Public Hearing - May 15, 2014

    


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

       3                  PUBLIC FORUM:  ORANGE COUNTY

       4         PANEL DISCUSSION ON NEWBURGH'S HEROIN EPIDEMIC

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

       6
                               Newburgh Armory Unity Center
       7                       321 South William Street
                               Newburgh, New York 12550
       8
                               May 15, 2014
       9                       10:00 a.m. to 12:00 p.m.

      10

      11
              PRESENT:
      12

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

      15
                 Senator William J. Larkin, Jr., Forum Moderator
      16         Member of the Joint Task Force

      17         Senator John J. Bonacic
                 Member of the Joint Task Force
      18

      19

      20

      21

      22

      23

      24

      25







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       1
              PANELIST INTRODUCTIONS:                       PAGE  4
       2
              Paul Arteta
       3      Lieutenant
              Orange County Sheriff's Office
       4
              William Barbera
       5      Chief
              Rockland County Sheriff's Office
       6
              Anne Calajoe
       7      Director of Alcohol and Substance Abuse Services
              Rockland County Department of Mental Health
       8
              David Gerber
       9      Director of Counseling and Shelter Services
              St. Christopher's Inn, Garrison, New York
      10
              James Conklin
      11      Executive Director
              Alcoholism and Drug Abuse Council of Orange County
      12
              Michael Ferrara
      13      Police Chief
              Newburgh, New York
      14
              Greg Gaetano
      15      Chief Criminal Investigator
                 Representing Sheriff Carl DuBois
      16      Orange County Sheriff's Office

      17      Dave Hoovler
              District Attorney
      18      Orange County

      19      David Jolly
              Chief Operating Officer
      20      Jonnie Wesley-Krueger
              Chief Advancement Officer
      21      Greater Hudson Valley Family Health Center

      22      Michael Kavanagh
              Chief Narcotics Prosecutor
      23      Ulster County District Attorney's Office

      24

      25







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       1
              PANELIST INTRODUCTIONS (Continued):
       2
              Judy Kennedy
       3      Mayor
              Newburgh, New York
       4
              Darcie Miller
       5      Commissioner of Mental Health
              Orange County
       6
              Nancy Montgomery
       7      Deputy Director of Grants for
                 Sean Patrick Maloney, and
       8      Deputy Supervisor, Town of Phillipstown

       9      Steve Neuhaus
              County Executive
      10      Orange County

      11      Rob Ross
              Chief Executive Officer
      12      St. Luke's Cornwall Hospital

      13      John Westerman, Jr.
              Pharmacist, Previous owner of Ace Pharmacy
      14      Newburgh, New York

      15
              START OF PANELIST PARTICIPATION               PAGE  5
      16
              AUDIENCE PARTICIPATION AND Q&A                PAGE 60
      17

      18

      19                            ---oOo---

      20

      21

      22

      23

      24

      25







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       1             SENATOR LARKIN:  Let's start from my right,

       2      and introduce yourself to those in the audience.

       3             CHIEF WILLIAM BARBERA:  Chief Bill Barbera,

       4      Rockland County Sheriff's Office.

       5             JOHN WESTERMAN, JR.:  John Westerman.  I'm a

       6      community pharmacist, Newburgh, New York.

       7             DAVID GERBER:  David Gerber, director of

       8      counseling and shelter services at

       9      St. Christopher's Inn in Garrison, New York.

      10             ANNE CALAJOE:  Anne Calajoe, director of

      11      Alcohol and Substance Abuse Services, Rockland

      12      County.

      13             DAVID JOLLY:  David Jolly, Greater Hudson

      14      Valley Health Center.

      15             JONNIE WESLEY-KRUEGER:  Jonnie

      16      Wesley-Krueger, Greater Hudson Valley Family Health

      17      Center.

      18             MAYOR JUDY KENNEDY:  Mayor Kennedy, city of

      19      Newburgh.

      20             Wow, that's a loud one.

      21             MICHAEL KAVANAGH:  Mike Kavanagh, chief

      22      narcotics prosecutor from the Ulster County DA's

      23      Office.

      24             SENATOR BOYLE:  Senator Phil Boyle, Chairman

      25      of the Heroin Task Force.







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       1             SENATOR LARKIN:  Senator Bill Larkin.

       2             SENATOR BONACIC:  Senator John Bonacic.

       3             STEVE NEUHAUS:  County Executive

       4      Steve Neuhaus.

       5             DA DAVID HOOVLER:  District Attorney

       6      David Hoovler.

       7             NANCY MONTGOMERY:  Nancy Montgomery, deputy

       8      director of grants for Sean Patrick Maloney, and

       9      deputy supervisor with the Town of Phillipstown.

      10             DARCIE MILLER:  Darcie Miller, commissioner

      11      of Orange County Department of Mental Health.

      12             ROBERT ROSS:  Robert Ross, CEO,

      13      St. Luke's Cornwall Hospital.

      14             CHIEF MICHAEL FERRARA:  Mike Ferrara, Police

      15      Chief, here in the city of Newburgh.

      16             JAMES CONKLIN:  Jim Conklin, executive

      17      director of the Alcoholism and Drug Abuse Council of

      18      Orange County.

      19             GREGORY GAETANO:  Greg Gaetano, Orange County

      20      Sheriff's Office, representing Sheriff DuBois.

      21             LT. PAUL ARTETA:  Paul Arteta, Lieutenant,

      22      Orange County Sheriff's Office.

      23             SENATOR LARKIN:  Thank you all.

      24             Good morning.

      25             First of all, we'd all like to thank each and







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       1      every one of you for attending.

       2             This is a very, very important subject, and

       3      we're here to discuss:

       4             How did this take hold of our communities?

       5             More importantly, what can we do,

       6      collectively, to address this issue, and return our

       7      communities to normalcy?

       8             You can't turn on [sic] a newspaper today or

       9      you can't turn on a television or a radio without

      10      hearing about somebody OD'ing or something else.

      11             We have a crisis in our communities, and we

      12      have to address it.

      13             My good friend Phil Boyle, who's the Chairman

      14      of this for the State, has been going around the

      15      state on this subject.

      16             Last week, my good friend John Bonacic had

      17      one in Monticello.

      18             I've had people call me and saying to me, and

      19      John's told me the same thing, they didn't realize

      20      it was an issue in our communities.

      21             I don't know what they've been reading, but,

      22      ladies and gentlemen, this is important.

      23             Please don't walk away from here today and

      24      say, "Ah, we heard a big story, John."  Or, "Phil,

      25      we heard a big story."







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       1             Listen, and participate with us.

       2             If you're hearing something here that you

       3      don't understand, just stand up.  There's a

       4      microphone right there.

       5             And at this time, I'd like to turn it over to

       6      Phil Boyle, our Chairperson.

       7             SENATOR BOYLE:  Thank you so much, Senator.

       8             And I couldn't thank Senator Larkin enough

       9      for hosting this Task Force forum.

      10             This is the twelfth of 17 forums we're

      11      hosting around the state.

      12             And we're hearing across the state some of

      13      the same problems in each community regarding the

      14      heroin and opioid epidemic, and some new issues.

      15             And I'm looking forward to hearing from this

      16      distinguished panel and from the people in the

      17      audience.

      18             What I usually start by saying is that, if

      19      you -- whatever area of the heroin epidemic you are

      20      facing, whether it's you're a law-enforcement

      21      official, a treatment provider, or a prevention

      22      expert, a family member, an addict yourself, and you

      23      say to yourself, "There's a law that I'd like to

      24      change to make this situation better," please, this

      25      is what we're looking for today; ideas for







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       1      legislation which we will be introducing in the

       2      coming weeks, and passing in the State Senate.

       3             With your input, we are going to beat this

       4      serious crisis once and for all in our state.

       5             And I'd like to thank again, Senator Larkin,

       6      for hosting.

       7             And, Senator Bonacic, if you would like to

       8      say hello?

       9             Senator Bonacic?

      10             SENATOR BONACIC:  This heroin epidemic

      11      transcends every neighborhood, whether you're rich

      12      or poor.  I don't care about your ethnic persuasion.

      13      It affects everyone.

      14             And we in government are going to try to do

      15      our best to get ahead of the curve, but we also need

      16      the input from community.

      17             We need government and community to help us

      18      fight this epidemic.

      19             Thank you.

      20             SENATOR LARKIN:  Go ahead.

      21             SENATOR BOYLE:  We -- these forums are very

      22      informal, and it's not really a -- testifying like

      23      an expert like in a normal hearing.  It's a forum

      24      and roundtable.

      25             And that's why we just ask everyone, if you







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       1      have some ideas, give us a couple of minutes of your

       2      input from your area of expertise, and then let's

       3      have an open exchange, an open dialogue, both with

       4      the panelists and with anybody in the audience.

       5             Just raise your hand and we can get you a

       6      microphone.

       7             Or, if you want to just write down your

       8      question or comment, we'll be happy to respond, as

       9      well.

      10             We usually start out with the area of

      11      prevention.

      12             Obviously, what's going on is our young

      13      people, and that the average age of a heroin user,

      14      an opioid user, is get younger and younger.

      15             So, are there programs that you've seen for

      16      people that are in the -- whether you're in the

      17      prevention area or not, that you know of that are

      18      effective, that you've been using around here, or

      19      some that are not so effective?

      20             Because we're looking, as part of this

      21      legislative package, for proposals on what to fund,

      22      and what to defund if it's not working.

      23             Are there anybody from our panel that can

      24      give us some insights?

      25             Don't all answer at once.







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       1                  [Laughter.]

       2             MAYOR JUDY KENNEDY:  I know --

       3             SENATOR BOYLE:  Yes, Darcie?

       4             MAYOR JUDY KENNEDY:  Go ahead.

       5             DARCIE MILLER:  I don't understand the

       6      question.

       7             SENATOR BOYLE:  Oh, I'm sorry.  The acoustics

       8      are a little questionable.

       9             We're looking for some prevention programs

      10      that may have been used here that are effective, or

      11      not so effective.

      12             Any insights you have on what you think is an

      13      effective prevention program to stop our kids from

      14      ever trying these drugs in the first place?

      15             DARCIE MILLER:  I'll start with that answer,

      16      and I'm sure Jim Conklin from ADAC will have a lot

      17      to add as well.

      18             In Orange County, we recognize the epidemic

      19      proportions that we're dealing with with opioid

      20      addiction of both heroin and painkiller prescribed

      21      medications.

      22             And with that, we put a task force together

      23      last year, completed some recommendations, which

      24      I have given copies to the Senator.  The support of

      25      our County Executive, Steve Neuhaus; and







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       1      Dave Hoovler, our District Attorney; as well as our

       2      Sheriff; all have contributed to these

       3      recommendations that have been put forward in our

       4      county.

       5             With that, we've begun implementation.  We've

       6      had stakeholders, from prescribers, to hospitals, to

       7      prevention providers, treatment providers, schools,

       8      coming together to address this issue.

       9             One of the greatest accomplishments we've

      10      had, is having all 18 school districts agree to use

      11      the Pride Survey in grades 8, 10, and 12, and

      12      collect that data that will help us to target our

      13      prevention strategies.

      14             We've already begun to do community

      15      prevention outreach.  We've' been in our schools.

      16      We've partnered with them to bring community

      17      together, to bring the adolescents, as well as to

      18      bring the parents together, to educate them about

      19      the risk of opiates; the impact it can have on our

      20      young people, understanding that adolescents' brains

      21      are still developing and they are particularly

      22      vulnerable to this kind of a brain disease.

      23             We have seen that our treatment providers,

      24      the numbers of people entering treatment for opioid

      25      addiction has tripled since 2006.







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       1             We are outraged by those numbers, and are

       2      committed to working together to address these

       3      issues, through education, prevention, bring --

       4      educating our prescribers in the best practices for

       5      when to prescribe and how much to prescribe; as well

       6      as our communities, to partner with them in

       7      developing coalitions, expanding peer supports; and

       8      being as effective as we can to prevent the need for

       9      treatment.

      10             And I'm sure you'll get into discussion about

      11      treatment.

      12             JAMES CONKLIN:  Thank you, Darcie.

      13             I guess we should probably start by saying --

      14             SENATOR LARKIN:  Speak up a little bit.

      15             JAMES CONKLIN:  Sorry.  Yes, sir, Senator.

      16             I guess we should start by saying that we're

      17      not going to have, you know, one bit of funding or

      18      one piece of legislation that's going to address

      19      this multifaceted issue.  It's affecting every

      20      community, every neighborhood, every town,

      21      throughout the state of New York.

