ORIGINAL : HOUSE OF REPRESENTATIVES

-l COMMONWEALTHOF PENNSYLVANIA APPROPRIATIONS COMMITTEE HEARING

IN RE: BUDGET HEARING ON DRUG AND ALCOHOL FUNDING AND HUMAN SERVICES FUNDING

PHILADELPHIA COLLEGE OF OSTEOPATHICMEDICINE 41.80 CITY AVENUE EVANS HALL AMPHITHEATER PHILADELPHIA, PENNSYLVANIA

TUESDAY, APRIL 22, 2003, L:35 P.M.

BEFORE:

HON. DAVID ARGALL, CHAIRMAN HON. GIBSON ARMSTRONG HON. MATTHEW BAKER HON. CRA]G DALLY !L HON. GENE DiGIROLAMO HON. EUGENE McGILL .",..1,] HON. SAM ROHRER HON. STAN SAYLOR HON. CURT SCHRODER HON. PETER ZVG HON. DWIGHT EVANS HON. DANIEL FRANKEL HON. KATHY MANDERINO HON. ANTHONY MELIO HON. PHYLLIS MUNDY HON. THOMAS TANGRETTI HON. LeANNA WASHINGTON HON. JAKE WHEATLEY

SHERRI A. REITANO, RPR NOTARY PUBLTC

d$k--". t+Httl 2336N. SecondStreet (717)234-5922 ,\.3 l#til l lryiltl Harrisburg,PA 17110 FAX(717) 234-6190 .:. -r }r{lll I -TJo 03 - og b 1 INDEX

2

3 WI TNESS PAGE

4 Michele Denk 6

Deb Beck T7

6 Frederick W. Anton, III 23

7 Mark Sarneso 27

I Michael Har1e 3l_

9 David Slinger 38

10 Gary Tennis 45

1t- Dickie Noles 51

L2 Secretary Estelle Richman 65

IJ

t4

1q

16

I7

1B

19

20

2L

22

23

24

25 1 CHAIRMANARGALL: Good afternoon, everyone.

2 On behalf of the House Appropriations Committee, f

3 would like to welcome everyone here to this second in

A Cl a continuing serj-es of hearings looking at the budget

5 as originally given to us by Governor Rendell. He has

6 said that while the bar is high, there may in deed be

7 room for modifications.

X A11 that you need, of course, is L02 votes

9 in the House, 26 in the Senate, and the Governorrs

10 signature. So we understand how that process works in

11 Harlisburg, and that is why we are here today t2 We will be looking at the potential impact l-3 of reductions already approved as well as looking for

14 other potential reductions in the budget. And I think

1q of special interest is today to look to see how

L6 agencies.both in the public sector and in the private t7 sector can deal with the reductions in the budget

1B al-ready suggested.

19 The goal, of course, in moving Pennsylvania

20 forward"is to control both State spending as well as

2t State taxes. We need to target those tax doIlars

22 especially in difficult year to those areas where

23 they are the most needed z.r Whether it is in revitalizing a community,

25 whether it is in turning people I s lives around getting 't I them back on the right startr w€ will be looking today

2 and in the hearings to come to see how we can stretch

3 those tax dollars that we have been given by the

4 taxpayers of Pennsylvania to the maximum. Thatrs why

5 we are here today.

6

7 impacted by the reductions in both drug and alcohol

B ' funding as well as in human services funding.

9 And our goal today and I would ask all

10 of the members of the Approprj-ations Committee to be

11 concise and to the point so that we can get the

t2 maximum number of questions both asked and answered

13 today according'to our five-minute rule

T4 Our goal is to understand the priorities of

15 the Governorrs budget as it pertains to funding for

16 drug and alcohol and. human services funding, and to

I7 'understand how the impacted organizations and the

1B Department of Public Welfare will operate with the

19 isting reductions

20 We will introduce the first panel in just a

2t moment. We will go until 2:30. We wil-l- then bring on

22 the Secretary of the Department of PubIic WeIfare.

23 And we wilL conclude here by 4:00. Many of the : 24 members of the committee have other appointments. I

25 know I need to be in Lancaster by six, and so we wi]l I need to conclude on schedule.

2 So before we go any further, I'd like to

3 introduce the Minority Chairman of the committee,

4 Representative Dwight Evans. I was asking him if the

q halL here is named in his honor. He can explain that

o or he can do anything else that he now chooses.

I Dwightr w€1come

I REPRESENTATIVEEVANS: I would ].iKe Io

9 thank the Chairman for conducting this hearing, and I

10 want to .thank all of you for showing up today to just

11 voice your opinion and your thoughts.

1,2 The Chairman this is one of I think

13 seven more hearings that he wiLl be conducting with

L4 the rest of.the members throughout the Commonwealth of

I3 Pennsylvania. This is not an issue of a partisan

16 issue. This j-s an issue about us trying: to work

1,7 together to solve this budget issue and move the State

18 forward again. Again, I wouLd like to thank the

19 Chai rman

20 CHAIRMAN ARGALL: Thank you. For those

2t questions that are not that we run out of time for

22 today, I encouraged aLl of the members of the

23 committee at our last hearing in Harrisburg to provide

24 them to me in writi*g; and we will follow-up with the

25 appropriate agencies to get answers. 1 As I had said earlier, time permitting we

z will- hold questions with our first panel until a1l

? have presented. And then for those groups that were

4 able to come to us perhaps in the last few days when

the schedule was already put togetherr w€ will not be

able to fit you in today. But we will take statements

7 in writing, and we will make that part of the

committeers legislative record.

9 And so once againr w€lcome aLL of you to

10 this beautiful location. I would now Like to brinq

11 forward our first testifier.

L2 MicheIe, if you will introduce yourself and

13 we can begin.

L4 MS. DENK: Good afternoon. My name is

15 Michel-e Denk. f rm the executive director of the

16 Pennsylvania Association of County Human Service t1 Administrators, the alphabet soup acronym is PACHSA.

LB Werre an affiliate of the County Commissioners 'staf 19 Association. I am part of the f at CCAP.

20 We would really like to thank you for the

2L opportunity to come this afternoon to provide

22 testimony regarding the budget that has been passed

23 and its impact on the community and loca1 human

24 servr-ce programs.

25 . I'm al-so here to ask that you restore the l_ cuts that were made to human services that have been

2 j-ncluded in the 2OO3-2004 State budget.

Counties in Pennsylvania are the caretakers

4 of our communities. They preserve d.emocracy by

administering the election process. They improve

6 health and welfare by helping families and individuals

7 in need and responding in times of emergencies.

x -They preserve and showcase Pennsylvaniars

9 naturalr cultural, and historical resources through

10 careful and effective planning and economic

L1 development. Counties are the State's partner in the ' L2 del-ivery of human services . l3 Counties must work within the limitations

L4 of complex state and federal regulaLions to develop l_5 programs and initiatives that respond to locally

16 identified needs i-n the most economic and efficient

L7 manner possible..

LB The state and federaL government are the

19 primary sources of funding for q11 services provided

20 throu'gh county human servj-ces.

2L In many instances .l-ocal dol-lars are

22 required to match federal and state do11ars.. Counties

23 use local tax revenue for that purpose.

24 The budget as has been passed will have a

25 devastating effect on locaL human service's in all 67 1 counties.. We will not be able to absorb the budget

2 cuts or fund that critical service that will be

eliminated through this draconian budget.

4 We have assessed the impact of the budget

q on consumers of human services. And it will be

6 devastating to individuals in our communities. 'The 7 need and demand for services will not

U be reduced because the funding has been eliminated.

9 Individuals and famiLies will be forced into more

10 costly methods of treatment such as hospitals, nursing

11 homes, prisons, and institutions if community-based t2 services are not available. Hospital emergency rooms

13 wiLl- be overflowing as the community support services

14 are cut.

15 Last year, counties provided services to

L6 652, 000 people through the Human Services Development

L7 Fund. The flexibility of HSDF has allowed counties to

1B creat e a service delivery system that meets the unique

19 demands that have been localIy defined and to fill

20. gaps in services.

2L Over 500 agencies throughout the state have

22 received human service funding Iast year. HSDF also

23 supplements the county human services systems, Mental

24 Health/MentaI Retardation, Drug and Alcohol, Aging,

25 and Children and Youth Services. L HSDF funding is being used in York County ; z for example to reduce the waiting list for vocational

3 rehabilitation services for persons with mental

4 re tardat ion

5 Statewide HSDF funds have been used to

6 serve 1,598 individuals with mental retardation.

7 Thirty-four counties use HSDF to supplement services

I provided through the Aging system.

9 HSDF funding is being used effectively to

10 maintain individuals in their homes and communities.

Ll_ In AlLegheny County there are estimates that as many

1,2 as 165 residents wiII be placed in institutions once

13 the HSDF is cut. Another l-35 are at ri-sk of

L4 incarceration.

L5 More specifica11y, LL Allegheny County

16 residents are able to live in the community supported l7 by services through contract with the Three Rivers

1B Center for Independent Living. These services cost

LY $16r?04 a year to fund the three cLients. Once the

20 HSDF is cut, these three individuals will be

21, institutionalized at a projected cost of $4B,O0O per

22 year per person.

23 Eight others are at risk of

24 insti tut ional i zat ion . The total cost could be as high

25 as $528,000 per year. 10

I t . HSDF funding saves taxpayers money by

z allowing people to remain in their homes and function

3 to their fullest potential.

4 In Cumberland and Perry County, dialysis

patients will be faced with a choice of entering a

6 nursi-ng home when their transportation services are

7 cut.

B The Human Services Development Fund is less

9 than two-tenths of 1 percent of the DPW budget. V{e

1_0 woul-d suggest reallocating the HSDF cut across other

11 cost centers within Welfare and enabling and

I2 preserving the counties' ability to triage a response

13 to other cuts. By keeping as much of the HSDF as

14 funding intact as possible, counties riltt be able to

respond to the other cuts that will be necessary.

L6 Wer re told that HSDF was eLiminated because

L7 it does not leverage funding, federal funding at the ' 1B state 1eve1.

1v In fact, county programs do use HSDF to

20 leverage other funding. Some of it is federal, some

2t of it is. state money but it is .done at the Local

22 . level

23 1 HSDF also allows county coordinators to

24 develop unique programs that cross our categorical-

25 systems and create solutions to barriers. for citizens l_1

L with multiple needs. HSDF dollars leverage human

capital.

3 One county funds a portion of the local

4 volunteer centers operated by the United Way. At the

f volunteer center one single HSDF do11ar leverages 160

hours of vol-unteer time at a multitude of community

7 agencies.

B The HSDF also leverages access to service

9 for thousands of Pennsylvanians through community

10 centers and family centers as well as information and l_1 ref erral networks.

L2 Training and staff development efforts have l-3 made our system more efficient. York County operates

L4 a comprehensive training program designed to"serve l5 alL human service agencies and providers making the

16 whoLe system more responsive to the community needs.

L7 Caseworkers and direct care staff have an

1B opportun i ty to learn conversational Spanish, an

19 invaLuab 1e tool that increases access for this

20 important t arget population

2t Counties. such as Chester and Franklin have

22 been able to increase efficiencies in overall nlanni-ng

23 and administration by utilizing the HSDF to form a

24 consolidated human service department that oversees

25 the funding and operation of all of the categorj-caI L human services within the county.

2 In all, 47 counties utilize HSDF to improve

J service coordination to their resi-dents. The

.t efficj-ent use of state dollars through the Human

Service Development Fund is critical to the ongoing

6 operation of services at the county level- and the

7 continuation of the effective partnership that exists

I between the counties and the state.

9 The partnership between the counties and

l_0 the state has also been devastated by the cuts to the

Lt drug and al-cohol system. The budget wilL require a

L2 $64 million cut to our treatment capacity across the

IJ state. - tt l-4 It has taken decades to build this capacity

15 through.a patchwork of funding f5om various local I

L6 federal, and state sources. Counties do not have the

L7, capacity to replace the funds that wiLl be lost.

1B We are not the primary funders for

t9 addictions treatment. Untreated addiction will have a

20 profound economic impact throughout the state. In

2L 1999 the National Institute on Drug and Alcoho1 abuse,

22 NIDA, published a study t Princ:p-l.es of Drug Addictjon

23 Treatment: A Research-Based Gurde. At that time NfDA

24, estimates the treatment savings, including health care

25 savingsr €Xceeded the costs of actually providing the 1 treatment by a 12 to 1 ratio

2 go on to state that every : Ih"y dollar

? invested in treatment yield.s a return of between $4

4 and $Z in reduced costs of drug-related crime,

criminal justice costs, and theft.

6 The 40 percent reduction in funding for '1 intermediate punishment programs from the pennsylvania

U .. Commission on Crj-me and Delinquency would increase the

J cosL of addiction to society.

10 These funds allow nonviol-ent offenders to

11 participate in an addictions treatment program as an

L2 alternative to incarceration. When these services are

1? cut, county prisons wilI be forced to accommodate

14 increase.d population; and offend.ers will not have

15 adequate access to rehabil-itation.

16 The loss of the treatment capacity will

17 also have a dramatic impact on families served through

r IX our Children and Youth programs. At leas t 67 percent

19 of the children 1n the Children and youth system come

20 from families where substance abuse is a major issue.

2t

22 times more likeIy to be abused, 4 times.more'likely to

ZJ be neglected; as a result, more l-ikely to enter care,

24 to remain in care for a longer time, and reenter care

25 after they have been discharged. L4

L . Cuts to the mental health - funding will also

2 have an impact on the Children and Youth population.

J At least 80 percent of the children placed outside of

r+ their homes have developmental, behavioralr or

emotional problems with a primary need for mental

6 health services.

7 The Children and Youth service system will

I . pay the price for the cuts in the other categorical

9 human services. County Children and Youth agencies as

10 a mandated entitlement service will become

1l- overburdened by clients unable to be served in the

t2 most appropriate manner and by the costs of providing

13 these services.

I L4 The budget cuts will have an immediate

L5 ef fect on the children already being served and the

16 providers in the communities by impairing their

L7 ability to ensure that the most effectj-ve services are

1B avai-labIe.

L9 Treatment may be delayed resulting in more

20 children at risk of being abused and neglected, ' 2T j-ncreased delinquent behavior and placement, increased

22 domestic v1olence. More children will be placed in

23 costly residential care making reunification efforts

24 difficult and less 1ike1y to succeed.

25 Close to $26 million have been sLashed from 1_5

1 the behavioral heal-th services initiative. That will

2 Iimit our ability to serve individuals who do not

qualify for medical assj-stance and have insufficient

? funds to pay for services.

Many of these consumers will become

6 homeless because they do not receive the support or

7 treatment including medication. Many wiLl be

I convicted of petty crimes and enter county prisons.

9 Others will be committed to state mental hospitals.

L0 Restoring the costs of substance abuse and l_l mental health treatment is a worthy investment.

L2 Eliminating the funding will not make the problems go

1J away.

L4 If this budget remains unchanged, vital

15 services wiLl not be available af ter ,fune 30th. We l_6 are stilI in the process of assessing the true

L7 economic impact that these cuts may have on a

18 county-by-county basis .

IY AIlegheny County human servi-ce providers,

20 for example, have projected that 89 individuals wilI

2L lose their job as a result of the 90 percent reductio4

22 in.the Human Service Development Fund aLone.

