Public Hearing - April 24, 2014

    


       1      BEFORE THE NEW YORK STATE SENATE MAJORITY COALITION
              JOINT TASK FORCE ON HEROIN AND OPIOID ADDICTION
       2      ------------------------------------------------------

       3                  PUBLIC FORUM:  PUTNAM COUNTY

       4       PANEL DISCUSSION ON CARMEL HAMLET'S HEROIN EPIDEMIC

       5      ------------------------------------------------------

       6

       7             Paladin Center Tactical Training Facility
                     39 Seminary Hill Road
       8             Carmel Hamlet, New York 10512

       9             April 24, 2014
                     6:00 p.m. to 7:30 p.m.
      10

      11

      12      PRESENT:

      13         Senator Philip M. Boyle, Task Force Chairman
                 Chairman of the Senate Committee on Alcoholism and
      14         Drug Abuse.

      15
                 Senator Greg Ball, Task Force Forum Moderator
      16         Chairman, Veterans, Homeland Security, and
                 Military Affairs
      17
                 Senator David Carlucci, Task Force Vice Chairman
      18         Member of Task Force
                 Chairman, Mental Health and Development Disabilities
      19

      20

      21

      22

      23

      24

      25







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       1
              SPEAKER INTRODUCTIONS:                          PAGE
       2
              Steve Salomone                                    12
       3      Co-Founder
              Drug Crisis In Our Back
       4
              Susan Salomone                                    15
       5      Co-Founder
              Drug Crisis In Our Back Yard
       6
              Carol Christiansen                                16
       7      Co-Founder
              Drug Crisis In Our Back Yard
       8
              Karina Christiansen                               17
       9      Co-Founder
              Drug Crisis In Our Back Yard
      10
              Peter Convery                                     20
      11      Undersheriff
              Putnam County
      12
              Michael W. Daily, M.D., FACEP                     22
      13      Emergency Services
              Albany Medical Center
      14
              Bill Matthews, P.A.                               25
      15      Harm Reduction Coalition
              New York City
      16
              Amy Sucich                                        27
      17      Assistant Clinical Director
              St. Christopher's Inn
      18
              Frank Pelligrino                                  27
      19      Assistant Clinical Director
              St. Christopher's Inn
      20
              Joseph P. Donat                                   27
      21      Deputy District Director
              For Congressman Sean Patrick Maloney
      22
              Ginny Nacerino                                    28
      23      Putnam County Legislator
              District 4
      24

      25







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       1
              SPEAKER INTRODUCTIONS (Continued):              PAGE
       2
              Michael Nesheiwat, M.D.                           28
       3      Chief Coroner, Putnam County
              Medical Director, Putnam County
       4           Correctional Facility

       5      Carl Albano                                       28
              Chairman
       6      Putnam County Legislature

       7      Kevin Wright                                      29
              Retired District Attorney of
       8           Putnam County and
                   Mahopac County Legislator
       9
              Andrew Falk                                       29
      10      Local Political Candidate
              Putnam County
      11
              Sherry Gover                                      30
      12      Dept of Community & Family Services
              Dutchess County
      13
              Ginger Doulos                                     30
      14      Substance-Abuse Counselor, and
                   New York State-Licensed
      15           Mental-Health Counselor
              Facilitator of GRASP
      16           (Grief Recovery After A Substance Passing)

      17      Elaine Pawlowski                                  30
              South Salem Parent
      18      Volunteer for Shatterproof

      19      Jack Mack                                         31
              Resident
      20      Croton-On-Hudson

      21      Joanna Biaggi                                     32
              Guidance Counselor
      22      Brewster Central Schools

      23      Bob Cohen                                         32
              Parent, Ossening
      24      Church Youth Counselor

      25







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       1
              SPEAKER INTRODUCTIONS (Continued):              PAGE
       2
              Meghan Fialkoff                                   32
       3      Northeast Executive Director
              Foundation For A Drug-Free World
       4
              Daphne Olson                                      33
       5      Director for the Hudson Valley
              Foundation For A Drug-Free World
       6
              David Tidman                                      33
       7      Main Speaker for schools, YMCAs, and
                   police explorer groups in
       8           five-boroughs area
              Foundation For A Drug-Free World
       9
              Danielle Sullivan                                 34
      10      Assistant Principal
              Brewster High School
      11
              Lorraine Bixler                                   34
      12      In Recovery
              In the process of becoming certified
      13           for drug treatment

      14      John Regan                                        34
              Genesis House Addiction Treatment Center
      15
              Don Williams                                      35
      16      In Recovery
              Sponsor of people in 12-step recovery program
      17
              Dorothy Petrie                                    37
      18      Nurse
              Cadence Pharmaceuticals
      19
              Connie Hussey                                     37
      20      Resident
              Putnam County
      21
              Mike Piazza                                       37
      22      Commissioner
              Putnam County departments of Mental Health,
      23           Social Services, and the Youth Bureau

      24

      25







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       1
              SPEAKER INTRODUCTIONS (Continued):              PAGE
       2
              Kristin McConnell                                 39
       3      Director
              National Council on Alcoholism and
       4           Drug Dependence
              Putnam County
       5
              Alonzo West                                       39
       6      President of Westchester Corrections Officers'
              Benevolent Association.
       7      Also, an Executive Board Member of
                   Lexington Center For Recovery
       8
              Keith Fennelly                                    39
       9      Retired Chief
              Westchester County Career Fire Chiefs Assoc.
      10
              Buck Heller                                       39
      11      Executive Vice President
              Peers Influence Peers Partnership
      12
              Steven Valicho                                    40
      13      Vice President
              Peers Influence Peers Partnership
      14
              Frank Reale                                       40
      15      President
              Peers Influence Peers Partnership
      16
              Fran McCarthy                                     41
      17      Retired Nurse from Putnam Hospital Center
              EMT Volunteer with the Carmel Volunteer
      18           Ambulance Corps, and
                   the Lake Carmel Fire Department
      19
              Maureen Guido                                     41
      20      EMT
              Carmel Volunteer Ambulance Corps
      21
              Mike Nattle [ph.]                                 41
      22      Detective Sergeant
              Town of [unintelligible] Police Department
      23
              Robert Willis                                     41
      24      Captain
              New York State Police, Troop K
      25







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       1
              SPEAKER INTRODUCTIONS (Continued):              PAGE
       2
              Robert Tendy                                      42
       3      Supervisor
              Town of Putnam Valley
       4
              Sam Oliverio                                      42
       5      Putnam County Legislator, District Number 2
              Also, Chairman of the Health Committee,
       6           Putnam County
                   Also, Assistant Principal,
       7           Putnam Valley High School

       8      Tom Manko                                         42
              Superintendent
       9      Mahopac Central School

      10      Dr. Terrence Murphy                               42
              Councilman
      11      Town of Yorktown

      12      Hugh Fox                                          43
              Former Firefighter, City of Yonkers
      13      Chair, Senator Ball's Public Safety and
                   Fire Safety Advisory Board
      14

      15      OPEN-FORUM PARTICIPATION BEGINS                   43

      16                            ---oOo---

      17

      18

      19

      20

      21

      22

      23

      24

      25







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       1             SENATOR BALL:  Okay, ready; we'll start.

       2             Do you mind if we start with the pledge of

       3      allegiance?

       4                  (All present recite, as follows:)

       5             "I pledge allegiance to the flag of the

       6      United States of America and to the republic for

       7      which it stands, one nation under God, indivisible,

       8      with liberty and justice for all."

       9             SENATOR BALL:  Thank you.

      10             Okay, well, I want to thank everybody for

      11      coming today.

      12             I certainly want to thank Paladin for hosting

      13      us.

      14             And, they've asked me to point out the two

      15      exits, over to the left and over to the right.

      16             But I want to thank them for hosting us once

      17      again.

      18             You know, we did a Homeland Security -- the

      19      second Homeland Security roundtable with a group of

      20      law-enforcement officials.

      21             And about a year ago, when we did the first

      22      summit on homeland security, I mean, the issues were

      23      very focused on terrorism, specifically.

      24             And it's amazing how, in one year, how the

      25      conversation of that roundtable completely shifted







                                                                   8
       1      to heroin, opiate abuse, and addiction, and its

       2      impact in our communities; and we're talking about

       3      suburban communities, rural communities, urban

       4      communities.

       5             So, I want to thank Senator Boyle who came

       6      all the way from Long Island.

       7             And that's a hell of a trip.  I hate that

       8      trip.

       9                  [Laughter.]

      10             SENATOR BALL:  So, thank you.

      11                  [Applause.]

      12             SENATOR BALL:  Welcome to Putnam County.

      13             Next time you can wear jeans, I promise.

      14             And, Senator Carlucci, also a very good

      15      friend and colleague, who came all the way, I'm

      16      assuming, from Rockland.

      17             SENATOR CARLUCCI:  That's right.

      18             SENATOR BALL:  Right?

      19             So thank you very much for both of you being

      20      here.

      21                  [Applause.]

      22             SENATOR BALL:  I'll just -- I'll be brief,

      23      and be seated, like I learned at the United States

      24      Air Force academy.  And then what we're gonna do is,

      25      both of the Senators will speak, and we'll go around







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       1      the table, have everybody do a very brief

       2      introduction.

       3             And then what we want to do is, get into a

       4      detail- and deliverable-oriented conversation about

       5      what we can do as legislators to assist.

       6             And I think the three categories are:

       7      Prevention, treatment, and law enforcement.

       8             Thank God you're here.

       9             So, we'll focus on those three categories.

      10             And, Senator Boyle and Senator Carlucci have

      11      a little bit of experience from previous forums, so

      12      we can do that.

      13             I think a couple years ago, even, and we've

      14      done a very good job as a state, I believe, at

      15      cracking down on prescription-drug abuse, but, we've

      16      seen the balloon effect.  We know how the drug

      17      industry works internationally with the balloon

      18      effect, and now we've seen it locally.

      19             We did a good job in one area, and now we've

      20      seen a shift to where, many times, young men, young

      21      women, are needlessly dying in our communities.

      22             And I think it was easy for certain

      23      legislators and suburban communities to say:  You

      24      know, that drug-addiction thing, that's mostly an

      25      inner-city problem.







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       1             And these are our kids, and it is an

       2      epidemic.  And we have to do everything that we

       3      possibly can to make sure that we come together as a

       4      community.

       5             And that's exactly why we're here today.

       6             So I know that there's no magic bullet, but

       7      to the extent that we can help, that's why this

       8      Task Force was set up so proactively.

       9             So, without further ado, Senator Phil Boyle.

      10             SENATOR BOYLE:  Thank you, Senator.

      11             And I would like to thank Senator Ball for

      12      his leadership on fighting this heroin epidemic, and

      13      it is a statewide epidemic.

      14             I've been to Buffalo, out to Suffolk County

      15      where I'm from.

      16             And, talk about traveling, I'm leaving here

      17      tonight to drive to Plattsburgh for a forum tomorrow

      18      morning.

      19             But I can tell you that, I'm the Chairman of

      20      the Senate Alcohol and Drug Abuse Committee, and in

      21      that regard, the Senate leadership asked me to chair

      22      this Task Force, along with Vice Chair

      23      Senator David Carlucci, who's the Chairman of the

      24      Mental Health Committee in the Senate.

      25             And, we're holding 14 forums around the







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       1      state.  This is the fifth one.

       2             And, we're getting a lot of good insights.

       3             Basically, we have to issue a report by

       4      June 1st, on ideas for combating this heroin

       5      epidemic.

       6             We're gonna pass legislation right after

       7      that, based on the report.

       8             So, with the distinguished panel in the room,

       9      and from any ideas we can get from anybody in the

      10      room, about what you've experienced -- whether it's

      11      in law enforcement, whether it's treatment, whether

      12      it's prevention -- if you had to say, "There ought

      13      to be a law to help combat this," that's what we're

      14      looking for.

      15             We're looking forward to a great conversation

      16      this evening.

      17             And thank you again, Senator Ball.

      18             SENATOR BALL:  Thank you, Senator Boyle.

      19             Senator Carlucci.

      20             SENATOR CARLUCCI:  Well, thank you so much.

      21             I want to thank Senator Ball for putting this

      22      together, and thank Senator Boyle for leading the

      23      Task Force.

      24             This is an extremely important issue, and I'm

      25      really just gratified to see so many people in the







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       1      room tonight.

       2             It's a beautiful day, but you're here today

       3      to spend some time, to really talk with everyone

       4      here about ways that we can tackle this issue.

       5             And like was said by my colleagues, we know

       6      that it's not gonna be a silver bullet.

       7             There's not some magic piece of legislation

       8      that we can pass that will drastically change this

       9      issue.  We know that it's gonna be a combination of

      10      issues.

      11             It's gonna be law enforcement, educators,

      12      leaders in the community, to really come together

      13      and tackle this important problem.

      14             So, I want to thank everyone here tonight,

      15      and look forward to listening to you.

      16             SENATOR BALL:  I do want to thank, as well,

      17      for being here, the Salomone and Christiansen

      18      families who are here, and give them some time to

      19      speak as well.

      20             If you guys want to start off.

      21             And thank you for all the good work that

      22      you've done in our community.

      23                  [Applause.]

      24             STEVE SALOMONE:  Hi, I'm Steve Salomone.

      25             Thank you, Senator Boyle, for putting the







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       1      event on.

       2             We founded, with the Christiansens, these

       3      four parents started the Drug Crisis In Our

       4      Backyard.

       5             We lost our sons to drug addiction; to an

       6      overdose.  And as a result of that, we felt we

       7      wanted to come out and do something about it, rather

       8      than, you know, just retreat.

       9             What we heard, when we started to talk to

      10      people, was the crisis was large, and people were

      11      embarrassed to talk about it.

      12             And what we wanted, our group is about, is to

      13      provide a forum for people to come forward and say,

      14      "I need help," because people feel that it's a

      15      character flaw, but it's not.

      16             Addiction is a disease, and it needs to be

      17      treated like a disease.

      18             So that's primarily what our mission is.

      19             I'm not gonna steal the show here, but a

      20      couple of comments I would like to make:

      21             The drug issue has two components: it's

      22      supply and demand.

      23             The supply side of it is where law

      24      enforcement comes in.  And we need to address that,

      25      and we need to pass legislation for that.







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       1             But where we really can have an impact is on

       2      the demand side, and that's about changing culture;

       3      And that's about getting our young people to not

       4      choose to use drugs, because it's not the cool thing

       5      to do anymore.

       6             And I think that's really where we need to

       7      have a strong impact, because once someone is

       8      involved in the problem, and it's an opiate, their

       9      decision to stop using is not their decision

      10      anymore, because now they're forced to continue to

      11      use because their brain chemistry and the way they

      12      act is different, 'cause they're addicted.

      13             So I think we need to think about ways to

      14      address the demand side of the problem.

      15             And, lastly, what I'd like to say before

      16      passing it on:  If there's one area that I think we

      17      might be able to have some impact with legislation,

      18      the health-insurance industry is not addressing this

      19      problem.

      20                  [Applause.]