      22             One of the things that I think in prevention

      23      we're looking at doing, and we've been doing it at

      24      the community level, and I'd like to continue and

      25      develop some programs that do it at the school







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       1      level, is taking the community-mobilization approach

       2      to prevention.  And it shouldn't be directed or

       3      targeted.

       4             Although we come together to address a

       5      specific epidemic today, our effort shouldn't be

       6      addressed at opiates.  It should be addressed at

       7      changing the norms, accessibility, and availability

       8      to all substances of abuse in our communities, and

       9      to having a different mindset in how we address

      10      that; to having the message be correct and delivered

      11      by every adult.

      12             One of my favorite soapboxes when it comes to

      13      substance-abuse prevention treatment, is it has so

      14      little to do with children and so much to do with

      15      adults.

      16             Children are doing exactly what we should be

      17      expecting them to do, developmentally.  They're

      18      pushing away from their family of origin, they're

      19      developing their peer group, they're establishing

      20      their own identity, and they're moving on to, you

      21      know, take their place in the adult world.

      22             That's their role and goal through that stage

      23      of life.

      24             We're creating the environment that they do

      25      that in.  And as long as we have crack pipes on the







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       1      counters at Mobile Marts and Philly blunts all over

       2      the place, we're sending a message of tacit

       3      approval.

       4             I think it's the adults in the community that

       5      need to learn --

       6                  [Applause.]

       7             JAMES CONKLIN:  Thank you.

       8             I think it's the adults in community that

       9      need to learn the message and the science of

      10      prevention and implement it appropriately.

      11             We have to do a better job for our kids.

      12             Our prevention programming has always been,

      13      "Well, buy this curriculum."  And the school

      14      district can spend ten, twenty, thirty thousand

      15      dollars on a curriculum, it doesn't address the

      16      entire strata of their school district; it doesn't

      17      address all their problems and needs.

      18             So we're looking at make something changes in

      19      our prevention strategies at ADAC, and looking at it

      20      a little bit differently of how we approach the

      21      situation.

      22             SENATOR BOYLE:  That was an excellent point.

      23             I'm sorry.

      24             One of the things is that, we see that

      25      it's -- we shouldn't be just one forum for the







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       1      students, which they do once a year.  It's got to be

       2      an ongoing thing.

       3             Mayor.

       4             MAYOR JUDY KENNEDY:  I wanted to say that,

       5      I've been working with Team Newburgh.

       6             And I see Martin Colavito [ph.] out there.

       7             And one of the things that is happening

       8      there, we've got some legislation ready, that has to

       9      do with all of the drug paraphernalia that is

      10      available in bodegas and everywhere.  And it's

      11      packaged for children, with sugar, and bright

      12      colors, and all kinds of interesting things.

      13             It's packaged for children.  And it's in

      14      right where candy and all that stuff is.

      15             And I think that -- we're looking at it at a

      16      local level, but at least at a state level, can that

      17      be handled like cigarettes?

      18             It's got to be up, behind the counters, you

      19      have to ask for it.  And, it can't be really

      20      targeted towards children.

      21             It's something we could do to make it lots

      22      harder to have the paraphernalia available.

      23             And it's a small step, but it's a good step.

      24             The really big issue that we have right now,

      25      that's kind of holding us up, is how do we enforce







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       1      that, and put some teeth in that law, so that, you

       2      know, our police officers and everybody else can

       3      really go after it?

       4             So I think making it much more difficult

       5      would really help.

       6             And I agree with the gentleman down there, we

       7      need to get our parents involved.

       8             We have too many painkillers around home, we

       9      have everybody popping pills for whatever little

      10      ache and pain they've got, and the kids have access

      11      to that immediately.

      12             We have got to do something to educate our

      13      parents about having the availability of all these

      14      painkillers that immediately jump to the opiate

      15      drugs.

      16             SENATOR BOYLE:  Does the local and -- law

      17      enforcement, or the city or municipalities, do a

      18      Shed The Meds or Drug Take-Backs in this community

      19      communities, and are they effective?

      20             DA DAVID HOOVLER:  I'm the District Attorney.

      21             I think -- what I hear here, and what I see

      22      in the county, is showing a lot of trends:

      23             First, I think the collaboration that we're

      24      undertaking in the District Attorney's Office, with

      25      ADAC, with mental health, Orange County Mental







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       1      Health, with our health-care providers, from a

       2      law-enforcement standpoint, we have to realize that

       3      enforcement alone is not the answer to any of the

       4      problems we have.  It has to be a multifaceted

       5      approach, it has to have an educational component,

       6      so that people are aware of the signs and symptoms

       7      of addiction.

       8             And it has to be a vigilance, with our

       9      parents, with our child-care providers, with our

      10      relatives.  You have to see the problems as they're

      11      coming before you, and you have to understand that

      12      your social background, your ethnic background, your

      13      economic background, that anyone can fall victim to

      14      heroin, opioid addiction, and drugs in general.

      15             The second aspect -- or that would be the

      16      first prong.

      17             The second aspect has to be, that those

      18      individuals, those people, that are closest to those

      19      who are addicted, you have to empower them to

      20      somehow seek the treatment; to reach out, to get the

      21      treatment, and then force them, to the best you can,

      22      to go there and seek the treatment, understanding

      23      that the person that's addicted drives the ship, but

      24      have you to provide as much support as you can.

      25             The third aspect, where my office becomes







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       1      involved, and while prosecutors, we are educators,

       2      we are advocates.  At the end of the day, our job is

       3      to make the community safe.

       4             The enforcement aspect, as a district

       5      attorney, the last thing I want to see is people

       6      being arrested.  But when they denigrate the quality

       7      of life of the citizens of the county or the state,

       8      enforcement action has to be taken.

       9             So I think that, under the umbrella of

      10      looking at the problem, as long as we always focus

      11      that there has to be a multifaceted approach, there

      12      has to be education, empowerment, and enforcement

      13      of, you know, these three prongs working together.

      14             But just to talk -- to answer the question:

      15             The scope of the problem in Orange County,

      16      and I will be very brief and tell you what we're up

      17      against.

      18             This year alone, drug indictments, where a

      19      grand jury indicts somebody for narcotics, a

      20      felony-related offense, in this county this year,

      21      for the first quarter, through April 30th, drug

      22      indictments are up 75.5 percent.

      23             Heroin indictments, for people, possession of

      24      heroin, felony weight, are up 100 percent from last

      25      year;







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       1             Cocaine indictments for people possessing

       2      felony-weight cocaine are up 53.8 percent.

       3             Here's the staggering number that's coming:

       4             The total number of drug-sale indictments,

       5      where someone has physically sold drugs primarily to

       6      an undercover police officer, someone that they do

       7      not know is a law-enforcement agent, these

       8      indictments have increased 217.6 percent.

       9             Now some of that is because of our stepping

      10      up the enforcement aspect, but never in my years of

      11      law enforcement or in the criminal justice field or

      12      as a practicing attorney, have I seen increases like

      13      that; nor have people that have worked in the

      14      District Attorney's Office.

      15             So that's what we're up against.

      16             And I think the first step is having forums

      17      like this, and understanding that we do have a very

      18      serious problem.  And then we must understand that

      19      that problem affects every one of us.

      20             That the child or the adult who is addicted,

      21      it not only affects their family, it affects all of

      22      us, because it affects the insurance companies, it

      23      affects the providers.

      24             There's a cascading effect that this epidemic

      25      has, that starts with the person that's addicted,







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       1      and ends up all the way through health care, our

       2      social -- our society, as well as our

       3      law-enforcement society.

       4             And I think that's what we really have to

       5      start getting a grasp that the problem is much

       6      greater than we want to acknowledge.

       7             SENATOR BOYLE:  Mr. Kavanagh, we've seen

       8      similar numbers in Ulster County for arrests?

       9             MICHAEL KAVANAGH:  We are.

      10             I don't have the statistics available, but

      11      I can tell you, having indicted a majority of the

      12      cases this year, and last year, involving narcotics,

      13      that we're seeing far more heroin and

      14      diverted-pharmaceutical indictments than we have in

      15      the past.

      16             And just to add something:  I think

      17      prevention that was addressed already should be the

      18      primary topic that we talk about here today,

      19      because, very often, when law enforcement gets

      20      involved, it's already too late.  People are

      21      addicted, that bridge has already been crossed, and

      22      it's very difficult to go back and undo that.

      23             What we like to do, I know in Ulster County,

      24      one of the things we focus on is, once law

      25      enforcement gets involved, we do try to encourage







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       1      treatment.

       2             And when I say "encourage," I think it's more

       3      appropriate to say we threaten treatment, because,

       4      in my experience, once somebody becomes an addict,

       5      they are not going to seek treatment voluntarily.

       6      They need to have a gun at their head, so to speak.

       7      They need to hit rock bottom.

       8             And that's how we can help in law

       9      enforcement.  And we try to achieve that, with

      10      limited success.  We have a drug court that's very

      11      successful.

      12             I know that many county courts have a

      13      diversion program which is very successful.

      14             So there is some hope, but, by and large,

      15      once we're involved, it's an uphill battle from

      16      there.

      17             SENATOR BOYLE:  Mr. County Executive?

      18             STEVE NEUHAUS:  Just following up on what the

      19      District Attorney said, one of the things that we've

      20      started doing this year, when we make arrests, is a

      21      three-pronged approach when we make the presentation

      22      to the public.

      23             Number one --

      24             [Microphone passed to speaker.]

      25             STEVE NEUHAUS:  Thank you, Senator.







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       1             The first thing we do is, the law enforcement

       2      explains to the public how the arrest was made.

       3             Number two, the District Attorney talks about

       4      how the prosecution, and what the sentence they're

       5      looking at.

       6             The third thing, which I think is a critical

       7      thing, and I think it's what everybody's alluding to

       8      and what's been mentioned so far, is the education

       9      process.

      10             We have a picture of each individual on a

      11      screen behind us, and we say:  This is somebody's

      12      husband, wife, mom, daughter, dad, cousin.  Somebody

      13      knew they had an addiction, or somebody knew they

      14      had a problem.

      15             And like it was just mentioned, somebody has

      16      to force them to get help.

      17             And what we're trying to get the message out,

      18      is that we don't want to make the arrest.  We don't

      19      want to endanger our public.  We don't want to have

      20      the District Attorney busier than they are now.

      21             But we have a million resources available in

      22      Orange County right now.

      23             Darcie Miller just mentioned, from

      24      Mental Health, as well as the many other people here

      25      down this panel, if you get the awareness out there.







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       1             And one of the silver linings, if there is

       2      anything to Philip Seymour Hoffman's death, is that

       3      it brought widespread awareness of heroin and some

       4      of the impacts in society.  It was a horrible thing,

       5      but it made the headlines that sometimes don't get

       6      the word out there.

       7             So, the -- getting the awareness and the

       8      education out there is critical to really combating

       9      this.

      10             So thank you, Senator.

      11             SENATOR BOYLE:  That's a wonderful program,

      12      and I think it should be used in more counties

      13      across the state.

      14             It was mentioned, for those looking for

      15      treatment, that have hit rock bottom, they'll look

      16      for a detox and/or a referral to -- for

      17      rehabilitation, and inpatient treatment, perhaps, or

      18      outpatient treatment.

      19             One of the problems we're seeing around the

      20      state is the coverage -- insurance coverage.

      21             People are saying, "Okay, I'm ready to get

      22      off drugs, I'm ready to get clean."  And, either

      23      their parents or themselves, they call the insurance

      24      company, and the medical -- and the insurer says,

      25      Well, it's not medically necessity.







                                                                   24
       1             So for any of the providers here -- the

       2      treatment providers, can you explain what you're

       3      experiencing in terms of coverage, and getting

       4      people in there and the help they need?

       5             Yes.

       6             ROBERT ROSS:  Well, first of all, I have to

       7      thank Senators Larkin and Boyle for convening this.

       8      This is a very important topic.

       9             We at St. Luke's Cornwall are kind of at the

      10      end of the stream here.  We have seen, in the last

      11      year, a threefold increase in overdoses in our

      12      emergency department.

      13             Think about that for one minute.

      14             We as a community, we as a society, are

      15      paying for the treatment of people when they've

      16      reached the worst moments in their lives, and not

      17      spending the money up front for prevention, for

      18      treatment, for interceding when necessary, for that.

