Thursday, March 27, 2014

Governor declares public health emergency

This is great news. I applaud the efforts of the Department of Public Health and especially Commissioner Cheryl Bartlett for rising to the occasion.

As a member of the Interagency Council on Substance Abuse and Prevention, I look forward to the discussions we'll have about bringing more treatment to the fore and adding to our drug court/jail diversion programs. The immediate action relative to Zohydro is welcomed as is clearing the way for all first responders to carry and administer Narcan.

I've been preaching this stuff for awhile, so today is a good day for me.

GOVERNOR PATRICK DECLARES PUBLIC HEALTH EMERGENCY, ANNOUNCES $20 MILLION AND SEVERAL ACTIONS TO ADDRESS OPIOID ADDICTION EPIDEMIC

Convenes emergency session of Public Health Council to immediately put directives into effect

BOSTON – Thursday, March 27, 2014 – Governor Deval Patrick today declared a public health emergency in Massachusetts to address the growing opioid addiction epidemic, and directed the Department of Public Health (DPH) to take immediate action to combat overdoses, stop the problem from getting worse and help those already addicted recover, with an increase of $20 million for treatment services for the general public and criminal justice systems.

The Governor’s Public Health Emergency declaration provides emergency powers to DPH Commissioner Cheryl Bartlett, RN, who will work with the Public Health Council to take the following actions:


1. Universally permit first responders to carry and administer Naloxone (Narcan), a safe and effective opioid antagonist that, when timely administered, can reverse an overdose and save a life. Naloxone will also be made widely available through standing order prescription in pharmacies in order to provide greater access to family and friends who fear a loved one might overdose.

2. Immediately prohibit the prescribing and dispensing of any hydrocodone bitartrate product in hydrocodone-only extended-release formulation (commonly known as Zohydro) until determined that adequate measures are in place to safeguard against the potential for diversion, overdose and abuse.  The introduction of this new painkiller into the market is a huge danger to the individuals already addicted to opiates and looking for something stronger.

3. Require the use of prescription monitoring by physicians and pharmacies to better safeguard against over-prescribing.

4. Re-task the Commonwealth’s Interagency Council on Substance Abuse and Prevention with added members from public health, provider organizations, law enforcement, municipalities and families impacted by the opiate epidemic, with the directive to make recommendations in 60 days on further actions that can be taken, including, but not limited to: how to better coordinate services, align private insurance with state issued insurance and how to divert non-violent criminal defendants struggling with addiction into treatment programs.

5. Finally, dedicate an additional $20 million to increase the use and availability of treatment services.

Commissioner Bartlett today also issued a public health advisory to help increase education and community engagement to support all treatment options to combat and prevent the spread of opioid addiction.

“These actions will help slow the rise of this dangerous addiction;” said Commissioner Bartlett. “Together, these steps will raise awareness in our communities, help save loved ones who tragically fall down from their disease and build important bridges to long-term recovery.”

Wednesday, March 26, 2014

Commissioner Roche cannot end DCF crisis


The disappearance of five-year-old Jeremiah Oliver sometime between September and December 2013 touched off a crisis at the Massachusetts Department of Children and Families (DCF). Criticism has been non-stop, much of it waged at DCF Commissioner Olga Roche but also at our seemingly lightly engaged governor and the state's oversight agencies.

To be fair, Commissioner Roche has been in the driver's seat for a short time. Secretary of Health and Human Services, John Polanowicz, promoted her to acting commissioner in April 2013 following a six-year stint by Commissioner Angelo McClain. The secretary then removed "acting" from Roche's title in October 2013, ironically during the time when Jeremiah Oliver was missing and his DCF case worker was skipping required home visits.

Laying blame is an interesting exercise, one that gets a great deal of press and generates reams of letters to the editor, but it does not solve the problem. It is clear that the DCF requires strong leadership, someone with the skills to promptly assess key areas of organizational and personnel failings, and with the power to make the necessary changes without undue interference from labor interests--those negotiations can come later.

Even if Commissioner Roche's background and skill set matched what is necessary to rescue the DCF, she would not be in a position to execute the plan. The department's shortcomings certainly fall heavily on McClain, but being the watch commander while the agency came unraveled eliminates Roche from the list turnaround candidates. This is further illustrated by the "no confidence" letter signed by many of the DCF's caseworkers.

