<DOC>
[110th Congress House Hearings]
[From the U.S. Government Printing Office via GPO Access]
[DOCID: f:44006.wais]
COMBATING DRUG ABUSE AND DRUG-RELATED CRIME: WHAT IS WORKING IN
BALTIMORE?
=======================================================================
HEARING
before the
SUBCOMMITTEE ON DOMESTIC POLICY
of the
COMMITTEE ON OVERSIGHT
AND GOVERNMENT REFORM
HOUSE OF REPRESENTATIVES
ONE HUNDRED TENTH CONGRESS
FIRST SESSION
__________
OCTOBER 1, 2007
__________
Serial No. 110-69
__________
Printed for the use of the Committee on Oversight and Government Reform
Available via the World Wide Web: http://www.gpoaccess.gov/congress/
index.html
http://www.oversight.house.gov
----------
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44-006 PDF WASHINGTON : 2008
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Washington, DC 20402-0001
COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM
HENRY A. WAXMAN, California, Chairman
TOM LANTOS, California TOM DAVIS, Virginia
EDOLPHUS TOWNS, New York DAN BURTON, Indiana
PAUL E. KANJORSKI, Pennsylvania CHRISTOPHER SHAYS, Connecticut
CAROLYN B. MALONEY, New York JOHN M. McHUGH, New York
ELIJAH E. CUMMINGS, Maryland JOHN L. MICA, Florida
DENNIS J. KUCINICH, Ohio MARK E. SOUDER, Indiana
DANNY K. DAVIS, Illinois TODD RUSSELL PLATTS, Pennsylvania
JOHN F. TIERNEY, Massachusetts CHRIS CANNON, Utah
WM. LACY CLAY, Missouri JOHN J. DUNCAN, Jr., Tennessee
DIANE E. WATSON, California MICHAEL R. TURNER, Ohio
STEPHEN F. LYNCH, Massachusetts DARRELL E. ISSA, California
BRIAN HIGGINS, New York KENNY MARCHANT, Texas
JOHN A. YARMUTH, Kentucky LYNN A. WESTMORELAND, Georgia
BRUCE L. BRALEY, Iowa PATRICK T. McHENRY, North Carolina
ELEANOR HOLMES NORTON, District of VIRGINIA FOXX, North Carolina
Columbia BRIAN P. BILBRAY, California
BETTY McCOLLUM, Minnesota BILL SALI, Idaho
JIM COOPER, Tennessee JIM JORDAN, Ohio
CHRIS VAN HOLLEN, Maryland
PAUL W. HODES, New Hampshire
CHRISTOPHER S. MURPHY, Connecticut
JOHN P. SARBANES, Maryland
PETER WELCH, Vermont
Phil Schiliro, Chief of Staff
Phil Barnett, Staff Director
Earley Green, Chief Clerk
David Marin, Minority Staff Director
Subcommittee on Domestic Policy
DENNIS J. KUCINICH, Ohio, Chairman
TOM LANTOS, California DARRELL E. ISSA, California
ELIJAH E. CUMMINGS, Maryland DAN BURTON, Indiana
DIANE E. WATSON, California CHRISTOPHER SHAYS, Connecticut
CHRISTOPHER S. MURPHY, Connecticut JOHN L. MICA, Florida
DANNY K. DAVIS, Illinois MARK E. SOUDER, Indiana
JOHN F. TIERNEY, Massachusetts CHRIS CANNON, Utah
BRIAN HIGGINS, New York BRIAN P. BILBRAY, California
BRUCE L. BRALEY, Iowa
Jaron R. Bourke, Staff Director
C O N T E N T S
----------
Page
Hearing held on October 1, 2007.................................. 1
Statement of:
Franklin, Lena M., director of Recovery in Community; Rita C.
Fayall, program coordinator Meet Me Half Way Village
Center; Leon Faruq, program director of Operation Safe
Streets East; and Sheryl Goldstein, director mayor's Office
on Criminal Justice........................................ 12
Faruq, Leon.............................................. 20
Fayall, Rita C........................................... 15
Franklin, Lena M......................................... 12
Goldstein, Sheryl........................................ 25
Heller, Ellen M., Circuit Court Administrative Judge,
president of the American Jewish Joint Distribution
Committee; Jamey H. Weitzman, Associate Judge, District
Court of Baltimore City; David W. Young, Associate Judge,
Baltimore City Circuit Court; Dr. Joshua Sharfstein,
Commissioner of Health of Baltimore City; and Dr. Philip J.
Leaf, professor, Johns Hopkins Bloomberg School of Public
Health..................................................... 45
Heller, Ellen M.......................................... 45
Leaf, Dr. Philip J....................................... 68
Sharfstein, Dr. Joshua................................... 61
Weitzman, Jamey H........................................ 51
Young, David W........................................... 60
Letters, statements, etc., submitted for the record by:
Faruq, Leon, program director of Operation Safe Streets East,
prepared statement of...................................... 22
Fayall, Rita C., program coordinator Meet Me Half Way Village
Center, prepared statement of.............................. 17
Franklin, Lena M., director of Recovery in Community,
prepared statement of...................................... 14
Goldstein, Sheryl, director mayor's Office on Criminal
Justice, prepared statement of............................. 28
Heller, Ellen M., Circuit Court Administrative Judge,
president of the American Jewish Joint Distribution
Committee, prepared statement of........................... 48
Kucinich, Hon. Dennis J., a Representative in Congress from
the State of Ohio, prepared statement of................... 4
Leaf, Dr. Philip J., professor, Johns Hopkins Bloomberg
School of Public Health, prepared statement of............. 70
Sharfstein, Dr. Joshua, Commissioner of Health of Baltimore
City, prepared statement of................................ 64
Weitzman, Jamey H., Associate Judge, District Court of
Baltimore City, prepared statement of...................... 53
COMBATING DRUG ABUSE AND DRUG-RELATED CRIME: WHAT IS WORKING IN
BALTIMORE?
----------
MONDAY, OCTOBER 1, 2007
House of Representatives,
Subcommittee on Domestic Policy,
Committee on Oversight and Government Reform,
Baltimore, MD.
The subcommittee met, pursuant to notice, at 9 a.m., in
Ceremonial Moot Court Room, University of Maryland School of
Law, 500 West Baltimore Street, Baltimore, Maryland, Hon.
Dennis J. Kucinich (chairman of the subcommittee) presiding.
Present: Representatives Kucinich and Cummings.
Staff present: Jaron R. Bourke, staff director; Charles
Honig, counsel; and Jean Gosa, clerk.
Mr. Kucinich. Good morning. The Domestic Policy
Subcommittee of the Committee on Oversight and Government
Reform will now come to order.
Today's hearing will examine innovative approaches to
combating drug abuse and drug related crime in Baltimore.
Now, without objection, the Chair and other Members will
have the opportunity to make opening statements, followed by
statements of the witnesses not to exceed 5 minutes.
Without objection, Members and witnesses have 5 legislative
days to submit a written statement or extraneous materials for
the record.
And without objection, we will be joined on the dais by
Members not on our committee for the purpose of participating
in this hearing and asking questions of our witnesses.
I want to begin by recognizing the considerable
contributions of Congressman Cummings in organizing this
hearing. Congressman Cummings' commitment to his home city of
Baltimore, as you know, is profound.
This is only the most recent of field hearings on the
city's efforts to combat drugs and crime that he has helped
this committee to convene. These hearings continue to be
important, both because of the pressing issues facing Baltimore
and what this city's experience tells us about national drug
control and violence prevention efforts.
As we all know, the levels of drug abuse and drug related
violence in Baltimore are unacceptably high. It is estimated
that 60,000 of Baltimore's 650,000 residents are drug
dependent, mostly abusing heroin and cocaine. By many metrics,
Baltimore is the most violent major city in the country and
recent indicators are troubling. Non-fatal shootings and
juvenile shootings are up and, most tragic, homicides have been
creeping upwards since 2002. The city is on pace for more than
300 murders for the first time since 1999.
Five years ago our predecessor subcommittee held a field
hearing in the War Memorial Building to examine what is termed
Baltimore's innovative drug demand reduction strategy. Since
then, ``The Wire'' has allowed a larger audience to learn about
some versions of the Baltimore drug and crime problems.
In some respects, this hearing involves the same themes as
the earlier hearing. It looks at city-led and community-wide
efforts to provide effective drug treatment and in particular
the role of drug treatment courts in this process.
It also highlights how crime reduction efforts are part of
the solution. Back then it was methadone provision. Now it is
buprenorphine.
By focusing here on drug treatment, the coordinated
provision of services and community-based violence prevention,
I do not want to suggest that law enforcement and policing
strategies are not crucially important; they are even if they
are not the main subject of this particular hearing.
In this subcommittee, we will look at the ways in which
Federal policies, including the Tiahrt amendment and inadequate
gun ownership registration, are stalling the efforts of local
law enforcement to remove illegal drugs from the streets. In
addition, criminal justice is not just policing. As the highest
criminal court coordinator will explain, there are many other
effective strategies. Nonetheless, drug abuse is largely a
public health problem, and combating drug abuse is dependent on
a coordinated strategy to offer at risk individuals multiple
services.
Put another way, because drug abuse and drug related
violence have multiple causes, programs and strategies to
combat them must be multifaceted and provide multiple services
in a coordinated fashion. Not just drug treatment, but job
training, financial assistance, and referrals to mental health
facilities when needed.
Similarly, to combat gangs and prevent violence it is not
enough to place people behind bars. Instead we need to develop
programs that ensure that youths stay in school, learn to
resolve their differences peacefully, stay off drugs, and plan
for a career.
That is the insight behind what our witnesses will
variously term wrap around services or provision of a spectrum
of services. A panel of witnesses will introduce a lot of these
programs today. And they will discuss initiatives operated by
community groups and faith groups.
This committee will also hear from a panel of judges who
together have been most instrumental in Baltimore's successful
implementation of drug treatment courts. Drug courts have been
an effective route for coordinating criminal justice agencies,
mental health, social agencies, and treatment communities to
provide multiple services. Drug courts demand accountability
from their participants and are sophisticated about monitoring
outcomes and ensuring best practices as to how to operate.
The judges will describe efforts to improve these courts by
providing more rapid evaluation and treatment referrals, a
wider array of participants and expanded services. They will
also explain how the problem-solving court model is being
applied to children and families in juvenile drug courts, teen
courts, truancy reduction courts and family courts.
Important questions are raised by the simultaneous
development of judicially led problem-solving courts and non-
judicial programs that aim to provide a similar spectrum of
services.
They are working at now to coordinate existing services in
order to prevent wasteful replication. Further demands of
collaboration and coordination have been reflected in
institutional changes, and there are other challenges specially
for the Federal Government. Does the government adequately fund
drug treatment and types of institutions like drug courts that
have been shown to be effective? Does the Federal funding
process hinder the development of programs that provide
multiple services because these programs naturally need grants
from multiple Federal funding sources?
Breaking the cycle of drug addiction and violence in
Baltimore or in any other city, for that matter, is an immense,
but not an insurmountable task.
Understandable frustration about the persistence of these
problems should not blind us to the fact that those who care
passionately about this city, church members, social workers,
judges, public policy advocates alike, and Congressman Elijah
Cummings, have made progress identifying types of interventions
that work.
To help, the Federal Government must be attentive to what
is working. That is what we are going to hear about today.
At this time, I am pleased to introduce the gentleman who,
in so many ways, has brought to the forefront matters of great
concern to this community. He has brought them to the U.S.
Congress and he has demanded that Congress pay attention.
Whether it is health matters, housing matters or matters that
relate to criminal justice and drug treatment and prevention,
Congressman Elijah Cummings has been there and I am so grateful
to Congressman Cummings, Elijah, to be with you here today in
your home area, about this community you love so much about the
matters that you are so concerned about. So the Chair
recognizes Congressman Cummings.
[The prepared statement of Hon. Dennis J. Kucinich
follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Cummings. Thank you very much Mr. Chairman. And I want
to thank you and I am sure the audience is well aware that you
were the former mayor of Cleveland, OH, so you are familiar
with many of these problems.
I want to thank you for holding this vitally important
hearing to seek out the best practices for combating drug abuse
and drug related violence.
I also want to thank the University of Maryland Law School.
Dean, I thank you for hosting us this morning.
