Senate Committee Conducts Hearing on the Effect of Methamphetamine Use and
Addiction on the Child
Welfare System; Panel Includes Individuals in Recovery from Addiction to Methamphetamine
On April 25th, the Senate Finance Committee convened a
hearing entitled, "The Social and Economic Effects of the Methamphetamine Epidemic on America's Child Welfare System." Led by
Committee Chairman Charles Grassley (R-IA) and Ranking Member Max Baucus (D-MT), Senators Olympia Snowe (R-ME), Ron Wyden (D-OR), and Gordon Smith
(R-OR) also participated in the hearing. Witnesses providing testimony to the Committee included: Allison Bruno, a mother in
recovery from addiction to methamphetamine; Aaronette and Darren Noble, parents in recovery from addiction to methamphetamine and their son, Joey
Binkley; Kevin T. Frank, Regional Administrator for the Department of Public Health and Human Services, Child and Family Services Division in South
Central Montana; Nancy K. Young, Ph.D., Director of Children and Family Futures, Inc. at the National Center on Substance Abuse and Child; and
Reverend Frederick Aigner, Ph.D., President/CEO of Lutheran Social Services of Illinois.
In his opening statement to the Committee, Chairman Grassley spoke
about the problem of methamphetamine use around the country, noting the toll methamphetamine has taken on families, communities and the social
welfare infrastructure. In introducing the panel of witnesses that included three individuals who are in recovery from addiction
to methamphetamine, Chairman Grassley acknowledged misperceptions that addiction to methamphetamine cannot be treated, and expressed that the
presence and testimony of the witnesses were proof that addiction can be treated and that recovery from addiction is possible.
Senator Baucus, in his comments to the Committee, spoke about
methamphetamine use prevention efforts taking place in his state of Montana. Senator Baucus also cited the ability of people in
recovery to tell their stories as a powerful way of helping to prevent young people from using methamphetamine and other drugs.
Senator Wyden spoke about drug addiction treatment as extremely cost-effective, noting the collateral effects and costs associated with
untreated addiction to the criminal justice and healthcare systems. In her comments Senator Snowe discussed the importance of
intervening early with young people through education and prevention efforts.
In testimony to the Committee, Ms. Bruno and Mr. and Mrs. Noble all
spoke about their successful experiences in drug addiction treatment; each of these panelists noted that the ability for their children to also
receive services, and the presence of a comprehensive array of services for all of their family members were both key to their recovery process. Mr.
Binkley spoke about his parents becoming healthy through addiction treatment services that were offered to his entire family. In
response to a question by Senator Grassley on availability of treatment, Ms. Bruno spoke about waiting lists and particularly the number of women
with families who are trying to get into treatment programs that also provide comprehensive services to their family members. Ms.
Noble spoke about the importance of services to support individuals in recovery. Mr. Noble spoke about the need for treatment to be more accessible,
and about the need to educate parents about addiction so that they can see the signs and help their children. In response to a question by Senator
Baucus about the importance of prevention programming, Ms. Bruno emphasized that school-based prevention programs are critical to educating young
people about how drugs affect and harm the body.
In the second witness panel, Dr. Young of the National Center on
Substance Abuse and Child Welfare spoke about how, although emphasis has been placed on fighting methamphetamine, the problems with addiction in the
United States are not a single-drug issue. In discussing the need for drug treatment services, Dr. Young cited the extremely high
number of people who need such services but are not able to receive them. In response to a question by Senator Grassley about the
high number of women who use and become addicted to methamphetamine, Dr. Young spoke about the need to understand that trauma, abuse and domestic
violence are often significant factors and that addressing these needs with addiction treatment and mental health services is critical.
In his comments, Mr. Frank of the Child and Family Services Division in South Central Montana emphasized that addiction to methamphetamine and
other drugs affects people across socio-economic lines. Mr. Frank also spoke of the importance of education and awareness efforts
about the dangers of methamphetamine and other drugs, and of the importance of collaboration between community agencies and groups. Reverend
Frederick Aigner of Lutheran Social Services of Illinois spoke about the need for additional resources to support drug addiction treatment programs,
particularly in rural parts of his state of Illinois, so that individuals receiving treatment services could remain in treatment for longer periods
of time where appropriate. Discussing the child welfare system and the role of methamphetamine, Reverend Aigner spoke about the
need for addiction counselors to work on child welfare services teams and for more training money to be provided to assist children of people with
addiction histories.