      19             We have shown that we can work

      20      collaboratively with government, with other

      21      providers, to make sure that we get in front of this

      22      situation and make sure that patients get the

      23      treatment that they need.

      24             We find all the time that payment is a key

      25      issue here.







                                                                   25
       1             People come into our emergency department, we

       2      treat them at the moment, and send them back out

       3      into the community, but the funding isn't there to

       4      get them the right treatment.

       5             Funding isn't there for appropriate

       6      outpatient treatment.  Funding isn't there for

       7      appropriate inpatient treatment.

       8             And what we find is, we'll see them back in

       9      our emergency department weeks or months later.

      10             We have to decide, as a society, where we

      11      want to spend our health-care dollars.

      12             And where it needs to be spent is on

      13      collaboration and treatment and funding up-front,

      14      and not at the back end when they show up in a

      15      crisis at our emergency department.  That's not

      16      where it should be.

      17             So, absolutely, funding and payment is a key

      18      issue.  And we have to look at how we can put more

      19      funding into treatment, and less funding into

      20      handling it when it's a crisis at the end of the

      21      line.

      22             Thank you.

      23                  [Applause.]

      24             DAVID GERBER:  Senator, thank you for turning

      25      the discussion in this direction.







                                                                   26
       1             At St. Christopher's Inn, just to give you an

       2      idea of the shift in our population, in 5 years, the

       3      number of people who come into our outpatient day

       4      rehabilitation program, the number of people who are

       5      heroin-primary, has grown 51 percent in the last

       6      5 years.

       7             That, while the average age of people,

       8      18 to 25, has gone up 62 percent.

       9             So we're seeing decreases in alcohol use,

      10      increases in heroin, and the population getting

      11      younger and younger and more complicated.

      12             The problems that we're facing -- and

      13      St. Christopher's Inn is the largest provider of day

      14      rehabilitation services in the state.  And what

      15      we're facing right now as a field, is that programs

      16      are closing, so access to care is dwindling.  Rates

      17      are being cut.

      18             At St. Christopher's Inn, the new

      19      implementation of the APG rates for outpatient

      20      treatment providers, we underwent a 13 percent cut

      21      in our rates.  We've had to scale back services as a

      22      result.

      23             And insurance companies are denying care, and

      24      limiting days of care to the point where they're,

      25      clinically, insufficient.







                                                                   27
       1             We have one insurance company that said:  We

       2      don't authorize more than 14 days of treatment for

       3      anybody.

       4             Well, for someone who's been a heroin addict

       5      for a year, 5 years, 10 years, you can imagine a

       6      chronic, debilitating, deadly disease, and an

       7      insurance company saying, We can only give you

       8      14 days of treatment.

       9             It's just, clinically, not enough.

      10             JONNIE WESLEY-KRUEGER:  And at the same time

      11      as we're talking about treatment, and some of the

      12      barriers to securing effective access to treatment,

      13      what we have at this moment in time, and some of my

      14      colleagues in the room will know and shudder as

      15      I say this, there is a massive overhaul at this same

      16      moment, in looking at the delivery of health care.

      17      There is an initiative right now, in terms of the

      18      redesign of Medicaid.  And it is very much about

      19      shifting away from paying for services rendered to

      20      producing outcomes.

      21             Well, in this regard, of course, we're all

      22      seeking, what are the very best outcomes that can be

      23      generated?

      24             The obstacle and the immediate up-front, is

      25      how to make the transitions so that the systems are







                                                                   28
       1      coordinated, they are integrated, they are as

       2      comprehensive and effective as possible.

       3             But, there is still a reality to the delivery

       4      of care, which, you know, by everybody's stretch of

       5      the imagination, recognizing the overall goal is

       6      about treating the healthiest [inaudible/someone

       7      coughing].

       8             And there are certain dollar-and-cents

       9      realities about what that's going to mean.

      10             And in our pursuit of this redesigned system

      11      that we want to see fully actualized by 2020, can

      12      we -- do we make sure that we can avoid creating

      13      further problems and difficulties, especially in the

      14      face of this onset of this epidemic that is

      15      impacting us in so many myriad ways.

      16             The other thing that I had wanted to say, and

      17      I'd like to go back to, not on the grander scheme of

      18      the whole redesign of the system, and how do we

      19      drill it down to really being effective, and our

      20      addressing some of these issues on the treatment

      21      side.

      22             And, of course, as we said earlier, by

      23      Dave Hoovler, in terms of the need for the

      24      comprehensive approach, one of the pieces of minutia

      25      that we're finding, as our center for recovery







                                                                   29
       1      continues to be the only opioid-treatment program

       2      here in the county, is -- and I say this with a

       3      tremendous degree of surprise, still is, drug

       4      dealers are incredibly entrepreneurial.

       5             And one of the things we have discovered, is

       6      that drug dealers know the location of treatment

       7      facilities, recognize that this is a known customer

       8      base, and make a point of setting up business within

       9      the proximity of.

      10             So, as we are struggling to work to ensure

      11      the success of our patients seeking treatment, we're

      12      also struggling and working collaboratively with

      13      law enforcement here in the city of Newburgh to

      14      identify how we create a safe environment, so that

      15      folks that are pursuing treatment can do so without

      16      the distractions of somebody standing there, going,

      17      "We got you covered."

      18             SENATOR BOYLE:  Yeah, that is actually one of

      19      the areas we're looking at in terms of the

      20      legislation, to increase penalties for dealing drugs

      21      in the vicinity of a treatment.

      22             JONNIE WESLEY-KRUEGER:  We vote yes.

      23             MAYOR JUDY KENNEDY:  The vicinity of schools,

      24      too.

      25             SENATOR BOYLE:  Without a doubt, without a







                                                                   30
       1      doubt.

       2             JOHN WESTERMAN, JR.:  Excuse me, if I could

       3      jump in?  And I apologize for the -- there's a

       4      couple of bullet points that have been mentioned

       5      here this morning, that I would like to comment on.

       6             As a pharmacist, I'm tending to look at

       7      things from the perspective of prescription-drug

       8      abuse.  And I realize the primary focus of this

       9      forum is to identify, maybe, solutions to the heroin

      10      side.

      11             But I think it's important to draw the

      12      parallel and the -- identify and recognize the

      13      pathway between what may start out as

      14      prescription-drug abuse in many households, and

      15      ultimately end up in the illicit market.

      16             There has been recent legislation that was

      17      passed approximately a year ago in New York State,

      18      called "I-STOP," which is the Internet system for

      19      tracking of overprescribing.

      20             And essentially what that has done, is it has

      21      created a database within the state that would allow

      22      physicians -- actually mandates that physicians or

      23      any prescriber check that database, to make sure

      24      that we're not -- their patients are not doctor

      25      shopping; using multiple prescribers and multiple







                                                                   31
       1      pharmacies to obtain prescription drugs.

       2             So the net result of the I-STOP program is

       3      that it's been extremely effective.

       4             I'm also licensed to practice pharmacy in the

       5      state of Florida, and they were about a year ahead

       6      of the curve on this situation, because they had an

       7      explosion of Oxycontin diversion, and they were

       8      known as the "Oxy capital of the country."

       9             So, they really had to address this problem a

      10      little bit earlier on the time curve than

      11      New York State.

      12             So I've had experience dealing with them in

      13      that location, as well.

      14             And the bottom line is, that program has been

      15      extremely effective.

      16             The unintended consequence of that, however,

      17      is that we still have addiction problems.

      18             We still have a problem, where -- and someone

      19      mentioned earlier, prevention, prevention,

      20      prevention, and I couldn't agree more.

      21             We need to stop it at the source, because

      22      someone gets in a situation where they become

      23      addicted to prescription narcotics, and, now, with

      24      I-STOP and other programs like this going on in

      25      multistate venues, it's becoming more and more







                                                                   32
       1      difficult for people to get larger quantities of

       2      these prescription drugs to support their addiction.

       3             So you've got a problem where the addiction

       4      has occurred.  Now you've got a patient that needs

       5      to satisfy this addiction.

       6             In the past, they've been able to go to

       7      multiple physicians and pharmacies and obtain these

       8      drugs, often, sometimes using insurance.  Obviously,

       9      they can get one bite of the apple with that, and

      10      then pay cash for the others, which is why they flew

      11      under the radar for so long.

      12             But, now, this has become more difficult, if

      13      not impossible.

      14             So to satisfy their addiction, they're now

      15      going to the illicit stream.

      16             So now you've got people that are

      17      middle-class, upper-class, America -- the

      18      cheerleaders, the football players, everybody

      19      else -- people that have had chronic illness or some

      20      kind of disability that have just -- that have --

      21      were taking these potent pain relievers, and then

      22      got into a vicious cycle where they became addicted.

      23             You've got these people now that can't

      24      satisfy their needs, and they're going into the

      25      illicit market, and you're creating a whole other







                                                                   33
       1      host of problems associated with that now.

       2             So, while the -- while I think what you're

       3      going to see, is probably a tightening of the

       4      prescription-drug diversion situation at the expense

       5      of the heroin and the illicit side.

       6             And, again, to -- and I hate to belabor the

       7      point, but we talk about prevention, prevention.

       8             We can't do enough to get involved at the

       9      early stages.  We've got to get to our kids.

      10             Mayor Kennedy, you pointed out the

      11      stockpiling of drugs being an issue and the

      12      Take-Back program.  And I don't know if that was

      13      actually answered.

      14             But I know there was one last -- what,

      15      I think April 26th.  And I got a thing -- I'm a

      16      member of the National Association of Boards of

      17      Pharmacy.  And they track these things.  And it was

      18      the largest Take-Back event, ever.  And I forget how

      19      many tons of controlled substances were returned,

      20      nationwide.

      21             So it's a hugely successful program,

      22      I believe.

      23             But as a community pharmacist, we have been

      24      trying to get the DEA to allow community pharmacies

      25      to accept unwanted, undesired controlled substances







                                                                   34
       1      back, for destruction, from our patients.

       2             This has been languishing around at the DEA

       3      level for well over a year.

       4             And in terms of a possible solution, I would

       5      ask the legislative -- our legislative members of

       6      this body, perhaps, reach out to their colleagues on

       7      the federal side, the members of Congress --

       8      Senator Schumer, Senator Gillibrand -- let's see if

       9      we can urge the DEA to move forward on this pathway

      10      to get it legal, for the pharmacies and the

      11      pharmacists that choose to, to be able to take back

      12      these unwanted controlled substances from their

      13      patients for destruction.

      14             Get them out of the medicine cabinets where

      15      our kids and other family members can get ahold of

      16      them.

      17             That's a no-cost solution.

      18             I mean, that's really a no-cost solution.

      19      It's is a fairly easy thing to do, and it comes at

      20      no charge to the taxpayer or anybody else.

      21             I think it would be extremely effective.

      22             And I'm sorry I monopolized a lot of time,

      23      but, thank you.

      24             CHIEF WILLIAM BARBERA:  Just to feed off of

      25      that a little bit:  This is not an Orange County







                                                                   35
       1      issue, this is not a Rockland County issue.  This is

       2      a national issue.

       3             And I agree with my pharmacist friend here,

       4      we need to get that medicine out of the medicine

       5      cabinet.

       6             In Rockland County, we did work with the DEA.

       7      Took Sheriff Falco well over a year to get the

       8      authorization.

       9             But, 24 hours a day, you can come into the

      10      Sheriff's Office, and some of the local police

      11      departments, and drop off unused narcotics that you

      12      have in your medicine cabinets.

      13             It's anonymous.  You walk through the door,

      14      we don't even ask who you are.  Come in.  We have a

      15      mailbox secured to the floor.  You anonymously throw

      16      it in there.

      17             And, last month, we destroyed over 700 pounds

      18      of unused narcotics from the Rockland County area.

      19             So far we've had -- in the past four months,

      20      we've had eight deaths associated with overdose in

      21      Rockland County.

      22             Rockland is significantly smaller than

      23      Orange.  That's two deaths per month.  That's

      24      something we can't afford to have in our community.

      25             So, I thank you all for being here.







                                                                   36
       1             Thank you.

       2             SENATOR BOYLE:  Thank you.

       3             Yes.

       4             DAVID JOLLY:  So one of the issues we

       5      noticed, too, at the Greater Hudson Valley Health

       6      Center, our center for recovery, which does,

       7      methadone maintenance, is our primary role, is that

       8      our waiting list today has reached 80.

