Last Updated 11/06/97 13:01

March 21, 1997

pea  JUDICIARY COMMITTEE             11:00 a.m.





PRESIDING CHAIRMEN:      Senator Williams

                         Representative Lawlor





COMMITTEE MEMBERS PRESENT:



REPRESENTATIVES:         Scalettar, Farr, Abrams,

                         Amann, Bernard, Bysiewicz,

                         Cappiello, DeMarinis,

                         Doyle, Fox, Graziani,

                         Fritz, Green, Hamzy,

                         Henrici, Martinez,

                         Mazzoccoli, McCavanagh,

                         Michele, Nystrom, O'Neill,

                         Roraback, Sauer, Staples,

                         Winkler



SENATORS:                Upson, Kissel, Somma





REPRESENTATIVE LAWLOR:  This first hour is reserved for

legislators, agency heads and municipal officials.

We have a separate sign-up sheet for them.  And

first on that list is Commissioner Armstrong.



COMMISSIONER ARMSTRONG:  Good morning, Senator Williams.

Representative Lawlor, Senator Coleman,

Representative Scalettar and all members of the

committee.  I want to thank you for the opportunity

to address HB6991, AN ACT CONCERNING DRUG POLICY

before you this morning.



First I'd like to acknowledge the hard work and the

dedication of the Governor's Blue Ribbon Task Force

on Substance Abuse; the Connecticut Alcohol and

Drug Policy Council and David Bilken and members of

the Connecticut Law Revision Commission.  The

efforts to introduce strategy options in the fight

against drug abuse have culminated in an excellent

work product.   I also recognize the all entities

are working very hard together in order to

determine the best strategies to pursue toward more

effective action and I certainly support these

continuing efforts.



I did read with great interest the report to the

Judiciary Committee as well as HB6991 and believe

that many of the initiatives discussed are worthy

of pursuit.  One issue, however, that gives me

pause is that of introducing methadone into a

correctional confinement setting.  While I

understand that many of the researchers have

determined that methadone maintenance and

detoxification may result in greater stability for

certain addicts, I would be remiss in my

responsibilities as the Commissioner of Correction,

if I did not point out several of the down sides of

this treatment regiment, whether detoxification or

methadone maintenance.



The current Department of Correction drug treatment

programming and philosophy relies upon working

toward a drug-free environment and abstinence.

That is, our focus is giving the offender

population an opportunity to break the cycle of

addiction and drug dependent mentality while

incarcerated.



If we offer methadone even with the strict confines

as suggested, we could create a craving within the

drug dependent mentality and offenders would likely

gravitate toward the continued chemical dependency

in what I expect to be significantly large numbers.

Such an approach goes against the model that seems

to be most effective within the confines of the

correctional system.



Although we do continue to experience discoveries

of contraband narcotics within the confines of

prisons, I do believe that our interdiction efforts

are paying off and that there is less now than

previously.  It is my professional opinion that

maintaining an addiction within a correctional

setting does not enhance the public safety, the

safety of my staff or the legitimate correctional

objectives which we seek to promote.



As many of you know, the Department of Correction

has a substantial number of inmates who are

diagnosed with substance abuse and substance

dependence disorders.  In addition to abstinence we

have always addressed this cluster of disorders

through counseling service, self-help groups, and

where appropriate, medical intervention.



We presently have a detoxification protocol that's

been developed by our health services division to

assist those individuals who experience acute

withdrawal symptoms.  This protocol includes

medication such as Vistaril and Clonidine that are

administered when necessary and if the withdrawal

systems are acute, the inmate would be transferred

to one of our five infirmaries for 24-hour medical

monitoring.   Such a protocol is consistent with

the standards outlined by both the American

Correctional Association and the National

Commission on Correctional Health Care.



In addition, since the Department of Correction has

been successful in monitoring and treating

withdrawal, I'm very cautious about the use of a

controversial substance such as methadone.  My

caution focuses on the security risks that this

drug presents.  Not only will the drug dependent

mentality crave the substance, it can also become

an instant black market commodity within the prison

walls that creates a risk of safety to my staff as

well as other inmates.



The Ryker's Island data suggests that without

methadone individuals are likely to re-offend.

While I will not dispute this study in the

statistics, I'm left wondering why there is not  a

multitude of prison based methadone maintenance

programs.  If the primary concern is that these

individuals will return to the community and resume

a heroin habit, it would seem to me that a

potential option would be for the methadone program

clinicians to re-engage their clients prior to

their discharge from custody upon return to the

community.



The Department of Correction has developed a

similar program with the Department of Mental

Health and Addition Services for inmates with

serious psychiatric disorders.  In this

collaborative effort, clinicians from designated

mental health centers follow their clients, track

them through our system in an effort to rap around

services prior to the release from custody for a

successful transition into the community.



Finally, the cost of such a program is high.  To

implement such programming would require additional

staff and dollars that we simply do not have.  I

would request that you allow me and my staff to

continue to do their jobs in a fashion that is

consistent with the protection of the public,

institutional safety and in the interest of

breaking the cycles of addition, rather than

providing a crutch with which an individual

ultimately delays dealing with a terminal

affliction.



Again, I want to recognize the efforts of everyone

who's been working towards development strategy

options.  And I thank them for their hard work and

I'd be happy to answer any questions you would have

for me.



REP. LAWLOR:  Thank you, Commissioner.  You mentioned

the Ryker Island experiment.  My understanding is

that its been there since 1988.  How did they in

New York deal with the concerns that you have

raised here?



COMMISSIONER ARMSTRONG:  Well, I don't know because I

haven't spoken with the prison officials in Ryker's

Island.  I have placed some calls and I would like

to meet with them.  David Bilken is brokering a

meeting so that we can continue to explore that.



REP. LAWLOR :  And as you read the proposed statutory

language that would mandate you to provide

methadone to inmates?



COMMISSIONER ARMSTRONG:  As I read it, I would read that

they would require me in one of the jails to set up

a program which would require me to offer it and

make it available.



REP. LAWLOR:  Do you think the current laws would

prohibit you from doing it if you thought it would

be effective?



COMMISSIONER ARMSTRONG:  Well, I should add that

currently under a consent decree we have a

methadone detox program for females under West

versus Manson at the York Correctional Facility.

That is because of the risk that withdrawal and

acute symptoms would present to pregnant females.

The program is maintained per order of that consent

decree.



So that does occur.  We have had prior experience

with methadone maintenance, I think it's worthy to

note.  Often times offenders who are out in the

community under methadone maintenance would come

back in having re-offended. When they came back re-

offended, they were not only taken methadone, but

they had also crossed addictions that were present

as well.



They had resumed shooting heroin or using other

chemical substances as well.  So it was not a

simple return to methadone.  It was another

withdrawal from additional cross additions as well.

We had some problems before with that, and again, I

think that one of the values of the correctional

setting and the withdrawal process itself began

recognizing that the symptoms is like have the flu.

It's uncomfortable.  It's difficult.  But it does

fit directing people at that point to effective

treatment strategies.



I think the bottoming out is pretty much a standard

provision that most people who become motivated

towards treatment experience and then look for the

treatment and look seriously at it.  And I

certainly wouldn't want to make it comfortable for

someone to face that decision.   I think that

that's where they actually make good decisions.



REP. LAWLOR :  Is it possible to get heroin in our

prisons today in Connecticut?



COMMISSIONER ARMSTRONG:  Is it possible?  Sure, if we

have people who are committed to it.  We spent

millions of dollars outside the prisons fighting

heroin.  You can get it in the free society with

the amount that we've invested there.  You

certainly can find ways to breach our security.



I think we're doing much better than we've ever

done in this state.  I was just counting up some

numbers.  We've done this past year about a dozen

prosecutions for people who have attempted to bring

it in or have brought drugs in and been detected.



We have K-nine sweeps on the average of twice a day

in housing units for offenders.  We use telephone

monitoring religiously to prevent that from

occurring.  And again, I think just our overall

strategy of drug testing targeting offenders who

are at risk has been tremendously effective in

reducing the amount of occasions where we have

that.



REP. LAWLOR:  And do you keep statistics on how often

you find syringes, for example, in prison?



COMMISSIONER ARMSTRONG:  Yes.  We document every

occasion where we find narcotics.  We document

every occasion that we make an arrest, etc.  We are

right now in the process of getting some better

statistics in terms of the number of arrests that

we have in process, investigations that are under

way.  And we've taken a very strong position on

that.



REP. LAWLOR:  So about how many syringes do you find?



COMMISSIONER ARMSTRONG:  Syringes not too many at this

point in time.



REP. LAWLOR:  About?



COMMISSIONER ARMSTRONG:  I couldn't answer from here,

but I'd say very few.



REP. LAWLOR:  One a month?  One a week?



COMMISSIONER ARMSTRONG:  Couldn't tell you from here.  I

will get you the numbers though.



REP. LAWLOR:  Okay.



COMMISSIONER ARMSTRONG:  I'd be happy to get those from

you.



REP. LAWLOR:  And how about finding heroin or cocaine or

marijuana inside prisons?  That happens I take it?



COMMISSIONER ARMSTRONG:  I'd say we probably find a

substance more often than we find a syringe.   But

I couldn't tell you.  Again, I will get you some

statistics on that.



REP. LAWLOR:  So you mentioned that in the women's

prison facility there's an ongoing methadone

program.  The problems you outlined on the outset,

how are those dealt with at the women's prison?



COMMISSIONER ARMSTRONG:  It's a detoxification program

so it is somewhat limited.  It would not be a

maintenance program.  There are two very, very

different pieces of this.  Basically it's because

of what I understand the half life of heroin

addiction in your system to do.



In other words, the withdrawal symptoms over the

course of time take longer with heroin than it may

other substances.



REP. LAWLOR:  So how long is methadone administered to

inmates?



COMMISSIONER ARMSTRONG:  I believe it's depending upon

the individual and the acuteness, but I would say

up to about 30 days or so for a detoxification

program.



REP. LAWLOR:  So are you aware that in the Ryker's

Island program that it's only for inmates who are

in for a relatively short period of time?  A month

or two?



COMMISSIONER ARMSTRONG:  Yes, I was aware of that.



REP. LAWLOR:  And are you aware that basically what that

is it's a relationship between the in-the-facility

program and the outside-the-facility program to

begin to wean people who are chronic offenders off

of heroin and get them onto some sort of health

treatment program?



COMMISSIONER ARMSTRONG:  I am all for that, but I do

believe that we have to recognize that once we have

the controls to the confines of the prison that it

does make a difference in the type of environment

and climate that I believe is very important for me

to maintain.



I am no adverse and I do believe that we should

look at the strategy of how we connect,

particularly when we put the person back to the

free society, recognizing they were short term in

the jail system and will likely return to the ready

availability of whatever drug of choice they have.



That may be the most appropriate point.  So that we

have a system that does not cause other problems

within what we have made some great strides in.



REP. LAWLOR:  So is what you're saying that you think to

try and do this today would create too many

practical problems, but --



COMMISSIONER ARMSTRONG:  If I made methadone available

inside the prison system, it would change both my

procedures and my protocols that have been very

successful.  I think it would probably diminish

those people who wish to take advantage of

programs.



I do have to recognize withdrawal is probably very

difficult for those people who have to experience

it.  We do have some degree of treatment which

makes it a bit more comfortable.  But I think to

make people too comfortable under an addiction is

only going to delay dealing with the problem.



I do again, that's somewhat of a personal

perspective.  I used to be a counselor in the

system and I recognize that those people who wanted

to change always told me it was as a result of

bottoming out.  That they realized that the jail

experience has been valuable to those individuals

who want to change based upon the withdrawal

experience as well.



It really starts to add things up.  They have no

availability of the drug.  They start to see much

clearer where they've put themselves.  I think it's

very, very important that that is a part of the

process to be recognized in people who desire to

seek treatment.