      21             STEVE SALOMONE:  People are being turned

      22      away.

      23             We get calls all the time.  People need help,

      24      and they don't have any money, and they don't know

      25      where to go.







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       1             And we need to get insurance industry to

       2      start providing coverage to help people get better.

       3             And, that's where we need to go.

       4                  [Applause.]

       5             SENATOR BALL:  If I can just follow up on

       6      that, too, what I would like your input on:  We have

       7      introduced a bill, 7071, specific on the insurance

       8      industry, and some of the issues where we see that

       9      they're really not providing the safety net that are

      10      necessary to deal with the issues.

      11             So, if you can review that, and everybody

      12      else here.

      13             I don't know if you have that in the packet,

      14      or not, but if you want a copy, take a look at it,

      15      and let me know.

      16             Thank you.

      17             SUSAN SALOMONE:  Hi, I'm Susan Salomone, and

      18      thanks so much for having this roundtable.

      19             It's so necessary.

      20             We're -- we're five people that lost our

      21      loved one.

      22             The Christiansens lost their son Eric [ph.].

      23             We lost our son Justin [ph.].

      24             But there are many people that have lost

      25      their children.







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       1             We're just two couples.

       2             I'm sure there are other people in this room

       3      that have lost their children or lost a loved one.

       4             And our mission really is to make this

       5      something that people are not afraid to talk about.

       6             To destigmatize this problem, this disease,

       7      so that people are not afraid to talk to someone

       8      about it.

       9             That I -- I feel that if we can do that, then

      10      more and more people will come out, and then the

      11      legislators have to listen to us, and then the

      12      health companies and the insurance companies have to

      13      listen to them.

      14             So I think it's, like, a snowball rolling

      15      downhill, but the first part of it is coming out,

      16      and doing this.

      17             And when our sons died, nobody was talking

      18      about it.  And now they're starting to talk about

      19      it, two years later.

      20             So, I think we're make something headway.

      21             Thank you.

      22             SENATOR BALL:  Thank you.

      23                  [Applause.]

      24             CAROL CHRISTIANSEN:  Hi, I'm

      25      Carol Christiansen.







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       1             I want to thank the Senators for having this.

       2             Thank you very much.

       3             I'm co-founder with the Salomones, and my

       4      husband and my daughter Karina, Drug Crisis In Our

       5      Backyard.

       6             Besides the awareness, what I would like to

       7      bring out is the focus on the doctors that prescribe

       8      this.

       9             You know, my son went for back pain, and a

      10      year and a half later he died; he OD'd from opiates.

      11             So, how does that happen?

      12             You know, he was a New York City detective,

      13      and this happened to him.

      14             So if it could happen to him, it could happen

      15      to anybody.

      16             And that's our focus, also, is the doctors,

      17      you know, what's their responsibility in this?

      18             Thank you.

      19                  [Applause.]

      20             KARINA CHRISTIANSEN:  Hi, my name is

      21      Katrina Christiansen.

      22             Eric was my older brother.

      23             I am also a doctoral student in public

      24      health, so I'm gonna bring out some public-health

      25      information tonight so we have some context for the







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       1      discussion.

       2             There are 12 billion people in America using

       3      pain killers, non-medically.

       4             "12 billion people, non-medically."

       5             A hundred people die every day from an

       6      overdose.

       7             In 2008, there were 36,000 deaths, and most

       8      of those deaths, those overdose deaths, were from

       9      prescription drugs, the majority of which, of

      10      course, are pain killers.

      11             We have an idea of drug dealers or drug use

      12      as a kind of shadowy organization, a shadowy

      13      activity, but less than 5 percent of the pain

      14      killers that people use or abuse come from drug

      15      dealers or strangers.

      16             The vast, vast majority of the pain killers

      17      that people are using, abusing, and dying from come

      18      from friends, relatives, and legitimate

      19      prescriptions.

      20             It is overwhelmingly an issue of diversion

      21      from legitimate prescriptions, which, to echo my

      22      mother's point and Steve's point, is why we have to

      23      deal with the vast quantities of opioid analgesics

      24      that are being distributed to patients without,

      25      often, their knowing, and certainly without people







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       1      understanding, the risks associated with taking.

       2             The doctors aren't trained on the risks

       3      associated with opioids; and, so, patients certainly

       4      aren't aware of the risks.

       5             One last fact:  We've had a four-hundredfold

       6      increase in the sale of opioid pain killers in the

       7      last 15 years, and so my question is:

       8             Are we in four times more pain?

       9             Are we four times better off?

      10             Do we have -- are we four times less disabled

      11      now that we have four times the increase in

      12      prescription pain-killer use?

      13             Chronic pain is real, and people deserve to

      14      get relief, but the pain killers that people are

      15      taking are, by and large, inappropriate.

      16             And, so, I am really excited about tonight,

      17      and about all the people here.

      18             And I'm very thankful to the Senators,

      19      because it needs to be culture, it needs to be

      20      policy, it needs to be law enforcement.  It's a

      21      multi-pronged effort.

      22             So, thank you.

      23                  [Applause.]

      24             SENATOR BALL:  We were just joined, I saw:

      25             Superintendent Manko.







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       1             Councilman Terrence Murphy;

       2             As well as, Hugh Fox, who chairs my

       3      Public Safety Advisory Council, and is with

       4      Westchester County, who's gonna be joining us up

       5      here.

       6             So, I -- just-- to follow up on the

       7      deliverables, there are two things that came out

       8      just from that:

       9             Number one is, the insurance-coverage issue;

      10             Number two, docs, you know, prescribing

      11      opiates, and how to deal with that.

      12             So we're keeping track, and we'll continue to

      13      follow up.

      14             Can we go to the right, and around the room

      15      now, would that be okay, and just introduce

      16      yourself?

      17             The Pope of Putnam County, right,

      18      Peter Convery.

      19             UNDERSHERIFF PETER CONVERY:  Good evening.

      20             I'm Undersheriff Peter Convery, representing

      21      Sheriff Don Smith who will be en route.

      22             And I just want to thank all of our

      23      law-enforcement partners here.

      24             And it is a crisis.  Law enforcement

      25      addressed that.







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       1             And Putnam County Sheriff's Office, this past

       2      week, every deputy sheriff investigator's been

       3      trained in Narcan.

       4             So we're prepared right now.

       5             We're making arrangements to purchase the

       6      Narcan and have it issued to our deputies.

       7             Now, that's one case that we're looking on

       8      the law-enforcement side.

       9             But what you're talking about, it's an issue.

      10             Putnam County Jail is the mental-health

      11      hospital of Putnam County.

      12             If you have a crisis, you're better off if

      13      somebody in your family gets arrested, because if

      14      they come through our jail, they're gonna get help.

      15             I think what you're finding out here, you're

      16      not getting that in the hospital because the

      17      insurance companies aren't working with it.

      18             And the other aspect, we're product -- the

      19      product that we have with heroin, we have the good

      20      doctor here from Albany Medical who's gonna tell

      21      you, we've been very vigilant on the barbiturates

      22      prosecution.

      23             Right now, Oxycontin is very hard to get.

      24      It's very, very expensive.

      25             We have Prescription Drug-Back days.







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       1             We have one this Saturday at Putnam Hospital,

       2      where people cleaning out their medicine cabinets,

       3      they're turning in.  People are cognizant of that.

       4             But what is done now, heroin is the drug of

       5      choice.  It's very inexpensive, and for what reason,

       6      they've turned to heroin.  And it's an epidemic.

       7             It's in Washington County.  It's throughout

       8      the state of New York.

       9             So, we really have to come together,

      10      everyone, and put pressure on, and find out why

      11      middle-class people are shooting heroin.

      12             And on the law-enforcement side, we're gonna

      13      continue to stay vigilant.  We're making arrests,

      14      we're following up every day, but the community has

      15      to help.

      16             And I think that's something that's -- I have

      17      to thank you, Senator, tonight, to bring us all

      18      together for this.

      19                  [Applause.]

      20             DR. MICHAEL DAILY:  Senator, thanks for

      21      allowing me to come down and join you here today.

      22             My name's Michael Daily.  I'm an emergency

      23      physician up in Albany.

      24             I have a lot of paper in front of me that

      25      I have put a lot of lines through, and I'm not going







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       1      read, I promise.

       2             But, I think that --

       3                  [Applause.]

       4                  [Laughter.]

       5             DR. MICHAEL DAILY:  I think it's important to

       6      recognize all of these prongs, because this is a

       7      problem that goes across all of society right now,

       8      and hits us in the emergency department, both coming

       9      and going.

      10             Very frequently, physicians are the sources

      11      of these original prescriptions, as the

      12      Christiansens said so eloquently.

      13             We need to watch our prescribing practices

      14      and consider how that should be done safely,

      15      because, really, these medicines are good medicines

      16      if used well and used prudently.

      17             SENATOR BALL:  Are there guidelines for the

      18      doctors that they have to abide by?

      19             DR. MICHAEL DAILY:  There are.

      20             The I-STOP program provides some guidelines.

      21             But among the things that we're using now,

      22      and training our residents in doing, for example,

      23      is, write for 11 pills, write for 21 pills; write

      24      for something that's a reasonable small amount of

      25      medicine.







                                                                   24
       1             And if you think someone is going to need a

       2      lot of medicine for a longer period of time, give

       3      them a refill of a smaller amount, and have them go

       4      and get that refill when they make the choice.

       5             I was at a law-enforcement conference,

       6      talking about the opioid problem.  And a very

       7      high-ranking law-enforcement official stood up and

       8      said:

       9             "I'm a cop.  I got shoulder surgery.  My

      10      doctor knew it was potentially gonna hurt me, and

      11      wrote me for 75 Percocet.  I took one.  I didn't

      12      like the way made me feel.  I left it in my medicine

      13      cabinet.

      14             "My wife's a cop.  She had knee surgery.  She

      15      took one of the 75 Percocet that her doctor

      16      prescribed to her, and left the rest in her medicine

      17      cabinet.

      18             "We've got 148 Percocet in our medicine

      19      cabinet right now, and we have teenagers in the

      20      house.  We may be cops, but we're not exempt from

      21      this disaster."

      22             I'd like to point out, up in our area, there

      23      is only one constant take-back zone, which is the

      24      lobby of the Troop G Headquarters in Colonie,

      25      New York.







                                                                   25
       1             That's the only place where, every day, you

       2      could drop off your meds.

       3             Among the things that we need to do, is come

       4      up with a good way for people to give back the drugs

       5      they don't want before they get diverted into the

       6      hands of our children.

       7             The idea of Narcan programs is profoundly

       8      important.

       9             Law enforcement is one location.

      10             They can be very, very usefully implemented.

      11             We need to watch this, and make sure that

      12      these programs are successful as possible.

      13             And we need to continue altering our

      14      prescribing practices, to make sure that we are

      15      contributing to good health care without

      16      contributing to additional problems.

      17             SENATOR BOYLE:  Thank you, Doc.

      18             DR. MICHAEL DAILY:  Thank you.

      19             SENATOR BALL:  Thank you.

      20                  [Applause.]

      21             BILL MATTHEWS:  Hello, I'm Bill Matthews.

      22      I am a physician assistant with the Harm Reduction

      23      Coalition in New York City.

      24             We work with the New York State Department of

      25      Health to promote their opioid overdose-prevention







                                                                   26
       1      program.

       2             What that is, is that it's a way of putting

       3      the same drug that's carried by ambulances, when

       4      they respond to an overdose, that same drug called

       5      "naloxone," or known by its old brand name,

       6      "Narcan," can be given out in a blue bag, like this,

       7      to anyone who might be around when an opioid

       8      overdose occurs.

       9             And you can spray this medicine up someone's

      10      nose, and save their life in minutes.

      11             Too often, the ambulance doesn't get there

      12      fast enough, and there are many cases in which the

      13      ambulance's never called at all, because of fear of

      14      the police coming, and all the circumstances around

      15      that.

      16             I'm gonna be talking to you more later, a

      17      little bit longer, demonstrating some of this.

      18             And then, when this event is over, I'm going

      19      to do a short training, though it won't be as short

      20      as I wish because so many of you are here, that, to

      21      hand out these kits, so if anyone who wants to have

      22      a kit can walk out of here with one.

      23             We have 100 kits with us today.

      24             SENATOR BALL:  Thank you.

      25             So, guys, this is what we're gonna do, if we







                                                                   27
       1      can -- because -- limit the applause, unless I'm

       2      speaking, and then feel free to applaud, so we can

       3      we can get around the room.

       4                  [Laughter.]

       5             SENATOR BALL:  I wasn't kidding there, it

       6      wasn't a joke.  Mr. Piazza can tell you that.

       7             No, I was kidding.

       8             But, if we can get around the room quick,

       9      just say who you are and where you're from, and then

      10      we'll get into a good conversation; because,

      11      otherwise, we're gonna be here all night.  And I'm

      12      not gonna -- you know, we gotta get down to the

      13      dirty details.

      14             Okay?

      15             Okay, who you are and where you're from.

      16             AMY SUCICH:  Amy Sucich, and I'm the

      17      assistant clinical director at

      18      St. Christopher's Inn.

      19             FRANK PELLIGRINO:  How you doing?

      20             I'm Frank Pelligrino.  I'm a social worker

      21      and substance-abuse counselor at

      22      St. Christopher's Inn.

      23             JOE DONAT:  Hi, I'm Joe Donat,

      24      Deputy District Director for

      25      Congressman Sean Patrick Maloney.







                                                                   28
       1             GINNY NACERINO:  Good evening.  I'm

       2      Ginny Nacerino, Putnam County Legislator,

       3      District 4.

       4             DR. MICHAEL NESHEIWAT:  Michael Nesheiwat,

       5      private-practice physician, Chief Coroner of the

       6      County, and medical director of the Putnam County

       7      Correctional Facility.

       8             SENATOR BALL:  Also has the crazy

       9      responsibility of being my personal physician, so...

      10                  [Laughter.]

      11             CARL ALBANO:  I'm Carl Albano.  I'm the

      12      Chairman of the Putnam County Legislature.

      13             Senators, thank you for this much-needed

      14      forum.

      15             I just would like to make one comment.  I may

      16      not stay the whole meeting.

      17             To me, if you had to pass legislation,

      18      I would actually limit or prohibit prescriptions to

      19      children under a certain age.

      20             They've all survived in the past.

      21             You may pick an age of 21, 22, whatever it

      22      may be.

      23             The world has survived without this in the

      24      past.

      25             There's Motrin, there's other things; they'll







                                                                   29
       1      move on.

       2             That would be a clear way to really have a

       3      serious effect on the young, and that's who's --

       4      that's where it starts.

       5             Thank you.

       6             KEVIN WRIGHT:  I'm Kevin Wright, the retired

       7      district attorney of Putnam County and

       8      Mahopac County Legislator.

       9             And, I prosecuted my first narcotics case

      10      39 years ago, and we're still losing the battle.

      11             ANDREW FALK:  I'm Andrew Falk.  I'm a local

      12      political candidate; but more importantly, I'm the

      13      father of a 10-year-old and a 6-year-old.