Now is the time for Commissioner Roche to step down, with or without Governor Deval Patrick's acceptance, and for the governor to appoint a recognized leader who can manage the process of bringing the DCF back from disarray to refocus on its mission. The temptation to ride out the situation until our new governor is sworn in on the first Thursday in January may be strong, but it is a reckless course of inaction that would not serve the constituents of the DCF, our most vulnerable children.

Sunday, March 9, 2014

Medical marijuana dispensaries will be cash cows

Christine Legere, reporter for the Cape Cod Times, looked into security challenges that an all-cash medical marijuana dispensary will face. See her article at http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20140309/NEWS/403090352/-1/NEWS01.

She outlines some of the plans that Medical Marijuana of Massachusetts, former congressman Bill Delahunt's enterprise, has for placing armed guards in each dispensary and making home deliveries in armored trucks. Because selling marijuana, medical or not, is against federal law, banks are sitting on the sidelines, not willing to offer their services to pot businesses. No checking accounts, no credit card transaction services, no mortgages or equipment loans, and no working capital lines of credit.

An extension to Legere's story about security measures required by an all-cash operation is how this cash is going to be accounted for and whether all of it will be reported on a tax return.

There is great temptation for a clerk running a cash register to pocket some of the proceeds. Unlike credit card transactions, there is no independently produced record of each sale. Paper receipts are only as good as their consistent use and the accuracy of the information printed on them. At $350 an ounce, there is room for skimming more than a few bucks here and there without detection.

On top of this, there is also motivation on the part of registered marijuana dispensary (RMD) owners to counter the onerous Internal Revenue Code "drug kingpin" rules that strip them of the ability to deduct expenses that are common tax write-offs for a typical business. This is not to say that budding RMD managers are dishonest, but overstatements and outright lies on licensing applications by several of them have already been exposed.

Adding fuel to this hard-to-control fire is the insistence of the state government that RMDs be vertically integrated. Dispensaries must grow their own supply of medical marijuana. While this arrangement may seem like a good idea from the standpoint of tracking product from seed to sale, it eliminates one more point of independent verification in terms of accountability. The purchase of medical marijuana plants or prepackaged ready-for-sale products by one company from another creates an auditable transaction. By requiring vertical integration, no such company-to-company transfer happens and the ability to obscure accountability is enhanced.

All of this adds up to a business that will be nearly unauditable by the state's Department of Revenue. Detection of underreported receipts will be next to impossible. Documentation of expenses, all paid in cash, could be easily manipulated. Diversion of product will also by hard to detect. This will leave auditors insufficient evidence to conclude whether an operation is straight up or not.

The opportunity for obfuscating the flow of cash may well lead to inaccurate tax returns and underpayment of income taxes which, of course, will be laid on the backs of taxpayers.

Thursday, January 30, 2014

Can we have our money back? Pretty please?

Similar scenarios to that which is unfolding in the Town of Sandwich, Massachusetts, are happening around the commonwealth. Every town and city is in the same boat.

On January 16, 2014, the select board listened to the Department of Public Works director lay out plans for dealing with the town's deteriorating roadways. Originally pegged at $10 million last fall, the director sharpened his pencil and presented a prioritized project list totaling $6.6 million. In addition to this, the town needs an extra $300,000 annually to keep up with ongoing maintenance and repairs.

While the board contemplates boosting the DPW annual budget by $300,000, Governor Deval Patrick sits atop nearly $400,000 in local aid for road construction and maintenance (referred to as Chapter 90 funds) that was included in this year's budget, which ends on June 30, 2014, but was never distributed to the Town of Sandwich. And the town is not alone.

In fact, the state's budget for Chapter 90 funds was increased from $200 million in fiscal year 2013 to $300 million in 2014. Initially, the governor released $150 million of the $300 million appropriation and was later coaxed into releasing an additional $50 million to match the prior year's distribution. Governor Patrick claimed that distributing the entire appropriation would be fiscally imprudent because of uncertainty about the amount of tax revenues coming into the state's coffers.

That "conservative" approach flies in the face of the facts. First, the governor filed a supplemental budget last August for fiscal year 2013 that put excess revenues totaling $500 million in the "rainy day" fund. Second, the revised revenue estimate for fiscal year 2014 is $400 million above the original estimate upon which the budget was built. That balanced budget, by the way, included $300 million for Chapter 90 funds even at the lower revenue estimate.

