Public Hearing - May 16, 2014

    


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

       3                 PUBLIC FORUM:  CHEMUNG COUNTY

       4          PANEL DISCUSSION ON ELMIRA'S HEROIN EPIDEMIC

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

       6
                               Elmira College
       7                       Hamilton Hall
                               1 Park Place
       8                       Elmira, New York 14901

       9                       May 16, 2014
                               10:00 a.m. to 12:00 p.m.
      10

      11

      12      PRESENT:

      13
                 Senator Thomas F. O'Mara, Forum Moderator
      14         Member of the Joint Task Force

      15         Senator Michael F. Nozzolio
                 Vice Chairman of the Joint Task Force
      16
                 Assemblyman Chris Friend
      17
                 Assemblyman Philip Palmesano
      18

      19

      20

      21

      22

      23

      24

      25







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       1
              PANELIST INTRODUCTIONS:                       PAGE  9
       2
              Chris
       3      Recovering Heroin Addict

       4      Jim Allard
              Undersheriff
       5      Steuben County

       6      Brooks Baker
              District Attorney
       7      Steuben County

       8      Mike Ballard
              Environmental-Prevention Specialist
       9      Council on Alcoholism

      10      Frank Bourke, Ph.D.
              Executive Director
      11      The Research and Recognition Project,
                  Corning, New York
      12
              Julie Charlanow
      13      Director of Treatment and
                 Prevention Services
      14      Trinity of Chemung County

      15      Hollie Hall
              Senior Director
      16      Alfred State Health and Wellness Services

      17      Laurel Headwell
              Alcohol and Drug Education Coordinator
      18         in Yates County Council on Alcoholism and
                 Addiction for the Finger Lakes
      19
              Susan Hewitt
      20      Supervisor
              Tioga County Alcohol and Drug Services
      21
              Joseph Kane
      22      Captain
              Elmira Police Department, currently assigned to
      23         the detective bureau

      24

      25







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       1
              PANELIST INTRODUCTIONS (Continued):
       2
              Helen Kaplan
       3      LCSWR
              Alcohol and Drug Council of Tompkins County
       4
              Debbie McCormick
       5      Participant of Arbor Development

       6      John McNelis
              SRO
       7      Canisteo Police Department

       8      Jim Mulcahy
              Employee
       9      Arbor Housing and Development,
                 Maple Leaf community residence,
      10         Hornell, New York

      11      Wendy Recktenwald
              Director of Human Resources
      12      Alfred State College
                 Also, director of the CASAC program
      13         Also, outpatient therapist at MATCH

      14      Jim Ritter
              SRO, Elmira City School District
      15      Chemung County Sheriff's Office

      16      Bill Rusen
              CEO
      17      Cayuga Addiction Recovery Services,
                 Ithaca, New York.
      18
              Sarah Salisbury
      19      Clinical Program Director
              Tioga County Mental Hygiene
      20
              Christie Speciale
      21      Executive Director
              Tioga County Council on
      22         Alcoholism and Substance Abuse

      23      John Thweatt
              Chief Assistant District Attorney
      24      Chemung County

      25







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       1
              PANELIST INTRODUCTIONS (Continued):
       2
              Nan Woodworth Shaw
       3      Instructional and Student Support Services
              Watkins Glens Schools
       4
              Bill Yessman
       5      Sheriff
              Schuyler County
       6

       7
              PERSONAL STORY                                PAGE 11
       8
              START OF PANELIST PARTICIPATION               PAGE 17
       9
              AUDIENCE PARTICIPATION AND Q&A                PAGE 87
      10

      11

      12                            ---oOo---

      13

      14

      15

      16

      17

      18

      19

      20

      21

      22

      23

      24

      25







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       1             SENATOR O'MARA:  Thank you.

       2             Can everybody hear me okay?

       3             Good morning, everyone, and welcome to our

       4      New York State Senate Joint Task Force on Heroin and

       5      Opioid Addictions.

       6             The Chairman of this Senate Committee is

       7      Senator Phil Boyle from Long Island.  He,

       8      unfortunately, is unable to be with us today.

       9             We've had close to 20 of these forums across

      10      the state already, and he had a commitment in his

      11      district he had to be at.

      12             We will be joined in a few minutes by

      13      Senator Mike Nozzolio, who is my colleague just to

      14      the north of my district.  He has the northern part

      15      of the Finger Lakes, while I have the southern part

      16      of the Finger Lakes and the Southern Tier.

      17             And it's a pleasure to get this forum on this

      18      very important topic, and this critical issue across

      19      our communities; urban, suburban, and rural.

      20             It is not missing any aspect of our life here

      21      in the Southern Tier and Finger Lakes, as well as

      22      the larger cities in New York.

      23             It's a devastating problem that we're seeing,

      24      which is why we saw the need to have these forums

      25      across the state, to look for ways from -- to build







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       1      awareness of the issue, which I think we've been

       2      doing very effectively, particularly with the media

       3      coverage that we have got across the state with

       4      these, to bring the attention to this matter; to

       5      talk about prevention, talk about treatment and

       6      recovery, talk about law-enforcement issues, and

       7      what tools we might be able to do to better provide

       8      law enforcement to go after the dealers, in

       9      particular, on these issues, and to work with our

      10      treatment providers on some of the barriers that we

      11      have from insurance, to cost, to be able to make

      12      these services available to those who are addicted

      13      to it.

      14             So it's -- I will just kick it off with that.

      15             We're going to go around and introduce

      16      everybody around the table here.

      17             If you could just, please, we'll go in order.

      18             I'll give Phil and --

      19      Assemblyman Phil Palmesano and

      20      Assemblyman Chris Friend, a chance to do some

      21      introductory remarks here, and then we'll go around

      22      and introduce everybody.

      23             I want to thank Elmira College,

      24      President Ron Champagne who's in the back here, with

      25      Mike Rogers [ph.] with him.







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       1             This beautiful facility that we have here,

       2      and they so often open their doors to us to have

       3      these community forums.

       4             And, really, there's not much more of an

       5      impressive facility in all of my district to be able

       6      to host something like this.

       7             It always reminds me of Harry Potter and

       8      Hogwarts.

       9                  [Laughter.]

      10             SENATOR O'MARA:  But I haven't seen any fly

      11      through here in all the forums we've done here.

      12             But, good morning, and thank you for being

      13      here.

      14             I'll start it out with

      15      Assemblyman Chris Friend, who represents

      16      Chemung County and Tioga County and part of

      17      Broome County.

      18             ASSEMBLYMAN FRIEND:  Thank you, Senator.

      19             I'd like to thank Senator O'Mara and

      20      Senator Nozzolio for putting this panel together,

      21      and for traveling across this state and taking input

      22      to see where this epidemic is occurring, why it's

      23      occurring, and how we can best use the State

      24      resources to combat the problem and help out all of

      25      our state agencies and local partners to take care







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       1      of this issue.

       2             So I'm looking forward to hearing your

       3      comments today, and hope we can have some productive

       4      conversations.

       5             Thank you.

       6             SENATOR O'MARA:  Thank you, Chris.

       7             Assemblyman Palmesano.

       8             ASSEMBLYMAN PALMESANO:  Good morning.

       9             Thank you, Senator O'Mara.

      10             And, again, to Senator O'Mara,

      11      Senator Nozzolio, and Senator Boyle, for having

      12      these hearings around the state.

      13             And thank you to all of you for taking time

      14      out of your busy schedule to be here, to share your

      15      expertise, your stories, on an issue, and an

      16      epidemic, that's a major problem for our region and

      17      our state.

      18             So I'm looking forward to hearing your

      19      opinions, your thoughts, and things we can do better

      20      at the State to help give you the tools and

      21      resources you need to address this major problem

      22      facing our state.

      23             SENATOR O'MARA:  Thanks, Phil.

      24             And if we could just go around, at least the

      25      table here.







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       1             We'll start with you, Jim; and just introduce

       2      yourself and where you're from, and we'll just go

       3      around the horn.

       4             JIM MULCAHY:  Jim Mulcahy.  I work for

       5      Arbor Housing and Development at our Maple Leaf

       6      community residence in Hornell, New York.

       7             DEBBIE McCORMICK:  Hi, I'm

       8      Debbie McCormick, and I'm representing

       9      Arbor Development as a participant.

      10             DA BROOKS BAKER:  I'm Brooks Baker,

      11      Steuben County District Attorney.

      12             CHIEF ADA JOHN R. THWEATT:  And I'm

      13      John Thweatt, the Chief Assistant District Attorney

      14      for Chemung County.  I prosecute most of the

      15      felony-level drug crimes in the county.

      16             SHERIFF WILLIAM YESSMAN, JR.:  Bill Yessman,

      17      Schuyler County Sheriff.

      18             JOHN McNELIS:  John McNelis, Canisteo Police

      19      Department.  I'm the SRO at their local district.

      20             JIM RITTER:  Jim Ritter from the County

      21      Sheriff's Office, SRO to EFA.

      22             CHRISTIE SPECIALE:  Christie Speciale, the

      23      executive director at Tioga County Council on

      24      Alcoholism and Substance Abuse.

      25             FRANK BOURKE, Ph.D.:  Dr. Frank Bourke,







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       1      executive director of The Research and Recognition

       2      Project in Corning.

       3             HELEN KAPLAN:  Helen Kaplan, LCSWR, from

       4      Alcohol and Drug Council of Tompkins County.

       5             JULIE CHARLANOW:  Julie Charlanow, director

       6      of treatment and prevention services at Trinity of

       7      Chemung County.

       8             WENDY DRESSER-RECKTENWALD:  I'm

       9      Wendy Recktenwald.  I'm the director of human

      10      resources at Alfred State College.

      11             I'm also the director of the CASAC program,

      12      where we teach drug and alcohol counselors.

      13             And, I am also an outpatient therapist at

      14      MATCH.

      15             HOLLIE HALL:  Hollie Hall, senior director at

      16      Alfred State Health and Wellness Services.

      17             MIKE BALLARD:  Mike Ballard.  I'm with the

      18      Council on Alcoholism.  I am the

      19      environmental-prevention specialist there.

      20             LAUREL HEADWELL:  Laurel Headwell, Alcohol

      21      and Drug Education Coordinator in Yates County, for

      22      the Council on Alcoholism and Addictions for the

      23      Finger Lakes.

      24             SARAH SALISBURY:  Sarah Salisbury.  I'm a

      25      clinical program director at Tioga County Mental







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       1      Hygiene.

       2             SUSAN HEWITT:  I'm Susan Hewitt, supervisor

       3      at Tioga County Alcohol and Drug Services.

       4             CAPTAIN JOSEPH KANE:  Captain Joseph Kane

       5      with the Elmira Police Department, currently

       6      assigned to the detective bureau.

       7             And for four years, I was assigned as the

       8      commander of the drug enforcement unit.

       9             CHRIS:  Chris.  I'm a recovering heroin

      10      addict.

      11             WILLIAM RUSEN:  I'm Bill Rusen.  I'm the CEO

      12      of Cayuga Addiction Recovery Services located in

      13      Ithaca, New York.

      14             SENATOR O'MARA:  All right, well, thank you

      15      all for being here.

      16             As you can tell, I think, going around here,

      17      the little closer you are to the microphone, maybe

      18      the little louder it is, so don't hesitate to pull

      19      it and drag it towards you when you want to address

      20      the forum.

      21             I think the way we'll start out here this

      22      morning, is we want to hear a personal story from

      23      Chris, here, a recovering addict, to tell a little

      24      bit about where he got to where he is today, and

      25      what his direction is.







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       1             So, Chris, we very much appreciate you

       2      sharing your personal story with us.

       3             CHRIS:  Thank you, Senator.

       4             Hello, everyone.

       5             Thank you for having me, letting me share.

       6      It's a great honor.

       7             I've been in recovery for almost a year now.

       8             I just want to speak about what heroin has

       9      done to my life in its use.

      10             It really changes the person you are, the

      11      person you think you are; your mind, everything

      12      about you.

      13             It changed me completely.

      14             I -- it basically threw all my morals and

      15      values away.  Anything that I believed in, I didn't

      16      believe in it no more.  My compassion, my care for

      17      other people went away.

      18             It basically turned me into an evil person.

      19      I was willing to commit crimes, go to any length to

      20      get my next fix, my next use.

      21             Uhm, and the hard part about it is, when it

      22      gets out of control like that, I have to resort to

      23      crime to support myself.  I would have no job.

      24             I'd be in the midst, I'd be sick at friends'

      25      houses, on the streets.  I'd break into cars and







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       1      sleep in the cars at night, you know, just to have a

       2      place to live, because it would get so serious that

       3      I would be hurting my family.  I would stealing from

       4      my family, stealing money.  So they don't want me

       5      around, and I would use it to support my addiction.

       6             And it's a really hard thing to come to terms

       7      with that, which is why I'm so grateful to be in

       8      recovery.

       9             I feel like heroin personally gave me the

      10      tools to ruin every relationship I've ever been in

      11      with anybody, including family.

      12             And recovery is helping me gain these tools

      13      back, which is what I love so much about recovery.

      14             If it wasn't for CARS (Cayuga Addiction

      15      Recovery Services) and The Matrix Program,

      16      I wouldn't have control of my life.  I wouldn't be

      17      here today.  I'd be on the streets of any given

      18      county -- any given county in New York, wreaking

      19      havoc on the community, because that's how I grew

      20      up, that's what I knew, being involved with

      21      addiction and heroin and opiates.

      22             Like I said earlier, it just completely

      23      changes who I am and my way of thinking.

      24             Being sober today, I'm happy that I can

      25      communicate with people, I can have relationships,







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       1      and I can express what this addiction does to my

       2      mind as a person, and how I go from being somebody

       3      good to I feel like I'm somebody evil, and I feel

       4      like I'm not a part of the community.

       5             But now, today, it's different, and it's the

       6      opposite.  And I feel great.

       7             And I'm very thankful to be here.

       8             Thank you for letting me share my thoughts on

       9      heroin.

      10             SENATOR O'MARA:  Thank you, Chris, for

      11      sharing that.

      12             And Chris's story is so similar to so many

      13      stories we've heard from these forums across the

      14      state, from individuals that have been willing to

      15      step up and talk about it personally, and the impact

      16      it's had on their lives.

      17             Chris, I'd like to ask you a question or two,

      18      and if you could explain just how accessible heroin

      19      is in our communities.  The difficulties, if any,

      20      you have in finding it, and what the cost is.

