R0undtable Discussion to Examine the Issues Facing Communities in the Wake of Increased Heroin and Opioid Abuse

1 NEW YORK STATE JOINT SENATE TASK FORCE

ON HEROIN AND OPIOID ADDICTION 2 ---------------------------------------------------- 3

R0UNDTABLE DISCUSSION 4

TO EXAMINE THE ISSUES FACING COMMUNITIES 5

IN THE WAKE OF INCREASED HEROIN AND OPIOID ABUSE 6 7 ---------------------------------------------------- 8

Chenango Valley High School 9 221 Chenango Bridge Road

Binghamton NY 10 11 April 13, 2016

4:00 p.m. to 6:00 p.m. 12 13 PRESIDING: 14 Senator Frederick J. Akshar, II, Sponsor 15 Senator George A. Amedore, Jr., Chair (not present) 16 Senator Robert Ortt, Chair 17 Senator Terrence Murphy, Chair 18 19 20 21 22 23 24 25 1

SPEAKERS:2

Lisa Bailey 3 Parent and Founder of Valley Addiction and Drug

Education (ADE) 4

John Barry 5 Executive Director/Southern Tier AIDS Program (STAP) 6 Michael John Barton

President/Dreams Over Drugs Foundation 7

Stephen Cornwell, Jr. 8 Broome County District Attorney 9 Ernest Cutting, Jr.

Chenango County Sheriff 10

George Dermody 11 President & CEO/Children's Home 12 Patrick Garey

Captain/New York State Police, Troop C 13

Jill Alford-Hammitt 14 Substance Abuse Prevention Program Manager/Lourdes

Youth Services 15

Gary Howard 16 Tioga County Sheriff 17 Art Johnson, CSW

President - New York Public Welfare 18 Association/Commissioner - Broome County Departments of

Social Services and Mental Health 19

Joseph McBride 20 Chenango County District Attorney 21 LuAnn Natyshak

Pastor/Inside Out 22

Kathleen Newcomb 23 Captain/Broome County Sheriff's Office 24 Dr. Keith Nichols

Family Medicine 25 1 SPEAKERS (Continued): 2

Honorable William Pelella 3 Binghamton City Court Judge 4 Carmela Pirich

Executive Director/Addiction Center of Broome County 5

Ruth Roberts, LCSW-R 6 Director of Community Services/Chenango County

Community Mental Hygiene Services 7

Dr. Christopher Ryan 8 Medical Director/Broome County Health Department 9 Barry Schecter, MSW, CASAC-R

Chronic Pain and Addictions Counselor/Keith Nichols 10 Family Care 11 Ray Serowik