I think we will only defer some real substantial

steps towards treatment if we make them comfortable

in a process.  And again, please don't mistake

this.  It's not mean spiritedness at all.  I really

do believe in programs, I believe in the

effectiveness of programs.  But I think they've got

to be well gauged as to where to do those.



REP. LAWLOR:  Well, I think we're just looking to save

money mainly, so I think as I understand the way

they do it in New York, which has been very

successful and documented and studied from here to

kingdom come.  The way they do it is they target

only people who are in for a very short period of

time.  And these are people who have been in and

out, in and out, in and out for years in many

cases.



And for those individuals they find that they are

successfully getting them into drug treatment,

avoiding future incarceration, returning them to

employment by targeting carefully the methadone

program and they do it only in the facilities which

are dealing with these short-term stays.  The pre-

trial type confinement.



COMMISSIONER ARMSTRONG:  I hope I didn't sound like I

disagreed with their target group.  I do think

that's a good group to focus on.  I think if they

are going to do something with that we could

certainly cooperate with the identification.



I think it becomes a problem for me where we

introduce the methadone into facilities.  I do

think it's important as these people will be

identified as a high-risk group and will be let

back out into the free society, that we do

gravitate those whom we can towards effective

controls.



That's a public protection issue and I do believe

that's good public protection if again, we don't

compromise it in another aspect, such as inside my

facilities.



I think we can identify those folks.  I think we

can be cooperative.  I like the model we've had

with the Department of Public Health and Addiction

Services and wraparound services.  I think it's

most appropriate as a public protection issue as

they are returning to the community, but as we also

have another support system that's available for

them to be directed into treatments which will

change the cycle of addiction.



REP. LAWLOR:  And you'd be willing to meet with Mayor

Guliani's staff and the corrections people from New

York to talk about how they've solved these

problems there?



COMMISSIONER ARMSTRONG:  Yes.  David Biklen has done a

fine job in the information he's gotten me and he

has also agreed to broker the meeting and I'm

looking forward to that.



REP. LAWLOR:  Great.  Okay.  Other questions?

Representative Farr?



REP. FARR:  Just so I understand it, and I think you

expressed your concerns about these programs

before, the methadone program in the jail.  We

first envisioned or I envisioned that we would do

it when people got arrested, you know, that were

arrested that a long time drug abuse, people would

be suitable for methadone, and got arrested and you

pointed out that the problem that they haven't been

sentenced yet is you don't know whether they are

going to be long-term or short term.



And, therefore, if you get somebody on methadone

and they get a long sentence, then what do you do

with them?  Then you've got to withdraw them from

methadone.



COMMISSIONER ARMSTRONG:  That's correct.



REP. FARR:  Then if you have somebody who's long term,

they've completely withdrawn from drugs, you now

put them back on methadone right before get

released?  I mean, that's -- I don't know whether

that's good or bad.  New York's program I gather is

for people as Mike described it, somehow they've

identified those people that are going to be short

term that are long term drug users.



I don't know what -- it seems to me that percentage

of our population is relatively small because most

of the long-term drug users that end up in jail I

think would tend to get longer sentences and if

they get a longer sentence, then why -- how would

you use the methadone program?



COMMISSIONER ARMSTRONG:  It gets a bit awkward.  I'm

probably not the best person to determine which

people will not come back to me.  That's more of a

judicial matter.  A lot of the screening which

would occur for the people who might be most

appropriate for this would likely occur at court.



Again, it's sort of a directional process where I

don't have control over who stays and who goes,

especially in the pretrial area.



So as I say, it may be most appropriate to have an

identification system that is set up and not have

the methadone introduced necessarily because of

those other issues, some of which you touched on.

But as well, the commodity inside the prison could

be a black market commodity.  A person who is not

on a drug could actually get high on the methadone.



And certainly it's a system of assessment and

gauging the proper amount of methadone so that a

person really does detox without the physiological

problems that occur.



So there are a lot of things in there.  Again, my

concern would be community protection, public

protection.  And I think that as I see it right now

we could have a part in assisting in the

identification and the screening process for those

individuals who might be most appropriate.



But I think in terms of serving public protection

as well as institutional security and order, it

might be best for those people who haven't been

identified and who will leave the system to be

caught in the net before they go and be brought

directly to the resources.



REP. FARR:  Let me just say I asked your staff for some

data on the use of drugs within the prisons and I

talked to somebody this morning and they had

indicated that you were still gathering that data.



But that -- and the one study that he had looked

at, in one institution where they had done targeted

drug testing and these were drug testing at people

that they considered to be high risk, people who

had been out on furlough, people that were short

term there, that might have access.  That those

people that the rates were something in the 14 to

17 percent.



They found 14 to 17 percent of those people who had

used drugs.  But that was a very targeted

population and if that's population is at 14

percent, then overall population in the institution

would be certainly below single digits and to me

that certainly reflects that we don't have the

situation that's been described in other states

where access to drugs is rampant and that doesn't

surprise me knowing the way you run your

institutions.



So I would appreciate getting that data as well

when you finalized it.  Thank you.



REP. LAWLOR:  Thank you.  Representative Fritz.



REP. FRITZ:  Thank you, Mr. Chairman.  Commissioner, I

was quite concerned with the section of the bill, I

believe it's section 7 where it talks about your

establishing a pilot research program of methadone

maintenance at the York Correctional Institution.

And additionally over in that same section in line

182 where it talks about you providing up to 500

treatment slots.



I was wondering if you had any inclination or any

estimate about the approximate costs of such beds

and such a program and have you any idea where you

would be putting any of these beds?



COMMISSIONER ARMSTRONG:  I don't mean to be flippant,

but it's more than I have.  It's quite a

substantial amount of money.  Again, I'm guessing

that methadone maintenance would be about $5,000

per year per offender.  And again, it's

indeterminant at this point.



REP. LAWLOR:  Other questions?   If not, thank you very

much, Commissioner.



COMMISSIONER ARMSTRONG:  Thank you.



REP. LAWLOR:  Tom Siconolfi.



THOMAS SICONOLFI:  Good morning, Senator Williams,

Representative Lawlor, and members of the Judiciary

Committee.  I'm Tom Siconolfi, Director of Planning

at the Office of Policy and Management.  And I'm

here on behalf of Governor Rowland and Secretary

Kozlowski to testify on two subjects.



One, the governor's recommended allocation of block

grant funds under the drug control and system

improvement block grant.  And secondly, to offer

testimony on HB6991.  I've submitted extensive

written testimony on both and based on the

committee's preference we could deal with the block

grant first or combine my oral comments and get

right into questions.  Whatever you think would be

preferable.



REP. LAWLOR:  Oh, I'm sorry.



THOMAS SICONOLFI:  You weren't hanging on every word,

Mike.



REP. LAWLOR:  Testify on the block grant first.



THOMAS SICONOLFI:  Sure.  The drug control and system

improvement block grant is a grant from the U.S.

Department of Justice that supports a wide range of

initiatives across many justice agencies.  The

leaders of those agencies as well as other federal,

state and local officials were instrumental in

helping us to procure the allocation plan that we

submitted for your consideration.



They assisted us by reviewing current grant funded

initiatives, evaluating requests that were made to

fund newer, expanded programs and in reaching

consensus as to the best use of what are really

very limited dollars.



They recommended ultimately that the majority of

these 1997 block grant funds, some $6.7 million, be

used to continue programs already in existence and

supported by grant funds.  They also suggested that

the remaining funds, about $1.1 million, be used to

expand the drug court program to two additional

sites.



And overall the allocation plan, I think you'd be

able to find five priorities within it, and those

include alternatives to incarceration, particularly

for juveniles; youth crime through drug education,

school safety and gang initiatives; law enforcement

task forces that target narcotics, fugitives, auto

theft, financial crimes and street crime; court

system improvements including death penalty

litigation, youthful offenders program, judicial

resource enhancements in court security; and also

development of a criminal justice information

system, which is a requirement of these federal

dollars.



And in putting together this program plan and the

priorities, the committee purposely avoided

earmarking any of these so-called DCSI funds for

programs that are well supported with other dollars

that we have available.  And accordingly we would

ask the Judiciary Committee to bear in mind that

this allocation plan represents only a small

portion of the total dollars that we're providing

for state and local justice initiatives.



Some of the other money which should be taken into

account includes the state-funded Drug Enforcement

Program, which provides about 100 municipalities

with $9 million for drug enforcement and drug

education activities.



Safe Neighborhoods Program, under which state

support for -- the state is supporting 158 new

police officers in 12 communities at a cost of

about $6 million a year.



And the new federal program, the Local Law

Enforcement Block Grant Program, under which we

received about $3.3 million and virtually every

community in Connecticut is getting some portion of

that, large or small depending on their violent

crime problem.



There are also many other federal grant programs

that I haven't listed that we also use to undertake

special initiatives as well.



But in summary, this allocation plan helps balance

resources across the justice system and I would say

that in our experience looking at issues like

prison overcrowding, curbing the sales of illegal

drugs, cracking down on gangs or violent crime,

we've always been most successful when all

components of the system are adequately funded.



And in conclusion, on the block grant, we would

respectfully suggest that the Judiciary Committee

concur with the Appropriations Committee and

approve the allocation plan as submitted by the

governor.



I'd be happy to answer questions at this point or

move onto HB6991 as you choose.



REP. LAWLOR:  I think one of the reasons we wanted to

have a discussion of the block grant as part of

this overall public hearing today was to get some

sense of where the state is deploying its resources

in the fight against drugs, and especially drug

abuse and drug use for children.



How would you basically describe the general state

strategy and why is it that this particular

proposal on spending the federal money is

consistent with that strategy?



THOMAS SICONOLFI:  Well, I think it's consistent in a

number of ways.  A substantial part of the money --



REP. LAWLOR:  Well, first start with what's the strategy

now?



THOMAS SICONOLFI:  The strategy as it stands right now,

is again, to balance within the system a

combination of needs including moving on

alternatives to incarceration, particularly for

juveniles in order to help implement juvenile

justice reorganization as the legislature adopted

two years ago.



And secondly, to make sure that the state and local

police have adequate resources to target the kind

of crime that the public is most concerned about

right now, which includes gang activity, drug

sales, gateway crimes among juveniles like auto

theft that lead to other offenses and chronic

criminal careers and so forth.



And what you would see at this point is that about

$1.7 or 8 million supports those special task

forces, mostly run through the State Police, but

also supporting local police with the same dollars.

Several million of this grant is earmarked for

judicial programs to implement some of those

programs in a continuum of juvenile sanctions that

the legislature and the executive branch and

judicial all bought into so completely two years

ago.



And there are other programs relative to -- which I

would call special needs, such as the death penalty

litigation attorneys that we're funding in both the

Division of Criminal Justice and the Chief Public

Defender's Office.  Certain court enhancement

programs that we're undertaking.  And those dollars

in conjunction with particularly the drug education

part of the drug enforcement program we think give

us a well-rounded strategy that supports

enforcement, treatment through alternative programs

and education to try to keep young people from

being involved with violence, gangs and drugs.



REP. LAWLOR:  Other questions?  Representative Farr.



REP. FARR:  I have a few specific questions on the block

grant.



First of all, we're spending $170,000 of the block

grant on the DARE Program.  And from reports that I

get there are other programs, drug education

programs that may be more effective than that.  And

I guess my concern in our educational areas is that

we don't do a very effective evaluation of

programs.



And are we spending any of the money in the block

grant in terms of evaluation of educational

programs?  Is there any money specifically set

aside for that?  Cause I've become convinced that a

lot of the money we spend, not just in drugs, but

in most of our state agencies, we don't measure

results.  How do we know whether we're spending it

right?



THOMAS SICONOLFI:  The evaluations that are specifically

funded in this program are probably not earmarked

at the drug education component.   There's an

evaluation being done now of the Sex Offender

Program that runs through the Office of Adult

Probation.



The DARE Program is a very well supported program,

as you know, among local police and State Police.