With a billion or so of extra cash piling up, there is no reason not to distribute the remaining $100 million in road funding, a 50% increase over last year's budget. For the Town of Sandwich, this amounts to an additional $395,390.

The irritating part of this holdback is that the $100 million increase is already paid for. The taxpayers' money is in the bank. All that is necessary is to release it back to Massachusetts towns and cities. Yet, the Sandwich select board is contemplating asking taxpayers to pay a second time to fund the same repairs and maintenance. How is the governor going to fulfill his 2006 campaign promise to lower property taxes when he puts towns and cities in this predicament?

On January 29, 2014, the House voted to fund Chapter 90 again at the $300 million level for fiscal year 2015 with the hope that the governor will see fit to spend the appropriation as planned. In the meantime, mayors, town managers, city and town councils, and select boards should be calling the governor to ask this simple question: Can we have our money back? Pretty please?

Friday, January 3, 2014

Jerry Madden, leading the way on crime reforms

I caught up with Jerry Madden, retired Texas state representative, in Dallas on November 27, 2013 to ask him how Texas became one of the first states to pass sweeping crime and justice reforms in decades.

Texas, with its reputation for locking 'em up and throwing away the key, not to mention its famous Death Row in Huntsville, seemed an unlikely state to embrace such reforms. It all started with marching orders for Madden, the newly appointed chairman of the Committee on Corrections, issued by the Speaker of the House: "Don't build any more prisons, Jerry. They cost too much."

With no particular experience in the court or prison systems, Jerry Madden tapped into his 12 years of legislative experience and his military and engineering background to search for solutions to the ever growing prison population that was costing Texas huge amounts of money and having little or no impact on crime.

I boiled down our hour-and-a-half interview to 22 minutes, capturing Madden's approach to managing Texas' burgeoning inmate population while dropping its crime rate to a 35-year low. Learn from this sage, 70-year-old Texan how he asked the unasked questions and challenged the status quo to start a movement that is spreading across the country.

Tuesday, December 24, 2013

Twelve Days of 2013

The Twelve Days of Christmas are upon us and, for the 30th time, investment house PNC has put a price of $114,651 on the 364 gifts called out in the song, a 6.9% increase over 2012. This accounting includes 12 partridges in pear trees, 22 turtle doves, 30 French hens, etc.

As much as I enjoy these go-on-forever songs, including Little Drummer Boy and 99 Bottles of Beer on the Wall, I decided to tap the idea of the Twelve Days of Christmas, not for musical purposes, but to compile a list of the twelve days of 2013, one from each month, that I consider the best gifts I have received this year from my lovely bride.
 
January 2nd - The culmination of months of hard work, no small amount put in by Mary as coordinator of my campaign for reelection, this was swearing in day on Beacon Hill. Mary understands my desire to serve as state representative and is my confidante and sounding board as I talk incessantly about how we can improve Massachusetts.
 
February 4th - Mary was amazingly supportive and engaged in my first colonoscopy. She even okayed my article about my experience published in the Barnstable Patriot to encourage others to step up to (or back into) this procedure. See the article here: http://www.barnstablepatriot.com/home2/index.php?option=com_content&task=view&id=32115&Itemid=37
 
March 3rd - This is our son Chris' birthday. He's the oldest of our six kids and one of two children that Mary brought into our "Brady Bunch" of six. Mary has been the best mother and step-mother any child could hope for. All six are better off today because of her.
 
April 15th (Tax Day) - On top of everything else she does, Mary manages our CPA office, keeping the work flow moving and dealing with our many clients. She has my absolute trust and no one could be a better face and voice of our business.
 
May 28th - Mary is a 15-year breast cancer survivor. This was the date of her most recent mammogram. I never take it for granted that her early detection in 1998 was a life saver.
 
June 5th - On a day that should be All About Mary, her birthday often turns into There's Something About Mary in the middle of my crazy schedule. After energy education awards, realtors' day, and a formal voting session, Mary was very patient awaiting my return from Boston to celebrate her birthday.
 
July 4th - The Fourth of July starts the parade of our Cape Cod summer visitors. The amount of preparation that goes into being ready for the kids and grandkids is more than most realize and Mary is the one who figures it all out. This summer was no exception and a good time was had by all.
 
August 19th - Mary's volunteerism is a gift to everyone. This was the date of the organizing meeting for Sandwich's First Night, an event that was spectacularly successful last year and promises to be even better this year. If you want it done right and on time, Mary's the one you can count on.
 