Broome County EMS Coordinator 12

Penny Stringfield 13 Parent 14 Alan Wilmarth

UHS Administrative Director of Behavior Health 15

Joseph Zikuski 16 City of Binghamton Police Chief 17 18 19 20 21 22 23 24 25 1 SENATOR FREDRICK ASHKAR II: Okay, everyone, 2 I think we'll get started. Good afternoon and thank 3 you for joining us. I'm Senator Fred Akshar, and it 4 is an honor and privilege to be here representing 5 this great community in the New York State Senate, 6 and I want to welcome you all to the Roundtable 7 Forum of the New York State Senate Task Force on 8 Heroin and Opioid addiction. 9 I would like to thank Superintendent David 10 Gill. I'm not entirely sure if he's in attendance 11 but -- there you are. Superintendent, thank you 12 very much for your leadership in this community, and 13 your steadfast friendship, quite frankly, when I was 14 in law enforcement, and our friendship continues 15 while I'm in the New York State Senate. I thank you 16 for that. I promise you we'll do our best to be out 17 of your here by 6:00 p.m. 18 As many of you know, this heroin epidemic is 19 something that's near and dear to my heart. As a 20 15-year member of law enforcement, I spent a 21 considerable amount of time working in the 22 undercover narcotics world, and I have seen 23 firsthand how this scourge has ruined loving 24 families, and I myself admit that at one point in my 25 career, I thought that enforcement was the key to 1 solving this solution. 2 But as I grew in my own career and educated 3 myself, clearly we know that that's not important. 4 I applaud the work that law enforcement does, quite 5 frankly, on a daily basis. 6 The men and women in uniform work extremely 7 hard to deal with this issue, but, it is clear to 8 me that we need to do more by way of education, 9 prevention, treatment and most importantly, support 10 for families. 11 Even more importantly, I think is ensuring 12 that folks who need treatment have proper access to 13 treatment. I have said often, and many of you have 14 probably heard me say that this is a community issue 15 that requires community response. And parents, 16 families, schools, law enforcement, treatment 17 providers, and the government all have important 18 roles to play. 19 I think it is important to say this now, that 20 it is incumbent upon all of us sitting at this table 21 and everybody who is involved in this community to 22 set our political differences aside and our 23 personalities aside. Because if we don't do that, 24 we're going to stifle progress. 25 And it is critically important to the people 1 that we're trying to help that we don't allow that 2 to happen. And that's quite frankly what brings us 3 here today. 4 We have an outstanding panel of local 5 stakeholders here to discuss their roles in 6 combating this epidemic and I am pleased to be 7 joined by two of our task force co-chairs, Senator 8 Terrence Murphy, who is currently traveling. He'll 9 join us as soon as he gets here from Westchester 10 County. And Senator Rob Ortt from Western New York. 11 Senator Ortt, thank you very much. And our good 12 friend and neighbor from the west, Senator Tom 13 O'Mara. 14 So today's forum, what we're trying to 15 accomplish is three things, to explore what's 16 working locally, in our battle against heroin, 17 number two, to identify what gaps in service remain, 18 and I think we all understand that there are gaps 19 that need to be filled. And to discuss what we can 20 do at this state level to help to reduce barriers to 21 care and strengthen our approach at the state level 22 to addiction. 23 Oral testimony is limited to those on the 24 panel today. However, I recognize that there are a 25 lot of people in the audience who have been touched 1 by this epidemic and are equally qualified to speak 2 on the subject. There simply isn't enough time, nor 3 is there enough room on this stage. 4 If you've prepared written remarks, please, 5 do your best to put them in the box out front in the 6 table that says written remarks. Also, you'll find 7 the written remarks section here. 8 You can fill that out while you're here or 9 take it home and mail it to my district office, or 10 of course, you can visit our website, 11 akshar.ny.senate.gov to provide your written 12 testimony. 13 The only thing I ask is that if you're going 14 to provide written testimony, you do so by April 20, 15 because the members of the task force need some time 16 to digest that and put it all together. 17 And, finally, if you would like to receive 18 legislative updates as to what the task force is 19 doing on a daily and weekly basis, I ask that if you 20 don't put any written testimony, you simply put your 21 contact information, and we'll ensure that you stay 22 up to date. 23 Before we get started, I want to take a 24 moment to recognize some special guests who are with 25 us in the audience today. First and foremost, most 1 importantly, are the courageous men and women on my 2 heroin advisory committee. 3 I thank you folks for your willingness to 4 come and see me on a regular basis. Your 5 willingness to share your stories, and the trials 6 and tribulations that you have been faced with in 7 your lives, because quite frankly, it continues to 8 allow me an opportunity to educate myself, and it 9 affords me an opportunity to craft my personal 10 legislative agenda. 11 Assemblywoman Donna Lupardo, Assemblyman 12 Clifford Crouch, City of Binghamton Mayor Rich 13 David, County Executive Debbie Preston, members of 14 the Broome and Tioga County Legislatures, including 15 Tioga County Chair Marte Sauerbrey. Marte, thank 16 you for being with us today. Chenango Valley's Yes 17 Leaders and their adviser Matt Stanton, and leaders 18 from the Tioga County Council on Alcoholism and 19 Substance Abuse in the Broome Opioid Abuse Council. 20 So I thank each of you for coming. 21 Without further ado, I want to introduce my 22 colleagues from the New York State Senate. Senator 23 Ortt, I'll start with you. Do you want to make some 24 brief of opening remarks? 25 SENATOR ROBERT ORTT: Yeah, and I'll be very 1 brief, because we want to get to our panelists at 2 our roundtable here. 3 But this is my seventh hearing or roundtable 4 discussion that I have attended since being a member 5 of the task force around the state. I've had one 6 many my district, in Niagara County, I have been to 7 Long Island just last week. I have been to 8 Penn Yan, I have been to Rochester, Albany. 9 And while there are differences in each of 10 those areas, sometimes significant, there are a lot 11 of similarities and themes that you hear. In fact, 12 it almost gets to the point for me that I couldn't 13 tell you where I was, because you start to hear the 14 same issues over and over and over again as it 15 relates to this epidemic. 16 You hear the heartbreaking stories from 17 moms and dads. You hear the challenges that law 18 enforcement are facing every day trying to keep up 19 with this epidemic. And you hear from -- a lot of 20 times from the providers who are on the front lines 21 of this, trying to get people -- they can't get 22 people in fast enough. There's a waiting list. And 23 there's a lot of challenges. 24 So as my colleague Senator Akshar said, who I 25 want to thank, by the way, for doing this and 1 putting this together. Even though I have been 2 around the state, we've done six or seven or eight, 3 they haven't happened in every district. 4 And the fact of the matter is, there are 5 certain Senators who have really made the push and 6 focused on this and brought people in their 7 community together to hear from them, and as he 8 said, this helps us better represent you, and helps 9 us craft real reform and real legislation that makes 10 a difference. 11 And so I want to thank him for doing this. I 12 want to thank my colleagues on the task force, 13 Senator O'Mara for being here as well. 14 And you know, there's not one thing that we 15 can do. I wish there was one thing that we could do 16 tomorrow that would make it all better. And I 17 realize, you know, depending on who you talk to, if 18 you talk to law enforcement, there might be one or 19 two things that they think you should do 20 immediately. 21 If you talk to providers, there might be one 22 or two things they think you should do talk to 23 family. The bottom line is, it is going to take 24 several reforms, both resources, and I'm proud to 25 say we just secured an additional new $25 million in 1 the recently-enacted budget specifically focused to 2 combating heroin and opioid abuse, specifically. 3 That is a part of 166 million overall funding 4 in the budget that goes to combating substance 5 abuse, heroin, opioids, alcohol and the like. 6 So were it not for these hearings, were it 7 not for many of you in the audience, and were it not 8 for my colleagues up here, that $25 million would 9 not be in the budget this year. So we're clearly 10 making strides, we're making progress. 11 It's a start. But there are things that we 12 need to do beyond resources. You know, we need to 13 make sure that access to treatment is a real 14 priority. Almost treatment on demand. You know, if 15 somebody comes and says I need treatment, I'm a 16 heroin addict, I need treatment, you can't say come 17 back in a month, because you're probably not going 18 to see that person again. 19 And I also think we, on the law enforcement 20 side, really zero in on the dealers who are using 21 Fentanyl and cutting up the heroin with Fentanyl. 22 Fentanyl, for those that don't know, is extremely 23 lethal, and I'm sure we're going to hear about that 24 after today. That is one of the biggest reasons 25 you're seeing the amount of deaths that you're 1 seeing as it relates to this epidemic because of the 2 Fentanyl. It is 40 times more lethal than heroin. 3 And there are dealers who are knowingly -- in 4 fact, there was a dealer in Buffalo not far from 5 where I represent, he actually had Fentanyl and he 6 was cutting it up with heroin. In my opinion, 7 that's akin to murder, the same as if he went up and 8 shot somebody, because he darned well knows when he 9 sells that bag of Fentanyl to somebody, it is highly 10 likely you'll never see that person again. 11 So there's a lot of things we can do, and 12 there's going to be some differences certainly as we 13 go forward on the proper course. But I think if we 14 come up with a comprehensive package of reforms, and 15 I know we're going to do this session along with the 16 resources we have in the budget, we're going to 17 save lives, and we can really put a stop to this 18 epidemic. 19 So I want to thank all of you who are here 20 today for the courage, for taking ownership of it as 21 a community, and I want to thank the folks who are 22 up here as well. 23 SENATOR FREDRICK ASHKAR II: Thank you very 24 much, Senator Ortt. Senator O'Mara. 25 SENATOR THOMAS O'MARA: Thank you, Fred, and 1 thank you for having this forum here today. 2 As Fred said, I represent the district of the 3 immediate west of Tioga County. I include Chemung, 4 Tomkins, Yates, Schuyler and Steuben Counties in my 5 district, so it's wide ranging. It's suburban, it's 6 small cities, it's rural. 7 And this issue of heroin abuse and addiction 8 is affecting everybody. It's not just an urban 9 problem, it's not a suburban problem, it's not a 10 rural problem, it's not rich or a poor problem. 11 It's affecting all socioeconomic classes like 12 nothing I have ever seen before. 13 And the additional fund in this year's budget 14 bringing our total spending up to $166 million 15 towards addiction programming is very important. 16 But as the Senators have said, money is not the 17 whole answer. And it's going to take the whole 18 community's involvement to work on this issue at all 19 levels. 20 Not just with money, but with community 21 involvement to tackle this from where we need to be, 22 improving our methods on prevention, improving our 23 treatment to access for detoxification and inpatient 24 treatment beds that are woefully lacking across the 25 state that we need to make improvements on, and I 1 really look forward to the input that we get from 2 those on the panel here today and thank you all for 3 participating. Thank all for coming and taking time 4 out of your day to be here and get involved in this 5 important issue. 6 You know, I am a former district attorney, 7 where I worked as an Assistant DA in Manhattan, and 8 as District Attorney in Chemung County, and I firmly 9 believe that this is not an issue that we are going 10 to arrest, prosecute and jail our way out of, no 11 matter how strong and how good our law enforcement 12 is on these issues. It's just -- it's an addiction 13 problem, it's a health problem that we're going to 14 need to deal with more than just the crime basis 15 that by increasing improvement to access. 16 You know, I have three teenaged children, and 17 this issue really scares the hell out of me in 18 looking at my three kids that certainly, I think, 19 are good kids. 20 But I've seen so many stories in these task 21 forces that we have had around the state of mothers 22 and fathers talking, sisters and brothers talking 23 about individuals that have gotten wrapped up in 24 this addiction so easily, and many times as a result 25 of opioid pain killers given as a result of surgery 1 or other health problems that lead to this addiction 2 and causes people to then turn to heroin, because 3 frankly, it's cheaper and easier to get. 4 So you know, we have to look at the criminal 5 problems, as I said, as a former District Attorney 6 and firmly believe in increasing our ability to go 7 after the dealers that peddle this scourge to our 8 citizens, to increase penalties for that, 9 particularly those where it involves a death. 10 Senator Ortt said, in going after that, and 11 we've been pushing for legislation to do that and 12 have passed that in the Senate last year and this 13 year, and we will continue to work on trying to get 14 that through the other house of the legislature and 15 before the Governor. 16 But, really, it's a problem of prevention and 17 treatment that we're all looking forward to your 18 input here today, and thank you for having me here 19 today, Fred. 20 SENATOR FREDRICK ASHKAR II: Senator O'Mara, 21 thank you very much. What I would like to do in 22 terms of making sure that everybody in the audience 23 knows who everybody on the panel is, Dr. Ryan, if 24 I could start with you, just simply introduce 25 yourself, and, you know, title and who you're with, 1 and we'll work our way around the table and we'll 2 start our discussion. 3 Dr. CHRISTOPHER RYAN: Great. I'm Chris 4 Ryan, I'm the Medical Director at the Broome County 5 Health Department. 6 RUTH ROBERTS, LCSW-R: I'm Ruth Roberts. I'm 7 the Director of Community Services in Chenango 8 County, responsible for the planning and oversight 9 of the three disabilities, mental health, 10 developmental disabilities, and substance abuse. 11 JOSEPH McBRIDE: My name is Joe McBride, I'm 12 the Chenango County District Attorney. 13 STEPHEN CORNELL, JR.: I'm Steve Cornell, 14 Broome County District Attorney. 15 HON. WILLIAM PELELLA: William Pelella, 16 presiding judge of the treatment drug court -- Drug 17 Treatment Court Program for Broome County, as well 18 as the Veterans Treatment Court Program for Broome 19 County. 20 CARMELA PIRICH: Carmella Pirich, Executive 21 Director of the Addiction Center of Broome County. 22 JOHN BARRY: John Barry, the Executive 23 Director of the Southern Tier AIDS Program. We 24 operate syringe exchange programs, so I'm the voice 25 of harm reduction on the committee. 1 JILL ALFORD-HAMMITT: Jill Alford-Hammitt, 2 with Lourdes Student Assistance Program. I'm the 3 Program Manager. 4 ALAN WILMARTH: Alan Wilmarth. I'm the 5 Administrative Director of Behavioral Health for 6 United Health Services System. 7 ART JOHNSON, CSW: Art Johnson, Broome County 8 Mental Health and Social Services Commissioner. 9 I've worked in the chemical dependency treatment 10 field for 37 years. 11 LISA BAILEY: I am Lisa Bailey. I am the 12 parent of a child with an addiction problem. I'm 13 also the founder of Valley Addiction and Drug 14 Education. 15 MICHAEL JOHN BARTON: I'm Michael Barton. 16 I'm Founder and President of Dreams Over Drugs 17 Foundation. 18 LuANN NATYSHAK: I'm LuAnn Natyshak, I'm a 19 pastor with Inside Out Ministries doing jail 20 ministry. 21 PENNY STRINGFIELD: I'm Penny Stringfield. I 22 am a parent who lost a child to a heroin overdose. 23 I'm also the co-president of the Addiction Center of 24 Broome County Board, and a board member of Truth 25 Farm. 1 Dr. KEITH NICHOLS: Keith Nichols, I have 2 been practicing family medicine in Owego for about 3 35 years. 4 BARRY SCHECTER, MSW-CASAC-R: My name is 5 Barry Schecter. And I'm a clinical social worker, 6 and I work with Dr. Nichols. 7 GEORGE DERMODY: I'm George Dermody, the 8 Chief Executive Officer of the Children's Home, 9 Wyoming conference. 10 CAPTAIN PATRICK GAREY: I'm Pat Garey. I'm a 11 Captain with the New York State Police, Troop C. 12 JOSEPH ZIKUSKI: Joe Zikuski. I'm the Police 13 Chief for the City of Binghamton, and along with the 14 Sheriff's Department, we have a narcotics task force 15 that consists of 15 investigators along with our 16 street crimes unit and additional seven officers 17 which are trying to fight this battle on our side. 18 CAPTAIN KATHLEEN NEWCOMB: Good afternoon. 19 My name is Kate Newcomb. I'm the Captain with the 20 Broome County Sheriff's Office. 21 SHERIFF GARY HOWARD: Gary Howard, Sheriff, 22 Tioga County. 23 ERNEST CUTTING, JR.: I'm Ernie Cutting, 24 Sheriff, Chenango County. 25 RAY SCROWIK: Ray Serowik, I'm the Emergency 1 Medical Services Coordinator for Broome County in 2 the Office of Emergency Services. 3 SENATOR FREDRICK ASHKAR II: Well, again, to 4 everybody, I say thank you for your willingness to 5 come here today and take time out of your busy 6 schedules and partake in this roundtable discussion. 7 With that said, Penny, if you would be so 8 kind to start the discussion and to everybody on the 9 panel, I want this to be as interactive of a 10 conversation as possible. So I'll try to lead the 11 conversation the best that I can, but as issues 12 arise, if you have something to say about a 13 particular issue that we're discussing, please, just 14 chime in and, Penny, you hold a very special place 15 in my heart, and I would love for you to discuss 16 this -- or excuse me, start this discussion. 17 PENNY STRINGFIELD: Thank you. As you hold a 18 very special part in my heart as well. 19 My son died in February of 2015, and he had 20 begun a group called I'm Dope Without Dope, and was 21 trying to work with and help people who were 22 struggling with the same addiction that he was. 23 When he died, I decided that the only thing 24 that I could do at that point was to continue his 25 voice. And I spoke at a forum at SUNY Broome, and 1 the next time I spoke, it was at a BOAC meeting, and 2 Senator Akshar asked me as a parent if there were 3 two things that I could accomplish by what I was 4 doing with my voice, I said it would be that I would 5 end the stigma of addiction and that I would do 6 everything in my power to make sure that we had the 7 proper treatment in our area that we need. 8 I think we've come a long way with the 9 stigma. And I think one of the reasons for that 10 is because the heroin face is very personal now. 11 Almost everyone knows someone who's been affected by 12 this. 13 I feel privileged that I have a voice as a 14 parent, and I have shared Johnnie's story for many, 15 many months to anyone who would listen. So if I 16 could have a minute, I have just three very short 17 stories of other parents who have lost their 18 children. 