      21             CHRIS:  The accessibility is not a problem

      22      when you have the money.  And usually, for me, it

      23      was resorting to crime.

      24             It just seems like today you can -- in any

      25      populated area, you can walk down the street, past a







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       1      bar, and you can tell who the people are that do it.

       2      You know, most of them, they're nodding out.  They

       3      look like they're half asleep.  They're sick.  And

       4      those are the people that you confront.

       5             And, for me, I could just go up to these

       6      people and ask them, and there's a good chance that

       7      they'll be, like, Hey, and I know where to find it.

       8             It's all just a matter of just asking, it

       9      seems like.  It's like asking a simple favor.

      10             And -- what was the other question?

      11             SENATOR O'MARA:  Cost.

      12             CHRIS:  Cost.

      13             Cost, it can vary.

      14             Heavy populated areas, cities, it's very

      15      cheap to get.  You -- typical drug dealers like to

      16      sell bags at certain amounts, like, 5, 10, 15,

      17      20 dollars, like that.

      18             So whatever you have in your pocket, these

      19      drug dealers are so greedy for the money, that

      20      they'll take anything you have.  You don't -- it

      21      doesn't even have to be money.

      22             For me, when I was in my criminal ways,

      23      stealing, it was all a matter of even just asking

      24      for an item.  "What do you want and I'll steal it

      25      for you" type of deal.







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       1             So accessibility was never a problem.  It's

       2      everywhere.

       3             SENATOR O'MARA:  What have you found,

       4      difficulty-wise, as part of the recovery process,

       5      and any difficulties in accessing the treatment?

       6             I mean, obviously, I think, first, you've got

       7      to come to the realization that you want to make a

       8      change for yourself.

       9             But then what do you find -- what have you

      10      found, in your, you know, going through the process

      11      of getting to the right contacts and the right

      12      services to help you with -- through this process?

      13             CHRIS:  For me on that aspect, New York State

      14      Parole was a great reference for me.

      15             I did get caught up in my addiction pretty

      16      bad, and I had gone to prison.  And, uhm, as a

      17      matter of getting out of prison and continue to

      18      violate parole, they noticed that I had a problem.

      19             And, it was just as simple as saying, "I have

      20      a problem and I need help."  And they were willing

      21      to really go through the research for me, and as to

      22      how I found CARS.  And the judge let me get involved

      23      with it.

      24             And it was so welcoming.  They just took me

      25      right on, CARS.







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       1             Any rehabilitation service I had talked to,

       2      even like sitting in jail, like, it's so welcoming,

       3      they make you feel welcome.  And they give you the

       4      great story of how you can get better.

       5             And at the time, being sick, it's not

       6      believable.

       7             But once I got into the process, I was more

       8      open to it.  I was willing to open up and speak; and

       9      I have to speak from my heart to get my message

      10      across.

      11             And the treatment that I've been going

      12      through, it's just been so welcoming and so great.

      13      And I'm so grateful for the life that I have because

      14      of it.

      15             SENATOR O'MARA:  Thank you.

      16             Well, again, thank you sharing with us.

      17             Bill, you're here with Chris today.

      18             If you'd like to talk a little bit about the

      19      Cayuga Addiction Recovery Services (CARS), and what

      20      issues you see in, really, access to treatment for

      21      the addicts?

      22             WILLIAM RUSEN:  Sure.

      23             Well, first, again, I want to thank

      24      everybody, the Task Force and all the hosts here,

      25      for offering this opportunity.  I'm really grateful







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       1      for it; so, thank you.

       2             I'm also really grateful for Chris.

       3             Chris and I drove down today, and believe it

       4      or not, we had a very extensive conversation about

       5      Joseph Campbell's "The Hero's Journey" and "The Hero

       6      With A Thousand Faces."

       7             And I think that's one of the things I always

       8      find, the more time I spend with men and women in

       9      recovery, is that once things start to clear up,

      10      these are your sons and your nephews and your

      11      brothers and your fathers, and all those people.

      12             That's exactly who they are.

      13             And sometimes it's safe and pleasant to

      14      think, Well, that doesn't happen here, and that's

      15      not in my family, and I don't have to worry about

      16      that.

      17             And that helps us in some -- sometimes, a

      18      defensive way, to feel like, Well, that could never

      19      happen to me, and that couldn't be my son or my

      20      brother or anybody else.

      21             And that's just not true.

      22             One of the biggest changes I've seen over the

      23      last year or so, is I have never gotten, ever,

      24      gotten as many phone calls from men who -- and young

      25      men, like Chris, who I -- I had three calls in the







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       1      last two weeks, of a young fellow who knew me

       2      from -- I do some programming in our residential

       3      program.  We do a group on the seven habits of

       4      highly effective people -- who called me up, a young

       5      fellow named, we'll call him "Steve," and he said,

       6      "Bill," he said, "I'm a mess.  I'm really doing bad.

       7      I need" --

       8             And until the heroin epidemic really hit,

       9      I never got phone calls like that.

      10             And people were -- obviously, had their

      11      challenges, and were going up and down and having

      12      relapses.  But there's something really different

      13      about this that makes the addicted men -- and

      14      I always connect with men, and I assume that's

      15      because of -- you know, that, my gray hair, and my

      16      two boys are 35 years old, so -- but they always

      17      connect with me.

      18             I've never had those phone calls before this

      19      started about a year or so ago.

      20             It's just stunning to me, to have an addicted

      21      man who's using, young man, call you up and say,

      22      "Hey, man, I'm a mess.  I got to get in someplace.

      23      I got to get help because this is not working

      24      anymore."

      25             So, I just wanted to share that personal







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       1      part.

       2             So, again, I want to thank everyone here for

       3      giving me the opportunity to speak.

       4             I just want to offer something.

       5             I've been doing this kind of work for

       6      35 years in four different states, from Pennsylvania

       7      to Washington to New Hampshire to here.

       8             And I haven't just done substance-abuse work.

       9      I've worked in mental and primary health care.

      10             So, I've helped a lot of people access a lot

      11      of services in a lot of different places, so I think

      12      I'm pretty sure I know an epidemic when I see it.

      13             And I thought the Task Force use of that word

      14      was not in anyway, hyperbole.  I thought it was

      15      really appropriate to use that word.

      16             We run an intensive residential rehab

      17      program, a 6-month program, basically, where we have

      18      53 hours a week of programming.  And that serves

      19      25 counties that stretch from Rochester to the

      20      Pennsylvania border, to Utica, to, like, out in

      21      Jamestown.

      22             And so I think we can make some pretty fair

      23      judgments about what Upstate New York looks like.

      24             And if you could look at the statistics that

      25      happened between 2007 and 2012 that we looked at,







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       1      you would be stunned how, in such a compressed

       2      period of time, you could have such a transformation

       3      in the demographic group of people you're serving.

       4             And the biggest one I'll share with you is,

       5      in 2007, 13 percent of the people who came into our

       6      residential program were -- their primary addiction

       7      was to heroin or opiates.

       8             Okay?  So I want you to keep that in mind,

       9      "13 percent."

      10             In 2012, 5 years later --

      11             And all of you, to the sociologists, because

      12      we're in a college here, right, you know if any

      13      phenomena happens in a compressed period of time,

      14      that's a significant issue.

      15             -- in 5 years, it went to 48 percent.

      16             So imagine what that does to a system, when

      17      you start to think about that.

      18             The answer I think is self-evident.

      19             I just want you to know, the other people I'm

      20      here to speak for -- and Chris did a really good job

      21      of speaking for himself, and, in a sense, for others

      22      in recovery, so I'm going to speak for the people

      23      that aren't here, or to some -- I shouldn't say,

      24      that there are people here that are actually doing

      25      the work.







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       1             The system and the good, hard-working people

       2      who believe in transformation rehabilitation stand

       3      almost, literally, in the breach.

       4             I always think of the corps of trees at

       5      Gettysburg, and how close we came to the -- to

       6      Pickett's Charge succeeding.  And it was only

       7      because of a couple dedicated men who refused to

       8      give up in the breach.

       9             And that's what the people who do this work

      10      are like, as wave after wave of this epidemic throws

      11      itself upon the meager fortifications that

      12      dedication, knowledge, experience, and, yes, even

      13      love, have built up over the years.

      14             However, those meager defenses, which never

      15      were stout, nor, never were robust, cannot hold up

      16      against the kind of epidemic and the kind of assault

      17      that occurs to this care system that is built to do

      18      the work that it's presently trying to do.

      19             And I just want you to know that there are

      20      times that we are -- that the -- we recognize our

      21      fortifications are inadequate, and we are

      22      overwhelmed by the cunning, vicious, and patient foe

      23      we now face; and that's heroin.

      24             So, you know, I think it was Teddy Roosevelt

      25      said, you know:  If you have a problem and you don't







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       1      offer any solutions, well, then all you're doing is

       2      whining.

       3             And I don't want to whine.

       4             So, here's two big things I'd like somebody

       5      to consider, to look at:

       6             First is the issue of access to care.

       7             Treatment services must be sanctioned by

       8      OASAS and Medicaid to be allowed to be delivered

       9      outside of OASAS-licensed facilities.

      10             Presently, the only way we can get paid, or

      11      even count the services, that's amazing.

      12             If we do a service outside of a

      13      OASAS-licensed facility, not only do we not get paid

      14      for it, according to the State of New York, it

      15      didn't happen, it didn't count, in terms of our

      16      activity.

      17             This one change would allow treatment

      18      services to spread and proliferate into counties and

      19      out of buildings to places where the clients and the

      20      need is.  This would be a worthwhile, far-reaching

      21      effort that can fundamentally change

      22      substance-use-disorder work, and change it from a

      23      marginal service to a mainstream one that is much

      24      more easily integrated into overall patient care and

      25      well-being.







                                                                   24
       1             Sub suggestion:  Suboxone treatment must be

       2      made more widely available.

       3             It appears obvious that this form of

       4      chemotherapy is a long-term rather than a short-term

       5      intervention, that perhaps can be best be thought of

       6      in a similar way to the long use -- long-term use of

       7      modern antidepressants rather than a short-term

       8      intervention, such as a two-week course of

       9      antibiotics.

      10             The present limitations have resulted in long

      11      waits and very limited opportunities throughout the

      12      central -- throughout central New York and the

      13      Southern Tier.

      14             And these stories have appeared in the

      15      Syracuse paper, and the significant challenges in

      16      that way.

      17             The second recommendation I would ask for

      18      consideration, is to build a foundation and

      19      much-needed infrastructure within the

      20      substance-use-disorder care system itself.

      21             The average age of a credentialed alcoholism-

      22      and substance-abuse counselor in New York State is

      23      55 years old.

      24             So you know we're in a -- we have a group of

      25      people that are going to age out, and there's nobody







                                                                   25
       1      taking their place.

       2             The field desperately needs an infusion of

       3      energy and talent by motivated individuals ready to

       4      do the work of transformation.

       5             I believe this is very doable, given that

       6      this credential was designed to allow the

       7      non-traditional paraprofessional to become the

       8      nontraditional professional.

       9             This field will appeal not only to the young

      10      person, but also those in mid career who are

      11      considering a change.

      12             I believe this offers many opportunities to

      13      many segments of the state's workforce.

      14             Resource enhancement to build skills and

      15      capital, both financial and human, of organizations'

      16      individuals that work within them to deal with the

      17      demands of this epidemic.

      18             For example, a focus on the role of trauma,

      19      and what it might -- what it may be -- what -- it --

      20      it may be its key role in causing and exacerbating

      21      both the onset and treatment-resistant nature of

      22      addiction, in general; and heroin addiction, in

      23      particular.

      24             And, finally, I would ask that, although good

      25      work continues in this area, to break down the







                                                                   26
       1      silos, once and for all, between the Offices of

       2      Mental Health and the Offices of Alcoholism and

       3      Substance Abuse, because I think there's a great

       4      deal of benefit to be done in that way.

       5             And my hope is that the resources and

       6      expertise can be respected and augmented so that

       7      much-needed synergy can build while, improving the

       8      care of our clients, and unleashing the potential of

       9      our staff in the improvement of treatment and

      10      clinical outcomes that will benefit our families and

      11      communities.

      12             So, again, thank you for the opportunity to

      13      speak.

      14             And, uhm -- thank you.

      15             SENATOR O'MARA:  Thank you, Bill.

      16             And thank you for those -- some of

      17      statistics.

      18             You know, as I see the heroin epidemic that

      19      we have right now, it seems to me, even though I was

      20      quite young in the early '60s and early '70s,

      21      the heroin epidemic of today seems to be much larger

      22      and more pervasive than the drug problems we had in

      23      that, really, I guess what is considered kind of our

      24      "Hippie Era," and drugs being used during that late

      25      Vietnam Era, and that.







                                                                   27
       1             But, you know, a couple thing jumped to mind

       2      when you mentioned the stats of the last five years,

       3      and the issues that you're seeing, growing from

       4      17 percent of your case load, to 48 percent, in

       5      5 years.

       6             You know, back in the early '70s,

       7      New York State enacted what was called the

       8      "Rockefeller drug laws," and that cracked down a lot

       9      on the major drug activity that was going on during

      10      those times.

      11             And now when you mention, 5 years, and great

      12      increase you've seen, I have to look and say that,

      13      in 2009, the New York State Legislature and the

      14      governor enacted so-called "Rockefeller drug-law

      15      reforms" that substantially retracted from the

      16      criminal penalties for drug dealing, drug

      17      possession.

      18             And we've seen that just in this short time,

      19      these five years.  And I think that that has

      20      something to do with it, and that we -- basically,

      21      drug dealers, who we really should be targeting with

      22      our criminal prosecutions, should be harshly treated

      23      within our criminal justice system.

      24             Another aspect that I think that has helped

      25      influence this growth in heroin, is some legislation







                                                                   28
       1      that has worked in New York State, but I think it's

       2      helping to contribute to the heroin epidemic; and

       3      that's the I-STOP program that was enacted just

       4      two years ago, which required the tracking of

       5      prescriptions by physicians and pharmacists to

       6      opioid-based painkillers.

       7             And there was -- I think, it was either the

       8      last year or the year before, there was 22 million

       9      prescriptions for painkillers in New York State.

      10             Now, we only have a population of about

      11      19 million people.

      12             That's pretty outstanding.

      13             Now what has happened with I-STOP, and,

      14      actually, we did some legislation that was

      15      effective, it cracked down on these prescriptions

      16      being issued, and doctor shopping by the patients,

      17      and getting multiple prescriptions and selling those

      18      opioid drugs on the street.