Materials from the Senate Finance Committee hearing, including full
witness testimony and Committee member statements, can be found at:
http://finance.senate.gov/sitepages/hearing042506.htm
A webcast of the hearing can also be viewed at:
http://finance.senate.gov/sitepages/hearings.htm.
Legislation to Reauthorize the Office of National Drug Control Policy (ONDCP)
Introduced in the
Senate
On April 6th, Senators Arlen Specter (R-PA),
Joseph Biden (D-DE), Charles Grassley (R-IA), Orrin Hatch (R-UT), and Carl Levin (D-MI) introduced S. 2560, legislation to reauthorize the White House
Office of National Drug Control Policy (ONDCP). H.R. 2829, similar legislation to reauthorize the ONDCP, was approved by the full U.S. House of
Representatives in March.
The "Office of National Drug Control Policy Reauthorization Act of
2006" would:
- Require that the ONDCP Director:
- Annually submit a description of a national drug control
performance measurement system to Congress that develops two- and five-year performance measures and targets for each National Drug Control Strategy
goal and objective established for reducing drug use, availability and the consequences of drug use
- Coordinate the development and implementation of
national drug control data collection and reporting systems including an assessment of the adequacy of the coverage of existing national treatment
outcome monitoring systems to measure the effectiveness of drug addiction treatment in reducing drug use and criminal behavior during and after the
completion of drug addiction treatment
- Coordinate with the private sector to promote private
research and development of medications to treat addiction
- Contract with a nonprofit corporation that works with
States on laws and policies to address alcohol and other drug issues, under which the corporation shall revise the model State drug laws developed by
the President's Commission on Model State Drug Laws and draft supplementary model acts to meet changes in States' substance abuse
issues
- Require that the National Drug Control Strategy,
submitted yearly by the President, include:
- Comprehensive, research-based, long-range, quantifiable
goals towards reducing drug abuse and its consequences
- Annual quantifiable and measurable objectives and
specific targets to accomplish long-term quantifiable goals that the Director determines may be achieved during each year
- An assessment of current illicit drug use and
availability, the impact of illicit drug use, and treatment availability; this assessment must include estimates of drug prevalence and frequency of
use, drug use in the workplace and the productivity lost by such use, and drug use by people who have been arrested, or are on probation or
parole
- An assessment that examines hospital emergency use by
individuals using illicit drugs, the quantity of illicit drug-related services provided, the annual national health care cost of illicit drug use and
the extent of drug-related crime and criminal activity
- A review of the status of, and trends in, drug treatment
in the United States, by assessing public and private treatment utilization and the number of individuals using drugs the Director estimates meet
diagnostic criteria for treatment
- A summary of the efforts made to coordinate with private
sector entities to conduct private research and development of medications to treat addiction by screening chemicals for potential therapeutic value,
developing promising compounds, conducting clinical trials, seeking Food and Drug Administration approval for drugs to treat addiction, marketing the
drug for the treatment of addiction, urging physicians to use the drug in the treatment of addiction, and encouraging insurance companies to reimburse
the cost of the drug for the treatment of addiction
- Require that the Chief Scientist at the Counterdrug
Technology Assessment Center identify demand reduction basic and applied research needs and initiatives, in consultation with affected National Drug
Control Program agencies, including improving treatment through neuroscientific advances, improving the transfer of biomedical research to the
clinical setting and, in consultation with the National Institute on Drug Abuse, examining addiction and rehabilitation research and the application
of technology to expanding the effectiveness and availability of drug treatment
- Revise the current law governing the suspension process
for grantees through the Drug-Free Communities Act by requiring that a grantee could not be suspended or terminated unless the grantee was afforded a
fair, timely and independent appeal prior to such suspension or termination; in addition, the Director would be precluded from imposing any
eligibility criteria on new applicants or renewal grantees that is not provided by statute
Following S. 2560's introduction, the legislation was referred to
the Senate Judiciary Committee where it awaits review. The text of both S. 2560 and H.R. 2829 can be found at: http://thomas.loc.gov.