23 Other counties will face proportionate

24 reductions. As jobs are eliminated, Iocal- providers

25 will close and the local community economy will- be l_6

impacted.

2 Human service workers pay taxes, purchase

3 goods and servj-cesrvj-ces in ou.our communitier s, and rent and

purchase housing.

5 I wouLd ask you to examine the negative

6 mul-tiplying effect that a $103 millj-on cut to the

7 human servj-ces system will have on the local

B

9 The impact is far greater than the actual

10 dollars cut from DPW's budget. The progress that we

11 have made with work force development and recruitment

L2 and retention efforts during the past few years will

L3 be lost as agencies close or significantly reduce

L4 their staff. rb What is the net result of eliminating jobs

L6 in one service area and subsequently spending tax

I7 dollars to reduce Pennsylvania's Brain Drain and out

L8 mi gra t ion? l_9 The budget that has been passed. does not

20 a1low county human service programs to adequately meet

2L the needs of citizens and families within our

22 community.

23 Counties will be left to address the

24 combined. impact of these devastating cuts. Werre

25 hopeful of an opportunity of reinstating these monies I7

1 before agencies are closed.

2 Thank you again for your consideration. We

3 have written mat.erial. We have material available on

4 the web site. I ' d be happy to answer any questions

5 that you have

6 CHAIRMAN ARGALL:;ALL: WeWC don'tdOT have the time

.7 fo1 Auestions with the rest of the panel. Tharrk you,

B Mi che 1e .

9 MS. DENK: Thank vou: ' l-0 CHAIRMANARGALL: Deb Beckr. Pfease.

11 MS. BECK: Fred, do you want to come down

L2 as well-? Hers making me go on my own. All right, l3 Fred . r.i CHAIRMANARGALL: PIease identify yourself

15 and begin your testimony

16 . MS. BECK: Irm Deb Beck. Is the microphone

L7 on? . Did that work? I just got to ask, anybody here

1B think treatment works? l9 ' I wanted to make sure I was in the right

20 pIace. It sounds like I am. My name is Deb Beck.' I

2T am the president of the Drug and Alcohol Service

22 ' Providers. I am not going to read along. You have

23 the packet from us.

24 My notes don't match what you have. You

25 will be able to go back and look at some of the 18

1 research in there at your l-eisure

2 Irm a clinician turned advocate. I ran a

? skid row program in Harrisburg for many years and

4 became a public policy advocate. And the last time I

q was at the bottom of an amphitheater I was teaching

6 Addiction Physiology to Hershey Medical SchooI

7 students. I hope you won't be quite as dissecting as

B they were.

Y A few days dgor Ash1ey's mother returned my l-0 call from AshIey's grave. You see, it was Ashley's

LL birthday. It would have been her 18th birthday.

L2 However, Ashley was only able to get a few l-3 days of the addiction treatment. And because of the l4 overwhelmed seriousness of this illness, I wanted to

15 start my remarks there

16 In case there is anybody i.n the viewing or

17 listening audience that does not already know

LB al-cohof j-sm and other drug dependencies are l_9 progressive, always fatal illnesses if they are

20 allowed to go unchecked. Irm going to say it again.

2L These are'fatal illnesses if they are

22 al l-owed to go unchecked. For thi s reason, this

ZJ hearing, and what you do today and the weeks that

24 follow around this budget is l-ife and death important.

25 It is life and death importanL to one in four famiLies L9

1 I in the State of Pennsylvanj-a, our great state..

2 And one in four f amilies within our vj-ewing

d.istance and maybe here today in fact, I know.here

4 today " -- is struggling with an untreated alcohol-ic or

5 drug .addicted loved one in the family. And oh, how

6 the family suffers. Oh, how they suffer. Ashley's

7 mother returned my call from her grave site.

R Of cours€r one in four of you already know

9 about this' struggrle upf ront and personaL because it j-s

10 go ing on in your home. You know about it. frm not

1l_ go ing to talk any more about it.

T2 One in four families are affected. One in

13 ten citizens will develop an unt reated addiction. And

L4 f want to assure you we don't get people who get drunk

once in a whil-e in our treatment facilities. That l_6 isn't who shows up in drug and alcohol addiction

T7 treatment. Sometimes the publ ic doesn't know that.

IU And I know you have good press coverage for this

19 today

20 But even if you do not have a l-oved one in

2t your immediate family, the truth you are affected.

22 No one gets out of this life unscathed by an untreated

23 drug or alcohoL addicted person. Every addicted z.t person affects a minimum of 6 to B others in their

25 immediate environment, in their community, in their 20

I 1 neighborhood. It is drastic. It is dramatic. It is

z financial. It is emotional. r may run over you with

{ my car. NIDA and AAA have tried to put a number on

I the easy-to-measure costs of untreated addiction and

q the number they put on it and the data again is in

6 the packet for you is $246 billion a year is what

7 it costs us not to treat this problem.

X It is an annually renewing $246 billion a

9 year. That is the easy stuff to measure. And I donit

1_0 know how, dear God, we put a prj-ce tag on the heart l_1 break of a parent who has lost a child.

I2 We spend less than 5 Percent of this amount

13 on prevent.i-on and treatment nationally and our state,

T4 kind of matches that.

15 . So we pay over and over again. But on the

16 other hand, the cost benefits of the treatment are l7 overwhelming and again are in your packet. Irm not

Td going to bore you with the details of that. l-9 There is no serious disagreement in the

20 research in the research that costs to. treat

2L untreated addiction. It turns out that you don't even

22 have to like the untreated alcoholic or an addict in

23 your family to see the value of doing treatment and

24 that you can save money and you .can keep other

25 famiLies from having to suffer as some of you have in 2I

l_ this room

z

3 health care'costs, crime as yourll see in the

4 packet and in the workplace. Treating it saves

5 money in all three domains. For every dollar spent,

6 we save $7 to $12 on other things

7 .During the war in Vietnam. over a 1-S-year

X perJ-od, 50, OOO young Americans lost their lives. And

Y the natj-on rose up and' said the price is too high. l_0 Let's bring the children home. Let's bring the young

11 people home. Bring them home. What price our

1,2 ch i ldren ? l_3 But every year in America, 130, O0O

1,4 . Americans die every year from untreated addiction. 15 130'ooo' "":'::-';":l:: 16 -,t"::::.'";:'"*n" will t7 rise up and say the cost is too high? What price our . L8 children? Let's bring them home. The Pennsylvania

LY budget before us contains over $104 million in cuts.

20 And that material is al-so in your packet.

2T This is over half of the state money

22 . available f or l-ocal spending, Ii f e-saving spending.

23 40rO0O Pennsylvanians will be unable to go to

24 treatment in the next year. And who are these 40r000

25 people? Well- r w€ know who t.hey are. 22

a I They are our mothers, our fathers, our

2 si-sters, and our brothers. They. are not somebody

3 other. They are our childrenr our neighbors,

4 co-workers in the work force. We are the people it

turns out, folks. We are also the taxpayers.

6 FinalIy, folks, I have been reduced to

7 comi-ng here today. Irve become a treatment broker. I

.X beg for free service every day. I bump waiting lists

9 and still the caIls come with a heart numbing

10 regularity to my office and to my home. The families

1l_ call with pain, acidic pain that is strong enough to l L2 bleed.and melt the heart of stone.

13 And I will tell- you there are happy,moments

L4 as wel-l. I have a letter with me todav f rom a woman

1q who is wrj-ting to teII me her young daughter j-s doing

L6 well- and thanking me for getting her service. She

L7 thought her daughter would. d.ie. l_B I f eel- terrible about this l-etter. Let me t-9 teII you why. I bumped a waiting list which means

20 somebody else's motherrs child did. not get help so

2t this one could live

22 In closirg, Ifm here today to lay my burden

23 which is our burden at your feet uttg to plead with

24 your to beg you for restoration of $104 million in the

25 treatment budget. What price -- what price our 23

1 chi ldren ? Thank you for your time.

2 CHAIRMANARGALL: Mr. Anton, if.you would'

J like to identify yourself, please

4 MR. ANTON: My name is Fred Anton. I am

the Chairman of the Pennsylvania Manufacture rs

6 Association.

7 'I would like to thank you, Chairman Argal1

B and Vice Chairman Evans particularly and other members

9 of the committee for this historic what I t0 understand is a historic event appearing for a budget ll_ hearing in PhiIadelphia. t2 For the last 13 years I have had a great

13 interest in doing what I can to help those who are

I4 trying to recover from al-cohol and drug addiction:

15 In accord with that interest, I have.become l_o a member of the Board of National A]liance for Model t7 Drug Laws out of Washington, DC.

1B This organization developed out of the

19 President's commission stud.ying this subject. The

20 President's commission on Model State Drug Laws now

21, the National- Alliance urges that states adopt the ful1

22 continuum of the addiction treatment services as a

23 part of state alcohol and drug strategy. I joined

24 this board because I'm committed to its goals and

25 fully endorse its findings regarding addiction 24

1 treatment.

2 In this regard. I am here today to urge you

3 to restore $104 miLlion in funds that were cut from

4 addiction treatment services during passage of the

5 state budget.

6 To be I approach this problem as a

I businessman. AIcohoI and other drugs are widely

B avail-able in our neighborhoods, in our schools, and in

9 our workplaces.

10 Yet children must have communities

1l characterized by caring and safety to thrive and grow'

in confidence and to learn the skills we need for the

13 22nd century.

14 To be compet i t ive and prod.uct ive , our work l_5 sites must be free of distraction and danger caused by

16 alcohol and d.rugs

L7 f know the Governor is concerned about

18 economic development but so am I. And I wonder how

19 can we succeed at economic development without making

20 a serious investment in a sober and stable workplace.

27 Let me just make a few comments on the

22 issue. The impact of untreated alcohoL and drug

23 problems on our nationrs work force have been well

24 researched and is quite redundant. Some of this

25 research is in your packet, and it will be presented 25

1 by other experts in this area far more expert than I. I 2 Prior to addiction treatment, the research finds heaLth care utiLization, high rates of

4 accidents, absenteeism, and disciplinary actions

5 incurred by the addicted employee.

6 After treatment there are dramatic

'7 reductions in the use of health care and the accident

o rates, absenteeism, and disciplinary'action. In the

9 work force today there are many people with alcohol

L0 and drug problems already there struggling to hold

11 down their jobs

L2 Other employees have children and loved

IJ ones with the illness. However, not all workers have

L4 insurance or'are able to access insurance coveragfe for

15 addict ion treatment.

16 The dollars cut from the treatment budget . t-7 are Iife-saving dollars for these workers without

1B insurance. Outside the work force there are many who

19 have already lost jobs as a result of alcohol or drug

20 probl ems .

2T Without treatment, this group of men and

22 women will remaj-n trapped in a downward spi-raI with no

23 ability to get or retain a job because of productive

24 caxpayers, citizens of our state

25 In this bleak picture of struggling job 26

Ioss, addiction treatment is a very bright light

2 indeed. And the dollars under discussion are a wise

3 investment in our state.

4 fn closing not quite in closirg, but in

5 finishing this statement before I make a persona*

6 remark, it appears we are headed in the direction of'a

7 tax increase.

B If werre going to do this, why shouldnr t we

9 ensure the restoration of these jobs and life-saving t-0 problems and get our work force moving. l- l_ f feel every bit as emotional as Deb Beck

L2 about the importance of drug and alcohol treatment for

IJ those struggling. I know many people personally who l4 have been in rehab and who have benefited from l_5 extensive treatment and rehab programs. l-6 I do not believe that drug: and alcohol

1.7 treatment only works for 20 percent of the

1B population -: of the people who go.

19 I know many people who have been in rehabs,

20 good people who have been in rehabs 2, 3, 4 times and

2I now are sober for 5, 10, 15 years. Many, many people.

22 Treatment does work

23 My own personal view is before one new

24 dollar is spent for education in the Commonwealth of

25 Pennsylvania or for economic development, that the 27

t_ $104 million for this program should be restored.

2 Thank you very much

3 CHAIRMANARGALL: Mr. Sarneso.

4 MR. SARNESO: Us treatment provj-ders stick

q together. My name is Mark Sarneso, and I am executive

6 director of White Deer Run. White Deer Run is one of

7 the. Iargest drug and alcohol treatment systems in the

x St ate ' 9 Irm also proud to be chairman of DASPOP.

l_0 And in that I have the delicious pleasure to be Deb

l-1 Beckrs boss. So if any of you ever feel the need to

L2 teII Deb to do something, call me and I ' 11 make sure

l_3 she does that or she'11 pretend that I asked her and

L4 told her to do something.

L0 White Deer Run operates 26 Licensed drug

16 and alcohol treatment centers in 18 counties across

L7 the State. And between Mike and I, we probably cover

18 most of the state.

1_9 The counties that White Deer Run have

20 operations in -- and I ' l-1 just list them if you don't

27 mind me reading off. I usually forget one or two of

22 them. ALlegheny, Lawrence, Erj-e, Westmoreland,

ZJ Cambria, Indiana, B1air, Dauphin, Union, Lycomi.g,

24 Lancaster, Berks, Lebanon, Lehigh, Northampton, I 25 SchuylkiII, FrankIin, Clinton, Columbia. 28

1 As I mentioned, it is a large system. We

z have 700 employees located across those 26 sites in

those 1B counties.

4 It's ironic that Irm coming to ask you-, to

5 plead you, beg you to find a way to restore $f04 'd.rug 6 million of and alcohol funding'. ft was just last

7 year that we were in Ben Salem and we were talking

I about an additional $10 million of funding for drug

9 and alcohol treatment because the State didnrt have

10 enough funding to meet the need.

11 . Instead of asking for a $10 million

L2 increase, we are now trying desperately to stop the

l-3 $104 million cut. My fear is that Pennsylvania is

1A J- .t waving the white flag on the war on drugs. Some

15 people think this is a .Iuly 1st problem. This is a

16 middle of March problem.

t7 The census throughout the system and census

l_B 'is certainly one indication of the ability for the

L9 addiction. Census

20 is plummeting across the street in all of the

2L programs. Every program that Irm aware of, their top

22 manag:ers are meeting to talk about what programs are

23 we going to cut, what programs are we going to

z+ eliminate, what staff are we going to reduce, what I 25 communities are you not going to have an option to 29

1 treat those in need?

2 , Those decisions are being made now. I will

make the f inal decis j-ons about my system by the end of

4 this week. I will cut at l-east 10 or 15 percent out

5 of my entire operation for this month

6 My fear is that next month I ' I1 probably

7 have to cut another 10 or 15 percent and then the

F following month another 10 or 15 percent.

9 These are people that are -- these are tax

10 paying citizens that will no longer have jobs. These

1L' are resources in the communities that will no longer

IZ be there.

13 Long-standing community assets, rehabs that

ICI have been part and parcel of the life blood of your

15 communities are now talking about folding their tents l-6 and going away.

L7 And I. know some people sometimes cynically l_B sdy, weII, when the money is restored they will pop

19 back up. No, they wonrt. Mr. Anton talks aboutr you

20 know, represents manuf acturing associ.ations. What

27 happens to" a plant when you stop making stuff in a

22 plant? It rusts. It breaks down. It goes away.

23 We are going to be losing valuable

24 resources. People that know how to treat people who

25 have addictions. Wefre losing them now. Irm losing 1 them this week from my program. I t 1I lose more of

2 them next month from my program.