      14             And when I left -- when I dropped off my son

      15      this morning, Senator, at the bus stop, and he asked

      16      if he would see me tonight, I said:  No.  We have a

      17      heroin problem in Putnam County, and I'm gonna go,

      18      Senator Ball's having a roundtable.

      19             And I asked him:  Do you know what heroin is?

      20             And he said:  Yes.

      21             He takes the D.A.R.E. program.

      22             And I hate the fact that my son who's turning

      23      11 next week, I have to ask him if he knows what

      24      heroin is.

      25             But, we can't pretend that it's not here, and







                                                                   30
       1      it is here.

       2             And I'm glad everybody -- you know, I would

       3      just ask, if I don't say anything else tonight, we

       4      have to talk about it, because if we pretend that

       5      we're in Putnam County and our kids are good kids,

       6      it's gonna overtake us.

       7             And thank you for having this forum tonight.

       8             SENATOR BALL:  Thank you.

       9             SHERRY GOVER:  Hi.  My name is Sherry Gover.

      10      I'm from the Dutchess County Department of Community

      11      and Family Services.

      12             But more importantly, I lost my son to an

      13      opiate overdose.  And I -- he had had a rotor cuff

      14      surgery, became addicted to opiates, and died from

      15      an overdose five years ago.

      16             GINGER DOULOS:  My name is Ginger Doulos.

      17             I'm a -- from Dutchess County.  I'm a

      18      substance-abuse counselor, New York State-licensed

      19      mental-health counselor.

      20             I also facilitate a bereavement group called

      21      "GRASP" (Grief Recovery After A Substance Passing).

      22             And I also lost a son as a result of heroin

      23      addiction.

      24             ELAINE PAWLOWSKI:  My name's

      25      Elaine Pawlowski.  I'm from South Salem.







                                                                   31
       1             I'm here as a parent, and I'm also here as a

       2      volunteer for Shatterproof, which is the first

       3      national organization that's set up like the

       4      American Cancer Society.

       5             We are trying to get the information out

       6      there as an organization that large, so that the

       7      stigma is reduced, and that treatment facilities are

       8      held accountable for the treatment that they give to

       9      patients;

      10             Laws are changed and advocated throughout the

      11      United States for 911 laws and naloxone laws;

      12             And, also, that physicians and insurance

      13      companies do pay for evidence-based treatment.

      14             Not old treatment, not AA treatment, that is

      15      dated, but treatment that is research-based.

      16             So, I do have some materials out there, and

      17      I can talk a little bit later.

      18             JACK MACK:  Hi, my name is Jack Mack.  I'm

      19      from Croton-On-Hudson.

      20             Like Elaine, I lost my son Casey [ph.] to a

      21      heroin overdose a year and a half ago.

      22             And, someone talked about jail being a -- an

      23      alternative for treatment.

      24             New York State prison system is the largest

      25      drug-treatment provider in the state.







                                                                   32
       1             I worked at -- in the state prison system for

       2      8 years, and it's not a good place for rehab, so

       3      don't go that route.

       4             Thank you.

       5                  [Applause.]

       6             JOANNE BIAGGI:  I'm Joanna Biaggi.  I'm a

       7      guidance counselor at Brewster Central Schools.

       8             SENATOR BALL:  Thank you for being here.

       9             BOB COHEN:  I'm Bob Cohen.  I'm a parent from

      10      Ossining, and a youth leader in my church.

      11             Also, a recovering heroin addict, 26 years.

      12      AA saved my life.

      13                  [Applause.]

      14             MEGHAN FIALKOFF:  My name is Meghan Fialkoff.

      15      I'm the northeast executive director for

      16      Foundation For A Drug-Free World.

      17             We're the largest nonprofit drug-education

      18      program in the world, and we provide a free

      19      curriculum to schools and after-school programs.

      20             And I'm just gonna show four of the booklets,

      21      because I know I have very limited time.

      22             We have prescription-drug abuse booklets,

      23      heroin booklets, pain killers booklets, and drug

      24      booklets.  And these are for free.

      25             So if any school, you want to have a







                                                                   33
       1      statewide distribution of any of those booklets or

       2      statewide curriculum, that is for free.  The schools

       3      only have to pay for postage.

       4             We can provide free materials tonight.

       5             And, we have portfolios for anyone who wants

       6      information as well.

       7             DAPHNE OLSON:  Hi, I'm Daphne Olson.  I'm a

       8      local.

       9             And, I lost a sister to heroin abuse.  And a

      10      brother -- my brother's family was ruined due to

      11      that.

      12             And drug-prevention education has been a big

      13      part of my life for about the last 45 years, because

      14      heroin is not new.

      15             My sister was a heroin addict in 1955.

      16             So, I work with Meghan.  I'm the director for

      17      the Hudson Valley.

      18             She's my boss.

      19             And --

      20                  [Laughter.]

      21             DAPHNE OLSON:  And I believe I've found

      22      something that works.

      23             DAVID TIDMAN:  My name is David Tidman.

      24             I work with Meghan Fialkoff, with the

      25      Foundation For A Drug Free-World.







                                                                   34
       1             I'm the main speaker for the schools,

       2      YMCAs, and police explorer groups in five-boroughs

       3      area, and we give free drug-education presentations

       4      and lectures on a daily basis throughout the

       5      boroughs area.

       6             We have a bit of a change to the

       7      "Just Say No" motto, where we changed that word

       8      "N-O" to "K-N-O-W."

       9             Because we focus on the fact that education,

      10      preemptively, is probably the best cure for the

      11      problems we're trying to deal with.

      12             DANIELLE SULLIVAN:  Good evening.

      13             My name is Danielle Sullivan.  I'm an

      14      assistant principal at Brewster High School.

      15             LORRAINE BIXLER:  I'm Lorraine Bixler, in

      16      recovery as well, and in the process of getting

      17      certified for treatment -- drug treatment.

      18             JOHN REGAN:  Hi, everyone.

      19             My name is John Regan, from Genesis House

      20      Addiction Treatment Center.

      21             I work in New Jersey, Pennsylvania, New York,

      22      Connecticut, and Delaware.

      23             If anyone here is looking for treatment for a

      24      loved one, because I work in all the states, a lot

      25      of insurance companies are tough, I will find help







                                                                   35
       1      for one of your loved ones.

       2             So, if you do have someone that's in need of

       3      help, please see me after the roundtable, and I'll

       4      make sure, even if they have no money, I'll find a

       5      state-run program somewhere.

       6             Thank you.

       7                  [Applause.]

       8             SENATOR BALL:  Thank you.

       9             When we talk a little bit on the treatment

      10      side, I want you to dig into your experiences with

      11      dealing with the insurance companies.

      12             Okay?

      13             JOHN REGAN:  Okay.

      14             DON WILLIAMS:  Senator Ball, thank you for

      15      this chance to be here tonight, and distinguished

      16      guests, and everybody else.

      17             My name is Don Williams.  I'm an addict and

      18      an alcoholic in recovery, in a program written so

      19      simply even I can do it.

      20             You know, I spent about 15 years in prison

      21      myself before I found a simple way to -- a simple

      22      way of life that is all about getting the message

      23      out, and I think we talked about it earlier.

      24             And I just recently, with Elaine, spoke at my

      25      high school right here in Carmel, to the ninth-grade







                                                                   36
       1      students, to try to get the message out.

       2             What my job to do is, to sponsor people that

       3      come through this program, on their first day and on

       4      their last day.

       5             It's a 12-step program that's just the

       6      greatest gift in the world that I've ever received.

       7             I had a 45-year drug addiction, and I lost my

       8      only brother in 1977 to opioids.

       9             You know, I think prevention starts with our

      10      young.

      11             You know, it's in Carmel High School, so it's

      12      probably in the middle schools and grade schools,

      13      too.

      14             And I just hope I get another chance to speak

      15      at another school one day, you know.

      16             I also speak at the Putnam County Jail once a

      17      month.

      18             Since being a prisoner myself, and a convict

      19      for most of my life, and I turned over a new leaf

      20      seven years ago.  And the greatest gift in the world

      21      I could give is just to give back what was so freely

      22      given to me.

      23             Thank you, Senator.

      24             SENATOR BALL:  Thank you for being here and

      25      sharing your experience.







                                                                   37
       1                  [Applause.]

       2             DOROTHY PETRIE:  Hi, my name is

       3      Dorothy Petrie.  I'm a nurse.  I'm from

       4      Upstate New York.

       5             And I work for a company,

       6      Cadence Pharmaceuticals, that makes a product, a

       7      non-opioid pain medication, that allows patients who

       8      are having surgery to significantly reduce how much

       9      opioids they use during surgery.  And in some cases,

      10      for recovering addicts.

      11             They can go through surgery with no opioids

      12      whatsoever, and manage their pain better.

      13             CONNIE HUSSEY:  Hi, I'm Connie Hussey.

      14             And I have a family member who is recovering

      15      from an opioid addiction, that also started with

      16      back pain.

      17             We moved to Putnam County, thinking that this

      18      wouldn't happen.

      19             It didn't happen in lower Westchester.  It

      20      didn't happen in the city.

      21             It happened right here in the sleepy little

      22      town.

      23             MIKE PIAZZA:  I'm Mike Piazza.  I'm

      24      Commissioner of Putnam County departments of Mental

      25      Health, Social Services, and the Youth Bureau.







                                                                   38
       1             NORA TOVITSKI [ph.]:  Hi, everybody.

       2             My name is Nora Tavitski [ph.].  I'm a social

       3      worker --

       4             Can you hear me okay?

       5             Doesn't sound like it's going over.

       6             Okay.

       7             -- the director of community services for

       8      Arms Acres, right up the road, which is inpatient

       9      and outpatient services for adolescents and adults.

      10             I've been in the field for over 25 years.

      11             I have to say, I could talk about any topic

      12      all day and all night with you, but the one that's

      13      on my mind is -- right now is about the insurance

      14      companies.

      15             Day in and day out, we are fighting with

      16      insurance companies, not just to get people in

      17      treatment, but to keep these people alive: our loved

      18      ones and our families and our friends.

      19             And I can't tell you how upsetting it is that

      20      they get refused.

      21             They're going against the parity laws, and

      22      our folks have to sit in waiting rooms for three,

      23      four, or five, six hours, waiting for an answer, and

      24      often that answer is no.

      25             We need your help.







                                                                   39
       1             I'm here to help.

       2             SENATOR BALL:  What we're going to do is, if

       3      everybody doesn't mind, is we're gonna jump right

       4      into that conversation first, and then we'll go to

       5      the others.

       6             KRISTIN McCONNELL:  Good evening.

       7             I'm Kristin McConnell.  I'm the director of

       8      the National Council on Alcoholism and Drug

       9      Dependence of Putnam County.

      10             We're a licensed prevention provider from the

      11      New York State Office of Alcoholism and Substance

      12      Abuse Services.

      13             ALONZO WEST:  Good evening.

      14             I'm Alonzo West, president of Westchester

      15      Corrections Officers' Benevolent Association.  And,

      16      also, an executive board member of Lexington Center

      17      For Recovery.

      18             KEITH FENNELLY:  Chief Keith Fennelly,

      19      retired, Westchester County Career Fire Chiefs

      20      Association.

      21             BUCK HELLER:  Hi, I'm Buck Heller,

      22      executive vice president of Peers Influence Peers

      23      Partnership.

      24             And this year we've produced a documentary,

      25      which we would hope everyone can see.







                                                                   40
       1             STEPHEN VELICHKO:  Hello, my name is

       2      Stephen Velichko.  I'm the vice president with

       3      Peers Partnership.

       4             And I had the opportunity to conduct a lot of

       5      these interviews in our documentary this year, and

       6      have seen a lot of the destruction that heroin has

       7      caused, not only to those who are addicted, but to

       8      their loved ones, as well.

       9             FRANK REALE:  Good evening, everybody.

      10             My name is Frank Reale, and I'm the president

      11      of Peers Influence Peers Partnership.

      12             I would like thank Senator Ball for arranging

      13      for the opportunity for our sharing our documentary

      14      film, "Chasing It," with all the school districts in

      15      the State Senate District 40.

      16             So, appreciate that, Senator Ball.

      17             SENATOR BALL:  Thank you.

      18             And we will continue to follow up, using

      19      funding from the State, to the extent possible, to

      20      the school districts that are interested, to get

      21      that documentary out.

      22             For the people that have not seen that

      23      documentary, and I say that to my colleagues as

      24      well, you should take a moment to take a look at it.

      25      It's extremely compelling, and I think it would be







                                                                   41
       1      extremely effective to get this into our schools.

       2             So, if I'm in Senate 40, I'm here to help,

       3      just let me know, to the superintendents and

       4      principals and guidance counselors that are here

       5      today.

       6             FRAN McCARTHY:  I'm Fran McCarthy.  I'm an

       7      EMT volunteer with the Carmel Volunteer Ambulance

       8      Corps, and the Lake Carmel Fire Department.  And,

       9      I'm a retired nurse from Putnam Hospital Center.

      10             MAUREEN GUIDO:  Maureen Guido, and I am a

      11      35-year member of Carmel Volunteer Ambulance Corps.

      12      I'm an EMT.

      13             And, this is a great, great opportunity to

      14      get us all together and fight this problem.

      15             Thank you.

      16             MIKE NATTLE [ph.]:  Good evening.  I'm

      17      Mike Nattle [ph.], with the Town of [unintelligible]

      18      Police Department.  I'm a detective sergeant with

      19      them.

      20             CAPTAIN ROBERT WILLIS:  I'm Captain

      21      Robert Willis from the New York State Police,

      22      Troop K.

      23             Thank you, Senator Ball, for inviting us here

      24      this evening.

      25







                                                                   42
       1             ROBERT TENDY:  Robert Tendy.  I'm the

       2      supervisor of the Town of Putnam Valley.

       3             SAM OLIVERIO:  Sam Oliverio, Putnam County

       4      Legislator, District Number 2.

       5             Also, the chairman of the health committee in

       6      Putnam County, and an assistant principal at

       7      Putnam Valley High School.

       8             TOM MANKO:  Tom Manko, Superintendent,

       9      Mahopac Central School.

      10             Senator Ball, continue to do the work that

      11      you're doing, 'cause we need this kind of exposure,

      12      and bring all of our resources together.

      13             Thank you.

      14             SENATOR BALL:  Thank you, sir.

      15             Once, again, a pleasure to work with you.

      16             SENATOR BALL:  Just, very quickly, we have

      17      Councilman Terrence Murphy.

      18             If you want to [unintelligible], and then

      19      Hugh Fox.

      20             TERRENCE MURPHY:  Sure.

      21             First off, Terrence Murphy,

      22      Dr. Terrace Murphy.  I'm a councilman in the town

      23      of Yorktown.

      24             Very briefly, I refused to pass our budget in

      25      the town of Yorktown unless we developed a narcotics







                                                                   43
       1      unit to address this serious issue in northern

       2      Westchester, and Putnam County right here.

       3             And it's about time we took our heads out of

       4      sand and address this head-on, and we'll continue to

       5      do it.