       9             So a person in need of treatment today is not

      10      going to get access very quickly, which presents

      11      a -- as we all know in the field of recovery, when a

      12      person reaches a certain point and they're ready to

      13      take that step towards recovery, we have to have

      14      access perfect for that patient to get in the next

      15      day.

      16             If they're not in quickly, by the way, the

      17      opportunities exist for them to go back, and to

      18      wait.

      19             And we also agree with the District Attorney,

      20      by the way, that the law enforcement and the

      21      prosecution, mandated treatment works.  It gets

      22      people in the door.

      23             When a person's in the door, it's our job to

      24      keep them there.  And we're good at that.

      25             So, we can't say enough about the effect of







                                                                   37
       1      law enforcement and mandated treatment through the

       2      courts.

       3             SENATOR BOYLE:  Just to follow up with that

       4      question:  Are there sufficient detox beds in the

       5      area of Orange, Ulster, Rockland, before you go to

       6      treatment?

       7             I mean -- and what kind of delay are we

       8      looking at?  Are we talking, a couple of days? a

       9      couple of weeks?

      10             Because some areas of the state, for those

      11      who can get to detox, they have to wait 14 days or

      12      more to get into the treatment.  And, obviously,

      13      they're overdosing when they get back out.

      14             DAVID JOLLY:  Experts, right here.

      15             ANNE CALAJOE:  Well, I'm from Rockland, but,

      16      most of the time, people that are going to the

      17      ERs in Rockland are being denied admission,

      18      because opiate is not considered a medical

      19      necessity.

      20             So what happens, is that there are beds

      21      available, but people aren't getting admitted.

      22             And what's happening, is when people are

      23      turned away, they just go back out on the street and

      24      they just keep using more heroin, which, really, it

      25      increases the potential of overdose because people







                                                                   38
       1      are trying to avoid withdrawal.

       2             So, people are just going back out after

       3      they're at the point of being ready to go into a

       4      hospital and to go into detox, and then they're

       5      being told, No, we can't admit you.

       6             So it's a very frustrating process for

       7      everyone.

       8             For families, families are like really to the

       9      point where, like, What do we really do?

      10             This isn't like -- as far as their child, it

      11      is a medical necessity.

      12             It's -- and people don't understand, you

      13      know, like, why they're not being admitted when

      14      they're ready.

      15             One of the other things is that -- we're

      16      finding, is that when people continue to use heroin,

      17      they're out there with their friends, with their --

      18      out in the community.  And what's happening is,

      19      people are overdosing all over.

      20             And one of the things that we have found to

      21      be effective in Rockland is, Blaisdell, our

      22      inpatient rehab program, has been, basically,

      23      training all their patients, families, staff, the

      24      community, on the overdose-prevention kit.

      25             So when people come into their treatment







                                                                   39
       1      program, if you're a patient or if you're a family

       2      member, you can receive the training for the Narcan,

       3      to reverse the withdrawal -- the opiate overdose.

       4             So that has been very effective in spreading

       5      that throughout the community, and that's happening

       6      there for at least two years.

       7             But one of the other things that we've done

       8      just recently is, in the beginning of April, we

       9      started to work with the Rockland paramedics.  And

      10      the Clarkstown Police Department was the first

      11      police department to be trained to administer the

      12      nasal-spray Narcan, which has been very effective in

      13      the community, as well.

      14             And we're going to continue to train all the

      15      police departments in Rockland County, to help with

      16      that process.

      17             So that has been helpful in our community.

      18             The other thing that we're trying to do, as

      19      Nyack Hospital is opening -- has been working on

      20      doing an ambulatory detox, because of all the people

      21      that are being denied access.

      22             But the only -- it's not really a perfect

      23      solution because that's for mild to moderate

      24      withdrawal, so you can't be using and in severe

      25      withdrawal.







                                                                   40
       1             So, it's really not the total fix to the

       2      problem, but it's an attempt.

       3             But we're supposed to have sometime, probably

       4      June or July, we'll probably add that service in

       5      Nyack.

       6             SENATOR BOYLE:  One second.

       7             Does -- Chief, did you want to comment on

       8      that?

       9             CHIEF WILLIAM BARBERA:  Just one more piece,

      10      on Narcan, we're going to use that in

      11      Rockland County.

      12             What it is, the first person on the scene is

      13      usually a police officer.

      14             And you have seconds.  When someone's

      15      overdosing, you only have seconds, if not minutes,

      16      to save their life.

      17             Narcan is a medicine that immediately

      18      reverses the effects of an overdose.  It's actually

      19      a spray that the officer can put spray into -- in

      20      the person's nose.

      21             As the Chief of Police, I did not want this.

      22      I was very afraid of my officers administering

      23      medicine.

      24             But speaking to the Rockland paramedics, they

      25      assured us it has zero effect on anyone who doesn't







                                                                   41
       1      have any opiates in their system.

       2             "Zero effect."  Nothing.  Can't harm a person

       3      at all.

       4             It will immediately reverse the effects of a

       5      persons who's overdosing; so, therefore -- and,

       6      actually, the good news, I spoke to one of my

       7      colleagues, the Chief of Newburgh, they're going use

       8      it here in Orange County, as well.

       9             We're going to use it in Rockland.  And here

      10      in Orange, as well.

      11             DAVID GERBER:  Senator, [unintelligible] when

      12      you talk about the availability of detox beds, how

      13      moot a point that is if you follow the money,

      14      because the reality is, come next year, when

      15      fee-for-service Medicaid ends and all Medicaid

      16      becomes managed care, all of the funding is calling

      17      for incentivizing decreased detoxification

      18      inpatient, decreased emergency room visits.

      19             And, unfortunately, you know, many of us are

      20      already seeing limits and decreases in outpatient

      21      care, as well.

      22             At St. Christopher's Inn, we're getting calls

      23      every day from family members that don't know what

      24      to do with their kids, trying to get them off the

      25      street, being denied at a detox or an inpatient







                                                                   42
       1      rehab by an insurance company.

       2             And we came up with the idea to create a

       3      crisis respite center, and it gained a bit of

       4      traction.

       5             Office of Mental Health asked to us write up

       6      a proposal.

       7             And, after we submitted the proposal, they

       8      said:  No, thanks.  We want to focus more on

       9      mental-health issues.

      10             So, you know, we have the capacity, in a very

      11      unique setting, to provide an inpatient-like

      12      program, but there is no funding for it currently,

      13      and nobody willing to fund it, unless we move for a

      14      private-pay model.

      15             So, you know, the availability -- we have an

      16      ambulatory detox license.  We're one of the few

      17      outpatient providers that has actually held on to an

      18      ambulatory detox license, and we've done so because

      19      our unique shelter setting allows people to stay

      20      inpatient; and, yet, be treated for ambulatory

      21      detox; and, yet, we've gotten one referral in the

      22      past year.

      23             Westchester County, I believe, has 72 detox

      24      beds.  They're generally full, without much of a

      25      waiting list.







                                                                   43
       1             There is zero beds in Putnam County.

       2             So, I don't know if that answers your

       3      question.

       4             JOHN WESTERMAN, JR.:  I'd just like to add

       5      one comment to the discussion around the Narcan,

       6      which is naloxone.

       7             Some of you may be aware that there's been a

       8      product that's been made available within the last

       9      30 days, and it's call "EVZIO," E-V-Z-I-O.  It is,

      10      basically, a consumer-, layperson-based product.

      11             For those of who have ever used an EpiPen, or

      12      carried an EpiPen, to reverse allergic symptoms,

      13      it's an epinephrine pen, for yourself or your child,

      14      this is, basically, a similar packaging of the

      15      naloxone, brand name "Narcan," that's been referred

      16      to by Bill and others.

      17             It immediately reverses the effects of

      18      opiate, the respiratory depression, the CNS

      19      depression; all of the classic things, the killers.

      20             But the advantage of this product -- and I'm

      21      not a paid endorser of this -- but the advantage of

      22      this product is, it is a -- in a self-injector

      23      format.

      24             The advantage of it being an injection, if

      25      the person is really out, totally out, nasal spray







                                                                   44
       1      may not be effective.

       2             So the advantage of this product is, it

       3      actually -- when you remove the cap, it actually

       4      gives you an audio message as to how to proceed.

       5             It will tell you:  Remove cap.  Remove this.

       6      Put this -- place this on this part of the body for

       7      X number of times.  Whatever.

       8             It's very, very user-friendly, and it's

       9      designed to be used by a layperson.

      10             It's just been out within the last 30 days.

      11             The problem is, it requires a prescription.

      12             And I believe there's legislation that was

      13      passed, I believe by both the Assembly and the

      14      Senate in New York State, last week, awaiting the

      15      Governor's signature.

      16             And as of last week it had not been signed,

      17      but, maybe someone at this table knows the answer.

      18             But, it would allow that product to be

      19      prescribed by a physician, and available to anybody.

      20             A parent in a household, or if you had a

      21      family member that was at risk, you could actually

      22      obtain this product and have it on your person.

      23             Because, as Bill mentioned, time is of the

      24      essence.  If you have an overdose, you haven't got

      25      10, 20 minutes to fool around.  You've got to give







                                                                   45
       1      this immediately.

       2             So this has to be, first responders,

       3      definitely, should all have it.  But I think the

       4      families should also, for those people who have

       5      family members at risk, they should have this

       6      available to them.

       7             And I would go one step further, it might

       8      even be considered that we have some kind of ability

       9      for maybe the State health commissioner or the

      10      County health commissioner to have a standing order,

      11      for instance, in place for this, so that you

      12      wouldn't even need a prescription.  You could get it

      13      anonymously at the pharmacy, if you chose to have

      14      it.

      15             Because it has zero abuse potential, as Bill

      16      said.  It can only be of benefit.  And it's a

      17      lifesaver.

      18             SENATOR BOYLE:  Yeah, and the mechanism

      19      you're referring to is kind of like an EpiPen for

      20      Narcan; right?

      21             JOHN WESTERMAN, JR.:  Correct.

      22             SENATOR BOYLE:  It's a great thing.

      23             For those of you who have not taken the

      24      training for Narcan, it's not a big, long course.

      25      It's, literally, a 45-minute class you can take.







                                                                   46
       1      And, save a life, God forbid, if you ever have to,

       2      of a neighbor or a loved one.

       3             Darcie?

       4             DARCIE MILLER:  Yes, thank you, Senator.

       5             I just want to speak about the capacity here

       6      in Orange County, and I would say shame on us if one

       7      of our detox beds is vacant.

       8             With the proportion of the issue that we're

       9      dealing with, there shouldn't be a single bed vacant

      10      in this county.

      11             Unfortunately, there are times when they are

      12      for all the reasons that have been already been

      13      mentioned by our neighboring counties.

      14             When someone goes to the emergency room,

      15      asking for help, looking for treatment, if they're

      16      not sick enough, if they haven't failed out of

      17      enough outpatient services, they are turned away and

      18      told to come back later.

      19             That is just unacceptable, considering the

      20      depth of this issue and the addiction, and the need

      21      for services to help them recover.

      22             We are 100 percent supportive of your bill to

      23      require insurance companies to pay for the level of

      24      care that's recommended by the clinical provider

      25      who's doing the assessment.







                                                                   47
       1             And we thank you for that effort and moving

       2      it forward.

       3             I also want to say that it's on the

       4      service-provider system to ensure that we're

       5      providing best-practice intervention to support

       6      people through their recovery process, using things

       7      like motivational interviewing, and cognitive

       8      behavioral therapy, and trauma-informed care.

       9             We also need to take away some of the stigma

      10      that's connected with the medical medication support

      11      that helps people in their recovery.

      12             We haven't talked today about the stigma.

      13             And the reason why so many people don't come

      14      forward to get help, because most of them

      15      accidentally become addicted.  They start taking

      16      opiate painkillers, and before they know it, they're

      17      addicted, and they're shocked that they're now

      18      shooting up heroin.

      19             And for us in this region, it's even more

      20      dangerous, because our young people are shooting

      21      heroin and they're not educated about the use of

      22      heroin.

      23             In New York City, it's been around much

      24      longer than in our communities.  And our young

      25      people are not using heroin in safe ways.







                                                                   48
       1             No one uses it in safe ways, but our young

       2      people aren't aware of the risks.  And that's why

       3      the education is so important for them.

       4             But when we talk about using Suboxone or

       5      using methadone, methadone, for example,

       6      Greater Hudson Valley Family Health Care Center has

       7      400 slots for us here in this county.