Legislation Introduced in Senate to Make Indian Tribes Eligible for
Grants to Fight
Methamphetamine Use
On April 5th, Senator John McCain introduced S. 2552,
the "Indian Tribes Methamphetamine Reduction Grants Act of 2006." S. 2552 would amend current law to give Indian tribes
eligibility to receive grants aimed at reducing methamphetamine use and addiction. In his introductory comments on the
legislation, Senator McCain spoke of the widespread problem of methamphetamine use and addiction in Tribal communities, and expressed that S. 2552
would be a step toward eliminating the problem with methamphetamine in Indian country.
Specifically, S. 2552 would give tribes eligibility to receive
funding through the methamphetamine hot spots grant program, the grant program for drug endangered children, and the recently authorized grant
program to address methamphetamine use by pregnant and parenting women in the criminal justice system.
Senators Maria Cantwell (D-WA) and Byron Dorgan (D-ND) are
co-sponsors of the legislation. Following S. 2552's introduction, the legislation was referred to the Senate Judiciary Committee
where it awaits review. The text of S. 2552 can be found at: http://thomas.loc.gov.
House Committee Conducts Hearing on Reauthorization of the Ryan White CARE Act; House Members Discuss Increased Need for Supportive
Services,
Including Drug
Addiction Treatment for People with HIV/AIDS
On April 27th, the House Energy and Commerce
Subcommittee on Health, which has jurisdiction over reauthorizing the Ryan White Care Act, held a hearing, "Reauthorizing the Ryan White CARE Act:
How to Improve the Program to Ensure Access to Care." The Ryan White CARE Act provides federal funding for health care and supportive services to
people living with HIV/AIDS. The CARE Act expired in October of 2005, but the program continues to receive funding. Congress is
preparing to reauthorize the legislation and it has been reported that Members and their staff have been working closely together in a bi-partisan,
bi-cameral process to develop reauthorization legislation.
The hearing was led by Subcommittee Chairman Nathan Deal (R-GA);
members participating in the hearing were: Subcommittee Ranking Member Sherrod Brown (D-OH), full Committee Chairman Joe Barton (R-TX) and
Representatives Charles Norwood (R-GA), John Shimkus (R-IL), Lois Capps (D-CA), Michael Burgess (R-TX), Tammy Baldwin (D-WI), Henry Waxman (D-CA),
Anna Eshoo (D-CA), Mary Bono (R-CA), Edolphus Towns (D-NY), Ted Strickland (D-OH), Fred Upton (R-MI), Frank Pallone (D-NJ), Joseph Pitts (R-PA),
Bobby Rush (D-IL), Michael Ferguson (R-NJ), Eliot Engel (D-NY) and Edward Markey (D-MA). Witnesses providing testimony to the Subcommittee were: Dr.
Elizabeth Duke, Director of the HIV/AIDS Bureau at the Health Resources and Services Administration (HRSA), Dr. Kevin Fenton, Director of the
National Center for HIV, STD and TB Prevention at the Centers for Disease Control and Prevention; and Dr. Marcia Crosse, Director of Public Health
and Military Health Care Issues at the U. S. Government Accountability Office.
In his opening statement to the Subcommittee, Chairman Deal spoke
about the need for reauthorization of the CARE Act and for the reauthorizing legislation to reflect changes in the HIV/AIDS epidemic that have
occurred over the last six years. In response to statements by a number of Committee members who expressed concern that the
witness panel did not include any representatives from stakeholder groups or people living with HIV/AIDS, Chairman Deal did express that the
Subcommittee was going to hold a roundtable on CARE Act reauthorization that would include representatives from stakeholder groups in the near
future. In his comments to the Subcommittee, Ranking Member Sherrod Brown expressed that progress has been made in reducing stigma
associated with HIV/AIDS, finding successful treatments and standards of care; however, Congressman Brown also expressed that more needs to be done,
noting that roughly half of those individuals with HIV/AIDS are not receiving care. Congressmen Norwood and Burgess, both medical
doctors, spoke about the need for additional resources in the South, particularly in rural areas and within communities of color where the rate of
incidence of HIV/AIDS continues to increase. Full Committee Chairman Barton identified the CARE Act hearing as very important and emphasized that,
despite certain reports, legislators were planning to reauthorize CARE Act as soon as possible.