But many of our communities are also doing other

programs.  Here's Looking at You 2000 and other

anti-drug curricula.



One of the things that we would agree with is that

our whole strategy on drug education needs to be

looked at and the Alcohol and Drug Police Council

which is co-chaired by Tom Kirk from Demus &

Brandacisco from the governor's office, recently

produced a report with a major recommendation that

said: let's take a look at all the dollars we're

putting into drug education and see if we're doing

it as effectively as we might, see if it's time to

reshape curricula in some fashion.



So the State Police participate on that council, as

does OPM, the Department of Education and others.

So we're going to work together in the next few

months to try to take that had look at our drug

education efforts.



REP. FARR:  But there's nothing allocated under the

block grant for that evaluation?



THOMAS SICONOLFI:  No, there is not.x



REP. FARR:  And so where would we get the money to do

the evaluations?



THOMAS SICONOLFI:  Well, the evaluations -- I'm not sure

I would call it a formal evaluation from a research

standpoint, but the individuals who are running all

of these programs, prevention experts from Drugs

Don't Work and the like, are going to sit down at

the table together and take a look at what the best

practices are now, what the literature says is

working and isn't.  Take a look at what we're

funding and possibly redirect some of that money or

not.



It may be that people will feel comfortable that

what we're doing is the right mix of prevention

programming.  I couldn't say yet.



REP. FARR:  Let me ask you about a couple of other

specific programs that are funded in here.   The

drug session, I know that the drug session we get

anecdotal evidence back about its success.



THOMAS SICONOLFI:  Yes.



REP. FARR:  But is there a formal evaluation of the drug

session?  Do you know?  Has there been a formal

evaluation?



THOMAS SICONOLFI:  I believe we are.  I was just looking

back to Bill Carbone from the Office of Alternative

Sanctions and Judicial Branch which is actually

administering the program and Bill is indicating

that, in fact, there is a formal evaluation

component which is built into the $420,000 that

funds that program.



REP. FARR:  But we don't have it back yet?



THOMAS SICONOLFI:  No.  The program has only been

running I think about eight months.



REP. FARR:  Okay.  The other concern I have is we're

talking about spending money, a considerable amount

of money on expanding of the drug sessions.



THOMAS SICONOLFI:  Yes.



REP. FARR:  And the language it says: a new adult drug

session in Waterbury and a pilot juvenile session

in Hartford.  The report we got back from the judge

that was running the program is that, in fact, the

program has turned out to be different than it was

envisioned.



THOMAS SICONOLFI:  Right.



REP. FARR:  In that instead of getting young offenders

we get old offenders instead of getting people that

are, you know, new drug users, we're getting people

who are kind of at the bottom of the barrel.

They've been on drugs and gone through the system

multiple times and they are trying to get off of

it.



And I guess I have questions about how you can have

an effective juvenile drug session based upon all

the reports that we got back in that at the

juvenile level you don't have the juveniles

interested in getting into these programs.



THOMAS SICONOLFI:  Well, I think there's a couple of

things happening here.  One, our original intent

was to expand the program so that it would be in

four adult court locations.  But there was quite a

bit of support within the Alcohol and Drug Policy

Council for trying a pilot program that would

target juveniles.  And so we changed the mix and

came up with the notion of doing one juvenile-based

drug program.



I think one of the issues we need to keep in mind

is that in terms of remaking the juvenile system

and developing a continuum of sanctions much like

we have on the adult side, it's in its infancy.  A

number of the programs that the legislature deemed

should be enacted and established are just

beginning.   DARE reporting centers for juvenile

offenders are just getting off the ground.



And so I think we're in a point similar to where we

were in the adult system several years ago when it

was easier for offenders to take what looked to be

a harsher sanction on face value, prison, to an

tough alternative program.  But I think once that

mix of juvenile alternative programs is in place

fully, which will include some tough supervision

programs, then programs like the drug court will

become more attractive because there won't be the

easy out.



We're still dealing with a situation where the

average stay at Long Lane for juveniles is no where

near where we want it to be.  It's only about four

and a half to six months and DCF is looking at a 12

to 18 month program.  That's our goal in remaking

Long Lane School.



So once those changes are in place I think we do

have fair experience on the adult side that says

that's the point at which tough alternatives can

work.  But if you don't have tough sanctions on the

top end as an alternative, then programs like this

will look tough to kids and they'll look for

another avenue.



REP. FARR:  I agree.  I'm just saying that I don't see

the benefit of saying we're going to set up the

program.  We don't have the sanctions out there now

to make this look attractive.  It seems to me if we

set up a juvenile court program right now today

nobody is going to opt for it.



THOMAS SICONOLFI:  Well, the three day reporting centers

for juveniles that we were describing are just

beginning.  I think it's a first quarter and second

quarter of '97 initiative.  I'm anticipating that

starting this juvenile program, the drug session,

probably wouldn't begin until September or October

by the time we got it off the ground.



So some of those additional sanctions should be in

place at that point, but we're going to have to

look at it closely.  I think your concerns at this

point are valid.



REP. FARR:  My overall concern with the way we spend the

money is that we don't have enough money in this

for evaluation.  Now you've got administrative

funds $433,000.



THOMAS SICONOLFI:  Yes.



REP. FARR:  I'm not sure how much of that is evaluation

components?  Do you know?



THOMAS SICONOLFI:  Of the $433,000, none.  At this point

that 5 percent is supporting staff at OPM who are

not only administering this grant, but also the

other grant programs that I mentioned earlier. It's

four or five full time equivalents that are being

funded under the program and there's some equipment

and other operating expense money.



But the administrative side strictly supports OPM

based planning and program management activities.



REP. FARR:  Well, I can keep saying that but it's clear

to me that if you don't put evaluations in place

and we keep spending all this money that most of it

or a substantial portion is going to be not spent

wisely.



THOMAS SICONOLFI:  Point well taken, sir.



REP. LAWLOR:  Representative Scalettar.



REP. SCALETTAR:  Good morning.  I will follow with two

lines of questioning that Representative Farr was

talking about.



One is with respect to evaluation of programs,

which I think is very important and I know that the

Office of Alternative Sanctions has really made an

effort to incorporate that.  When we talk about

drug policy and the importance of drug policy, both

with respect to drug abusers and the safety of the

community, I think it's very important to include

the Department of Corrections in our evaluations.

And that's something where people don't often ask

for it, so I just make that point to you.



In thinking about the future that we want to

compare the results of what's happening by sending

people to prison and programs in prison so that we

can really see how we're -- what's the best and

most cost effective way to spend our dollars.



Also with respect to the juveniles.  What Judge

Simone told us about the drug court is that they

expected to get 16 to 19 year olds, not the

juveniles.  I think juveniles and what you're

targeting here is very important and new and that's

the 14 and 15 year olds, perhaps even younger.



And they expected to get the 16 and 19 year olds

but are not, and he actually pointed out to us

something in the law which we might be able to

change to make a difference in that.



So I don't know if you have any comments about

either of those.



THOMAS SICONOLFI:  Well, relative to the second point,

one of the main features of the juvenile justice

reform bill was to make juvenile records that

previously hadn't been available in the adult

court, available to court personnel.



And so kids who previously looked as if they had a

clean record and would start anew as an adult, can

no longer do that.  So I was of the impression that

the availability of those records so that the adult

system would look at those 16 and 17 year olds as

they truly existed in the juvenile justice system,

combined with the sanctions would provide an

incentive to get into these programs.



But again, currently it's not being borne out in

New Haven.



REP. SCALETTAR:  Thanks.



REP. LAWLOR:  Are there other questions?  Representative

Nystrom.



REP. NYSTROM:  Thank you, Representative Lawlor.

Through your testimony on one section of 6991,

which is the repeal of Section 21a-278, but I

didn't hear you elaborate too much on that.



THOMAS SICONOLFI:  Well, I had oral testimony I had

hoped to offer on 6991 and I thought that perhaps

we would finish the block grant and I would make a

few remarks and answer questions on that, at the

committee's pleasure, of course.



REP. NYSTROM:  Okay.



THOMAS SICONOLFI:  With the permission of the chair,

could we move off the block grant and --



REP. LAWLOR:  Sure.  Oh, I'm sorry.  I thought we had

kind of were mixing.  Representative Fritz.



REP. FRITZ:  Thank you, Mr. Chairman.  I have one

question on the block grand and it deals with this

communication that came from the governor that

talks about that has the chart at the back and I

would assume this is the drug control and system

improvement fiscal year '97 funding plan?



THOMAS SICONOLFI:  Yes.



REP. FRITZ:  I would assume that you had put these

numbers together.  Could you explain to me why

there's $1,123,890 left if I'm reading this

correctly, in terms of carry over from the 1996

funding?  Or is that the money supposedly from

January to July of '97?   Could you elaborate on

that please?



THOMAS SICONOLFI:  Sure.  We try to keep programs for

funding on the fiscal year cycle.  It works better

for us and it also works better at a point where we

ask the legislature to pick up funding for a

program.  And often programs there are people who

are expected to be employed who are not.  There are

programs expected to start in September that may

not start until October or November.



And it's not until the end of the fiscal year, when

we get our final reports, that we identify the

amount of money that was unspent.  And so the

amount that you're referring to would be an

accumulation of funds from any of a number of grant

programs that simply spent less money than we

anticipated.



There was one area where we had a substantial carry

forward and that was from a school safety

initiative which we deferred for one year.  And so

we didn't spend any of the money we had originally

earmarked for that.  But those would be the causes

of carry over funds.



REP. LAWLOR:  Representative O'Neill.



REP. O'NEILL:  Over the last couple of years we've done

a lot of studying about the issues related to drugs

in the legislature and the governor's had I'm not

sure if it was a task force or a study that his

people put together that I guess culminated in the

council.



And the Law Revision Commission did about a two-

year study and the program review and investigation

did one targeted for teenaged drug use,

particularly and aside from the drug courts which

sounds like from what we're hearing, at the present

time they attract adults more than teenagers.  And

sort of agreed that that probably will continue

until or unless we change some systems to

incentives teenagers to use the drug court rather

than the other things that are available to them.



But that may or may not happen.  That's kind of

like potentially, but I'm not sure that I know of

anything specifically that leads us in that

direction.  So I guess my first question is in

following up on that question or issue of

incentives, changing the incentive structure.  Is

there anything proposed to do that?



THOMAS SICONOLFI:  Well, as I mentioned earlier, I think

the incentives will come to pass in the form of

tougher sanctions that are being put in place for

younger offenders through juvenile justice

reorganization,  combined with the opening up of

records that people amass as a juvenile to the

adult system.



I think when that is fully in place the adult court

will begin to treat 16 and 17 and 18 year olds who

previously looked like they were just beginning

their criminal career appropriately based on their

record, which wasn't available in the past.



And so when that happens I think the alternatives

to participation in a program like the drug court

will be a tougher sentence than might be faced by

that 16 year old or 17 year old.  And that's the

incentive to get into the program.



Right now, again, as a juvenile there's little

incentive.  If terms at Long Lane are insufficient

and as a 16 or 17 year old there may not be

sufficient incentive if, in fact, your full record

was not known to the adult court and you're likely

to face a non-conviction sanction for the offense.



REP. O'NEILL:  But these are things that are in effect

already past in terms of legislation?



THOMAS SICONOLFI:  Yes, and also things that are

happening budgetarily relative to juvenile

sanctions.  The judicial branch has a program over

three years to dramatically increase the programs

that are out there for younger offenders and that's

being implemented across that period of time.  Not

everything is in place yet.



REP. O'NEILL:  Because so in effect we won't know maybe

for a year or two whether what we think intuitively

which should work which is that if there are higher

sanctions, not so much that we've changed the

sanctions while we've done that a little bit, but

mostly because we've changed the rules by which we

evaluate someone to decide what sanction they are

likely to get as a juvenile?



But we won't know that for a couple of years

whether that's really working.  I mean, but we're

going to be doing the drug courts before that

happens.