      19             Now it has taken those individuals that were

      20      addicted to those painkillers and forced them to

      21      find other alternatives, which turns out to be

      22      cheaper, and I think just as prevalent, in heroin.

      23             And that's part of the reason for the growth

      24      and the epidemic that we have today.

      25             So if we could turn it a little bit to the







                                                                   29
       1      enforcement, the criminal aspects of this, and then

       2      we'll get back to the addiction-recovery services.

       3             And that if we can open it up to our

       4      district attorneys that are here, to our

       5      law-enforcement sheriffs that are here.

       6             And we have been joined, since we started, by

       7      Undersheriff Jim Allard from Steuben County.

       8             Thank you being here, Undersheriff.

       9             And I don't know if anybody wants to

      10      volunteer to kick it off on this kind of focus?

      11             DA BROOKS BAKER:  Senator, I would be happy

      12      to start.

      13             One, I want to thank you and the Assemblymen

      14      for being here today.

      15             I think recognizing this as an epidemic is

      16      truly accurate.

      17             I don't have the same level of stats that

      18      Mr. Rusen does, but I have a very scary stat from

      19      Steuben County; that in the last 12 months we've

      20      lost 10 people to drug overdoses.  People from

      21      6 months old -- I'm sorry, 6 hours old, to 48 years;

      22      people who should be alive but for heroin, opiates,

      23      and bath salts.

      24             And in that same time frame, we've had one

      25      murder and we've had one vehicular homicide.







                                                                   30
       1             That, to me, bespeaks what the most dangerous

       2      thing in our county is right now, and that's drugs.

       3             We have worked hard to deal with drunk

       4      drivers, and that's how we end up with one vehicular

       5      homicide.  That person's in prison and is going to

       6      stay there for a very long time.

       7             The murder -- the people facing the murder

       8      charges are in jail, pending trial in October.

       9      They're looking at 25 years to life.

      10             The people who sold the drugs, gave the

      11      drugs, provided the drugs, for those 10 people that

      12      died, cannot be prosecuted under New York State law.

      13             There's nothing can I do with them, and

      14      that's a very frustrating thing for us.

      15             I don't understand how and why we face a

      16      situation, where, if you drink and you drive and you

      17      kill someone, you commit manslaughter, and, the

      18      state prison system keeps you in for the maximum

      19      time frame.

      20             Where, if you sell drugs and the person dies,

      21      you can't be prosecuted for manslaughter.

      22             If you are prosecuted, the state system

      23      pushes you out as fast as humanly possible.

      24             It doesn't make sense.

      25             I think you hit the nail on the head with the







                                                                   31
       1      Rockefeller reform situation.

       2             You know, five years ago, there was a

       3      prediction made by district attorneys --

       4      District Attorney Fazzary is here -- by members like

       5      yourself, who understood the realities of drug

       6      sales, that if we do this; if we reform our drug

       7      laws, and within five years we're going to have an

       8      epidemic because our dealers will be back on the

       9      street and we will emasculate our ability to

      10      prosecute those folks.

      11             And that's come true.

      12             It's not -- unfortunately, we're not in a

      13      situation where "I told you so" works.  Now we have

      14      to do something about it.

      15             And, you know, there are different things we

      16      can do.

      17             From a prevention point of view, there's not

      18      much we can do in law enforcement, except, stop

      19      people from selling drugs.  And that means

      20      increasing penalties.  Give us a statute to punish

      21      people for killing people by selling drugs.

      22             Fund our drug courts.  That's the one thing

      23      we can do, so we can help folks like Chris.

      24             There are people out there who commit crimes

      25      because they're addicted to drugs.







                                                                   32
       1             And our drug-court programs are fantastic.

       2             Those were started seven or eight years ago.

       3      They were a tough sell for prosecutors, but, quite

       4      frankly, I'm sold; they work.

       5             However, in the last couple years, Albany has

       6      seen fit to defund those.

       7             We've lost our coordinators.  We lost one of

       8      our drug-court participants in the city of Corning

       9      to a heroin overdose not a month ago.

      10             If we'd had the level of supervision we used

      11      to have, we might not have lost him.

      12             So that's another reality, is, even some of

      13      the good programs we have that can help people

      14      aren't being funded the way they should.

      15             So I guess that's where I would start.

      16             But I thank you for recognizing the problem,

      17      and I hope you can help us put the teeth back in,

      18      and also help the folks that we've created a system

      19      designed to help.

      20             SENATOR O'MARA:  Thank you, Brooks.

      21             Anyone else want to add on to that from the

      22      law-enforcement perspective?

      23             I will note that we have been joined by

      24      Joe Fazzary, the Schuyler County DA.

      25             And a couple of rows back from him,







                                                                   33
       1      Weeden Wetmore, the Chemung County

       2      District Attorney.

       3             Thank you for being here, Weeden.

       4             Bill?

       5             SHERIFF WILLIAM YESSMAN, JR.:  Thanks,

       6      Senator.

       7             And thanks, Chris, for sharing your story

       8      with us.

       9             This is a problem that goes beyond just drug

      10      possession, drug use, drug sales.  It's filling up

      11      our jails with other crimes; burglary, robberies,

      12      larcenies, assaults.

      13             You know, you read in the paper every day

      14      these shootings that are taking place.

      15             Yesterday I Googled just "heroin arrests,"

      16      just to see what I got.  And I had, like, five in

      17      our region in the last three weeks that were major

      18      arrests involving heroin.

      19             And, you know, a couple years ago, if you saw

      20      heroin, it was, like, Wow!

      21             I mean, it's not impacting us in

      22      Schuyler County greatly right now.  We haven't seen

      23      a lot of it, but we know the people from our county

      24      are going into Ithaca, they've going -- coming down

      25      to Elmira, they're going down into Corning, other







                                                                   34
       1      areas, to get the heroin and use it.

       2             The Drug-Back days, we're -- Take-Back days

       3      we're doing with the DEA.  We have a permanent

       4      collection box in our lobby for prescription

       5      medications, and that fills up every two weeks.  And

       6      it's a large mailbox.

       7             That's helped cut down on our

       8      prescription-drug abuse we've seen, but, this is

       9      filling up our addiction-counseling agencies, our

      10      rehabs.  There's waiting lists to get in.

      11             I see this from our people.

      12             We're also seeing, where people are being

      13      sentenced to, you know, three to five years, they're

      14      back out in the street in six to eight months.

      15      They're going into drug treatment, and they're right

      16      back out on the street again.

      17             And, you know, I don't think they're

      18      necessarily dealing with their issues like they

      19      should be.  You can't cure someone in six months.

      20             So, this is the things we're dealing with.

      21             We just had a local young woman in our county

      22      overdose down here in Elmira, and she's fighting for

      23      her life right now because of this problem.

      24             So it's something that we have address.

      25             You know, we're -- my 30 years in







                                                                   35
       1      law enforcement, we're seeing now where we're

       2      outfitting our officers with Narcan to help fight

       3      overdoses.

       4             I've never seen law enforcement have to take

       5      this approach, to where we have to, you know, supply

       6      and train our officers to fight drug overdoses.

       7             And, you know, our thing is to save lives,

       8      and that's what we're doing.  We're working with the

       9      Attorney General's Office right now to outfit my

      10      staff with Narcan, so they have it.

      11             But I want to thank you for the opportunity

      12      to speak.

      13             SENATOR O'MARA:  Thank you, Bill.

      14             Thank you, Bill.

      15             And the Narcan, we'll get into that a little

      16      bit further.

      17             We had hoped today, to have part of our forum

      18      be a Narcan training session, and have some kits

      19      available, but due to some of the programs at the

      20      State right now, we weren't able to get ahold of any

      21      Narcan kits because they're moving out the door and

      22      they are being distributed.

      23             And, you know, everybody that's -- that I've

      24      talked to about the Narcan kits, it's just -- it's

      25      like a miracle when it's utilized.







                                                                   36
       1             But it is important that we get those into

       2      hands of law enforcement, into the hands of our

       3      first responders -- our EMTs, our ambulances, our

       4      fire departments -- who are first on the scene,

       5      because that drug, really, for a pretty low cost, is

       6      clearly saving lives.

       7             But, we need to follow up after we save that

       8      life to make sure that they're not going to need

       9      Narcan again.

      10             I think there was an article I read just last

      11      week, or maybe it was this week, an individual that

      12      had been revived by Narcan, I think, three or

      13      four times.  It's just -- it's incredible.

      14             And that -- that -- that, I think, sets a

      15      tone pretty clear on just how powerful that

      16      addiction is; that you're going to be revived, and

      17      then go back and do it again.

      18             We've been joined by Senator Mike Nozzolio,

      19      who is a Co-Chairman of this Task Force going around

      20      the state.

      21             Mike, thank you for coming down today to be

      22      with us.  And, we've had a productive conversation

      23      so far.

      24             So, thank you.

      25             SENATOR NOZZOLIO:  And if I could just say,







                                                                   37
       1      thank you, Senator O'Mara, for setting up this

       2      forum.  That this is a series of forums across the

       3      state.

       4             Senator O'Mara's been a participant, an

       5      active participant, in those forums.

       6             I thank Assemblyman Palmesano and

       7      Assemblyman Friend for being with us.

       8             That, Narcan, at one of our prior hearings

       9      and forums in the upstate area, I -- we asked a

      10      first responder how many times they had administered

      11      Narcan, and he said, "four."

      12             And I said, "Well, over what period of time

      13      was that?"

      14             And he said, "Within the last month."

      15             And that just -- Sheriff, that just gives

      16      kind of the scope of the problem upstate; not just

      17      downstate.

      18             Thank you, Senator O'Mara, for setting up

      19      this forum.

      20             SENATOR O'MARA:  Thank you.

      21             John McNelis.  Attention!

      22                  [Laughter.]

      23             SENATOR O'MARA:  I'd like to get your

      24      perspective, as a School Resource Officer, and what

      25      you're seeing in our schools.  Maybe recommendations







                                                                   38
       1      on what we can do on awareness and prevention

       2      activities with our youth, to, hopefully, avoid

       3      getting involved in this in the first place.

       4             JOHN McNELIS:  Yeah, I think that's a key

       5      component, is prevention.

       6             And the irony, is that it requires, you know,

       7      money and resources.

       8             But on the flip side --

       9             SENATOR O'MARA:  Pull the mic just a little

      10      bit closer.

      11             JOHN McNELIS:  That requires money and

      12      resources, you know, for the schools.  But, you

      13      know, the flip side of that is, obviously, it will

      14      pay off exponentially down the road in terms of

      15      money and resources.

      16             You know, one of the things I think the

      17      schools would like to see is more -- you know, when

      18      you face these budgetary constraints, you know, one

      19      of the first things you cut is nonessential

      20      services, and sometimes guidance counselors and

      21      stuff like that are becoming nonessential.

      22             And, you know, again, the irony there is,

      23      when you face a complex problem like this, they

      24      become more essential.

      25             And that's where we should be.  You know,







                                                                   39
       1      those resources can really help.  You know,

       2      social workers, more guidance counselors, because,

       3      you know, obviously, the addictive nature of some of

       4      these drugs we didn't see 25, 30 years ago, the

       5      variety of some of these drugs, and it complicates

       6      the problem, and it requires more complicated

       7      solutions.

       8             And, you know, like I said before, the irony

       9      of that is, you need more.  Where we should be

      10      adding, we're cutting.

      11             And I think if we add more, obviously, we're

      12      going to -- it will pay off down the line.

      13             I mean, one example in the Hornell area is,

      14      unfortunately, we lost, you know, the psych unit at

      15      St. James.

      16             And, you know, that -- the ramifications of

      17      that there, you know, obviously, more -- you know,

      18      more pressure on law enforcement, prosecutors.

      19             And, I mean, even right down to the

      20      fire department, you know, the fire department is

      21      now transporting patients 40, 50, 60 miles, to see

      22      if they can -- you know, just to see if they can be

      23      evaluated and admitted.

      24             So it's kind of a vicious cycle.

      25             And, you know, obviously, all the people







                                                                   40
       1      here, like I say, I think if we can throw a little

       2      bit more time and money and resources, it's going to

       3      pay off exponentially down the road.

       4             SENATOR O'MARA:  I think you make a great

       5      point with the psych unit at St. James closing down,

       6      and the limited number of psych beds or psychiatric

       7      mental-health facilities that we have here, which

       8      was certainly a major issue that we've dealt with

       9      over the last year here with the threatened closure

      10      of the inpatient beds at the Elmira Psychiatric

      11      Center.

      12             And I think there's, at least from my

      13      research, a strong relationship between

      14      mental-health issues and addictions and drug use.

      15             So, maybe we can spin it back over to the

      16      other side of the table now, to our treatment

      17      providers that are here, to talk about what you're

      18      seeing in your communities.

      19             You know, if John is seeing this in

      20      Canisteo-Greenwood, not exactly the urban center of

      21      New York State, it's clear that it's everywhere.

      22             So, if anybody over here on this side want to

      23      get the discussion started on the treatment aspects,

      24      access, the process involved in it?

      25             I know we've talked in the past a lot about







                                                                   41
       1      insurance issues, and concerns with lack of access

       2      because of insurance rejections, and the treatment

       3      process, in general.

       4             Don't be shy.

       5             Bill, yeah, you can go.

       6             WILLIAM RUSEN:  I think one of the main

       7      challenges for the substance-use-disorder treatment

       8      system is every other health system, which is, as

       9      people transfer into Medicaid managed care, which is

      10      going to look a lot more like talking to an

      11      insurance company, what we always say at CARS is

      12      this:

      13             If an insurance company authorizes, let's say

      14      20 visits, and you get to the 19th visit and you'd

      15      like to have a few more, you call the insurance

      16      company and say, I'd like to have a few more visits.

      17             And all they have to do to win the game is

      18      not return the call, because the default is, the

      19      answer is no, until you get a yes.

      20             So, you know, we've had -- I mean, the number

      21      of people, just in the last five years, you know,

      22      support-service people, and their time that we've

      23      had to direct at just getting a yes, and getting a

      24      return phone call, has significantly increased.

      25             Now -- and, again, remember, we exist in this







                                                                   42
       1      sort of pie, if you think of our budget as a pie,

       2      and the more you take up with support services, that

       3      doesn't mean you get an extra pie.

       4             And, so, the amount you have left over for

       5      other things, like, you know, salaries and treatment

       6      and charity care, goes down.