       8             The New York State Office of Alcoholism and

       9      Substance Abuse said our need is for more like

      10      800 slots.

      11             That leaves us 400 less shots than what we

      12      need to provide the care that our community members

      13      need.

      14             We also have to look at Suboxone as a

      15      supportive treatment, and naloxone.

      16             When people talk about using those

      17      medications to support people in their recovery,

      18      there's some stigma even among our own system of

      19      providers saying, we're replacing one drug with

      20      another.

      21             That may be true, for example, with

      22      methadone.  But it is a controlled treatment,

      23      sanctioned supportive response, to help somebody

      24      stay off of a street drug that has taken away the

      25      quality of their lives, and leading to the death for







                                                                   49
       1      so many.

       2             One in nine -- one person dies every

       3      19 minutes in our country due to drug overdose.

       4             Using the medications that can assist them,

       5      and having quality lives, remaining with their

       6      families, staying in their communities, having

       7      employment, we should all speak strongly for support

       8      of that kind of treatment.

       9             Whether it's done in a detox setting, in an

      10      inpatient rehab, or, as we are now allowed to do, in

      11      our outpatient settings, to provide that support.

      12             CHIEF MICHAEL FERRARA:  If I may chime in?

      13             As the Police Chief here in the city of

      14      Newburgh -- I think you can hear me -- I've said

      15      this before:  As far as law enforcement is

      16      concerned, it should be the last part of the chain,

      17      when it comes to the epidemic of heroin and the drug

      18      addiction that's related to it.

      19             Legislation, education, training, and

      20      especially for the young people, is very important,

      21      not just Newburgh, but for the entire Hudson Valley,

      22      and the entire state.  It's in epidemic proportions.

      23             I grew up in the '60s, and it was never as

      24      bad as it is now.

      25             As far as law enforcement is concerned,







                                                                   50
       1      heroin, especially, is a hard -- it's a hard crime

       2      to tackle.

       3             Unlike a lot of the drug markets, from my

       4      notes, that predominate the entire Hudson Valley,

       5      those running heroin are mostly independent and they

       6      deal in some quantities.

       7             Narcotics officers have indicated to me that

       8      dealers and buyers tend to be even more suspicious

       9      of outsiders that they don't know.

      10             That complicates law enforcement, as far as

      11      making arrests when it comes to heroin, for those

      12      two reasons; mostly, because the police department

      13      has a problem conducting the sort of buy-bust

      14      operations that are the baseline for most of our

      15      narcotics work, and always has been for years.

      16             These are the inherent challenges:

      17             Most heroin gets to Newburgh by car.  It's

      18      delivered that way by dealers who crisscross our

      19      neighborhoods.  They're not coming down with a kilo.

      20      They're coming down and getting an ounce, and then

      21      they're splitting it up and spreading it out that

      22      way.

      23             We've seen indications that some suspects

      24      known for mostly selling crack and marijuana are

      25      switching now to heroin where the true profits are.







                                                                   51
       1             Just recently, in the past couple months, in

       2      the city of Newburgh, we've made about 60 arrests,

       3      and we've seized about 1200 grams of marijuana,

       4      60 grams of heroin, 82 grams of PCP, 75 pills, 40 to

       5      50 handguns.

       6             It's all combined.  It's not as organized as

       7      you think, but it's a systemic problem that's

       8      spreading, not only in Newburgh, but it has to be

       9      dealt with.

      10             I'm looking forward, as the Police Chief, to

      11      distribute the Narcan.  That's a great idea.

      12             As police officers, if we can do anything, we

      13      are first responders.

      14             I happened to be a first responder, just the

      15      other night.  We had a heroin overdose in the city

      16      of Newburgh, up on Gidney Avenue.  I was one of the

      17      first law officers that arrived at the scene.

      18             It was too late, even if I had the Narcan

      19      with me.

      20             But I hope, in the very near future, we will

      21      have the training, the policies, and the Narcan for

      22      distribution by all officers; and, hopefully, that

      23      will save lives.

      24             I support the idea.

      25             It should come from the New York State







                                                                   52
       1      Chiefs, downward through all the other police

       2      chiefs, which they can spread through their

       3      officers.

       4             That's it, that I have.

       5             GREGORY GAETANO:  Thank you.

       6             Greg Gaetano from the Sheriff's Office.

       7             Just to follow up on what Chief Ferrara had

       8      mentioned, our deputies, in our first stipend

       9      training, received special training on criminal

      10      interdiction, and picking up that -- those drugs as

      11      they're floating around Orange County.

      12             The Sheriff is committed to narcotics

      13      enforcement, be it at a street level, working with

      14      different local agencies, working with the

      15      District Attorney's Office.

      16             I have our commander of our narcotics unit

      17      with us today.

      18             And, enforcement is important, yes.

      19             Education is important, yes.

      20             And I think, when we take this multifaceted

      21      approach, we're looking at thinking outside the box.

      22      It's called a "paradigm shift."

      23             And I think that's why it's important for

      24      audience members, also, to have an idea of a

      25      suggestion.  Like a brainstorming session.







                                                                   53
       1             It might sound crazy, it might sound weird,

       2      but it can't hurt.

       3             So I've got some ideas that I want to just

       4      discuss with the DA and the Senators, in terms of

       5      legislation.

       6             It might be out there a little bit, but

       7      I think it's worth a shot.

       8             And as we think outside the box, and continue

       9      to think further outside the box, our office is

      10      involved in the Operation Safe Scrip.

      11             We accept drugs, unwanted prescription

      12      medicine, Monday through Friday, 9 to 5.

      13             We have special pickups, four times a year.

      14             We're going to be setting up in September

      15      over at the rec park, picking up hazardous waste and

      16      prescription medications.

      17             Lieutenant Arteta was recently trained on the

      18      use of this Narcan.

      19             So these are all good, progressive ideas, in

      20      terms of tackling this.

      21             But from that multifaceted approach, and

      22      thinking outside the box, I think is a

      23      collaboration, the dais and the community, we can go

      24      forward with fresh ideas.

      25             Thank you.







                                                                   54
       1             CHIEF MICHAEL FERRARA:  If I could add one

       2      more thing?

       3             I've always said, from what we've found out,

       4      you know, in law enforcement locally, and over the

       5      past few years, of all the drug dealers that we

       6      find, it's nothing compared to what grandma has in

       7      her medicine cabinet, and what's available.

       8             It's prescription medication that the kids

       9      get ahold of.  And it's just completely -- it's not

      10      protected, and it gets into the hands of the -- of

      11      young people throughout the city, the county, the

      12      state.

      13             That's a major issue, and that is -- that's

      14      something that should be considered at any given

      15      time.

      16                  [Applause.]

      17             JAMES CONKLIN:  Actually, 56 percent of the

      18      individuals who start with prescription medications,

      19      start with it from a friend or family member for

      20      free.  It's not some deep, dark stranger in some

      21      alley who's exposing them.  It's a free source.

      22      It's friends, family; it's people that they know and

      23      care about.

      24             It makes it a lot easier when grandma's name

      25      is on the bottle.







                                                                   55
       1             SENATOR BOYLE:  Thank you very much.

       2             Now -- oh, I'm sorry.

       3             Mayor?

       4             MAYOR JUDY KENNEDY:  I think we're probably

       5      getting ready to wrap up.

       6             Two thoughts that have been stirring around

       7      in my mind for, actually, quite a long time, and it

       8      doesn't apply at the local level.

       9             This problem is not a local problem.  It's

      10      not a state problem.  It's probably not even just a

      11      national problem.

      12             It's an international problem; and there's so

      13      many factors involved with it.

      14             And so the two things that I'm thinking

      15      about, one of them is a national policy, and the

      16      other one may be a national policy in how we deal

      17      with it.  So, I don't know exactly what we can do as

      18      a state.

      19             But, you know, the issue of the prescription

      20      drugs that come out, and so many of it -- so many of

      21      these things start with our young people and getting

      22      hooked on the prescription for various reasons:  The

      23      football player that has the injury.  The operation.

      24      The hurt, whatever it is.

      25             I just had a hip replacement about six,







                                                                   56
       1      seven weeks ago, and I was encouraged to take as

       2      much pain medicine as I wanted.

       3             It was, "Don't feel anything."

       4             I happen to be one who says, "I want to feel

       5      it.  I want the know what's going on.  I want to

       6      understand what my body is doing."

       7             That's not a very common practice today in

       8      that idea.  Everybody takes a pill for everything.

       9             So I think there's a cultural problem that we

      10      have to deal with.

      11             But the prescription companies, let's talk

      12      about how to pay for a few things.

      13             The companies that make opiate drugs, how

      14      about a national policy, that there's a fund that

      15      every one of these drug companies need to contribute

      16      to for treatment of these drug overdoses?

      17                  [Applause.]

      18             MAYOR JUDY KENNEDY:  They're part of the

      19      problem, and they need to be part of the solution.

      20             And we -- the insurances, that just drives up

      21      all of our insurance.

      22             But those drug companies, they're making a

      23      fortune on this, and they need to be putting into

      24      the pot to fix it.

      25             And the other policy, and it may sound







                                                                   57
       1      strange, is our farm policies.

       2             I happen to travel internationally, and

       3      I have a son that lives in Mexico.

       4             And one of the things is, I've really studied

       5      the Mexican agriculture.

       6             Our farm policies actually killed the Mexican

       7      corn farmers' crops, and their ability to sell,

       8      because they could not compete with our subsidized

       9      corn crops.

      10             And so what did they turn to?  Something we

      11      can't grow.

      12             Guess what?  There's your source of heroin.

      13             And, so, our farm policies have actually

      14      driven foreign countries into producing the plants

      15      that create the opiate drugs.

      16             We have got to start looking at the very

      17      source of what's going on.  Those are national

      18      policies, but they've got to be looked at.

      19             SENATOR BOYLE:  Thank you very much, Mayor.

      20             We're going to open it up to comments and

      21      questions from the audience in just a couple of

      22      minutes.

      23             I'd just like to touch on, for the

      24      law-enforcement officials here, prosecutors, and

      25      police officers:







                                                                   58
       1             In the various forums we've had so far, we've

       2      heard from different DAs and police chiefs about

       3      whether the laws are sufficient in terms of

       4      prosecution.

       5             Generally speaking, I'd say, downstate, they

       6      don't think the laws are sufficient enough.

       7      Upstate, further upstate, they think they are.

       8             What are you feeling in these communities

       9      here, Mr. District Attorney, in terms of the current

      10      criminal penalties?

      11             Can they be increased?  And if so, and how

      12      would you do it?

      13             DA DAVID HOOVLER:  I think, in general, what

      14      we see here in Orange County, is we see a lot of

      15      drug sellers and drug dealers flee from Pennsylvania

      16      and come over the border here and make sales in

      17      New York, because our drugs are -- our laws are a

      18      little more lax.

      19             I personally, my opinion, is that I think

      20      those who sell drugs, the penalty should be harsher

      21      because of the aspect of the selling.

      22             But, obviously, in every circumstance, the

      23      facts and circumstance of every case, discretion has

      24      to be applied.

      25             But, in general, I believe they should be







                                                                   59
       1      harsher, I believe, the penalties.

       2             I came through the system as a young

       3      prosecutor years ago when the penalties were much

       4      harsher.  They've been relaxed.

       5             I think that this epidemic, there has to be

       6      harsher penalties for what is happening.

       7             We are seeing more and more repeat offenders

       8      who just go through the system, come right back out,

       9      and we have to deal with them again.

      10             But once again, it's a -- there has to be a

      11      global approach.

      12             It has to be global; it has to be education,

      13      prevention.

      14             But I just want to say one thing that

      15      Darcie Miller hit on:

      16             When people go and they try to seek treatment

      17      in an emergency room, and they're turned away, and

      18      they haven't met all the requirements that are

      19      needed to get into a long-term treatment facility,

      20      that is when they are at their weakest; that is when

      21      they commit other crimes.

      22             And I can tell you that, in Orange County,

      23      80 percent of the crimes that we prosecute have some

      24      connection to either drug or alcohol abuse.

      25             And that is a staggering fact that we have to







                                                                   60
       1      live with, because it's a cost that we all pay.

       2             But for the most part, those that are

       3      addicted to opiates, when they are turned away is

       4      when they are most likely to commit some other

       5      collateral crime; a larceny, a forged check,

       6      a theft.  And we see more and more of that.