September 26th - This was the date of the theater debut of Anonymous People on Cape Cod, a celebration of addicts in recovery sponsored by Gosnold on the Cape. Mary really gets this issue and understands how we need to change course in order to get a handle on addiction. She pushes me to continue making this a defining issue for me as state representative.
 
October 31st - We used to decorate our house off Old County Road for Halloween, adding music and effects to entertain/terrify the neighborhood kids. As you can imagine, it was Mary that always put things together, saving the best stuff from the year before and getting a few new things to make the evening more fun. Where we are now we get no trick or treaters. Five years, no one. But Mary never gives up. She's always got a bowl of treats ready to go, just in case. I love her optimism.
 
November 27th - Again, in a show of support and selflessness, Mary allowed me to take two days out of our Texas trip to meet with people who put Texas on a different and successful track relative to the sentencing and treatment of nonviolent criminals with substance addictions. I am grateful that Mary takes all of this in stride, knowing that this is important to me and, more than that, important to her.
 
December 18th - I had meetings in Boston this day and had committed to attend the House of Representatives Christmas party that evening. At about 2pm, I started having second thoughts about the party and being away from Mary. I picked up the phone and, in the most persuasive way I could, talked her into jumping on the bus, meeting me at South Station, and heading over to the party as a couple. We stayed at the hotel that night and returned to the Cape after a morning meeting I had at the Statehouse. Mary loves spontaneity. That is a gift I cherish.
 
These are twelve days of 2013 that stand out to me but, to tell it straight, not a lot more than the rest of the days that I am engaged by, motivated by, encouraged by, entertained by, consoled by, and loved by the most important person in my world.
 
Here's to a prosperous and wonderful 2014, my love.

Friday, November 1, 2013

Letter from a recovering addict

I received this letter from a Boston attorney who has been in recovery for many years and experienced the devastation that his addiction had on his health, family and firm.

Representative Hunt:

Thank you for taking the time to meet with me to discuss the substance abuse problem facing us as a country, as a state, as families and as individuals who are suffering. This is such an enormous problem, yet I do not think it has ever received the type of thoughtful response it deserves.  

This problem causes such great pain for the individuals and families affected. This pain alone should more than justify and all-out effort to treat the problem as the public health epidemic that it is. Unfortunately, such great misunderstanding exists among a large percentage of the electorate and their representatives as to the nature of this mental illness, and it is a form of mental illness, that overcoming this is a tall order.  

Once addicted to drugs or alcohol (or both), the sufferer is truly unable to stop. Even worse, the mental obsession to continue to use, coupled with the physical compulsion to use, leads many addicts and alcoholics to engage in behavior that is, at best, self-destructive (i.e., neglect of health, work and family) and, at worse, truly sociopathic (i.e., theft, robbery, rape and murder).

All of these negative behaviors have a societal cost associated with them. It saddens me that the pain inflicted upon the suffering addicts and alcoholics is not reason enough to put significant resources, commensurate with the scope of the problem, into combatting addiction. If the disease were better understood, I believe this might be different. I do not hold out great hope for this happening, but I will, God willing, spend the rest of my life educating anyone willing to listen.

Perhaps, the best way to get this problem the resources devoted to it that it surely justifies is to quantify the costs in dollars.

Most large business organizations, unions, and governments already see the value of devoting significant resources towards the rehabilitation of their employees. EAP (Employee Assistance Programs) exist at most large companies. The legal profession has LCL (Lawyers Concerned for Lawyers), a mandatory charge on every lawyer's yearly bar dues. I am aware of similar efforts in the medical and law enforcement (police) professions. Intelligent people see the value in saving lives, families and organizations from the ravages of addiction.

The problem is that this still leaves the vast majority of people without many real alternatives. Correctional facilities, although rife with illegal drugs and alcohol within their walls, seem to be society's answer to the problem. Many people do get sober (or clean) in prison, but this is hardly cost effective and the rehabilitation rates are abysmal--just look at the recidivism rates.

Treating people prior to their involvement in the criminal justice system, would be best. Diverting them into treatment after their involvement in the criminal justice system, but prior to incarceration, would be next. Treatment in prison should be a last resort, but is still worth the effort. Unfortunately, by the time prison is in the picture the sufferer has a reduced probability of getting into recovery.