As you already know, violent crime is on the rise
nationwide. According to a report recently released by the
FBI's Uniform Crime Reporting Program, robberies surged in 2006
by 7.2 percent, homicides rose by 1.8 percent and violent
crime, overall, rose 1.9 percent. Taken together, 2005 and 2006
represent the first steady increase in violent crime since
1993.
Here in Baltimore we have seen incidents of violence and
gang activity increase at a record breaking pace. As of now,
more people have been killed in Baltimore this year than at
this time last year. We will not know for sure what has caused
this national spike in crime until a full analysis is
conducted, however, there are many things that we do know from
the decades we have spent working to bring peace to our
community. However, in Baltimore's inner city, the inner-inner
city, I have seen the young men in my neighborhood lured into
prison instead of college by illegal drug traffickers. I've
also seen the young women seduced by addiction into selling
their bodies on our streets. It is almost impossible for me to
express how deeply I am troubled by this waste of human life.
Drug abuse and drug related violence have destroyed whole
generations in our community and in so many communities across
the country. Not only has it destroyed communities, but it has
brought a lot of pain.
As you know, Congressman Kucinich has stood for several
years as ranking Democrat in the predecessor committee to this
committee, the Subcommittee on Criminal Justice, Drug Policy,
and Human Resources. We are all acquainted with Representative
Congressman Souder, who was the Chair then, and of course
Congressman Souder is from Indiana. And we tried to identify
the best practices in our national effort to stamp out the
scourge of illicit drugs. You would assume that a Congressman
from a rural Indiana town would have little in common with a
Congressman from the inner city of Baltimore, and in many ways
that would be correct. However, Congressman Souder, a
Republican, and I were able to find common ground in our
efforts to identify drug treatment and prevention strategies
that work.
Congressman Souder's community is plagued mostly by
methamphetamine addiction, whereas cocaine and heroin addiction
are more common here, but the result is still the same. Drug
abuse and drug related violence know no boundaries. They are
equally destructive to all communities, Black, White, rural and
urban.
In our past oversight investigations, we have frequently
turned to Baltimore City, historically a leader in implementing
innovating drug treatment and prevention strategies. Chairman
Kucinich, I sincerely appreciate your willingness to continue
that tradition today.
This morning we will hear from the individuals on the
ground who are responsible for providing drug treatment and
services. We will hear testimony regarding a highly effective
drug treatment court model for which the State of Maryland has
been a national leader.
Providing comprehensive drug treatment to non-violent
offenders has been shown to stop drug related violence before
it even starts. In this process we will also examine the
emergence of other problem-solving courts, such as truancy
courts and teen courts, which are aimed to address the needs of
at risk youth. Finally, we will hear from city leaders on the
identification and implementation of best practices, with such
groundbreaking efforts as the Baltimore Substance Abuse System
[bSAS]. Since it was established in 1990, bSAS has been in the
forefront of harm reduction efforts. I applaud its recent
efforts to widely distribute the highly effective, low risk
opiate dependency treatment, buprenorphine.
Baltimore's Mayor Sheila Dixon has long been a leader in
our shared fight against illegal drugs. I fully expect that the
Mayor will continue to implement an aggressive drug control
strategy that builds on the success of the past while meeting
the new challenges we face. And I look forward to learning more
about that strategy today.
I find it unconscionable that we are spending billions of
taxpayer dollars to fight terrorism overseas while failing to
address the terrorism right here in our own backyards. That,
Mr. Chairman, is why it is so critically important that we hold
hearings like this one.
Again, I agree with you that the programs that we have
found in the past are the most effective and efficient of those
that provide holistic treatment and services to our
constituents.
I thank you again for holding this vitally important
hearing. And I thank all of our witnesses for being with us
today.
And it's my understanding, Mr. Chairman, that many of the
law student friends will have to be leaving us to go to class
at 10. So I hope that everybody will understand that these are
the future lawyers of America and we want them to get every bit
of knowledge that they possibly get, as much as we would love
to have them with us.
And I want to thank all of you for taking your time to be
with this morning.
With that, Mr. Chairman, I yield back.
Mr. Kucinich. Thank you very much, Congressman Cummings.
And to those who are scheduled to go to a class, thank you
for being here for the beginning of this hearing.
Are we going to have all the lights turned off? That is not
the way I work. OK.
So as people are filing out, we will give you a chance to
file out and then we will start with the introduction of the
witnesses.
By the way, as you are leaving, this committee meeting is
being taped and it will be on our committee Web site. So you
will have a chance to watch it if you are on your way to class
and can't be here for today.
I am going to begin by introducing our first panel.
Is it Lena or Lena?
Ms. Franklin. Lena.
Mr. Kucinich. Lena Franklin is director of Recovery in
Community, a Baltimore substance abuse treating center that
provides multiple services to its patients. She received a
fellowship from the Weinberg Foundation 2007 for her work.
Recovery in Community is one of three grassroots centers that
makes up Baltimore city's Threshold to Recovery Program.
Threshold centers offer a nontraditional holistic approach to
substance abuse recovery with a range of options including all
night 12 step meetings, acupunture, mediation, tai chi and
buprenorphine.
Rita Fayall, welcome. Currently works as program
coordinator for the Meet Me Half Way Village Center, a program
founded by her husband which provides mentoring and family
support services for students and families of Garrison Middle
and Forest Park High Schools. Mr. Fayall is a long time
grassroots community organizer and activist in northwest
Baltimore where she has worked to help residents and
stakeholders organize and take action to improve the quality of
life for themselves and their families. Meet Me Half Way is
part of Project Garrison, a faith-based, community-based
nonprofit dedicated to advancing public safety faith-based and
economic development initiatives in northwest Baltimore.
Leon Faruq, welcome, is currently the program director of
Operation Safe Streets East, a shooting and homicide reduction
initiative in east Baltimore. He also serves as the director of
reentry services for the Living Classrooms Foundation where he
oversees pre-release and post-release services for juvenile and
adult ex-offenders. Mr. Faruq was founding director of Respect
Outreach Center, a community-based ex-offender run reentry
organization. He's a member of the mayor's Ex-Offender Steering
Committee, Maryland Division of Corrections Useful Offender
Initiative Task Force and Baltimore City's Ex-Offender
Employment Steering Committee, and is an Open Society Institute
fellow.
Sheryl Goldstein, is that correct? Was appointed director
of the Mayor's Office on Criminal Justice in February 2007.
Welcome. Prior to her appointment she worked for the Center for
Court Innovation, a public/private partnership with the New
York State Unified Court System that focuses on problem solving
initiatives. At the center she created and operated a
community-based mediation center in Crown Heights, Brooklyn,
helped develop community justice centers in Red Hook and Harlem
and assisted criminal justice agencies, governments, NGO's and
community groups. She has also served as criminal justice
coordinator to the Baltimore County Executive Jim Smith, worked
on legal reform in Kosovo and litigated criminal cases for 6
years.
I wanted to thank all of the witness for being here, and
thank those who are in attendance in the audience.
It is the policy of the committee on Oversight and
Government Reform to swear in all witnesses before they
testify. I would ask that you would rise and raise your right
hands.
[Witnesses sworn.]
Mr. Kucinich. Thank you.
Let the record reflect that the witnesses answered in the
affirmative.
And I will ask that the witnesses now give a brief summary
of your testimony. I want you to keep in mind that this summary
should be kept 5 minutes or under in duration, but also your
complete written statement will be included in the record of
this hearing.
Ms. Franklin, let us begin with you. And again, thank you
so much for your presence here today. You may proceed.
STATEMENTS OF LENA M. FRANKLIN, DIRECTOR OF RECOVERY IN
COMMUNITY; RITA C. FAYALL, PROGRAM COORDINATOR MEET ME HALF WAY
VILLAGE CENTER; LEON FARUQ, PROGRAM DIRECTOR OF OPERATION SAFE
STREETS EAST; AND SHERYL GOLDSTEIN, DIRECTOR MAYOR'S OFFICE ON
CRIMINAL JUSTICE
STATEMENT OF LENA M. FRANKLIN
Ms. Franklin. Thank you.
Recovery in Community, Inc., is a program that started in
Baltimore City with funding from the Abell Foundation and
Weinberg Foundation in 1999 in three of the oldest southwest
Baltimore neighborhoods in southwest Baltimore, which was
Franklin Square Fayette Street Outreach and Boyd Booth.
The program was designed with input from the community as
well as representatives from Health, Human Service and law
enforcement agencies. After locating to its permanent site in
1999, it began to offer services to the community itself.
Recovery in Community differs significantly from the major
existing drug treatment outpatient programs in that it provided
from the beginning a street outreach component as well as
transitional housing. Because one of the things that was found
in, I guess we would call needs assessment prior to the program
opening, was that traditional outpatient when looking at 3 to 6
month involvement that did not address all of the other
barriers, a lot of the barriers in terms of treatment, that it
was not useful. The community did not see it as useful. And
also our experience tells us, that is, people are involved in
treatment that if we do not address the barriers, then it sets
up the likelihood that they are going to be continuing to
recidivate or, you know, keep coming in and out because all of
the things that they need are not being addressed.
So a big part of what we do at Recovery in Community is the
piece where we do concentrate on comprehensive case management
in addition to the outreach, in addition to the transitional
housing and nontraditional kinds of services inclusive of
acupunture, as was talked about before.
The process is also an ongoing thing in that we do not look
at finite level or finite times that people are in treatment.
Recovery in Community expects that when folks walk through the
door they make a commitment, as we make a commitment to them,
they make a commitment to us for at least 1 year. So as a part
of our service we see that the graduation that we do at the end
of 1 year being enrolled in treatment as well as whatever time
it takes them to achieve 9 consecutive months of clean urines,
that we do a huge graduation where we do the dedicated speaker,
the dinner inviting the family, community everybody. Because we
see that it's a great accomplishment to so many of our folks,
you know not having ever finished something and to be able to
be allowed to celebrate it with their family, friends and
community.
As a part of the concept of Recovery in Community also
we're not just looking at the individuals that are identified
or effected with the substance abuse problem. Because, as we
know, substance abuse effects everybody not just the
individual, but the families as well as the community. So it's
always one of my things that if I ever forget, or start to
forget, what it is that I'm doing all I have to do is remember
the name Recovery in Community. Because unless we are
addressing all of the community in terms of families,
individuals and the neighborhoods themselves, then we're really
not doing a good job I don't feel in dealing with the problems
as we see them.
We have had since we began treatment in 1999, 257 folks
that have completed the 1-year minimum and 9 months of
consecutive clean urines. And of those 257, 203 of them were in
traditional housing. And so it just kind of indicates to us how
important transitional housing is as a part of this process.
As you talked about it in my introduction, we're also
involved in the Threshold to Recovery project. And we see that
as a natural extension of what we do. We don't see our
involvement with our client, again, is just in these increments
of 3, 6 months that kind of thing. We truly believe that in
order for people to continue that continuum of recovery in
being and getting the support, that we can't just talk about
the treatment part of it. We also have to talk about the
recovery part of it. Because as you know, with all of the
difficulties that people experience as a result of their
substance use; employment, housing, family support, all those
kinds of things that, again, we have to address that it takes
time for folks to be able to get back on the level ground and
the footing that allows them to maintain recovery in the long
run.
So we design our program, as we continue to develop our
program and to bring in other initiatives or to be involved in
other initiatives as a Threshold to Recovery, then it's very
apparent to us that we have to continue our efforts in
developing programs with community input with other agencies,
social services agencies within our community. We have
collaboratives with employment services, with legal services,
with the family treatment or the family health center that is
located in our community as well.
Did I do 5 minutes. OK. But I think that in a nutshell kind
of gives you an overview of what it is that we do.
[The prepared statement of Ms. Franklin follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you very much for your testimony, Ms.
Franklin.
Ms. Fayall.
STATEMENT OF RITA C. FAYALL
Ms. Fayall. Meet Me Half Way Village Center is a school-
based mentoring and family support program run by community
residents. Operating from the basements of Garrison Middle and
Forest Park High School in northwest Baltimore, center staff
mentors students and coordinate wraparound services for the
students, their families and neighbors.
Meet Me Half Way operates full time during the school day.
The Program impacts youth, drug abuse and violence prevention
by providing mentoring, career exploration and other positive
alternatives and provides interventions through counseling,
referral and support services.
Center staff conduct conflict resolution sessions and
lunchtime conversation circles. There is a kinship support
group for grandparents and other relative care givers,
individual and family counseling, grief support groups and GED
classes.