THOMAS SICONOLFI:  Well, I would hope and I would expect

that we'll make adjustments to the court program on

the move.  As we learned from our first experiences

in New Haven, we'll hopefully make adjustments that

will get incorporated into the new sites and also

into New Haven program.



But again, that program I believe is quite a bit

less than a year old and so we're really just

beginning to see how it's working, whether or not

people are staying in it, whose failing.  There is

a formal evaluation underway.  Judicial also has a

formal evaluation underway of its full juvenile

sanctions program.



So that kind of information is going to take awhile

to get back.  But the kind of adjustments that can

be made internally there's no reason why we can't

make those as we go.



REP. O'NEILL:  Okay, but in other words, we don't, in

effect we don't know if the drug courts are going

to get at the teenagers right now.



THOMAS SICONOLFI:  All the evidence would say that it's

not getting to the population we had hoped and I'm

not certain whether or not we've identified the bet

way to make that change in the short term.



REP. O'NEILL:  But we're going to go ahead and do more

drug courts?



THOMAS SICONOLFI:  Because the feedback has been that

even the target population that is participating,

or the population that is participating as opposed

to the target population, is benefitting from the

program.



So the feedback we're getting from prosecutors and

public defenders and Judge Simone and others in the

New Haven district is that the program works very

well.  It's just not working, it's not drawing the

same group we expected to draw earlier, which is

not to say that it's not valuable (tape ended) for

the slightly older population than it's actually

getting.



And based on that the assumption is that the

program has value for either.  We would prefer to

target the younger population.  We're going to try

to make adjustments to do that.



REP. O'NEILL:  Because the main problem that seems to be

reported in the media and seems to have cropped up

in all the research that I was on the Law Revision

Commission and I worked fairly closely with keeping

track of the research that was being collected and

so forth, is that we've had a fair amount of

success with older drug users.



Or put it this way, the problem that we've had

failure with more than anything else is with the

younger people, teenagers.  And that for better or

for worse the programs that have been put in place

over the last 15 years if their objective was to

discourage adult drug use, have been somewhat

successful.



Over the last five or six years teenage drug use is

what seems to have gone up.  And so if that's where

people want to focus or at least right now they are

saying well, this is where the rise is.  This is

where we should focus our attention.  And that I

guess isn't based on what we know now isn't really

addressed by anything in here.  Or am I

misunderstanding what we're doing?



I mean, assuming that, you know, if we don't know

for sure whether the new incentives will get the

teenagers into the drug courts and basically the

drug courts is where we're putting what little new

money we have.



THOMAS SICONOLFI:  My sense is that the alarm that

people are experiencing about an increase in drug

use among youth is primarily in the non-criminal

justice population.  And the initiatives that

people want to undertake in response are primarily

drug education activities at the school-age

populations who are involved recreationally, if

that's the right word, in drug use before they

become more seriously involved or for some, and

it's going to be a small number before some become

involved with the criminal justice system.



So that's one of the reasons that we want to take a

hard look at the current drug education programs

we're funding and try to say wait a minute here.

If, in fact, drug use is up among that population

yet we're still spending $4 or $5 or $10 million on

drug education in the schools, then it's time we

take a hard look at our drug education curricula

and decide if it needs to be adjusted.



Is it stale?  Are there new initiatives that should

be incorporated into it?  That's the purpose of

looking at those programs.  But I think the general

concern that's out there is for a population

perhaps different from this one.  The one addressed

by either the drug court or by any of the programs

funded in the DCSI grant program.



REP. O'NEILL:  Well, but the DARE Program really is --

is it supposed to be model for younger children of

an anti-drug education that's kind of a broad

spectrum not really targeted?  At least as far as I

understand it's not like you find the children of

heavy drug users and --



THOMAS SICONOLFI:  Right.



REP. O'NEILL:  I mean, this is something that's

available to the general student population.  And

that's the target audience for that program.  So it

does seem like there's nothing programmatically or

legally that inhibits the use of this money for

educational type of purposes.



THOMAS SICONOLFI:  Well, actually this money -- that's a

good point.  This money has to be used for criminal

offenders.  Either to prosecute them, treat them.

This particular block grant is not available for

general prevention activities.



The DARE money that's in the small amount of DARE

money here supports training, which is allowable.

But that's the reason why we use the state drug

enforcement program to fund actual drug education

in schools.  This money must be used for a justice

population.



Libby Graham from OPM just pointed out another good

point which is that you can only do drug education

with this money if it's done by law enforcement

officers and that's why we've been involved with

DARE.  By and large drug education activities are

being funded elsewhere because the money is more

appropriate from those other sources.



REP. O'NEILL:  The other thing that we cropped up with

and I realize this is relatively new and you've

been putting this package together for some time.

But there's a lot of thinking that's kind of -- at

least in my mind is moving in a direction towards

something like these methadone programs that do

seem to have a fair amount of success with the hard

core drug user that nothing else seems to be able

to reach, and the criminal justice system doesn't

necessarily represent an effective way of

converting them if they are essentially being

treated as a physical problem that has to be cured

with a medical type or a physical cure, not

psychological type of approaches.



And I don't see anything in here.  Is this

something that is in the process of being looked

at?



THOMAS SICONOLFI:  Not through this particular

initiative, but I think Deputy Commissioner Tom

Kirk from DMHAS will also be testifying this

morning.  He's the co-chair of the Connecticut

Alcohol and Drug Abuse Policy Council and I think

he's going to be making remarks and answering

questions relative to some of the features of the

law revision proposal that talk about methadone

programs and the like.



So I think Dr. Kirk might be in a better position

than I to answer that question.



REP. O'NEILL:  Thank you.



REP. LAWLOR:  Other questions?  I think you wanted to go

onto 6991, right?



THOMAS SICONOLFI:  I understand the committee's time

constraints and I would just quickly summarize for

you.



REP. LAWLOR:  Can I -- rather than that let me just ask

you two quick questions.



THOMAS SICONOLFI:  Okay.



REP. LAWLOR:  You mentioned during your discussion that

we need to take a look at our drug policy to decide

what to do.  Especially as it relates to kids.



THOMAS SICONOLFI:  Drug education policy I think is the

specific comment that I made.



REP. LAWLOR:  The reason that sort of sparked my

interest is because I think that if nothing else,

everyone would have to agree that over the past two

years more effort has been invested in rethinking

our drug policy and looking at alternatives that

might be options for us to consider.



And I think one of our goals is this year, rather

than to look at it some more, is to make some

policy decisions about whether or not there are

other things which we can explore which might be

more effective and are there -- do you see options

like that in any of the bills that are before us

today?  Things we haven't tried before that might

be worth taking a look at to see if they'd work for

us?



THOMAS SICONOLFI:  Well, we are generally supportive of

the expansion of drug courts, although I think

based on the proposal in 6991 financially it's not

workable right now.  We anticipate that that would

cost as written $10 to $12 million to implement.

Having done four courts in one year based on the

proposal we have now it would be quite an

accomplishment and future expansion really ought to

be tied to available dollars.



So that's one area that we would certainly agree.



REP. LAWLOR:  Well, can I just ask you in terms of money

have you ever taken a look at the current prison

population and determine how many or rough

percentage of inmates are there purely on drug

possession and sales charges?



THOMAS SICONOLFI:  I saw numbers recently which would

indicate that I think there were about somewhere

over 3,000 who you could categorize as being

incarcerated for a possession or one of the sales

statutes.  About 330 or 350 of them were in for

sales by non-drug dependent persons.  One of our

concerns.



Eighteen hundred or so were incarcerated for under

2182-77 general drug sales by what could be drug

dependent individuals and a spattering of others.



REP. LAWLOR:  Two thousand four hundred?  Okay.  And do

you have any idea if we're talking 3,300-3,400

inmates, what the cost of that is every year?



THOMAS SICONOLFI:  Well, a figure that's been thrown

around often and I'm not sure it's really an

accurate one, is a figure of about $25,000 per

person per bed.



REP. LAWLOR:  Is that too low or too high?



THOMAS SICONOLFI:  Well, I think it depends on how you

look at it because there's a basic cost to open a

prison.  And whether you put five people in there

or 500 there's a certain cost to run that facility.

The incremental cost to add a certain number of

inmates is very low, until you reach a point where

you have to add additional staff or build

additional space onto it.



So I don't think it's a simple number.  We've used

25,000 to give us a ballpark figure of the global

cost of all corrections and all the facilities we

run based on the number of inmates we hold.



But I would not want to hazard a guess as to if we

were opening a new facility specifically for these

offenders?  Then that cost would be somewhat higher

than the $25,000.  If we were incorporating them

into prisons we already had, quite a bit lower.



I don't believe there's one number you would want

to hang you hat on at this point.



REP. LAWLOR:  But if you did multiply 3,400 times

$25,000 it would come out to be $86 million.



THOMAS SICONOLFI:  Our sense at this point is that is

again, the notion of balance, Representative

Lawlor.  It's that we need to invest in drug

education which we're doing.  We need to invest in

local policing so that communities can do a better

job of suppressing crime and drug sales than they

are doing now.



We need to be tough when repeat criminal offenders

come before the courts and make sure that there's

accountability for those offenders.  And we need to

provide treatment opportunities so that those

involved with drugs have an opportunity, more than

one opportunity, depending on the setting, to break

that habit.



And so what we're urging is a balanced approach.

We think the funding plan we described is a

balanced approach, but we would also suggest that

some of the changes in 6991 removing mandatory

minimums, allowing multiple participation in those

special pre-trial programs, would upset that

balance --



REP. LAWLOR:  How many people are in on mandatory

minimums today?



THOMAS SICONOLFI:  Excuse me?



REP. LAWLOR:  How many people are actually convicted on

mandatory minimum charges?



THOMAS SICONOLFI:  I don't know about convictions, but

as I mentioned on 21a-278 which has a mandatory

minimum, that's sales by a non-drug dependent

person, there are 350 people incarcerated.  Of

those who are not serving a mandatory minimum on

those drug charges it would seem to be over 2,000.



REP. LAWLOR:  Well, the statistics I have show six on

21a-278 on December 31, 1996.



THOMAS SICONOLFI:  I was looking at a chart from DOC

that showed as I said I think 350.  The one that

was very low was 21a-278a which is the three

special conditions sales within 1,500 feet of a

school, public housing project, day care center,

sales where an adult uses a minor as an agent and

the like, those are add-on penalties and I could

find few people serving sentences currently for

those.



Most of the people selling drugs fall into the two

categories of 277, sales by someone who may be drug

dependent and 278, sales by non-drug dependent

individuals.  And as you know, charging those

higher offenses, the offenses with the greater

penalties and the mandatory minimums is a very

effective plea bargaining tool and for the courts

and prosecutors in moving cases.



And so you can't underestimate the number of

individuals charged with either 278a or 278 who

show up in DOC on those 277 charges because of a

plea bargain.  So I think again, the DOC

information is one snapshot, but doesn't give you a

really complete picture of who those people are and

what kind of offense they actually committed.



REP. LAWLOR:  Well, if you could help us find that 300

number somewhere.  I mean, the chart I've got I

don't see it.  The only one I see for 278 it says

six.



THOMAS SICONOLFI:  I was looking at a March 16, 1997 DOC

summary chart which I will provide to the

committee.  But the total number I had was about

330.



REP. LAWLOR:  And second, Representative O'Neill was

asking some questions about the drug court and

stuff and as I recall, Judge Simone's what he said

when he participated in the forum we had last week

was that the main obstacle appeared to be the

lawyers who were advising the young people to take

AR or YO rather than go into drug court.  Not

because they couldn't benefit from drug court, but

because they'd be exposing themself to a seven year

felony conviction by going.  So, maybe that would

solve that problem if we could eliminate those

options.