       7             So I think this is going to be a big

       8      challenge as we move forward, and more and more of

       9      our services look like talking to the typical

      10      insurance company versus what was a more easily

      11      accessed system that we had been using with

      12      Medicaid.

      13             So, I just wanted to -- that's my commentary

      14      about insurance.

      15             SENATOR O'MARA:  Thank you, Bill.

      16             Yes.

      17             HELEN KAPLAN:  To add to what Bill said, one

      18      of the things that we're seeing in Tompkins County,

      19      and I'm sure it's true in other counties, as well,

      20      is that when you're trying to get somebody inpatient

      21      and they have insurance, like Medicaid, they have to

      22      fail repeatedly; meaning, not succeed, not keep

      23      sober, repeatedly, before their insurance will pay

      24      for them to go to a 24-hour facility, a 28-day

      25      program.







                                                                   43
       1             So the ramifications of a person failing

       2      repeatedly before they get the care that's needed

       3      have ripple effects on the whole community, in the

       4      form of crime, in the form of homelessness, you

       5      know, in the form of all kinds of problems, at --

       6      both, at the clinic, and I'm sure at the police

       7      level, we see.

       8             And that's a problem, to make a person have

       9      to fail so many times before they get the care they

      10      need.

      11             JULIE CHARLANOW:  And I know this has already

      12      been touched on, I just want to stress the

      13      importance, and I'm sure you've heard it all

      14      throughout the state, the issue with not having

      15      enough doctors able to provide and prescribe

      16      medication-assisted treatments, like Suboxone.

      17             We have one doctor, our medical director in

      18      our facility, which is a very large outpatient

      19      substance-abuse clinic here in Elmira.

      20             On any given day, we have approximately 350,

      21      360 active clients in our programs.

      22             The last check, which is pretty consistent

      23      across all three of our clinics here in Elmira, and

      24      two of our offices in Livingston County, roughly,

      25      14 to 15 percent of our clients have a primary







                                                                   44
       1      opiate addiction.

       2             So, with only one doctor able to prescribe,

       3      you know, a limited amount of Suboxone, we are in a

       4      bind of having to choose who we're able to put into

       5      our Suboxone programs.

       6             So, having more, having more of that resource

       7      available, would certainly help keep people in the

       8      outpatient setting, too.

       9             We're at a -- you know, at a crossroads,

      10      where we can't get people into inpatient residential

      11      settings as much as we would like to, so we're

      12      trying harder to make them succeed, help them

      13      succeed, in the outpatient setting, but we have

      14      limited resources there, as well.

      15             So, I'm sure you've heard it everywhere else,

      16      but, it is, it's truly a very big issue.

      17             SENATOR O'MARA:  We have heard it other

      18      places, but it's critically important that we

      19      continue to hear it, and that certainly helps us do

      20      the job that we need to do, as legislators, to focus

      21      programs in the right direction.

      22             And that -- and to -- certainly, it helps

      23      continuing to bang the drum on public awareness and

      24      just the extent of the issues that we're dealing

      25      with.







                                                                   45
       1             SENATOR NOZZOLIO:  If I may add, that

       2      Senator O'Mara probably said this already, but the

       3      focus of the Task Force is to look at prevention,

       4      treatment, and then, of course, prosecution; and

       5      look at the three equally.  And that those

       6      three series of issues are going to be the key to

       7      stopping this problem.

       8             One of the issues we've been dealing with is

       9      how, adding insult to injury, our Medicaid dollars

      10      are actually being stolen from us by the

      11      organized-crime elements of our society; paying

      12      individuals in homeless shelters to give their

      13      Medicaid card away, sell it away for $20, and then

      14      have that card be used for phoney prescriptions for

      15      Oxycontin, at a $30-per-pill street value.

      16             And two cases in New York City alone, that

      17      we've been privy to, resulted in a billion dollars,

      18      "a billion dollars," worth of illegal obtaining the

      19      medicine, and, in effect, obtaining it, insult to

      20      injury, with taxpayers' dollars.

      21             One of the issues the Task Force is dealing

      22      with, is trying to figure out if we should change

      23      the percentages of seizure.

      24             Right now, the law-enforcement agency that

      25      has the responsibility for seizure of illicit-drug







                                                                   46
       1      trade, in effect, keeps a portion of that.

       2             A portion goes to treatment at the OASAS

       3      level, or funding to OASAS at the state level.

       4             And, then, a portion of it goes to the

       5      Attorney General, whether or not the

       6      Attorney General is involved in the case or not.

       7             We're looking at changing that, and

       8      increasing the treatment dollar.

       9             What is law enforcement and treatments'

      10      opinion of that potential change?

      11             SHERIFF WILLIAM YESSMAN, JR.:  I think it

      12      would help.

      13             You know, the problem is, we have to get to

      14      the underlying factor, and that's the addiction.

      15      And, you know, because, without doing that, our

      16      business increases in law enforcement.

      17             If we can get to these people and deal with

      18      their issues on that level, I think it would help

      19      immensely with our issues.

      20             SENATOR NOZZOLIO:  Treatment side?

      21             CAPTAIN JOSEPH KANE:  If I can go back to the

      22      law-enforcement side of this, I did four years in

      23      the drug-enforcement unit, and when I first started

      24      that unit, even four years ago, heroin wasn't the

      25      issues that it is; and heroin, opiates, that entire







                                                                   47
       1      category.

       2             Just since I left in November, we've seen

       3      prices just cut in half, which is putting more

       4      product out to users.

       5             The issue is, it's not a police problem.

       6             Statistics show that people who end up in

       7      jail come out and they're not cured.  It's not a

       8      cure; jail's not a cure.

       9             But I'm not saying we should back off the

      10      people who are selling.

      11             But from a user standpoint, the people who

      12      are locked up, such as Chris, for stealing, you

      13      know, phones, money, it's a community issue for each

      14      and every one of us, if we have not already been

      15      affected by it.

      16             A few things:

      17             Many people have prescription medications in

      18      their medicine cabinets.  They end up in kids'

      19      hands, or who knows whose hands.  Each of those

      20      events tends to -- it has more of an effect on

      21      somebody who is a user, and it creates users.

      22             The -- back when -- in November, when we were

      23      buying heroin, we could buy 10 bags of heroin.  It's

      24      called "a bundle."  And we were -- the best price

      25      that we could get when we were buying it was $170.







                                                                   48
       1             I just saw in the last two weeks that they

       2      bought 10 bags of heroin for 75.  So that's even

       3      greater than a 50 percent reduction in cost, and

       4      it's just flooding -- flooding our society with

       5      heroin.

       6             When we dealt with CIs before, the

       7      "confidential informants," before this heroin came

       8      to the scale it is now, we didn't always worry that

       9      our confidential informants weren't going to be

      10      around.

      11             Now it's a huge concern.

      12             We often have to -- you know, we work with

      13      somebody, and from a law enforcement, we don't

      14      always offer that treatment, but, in my opinion,

      15      it's a treatment issue.

      16             Again, jail doesn't cure people from

      17      addiction.  It can keep you away from it for some

      18      time, but statistics show that people who are

      19      released from, you know, a short jail stay are going

      20      right back to the issue.

      21             Again, as a community, people who are leaving

      22      cars unlocked, or even pills within cars, we have

      23      people going around, nearly nightly, going into

      24      vehicles, taking whatever that they can, whether

      25      it's money, electronics equipment, and/or pills.







                                                                   49
       1             If somebody leaves the pills, you're just

       2      asking for to be the victim of a crime.

       3             We need to get rid of those.

       4             We just had a conversation in our department

       5      this morning about what we can do take those back,

       6      the opiates that are, you know, all the pain pills

       7      that are, out in our community, because, again, they

       8      will end up in the wrong hands.

       9             As long as we have users, we're going have

      10      dealers.

      11             I think it's, again, a treatment issue.

      12             I don't think -- you know, locking up the

      13      dealers, we're going have another dealer that comes.

      14             Back some time ago, when we had -- when I was

      15      involved in the narcotics, we would purchase a

      16      bag -- a single bag of heroin in the city of Elmira

      17      for 20 to 25 dollars.  But in, say, Harrisburg,

      18      Philadelphia, they were going for $6 a bag.  In

      19      New York City it was about $7 a bag.

      20             So the markup was huge in our area.

      21             We -- I spoke with a member of the

      22      Watkins Glen community, and they were getting, like,

      23      $35 a bag.

      24             So, the dealers are making a fortune of off

      25      this.







                                                                   50
       1             And, again, like somebody said earlier, they

       2      will take orders.  If somebody wants a TV, they'll

       3      go steal a TV, and then end up with product.

       4             Narcan, I think we see that as an issue with

       5      somebody who overdoses.  And that's not the only

       6      issue we're going to deal with, as far as the police

       7      or anybody else in our community.

       8             Somebody is going to come running to a police

       9      officer with a 2-year-old child who has accidentally

      10      ingested pills from a medicine cabinet that is just,

      11      basically, sitting around.

      12             And those are the people that we may leave

      13      out sometimes.

      14             We're looking at the person who has an

      15      addiction that's actually using, but there's other

      16      people that are affected in each and every one of

      17      our families.

      18             A couple examples of people who I've seen:

      19             When somebody comes to us and has been

      20      arrested, one of the first questions I always ask

      21      was, "How did you get injured?" because there was

      22      usually a story behind it.

      23             We've dealt with somebody, a member of our

      24      military, jumped out of an airplane, parachuting, as

      25      part of his military duty.  Injured his back, ends







                                                                   51
       1      up a pain medication; subsequently, heroin, and he

       2      died of an overdose, I think, two months ago.

       3             Another example:  We had a female who was a

       4      Division 1 track star and athlete, and she had a

       5      knee injury, ACL/MCL.

       6             She ends up -- her coach, obviously, wants

       7      her to perform.  Provides her these, you know, Oxy

       8      opiate pain pills.  She ends up addicted, and now

       9      she's in our system, and just recently got arrested.

      10             So, it's good people who are addicted to

      11      heroin, and I think we need to focus on the

      12      treatment side of it.

      13             And I think that's a great idea, with the

      14      money that we sometimes take in, that we may focus

      15      on jails, that we look toward a treatment side.

      16             ASSEMBLYMAN PALMESANO:  Captain, and

      17      Mr. District Attorney, are you sending any of these,

      18      who have broken the law because of drugs, otherwise

      19      would not have broken the law, are any being

      20      sentenced to Willard?

      21             DA BROOKS BAKER:  Yes.  We use Willard a lot.

      22             You know, in our office the process is, and

      23      we utilize our drug-court people for this a lot, and

      24      drug and alcohol evaluations during the presentence

      25      process, to make these determinations.







                                                                   52
       1             And, so, there are two sets of people.

       2             There are sets -- there are people who commit

       3      crimes that are drug crimes.  People who sell drugs,

       4      but are not addicted to drugs;

       5             And there are those folks who commit crimes

       6      because they are addicted to drugs.

       7             We try to treat those folks very differently.

       8             Willard is a great avenue for those folks who

       9      commit crimes because they're addicted to drugs, and

      10      we use that.

      11             We also use our drug courts a lot for that.

      12             I just wanted to touch on the funding thing

      13      very briefly.

      14             Increasing the percentage that would go to

      15      OASAS would be a fantastic thing.

      16             I think, right now, about 30 cents on every

      17      dollar goes directly to OASAS out of our

      18      forfeitures.

      19             The problem is, in rural counties, our

      20      forfeiture numbers are small.  I would bet that,

      21      probably, are 30 percent.  And we aggressively

      22      pursue forfeiture in Steuben County, the

      23      drug-seizure money.

      24             Probably, that 30 percent every year might

      25      fund 1 or 2 people for a 28-day stay in an inpatient







                                                                   53
       1      program.  That's not going to be enough to move the

       2      ball to handle treatment.

       3             I think there is an example of a program that

       4      was started right here by Senator Smith, in

       5      Chemung County, that dealt with prosecution,

       6      education, treatment, and prevention, the Stop DWI

       7      program, where the offender pays a price.

       8             There is no minimum fine for drug offenses

       9      right now.

      10             In the DWI world, you -- you impose a minimum

      11      fine.  That fine goes right back into prosecution,

      12      treatment, and enforcement.

      13             That kind of a model could really help us and

      14      not put this burden back on the taxpayer.

      15             SENATOR O'MARA:  How do you deal, Brooks --

      16      I think most individuals, when they get addicted,

      17      they lose their job, they lose their family, they

      18      lose any means of support.

      19             How are you going to impose fines on those

      20      individuals, I guess?

      21             DA BROOKS BAKER:  Again, that's always going

      22      to be in the discretion of when to impose a fine.

      23             There is no minimum fine required.

      24             Now, a lot of people who are drunk-drivers

      25      have those same realities, and they pay their fines.







                                                                   54
       1             That's a price of being involved in another

       2      addictive substance and putting the community at

       3      risk.

       4             That may just be a price associated with it.

       5             However, a lot of folks who are involved in

       6      drug crimes are not addicts.  There are a lot of

       7      people involved in drug crimes who are simply

       8      sellers, and those folks could certainly foot that

       9      bill.

      10             CHRISTIE SPECIALE:  Can I touch on the

      11      prevention piece of this aspect?

      12             SENATOR O'MARA:  Yes.

      13             CHRISTIE SPECIALE:  We're all here because

      14      there is obviously a problem, and we're dealing with

      15      it the best that we can.

      16             But, on a prevention standpoint, you know,

      17      these -- this costs our nation over $600 billion a

      18      year, and, what are we doing to prevent this?

      19             You know, I have a staff of three that covers

      20      Tioga County, and it's very difficult to do the work

      21      that we do to provide our evidence-based programs

      22      that are shown to decrease this behavior.

      23             It's among the most, you know, high -- the

      24      most costly health problem in the United States.

      25             And, you know, investing in prevention is,







                                                                   55
       1      definitely, it makes great economic sense.

       2             According to a new study conducted by

       3      Washington State University:  Communities will reap

       4      substantial savings by using effective drug-abuse

       5      violence-prevention programs.

       6             Among the most dramatic findings was one that

       7      they used, a program that we use, called

       8      "Life Skills."  And it produced a $50 benefit for

       9      every $1 invested into these prevention programs.

      10             You know, and our funding just continuously

      11      gets cut.

      12             And we have studies that are showing that,

      13      for every $50 invested into this, it's -- or every,

      14      I'm sorry, $50 produced every, you know, dollar is

      15      invested as the outcome with this.