By July 1, my program which is in your

4 communities is not going to look anywhere near what it 'like 5 looked a month ago. So the urgency real-Iy is

6 now. This is a problem now.

7 We are in desperate means in terms of a

I $104 million cut. But that cut and the spector.of

9 that cut and the psychofogy of that cut and the'

L0 reality of that cut is affecting your communities now. t_l- God bless you if you have a loved one or

L2 one of your constiLuents have a loved one that needs

IJ help now because my fear is they are not going to get

L4 J-E, nOW . ' L5 As I mentionedr w€ employ over ?OO people

16 in our system. The average salary in our system i-s

L7 $25rOOO. It is not much but it is $25rOOO a year.'

1B Every one of those ?00 employees' positj-ons 'white 19 is at risk. Deer Run spends tens of mirrions of

20 dorlars a year purchasing services from contractors

2t and vendors and retail- stores and food merchants.

22 They are going to go away ltt ZJ In some of our communities such as in

24 Allenwood, Pennsylvania and Williamsport, pennsylvania

25 if we are not the largest employer in those 31

1 communitiesr w€ are certainly one of the largest

z employers in those communities. And those communities

are .going suf f er hardship as we beqin to close our .to 4 doors which we wil-l do. There is no way that the. drug

q, and alcohol treatment system is going to be able to

6 handle the .impact of $104 rnil-lion in cuts.

7 message I realIy wanted to give is

B again that this is not a.Iu1y l problem. This is

9 happening now. Your infrastructure, the drug and

10 al-cohoI treatment system that Pennsylvanj-a has built

11 up over, years and has been'recognized nationally as

t2 being a bellwether state for not just humanity in

13 terms'of fighting this horrendous disease but aLso

t4 underdtanding the unintended. co.nsequences when you

15 cut -- when you cut an activity that for: every dollar

IO you spend on an activity, somewhere else in the system

L7, you save $7 to $12.

L8 To have that kind of foresight and have

lv that kind of humanity to treat your feIlow citizens,

20 Pennsylvania now, again I reiterate, we are waving the

21" white flag on our war on drugs. And I plead al-l- of

22 you on this committee to do what you can to stop that.

23 Thank you.

24 CHAIRMANARGALL: PIease identify yourseLf. .. 25 MR. HARLE: Good afternoon. Thank your Mr. - 32

I Chairman, for the hearings. You are also my State

2 Representative from the County of Schuylkill where

3 Fountain Springs, our women and childrenr s program,

is.

So I thank you. I also want to thank

6 R'epresentative DiGirolamo for these hearings. And I

7 al-so want to mention that I was in the hearing on

I September 9th Irm sorryr on April 19th of last year

and one of the things that happened is that because

10 many of .the we have a heroin epidemic. If anybody

11 has been reading the papers, we 'have a heroin epidemic

t2 while this is going on.

l-3 There is about l-30 people that were on a

I L4 quilt of women who have mothers who lost their

children at that hearing.. And f was pretty hopeful

L6 that we were going to start to have the idea of

t1 denial would start to break through

IU It teaches me a lesson and that lesson is

19 one day at a time. Donrt get too far ahead of

20 yourself. Dontt get too far behind yourself. But Irm

2T not complaining and I fm not whining

22 understand this state has a tremendous

z5 budget deficit. I have one too. Mine is not as great

ztt as yours. But if the same decisions that need to be

25 made about who gets in the door and. who doesD't, Irm 33

L making those decisions today

2 And I have some informati-on here to kind of

share with you on what that impact will be to me and

4 to the rest of the to the people that I work with.

5 My testimony is kind of brief. Irm the

6 past president of the Philadelphia Alliance of Drug

7 and AIcohol Mental HeaIth and Mental Retardation

I programs. I am the past president of DASPOP, past

9 president of Pennsylvania A11iance. I've been doing l0 this for about 30 vears. I've never seen it this bad. rL frve never seen it this bad. These cuts

L2 are horrendous. They are not going to be able to just

13 be eliminated or kind of just werre going to be able t4 to work our way around them or work around them. It

15 is not going to happen.

16 I. have facilities in Chester, Delaware,

L7 Montgom€ry, PhiladeIphia, Cumberland, Dauphin,

18 Lancaster, Northumberland, Schuy1kill and Erie

IJ Counties. I also contract probably along with Mark

20 every county almost in the State. There is all but

2L maybe ten counties in the State that I dontt and this

22 guy does.

23 Most importantly, I I 11. go right to the z.) point. Youfve heard about the facts. I'm going to z5 give you what it means to my agency 34

1 We have 835 emploYees. Of th'at 835 I 2 proDaory around 4OO will lose their jobs. The total 3 salaries are about $ f O mil-l-ion. The loss of taxes is

4 about $Z miIIlon.

It wil-I cost the Commonwealth for me to let

these folks go about $2.5 million in lost just

7 Pennsylvania state income tax and unemployment

-U compensation. That's $3OO,0OO immediately in reduced

9 State taxes. -- L0 Almost all of my families almost all of

l-1 my employees have families. They are in all of these

1,2 communities throughout the State. Their ed.ucation

13 ranges from GEDs to PhDs. Most of these people though

74 have committed their lives to this. You have to

15 understand this is not like they are going to go work

L6 somewhere eIse. They have commj-tted their lives.

L7 They don't make a lot of money. ' 1_B Most of my employees wouJd make more money

19 somewhere else. And most of them will have to be

20 retrained and probably will- leave our field all-

2T together and maybe get into maybe auto sales or

22 insurance saIes.

23 We can sell ourselves products. I donrt

24 know who is going to purchase them though. Another

25 important thing is that I took that statistic and 35

"and L Looked at if I took that $100 miLLion went

2 statewide with it and Looked at all of the other

J problems that Irm Ifm actually talking to two

4 programs right now that would like me to bail them out

f because they were going under prior to this cut.

6 One is in Philadelphia with L3O employees

7 and the other one is'in Erie County. They were .asking 8 for help prior to this. We were underfund.ed. You

9 have got to remember we were underfunded before this.

10 Wee I re not complainingcoml But we were

11 underfunded'before this. We couldn't serve what we

1,2 had. You'11 see buttons around here that say 630rO0O

1? people. That's the people who werenrt getting

14 treatment already.

1_5 " So you ought to know this is serious. This

16 j-s very serious. That will mean about 4, 000 lost

L7 jobs, about $28 rniLlion in taxes. And if we look at

18 these savings, the lost power of J-ncome, that means if t_9 they go on unemployment, they get half of their

20 salaries. ' That I s about $4 0 mil1ion. That total is

2L $ 68 million. That is almost a hundred mill-ron dotlars

22 we cut. Now just think if they all -- if 50 percent

23 of those people all got jobs the next day immediately,

24 that would only be haLf of that or $34 milIion.

25 So this is going to have an economic impact 36

l- on usr just the employees and just the infrastructure

2 More importantly though to me because I rm not in the

3 field for jobs, to keep people in jobs. I wish we

4 didnrt have a drug problem so that nobody could work

q in our field. That would be my goal

6 My board of d.irectors wouLd like me to go

7 out.of business. That's my job, to put us out of

B business. But Ifm not the person who brings these

9 addicts to the program. Don't blame me for it. Irm

L0 not the one creating them. l1 Okay. It isn't something I have in the

L2 back room that Irm churning out new addicts. Some of

13 the social problems that by the wdy, addiction

L4 breeds addiction. Recovery breeds recovery.

15 If we stop that process

16 this room have seen it happen. Whole families have t7 gotten better. WhoIe communj-ties are starting to get

18 better. You don't want to give somebody a job and an

19 apartment who is still using crack. But you

20 definitely want to give them a hammer and get them to

2L build their own house.

22 You want to give them an opportunity in a

23 job. And those people will take advantage of them. zq Many in the room right now who have come from that.

25 You have done that. Thank you. I'm 37

t I actualLy not emotional about this Irm feeling l-ike

2 letting it go.

? One of the things that really bothers me is

4 that thg $104 rnillion cut if we take t'hat ?'to !, the

National Institute of HeaIth, the National Institute

6 of Drug Abuse, they all say

7 and by the wdy, nobody likes drug and alcohol

B treatment.. Thatrs not something that we all, you

9 know, want to go to, want to hang out with.

10 When I bring it up at parties, they want to

1t get away,:f rom me. You know what I mean? So I

L2 understand this is not something that we like to talk

13 about. But I need to talk about it. l_4 That means that if we save

1J numbers Irm giving you are conservative. Nobody lets

16 us get away'with throwing numbers out .there like some

1,7 people do.

18 make sure that our numbers are

19 real. $7 for every dollar we spend. That means if

20 there is a $104 nill ion cut, we have got about .a $721

2t million in i.ncreased spending in some other areas.

22 And. I can tell you where it is. It is

23 going to be prisons. It is going to be in Chil-dren

24 and Youth agencies. It is going to be those

25 families -- I have a hundred families in treatment 1 ' now. They each have about 2.3 kids. It is their

2 kids. It is juvenile institutions

And I was thinking, where do these people

4 ' go to work at? Do they go to work in jaits as prison

q guards? Do theY qo becomeecome goqo to work in juvenile

6 detention cenLers?

7 I'm thinking about where they go to work

I at . They'd have to be retrained. we coul-d retrain

9 them. We could build rnore juvenile detention centers

10 could Put them to work there.

L1 That t s not the way I think we want to have

I2 . Pennsylvania. Thatts not the legisLature I know

13 That's not the Governor I know

14 ' Please think about these cuts. We

15 understand that there is a we will take our we

up with 16 . will be creati-ve, but we canr t come $104

L7 million. Welre not that creative. .Thank you.

18 CHAIRMANARGALL: PIease identify yourself.

IY MR. SLINGER: My name is David Slinger.

20 Irm also with Gaudenzia and Irm here today rea]Iy aS a

2t repre.sentativer as a recovery person who fi.ted

22 from State funding for treatment.

I would like to say good afternoon to 23 .the 24 Chairman and the members of the committee. And I

25 would like to express my appreciation. First of all 39

l_ as Representatives of the Commonwealth, I would like

2 to thank you for the public funding that paid for my

3 treatment 2L years ago without which I truly believe I

4 would be.-: f would be dead today.

tr f ' d also thank you for the. opportunity to

6 give testj-mony and speak on behalf of the tens of

thousands of addicts and alcoholics who will- be denied

I access to treatment if we donrt.reinstate these funds.

9 And make no mistake about it, many people

10 will die as a direct resuLt of these budget cuts if

L1 these funds are not reinstated. My intention is to

t2 present myself to you as someone who has benefited

1? from State funded treatment services, to be one

I L4 example; living proof that this money is well spent ' IJ and has an impact

16 : I've benefited from this funding. My

77 parents have benefited. My children have benefited.

18 And my community has benefited

19 In the bl-ue coIIar Philadelphia.

20 neighborhood where I grew up, abuse of alcohol and

2T drugs by teenagers'was almost a right of passage.

22 For some it was a phase. They drank,

23 smoked pot, took a few pil]s, and gradually moved on

24 to a more responsible way of life..

25 For others like myself, this was the 40

1 beginning of a slippery slide downhill that . leads

2 insidiously to a life of degradation and pain for all

{ , that is good and valued is swept away. And you reach

9 a point where the only future you can see is a prlson

cel1 or a grave. And the sad thing is that you become

6 resigned to'thut and you accept it.

7 My addiction lasted about a decade from the

B age of 15 to 25. Although I used before the age of

Y 15, by the age of 15 .I had a serious problem.

L0 During that'decade of addiction, especially

1l_ the last half of it, I was unemployed. I. was a

L2 criminal. I was a danger to my community. I will not

13 go into detail about the crimes I committed. I was

L4 like many other addicts. I stoIe. , I lied. I

15 cheated.. I committed petty crimes and serious crimes. l-o At times under the influence I was a serious menace.

17 I had two good parents. and I only later when

IU I had children of my own did I begin to comprehend the t_9 pain that f put them through. Fortunately for il€r my

20 criminal activity l-ed. me to the doors of Gaudenzia in

21 '81, in 1-98l-.

22 And when I went into treatment, my only

23' motivatj-on was to avoid going to prison. I had no

24 desire to stop my drug use. Actually, that's an - 25 .understatement 41

'l- When I arrived at Gaudenziars doors, I did

2 not know that such a thing was possible. I had never

met a recovering addict.

4 The idea of living without drugs was so

q. foreign to me that I could not grasp- the concept. An

addict was who f was. It was part and parcel of my

7 identity.

x After being in treatment for some . time and

9 being exposed to recovering people that were just Like

1-0 me who told stories and shared feeLings that were just

L1 like mine, I slowly began to accept the truth about

L2 who f was and what I was doing to myself. And I began

IJ to realize that life without drugs was possible.

1,4 Early in my recovery I struggled with the

clean and sober forever. But at some idea of staying l6 point I came to believe in the concept of one day at a

L7 time and realized I did not have to worry about

IB staying clean forever, just today.

t9 With individual and group counseling and

20 all of the other tools of recovery made available to

2L me in treatment, I changed.

22 I can now divide my life into clear pre and

23 post treatment. In a very real- sense f was not the

24 same person by the time I completed treatment.

25 Immediately after the treatment I was employed. I 42

1 chose to remain working j-n the f ield of treatment and

2 recovery.

3 Shortly after leaving treatment, t was

4 married. With the encouragement of'other staff at the

facility where I worked, I d.ecided to return to

6 school. And. eventually I was able to graduate magna

7 cum laude from the Wharton School.

B I remember I was at Penn holding in my hand

9 my Penn student ID and the ID that I still had from

10 the Philadelphia House of Corrections. I used to

11 think that these two photo IDs would be a very good

L2 advertisement. for the effect,iveness and intervention

1? of treatment. Sometimes a picture really is worth a

L4 thousand words.

I now have two children. My oldest son is

16 a senj-or at Central High School in Philadelphia. He

L7 excel-s academically. He is j ust now receiving t8 responses from his college applicatlons.

1_9 And I think of the children of active

20 addicts. And I rm grateful that f rm there for my two

2L sons to gj-ve them the support that they need

22 f come from a large family. Irm one of

23 nine children. Three of my siblings have had

24 substance abuse probl-ems severe enough to warrant

25 treatment. A11 three by the time the treatment was 43

1 necessary to save their lives were unemployed and

2 unLnsureo. ,

Even if they had jobs with insurance

4 coverage as this progressive disease took its toII,

all of that was gone by the time they decided to call

6 the rehab. This is a very common process.

7 AlI four of us had to rely on some form of ' I public funding to enter treatment. Of the four of usr

Y three are currently sober, more than 20 percent. One,

10 my older brother, has died of an overdose. Treatment

1L of this disease like treatment for cancer or any other

L2 life-threatening disease is not always successful

13 My younger brother whose treatment was by

14 BHSI now has five years of sobriety and is working on

15 his bachelor's degree.

16 Without sounding boastful, I can also say

17 that those of us who have stayed sober have had an

1B impact on others, what Michael was talking about, that

19 recovery does spread

20 I cannot tell- you how many times I have

2t made phone calls to families, to treatment facilities,

22 or how many times I have driven people to rehab to z5 start the process.