       6             And thank you, Senator Ball, for holding it.

       7                  [Applause.]

       8             HUGH FOX:  Hugh Fox, former firefighter in

       9      the city of Yonkers for 32 years.

      10             I chair the Senator's Public Safety and

      11      Fire Safety Advisory Board.

      12             We've had a roundtable before on many issues

      13      with the Senator.

      14             But, it's amazing to look around this room

      15      and see everybody, that this isn't one segment or

      16      one area of a problem, but it affects all of us; all

      17      of us, and many more.

      18             So, Senator, it's a -- it's so damned good

      19      that you put this together, because we need this.

      20             SENATOR BALL:  Thank you.

      21                  [Applause.]

      22             SENATOR BOYLE:  So what we'll do now, and

      23      just for those of you who -- I see many important

      24      officials and family members in the audience.

      25             Just because you're in the audience doesn't







                                                                   44
       1      mean you're off the hook.

       2             Please engage in this conversation, and we'll

       3      moderate it to the extent that we possibly can.

       4             I don't think I have to say this at this

       5      event, but I always say it:  All of our

       6      conversations are based upon mutual respect.

       7             That's it.

       8             We don't fight, we don't bicker, we don't

       9      overtalk each other.  Mutual respect; one person

      10      talks at a time.

      11             If you want to yell at anybody, yell at me.

      12      That's what I'm here for.

      13                  [Laughter.]

      14             SENATOR BOYLE:  But, I don't think I have to

      15      say it in this crowd, but let me put that out there.

      16             We have folks, Amy and Frank, who are going

      17      to speak specifically on the insurance issue.

      18             Then we'll bring that up to anybody else

      19      who's interested in talking about that.

      20             And they're with St. Christopher's Inn in

      21      Garrison, New York.

      22             Amy.

      23             AMY SUCICH:  Thank you.

      24             Yeah, uh, all clinicians are spending a lot

      25      of time, trying to get visits for our young opiate







                                                                   45
       1      addicts, and, those visits are being denied.

       2             If they're granted visits, they're certainly

       3      not at a level that's therapeutically beneficial.

       4             So they get a couple of days, three days, and

       5      then they have to reauthorize the visits.

       6             Inordinates amounts of time.

       7             And, you know, these young people get, maybe,

       8      a total of 12 visits, you know, to deal with this

       9      problem.

      10             We're lucky.  We have the ability to treat

      11      them five days a week, even though they're only

      12      supposed -- we get, you know, reimbursed for

      13      three days a week, we treat them for five days a

      14      week because of the nature of our program.

      15             The men live in our shelter, and they attend

      16      treatment in our day rehab program.

      17             So, you know, we have the ability to do that.

      18             However, this problem is going to get a lot

      19      worse.

      20             Next year, all of Medicaid will be managed

      21      care, and, with the managed care, this is gonna be

      22      the same kind of difficulty.

      23             Those visits are gonna be doled out very,

      24      very skimpily.

      25             And, you know, we're not sure what we're







                                                                   46
       1      gonna be able to do with that.

       2             Our reimbursement rates are dropping

       3      dramatically.  We've lost -- 13 percent, our

       4      reimbursement rates have gone down over the last

       5      4 years.  That money continues to drop.

       6             If, you know, reimbursement rates go down, it

       7      affects our budget, which affects the programs we

       8      could offer the people who come to us.

       9             We have 174 men living with us.

      10             We have tried to put together a crisis

      11      respite program, a crisis respite center.

      12             We were told to put together this proposal,

      13      and we did that.

      14             The proposal, however, was denied by the

      15      Office of Mental Health.  They want to use that

      16      money in other ways.

      17             We have, you know, parents and family members

      18      calling us daily.

      19             I get these phone calls, my boss gets these

      20      phone calls, Nora gets these phone calls:  People

      21      crying; they don't know what to do with their

      22      children.

      23             And when the insurance is being denied, we

      24      want to provide a short-time safe place for them to

      25      be off the street.







                                                                   47
       1             We have a space available, we have a

       2      proposal, and we can't get the funding to put, you

       3      know, the proposal intact.

       4             So, you know, this is of crisis proportion.

       5             I know there have been 78 deaths in

       6      Lower Hudson Valley last year.

       7             There were six just in Putnam in the past

       8      year, I'm being told.

       9             And, you know, rates are dropping, and

      10      insurance are cutting visits.

      11             SENATOR BALL:  So can you -- can you step me

      12      through -- say I have a son or a daughter, find out

      13      that they're addicted, and -- you know, and they're

      14      in a really tough spot.

      15             Can you step me through how they would find

      16      their way towards your -- if I come to your door,

      17      what is our battle gonna be to get that kid

      18      treatment right now?

      19             AMY SUCICH:  They have to go into our

      20      admissions department, and the first thing that has

      21      to happen -- and like I said, we're lucky, we're a

      22      shelter.

      23             SENATOR BALL:  First, can a parent actually

      24      force their kid to go?

      25             AMY SUCICH:  A parent can't force the child







                                                                   48
       1      to go -- their young adult to go.

       2             We're an adult program, so they have to be

       3      18.  We need to speak to the adult.

       4             SENATOR BALL:  If you have a kid that's

       5      addicted, who's doing heroin, and you want to get

       6      him treatment --

       7             AMY SUCICH:  Yep.

       8             SENATOR BALL:  -- short of being dead or

       9      going to jail, how do you get him into a facility,

      10      right now?

      11             AMY SUCICH:  You know, you bring -- you --

      12      there has to be a bed, first of all.  And we're

      13      running at a -- you know, there's waits for beds all

      14      the time.  And 174 beds, we have waits for beds all

      15      the time.  We run it a week or two waitlist.

      16             So we have, right now, 174 beds and 4 cots

      17      out.

      18             SENATOR BALL:  So a week or two.

      19             So your kid, near overdose, whatever it is,

      20      you catch them, what do you do in those two weeks?

      21             Chain your kid to the --

      22             AMY SUCICH:  As I'm saying -- well, that's

      23      why we're trying to provide this respite service,

      24      with some beds, so kids who are in crisis can come

      25      in --







                                                                   49
       1             SENATOR BALL:  So, but what's the safety net?

       2             And I'm not badgering to badger.

       3             It's important to understand:  So what's the

       4      safety net during that two-week period, after you

       5      realize that your kid is chronically addicted to

       6      heroin and is about to kill himself?

       7             AMY SUCICH:  Right, and that's why you --

       8             SENATOR BALL:  Where's New York State come

       9      in?

      10             AMY SUCICH:  If the kid is about to -- if the

      11      kid is about to kill himself, he needs to be in a --

      12      you know, a psych unit.

      13             SENATOR BALL:  I don't mean kill himself.

      14             I don't mean, literally, kill himself by

      15      overdosing --

      16             AMY SUCICH:  That's exactly why we need

      17      respite.  We need safe places, to get kids off the

      18      street, to get kids out of houses, where there is a

      19      safe place where they can be before -- it's not --

      20             SENATOR BALL:  You still have to volunteer to

      21      do that; right?

      22             AMY SUCICH:  Excuse -- well, they have to

      23      volunteer.

      24             We have a lot of kids who we call are our

      25      "mom-dated" or "dad-dated," so they're not really







                                                                   50
       1      voluntary.  You know, they come in because they have

       2      no place else to go.

       3             Mom says you can't live in the house anymore

       4      unless you go into treatment, so they'll come into

       5      treatment.

       6             SENATOR BALL:  Yeah.

       7             ELAINE PAWLOWSKI:  Could you interrupt for a

       8      minute?

       9             AMY SUCICH:  Sure.

      10             ELAINE PAWLOWSKI:  If you have a good

      11      relationship with your child --

      12             SENATOR BALL:  Can you speak into the

      13      microphone.

      14             ELAINE PAWLOWSKI:  If you have developed a

      15      good relationship with your child, the first thing

      16      you should do, is when you go to the hospital, you

      17      can sign a medical-waiver form.

      18             So even when they're 18, or 17, as a parent,

      19      and because your son has signed that form in front

      20      of the hospital, or in front of medical staff, or

      21      it's been notarized, or whatever, you can have

      22      access to all their medical records.  You can also

      23      work with them through the system.

      24             I've done this with my son from day one, when

      25      they turn 14 or 15, just because you never know.







                                                                   51
       1             They may be somewhere else, they may be --

       2      they may have drank something, you just don't know,

       3      so someone has to step in.

       4             So when you still have a good relationship

       5      with your child, get all those papers signed, and

       6      keep them signed.

       7             AMY SUCICH:  Excellent idea.

       8             ELAINE PAWLOWSKI:  So that when you go to the

       9      hospital, you can say:  I'm their mother.

      10      I understand they're 17, or 18, they don't want to

      11      be here.  We've worked together.  You know, they may

      12      be heroin -- on heroin right now so that they're not

      13      very livid.

      14             And, you have much more power that way.

      15             AMY SUCICH:  Right.

      16             ELAINE PAWLOWSKI:  And then they also know --

      17      that the facility knows that the parents and the

      18      child are working together.

      19             That's like the number one thing that any

      20      parent can do.

      21             Sorry to interrupt.

      22             SENATOR BALL:  No, that's good.  That's what

      23      we need.

      24             Nora, you can speak a little bit to the

      25      process to actually get an insurance to cover once







                                                                   52
       1      they come to your door?

       2             What do the parents have to do?

       3             NORA TOVITSKI [ph.]:  Okay, so, somebody

       4      wants to -- treatment, they come to Arms Acres.

       5      They've -- I've made the phone call.

       6             Most insurance companies now --

       7             And I'm gonna add -- ask, anybody who wants

       8      to add to this process, who knows this, Amy,

       9      anybody, please feel free to do so.

      10             They come into Arms Acres.  They're waiting

      11      in the waiting room.

      12             Most insurance companies now are asking for,

      13      and require, what's called a "face-to-face."

      14             So, Mary or Joe can be sitting in the waiting

      15      room, and now they're required a face-to-face, which

      16      means they have to meet with the nurse.  The nurse

      17      does a thorough physical and an interview with the

      18      patient.

      19             They call the insurance company, they give

      20      them the information.

      21             The insurance company says:  I'll get back to

      22      you.

      23             So now they have to wait an hour or two or

      24      three.  They might call back, and they may approve

      25      or deny.







                                                                   53
       1             What they're saying now is:  Okay, well, you

       2      have -- which is against the law, basically -- you

       3      have failed -- you have not failed outpatient.  You

       4      are -- you can do this on an ambulatory detox level.

       5             Or, they'll just outright deny.

       6             And then it may go to a doc-to-doc review.

       7             And people are waiting, potentially, up to

       8      five or six hours, waiting for an answer from the

       9      insurance companies.

      10             Only -- so it's very hard to tell a family:

      11      You know what?  We want you, and we see the need for

      12      you to be here.

      13             But, it's very difficult to tell a parent, or

      14      a husband or a wife, or an aunt or uncle, somebody,

      15      come packed, but we don't know if you're gonna be

      16      able to stay.

      17             And I would like to mention that my colleague

      18      and good friend Dr. Roe [ph.] from our outpatient

      19      department is here.  And I would like us to turn to

      20      him, for a second.

      21             I'm putting him on the spot, but is there

      22      anything you would add to that Dr. Roe?

      23             Can you grab a microphone, Doctor?

      24             DR. ROE [ph.]:  It's a great deal to add,

      25      but, one of problems is:  If we do get somebody







                                                                   54
       1      admitted, we may get just a few days, where we just

       2      begin to scratch the surface, and then the ground is

       3      cut out from underneath the treatment system, so

       4      that we can't continue to treat patients who need

       5      longer-term treatment.

       6             And that's one of the things that Arms Acres

       7      and St. Christopher's is capable of doing, is

       8      providing the length of treatment.

       9             People are not gonna get over an opiate

      10      addiction in 5 days or 2 weeks, or even 28 days in

      11      many cases.

      12             So this is the biggest issue with the

      13      insurance companies.

      14             Even if they give us a paltry few days, they

      15      cut the ground out from underneath the treatment

      16      systems, and our patients.

      17             NORA TOVITSKI [ph.]:  The next step with that

      18      I would add --

      19                  [Applause.]

      20             NORA TOVITSKI [ph.]:  The next step I would

      21      add, is when they do refer someone to an outpatient

      22      level, sometimes they have to come two or

      23      three times a week.

      24             The co-pays are astronomical.  The families

      25      can't afford the co-pays, and I can't blame them.







                                                                   55
       1      They're like 30, 40, 50 dollars.

       2             I'm working with a family today that wanted

       3      to come into treatment, who had a $4,000 deductible.

       4             It's unheard of.

       5             MIKE PIAZZA:  It's just the beginning.

       6             NORA TOVITSKI [ph.]:  I'd also like to refer

       7      also to Mike Piazza, because I know he has a lot to

       8      say on this, too.

       9             MIKE PIAZZA:  Thanks, Nora.

      10             Senators, it's very important, too, that you

      11      recall, as Amy mentioned:  If you are lucky enough

      12      to have fee-for-service Medicaid right now, you

      13      don't have those kinds of limits and those kinds of

      14      difficulties in getting into treatment, and even

      15      staying in a little longer.

      16             But one of the concerns we have, is when we

      17      go through the Medicaid redesign, and go into the

      18      managed-care takeover, for our region it will be

      19      July 1st, next year, of 2015.

      20             These issues that you're hearing about on

      21      private and third-party insurance are going to occur

      22      in the Medicaid population, as well.

      23             And Amy mentioned the crisis respite.

      24             Well, we put together this proposal for OMH,

      25      which really was trying to put a square peg into a







                                                                   56
       1      round hole, which is why OMH didn't -- rejected it.

       2             They were looking more for an OMH -- an RCE

       3      (a Regional Center For Excellence) drawdown of the

       4      state psychiatric hospital beds.

       5             But one of the advantages -- what we're

       6      talking about, what we're working on together,

       7      Arms Acres and Putnam Family Community Services, and

       8      St. Christopher's Inn, is a proposal that will take

       9      advantage of beds, that can -- that will be cheaper

      10      than a regular hospital bed, and will still serve

      11      the purposes.

      12             As many of the parents are here tonight, when

      13      someone is ready for treatment, they're ready for

      14      treatment.

      15             And if you hold them off for a -- five days

      16      or two weeks, they will get high during those

      17      five day or two weeks.

      18             So, we want to be able to get them

      19      immediately into a safe place, which is the proposal

      20      that St. Christopher's started, and which was

      21      really picked up and shared with all of the

      22      providers in Putnam County.

      23             JAIME McARDLE:  My name is Jamie McArdle.

      24             I have a 20-year-old addict son.

      25             He is currently an addict --







                                                                   57
       1             SENATOR BALL:  Ma'am, do you mind, just, in

       2      the microphone.

       3             JAIME McARDLE:  I have a 20-year-old son.

       4             He is currently an addict.

       5             He was turned away at St. Christopher's.

       6      He was turned away from Lexington.  He was turned

       7      away from Arms Acres.