19 My son battled his opioid addiction for ten 20 years that started with a prescription for Oxycontin 21 for a football knee injury in high school. He 22 graduated college and was a successful chef. He was 23 charismatic and had an enormous heart. 24 He entered sobriety in jail in 2013 and 25 maintained it when he got out, living his life in 1 preparation to care for his son he was trying to 2 establish paternity of through family court. When 3 the baby was eight months old, the judge finally 4 ordered DNA tests. Two days later, the baby died. 5 My son lost his son and six months later my son lost 6 his life to a heroin overdose. 7 After a long struggle with opiate addiction, 8 Katie lost her battle. Katie was a passionate, 9 fearless and unconditional lover of those less 10 fortunate, always rooting for the underdog. Katie 11 loved the City of Binghamton. She was intelligent, 12 witty and complex. She had a special way with 13 words, and her favorite past time was sharing her 14 views and opinions on Facebook. Katie, you deserved 15 more, and the world was a better place with you in 16 it. You were one of a kind. 17 I don't need to read the last story because 18 it's Johnnie's. Johnnie was also compassionate, 19 loving, kind, he sang in the church choir. He 20 preached every Sunday on youth Sunday. He loved his 21 grandmother. He loved his sister and he loved his 22 dad. He loved me. He played sports. And he 23 struggled for five years with addiction, also after 24 having his acl replaced when he was a sophomore in 25 high school and became addicted to pain pills. 1 For many years, we worked tirelessly to get 2 Johnnie into rehab, and he would get into rehabs 3 over and over and over again, for three weeks, two 4 weeks, one week, outpatient. There was never enough 5 treatment and there was never local treatment, 6 comprehensive treatment for him. 7 I truly believe that some of our people who 8 are addicted probably are better if they can leave 9 their community. They need to get away from 10 everything. I don't think that about my son. 11 He also struggled with depression and 12 anxiety, and he needed his family, and his friends 13 and his church. And every time we sent him away, he 14 became more anxious and more depressed. 15 And what I'm asking right now over and over 16 and over and over and over again is, please, help us 17 to get the services that we need. 18 When I talk to parents that spend days and 19 weeks on the telephone calling places, begging 20 insurances, it's wrong. It's wrong. And the longer 21 that we don't do something about this, the more of 22 our children we're going to lose. Thank you. 23 SENATOR FREDRICK ASHKAR II: Penny, thank you 24 very much. 25 Lisa, if you wouldn't mind, as a parent, 1 speaking a little bit now. 2 LISA BAILEY: Sure. I tend to talk too much, 3 so I had to write it down to keep me quiet a little 4 bit. 5 Over two years ago, my husband and I started 6 up a community group called Valley ADE. Our group 7 provides support, information, education, and 8 referrals for families and addicts. We started it 9 because we know every emotion that comes with being 10 the parent of an addict. We know the loneliness, 11 the fear, the guilt, the sadness, the heart breaking 12 and heart wrenching emotions. We live it daily. 13 You see, we have a son who battles addiction. 14 We were the good parents, the present ones, the 15 tight-knit family. We had the white picket fence. 16 My son was very smart, top of his class, 17 basketball star. Unfortunately, that basketball 18 star status got him many concussions because he was 19 quite aggressive. His last concussion was labeled 20 as a traumatic brain injury. That's where the 21 initial drug use started. 22 His headaches were severe and the pain 23 medications were prescribed. Everything when 24 downhill from there and it spiraled out of control. 25 Things got bad, we were scared. My husband and I 1 would take turns sleeping out of fear. We lived in 2 disgrace, embarrassment and total guilt. We didn't 3 talk. You didn't tell anybody your problems. 4 At this point it was two years -- or it was 5 his senior year, and it was two days after his high 6 school graduation. 1:00 a.m. in the morning, we 7 find my son non-responsive and blue. My husband 8 grabbed him, held him, and begged him not to leave 9 us. 10 They found rat poison in his system. They 11 believe that his drugs were laced with rat poison. 12 He had total heart failure, kidney failure, lung 13 failure and was on life support. We were told to 14 say our good-byes to our only son. 15 However, he survived the unthinkable. That's 16 when I found out I had no clue what to do. I didn't 17 have the answers. I was the mom. I was supposed to 18 know what to do. 19 He walked out of that hospital with a 20 follow-up appointment for his heart and that was 21 all. No information on addiction, no information on 22 rehab, no information on detox, absolutely nothing. 23 We didn't know where to turn. 24 Countless hours at the computer with tears 25 streaming down our faces. Four overdoses later, a 1 family torn apart, a drained savings account, and 2 countless stolen -- or stolen money and family 3 heirlooms, here we are. 4 He has attempted inpatient, outpatient, 5 vivitrol, Suboxone, but every time he comes home, 6 the addiction is too strong for him. 7 During a tough time of addiction for my son, 8 I heard a very special speaker say to think about 9 your family in a boat. It's the parent's 10 responsibility to keep that boat calm. It's the 11 addict that wants to rock the boat and turn it 12 upside down. 13 She said sometimes, you have to protect your 14 family, and to do that, you have to throw your 15 addicted child out of the boat. I hated that boat 16 story, and I hated it that night. It goes against 17 my enabling personality. It goes against everything 18 a mom is supposed to do. 19 We got home that evening after we heard that 20 story to find our son passed out with his drug 21 paraphernalia beside him. I heard my husband 22 screaming. I took a couple of deep breaths and went 23 upstairs. My son finally came around, and I told 24 him very calmly and simply, to get out. I was done, 25 and I wanted my boat, I wanted my family back. 1 He is now in rehab in Florida. He's been 2 there a little over two months. Does he still try 3 to rock my boat? Absolutely. But my boat is not 4 going to tip anymore. I'm attempting to let go 5 without ever giving up on my son, without ever 6 giving up his hope. 7 But daily we fight addiction, and the stigma 8 and the demons associated with it. You've heard 9 that drugs do not discriminate. No child wants to 10 grow up to be that drug addict. Every addict is 11 somebody's child, somebody's brother, somebody's 12 sister, somebody's loved one. 13 I think one of the hardest things was giving 14 up who my child was. Giving up the hopes and dreams 15 I had for him, giving up that sweet innocent boy who 16 loved his basketball. 17 Our group over the past two years has helped 18 nearly 25 people get into rehab, referred countless 19 families to different counselors, and done a variety 20 of community services. We hold support groups for 21 families. But we need help. We are just volunteers 22 helping each other in our community. 23 We need to provide access to treatment and 24 long-term effective treatment options. We need to 25 provide information, resources, and education. 1 Drug addiction is an illness, and I think 2 that we are missing out on treatment opportunities 3 and options, especially for the families in our 4 area. There's treatment for all other diseases. 5 When you are discharged from the hospital, you're 6 given appointments and follow-up care for all 7 diseases, except addiction. When you walk out of a 8 hospital, after you have had an overdose, you walk 9 out. 10 We are missing the boat here. I'm so very 11 proud of our accomplishments. I am so very proud of 12 the group that we have here. I am so very proud to 13 live in New York State where we have people that 14 care about heroin addiction. But I still can't beat 15 my son's addiction for him. 16 I have learned ways to take care of myself 17 and my family. I reach out for help. I talk a lot. 18 I cry. And I pray. Drugs, again, do not 19 discriminate. Addiction happens in the white picket 20 fence families. And drugs affect not only the 21 addict, the mom, the dad, the grandparents and the 22 whole community. 23 But as a community, we need to pull together 24 because you can't just come to these forums and you 25 can't just listen to people speak, you have to do 1 something, and something is better than nothing. 2 Thank you. 3 SENATOR FREDRICK ASHKAR II: Thank you, Lisa. 4 I want to hit just a couple of things that were 5 brought up and then I'll move to Jill and Michael, 6 if I could, about community outreach. 7 But, Dr. Ryan, could you speak specifically 8 about maybe some statistical data about prescribed 9 prescription medication, specifically in our 10 district here that I represent? And I know that 11 we've probably had some type of conversation before 12 about that. The numbers are quite startling, are 13 they not? 14 Dr. CHRISTOPHER RYAN: I don't have any data 15 readily available on, say, for example, numbers of 16 prescriptions in our county -- you know, that's just 17 kind of recently begun to be monitored with the 18 I-STOP program. 19 SENATOR FREDRICK ASHKAR II: Art, can you 20 weigh in on the statistics? 21 ART JOHNSON, CSW: Yes, I can. This was 22 actually the first thing on my list to talk about. 23 If New York State doesn't further reduce the 24 unnecessary narcotics prescribed by doctors, 25 dentists and other practitioners, we are never going 1 to see this problem go down. 2 Last year, in Broome County alone, Medicaid 3 paid for over $900,000 doses of narcotics prescribed 4 by doctors, dentists and other prescribers. If you 5 add private insurance to this, there could have 6 been three million doses, pills, shots, patches, 7 everything together prescribed in Broome County. 8 If we could get a ten percent reduction, that 9 would be 300 doses of unnecessary narcotics out of 10 people's medicine cabinets. Every time I bring this 11 up, people in the room say, yes, you know, I have a 12 tooth extraction and the doctor gave me a month's 13 supply of Percocet. I only used up with day's 14 worth. Or I had a minor orthopedic procedure, and I 15 really did not want any medicine, and the doctor 16 gave me a month's supply of Vicodin. 17 New York State could also strengthen I-STOP. 18 This is a state regulation that requires doctors and 19 other prescribers to look up a patient in a database 20 to see if someone else is prescribing then 21 narcotics. I think that this is the single most 22 important intervention New York State has done to 23 reduce the number of new addicts coming up. But, we 24 need to do more. 25 Before I-STOP, before the I-STOP program, you 1 would have addicts getting prescriptions for 2 narcotics from three, four, five, six different 3 doctors. 4 This policy, again, more than anything else, 5 is preventing new people from becoming addicts. And 6 emergency departments, I think, should be required 7 to review -- to work with this database. They are 8 currently excluded, I believe. And I'm not sure 9 that anyone from the state is reviewing this 10 database, because I recently heard from an addiction 11 treatment provider that when they look up their 12 patients in the system, they can see that some of 13 the people had three, four narcotics and maybe a 14 Benzodiazepine like valium or some other 15 tranquilizer-type medication prescribed to them. 16 SENATOR FREDRICK ASHKAR II: Thank you. 17 Jill, can we -- just a little bit off topic, could 18 we talk about stigma and reducing that? Right, 19 Penny? I mean, that was one of the biggest things 20 that we try to accomplish especially -- 21 PENNY STRINGFIELD: Can I just quickly say 22 something about that? I think that I one of the 23 things that we're seeing, and the second story I 24 read was actually a local recent obituary. 25 When Johnnie died, we made a decision as a 1 family not to say that he had died unexpectedly. We 2 said that he had died from an overdose, and we asked 3 that as a legacy to him, that people reach out to 4 those around them that were struggling with the same 5 addiction. 6 And I think that the more that we do that, 7 the more that we talk to people, the more that we're 8 all honest, that is helping to lift the stigma, 9 because it's not another person, it's usually 10 someone that's very close to you and in your own 11 life. 12 SENATOR FREDRICK ASHKAR II: Very good point. 13 And I think in terms of helping to reduce 14 that stigma, it's -- I think we have a concerted 15 effort with -- in terms of community outreach. And 16 I think that as a community -- 17 PENNY STRINGFIELD: Yes. 18 SENATOR FREDRICK ASHKAR II: As a community, 19 I think we have done fairly good job at that. And, 20 Jill, I'll ask you to speak a little bit about what 21 you're doing and some of the activities that you've 22 been partaking in, some of the groups you're working 23 with. And, Michael, maybe you specifically can talk 24 about Dreams Over Drugs and what you have been able 25 to accomplish since you're been working in this 1 arena. So, Jill, would you talk a little bit about 2 that. 3 JILL ALFORD-HAMMITT: Sure. Thank you. Over 4 the past 14, 15 months, through the Broome Opioid 5 Abuse Council and Lourdes Student Assistance 6 Program, we have provided about 15 or 16 heroin 7 awareness events. A lot of them are made up of a 8 panel, much smaller than this. But we've also done 9 some different things. A roundtable format for 10 school personnel, out in Deposit. We have done 11 roundtable formats for parents and some of the local 12 school districts. 13 And we're looking at doing a debate-type 14 project between panel members and students to try to 15 pull students' interest into this subject. 16 I think that what we have done is we've done 17 is we've gotten people talking. I just came from a 18 meeting this afternoon with a gentleman from Endwell 19 who was incredibly moved by the heroin awareness 20 event that happened in Maine-Endwell. And he's come 21 up with an idea. 22 I have met with a member of the Endwell 23 rotary Monday who was also very moved and wanted to 24 learn more about this topic. And that's what I'm 25 hearing people say. They're talking about it, 1 they're finding out about other people who are 2 affected, and they want to know what they are 3 talking about. 4 I think as a community, we're working very, 5 very hard to reduce this stigma, and by getting 6 those conversations out there, with accurate 7 information, we can really, really make a dent in 8 reducing the stigma, educating the community, and 9 hopefully, get parents talking to their kids. 10 Additionally, the Community Education 11 Committee of the Broome Opioid Abuse Council is 12 putting out wallet cards that have fast facts for 13 parents as well as questions that they can ask 14 providers to address the issue of overprescribing of 15 medications. 16 SENATOR FREDRICK ASHKAR II: Thank you, Jill. 17 Michael? 18 MICHAEL JOHN BARTON: So when I introduced 19 myself a moment ago, I introduced myself as the 20 founder and President of Dreams Over Drugs 21 Foundation. What I neglected to mention is that I'm 22 also a recovering heroin addict, nine years. 23 [ Applause ] 24 MICHAEL JOHN BARTON: Thank you. When I was 25 using, I never thought that it could possibly get 1 any worse, that the problem could ever get any 2 bigger. And I was definitely wrong. 3 But through my recovery, you know, I couldn't 4 help but take notice to all the families that were 5 suffering, and, you know, all of the young people 6 that we were losing. 7 It seemed like every week, you know, you see 8 something in the news or in the newspaper, and what 9 myself and a couple of my colleagues did, we got 10 together, and pretty much we came up with this idea 11 that we were going to go into some of our local 12 schools and talk to the kids and kind of share our 13 experiences with them. And, you know, take it from 14 there. 15 And, you know, we started out, we went to 16 Union Endicott first. And it kind of just grew from 17 there. So we've been going from school to school, 18 doing presentations in health classes and even in 19 auditoriums like this. I've actually done a 20 presentation in this auditorium before. So it's 21 been really good. The students are really receptive 22 to what we tell them. 23 And I think the majority of them probably 24 know someone or have a loved one that is addicted or 25 was addicted. So they really see the need to kind 1 of learn about it. And we're just getting really, 2 really good feedback, really positive feedback, you 3 know, doing these presentations. So I would like to 4 thank you for having me, and -- 5 SENATOR FREDRICK ASHKAR II: It's an absolute 6 pleasure, Michael. 7 MICHAEL JOHN BARTON: Thank you, sir. 8 SENATOR FREDRICK ASHKAR II: I applaud you 9 for your efforts and your sobriety. So Penny and 10 Lisa, do you -- from a parent's perspective, do you 11 think that these community events are helping reduce 12 the stigma surrounding this issue? 13 LISA BAILEY: I absolutely do. I mean, we've 14 done -- I've done quite a few different panels, and 15 the people that come up and talk afterwards, you get 16 the community talking to you. 17 And I remember one panel that we did, and I'm 18 sorry, I don't remember the place, but the mother 19 came up to me and she was so excited, and she had 20 her two sons with her. And she said, I remember you 21 from the first time you spoke, she said, and my son 22 was sitting right there. She said and now, I'm 23 bringing my second son to hear you speak, and she 24 said, you know what? When my third son gets a 25 little bit older, he will be coming to one of these 1 panels, so they're really opening up. And I think 2 it's really opening up the conversation with the 3 children as well. 4 SENATOR FREDRICK ASHKAR II: Great. Penny? 5 PENNY STRINGFIELD: I certainly agree with 6 that as well. I also think that people who may 7 never have thought about this or dreamed that they 8 would be involved in working on this, because of our 9 voice and our advocacy are. Jill spoke about the 10 Endwell Rotary. 11 I had Carmella come to the Binghamton Rotary 12 to speak, and that spurred an interest in someone 13 from Rotary to look at a Rotary international grant 14 to help with some additional funds and treatment 15 here. I know as I was struggling with what I was 16 struggling through with Johnnie, I had that fear 17 constantly that people in my professional life would 18 find out what was going on, what a mess my family 19 was. 20 And when it all finally fell apart, a client 21 that I had worked with for over 30 years came to me 22 and said, I had no idea, and I also had no idea what 23 a terrible epidemic this was in our community, and 24 he has since become very actively involved. 