THOMAS SICONOLFI:  Well, I think as I mentioned earlier

if we look at our experience on the adult side some

years ago we had the same problem with many of our

alternative programs when prison time served limits

were very low.  And what corrected it wasn't

changing the statutes relative to the charges, but

providing sufficient bed space so that prison was a

real deterrent.



I think we could look at this the same way and say

it may not be a matter of changing the penalties

for the offenses, but making sure that there's

adequate sanctions for the most serious offenders

so that it represents a genuine threat.



REP. LAWLOR:  I thought the other part of that was the

alternative sanctions program?  Building prisons

and --



THOMAS SICONOLFI:  It's a combination.  No question

about it.  But what really helped the participation

in the programs was the fact that prison became a

real deterrent, not changes we made in penalties

for any particular offenses.



REP. LAWLOR:  Are there other questions?  If not, thanks

very much.  Oh, Representative Nystrom has a

question.



REP. NYSTROM:  Thank you.  Just one follow up.  Could

you tell the committee that if we, in fact,

eliminate these revisions for higher penalties and

the restrictions on the treatment programs, is that

going to actually cause a higher cost to be

incurred?



And the reverse of that since '95 when we put these

restrictions in on access, has there been a

decrease in cost to the state?



THOMAS SICONOLFI:  I'd have to be honest and say that I

haven't seen any information one way or the other

about cost relative to those programs.  The

restrictions were put in place because prosecutors

said clearly that individuals at the time when

juvenile records were still being held as

confidential, that an individual would have an

extensive record on the juvenile side, start fresh

on the adult side and have two or three non-

conviction programs available to them before they

ever had their first conviction.



And that was the impetus for making the change.

But I have no information concerning costs one way

or the other.



REP. NYSTROM:  Do you think it exists or may exist in

the future?  I mean, the change is relatively

recent being in '95 it was enacted.  Is that

something you might be able to get your hands on?



THOMAS SICONOLFI:  We may.  Honestly I would suspect

there may be some increased costs from some

individuals who go to prison who otherwise wouldn't

have.  On the other hand there may be an offsetting

cost of crimes that those individuals might have

committed if they were out that they are not

committing while they are incarcerated.



So I'd like to think about how we could give you

good information about that.  But I think there's

items on both sides of the ledger.



REP. NYSTROM:  Thank you.



REP. LAWLOR:  Are there other questions?  Is there

anything else you needed to say?  Or are you all

set?



THOMAS SICONOLFI:  I'm okay.  Thank you.



REP. LAWLOR:  We're just beyond our first hour and what

we've done the last couple of meetings is rotate

back and forth between members of the public and

state agency speakers.  So why don't we switch to

the first person on the public sign-up sheet is

Jack Reige.



We're going to go back and forth.  So it will be

Jack Reige followed by Deputy Commissioner Kirk

followed by Dr. Alvin Novik followed by David

Biklen followed by Steven Duke followed by John

Bailey.



JACK REIGE:  Good afternoon, Senator Williams,

Representative Lawlor and members of the committee.

My name is John Reige and I'm a practicing attorney

in Hartford, Connecticut.  I also have been

involved in educational matters for a number of

years serving on boards of several private

secondary schools, a college and a graduate school.

And have been on the state Board of Education for a

four-term term.



But my interest has really been sparked in this

whole area by serving as a tutor in an elementary

school in Hartford, Connecticut for 15 years.  And

I've seen in all of these institutions the tragic

results of drug abuse which cuts across all lines,

all communities.



I am greatly encouraged by the amount of attention

which is being given in the country and in

Connecticut to this whole issue.  I am aware of the

report of the Governor's Blue Ribbon Task Force on

substance abuse.  The recommendations of the Law

Review Commission and the initial report of the

Connecticut Alcohol and Drug Policy Council.



An obvious conclusion from all of these seems to me

that we certainly need and I think what you're

going to be providing is an integrated plan for

alcohol and drug enforcement, treatment and

prevention.  From my perspective, however, I

particularly urge you to consider shifting from the

emphasis on criminal justice to an equal emphasis

on treatment and prevention.



In this connection, I heartily endorse the policy

council's recommendations to increase the

effectiveness of school-based drug prevention and

refocussing school-based efforts to identify and

treat substance abusers at earlier stages of drug

involvement.  And to increase the use of

indeterminent sentencing and court ordered

treatment.  Thank you.



REP. LAWLOR:  Thank you, Attorney Reige.  Are there

questions?  If not, thank you very much.



Deputy Commissioner Kirk.



DEPUTY COMMISSIONER KIRK:  Good afternoon.  Senator

Williams, Representative Lawlor, members of the

Judiciary Committee, I'm Tom Kirk.  I'm wearing two

hats today.  One as the co-chair of the Connecticut

Alcohol and Drug Policy Council and secondly,

deputy commissioner within the Department of Mental

Health and Addiction Services.



Let me preface my comments by emphasizing the

significance of the hearing and the events that

have taken place in Connecticut over the past year

related to drug policy.  All the various reports

really have produced an extremely important

positive focus on the issue of drug policy in

Connecticut.



The various forums and hearings that have taken

place in the past two weeks at the legislature have

reinforced the valuable information presented in

the various reports.  Legislative activities are

now taking place that appropriately address

substance abuse as an economic, health and public

safety issue.



I want to stress the importance of that point

because it has far-reaching implications for how we

purchase our services, substance abuse services,

particularly since 90 percent of the substance

abuse services in the state of Connecticut are not

state operated.  They are provided through

community-based private nonprofit funders.



It also has significance for how we approach

resource development strategies, how we address

program evaluation and outcomes.  It even extends

to something as simple and fundamental as what is

treatment versus what is supervision?



The four reports consistently call for Connecticut

to adopt an informed drug policy.  Of the four

reports, the Alcohol and Drug Policy Council's is

viewed by some as the most conservative.  That is

for good reason.  The perspective of the Council

was quite comprehensive with its recommendations

placing equal emphasis on health, criminal justice

and economic issues.  The members of the Council

extended their focus to pragmatic issues, for

example, specific resource development strategies

to support the implementation.



In the spirit of promoting an informed policy as

far as substance abuse, I offer the following

comments on the bills before you today:



SB1064, AN ACT ESTABLISHING A DRUG INTERVENTION AND

COMMUNITY SERVICE PROGRAM FOR FIRST-TIME OFFENDERS.

It's a pretrial diversion program for persons

charged for the first time with violations of

possession of drug paraphernalia or of drugs. It's

an eight-week drug intervention program which is

appropriate for persons with the particular level

of disease or disorder that would be identified for

this program.



Following the eight-week intervention program the

person would then participate in four days of

community service in the community service labor

program.  Upon successful completion of the program

the charges would then be dropped.



This unique program was first recommended by the

Blue Ribbon Task Force on substance abuse in

February '96.  It was affirmed by the Law Revision

Commission.  It was affirmed by the Connecticut

Alcohol and Drug Policy Council.



It offers a great opportunity to interrupt the

progression of substance abuse and reduce

recidivism.  The requirement to participate in the

community service program would reinforce the

therapeutically valuable notion that persons must

be held accountable for their activities.



I wish to emphasize a particularly important point.

From my 25 years in working the area of prevention

and treatment including within the criminal justice

system, I cannot emphasize enough the concept of

user accountability as a critical component of

effective prevention, intervention, treatment and

criminal justice initiatives.



We cannot deny the reality of that particular

concept.  Please note that Section 37 of HB6991

also establishes a pretrial drug education and

community service labor program, as compared to the

one that emanated from the council. But there are

some significant differences.



The Criminal Justice Committee of the Connecticut

Alcohol and Drug Policy Council which was co-

chaired by Judge Ment and Chief James Thomas, the

past president of the Police Chief's Association

support of this bill.  Unlike HB6991, the Council's

bill is restricted to first-time offenders, it has

a fixed number of days that persons must

participate in community services, and excludes

from the program persons accused of selling or

distributing drugs from the program.



The Department of Mental Health and Addiction

Services as a member of the council, therefore,

urges your support for SB1064.



Pretrial education system, SB1063.  Several months

ago I pulled together all the providers of pretrial

education services in the state of Connecticut

because they were interested in an increase in

their rate.  I said we would not go for an increase

in your rate until you had the opportunity to

review the quality of the program and the content

of the program.



They came back with an outstanding design which is

being proposed here.  The PAES program, Pretrial

Alcohol Education System, last year in 1996 there

were about 6,000 persons who participated in it.

That's about 20 percent increase from 1995.



And if you keep in mind the fact that the National

Traffic Safety Association estimates that for every

traffic fatality the cost involved are close to

$750,000.  This is an extraordinary effect of

investment.



The PAES Program has a 92 percent completion rate.

Again, an indicator of something worth supporting.



The bill would update and streamline PAES Program.

Under the current program there's an eight-week

version and a 10-week version.  And what the group

suggested and deemed to support is the 10-week

version with an increase in the fee.



These providers, it should be noted, have not had

an increase in their fee since 1981 when the

program first started.



SB1256, THE DEPARTMENT OF MENTAL HEALTH AND

ADDICTION SERVICES COURT LIAISON PROGRAM AND

DISCLOSURE OF CERTAIN INFORMATION.  It is being

requested by the department because it will improve

the utilization of costly, intensive residential

treatment beds.



Under the current court liaison program, which is

an option for drug-dependent offenders, DMHAS must

guarantee a treatment space within 45 days of the

date it submits examination report to the court.

We have to reserve this bed or the slot before

there has been a court referral for treatment.

SB1256 is going to change the requirement so that

the bed is provided within five days of the actual

court order for treatment.



I wish to emphasize here some data which supports

the need for this particular program.  Between July

and December of 1996 a total of 406 persons were

identified by DMHAS evaluators for residential

treatment at state-operated facilities.  Of those,

only 37 percent were actually granted.  The balance

were no shows.



Two hundred fifty-four persons who were not ordered

for treatment we had to reserve the beds for their

use.  SB1266 would free up treatment space by

ensuring the beds are held only for those persons

for whom the court has granted referral to

treatment.



I now wish to comment on HB6991, AN ACT CONCERNING

DRUG POLICY.   This provides the statutory language

to implement the recommendations of the Law

Revision Commission.  I would like to compliment

the Law Revision Commission and its executive

director, David Biklen, for the quality of their

report.



Several of the recommendations parallel the themes

of the Connecticut Alcohol Drug Policy Council as

well as other reports.



I also wish to emphasize that this consensus offers

the opportunity for starting points for working

together for a balanced drug policy for

Connecticut.  While there is consensus for many of

the themes, there are some differences which I

think we need to keep in mind.



On the positive side, the Council agrees with

HB6991's proposal to establish standards and

responsibility for collection, management,

evaluation of information related to substance

abuse.



There is also consensus on the need to analyze data

and to report annually on client demographics and

trends, risk factors and measures of effectiveness.

As we strive to meet these objectives, the Council

recommends that we build upon the current strengths

of existing systems rather than starting totally

anew.



I've enclosed in your folder some briefing

materials that have been drawn from part of the

data system that DMHAS has responsibility for

managing.  Every licensed substance abuse program

in the state of Connecticut, as well as the

community providers that we have under contract

have to report their admissions and discharges via

this system.  And this is where the data comes

from.



Review of this material will reflect that the basic

data system and the academic partnerships with Yale

and UConn already exist within DMHAS pursuant to

Section 17a-451 to meet HB6991's data objectives.

That by itself we know will not do the tasks that

we have ahead of us.



What the Council concluded was the development of

this collaborative, cross agency data system could

best be directed by an outcome implementation work

group of which OPM would be a member, as would be

our academic partners from Yale and UConn and other

state agencies who designed the Council's outcome

recommendations.



The Law Revision Commission on the other hand

recommends that OPM bear this responsibility.  Let

it be clear that whatever options chosen,

significant new resources would be required to

comply with this mandate, but less so if built upon

existing data systems such as that maintained by

DMHAS.



Let me also emphasize that whatever approach you

come up with you can count on the Council and DMHAS

as a state agency to fully cooperate to achieve the

objectives that we've set out based upon this goal.