Welding, printing and carpentry equipment has been
purchased or denoted to introduce youth to trades and career
exploration. Licensed community professionals volunteer their
time to perform the services or classes for the students.
According to the director, 90 percent of what the staff
does is listen.
That is what is unique about Meet Me Half Way. Students say
this is the one place where adults actually listen to children.
Until very recently the staff did not even realize the impact
the program has relative to drug usage, drug related crime or
gang violence until one student shared that she spends so much
time in the basement because it is one of the few places where
she is not being recruited by gang members. Other then admitted
that there are recruiters in the building and that this is a
serious issue for students.
Last week when a girl was beaten by several girls, she
returned 2 days later with nine girls to attack her own cousin
because she did not join in to help the fight. The cousin was
reluctant to have staff call her mother because she said her
mother would make her fight each of the 10 girls individually
while the mother stood guard to make sure it was fair fight.
The cousin is the young lady who is trying to resist gang
involvement.
Last summer, four youth workers returned from lunch
admittedly under the influence of marijuana and were sent home
for the day. Rather than terminate the young men ages 15 to 17,
program staff decided unanimously to give them the option to
undergo drug testing and treatment for the duration of the
summer work assignment as a condition of their continued
employment. Program staff collaborated with a nearby treatment
facility and each youth accepted the offer.
One was reluctant to submit to the test because he was
already on probation through the courts and because he believed
the treatment was not really going to make a difference because
he said all the people in his house smoke marijuana.
Sometimes it is the parents who seek help from Meet Me Half
Way. In two separate runaway cases within the past few months
program staff have helped parents to secure residential
placement and treatment for the students on the very day they
were located.
All these cases are fairly representative of issues faced
by Meet Me Half Way staff and clearly illustrate the need for a
comprehensive approach that involves family and community
stakeholders.
To maximize the impact in combating youth drug and gang
involvement, the program's parent organization Project
Garrison, Inc. coordinated a drug-free community coalition
following the guidelines set forth by SAMHSA. On this past
Saturday a Recovery Walk was held on Park Heights Avenue in
Baltimore to celebrate recovery. Over 350 people participated
in the walk sharing their support and appreciation for the
support of those in recovery.
Meet Me Half Way has just started its fifth school year and
conflict resolutions are down from 61 in September 2005 to 17
this September. Out of school suspensions are down by over 83
percent. Last year student attendance improved and an
unexpected result, teacher attendance also improved.
Thank you.
[The prepared statement of Ms. Fayall follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you very much for your testimony.
Mr. Faruq.
STATEMENT OF LEON FARUQ
Mr. Faruq. Thank you.
Operation Safe Streets is based on the CeaseFire model to
reduce shootings and homicides in high risk neighborhoods. The
model has five core components: Community coalition building,
street outreach, public education, clergy involvement and law
enforcement collaboration.
The program seeks to create behavior change and shift the
social norm that violence is acceptable through repetitive
prevention messages and concrete services that support and give
credibility to the message.
The key message is that shooting is not acceptable in our
communities. Operation Safe Streets site focus on Police Post
221 in the southeast police district. This area is selected
based on its high rate of violence including homicides and
shootings. We deliver stop shooting messages through our
outreach workers, community leaders, posters and flyers. We
also emphasize that this message at Safe Streets events. Our
workers are on the streets Tuesdays and Wednesdays from 2 p.m.
until 10 p.m. and on Thursdays, Fridays and Saturdays they're
on the streets from 6 p.m. until 2 a.m.
Our outreach workers are hired from the community. They are
working with similar backgrounds to those who they are trying
to reach. These are individuals who are respected n the
community. The outreach workers both deliver the message that
shooting is not OK and are able to interrupt and de-escalate
volatile situations before they lead to violence. We have four
outreach workers in our site, four full time and one part time.
The workers identify at risk individuals, they canvas the
neighborhoods, they case manage clients, they work with youth
and they identify and they mediate conflicts in the community.
An example of a conflict mediation one of the outreach
workers recently mediated a conflict between two groups related
to a theft of a drug stash. The situation escalated to the
point where friends were involved and violence was threatened.
The outreach worker was able to bring both subjects away from
their friends and engaged them in mediation where they
discussed the situation and talked about the issues and
misunderstanding relating to the conflict. And the situation
would have likely ended in violence was resolved in a peaceful
manner.
We have over 20 conflict these kind of mediations, and most
of them in my opinion I believe they would have led to
violence.
Workers continue to monitor situations and are prepared to
intervene again if needed.
We organize a response to shootings in our area. The
response emphasize the message that shootings is unacceptable
and bring the community together and heals community spirit.
Responses can be a vigil, a march or some other kind of
activity.
We also conduct community events such as midnight barbecue,
movie nights and basketball tournaments. Our most recent event,
Peace Night Out, included a community resource area, free
drinks non-acholic, free food, a dance contest and musical
performances. The event drew a crowd of approximately 250
community members and stressed the importance of reducing
shootings and homicides in the targeted area.
The community oriented events promote confidence in the
program and allow community members to take ownership of the
program and its message.
Operation Safe Streets have been operating in the east side
of Baltimore in this part of McElderry Park since June 2007. At
that time there had been five shootings in that targeted area,
and Operation Safe Street had responded to each shooting by
galvanizing community members to deliver the message that
shooting is not OK.
There have been between 65 and 200 community members at
each of these shooting responses. In addition, Operation Safe
Streets have held four community events in a targeted area
since June with between 175 and 300 residents attending these
events. The program has handed out over 5,000 public education
materials. Outreach workers have mediated over 20 conflicts and
assure that these conflicts did not result in shootings and
homicide.
We are optimistic that this program, we have an impact in
reducing homicides and shootings in Baltimore.
And thank you for your time and attention to this important
issue.
[The prepared statement of Mr. Faruq follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you very much for your testimony.
Our next witness is Ms. Goldstein.
STATEMENT OF SHERYL GOLDSTEIN
Ms. Goldstein. Thank you. Good morning, Mr. Chairman and
Congressman Cummings.
I appreciate the subcommittee's desire to help cities like
Baltimore reduce violence, and I thank you very much for the
opportunity to testify here today.
Baltimore is a city with many strengths, but we also have
some serious challenges. Gang culture and criminal activity are
threats to the many law abiding citizens of our city and they
create some long term challenges because gangs recruit young,
and young people who commit crimes often spend their entire
lives on the wrong side of the law. Many never could finish
school, many have very limited employment options. And
unfortunately, all too many end up in jail or becoming the
victims of violence.
Preventing juvenile crime, combating gang activity and
reducing youth violence in Baltimore City requires a citywide
effort, including local, State and Federal agencies, social
service providers, community-based organizations, faith-based
groups, neighborhood associations, community leaders, residents
and youths. And it is really my privilege to sit on a panel
with three people who represent community-based organizations
that are in the trenches doing this work. Because without
partnerships with people like you who have been out there and
are working with the people, the city could never be
successful, or nearly as successful in combating violence and
helping the people in our community. So I thank you and applaud
what you are doing.
We must all work together to address health concerns,
substance abuse, criminal justice, recreation, employment and
other socio-economic issues confronting Baltimore's youth.
What we see in Baltimore today is that youth involvement in
gangs and violence is a growing concern. Police estimate that
we have over 50 known criminal street gangs with over 1,500
adult members. This number is an interesting number in that
last year we had 170 known criminal street gangs. We are not
losing criminal street gangs, they are just becoming more
organized in identifying themselves as Blood sets and Crip
sets. And so while the numbers are growing, the gangs are
actually become more organized.
School policy estimate that we have 600 high school
involved in 60 gangs. Six hundred youth involved in gangs in
middle schools and elementary schools.
Juvenile violence and juvenile crime is also on the rise.
Last year 9,000 young people were arrested and put in the
juvenile justice system. A third of those young people were
arrested for substance abuse related crimes.
Juveniles account for nearly 20 percent of all people
charged with adult felony gun charges this year. And even more
disturbing is that Baltimore City has experienced a 64 percent
increase in juvenile shooting victims and juvenile shooting
suspects from last year.
Mayor Dixon has adopted a multifaceted approach to combat
gangs and youth violence. The strategy includes law enforcement
and prosecution components which are not the focus of this
hearing, but recognizing the police and prosecutors cannot do
this alone.
Mayor Dixon's administration supports gang and juvenile
crime reduction through outreach, community partnership and
providing opportunities to those who choose to take positive
steps toward realizing their full potential. The goal is to
create a full continuum of services and supports, starting at
creating opportunities for young people and others to keep them
out of the system entirely, keep their lives free of crime,
engage in positive opportunities as well as programs and
systems that will intervene with young people who get in
trouble with the law at all points in the system.
In my written testimony I have presented a number of
different programs, and I wanted to highlight a few of the
really promising programs that we have research and data on for
the committee.
One of the main initiatives under Mayor Dixon starting in
January of this year was to create more outreach opportunities.
One of the things that we find is that there are many people
who want to access opportunities and services but can't get
connected, don't know about those opportunities.
Mr. Faruq just testified about Operation Safe Streets. With
the support of Federal funding, Baltimore City has been able to
launch two Operation Safe Streets sites. The east side site
started in July and we have just funded a site on the west side
of town as well.
This program is modeled on Chicago's CeaseFire, which is an
outreach program to prevent and reduce homicides and shootings.
It is a program that really focuses on having people who have
street credibility, who are either ex-offenders or who have
been involved in gangs in the past out on the streets at
nontraditional times when most people are out on the streets
and conducting outreach to try to get people to make different
choices and to link them with different support, such as
substance abuse treatment, job training, job opportunities so
that they change their lifestyle.
In Chicago, CeaseFire achieved reductions in shootings of
between 25 and 67 percent in different communities. And we are
optimistic that we will see these same results here in
Baltimore.
Baltimore is also partnering with grassroots organizations
that have been working on the ground and have been successful
just on their own reaching out to people to try to get them out
of the lifestyle and connected with positive supports. So far
the city has partnered with and has funded programs such as
Reclaiming Our Children & Community Project, Precision Youth
Power, On Our Shoulders and New Vision Youth Services. These
four programs are an example of programs that were started by
people who used to be in gangs or were in the criminal justice
system who wanted to change their lives and change other
people's lives. And we are continuing to build those
partnerships, investment in those programs to help people to
change their lives.
Another program that I want to talk about is the Health
Department's Office of Youth Violence Prevention runs a program
called Operation Safe Kids.
Operation Safe Kids was developed in response to young
people who were at risk of violence. The program really seeks
to engage young people who are in the juvenile justice system
as an alternative to placement or detention, and it is focused
on young people who are either likely to be victims or
perpetrators of violence.
What we find in these young people is that many of them
have multiple prior arrests, five or six for CDS and other
types of offenses. And many of them have their first arrest as
young as age 13.
The outcomes of this program are promising. The total
arrests for young people in the program after their first year
dropped by 32.9 percent. Arrest for drug crimes dropped 41.2
percent. And arrest for violent crimes dropped 44 percent.
One of our other lessons learned by that program is that
for every 10 percent increase in employment of participating
youth was associated with a 20 percent drop in arrests, which
takes me next to looking at our Mayor's Office of Employment
Development.
The Mayor's Office of Employment Development has really
taken a leading role on providing opportunities for young
people who are at risk of not completing school or out of
school. The Youth Opportunity Centers have reconnected over
1,000 youth each year who have dropped out of school to a broad
menu of academic, personal growth and employment opportunities.
Our Futures program serves nearly a 1,000 young people each
year who are at risk of dropping out of school and keeps them
in school. And 5,000 city teens are employed each summer
through the Mayor's Office of Employment Development's Youth
Work Summer Jobs Program.
These programs all have proven to reduce dropout rates and
to reduce arrests.
So I see that my time is up. And if there are any
questions, I would be happy to answer them.
Thank you.
[The prepared statement of Ms. Goldstein follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. I want to thank Ms. Goldstein for her
testimony.
And maybe what I could do is to begin with questions of
you. What percentage of at risk children in Baltimore do you
estimate are served by the more aggressive multi-service
intervention, be it in Teen Court or Operation Safe Kids, and
has these saturation services reached the point where you can
see an improvement in overall social indicators like school
attendance, new drug indication, gang affiliation, level of
violence?
Ms. Goldstein. Sir, these programs reach a very small
number of children. Operation Safe Kids reaches about 100/150
kids a year, our Teen Court service about 200 kids a year. So
while they are programs that are successful with the young
people they intervene with, it is a very small number of young
people who are receiving those services. And so in terms of
saturation services, absolutely not. We would certainly need
more support and funding for that.