      16             So prevention programs are definitely,

      17      I think, a must in our communities.

      18             SENATOR O'MARA:  Thank you.

      19             LAUREL HEADWELL:  I'd like to comment on that

      20      also.

      21             Sorry.

      22             I work for the Council on Alcoholism and

      23      Addictions for Yates County in the Finger Lakes, and

      24      I'm their education coordinator for Yates County.

      25             And I'm finding that I'm needed in a lot more







                                                                   56
       1      schools than doing prevention counseling, but, the

       2      funding isn't there, also.

       3             I work with the risk and at-risk youth for

       4      providing the life skills, as she talked about,

       5      anger management, parenting programs; however,

       6      they're not being covered, they're not being there

       7      enough, because there's just a lack of funding.

       8             We just lost some of our funding, and

       9      eliminating a peer-prevention program.

      10             So, that would be nice to have more funding

      11      to get those types of programs back into the

      12      community.

      13             Also, mandating programs, we're finding that

      14      a lot of people are being pushed towards coming to

      15      us, but then they can decide and say, "No, I don't

      16      want to come visit you.  I don't want to do this

      17      anymore," so they leave; or they don't have to

      18      fulfill those requirements.

      19             We have a program for -- it's called

      20      "AD PEP" [ph.].  It's a drug- and alcohol-awareness

      21      program.  It's a 3-session, 6-hour program.

      22             I just had one, actually, last night, and

      23      it's where they're mandated to come.  They have to

      24      serve that time, and then they leave, and,

      25      hopefully, learn from what we have tried to prevent







                                                                   57
       1      them and give them the information on.

       2             Another thing is, going into colleges and

       3      doing a drug training for RAs and RDs,

       4      presenting the colleges with what issues they might

       5      be seeing or coming in contact with.

       6             I mean, I know it's a critical problem.

       7             I go into Cayuga College and do training

       8      sometimes for their RAs and RDs, but there could

       9      always be more.

      10             So, that would be great if we could get more

      11      funding in that sense.

      12             SENATOR O'MARA:  Thank you.

      13             SARAH SALISBURY:  Senator, I just wanted to

      14      speak, too.

      15             I'm from Owego.  We're Tioga County Alcohol

      16      and Drug Services.  We're locate between Binghamton

      17      and Elmira.

      18             And, I hear the term "treatment issue" coming

      19      up a lot.  And, you know, the thought that comes to

      20      mind for me is that addiction recovery really isn't

      21      time-limited.

      22             You know, you spoke about, uhm, maybe having

      23      to use the Narcan three, four, five times on

      24      one individual, and, you know, recovery can take

      25      one, two, three, or ten times for any individual.







                                                                   58
       1             So, you know, what I found to be successful

       2      is working with law enforcement, drug courts, and

       3      having probation involved, parole, that mandates

       4      patients to stay in treatment, because that's one of

       5      the big barriers we run into, is keeping them in the

       6      clinic.  Or, you know, they decide to max out their

       7      time in the jail so that they don't have to come

       8      back to treatment and talk about, you know, those

       9      uncomfortable things that they don't want to talk

      10      about.

      11             Some of the other barriers we've already

      12      touched on today are, obviously, the authorizations,

      13      the insurance.

      14             We're getting so many denials, and, you know,

      15      we've got people that are withdrawing, you know,

      16      right in our offices, and, you know, detoxing.

      17             And we've got an insurance company on the

      18      phone, saying:  Well, you know, they're not detoxing

      19      enough.

      20             You know, not really sure how much worse it

      21      could get at that point for them.

      22             The other thing is lack of bed availability

      23      and, you know, crisis centers.  You know, safe

      24      places for them to go while they're waiting for an

      25      inpatient bed.







                                                                   59
       1             You know, obviously, they can come to

       2      outpatient treatment in the interim, but, you know,

       3      where are they going when they go home at night, you

       4      know?  Right back to that environment.

       5             So we're left wondering if they'll even show

       6      back up the next day, and hoping for that.

       7             And then adolescents is a whole nother

       8      problem altogether, because you can't send an

       9      adolescent to detox.  We have to, you know, tell the

      10      parent to take them to an emergency room, and,

      11      hopefully, they will follow through on that.

      12             But, there's not really a lot of places for

      13      them to go, in general.

      14             SENATOR O'MARA:  What do -- can anybody speak

      15      to the Southern Tier, the southern Finger Lakes

      16      region, as to -- as what's available for detox

      17      centers?

      18             SARAH SALISBURY:  The Addictions Crisis

      19      Center is in Binghamton, but I don't think that they

      20      have that many beds.  And, you know, they'll keep

      21      them for 14 days.

      22             But that's about it, in the Binghamton area.

      23             SENATOR O'MARA:  And the next closest to

      24      Elmira, does anybody know where that would be?

      25             MIKE BALLARD:  I think Schuyler -- I work in







                                                                   60
       1      Schuyler County some of the time.  I think a lot of

       2      times when they see problems there, they -- we

       3      contact FLACRA, but I think the crisis center is in

       4      Clifton Springs.  So, I think that was, you know,

       5      one of our only choices to send people to.

       6             SENATOR NOZZOLIO:  How about Dick Van Dyke?

       7             MIKE BALLARD:  We do utilize Dick Van Dyke

       8      sometimes.  I think the choices there are a little

       9      bit limited there sometimes, from our standpoint.

      10             I don't know -- our educators, more or less,

      11      contact the people.  I don't work directly with

      12      those people.

      13             But, yeah, I think it's an option, but not a

      14      well-utilized one.

      15             HELEN KAPLAN:  And you should know that, in

      16      Ithaca, we don't have a crisis or detox center, so

      17      we send our people to Elmira, and all the other

      18      counties, and Medicaid has to foot the bill on

      19      transporting them long distances.

      20             And as one of my fellow panel members has

      21      alluded to, it's difficult to get that person to the

      22      facility when they're living, many of them, in

      23      county-subsidized drug houses.

      24             So that's something I think is really

      25      important to touch upon today, is that we have a







                                                                   61
       1      housing crisis that's serious, at least in

       2      Tompkins County.  I'm sure in other counties as

       3      well.

       4             If I want to get somebody into safe sober

       5      housing, I don't really have options that my clients

       6      can afford.

       7             And when we go to the Department of

       8      Social Services, what we find is that they're

       9      collaborating with slum Lords who will happily

      10      fleece their pockets and put our clients in these

      11      substandard situations.

      12             I think that, you know, the dogs and cats at

      13      the SPCA live more comfortably than individuals who

      14      are trying to recover from opiate addiction.

      15             And I'm glad that the cats and dogs are

      16      comfortable, but I think that people with, you know,

      17      heroin addictions deserve to be in the kind of

      18      housing that you or I or anybody who may not be in

      19      recovery would like to live in.

      20             CHRISTIE SPECIALLE:  And then a lot of these

      21      houses I know are located in areas that are the

      22      least desirable to put these people back into the

      23      community.  You're putting them into a community of

      24      other users.

      25             SENATOR O'MARA:  Maybe we can get up here to







                                                                   62
       1      Jim and Deb with Arbor Housing, on this angle, from

       2      housing, and what you're seeing in your communities

       3      where you serve.

       4             JIM MULCAHY:  My name is Jim Mulcahy.  I work

       5      for Arbor Housing and Development.  I work at a

       6      community residence that deals with addiction in

       7      Hornell, New York.

       8             One thing that I've kind of been hearing a

       9      little bit of, and it's something I've thought about

      10      recently, is, you know, as we speak of the funding

      11      that's going to be available or not be available:

      12             I've worked in this field for about 10 years,

      13      and it's not to minimize anything from 5 years ago,

      14      7 years ago.

      15             More typically, we dealt with other drugs,

      16      alcoholism, through our facility, which is just one

      17      facet of what Arbor does.

      18             More recently, it's become the heroin, the

      19      opiate, addiction that's in the Hornell area.

      20      Canisteo-Greenwood.

      21             I live in Cohocton, which is a tiny little

      22      community.  It's there.

      23             And what I find alarming, I guess, in the

      24      sense that, you know, from talking to other people

      25      in the agency that handle more of the funding that







                                                                   63
       1      we get through Medicaid that keeps our doors open,

       2      or through state grants, government grants, that

       3      that funding is less and less.

       4             But, we're facing new challenges with new

       5      people coming in with heroin addiction or opiate,

       6      which presents a whole new set of challenges in

       7      trying to help that person in, like, a therapeutic

       8      environment, to give them a place to live.

       9             You know, I don't like to use the term

      10      "group home," but they come out of a, say, MATCH

      11      inpatient program, which is a 28-day inpatient

      12      program, we still keep them linked up to the MATCH

      13      program on outpatient services or Steuben County

      14      Mental Health, Steuben County substance-abuse

      15      services, and we kind of help them on a different

      16      level, and still keep them linked with the services.

      17             And then to -- come to find out, well, they

      18      don't -- they're not going to be able to go to

      19      SCASAS, the Steuben County substance-abuse program,

      20      anymore.  They won't pay for it.

      21             It presents new sets of challenges for us.

      22             How do we help this individual?

      23             I mean, we're helping them as best as we can,

      24      from our standpoint, and providing them a place to

      25      stay, meals, and on top of, you know, trying to







                                                                   64
       1      reteach them life skills; how we can move them up a

       2      set of programs that are in the Hornell area, from

       3      our place, to an apartment program, to a

       4      supportive-living program.

       5             All that can't be done if the funding's not

       6      there.

       7             And then we hear:  Oh, well, we have this

       8      opiate/heroin addiction in the area.  Oh, by the

       9      way, the funding's not there, so, your doors might

      10      close.

      11             Then we can't help anybody, you know?

      12             So, I mean, those are things that I find

      13      alarming, you know, as a professional in this field.

      14      Like, how are we going to continue to help people,

      15      facing the new challenges we face right now?

      16             And, you know, and it's -- I've heard it

      17      several times here.

      18             Heroin, it's gotten into our area, and it's

      19      cheap.  You know, people can get it for 5, 7 dollars

      20      a bag.

      21             Yep, they couldn't get the pain pills

      22      anymore.  Medicaid wouldn't pay for that.  "Well,

      23      I can get heroin for 5 bucks a bag."

      24             You know, and -- so we get those people into

      25      a rehabilitation program, and then into our program.







                                                                   65
       1      And as we try to give them the skills and give them

       2      the assistance they need to be sober, face their

       3      addictions, get past their addictions, and live a

       4      better life in the community again, reintroduce them

       5      to the community; and, again, you know, not to

       6      re-spin the wheel, but, we can't do that if the

       7      funding is not available.

       8             So, I mean, those are just kind of the

       9      challenges we face immediately, right now.

      10             SENATOR O'MARA:  Deb, do you want to add

      11      anything?

      12             DEBBIE McCORMICK:  Yes.

      13             I'd like to add that I have been a heroin

      14      addict for 30 years.  And, I was lucky enough to

      15      have access to wonderful treatment, both physical

      16      and emotional.

      17             I lost my son when he returned from Iraq.  He

      18      overdosed on fentanyl patches, and my life just

      19      spiraled out of control.  And I ended up getting

      20      arrested for committing crimes to support my habit.

      21             And, my recovery has just been amazing, from

      22      the beginning to end.

      23             I started out going to MATCH for a 28-day

      24      program.  I did notice during that time that a lot

      25      of my peers had to leave after two weeks because of







                                                                   66
       1      their insurance.

       2             I was then transported to Newark, New York,

       3      to a place called HANAC Hall, which is SOSHA [ph.].

       4             And then I stepped down to a

       5      supportive-living house in Geneva, FLACRA.

       6             And then to an Arbor Development apartment.

       7             I'm also a member of drug court.

       8             And, I just can't say enough about the care

       9      that I received.

      10             SENATOR O'MARA:  Thank you for sharing that.

      11             If we could segue into your comments on your

      12      son, in returning from Iraq, and his service,

      13      Dr. Bourke, at the end down there, is a longtime

      14      friend of mine, is involved with treatment of

      15      veterans, is a psychologist.

      16             And, Frank, if you could talk a little bit

      17      about your work in Corning, and The Research and

      18      Recognition Project that you're involved with, and

      19      how this kind of relates to the drug addictions and

      20      the combination of things that really are affecting

      21      our veterans that are returning.

      22             FRANK BOURKE, Ph.D.:  And I imagine you were

      23      a little surprised to see me walk in this morning.

      24             SENATOR O'MARA:  Never surprised to see you

      25      anywhere.







                                                                   67
       1                  [Laughter.]

       2             FRANK BOURKE, Ph.D.:  In the sense that, the

       3      last 10 years, I've been working with posttraumatic

       4      stress disorder, which, of course, is the big hit on

       5      veterans coming back.

       6             What Tom doesn't know, is that I came today

       7      because I ran a storefront in Harlem in the '60s.

       8             At the same time that I was finishing up my

       9      graduate work, my first cousin came to me.

      10             Actually, my aunt, saying, "You've got to

      11      help your cousin.  He's addicted to heroin."

      12             So I wound up, in addition to running the

      13      storefront in Harlem, which was a community

      14      devastated by heroin at the time.

      15             You could sit on the third or fourth floor of

      16      any of the apartment buildings then, and look out

      17      the back windows during lunch, and identify five or

      18      six apartments being robbed by people going up the

      19      back fire escapes.  Any lunch, any day of the week.

      20             You couldn't walk the streets safely.

      21             It was a community devastated by heroin.

      22             And in the middle-class community where I was

      23      born, in Brooklyn, it was also being devastated much

      24      more quietly in the same way that Harlem was.

      25             I wound up running a small







                                                                   68
       1      drug-rehabilitation program in a house given to me

       2      by the New York State Diocese, for three years.

       3             So I learned about heroin in a very up-front

       4      fashion.  Without being an agency, we did

       5      preliminary intakes, cold turkey.

       6             And those of you who work with heroin know

       7      what those first two or three days look like.

       8             I worked with 16 fellows in the course of my

       9      time there.  None of them lived past 45.

      10             I'm 71 now.

      11             Those were all people to me.

      12             When I saw "heroin" on the agenda here, Tom,

      13      the word has a different connotation than

      14      recreational drugs; than the kids smoking pot behind

      15      the school.

      16             This is an epidemic because the drug itself

      17      has a set of properties.

      18             I live on a farm up in Hornby, above Corning.

      19             And as an -- just an interest last night,

      20      I asked my two daughters who are in their 30s and

      21      were raised in Corning, about heroin.  And they

      22      don't differentiate between heroin and recreational

      23      drugs.