Our courts, prisons, social service agencies, businesses, and individual families are spending enormous resources dealing with the after effects of alcoholism and drug addiction, with very little attention given to the alcoholic/addict. Get the sufferer into recovery and all those other problems go away. Society gains another productive member and the pain ends. This should be the goal.

Thank you again for your time and your efforts.

Bill

Sunday, October 13, 2013

Finding out what's in ObamaCare

Listening to Paul Krugman on ABC's This Week with George Stephanopoulos, you'd believe that the measure of success for ObamaCare is someone being able to log into the insurance exchange and create an account. He assures us that these glitches will be resolved.

There is no doubt that the not-ready-for-prime-time Internet software will be fixed eventually. That's not what people will be fuming about in November of 2014. Two aspects of the ACA will be front and center when voters are about to cast their ballots.

First, when the $515 million healthcare.gov website (see the NY Magazine article here) is fixed, health insurance shoppers will get to see pricing for bronze, silver and gold plans. For millions of people, this will be sticker shock because of their expectations, fueled by the President and his administration for several years, that policies offered under the Affordable Care Act will be affordable.

Adding tens of millions of newly-insured individuals and families to our already short-handed health care system, particularly with respect to primary care physicians, will not be without its challenges. Health care delivery is not immune to the effects of supply and demand. When supply is dwarfed by demand, expect 1) higher prices, 2) longer lines, and 3) inferior quality.

As we close in on January 1, 2014, we will hear report after report of people being unwilling or unable to pay the premiums, deductibles and co-pays for the plans that meet the minimum coverage standards of the ACA. Many will sign up anyway with the idea that they might be able to make ends meet, but later will realize that hope doesn't change the fact that family budgets have limits. This epiphany will come about during the height of the U.S. House and Senate re-election campaigns.

Second, in spite of the fact that businesses have been given a hiatus until January 1, 2015 to meet their ACA mandates, millions of employees who fall below middle management in the corporate hierarchy will feel the brunt of full-time jobs being slashed to part-time status in advance of this start date. A 29-hour work week will be commonplace for these folks, the magic number for businesses to avoid the ACA requirement to provide employee health insurance.

In an effort to balance the family budget, second jobs will also become the norm for those who lose their full-time status and their corresponding benefits. Oddly, the selfless act of working harder to keep their heads above water will also push many beyond the threshold for receiving subsidies to help pay for their ObamaCare.

Even if a family of three's income falls below the $73,000 subsidy threshold, say $65,000, insurance premiums will be capped at around $6,000 per year for a high deductible policy, but the family would put at risk another $8,000 to cover the maximum annual out-of-pocket exposure. Will people consider putting up $14,000 for health insurance affordable? (See the chart here.)

As Nancy Pelosi famously proffered: "...we have to pass the [health care] bill so that you can find out whats in it...." Voters will be finding out what's in the bill just in time to weigh in at the polls on November 4, 2014.

Friday, September 13, 2013

Addiction and Crime - A Way Forward


Addiction and Crime – A Way Forward

Randy Hunt, State Representative
Massachusetts 5th Barnstable District
September 2013

  

Serving on the Joint Committee for Mental Health and Substance Abuse as well as the Interagency Council on Substance Abuse and Prevention has given me a view into the problem of substance abuse that few people outside of the treatment arena are afforded. Three truths I have come to realize are 1) substance abuse is wider spread than most people believe, both geographically and socioeconomically; 2) treatment works; and 3) relatively few people seek out treatment.

Over the past ten years, legislators, governors and state administrators across the country have begun to see the folly of incarceration as a solution to the problem of substance abuse. It is the most expensive and least effective way to address the issue, a veritable turnstile for repeat offenders who do not get the treatment they need. Nonviolent criminals with a substance addiction are crowding our prisons—about one-quarter of all inmates in the U.S.—and costing enormous sums of our states’ limited resources, resulting in other areas of state governments, such as education spending and transportation infrastructure investments, getting short-changed.

Addiction and Crime, A Way Forward is a policy initiative to reduce substance abuse in Massachusetts by focusing on the population of nonviolent criminals with a substance addiction who interface with the criminal justice system. It is, by no means, an omnibus solution for all addicts, the majority of whom never encounter the police, courts and detention; but it is a way to deal with thousands of people who are responsible for the majority of our property crimes, domestic abuse situations, and serious vehicular crashes—all of this with the promise of saving taxpayer dollars.