Mr. Kucinich. You have broad experience in New York and
other localities. Can you tell us how Baltimore compares to the
other localities in criminal justice strategies and the
services it offers? And does it offer more programs that have
been shown to work?
Ms. Goldstein. I think it is hard to make those types of
comparison. I think that Baltimore has a number of programs. It
has actually recently started a number of programs that are
successful for the small populations that it serves.
New York City, you know which is probably my best basis of
comparison, has a broader scale and scope of programs. It
serves a larger number of people.
I think Baltimore has faced many challenges in terms of
trying to serve these populations. And the more support that we
could obtain from Federal sources would be greatly appreciated.
Mr. Kucinich. Let me go to that then. What can the Federal
Government do better to help support criminal justice and
public health strategies that work?
Ms. Goldstein. I think a few things. First, you know, I
think as Congressman Cummings began at the hearing, you know
it's really a holistic approach. And we need more after-school
opportunities for young people. You know the data shows that by
the time these kids are 13 it is almost too late in terms of
trying to intercede. So we need more opportunities for young
people, more early intervention and prevention program, more
opportunities earlier on.
And then as you can see even from my description, the
programs that we have developed here are intervention programs
for kids who are already in the system. We have not had the
resources to do real prevention programs for the young person
who is first stopped by police. You know, for the very first
time they should not even be arrested, but could be referred to
a service program to meet their needs. So certainly early
intervention and more opportunities are needed.
Mr. Kucinich. Thank you.
Mr. Faruq----
Mr. Faruq. Yes, sir.
Mr. Kucinich [continuing]. I can see from background that
you spend time out on the street.
Mr. Faruq. Right.
Mr. Kucinich. And you are talking to these young people.
Mr. Faruq. Yes, sir.
Mr. Kucinich. Can you relate to us what are they thinking?
What is it that draws them into the violent crimes and the drug
abuse? If you could characterize it in a few minutes, how would
you characterize what is going on in the street with these
kids?
Mr. Faruq. You know, they characterize it that they are
trying to eat. Their characterization is that they are trying
to eat. They do not see a lot of opportunities in trying to
negotiate the system to come for some success with a meaningful
lifestyle. So they think that they do what they do best or know
best.
So, hopefully, some of the things that we want to do is to
partner with them to show them there is something different.
And to take their hand and partner with them to get to
negotiate the system to try to unveil opportunities. To show
that there's hope.
And, you know, them seeing the outreach workers, used to
sharing their lifestyle and that outreach workers having turned
their lives around and doing something different, then that is
an example of hope. If he can do it, I can do it. So there is
hope presented in the outreach worker who used to be on that
side of it.
And for many of them, do not have hope, you know. So also
with the hope is the possibilities that it is possible for me,
too.
But their characterization is that they are trying eat, so
they are trying to make a living. You know, they are trying to
get money. But, you know, the thing that we want to do is that
they can this without risk, without going to jail.
Mr. Kucinich. My time has just about expired and I am going
to go to Mr. Cummings for questions. We are going to have one
more round of this panel, Mr. Cummings, so we can get all the
witnesses' reflections.
I just want to say that while your testimony focuses on
what you are doing to try to help deal with the situation with
drug abuse and violent crimes, I think it is important for us
to try to get under it and ask some questions about why.
Because we may learn something from that as well, and you are
the ones that are dealing with these young people every day. I
think you have some reflection, and that is why I asked those
questions.
The Chair recognizes the gentleman from Maryland, Mr.
Cummings.
Mr. Cummings. Thank you very much, Mr. Chairman.
As I was listening you, Mr. Faruq, a lot of people do not
know this but I met Mr. Faruq many, many years ago in prison
when I was teaching a course for Compton State many years ago.
And I thought about something that is in the movie ``Sicko''.
And going back to what you just said, Mr. Chairman, and in that
movie by Michael Moore a parliamentarian from England said
something that is so profound. They were trying to figure out
why, for example, do we have universal health care, some form
of it, in France and in England but not America. And he said
something to this effect. He said, first of all, the people
would rise up if they didn't have it. But then he said if you
keep people sick, unhealthy, if you keep them uneducated and if
you keep them hopeless and helpless, they will not rise up.
And when I think about all that you are saying, this whole
thing of holistic, I want you to talk about the holistic piece.
I think you have talked about, Ms. Franklin, and I think all of
you hit on it to a degree.
One of the things that I have noticed is that you can get--
it seems like even when we pull, that we are able to folk
saying not to use drugs. You have to have something to replace
that. And going back to what you said, Mr. Faruq, one of the
things you got to establish is hope. Because when people are
not hopeful, that is a real problem.
So going back to, Ms. Franklin, how do you or Ms. Fayall,
how do you all get to that piece? You know, how do you get that
piece where a person perhaps has fallen or is falling and then
you are able to get them at least hold the falling, stop the
falling for a moment, but then get them back on the right
track? Because you talked about 257 people who I think you said
has successfully stayed clean for a whole.
Ms. Franklin. Completed the program.
Mr. Cummings. And you said 203 were in transitional
housing.
Ms. Franklin. Yes.
Mr. Cummings. Housing is one thing. I mean, we are talking
about basics.
Ms. Franklin. Right.
Mr. Cummings. So go ahead.
Ms. Franklin. And that is what we're talking about, we are
talking about basics. But the real basic that we are talking
about in Recovery in Community is providing a community of
support so that the program does not just stop just because you
have completed your 12 months or whatever, however long it
takes you to get to that point. It is about providing a place
where people can be if they pass or fail in success or failure
so that, you know, understanding that as a part of the process
of recovery that is a process.
I look at it as any other chronic illness, chronic disease,
diabetes, hypertension all those kinds of things. We do not
beat people up because they do not stick to their dietary
regiment in diabetes. We understand. Very clearly we understand
that once you got it under control, then what happens with is
that we make a decision well I am doing good now, I can just go
back to my old habits. We do not beat people up for that. But
we beat people up for that in terms of substance abuse, in
terms of relapse and that kind of thing.
Now that is not to say that relapse has to be a part of it,
but we need to understand that relapse sometimes is a part of
it. And what we do, what we can do in that process in terms of
support or we can make them feel even worse than they already
feel and alienate them from the treatment process or we can
help them to stay in the process and understand that you are
not failure just because that happened.
The whole thing of, you know, looking at all the things
that are impacted. We also know that a number of our folks are
impacted with mental health issues. That we have gone out into
the community and gotten folks that are interested and willing
to provide mental health services to our folks who do not have
insurance or who are eligible for insurance under the gray
zone, whatever, with the mental health services. But again----
Mr. Cummings. I see my time is running out. Yes.
Ms. Franklin. Yes.
Mr. Cummings. But let me just ask this question. The other
thing I am very concerned about, you know one of the things
that has always concerned me and we have seen it in Washington
when people come just doing some investigations that we have
done, we have seen sometimes people providing services,
services like drug treatment and in some instances the drug
treatment is not what it ought to be. And people are making a
profit. The addict is not getting properly treated.
And in talking to addicts that I have known, they tell me
that if they go into something that they find to be false or
they think it is just not the real deal, that it sets them even
further back. Yes.
Ms. Franklin. Yes.
Mr. Cummings. Maybe in the future answering of questions
you all can get into that a little bit.
And the other piece that I am concerned about is how do we
interact with the various agencies? I mean, sometimes I think
that what we do is we set up situations, we almost set
ourselves up for failure. In other words, if I have an agency
that is doing this and doing well, how much interaction with,
say, the job component do I work with; the health community, do
I work with? I mean things that are already in place for people
who are experts. I am not saying that you do this, but
sometimes I think that what happens is we are trying to do so
much but if we zeroed in and a better interaction and like a
web of services coming to truly wraparound the people who are
experts on these things, so if somebody needs I can send them
to somebody that is all they do is find people job and train
them. If they got health thing--you know, you hate to be
sending people to different places. But if they are got to help
them, perhaps if they are suffering from some chronic disease,
sending them to the appropriate place for that.
Again, going back to what the parliamentarian said in
``Sicko'', uneducated, unhealthy, hopeless and helpless. And I
think if we can get, going back to what you were saying Mr.
Chairman, to some of those things and truly provide a safety
net for them, I think you can get to the bottom of some of
this.
Mr. Kucinich. We will take one more round of questions for
this panel.
I would like to go back to a discussion that you started
with Ms. Franklin relating to the mental health issues. These
young people we are talking about, they are living in an
environment where there is a lot of violence, where the
violence might be inside the home as well as outside the home,
while people in the home may not have a secure sense of
economic vitality, may not have jobs, right?
Ms. Franklin. Yes.
Mr. Kucinich. They are likely not to have health care,
right?
Ms. Franklin. Yes.
Mr. Kucinich. That kind of an environment is really ripe
for mental health problems for anyone.
Ms. Franklin. Yes.
Mr. Kucinich. And would you agree with that?
Ms. Franklin. Yes, I would, absolutely.
Mr. Kucinich. So these young people if we are looking at
looking at young people in situations where they could become
at risk, one of the areas that we should be looking to and
we're seeing is access to mental health.
Ms. Franklin. Yes. Absolutely.
Mr. Kucinich. Tell me more about your experience in that, I
mean if you can think of any cases in particular.
Ms. Franklin. Well, we do not treat young adults.
Mr. Kucinich. I understand.
Ms. Franklin. OK. But one of the issues, what we do with
that is that we work within the community, within the community
where we are. And, you know, there are a couple of hospitals
and community mental health centers that are right there that
we take advantage of that we have our clients to be able to go
there without having to go through a bunch of barriers to
access and treatment, as well as providing space in the
facility for those community folks to come in and provide
mental health services to our people, as well as to the
families, the children the other folks that are impacted that
are associated with our clients that are involved in treatment
at our program. And we see that working very well.
As a matter of fact, we have been fortunate that we have
been able to raise some funds to develop a community mental
health center right across the street from where we are. And
one of the providers that has been coming in to see our clients
has agreed to set up an office there that is not only going to
treat and be available for the folks that we see, but for the
folks in the surrounding community. So it's not going to be
just for adults, but it's going to be for children and anybody
who is in need of mental health services and they have the
ability to be able to find out their eligibility for coverage
for their mental health services medications as well as
treatment. So that is one of the outcomes that we have had that
has been very successful with having mental health as an
integral part of what we do. Because we know that people are in
need of those services just because of the circumstances in
which you have so elegantly describes: You know, in just living
in a situation like that will set you up for----
Mr. Kucinich. Right. It is a tough society out there for a
lot of people, particularly for children.
Ms. Franklin. I am sorry?
Mr. Kucinich. I said it is a tough society out there for a
lot of people, particularly for children.
Ms. Franklin. Absolutely. Absolutely.
Mr. Kucinich. And these programs that you are setting up
where it is a sense of prevention and then referral become----
Ms. Franklin. Right.
Mr. Kucinich [continuing]. Life savers for young people.
Ms. Franklin. Yes, we are.
Mr. Kucinich. Congressman Cummings and I have had this
discussion about looking at drug addiction as, first, a health
problem. It can be a physical and emotional health problem. And
if it is delegated, it ends up being a criminal justice
problem. Would you agree with that?
Ms. Franklin. Yes, I would. Absolutely.
Mr. Kucinich. I have a minute for another question here. I
wanted to Ms. Fayall how do students end up in your program? Is
it voluntary or----
Ms. Fayall. It is voluntary. They also can be recommended
or referred by administration. We have a membership of 1,100
students who have voluntarily come down and joined the center.
And it is just not for troubled youth. We help them with
anything that is on their minds. It could be something like
starting a new club, a dance group; anything that they want to
do, anything that they are having issues with. It can be health
related. We help families to meet their basic needs. We do
perform the wrap around services. We have outreach to all kinds
of agencies. We have a retired social worker who is on staff
who provides the resources that the students need to get what
they want.
Mr. Kucinich. Now in your written testimony you state that
suspensions are down 83 percent after the implementation of
your program. Do you attribute this decrease to improvements in
student behavior or the provision of alternative sanctions to
your program?
Ms. Fayall. The first year that we were there the policy
was in force yet. But the students were able to come down. The
one thing we do, we offer in-house suspension so that instead
of sending the children home or out on the streets, they come
downstairs. They're out of the student population. And while we
have them down there, we work on the issues that led to the
behavior in the first place rather than punishing the behavior
or trying to find out specifically what is going on, meet the
need where the student is and literally meet them halfway.