      24             We are, in terms of prevention, in need of a

      25      widespread and quick education program, much like







                                                                   69
       1      you see smokers on television, drunk-driving,

       2      et cetera.

       3             I don't think that we as a state community

       4      are aware of the danger.

       5             I was in the last epidemic on the streets,

       6      with people.  It was an epidemic.  It was

       7      devastating.

       8             It has something to do with the nature of the

       9      addiction process itself with these particular

      10      drugs.  I think that needs to be gotten out.

      11             The second piece I'd like to go to is, after

      12      I left Cornell University, I built a management -- a

      13      psychiatric management company, which did very well.

      14             I opened and ran 12 psychiatric centers, 6 of

      15      which had alcohol- and drug-rehab centers in

      16      conjunction with them.  They're mostly in the south

      17      and the midwest.

      18             All of those are either closed or half the

      19      size that they were 15 years ago.

      20             The insurance companies have withdrawn from

      21      the support for inpatient care because of the

      22      economic strain it puts upon them.

      23             And I wanted to ask you a question at this

      24      point, Tom, Senator Nozzolio:  Is there a mechanism

      25      for pushing these insurance back to taking







                                                                   70
       1      responsibility for inpatient psychiatric and alcohol

       2      and drug care?

       3             SENATOR O'MARA:  Well, it's certainly a focus

       4      of this Task Force, and part of what's been coming

       5      out loud and clear through the nearly 20 of these

       6      events we've had across the state, and will

       7      continue, that it's going to lead us to, hopefully,

       8      a package of reform legislation to deal with the

       9      issues.

      10             And insurance is something that has been

      11      brought up repetitively, and it's something we're

      12      going to be looking at, because, obviously, we hear

      13      a lot about unfunded mandates at all levels.

      14             And insurance companies consider any mandate

      15      we put on them to be unfunded, and that's passed

      16      along to rate payers.

      17             And it's a matter of doing it the right way,

      18      setting what our priorities are, and being very

      19      careful about such mandates, because they do lead to

      20      increased expenses.  It's going to pop out

      21      somewhere, the expense.

      22             But that's certainly an aspect of what we're

      23      all about here today.

      24             FRANK BOURKE, Ph.D.:  Okay.  And I --

      25             SENATOR NOZZOLIO:  I think of all the







                                                                   71
       1      suggestions made across the state, and yours is,

       2      Doctor, very timely, very important, it's going to

       3      be an extremely difficult fight for us to recognize

       4      and realize what you're suggesting, and what's been

       5      suggested up here, I think Mr. Rusen said it also,

       6      that we need to have public support for this.

       7             And, it's something that certainly is on the

       8      agenda of the Task Force, will be considered.

       9             But if it's proposed, it's certainly going to

      10      have to have a lot of citizen support for it to be

      11      realized.

      12             FRANK BOURKE, Ph.D.:  I think that getting

      13      the word out on the virulence of the epidemic, and

      14      the economic, and cross-support, cross-cultural,

      15      cross-helping agency problems, the strains that this

      16      puts on the entire system.

      17             You could go into any of the emergency rooms

      18      in Harlem or the Bronx in the '60s, and the rooms

      19      would be clogged.  You couldn't get care because of

      20      the drug-addiction problems that were sitting in the

      21      emergency rooms, untreated, on a regular revolving

      22      basis.

      23             That's translatable.  I can give you all the

      24      numbers to support this, Tom, in terms of the effect

      25      in dollars and cents.







                                                                   72
       1             CHRISTIE SPECIALE:  [Not on video.]

       2             Over $600 billion.

       3             FRANK BOURKE, Ph.D.:  On the system, yeah.

       4             I'm dealing with PTSD.  It's an $18-billion

       5      problem coming.

       6             You could bet, I would bet, that you could

       7      multiply that figure by 100, in terms of the

       8      proportion of harm that a heroin epidemic will

       9      produce.

      10             Anything I can do to help, Tom, you can count

      11      on me, from this point on.

      12             SENATOR NOZZOLIO:  Thank you.

      13             SENATOR O'MARA:  Thank you, Doctor.

      14             Susan.

      15             SUSAN HEWITT:  Yeah, thank you.

      16             Thank you for giving me the opportunity to be

      17      here.

      18             I purposely wanted to speak to the insurance

      19      issue today, and a couple people have mentioned it.

      20             And, you know, especially with heroin, one of

      21      the things most of the drug companies -- or, excuse

      22      me, insurance companies are requiring is a failed

      23      outpatient, as was mentioned earlier.

      24             And, you know, with heroin, that's a

      25      particularly dangerous, and often fatal,







                                                                   73
       1      requirement.

       2             Heroin users, if you can get them in a place

       3      where they're someplace safe, you need to really act

       4      at that point.

       5             Failing at outpatient, when you lose them,

       6      you lose them.

       7             It's a different thing than somebody --

       8      obviously, there are different stages of alcoholism,

       9      and whatnot, and I'm not trying to minimize that at

      10      all, but, you know, if you have an alcoholic who

      11      picks up a drink, drinks for even a couple of days,

      12      you can often grab the -- you know, bring them back

      13      in.  And if they're in outpatient treatment, you can

      14      get them back.

      15             Heroin users are gone.

      16             We have lost, I know at least five -- we've

      17      had at least five heroin overdoses in little rural

      18      Tioga County since the first of year.  There may be

      19      more, but there's five that I know about.

      20             By the way, one of those could have been

      21      saved by Narcan if it had been available to the

      22      police.

      23             But --

      24             SENATOR NOZZOLIO:  Did they all result in

      25      death?







                                                                   74
       1             SUSAN HEWITT:  We had the five deaths, yes.

       2             SENATOR NOZZOLIO:  Five?

       3             SUSAN HEWITT:  Yes, five deaths in

       4      Tioga County --

       5             SENATOR NOZZOLIO:  The first four were --

       6             SUSAN HEWITT:  -- since the first of the

       7      year, yeah.  Yes.

       8             And I don't know the circumstances around

       9      most of those.  One, I do know, could have been

      10      saved by Narcan.  He was found in his home by his

      11      mother.  Died in the hospital.

      12             If it had been available either in the home

      13      or in the ambulance, he would have lived.

      14             He was a 24-year-old, with a lot of

      15      potential, from a very -- you know, I don't want to

      16      say good background, because I don't -- I don't want

      17      to kind of rate one family over another.

      18             But, you know, and that's exactly who we're

      19      seeing, and who are dying, are the 20-somethings

      20      from responsible, respectable backgrounds.

      21             And it was said here, you know, these are our

      22      family members, and no different than anybody here

      23      in this room.  And, it's just so sad.

      24             I've been with Tioga County for 20 years, and

      25      I've never seen the deaths.







                                                                   75
       1             I was in the Waverly office, working through

       2      the meth epidemic back a few years ago, which, of

       3      course, is doing its own little resurgence.  And

       4      that's -- you know, our office was a half mile over

       5      the state border from Bradford County, which was --

       6      I think it was, was it "Time Magazine" that reported

       7      that as the meth capital at the time.

       8             And there was a lot of devastating things

       9      that happened, certainly, but, I didn't see the

      10      deaths.

      11             And we have the deaths going.

      12             And, you know, the thing with heroin is, if

      13      you're away from it, you know, you build up a

      14      tolerance and they use quite a bit.

      15             But as it -- and some other people could

      16      certainly speak to this better than I can, but, if

      17      you go back to using after being clean, your

      18      tolerance is extremely decreased, and that's when we

      19      see a lot of the overdoses.

      20             And if you have a person in outpatient

      21      treatment and they pick up, and you try to get them

      22      inpatient, and you can't, or even if you know they

      23      need inpatient right from the beginning, if they're

      24      clean for a while, then they pick up again, we're

      25      liable to lose them.







                                                                   76
       1             And what a loss.  You know, we're losing a

       2      lot of really great, great people.

       3             And it's my understanding that there is a

       4      bill, an open -- a bill open in the Senate, that

       5      would require insurance companies to pay for

       6      inpatient treatment if it's recommended by a

       7      qualified health professional.

       8             And I would have to urge passage of that, if

       9      possible.

      10             And thank you for letting me speak.

      11             SENATOR O'MARA:  Thank you.

      12             We're going to open it up in just a couple of

      13      minutes to anybody from the audience out there that

      14      would like to make a statement or comment, ask a

      15      question.

      16             There's a podium over to the right for

      17      anybody that would like to speak, so, keep that in

      18      mind for the next couple of minutes.

      19             We've got about a half hour in our time slot

      20      to continue here.

      21             And, Susan, I think your comments on, you

      22      know, this isn't just a problem for, you know, a

      23      certain class of people that you think would be

      24      associated with it.

      25             We had a hearing of this Task Force in Auburn







                                                                   77
       1      last week, in Mike's district, and we heard from the

       2      mother of a daughter who died of an overdose a year

       3      ago.  She graduated from Cortland University,

       4      magna cum laude.  Was having trouble finding the

       5      right employment and work, getting depressed, and

       6      started using heroin.

       7             Her mother found out about it, confronted her

       8      on the telephone about it.  She basically admitted

       9      it, and the mother was going to get her the next

      10      day.  She overdosed that night.

      11             It's just how tragic and how quick.

      12             It was just such an incredible example of

      13      that.

      14             So, is there anybody else on the panel here

      15      that would like to add anything before we open it up

      16      to --

      17             Yes.

      18             NAN WOODWORTH SHAW:  Yes, hi.

      19             Nan Woodworth Shaw from Watkins Glen Schools.

      20             And what I've heard Dr. Bourke say, I can't

      21      stress enough the need to really look at

      22      inter-agencies and systems.

      23             And I haven't really heard the devastation to

      24      families.  And in the schools, we're seeing the

      25      impact on young children, in particular.







                                                                   78
       1             And it's at a crisis level.

       2             In other words, if somebody is arrested or

       3      gets the treatment that they need, the impact on

       4      their families and very young children is really

       5      phenomenal right now.

       6             So, we need our systems working together so

       7      that we're right there for those kids, you know, and

       8      the families left behind.

       9             So there's so much permeating aside from

      10      this.

      11             In Schuyler County, that's -- what's come

      12      mostly to our attention, is meth at this point.

      13      But, I've heard, especially with some young adults

      14      that were just mentioned, too, there is a heroin

      15      impact, as well.

      16             But -- but like I say, in the schools, the

      17      real direct impact is these very young children.

      18             SENATOR O'MARA:  Thank you.

      19             UNDERSHERIFF JAMES ALLARD:  If I could?

      20             SENATOR O'MARA:  Yeah.

      21             UNDERSHERIFF JAMES ALLARD:  One thing we

      22      haven't talked about is the county-jail aspect; the

      23      impact, and the opportunity for treatment.

      24             Currently, I know in the Steuben County Jail,

      25      we're typically around 160 to 180 inmates that are







                                                                   79
       1      there, usually from three to nine months.  And,

       2      probably 80 percent of them have some sort of

       3      mental-health treatable issue, that the underlying

       4      issue is substance abuse.

       5             We have two full-time mental-health

       6      counselors who focus almost completely on suicide

       7      prevention.

       8             We have no treatment counselors for heroin or

       9      opioid abuse because the resources aren't there.

      10             And it seems like this would be an incredible

      11      opportunity for treatment within the county jails

      12      across the state, especially as the psychiatric

      13      treatment centers reduce and close.  Again, those

      14      folks that are so desperate to seek on their

      15      addiction, will do anything to get and meet that

      16      addiction, they end up with us.

      17             And we expend tremendous resources, not just

      18      on the constant watch which accompanies their

      19      withdrawal when they're first in our facility, but

      20      also for the treatment as they continue to seek, and

      21      all of the disciplinary issues we experience as they

      22      attempt to find a way to seek those drugs even while

      23      they're locked up.

      24             So it's a huge impact on our budget, but

      25      it's, also, I feel, a huge opportunity for treatment







                                                                   80
       1      that has been virtually unexplored.

       2             NAN WOODWORTH SHAW:  And finding appropriate

       3      treatments for the dual-diagnosis is very, very

       4      difficult, you know, and very difficult to get

       5      through insurance companies, again.

       6             SENATOR NOZZOLIO:  What's happening now,

       7      Sheriff, at our local jails?

       8             We've heard from other custodians, like

       9      yourself, such as yourself, they feel grossly

      10      inadequate to be able to deal with the issue.  Their

      11      officers aren't trained in the issue.

      12             UNDERSHERIFF JAMES ALLARD:  Right.

      13             SENATOR NOZZOLIO:  They don't have

      14      professionals in the situation to do that.

      15             UNDERSHERIFF JAMES ALLARD:  Right.

      16             A lot of our -- again, there's no training

      17      within the DCS curriculum, anywhere.

      18             SENATOR NOZZOLIO:  Local.

      19             UNDERSHERIFF JAMES ALLARD:  Even statewide,

      20      there's no training to be given to the correction

      21      officers to teach them how to interact with an

      22      opioid or heroin addict.

      23             There is, on the mental-health side, they're

      24      so overworked.  Again, you've got 2 folks treating

      25      150 mental-health patients on any given day, that







                                                                   81
       1      they simply don't have the time and resources to

       2      engage in any kind of substance -- substantive

       3      substance-abuse treatment.  They just don't have the

       4      time.

       5             SENATOR NOZZOLIO:  What type of programs

       6      would you suggest?

       7             UNDERSHERIFF JAMES ALLARD:  Any kind of

       8      addiction-based program that we can get in there.

       9             And, again, even if we can affect 10 percent

      10      of our population, that's a tremendous opportunity.

      11             And the ones that are there, some are going

      12      to respond, some are not going to respond, but to

      13      have it available, if we can get some sort of

      14      addiction-based that is not just for alcohol.

      15             That's all we have currently is alcohol

      16      treatment, but we don't have anything for the

      17      opioid-based addiction.

      18             And the other side that we're seeing, also,

      19      is the mixture of the heroin with bath salts and

      20      methamphetamine use.  We've seen a tremendous

      21      increase in that, where, because the meth -- or the

      22      heroin is so much less expensive than some of the

      23      prescription drugs they used to mix with, to ease

      24      the coming down from the bath salts or the

      25      methamphetamine, now they're using heroin as that







                                                                   82
       1      supplement to ease it, and which seems to be a much

       2      more addictive way to go.

       3             But, again, it's because the price is so low.

       4             SENATOR O'MARA:  What percentage of your

       5      inmates, would you say, have an addiction issue, and

       6      what percentage have mental-health issues, in your

       7      jails?