       8             Whether he has insurance or doesn't, he's

       9      turned away.

      10             He is dually diagnosed, so there are not

      11      treatment centers for mental health and addiction.

      12             My son is now on the street, currently on the

      13      street, because I cannot have him in the home with

      14      my twin 16-year-old daughters.

      15             I don't know where he's staying, I don't even

      16      know if he's alive today, but he is in

      17      Putnam County, and he's got no place to go.

      18             SENATOR BALL:  So how do we solve -- I mean,

      19      literally, right now, and I -- you know, I ask for

      20      the professionals in the room, how do you solve that

      21      mom's problem?

      22             DR. MICHAEL NESHEIWAT:  Senator, if I could

      23      just say a few words?

      24             SENATOR BALL:  Doc.

      25             DR. MICHAEL NESHEIWAT:  I feel your pain, and







                                                                   58
       1      I understand where you're coming from, but I do have

       2      to say something, and it's called "tough love."

       3             We are very fortunate people.  We may or we

       4      may not be able to take care of our loved ones, and

       5      put them in an Arms Acres or in a facility.

       6             But, unfortunately, working at the

       7      correctional facility, there's a lot of young adults

       8      that we love, that don't agree, and will not agree,

       9      with the parent, and the parent's frustrated.

      10             I've had parents come to my office, crying to

      11      me, from, attorneys, doctors, plumbers, lawyers, law

      12      enforcement, concerned about their child, and they

      13      can't do a thing, just like you.

      14             And let me tell you what happens:  They are

      15      incarcerated.

      16             They need to get money to pay for the drugs.

      17      They eventually will wind up with law enforcement,

      18      and wind up at the jail.

      19             Some parents have had their child turned over

      20      to law enforcement.  That's called "tough love."

      21             They're incarcerated, and we put them in a

      22      detox program at the Putnam County Correctional

      23      Facility.

      24             JAIME McARDLE:  My son was in Putnam County

      25      Jail for three months.  I had him arrested on







                                                                   59
       1      burglary charges.

       2             DR. MICHAEL NESHEIWAT:  And I understand

       3      that, and it's gotta be tough love to do that.

       4             And --

       5             JAIME McARDLE:  The day he got out, he picked

       6      up again.

       7             He was put on mental-health medication.  And

       8      when he was released, he was not given refills,

       9      nowhere to go from there.

      10             There is no referral system.

      11             ELAINE PAWLOWSKI:  You're absolutely right,

      12      that is a problem.

      13             You can check with St. Vincent's.  That's a

      14      dual-diagnosed.

      15             You can check with Four Winds, that's a

      16      dual-diagnosed.

      17             And Silver Hills is dual-diagnosed.

      18             Now --

      19             JAIME McARDLE:  St. Vincent's, he was denied.

      20             ELAINE PAWLOWSKI:  Yeah.

      21             Now, when you're -- this is the key crisis

      22      here:  The criminal justice system is not a

      23      hospital.

      24             SENATOR BALL:  So before we move forward --

      25      ma'am, before we move forward on this:







                                                                   60
       1             Susie, can you make sure that you get her

       2      information?  Maybe we follow up with her today, and

       3      do everything we can to help her.

       4             ELAINE PAWLOWSKI:  The criminal justice

       5      system -- there is a problem with society.  The

       6      criminal justice system has to deal with medical

       7      issues.

       8             These are medical issues that have fallen

       9      apart, because the health system in this country

      10      does not take care of their mentally ill, and does

      11      not take care of those with addiction problems or

      12      with substance-use disorder.

      13             Now, when someone says that that's good, be

      14      tough love, let the criminal justice system deal

      15      with it, that's absolutely the wrong way to go.

      16                  [Applause.]

      17             ELAINE PAWLOWSKI:  They are not doctors, they

      18      are not lawyers.  They are there for [inaudible].

      19                  [Applause.]

      20             ELAINE PAWLOWSKI:  We need to change the

      21      health system, the insurance system, and how people

      22      are treated, so that they are not treated with tough

      23      love.  They are treated with compassion, and they

      24      are treated with care, just as if they had a heart

      25      condition or they had cancer.







                                                                   61
       1             There is no other excuse.

       2                  [Applause.]

       3             SENATOR BALL:  Let me just get in here for a

       4      second.

       5             UNKNOWN SPEAKER:  Can I --

       6             SENATOR BALL:  No, look, just let me just get

       7      in here for a second.

       8             I think that this is the -- I've been to, in

       9      8 years, probably 600 forums, debates, and public

      10      events.

      11             And I have watched events, where everybody

      12      gets heated, and has a conversation that should be

      13      on the Phil Donohue Show, but doesn't go anywhere.

      14             Now, we have a mom who has a son, who she

      15      doesn't know where he is.

      16             And whether it be the correctional facility,

      17      or the morgue, I don't know how she sleeps.

      18             Now, we can either have a conversation about

      19      how to solve that.

      20             And if it can't be solved, that's the

      21      problem, and then we have to get involved to figure

      22      out how to solve it.

      23             But to debate back and forth isn't gonna

      24      solve a damned thing.

      25             And I'm not gonna allow it to happen tonight.







                                                                   62
       1             So, I want people to speak specifically about

       2      how to help moms like that.

       3             Does anybody -- okay.

       4             CHARLOTTE YOUNG:  My name is

       5      Charlotte Young --

       6             SENATOR BALL:  Please grab the mic.

       7             CHARLOTTE YOUNG:  Oh, sure.

       8             My name is Charlotte Young.

       9             I do want to say that I thank the

      10      Putnam County Facility for saving my son's life.  He

      11      even says it.

      12             But, they also have to be wanting to get

      13      cured.

      14             But, also, when they are let go from that

      15      facility, yes, parents have to be their backup, and

      16      they have to go to meetings, and get a group.

      17             My son couldn't get Medicaid, he couldn't get

      18      any kind of medical help, when he was addicted.

      19             I've gone through hell.

      20             It costs the parents.

      21             All these parents, financially, are probably

      22      stressed out.

      23             I am one of the lucky ones so far so far.

      24             My son has turned his life around.  He is a

      25      productive member of society.







                                                                   63
       1             And, I just wanted to thank the police force,

       2      and he even said it, they saved his life.

       3             He would have been dead by Christmas.  This

       4      past Christmas.

       5             And that's all I want to say.

       6             Jail is not the answer.

       7             We do need health insurance for our children.

       8             And my son got addicted because he went

       9      through cancer treatment, and then he got addicted,

      10      and didn't tell me.  So -- because there's a shame

      11      to it.  Okay?

      12             And I have a good relationship with my son,

      13      and he never would tell me about it, until it was

      14      too late.

      15             Okay?

      16             Thank you.

      17             FRANK PELLIGRINO:  Excuse me, Senator?

      18             Over here.

      19             SENATOR BALL:  Hey, please.

      20             FRANK PELLIGRINO:  Again, I'm

      21      Frank Pelligrino.  I'm a counselor at

      22      St. Christopher's Inn.

      23             And I really do feel for the woman who has a

      24      sick son.

      25             And part of the frustration is that sometimes







                                                                   64
       1      there is nothing that anyone can do if the person

       2      themselves doesn't want help.

       3             I myself am in recovery.  I got sober when

       4      I was 21.  I've been sober now 10 years, and I had

       5      the benefit of, at the time, the Medicaid system

       6      would give people access to treatment.

       7             And part of the problem is, right now, the

       8      opiate epidemic specific, is the highest it's ever

       9      been, and there's more cutbacks now from insurance

      10      companies, from Medicaid, that are not allowing

      11      people to get the treatment they need.

      12             I'm on the front lines, and, you know, I have

      13      to send in insurance reviews.

      14             And when these insurance companies hear,

      15      after three days, that, you know, the client needs

      16      more treatment, they say:  Well, he should be better

      17      by now.

      18             And so they don't get it.

      19             I mean, "90 days" seems to be the magic

      20      number.

      21             If people can get treatment for 90 days that

      22      would be great, but we're struggling to get

      23      treatment for 5, 10, 15 days.

      24             SENATOR BALL:  So what I need, and I think

      25      what we need, and I -- is to, specifically, on that,







                                                                   65
       1      what should we do legislatively?

       2             And I -- you know, we just fought a battle on

       3      the out-of-network issue.  We had surprise medical

       4      billing.  It's been a hell of a fight.

       5             I had a constituent in my district that had a

       6      heart attack, and when they went out of network,

       7      which they didn't they think they did, they felt

       8      that they were entirely covered, and they got a

       9      surprise bill for $100,000 and nearly had another

      10      heart attack.

      11             And I know the fight it was to get that

      12      legislation done in this budget.

      13             The insurance companies are very powerful.

      14      They have a very strong lobby.  And it's going to be

      15      a hell of a fight.

      16             But, we can get it done.

      17             So, specifically, and you are on the front

      18      lines, and to the other organizations that are here:

      19      What needs to be done to deal with them, to make

      20      sure that that safe -- because three days is BS.

      21             I mean, you can't get over an addiction to

      22      Pepsi-Cola in three days, you know.

      23             FRANK PELLIGRINO:  Yeah, and we have a

      24      shelter part of our program, and clients typically

      25      come in, before they even start treatment, they're







                                                                   66
       1      there for two weeks.  And after two weeks, not much

       2      has changed.  I mean, they're still shaking like a

       3      leaf after two weeks.

       4             So, it's really -- it blows my mind how

       5      insurance companies can say, "Sorry, he should be

       6      better by now."

       7             And just to note:  Right now, there are

       8      State-run facilities that will take people with no

       9      coverage.

      10             So if you are getting denied by other

      11      facilities, you can get in contact with OASAS.  On

      12      their Web site, they have several State-run

      13      facilities that will take you with no coverage.

      14             SENATOR BALL:  I think, ma'am, you wanted

      15      to --

      16             AUDIENCE MEMBER:  I want to reiterate what

      17      this mother said:  I have also dealt with trying to

      18      get into Arms Acres -- my son trying to get into

      19      Arms Acres, and trying to get into

      20      St. Christopher's.

      21             Insurance:  Seven years my son has battled

      22      addiction.  Our health insurance guarantees 30 days

      23      of inpatient treatment every year.

      24             In seven years, he's been granted six days of

      25      treatment.  Okay?







                                                                   67
       1             We have gone the route of him being so

       2      desperate to get in, and not being able to go into

       3      an emergency room, not being able to get into a

       4      facility, that he has said:  Well, I'm not suicidal,

       5      I'm not gonna jump off a bridge, but if I go back

       6      out on to the street today, there's a very good

       7      chance that I'm gonna overdose, so let me go on to

       8      the psychiatric ward.

       9             Again, the psychiatric ward will only be

      10      approved for two days, and then he's sent to a

      11      homeless shelter without the medication that he's

      12      now been on for two days.

      13             Then the homeless shelter, he's on a list for

      14      St. Christopher's, which is a three-week list.

      15             But, then, he gets denied by

      16      St. Christopher's.

      17             And I'm not bashing St. Christopher's.

      18      I mean, I know that they're doing everything that

      19      they can do.

      20             But it gets denied by St. Christopher's

      21      because of his psychiatric evaluation.

      22             The only reason he went on to the psychiatric

      23      ward was because there was no place else to go.

      24             This is a disease.

      25             No family member would be expected to sit







                                                                   68
       1      there and tell their asthmatic loved one to just

       2      breathe more easily.

       3             They would not be told to tell their loved

       4      one, you know, don't let those cancer cells divide,

       5      until there's time.

       6             This is a disease, and we have to get the

       7      insurance companies to be responsible.

       8             If somebody has benefits, they have to be

       9      allowed to use those benefits.

      10             I was once crying in the Arms Acres office.

      11             My son was homeless, transportationless, and

      12      insurance says:  If he doesn't do outpatient first,

      13      then he can't go into inpatient.

      14             The end of the story, is that this is what

      15      I have left of my son.  These are his ashes.  He

      16      died six weeks ago today from a drug overdose.

      17             And this ravaged -- this disease ravaged his

      18      brain, and maybe he never would have beat it.

      19             Just like, some people, no matter what

      20      facility they go to, can't beat cancer.

      21             But I will always wonder:  What if he could

      22      have gotten the treatment he needed?

      23             So, there can't be lip service.

      24             You have to keep asking those questions, and

      25      keep interrupting, and keep saying "What can we do?"







                                                                   69
       1             Because her son, my -- my son's battle's

       2      lost, but her son's isn't.

       3             We have to keep fighting this.

       4                  [Applause.]

       5             JACK MACK:  With all due respect, we are the

       6      little people, and we're not gonna be able to craft

       7      legislation.

       8             You're very clearly hearing -- you're very

       9      clearly hearing some of the heartbreaking stories.

      10             I have a question for Amy.

      11             I had heard that, with the implementation of

      12      the Affordable Care Act, there might be more parity

      13      for these mental-health and addiction issues, and

      14      that might be hopeful.

      15             Is there anything to that?

      16             AMY SUCICH:  Supposed to be, but we haven't

      17      seen that actually being realized.

      18             I mean, we just don't have -- we don't see

      19      that being realized with the insurance companies;

      20      not at all.

      21             Somebody said that --

      22             SENATOR BOYLE:  If I could?

      23             One of the issues that we've heard about:

      24             And, obviously, Senator Ball's taken a

      25      leadership role on this, in terms of legislation,







                                                                   70
       1      mandating insurance coverage.

       2             And Senator Kemp Hannon from Long Island has

       3      a similar legislation that we're working on.

       4             Mandates are a little tough, especially on

       5      this level.

       6             But one of things we've heard from other

       7      forums, and, please, let me know what you think, is

       8      that, when people are trying to get treatment for

       9      their loved ones, the insurance companies are

      10      saying:  We're not gonna cover it because it's not

      11      medically necessary.

      12             UNKNOWN SPEAKER:  Right, right.

      13             SENATOR BOYLE:  And so what we're trying to

      14      do is have -- sit down, and I've talked to the

      15      insurance-company executives and health-care

      16      providers and treatment providers about getting on

      17      the same page.

      18             Because I've talked to 11 different insurance

      19      companies, and they all have different definitions

      20      of "medically necessary."

      21             UNKNOWN SPEAKER:  Exactly.

      22             SENATOR BOYLE:  And the vast majority of

      23      them, no one can possibly make every one of the

      24      criteria.

      25             So we want one uniform definition of







                                                                   71
       1      "medical necessity" for opiate addiction and

       2      treatment.

       3             And I think that might be a big way to go in

       4      this in the coming weeks.

       5             UNKNOWN SPEAKER:  Yeah.

       6             UNKNOWN SPEAKER:  Sounds good.

       7                  [Applause.]

       8             SENATOR CARLUCCI:  If I can just jump in,

       9      again, I'm Senator David Carlucci.  I chair the

      10      Mental Health Committee in the Senate.

      11             Commissioner Piazza, you mentioned about

      12      Medicaid fee-for-service, and we are moving to

      13      managed care.  And it's something that we've had

      14      tremendous issues, with the mental-health

      15      population, with people with developmental

      16      disabilities.