Section 4 would also require the establishment of

an advisory council to be chaired by OPM.  The

Connecticut Alcohol and Drug Policy Council which

is composed of representatives of legislative,

judicial, executive branches, as well as private

experts, is already in place to advise on statewide

policy.  This Council has a proven track record of

successful development of policy as well as

effective plans for implementation and resource

development.



In fact, I think it's interesting that many of the

ideas originating with the Blue Ribbon Task Force

and further developed by Alcohol and Drug Policy

Council, contributed to many of the uniform themes

in the various report.



Relative to the value of the Council and how it is

being handled, I reference a letter from Dr. James

Liebermann who is the Director of Health for the

Town of Greenwich and who is a member of the

Alcohol and Drug Policy Council.  He sent it to the

co-chairs of the Judiciary and Public Health at the

time of the forum.  He's a retired U.S. Assistant

Surgeon General of the United States.



In his comments on the Council: "Indeed, in my

view, the governor made a wise decision allowing

the public and private membership of the Council to

experience the kind of freedom that's necessary to

fashion recommendations designed to effect societal

changes.  What a mistake it might have been had the

Council become an organizational entity of state

government.  Surely it might have lost its

spontaneity, enthusiasm, innovative design and

momentum as frequently happens at various levels of

government."



On another point, methadone.  Section B of HB6991

establishes a pilot program for methadone treatment

to be provided in locations separate from a

methadone treatment programs.  I agree with the

concept of a pilot program involving participating

physicians, but I do not share the emphasis on the

increased access noted in the Law Revision

Commission report as being the reason for this

effort.



What I think we should pay more attention is the

current best thinking on methadone maintenance

approaches, and particularly attention to phases of

treatment.  I think you also have to give thought

to the future implications of financing a methadone

maintenance program in accord with this

recommendation.



I'm sure it's a given, but obviously you need to be

aware of the fact that Methadone treatment is

highly regulated by the DEA and FDA and whatever

efforts we intend to pursue have to be consistent

with that.



As part of the recommendation, the HB6991 requires

two participating physicians per region on the

first year of the program.  No fewer than five per

region thereafter.  I question whether the latter

is essential.  What's the basis for these numbers?

These physicians will have to have special

qualifications.  It's not clear how DMHAS could

ensure the designated level of participation.



While DMHAS supports the efficacy of methadone

treatment and adoption and testing of best practice

models, we ask that all be very careful in their

examination and prioritization of the demands for

limited substance abuse resources as we make

decisions regarding new programs.



The Council supported progressive implementation of

a full capacity service system.  What we all have

to understand is that when you're talking about

treating substance abusers there's not one method

of approach.  There are at least nine different

levels of care for substance abusers.  Methadone

maintenance is one of the levels of care.  We are

interested in a full, comprehensive effective

system.



Section 9 of HB6991 requires the Department of

Public Health to study issues related to the

development of substance abuse screening and

intervention protocols to be used for hospital

admissions.  This theme was the same one that was

echoed by the Health Care Committee of the

Connecticut Alcohol and Drug Policy Council.  That

committee, in my view, was one of the most

effective.  It included representatives of the

Department of Health, HMO's, the Commissioner of

the Department of Insurance, private physicians and

other health care stakeholders.



There are differences in strategies between Law

Revision and our committee as to how this

particular recommendation should be implemented.

But here again, you can be sure that all the

critical stakeholders will work together to find

common ground to ensure the success of this

initiative.



My written testimony reflects comments about CON.

I'm not going to mention that.  The essence of it

basically is that the CON as reflected in HB6947 we

think will provide broader exemptions for health

care than the one included in the current bill.



Needle exchange drug, the needles and syringes.  I

would urge us to give thought to the fact that one

of the primary benefits of those who support needle

exchange is that it brings the participants closer

to health care services.  If you increase the

number of needles, the available supplies to them,

they are going to have less frequent contact with

health care providers.



DMHAS is strongly opposes one part of HB6991 that

involves administering heroin as a method of

treatment.  While the Blue Ribbon Task Force and

Connecticut Alcohol and Drug Policy Council support

exploration of alternative treatment models for

chronically dependent persons, prescribing heroin

could never be supported as a valid treatment

protocol.



In closing, I wish to emphasize a couple of things.

At the outset of my testimony I applaud the efforts

you are making to develop informed decisions

related to drug policy for Connecticut.  The

reports that have been produced all emphasize

coordination collaboration.  They all emphasize

efficiency effectiveness and they all urge the

development of sound drug policies.



What I urge us all to do is to pool our collective

commitment and wisdom to draw upon the best points

of each of these reports to yield a balance

substance abuse policy for Connecticut citizens.



I'm sure that you can count on the members of the

Alcohol and Drug Policy Council, DMHAS as a state

agency is a member of that council, to work closely

with you to provide further information as you

continue this process.  Thank you for your

attention.



REP. LAWLOR:  Thank you, Commissioner, and obviously you

have gone well beyond the normal three minute

limitation we have, but I thought in light of the

extensive work that has gone into this, especially

by the group that you have chaired, it was

important for this committee to hear what you had

to say.



And also I think it's one of the problems in drug

policy historically has been two separate tracks

seemingly heading in opposite directions.  The

criminal justice track and the public health track.

And I think for the first time beginning to steer

each towards the other and as you pointed out, and

I'm glad you emphasized it, that user

accountability is such an important part of this

whole process of discouraging drug use by children

and by adults.



And I think the best suggestion that included in

your remarks was sort of the DWI program like

recommendation for drugs.  And that to make sure

that people coming in on entry level get

immediately referred to at least a minimum of

screening and treatment because I think one of our

greatest frustrations and if you look at the

statistics they are very scary and that is the

overwhelming majority of people arrested for first

or second or third offenses of drug use, walk out

the court with nothing happening to them.



In other words, the charges are normally dropped. I

think two thirds of the cases, we've got the

numbers here somewhere, the charges are just

dropped and nothing happens till the fourth or

fifth time around and by then often it's too late,

etc.



And I think you're quite right that if we could

enhance accountability by making sure the first

time in something constructive happens, not

necessarily cart you off to jail, but get you into

a treatment program.  That's a great suggestion so

I appreciate it.



Are there other questions?   Representative

Scalettar and Representative O'Neill.



REP. SCALETTAR:  Thank you.  Good afternoon, Dr. Kirk.

I also wanted to comment on the fine work of the

Council and the work that you and Brenda Cisco did

in this report and how important it is that so many

segments of our society and of our government here

are coming together to really look at drug policy.



And I particularly appreciated your

characterization of the issue which I've been

working on also that it's an economic health and

public safety issue.  And I think if we all look at

it that way and work on maximizing all of those

aspects of it, we'll come up with a very good

result and thank you for your help in this.



DEPUTY COMMISSIONER KIRK:  Thank you.



REP. LAWLOR:  Representative O'Neill.



REP. O'NEILL:  One of the comments that is in your

written testimony and I think you also read it is

that prescribing heroin would never be a treatment

protocol.  And I was wondering if you could

elaborate as to why that is.  I mean, is that sort

of like that I should know that off the top of my

head?  Or why?



DEPUTY COMMISSIONER KIRK:  Maybe it's more of a

philosophy.  I've run methadone programs.  I've

been involved in all forms of treatment.  I'm a

psychologist by training and I simply cannot accept

a conclusion that there is not a form of effective

treatment that can be provided for persons with

different levels of substance abuse difficulties.



That recommendation in my judgement concludes that

these folks are failures.  There's nothing we can

do other than give them pharmaceutical heroin.  So

maybe it's more of a philosophical point of view.



I think there are approaches.  I think one of the

things that you have to pay a great deal of

attention to and you're really hinting at it in

several points is the fact of intervention.  I

talked about this the other day when you went

through the drug forum.



If you look at Law Revision, if you look at Program

Review, if you look at the Blue Ribbon, if you look

at Alcohol and Drug Policy Council, they use the

word intervention very, very frequently.  Do not

look, do not approach that word very, very loosely.

As I mentioned to Representative Scalettar the

other day in a separate conversation, you have to

understand that intervention is a formal activity.

It's a formal approach.



The block grant, for example, the federal block

grant does not allow us to spend a dime on

interventions.  Most health care plans will not

allow -- they are not going to pay for

interventions.  But when your questions to Tom

Siconolfi about the drug court and many of the

things that were good doing here, we have to get to

the point of being able to convert what I call need

into demand.



There are lots of people out there who need

services.  But please understand.  It's one of the

hardest lessons I had to understand from my point

of view was that if everything about alcohol and

drugs was so terrible, none of us would be here.

We wouldn't need treatment programs cause people

wouldn't do it.



The reality is these are mood-altering substances.

They make people feel good.  And as a client once

told me after we had a counseling session for an

hour he said, doc, your sessions are very, very

good, but it's like a dose of codeine.  It wears

off in 30 minutes.



What he had was better than what I had to offer to

him.  So when we talk about the severe methadone

chronic dependent population, the challenge for us

is to come across with better interventions, and to

get them to the point where as a result of some

exposure to these interventions, as exposure to

treatment, they will improve.



I just can't accept writing off these persons as

non-responsive to any form of treatment.



REP. O'NEILL:  Okay.   So what it really is is if we

didn't call it heroin treatment, but sort of just

abandonment of treatment and supplying them with

heroin so they don't steal.



DEPUTY COMMISSIONER KIRK:  That's my opinion.



REP. O'NEILL:  Okay, that's how you would view it and

then okay, that's how you would say we should

instead of pretending that it's treatment, we just

sort of give up on them as untreatable and just

make them comfortable sort of approach.



DEPUTY COMMISSIONER KIRK:  As formidable as substance

abuse is, as a reality to this state and elsewhere

in the nation, I just don't think we should be

putting our resources in that particular approach.



REP. O'NEILL:  Although if the only way to prevent

someone who's a heroin addict from either being in

prison and costing us whatever it costs, $25,000,

$30,000, $35,000 whatever pick a number.  Or out on

the street doing perhaps $40,000 or $50,000 worth

of damage by burglarizing and stealing cars and

jeopardizing everybody's health because he's doing

all kinds of other things in the process of that,

certainly from a pure utilitarian kind of

standpoint it would arguably make sense to just

give him what it is he seems to want.



DEPUTY COMMISSIONER KIRK:  To me that's a social policy

issue for all of us to consider whether we would be

willing to accept that.



REP. O'NEILL:  Okay, but you're not because you think

that everyone is treatable?



DEPUTY COMMISSIONER KIRK:  I think that everyone is

treatable and that the challenges to come up with

the approaches.  I think there's enough data from

all the different studies that demonstrate the

efficacy of treatment.



I was up at Harvard two weeks ago from today at a

conference in which some of the major players were

reviewing what has really worked in treatment.

What has worked in prevention.  And one of the

points that was mentioned based upon extensive

reviews of the literature is that -- and it goes

back to the user accountability.



One of the critical components, critical

requirements for effective treatment is what they

called compulsory supervision.  Now compulsory

supervision can take many forms.  It can be my

sponsor in AA.  It can be my sponsor in the

Narcotics Anonymous.  It can be my employer through

an EAP program.



The mentoring programs that you will hear people

push as far as prevention activities, they are all

examples of compulsory supervision of one form or

another.  I think we should pay more attention to

them.



As an aside to that but related to that, if you

look at the drug survey results that UConn did for

us for 1995 and the new study is beginning for

1997, most kids do not substances.  And one of the

interesting parts of that study was asked why don't

they use?  What was the number one reason why 80

percent of these kids did not use substances?  They

were concerned about their health.



What was the number two reason why they didn't use?

Parental disapproval.



What was the number three reason?  Self-esteem.

For us to walk out of this room and to think that

due to all the attention that we're paying to

substance abuse that the policies of prevention and

treatment have failed all these years is simply

there's no basis to it.