Mr. Kucinich. Thank you very much.
Mr. Cummings.
Mr. Cummings. Yes. Ms. Goldstein, the gang situation. You
were talking about one of the programs and you were saying in
answer to the chairman's question that there was a limited
number of young people that you could help, is that right?
Ms. Goldstein. Yes.
Mr. Cummings. And so that means that there are probably a
lot of people who need the services but do not get them.
Ms. Goldstein. Absolutely.
Mr. Cummings. Do you have any idea what kind of numbers we
are talking about? I think you said it was a hundred and
something that you are. What program was that?
Ms. Goldstein. I think we were talking--if you look at just
the school dropout rates, for example. You know in Baltimore
City, as we know, our graduation rate is about 50-60 percent.
And when we look at our programs that serve our out-of-school
youth in terms of education and employment opportunities, we
are serving 500,000 young people a year. So just looking at
that universe there are so many young people who are out of
school and who are susceptible to those types of opportunities,
as Mr. Faruq said, because they do not have other opportunities
or hope. That is a huge number.
Mr. Cummings. What would you all like to see us do on the
Federal level to help you address these problems?
Ms. Goldstein. I think we need more resources to create
what you have talked about, which is a seamless web of services
so that we can catch young people early and provide them
opportunities to stay on the right path.
And I think one of the struggles that you were talking
about is you have different people who have different areas of
expertise and they need to be connected up. But research also
shows that if you send people to five different places, they
don't often get there. And so the challenge is sort of creating
one stops. You know, one stop shops where you can colocate
people who have that expertise so that they can provide the
maximum services to that group of folks.
And I would say that really what we need is more funding
opportunities to support those types of initiatives so that we
can help people before to keep them in school, to keep them out
of trouble and then to catch young people at all places along
the system to give the supports and services they need in a
holistic fashion.
Mr. Cummings. Mr. Faruq, with regard to mediation, you
talked about trying to get to folk before they get into some
very violent situations. Do you find folk open to that? It
seems like that would be very difficult at times?
Mr. Faruq. Actually, when you got the right people it is
very easy.
The guys that we choose have a lot of credibility with the
population that we are targeting. They have a lot of influence.
In some cases, they even have command.
So when issues erupt and they present themselves, they are
in a situation where, first, they already got the respect. So
they are in a strategic position where they can mediate from
all sides because all sides respect them, you know. And they
take their word at heart.
And I think this has emerged as a real cornerstone in our
approach. Because it is preventive. You know, in most of the
incidents that we have mediated, you know that come out with
peaceful resolution, even to the extent where we have mediation
where guys hugged and shook hands after they was threatening
each other.
Mr. Cummings. Yes.
Mr. Faruq. You know, I would also like to add that with
this approach is a public health approach. And what it does is
to try to sift a behavior norm. You know, violence is a learned
behavior. You know, so with credible messages, with a credible
message we try to change the behavior. You know, in the same
way that the smoker who was changed by having this credible
message, dominated the person with the message and then all of
a sudden the expectations about smoking changed. You know,
drunk driving the same thing.
And so it is with violence, you know, that we can change
how people look at violence. That people can begin to see that
they can have another outcome and there are other options other
than violence.
You know, when we have people that they used respect
representing that, talking that, pushing that and we dominate
environment with this message, that we can bring about a
change. It's so evident in Chicago.
Mr. Cummings. And so you take them to a bigger picture?
Mr. Faruq. Yes, sir. Yes, sir.
Mr. Cummings. All right. Well, I thank all of you.
And, Mr. Chairman, I just say that there were a number of
people who wanted to testify, but the limitations of these
hearings limited it. So I am hoping that we will be able to get
some of their written testimony and get it into the record.
Mr. Kucinich. Thank you, Mr. Cummings.
We certainly want to invite the testimony of those who are
interested in this. And we have 5 days to do that. So ordered.
I want to just make a brief comment before we dismiss this
first panel.
Mr. Faruq, you started to talk about violence being learned
and nonviolence can also be learned. I mean, that is what Dr.
King's life was about, that is what the teachings of Christ and
Gandhi were about.
There's a proposal in the Congress, H.R. 808, to create a
Cabinet level department of peace and nonviolence. And it
directs itself to these domestic issues of domestic violence,
spousal abuse, child abuse, violence in the schools, gang
violence, gun violence, racial violence, violence against gays,
police/community clashes. And I would just recommend for your
interest a bill which I'm the author of, and I believe Mr.
Cummings is one of the co-sponsors of. Because it really
reflects the deep understanding that you have about how you can
teach nonviolence just as people learn violence. That is a very
important observation. I think everyone here on the panel
understands that, and I just wanted to share that with you.
On behalf of the committee, I want to thank the witnesses.
Not only for their testimony, but for the service which they
give to the people of this community in providing a path for
hope and recovery. So thank you.
And at this point we will dismiss the first panel. Staff
will prepare for the second panel. We are going to actually
combine the second and third panels to facilitate the testimony
of some of our witnesses.
I would ask all those in the audience to please join me in
expressing appreciation for the first panel.
[Recess.]
Mr. Kucinich. The committee will come to order, please.
Thank you.
I want to welcome our second and third panel of witnesses
for coming forward. And I would like to begin with the
introduction of this panel, so those who are in the audience
can understand the significance of having this distinguished
group of people here to testify.
I will begin by introducing the Honorable Ellen M. Heller.
She was appointed as a Circuit Court Judge for Baltimore City
in December 1986. She became the Judge in charge of the civil
docket in 1993 and served in that position until 1999. She
became the first woman in Maryland to be appointed as the
Circuit Administrative Judge overseeing the entire court, that
was in 1999. Although Judge Heller retired in December 2003 she
continues to sit part-time as a trial judge and coordinates and
sits on the Felony Drug Diversion Initiative. Prior to her
appointment on the bench she served as an Assistant Attorney
General of Maryland and was Deputy Chief of the Educational
Affairs Division. Judge Heller is currently president of the
American Jewish Joint Distribution Committee which provides
humanitarian assistance to both Jewish and non-Jewish
communities globally.
The Honorable Jamey H. Weitzman has served as Associate
Judge of the District Court of Baltimore City since 1991. She
founded the first drug treatment court in Maryland in 1994 and
continues to serve as its supervising judge and developed Teen
Court, which provides alternative sentencing for troubled
youth. Judge Weitzman designed and chaired Maryland's Drug
Treatment Court Commission and serves as Chair of Maryland's
Problem Solving Courts Committee. She's the author of Drug
Courts: A Manual for Planning and Implementation. Serves on the
faculty of the National Judicial College. And has lectured
nationally and abroad regarding therapeutic justice and drug
courts.
The Honorable David W. Young has been Associate Judge of
the Baltimore City Circuit Court since 1996 where he presides
over the Baltimore City Juvenile Drug Court and has worked on
developing the city's Family Dependency Drug Courts. He's Vice
Chair of the Foster Care Court Improvement Implementation
Committee. Prior to his current appointed Judge Young served as
Associate Judge with District of Court of Maryland and
Assistant City Solicitor to Baltimore. He's taught at the
University of Baltimore School of Law. Has been a long time
trustee of the Bethal AME Church and member of the Board of
Directors of the YMCA of Greater Baltimore.
Dr. Joshua Sharfstein has served as commissioner of Health
of Baltimore City since December 2005. From 2001 to 2005 he
worked on the Democratic Staff of the Government Reform
Committee of the House of Representatives for Congressman Henry
A. Waxman.
So, just want you to know there's a future after this.
Dr. Sharfstein is a graduate of Harvard Medical School,
trained in pediatrics at the Boston Medical Center and
Children's Hospital and completed a fellowship in general
academic pediatrics at Boston University.
Dr. Philip J. Leaf is a professor in the Johns Hopkins
Bloomberg School of Public Health with joint appointments in
the School of Medicine, the School of Professional Studies in
Business and Education and the Kennedy Krieger Institute. At
Johns Hopkins he is director of the Center for Prevention of
Youth Violence, co-director of the Center for Prevention and
Intervention, senior associate director of the Urban Health
Institute. For two decades Dr. Leaf has worked with community
groups, schools systems, law enforcement officers, ex-offender
groups and the faith community of strengthening families and
communities and buffering the effects of violence over
neighborhoods. In 1995 he received the Johns Hopkins University
Martin Luther King, Jr. Award for community service for his
work in Baltimore.
I want to thank members of this panel. This is, indeed, a
distinguished panel. And we are eager to hear your testimony.
It is the policy of the Committee on Oversight and
Government Reform to swear in all of our witnesses before they
testify. So I would ask, if you will, to rise and raise your
right hands.
[Witnesses sworn.]
Mr. Kucinich. Thank you very much.
Let the record reflect that the witnesses have answered in
the affirmative.
As with the first panel, I asked that each witness give an
oral summary of his or her testimony, bearing in mind to keep
the summary to 5 minutes or under in duration. But your entire
written statement will be included in the record of this
hearing. And, again, our gratitude.
We are going to begin with Dr. Sharfstein. We are going to
begin with Judge Heller. OK. Go ahead, Your Honor.
STATEMENTS OF ELLEN M. HELLER, CIRCUIT COURT ADMINISTRATIVE
JUDGE, PRESIDENT OF THE AMERICAN JEWISH JOINT DISTRIBUTION
COMMITTEE; JAMEY H. WEITZMAN, ASSOCIATE JUDGE, DISTRICT COURT
OF BALTIMORE CITY; DAVID W. YOUNG, ASSOCIATE JUDGE, BALTIMORE
CITY CIRCUIT COURT; DR. JOSHUA SHARFSTEIN, COMMISSIONER OF
HEALTH OF BALTIMORE CITY; AND DR. PHILIP J. LEAF, PROFESSOR,
JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC HEALTH
STATEMENT OF ELLEN M. HELLER
Judge Heller. Thank you.
Good morning, Chairman Kucinich and Congressman Cummings. I
am very appreciative of the opportunity to address you today on
behalf of the Circuit Court for Baltimore City, which is in
Maryland the State trial court in Baltimore, a court of
unlimited jurisdiction with civil, family, juvenile and Judge
Young has been a long time Judge in the Juvenile Court, as well
as the criminal docket.
My testimony today is going to focus on the Felony Drug
Diversion Program, a special initiative that was begun in 2003
with great assistance, indeed I would say 100 percent
assistance, from Congressman Cummings in response to a crises
at that time that had hit the city. There had been a horrific
murder of a family that had been reporting drug crimes in their
neighborhood. But in addition, there were many drug arrests.
The dockets were clogged. And there was a need to tweak what we
already had in order to see what we could do.
And out of the crises that occurred at that time, and
unfortunately and the testimony today will indicate it is still
there. For example in 2006 I got statistics and I was told
there were 3,358 new felony drug offenses in the Circuit Court
for Baltimore City alone. That doesn't include the misdemeanor
drug offenses that Judge Weitzman will talk about, a high
percent not abating. But we were looking for a model that would
get the felony drug offenders, those not violent offenders who
faced 5 to 20 years real time into a different situation that
incarceration, where I am sure you are aware there is very
little drug treatment especially in the State prisons, and
there has been as long as I've been on the bench there has been
almost no drug treatment for the incarcerated community, and
where people were released with almost no support services,
only to re-enter once again.
So we worked as a team. And I heard this morning
Congressman Cummings talk about the need just a few moments ago
to work as a team. This court couldn't have been developed
without them and continuing now a positive relationship between
the partners in the criminal justice system, the Office of the
Public Defender, the Office of the State's Attorney, the
Division of Parole and Probation, the Division of Corrections,
Baltimore Substance Abuse systems just all the way down the
line to come up with a new variation on the umbrella drug
treatment court. And let me tell you quickly the features.
We wanted to make sure within a month of arrest we were
going to have an individual into treatment. And, again, these
are people who have long records, felony charges who faced 5 to
20 years incarceration. We were able to do that.
We found, although we had thought we were going to have a
continuum of services that the population we were addressing
needed long term residential structured placements. And they
had to be quality of placements. We didn't want to set people
up to fail and go back into the system. We were able to do that
with the assistance of Baltimore Substance Abuse Systems. We
only used placements that they have certified as adequate and
appropriate.
We wanted to have in-court assessors. Never in the history
of Maryland have we put accessors in the court so that right
there and then we could have people brought over within 30
days. They were literally assessed in the morning. If found
appropriate, brought down in the afternoon before the judge.