25 So, yes, I do think that all of these forums, 1 all of these workshop, all of these voices are 2 making a difference in the stigma. 3 This past Monday, the Guardian, which is an 4 international newspaper, printed an article about 5 two families who lost their children, mine was one 6 and also a family that was very much affected by 7 addiction. And I was amazed at the people who 8 reached out to me. So, yes, I think our voices are 9 helping lift the stigma. 10 SENATOR FREDRICK ASHKAR II: Strength in 11 numbers, right? I think that's clear. 12 George, could you talk very briefly about 13 what you're doing over at the Children's Home in 14 terms of prevention, and I know the last time you 15 and I spoke, you talked about a new program that you 16 were going to spin up. So could you talk about that 17 a little bit? 18 GEORGE DERMODY: Certainly. Thank you, 19 Senator. I know one of the thoughts coming here 20 was, what's working or what we need to do, and I 21 think really what you're evidencing here is 22 collaboration. And I'm really excited. 23 As you know, I've only been at the Children's 24 Home for a short period of time, and one of the 25 things that I have heard is that, some of our 1 children who would normally come into a facility 2 like the Children's Home, but also had substance 3 abuse issues or challenges were having to go outside 4 the community to receive the services they need. 5 So, they were away from family, away from friends, 6 away from the positive aspects of their life. 7 So in trying to address that issue, we really 8 saw the best way was a partnership, and I think what 9 we're evidencing here. I'm really pleased and proud 10 to announce that with Commissioner Johnson's 11 support, that Carmella, through an ACBC and the 12 Children's Home, are joining in a partnership to 13 make a small contribution. 14 And that is that we're going to have some 15 adolescent treatment options available for -- 16 initially for young people being served by the 17 Children's Home. Some of them in our community 18 programs and some of those that are in our 19 residential programs, and I think we'll be able 20 to keep a few more young people closer to their 21 supports. 22 And that's just a small thing, but it's also 23 a model. I think it's a model that, you know, in 24 terms of this forum, that the more we collaborate, 25 the stronger that we are. The more we work 1 together. 2 And if I could just add, while I'm speaking, 3 Senator, one of things I think I would hope the 4 legislature would remember, is the toll that 5 addiction takes on children and other caregivers, 6 and not just immediate, but the legacy. And I think 7 I can best explain that with two very quick stories 8 of things that have happened to me. 9 I was working with a ten-year-old boy 10 recently who wasn't in class. And I said, "It's 11 math class, why don't you go in? Math can be fun." 12 And he looked at me and said, "You know, I really 13 can't go in right now, I found out this morning that 14 my mom is going back to jail," dealing with her 15 addiction and her substance abuse. 16 And so that issue was on him, and that was 17 math. His ability to grow, his ability to learn. 18 And there was a young woman, 13 years old, within 19 the last two weeks who just came into our care, who 20 on a phone call, with people that are supporting her 21 said, "You know, mom, you need to either choose the 22 needles or me." 23 And those stories, I know, for many people on 24 the panel are quite common and they are in aware of 25 them. But the issue and the challenges, that the 1 affect this trauma has on those young people, on 2 their brain development, on their ability to 3 leadership, their ability to feel joy, their ability 4 to form supportive and trusting relationships. So I 5 think there's a lot that we need to continue to do 6 to make sure that the services and supports are 7 there for children, and if I could also put in a 8 plug for parents. 9 Many times grandparents and relatives who 10 are caring for children while, you know, a primary 11 parent is dealing with addiction that grandparents 12 who are parenting again need all of the support that 13 we can provide. They need the access to services so 14 that we could help children grow and develop, 15 because if through the trauma of this addiction, if 16 we don't help the children recover so that they can 17 grow, they can learn, and they can form 18 relationships, we're just going to recycle an issue. 19 So I would hope that the task force would 20 look for any ways that they can to provide those 21 additional supports to children affected by this. 22 SENATOR FREDRICK ASHKAR II: Thank you very 23 much, George. I wanted to kind of change gears a 24 little bit, if we could. 25 And John, I think I'll allow you to start 1 this portion of the conversation about harm 2 reduction, what we're doing. If you could speak 3 specifically about Narcan in the community, and 4 needle exchange and then, Ray, if you'd be so kind 5 to talk about the deployment of Narcan from an EMS 6 and fire and law enforcement perspective. 7 And once we're through with that, I think 8 we'll change gears once again and start to talk from 9 a law enforcement and a prosecution standpoint and 10 what we're doing. So, John. 11 JOHN BARRY: Wonderful. Last year, the staff 12 at the Southern Tier AIDS Program distributed 1500 13 Narcan kits. That's just in our local area. 14 According to the New York State Department of 15 Health, Naloxone was administered during 11,992 16 emergency medical service calls in 2014. This was a 17 57% increase from the previous year. This is a good 18 thing. Those are lives that have been saved. 19 Let's go back to harm reduction. A lot of 20 people don't know what harm reduction is. That's 21 what syringe exchanges do. And the easiest way to 22 nutshell it is, we're trying to keep people alive 23 long enough to quit using drugs. 24 We know that even in the midst of active 25 addiction, we can prevent some of the harm that 1 arises from drug use. This is why your personal 2 doctor agrees to continue seeing you even while you 3 are smoking, drinking alcohol, eating cheese 4 burgers, all of those things that we all do but we 5 know that we shouldn't. 6 She knows that continuing to treat you is 7 more effective than abandoning you and waiting for 8 you to, I'll put this in quotes "hit bottom." The 9 bottom for some people is death. And we can reach 10 people before they get there. 11 So what is working locally in our battle 12 against heroin addiction? Well, the syringe 13 exchange programs are working. They are preventing 14 HIV, Hep C, abscesses, heart infections, and serving 15 as an entry point to get people into substance use 16 treatment. 17 Our syringe exchange programs, for people who 18 don't know this, have dedicated staff that all they 19 do is put people into treatment, all day, every day. 20 Very soon, we'll be providing the services of 21 a physician and a registered nurse in our Ithaca 22 Syringe Exchange Program to prescribe Suboxone, 23 wound care, and teach people proper injection 24 techniques. Again, to avoid infections. 25 These interventions are going to reduce 1 medical costs, keep people out of emergency rooms 2 and hospitals. I heard someone mention earlier 3 people go into the ERs, and nothing being done if 4 they leave against medical advice. 5 And you should know that Alan and I have been 6 having some discussions recently about those folks 7 who don't have to get nothing when they leave. They 8 can be referred to the syringe exchange programs or 9 perhaps, you know, my staff can even come out and 10 meet the person before they leave. That would be 11 ideal. 12 So it's not a perfect solution, it's not 13 treatment, but again, hopefully it would keep the 14 person alive so that they could rejoin their family 15 and get clean eventually. 16 If I was going to ask for a wish list, I 17 think that probably some more money for medical 18 services in the syringe exchange programs would be 19 helpful. Again, in the hopes of keeping people 20 alive and funneling them into treatment. 21 These services should probably be expanded. 22 Within the last several weeks, I've been fielding 23 calls from Elmira, Delhi, Hancock, Walton, and other 24 small towns, from people asking me if we can bring 25 the syringe exchange van to their locality and offer 1 our services. 2 Currently, we do not have the staffing to do 3 that. But it would certainly be helpful, it seems, 4 if people are making the calls to me. 5 I'm a big fan of medication takeback days. I 6 don't think that we have enough of those available 7 for folks, and we've been doing some research on it 8 up in Chenango County. There's a very active group 9 there. I've talked to some folks lately who say 10 when they do these, they get garbage, like 32 gallon 11 garbage cans full of prescriptions. That sounds 12 like a ridiculous amount, but go home tonight and 13 look to your own medicine cabinet. I think you'll 14 be shocked what is kicking arm in there. We all 15 just look past it when we go to get the toothpaste, 16 but there is probably some things in there. 17 And also I would certainly like to make a 18 plug for an expansion of Medicaid, medication 19 assisted treatment, like Suboxone and methadone. 20 Thank you. 21 SENATOR FREDRICK ASHKAR II: Senator O'Mara 22 has a couple of questions. 23 SENATOR THOMAS O'MARA: I would just point 24 out, in this year's budget, in addition to the $165 25 million we've got in there for addiction services, 1 there is an extra million in there to help to set up 2 more permanent drug collection sites in communities 3 so that it's on a more regular basis and you don't 4 have to wait or, you know, have to see the notice of 5 the event, so I think it's going be helpful in that 6 regard. 7 With regard to the syringe exchange and those 8 programs, and this increase in the heroin epidemic 9 that we've had, are you seeing -- and maybe not just 10 you, but anybody here in the health community, 11 increases in the incidence of AIDS or Hep C or those 12 types of health issues as a result of reusing 13 syringes? 14 JOHN BARRY: You're not, no. As a matter of 15 fact, we have very good data from the Department of 16 Health. 17 If you look back at the AIDS epidemic, in the 18 early 1980s, about 52% of HIV infections were due 19 to people sharing injection equipment. That number 20 now is 3% of HIV infections every year are due to 21 people sharing injection equipment. So that is an 22 unqualified public health slam dunk of a success. 23 SENATOR THOMAS O'MARA: My district includes 24 the City of Ithaca, which has come out with a 25 proposal for pursuing heroin injection site in the 1 city for addicts to come in and actually shoot up 2 heroin on the site. 3 I think that speaks to really the extent of 4 the problem that we're having here. I don't 5 personally agree with that. Frankly, I was quite 6 taken aback by that proposal when I first heard of 7 it. But, since this is your area of expertise, do 8 you have any thoughts on that type of a program? 9 JOHN BARRY: Certainly, I do. These type of 10 facilities are operated in 66 different cities, in 11 ten different countries, and they have been operated 12 in those cities and countries for decades. There 13 are literally hundreds of studies about what happens 14 at these facilities. 15 And if you look at the research, what it says 16 is that they reduce overdose deaths, they do not 17 encourage drug use, they provide treatment, they 18 reduce risky injecting and transmission of 19 infectious diseases, they improve the public order 20 by reducing discarded syringes and public injecting. 21 They reduce crime, and they're cost effective. So 22 that's a quote, of course. 23 But what that all means is, you don't have 24 people doing things like injecting in the bathrooms 25 of local businesses, you don't have people 1 discarding syringes. The one that operates in 2 Vancouver, you have a detox right upstairs, so that 3 when people decide they've had enough, they can 4 just literally go upstairs and begin the treatment 5 process. 6 So I understand that these ideas are 7 difficult for some people, and that's okay to 8 struggle with these ideas. They are radical 9 proposals. But I think we're at a place where 10 perhaps we need to entertain doing something 11 radical. 12 SENATOR THOMAS O'MARA: All right, well, 13 thank you for your perspective on that. You know, I 14 do have trouble wrapping my arms around it, for 15 sure. 16 JOHN BARRY: You're not alone. 17 SENATOR THOMAS O'MARA: But certainly what I 18 think it really highlights, you know, just the 19 extent of the problem that we have that we're even 20 considering measures such as that. But, I do 21 appreciate your input on that. 22 SENATOR FREDRICK ASHKAR II: What about in 23 Chenango County in terms of Hep C, HIV, Ruth, what 24 are you seeing? Let Ruth talk real quick. 25 RUTH ROBERTS, LCSW-R: Actually, it was the 1 Hep C numbers that were climbing that caught our 2 attention before we even started paying attention to 3 the heroin use and epidemic. 4 And that came to our attention through our 5 public health, and then that began the conversation, 6 and it was actually in that, that we were able to 7 pull some folks together that were the beginning 8 of a substance abuse prevention coalition that 9 initially was focusing entirely on this heroin 10 epidemic in Chenango County. 11 The AIDS numbers have always been quite low, 12 and I don't -- I don't believe that there has been 13 any movement in those numbers, but the Hep C was 14 definitely catching our attention, and we continue 15 to monitor that. 16 SENATOR FREDRICK ASHKAR II: John, very 17 briefly. I know last time I was in your company, 18 you talked about the cost associated with 19 Hepatitis C. 20 Could you hit that for the group out here, 21 and for those on the panel. How expensive it is to 22 treat that? 23 JOHN BARRY: Sure. There are some very new 24 and effective medications that a 12-week course of 25 treatment is anywhere from 60 to $90,000, depending 1 on the medication that your doctor prescribes. 2 There was a recent report on Medicaid, and I 3 think it was saying that for the third quarter of 4 2015, 10% of total Medicaid pharmaceutical costs 5 were due to Hepatitis C drugs. So that's just the 6 medications. That's not the full course of 7 treatment. That's the meds. And then on top of 8 that, you have lab work, doctor's fees, those sorts 9 of things. So it can easily reach $100,000 per 10 case. 11 SENATOR FREDRICK ASHKAR II: Alan, what about 12 in the UHS system, are you seeing an increase in 13 Hep C and the like? 14 ALAN WILMARTH: In the Hepatitis C area, we 15 are, particular in the methadone clinic where, you 16 know, probably 87, 88% of the people admitted are 17 using IV. And as John said, we have seen very, 18 very little HIV change with this, but we have seen 19 Hepatitis C. 20 The other thing relative to the cost of 21 Hepatitis C treatment, prior to the advent of these 22 newer medications, the treatment of Hepatitis C was 23 with medications that would enhance profound levels 24 of depression in many of our patients, and so 25 treatment, attempts to treat, Hep C resulted in 1 substantial relapses into substance use, which then 2 starts the cycle all over again. 3 So there's an interplay between treatment of 4 Hepatitis C and relapses with substance abuse. 5 We're not seeing it as much with the newer 6 medications, but it has been a long-standing issue. 7 SENATOR FREDRICK ASHKAR II: Thank you. 8 So let's go back to Narcan. Ray, could you 9 hit on what you've been focused on in your efforts 10 in terms of first responders, law enforcement, and 11 the like? 12 RAY SCROWIK: Certainly, Senator. In early 13 February of 2014, I was approached by Sheriff David 14 Harder, and then Captain Fred Akshar, his law 15 enforcement commander, for assistance in 16 establishing a program to train and equip law 17 enforcement officers with Naloxone, which was a 18 medication very familiar to me. We've used it in 19 emergency medical services for decades. 20 We quickly got that program up and running. 21 Folks at the New York State Department of Health 22 AIDS Institute which administered the regulations at 23 the state level, told us it was one of the very 24 first programs in New York State to train and equip 25 law enforcement officers. 1 We quickly got that program up and running, 2 and the first case was successfully treated the 3 following month in March, rather famously now. 4 Since that time, we've been joined in the 5 effort by virtually all of the municipal police 6 departments in the county, law enforcement agencies 7 at Binghamton University and SUNY Broome Community 8 College, the County Security Division, and 9 unfortunately, when we started this program, we were 10 seeing on near fatal overdoses in this county at the 11 rate of one, two, maybe three a week. 12 I can tell you now, sadly, it is an everyday, 13 often several times a day occurrence in this county. 14 What I can tell you is that we are prepared to 15 handle these overdoses. If we are called and are 16 called in time before it becomes irreversibly fatal, 17 we can predictably, reliably resuscitate these 18 overdoses. 19 Naloxone, of course, does not cure addiction. 20 It merely provides another opportunity for the 21 individual to address the addiction problem. Going 22 forward, again, parallel programs have equipped 23 emergency medical services and fire service 24 responders with Naloxone as well, and we're well 25 equipped to treat the overdoses when they come. 1 That's the underlying problem that has yet to be 2 solved. 3 SENATOR FREDRICK ASHKAR II: I don't mean to 4 put you on the spot, but do you have any statistical 5 data since we began distributing it in terms of how 6 many lives we've saved? I know you're clearly going 7 to speak about Broome, but since we started to 8 distributing it to the masses, if you will, law 9 enforcement, EMS, fire. 10 ALAN WILMARTH: Well, I can speak to the law 11 enforcement program, because they report directly to 12 Dr. Ryan as the Clinical Director of the program 13 and myself. And there's been 64 cases since the 14 program began in 2014 involving five law enforcement 15 agencies here in Broome County that have actually 16 administered it. 17 In many cases, the Naloxone is administered 18 by fire, EMS responders, and they have a separate 19 reporting system. So certainly, their use of 20 Naloxone has surged over this time period as well. 21 So again, it's an everyday occurrence, but if 22 we're called in time, we have, in all cases, really 23 been able to reverse these overdoses. 24 SENATOR FREDRICK ASHKAR II: What about in 25 terms of funding for Narcan? I guess I'll ask all 1 three of you, John, Dr. Ryan and Ray, are a lot of 2 agencies self-funding these programs? I know that 3 AG Schneiderman put up some money, but, you know, 4 that money is used and gone, so is there something 5 that we can do, my colleagues and I, to ensure that? 6 ALAN WILMARTH: A sustained source of 7 funding, specifically for emergency responders to -- 8 in addition to the replacement of Naloxone actually 9 used on patients there, of course, is the fact that 10 this is a pharmaceutical with an expiration date, 11 typically about 18 months by the time it gets to the 12 end user, and it needs to be replaced periodically, 13 which is really the major part of the cost. 14 SENATOR FREDRICK ASHKAR II: Okay. Thank 15 you. John, is there some talk about a syringe 16 exchange in Chenango County? 