Why Addicts Commit Crimes

Is Free Will No Longer Free?
Much has been said in recent years about addiction being somewhere between an uncontrollable behavior and a conscious choice. Some characterize it as a mental disease that should be de-stigmatized and dealt with as we do physiological diseases; that is, treatment by professionals in appropriate settings for the appropriate amount of time with the backing of health insurance or public assistance. Others believe in a personal responsibility model that is essentially “you broke it, you fix it” (http://abcnews.go.com/US/story?id=90688&page=1&singlePage=true).

A debate has emerged about whether an addict loses free will, particularly an abuser of opiate drugs which present very powerful physical withdrawal effects. Why would a previously productive person start down the road of committing petty crimes, wrecking relationships, and defying common sense? Would a person with free will choose to ruin their lives and the lives of people around them?

Some argue that it is not free will that is lost, but rather that an addict’s belief in free will turns to disbelief (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2757759/). That may seem a bit nuanced, but someone who declares “I can’t help it” probably finds it expedient to disavow his free will, thus avoiding self-incrimination.

Irrespective of the academic debate about addiction’s connection to loss of free will, it is a fact that, by force or by choice, addicts engage in destructive behaviors and often are unable to pull themselves out of their downward spiral. Along the way, many addicts commit crimes, from illegal drug possession to property theft, from embezzlement to robbery.

Sometimes, the first significant manifestation of a loved one’s drug habit is an arrest. Perhaps changes in the addict’s behaviors and routines went unnoticed or were chalked up to the stresses of school or a job or a relationship. Often the crimes committed are of a nonviolent nature but come with stiff penalties. In fact, about a quarter of all inmates in the United States are nonviolent criminals with a substance addiction (http://www.nationalreview.com/corner/269208/prison-math-and-war-drugs-veronique-de-rugy).

At the point where interdiction and treatment are most called for, our justice system parks nonviolent criminals with a substance addiction in prison, where recovery is rare.


Treatment versus Incarceration
 
Treatment Does Work
Doug Sellman, Professor of Psychiatry and Addiction Medicine at the National Addiction Centre in Christchurch, New Zealand, describes the ten most important things known about addiction (http://www.scribd.com/doc/45303234/The-10-Most-Important-Things-Known-About-Addiction-Sellman-Addiction-2010-See-response-by-Sobels-Missing-the-Continuum):

(1) Addiction is fundamentally about compulsive behavior;

(2) Compulsive drug seeking is initiated outside of consciousness;

(3) Addiction is about 50% heritable and complexity abounds;

(4) Most people with addictions who present for help have other psychiatric problems as well;

(5) Addiction is a chronic relapsing disorder in the majority of people who present for help;

(6) Different psychotherapies appear to produce similar treatment outcomes;

(7) “Come back when you’re motivated” is no longer an acceptable therapeutic response;

(8) The more individualized and broad-based the treatment a person with addiction receives, the better the outcome;

(9) Epiphanies are hard to manufacture; and

(10) Change takes time.

The referenced article provides a summary on each of the ten points and encapsulates some of the difficulties and frustrations related to addiction treatment, but however difficult and frustrating treatment options can be, there is one consistent finding across many studies of treatment versus incarceration: Treatment costs a fifth or less compared with the costs of incarceration (http://www.justicepolicy.org/uploads/justicepolicy/documents/04-01_rep_mdtreatmentorincarceration_ac-dp.pdf).

With such a “bang for the buck,” why wouldn’t legislators, administrators and adjudicators call for more treatment and less prison time for nonviolent criminals with a substance addiction? Even with relapses and recidivism being factors in treatment cost, an addict could go through treatment five times before equaling the cost of one incarceration. The fact is that drug offenders who complete treatment programs recover and stay sober at much higher rates than those who receive no treatment while incarcerated.


Drug Diversion Programs
Non-Violent Offenders Get A Second Chance
The good news is that states have started to embrace the concept of treatment as an alternative to incarceration, including Massachusetts. One of the staunchest advocates of treatment for nonviolent criminals with a substance addiction is Judge Mary Hogan Sullivan, the Dedham District Court’s presiding justice and director of specialty courts in the District Court Department (http://www.boston.com/news/local/massachusetts/2013/03/23/newton-district-court-launches-drug-court-program-newton-court-adds-drug-treatment-session/LU9zGdBpysehw2ZVGLujDN/singlepage.html).