Entered the program the very next morning because of the
cooperation with the Division of Corrections actually
transported by the division into a residential placement where
they stayed for a minimum of 6 months. Twenty-four hour
turnaround within a month of arrest. And we are still doing it.
We have structured after care. We learned soon into the
program that we needed more services as people succeeded.
I also heard this morning there had to be hope and
something to replace the drugs. And we did that with job
training and liaisons with job opportunities.
We started to evaluate and we continue each month to look
at our statistics and have a meeting of that whole team. There
is a very positive, cooperative nice to see environment with
the State's Attorney and the Public Defenders talking with each
other. The Division of Parole and Probation agents who are
specially trained take a special interest in each of their
clients.
What are the achievements? In 2004 we had the largest
number of people. Seventy-three percent successfully completed
treatment, 86 percent of those who did complied with their
conditions of probations.
In 2007, 4 years down the line, 68 percent of our people,
that's almost 70 percent, of either successfully completed the
entire program or in successful good standing in drug
treatment. That's a really fine statistic that we work on.
Cost saving. In contrast to the $25,000 noncapital expense
of incarceration. This, again, we are talking about residential
long term care for a minimum of 6 months, our average cost for
diversion is $6,535. So that is quite good.
Are there needs? Yes. Needs for quality drug treatment
programs.
Need for job opportunities and employment for felony and
criminal offenders so that they can qualify for them. Need for
what we call dual diagnoses programs. Chairman Kucinich, mental
health issues are a very large part of adult offenders. There
is a shortage of programs. I have actually kept people
incarcerated for months while we try to search a program that
would take these so called dual diagnoses individuals. They
almost do not exist.
We need housing. I have a man right now who is almost
finished our program, was in from the beginning. He is confined
to a wheelchair. He has been drug free for 3 years. He has a
job, notwithstanding his paralysis. He has no housing. He no
longer qualifies because of his felony conviction. And he needs
supportive housing.
So I want to end. I think my time is up. But saying I thank
Congressman Cummings for the chance to work with the team at
the court. I think this is a program that can be replicated.
And we are actually this year expanding it in the Circuit
Court. It could be replicated across the country.
And I also think that the services you talked about, not
only help the offender, help the clogged dockets. They
introduced back into the community productive, self-sufficient
participants in our society.
Thank you.
[The prepared statement of Judge Heller follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you, Judge.
Judge Weitzman.
STATEMENT OF JUDGE JAMEY H. WEITZMAN
Judge Weitzman. Good morning, Chairman Kucinich and
Congressman Cummings. I am honored to be able to testify and
show off a little bit about what we're doing here in Baltimore
City. Judge Heller has already elegantly spoke about Drug
Court. It is one of my babies, too.
Started it in 1994 and it is one of the first in the
country. And the hallmarks of Drug Court are clear. It's
immediate, intensive treatment and collaboration, intensive
monitoring. And that famous word that I find to be of biblical
proportions to me is holistic support systems.
But I would also like you to consider some other programs.
So by way of illustration, consider Alese, who was a 14 year
old who was arrested for fighting in schools. And she already
has a distinguished criminal history of thefts and disorderly
conducts, and fighting, and five suspensions under her belt
already, poor grades. So we've diverted her into Teen Court,
which is a program that is run by children, staffed by
children, all of the criminal justice positions are by the
children and then the jury of their peers sentences. It
provides a holistic sentence that tried to address the needs of
the child, such as mandatory jury sentences, jury duty, peer
mediation, anger management.
We also have a social worker that is on staff to triage
services to Alese and her family so that we can get to the
underlying problems that are contributing to the criminal
behavior.
Teen Court has been running for the last 7 years in
Baltimore City. Unfortunately, we can only handle 250 people so
far, children. Just a drop in the bucket. But so far the
statistics show tremendous success.
How about the child named Alex? He already has 24 absentees
in the last previous two quarters of school and 18 days of
being tardy. He doesn't wear uniforms when he comes to school.
He has an attitude. We find out that when he doesn't come to
school, his little sister doesn't get to school either. So
enter the truancy program which tries to provide support
services to the child to try to find out why, what is causing
this truancy. And then, of course, there is collaboration with
the school system.
So these three programs highlight just three of the problem
solving programs in Baltimore City, but they really attempt to
try to meaningfully effect children's lives by getting them
away from the maelstrom and the cycle of violence and crime.
But they are all significant because of the extreme
collaboration, the wonderful collaboration of criminal justice
and non-criminal justice partners such as business community,
social clubs.
I am proud to say in Drug Court, for example, we have a
wonderful partnership with Goodwill Industries where they
actually provide job training and placement for our folks so
that they can get a meaningful wage and living. And it's so
successful in Baltimore City that Goodwill is now trying to
market this throughout the country.
But do not make no mistake: These programs are not easy.
This is not hug-a-thug justice, as Judge Young likes to say. It
requires intense work and a lot of judicial monitoring and
accountability of the defendants and the team members as well.
But my passionate assertion of the effectiveness of these
programs are really supported by numerous evaluations of Drug
Court which show its success. We are making taxpayers. We are
having drug free babies born to our folks. And so there's
numerous, wonderful intended and unintended consequences to
Drug Courts as well as the Teen Courts which we have.
Truancy courts are a little young, but I have every reason
to believe and do believe that they will benefit from the same
success.
The sum is definitely greater than the parts, and it costs
money to run these. Nothing comes for free. And so if anything,
I would ask that the Federal Government partner with us to
provide more of these programs to the community.
Thank you.
[The prepared statement of Judge Weitzman follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you, Your Honor.
Judge Young.
STATEMENT OF DAVID W. YOUNG
Judge Young. Good morning, Chairman Kucinich and
Congressman Cummings.
If I might just, I believe you said that I was a graduate
of the University of Baltimore. I am actually a graduate of
this fine institution where my classmate was Judge Heller, and
one of our predecessors was Congressman Cummings.
Mr. Kucinich. I thank the gentleman. And the record will be
corrected to reflect that. Thank you.
Judge Young. Thank you.
Since 1998 the Baltimore City Juvenile Drug Treatment Court
has offered comprehensive intensive outpatient drug treatment
to juvenile offenders between the ages of 15 and 18. The
exciting thing about Drug Treatment Court is it works. As Judge
Weitzman said, we have a hard time explaining to people that
Drug Treatment Court is not hug-a-thug, it is intensive. The
participants in Drug Treatment Court in the initial phase of
the three phase program are required to attend 5 days a week.
They have an individual counselor. They are required to
participate. They have an addiction counselor. Additionally,
they are required to undergo random urine analyses,
breathalyzers and to attend NA and AA.
As if that's not enough, they are required to go to school.
Each one of them is given an educational assessment. If they
are in school, they are required to go to school. If they are
not in school, they are required to go to either the YO
program, the Youth Opportunities Program which is operated
through the Mayor's Office of Employment Development or to the
Baltimore City Community College.
We also provide intensive services to families in the way
of functional family therapy. And the one thing about Juvenile
Court is there is a device called the Order Controlling
Conduct. So if your child is court involved, the court does
have within its authority that we can require the families to
also receive services.
We are also fortunate to have family intervention
specialists who come to us through the Johns Hopkins
University. And their job is to do a family assessment and to
identify ongoing family needs. As was said earlier, addiction
is a family disorder.
We also have discovered that many of the youth
participating in Juvenile Drug Treatment Court have mental
health problems and they are, in fact, self-medicating. So we
have a relationship with the University of Maryland Hospital.
As a matter of fact, our drug treatment is conducted through
the Harambee Drug Treatment Program, the addiction counselors.
We also have a relationship with the Johns Hopkins
University. Many of our participants do suffer from depression.
Many of them have been diagnosed with ADHD. And so we take a
comprehensive approach to addressing their needs. This is a
collaborative effort. We have a dedicated State's Attorney,
Prosecutor, a dedicated Public Defender. They always see the
same judge, yours truly, but they have the same counselor.
In addition, we do recommend them if they are in need of
vocational training to one of the programs in the community.
Judge Weitzman mentioned the Goodwill. We were fortunate to get
a grant through the Administrative Office of the Courts that
allows us to refer teenagers to the Goodwill Industries for job
readiness. And quite a few of them have now actually been
transferred into full time positions.
There are needs. What they need? We need more inpatient
treatment. Many times we refer youngsters to inpatient
treatment, but there are only one or two programs that will
take them. Additionally, even when they go they are released
after, as short a period is 3 to 7 days.
We need independent living programs so that they can be
referred to independent living. Many of them are 18. They have
no family or a fractured family to go home to.
We need professionals who are college educated who have
backgrounds in juvenile justice who want to work with young
people rather than hiring people for whom it's not a calling,
it's just a job.
We need advocates at the national level, such as yourself
and Congressman Cummings to say that children count and that
drug treatment courts work.
And finally, we do need more resources for after care. When
youngsters graduate from the Juvenile Drug Court or they get a
certificate of completion we need after care. It costs, I'm
told, $68,000 a year for an out of home placement. And so we
just need some resources to keep these people at home.
I thank you for the opportunity address you.
Mr. Kucinich. Thank you very much for your testimony, Your
Honor.
Dr. Sharfstein.
STATEMENT OF DR. JOSHUA M. SHARFSTEIN
Dr. Sharfstein. Thank you. Thank you very much, Chairman
Kucinich and Congressman Cummings. I really appreciate the
opportunity to be here. And I am also pleased that you heard
about the Safe Streets program earlier today, which is run out
of the Health Department.
I am testifying as the health commissioner. And I think to
look at some of these issues from a public health perspective,
meaning across the whole city and looking at the whole need, I
think the key word is capacity. How do you have the capacity to
serve the people who need to be served so as many people as
possible can turn their lives around? How do you wind up not
just talking about individual programs that are making a
difference for the people they are serving, but overall what is
the need and are we meeting that need over.
And I think when you think about capacity there are two
ways to go. One is that there need to be more resources. No
question about it. One of the ways that I think would make a
difference, particularly for drug treatment in Baltimore, is if
the State of Maryland passes the Medicaid expansion that's been
proposed. Because Medicaid will cover at least outpatient
substance abuse treatment. And there would be tens of thousands
of more people in Baltimore who would qualify for drug
treatment through Medicaid.
There is also, you know, additional resources for drug
courts, other things that would be extremely helpful. But what
I am going to talk about in the next 3 minutes is an approach
to capacity that does not necessarily require additional
funding. It is using funding already in the system. It is using
a new technology called buprenorphine that is available to
provide highly effective treatment for heroin addiction, but
necessarily in the substance abuse system, but actually in the
medical systems. And Congressman Cummings has been a national
leader in this because of the legislation that he sponsored.
It used to be that every hospital could have 30 patients
receiving buprenorphine. And then it became every doctor 30
patients. And then it became 30 patients per year, and then up
to a 100. This is any licensed physician in the city of
Baltimore.
So if you are thinking about capacity when you have all
these limits to drug treatment; funding and locations in the
drug treatment system. If you can tap into the medical system
in Baltimore as a sponge to soak in patients, giving them very
high quality treatment where the evidence is 6 months of
treatment, 75 percent of them may be absent from drugs, from
illicit drugs. It's just a huge potential impact of the city.
So just briefly, we have been embarked for about the last
year on a big effort to try to make this work in Baltimore.
And, you know, if you can do that, that frees up resources in
other places. I agree there are deficiency. We need more
residential care. If we can shift some of our nonresidential
care into the medical system, then we can free up resources to
do that or for more people to come into the system.
Buprenorphine is similar methadone in the sense that it
stimulates the same receptors in the brain as heroin and can
keep people without getting a high from really craving heroin.
But it is different in the sense that at high doses it
antagonizes itself. So it is very hard to overdose. In fact, if
you give buprenorphine to someone high on heroin, it
precipitates withdrawal. So the risk of abuse is much less. The
risk of diversion is much less. And that's why they consider it
safe for doctors in the substance abuse system to prescribe.
In November last year we became the first city to pay for
any doctors in training buprenorphine. And we have over 110
physicians who have signed up for training around the city, and
over 50 of them have completed through that effort.
We have basically broken it into three parts. The first
thing is the patient calls us needing help. They go into the
substance abuse system as they did before for 3 or 4 months to
intensely receive buprenorphine, counseling and other services.
As soon as possible we get a social worker to meet with
them and try to get them access to a very basic kind of health
insurance, called the Primary Adult Care Program or Medicaid.