17 JOHN BARRY: That is under discussion. We've 18 certainly ruled that out in the substance abuse 19 coalition, and I think that many people in the 20 community are on board with the idea. It's not an 21 idea that you will ever get 100% of the committee on 22 board with and that's okay. 23 We have sent out letters to the state level 24 representatives, because that's the last step that 25 the AIDS institute has asked us to take at this 1 point, to see if there are any concerns or 2 objections. 3 SENATOR FREDRICK ASHKAR II: So let's talk 4 specifically -- let's change gears and let's go to 5 law enforcement and prosecution, if we could, and 6 let's focus our energy right now on Chenango County, 7 so I would ask Sheriff Cutting and DA McBride to 8 weigh in on issues that you're being faced with in 9 your particular jurisdiction, and again, where my 10 colleagues and I can be helpful, and then we'll move 11 to Tioga and Broome and talk about some of the 12 things we're doing there from a law enforcement and 13 a prosecution standpoint if that's okay. 14 JOSEPH McBRIDE: Sheriff, please go. 15 ERNEST CUTTING, JR.: Sure. I guess I'm 16 going to go back to probably about seven years ago, 17 how it started for us. I was in a local restaurant 18 with my son, he was then, I think, seven or eight 19 years old. We had gone if in for breakfast. The 20 girls had gone shop. You know, life was good. 21 And we walked in and I sat down, and pretty 22 soon I was inundated by people in this community, 23 small community, part-time police department, and 24 their concern with the drug problem that they had in 25 that community. And it got so bad, it was a pretty 1 contentious point, and I made a commitment to them, 2 you know, look, my son is here, I will be back 3 Monday morning. This was a Saturday morning. And 4 I'll meet with the business leaders in that 5 community and we'll address this issue is. 6 And going forward we addressed that. And 7 then we really started taking a hard look at what 8 was going on, and we assigned people specifically to 9 narcotics investigations, and in that next two 10 years, we probably made over 200 arrests 11 specifically related to heroin in Chenango County. 12 Some of the issues and problems we have in 13 Chenango County, it is a very rural county. Again, 14 resources, we have 23 people, including undersheriff 15 and myself in law enforcement specific him. We rely 16 heavily on the public that gives us information. We 17 have several ways the public can get us information 18 anonymously. We continue a lot of those 19 investigations. 20 Many of those people come into the jail. 21 They go through a terrible time, detoxing from 22 drugs, heroin specifically. One of the things we're 23 talking about now is having a door-to-door type 24 thing. Once they come in, they're detoxed. Prior 25 what we would do is release inmates back out on 1 street and many of them who had no resource, 2 nothing, they are going back to the same problems, 3 the same issues they came from. 4 And they would fall right back, and it is a 5 revolving door, and they turn around and come right 6 back into the jail, you know. Sometimes within a 7 day or two. 8 What we're trying to put together now working 9 with mental health, DSS and a lot of the service 10 drug court and drug -- drug and alcohol in Chenango 11 County is when those people are there, we have them 12 detoxed and they'll interview the inmates, and see 13 who seriously wants to get into treatment. Who 14 wants help. 15 You're going to have the people that are 16 going to give you lip service, or not going to 17 really want help and then you're going to have those 18 people that do. We're going to look for those 19 people that sincerely want help, and try to get them 20 a door-to-door -- once they are released the from 21 incarceration, that we can take them right to a 22 treatment facility, so that they can get help. 23 We feel that that's the best time we're going 24 to have in the public safety system, when we have 25 them, to get then help. One of the things we're 1 seeing now is, we have a big mass change in heroin. 2 It's changing now to meth. And the one-pot method. 3 We're seeing a tremendous influx now of meth. 4 We have probably made close to 40 arrests in 5 the last year related to meth in the one-pot method. 6 It's extremely toxic. The chemicals that they use, 7 individually by themselves, and they combine them 8 together, to create this, and they're just disposing 9 of these chemicals all over. 10 We find them in State property, State land, 11 communities, parks, so we're now shifting gears 12 little bit from heroin. Heroin, while it's still 13 extremely prevalent in Chenango County, we're not 14 getting the large dealers like we did initially. 15 We pretty much attacked that head on. We're 16 getting a lot of smaller dealers that are using to 17 supply their own habits, and they carry a very small 18 amount, so they can't be, you know, caught with a 19 lot. They have stash houses and that type of thing. 20 Moving forward, public education, I think, is 21 extremely important. Again, we're not going arrest 22 our way out of this problem. 23 It's going to take a lot of different 24 organizations coming together, to address this 25 issue. And I think, you know, these forums are 1 great to allow us to build the capacity, and 2 direction that we're going to need to address this. 3 SENATOR FREDRICK ASHKAR II: Thank you, 4 Sheriff. DA? 5 JOSEPH McBRIDE: Thank you, and thank you, 6 everyone, for giving me the opportunity to speak. 7 Chenango County is a small rural county in 8 upstate New York. And we're a history of farm 9 communities, and this is a very strange problem to 10 have in our community. And a problem that didn't 11 develop overnight. 12 We've always had a touch of heroin over the 13 last 30 years, but over the last ten years or so, 14 we've had a tremendous problem. One of the ways 15 that I was introduced to the heroin problem is by 16 covering -- I'm the DA, so I do the felony cases and 17 do the murder cases, but every once in a while, I 18 have to cover the justice courts in every small 19 towns. 20 And the small town of Sherburne, I was 21 covering a case, and there was a kid there with a 22 John Deere hat, looked like he just got done haying, 23 and he was in front of the judge. And he was there 24 for possession of heroin. I couldn't believe it, 25 that this had come to our town, and this is the face 1 of heroin now. 2 Now, as we know, over the past five to seven 3 years, heroin has come -- it is not only in Chenango 4 County, it is all over. But, in our small little 5 county, I get to see the people that have grown up, 6 that were on my little league team and that I have 7 seen. 8 There are two that come to mind in the last 9 year. One of them had an overdose and was actually 10 brought back from Narcan, and he's doing very well. 11 He's completed his treatment. He's completed his 12 treatment court, and he's done very well on his road 13 to recovery. 14 Another gentleman, who was from City of 15 Norwich, had been battling with heroin for a long 16 time, and he lost his life to his addiction. So we 17 have seen it all. And it affects the family, it 18 affects everybody in our community, and it is not 19 just a poor person's or rich person, everyone is 20 susceptible. 21 So what are we doing about it? We're working 22 as a group to try to get the word out, and one of 23 the groups that the Sheriff spoke of, and I'm sure 24 that my -- the head of our alcohol and drug services 25 is going to speak to today, is we're trying to work 1 together to see what we can do for prevention. 2 And what we need to do and even being here 3 today, we need to instead of the groups that are 4 going out to the schools, that's great. But right 5 now, this has been about a ten-year problem. We 6 have to change the programs that are in the schools. 7 It shouldn't be just myself and everybody else who 8 can -- to make the time in their day to get that 9 done. It is a health crisis. 10 When I was a young man, they started health 11 class, and we talked about it. It was to teach us 12 all about the things that they thought we knew in 13 the 1970s, right now, we need that mandatory 14 education about the involvement of drugs and 15 specifically, heroin because as we all know, heroin 16 is different, it is a lot worse. 17 When we were growing up, we knew that you 18 could do a lot of bad things in life, but if you 19 used heroin, you would die. Our kids don't know 20 that. And whether it starts with the pills, mostly 21 does, we need to do something about that. 22 The next thing that we need to do is, and I 23 spend a lot of my time, and Steven will tell you, we 24 put people to jail. And in the beginning when I did 25 this, I was really against putting little kids to 1 jail. Young kids. 2 But, to be honest, I believe at least 3 initially for those five days, seven days, and we're 4 saving their lives. But what we need to do is be 5 able to get treatment for those kids so that we have 6 a place to put them, so if we decide that we want to 7 make sure that they are supervised and they have a 8 place to go, that we could do that right away. That 9 is impossible right now. 10 One of the real problems is, that in our 11 county and throughout the State of New York, the 12 people right next to me who are the experts, in 13 alcohol and drug services, their hands are tied. If 14 I am a drug -- heroin addict, and I need help and I 15 go to them, they don't have the ability to assess me 16 right away. And they have to send me down the road 17 for an appointment two to three weeks. 18 And then, not only that, but they can't refer 19 me to all of the open beds that are available in 20 New York, because they are not allowed to do that 21 unless they have a full assessment themselves. 22 We need to change the rules and regulations, 23 we have to let them do their job, and we allow them 24 to send people to beds that are available in our 25 state, so our kids don't have to go to Florida and 1 everywhere else to get the services that they need. 2 Once again, it is an ongoing problem. We get 3 the prevention and education in the school system. 4 And two, get the services for the people that need 5 it. 6 One last thing, everyone in jail right now, 7 when they are released from jail, no matter whether 8 it is two months, three months, four months, when 9 they were on crack, when they were on cocaine, they 10 had at least a good period of time to change their 11 life. 12 My experience is that we're letting these 13 people out without the services there. A lot of 14 them are dying of overdoses almost immediately, 15 because they are taking the drugs that they took 16 beforehand, their bodies aren't used to it, and 17 we're losing bodies all the time. 18 We can't continue at this rate, especially by 19 regulations, by the Senate, by the government, to 20 allow the people in alcohol and drug to get these 21 people in right away. And it is a crisis situation. 22 To get these people in right away. And it is a 23 crisis situation. And that's my request. 24 SENATOR FREDRICK ASHKAR II: So I know we're 25 going to -- 1 [ Applause ] 2 We're going to continue down the law 3 enforcement track but, allow me to digress, and 4 Ruth, can you speak to that, because I need to be 5 educated on the hurdles that you're faced with as 6 the DA spoke. 7 RUTH ROBERTS, LCSW-R: Sure, I would be glad 8 to, thank you. I was hoping we could talk about 9 treatment, too, in all of this as well. So, thanks 10 for the segue, Joe. 11 What Joe is referring to is, and by the way, 12 in Chenango County we have a county-operated 13 outpatient, we have an outpatient clinic that serves 14 individuals who have chemical dependency needs. 15 That clinic is now co-located with our outpatient 16 mental health clinic, so we're actually positioned 17 to better serve individuals who really need services 18 from both clinics. 19 But we're a county-operated clinic. We're 20 the only OASAS and OMH licensed outpatient clinic in 21 a small rural county. The first thing I would say 22 that we struggle with is relative to the regulations 23 that we're faced with in order to deliver services. 24 And I have to admit to you today, I'm a clinician, 25 but on a day-to-day basis, I'm not actually doing 1 the work that I'm asking my clinical staff to carry 2 out. 3 And when I stop and listen to what is 4 required by OASAS in terms of the Part 82 Outpatient 5 Clinic Regulations, what's required by Medicaid, 6 what's required by commercial insurance products, 7 what's required by managed care organizations, just 8 to be able to get people the level of care that they 9 need, the amount of care that they need, it makes my 10 head hurt. 11 And I just keep thinking there's got to be a 12 more efficient, effective way to do this. I have 13 people lined up and ready, willing, trained, experts 14 who want to help people. 15 And we have to think like criminals 16 sometimes, to try to figure out how to maneuver all 17 that's in front of us in order to get the services 18 that those individuals need. It comes down to -- 19 and the heroin epidemic has really blown this out of 20 the water, because we have to act fast. People's 21 lives are on the line. 22 With other drug addictions, we had some time. 23 We could usually -- we weren't looking at life and 24 death situations. This is different, this heroin 25 epidemic. And so it comes down to access. It comes 1 down to timely access. It comes down to being able 2 to move people to the level of care of treatment 3 they need. 4 There have been some, you know, improvements 5 recently with the new locator tool that OASAS has 6 given us. It has provided us a common language, so 7 that when we're on the phone talking with another 8 provider on the other part of the state, we're 9 speaking the same language. 10 So there are some small improvements, but, 11 you know, if I can ask anything, I would ask that 12 our State agency that regulates these outpatient 13 programs, I would just ask that they be willing to 14 come to the table, and really look at what is 15 getting in the way of actually helping people. So 16 regulatory relief. 17 We run into it with our prevention programs 18 as well. We are really very limited into what we 19 can do, and we need prevention. And I don't believe 20 that it should just be OASAS doing prevention. I 21 think it was mentioned earlier, this needs to be a 22 collective impact. I really believe that. 23 I think that we, as a community, need to 24 start talking about prevention in primary care, 25 pediatric sites. I think we need to be talking with 1 parents, prenatally talking about prevention. That 2 message needs to follow in through the schools and 3 all of the medical community and throughout all of 4 the community itself. 5 The faith community, it certainly has a role 6 in that. But that message needs to be delivered 7 throughout. And we're really talking about changing 8 social norms. And that takes time. And that also 9 takes a collective impact. So regulatory relief. 10 And we've talked a little bit about the forensic 11 services or what I refer to as forensic. Those 12 services in the jail. 13 I believe we are missing many opportunities 14 at that stage, and I'll describe it sometimes as a 15 "come to Jesus moment." Sometimes, you know, they 16 are in jail, and they realize they need to change 17 their lives and they want to -- there's some level 18 of motivation. That is the time that we need to 19 take every opportunity to engage individuals. 20 We have started in Chenango County to do what 21 we're calling transitional supports, working with 22 our sheriff. And where we're -- we have a case 23 manager-type position and a peer advocate. Someone 24 who's been there and done that and is in recovery. 25 They team up and they engage an individual 1 before they leave the county jail, and they really 2 come up with what's the plan. And it might be how 3 to access treatment, but it might also be where are 4 you going to live? And how are you going to support 5 yourself? And what's the plan to apply for 6 Medicaid? 7 So all of that gets worked on before the 8 individual actually walks out of the county jail. 9 So we just started doing that in January, and I'm 10 hoping that will help in some of the, you know, the 11 round door turning door that we see often with -- 12 particularly this young population. 13 But you have to understand again, almost 14 80 percent of the individuals currently sitting in 15 the county jail have some history of substance use 16 or abuse in this their story. And a lot of that is 17 based on self report, so the number might actually 18 be higher. 19 Our State agency, OASAS, gives us no dollars, 20 no funding for those services in the jail. I do 21 that work in the jail with my OMH dollars. I also 22 have a full-time forensic person that's in the jail. 23 I'm using those OMH dollars to provide services for 24 this 80-plus percent of individuals who have 25 substance abuse needs in -- or substance abuse 1 treatment needs who are currently in the county 2 jail. 3 So I think it is time for OASAS to wake up 4 and say, you know, we need to look at this 5 opportunity, and also, you know, put some money 6 behind it because this -- I look at the forensic 7 population as an area where there is great 8 opportunity. 9 And let me also say, we talked about the 10 stigma. You know, oftentimes in these communities, 11 this group of people is considered by the public as 12 the least deserving. You have individuals who are 13 addicts, they have a history of criminal behavior, 14 they are in the county jail, or they have been in 15 and out of the county jail, and it is difficult for 16 the public to see them as deserving any help or 17 services. 18 And we have to turn that around, too. And I 19 think one way to turn it around is to get our own 20 New York State agency to recognize that this is a 21 valuable opportunity. 22 SENATOR FREDRICK ASHKAR II: It is pretty 23 amazing. I was part of the budget negotiation 24 process in the mental hygiene budget subcommittee 25 and to talk to the commissioners and ask specific 1 questions about funding. They would argue that we 2 have plenty of money, and you know, we don't need 3 additional money, but we all know that that's not 4 true. 5 So you know my love is for law enforcement, 6 but can we stay on the treatment piece and then 7 we'll move to law enforcement. I think that would 8 make the most sense. 9 So Carmella, do you want to weigh in on what 10 you're doing and what your agency is doing? Ask 11 Alan to weigh in as well, and Dr. Nichols, we'll 12 come down to you and the program that you're 13 involved with in Tioga County, and then we'll come 14 back to law enforcement. 15 CARMELA PIRICH: I would just totally echo 16 that there are really regulatory barriers that do 17 not allow us to provide services the way that we 18 need to. And the heroin epidemic is just a huge 19 game changer. You know, sometimes we will have 20 clients even with lots of treatment, lots of 21 support, and they're extremely difficult to help 22 them stabilize. 