What we have to do is reinvigorate what we have and

pay more attention.  I share Representative Farr's

emphasis on let's pay a great deal attention to

what works.  And that's the kind of approach that

we are flagging at this point in time.



I think it's a policy, but I think it's a

philosophical issue.



REP. O'NEILL:  Okay, thank you.



REP. LAWLOR:  That's interesting, Dr. Kirk, because as I

understand this thing it's based on something that

goes on in Switzerland.  I guess its been

relatively successful there.  But I guess what

we're groping at is what is, and you would know

better than us, how do you deal with these guys?



I guess what they do is they target people who have

been heroin addicts for 20 or 30 years.  They don't

respond to any treatment.  They go to jail.  They

come out of jail.  They get arrested again and they

come back in.  And how do you deal with people like

that now?  What effective treatment programs are

there for people in that category?



DEPUTY COMMISSIONER KIRK:  If you keep in mind the

methadone maintenance, to get to the point of

beyond methadone maintenance, one has to have tried

alternative treatment approaches and demonstrate X

amount of time of dependence.



It's a very extensive review that goes on.  I think

my own view is that the essence of good care is

dependent upon your ability to keep me involved

with the care.  One of the things we're doing, it's

in the package that you have in front of you.  One

of the things we're paying a lot of attention to is

the ability of programs to retain the person in

treatment particularly in the early months.



You can call it engagement.  You can call it

intervention.  You can call it what you wish.  One

of the advantages of compulsory programs such as

you may have within a prison setting, such as you

may have in some of these other areas, is that

forces the individual to stay involved with an

opportunity where over a period of time they will

pick up the value of the particular methods.



And so I think that the mandatory component from an

intervention point of view is critical.  I think

related to that and again, this is what we're

doing.  We're looking at the drop out rates from

programs from different types of modalities.  We're

looking at some of the client characteristics that

contribute to that.



Your health care plan.  My health care plan.  They

pay a lot of attention to what they call best

practice patterns and they will only reinforce best

practice patterns.  That type of approach is -- do

I have an answer for you right now specifically?

Not necessarily so.  But that's the type of

approach which is going to give us that.



If we paid more attention from a dollar point of

view, an investment point of view to the kind of

population that you're talking about,

Representative O'Neill is talking about, and say

let's come up with an alternative.



I'll just as soon somebody say fine.  I'll take X

number of dollars.  I'll take a group of people who

are skilled in methadone treatment.  I'll take a

group of people who understand how difficult it is

to give up substances and let me do a pilot for a

year to see if I can come up with an alternative

approach to simply saying let's give them heroin

for whatever period of time.



I think there's better ways to approach it.



REP. LAWLOR:  Great.  You had mentioned alcohol and I

think in your remarks and I think we sort of get

off the track sometimes and we only focus on, you

know, marijuana, cocaine, heroin, etc., and I

remember from some of the early meetings that

alcohol seemed to be as big as, if not bigger

problem than drugs, especially for young kids.



And I'm sure we'd all agree that alcohol in the

hands of kids is illegal, dangerous and wrong.  So

what should we -- what should our policy be there

and what are the current penalties for that kind of

stuff and is that a bigger problem among the young

kids and how does that work?



DEPUTY COMMISSIONER KIRK:  Clearly when you look at the

younger population you're more likely to find

alcohol as part of the substance profile, from an

experimentation point of view.



If you look at the data that I've given you over

the last year, we pay a great deal of attention to

age of first use.  Alcohol, marijuana (tape ended)

frankly they are about equal to one another in

terms of the age of first use.



If you look at the data from the surveys that we

did through UConn, alcohol in the northeast part of

the country as well as in Connecticut continues to

be a heavily used substance among that population.

We have had improvement in that area let's say from

'89 to '95.  But none of us, I don't think any of

us in this room as parents, grandparents or

whatever it is we are, are willing to accept that X

percent of the kids in this state within the course

of a month are driving with someone who is using,

who is under the influence of alcohol.



What we've done in the prevention area within the

dowers of Mental Health and Addiction Services

provides or has responsibility for, we have at

least 12 programs that we call research and

demonstration programs that were started before I

came on about 15 months ago.



They are intended to identify best practices in the

prevention area that would be effective

alternatives from a prevention point of view.  Some

of them range from mentoring.  Some of them range

from peer support.  Some of them range from

attention to high-risk kids.



These programs will be finishing up and October and

our intention then is to what we call seed and

feed.  Take the best of these principles that are

developed from these 12 programs and seed them

around the state.  So that as appropriate for the

particular populations we can come up with

alternatives.



If you also recall in the materials I sent you some

months ago, one of the big advantages of the study

that was done for us at UConn as far as youth

substance abuse was to tell us how the state, how

the different areas of the state vary.  What

happens in the eastern part of the state with youth

is not the same as it is for south central.



And when you talk about a well developed strategic

strategy you better pay attention to aligning

resources in accord with what each individual area

needs.  This may sound simplistic, but I truly

believe it.  And that is that the most effective,

the most critical element for an effective

substance abuse approach, from prevention point of

view, is what I call the Connecticut Partnership

for a Healthy Community.



And what a Connecticut Partnership for a Healthy

Community means that I as a parent, you as

legislators, everyone in this room, whatever our

role is, that we must take individual and full

responsibility for accepting the fact that

substance abuse, whether it be for underage youth

or substance abuse among illegal substances, is

simply an unacceptable reality.



When you look at the effective programs, what has

worked well, it's where the entire community gives

the same message as to what is and is not

acceptable.  So yes, we can concentrate on high-

risk kids, but when I indicate to my 13 year old

daughter and when she and her brother understand

that in our family there are certain things and

values that are acceptable, and those that are not.



When she hears the same message from her school,

when she hears the same message from her peers,

when she hears the same message in church and

wherever it is that we do our worship, that is the

single most important theme for an effective

prevention strategy.  It sounds simplistic, but I

tell you folks, it works.



REP. LAWLOR:  And your concern about mixed messages,

alcohol, drugs --



DEPUTY COMMISSIONER KIRK:  And this is why there's so

much --



REP. LAWLOR:  -- tobacco.



DEPUTY COMMISSIONER KIRK:  Fair amount of, you know,

when someone talks about something that is

perceived as well we're giving it more approval,

the concern is a mixed message.



REP. LAWLOR:  Other questions?  Representative Hamzy.



REP. HAMZY:  Thank you, Mr. Chairman.  Dr. Kirk, if you

can, if it's possible, can you just take me through

what the steps are when someone is referred for

treatment let's say it's someone who has been

convicted of possession and use of heroin.  What

happens to that person when they are referred for

treatment?



DEPUTY COMMISSIONER KIRK:  If they are coming through

the criminal justice unit, at some point, and

whether it's our court liaison staff or Bill

Carbone's unit where alternative incarceration.

Somewhere there is an assessment that's done as to

the severity of the problem.



Based upon that assessment a recommendation is made

as to appropriate treatment or appropriate care.

In the court and my colleagues in the criminal

justice system could probably give a better read

than I can, is that there's a linkage that's made

between the fact that the person has this

particular difficulty and entering them into a

formal treatment program.



If you were talking about someone who was not

incarcerated, but the judge what I call made him an

offer he couldn't refuse, he will go ahead and make

an arrangement within his locality for an

assessment.  The assessment for someone with heroin

is going to be a comprehensive assessment. It's

going to be asking them about the pattern of use,

how long they've used, how frequently they use.

Because as I mentioned right at the beginning,

everybody doesn't need the same level of care.



So we have to pay attention to severity.  Based

upon that assessment, let's say it was made today

at clinic X, some part in the state, that person

would then be assigned to a level of care that is

appropriate for what it is they need preferably

within two days of the time the assessment is made.



In the eastern part of the state one of the

interesting things that occurred as a result of the

Norwich Hospital closing is that we put into place

what we call pretreatment services.  If there's a

problem with available bed, or a problem with

available slot for particular care, the providers

in that region are mandated to provide some type of

bridge services until the person can be put into

the care.



That's the essence of it.  A very, very good

assessment and then assignment to a level of care.

As I said in the beginning and when you look at the

materials that we've given you, there are probably

six or seven, nine different levels of treatment

that are appropriate to a particular person.



If you want to look at what the literature says and

what works best, what works best is matching the

level of care to the severity of the particular

person's problems.



REP. HAMZY:  And when you talk about treatment, what's

involved in treatment?



DEPUTY COMMISSIONER KIRK:  Good question.  The most

common forms of treatment approaches are going to

include at least three things.  One of them is that

educating the person involved as to the substances

they are using and the effect they have on the

individual.



If you look at what we call interventions, they

have an acronym called frames, F-R-A-M-E-S.  And

what you have to do is No. 1, give me feedback as

to the effect of the substance on me.  So, there's

feedback through that education.



Secondly, you've got to communicate to me that I

have responsibility for my actions.  I may not be

responsible for having developed the problem for

drug because of possibly genetic factors, but I

have full responsibility for using the tools

available to maintain my sobriety.



So there's an emphasis not only on here are the

tools, but this is what you need to do to take

responsibility for your actions.  I think the third

point that in terms of the types of approaches is

some type of mix between individual and group

counselling.  Because one of the advantages that

effective treatment highlights is how I compare to

my peers.



Why is AA so effective?   Because if I go to an AA

meeting and you go to an AA meeting we have a

problem.  We can look at people in the room as they

say, who have a problem that we had.  I may not

think in my first time at an AA meeting that I can

do anything about my problem.  I am buoyed.  My

spirits are lifted by the fact that other people in

that room who had worse problems than I did are

able to get back.



I have to find somebody who took the medicine and

got better as a result.  Because I know my

medicine, whatever it is, alcohol, heroin or

whatever, it does something for me.  I pay a

terrible price.



So the combination of education, the combination of

counseling, the combination of clearly accepting

responsibility and finally what some say are the

most important, show me somebody who got better

taking the medicine that we have.  That's why

alumni groups as part of treatment programs are so

critical.  That's why mentoring programs and

prevention.



I've got to see, my daughter has to see an eleventh

grader who she admires who doesn't use substances

and say, I want to be like her.



REP. HAMZY:  Now, but in order for this to be effective

doesn't someone have to be -- doesn't someone have

to respond positively?



In other words, you have to be, you have to want to

reform your ways?



DEPUTY COMMISSIONER KIRK:  Right.  And that's where the

interventions that the comments Representative

Lawlor before.  Intervention strategies that have

been defined, the folks at UConn have come up, have

major studies that have defined very, very

effective intervention strategies.



And what I've tried to emphasize before is that

whatever the formats that we approach through

DMHAS, through Alcohol and Drug Policy Council, Law

Revision Commission.  We have to pay more attention

to those intervention strategies.



In a way what we're saying is you have to make me

an offer I can't refuse.  Now, you cannot make me

get well from my substances.  But you can help to

make me sit at the table until I can realize as a

result of these different approaches, that I can

turn my life around.



It goes back to the point of converting need into

demand.  So the mandatory types of approaches that

keep me involved in services for X period of time

they are going to help to convert my need into

demand.  But you're right.  You cannot make someone

suddenly say I want to do this.



But I think the approaches that are out there and

with the emphasis on intervention that's the way we

should be going.



REP. HAMZY:  Now I heard talk about the use of

methadone.  Methadone, is that a substance that's

used to treat a specific type of addiction?



DEPUTY COMMISSIONER KIRK:  Yes.  Methadone is the most

effective approach for people who are opiate

dependent.  In the substance abuse population that

we've treated in the state of Connecticut, we have

about 35,000 people in treatment during the course

of a year.  Those 35,000 people are involved about

in what we call episodes of care, about 55,000

episodes of care.



If you look around the state, in different regions

at any given time about 8 to 12 percent of that

population is involved in methadone treatment.

They have been involved in other courses of

treatment before.  If you look at the age of them,

typically they are in their mid-30's.  They are

older than the rest of the population.