       7             And I think, when it comes to this problem,

       8      the insurance issue looms so large in this room,

       9      that I hope that, somewhere down the road, with the

      10      legislators that we have, with our Senators, with

      11      our Assembly members, that something can be done in

      12      that area, because I think that would help

      13      dramatically.

      14             SENATOR BOYLE:  Thank you very much.

      15             And we are seeing that, too.

      16             In terms of the cost, you're looking at jail

      17      versus treatment, and jail is much more expensive

      18      wherever -- in any part of the state.

      19             I would like to open it up to the audience

      20      now, and ask Mr. Matthew Turnbull, a County

      21      legislator here in Orange County, to say a few

      22      words.

      23             MATTHEW TURNBULL:  Yeah, my name is

      24      Matt Turnbull.  I'm a County legislator.  I'm also a

      25      recovered addict.







                                                                   61
       1             I was just thinking, while I was sitting

       2      there, listening to this panel --

       3             And, by the way, I want to thank the

       4      Senators.

       5             I want to thank the Senators for this very

       6      timely and necessary forum.  You know, it is really

       7      important that we address this problem, you know,

       8      and do it aggressively.  And there's just so many

       9      things that have been said, that makes it clear to

      10      me that the problem is understood, you know, and the

      11      importance of doing something is really on the table

      12      at this point.

      13             So I want to speak to something I really

      14      haven't heard much of, you know.

      15             You know, I'm still reluctant to talk about

      16      this problem of being an addict, you know, because,

      17      you know, there's still that sense that, you know:

      18             What's wrong with me?

      19             You know, why was I that way?

      20             Why was I different?

      21             Why was I not able to control it?

      22             You know, I had a father who used to listen

      23      to German marching music.  And, you know, to him, it

      24      was all about willpower.

      25             And that did not work for me.







                                                                   62
       1             You know, it wasn't until I kind of bought

       2      into the disease concept that I started to have

       3      success.

       4             But, you know, I used all the different

       5      drugs.

       6             One of my strategies, to keep from getting in

       7      trouble, was to go from one drug to another.

       8             So when I got addicted to using alcohol, then

       9      I would go to barbiturates.  And then I would go to

      10      using crystal meth intravenously.

      11             You know, one thing to another; one drug to

      12      another drug.

      13             In the '60s -- we all know what happened in

      14      the 60s -- made that very possible.  Not only

      15      possible, but all those drugs were very available

      16      back then.

      17             At the point I made a decision to get sober,

      18      to get drug-free, six years went by from the point

      19      that I made that decision, to when I finally got

      20      sober.

      21             I was in Rockland County.  I went to Pomona

      22      several times.  Went to Rockland State Hospital.

      23             I probably lost count.

      24             And I went away to a program up here in

      25      Sullivan County called "New Horizons," and I was







                                                                   63
       1      there for a year.

       2             I left that program, came back to

       3      Rockland County, and I lasted about another year

       4      before I picked up again.

       5             So my point is, I didn't just decide to get

       6      sober and I got sober.  It took about six years.

       7             The reason I finally got sober was, again,

       8      the acceptance that this thing that I was dealing

       9      with was going to kill me, unless I made it the most

      10      important thing in my life.

      11             And, amazingly, it's remained that way for

      12      33 years.

      13                  [Applause.]

      14             MATTHEW TURNBULL:  The number one important

      15      thing in my life is to stay sober and drug-free one

      16      day at a time.

      17             I continue to do that, and my wife continues

      18      to help me to do that.

      19             It's kept me very involved in helping others.

      20             And, you know, we've all heard the statistic,

      21      35 out of 36 addicts die from the disease.

      22             "35 out of 36."

      23             So the point that was made, that once a

      24      person is addicted, it's really -- you know, it's

      25      not likely that they're going to recover.







                                                                   64
       1             However, there is an environment that's

       2      successful.

       3             The environment that I found, it's called the

       4      "12-step program."  And that's where I got sober.

       5             Amazingly, after all these different programs

       6      and places that I went to, which all helped, I got

       7      information, but, where I finally did get sober was

       8      down in Manhattan.  Came out of a hospital after a

       9      short period of detoxification, and I went into a

      10      room, and I stayed in that room.  You know, every

      11      day of the week, you know, I worked.  I went to

      12      meetings.

      13             And it's been that way ever since, and now

      14      I've gotten to have a life.  You know, everything

      15      just worked.

      16             I was terrified that my two children, you

      17      know, would be genetically available to the disease,

      18      and I was sure that was going to happen.

      19             I guess they heard my story loud and clear.

      20             My son didn't drink his first beer until his

      21      junior year in college, you know.

      22             And my daughter is in her final stages --

      23      just came back from Nigeria, of all places -- in her

      24      final stages of completing her doctorate from

      25      Brown University.







                                                                   65
       1             You know, and my point is, that the

       2      prevention is super-important, that these -- our

       3      children, our most important resource, doesn't start

       4      down this road.

       5             But once somebody is addicted, they need to

       6      know there is a way.

       7             You know, we see people come into the rooms

       8      and they're mandated.  That's a good thing.

       9             Most of these mandated people that come into

      10      the rooms stay off drugs, you know, because they

      11      accept it's an ongoing thing.

      12             They need it.  They need that daily reprieve,

      13      you know.

      14             If they don't have that, it's very unlikely

      15      that they're going to stay sober.

      16             Thank you.

      17                  [Applause.]

      18             VIRGINIA:  [Not using a microphone.]

      19             Good morning.

      20             My name is Virginia.

      21             SENATOR BOYLE:  Can you use the microphone,

      22      because it's being recorded.

      23             Thank you.

      24             VIRGINIA:  Hello.

      25             Is that good?







                                                                   66
       1             UNKNOWN SPEAKER:  Turn it on.

       2             SENATOR LARKIN:  A little louder.

       3             SENATOR BOYLE:  That's good.  You're good.

       4             VIRGINIA:  Okay.

       5             Hello, good morning.

       6             My name is Virginia.  I am a health educator.

       7             And, I'm not going to take time to go over my

       8      resume.

       9             So, I wanted to say, first of all, thank you,

      10      thank you, thank you very much, for doing this

      11      forum.

      12             I do think that this is important.

      13             And I do think that every single person on

      14      this panel should be congratulated for doing this

      15      type of work.

      16             One of the first things that you said when

      17      you started this discussion, was about involving the

      18      community.

      19             I am very disappointed that this is what we

      20      consider our community, because, Newburgh, the

      21      community of Newburgh, would actually have this

      22      filled up and lines outside the door.

      23             I found out about this forum quite by

      24      accident, because I happened to talk to Jim, the

      25      director of the Armory, about another program







                                                                   67
       1      I wanted to do here.

       2             And he said:  Did you know?

       3             And then I went to the website, and I found

       4      out about it.  And I only spoke to two other people

       5      who knew about this program.

       6             So -- and I -- I get tons of e-mails every

       7      day, and I send out tons of e-mails, and this was

       8      not promoted in any way, that I could see, among the

       9      community activists of the city of Newburgh.

      10             So that's my one criticism.

      11             My second one is, that we need to really

      12      focus on, and you did talk about prevention.

      13             And other than Jim, I don't see a real force.

      14             And I know you all understand the role of

      15      intervention, but I don't see a real force because,

      16      the team of -- Team Newburgh, which provides

      17      prevention programs, and I don't mean treatment

      18      programs, but has a significant -- we hit the

      19      streets twice a month, every two weeks, and -- and

      20      have a major activity going on here, was not invited

      21      to be on this panel.

      22             Why Team Newburgh was not invited to be on

      23      this panel really perplexes me.

      24             Another question I have is:  There are

      25      three treatment facilities in the city of Newburgh:







                                                                   68
       1      Restorative, the Center for Recovery, and

       2      Catholic Charities.

       3             Now, I know the Greater Hudson Valley Family

       4      Health Center is here, but nobody's here from the

       5      Center for Recovery, nobody is here from

       6      Catholic Charities, and nobody is here from

       7      Restorative.

       8             Why are they not here?

       9             Blaisdell, major, wonderful program.

      10      I've referred so many people, and did aftercare for

      11      so many people.

      12             But we need more people on the front lines,

      13      in the forefront, that do this work, to be able to

      14      advise us all on what's the best way to get this

      15      work done.

      16             Who's here from the medical field?  Again,

      17      the Greater Hudson Valley Family Health Center.

      18             And I can tell you, right now, that anybody

      19      goes to the Greater Hudson Valley Family Health

      20      Center to do doctor shopping, they're going to hit a

      21      stop sign, because the Greater Hudson Valley Family

      22      Health Center does not allow doctor shopping.  Will

      23      not just give out opiates indiscriminately.

      24             I can't say that for other practices in

      25      Newburgh.







                                                                   69
       1             Okay?

       2             So where are all the medical facilities

       3      that -- that -- that function here in Newburgh, and

       4      treat all our patients, and get a majority -- start

       5      that whole ball rolling in a lot of the cases?

       6             They're not being addressed here.

       7             Anybody here from the school district?

       8             Anybody here from the drug courts?

       9             I understand the need to make laws.

      10             And I agree, that when comes to drug

      11      trafficking, we need legislation, we need hard laws.

      12      We shouldn't allow people to completely come into

      13      our communities and destroy it.

      14             I agree 100 percent.

      15             But if you really want to solve this problem

      16      of drug addiction in a little community like mine

      17      that I care about the most, you have to address the

      18      hearts and minds of people.

      19             You to have the actual people who are really

      20      being affected by this on a day-to-day level, come

      21      here and tell you what their life is like, and what

      22      they need.

      23             And until we can hear what people need, we

      24      won't be able to begin the healing process.

      25             Until we can empower the people who really







                                                                   70
       1      need the help, so that they can get off of drugs and

       2      off of substances, then we won't really make an

       3      impact in the community.

       4             Thank you.

       5                  [Applause.]

       6             SENATOR BOYLE:  Thank you, Virginia.

       7             I will say that this is not an end.

       8             This is -- obviously, we're limited in terms

       9      of space for the people today.

      10             But any of these groups, any of the groups

      11      that you know of, that can contact my office, we're

      12      going to be taking testimony.

      13             This is wide open.  They can e-mail me, call

      14      me, call my office, and we're going to use their

      15      testimony.

      16             UNKNOWN SPEAKER:  [Inaudible.]

      17             SENATOR BOYLE:  Please.

      18             AUDIENCE MEMBER:  Hello.

      19             SENATOR BOYLE:  You can just keep talking, it

      20      will pick up.

      21             Just keep talking.

      22             AUDIENCE MEMBER:  [Inaudible.]

      23             SENATOR BOYLE:  No, turn it back on.

      24             AUDIENCE MEMBER:  [Inaudible] for the drug

      25      court in Rockland, but I live in Orange County.







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       1             And I just want to -- I feel like if I went

       2      home and didn't say this, I would be feeling bad

       3      tonight:  I agree with Darcie, what we need is the

       4      ability to get these people the help when they're

       5      ready.

       6             I can't tell you how many times I have

       7      directed somebody to go to a detox, or even a detox

       8      that wouldn't take them because they didn't meet

       9      this certain criteria, or they get to the point

      10      where they're going to go into a 28-day program and

      11      they're rejected because they hadn't failed an

      12      outpatient program in a certain period of time.

      13             That really is very scary, because these

      14      people are finally getting to the point where they

      15      are accepting help, want help, and we're not able to

      16      give it to them.

      17             And I just want to say, also, I do agree with

      18      the law enforcement dictating them to go to

      19      treatment, because I've seen it.  I've been working

      20      there for 15 years, and it works.  It really does.

      21             So I just felt, like, you asked us what we

      22      need?

      23             We need help with the insurance companies and

      24      the hospitals to get these people the help.

      25             Thank you.







                                                                   72
       1                  [Applause.]

       2             SENATOR BOYLE:  Thank you very much.

       3             One of the things I will say --

       4             Please, come on up.

       5             -- regarding the requirement of failing, in

       6      terms of outpatient, before they're admitted to

       7      inpatient, that is one of the areas we're looking at

       8      in terms of our legislation, with the issue of

       9      "medical necessity."

      10             We can't have it.

      11             And we've heard it countless times across the

      12      state, about parents who try to get their child into

      13      treatment and they were told:  No, it's not

      14      medically necessary.  They have to fail at

      15      outpatient a few times.