23 So even, you know, the day after they 24 successfully complete their long-term treatment, 25 after the inpatient, after, you know, nine months of 1 outpatient, we'll see a relapse, so it's very, very 2 hard to stabilize. 3 So I think that we do need more research to 4 figure out what actually is really, really going to 5 help. Because, you know, even sometimes with lots 6 of services, you know, people are just really 7 struggling. 8 From 1997 to 2008, I worked in Baltimore and 9 if you watch Drugs, Inc., supposedly Baltimore is 10 the heroin capital of the country. But, you know, 11 in that space, in the City of Baltimore, we had five 12 outpatient detoxes. We haven't had a detox here 13 since 2010, so ACBC in November, one of my 14 colleagues that I used to work with in Baltimore, 15 pretty much gave me everything, all the protocols. 16 And we're ready. You know, we're ready to 17 start some demolition and kind of prepare the space. 18 I've been working with my landlord, and we have the 19 floor plans. So we're looking for startup, and 20 that's not a silver bullet, but it might be a buck 21 shot. 22 You know, if we can get ten people a week 23 properly detoxed so they will actually feel okay, to 24 do some treatment, inpatient or outpatient or 25 whatever, I think that it would help. 1 Because we see a lot of people, maybe 10 to 2 15 a week that they are not going to make that 3 referral to Conifer Park. We're not going to get 4 this them that bed at Syracuse Behavioral Health. 5 They are not medicated at the ACC, so we can put 6 forth our very best effort to provide them timely 7 access, and they're not going to make it. You know, 8 it is just not going to help to stabilize them. 9 And I also will echo Ruth's sentiment about 10 the collective impact model. I think we're at the 11 point where we have communicated a lot. We have 12 done a lot of forums, but we need a framework. We 13 need a structure and we need a plan, because 14 literally, like, last night, I got my kid and drove 15 her to ACBC to the clinic because my janitor found 16 needles in the bathroom. 17 And I can't -- let somebody come in the 18 morning and like, it's just there. It's every day 19 we're literally just putting out fires, putting out 20 the next fire, and you know, just not seeing people 21 stabilize the way that we want to, even with being 22 in treatment. 23 And also, you know, like the demand has 24 increased so much, you know, like there's not enough 25 room anymore. You know, like, we would expand 1 services but where? You know, like you run out of 2 space, and you have got vacant positions, and I 3 don't have an office for people, you know, like, 4 it's hard to co-locate clinicians in an office 5 because obviously you need some privacy. 6 You can't have two clients and two 7 counselors, you know, in a room at the same time. 8 So -- and I think that the state, like they need to 9 come to Jesus. No offense. I'm seriously, the 10 regulations. It's bad. 11 SENATOR FREDRICK ASHKAR II: We will -- my 12 staff and I will circle back with the treatment 13 providers and talk specifically about the regulatory 14 reform that needs to happen and then I'll 15 communicate that to the co-chairs of the task force 16 and hopefully we can put pen to paper and help with 17 that. 18 And one thing that I have learned in Albany 19 is that, there's a great deal of bureaucracy, and 20 things -- 21 [ Laughter ] 22 There's a lot of personality in Albany, and 23 there's a ton of bureaucracy and things don't move 24 nearly as fast, but I want you to know that I'm 25 advocating very strongly and as hard as I can to get 1 you that startup money that you need to expand your 2 services. 3 So I'm working diligently on that, and if I 4 had my way, we'd have the money today. But again, 5 there's just so much bureaucracy, it doesn't happen 6 that quick. So we're working on that. 7 CARMELA PIRICH: Thank you. 8 SENATOR FREDRICK ASHKAR II: Dr. Nichols, 9 can you speak to your program and Mr. Schecter? 10 Dr. KEITH NICHOLS: Yes. I'm humbled to be 11 up here with all of these people, particularly with 12 people who have lost children and other loved ones 13 to the problem. I feel I'm not up to the level of 14 commitment, the loss that they've gone through, but 15 in any case, to treat this problem, because I'm one 16 of the people that treats it, requires a 17 comprehensive, biological, psychological and social 18 approach to the drug addiction and to the related 19 but very distinct problem of chronic pain 20 management, which is actually in many ways even more 21 challenging medically speaking. 22 And I think that Barry and I have, over the 23 last ten or so years that we worked in the same 24 office, evolved an efficient and for the most part, 25 effective approach to the problem. 1 Generally, I try to provide comprehensive 2 primary care services to anyone that we're treating 3 with Suboxone, vivitrol or any other medical 4 treatment for addiction, and similarly, with chronic 5 pain management. And there are a lot of challenges, 6 we're very busy. But, it's not really particularly 7 lucrative. That's one. 8 I think by virtue of my training, I am very 9 well qualified to undertake this medical and 10 psychological treatment approach, and I think that, 11 family medicine doctors in general are the best 12 people to do it because, frankly, psychiatrists 13 often don't have the medical, the biological medical 14 background to feel comfortable using a lot of the 15 powerful drugs that are required, opiates and so 16 forth. 17 And unfortunately, I see very little, if any, 18 support for family practitioners in this area to 19 pursue this treatment. Very little support coming 20 from the healthcare institutions that dominate the 21 healthcare in the area. A lot of -- I think I-STOP 22 is good. That's where you have to check on the 23 computer to see if somebody is doctor shopping and 24 so forth, but we've been pilloried for little 25 technical glitches and so forth by I-STOP personnel. 1 That's anxiety producing and upsetting, but I 2 understand. DEA has been in the office looking over 3 the records, fine. No problems. But, again, it 4 doesn't happen with any other part of my practice 5 that you got the guys with the suits in there 6 looking over things, page-by-page, and asking all 7 sorts of questions. 8 And insurances are not helpful in the least. 9 The opposite to try to get them to pay for drug 10 testing and urine drug screens and everything is 11 just a constant fight, frustrating. 12 The transition of the patients between 13 different levels of care, it is terrible. If they 14 need higher levels of care, we have to basically 15 plead and cry and spend hours begging people to take 16 them and get the insurances to pay for it. Just 17 really frustrating. 18 So -- but anyway our system works. I 19 actually like it. It may sound like I don't with 20 all of these complaints, but, we get along well, and 21 I think we do a good job, and I think it could be a 22 model for other family doctors to do it, if they are 23 interested. 24 Family practitioners are perfectly trained to 25 do this or family nurse practitioners also. They 1 have the psychiatric and the medical training that 2 you need to do this. Especially chronic pain 3 management. Pain management doctors aren't 4 necessarily set up to do addiction treatment. 5 Anyway. 6 SENATOR FREDRICK ASHKAR II: Doctor, let me 7 weigh in here. After speaking with you and gleaning 8 some information at Senator Seward's heroin 9 roundtable, I authored a letter to United States 10 Senator Charles Schumer, and Kirsten Gillibrand in 11 an effort to get them to move on the Treat Act, 12 which would allow others to participate in the 13 prescribing of Suboxone, and we urged them to move 14 on that. 15 Dr. KEITH NICHOLS: Non-physicians. 16 SENATOR FREDRICK ASHKAR II: To make it more 17 readily available. 18 Dr. KEITH NICHOLS: Good idea. That would 19 really help. 20 SENATOR FREDRICK ASHKAR II: Yeah. And 21 again, we gleaned that from our conversation that 22 you and I had and hearing from another doctor in 23 Oneonta, so we're hopeful that there will be some 24 movement on that. But, again, there's even more 25 bureaucracy in Washington than there is Albany. 1 Dr. KEITH NICHOLS: Again, I appreciate that. 2 SENATOR FREDRICK ASHKAR II: Barry, thanks. 3 Yes, please. 4 BARRY SCHECTER, MSW-CASAC-R: Yes, thank you, 5 thank you very much. I wrote some notes. 6 First thing, first comment when Senator Ortt 7 introduced himself, the words that I heard, 8 treatment on demand, they just go to my core, 9 because that's probably the best thing that could 10 happen. It doesn't exist right now. 11 I wrote some notes so that I didn't go too 12 tangential. So the first thing I wrote was what are 13 the roadblocks to treatment and recovery? And the 14 first thing that I thought of was stigma. And 15 that's what I have heard us talk about here. How 16 could we normalize treatment? 17 I see people every day, many people, that 18 have addiction problems. I have a list right now, 19 probably, probably for our office in Tioga County, 20 120 people waiting for care. Why is that? Why is 21 that? Well, because Dr. Nichols can only 22 prescribe medicine for 100 people. That's the law. 23 That's -- now, there's no such law for how many 24 patients can get prescribed opiates or opioids. 25 Every primary care doctor that has a DEA 1 number can do that. But not every primary -- not 2 every doctor who has a DEA number can prescribe 3 Buprenorphine, nor, going along with stigma, do they 4 want to. Because let's be very clear: 5 My patients tell me, I'm talking about people 6 that have been stable, ten years, grandfathers, 7 people with positive, good careers, that when they 8 go to the pharmacy, and they get a prescription for 9 Suboxone, pharmacy tech might look at them and roll 10 their eyes. What do you think that makes a person 11 feel like that actually has a good life? 12 I just -- I just needed to say that, but I 13 think that if we could somehow normalize treatment, 14 take the fear of criminality out of addiction. I 15 understand, I understand we've got all the law 16 enforcement people here. 17 What I'm saying, is for a person that's 18 addicted to opiates, by their very existence, they 19 are committing a criminal act. That makes them at 20 risk to be incarcerated. That means not having 21 their drug, that means withdrawal. That means more 22 anxiety. That means more use of drugs. It's a very 23 vicious cycle. How can we do that? 24 I think we could -- if we treated it like any 25 other healthcare issue, if we used -- utilized 1 medication counsel, peer counseling. I made a note, 2 the ICRC which regulates CSAC now has a credential 3 for peer counseling. It is, frankly, not as 4 rigorous as a CSAC, but it's what people need. 5 People don't always believe what I say as a 6 professional, I look -- at least on the surface, I 7 look better to some of my patients. But they do 8 listen to other people that are going through this 9 recovery process. And I think that's essential. 10 If we could get into NDAC, another national 11 organization, and the National Alliance of Methadone 12 Advocates, NAMA, also offer peer credentials. I 13 think we need to close the loop that's going on. 14 When I send someone to the Addiction Crisis Center, 15 and I discussed this with Art, Art Johnson, when 16 somebody goes to the ACC and they have opiate 17 addiction, heroin addiction, then probably they are 18 not going to stay more than a day. Because the next 19 day, they are in withdrawal. And they just leave. 20 They have to leave. 21 Could we not? And I was pleasantly surprised 22 that loop might be closed. We can prescribe 23 Suboxone at places like ACC. After a thorough 24 biopsychosocial evaluation is completed, I'll go 25 even one step further. Perhaps we could use that in 1 the jail. Wouldn't it make -- a person who is in 2 jail, I get it. They're in jail. But isn't it a 3 burden on the Sheriff's Department, on the medical 4 staff to treat people, somehow keep them there while 5 they're going through withdrawal? 6 Think about that. I don't think that -- I 7 just don't think that -- I think we could do it. I 8 think we could make strides together. 9 This is a wonderful group. Thank you for 10 letting me be here. 11 SENATOR FREDRICK ASHKAR II: Thank you, 12 Barry. LuAnn, could you speak about your program 13 from -- your faith-based perspective and then we're 14 going to move on to law enforcement. 15 LuANN NATYSHAK: Yes. Thank you, Senator, 16 for asking me to be on this panel. I don't take it 17 lightly. 18 Five years ago, I began ministering in Broome 19 County Jail, specifically to the women. And my eyes 20 were opened very quickly that -- I'm glad somebody 21 said that, it was 80%. I think it was 99% heroin 22 addiction in there, and the reason they were there. 23 I've seen the spectrum of three generational 24 drug addicts, actually in there one time, and one of 25 them was pregnant, so there was four generations of 1 this family in there. And then I've seen college 2 graduates, I've seen women that had one semester 3 away from her degree at Penn State, and her life was 4 gone and done because of heroin. 5 I conduct chapel services for them. And I 6 came across the revolving door, the revolving door, 7 and I said, this is not -- this ought not to be. I 8 had a parent of one of the girls say to her, this is 9 the poor man's rehab. And I thought to myself, if 10 this is a rehab, I need to make a difference in 11 here. 12 So I started doing non-contact visits with 13 each of these women, trying to get them to think 14 right thoughts, make right choices, and so then I 15 was able to do, once a week, the door opened for me 16 to do classes on recovery, every Tuesday. And I 17 will give them weekly homework. And let me tell 18 you, they love it. They love getting their 19 homework. They love doing it. 20 But I'm only allowed a half an hour, a half 21 an hour out of seven days a week to do that class 22 time. Then I began one-on-one mentoring. And, at 23 this point, Broome County Jail has been so 24 cooperative with me, I'm able to go right into the 25 pods, sit down with a girl one-on-one, and we talk, 1 and it's -- it is a coaching. I'm coaching them in 2 their mind, spirit and body. 3 So I saw that there was the revolving door, 4 and I wanted to make a difference on that. So my 5 second goal was an exit interview, and what I do is 6 I sit down with the girls and I say, where are you 7 going to live? What kind of recovery do you need? 8 And what church do you think you're going to go to 9 when you leave here? 10 And I now have a team of 12 women who are 11 volunteers, who will, at a phone call, pick up those 12 girls, take them for coffee, take them to a meeting, 13 and just encourage them, and there's some meetings, 14 you know, faith-based meetings in this community, 15 Free in Christ, Celebrate Recovery, and Brand New. 16 And I will pick up a girl, we will pick up 17 girls and take them to meetings. I am seeing 18 success, after five years. I have girls, women that 19 have completed their GEDs, working towards their 20 college degrees. They are successful in the 21 workplace. And most importantly, I'm seeing 22 restorations of families. Moving forward, I would 23 love to have more class time in there. Ruth, you've 24 got the answer. 25 We've got to spend more time inside there 1 and -- I didn't see -- Barry, yes. Broome County 2 Jail is the poor man's rehab. Let's make it a good 3 one. I'm willing to do it. I volunteer my time. I 4 have 12 members that volunteer, inside and out. We 5 want to see heart changes from the inside out, and 6 we need to help them on the inside and out. 7 I need -- we need to stop the revolving door. 8 We need to stop the deaths. And, that is my vision 9 to be successful in this program. This is such a 10 complex issue. This is my piece of the issue that 11 I'm willing to go to bat for, for these women, and 12 ultimately, I'm going to start a program for the 13 men. 14 So, thank you for having me here. It's been 15 very enlightening. 16 [ Applause ] 17 SENATOR FREDRICK ASHKAR II: LuAnn, thank 18 you. I think you're very inspirational. I think 19 it's important moving forward that we keep 20 faith-based leaders on the forefront of this issue 21 and we do a better job as a community of ensuring 22 that faith-based leaders are part of the 23 conversation that we have. 24 LuANN NATYSHAK: Thank you. 25 SENATOR FREDRICK ASHKAR II: You're welcome. 1 Changing gear as little bit, DA Cornwell, can you 2 just speak about the things that you're seeing, 3 the program that you're running, and then your 4 involvement with Judge Pelella, and we'll segue into 5 drug court in Broome County and how you've expanded 6 that program? 7 STEPHEN CORNELL, JR.: Great, thank you. You 8 know, we've taken a perspective that it's -- there's 9 a supply side component and a demand side component. 10 The supply side component are the drug 11 dealers and the suppliers, and the demand side are 12 the users. So it made that very clear. On the 13 supply side, I haven't given up on the supply side. 14 I know we can't arrest our way out of the problem, 15 but I can arrest enough people to clean up Broome 16 County. That is my goal. 17 So we have increased by -- we have three 18 times as many indictments this year for drug dealers 19 as we did last year. We don't plea bargain with 20 drug dealers. They have to plea to the charge or go 21 to the Judge and ask for a sentence or go to trial. 22 So that's how we've been very aggressive. 23 We're being smarter about and it not harder. 24 We've created intelligent-based system with the help 25 of all of our local police chiefs and the sheriff 1 and the National Guard to come in and help really 2 put our finger on who the targets are, the people 3 that we want to go after, and we're going to make 4 their life as miserable as possible. 5 Go after them at DSS, go after them if they 6 are cheating on welfare, which a lot of them are, go 7 after them in family court, go after them, you know, 8 any way that we can to make their lives as miserable 9 as possible. That's my goal, to make it as 10 uncomfortable in Broome County for drug dealers as I 11 can. 12 That includes working with authorities in 13 New York City, so that's the supply side. The 14 aggressive DA side that -- the prosecution that I 15 think we have to do and recommit to that, and we are 16 doing it, we're seeing results rights away moving 17 cases quickly into indictment and prosecuting them 18 very aggressively. 19 As you can tell, I don't mince words. That's 20 what I'm doing is, and drug dealers are starting to 21 get that message. 22 On the demand side, there are two types of 23 demand side cases. You have people that are charged 24 with crimes and people that aren't charged with 25 crimes. If they're charged with crimes, and they're 1 not violent crimes, they're sex offender crimes, 2 things of that nature, we are referring them to 3 drug treatment court to Judge Pelella, and we've 4 increased the incentives so people shouldn't be 5 stigmatized with a felony for the rest of their 6 lives. 7 They complete drug court and they stay clean, 8 felony should be gone off their record. If they are 9 misdemeanor crimes, they should get in and we need 10 to catch them early. It wasn't always the case. 11 Now, I have expanded that, catch them early with 12 misdemeanor cases, wipe out their record, their 13 misdemeanor record if they succeed. 