       8             UNDERSHERIFF JAMES ALLARD:  They're so tied

       9      together.

      10             NAN WOODWORTH SHAW:  Yeah.

      11             UNDERSHERIFF JAMES ALLARD:  I mean, I would

      12      say the majority of the mental-health issues have

      13      underlying substance-abuse issues.  It's a -- it

      14      would be a very high number.

      15             DEBBIE McCORMICK:  Senator, may I speak?

      16             SENATOR O'MARA:  Yes.

      17             DEBBIE McCORMICK:  I would just like to share

      18      my experience with you, for jail.

      19             I've been in jail four or five times since

      20      the death of my son.

      21             Uhm, basically, you are in a cell, detoxing,

      22      with no supervision.

      23             I've been told that that's too bad for me,

      24      because I did it myself, to myself.

      25             There's not much -- the church -- going to







                                                                   83
       1      church was the best thing that could I have done

       2      when I was in jail, and AA meetings.

       3             But, basically, you're being punished, and

       4      detoxing, and being very sick, with no relief.

       5             SENATOR O'MARA:  Yes.

       6             ASSEMBLYMAN PALMESANO:  This, uhm --

       7      Undersheriff Allard, I know Mr. Rusen, you asked

       8      [unintelligible], I didn't know -- because you said

       9      there's no availability, because of the resources,

      10      to offer the drug -- the treatment, the counseling,

      11      in the jails, because of resources.

      12             And you mentioned that there's some

      13      restrictions to go outside of a state facility, like

      14      an OASAS or a licensed facility.

      15             Is that something that, where a facility or a

      16      jail might not have the resources, but they could

      17      partner with a treatment facility to go into those?

      18             Because -- is that something that's even

      19      feasible if those restrictions were released?

      20             WILLIAM RUSEN:  Let me say, you know, from my

      21      perspective, this is all about -- I worked in the

      22      community health-center system out in

      23      Washington State.  And anytime you can put a system

      24      together in which you put the care out there, I can

      25      remember seeing 200 kids in Basin City, Washington,







                                                                   84
       1      lined up to get vaccinations.

       2             Okay?

       3             And so from that, I'm the first guy to stand

       4      up and say, "Me" [raises hand].

       5             If we can have an arrangement where at least

       6      I could cover my costs.

       7             I don't think it's really fair for me to do

       8      it in a way that's going to make me close down the

       9      rest of my organization.

      10             So I'm the first guy -- if we can work out --

      11      if we can work out a way that at least my costs

      12      could be covered, I'll be in his jail tomorrow.

      13      Okay?

      14             I mean, that's the -- that's -- what we've

      15      done.  And I'm not in a safe facility.  I'm a small

      16      not-for-profit organization.

      17             And when I say an "OASAS-licensed facility,"

      18      I mean my building, which is inspected by OASAS and

      19      given a license, then I can provide services there.

      20             But I can't go outside that building.

      21      I, literally, can't do it on the street.

      22      I, literally, can't walk across the street and do

      23      it.

      24             I mean, I could do it, but, (a) I'm not going

      25      to get paid, (b) it's not going to count, and







                                                                   85
       1      (c) I could get in trouble.

       2             Okay?

       3             So from that perspective, if we could get --

       4      you know, being able to provide these services in

       5      non-traditional, non-licensed buildings, because

       6      that's what you're talking about, would, just, in

       7      the same way, put those services into where the

       8      people are and out of buildings.

       9             And both things can happen:  They can still

      10      be in the buildings, but they can also be out there.

      11             And, again, I use the example of, when

      12      I worked out in La Clinica in Pasco, Washington, we

      13      vaccinized [sic] 200 kids.

      14             Those 200 kids didn't come to Pasco,

      15      Washington.  We went out to Basin City, which,

      16      believe me, is about two buildings, and we lined up

      17      200 kids.  And we didn't ask what their immigration

      18      status is.  We didn't ask any of those questions.

      19             All we did is, we vaccinated those kids

      20      because they needed to be vaccinated.

      21             And -- now, did we save some money?  I'd like

      22      to think we did, because those kids didn't get sick.

      23             I don't know.

      24             All I'm saying is, that's the only way to get

      25      the services out there.







                                                                   86
       1             I worked in community mental health for many,

       2      many years.  And the most effective stuff you can

       3      do, I've done it in schools, is get out there and do

       4      the work in the places it's needed.

       5             CHRISTIE SPECIALLE:  We are an OASAS-funded

       6      organization, but being a prevention agency, we are

       7      not licensed under OASAS.  We are able to go into

       8      the jails and into the schools to provide our

       9      services.  It is not treatment-based.  It is

      10      education-based.

      11             However, in the treatment programs, I know

      12      that they provide a lot of education.

      13             Our problem is, our Tioga County Jail has

      14      been more than, you know, open to having us come in

      15      and provide education services.

      16             It's the lack of staff that we have to meet

      17      our community needs.

      18             Once all the heroin happened, the deaths in

      19      Tioga County, our phone wouldn't stop ringing with,

      20      What can you do?  What can you do?

      21             And being such a small organization, with our

      22      funding continuously getting cut, we are able to go

      23      into the jails, into the schools, and into the

      24      community, which is what we do, with a very limited

      25      number of staff.







                                                                   87
       1             SENATOR O'MARA:  At this time, we'll open it

       2      up for anybody in the audience.  Just raise your

       3      hand if you would like to --

       4             Yes, you in the front, if you could go over

       5      to the podium and use the microphone.

       6             And, sir, you can be second.

       7             DEB DiBARTOLO [ph.]:  Hi, my name's

       8      Deb DiBartolo [ph.]. I'm a family nurse practitioner

       9      in Tompkins County.  I do work at the

      10      Tompkins County Jail, but I'm not representing the

      11      jail.  I'm representing my own opinions here.

      12             One thing that I'd like to suggest, as far as

      13      the Suboxone-treatment program goes, is, right now,

      14      that's just opened for physicians to prescribe.

      15      It's not available for a nurse practitioner to

      16      prescribe.

      17             And as we see changes in health care, nurse

      18      practitioners are going to be our front line in

      19      primary care.

      20             Considering opening up that privilege to

      21      nurse practitioners so we have that available to

      22      more clients, to provide more treatment, might be an

      23      opportunity we might want to take a look at as a

      24      community.

      25             I'd also like to make a comment about the







                                                                   88
       1      importance to meet somebody who's withdrawing from

       2      their heroin or opiate, particularly when the

       3      opportunity arises.

       4             So many of my patients that I see, both in my

       5      community practice and at the jail, there comes a

       6      time in your addiction you're not using anymore to

       7      get high or to have fun.  You're using so you don't

       8      get sick.

       9             And we miss huge opportunities, both in the

      10      hospital and at the jail, and even at the clinic

      11      level, not because we don't care, but because we

      12      don't have the funding to manage this.

      13             And, in fact, if I have somebody coming in

      14      dopesick, I have nothing to offer them except some

      15      clonidine, which is, essentially, not very

      16      effective.

      17             If I have any opportunity to get them to

      18      treatment from where I live, I usually have to send

      19      them to Syracuse for an inpatient treatment.

      20             Hospitals generally do not admit patients for

      21      opiate withdrawal.  It is not considered a

      22      life-threatening event.  But, we miss a huge

      23      opportunity.

      24             And if we miss that opportunity, we're

      25      sending these folks back out on the street to use







                                                                   89
       1      again, just to prevent being dopesick.  And laying

       2      and puking and having leg cramps and bone pain and

       3      diarrhea and sweats and chills for four or five or

       4      six days is an immiserating, immiserating

       5      experience.  And no one wants to go through that.

       6             And that does happen in the jails, as well,

       7      unfortunately, and I have seen it at every jail I've

       8      worked at, from Rikers Island, right straight up

       9      through Upstate New York.

      10             So intervention, at some point, whether we do

      11      a temporary Suboxone taper, have that available in

      12      the jail, or some other humane way to help these

      13      folks, and not miss this opportunity to bring them

      14      into treatment and let them know we're on their

      15      side, instead of just constantly shutting doors.

      16             When we shut doors and we say, "This problem

      17      is your problem," we wouldn't say that to a diabetic

      18      coming into a hospital with hyperglycemia.

      19             I don't know why we're saying that to our

      20      substance-abusers who are coming into, trying to

      21      seek my help and my care.

      22             And I think it's just very shameful of us, as

      23      a society, that we're doing that to other members.

      24             I'd like to say, about the I-STOP program,

      25      I think it's been very effective.







                                                                   90
       1             Just in the past nine months I've been using

       2      it in private practice, I have seen a significant

       3      decrease in the number of patients coming into my

       4      clinic seeking opiate medications.

       5             It, uhm -- it's not the panacea, obviously.

       6      People that are getting drugs in Pennsylvania, and

       7      stuff, are getting prescriptions still down there,

       8      I can't search them down.  But I have seen a

       9      significant decrease in the number of clients I'm

      10      seeing.

      11             Where I do see we still have a problem,

      12      though, HIPAA, a good idea gone bad.

      13             The nature of substance-abuse disorder itself

      14      is secrecy.  And, the fact that I can't share

      15      information freely, even though it does protect

      16      people's rights, sometimes does prevent me from

      17      getting what I need to assure that I'm not enabling

      18      an addiction, as well.

      19             So, HIPAA, good idea gone bad.  Maybe

      20      something we need to work on in the future as far as

      21      substance-abuse treatment.

      22             The other thing, one more thing I'd like to

      23      say is, life-skills treatment in the jail I think

      24      would be very effective.

      25             Monroe County Jail, there's actually







                                                                   91
       1      published literature, evidence-based published

       2      literature, on the program that they're doing there,

       3      where they do a transitional-care program.

       4             They start in the jail, transition to the

       5      community, and then go back for re-enforcement after

       6      people graduate from that program, has been shown to

       7      be effective.

       8             As far as I know, it's only the Monroe County

       9      Jail that's using that model for their treatment for

      10      folks that are being released.

      11             But it's a good opportunity, with

      12      evidence-based practice to support it, that we might

      13      want to look at in the future.

      14             Thank you.

      15             And you guys rock.  Thanks for doing a good

      16      job.

      17             SENATOR O'MARA:  Thank you.

      18             Thank you for being here.

      19             Yes, sir.

      20             KEN:  Hello, my name is Ken, and I'm a

      21      patient at Trinity of Chemung County.

      22             And a few things I want to touch on that you

      23      guys talked about, the Assemblyman here, he was very

      24      correct that OASAS needs to lift some of its

      25      restrictions to allow people to practice off of







                                                                   92
       1      site.

       2             I know at the jails, I've been there a few

       3      times myself, and the thing about jail is, when

       4      there's a few people that are trying to do right and

       5      go to these AA programs, and stuff, you are then put

       6      back in a population with a lot of people that are

       7      not; that don't want to do that, don't want to get

       8      clean and sober.

       9             And the mentality you end up leaving jail

      10      with is not a positive one.

      11             If the jailers, I mean, if it was possible to

      12      separate the people who were trying to do this and

      13      put them on a different block, I believe that would

      14      help a lot.

      15             I know it would have helped me a lot when

      16      I was there, from the people that are just talking

      17      about getting out and wanting to use again.

      18             A few other things I wrote down here while

      19      you guys were speaking:

      20             The prosecutors:  I know that, when I got

      21      into trouble, it was very easy to talk my way into a

      22      short sentence.

      23             Even though it was my fourth or fifth time

      24      caught stealing for drugs, I was -- very easily

      25      could talk my way into a 60-day sentence.  I was







                                                                   93
       1      back out on the street in 40 days.

       2             I believe that if we gave longer sentences,

       3      with probation on the back end of it, with mandatory

       4      AA meetings and NA meetings, it's the greatest

       5      resource I have today, is AA and NA meetings.  It's

       6      what really keeps me sober, and they're completely

       7      free.

       8             Just, I don't believe 40 days is enough

       9      for -- to break a habit.  Longer sentences are

      10      critical, I believe.

      11             I know they're talking about it, but

      12      drug-testing people on social services is huge.

      13             A lot of these addicts, they live for free

      14      off the State.  And all the money they have, they

      15      spend on drugs.

      16             I mean, if they're not able to pass a drug

      17      test, I don't believe that their rent should be

      18      paid.

      19             I know I lost a job.  And it wasn't until

      20      I lost everything in my life: my family, my house,

      21      my job.

      22             Uhm, I lived in a tent for a long time in

      23      Ithaca, and, in order just to keep using.

      24             But, I mean, encourage family members of

      25      people who are using to cut them off.







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       1             I mean, it sounds harsh, but it's the only

       2      thing that gets to people, is when you have nothing

       3      left, is only when you will recover.

       4             Just a few more things.

       5             I know that there's a -- some of these drug

       6      houses, the landlords, they know what's going on.

       7             In particularly, I know there's a house down

       8      on Gray Street, and the landlord, she only allows

       9      drug dealers to manage the house, you know, because

      10      they pay her, and, you know, she ends up with larger

      11      pockets because of it.

      12             And I believe there should be stiffer

      13      penalties, not only on people that know people are

      14      dealing drugs out of their house, but if they know

      15      people are using drugs in the house, and they're not

      16      getting them out of the house.

      17             I'm in the current process, I'm going to be

      18      closing on a house next week, on Third Street.  And

      19      I plan on putting in all my leases, that if there's

      20      any drugs or alcohol on the premises, that you will

      21      be immediately evicted within 10 days, because

      22      that's the quickest time I can do it by law.

      23             Because I do believe there needs to be more

      24      sober-living houses in the community that are not

      25      run by treatment facilities or anything like that.







                                                                   95
       1             Like, these landlords have the ability to

       2      make sure there are not drugs in these houses.  They

       3      just have to get up, you know, and go check on the

       4      houses every now and then, and they'll see, the

       5      activity is clear.

       6             If the house is not clean, and stuff like

       7      that, you know that people are not living correctly.

       8             And I know that needle-exchanges cost money,

       9      but, if we could make it so that the local

      10      pharmacies, they just send a list to the sheriff's

      11      department of people buying needles, you know,

      12      I believe it will give law enforcement a much

      13      clearer statement on, you know, who the drug users

      14      are -- in the community are, and make a it better

      15      available for them to crack down on them.

      16             That's all I have.

      17             Thank you.

      18             SENATOR O'MARA:  Thank you very much.

      19             ANDY DRAKE:  My name's Andy Drake.  I'm also

      20      a Trinity of Chemung County.