      16             And one father told us that he said to them:

      17      You mean by "failure," you mean my son overdosing,

      18      is what you're really talking about.

      19             And that's exactly what happened.

      20             Sure.

      21             MARTIN COLOVITO [ph.]:  My name is

      22      Martin Colovito, and I do work with Team Newburgh.

      23             I want to echo what Jim started with before,

      24      in regard to prevention, and kind of add to that in

      25      regard to communities.







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       1             And I would ask everybody here to look at

       2      each and every community almost like they would look

       3      at a person that suffered trauma, that suffered

       4      depression, that suffer a whole lot of issues, that

       5      make them unique.

       6             All right?

       7             And consider that in regard to whatever we

       8      come up here today, because, I want to speak for

       9      Newburgh, because that's where I work, that's where

      10      my heart is.  All right?

      11             When I look at Newburgh, and I look at the

      12      kids that we deal with all the time, the constant

      13      thread is hopelessness.

      14             Where do we go from here?

      15             Why should I stay in school?

      16             There are no jobs.  There aren't this, there

      17      aren't that.

      18             And the collateral issues that feed the

      19      problems need to be addressed, because if they're

      20      not addressed, the problems aren't going to go away.

      21             We are conditioned to react to crisis.

      22             As a culture, as a society, we are

      23      conditioned to react to crisis.

      24             We need to start thinking preventively.

      25             I know we talked about that before.







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       1             And everybody since Jim talked, talked about

       2      the kids, the kids, the kids, the kids.

       3             Well, if I'm dealing with parents who say,

       4      "Thank God my kid's smoking weed, they're not

       5      shooting dope," you know -- you know, the perception

       6      that the parents have feed the kids.

       7             All right?

       8             And so, from a treatment perspective, which

       9      I worked in for about 30 years, and I'm in

      10      prevention for about 5 years, from a treatment

      11      prevention, we treat the individual.

      12             We take that individual, we embrace them,

      13      and, hopefully, it's a compassionate and encouraging

      14      environment, and we provide a venue for change.

      15             From a prevention perspective, we do the same

      16      thing with communities, and with our children and

      17      adults.

      18             And if we forget the adults, the children are

      19      not going to be addressed.

      20             So really what I wanted to kind of bring up

      21      here is, is the one thing is to recognize the

      22      differences in community.

      23             How in Port Jervis, being in the tri-states,

      24      has an effect on them that doesn't have on Newburgh,

      25      but the personality or the culture of Newburgh is







                                                                   75
       1      different than Port Jervis.

       2             But don't forget, if Newburgh goes,

       3      Port Jervis goes.

       4             You know, if Warwick goes, Newburgh goes.

       5             We have to address it collectively, but we

       6      have to remember, you know, the individuality of

       7      each community.

       8             So, I don't want to take any more of your

       9      time, but have a good day.

      10             SENATOR BOYLE:  A great point.

      11             Thank you very much.

      12                  [Applause.]

      13             JACK MACK:  [Microphone turned off.]

      14             My name is Jack Mack from across the river.

      15             [Microphone turned on.]

      16             JACK MACK:  Better?

      17             Elected officials, members of the general

      18      public, my name is Jack Mack.  I'm from across the

      19      river in Croton-On-Hudson, in Westchester County,

      20      where this Task Force is not holding a public

      21      meeting.

      22             I have a dog in this fight, because my

      23      24-year-old son Casey died of a heroin overdose on

      24      Labor Day 2012.

      25             Since I only have a couple of minutes, I'll







                                                                   76
       1      be blunt.

       2             What I think you need to hear and do is this:

       3      Follow the money.

       4             I don't mean the two-bit, small-time drug

       5      dealers on the streets.

       6             I don't even mean the drug kingpins who we've

       7      been hearing about for the last 45 years.

       8             I'm talking about the big money.

       9             Ask yourself:  Who's making a profit from

      10      this opioid-overdose crisis?

      11             Yes, Mayor [pointing].

      12             My son didn't get his opioid addiction from

      13      heroin.  He got it from painkillers.

      14             20 years ago, you could hardly get a

      15      painkiller.

      16             Now, it's the most widely used prescription

      17      drug in America.

      18             What happened?

      19             Did we become a nation of weaklings unable to

      20      endure any ache or pain?  No.

      21             What happened, was the drug companies sold us

      22      a bill of goods.  They spent money, persuading us

      23      and our doctors that we didn't have to suffer

      24      anymore.

      25             Even more deceitful, they told us we didn't







                                                                   77
       1      have to worry about getting addicted to painkillers.

       2             And they have been raking in the profits ever

       3      since.

       4             If they were selling us poison, you would do

       5      something to stop them.

       6             But what they are doing is more profitable

       7      than poisoning us, because we keep coming back for

       8      more.

       9             Please, don't cooperate with them.

      10             Regulate them.

      11             Don't let their experts tell you how much the

      12      world needs painkillers; rather, have their experts

      13      explain how they're going to bring my son back to

      14      life.

      15                  [Applause.]

      16             SENATOR BOYLE:  Do you want to go?

      17             Go ahead.

      18             ROSEANNE SULLIVAN:  Hi, my name is

      19      Roseanne Sullivan.  I'm an Orange County legislator,

      20      and I'm also a school board member in the

      21      Pine Bush Central School District.

      22             I really would like to thank the Senators for

      23      sponsoring this today.

      24             I am so thrilled that you are putting this at

      25      the forefront of your agenda and on your priority







                                                                   78
       1      list.

       2             I have served on a committee with

       3      Darcie Miller, the Painkiller Prescription Safety

       4      Task Force.  And, I found it to be so educating.

       5             I had the opportunity to listen to all of the

       6      concerns from so many professionals who sat on that

       7      committee, and it really confirmed what I was

       8      hearing in my community the whole time.

       9             I'm speaking today, not only on behalf of my

      10      family, but on behalf of dozens of families who live

      11      in my district.

      12             There are so many cries for help, and they

      13      are looking towards us, they're looking towards you,

      14      for the help.

      15             I'm appalled when I hear families tell me

      16      that their children, or their parents, or their

      17      grandparents, sought help for addiction and were

      18      turned away because they were told that they haven't

      19      failed yet.

      20             That is appalling.

      21             And I'm hoping, that if you take anything

      22      away with you today, that this is what you take

      23      away.

      24             I have been to too many funerals, too many

      25      wakes, for people of all ages and people of all







                                                                   79
       1      demographics.

       2             I'm also going to tell you a personal story

       3      which is going to come from a different perspective

       4      that you may not have heard yet.

       5             So almost a year ago, my family and I were

       6      involved in a head-on collision.

       7             The person who was driving the car was also

       8      transporting her 6-month-old grandchild in the car.

       9             There were complaints made about her driving

      10      from at least 15 miles away.

      11             After the accident, she was flown to

      12      Westchester Hospital.

      13             When she got to the hospital, she refused

      14      medical attention and walked away.

      15             It was later found that she was in possession

      16      of drugs.  It could not be proven, though, that she

      17      was under the influence.

      18             I fractured my back in two different places

      19      in that car accident.

      20             My husband was injured, and so was my

      21      15-year-old daughter.

      22             When I tell this story, I tell people how

      23      important it is to wear your seatbelts, because I'm

      24      telling you right now, those seatbelts were the only

      25      thing that saved my life.







                                                                   80
       1             But the system is broken.  And this is a

       2      perfect example how the system is broken.

       3             I was told that there is a fault in the

       4      system that prevented the officer from getting a

       5      court order to arrest this person at the hospital.

       6             What a shame that this woman got away with

       7      this.

       8             And what's even worse, and as a school-board

       9      member for 17 years, and volunteering in the

      10      education field, I have to tell you, and as a

      11      mandated reporter, I have to tell you, that I am

      12      absolutely disgusted, and so sad, that this woman

      13      still has the opportunity to be a caregiver for this

      14      child.

      15             And it is no one else's fault but our own.

      16             So I'm not here to point fingers at anybody.

      17             What I'm here is to give you an example of

      18      how the system is failing the people who are crying

      19      out for help.

      20             And if we don't make this a top priority

      21      immediately, you will see more examples of this.

      22             Many times I sit and wonder, why did this

      23      happen to me?

      24             And then I think, Well, you know what?  Maybe

      25      there's some spiritual reason for it.  Maybe the car







                                                                   81
       1      behind me had small 3- and 4-years old in the car.

       2      Maybe they didn't have their seatbelts on.

       3             So maybe I was able to save their lives.

       4             It's a really good way to look at it when you

       5      don't have any other answers.

       6             And it's a really good way to look at it when

       7      you look at a very personal case that absolutely

       8      fell between the rocks.

       9             And, so, I want to you take this with you

      10      today.

      11             And please know, that if you ever need my

      12      support in any of this, I will be your advocate.

      13             I am here to help you.

      14             And I really just encourage each and every

      15      one of you, I don't know what I could do to help

      16      you, but please reach out to me.  I'll be there for

      17      you, for any help you need.

      18             Thank you.

      19             SENATOR BOYLE:  Thank you very much.

      20                  [Applause.]

      21             WENDY ROSARIO:  Morning.  My name is

      22      Wendy Rosario.

      23             And I do want to thank you very much.

      24             I'm moved by everything that's happened here

      25      today.  I tend to get very motional.







                                                                   82
       1             I work for the New York State Department of

       2      Corrections and Community Supervision.  And I work

       3      in an alcohol- and substance-abuse treatment

       4      program.

       5             I provide treatment to inmates who are

       6      chemically dependent: alcohol, drugs, whatever.

       7             One of you made a comment about, 85 percent

       8      of your arrests, there was a statistic, that they're

       9      drug-addicted.

      10             I believe I'm correct in what I had said.

      11             I sit in these groups with 20 inmates, in a

      12      small room, and most of them do not think that

      13      they're drug- or alcohol-dependent.  And they are.

      14             It's very frustrating, it's very scary for

      15      me.  And I do the best I can as a credentialed --

      16      the CASAC-credentialed alcohol- and substance-abuse

      17      treatment counselor and -- and a corrections worker.

      18             I coordinate this program, and I try my very

      19      best to help these inmates.

      20             On one hand, I get very frustrated, because

      21      I believe, yes, they need to be in prison.  And more

      22      people, when you are making the arrests, should do

      23      time.

      24             And I'm almost becoming a little cynical, in

      25      that you should really throw the book at them and







                                                                   83
       1      keep them in prison for a very long time, to keep

       2      our communities safe, and, hopefully, they'll come

       3      to the point where they realize that they need

       4      treatment.

       5             On the other hand, I look at treatment in

       6      prison, and I do see that it does help, and that men

       7      do get clean and sober, and they go out and they

       8      continue to get ongoing help.

       9             But there's so many of them that don't.  The

      10      minute they come home, they forget where they were,

      11      and they're right back on that road to destruction.

      12             I'm a native Newburgher, born and raised

      13      here, and I love my community.

      14             I left here for many years, and I'm back

      15      because I love Newburgh.

      16             I had two late-life babies, twins.

      17      They're 12, and I worry.  They go to South Middle

      18      School.  And, there's a lot of problems throughout

      19      the community of Newburgh.

      20             I talked to Mr. Ragusa [ph.], the principal.

      21             And being a prison worker, I offered the

      22      program that we have there, where these kids who are

      23      very troubled can come in, similar to the

      24      Scared-Straight Program, which I'm sure you're all

      25      familiar with, and let them see what prison life is.







                                                                   84
       1             But, again, I know in my heart that you're

       2      not ready, unfortunately, until you've hit a deep,

       3      dark abyss, that bottom, that only the addict can

       4      explain.

       5             So I don't know where I'm going with this,

       6      other than I will say I'm a little selfish right

       7      now.  I worry about my 12-year-old twins.

       8             They're good kids, and good kids become

       9      addicted.

      10             They're involved in every activity I can

      11      possibly keep them in as a single mom.  And I know

      12      that these kids, still, oftentimes, end up on that

      13      road.

      14             I wasn't going to disclose this, but I'm

      15      24 years clean and sober, and my life is what it is

      16      because of AA and NA.

      17                  [Applause.]

      18             WENDY ROSARIO:  Thank you.

      19             I've also attend CODA meetings, Al-Anon

      20      meetings...every meeting you can talk about.  And

      21      I've been to the Chit Chat, the family program,

      22      which turned my life around.

      23             So, I am proud of what I have done, and I do

      24      what I do for a living because I believe that people

      25      can change.