24 I know from my own experience the

25 possibility of change. I knew that if they took what 44

L was offered, that the day that I dropped them off at t 2 the treatment facility could be the beginning of a

J whole new.Iife and for many it was. I know that your

constituents want treatment to be avai-Iable to those

q who need it and seek it.

6 If there is an indigent crack or heroin

7 addict who decided he or she has had enouqh misery and

B wants to change, your constituents want that help to

9 be availabLe.

10 To deny treatment to someone who needs it

l_L and seeks it is j-mmoral-. And further, it is not in

72 the best interest of the community at large

1? An active addict is going to cost the

14 Commonwealth money. It is not just the cost of X

1q. number of days in jail per year. There is the cost of

L6 probation officers, pr€sentence investigators, public

t7 defenders. A11 of these things have to be paid for.

1B ' There are medical costs. There are crimes

19 against property and the associated insurance costs.

20 And there is the cost we cannot put a value orlr the

2L l-oss of human lives and the devastation of families

22 and communi-ties.

23 As I said earlier, if treatment was not

24 available to rn€r I would have died. . This is not an

25 overdramatization. And I beg this committee to bring 45

t- this message back to the general House membership.

2 The message is if these cuts are not.

reinstated, many people will die needlessly. They

4 wiIl die. for. nothing because the desired savings will

5 not be realized. The cost of doing nothing is

6 sometimes greater than the cost of action.

7 There are others more knowl-edgeable and.

B qualified than me who can provide you with all of this

9 data. I. noti-ced, you know, $3 to $7, $3 to $12. But

10 what Deb Beck said is clear, that the fact that there

11 is a multiple of savings is not debated by any of the

12 research.

1? So please do not 1et people die of some

L4 J-magr_nary savings that will never be realized. I nanK

15 you again for the opportunity to speak to you.

16 CHAIRMAN ARGALL: Mr. Tennis and Mr . NoIes,

L7 please. Pl-ease identif y yourself and begin as soon

1B you're prepared

19 MR. TENNIS: Good afternoorrr- Chairman

20 Argal1, Chairman Evans. I thank you very, very much

2t for the opportunity to testify here today

22 I have over the past L7 years represented

23 the Pennsylvania District Attorneyt s Association as

24 Iegislative liaison, chief of legislation in the DA's

25 office in PhiIade1phia, and Irm also secretary of the 46

1 National Alliance on Model State Drug Laws.

z I have testified many, many times in the

3 House .Iudiciary and Senate Judiciary Committees. Irm

4 usually here asking for tougher laws. I represent the

prosecutors around the state and we reaIly have a

6 single mission.

7 And our single mission is to urge in the

B legislature to urge whatever policies that are there

9 that we can that will bring down crime, that will make

10 our stree.ts safer and our homes safer for aII

l_1 Penns ylvani ans . . 1,2 I think of the many, many countless times

13 that I've testified on so many issues. I donrt l-4 think in fact, it is clear to me there has never l_5 been an issue that I testified on that is as important l_o as the j-ssue today in terms of impact on crime. This t7 is number one. This is the most important issue.

1B And I l-ook at all of the times I I ve

19 testified. Right now this is the one that I care

20 about the most because this is the one that will do

2t the most to make our streets safer. Or if these cuts

22 go through, Lo make our streets and our homes more

23 dangerous than they have been in the 23 years that

24 . Ifve been a prosecutor. 25 For most prosecutors if we donrt think 47

1 deeply about it

2 the success rate for treatment is not 20 percent, it

3 .is zero percent. Because when you're a prosecutor and

4 somebody gets treatment whether it is part of

5 probation or parole, the only way you see them again

o i q i f l-horr f ail. So we only See the f ailures in the

7 District. Attorneys' business.

X And yet when you Look at the research

9 actualfy, when I was appointed by President Bush, the

10 dad, as executive director for tLre Presidentrs

11 Commission on ModeL State Drug Laws, I have to say t2 that as a long-time prosecut,or even then in |gg2 I was

L3 skeptical about treatment because of what I said.. The

L4 system sifts out the successes. And the failures,

1-5 they all come back to us.

16 We contracted with Rutgers. I wanted to

1.7 know the truth because I thought I met with Deb

1B Beck who I had known and talked about treatment and it

19 seemed sensible. But I was realIy'skeptical about

20 whether it worked because I knew what I knew. I saw

2t what I saw. ' 22 We contracted. with a team of e.conomists

23 from Rutgers University. And I said, Iook, I know zq that there are reams of research out ther'e. Donrt do

25 new research. ,Just go through and do a 4B

1 microanalysls of all of the research that has been

2 done on cost benefit and on an impact on crime. And

teIl me what do an anaLysis. How good is the

research? Who did grood research? .4 .Who did bad q research? But give me kind of.a final take on whether

A we should be recommending strong treatment Iaws.

7 They came back and showed after doing

B spending I think about I or g months. We spent a lot

9 of money on the study. And.they came back showing a

10 minimum of $3 return very quickly for every dolLar

1L spent. t2 They showed. what every study has shown

L3 since then in terms of crime. And this is the issue

Iq we care about. And that is for people that are'in the

1_5 criminal justice system who get clinically appropriate

16 drug and alcohoL treatment it results in anywhere in

L7 the neighborhood of two-thirds to 70 percent reduction

L8 in future criminal activity. That is big, biq

19 ]-mpacc. . 20 ' There is no policy I can point to. There

2T is nothing in prevention. There is nothing in tougher

22 sentencing. There is nothing I can point to that

23 comes close to that kind of impact in terms of

24 reducing crime

25 For those of you who are skeptical about 49

I this, I guess you'd have to ask yourself why would the

2 Pennsylvania District Attorneys Association:- and it

-? is not just me. This is a unanimous position of the

4 DArs Association. Why would the prosecutors, the

elected district attorneys, al-I 67 around the state,

6 be so strongly supportive of drug .and al-coho}

.1 treatment? And that I s because when we go into court

I and we see the offenders coming through day-by-day,

9 day-after-dayr w€ek-after-week, we can see that what

10 the research shows is true. ' l_1 That about 80 percent -- and I think those t2 figures are even low based on my.experience. BO

13 percent of the people that are arrested in

L4 Pennsylvania have serious substance abuse problems. l-5 And the more serious the crime, the more likely it is l_o that they have a substance abuse problem.. t7 Pennsylvania Department of Corrections t8 reported a few years back at a meeting that I was at

19 that 92 percent of the State prison population had

20 serious substance abuse problems.'

2t Now if these cuts go through when these

22 people get out and they do get out they are

23 going to get out and there is not going to be

24 treatment'for them. They are going to hit the streets

25 st111. addicted; And they may have been free or may 50

not have been free of drugs during the time that they

' were in prison. But with the best of intentions that

they might have when they hit the streets, if they

don't get treatment they. are going to be using again.

q They are going to be dangerous again. There is going

6 to be more crime. It is going to be

7 State of Pennsylvania what is going' t'o happen. to crime '. B if these $104 million cuts go through.

9 I ask your let I s not do the experiment with

10 the -- with the safety of our citizens at stake. I 'urge L1 you this is not a right wing, ,this is not a left

L2 Iing issue. The research is truckloads of research

13 showing this and Irve looked at this. And my interest

14 ir thrs, like I say, is so1ely crime.

15 I just want to tal-k real quickly in

16 Pennsylvania, we divert over we have a thousand t7 people a day that are shifted from our prisons in

1B Philadelphia back that are in treatment that

19 otherwise would be in our prison system. Thatfs just

20 in Philade1phia.

2L Statewide that is going to be a much, much

22 Larger f igure. So whatever money t,he $f 04 million ' 23 involved, it is going to require much, much more money

24 to go back into prisons.

25 Alternatively, we could spend money . on 51

neither and just put dangerous, addicted offenders

back out on the street. I don't think it is a good

idea. From the prosecutorrs perspective, the first

4 duty, first obligation of government is to protect the

5 safety our citizens whether that be from foreign

6 powers, whether that be from terrorists: or whether

7 that be from people committing crime in our state.

I . This 9104 million is the most important

9 part of the budget I think in terms of fulfilling that

L0 highest obl iqration o f gove rnment

11 Therefore, I just urge you. And if I could

L2 get down on bended knee and beg and it would make a

13 difference, I would do that. I urge you to do

L4 whatever it takes to get that money back into the

15 budget. Thank you.

16 CHAIRMAN ARGALL: Mr. Noies, if you will

T7 identify yourself, please.

18 MR. NOLES: My name is Dj-ckie Noles . Iam

19 a recovering alcoholic. Irve been sober f9. 20 years.

20 I work for the and it is alr

2L honor to be here and thank you very much.

22 I am an employee assistance was a

23 former player. So I like those cheers for'the

24 Phi11j-es. And we I re going to run away with it. Mark

25 my words 52

1 I was a former baseball player. But now

2 Irm an emp.loyee assistance director of the.

? Philadelphia PhilLies . I get to dj-rect myself so

4 that's pretty neat.

But I rm also a recovering addict which I

6 tol-d you. My drug of choice was a1cohol. And the

7 other day I -- this meeting just kind of.spurred

B somb everything I heard here just made me feel

9 better and'better about myself. I alway" people !u11 10 God loves me in splte of knowj-ng me. And always tell

11 people my wife loves me in spite of knowing me too.

1,2 But when I told my wj-fe I was coming here

1_3 today and she said, well-, that should be right up your

L4 aIley. Your compassion and your passion is drug and

15 alcohol. It has been something I've given my whole

16 Iife to.

1,7 And when Irm done speaking, f hope yourlI

1B understand. why, not just because of me personally. t9 The other day I called DaIIas Green up and I called

20 hirn up and said, hey, D, this is Dickie . I I m in

21 Reading. Irm working with a player up here. I just

22 wanted to share something with you. Itrs April 9th. ' 23 ft's my 2Oth'anniversary of being sober. And he

24 didnrt call me back.

25 I was pretty agitated with him because he's 53

1 s everybody back. I .2 But he finally called me back and he was in tears. He ? was saying to.me that I really -- of all the things

4 ever experienced in my 1ife, to have the opportunity

5 to force you into treatment was one of them.

6 And Dallas did. When I went into

7 treatment, I was skeptical about treatment because I

B didn't think it would ever work on And I went

9 into treatment and it worked. And to share that with

10 you, I come f rom a l-itt1e bit of a dif f erent home.

11 My mother,was raped. Thatrs how I became

t2 child. She was a person never -- that never had a

L3 drink in her 1ife, never had a drug but probably was

l-4 affected by drug and alcohol more than anybody. I ever

J-J met in my life; and I've spoken to 3rOOO schools and

l_6 to many prisons. I do prison ministry too.

17 And, you know, the interestinq thing about

1B prison ministry and I ' 11 be in Clj-nton, New ,Jersey,

19 next week speaking to the women's prison up there

20 And you walk in and you have got a captive

2T audience, donrt get me wrong there

22

23 would have never done that if it woul-dnrt have been

24 for my drinking. I would have never done that if it

25 hadnrt been for the drugs. And if it wouldn't have 54

1 been for marijuana the drug everybody thinks is so

2 saf e -- I wouldn't be here today. And it is l-ike they

3 just come out and just as honest as can be and I would

4 say the numbers have to be higher than B0 percent of

why people are in pri-son today.

6 And as I thought about how to share with

7 this panel here about what recovery is and how

I treatment works, I thought about Christopher,

Y Brittany, and Nicholas. My two boys are Christopher

1o and Nicholas. My daughter is Brittany. Shets L7. l_1 And I thought about how .my mother went

I2 through her whol-e life and gave her life that I would

13 have a life. And I thought about how she reaIly never

14 understood the word and I believe everybod.y in here l_5 can kind of relate to this. This is not one of my l-6 normal speeches.

17 But f usually tell people that we all want

18 to be loved, belong, and be capable. And when I go

19 around to schools all across the country, I can tell

20 you that those children sitting in those seats, many

2L of those children experience what my mother

22 experienced, never hearing the words I love you.

23 kids hear it so much get angry .My they at 24 me. But my mother never had those word.s uttered to

25 her,. and she grew up in an alcoholic family that was 55

' I le f t. unt-reated.

2

AII -- as a matter of fact, I'm pretty successful.

4 I'm the oldest living male on my mother's sid.e of the

5 family and Ifm only 46 years old and addiction took

6 most of them.

7 , L really have dedicated^ my life to this.

B And I remember the first year I got the opportunity to

Y speak on this. I have been a

10 player. I have a ring. I hardly every

11 wear it. But I put it on when f go to the ballpark

L2 and I have to work tonight. And being in e World ' 13 Series was an accomplishment. And here in

I 14 Philadelphia, what a city. We won one. So we need

l_5 another

l-6 . But the day we won that, I thought this is L7 the ultimate for me. Nothing will ever touch this.

IX Etqr.since I was a kid in my backyard throwing up

1_9 aluminum foil my mother came from poverty -- and

20 hitting it with a broomstick, that was my baseball 'and 21, imagining in the seventh game of the Worl-d Series

22 I I l-l- have an opportunity to win the game, buy my

ZJ mother a house and everything would be, you know,

ztI perfect in life

25 And I thought about how what the 56

l_ world - what in the world happened to me? How did I

2 end up getting sued? How did I end up beating people

up? How did I end up getting kicked out of Venezuela?

4 Itm a pretty decent person. When Irm sober, I donrt

5 bother anybody

6 How did all of this happen to me? And I

7 woke up on April 9th of 1983 in a treatment facility

R going how in the world did this happen. I only

Y thought about my mother.

10 I pitched a one hitter againsL Tom Seaver.

11 And. I.remember my mother calling me up and saying when

12 people came through the gas station to pay me, they 'that's 13 were saying your son on Monday night baseball t4 that pitched that great game. Now. they are watching l_5 me on 60 Minutes and paying her going 'is that your l_6 son, that alcoholic that went into treatment for

T7 beating people.up. Boy, hers a Iittle bit of a nut.

18 And I thought about that. And I said, how t9 in the world can we put really a dollar figure on the

20 type of thing werre talking about here today?

2L When I sat on my mother I s death bed on

22 April 13th of Lgg7, she said I caused you to become an

23 addict. I said, rror mom, you did not. I chose to

24 become an addict. I chose to drink It was my

25 choice. But once f started drinking, I.didnft have

2 that choice. I wanted to be sober. I wanted to be.a

J Christian. I. wanted to -- many times I would set in '4 the shower as water poured down on me and Ird gor

,5 Lord, why'canrt I do things rj-ght? And I'd sdy, you

6 ,know, I must be the most useful I mean useLess, not

7 usefuL. I must be the worst person Irve ever met on

the face of the earth. I dontt even think I deserve

9 to live. Although, I have never thought about

10 suicide. I know people have but I never have. l-1 But as f sat in that shower and that water

L2 woul-d run on n€r I would think to myself , why am I --

1J why am'I even in this situation where I can even

14 affect children by throwing a baseball.

15 Now I wonder why I was in a situation to

L6 get treatment because f could. throw a baseb.al-I and

L7 there'are people out there if I would have never

1B signed with the Philadelphia PhilIies, I don't think

Lv I'd have been provided treatment. And because I coul,d

20 throw a baseball halfway decent, f got great

2L treatment.