14 There's a million dollars of income in 15 difference of someone that has a criminal record as 16 an 18-year-old versus no criminal record. They'll 17 lose a million dollars over the course of their life 18 in income because they're saddled with this record. 19 Well, if they clean up their problem and they 20 take care of things, they and get on straight and 21 narrow, then they don't need a criminal record. We 22 have done our job, we have corrected the behavior, 23 and we don't have to worry about the future crimes 24 and the increase in crimes. 25 I've also, on the demand side, if anybody 1 calls my office and they say that they're a heroin 2 addict and they want to go to treatment, they go to 3 treatment. I can tell you right now, we started our 4 program Operation Safe two months ago, and it took 5 a lot of grief from our DAs saying why are you 6 involved in this? This is not the District 7 Attorney's job to send people to treatment. It is. 8 Because if people are in treatment and they're off 9 the streets, they're not committing crimes and they 10 are not dying. So we're saving people's lives. 11 [ Applause ] 12 So that's why I have made it a focus. 13 That's how I'll help to keep Broome County safe. 14 Our numbers are far above all of the neighboring 15 counties. We're in the top ten in every bad 16 category you could be in, so we're about -- out of 17 62 counties in New York State, we have the highest 18 number of property crimes, because drug addicts 19 steal to feed their addiction. We're second highest 20 in overall crime rate, ninth in violent crimes and 21 tenth in drugs. And these include New York City, 22 the five counties in New York City. 23 So out of 62 counties, we're in the top ten 24 in everything, and it is not the good top ten, it is 25 the bad top ten. So, I figure we'd have to get 1 people off the streets and into treatment and it is 2 not available in our area. So we send people to 3 treatment. 4 I can tell you the last update we had was we 5 sent in two months, 70 people were placed in 6 treatment facilities. 7 [ Applause ] 8 And that's -- and that's no cost to 9 taxpayers. And what we do is do it the old 10 fashioned way. People come in, then help, we pick 11 up the phone and we call people. And there are beds 12 in New York State. There are beds every day 13 available in New York State. Not many, but they're 14 available and the website that the State has, it 15 doesn't work. It is not accurate. It's a joke, to 16 be perfectly honest. 17 There was a press conference website. It 18 doesn't work. Our volunteers will call around to 19 all of these facilities, so they had nine beds open, 20 three beds open, no, we haven't had beds open in two 21 weeks. So the website doesn't work. 22 If the website worked, it would save hundreds 23 of phone calls for our volunteers, calling around to 24 get people in. So if there are beds, we get people 25 in, and we get people in, we're teamed up with some 1 other facilities, and our treatment plan is that 2 they call us, we get them into treatment. 3 We have a doctor that we've -- we're going to 4 work with that will provide Suboxone or vivitrol, 5 basically guarantees -- it doesn't guarantee, but 6 it's -- part of the treatment process is to help 7 them to get into treatment. 8 But we get people in treatment between one 9 and 15 days. We have 19 people that are going to 10 treatment on the 1st. So we'll go from 70 to plus 11 19 so long as they hang on that long, but we lose 12 people along the way, sometimes because they go and 13 use, and there really isn't anything available for 14 them immediately in our area. 15 And so from my perspective, that's what we've 16 done. But, you know, the website's not helpful. It 17 doesn't work. It also doesn't help that in Broome 18 County you cannot get a drug assessment at the jail 19 unless you want to pay for it yourself. 20 So the fact that five years ago we had 21 somebody full time that worked for the County that 22 did drug assessments and now we don't have anybody, 23 and we haven't for a long time. Right now, there's 24 been nobody at the jail doing drug assessments since 25 October or November of last year. 80% of the people 1 there are drug addicts, and we don't have anyone in 2 the jail to assess them. If they did that, it would 3 be volunteer. 4 They pass the information on to the defense 5 attorney, and I'm not going the speak for all of the 6 DAs but, you know, if we have people that have been 7 placed into treatment or started taking Suboxone, 8 you know, and addressing the problem, let's get them 9 out of jail. 10 I mean, that problem is the drug addict's and 11 that's why they're committing crimes. We're not 12 talking about dealers, we're talking about all of 13 addicts, but you can't get somebody assessed. You 14 have to pay. When I was in private practice, we 15 would have to pay 300, 400, $500 to get anybody 16 assessed. Normal people can't afford that. 17 You know, and you're paying more in the back 18 end, because you're paying for the free attorneys, 19 and you're paying for the jail staff and the 20 overtime and all that. 21 So really, I mean, it's quite simply, if 22 somebody comes to us and they want treatment, we get 23 them into treatment. And right now, I can tell you 24 that we have 100% of people in treatment, and I 25 didn't want to give out that figure for the first 1 couple of months, because I knew it would change, so 2 I thought, but, we have placed 100% of the people. 3 Every person that came in to my office or 4 called my office and said they wanted to go to 5 treatment was placed in treatment. So it can be 6 done. But, it has been outside of Broome County and 7 outside of New York State. 8 And we have facilities that take people for 9 free because other states have stepped up and have 10 been doing things far in advance of what New York 11 State is doing. So, you know, you have to hit them 12 hard and be aggressive on the drug dealer side, and 13 find people treatment. 14 80% of my cases, 80% of my cases are related 15 to heroin. You know, I have 18 Assistant District 16 Attorneys, and I have 14,000 active cases, criminal 17 cases. 1700 felonies. And there are 13 of those 18 people prosecuting felonies. 80% of our cases are 19 related to heroin. And most of our violent crimes 20 are all related to heroin as well. So obviously, 21 the property crimes, but it's a violent crime, and 22 that's what we've seen, and we've seen our violent 23 crime rate is skyrocketing, and the numbers that 24 will come out soon will be startling. 25 But that's what we're seeing. So from my 1 perspective, hit them hard on the supply side, and 2 then, if -- I mean, demand side, if they have not 3 been charged, they go into voluntary program where 4 they'll see a doctor, and have the opportunity for 5 vivitrol or Suboxone and they go to treatment. 6 Our minimum facility now that we team up with 7 is 90 days. That's the minimum, and we'll team up 8 with a different facility, six months is their 9 minimum. See, when somebody comes in for treatment, 10 it shouldn't be give them a slip, they come back in 11 two weeks and they come back and start outpatient. 12 If you fail outpatient, you can get in for a 13 couple of weeks. If you fail that, you can get in 14 for a month. If you fail that, you can get in for 15 three months and that's absolute -- it doesn't work. 16 I mean -- 17 [ Applause ] 18 So how about the first time they come in, 19 they get six months of treatment. Those are the 20 numbers that we should be talking at, and the 21 facilities we work with have very high success rates 22 because they are minimum programs, 90 days, but 23 they're telling us they're going to keep people for 24 18 or 24 months, and when they come back out, then 25 they -- if it is determined that they need Suboxone 1 when they exit the program, or vivitrol when they 2 exit the program, that's what they do, and it helps 3 to transition when they get back home in the area 4 they came from. 5 So, it doesn't seem that difficult to me to 6 mandate that insurance companies pay for a 90-day 7 minimum program the first time somebody needs help. 8 You'll save that money in the long run, I think. 9 You know, everybody in the business, so to speak, 10 knows that. So that's what we're doing. 11 That's just basically my few ideas that I 12 apologize for taking so much time. But obviously 13 we're passionate about it and that's what we're 14 working on. 15 SENATOR FREDRICK ASHKAR II: Thank you for 16 your work on that and for the audience and everyone 17 else on the panel. We have a colleague Senator 18 Patty Richie from the north country who sponsored a 19 Bill that would require 90 days of treatment, and 20 the three of us are co-sponsors on that Bill. So 21 we're -- 22 [ Applause ] 23 Probably one of the things that we have heard 24 most about a reasonable amount of time for somebody 25 to get treatment, and hopefully we can move that 1 Bill in the Senate. And, again, I have said this, 2 and I know my colleagues have, this is such a 3 non-partisan issue, the Assembly should take it up. 4 I would encourage my colleague from the assembly to 5 help us to push that on that side of the building, 6 and hopefully the Governor would sign that. 7 So DA McBride and then Judge Pelella and then 8 I'm going to my friends from law enforcement. 9 Sorry. 10 JOSEPH McBRIDE: Judge, I don't mean to jump 11 in front of you. One other issue that we have 12 that's going on that is very important is 13 hypodermics in New York State are still illegal, but 14 there is a provision that if you obtain them 15 lawfully, then, in fact, that they're lawful. 16 But, there's no way for law enforcement to 17 prove that. It's creating a big problem in law 18 enforcement about whether or not they're legal or 19 illegal hypodermic instruments. 20 If state wants to -- 21 SENATOR FREDRICK ASHKAR II: You have to have 22 card, right, John? 23 JOHN BARRY: They should if they're in the 24 syringe exchange program. But they're also legal to 25 buy it from a pharmacy. 1 JOSEPH McBRIDE: Exactly. When you buy it 2 from a pharmacy, and John, you can correct me if I'm 3 wrong, you don't get a card, and there's no way for 4 them to know. 5 Now, that being said, there seems to be a 6 move in New York State to legalize that. If that's 7 going to happen, it's going to make my job, the 8 sheriff's job and every law enforcement officer's 9 job a lot easier. If we're either going to say that 10 it is legal or we're going to say it is illegal. If 11 we legalize it, then it's easier for people like 12 John to get needles to people. 13 If we decriminalize it, we can't give a mixed 14 message, because it is not fair to the officers who 15 are out there on the streets and trying to figure 16 out who has them legally and who has them illegally. 17 But now, if whatever the State decides to do, 18 the last issue is, and I'll hand the mic over, is, 19 there's a lot of needles on the streets, not only in 20 Chenango County but in Broome County, and throughout 21 New York State because of this problem. 22 What I would like to see, is not only that we 23 resolve the issue about who can have them legally, 24 but make it a more serious offense to dispose of 25 them illegally. Not only are you creating a health 1 hazard for everyone in your community, you're 2 putting your kids at risk, and in parks, parking 3 areas, and every other place. We need to make sure 4 that while we're fixing the heroin problem, we also 5 fix the needle problem that's occurring in all of 6 the communities in our area. 7 JOHN BARRY: I'm going to politely suggest 8 that if people were not being prosecuted for 9 possessing them, maybe they wouldn't be tossing them 10 away. 11 JOSEPH McBRIDE: Maybe you're right, and if 12 that's the case, we can solve that problem, but 13 there is a problem with needles in our community. 14 SENATOR FREDRICK ASHKAR II: We are about 15 five minutes before 6:00, so I'm going to ask Judge 16 Pelella to speak about the drug court system in 17 Broome County. We'll finish up with our friends in 18 law enforcement and then, everybody will be on their 19 way. Judge Pelella. 20 HON. WILLIAM PELELLA: Thank you, Senator. I 21 have been involved in the criminal justice system 22 for 35 years. I have been a prosecutor, a defense 23 attorney, and for the last 11 years a judge. 24 And I have had the honor and privilege of 25 presiding over the drug treatment court for the 1 last -- eleven years and for the last year presiding 2 over the veterans treatment court program as well. 3 The goal of those programs is to break the 4 vicious cycle of addiction. We have talked about a 5 little bit here today where someone uses, they get 6 arrested, they go to jail. They get out of jail, 7 they do it all over again and keep doing it until a 8 couple of things happen. Either they're in prison 9 for a very long time, or they're dead from an 10 overdose. And so what drug court tries to do is 11 with the cooperation of our partners in the 12 community, to try to break that vicious cycle of 13 addiction. 14 By treating the person, the entire person, we 15 deal with their health needs, we deal with their 16 educational needs, we deal with their employment 17 needs, and we deal with their addiction. 18 I have partners such as ACBC, New Horizons, 19 the YMCA, the YWCA, the Salvation Army, the District 20 Attorney, the halfway house, the public defender, 21 private attorneys such as Paul Battisti who is here 22 today who really want to look at the bigger picture 23 and try to help people who are involved in the 24 criminal justice system. 25 And what we do is, I have that whole team of 1 professionals helping me, assisting the court and 2 trying to treat the person and make them whole again 3 and take them from being someone who is in jail, 4 costing the taxpayers a lot of money, to making them 5 a productive citizen. 6 And over the years, I have been able to look 7 into the eyes of my participants, and I have seen 8 the tremendous grip that a drug such as heroin has 9 on a person. You can see it in their eyes. 10 I can see it on their face. The despair, the 11 lack of hope, the giving up. Just wanting to 12 survive for another day. We have also seen the face 13 of recovery. I have seen someone who has been able 14 to complete our program, and for the most part, our 15 program lasts a year and a half to two and a half 16 years. It's not an easy program. It's a program 17 where I have to balance the needs of the participant 18 with the rule of law. And I have to make sure that 19 they're held accountable, and that they're 20 responsible. 21 But by doing that, we really can make a 22 difference in their life. And I walk to work every 23 day, and recently I had a car pull up on Riverside 24 Drive, and somebody got out, and first as a judge, 25 you're always -- what's going on? But it was a 1 graduate of my program, and I could just see on her 2 face hope, the happiness, she's got her kids back. 3 She's working. She's doing something in her life. 4 She has hopes and dreams. 5 So our program is one of hope, not despair. 6 It is one of life, not death. And really, we're 7 talking about life and death, we're not talking 8 about criminal cases. And I'm really -- it is the 9 most rewarding work that I have done in the criminal 10 justice system, but at the same time, it's the most 11 difficult work that I have done. 12 But, I think that it is an example when we 13 come together as a community, particularly when we 14 take hard working professionals in the treatment, 15 along with the professionals in the criminal justice 16 system, and combine them and work together to help 17 these people that are in our program, it really can 18 make a difference. And I have seen it. 19 SENATOR FREDRICK ASHKAR II: On behalf of the 20 community, I thank you for your ongoing commitment. 21 [ Applause ] 22 To my friends in law enforcement, Captain 23 maybe we'll start with you and go down the line. 24 You know, I think in terms of maybe talk about the 25 things that you're seeing from a law enforcement 1 perspective and then quite frankly, I would like to 2 know where the legislature can be helpful from a law 3 enforcement perspective. 4 CAPTAIN PATRICK GAREY: First of all, thank 5 you, Senator. Thank you for holding the hearings 6 here, or the roundtable here and thank you to 7 everybody on the panel. 8 All of the main points have been touched. 9 From a law enforcement perspective, this is taxing 10 our resources unbelievably. Everything from 11 low-level petty crimes right up through. 12 I think I can speak for all of us. Any time 13 we get a report of a robbery, almost the first 14 instinct is what heroin addict is it? I think from 15 a law enforcement perspective, we're coming to 16 realize that, addiction is a disease. 17 I think like you, years ago, we all thought 18 that we were the solution. I don't -- now I can 19 absolutely say this is not a law enforcement 20 problem. 21 We deal with some of the problems related to 22 it, but it is absolutely a community problem. Where 23 this is coming from, and as you know, I spent 24 15 years with the State Police Community Narcotics 25 Enforcement Team, and one of things that I had that 1 people who worked for me do is interview anybody we 2 arrested or any informants that had any sort of an 3 addiction. And almost to a person, they've all 4 started with pills. 5 There are a few who started out with 6 marijuana and other drugs and progressed up through. 7 But, most of them, and many of them were legitimate 8 pill users, who before they even realized it, they 9 were addicted to drugs and also many of, you know, 10 who have been to panels before, I personally have 11 dealt with this, my niece was an addict who is now 12 two years recovered. 13 But I spent 15 years in charge of a narcotics 14 unit, and for a long time, I didn't know my niece 15 was addicted. I didn't recognize the signs. I 16 didn't ask myself the hard questions. And so what I 17 would put out is, prevention and awareness are the 18 key critical components of this, and certainly, 19 treatment is the third part of that. 20 And just to dispel any myths, in case they're 21 out there, from a law enforcement perspective, we 22 don't target users, ever. We would eat up our 23 resources in a matter of really minutes if -- I 24 think all of us could walk out today and target 25 25 or 30 users without even thinking about it. We 1 focus solely on dealers, and primarily on dealers 2 who are profiteers looking to make money off of it. 3 There are certainly people who are dealing 4 out there, to support their habit. We do arrest 5 them, they are committing crimes. And we do arrest 6 them. But I just wanted to make sure that that's 7 known, that it's really not even a consideration of 8 ours to go out and look for people who are actively 9 using. 10 And generally when that occurs, or people are 11 arrested for possession, it is one of two things. 12 It is either a patrolman who has come across the 13 drugs while they were in the course of their duties 14 one way or another, or, the arrest is the result of 15 possession with intent to sell, but we've targeted 16 them as dealers. 