In her testimony to the Committee, HRSA Administrator Elizabeth
Duke outlined the key principles for reauthorization of the Ryan White CARE Act that the Bush Administration released last July; these principles,
which the Administration would like reflected in CARE Act Reauthorization legislation, are: to serve the neediest first; to focus on lifesaving,
life-extending services; to increase prevention efforts; to increase accountability; and to increase flexibility. In determining
who the neediest individuals are in order to prioritize funds, Dr. Duke spoke about how the Administration would like to establish objective
indicators to determine the severity of need for funding core medical services. Under the Administration's proposal, seventy-five percent of CARE Act
funds would be allocated for core medical services.
Several members expressed frustration and concern about the
Administration's proposal for the CARE Act. Representatives Baldwin and Waxman criticized the Administration for not including a
precise definition of core medical services with the proposal principles. Congressman Waxman asked Dr. Duke specifically whether
nutritional, drug addiction treatment, mental health, and case management services would be considered as core medical services.
Dr. Duke responded by stating that the Administration is reviewing the many definitions of core medical services in an ongoing deliberative
process; however, Dr. Duke did also express that there are common elements on most lists of services and that case management, drug addiction
treatment and mental health services are included on most of those lists.
Members including Congressmen Rush and Pallone expressed concern
with imposing the core medical services requirement on Title IV funds, which provide supportive services to people living with HIV/AIDS and their
families that help people to access and remain in care. Congressman Rush expressed that Title IV services keep people in care and
support outreach efforts to young people that are critical. Dr. Duke agreed on the need to engage all communities in reaching out
to their members to bring them into care and expressed that it was not the Administration's intention that the title funding structure of the CARE
Act be dismantled. Congressman Pallone noted the need for increased resources for support services including drug addiction treatment for people with
HIV/AIDS including women, youth, and people of color.
A number of Subcommittee members expressed concern with recent
discussions about revising the funding formulas in the CARE Act. Part of the discussion focused on a recent GAO report that studied funding through
Titles I and II and sought to examine whether states with eligible metropolitan areas (EMAs) received more funding per HIV/AIDS case than states
without an EMA. Specifically, members of the New York delegation, including Congressman Towns, and the California delegation
including Representatives Capps, Waxman, Eshoo and Bono, expressed that changing the CARE Act funding formulas could result in significant amounts of
funding being removed from areas that have historically been hardest hit by the domestic AIDS epidemic. Congressman Towns spoke about the ongoing need
in New York and noted the need for additional resources for women and people of color. Congressman Towns did express concern that
New York could lose over $20 million in CARE Act funds if the funding structure is revised as proposed. In addition, Congressman Towns spoke about
the high rate of HIV/AIDS in prison, which four times higher than in the general population.
Dr. Fenton, in his testimony to the Subcommittee spoke
about the President's Minority AIDS initiative, and of the recent proposal to place HIV testing in all medical, jail and prison settings.
In addition, Dr. Fenton fielded questions on the requirement that, in order to receive CARE Act funding, states must now employ a name-based
AIDS reporting system. A number of members from the California delegation expressed concern that the state will lose funding
because the legislature recently approved a change to this form of reporting and the system will not be fully implemented by the required
date.
The Energy and Commerce Committee has yet to release draft
legislation to reauthorize the CARE Act. The Senate Health, Education, Labor and Pensions (HELP) Committee, which has jurisdiction over CARE Act
reauthorization on the Senate side, has also conducted hearings on reauthorization but has not yet introduced a piece of legislation.
Senator Tom Coburn (R-OK) introduced legislation to reauthorize the CARE Act, S. 2339 in late February, but this legislation is independent
from the bill the HELP Committee will develop for passage. Complete witness testimony from this hearing can be found at:
http://energycommerce.house.gov/108/Hearings/04272006hearing1847/hearing.htm