22 When I went into the treatment facility and

23 came out, I said, It11 never give a talk. That I s one

24 thing that they told me in treatment I had to do. And

25 I said, Ir11 never do it. And they said, you will 5B

l_ also have the opportunity to let go and grow. This is

2 just not the part of treatment that you stop at. You

? got sober. Now it is time to find out what life is

4 all about. And when I 1et go and I started to grow, I : 5 went out in the communitv. And I went down to Texas

A and a fellow friend of my by the name of Bobby Bragan

7 had me go to an elementary school of alL schools to

I give a talk

Y And after endi-ng up in Texas, f thought

10 Texas was not the American League. I thougtrt they

l_L were Triple A. I mean I got traded from the Chicago

L2 Cubs to the .

1J I mean my goodness. fn Chicago they

L4 cheered. In Texas they came with Detroit Tiger hats

15 and everything eIse. That was pre-Nol-an Ryan but

16 as Irm sitting in the school waiting to give. my talk,

I:7 I thought.what can I possibly say to these kids? Itve

tx been sober exactly one year of my life.

19 And I realized that there is important'

20 things in Life like God and getting married and having

2L children other than just throwing a baseball and

22 drinking.

23 I thought all baseball players did what I

zq did. And I found out Later on that they did not. And I 25 just to not get off base here and to think that there 59

l- is only -- you know, I heard somebody say this earLier

z and it hit my head. All of the baseball players that

J appeared in the papers. like myself, there is 1O and 15

4 and 20 per 1 that have gotten sober that you don't

q know abo.ut and some of them are even in the HalI of

6 Fame

7 So we need to understand thatr'and.they

B have the ability to keep their anonymity. Mine was

9 broken. I was told to go out and give these taIks.

L0 And that day in deep Da1las, Fort Worth, Texasr my

1l- life ,was. changed forever. Not because I got sober,

l2 but because I realized. there were other people out

13 there with the same problem as me.

L4 was sitting there giving my talk and a I 15 9-year-ol-d boy came up. And I heard that we have

16 given up the white fIag. I wilL never give up. But I

t7 hope someday I rm without a job. But I will teli- you

18 this, that the research that you read about drugs

19 being down, thatrs an absolute 1OO percent bold-face

20 1ie.

.2r Go to any high school- in America and they

22 are going to teII you your kids are smoking dope more

23 today than any other time. They are going to tell

zq you they are drinking more than any other time. And

25 they are going to tell you they donrt even know what 60

1 treatment is.

2 And f guarantee you can go right down,the

? street here. You can go wherever yo.u want to go

4 because..I rve done 3, OO0 school programs since my

.q sobriety. I don't know how you can put a price on

6 that. But I have been fortunate enough to walk around

7 and go to schools and give a message and have a whole

B basement full of letters where people said they turned

9 their lives around by the right messaqe and people

10 have said they accessed treatment.

1r , But the day it all started for me was the

L2 day a 9-year-oLd boy puIIed. on my shirt and sa j-d, Mr.

13 Noles, I have the same problem that you have

t4 And f looked at that litt1e boy 9 years old

15 and said you can't be an alcohofic. I mean there is

t-0 no way. He goes, youfre right. frm a drug addict.

1.7 My heart sank all the way down to my shoes. I said to

1B myself, what do I do?

19 Bobby Braganr dt that time the Texas 'Community 20 Rangeis Service Director, Iooked at me and.

2T said we don't know what to do. you better know what

22 to do b.ecause you went to treatment. I said Irve only

z5 been sober oqe year. I don I t know what to do. So I

24 got on the phone, and I cal-Led a treatment facility. I 25 This 9-year-o1d boy had a cocaine-addicted 61

1 mother. This 9-year-oId watched her snort cocar-ne

2 every night and decided to say to some of his friends

I qrrv=nA nrlF let s go down and see what they. are doing .tl s u

4. cocaine up his nose

q This 9-year-oId boy today has graduated

6 from a 4-year university. This 9-year-o1d boy today

7 has turned his whole life around and is now a teacher.

I Something mor-e important than a baseball player could

9 ever touch. And he is now teaching chil-dren and

10 w6rking all day just like I do, going out hoping he

l-1 can affect somebody to stay away from drugs and

\2' aIcohol. o 13 I think that story in itsel-f is far bigger tn end better than any story I could teII here today. I

15 would l-ike to share one story in closing with you. . 16, When I heard someone over here talking -- I think it

L7 was your Michael, talking about where do these people

l_B go when we train them, what ability do they have?

19 You knowr rny children were in the car the

20 other day and my son said to one of my baseball

2l players who I p.rcked up I have to pick up LO kids a

22 day. I coach. He said to Irr€r Mr. No1es, I I ve never

23 heard you curse. I said, I dontt curse. And my boys

.A 19 were kind of in the back going yeah, right. And I

25 said to -- I look at my son and I said, I don't curse. 62

1 Guys, you know that. They go, dad, you use that word

2 hell and you donrt use it according to the biblical

3 version all the time. And you use that word damn and

4 you ain't'taLking about water

.And I thought, that's the impact that my

children have got watching me grow up in my family.

7 Til"y, have gotten the right message, They have been

B raised right. So if I have done anything in my life,

9 I have raised my children to this point I got a

L0 L7-year-old daughter Lord l-et me live I hope to

1t_ continue to be positive. But I wonder what kind of t2 father would I have been with the addiction problems t3 that r had.

14 And I thought that where do we train these

ar J.J kids? I,want to teLl you I had a young baseball

16 player come to me this spring training and tell rr€r t7 Mr. No1es, Irm in recovery. I said, is that right?

1B He goesr yeah. And f appreciate the talk you gave

19 yeslerday, and f would like to get out to some

20 meetings. I said, how long have you been sober? And

2L he tol-d me.

22 And I said, well, teII me a little bit more

23 about your life. And this is the kids we don't train.

24 He said, weLL, vou know, I used to seLl drugs. I

25 said, how did you sel-l- drugs? He said, weII, I worked ' L at Burger King. What do you mean, Burger King? I '. 2 didn't get the point there. He said, well, you canft

5 work at McDona1drs. I said, why not? He said, Burger

4 King is open l-ater than McDona1d' s .

J He said, you know, all- the'kids play ba1l : 6 and they come in there and they got basketball games

7 and stuff. He said, you know what I do? I teIl them

I I work for you. You go play your basketball game.

9 You go play your football game. Let me work and I get

L0 that big check. And I don't cash it, Mr. No1es. I i-1 take that little pouch that these kids wear today and

1_2 I put my l-ast check in there and I quit. I really

13 didntt work at Burger King to earn a living. I worked

L4 at Burger King to come up with a disguise.

15 I sat on the streets and sell drugs. When l-6 the cops come by, they look at me. I sayr wdit a t7 minute, wait a minute. I just got off work.. Here is

18 my check. And I give the cop my check. And he said,

19 good boy, now go on home. And Irve got a reason to be

20 on the streets late. Hr: said, but, you know, the

2t important part of what I want to telL you, Mr. Noles,

22 is Irve got HIV. I go, is that right? He said, yeah.

23 And he says, I came forward to teII you

24 that f'm in recovery. But f also want you to know to

25 take precautions'so that f can keep everybody, 64

L protected around here. I said, weLl, how did that

2 happen? Do you even know?

3 He goes, we11, yeah, I know. S€€r there

4 are hookers on the streets. When I am out there

5 selling drugs, I get to know these hookers very well.

6 And when Irm out there, he says, once in a whiLe the

7 boys go,. hey, you knowr You can go talk to them gir1s.

x And f said, I don't want to do that. ' And every now

9 and then they wil-1 come over to me and sdY, could I

1_0 have some of that? And f gor rlo way. I got to selI

Ll this to make a living so I can buy my mother a

L2 refrigerator or something

13 And the guys told rt€r wel-l-, cut it up and

I L4 give her some and then you might get some sex. He

1q said, Mr. No1es, the temptation of being male, to be a

1_6 man hit me troo strong'and .d I did that.that But nobody told

L7 me that.those hookers were infected with HIV.

IB This same boy told me that he dated about

IY 15 girls in high school and had sex with about l-5

2o girls in high school. Thatrs why we canrt let this

2L' $ 104 mil-Iion go. Because I don' t know about your but

22 I got a l7-year-old daughter that I love enough to

23 stand in front of a truck and die for. And I donr t

24 want my 1-7-year-o1d daughter coming in contact with

25 that young man because nobody provided addiction 65

1 treat,ment for that young man until after the fact.

2 I want to thank you very much and I want to

J thank your Deb Beck, and God bless each and every one

.4 of you. And just use your hearts when you make these

5 decisions.

6 CHAIRMAN ARGALL: I'd like to thank each of

.1 'on those who have presented testimony both the human

B service cuts as welL as the drug and al-cohol cuts.

9 I think speaking for the committeei that

10 was f rom..the f irst witness to the last very, very

11 powerful testimony. Now f wouLd like to hear from

L2 Secretary Estelle Richman on behalf of the Department

J.J of Public WeLfare.

L4 If each of you would identify yourself, l-5 please. l-o SECRETARYRICHMAN: Good afternoon, t7 Chairman Argall and Chairman Evans, Representatives

18 and staff of the House Appropriations Committee. I am

19 Estelle Richman and I am .the Secretary of Public 'table 20 Welfare. At the I have the following members of

2L my executive staff with me today: Mike Nardone and

22 Steve Rosskopf. . z5 Throughout my career, there have been

24 several occasions when I have been told by people that z3 I couldn't do something in a certain way. And for 66

I those. of you who know me personally, I I ve never shied

z away from tackling a challenge. This budget is a

J challenge.

4 In fact, it makes my life in removing snow

tr in the City of Philadelphia look like itrs easy. We

6 come together today under unprecedented circumstances.

7 WhiIe the budget has passed, our discussions are just

B beginning.

9 It is important that we do discuss :- not

10 just for each of our constituencies but also for the

11' well-being of all Pennsylvanians.

T2 ffm sure everyone in this room today is

L3 aware of the significant cuts that the Department

L4 took. As you know, this administration inherited a

budget deficit estimated to be $2.4 billion for the t6 next fiscaL year.

L7 In order to present a balanced. budget as

1B required. by the 1aw, the Governor proposed

19 department-wide reductions that he said he hated and I

20 have termed draconian.

2t Because DPW represents more than a third of

22 the State general fund, the department shouldered a

23 majo.r portion of the def icit reduction burden ' 24 Although the DPW budget spares basic health

25 coverage for those on medical assistance, I recoqnize 67

"that l_ maly vulnerable people have been affected by this

2 budge t .

J Men ur,q women struggling with addictj-ons

4 have been affected by this budget. Victims of . violence and abuse have been affected. And our

6 neighbors, friends, and family struggling to make a

7 better Life for themsel-ves -- themselves and their

X chil-dren are affected

9 the future we must integrate our

10 services. We must work together with our sister

11 agencies and within the department

t2 ' In order to focus on the services we

13 deliver, the department must also improve itself. And t L4 I am committed to working with you to explore all

l-5 avenues of non-state funding sources to help plug

16 budget gaps

L7 As you know, the goal and vision of the

18 Department of Public Welfare is to enhance the ability

LY of Pdnnsylvanians who have life challenges to lead

20 . fult and vibrant lives.

2L This is a department whose . entj-re mission ' 22 is about serving people, vulnerabl-e people. And in a

23 time when we cannot do everything'that we would like

zq to do, we must focus on essential'quality-of-life I 25 issues: moving families toward self:sufficiency; 6B

1 safe, affordabl-e child care; health care services;

2 supports for adult and children with disabilities; and

J protecting children who suffer abuse and neglect.

4 As we move forwardr w€ must keep those

q reserved. in the forefront of our deliberative process

6 and keep in mind that the decisions made here have an

7 affect on mothers, fathers, and children living across

X our great Commonwealth.

9 We must remain committed to doing

10 everything in our power to make a difference and to

11 improve the lives of our families and children.

T2 know we al-I share this as a goal. t3 Thank you for an opportunity to come before

L4 the Appropriations Committee today. These j-ssues are

15 critical to al-I of usr and I would be happy to answer

1_6 your questions at this time

L7 CHAIRMAN ARGALL: Thank you, Madam l_8 Secretary. And frlL try to obey my own rule that I've l_9 encouraged my col-Ieagues to be concise and to the

20 point in asking the questions

21, We heard a variety of testimony today on

22 the subject of drug and alcohol funding. In looking

23 at the cuts that the Governor recommended to the

24 General Assembly, I would assume that the Cabinet was

25 to some degree involved in those cuts 69

l- Is there any research that shows .that the

z number of people in need of d.rug and alcohol services

3 will be declining in future years? Was that at all

4 part of the rationale in the cuts a's presented to the

5 General Assemblv?

SECRETARYRICHMAN: No. In fact in light

of the recession that the number of peopl-e who use

B abuse substance abuse as a way to heal pain wiLl

9 probably- increase in the future, not decrease.

19 CHAIRMANARGALL: As far as the rationale , 11 for the funding for the behavioral- services and the

L2 Act. 152 funding, I think we heard today that whil-e we

13 might save money in DPW it coul-d in turn create

I L4 additional costs for the department of corrections.

l_5 Have those numbers been carefully analyzed by the

16 administration?

T7 SECRETARYRICHMAN: My knowledge base

18 and again.two months ago f was supervising the prison

19" system here in Philadelphia. And. certainly there is a

20 direct relationship between the effectiveness of drug

21 treatment and whether or not we have drug treatment

22 and whether or not we see more people in the prisbn

23 system.

24

25 Philadelphia were very ef f ective, and we were abl-e to 70

1 see dramatic drops in the prison population over the

2 last .several years.

And certainly if we take that treatment

4 opportunity away, we will see prison populations go

5 up. I don't know yet the relationship entirely

6 between the State prison system and the loca1 prj-son

7 systems, jail systems. But certainly without drug and

B alcohol treatment available, the prj.son population

9 begins to jump pretty dramatically.

l_0 CHAfRMAN ARGALL: You mentioned in your

l_l testimony that at least part of the ratj-onale for the

L2 cuts in human services and drug and alcohol was the

13 fact that we were looking at State-only dollars that

I L4 were not matched by the federal dolLars. As we r re

15 wrestling with these cuts, werre still trying to

t_o understand the big picture

t7 Was that I mean first and foremost the main

1B reason,theon1yreasonthatthese1inej.temswere

IY targeted for cuts?

2d SECRETARYRICHMAN: I think as the folks

2t who handle the budget look at any department and look

22 at departmental cuts, they try to not sacrifice

23 f ederal dol lars at al-l f or state dollars.

24 And certainly in this budget that was

25 passed, that is to a large degree the case. The 71

number -- the largest amount of dollars in the

2 Department of Public Welfare actually comes from the

{ department -- comes from the federal government.

.i So aLmost every doll-ar that is capable of

r drawing down federaL dollars does that. The

6 department, Irm sure, looked at a variety of different

7 ways of reaching the target number. And the target

I number for DPW whs SL.1 billion that had to be cut out

9 of the budget.

10 And in doing that, the places looked were

1_1 indeed places that you wouldnrt affect federal match.

L2 And in fact, some of that $1.1 billion does affect l_3 federat match because there were no other places to

14 Iook for dollars.

15 . The dollars -- the al-ternatives I believe

16 and as I went back and looked at the budget and

L7 Iooking at I rm looking for the sheet that in

LB looking at "the federal where the doLlars would come

19 outr on the federal match, looked at, general

20 assistance in general and particularly the medically

2I needy-only area which is primarily state do1lars.