      17             What are some of the concerns that you have,

      18      that you're saying it's working now, people are

      19      getting coverage?

      20             What are some of the ways we can safeguard

      21      that as we move to managed care?

      22             MIKE PIAZZA:  Under Medicaid fee-for-service,

      23      at this point, there is much less restrictions on a

      24      person who is being covered with Medicaid

      25      fee-for-services.







                                                                   72
       1             If they meet the criteria for entry into

       2      Arms Acres or to St. Christopher's, or an outpatient

       3      program, or a mental-health unit, there's no one

       4      really looking over their shoulder.  You're not

       5      getting the, three days and out, show me what the --

       6      you know, show me the progress.

       7             When we go to managed care, in the

       8      managed-care plans now, the managed-care mental

       9      health -- the managed-care Medicaid plans now,

      10      you're treated the same way as, basically, the

      11      insurance that we have, or the Empire plan that we

      12      have; that they're gonna be checking every few days,

      13      you know, Is it medical necessary -- Is it medically

      14      necessary for you to go in?

      15             So our concern is, that, you know, for many

      16      young people who need long-term treatment, we

      17      encourage not having managed care for Medicaid, but

      18      going into a fee-for-service, because it allows them

      19      to get into long-term programs, treatment --

      20      residential treatment centers (RTCs).

      21             And so the concern is, that when everyone's

      22      under managed care, the insurance companies will be

      23      responsible for clamping down.

      24             So that's a concern.

      25             SENATOR CARLUCCI:  So it's even more







                                                                   73
       1      important, like Senator Boyle just talked about,

       2      that definition is so important to transcend, not

       3      just to private insurance, but also to managed care,

       4      and it probably would solve some of the concerns

       5      that you're talking about.

       6             MIKE PIAZZA:  Right.

       7             And I'll -- but on the other side now, I'll

       8      have to say, because Dr. Roe is here, and he --

       9      I was reminded:  Vistaril is a drug that's given for

      10      alcohol.  And under Fidelis managed-care plan, they

      11      have no problem providing it for Medicaid recipients

      12      who are covered by it.

      13             Under Medicaid fee-for-service, it's a much

      14      more difficult process to provide Vistaril.

      15             So on that level, you know, it turns the

      16      other way.

      17             DR. ROE [ph.]:  May I say, the problem is, we

      18      have the wrong people deciding what's medically

      19      necessary.  It's not doctors and treatment --

      20                  [Applause.]

      21             DR. ROE [ph.]:  We've got the fox guarding

      22      the hen house.  And what has been managed care has

      23      become "damaged care."

      24             SENATOR CARLUCCI:  Dr. Roe, do you have

      25      experience where you have prescribed to a patient







                                                                   74
       1      for inpatient facilities, or -- and you have found

       2      them being denied?

       3             DR. ROE [ph.]:  I had it happen, every week,

       4      I get on the telephone with what they call a

       5      "doc-to-doc."

       6             I talk to a doctor who's working for an

       7      insurance company, whose salary is being paid by the

       8      insurance company to find reasons to save money for

       9      the insurance company.

      10             What we need is an independent panel of

      11      treatment experts to define what is necessary, and

      12      that should be what manages care; not the insurance

      13      companies deciding what's medically necessary.

      14             UNKNOWN SPEAKER:  That's right.

      15             SENATOR BALL:  Ma'am?

      16             UNKNOWN SPEAKER:  Can I speak?

      17             SENATOR BALL:  Yes, sir.  [Indicating.]

      18             CHANEL FARASELI [ph.]:  Good evening,

      19      everyone.

      20             First, I want to apologize, because I'm a bit

      21      emotional right now, so I wouldn't be thinking as

      22      clear and elaborate and eloquent as I normally

      23      would.

      24             I also want to thank the Panel, every single

      25      member that's here today.







                                                                   75
       1             And I want everyone, parent or, you know,

       2      just neighbor, this is extremely --

       3             Okay.

       4             -- this is an extremely important meeting.

       5             I am so grateful that these forums are being

       6      held.

       7             I looked online previously, and I can tell

       8      you, I was elated to know, and I have put on my

       9      calendar, every day that I can possibly make it,

      10      that's up in Albany, that's here in Hudson County.

      11             I'm a lobbyist for every -- for the

      12      2,000 students in my school district, with

      13      Mr. Manko in Mahopac.

      14             I'm there, and they know me right away.

      15             My name is Chanel Faraseli [ph.].

      16             And they -- when I walk through, they say:

      17      Hi, Mrs. Faraseli.  Who are you here to help today?

      18             So this is critical.

      19             And I'm going to do everything that I can, so

      20      these loopholes and challenges don't happen, or at

      21      least we can reduce them.

      22             There's still gonna be challenges.

      23             Let's be honest and frank:  There are going

      24      to be challenges.

      25             But I challenge everyone here --







                                                                   76
       1             And side note, I did work for Senate and

       2      legislation.

       3             -- but, I challenge everyone here that's just

       4      on the panel, we've gotta make this a little bit

       5      more streamline.

       6             We've -- what it is, in plain simple

       7      language, is a catch 22:

       8             "You can't do this," as some of the other

       9      individuals have expressed.

      10             You can't do this more than three days,

      11      because you don't have a bed.

      12             You can't have a bed because insurance is

      13      making you wait there in the audience -- or, not the

      14      audience, the waiting room forever and a day.

      15             It's -- in the last month, in March, I saw a

      16      series on the Sunday paper.  It was in three

      17      installments.

      18             And I was -- I read it word for word,

      19      backward and forward.  And I knew then that I wanted

      20      to do whatever I can, because I have volunteered in

      21      the community for two decades.

      22             And I hope -- I wanted to speak, because

      23      I hope you can put a face with a scenario, with a

      24      real life story.

      25             I'm sorry to say, that I buried my son







                                                                   77
       1      Paul Jonathan Faraseli, only 24 years old, loved by

       2      everyone, two weeks ago.

       3             "Two."

       4             "Two weeks ago."

       5             And everyone has said:  How are you standing?

       6      How are you doing?  How am I laughing?

       7             I feel for this individual's pain right here,

       8      because I know her pain.

       9             I think the -- the only thing that got me

      10      through, first and foremost, was my faith.

      11             But barring that, because not everyone

      12      believes in a higher power, but barring that, there

      13      was so many signs, and I didn't -- did not have the

      14      support -- not financially -- I didn't have the

      15      emotional, logistics support from family, friends;

      16      the students, the clique, if you will.

      17             And trust me, Mr. Manko, I'm getting the

      18      names.  I'm getting the names; who, what, where, and

      19      how.

      20             As a Senate person, I'm very thorough.

      21             So, whatever I can do, I'm gonna do.

      22             And if that means I go to Washington, I'll

      23      bring a magazine on the train.  Okay?

      24             So, my heart may be heavy, but I am not gonna

      25      let my son's passing be in vain.  His is gonna be an







                                                                   78
       1      inspiration.

       2             And at that wake, we needed, not one, but

       3      two entire rooms.  About 100 people, including the

       4      principal, Dr. Peace [ph.]; counselors.

       5             I mean, what love that I have, and that's my

       6      comfort.

       7             But, the pain, I don't want anybody to have.

       8             This shouldn't be.

       9             What, we've got to get three days, when they

      10      need that magic number, "90."

      11             This is appalling.

      12             Frankly, it's unacceptable.

      13             And, this is a non-discriminatory situation.

      14             So just because you're sitting here and you

      15      don't know if a loved one is using, they very well

      16      could be, and we don't know that.

      17             They very well could be -- your child, your

      18      son, your brother -- and there's nothing that's

      19      going to be done by us reading a newspaper, and

      20      talking about it to our neighbor.

      21             That will not change anything.

      22             It's going to take solidarity, and it's gonna

      23      take action.

      24             So I leave myself open to any individual who

      25      would like to speak to me, who would like me to do







                                                                   79
       1      something.  A task force that I can join.

       2             That's why I wanted to make sure, when I knew

       3      this from Judge Reitz [ph.] in our town, that he

       4      needed a liaison.

       5             This was prior to my son passing.

       6             Anybody can stand up:  Oh, because it's your

       7      personal fight.

       8             Anybody can do that.

       9             Well, as I said earlier, those 2,000 kids in

      10      the Mahopac School District, I treat them as my own.

      11      I'm there for them.

      12             So, we have to get it together, and people

      13      need to be able to have somewhere to go, and talk.

      14             So, if we do that.

      15             Thank you.

      16             Thank you very much.

      17                  [Applause.]

      18             SENATOR BALL:  I think -- unless anybody has

      19      anything to add on the insurance issue, I think what

      20      we'll go to, is we'll talk a little bit, because --

      21      on the prevention side.

      22             And what I would like to do, as well, and we

      23      can get sign-up sheets, we will follow up, just

      24      locally, with a task force.

      25             If we can get everybody's e-mail and cell







                                                                   80
       1      phone who wants to be on it.  Make sure that your

       2      e-mail is clear.

       3             And that, as we legislatively work through

       4      these things or find funding for these things, or,

       5      administratively, we'll keep you in the loop, and --

       6      because we need your input on this stuff.

       7             Okay.

       8             BOBBY:  Can I have three minutes?

       9             Can I have three minutes to talk in the mic?

      10             SENATOR BALL:  Can you -- God bless, sir.

      11      Speak into the mic.

      12             BOBBY:  Thank you.

      13             My name is Bobby.  I'm a long-time resident

      14      of [unintelligible] Mahopac for 27 years.  I love

      15      this community.  I love the kids.

      16             What I see happen to these kids, these kids

      17      feel like there's no future.  That's why they go to

      18      drugs.

      19             There's no jobs for these kids.

      20             They go to college, they major in something,

      21      they get out on the street and go work at McDonald's

      22      or A&P.

      23             You go engineering school, you're at A&P.

      24             There's 60,000 engineers.  These people

      25      aren't dodos.  They work hard for what they got, and







                                                                   81
       1      they're on the street.

       2             That's the kind of country, that's what we

       3      dictate to these kids.

       4             My generation, nothing personal, we dictate

       5      to these kids.

       6             These kids are despairful.  They feel like

       7      there's no hope; that's why they go to drugs.

       8             I have an article here.  I have this.

       9             Anybody wants to read it, I'll put it out

      10      front.

      11             It's true grit, it's true grit.  It's about

      12      your kids.  It's about your kids and psychology.

      13             Read it, read it, it's true grit.

      14             It's better than a newspaper.

      15             "The New York Times," or "Daily Post," better

      16      than any newspaper we ever read.

      17             This is true grit.  Read it, read it, read

      18      it.

      19             Read it, and don't weep, don't weep.

      20             Just read it.

      21             SENATOR BALL:  Okay, thank you, sir.

      22                  [Applause.]

      23             BRIANNA [ph.]:  Hi.  My name is

      24      Brianna [ph.], and I am a drug addict.  I have

      25      ten years clean.







                                                                   82
       1             UNKNOWN SPEAKER:  Hi, Brianna.

       2             BRIANNA [ph.]:  Hi.

       3                  [Applause.]

       4             BRIANNA [ph.]:  Thank you.

       5             I grew up in Mahopac, and I got addicted to

       6      drugs in Mahopac.

       7             I come from a good family.  And, actually, my

       8      father was a president of Guiding Eyes for the Blind

       9      in Yorktown.

      10             And that's one of the things I wanted to

      11      mention.

      12             Sorry.

      13             I am hearing that we're having a huge problem

      14      with opening up a halfway house in Yorktown.

      15             I don't think that that should even be a

      16      debate.

      17             A halfway house is how I ultimately got cheap

      18      after six month of treatment in Florida.  I couldn't

      19      not stay here to get clean.  I needed to leave.

      20             I did go to Arms Acres for 28 days, but it

      21      wasn't enough.  I knew I needed more, and I ended

      22      up -- I ended up -- I just wanted to mention about

      23      the law enforcement and the tough love.

      24             Everybody's different, and it may work for

      25      some people.







                                                                   83
       1             I got arrested by a police officer that's in

       2      this room right now, and I had a heart attack

       3      two days later.

       4             It didn't work for me.

       5             But, in Florida, they have something that's

       6      called the "Baker Act."  And, anybody, a parent, can

       7      call the police and say, "My son is in danger to

       8      himself or another."  He can be arrested and brought

       9      to a psychiatric unit for three days.  And then that

      10      doctor will decide if he needs treatment or

      11      psychiatric help.

      12             Now, again, that goes into the insurance

      13      issue, we need to clean all that up, but I feel like

      14      that's something that could really help us here,

      15      because, as soon as the kid turns 18, there's

      16      nothing anyone can do.

      17             In Florida we had an option.

      18             I had to do it with a boyfriend of mine, and

      19      it worked.  And they arrested him and brought him to

      20      a doctor, and he got the help that he needed.

      21             Had the police officer that arrested me that

      22      day brought me to a detox, I probably would have

      23      stayed.  I didn't want to get high anymore.

      24      I wanted the help.

      25             But jail didn't scare me.  It was just a







                                                                   84
       1      hiccup in my day of getting high.

       2             And you're not gonna talk someone into

       3      treatment when they're high, or when they're coming

       4      down, and all they can think about is more drugs.

       5             So, if we can get something together like

       6      that, that law enforcement works hand in hand with

       7      the mental field, I feel like that could be a huge

       8      solution to, you know, people who don't know where

       9      their sons are right now.

      10             SENATOR BALL:  Is anybody else in the room

      11      familiar with that Baker Act?

      12             Okay.

      13             UNKNOWN SPEAKER:  There's also a Jennifer Act

      14      that has been initiated, and there's also a federal

      15      legislation, the SOS Act, as well, so that a parent,

      16      again with your signing the waivers, that you have

      17      more rights to work along --

      18             SENATOR BALL:  The federal level it is just

      19      legislation, though?  It hasn't --

      20             UNKNOWN SPEAKER:  Nothing's been approved.

      21             SENATOR CARLUCCI:  And in New York, we have

      22      Kendra's Law.  And this is something that I think we

      23      could work on, expanding Kendra's Law to include

      24      exactly what this young lady just spoke about.

      25             So, thank you.







                                                                   85
       1             AUDIENCE MEMBER:  What she's speaking about

       2      is the Baker Act.  And the Baker Act is more for a

       3      mental case.

       4             So, if you're saying that you're gonna commit

       5      suicide, and they have to take you in.

       6             And we kind of have that already going on in

       7      New York.  If you say you're gonna commit suicide,

       8      then you're able to go ahead and get into a

       9      psychiatric unit.

      10             What she really needs to refer to is called

      11      the "Marchman Act."

      12             The Marchman Act is a law, under the Florida

      13      statute, that enables a family member to obtain help

      14      for a loved one who is unwilling to seek

      15      substance-abuse services voluntarily.

      16             SENATOR BALL:  What is that called again?

      17             AUDIENCE MEMBER:  It's called the

      18      "Marchman Act."

      19             So that is something you can do as

      20      legislation, to be able to really help us.

      21             Because you opened up, asking:  How can

      22      someone get into a program if they don't want to go?

