here in Ketchikan that's desirous to testify. I thank you all very much for your input and we will be checking in tomorrow to see if there's any further need in Southeastern for further input. With that we'll sign off and say thank you, again. (Off record) END OF PROCEEDINGS