So that they then will have the capacity to transfer into the
medical system. This gets them health insurance that will at
least provide for some of their other needs and then the social
worker can help with other things to the extent possible.
Every single patient in our effort has been through this
process with the social worker.
Then after 3 or 4 months they move to primary care or
psychiatry where they can continue to receive a highly
effective treatment while receiving their counseling back at
the drug treatment center. At that point they become stable
patients in primary care and you can use that spot in the drug
treatment system for another person.
So it is a cycle that brings more people into drug
treatment and then uses the medical system in Baltimore as the
sponge. And it is a collaboration between Baltimore Substance
Abuse Systems, Adam Brickner its president is here, Baltimore
Health Care Access which organizes the social workers and
tracks every patient and the Health Department, which has taken
a lead in trying to enroll people.
The data is in the written testimony. Over 500 patients
have come in. We have 91 patients now who have moved over into
the medical system. And all those patients have other medical
conditions addressed. And we have over 100 doctors signed up,
and two residency programs in the city have committed to train
all their residents.
So there is a lot more to be done, but I think it is
important for you to know how the Federal effort on
buprenorphine is really having a big impact here in Baltimore.
Thank you.
[The prepared statement of Dr. Sharfstein follows:]
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Kucinich. Thank you very much, Doctor.
Dr. Leaf.
STATEMENT OF PHILIP J. LEAF
Mr. Leaf. Good morning, Chairman Kucinich and Congressman
Cummings. Thank you very much for inviting me today.
Before I run out of time, I want to highlight one of the
things that was mentioned today in passing numerous times, and
that is the role that Congressman Cummings played in the
development and support of programs. And I want to emphasize
not simply the funding that is available, but having a
Congressman who comes home every night to live in this city who
has close ties with lots of different kind of people here, and
whose staff actually sits on many of the planning efforts that
you are hearing about today. I think it has been one of the
important implications, it is around information exchange. It
is being able to access information and access information not
just for those of us at academic institutions or on the city
government, but in local community programs, the church groups,
other groups.
And I think one of the challenges is how to get information
about the opportunities that are out there, whether it is
Federal funding programs, whether it is best practices or
whether it is things that are working in your child's school to
people who really need to know those things. And I think
Congressman Cummings is a wonderful example.
We also benefit from having a Senator who lives in our city
and up until recently had two Senators living in our city. And
I think, again, at the information level, knowing what the
problems are, their staffs are really critical.
Increasingly, as you have heard, there is an agreement that
we require multifaceted response, a response involving not only
governmental agencies but also local school systems, providers
of substance abuse, the mental health services, the faith and
business communities, local institutions of high education,
civic association, ex-offender and ex-offender organizations
and parents, families and other caregivers. Local communities
and States increasingly are calling for systemic interventions
rather than programs. We have lots of programs. The issue is
how to fund these in a systemic manner, how to sustain these
and to expand the ones that are working so they can meet, as
you have raised to the previous panels, the real needs that
exist in these communities.
We have lots of things that work. Often people do not know
about them. Often the programs that work have difficulties
sustaining themselves because sometimes they are funded by one
time Federal funds for 3 to 5 years. And as Dr. Sharfstein
said, sometimes our normal funding procedures whether it is
Medicaid, State budgets or city budgets are not adopting as
rapidly as possible and as rapidly as necessary these proven
practices.
So clearly we are talking about lots of different
strategies. You have heard a little bit about the need for
community mobilization, particularly by those living in the
communities.
We need social intervention programs. Programs that are
supporting the full range of needs.
In Baltimore we have many youth who are essentially
homeless. Who move from different living circumstances 1 week
to another week. Maybe living with an aunt 1 week. Maybe living
with a friend another week.
We also have lots of children have to move through fairly
violent neighborhoods to get to school. And it is not
irrational as our chief executive officer of our school system
said at the Board meeting last week for youth having to move
through some of these neighborhoods to be carrying a weapon.
Not necessarily a gun, but a knife, a scissor, something that
is going to get them expelled from school because it really is
not safe for them to move to and from school. And clearly, that
is not an issue for the schools themselves. That is going to
require multiple government agencies, but also multiple
communities.
We do need service provision, but also we need
opportunities provisions. We need employment opportunities. And
has been mentioned, when we have individuals with multiple dual
diagnoses, substance abuse/mental health problems, we need to
use those strategies that have been shown effective for meeting
those needs.
We obviously need also suppression activities, but also
organizational change in development. We all need to change the
way we are working. And I think you have heard some very
positive examples of how programs have organized themselves
differently, have structured their funding systems differently,
have changed their collaborations.
Increasingly in the Baltimore City Public School system we
are also focusing on the behavior of the adults. Essentially,
as you have heard several people talk about, behaviors are
learned. Violence is learned. Well, nonviolence is also
learned. And we need to be training behavioral and problem
solving skills in our schools, but we also need to be
supporting the people in our faith community. The people in our
neighborhoods who have traditionally taught nonviolence, who
have taught problem solving, who have supported those most in
need.
Baltimore is paying increasing attention to the fact that
many of the individuals to be reached our communities suffer
not from a single problem, you have heard that today. In
Baltimore we do not encounter an individual who only has a drug
problem and others who have lots of assets and their deficiency
is violence. We have people who commit crimes or engage in
violence, do not have a lot of community supports and also have
very limited aspirations. And, again, I think the role models
are particularly important.
It is essential that we think about how the Federal, State
and local governments can be organized. But also supporting
families, supporting neighborhoods, supporting communities.
You have heard a lot about voluntary work. Many of the
programs you have heard about today were supported or if not
innovated through help with University of Maryland Law School,
University of Baltimore Law School. Again, we are fortunate in
Baltimore because we have wonderful educational institutions,
faith communities, we have many city and State organizations.
And I think some of the successes you heard today because we
really do have the confluence of the multiple partners in this
jurisdiction.
[The prepared statement of Mr. Leaf follows:]
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Mr. Kucinich. Thank you very much, Doctor.
I would like to start the questions with the Commissioner.
How do you think the city's buprenorphine initiative fits in
with the overall treatment philosophy? And is it a departure
from programs like methadone maintenance or abstinence-based
treatment?
Dr. Sharfstein. I think it's a great option to have for
patients. That it is very well established that almost--I would
say most heroin addicts will do just as well on buprenorphine
as methadone. There are some groups of people addicted to
heroin who will probably better on methadone. It is very
important to continue to have methadone as part of the
approach. But buprenorphine, some patients prefer it. It is
better tolerated in some respects. And because of the potential
to engage the medical system, it creates this potential for
really expanded capacity.
Mr. Kucinich. Now you made free buprenorphine available,
right, to every doctor practicing in Baltimore since October?
Are you satisfied with the level of participation among
doctors?
Dr. Sharfstein. That is one of the areas, we made the pre-
training available. And I think we would like to see more
doctors training. Right now it is not limiting the number of
patients who can be seen. But I think we would like to see more
doctors trained around the city.
One of the ways we are hoping to do that is through the HIV
program. The Ryan White money which comes in from the Federal
Government. The local planning council is putting some strings
on that money to try to make sure that it goes to clinics that
really do prescribe buprenorphine.
Mr. Kucinich. So with this free training what percentage of
doctors participated?
Dr. Sharfstein. Well, there are probably--there have to be
at least a few thousand doctors in Baltimore City. And so far
we have had about hundred plus a few sign up for training. So
as an overall percentage of doctors, it is pretty low. We are
looking particularly at internists, family physicians and
psychiatrist. I would say we could definitely better.
Mr. Kucinich. What kind of steps can the Health Department
or others like the Federal Government take to improve
participation?
Dr. Sharfstein. Well, I think particularly you look at
where the particular funding streams are. And I think the Ryan
White funding stream, like I said, is a real opportunity.
Because there is so much money coming in for treatment of
people with HIV. And the evidence is that if people who are
drug addicted and are also HIV infected if they are getting
their drug addiction taken care of, they will stay on their HIV
medicines better. They are less likely to infect someone else
because they will not be sharing needles.
So if we can take--you know, and basically I would like to
have the expectation in Baltimore that it is like a required
part of taking care of an HIV patient to have this as an option
for the right patient to prescribe buprenorphine.
Mr. Kucinich. So how many of Baltimore's drug addicted
persons could benefit from buprenorphine?
Dr. Sharfstein. Well we have, I think, the statistics I
have seen about 70 percent of the people seeking treatment of
heroin problems. So certainly I think right now we have about
3,500 people in the publicly funded system on methadone
everyday in Baltimore. And I think easily we could double or
triple that with buprenorphine if we could get that kind of
capacity.
Mr. Kucinich. Thank you.
Now Judge Heller, prior to the development of the Circuit
Drug Courts and the Felony Drug Diversion Initiative would the
individuals in the programs actually have served a substantial
portion of their felony sentences?
Judge Heller. That is not up to the courts. That is up to
the Parole Boards. But I would say nonviolent offenders, about
a third of their sentence. These days I think it is up to a
half of their sentence that they would serve. The problem is
they would spend, whether it is 2 years, 3 years, 6 years
incarcerated time. And you would think that merely being
incarcerated when someone reentered, they would be drug free.
But that is not true. And there is virtually no drug treatment
programs in the system.
This is a long answer. Today we are focusing even for those
who are in our programs like Felony Drug Diversion or
Incarcerated with reentry support.
Mr. Kucinich. If there were more funding just in your court
based on demand and reasonable eligibility criteria, how much
could you envision participation expanding?
Judge Heller. Oh, I think enormously. I think I gave the
statistic that in my court alone there were 3,358 felony drug
offenses. This is nothing else. Pure drug offenses. So we are
not talking about the robberies, the homicides, the gun. Most
of those people in State court in contrast to the so called big
traffickers and kingpins that are often in Federal court, are
really addicted people who have mainly nonviolent, although
long records who could benefit significantly diverting out of
the system into a treatment program, and once again reentering
this time with support for their addiction into communities.
Mr. Kucinich. Now the after care portion FDI is funded
largely through existing State, local and Federal funding. I
assume that the funding streams for this treatment are not
specifically earmarked for drug court referrals. Should they
be?
Judge Heller. You are getting a little out of my expertise.
I think I would say yes. But I have to be honest. I have
for 4 years, and this is one of the unfortunate challenges, you
come with a program that succeeds, initial funding ran out and
then we have been looking year after year, month after month,
at every level city and State for support services. I sometimes
think it is magic when the funding reappears. But it would be
very nice if it was targeted so we know it was there to help
these people.
Mr. Kucinich. Right. OK. Thank you very much, Judge.
Mr. Cummings and then we will have a second round of each
panel as well.
Mr. Cummings. You know, Dr. Sharfstein, buprenorphine. When
one is treated with that if that is a person--and I am going
back to Judge Heller and I think Judge Weitzman was saying,
that a lot of times we have people who have a dual----
Judge Heller. Dual diagnoses.
Mr. Cummings. What do you call it?
Judge Heller. Dual diagnoses.
Mr. Cummings. Yes, dual diagnoses. And we have talked about
that in our committee, in the Drug Committee when it existed
about how people have a drug problem, but they also there's an
underlying, and I guess it is the same thing, mental problem.
too. Probably going back to childhood in many instances.
So if we treat them with the buprenorphine, are we looking
at that dual piece, too? Because I am just wondering whether we
are just scratching the surface? You follow me?
Dr. Sharfstein. Yes. And for some patients the answer is we
are scratching the surface. For some patients they do very well
in buprenorphine. They do not need a lot of intensive mental
health treatment. Nationally about 40 percent of people with
substance abuse have serious metal health problems and 15
percent of people with mental disorders have substance abuse
problems.
Here is one of the big problems that is facing us in
Baltimore. The system of funding for substance abuse and mental
health are completely and utterly separate. They are not just
separate, they are totally different types.
Mental health is like an insurance program. Substance abuse
comes in in grants. They have each of their own sets of
requirements.
The Federal level you have SAMHSA, which is at least one
agency. The State level you have the Mental Health Agency and
the Substance Abuse Agency.
And, you know, maybe about 18 months ago somebody came to
me from a different agency saying that their job was to
coordinate the two agencies at the State level, and could I
help, you know. And I mean I am not even at the State level. So
I said ``Yes, I will do whatever it takes.'' But it is very,
very difficult.
I think just one of the ways we are seeing that is the
frustration of the judges are having for certain patients. But
across the system there is a real gap.