      23             SENATOR BALL:  Right, exactly.

      24             AUDIENCE MEMBER:  So that's what you can do

      25      on your side to be able to help that out.







                                                                   86
       1             I work at the Walter Hoving Home, which is a

       2      Christian women's facility that helps women come off

       3      drugs and alcohol, and I oversee the intake office.

       4             And the biggest dilemma I have, is people's

       5      family members calling, going:  How do we help

       6      someone?

       7             And I have to tell them they have to call us.

       8      That's all I can do.  And tell them to give

       9      information in hopes that they would call us.

      10             But sometimes they need that little push to

      11      be able to get the right place.

      12             But the Marchman Act would be something that

      13      the state of New York could be able to kind of

      14      follow.

      15             SENATOR BALL:  Okay, can we use that as a

      16      segue on the law-enforcement side?

      17             And if the law-enforcement officials who are

      18      here, who are willing to speak out, could speak up a

      19      little bit to what more can be done on the

      20      law-enforcement side?

      21             And then we do need to keep it moving,

      22      because we have the training that's coming up, and

      23      we need to keep it on the clock.  Okay?

      24             State Police you want to go first?

      25             CAPTAIN ROBERT WILLIS:  I'll just state that,







                                                                   87
       1      as the doctor from Albany mentioned:  Locally here

       2      in Troop K, at SP Poughkeepsie, we do have the

       3      mailbox drop for drugs that are in people's homes.

       4      They can bring, it's anonymous.  They drop it in the

       5      box, they can get them out of their home.

       6             That's one of the most dangerous things, is

       7      the leftover medication.  There's no reason to keep

       8      it at home.

       9             It is just something that, especially if

      10      someone may be an addict in the house, it's -- you

      11      know, it's a liability.

      12             You can bring it there, drop it off.  We

      13      don't take any names, it's totally anonymous.  It

      14      gets destroyed.

      15             Next week we're starting with Train The

      16      Trainer for troopers throughout the state of

      17      New York, in the Narcan.

      18             After they get trained, they'll come out to

      19      field throughout the whole state, train the

      20      troopers.  And, hopefully, within the next few

      21      months, we'll have the Narcan on patrol, where we're

      22      responding to the overdoses.

      23             As you know, the police, we're in a unique

      24      situation.

      25             We enforce the law.







                                                                   88
       1             Whether it's a trooper stopping someone on

       2      the side of the road, and they have narcotics on

       3      them; undercover drug operations; or responding to

       4      domestic disputes at residences, because parents

       5      have children in their house, that are under the

       6      influence of narcotics, and we have to take control

       7      of the situation.

       8             So we see it on every angle.

       9             And it's, just, the more, I think, with

      10      education, and the treatment facility for people, is

      11      the better that it can be for the whole community.

      12             AUDIENCE MEMBER:  Uhm, excuse me, can I say

      13      something, please?

      14             SENATOR BALL:  Sure.

      15             AUDIENCE MEMBER:  It's kind of just a little

      16      bit of what we've talked about the whole night.

      17             There's education and prevention, and that's

      18      a great thing if you can save children that way.

      19             We went into the physicians, where they have

      20      to be accountable with medication they give out.

      21      Maybe lower doses.

      22             I know the pharmacies are now changing the

      23      medications that, maybe they can't be dissolved as

      24      easy.  They might be long-acting.

      25             Okay, the next thing is, treatment and







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       1      programs.

       2             And I have to say I think St. Christopher's

       3      is a good program, but, we have our insurances.  And

       4      it's gonna get worse with Medicare and Medicaid.

       5             So why can't, as taxpayers, everybody in this

       6      room pays tax, there's a place that, at the time of

       7      crisis, that child can go?

       8             Because, like they said, if you don't get

       9      them there when they're in crisis, they can go out

      10      and use.

      11             The drugs now are mixed with fentanyl and

      12      things that are killing them like flies.

      13             So if we pay taxes, instead of playing with

      14      the insurance company, we should have a place to

      15      bring the children, because we are taxpayers, and

      16      there should be an open door, and a bed at that

      17      immediate second.

      18                  [Applause.]

      19             AUDIENCE MEMBER:  And then the next thing is,

      20      since the Oxycontin and the Vicodins and Percocets

      21      are more hard to obtain from physicians, or the

      22      pharmacy companies are changing their composition,

      23      we now need our law enforcers to get out there and

      24      bust the heroin dealers, because it's so damned

      25      cheap, it's all over.







                                                                   90
       1             So I feel we need a place to get them

       2      instantaneously.  And we need our cops out there,

       3      truly getting drug dealers, truly getting --

       4             SENATOR BALL:  Well, they're actually gonna

       5      be starting the training in a little bit.

       6             We went through, and I'll go through all the

       7      deliverable items that we've had, legislatively, and

       8      otherwise.

       9             Is there anybody else in the law-enforcement

      10      community -- from the law-enforcement community who

      11      would like to speak?

      12             Okay.

      13             AUDIENCE MEMBER:  Senator, the biggest

      14      problem we have with law enforcement is, we have

      15      weak mental-health laws, or, public-health laws that

      16      give us the position to actually enforce the law.

      17             Heroin, it takes a huge amount of heroin to

      18      make any kind of dent in a person.

      19             I mean, you take a half a gram of cocaine,

      20      you got a D felony.

      21             It doesn't work the same way with heroin.

      22      The laws against heroin are very weak.  And

      23      prescription drugs.

      24             CPCS 7 is a misdemeanor, and it's the biggest

      25      charge that we charge with, and we get nowhere with







                                                                   91
       1      it.

       2             SENATOR BALL:  Are there anymore specifics

       3      anybody can give on that, the fact that the laws are

       4      extremely weak on the -- specific on the heroin

       5      side, with law enforcement and the laws?

       6             JOE YASINSKI:  My name is Joe Yaskinski.  I'm

       7      the deputy commissioner for the County Department of

       8      Public Safety.

       9             And, we realized this was a major problem

      10      years ago.

      11             In 2011, the Putnam General Task Force for --

      12      which is called the "diversion unit," we have locked

      13      up doctors, pharmacists, people, selling narcotics

      14      to opiates and heroin to these individuals over the

      15      years.

      16             And if you just read the newspaper a couple

      17      days ago, ago, we had the first sentencing of an

      18      individual who was responsible for two deaths of

      19      two young men in Pearl River, and he's sentenced to

      20      a minimum of 10 years in prison for that.

      21             There's a 20-year minimum, but he took a

      22      plea, but he got 10 years for this.

      23             And I think that the state laws need to be

      24      enhanced.

      25             The federal law is the only law we can use to







                                                                   92
       1      actually combat this in a great way.

       2             So, there are many issues.

       3             And, also, couple of things were mentioned

       4      before.

       5             One of the gentleman here who lost a loved

       6      one, mentioned how parents are embarrassed to come

       7      to law enforcement, or anyone, to tell about this

       8      problem, because they feel embarrassed that their

       9      loved one has died.

      10             That information, we need that information.

      11             We need to get information of a loved one:

      12      Where they were hanging out.  Who they were dealing.

      13      With who their friends were.  Who -- with

      14      pharmacists they went to.

      15             These are the things that we need to do our

      16      job.

      17             So, if I had to just push one point across,

      18      it would be that: we need help from the public

      19      itself.

      20             And we also need some stronger state laws to

      21      assist.

      22                  [Applause.]

      23             SENATOR BALL:  Okay.

      24             And I ask that everybody follow up with

      25      suggestions on that.







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       1             I think Bob Tendy wants to speak.

       2             I don't know if our former district attorney

       3      wants to speak as well.

       4             Bob.

       5             ROBERT TENDY:  Everybody's solution is

       6      different.  There are many solutions, and we've all

       7      discussed a lot of them.

       8             But the gentleman to my left over here just

       9      made a point that I think is very valid.

      10             We have DWI laws, where if you have two DWI

      11      arrests, it's a felony.

      12             But I have clients who have 30 CPCS 7

      13      arrests, and they're all misdemeanors.

      14             And, it seems -- I'm a defense attorney, I'm

      15      saying this -- but it seems to me that that's kind

      16      of silly.

      17             I really think that if you have two or three,

      18      it should be -- it should rise to the level of a

      19      felony.

      20                  [Applause.]

      21             JOE:  Can I say something, Senator?

      22             Joe, from Westchester County.

      23             I know you guys have been doing a great job

      24      with regards to trying to work with the local

      25      municipalities, and with your drug-enforcement







                                                                   94
       1      units.

       2             Because, each municipality, to do it

       3      individually, is just not gonna happen.

       4             So, I know we've teamed up with you

       5      previously, you know, with our narcotics guy, and

       6      works -- has worked unbelievable with you guys.

       7             And I've talked to Undersheriff Peter over

       8      here, and he's willing to come on board.

       9             And, between Putnam and Westchester county,

      10      we've just got to get this done.

      11             JOE YASINSKI:  And I agree, and we have

      12      worked well with Putnam County for many, many years.

      13             I started out in 1974.  I was in a narcotics

      14      unit in 1975, and we had been working with the

      15      Putnam County Sheriff's Office from that time.

      16      I started 40 years ago.

      17             And, you're right, it's unfortunate that we

      18      have a lot of small departments that can't afford to

      19      handle these problems.  They need to get us

      20      involved.  They need the federal government to be

      21      involved.

      22             And that's what we do.

      23             JOE:  We've had a great relationship with

      24      you, and it's been working.

      25             JOE YASINSKI:  And just another -- another







                                                                   95
       1      point, too:  I know money is tight, but when we

       2      seize -- we seize properties and monies from these

       3      bums, and we use that to enhance our programs.

       4             So we take the money from them as well, and

       5      we use that for enforcement.

       6             So, again, it's --

       7             JOE:  We'll be working with you again real

       8      soon.

       9             JOE YASINSKI:  Okay.

      10             Thank you.

      11             KEVIN WRIGHT:  Senator, I -- I started a year

      12      after Joe, in Westchester County, and I think we

      13      worked a few cases over the years.

      14             But I remind everybody that, in 1972,

      15      New York State enacted what was heralded across the

      16      country as the most draconian drug laws in the

      17      history of mankind.

      18             And, it was society -- the

      19      intelligencia (ph.), the cool people, whatever --

      20      I don't quite know what it was, but, it was the

      21      society in which we lived that walked back and

      22      watered down those laws.

      23             I -- I don't understand how it came about,

      24      but I know that we had among the most horrific

      25      sentencing laws anywhere in the world.  And we still







                                                                   96
       1      incarcerate probably more people for drug offenses,

       2      on a per capita basis, than anyone in the world.

       3             We just don't seem to be getting our hands

       4      around the problem.  We've had the tough laws, and

       5      we've walked them back.

       6             UNKNOWN SPEAKER:  Can I make a comment on

       7      that?

       8             KEVIN WRIGHT:  I have a feeling that part of

       9      it -- gentleman just stood up and talked about our

      10      mental-health laws -- it seems to me that when the

      11      rights of those in the asylum became paramount, and

      12      they were just turned loose on streets, in what was

      13      thought to be a helpful, Christian act, I think we

      14      started down a path where we're afraid to say to

      15      someone:  You're a danger to yourself, you're a

      16      danger to society.  We're going to put you where, if

      17      you can't help yourself, at least you can't hurt

      18      others.

      19             But that needs to be more than four concrete

      20      walls.  It's gotta be coupled with good medical

      21      care.

      22             And this country is about to embark upon the

      23      decriminalization of almost anything that you can

      24      imagine.

      25             And if politicians don't demand, instead of







                                                                   97
       1      using the tax revenues that come from that, and the

       2      freed-up prison space, and the reduced criminal

       3      justice budgets, because they don't have to arrest

       4      these individuals anymore; if the taxpayers don't

       5      demand that the revenues that are saved from all of

       6      this decriminalization go into treatment and health

       7      care for the addicted, we're never going to get our

       8      hands on the problem.

       9             SENATOR BALL:  Thank you, Kevin.

      10             Before we follow up the third category on,

      11      actually, with the kids, if the -- I know Tom is

      12      here, other superintendents, principals, if you can

      13      tell us what's working in your schools, what's

      14      working in other schools, what's not working, and

      15      how we can help to make sure that we get to these

      16      kids at a young age.

      17             And, then, what is "age appropriate"?

      18             And what programs are working?

      19             Do you want to --

      20             DANIELLE SULLIVAN:  Hello.  I'm actually new

      21      to Brewster, Brewster High School, but one of the

      22      things that I can tell you that's worked

      23      universally, in any educational setting, I think the

      24      doctoral candidate -- I'm sorry, I forgot your

      25      name -- pointed it out, was the culture change; the







                                                                   98
       1      culture change piece.

       2             Educational outreach that involves both the

       3      students and their families, that they can attend

       4      and experience together, which creates dialogues.

       5             And I think middle-school aged is even

       6      appropriate, because the reality is, it's occurring

       7      in that age group.

       8             I see 14- to 18-year-olds all day, every day.

       9      And, at least once a day, there is some type of

      10      topic or mention, or even an incident, that is

      11      affecting a child in that age group that I hear

      12      about on a daily basis.

      13             And one of the key points that they always

      14      make is that, they would like the support.  They

      15      would like the family to be involved, as well.  And

      16      they don't always ask for it, but it is evident in

      17      the discussion with them.

      18             So I really do feel that the educational

      19      outreach, in terms of the prevention, with that age

      20      group, is extremely appropriate.

      21             And to do that we do need to change the

      22      culture in the school.

      23             SENATOR BALL:  Can peers influence -- can you

      24      guys just -- when is the showing -- the first

      25      showing that you guys are doing, so people can know







                                                                   99
       1      about that?

       2             UNKNOWN SPEAKER:  [Unintelligible.]

       3             SENATOR BALL:  And where is it?

       4             UNKNOWN SPEAKER:  [Unintelligible].

       5             SENATOR BALL:  And this is for the

       6      documentary.

       7             FRANK REALE:  We have the one-hour

       8      documentary, "Chasing It."  The first showing is

       9      scheduled for Friday night in Putnam Valley, at the

      10      Performing Arts Center in Putnam Valley.

      11             And we are now working with, I believe,

      12      three other schools that are going to be submitting

      13      the requests to you.

      14             And, we'll be -- we've contacted a couple of

      15      them already.  And, I think we have four now.

      16             And it's open to any school district in

      17      District 40.  And the program includes the

      18      documentary film, as well as three of our speakers.

      19             And one of the things we're going to ask the

      20      schools to do, and this is the most important part,

      21      I believe, we're going to open the door to the

      22      conversation, but we need the schools to provide the

      23      resources to continue the conversation.

      24             And those resources would be the guidance

      25      counselors and other folks that are in the health







                                                                   100
       1      industry.

       2             SENATOR BALL:  Do any -- anybody from the

       3      schools: Superintendents? Tom? Sam? Tom?

       4             TOM MANKO:  The issue that we have in

       5      schools, is having sustainable resources.