The system she has created is essentially probation with required addiction treatment and drug testing. Drug court, as it is commonly called, is an option for a convicted drug offender with the alternative being incarceration. In a 2003 study by the Center for Court Innovation, the recidivism rate among 2,135 participants in drug courts in six states was 29% lower over a three-year period compared with drug offenders who did not participate in the programs (http://www.samhsa.gov/samhsa_news/volumexiv_2/index.htm). Unfortunately, only twenty drug courts exist in Massachusetts and they depend greatly on the talent of their probation officers who, in many cases, learned their craft through on-the-job training.

Mission Direct Vet, a program specific to Massachusetts veterans with criminal charges combined with mental health disorders, such as post-traumatic stress disorder (PTSD), recently completed its five-year grant period, producing a model for dealing with this growing population. Paired with veterans who have had similar experiences, the results in terms of reduced recidivism were excellent. Moreover, given the statistical probability that the participant group would normally suffer several suicides, the fact that none were committed is particularly noteworthy (http://www.ndci.org/conferences/2011/agenda/F-21.pdf).

Critics argue that more should be done to offer treatment before an addict becomes a convicted criminal. It is not a matter of “either/or” but rather an issue of funding, which is hard to come by in either scenario, and creating points of interdiction that occur before an addict becomes a convict. Gosnold on Cape Cod, for example, is working to develop an interdiction program in primary physicians’ offices by training people to identify symptoms of addiction in patients who are there for other reasons. School-based drug education programs are a requirement of the omnibus opiate drug addiction bill that was passed in July last year but are yet to be incorporated in the statewide curriculum.


The Texas Experiment
Mandatory Treatment Saves Billions
In 2005, Texas began reforming drug sentencing and shifting money to drug rehabilitation and prevention programs, which has saved the state billions of dollars [in avoided costs] and reduced crime. Such reforms have earned the praise of unlikely bedfellows: NAACP President Ben Jealous and conservative activist Grover Norquist. The NAACP argues that sending people to jail for nonviolent drug offenses turns young people into hardened criminals and disproportionately affects black people, while Norquist argues that states waste taxpayer money locking up people who could be rehabilitated more cost-effectively (http://news.yahoo.com/blogs/lookout/texas-close-prison-first-time-state-history-175703769.html).

In August of 2011, the Texas governor announced that the state would, for the first time in its history, close down a prison due to a reduced prison population and the lowest crime rate since 1968. Two other prison closures have been authorized by the state legislature.

What Texas did to accomplish this seemingly herculean feat was to invest heavily in drug courts, electronic monitoring, and improved parole and probation monitoring of nonviolent criminals with a substance addiction. Texas is also not hamstrung by mandatory minimum sentencing, something once popular with both conservatives from the “lock ‘em up and through away the key” school of thought and liberals, whose unions saw job security in long sentences and overcrowded prisons (http://www.nationalreview.com/corner/355661/conservatives-welcome-eric-holder-criminal-justice-reform-bandwagon-vikrant-p-reddy).

The idea of offering, or forcing, treatment programs pays off in a number socially beneficial ways as well. Addicts who receive treatment find themselves able to hold a job, repair relationships, and return to productive society; all huge upsides compared with years of incarceration. Additionally, opportunities to “give back” abound in recovery programs that rely on peer counselors as an element of their treatment protocol.


Other States Climbing Aboard
Discovering That Treatment Is Effective and Cheaper

Since 2010, a number of conservative legislatures have passed major criminal justice reform packages. Ohio, Georgia, Pennsylvania and South Dakota joined Texas by moving from “tough on crime” to “a focus on recovery” when it comes to nonviolent criminals with a substance addiction. Overall, 28 states have embarked on major reforms during the past five years, with 19 of those states being led by Republican governors or GOP legislatures and nine by Democratic governors or legislatures.

There are still holdouts in some legislatures, primarily Republicans who believe that they’ll be cast as “soft on crime,” a stigma they believe could threaten their political futures. Legislative efforts in Florida and Indiana fell victim to arguments that public safety would be compromised if nonviolent criminals with a substance addiction weren’t locked up (http://online.wsj.com/article/SB10001424127887323836504578551902602217018.html).