22 And as those dollars were el-iminated, one

23 of the trade-offs would have been able to cut medical

24 assistance in just one caEegory would have given us ' 25 the amount of dollars that we needed 72

I . And if you look just at the medically

2 need.y-onIy population, it represents about 130,000

people across the state. They are low income and they

4 have medical expenses. Their primary issue is medical

expenses that qualify them for inmate coverage. In

6 eliminating that which would have prevented all of the

7 other eliminations, we would have had to cut l-30,000

B people without health coveragie

9 Of that l-30, O0O people, many of them live

L0 in nursj-ng homes. They are the b1ind. Threy are'the

1t disabled. They are the seniors. It would have

L2 included children, pregnant women, and those that

IJ suffer a catastrophic ill-ness or disabling injury

14 And despite the devastating consequences,

L5 the eli.mination of this category would have permitted l_6 us to save enough dollars not to prevent any other

L7 cuts. The problem is there still have to be cuts

18 somewhere.

19 This is a'people budget, just a plain

2o people budget. So any cut to this budget presents a

21" challenge and how do we go back to the federal

22 government, how do we look for other opportunities r oE

23 how do we look for opportunities to buil-d on top of

24 what the Governor has recommended to be able to make

25 sure that we take care of the people in the state 73

1 CHAIRMAN ARGALL: As you: can imagine,. werre I 2 helrrng from many of our colleagues in county 3 government about the cuts in the human services

4 funding.

r What kind of advice has the administration

6 been able to provide to county commissioners' and

7 administrators in regards to those cuts?

I . : SECRETARYRICHMAN: I think for the most

9 part f tried to meet with every single group over the

l-o last month essentially and tried. to find as many ways

l_L as possible to look further in our budget to see what

12 other additional other kinds of economies we can make,

13 where are other federal dol-Lars, where are other grant

t4 dollarsr and where else can we look for non-state

15 based dollars.

16 Our hope is to continue to work with people : t' l7 to be able to get as efficient as we can internally.

18 And as you know, we took a $34 miLl j-on administrative

l_v cut just'to the administration.

20 So we're even looking beyond to see what

2L else we can do to be able to replace as many of these

22 dollars as we possibly can.

23 But the main source of dolIars happens to

24 be the federal- government or looking for ways grants

25 and other grants and foundations can be gathered. 74

I ' 2 then at which time you're going to come back to the

3 General Assembly with suggestions on restoring this

4 cut but cut here instead?

SECRETARYRICHMAN: We11, you know, the

A budget has been passed. So our challenge right now is

7 to find other opportunities that we can do it. And

B ' Irm not sure this is such a lrve heard it phrased a

variety of different waysr dn unusual circumstance.

10 : CHAIRMANARGALL: That is certainly true.

11 SECRETARYRICHMAN: I Im not even Sure what

L2 the format 1s right now to come back and begin to

13 discuss with folks some of the opportunities we think

14 that we can garner. l-5 And but we are we actually want very

16 much to work with you. And if there is a way that you

17 want to suggest how to relook at this budget or how to

18 r build upon what the Governor has said that he wants to

19 do and how we can sort of put this on top of thatr w€ ' 20 are very willing to work with you to do that.

2! CHAIRMANARGALL: Thank you. And Irm sure

22 that we wiff Ue doing just that at the conctusion of

23 these hearings. Representative Evans.

24 EPRESENTATIVE EVANS: Thank you, Mr.

25 Chairman. Good afternoon, Madam Secretary. 75

t SECRETARYRICHMAN: GOOd AfICTNOON.

.2 rrd

3 like to hear a little bit on the area of health care.

4 About 15 years ago as a state we made a policy

5 decision of particularly people on medical assistance

6 towards the aspect of managed care. . ' 7 It seems that you and the administration

I now has kind of recommended that we go back the :

Y opposite direction with a fee-for-servj-ce system. And l_0 obviously the reason we Left the fee-for-service

L1_ system to go. to managed care was fi.rst and foremost

L2 was the issue around health care. Second. is some t< saving of dolIars.

L4 Can you tel-l- this committee in a very

15 specific way why you are in a sense recommending that . 16 you go back when it was a system where basically

[t doctors weren't willing to entertain a fee-for-service

;^ l_u system in the first place?

19 SECRETARYRICHMAN: I. have to be very

20 honest with your Representative Evans. This was a

2L rreal tough one for rt€r and Itm not sure that I can' .. 22 actually do all of the explanation of it because it is

23 counter-intuitj-ve in terms of why we went to a managed

24 care format and why going back to the fee-for-service

25 system at any level works for us. 1 . My understanding and I | 1I let Steve jump

2 in if r make a mistake is that the dollars to be

3 gained from shifting the general assj-stance

4 recipients from a capitation format to a

5 fee:for-service format and thatrs the only category

6 being shifted because it doesnrt dr.aw down federal

7 dollars is because of the cash flow ftoat.

I REPRESENTATIVEEVANS: RighI.

9 SECRETARYRICHMAN: In other words '

10 capitation is a prepaid system and. you pay it before

L1 the fact.

t2 REPRESENTATIVEEVANS: Right.

13 SECRETARYRICHMAN: The fee-for-service

L4 system retrospective system you t r.e paying

l-5 somewhere between 30, 60, or 90 days after the fact.

10 And being able to flip those systems saves the State

L7 doIlars, a fairly significant amount of dol1ars. And

L8 that is the shift. It is the cash flow shift that i-s

1_9 the primary reason for being able to do this. So it's

20 an ability to be able to gain additional dollars.

2L Now in l-ooking at that as I continue to

22 probe and to have a better understanding of how this

23 works, I think there is some ways that we can work

24 that system to be able to get the float without maybe I 25 doing the doing all of the flip 77

L So part of it is my understanding and

2 . getting up to speed to understand both the

J complexities of the budget and what leeway we may have

4 with the federal qovernment to do this.

Wer re al-so

6 shifting an administration, you also have people who

7 neef to get up speedI on the areiareas that they have

X not been as familiar with

Y But I do believe that there is a the

10 . dollars to be gained come from the float so to speak

Ll_ and moving from a prospective system, capitated

1,2 system, to a retrospective fee-for-service system.

13 And I ' 1I turn the microphone over to see

T4 how badly I did.

15 MR. ROSSKOPF: I I d say that was at l-east an l_6 A minus or an A. I don't think I can qdd

L7 significantly to that, Representative Evans. It was

1-8 Iargely a'matter, as the Secretary has indicated, of

19 trying to reiognize non-.state reimbursement for those

20 services.

2L REPRESENTATIVEEVANS: I clearly understand

22 what you have just expressed. But you recal-I the

23 "reason we went in that direction in the first place

24 was that because this population was not being cared

25 for. t_ Do you have any kind of by even .evidence 2 this flip that you're doing relating to the

beneficence of the Commonwealth or the State; on the

4 other hand, are the constituents being benefited?

6 SECRETARYRICHMAN: WelI, for the most part ' 6 flipping it, I would expect that most people wil-I stay

7 Yr.th thet'

6 ::,;r.:,-:";".'r::.."r..r,-" can srirr see

Y their doctor. Their doctor still bilIs. And since it

10 is primarily applicable to where Health Choices is

11 in other words, the parts of the state that are still

L2 on fee-for-service aren't affected by this. It is

13 only those parts that are within HeaIth Choices.

I4 REPRESENTATIVEEVANS : COTTCCI.

1q SECRETARYRICHMAN: You have two parts to

1_6 Health Choices. You have a physical- health care

L7 component, and you have a behavioral health care

L8 component. l-9 REPRESENTATIVE EVANS : COTTCCI.

20 SECRETARYRICHMAN: On the physical health

2L care component for the largest part people wiII get

22 the service they are doing now. They will continue to ' 23 see the doctor they are seeing now, and they will

24 probably stay with the framework.

25 There are servj-ces they l-ose. They lose 79

1- case management and theY Iose --'they lose some of the

2 voluntary services within that are provided'within

Health Choices.

t But for the most Part, the GA clients : basically receive the same thing are receiving !h"V physical health side 6 now on .the

7 . On the behavioral health side, the Loss is

B much more dramatic. Because the way the dollars have

9 worked, the two primary additions that the Hea1th

10 Choices behavioral health entities have provided to

11 the Health Choices contract that are not in the

L2 fee-for-service are residential proqrams and what we

1? call f OP, . intens j-ve outpatient. These are two primary

I l-4 programs that came about as a result of managed care.

15 They didn't exist in the end of the fee-for-servi

76 world and'they don't exist in !h" world outside of the

I7 HeaLth Choices areas.

l_o.A

19 they get dropped. Now there are some alternatives t'o

20 this one that we are beginning to investigate with the

21 federal government that may help mitigate that which

22 means we open the for example, we open the Medicaid

23 plan.' We begin to put some of these things in the

zt+ .plan and work.with the federal government to see if we

25 can change how the Medicaid plan works for us..' 80

1 And again, I tm going to look at as many

2 places I can to be able to look at some of these

3 issues, find solutions to some of these issues.

.t Particularly I mean this is where I spent the last

5 ten years of my Life

6 So it is obvj-ous that Irm not going to want

7 to take away programs that I spent so much time

B building up.

9 REPRESENTATIVEEVANS: And I guess I wouLd

10 only say to you that obviously I understand that in'

1L your case and in the Governor I s case that the t2 situation that you and the Governor walked. into is not

13 something you all created and I know that you had to t4 make difficult choices.

15 I only raise the question in terms of some t6 form of valuation of the decisions that you may have

L7 had to make rather quick on the fiscal side which also

1B may not save us in the long term in terms of shifting

19 the cost.

20 So that is kind of my concern is, is

27 there some way that you all are looking at to evaluate

22 that decision?

23 f und.erstand you have to balance the ' 24 budget. And I was joking with Steve. He must have

25 been to a thousand of these hearings, and you havenft 81

1 J- done bad by being at a lot of them also. I know

2 decisions have to be made; but, of course, You know

we I re balancing lives. That is what my concern was as

4 soon as f heard the recommendation.'

So I raise that dsr is there some form of

6 evaluation built in as you look at this decision as '7 .you move forward?

X SECRETARYRICHMAN: WeI1, I think that the

9 chal 1 enge .for us rigrht now is that we have a budget

10 that has been already passed. : l-1 REPRESENTATIVEEVANS: Right.

1,2 SECRETARYRICHMAN: So we need to look at

13 what. happens next and how do we either find more

14 do1Iars., how do we remedy a situation that lready

15 a fait accompli for lack of a better terminology, and

1,6 how do we n9w correct the situation that I believe

L7 that has already been sort of done l_B And my hope is that as we look at this and

19 we understand that where the Governor is heading is to

20 have a sound plan for Pennsylvania as we move forward,

2t that on top of both his education agenda and his

22 economic stimulus agendar w€ can also find ways to

23 accommoda,te some of the issues within these'budgets .

24 that I think are also very important

ZJ REPRESENTATIVEEVANS: Last question, Mr. B2

Chairman. The testimony we have heard earlierT

2 whenever you have to make reductions and you have to

? make those kinds of choices, werve heard. a lot around

question of staff reductionsr' economic !h" c. devel opment

Has that aspect been looked at

7 understanding what the impact meantf We heard one

person indicate that they may have to lay off as many

9 as I think 4OO or 41000. I mean that kind of impact

10 obviously -- I mean you know what that means to a

L1 local area. Any sense, any feelings about that?

L2 SECRETARYRICHMAN: V[e11, I know.that

13 impacted very significantly. What happened in order ': L4 for this decision to be made I canft go back to. But

1q certainly, the economic the impact on the programs

16 particularly in the Heal-th Choices area is going to be

1,7 very signif j-cant. We spent a lot of time building l.tt these programs.

19 You know I need to stop using the word we.

20 .The counties and the Health Choices prog:rams have had

2L to spend a ]ot of time buildinq up these programs.

22 They are. very effective programs.

23 The effectiveness of drug treatment in the

24 Health Choices areas is pretty profound. We know they

25 are effective. We know these programs work. We know B3

L that when we take them down, the people involved in I 2 building them up won't have j obs: We know that when people donrt get treatment, they end up in jails and

q ]-n prLsons.

q So we are very aware. Itm very aware. I

6 need to -- f tm very aware what the impact of not

7 having these programs wiII be.

B REPRESENTATIVEEVANS: Thank your Mr.

Y Chai rman

10 CHAIRMANARGALL: Thank Your Representative

1l Ll- Evans. Representative Dicirolamo from Bucks County.

L2 SECRETARYRICHMAN: Good afternoon.

l3 . REPRESENTATIVEDiGIOLAMO: GOOd AfICTNOON,

L4 Madam Chair. It is a pleasure to finally get to meet

15 you and welcome. We thank you for being here today.

L6 SECRETARYRICHMAN: Thank You. 'm. 17 REPRESENTATIVEDiGIOLAMO: I j ust going

18 to concentrate a little bit in my couple minutes on

19 the issue of the drug and alcohol funding. And we

20 heard some very compelling testimony here today that

2T t.reatment does work

22 And I can teII you from'my perspective as a

23 Representative that nothing is more frustrating to me

24 than having a parent come into my office who has a son

25 or a daughter who needs treatment, they donr t have 84

insurance; they don't have the money'to pay for

2 treatment.

J I can also tell you as a parent from a

4 personal experience that nothing is more devastating

5 on a family than having a family member addicted to

6 drugs and aIcohoI.

7 And we heard some very compelling testimony

B and at the very beginning Representative Evans said

9 this is not a parti-san issue. ..' l_0 We heard Deb Beck and she testified about a l- l_ mom calling her up at her daughterts grave site. Her

L2 daughterrs name was Ashley. And I have been through

13 two of those in my eight years as a Representative l_4 with a parent who had a son and a daughter who needed I 15 treatment and could not qet it.

16 I have a letter here that I would like to

17 read. And it is from General Barry McCaffrey who was

1B the former drug czar from the White House. He very

19 much wanted to be here todav but was not able to make

20 it. And he asked -- he sent this letter to me last

21- night and asked me if I miqht read the letter.

22 In my absence, please share this Ietter

23 with the committee at the hearing.

24 During my tenure as the director of the

25 White House Office of the National Drug Control ; 85

I Policy, I quickly realized that no serious national or I 2 state effort to reduce drug abuse can succeed without ? addiction treatment as a major component. '.4 This letter is prompted by the review of

q' "Pennsylvaniars proposed spending plan for addiction

6' treatment. The most recent budget eliminates $104

7 rnillion f or treatment of over 30, 0OO of the

I Commonwealthrs most vulnerable citizens and will

9 further devastate families i .

10 These cuts wiIl unfavorably affect

l- l_ families, crime rates, and access to emergency medical

1,2 services. In my judgment, the projected savings from

1? these. cuts will prove illusionary. Instead of paying

t4 for addiction treatments, the citizens of Pennsylvania

I5 will continue to pay for the problem with the

16 incieased crime and the accelerated use of health care

t7 by the chronically addicted

1B Research and experience have taught us that

1v addiction treatment is a wise investment. The

20 research .is extremely well-documented and persuasive. .: 2L Every dollal spent on treatment saves a

22 minimum of S? in other health care as well as in the

23 reduction of'crime. Many of us believe that the

24 aLcohol and drug addiction problem in our. country is

25 , our .most pressing domestic challenge. B6

1 With one in four families struggling to

2 help their loved ones overcome addiction to drug and

alcohol, this j-s an issue that we must confront with

4 s.giencef tesources, and compassion. Please add my . 5 'recommendation to those urging restoration of the

6 money and the t,reatment dollars in the State budget.