                                                                   85
       1             So I'm going to end this with:  I just hope

       2      that my children are going to be okay, and it's not

       3      just about Wendy Rosario's children.  It's about all

       4      the children in the community of Newburgh where

       5      I live that I see hurt and suffer and struggle.

       6             And I hate to see this, because I've been

       7      down that road.

       8             I pray my children don't go down that road.

       9             And I thank you all for every possible thing

      10      you can do.

      11                  [Applause.]

      12             SENATOR BOYLE:  Thank you.

      13             MARYANN McDONOUGH:  Good morning.

      14             Is it working yet?

      15             SENATOR BOYLE:  We just have -- this is a

      16      last comment, but I appreciate it very much.

      17             Please.

      18             MARYANN McDONOUGH:  Oh, thank you.

      19             Thank you for letting me speak.

      20             My name is Maryanne McDonough.  I'm a former

      21      County employee.  I was the managed-care director at

      22      Orange County Social Services.

      23             Dave Jolly was my boss at the time before my

      24      retirement.

      25             In the meantime, I've become a very big







                                                                   86
       1      community activist.

       2             And, Mr. Boyle, I guess I'm speaking more

       3      directly to you, because I think you're going to be

       4      able to take this --

       5             Are you talking to me?

       6             SENATOR LARKIN:  No, no.  Go ahead.

       7             MARYANN McDONOUGH:  Oh, I thought were you

       8      motioning to me.

       9             Anyway, I hope you can take some of this

      10      information back that I'm going to suggest.

      11             Just like the woman that spoke before me,

      12      I think there's some key people who are not here

      13      today and who need to hear this message.

      14             And one of those --

      15             I feel like I'm being sidetracked.

      16             Uhm, one of the key people -- some of the key

      17      people who are not here are the doctors, because the

      18      doctors out there are giving out drugs like they're

      19      candy.

      20             I know of a particular individual who went to

      21      a doctor and said, "I'm an addict.  Please don't

      22      give me painkillers."

      23             And the doctor's famous last words were,

      24      "Don't worry, I'll wean you off."

      25             The doctors need to be apprised of what the







                                                                   87
       1      consequences are for addicts.

       2             I don't know if you need to send them to

       3      AA meetings or Al-Anon meetings or Nar-Anon

       4      meetings, but you need to send them somewhere.

       5             This is not something that you can go on and

       6      off if you have the disease, as Mr. Turnbull said,

       7      of being an addict.

       8             Other groups I think you should be reaching

       9      out to are Al-Anon and Nar-Anon, because those

      10      groups are families of addicts, and they would be

      11      very happy to hear from you about what they can do

      12      to help their families.

      13             Because I'm telling you, out there I do a lot

      14      of volunteer work.  There are families that are

      15      hitting their heads against the wall.

      16             They are showing up at detoxes and being

      17      told:  Your family member is not sick enough.  They

      18      are not in extreme enough withdrawal to get any kind

      19      of services.

      20             And, lastly, there isn't treatment.

      21             If you have insurance, there isn't treatment

      22      because the insurance company won't pay for it.

      23             If you don't have insurance, then there's no

      24      treatment because there's no one to pay for it.

      25             These people are suffering out there.







                                                                   88
       1             And someone on your panel, I don't remember

       2      who, said it's not just the addict that's suffering,

       3      it's the family member; ultimately, it's the

       4      community.

       5             And what I would like to know, as a result of

       6      this meeting, I'm hoping that this meeting, the

       7      meeting you had in Sullivan County, the meeting

       8      you're having across the state, that these are not

       9      flash-in-the-pan kind of meetings, where you're

      10      doing a requirement, and you're going to have people

      11      come, and you can, you know, meet your statistics.

      12             I'm hoping that there is follow-up to this

      13      meeting; that the people who need to be involved,

      14      the people who should be involved -- the doctors,

      15      the patients, the family members -- that there's

      16      going to be something that will follow this meeting,

      17      and not just a report.

      18             Thank you.

      19                  [Applause.]

      20             SENATOR BOYLE:  Maryann, I can assure you

      21      that that is not going to be the case.  We're going

      22      to follow up with legislation.

      23             MARYANN McDONOUGH:  [Inaudible.]

      24             SENATOR BOYLE:  We're going to have

      25      significant legislation as a result of these







                                                                   89
       1      hearings.  This is not just a report to sit on a

       2      shelf someplace.

       3             Make it brief.

       4             We have last comments, but can you just make

       5      a brief comment.

       6             AUDIENCE MEMBER:  This is going to be brief,

       7      I promise.

       8             I am a parent of one of the addicts.  And

       9      I come from Middletown, New York, up here in

      10      Orange County.

      11             I know we're in Newburgh, and I thank you for

      12      the forum that we're having here in Newburgh, but we

      13      also have to address all around Orange County.

      14             It's not just here.

      15             We also have to address, not only -- that

      16      I am addressing, also, to what she just said, the

      17      young lady said here, in reference to the doctors.

      18             There are some doctors that are good doctors,

      19      not all, that are willing to help our youngsters,

      20      our young adults, and our future communities.

      21             But, unfortunately, there is health insurance

      22      that do not communicate with these doctors or do not

      23      help.

      24             In other words, I have a perfect example.

      25             I have a doctor here, that had a patient that







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       1      was doing very well on his treatment.  And because

       2      he was doing very well on his treatment, after the

       3      insurance came and told him they can no longer give

       4      him the treatment, after he was doing very well, and

       5      the doctor went:  Okay, I'm going to prove you a

       6      point.

       7             He went and put a prescription for Percocet,

       8      oxycodone, and right away, this prescription was

       9      filled.

      10             But for the Suboxone, they weren't filled.

      11             Why?  We do not know.

      12             We must address these insurance companies,

      13      also, that we must help our community, and also help

      14      those doctors that are willing, and willing to help

      15      the communities.

      16             And that's what I'm addressing.

      17             Because, my son was denied, also, for --

      18      I went from Rockland, I went from Port Jervis,

      19      I went all over the place, and because he wasn't

      20      sick enough, he was denied help.

      21             I had to put him in Middletown MAC.

      22             Has any of you been to MAC?

      23             It is ridiculous.  It is disgusting.

      24      Abandoned buildings all over.

      25             Why don't we use that area?  Why don't we put







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       1      our monies into that area to educate our future?

       2             Okay, they have a disease, but if we educate

       3      them, and we take those buildings and put other

       4      alternatives for them, they're willing to learn.

       5      They're willing to go out there and be a good

       6      human being in society.

       7             This is our future.  Not us; they are.

       8             That's what I'm addressing.

       9             Help them, also.

      10             Take that area.

      11             MAC is -- you go at nighttime, go at

      12      nighttime, how -- in Middletown MAC looks like.

      13             Would you like to leave your kids there?

      14             I sure didn't, I really didn't.  But did

      15      I have another choice?  No, I didn't, because he had

      16      to go to detox there.  He had to go there first

      17      before I can take him to RC Ward.

      18             And that's how we was accepted to RC Ward.

      19             Is he doing great now?  Yes, he has.  He's

      20      going to be two months clean, and he's only

      21      18 years old.

      22                  [Applause.]

      23             AUDIENCE MEMBER:  "18."

      24             And I expect that we can do something.

      25             Since we're here in the forum, maybe we can







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       1      address Middletown.  Maybe we can address Newburgh.

       2      We can address Port Jervis.

       3             We have all Orange County infested with

       4      heroin and opiate addiction.

       5             It's just not here.

       6             We must educate our kids.

       7             We must go to the schools, too, and tell them

       8      how sick they can get if they get on these drugs.

       9      How sick, what could happen to them.

      10             This is not being addressed totally and

      11      educated in that specific manner.

      12             Take our teenagers that have been addicted to

      13      all these drugs, take them to educate, and do

      14      something positive in the community, to educate the

      15      younger generation.

      16             That would help, also.

      17             So just look into that fact.

      18             I'm a parent of concern.

      19             I'm a parent of the community.

      20             I've also been an advocate for all young

      21      adults, and older adults, as well.  It's not just

      22      that.

      23             So, listen, as some doctors are willing to

      24      help.  They're not saying they're not willing to

      25      help.  They are.







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       1             I have one specific one that is willing, and

       2      has helped my son very dearly, while others turned

       3      away; while insurances didn't cover him.

       4             And mind you, they're from Orange County.

       5             And that's my point.

       6             Thank you very much for listening.

       7                  [Applause.]

       8             SENATOR BOYLE:  Thank you very much.

       9             Thank you.

      10             Senator Bonacic?

      11             SENATOR BONACIC:  First of all, let me thank

      12      our distinguished panelists for sharing their

      13      experiences.

      14             We had a forum last week in Sullivan County,

      15      and I can tell you that the experience and concerns

      16      that we heard today are similar to what we heard in

      17      Sullivan County.

      18             I want to thank the audience members who

      19      spoke.

      20             I want to thank Pete Lasier [ph.] who's here,

      21      who didn't speak, who lost his son to heroin

      22      experiences, who's been a strong advocate, and a

      23      partner with us, in trying to push back this heroin

      24      epidemic.

      25             Two thoughts that I'd like to share with you,







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       1      that Chairman Boyle and Senator Larkin know about.

       2             Number one:  Drug cartels are very

       3      intelligent.

       4             Heroin has been around for 40 years.

       5             The reason everybody is embracing it, because

       6      it's cheap, and we've squeezed the pharmacists and

       7      the physicians for excessive prescriptions for

       8      opiates.

       9             So what we're trying to do at the state

      10      level, is to have a holistic approach to be ready

      11      if, next year, there's a synthetic drug that's cheap

      12      than heroin, and something else comes at us, and

      13      we're ready.

      14             The second point that I would like to make,

      15      is that the Sheriff of Sullivan County came out and

      16      said, "My daughter is a heroin addict."

      17             It's extremely important, that if a family

      18      member is addicted to heroin, that you don't keep it

      19      a secret.

      20             And I congratulate those people that have

      21      come forward, because if we had a member that had

      22      cancer in our family, we would say "our family

      23      member has cancer."

      24             It's not something to run away from.

      25             It's something to get out there, to admit it,







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       1      so we can face the problem and try to get help for

       2      members of those families.

       3             I thank you all for being here.

       4             Thank you.

       5                  [Applause.]

       6             SENATOR BOYLE:  Thank you, Senator Bonacic.

       7             And I would like to also --

       8             Oh, yes.  These officials have to run.

       9             Just, very briefly:

      10             Thank you all for coming.

      11             Thank you for the panelists, for tremendous

      12      information.

      13             And, thank you, we've also been joined by

      14      Lee Redfern [ph.].  She was a clerk on our Drug and

      15      Alcoholism Senate Task Force in Albany, and was at

      16      the beginning of these forums.

      17             Thank you.

      18             Now she's come to Newburgh to go to nursing

      19      school, and help in another way.

      20             But I do want to thank all of you.

      21             We had great information.

      22             This is not the end, as I said.

      23             Please, contact our office.

      24             If you think of something tonight that you

      25      forgot to say, please contact us.  It's B-O-Y-L-E.







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       1      You can Google it.

       2             And, again, thank you so much,

       3      Senator Larkin, for hosting this wonderful forum.

       4                  [Applause.]

       5             SENATOR LARKIN:  I don't want to be

       6      repetitive, but John covered everything that we've

       7      been looking at.

       8             And as you heard from Senator Boyle, we hope

       9      to have something done, we will be, before the end

      10      of June.

      11             But the most important thing is, don't leave

      12      here today and say:  They're going to take care of

      13      it.

      14             We can't take care of it if you don't come to

      15      us.  You're in the communities, you know it.

      16             The panelists here explained of how they

      17      address it.

      18             Some people would love to speak today, but

      19      they don't like to do it in public.

      20             Send us your message.

      21             Make sure that what we put in writing and

      22      makes it law, it's something that you know and

      23      understand.

      24             This is the biggest incident.  It's bigger

      25      than Ukraine, it's bigger than Africa, it's bigger







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       1      than this.

       2             This is something that affects America

       3      100 percent.

       4             Please help us, because we will then be able

       5      to help you and your families.

       6             Thank you.

       7                  [Applause.]

       8             SENATOR BOYLE:  Thank you, Bill.

       9                  [Applause.]

      10

      11                  (Whereupon, at approximately 11:41 a.m.,

      12        the forum held before the New York State Joint

      13        Task Force on Heroin and Opioid Addiction

      14        concluded, and adjourned.)

      15

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