       6             You can come in and show a movie, and you can

       7      ask me to dedicate guidance counselors, but I have

       8      to tell you, in 13 years of education, we have to

       9      get children ready to graduate and be

      10      college-and-career ready, and there are only so many

      11      hours in a day.

      12             We have a 9-period day, and it's not long

      13      enough.

      14             And school districts are often charged with

      15      being the keepers of the door for citizenship, and

      16      character education.

      17             And you can ask us for resources, but we

      18      don't have enough to go around.

      19             So, our guidance counselors, our social

      20      workers, our school psychologists, have a plate

      21      that's overflowing right now with everything we have

      22      to do.

      23             I can't think of a more important topic than

      24      this, but at the same time, we have to get kids

      25      ready to graduate.







                                                                   101
       1             So, we need, and Senator Ball has been

       2      excellent at this, in providing school districts

       3      with long-term, sustainable resources so that we can

       4      hire people that can do this.

       5             Because I'm convinced, that you can show a

       6      movie, and you can say we're gonna bring parents in

       7      to watch this movie, and that's gonna change the

       8      world.

       9             But if the parents don't take the message

      10      home with them and sustain it, then it's not gonna

      11      happen.

      12             What we have to do, is build the systems in

      13      our school, with drug counselors, with prevention

      14      counselors, and somewhere along the line, I would

      15      like to be able to mandate moms and dads at every

      16      grade level, K through 12, to have to mandatorily

      17      attend drug-and-alcohol awareness counseling, and do

      18      it every year for 13 years.

      19                  [Applause.]

      20             SAM OLIVERIO:  We have an expert here,

      21      Elaine Santos, who comes to our of district

      22      periodically, once a month, with the Putnam County

      23      Communities That Care Coalition.

      24             What it is, it's a joint effort of school

      25      members, parents, students, representatives from the







                                                                   102
       1      County, the Mental Health Department, the Youth

       2      Bureau.  That's what it takes; and it's constant.

       3      It's not a one-shot deal.

       4             Elaine brings her advisers and her associates

       5      with her.  And our superintendent of schools sits

       6      there, I sit there, our SRO (our school resource

       7      officer) sits there, along with parents, and other

       8      people from the community, pastors, our Park and

       9      Recs people, our Town officials.  We have a

      10      representative from the town of Putnam Valley.

      11             That's what it takes; it's got to be a

      12      community effort.

      13             And I agree with Dr. Manko, it has to be

      14      constant.  It can't be a one-shot deal.  That

      15      doesn't work.

      16             And most importantly, Elaine makes it a

      17      point, and the Youth Bureau in this county makes it

      18      a point, to bring forward speakers to our building

      19      at least two, three, four, five, six times a year,

      20      talking about this problem, so that the parents

      21      continually hear the message:  Watch your children.

      22      Watch your children and know what's going on.

      23             And I have to applaud Elaine and

      24      Joe DeMarzo [ph.] and Mike Piazza for providing this

      25      service, not only to our school, but to so many







                                                                   103
       1      schools in the county; because it's second to none.

       2             SENATOR BALL:  Yes, sir.

       3             DAVID:  Hi, my name is David

       4      [unintelligible.]  I'm a member of this community,

       5      and I also have 24 years clean in

       6      Narcotics Anonymous.

       7             I'm a recipient of the tough love.

       8             My mom had me arrested twice.  I went to

       9      New York State Department of Corrections, where

      10      I heard the message of recovery.

      11             I hear all of this going on in the community.

      12             I've lost two siblings myself, I buried,

      13      since I came into recovery.

      14             I'm a homeowner.  I'm a taxpayer.  I have a

      15      13-year-old boy that I need to protect.

      16             My question to you here is:

      17             You've asked us -- you asked us, what can

      18      we -- you know, "Give me ideas."

      19             How many people from the insurance industry

      20      are here tonight?

      21                  [Laughter.]

      22             UNKNOWN SPEAKER:  Good question.

      23             DAVID:  I mean, this -- if we're gonna have

      24      an open dialogue, we need to know what we're

      25      fighting.







                                                                   104
       1             In 1992, I worked for New York State

       2      Department of OASAS down on 125th Street, under

       3      the L.

       4             The same problem I faced then, with the women

       5      that were walking the streets of New York, was

       6      getting them into a facility.

       7             We would put them on the train, and,

       8      hopefully, there would be a place in Turning Point,

       9      if there was a bed available.

      10             Same thing.

      11             I've done H&I work (hospitals and

      12      institutions) in my own time.  Into

      13      St. Christopher's, into Arms Acre, into

      14      St. Vincent's, I've done all the volunteer work

      15      there.

      16             It is the same question from 1992:  How do we

      17      get treatment for them?

      18             The legislation needs to change and close the

      19      loopholes in the insurance companies' pit.

      20             When you go to them and you ask them for

      21      help, and they tell you, "Your disease does not fit

      22      the medical criteria," that's the hole that I hear

      23      all the time.

      24             And I'm not even in the profession anymore.

      25      I'm just a member in the community.







                                                                   105
       1             That's where I'd like to see the action start

       2      taking place.

       3             Thank you.

       4                  [Applause.]

       5             SENATOR BALL:  Guys, what we're going to do

       6      is --

       7             ELAINE PAWLOWSKI:  Excuse me, if I can just

       8      address the school issue here?

       9             One thing that you seem to forget -- I've

      10      been in teaching for over 30 years -- is when you

      11      are in the school district, the Board of Ed controls

      12      much of what goes on in the schools.

      13             And they really need to be educated, that

      14      they can't cut the guidance counselors, they can't

      15      cut the psychologists, they can't cut the addiction

      16      services and the drug services, in the middle

      17      schools and the high schools.

      18             The other thing that they seem to cut, as

      19      well, is there's a 504 classification, that children

      20      can use when they have medical problems, and that

      21      includes addiction, that includes substance-use

      22      disorders.

      23             Parents don't like to use it, the school does

      24      not like to use it, but it is federal law.

      25             They don't use it, and you should be able to







                                                                   106
       1      use it, and it should be encouraged to use it, so

       2      that you get more of those programs.

       3             And there are grant programs available for

       4      that.

       5             And many of the school boards' committees do

       6      not recognize that as a priority.

       7             They may look for academic scholars and grant

       8      programs that way, but there's many other

       9      opportunities to get that into the school, as well.

      10             TOM MANKO:  While I hear what you've said,

      11      I have to disagree with you right on down the line.

      12             Our board of education is extremely

      13      knowledgeable about the Part 200 regulations, the

      14      federal 504, and the Part 300 in federal regs.

      15             We spend, probably, the largest portion of

      16      our academic budget on ELL, special-ed students, and

      17      those students who are in need.

      18             Our board gets it.

      19             We have a 2 percent property-levy tax cap,

      20      and we have a 3.5 percent cap on increases in State

      21      aid.

      22             Although, this year, under the Senators'

      23      guidance, we were able to bust that open.

      24             It comes a matter of, we have to balance the

      25      budget when we present it to our voters the third







                                                                   107
       1      Tuesday in May, or we can't present it, number one.

       2             Number two, it's got to be approved.

       3             And, number three:  Please believe me when

       4      I tell you, it's not just counselors and

       5      psychologists that get the hit.  We're taking a look

       6      at AP classes, honors' classes.  We're taking a look

       7      at higher student-teacher ratios in the elementary.

       8             It's not as simple as you portray it.

       9             ELAINE PAWLOWSKI:  No, I understand it's not

      10      simple, but what I'm saying is, there is a

      11      504 classification.  And if parents recognize, and

      12      get over that this is a shameful situation that

      13      they're in, there is help for them along that route,

      14      as well.

      15             And there's not enough people that take that.

      16             SENATOR BALL:  Ladies and gentlemen, so this

      17      is what we're gonna do:

      18             We have a -- there are about 100 --

      19      approximately 100 Narcan kits.

      20             Everybody who wants to stay for that

      21      training, I know we have about 100 people that

      22      signed up for the training, please do that.

      23             I would like Senator Carlucci and

      24      Senator Boyle to get some closing remarks.

      25             If I -- I'm gonna run through these very







                                                                   108
       1      quickly so they're on the record, and then we'll

       2      follow up.

       3             But, on deliverables, and if I forgot

       4      anything, you guys need to let me know.

       5             You can't hear me?

       6             KARINA CHRISTIANSEN:  Can I just say one

       7      thing?

       8             SENATOR BALL:  Yes, ma'am.

       9             KARINA CHRISTIANSEN:  I'm sorry.

      10             I'm gonna give a perspective of somebody in

      11      their 20s, still, thank God.

      12             People in this room are talking from the

      13      perspective of parents, and they're looking at their

      14      children.

      15             But we have to remember that these are men in

      16      their 20s.  These are adults.

      17             My brother started using at 26 years old.  He

      18      was an adult man.  He was a police detective in

      19      New York City.

      20             And, so, you're all coming from the very

      21      reasonable and important perspective of protecting

      22      your children, but we have to also remember, these

      23      are adult autonomous members of our society.

      24             SENATOR BALL:  Thank you.

      25                  [Applause.]







                                                                   109
       1             SENATOR BALL:  Okay, so on the

       2      law-enforcement side:

       3             We're gonna follow up with the Marchman Act,

       4      using Florida as an example, to give parents and

       5      relatives more input.

       6             We talked a little bit about, the laws

       7      against heroin in comparison to other narcotics,

       8      they're extremely weak and need to be strengthened.

       9             There's a suggestion from Bob Tendy,

      10      Supervisor Tendy, about two or three violations

      11      should be a felony.

      12             Treatment, the insurance companies right now

      13      are covering three days, when, really, for most

      14      folks, it should be 90.

      15             We need to dig into that.

      16             And, Senator Carlucci agreed, and

      17      Senator Boyle, of course, that we will, and we will

      18      do that as a team.

      19             The reimbursement rate, I know Amy from

      20      St. Christopher's talked about that.

      21             The insurance companies, Nora talked about

      22      that, requiring a face-to-face, and the

      23      complications there, as well as saying that,

      24      "not medically necessary."

      25             Senator Boyle talked about the need to







                                                                   110
       1      actually, properly, define "medically necessary,"

       2      and, not allow some guy with a pencil-neck, sitting

       3      behind a phone, talking about "medical necessity,"

       4      when we have people that are about to die.

       5             And, somebody else -- a parent also talked

       6      about the process needing to be much more

       7      streamlined.

       8             On the prevention end, this may not be the

       9      prevention, but, anyways, as a deliverable:  Docs

      10      are prescribing opiates, and Carol talked about

      11      this, in large quantities.

      12             We need to follow up on that:  Actually

      13      holding doctors and the medical community

      14      accountable, including the number of pills.

      15             It was brought up by Carl Albano, who I think

      16      has since left, about prescription to children under

      17      a certain age.

      18             And then, when we were talking about, I think

      19      it was Brewster --

      20             Principal from Brewster?

      21             DANIELLE SULLIVAN:  I'm an assistant

      22      principal.

      23             SENATOR BALL:  Okay.

      24             Well, next year, next year.

      25             -- a cultural shift, that we actually have to







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       1      involve the parents.

       2             And my -- are there any other superintendents

       3      in the room?

       4             My favorite superintendent, Tom Manko --

       5                  [Laughter.]

       6             SENATOR BALL:  No, it's true.

       7             -- brought up the fact that the schools are

       8      extremely strapped, so we need to do these things in

       9      the community, involve the parents, and move on.

      10             Guys, we will follow up.

      11             Susie -- if my staff can announce themselves?

      12             Susie is my chief of staff.

      13             Raise your hand, Susie McDonough.

      14             And then, [unintelligible].

      15                  [Applause.]

      16             SENATOR BALL:  If you have any easy

      17      questions, send them to me.

      18             If you have any really tough questions, give

      19      them to Senator Carlucci, or Susie McDonough.

      20             And then, [unintelligible] who's here, she's

      21      my legislative director.  So on the legislative

      22      side, if you're interested in being involved in the

      23      process, you know, please contact her.

      24             Senator Carlucci.

      25             SENATOR CARLUCCI:  Well, again, Senator Ball,







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       1      I want to thank you for putting this together.

       2             And I just really want to say, thank you, to

       3      everyone that's here tonight.

       4             Thank you to the parents who have lost so

       5      much, for sharing your story; for having the courage

       6      to stand up and share your experience.

       7             Because that's what it's gonna take.

       8             You know, we talked about some of obstacles,

       9      when we talk about an entrenched industry -- an

      10      insurance industry that doesn't like to change.

      11             I think, with all of the obstacles that we've

      12      talked about, I also see a lot of opportunities,

      13      because, we are in a changing time.

      14             Whether it's the Affordable Care Act, the

      15      move to managed care; locally, our Regional Centers

      16      of Excellence, with completely changing our

      17      psychiatric centers in the state of New York; what's

      18      important, as we transition, is that we have to take

      19      these ideas and these suggestions and make them a

      20      reality.

      21             And, I heard so many different, important

      22      ideas and problems, that I think that we can

      23      address.

      24             Whether it's dealing with Medicaid managed

      25      care, or dealing with private insurance companies,







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       1      making sure that there is respite for people that

       2      need it, these are really exciting ideas, if you

       3      will, that you've shared with us.

       4             And I really just want to thank you for that.

       5             We're continuing these hearings around the

       6      state.

       7             Locally, across the river, in

       8      Rockland County, we're gonna have a hearing, or,

       9      another, roundtable, Tuesday, May 27th, and that

      10      will be in the middle of the day.

      11             And, you know what?  We brought up a good

      12      and -- a good point was risen by someone in the

      13      crowd, about having the insurance industry here.

      14             So we'll make sure to invite them, to make it

      15      a point, particularly, to have them there on

      16      May 27th if we can't get them at a sooner meeting,

      17      to make sure that they're part of the dialogue, and

      18      they hear these stories; hear the stories of when

      19      they weren't there.

      20             So, I want to thank you all again.

      21             I thank Senator Ball, and thank

      22      Senator Boyle, and the staff here, for putting

      23      together this wonderful forum.

      24             So, thank you, and look forward to working

      25      with you all.







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       1                  [Applause.]

       2             SENATOR BOYLE:  I, too, want to thank

       3      Senator Ball and his great staff for putting this

       4      together.

       5             And, Senator Carlucci, thank you for -- so

       6      much for coming.

       7             I urge all of you, whoever -- if your

       8      schedule allows, to stick around for the Narcan

       9      training.  It truly is a miracle drug, and we will

      10      save lives tonight as a result of it.

      11             UNKNOWN SPEAKER:  Senator Ball?

      12             Senator Ball?

      13             SENATOR BOYLE:  Thank you to the panelists,

      14      and to the audience.

      15             We had -- we have great ideas coming out of

      16      tonight.

      17             And I promise you, that when we introduce

      18      legislation and pass it this Senate session, it's

      19      gonna be from the ideas we got tonight.

      20             Thank you so much.

      21             SENATOR BALL:  Thank you, everybody.

      22                  (Whereupon, at approximately 7:46 p.m.,

      23        the forum held before the New York State Joint

      24        Task Force on Heroin and Opioid Addiction

      25        concluded, and adjourned.)