7 Madam Secretary, this is the first time I

B had the opportunity to meet you. Everyone who knows

9 you and,I have talked to says besides being certaj-nly

10 very capable, that you are a very carinn, . Ll- compassionate person. ' t2 ';rrm not going to ask you any questions,

13 Madam Secretary. But I would just like to promise you t4 and,pledge to you that r am willing to do anything to

L5 work with you and the administration at some point

L6 over the next few weeks or couple of months to somehow l7 get this money back and restored in our state budget.

1B 'It is critically important to the health

19 and the well-being of our famiLies here in

20 Pennsylvania.

2L SECRETARYRICHMAN: Certainly,

22 Representative, this is hopefulLy.one of our few

ZJ unique budget years.

24 Although, I'm sure each budget year has its

25 own.personality. And my hope is that even though this 87

1 budget has been passed, that we can find a way to

2 address some of these most critical issues in addition

3 . to the Governorf s i-ssue that he's also put on the

table. And that while his package moves, that we

understand the importance of the people issues related

q to this issue -- to these needs

7 REPRESENTATM DiGIOLAMO: appreciate

B that very mucLr. Thank you .

9 CHAIRMANARGALL: Representative .Iake .WheatIey 10 from Allegheny County.

11 REPRESENTATIVEWHEATLEY: Thank your Mr. 'r."r"tary. L2 Chairman. Thank you, again, Madam I want l_3 to first begin by making a comment. Irm interested to . L4 know where aII of the bipartisanship began or where

15 was it in March, j-n early March when the Governor

16 presented his budget, when we had an opportunity to

L7 talk about these cuts and what it means to.the people

1B of this.Commonwealth

19 Where were all of my colleagues from across

20 the aisle who are now sitting here saying that drug

2t and alcohol treatment is important'but they voted yes

22 for a budget that cut it out and had no conversation z5 about it? They wouldn't allow legislators to even zq debate the issue. I wish we could have had this

25 conversation in March where we can talk about the these cuts. : Honestly, I don't know how your the

Governorr. or any other person who voted for this

4 budget can honestly make these decisj-ons and say this

F is a peoplers budget. This is not a peoplefs budget.

6 This is devastating to people. And for us

7 . to sit here and play games with people's Li.vesr. I

I canft I canrt understand how we can do that

9 f can't understand how we can sit here and

10 talk about this is meaningful to people but then vote l-1 for this stuff without having conversation about it, t2 without even knowing what it means to the people.

13 If you explain to me how you .ca* can sit L4 and offer a cut to drug and alcohol, behavioral health

15 that will eliminate these programs and say that was

16 the best decision that you guys could come up with and t7 for us as a General Assembly to not even engage in

1B conversation before we pass it, how can we do that?.

L9 That I s irresponsible. How can we? That I s my

20 que s t ion

2L SECRETARYRICHMAN: I'm not sure,

22 Representative, you want me to answer the question on

23 how the General Assembly can have passed a budget

24 without debate.

25 I mean is that the question? 89

REPRESENTATIVEWHEATLEY: How could we pass

2 a budget without debate? How can we even engage in

3 having a budget presented to us with a total

4 elimination of these programs?

5 SECRETARYRICHMAN: Okay. In the wisdom of

6 my eight weeks within the State gov.ernment, my

I experience tel1s me that under normal circumstances a

U Governor presents a budget. The budget is then

9 debated over several months wj-th the Secretary talking

10 about that budget. And there is an opportunity at

least in the past from my observation where the budget t2 has chang'ed sometimes significantly between the time

13 that it . is presented and the time that it is passed t_4 with oft.en that passing of that budget showing up

somewhere in late June very close to ,fune 3oth or l-6 afterwards. i L7 And by that time, budget problems have been

L8 addressed in some wdy, adjusted, amendedr or somehow

19 where there. have been major gaps; or problems with the

20 budget, sound debate by the GeneraL Assembly has

2L brought us a budget that we typically maybe with some

22 pain though can live with

23 This year was set different in many ways in

24 the debate is taking place and the discussion is

25 taking place after the budget has passed. 90

1 And my hope is even with.this aberration IN ? our behavior, what we come out with to operate in '? fiscal yedr '03-'04 is a budget that does not hurt

el peopl e .

5 CHAIRMANARGALL: Representative Stan

o Saylor from York County.

7 REPRESENTATIVESAYLOR: Madam Secretary,

B welcome.

9 SECRETARYRICHMAN: Good afternoon.

10 REPRESENTATIVESAYLOR: Thank you for

l-1 coming before the committee today. Without the

L2 funding there will be more demand placed on hospital

l_3 emergency rooms and law enforcement systems as we

l I L4 heard here today.

L5 Do you expect the county human services

l_o delivery system that we have in the state wilt somehow

1.7 replace those costs that they have l-ost particularly

l_d in light of the fact that the most flexibl-e fundinq

LY source that is out there for county government alnd

20 county programs, Human Service Development Fund, has ,

2t been drastically reduced by 91 percent?

22 . SECRETARYRICHMAN: I obvj-ously know the

23 HSDF, Human Service Development Fund, and its

24 flexibility very wefl; and it's the most flexible

25 dollars that any county has. It I s, the way counties 91

I actually .meet those internal needs that there is no

2 other. identified funding source to do

3 The certainly I donrt believe that

4 counties are going to be able to pick up the cost of

5 the programs that are lost and many, many very good

6 proqrams are going to have to close as a . resuLt of

7 this parti-cu1ar cut. ' B 'In many ways that counties that have been

9 able to be more effective to their wronged

10 constituents and be more responsive j-s something that

l-1 actually will be lost and very, very sorely missed. 'The T2 ' dif f erence is that on some of these

13 cuts is that once they go away -.- once many of the

1"4 programs go away and whether it is the HSDF programs

L5 or whether it is the drug and alcohol programs, they

t6 wonr t come back. That ' s the true 1.oss to us .

T7 . It's not that they are getting smaller and

1B that we'can grow them back. Many of these programs

19 once they go away, wer1l never get them back again.

20 And there are some very effective, good programs that

2! will be affected.

22 My guess is in many of these cases the

23 burden will end up being picked up in a variety of

24 different places depending on how the counties use l, 25 those. dollars. But most of all, the burden is 92

1 probably going to be plcked up by the people whose

lives they would have affected.

3 REPRESENTATIVESAYLOR: Thank you. Madam

4 Secretary, the purpose of Act L52 is to increase

5 availability of appropriate and most cost effective

6 non-hospital drug and alcohol detoxification and rehab

7 services.

I The intent was to est"ablish a health care

9 delivery system able to meet the needs and avoid

10 placement on waiting 1ists.

LL In particular, do you bel-ieve this is the t2 most cost-effective way or setting for these kinds of

1J services and what considerations have been given to

14 the cost differential between hospital detoxification

L5 and non-hospital detoxification?

16 SECRETARYRICHMAN: The non-hospital

L7 programs both detox and rehab are an incredibly t_u effective way to provide service. It is effective and

19 it is good.

20 We get much more servj-ce. We get a better

27 use of the dol-Iars, and we are much more able to track

22 those outcomes. z5 And to be able to look at these you z.t know, having lived through a stage where our pri-mary

25 service was hospitaL-based detox and having looked now 93

L at what a system has become over that inteivening ten

2 years of non-hospital based detoxr of non-hospital

rehab and^ of intensive outpatient services, yo, canrt

4 even begin to compare it is so dramatic. One was

5 runnj-ng 2-, 3-, 4-, $500 a day. The other runs a

6 couple of hundred or less

7 So that the cost-effectiveness is

X incredibly apparent when you are able to look at the

9 differences in those systems. And. I think that people

10 who have received service in a much more

11 community-based, non-hospital resid.ential format

12 understand the significant difference in being'in that

L3 different IeveI of environment ' l-4 . So when you look at how we spend our money

15 and whgre we get the best bang for our dollars, it is t6 certainly non-hospital rehab and. non-hospital detox.

L7 REPRESENTATIVESAYLOR: Chairman, do I

1B still have time? Last question, Madam Secretary.

19 Did the Governor in his budget preparations fook at

20 the 2O03-2004 budget for medical assistance with the

2\ cut of the Act L52 funds and the increased cost that

22 is going to be under medical assistance funds for this

23 current fiscal year coming up?

24 SECRETARYRICHMAN: I thinK when Ihe '' 25 the'Governor and his staff Looked at the DPW budget 94

1 I and the cut to the budget was $1.1 billion, it was

2 where to take these dollars. One of the suggest j-ons

3 was .to take out the entire general ass j-stance medical

4 needy-only area. That woul-d have produced the number

5 of dol-1ars.

6 The Governorrs decision -- and I think

7 that, one, based on that I needed to support was'that

B the number of people affected totally and the impact

9 back to the hospitals by creating 130,000 totally

10 uninsured individuals with no health insurance at all l-1 was a pretty serious impact.

12 These were decisions that had to be made

IJ that I believe are painful at best.' And one of the

L4 reasons I belj-eve they deserve honest debate on how we l-5 spend our doLlars, what is important, what needs to be

16 cut, and how we do it. t7 not having that debater w€ end. up with

18 a situation that the things that we cut maybe we

L9 shouldnrt.have, maybe we should have looked elsewhere.

20 But the bottom line is we still have a 52.4 billion

2! deficit. V[e have serious problems with our school

22 districts. We have serious problems in other manners

23 in which we run our Commonwealth.

24 "And we need to be able to look at a package

25 of change that includes a variety of different ways to OR

1 increase taxes that wiLL hopefully begin to give us

2 some ability to look to the future.

? But there when you begin to take a

I billion dollars out of a department Iike PubLic

a Vfelfarer'your choices become and as a very partisan

6 person as I am and looking at lifer:is that the cuts

7 have to be draconian.

x Anywhere you take dol1.:." within a budget

9 like this, yourre going to affect someone's life. I l_0 think the Governor in coming back and saying do not

LL el-iminate, do not be as other states, that he was not

L2 going to do the same ]evel of pain to a large group of

13 people as many of the other states around'us have done

L4 by eliminating an entire categorical area.

15 But and we did not and the State has not.

16 cut eligibility in a broad way. But again, anywhere

1,'7 you cut yourre going to have a great deal of pain and

1B that we do.

L9 . CHAIRMANARGALL: Representative Kathy

20 Manderino from Philadelphia. Kathy, f suspect if

2L we're not in your district right now. we are tgry

22 cLose.

23 REPRESENTATIVEMANDERINO: You are in my ztl district. "Welcome to the l-94th district. I think

25 Ianguage is very important, and I think it is 96

I important for us to be accurate and truthful.

2 And I want it on the record that this is

3 not a proposed spending plan. These are not suggested

4 budget cuts. This is an active law of tfre

5 Commonwealth o f Pennsylvania f or the f i'sca1 year

6 '2003-2OO4t and there are a 1ot of people that have to

7 take responsibility for this.

I The first one is the Governor and I will

Y get to that because he put the proposal on the table.

10 The second one is each and every person who voted yes

Ll_ for this because they put it on the Governorfs desk.

1,2

1.3 here, but the first thing we have to do is take

74 responsibility for what wefve done. . Because we could

L5 say whatever we want, but our actions speak louder t_6 than our words. t7 And our actions that made this Iaw our 'now 1B . actions.that made this Law are right what people

19 have to judge us by. . Because all the flowery words

20 can come out of my mouth that I want them to, but I

2L took an act or I didnft take an act based,on this

22 budget already and that's my public record.

23 Now having said that, the $f.1 billion cut

24 DPW was asked to make for a $2.4 billion deficit, it

25 is alniost 50 percent of the deficit came out of the 97

.L DPW budget. And we I ve already said' that the DPW

z budget is a people human services budget. It wasnrt

3 just dr:g and alcohol. It wasnrt just mental health.

4 Those are going to spill over into hospital

problems.- We took $28 million out of the hospital

6 uncompensated care l-ine item that we were using. We

7 took money from parents who have disabled children who

X were getting servj-ces for severely disabled people. : 9 Youfre right. A Lot of people were hurt by this

10 DUOgeE.

11 What I want to understand from the

L2 ,Governor t s perspective to the extent that you can give

t< it and I. will ask his budget secretary l-4 1.1 billion came out of DPW? Because, see, me as a

15 Iegr"]u:,o I have the ability to:et different

i 16 priorities.

1,7 , .l Had f been given the chanc€r my priority

1B would not have been for 50 percent of the budget to

19 come out of DPW. I would have looked at some other

20 spendingcategoriesandmaybetaken.a1ittIe,bit

2L bigger chunk out of their hide and left a littl-e bit

22 moie money in DPW.

23 That would have been my priority if I had

24 been alLowed to offer amendments, that would have been

25 my priority if I would have been able to debate the 98

I budget; that would have been my priority when I voted;

2 and that was my priority when I voted. Thatrs why f

3 voted no.

n My question to your Madam Secretary, is to

the extent that you can enl-ighten me on the decision

6 for 1.1 billion to come out of DPV[, f would like to

7 understand that decision.

B ;ECRETARYCRETARY RICRICHMAN: Reprersentative, I'm not

particularly comfortable speaking for someone else and

10 beginning to teIl you what their reasoning behind that

11 1S. '1,2 ' But my understanding is the two largest

L3 departments within State government are Education and

L4 Department of Public WeIfare, by far are the two very l_5 largest departments. 'And 16 within those two Iarge departments, t7 they tend. to look for the major amount of budget

1B neqotiation budget resolution of major budget issues l-9 somewhere within those frameworks. . Obviously, the

20 Governor was and the budget secretary were not

2t going to go to l-ook at education to look for some of

22 these decreases as they are trying to they have a

23 ver,y strong stimulus plan for education which is

24 critically important.and to us too.

25 And, you know, some of the good news is 1 that education and DPW'are going to form a partnership

2 now that helps us both get a better bang for our

doIIar. But that left DPW as one of the primary

4 places they began to look for those additional

a do I Iars .

6 The

7 balance a major budget deficit as you look. across the

I State, I canrt te11 you.

9 I do know that the package that they put

10 together bt looking at educat j-on, economic stimulusr.

l-1 beginning to look at the different ways that the

T2 dlfferent taxes will produce are all part of a package

13 that begins to move Pennsylvania to a different pIace.

I4 Had there been a different level of debate,

L5 maybe we woul-d have gotten to a dif ferent place in the

16 'end. But this is a signed budget. I have to go back.

\7 Steve Rosskopf, my budget director, does point out

18 that white the total amount cut was $1.1 million

19 billion, I'S sorry, the State part of that is it 1LB

20 and there are 118 million Bl-8 nillion.

21 . REPRESENTATIVEMANDERINO: Put a Dercent on

22 that as part of DPW's budget. Do you know?. fs that 6

23 percent, B percent?

24 MR. ROSSKOPF: Of the State budget

25 CHAIRMANARGALL: Pl-ease use the 100

1 mi crophone .

2 SECRETARYRICHMAN: l-0 percent .

MR. ROSSKOPF: It is about 10 percent

.t SECRETARYRICHMAN: It is about l-0 percent

5 of the State budget. ' 6 CHAIRMANARGALL: Representative Rohrer

7 from Berks County.