      21             Uhm, I believe one of the biggest things is,

      22      like, they said it's hard to get Suboxone doctors

      23      around here, but, like, my addiction started because

      24      of painkillers.

      25             I can go to the emergency room and tell them







                                                                   96
       1      I have a toothache or a backache, and they throw a

       2      prescription at me.

       3             Like, actually, I don't see how it's so hard

       4      to give medicine that is helping people get out of

       5      addiction, but, the addictive medicines themselves

       6      are so easy to get.

       7             And, also, like, with the hospitals, I went

       8      to St. Joe's for detox.  They kept me there for

       9      2 1/2 days, didn't give me any medicine, and then

      10      just let me go.

      11             And before I could get into a -- I went to

      12      Dick Van Dyke.  I had about a week in between where

      13      I was just out on the streets.  I ended up using

      14      again.

      15             Fortunately, I knew where to find Suboxone on

      16      the street so I wasn't using heroin.  But, like, it

      17      just seems like everywhere around here.

      18             Like, you can -- I can walk down the street,

      19      still, and find heroin in probably a half hour.

      20      Like, that's definitely, it's all over.

      21             Unfortunately, Elmira, too, is in the middle

      22      of every major city.  Philly, all of them, like, you

      23      can drive two hours, each way, and get it.  But,

      24      like, it's definitely everywhere around here.

      25             Besides that, Ken pretty much said everything







                                                                   97
       1      else.

       2             But, uhm -- like, definitely, the detox,

       3      like, centers, like, there's nowhere around here to

       4      really go for that.

       5             And, Suboxone, that's just, like, I know

       6      three or four people that died from heroin, that

       7      were trying to get into Trinity, but the Suboxone

       8      doctor couldn't take on anymore clients.

       9             So, like, that's all I have.

      10             Thanks.

      11             SENATOR O'MARA:  Thank you very much.

      12             JOHN BARRY:  Good morning.  My name is -- oh,

      13      that's loud.

      14             My name is John Barry.  I'm the executive

      15      director of the Southern Tier AIDS Program.

      16             We actually operate two syringe-exchange

      17      programs.  We cover an 8-county area, and we have

      18      syringe-exchange programs in Broome County, and also

      19      in Tompkins County.

      20             First of all, I wanted to let the elected

      21      officials know that I'm going to break from the herd

      22      here.  I'm not going to ask you for any money.

      23                  [Laughter.]

      24             JOHN BARRY:  I would only ask for permission

      25      to offer the lifesaving services that we offer.







                                                                   98
       1             I also want to give you my thanks for

       2      recently passing legislation so that you can have a

       3      standing order, and people -- community-based

       4      agencies, like ours, can pass out Narcan and

       5      Naloxone kits to people, to prevent overdoses.

       6             Now, if you could do me one additional small

       7      favor, and get the Governor to sign that --

       8                  [Laughter.]

       9             JOHN BARRY:  -- so that we can actually pass

      10      them out more readily, I would be eternally

      11      grateful.

      12             I have one in my hand, one of those kits.

      13      The Department of Health supplies these to us.

      14             Had our medical practitioner been available

      15      today, you would all be receiving that training.

      16             So, again, my apologies for that, Senator and

      17      Assembly people.

      18             But, again, please speak to the Governor on

      19      that matter and I would be eternally grateful.

      20             We see here [unintelligible] users every day.

      21             Our programs were begun to prevent HIV and

      22      hepatitis C, and we saved the taxpayers of New York

      23      a lot of money because of that.  Okay?

      24             So much money, and our programs have been

      25      found to be so effective, that, actually,







                                                                   99
       1      New York State has submitted paperwork to the

       2      federal government to make our services

       3      Medicaid-reimbursable.

       4             Don't take my word for it.  Look at the

       5      actions of New York State.

       6             In addition to preventing those infections,

       7      we take infected injection equipment off the street

       8      and dispose of it appropriately.

       9             We don't want the trash collectors to get

      10      stuck.

      11             We certainly don't want our law-enforcement

      12      officers to be stuck with a used needle while

      13      they're searching somebody.

      14             We provide opioid-overdose kits, as I pointed

      15      out, containing Narcan; train people how to use them

      16      appropriately to save a life.

      17             We refer people to treatment, and we assure

      18      that they get there.  It's one of the most important

      19      services we offer, in our opinion.

      20             And we're there every day when people come

      21      in, to say:  Have you had enough yet?  Is it time to

      22      go to treatment?  We can make that happen.

      23             And, finally, this is a cost-effective

      24      intervention.

      25             If we can prevent two people a year from







                                                                   100
       1      becoming hepatitis C-positive, we can pay for both

       2      of our syringe-exchange programs, all the staffing,

       3      all the supplies, all the disposal fees...all of it;

       4      the whole shebang.

       5             Now, I know there's some controversy around

       6      what we do, and I accept that as a piece of my job,

       7      but, I think that this thing has gotten so out of

       8      hand, that we probably need to reach out and take

       9      the help of anybody who wants to offer it.

      10             Thank you.

      11             SENATOR O'MARA:  Thank you.

      12             RICK HUGHEY [ph.]:  Good morning.

      13      I'm Rick Hughey [ph.].  I live in Schuyler County.

      14             I'm a retired correction officer with

      15      New York State.  I worked 20 years at

      16      Monterey Shock, which was a drug-treatment program.

      17             The State's slowly dismantling it.

      18             There's 600 beds there, capable of putting

      19      600 guys through that program.

      20             Saved a lot of lives.  I gave people a lot of

      21      discipline, a lot of motivation.

      22             I've heard today:  Drug epidemic.  Crime

      23      epidemic.

      24             We're going to have an epidemic of needing

      25      treatment programs and correctional facilities







                                                                   101
       1      again, so, why New York State's chosen to close one

       2      of the finest, that the Governor referred to as

       3      "groundbreaking" on the 25th anniversary a couple

       4      of years ago, I don't understand it.

       5             It's there, it's ready to go.

       6             In 2 1/2 months, it will be surplus property

       7      sold.

       8             And I think it's just wrong.

       9             They had one of the finest treatment teams in

      10      this region, and it's going to be gone if we don't

      11      save it.

      12             And you guys in Albany I know have been

      13      making the case.

      14             And we could be proactive and keep ahead of

      15      this heroin and opiate epidemic, let alone meth and

      16      everything else, by keeping this treatment program

      17      going.

      18             Thanks.

      19             SENATOR O'MARA:  Thank you.

      20             Thank you for your continued advocacy of

      21      Monterey.

      22             As you know, we've worked hand-in-hand

      23      against the closure of that, and we continue our

      24      efforts, and will continue.

      25             Everyone on this panel, and more in Albany,







                                                                   102
       1      understands the value and the importance of that

       2      program, and certainly the usefulness of Monterey in

       3      what could be very effective programs in our

       4      corrections department, to continue.

       5             So our work is not done in that regard, and

       6      we will continue that effort.

       7             Thank you.

       8             KEN:  Thank you, gentlemen.

       9             DA JOSEPH FAZZARY:  I think it's still

      10      morning.

      11             Good morning.

      12             My name's Joe Fazzary.  I'm the

      13      Schuyler County District Attorney.  I've been in

      14      that position now for over 16 years.

      15             We've talked about education, prevention,

      16      prosecution.

      17             I happen to work on all three of those

      18      fronts.

      19             My question really, today, is for Chris.

      20             Because, one of the things that I've done for

      21      the last 16 years, is go into every school district

      22      in Schuyler County, I've also done this at Corning

      23      Community College and Elmira College; going into the

      24      schools and talking to the kids about the really bad

      25      things that can happen with drug abuse.







                                                                   103
       1             My question to Chris is:  If you had somebody

       2      like me, or some of the other educators that are

       3      here, that got to you either in the middle school or

       4      in the early part of high school, would that have

       5      prevented you from getting into this addictive habit

       6      of heroin?

       7             CHRIS:  I think that would have been a big

       8      help.

       9             DA JOSEPH FAZZARY:  All right.

      10             And I guess my next question is:  Instead of

      11      having somebody like me standing there, trying to --

      12             And our biggest problem is methamphetamine,

      13      and so I try to tell the children:  This is what

      14      you're putting in your body.  This is what goes into

      15      making methamphetamine, and, the battery strips --

      16      the lithium-battery strips, the Coleman fuel...all

      17      of that stuff.

      18             Would it be better if, as educators, we were

      19      able to bring somebody like you, somebody like these

      20      two guys, into the schools, and be able to say,

      21      "This is what happened to me.  This is what happened

      22      to my life," would that have helped you more than

      23      just having somebody like me talk to you and show

      24      you on a projector, "These are the things that

      25      you're putting in your body?"







                                                                   104
       1             CHRIS:  Absolutely.  The story is written on

       2      the person.  You can see it.

       3             DA JOSEPH FAZZARY:  Right?

       4             I mean -- so I think that the point, Senator,

       5      is, we have throughout the state these education

       6      programs, but I think that we probably need some

       7      greater resources to be able to get to these kids

       8      earlier.

       9             And I'm not sure what the age is.  I don't

      10      know when we should start.

      11             I've gone as low as fourth grade, talking

      12      about drug abuse.

      13             And I've had a classroom of elementary-school

      14      kids raise their hands and say that they knew what

      15      marijuana was, and that they had seen marijuana in

      16      their household.

      17             About 100 kids, having about 5 that said they

      18      didn't.

      19             Now, did they all raise their hands because

      20      everybody else was raising their hands?  I don't

      21      know, but, numerous kids knew what marijuana was.

      22             And I went -- I took it a step farther, and

      23      asked:  Has anybody ever seen cocaine in their

      24      house?

      25             I probably had 10 kids say that they had seen







                                                                   105
       1      cocaine.

       2             So, I'm about the education.

       3             I've done the education, I've done the

       4      drug-treatment court, and I've done the prosecution.

       5             The prosecution, to me, is the last resort.

       6      That's for the people that, you know, we've tried to

       7      educate and weren't able to treat; or, you know,

       8      maybe they're just not ready to be treated.

       9             But -- so I throw that out for the people who

      10      that the education, and ask for your thoughts:

      11             When do we start, and what do we need to do?

      12             How do we get guys like Chris and these

      13      two gentlemen to come and help us?  Because they're

      14      the living examples.

      15             CHRISTIE SPECIALLE:  We can start our

      16      programs as low as in preschool.

      17             When we work with the lower-age range, we're

      18      focusing more on life skills, making good decisions,

      19      and things like that, before we actually get into

      20      touching on drugs or harder substances.

      21             But we can start, absolutely, at the

      22      preschool level.

      23             As far as getting, you know, people in

      24      recovery, we do; we have people that reach out to us

      25      offering that service.







                                                                   106
       1             Then we have to be careful, bringing that

       2      into the school.  A lot of times, we have to have

       3      background checks in order for educators to come

       4      into the school.

       5             And we also need to make sure that, you know,

       6      these people have been in recovery for a decent

       7      amount of time before we're bringing somebody to

       8      talk.

       9             Furthermore, it's a very slippery slope when

      10      we are doing that, because we don't want to send the

      11      impression that, Well, this person turned out okay.

      12             So it is -- and we've used it before.

      13      Colleen has used First Stop DWI; somebody who has

      14      suffered consequences.

      15             And I do think that it can be good.  It just

      16      is, it needs -- we need to be careful with the way

      17      we use it.

      18             SENATOR NOZZOLIO:  My frustration, is that

      19      all of us have supported the D.A.R.E. program.  The

      20      officers have been throughout our sheriffs'

      21      departments.  The district attorneys have been

      22      supportive of an educational program.

      23             I think, Mr. District Attorney, you hit it on

      24      the head.  We're hearing this time and again, that

      25      the only education really of value, apparently, on







                                                                   107
       1      this subject, is peer-to-peer.  And that when

       2      peer-to-peer is saying, "This is okay," then we have

       3      a very, very difficult process.

       4             We, as part of this Task Force, are going to

       5      try to help reevaluate all the drug-education

       6      programs.

       7             As good as they have been, I think the

       8      statistics certainly bear out, they have not worked

       9      regarding this heroin epidemic.

      10             And, that, I asked a young man about Chris's

      11      age in our New York City hearing, "Why did you turn

      12      to heroin?"

      13             And he indicated that -- and here's a young

      14      man of -- from a upper middle-class family, who had

      15      no real -- none of the real pressures of economics

      16      or other involvement -- he just said he was

      17      experimenting, and that one use of one medicine or

      18      drug led to another.

      19             And, how we stop that experimentation

      20      process, we certainly would welcome you.

      21             I praise you for what you do in trying to

      22      educate our young people.

      23             But, we need to find alternative ways that

      24      are, frankly, more effective in this area.

      25             And thank you for raising the issue.







                                                                   108
       1             Thank you for your work.

       2             DA JOSEPH FAZZARY:  Thank you.

       3             WILLIAM RUSEN:  [Inaudible] we've actually

       4      done this at the Dryden School, Trumansburg, and

       5      Spencer Van Ettan.

       6             And I'll be glad to volunteer and go up to

       7      Watkins Glen.  All we have to do is set up a time.

       8             There's a lot -- there's is a great place

       9      that's -- I stand second to none in my belief in

      10      evidence-based practices.

      11             I also believe there are some other things

      12      that we can do, from time to time, that are helpful

      13      in augmenting evidence-based practice.

      14             CHRISTIE SPECIALLE:  OASAS is cracking down

      15      and getting more strict upon the use of us using

      16      evidence-based programs and practices, too.

      17             SENATOR O'MARA:  All right, well, thank you

      18      all very much.

      19             We've exceeded our allotted time.

      20             I thank everybody for their participation in

      21      this very important issue, and look forward to our

      22      completing these forums around the state, with

      23      Mike Nozzolio and Senator Phil Boyle's leadership on

      24      this Committee, to come up with a package of

      25      proposals that will, hopefully, help all of us in







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       1      our various aspects of this epidemic we're facing.

       2             And, thank you all for coming here today.

       3             SENATOR NOZZOLIO:  Thank you, Senator O'Mara,

       4      and all of you for your participation.  It's very,

       5      very helpful.

       6             SENATOR O'MARA:  Have a great day.

       7

       8                  (Whereupon, at approximately 12:01 p.m.,

       9        the forum held before the New York State Joint

      10        Task Force on Heroin and Opioid Addiction

      11        concluded, and adjourned.)

      12

      13                            ---oOo---

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