Paradigm Shift for Massachusetts
Time to Expand Successful Programs

The message is clear that incarcerating our way out of the drug and alcohol addiction crisis has not worked. The “War on Drugs” has also proven that, in spite of all efforts to stop illegal drug flow into this country, the fundamental economic model of supply versus demand overwhelms all attempts to stamp out supply. If there is demand, someone will supply it. Is there any shortage of heroin on the streets of Boston or Hyannis?

Massachusetts needs to get serious about fully implementing criminal justice reforms relative to nonviolent criminals with a substance addiction and investing heavily in expanding our successful drug diversion programs. No one can sincerely argue that it’s not a good idea to repair lives, put families back together, get people back to work, reduce crimes that go hand-in-hand with substance abuse, and save taxpayer dollars at the same time.

There are three key items that need to be addressed in order to construct a reform bill. I will file legislation to authorize three commissions to both independently and collaboratively study and provide methods and costs for implementing the key objectives:

1)      Judiciary Commission: This commission would be comprised of members from all three branches of state government and nongovernmental advocacy groups to create eligibility criteria for mandated treatment/monitoring and propose necessary changes in existing laws to accommodate for this reform.  – The Texas law requires judges to put nonviolent criminals with a substance addiction with no previous felony convictions into a treatment program. For those with a prior felony conviction, the judge has latitude in choosing between a treatment program and incarceration. A similar construct should work in Massachusetts along with adjustment to or elimination of some mandatory minimum sentencing guidelines that extend to otherwise eligible nonviolent criminals with a substance addiction.

2)      Treatment Commission: This commission would be comprised of members from all three branches of state government and nongovernmental advocacy groups to develop plans to expand Massachusetts’ drug diversion programs to include every district court in the commonwealth. Additionally, this commission would specify the necessary resources and related costs for both internal and outsourced assistance required to accomplish this expansion. – There are 62 district courts, of which only 20 have a drug court. Clearly the cost of adding 42 more drug courts needs to be determined, but as important, the commission must create a plan for how Massachusetts would apply best practices with the goal of having consistently high quality of personnel and services across all of the drug courts. This expansion would also contemplate the subdivisions of drug courts, such as veterans’ and juveniles’ drug courts. Finally, the commission should consider a hybrid approach of incarcerated treatment for addicts who require the additional discipline of a 24/7 treatment facility.

3)      Corrections Commission: This commission would be comprised of members from all three branches of state government, unions, and nongovernmental advocacy groups to project the effects of a reduced prison/jail population on the operations and capital needs of the corrections system. – A few years into the implementation of the nonviolent drug offender changes in Texas, its legislature authorized the closing of three state prisons. The first actual closure was announced in 2011. These reforms also allowed the state to scrap plans to build two additional facilities. Similar results should be expected and planned for in Massachusetts. As prison/jail population declines, a plan needs to be in place to adjust operating and capital requirements to maximize cost savings. To this end, it is critical that consideration be made to retraining people to fill roles in the expanded drug court system and to repurpose space in our prison system to serve as treatment centers.

We must cast aside the old paradigm, be up to the pushback of status quo special interests, and tackle this issue head on. Working with my fellow legislators, I am confident that we will advance legislation to accomplish these goals and make Massachusetts a better place to live.

Monday, August 19, 2013

Pro-Choice movement requires explanation (guest editorial)

By Mary Wagner from East Sandwich

This is a letter to the editor that was not published by the Cape Cod Times.
 
Sunday's paper asked readers if they were "Ready for 2014?" I think there is a lot of explaining to be done on many subjects before we are ready for 2014. One example is the abortion issue--not the law, but other aspects of the Pro-Choice Movement.

* Abortion is a business, a billion dollar business. It includes the selling of body parts. Why does it need our tax dollars?

* People supporting abortion call their movement "pro-choice." But every effort made to require abortion centers to provide more information is rejected by "pro-choice" people. The average man who buys a new car spends more time and has more information about his car than most women have about the abortion they are about to have.

* The abortion movement is considered "a woman's health" issue and yet, across the whole country, very few centers are ever checked for adequate hygiene. Nor are the credentials of the personnel verified. Why not?

* We live in a time in which there are statistics for everything. ObamaCare is going to collect details not only about our health but our finances. And yet there are no records about abortions. How many women die in a year because of abortions? How many wish they did not have the abortion?What are the long term effects of abortions?

The thousands of women who march every year in the many Right to Life Marches carrying a sign "I regret my abortion" suggest there are consequences we are not hearing about. Why not?