17 SENATOR FREDRICK ASHKAR II: Thank you, 18 Captain. Chief Zikuski, thank you for being with us 19 today. 20 JOSEPH ZIKUSKI: Thank you, Senator. I'm 21 glad you left us to last, because you did not have 22 much time, and nobody could better represent us than 23 you, knowing what our needs are. 24 SENATOR FREDRICK ASHKAR II: Thank you. 25 CAPTAIN JOSEPH ZIKUSKI: Just coming from the 1 front lines and working closely with you. I can't 2 agree more with the Captain. You know from our task 3 force we don't target users. The few times we do is 4 to get to the dealer themselves. And that's not too 5 often. Patrolmen have their jobs that they have to 6 do. 7 From what you can do from us, I hear Ray's 8 figures, and he said 64 in the county. You know, we 9 buy our own Suboxone, and I think our stats are a 10 little separate from yours. 11 In city alone, in the 14 or 15, we 12 administered 78, just the police department. And 13 we're funded that ourselves, so we need a little 14 help there. It's not a huge amount of money. 15 The resources, as the Captain spoke about, I 16 don't have to tell you all the manpower we have 17 addressed to this, you know, and what we're doing, 18 and as far as taking some of the burden off of the 19 local community, you know, some money for overtime 20 because everybody is asking for cops, and you don't 21 know what they're doing. Can I have this position, 22 but maybe, you know, some funding where it is a 23 narcotics investigation where we can prove this is 24 what the money is being used for, because I don't 25 have to tell you about funding positions and how 1 they get used and things like that. 2 So, you know, just so everybody knows, you 3 know, I'm not going to bore with you any figures but 4 from state registry, opiate deaths in Broome County, 5 there were 31 of them in 2014. And in 2015, there 6 was 27, 12 being City of Binghamton. 7 We responded last year to 101 overdoses that 8 the police department and sometimes the fire 9 department goes, so that's just what we're dealing 10 with. But you know, we can't arrest our way out of 11 this, you know that. And we can't incarcerate our 12 way out of this. 13 This is a community problem, and I couldn't 14 agree more with the Captain that we are just a 15 little part of the solution at the bottom. 16 Everybody in this room is a solution. 17 You know, just close up with -- it's almost 18 embarrassing to say. A good friend's son just 19 recently had a problem. And they were at their wits 20 end, and I said have him arrested. And, you know, 21 turn them over to Judge Pelella, because I have a 22 lot of respect for him and his program. He saved 23 a lot of people. This is a kid, his parents have a 24 lot of money. And they're at their wits end, and he 25 stole his father's credit card and ran up thousands 1 and thousands of dollars. His grandfather didn't 2 even know it. Stole everything out of the house. 3 And I said, you know, it is unfortunate that's where 4 we're at. 5 They are calling me and calling my wife and 6 have him arrested. And let the judge have a shot at 7 him. So I think we need funding. Any way that you 8 can help his program, or any of these other programs 9 here, you know, that's how we're going to get out of 10 this situation. 11 SENATOR FREDRICK ASHKAR II: Thank you, 12 Chief. Captain. 13 CAPTAIN KATHLEEN NEWCOMB: Thank you very 14 much. Thank you, Chair. You know, I've heard the 15 statement here several times today that we can't 16 arrest our way out of this problem. 17 However, I want to make it perfectly clear 18 that law enforcement has a clear job to do, and that 19 is to arrest the drug dealers. As I think Captain 20 Garey referred to, that is our job. And we're going 21 to continue to do that. And I'm proud of the 22 numbers and the arrests that our drug task force 23 have done in conjunction with the Binghamton Police 24 Department, as well as the Johnson City Police 25 Department and the Endicott Police Department. 1 They work very, very hard, tirelessly, to arrest the 2 drug dealers in this community. With that being said, 3 I also am proud of the job that the law enforcement 4 community has done over the last couple of years with 5 turning around, you know, Penny spoke about the stigma 6 and turning around the stigma that the law enforcement 7 community has. The law enforcement community can be a 8 very jaded group of people. And they have turned that 9 around as far as awareness, as far as being on the 10 front lines and starting the Narcan program, saving 11 many, many lives. The programs that we have in our 12 correctional facility. I think that law enforcement 13 has done a very good job and I think that in recent 14 years, they have had the opinion where they could 15 arrest their way out of it, and with that being said, I 16 think that they have turned it around where we have 17 become much more aware of the problem, much more 18 sensitive to the problem. So I think that the law 19 enforcement community is doing a very good job there. 20 A few of the other programs that we've implemented is, 21 we're working with UHS as well as Fairview Recovery, 22 trying to help the addicts to get to the beds available 23 in our community here locally. We have I think 24 somebody had touched on this earlier but we have the 25 drug dropoff boxes. If I could speak on behalf of 1 Sheriff Howard, we try very, very hard to implement 2 these new programs, and to do everything that we 3 possibly can to help the community. So it is very 4 multi-faceted, I think, from a law enforcement 5 perspective. We're involved in a lot of different 6 ways. Whether it is through the correctional facility, 7 whether it is arresting the drug dealer, or whether it 8 is assisting the addict to get to the bed at the ACC 9 here locally in City of Binghamton. So I just want to 10 make that clear that, you know, law enforcement has a 11 pretty big lift. While it is probably not as big as 12 the treatment and the treatment options and some of the 13 struggles that these folks deal with, you know, we're 14 doing the best that we can too. 15 SENATOR FREDRICK ASHKAR II: I think that -- 16 yes. 17 [ Applause ] 18 I think everybody would agree that it is 19 certainly a very important tenet in dealing with the 20 issue. And Penny, I think I recall having one of 21 our first conversations about law enforcement having 22 a jaded view about this particular issue. 23 PENNY STRINGFIELD: Can I say something about 24 that a minute, is that all right? 25 SENATOR FREDRICK ASHKAR II: Yes, please. 1 PENNY STRINGFIELD: My son's teacher called 2 and told me that she had witnessed someone 3 overdosing and she had called for the police. And 4 when they came, they were able to administer Narcan 5 and were able to revive the young man. 6 Unfortunately, the two law enforcement officers who 7 cared for him at that time turned to each other in 8 front of her and said, "Yippee, saved another junky 9 today." That was a pretty devastating thing to 10 hear. And it was pretty much how I felt about law 11 enforcement officers, honestly. Probably one of 12 best things that happened for me was that I spoke 13 about that at a BOAC meeting, and Senator Akshar who 14 was undersheriff at the time stopped the meeting, 15 and apologized for all of his peers. 16 I have to say that when my son overdosed, the 17 people that came from EMS, and the police 18 department, worked tirelessly, tirelessly for an 19 hour to try to bring him back. So, yes, there 20 are -- we've come a long, long way I think as far as 21 stigma in our law enforcement, but we have a ways to 22 go. 23 CAPTAIN KATHLEEN NEWCOMB: Absolutely. 24 PENNY STRINGFIELD: One of the things that I 25 have a deep concern about is Narcan and where Narcan 1 is available. I think Narcan should be available in 2 our schools. I think Narcan should be available at 3 any living facility where someone is coming after 4 jail or treatment because it is a misperception to 5 think that because it is there, people are going to 6 use. If they are going to use, they're going to 7 use, and we should be able to save their lives if we 8 can. And thank you for all the times that you have. 9 CAPTAIN KATHLEEN NEWCOMB: Thank you, Penny, 10 for pointing that out. 11 SENATOR FREDRICK ASHKAR II: Last but not 12 least, my very good friend from Tioga County, 13 Sheriff Howard. Thank you, Senator. I'll make it 14 really quick. I'm just shy of my 40 years with the 15 sheriff's office, and I have seen this wave come 16 through every so often. And Captain Garey will 17 agree with me the methamphetamine problem that came 18 up in about the 2002, 2003, 2004, was huge, and 19 during that time, I was asked to go to Washington 20 and testify before the House Science Committee to 21 get some laws changed. Then I came back, I went to 22 Albany and I testified there to a task force. We 23 got some laws changed. Senator O'Mara was standing 24 next to me down in Elmira when Governor Pataki 25 signed some new laws in. So now you go to the drug 1 store to get Sudafed and you have to show your 2 license, and everything is tracked that way. That 3 was cutting the head off the snake. It is 4 coming back. And that's a different problem that 5 we're dealing with now. I agree with the captain 6 when he said that this is a community problem. We 7 can't solve this like we did with the 8 methamphetamine by get something laws changed, and 9 having some control. I have a relatively small 10 jail. Probably half of my inmates have some type of 11 addiction. It is a huge strain not just on my 12 corrections officers, but my medical staff and the 13 community because they are the ones that pay for the 14 addiction problems when they go into detox and when 15 we have to get them into the hospital for infections 16 and all of those other issues that come with it. 17 It is a community problem. A day doesn't go by 18 that -- we have a tip line on my website, anonymous 19 tip line -- that we don't get a tip about some drug 20 use, or drugs being sold. And I agree with the 21 chief and the captains, we're not out to get the 22 users. We need to cut the head off that snake and 23 those are the dealers. And it is time consuming, 24 and it is very expensive. 25 SHERIFF GARY HOWARD: And just one short 1 story. My son is a deputy sheriff in Oregon. And 2 when he was growing up, he said "What would you do 3 if you caught me with drugs?" I said "I would 4 arrest you and send you to jail." And that has 5 changed. Now I have a grandson who asked me the 6 same thing. And I told him, "I would take the drugs 7 from you, and get you some help." That's all I 8 have. 9 SENATOR FREDRICK ASHKAR II: Thank you, 10 sheriff. 11 [ Applause ] 12 CAPTAIN PATRICK GAREY: Senator, if I could 13 just add one suggestion for you to think about with 14 the legislature. And the chief and captain and 15 sheriff have all kind of touched on it in different 16 ways. But when the methamphetamine epidemic 17 started, one of the pieces of legislation that went 18 in was that law enforcement agencies had to send a 19 message to Albany indicating where a lab was, and it 20 gave us a tracking of what was occurring, where the 21 trends were, where the labs were coming and what 22 type they were. And one of the things that I have 23 found in dealing with this over the last year or so 24 is that we all have our own statistics with regard 25 to overdoses and when Narcan was used and when it 1 wasn't. And I know there are some things reported 2 to the state, but I would just suggest maybe looking 3 into all law enforcement, fire department, EMS, and 4 healthcare personnel, all being required when there 5 is an overdose of any kind, not just an opiate, but 6 any overdose, that that goes into some central 7 database where we get real numbers that we can track 8 what drugs are trending at that point and what is 9 causing overdoses. 10 SENATOR FREDRICK ASHKAR II: Thank you, 11 captain. Well we have clearly run over our time, 12 SSuperintendent Gill, again, thank you for your 13 hospitality. I'm sorry we went over 15 minutes. I 14 want to thank everybody on this panel for fighting 15 the good fight on the front line. I know it is a 16 huge lift, but it is clear to me that there are many 17 people in this community who care. And, you know, 18 I think the biggest thing, and I said it when we 19 started is that, we as leaders need to ensure that 20 we're setting personalities, and we're setting 21 political differences aside, and we're moving 22 together as one. I think that's the most important 23 thing because if we're not doing that, I think that 24 the only people that we're harming are the people 25 who so desperately need our help. So I would 1 encourage everybody to stay together, as tough as it 2 may be, but we all have ideas and plans, none are 3 more important than the next. Just important that 4 we move forward together as a team. So with that 5 said, Senator Ortt, do you have some closing 6 remarks? 7 SENATOR ROBERT ORTT: Not really. It is hard 8 to after that great discussion and great panel here 9 that you put together. I want to thank everyone for 10 being here as well. And I wanted to sort of 11 clarify, earlier I said you heard sort of similar 12 themes, but that doesn't mean you don't hear new 13 ideas, or new, very worthy suggestions from each 14 discussion. And this is no different. And I can 15 assure you that I am going to be having, I know 16 Senator Amedore was not here today. Senator Amedore 17 along with being a co-chair of the Heroin Task Force 18 is also the chairman of the OASAS subcommittee, and 19 I know he would be very interested to hear some of 20 the issues because that was -- that's a little bit 21 more nuanced or specific than I have heard after six 22 or seven hearings. I will be having a phone call 23 with OASAS, probably in the next week or two, much 24 to their chagrin because they generally don't like 25 to hear from me. But that's okay. So you know, we 1 heard some different suggestions, and like I said, 2 the plan is, this session, now that we're passed the 3 bill, you'll see some comprehensive legislative 4 reform package that's going to include a lot of 5 things. I'm not going be disingenuous. It is 6 probably not going to include everything that 7 everybody thinks should happen, but I think it is 8 going to include a lot of things that we can all 9 agree with good things. Does that mean there won't 10 be still challenges and battles? I think you heard 11 from the law enforcement, this is kind of an 12 insidious epidemic. It sort of moves, just when you 13 do this, you do I-STOP and then all of a sudden, 14 heroin pops up. Everything you try to do, it is 15 sort it sort of adapts a little bit, so we'll keep 16 fighting the fight and try to I think the best 17 solutions come from the bottom up. They certainly 18 do not start in Washington or in Albany. But you 19 already know that. They start on the ground level. 20 They start with in place just like this, they start 21 with everybody here who is on the front lines, they 22 start with people who have lost loved ones, and who 23 have the courage to turn that into something 24 positive. They start with people who are nine years 25 sober, who are leading the fight and setting good 1 examples. It is not these three people in the 2 middle here. It is everyone else up on this dais. 3 So I want to thank you for what you're doing. You 4 help us to be better legislatorss and you'll help 5 lead the reform efforts, and when we get some 6 positive reforms and every time we save another 7 life, it is because of the people on this stage, and 8 it is not because of anybody in the middle here. It 9 is all of you, so thank you for what you're doing. 10 SENATOR FREDRICK ASHKAR II: Thank you. 11 [ Applause ] 12 SENATOR FREDRICK ASHKAR II: Thank you, 13 Senator Ortt. Senator O'Mara. 14 SENATOR THOMAS O'MARA: Yes, thank you, Fred, 15 for putting this together, and I thank all of you 16 for coming out and sitting in and listening and 17 showing your concern of what's going on in our 18 communities. It is vital that we all work together. 19 We ave heard from our panelists here and certainly 20 thank you to all of our panelists for taking time 21 out and expressing your ideas to this as Sheriff 22 Howard said back when I was in the State Assembly, 23 in 2005 and we still had Governor Pataki, we pushed 24 for, with Sheriff Howard's leadership, a lot of 25 changes under the methamphetamine laws. And we had 1 a similar task force to this that I was on in the 2 assembly going around the state that led to a lot of 3 the positive changes that came out of it. 4 Methamphetamine still continues to be a problem. 5 And no matter what package of legislation we come 6 out of this year, this heroin will continue to be a 7 problem. We've just got to get a better grasp of 8 it. 9 I've been on this committee now in the 10 Senate, this task force in the Senate for three or 11 four years. In 2014, we did rounds of hearings 12 across the state. I participated in one in Elmira 13 in my district that we had, and that led to a 14 package of legislation that is a constant 15 progression. I guess is my point that we're working 16 on and we'll always be working to perfect this, the 17 access to treatment, the availability of treatment, 18 and just to deal with this real, real problem that 19 we have in our society. But thank you all for being 20 a part of this solution here. 21 SENATOR FREDRICK ASHKAR II: Thank you, 22 Senator O'Mara. 23 [ Applause ] 24 So Ruth, we'll make it a point, my staff and 25 I, to follow up with you and the others associated 1 with treatment in terms of regulatory reform, and 2 then I'm going to get that information back to 3 Senator Ortt and the other co-chairs so hopefully we 4 can put our heads together and move on something 5 like that again. I would encourage everyone in the 6 audience, if you want to submit written testimony to 7 please do so before you leave. To everybody who is 8 streaming this live at home, please, visit my 9 website, ashkar.ny.senate.gov and we'll accept your 10 written testimony there as well. Again, thank you 11 all on the panel for participating. I pledged 12 accessibility when I ran for the New York State 13 Senate, and I want everyone to know not only on this 14 panel, people who are watching at home, people in 15 this community, that I meant what I said. My door 16 is open to your ideas, your suggestions, your 17 issues, and where I can be helpful, I need to know 18 that, and I encourage everybody to come knocking 19 because I stand ready to fight the good fight for 20 you, and I have a remarkable staff that I have to 21 thank for putting this on. Please, a round of 22 applause. 23 [ Applause ] 24 There was so much more than simply setting up 25 tables and putting some nice red skirting around the 1 front of it. So I have them to thank for making 2 this happen, and it was a huge lift, and I'm 3 eternally grateful to each of you who made that 4 happen. And to the men in the back of the room, in 5 uniform, thank you very much for providing security. 6 We appreciate it very much. 7 [ Applause ] 8 So again, thank you all for participating and 9 coming out, and I wish you all a blessed evening. 10 11 (Whereupon, the public hearing held before 12 the New York State Joint Senate Task Force on Heroin 13 and Opioid Addiction concluded.) 14 15 ---oOo--- 16 17 18 19 20 21 22 23 24 25