We have renewed energy on this. We have a new head of
Baltimore Mental Health System who just started, who was an
Assistant Commissioner in New York. Who is really an expert in
how to do better for people with dual diagnoses or co-occurring
disorders. But there is no question it is a big frustration.
In our report about buprenorphine initiative we identified,
our goal was to have patients be free from heroin in their
urine and able to move into primary care after 90 days. That
was one of the targets we did not meet. And one of the reasons
it has taken so long and why some patients have never been able
to move over, like I told you 500 patients have started and
about 100 have moved over into primary care, is we think that
there are some patients who because of their mental health
issues have not been able to be successful. So a big focus that
we have now is to try to improve that mental health part. But
the system works against us, I think.
Mr. Cummings. Judge Weitzman, in your written testimony you
talk about short term funding leads to short term results. What
does that mean? Does that mean you cannot plan? I mean what
does that mean?
Judge Weitzman. The problem is multifaceted.
Mr. Cummings. And Judge Heller, you might want to chime in
on this also.
Judge Weitzman. The problem is multifaceted and needs
support from many different areas. And so just bursts of
funding does not really get to the problem.
So dribs and drabs of treatment, for example, where we need
long term residential treatment for example does not help.
We have multiple problems with dual diagnoses bucks. And we
need mental health slots as well as substance abuse slots.
One of the long term goals for my program in Drug Court is
to have a community Drug Court haven, so to speak the one-stop
shop where the folks do not have to go to many different
multiple places to get their health. They are treatment and the
courts, and the support services are one place which will help
facilitate their wellness. Because they are not able to manage
their lives as well. Plus money.
Mr. Cummings. Let's say we know we need. We have somebody
who needs the dual treatment. And they are doing everything
they are supposed to do. Do they sort of just hang there until
you get them the treatment? You follow what I am saying? Could
year? I mean, years, months?
Judge Heller. They can hang there and often with
unsuccessful results.
I have a woman that I was looking. She could not go in the
community because she just could not make it. She had major
psychiatric problems. We were looking for a dual diagnoses
program. I had no where to keep but over in the Baltimore City
Detention Center.
She said to me when she would come in for the monthly
monitoring, ``So I am incarcerated, Judge Heller, because you
cannot find a program, not because I violated--'' well,
originally she did or she would not be under the system. And I
had to say ``That is right.'' She was kept there for 5 months
waiting for us to find a program.
On your other questions, Congressman Cummings, having short
term funding is so important for a startup and creating
programs. But here in Felony Drug Diversion we created a
successful model that was working, and then the funding ran
out. And it would have been very easy to say no. But we kept
looking. I have to thank Dr. Sharfstein helping in part in the
interim for funding. But replicating and then expanding the
programs that worked is difficult if you only have short term
funding.
Mr. Cummings. Just one other question. You know, the
interesting thing is, you know I am just sitting here and I am
just thinking it sure would be nice to be able to prevent some
of this. Because the cost to society is so great. I mean, and
the individual. And I was just thinking ways that you all
could--I guess it is like with witness protection. I mean, you
would have thought that I was talking about something that
should have zero attention in the Congress. And to me it goes
to the very essence of our system of justice.
So do you all have any recommendations, you all are dealing
with these things on a daily basis, how we get over what you
all are talking about to our colleagues. I know that it is a
flip, but I am just curious I mean why do you think folk do not
see what you all see or understand it? Judge? I am sorry. It is
like we are walking down the hall in Washington and you got 30
Congressman and you just want to say ``Congressman,
Congressman,'' and everybody turns around.
Judge Young.
Judge Young. I think that many times, Congressman, public
perception drives public policy. And we are seeing it
especially in the area of juvenile justice where because
everything, the media is saturated with gangs everywhere you
go, we have noticed that there has been a shift away from
focusing on drug treatment and intervention programs toward
suppression even in our city. So one of the things that I think
is important is that our decisions be research based. That is
why we are fortunate to have the University of Maryland and
University of Baltimore collaborate so that we are making
decisions based on research as opposed to what the media tells
us.
I think there is an additional problem, and that is many
times we go into communities and we tell communities what is
best for them rather than bringing them in at the front end and
asking them help us determine what you need through needs
assessments.
And so one of my frustrations, if you will, with our
approach to juvenile justice is the 6 o'clock news determines
what is a priority versus what the young people in this city
actually need.
Mr. Kucinich. As I am listening to this testimony and to
answers to the questions, and I am sure everyone involved in
this hearing whether you are at the panel or on this dias or
whether you are sitting in the audience has to be thinking
about the connection between drug abuse, mental health and
crime and how many people are in our prisons are people who did
not get mental health treatment or treatment for an addiction.
And so the prisons end up being places where the people are
just held because their whole reality is distorted. I mean in a
sense if crime by definition is some behavior that is anti-
social, if someone goes through that labyrinth of drug use and
with the additional crippling factor of let's say a mental
health problem, how would they know what social is? How would
anyone know what normal is?
Judge, would you like to comment on that?
Judge Heller. I think they would not know. And I think your
observation brought to mind the following: One, we need
different models. Although drug abuse and mental health
problems these days in this country equate to incarceration,
that is costly, it is ineffective and it is not working and it
is clogging the courts; two, I think something Judge Young just
said, we are focusing as judges when we already have a problem
in the criminal justice system, which is almost at the end of
the road. All of us can focus much early on.
I know that the Johns Hopkins Bloomberg School of Public
Health has just started an Urban Health Institute where we are
going to actually look, this sounds ridiculously, prenatally,
early childhood education and the wrap around support so that
from the very beginning perhaps we will not have a next
generation here, but we can try to make health----
Mr. Kucinich. Well, yes, it actually makes sense. Because
you know we know from studies of prenatal that if a mother is
taking a lot of alcohol or drugs that has an effect on the
developing fetus. And so it is good to see that.
You know, obviously, Congressman what we are looking at is
a system here. And to talk about it prenatally. But then you
look at all the societal influences that occur as well; does
someone have a roof over their head, is there food on the
table, is there a job, is there some kind of an education, are
there goals out there that children have aspirations? I mean,
these things all come into play in terms of whether there is
enough social organization and stability to permit mental
health, a healthy mental climate to develop and whether or not
conditions develop that would precipitate drug use. I mean,
even in the best homes where everything seems to be stable you
can have drug abuse. But, you know, as you are talking I am
just drawing kind of diagrams here. And you think about all the
factors that are involved are and you are actually dealing with
them as best you can, which has really said something about
this community and about your Congressman.
I just wanted to make that observation.
And let me, perhaps, ask one final question here of Judge
Weitzman. Did you think that the problem solving court should
be expanded to include individuals who have committed acts of
violence? And could there be specific conditions on violent
offenders that address a monitor and attempt to rectify their
violent actions?
Judge Weitzman. The research is out on that. There are some
schools of thought that feel that violent offenders should be
in a whole another category of themselves. That we are really
trying to target people that but for their substance abuse or
other problems such as mental health, that they would not be
committing crimes. Violence tends to be psychopathic and is
higher on the risk scale. So they need other kinds of support
such as better monitoring perhaps.
Yes, any problem solving court I think can help criminal
justice issues. I think the complexity of it and the complexion
of it will look very different than the problem solving courts
that deal with the strictly social issues that we have.
Mr. Kucinich. Thank you.
Congressman Cummings to you for any final questions.
Mr. Cummings. Yes, just one question. Judge Heller, or all
three of you judges, the key I guess to the effectiveness of
the Drug Courts is having a hammer over the head sort of, so to
speak, to say that if you do not do this and you have the
certain things that they have to do. You say appear 5 days a
week and get the treatment, and get the education and whatever;
that they then may very well end up serving the sentence. But
then there are some who do not do it. I think you said 76
percent, Judge?
Judge Heller. In the beginning. Right now we have almost 70
percent success rate. But that means 30 percent do not make it.
Mr. Cummings. Right. And what do you find? I mean, first of
all when you look at all programs, that is a phenomenal rate.
But I am just wondering about that other 30 percent or so
percent that are not.
I mean what seems to be the kind of things that you hear?
Do you think they are more the dual situation problems? Do you
think it family problems that you just cannot seem to get to? I
am just curious.
Judge Young. I can tell you with many of the juveniles who
do not succeed in Juvenile Drug Court it is because even after
you get them clean, and even after you get them coming to the
program every night they go back to the same environment. There
is a great need to be able to help families transition, not
just the individual.
We had a young man who was almost murdered. He was shot and
even after he was in rehab and got himself together, his mother
lost her Section 8 voucher. So she moved right back to the
neighborhood where he had been shot. And so it's just an
ongoing need to help people, not only move up but also to move
out.
Mr. Cummings. That reminds me of a story when I had an
after care program some years before I went to Congress. And we
had a young man who had come out of the Boot Camp program. The
mother of his child lived on the east side and the guys in the
neighborhood had told him that if you come back on the east
side, we're going to kill you. Remember that? Well, we have
some people in the audience who know about that case.
And he decided that he was going to do it anyway. You know,
he was not going to be--and we begged him not to do that, to
find a way. We told him we would help move her on the west
side. But his manhood and other--you know, he's gone.
And I say that to say I guess some of the issues are so
difficult and they go so far back. I tell my staff that a lot
of the problems that we deal with are problems that were
created, going back to what you were saying, Mr. Chairman, when
folks were little kids. And trying to deal with that is very,
very difficult.
And so, Mr. Leaf, you have something on that? You look like
you need to say something?
Mr. Leaf. Well I think, as you said, some of the people in
the courts who are going through that also have little kids.
And so this is an opportunity. Again people are talking about
needing to support families, people do a lot of things for
their family including the illegal activities. And I think
recognizing that some of the relief won't be effective unless
it is also supporting the family needs besides the individual
needs.
Mr. Cummings. Right. Right.
Mr. Leaf. And your earlier question about how to convince
some of your colleagues. Unfortunately, ex-offenders and people
in recovery and even people with mental disorders, there's a
certain amount of stigma from being physical for some of them.
And as with any legislation, without having a consumer group,
without having a vested constituency who is actively advocating
for their own needs, it is probably very difficult to convince
legislators who have lots of demands on them where there are
lots of organized lobbying going on. And so how to support the
efforts of the ex-offenders, the people in recovery who are
successful. Some of them, you know, are in recovery for life
are very successful businessmen, academics. You know, it's the
whole range of both those individuals and ex-offenders. And you
can have it support those efforts so that they can be vocal and
visible about their successes, not about their problems. But
about their successes and their identification of where
additional successes could come from I think are part of the
solution.
Mr. Cummings. Yes?
Judge Heller. I think that there are some people that will
not make it because of their mental illness, their background,
their age or they just do not want to make it. I mean the
reality is you can't have everyone succeed. But, having said
that, every time we have had people drop out we look to see
what we could do better and might have done differently and
have kept that person in.
I do not really believe it is the Judge that is sitting
there with the gavel. I do not know that any of us actually use
a gavel, or I know as we are saying symbolically. I think what
keeps people in the program to succeed is quality care, quality
drug treatment. I think the structure is so important. And then
I heard a word at the previous hearing which I really must use,
and it is hope. And I think by letting people begin to think
they actually can change; these people have given up hope, you
can make a change. You can control our addiction. You can get a
job. You can get an education. You can actually move your
housing. And we are going to structurally be there with you for
the next few years while you do it. I think it does help
succeed.
Mr. Cummings. Thank you. Thank you all very much.
Mr. Kucinich. I want to thank the members of the panel for
their participation. And when you hear your testimony and your
answers, it is very clear that what your lives have been about
is saving other people's lives. And there cannot be any higher
service. And so thank you for what you do, continue to do.
And this has been a hearing of the Oversight and Government
Reform Committee, the Subcommittee on Domestic Policy. I am
Dennis Kucinich, chairman of the committee.
We want to thank the University of Maryland School of Law
for letting us use their Ceremonial Moot Courtroom. I think we
agree these facilities are beautiful and have been conducive to
this hearing.
The title of the hearing has been Combating Drug Abuse and
Drug-Related Crime: What is Working in Baltimore. We know what
is working and who is working at it, and we want to thank all
of you for making it happen.
Again, to Congressman Cummings. Thank you for suggesting
this hearing, for facilitating it. I look forward to continuing
to work with you on all these matters of importance to our
communities and to urban America.
This committee stands adjourned. Thank you all for being
here.
[Whereupon, at 12:06 p.m., the subcommittee was adjourned.]
[Additional information submitted for the hearing record
follows:]
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