But it's an effective approach.  It's the most

effective approach for those for whom opiate

dependence is not only current but has been for

some period of time.



What I do have an issue with with the Law Revision

Commission and I've spoken with David about this,

is that not everybody who uses heroin who comes

into our system should be on methadone maintenance.

It has to be for a certain period of time that

their problems occur.  It's got to be severe.



So methadone maintenance is the effective approach

for the certain level of case that needs that

particular service.



REP. HAMZY:  If I can just one last question.  What are

your thoughts on the legalization of drugs?  I

didn't mean to put you on the spot in the last

question.



DEPUTY COMMISSIONER KIRK:  No, it's just my personal

opinion as having worked in the field for as long

as I have, is that you never underestimate the

power of the substance.  And if you never used the

substances that these folks use, it's hard to

understand why people would take the point of view

that to legalize that and take the risk that

someone would go ahead and try this substance.



I mean, we're not talking about trying a cigarette.

We're not talking about trying a drink.  We're

talking about trying substances that within six

seconds are going to allow sensations in my brain a

pleasure that I can't get from other types of

alternatives.



I simply would not want any of us to take the risk

of having such powerful substances out there.



REP. HAMZY:  Thank you.



REP. LAWLOR:  Representative Martinez.



REP. MARTINEZ:  Hi, Tom.  How are you?  First of all,

let me just congratulate you on a really terrific

job with the Council.  And also on the tenacity of

the work you've been doing over at DMHAS.



DEPUTY COMMISSIONER KIRK:  Thank you.



REP. MARTINEZ:  Because you've been doing very good work

over there.



DEPUTY COMMISSIONER KIRK:  It helps to hear that once in

awhile.



REP. MARTINEZ:  All of us that understand what you're

trying to do, certainly know that it's not easy and

certainly know that you've been doing a bang-up

job.  I just wanted to say for the record that 99

percent of what you're saying I agree with.



And we do have some individuals who are sitting in

the audience who are probably going to be able to

talk about their experience and exactly prove some

of the things that you're mentioning now as

intervention techniques and methods and what works

and what doesn't work.



I was wondering if you could just to further

enlighten committee members and members of the

public, if you could concentrate a little bit on

talking about when we talk about particularly the

hard users and those individuals that end up

usually needing methadone or heroin use.



A lot of times we find that those folks aren't like

the rest  of us and don't have a family that they

can go home to and say, and tell them, look, don't

do that.  A lot of times we find that there's a lot

of generational issues involved in use.



And a lot of these social economic issues that are

involved in today's climate when we talk welfare

reform, we talk about the lack of jobs for that

population.  And we talk a lack of real training

for that population.  The engagement part of being

part of an effective tool to treat this disease.



Because as you were mentioning before having sort

of the family plan where we as legislators and

other folks have to become involved in what is out

approach as a state, as citizens to treat the

problem.



So if along with that if you could just add what

support services mean and wrap around support

services mean to effective interventions, I think

that would really help.



DEPUTY COMMISSIONER KIRK:  Okay.  No one should believe

that the methadone maintenance by itself is going

to be the solution to accomplish all the ends that

a person may have for restoring their life.



So the wrap around services are extremely important

because what you're trying to communicate to the

person is that as a result of putting their

substance abuse into remission, there are

alternative lifestyles.



Let me just give you a quick example.  I remember

treating a woman who was on methadone maintenance,

had long-term problems.  And she was a hairdresser

by trade, but she had not worked in years because

of her substance abuse.



So we finally got her to the point of being stable.

She was on a stable dose.  She was in treatment for

quite some period of time.  Then it was time to go

back and apply her trade.  But you get an idea of

the self-confidence of the persons involved when I

tell you what she did is she went to try to find a

job.



And what she would do is she would go into a

particular place, a hairdresser shop, and she would

say you're not hiring today, are you?  And she

couldn't understand why it was that over a period

of time how vivid a message that was.  She had to

get to the point of feeling confident about her

skills and that she was a worthwhile person.



And when you talk about methadone maintenance or

persons with that level, here is where the group

component is so important.  Because as you said,

they are different.  They are further along on the

way.  The family component much of it may well have

been dissipated.  So there's not that support

there.



Where are they going to get their support?  They

are going to get their support from the peers to

the point where internally they begin to kick in on

their on.  So the support services in terms of

income.  The support services in doing something

worthwhile.



One of the things that we used to tell people that

I would work with, clients, is that they would say

well, I feel better, but I don't really see what

worthwhile I'm doing.  So how much did you used to

spend a day for your substances?  And so usually

it's whatever -- it would be $100 a day.



So did you have the $100 to spend?  Not really.

They would steal.  They would do whatever they had

to do.  So do you have any children?  You know,

who's important in your life?  And one of the

suggestions was as they move from the point of the

early stages, take some of the money that they had

been spending, which they really didn't have.  They

couldn't afford, and do something, buy something

for somebody that you could look at, who's

important to you and say, that was an example of

the fact that I didn't use last week.



So it could be a kid in your neighborhood.  It

could be -- whatever it is.   That's vivid evidence

of that.  Last week you would have spent it on

substances.  They have to have some type of

feedback.  Is that, I mean, obviously is that a

formal treatment approach?  No, but you got to get

feedback that says I'm worthwhile.  That what I'm

doing is effective.



REP. MARTINEZ:  Thank you.   Just one more comment, Mr.

Chairman.  On the issue of heroin and heroin use, I

can't help but just reiterate again that I agree

with you 100 percent on that point of view.



I have seen camps set up where people are taken and

the issue is religion and how religion even in the

world of substance abuse treatment the higher power

and all that becomes so important and you focus on

religion and religion becomes sort of the what sort

of takes place of family and a lot of other things.

That keeps your mind focussed on doing the right

thing, and helping you throughout.



So I've seen camps for really down and out heroin

addicts work without the drugs basically kicking,

sort of doing the cold sweat kick.  Although I

certainly agree that methadone use on those stages

is probably what's appropriate with a quick weaning

down.



But I've seen people be able to kick that habit

without being on methadone all their life.  So I

certainly agree that there's other alternatives

that we have to look at when it comes to methadone

treatment.  Thank you very much.



DEPUTY COMMISSIONER KIRK:  Let me just add one quick

comment because I know this is something of

interest to you.  If you look at the data that I

gave you in the materials and in some we have given

you before, we are greatly, greatly concerned about

the latino population in this state with IV drug

use and use of heroin.



If you look at the profiles that you have there, of

the persons that we have in treatment, and we do

things based upon all sorts of variables that we

think are important.  The IV rate among the latino

population is the highest of all the groups that we

have.  Men, women -- it's close to 40 percent.



When you look at the black population that we have

in treatment, it's closer to 15 percent.  The white

population is around 20 to 25 percent.  The HIV

rate, the concern with this group here, the concern

that when we now look at some of the outcome data

that was pointed out before, we are not doing as

well with that particular group and keeping them in

treatment.



At a session with one of your colleagues from New

Haven the other day we were talking about detox and

the fact that the latino population we were having

a hard time keeping them in treatment.  And her

point was that what usually occurs is that if one

of the persons, latino persons in her detox unit

walked, usually a group walked with them.



REP. MARTINEZ:  That's very true.



DEPUTY COMMISSIONER KIRK:  We are not getting good

results.  And you talk about heroin and problems in

this state, that's one of the critical points you

must emphasize.  It's out of control.



REP. MARTINEZ:  Yeah, I've noticed that and I agree and

just this is an excellent document by the way.

It's a lot of good work went into this monitoring

of Connecticut's future.  Thank you.



REP. LAWLOR:  Thank you, Dr. Kirk.  We should invite

doctors here more often.  We're sort of soaking up

all this knowledge where we're used to the other

side of it.



Dr. Alvin Novik, speaking of doctors.  And as Dr.

Novik comes up I think it's appropriate to point

out two things.



First of all, that there is a mandatory democratic

house members caucus going on starting now in

another part of the building?  And also although

there are many members of our committee they come

and go during the public hearing.  And for those of

who you don't come here a lot you should know that

all of what is said here is broadcast throughout

the building on an intercom system we each have in

our offices.



And everything you say is taken down in a verbatim

transcript and kept with the bills that you're

testifying on for the life of those bills.  So just

because people aren't sitting here listening to you

speak at this moment doesn't mean that your words

won't have an impact on legislation, on this

legislation as it moves through the process.



So welcome, Dr. Novik.



DR. ALVIN NOVIK:  Thank you.  Good afternoon.  I'm Alvin

Novik.  I'm Professor of Ecology and Evolutionary

Biology at Yale and I'm the Editor-in-Chief of a

national journal called AIDS and Public Policy

Journal.  I'm also the founding chairman of the

mayor's task force on AIDS in New Haven and was the

originator of the project that the General Assembly

approved as a pilot project in 1990 that is the New

Haven Needle Exchange project.



And I'm the director designate of a new, what we

believe will be a new center, activated probably on

July 1st at Yale called the Center for

Interdisciplinary Research on AIDS.  I will be

directing the section on law policy and ethics.



My research and public service are directed at the

interface between the AIDS epidemic and the illicit

drug epidemic and I'll be speaking to bill 6991.



In the realm of these two highly interactive

epidemics, neither of which has been easily

addressed, the most difficult task of all is to get

the dialogue going that will lead to the

development of rational cost-effective policy in an

atmosphere of alienation, disdain and controversy.



Our state almost entirely through the General

Assembly has actually been a leader in developing

drug and HIV policy that have benefitted all

Connecticut, all Connecticut citizens, not just

those who are directed affected.  And policies of

which th real goal has been to protect us all to

benefit us all and to be cost effective and in that

path by our example to benefit the citizens of many

other states.



And that has been the case, for example, with our

needle exchange programs.  Essentially every aspect

of 6991 directly addressed profoundly serious

problems and does so in a way that is truly

mainstream.  That's the startling thing about 6991.

Mainstream to benefit the people of Connecticut and

to be cost effective.



We have become so accustom to severe drug policy or

severity on any proposed changed in policy that we

often fail to see what is truly rational and

actually conservative in the proposals that are

being proposed.



The proposals raised in my opinion are purely good

public health and good medical practice.  We're

taking the first step in shifting our state in its

war on drugs from total focus on law enforcement

and degradation to the incorporation of good public

health practice.  And as a result I believe we'll

be a beacon.



Essentially every aspect of 6991 represents

successful and often daring and brilliant

exploratory pilot projects in other communities

that Mr. Biklen and others of the Connecticut Law

Revision Commission have searched out for us and

have helped us see as models.



That's the advantage of our nation with 50

sovereign states.  Each can and does explore and

when it does so successfully, we can benefit from

their successes.  The proposals in 6991 are largely

based on those successes.



Finally, the HIV and illicit drug epidemics meet in

the most devastating fashion in our prison system,

in a way that confronts us as policy makers and

also gives us an opportunity to bring prevention

education and enlightened care to bare for the

first time.



These incarcerated men and women will re-enter our

communities.  It's to the advantage of all of us

that they re-enter our communities in the best

possible health...illicit drug-free if possible and

free of HIV.  To do so would be both cost effective

and indeed conservative.



I am truly excited to live in our state at a point

where we are addressing serious problems finally.

Many years, 70, 90 years into the drug epidemic and

15 to 18 years into the HIV academic, but I'm proud

that we have a history of having addressed some of

these problems previously and I feel with stepping

onto a path, a mainstream path actually of new

policy clarification.



The time limitation, of course, doesn't allow me to

address all the aspects of 6991.  But I would be

particularly prepared to answer questions if you

wish to raise them about needle exchange, about

methadone maintenance programs and about the

realistic possibilities of what kind of drug

treatment we can bring to our citizens.



REP. LAWLOR:  Thank you, Dr. Novik.  One concern I think

Dr. Kirk mentioned when it came to the clean needle

issue was that I guess one of the proposals in 6991

is to lift the limitation of 10 needles per

exchange or whatever it is