I REPRESENTATIVEROHRER: Thank your Mr.

9 Chairman. Mad.amSecretary, thank you for your

L0 comments today

1I There is no question about it. I think the

L2 scenario surrounding the budget that. was proposed and

IJ adopted is a Little more unusual than normal. I would l-4 agree with that

15 I think there has been several things that

16 have been somewhat perplexing as we're talking about

L7 this topic here dsr number one, why the Governor chose l-8 to cut so drastically deep on this area.particularly

1-9 in light of the testimony that werve heard.

20 : Another perplexing obviously observation is

2I that is that in the Governorrs second'address where

22 he basically is asking for around a 34 percent tax

23 increase overa11, that I believe during that time nor

24 have I heard since that time that he's asked for any

25 kind of a reinstatement of this funding. Is that l_01

1 where he t s continuing to stand?

z SECRETARYRICHMAN: We11, .at this point in

? time, the budget has passed. So I rm not sure he has

4 -- there is any other alternative other than to live

within the passed budget and hopefully get the tax

6 increase that I believe is right now focused on.the

7 two major initiatives he's painted forward

B But. that doesn't mean that as this body

9 debates the current issues which I believe are most

10 related to the taxes and to education, that part of

1L that debate cannot look at things to either return

L2 additional taxes to appfy, to be able to refund this.

13 I mean we stilL at this point while there is a

14 balanced budget if we are going to be able to return t5 these, there needs to be revenue.

L6 It is important to the Governor that the

L7 packaqe hers put forward for education and economic l_8 stimulus continue to move forward.

IY REPRESENTATIVEROHRER: BUt does the

20 Governor want this line item restored to where it was?

2L Do you know?

22 . SECRETARYRICHMAN: You need to that is

23 question for the Governor.

24 REPRESENTATIVEROHRER : You don't know.

25 Another observation here is that today we I ve been LO2

1 talking basically about treatment for addictions of

2 various types, drug and al-coho1.

It does strike me in light of a

reduction significant reductj-on in this area of

treatment for addictive behavior that the Governor has

chosen to include in his second address the 'l recommendation for implementation of slots at the

B tracks and for gambling which we all know l-eads to

Y addictive behavior and a significant cost associated

10 with that l-1 Do you have anywhere in this budget that

72 you know of if the Governor has included costs

13 sufficj-ent to predict addictions which the numbers are

14 between,L and 10 will need some treatment, 1 and 20

15 will become compulsive

16

L7 that the current rate expectation runs around 60r 0OO td need treatment. Where is the money going to come from

19 for this and what is that number?

20 SECRETARYRICHMAN: The -: I probably

2L before I go too far down this path probably need to go

22 back and check some of the data and information. z5 Having been in Philadelphia and having a

24 large proportion of folks make regular visits to

25 Atlantic City, we did not see a significant number of 103

1 people equiring therapy for addictions and did not

2 see a serious gambling addiction.format here

3 I.don't know I need I really do want

4 to look.up those numbers. I do also believe the

couns e 1 ing services that we have j-n many of our

6 behavioral health can work within the framework if

7 there are additional people

B But the amount that we've seen now with a

9 fair number of Philadelphians who regularly are going

10 to play slot machines in Atlantic City has not been a

11 significant number.

T2 REPRESENTATIVEROHRER: I Know that there

13 was a meeting in the Capitol some weeks ago where

14 there were numerous individuafs who chose. to reveal

L5 their anonymity and express the fact. that they have

L6 been dealing with this issue and in treatment for some

L7 time. Where does that treatment come out of? fs that

1b out of this same line item or where does that come

LY from?

20 SECRETARYRICHMAN: It depends on how it

2t gets diagnosed within the professional-s diagnosing. I

22 would expect it would be diagnosed as a mental illness

ZJ or mental health problem and be treated under mental z4 health. It would be reimbursed within the same

25 framework but not in the same area. So it wouldn't be L04

affected by this

2 REPRESENTATIVE ROHRER: Al-I right . r

3 appreciate you looking into that because it just seems

4 that it does appear to be a little odd to be

introducing a new form of behavior that:is going to

6 need treatment. Thank you, Mr. Chairman.

7 CHAIRMAN ARGALL: Thank you.

B Representatlve Phyllis, Mundyr my neighbor in Luzerne

9 County.

10 RtrPRESENTATIVEMUNDY: ThanK YoUI Mr

11 Chairman. Thank you, Madam Secretary. It is nice to

L2 have you here this afternoon

SECRETARYRICHMAN: Thank you.

1^ l-q REPRESENTATM MUNDY: I couldnrt agree

15 more that'language is important. And my col-Leagues

16 and I were sitting here earfier asking ourselves are l7 we in the twilight zone here, are we in a parallel

18 universe where you claim to care about these things

19 but yet you vote to cut the daylights out of thern?

20 It just seems to me that a lot of the

21, people sitting here today should have been asking

22 themselves if these cuts were the right thing to do

23 before they voted for this budget, before they put it

24 on the Gover'nor t s de s k z3 And now it seems to me that they need to be t-05

l- honest about whether or not they are prepated to vote

2 for a tax increase Eo restore the. cuts. Because if

they are.not, then this is all smoke and mirrors.

4 We know that the Governor is .asking and

5 I understand the Governor's theory, the Governorrs

6 idea we must endure a year of pain in order to broaden

7 our tax base and increase our revenue position and.

B enhance our revenue pos j-tion over the long term.

i 9 Frankly, I support the Governorfs -- for

10 the most part the dovernor's attempt at economic

1L development and education. And I hate to call it

L2 reform but enhancing the educationaL system to improve

13 academic achievement.

L4 But if werre going to talk about the i_5 restorations, could you give me some idea of what the

16 restorations that wetre all sitting here saying are so : t7 important and these things are so terrible for our

1B communities and, you know, those of us -- especially

19 those of you who voted for this. How much of a tax

20 increase are you going to have to support to restore

2L these line items ?

22 SECRETARYRICHMAN: I'm not,sure I can put

23 it in tax increase format. But as youtve heard, the

24 cut to the drug and alcohol system if you total all of

25 the dol-Iars together is a litt1e over a hundred 106

1 milIion. There are another hundred million that

2 affected the hospitals. There is about 35 million

3 that affected HSDF. 'primary 4 Those are some of the key, issues.

There were a.Lso cuts to a variety of smaLler

6 programs.

I The GA conversion is a float conversion

B that I think and I don't know the exact doLLar

Y amount on that. But those are the kind of figures

10 we're looking for. But I can't -:

l1 REPRESENTATIVE MUNDY: S.o we ' re tal king

L2 about

13 or .7 percent increase.

I 14 SECRETARY RICHMAN: You I re outside: my realm

l-J of. expertise. .And 16 REPRESENTATIVEMUNDY: IIm not totally

L7 sure of my number. But I'm looking at q significant:

t8 increase. And there are people sitting here who

19 arenrt even for the current proposal let aLone this .additional 20 money for restoration.

2t Since we didn't get to ask the providers

22 questions, I just want to say that those providers in

23 the room and those people who realIy care about these

24 issues should be prepared to qo back to your State

25 Representative and ask them these crucial questj-ons: 107

I WhV did you vote for this without any discussion, 2 without any public input, without any negotiation?

J And now that you voted for it, how much of

4 a tax increase are you willing to support to restore

J these important programs? These programs that the

6 cuts of which are going to devastate our communities.

7 So I know you're in a very difficult

B positlon. I can only hope that with the help of the

9 legisLature that you and all of us can work together l_0 to restore some of these cuts. But frankly, Ifm not t_1 optimistic.

L2 SECRETARYRICHMAN:. My hope is that indeed

IJ we stay focused on the folks that live within the

L4 Commonwealth of Pennsylvania and. making sure that

1q while we not l-eave a child behind, we donrt leave a

L6 mother and father behind either; and that we are able

L7 to do the right thing by our children which makes sure

1B they have the best possible education. .Becaus.e I

19 think if we looked at it, the correlation between kids

20 who don't graduate, kids who dropout, kids who aren't

2I educated who end up in our substance abuse system'is

22 pretty high

23 We have a system here. Part of that system

24 is education. Part of that system. is health care. We

25 need to keep our eye on both. l-0B

1 While there is no way that I could ever say

2 that education is not critically important and growing

our economy is not critically important and that's

4 part of the Governorrs vision and that is where he is

tr . J taking the State. Likewise as the Department of

6 Publ1c Welfare, I have an obligation to make sure

7 CHAIRMANARGALL: Representative McGill

B from Montgomery County.

9 REPRESENTATIVEMcGILL: Thank your Mr.

1_0 Chairman. Thank your Madam Secretary. f have lL listened' with great i-nterest to you this af ternoon.

L2 I've heard you on several other occasions. And I

13 thank you for being here and your frankness. ' 14 I guess it was March 4th that Governor

15 Rendell gave me a copy of his budget which I think I

16 saw you out in the hallway beforehand and said how did

L7 it look like for your department, and. you said it was l-B devas tat ing. ' 19 And at that pointr wo did vote on that

20 budget a week l-ater. That was the budget that the

2L Governor of' the Commonwealth of Pennsylvania gave to

22 the legislature. That's what he gave to us to telI us z5 what he was doing and f voted for that ztr He got it back. And unfortunately, he

25 didn't blue line your department. He just blue lined 109

1_ educa t ion

2 . So today we are here and I think what f

heard -- what frve heard is that from your testimony

4 and the other people that have been testifying before

'r J us today, that you are in agreement that,with the cuts

6 on the behavioral- side; what we are going to have is 't an"increase in drug and alcohol abuse and the problems

I associated with that

V I think that the decrease was by your

10 testimony and by others, that the decrease on the

1l_ behavioral side was because it. appeared to be easy. to

L2 pul-l those funds and not use f ederal f unds with that.

IJ I also heard you mention the term his t4 package severaL times today. So f t11 ask you a simple

15 question. With the Governor I s economj.c stimulus l

Ib package that he presented to us a month later or a

L7 month and a half later, do you believe that your

1B department will still be the unfavored son as it has

19 been so far ? ' 20 SECRETARYRICHMAN: The unfavored daughter?

2L REPRESENTATIVEMcGILL: Unfavored I | 1I

22 take either oner unfavored son or daughter. Because

23 we d.idn't see anything go back. And is 'this the

24 direction that you perceive the Governor taking the

25 commonweal-th with respect to health and human services t_10

in the next three years? I 2 SECRETARYRICHMAN: And again, I as f

J speak for the Governor, f would like you to remember

4 that Irm speaking for the Governor.

5 The Governor proposed a budget that focused

6 on education and economic development. And I think he

7 was he has been very cl-ear in saying that with this

I budget he expects that we will see some drastic

Y improvement in ou{ education system. And I believe he

10 has said on numerous occasions for every doLlar spent

L1 within our education system, we save dollars on the

t2 other end.

13 And he also hopes to stimuLate the economy

L4 in a way that in many cases we cdrr. grow ourselves out

1q of many of the issues that we have to face on a

16 day-to-day basis. And with that growth and with our

1,7 investment in education and with the d.ecrease in.

18 property taxes, Pennsylvania can begin to become a

L9 place that is more thriving.

2o With that, I think from his first budget

2L his anticipation was that there would not have been a

22 p'assed budget, that there wouLd have been debate; that

23 there would have been discussions. There would have

24 been pros and cons. And that as budgets have been

25 presented in other years, the budget as a document 111

within itself is not a perfect document.

2 The budget becomes a better budget for the

J State as we debate the pros and cons of that budget.

.4 And I think that indeed now we I re beginning to have

that debate.

6 We're beginning to express and allow people

7 to express their opinions of how this budget affects

I the people of Pennsylvania. And r ininf as this

9 debate conti-nues and the discussion continues over the

10 next couple months, hopefully we will somehow use

11 what opportunities may present us understanding. that

I2 we do have an active budget.

13 I have a real Live budget I need to live

14 with. This is not a proposed budget. I think it's

]J made clear this is not a theoretical budget. This is

16 tt:t an. unsigned budget. This is a budget that at this

T7 point and. as Secretary of DPW that I am legally bound

1B to live by. And in having to do that, I willlbe

19 working. very hard to find ways not to hurt people.

20 But as proposed right now, this is. the budget I have.

2L The Governor still continues to have a

22 vision of having a vibrant Commonwealth that educates

23 its children, focuses on its chil-dren' reduces

24 propgrty taxes as one of the ways to do that and

25 provides stimul-us enough that the State can continue tt2

I l_ to grow

Z REPRESENTATIVEMcGILL: Do you think that

this stimulus that is going to be created from this

.t will be enough to change what we have heard today in

5 the individuals that have sat in front of us and said

6 that the drug and alcohol problems that they have were '7 not necessarily from the type of education or type of

X upbringi ng ?

9 Do you think that that wiLl the stimulus

10 in the economy will turn around the impact it will-

Ll- have on your department?

L2 SECRETARYRICHMAN: I think the impact on

1? the department is immediate and the- growth that needs t4 to occur in the State takes more time l_5 I think if we want to replace the programs

16 that have been so described today so adequately by aIl

L7 of the providers, there wil] need to be additional

18 dollars other than the dollars proposed by the

L9 Governor.

20 REPRESENTATIVEMcGILL: Do you think we'11

2L ever be able to get back to the point you are right

22 now based on the direction that we are moving with

23 respect to education and economic deve.Iopment?

24 . SECRETARYRICHMAN: Without replacing some

25 of what I lost I think that needs to be replaced. 113

1 .Economic development takes place over a couple of - years. U 2 REPRESENTATIVEMcGILL: I thinK IIm out of

4 time. Thank you.

q CHAIRMANARGALL: Werre all out of time.

6 We have three additional questions. WeI re goir,rg to

7 follow up with you in writing if your staff can

x certainly cooperate with our staff. (: 9 I want to thank your Madam Secretary. I

10 al-so want to thank the members of the committee, the

11 other members that offered testimony today.

1.2 V'le al-L understand and I think the term

13 pain has been used. This is. a painful subject. This

T4 is an emotional subj ect.

l_5 I think I would be remiss if I didnft

l_6 mention on behalf of all of the members of the

l7 committee my thanks for everyone today taking part in

t-8 this process in a, I think, very deliberative way.

19 This hearing could have easily spun out of control

20 given the emotional subjects involved.

2T , And I realIy do respect everyone I s attempt

22 to address the subject in such a way that we can look

23 for solutions in this hearing as well as in the next

24 hearing. Which once again for members of this . 25 .committeer on Thursday in Pittsburgh we wil-l- be LL4

1 dealing with transportation and community and economic

2 development issues. And I understand that your11 be

3 back with us in the Wilkes-Barre area in a few weeks.

4 Once againr thank you to everyone.

,SECRETARYRICHMAN: Thank you very much.

6 (The hearing concluded at 4 p.m. )

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1 I hereby certify that the proceedings and

2 contained fuIly and accurately in the I evidence 1re

J notes taken by me in the proceedings of the above

4 cause and that this copy is a correct transcript of

the same.

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7 Sher r i I Notary Public

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10 NotarlalSoal ShorrlA. ReitanqNotarv public 11 .51fifli?tJfl '8-i''iPJliffi illT,oo. Member, T2 PennsylvaniaAssoclation ol Notaries

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