SUBSTANCE ABUSE AND MENTAL HEALTH

SERVICES ADMINISTRATION

CENTER FOR SUBSTANCE ABUSE PREVENTION

NATIONAL ADVISORY COUNCIL

Wednesday,

July 26, 2006

Sugarloaf Mountain and Seneca Rooms

Substance Abuse and Mental Health Services Administration

1 Choke Cherry Road

Rockville, Maryland

IN ATTENDANCE:

[Chairperson]{.underline}

Dennis O. Romero, M.A.

Acting Director

Center for Substance Abuse Prevention

Room 4-1057

1 Choke Cherry Road

Rockville, MD 20857

[Executive Secretary]{.underline}

Tia Haynes

Committee Management Specialist

Center for Substance Abuse Prevention

Room 4-1066

1 Choke Cherry Road

Rockville, MD 20857

[Members]{.underline}

Sylvia Rodriguez Andrew, Ph.D., J.D.

St. Peters and St. Joseph Children\'s Home

919 Mission Road

San Antonio, TX 78210

Don Coyhis

Substance Abuse Prevention Advocate

6145 Lehman Drive

Colorado Springs, CO 80918

Paul J. DeWispelaere

President and CEO

PRIDE Youth Program

4 West Oak Street

Fremont, MI 49412

Sue Rusche

President and CEO

National Families in Action

2957 Clairmont Road #150, N.E.

Atlanta, GA 30329

Mitchell E. Sahn

KJMC-LLC

775 West Park Avenue

Long Beach, NY 11561

IN ATTENDANCE:

Alan H. Shinn

Executive Director

Coalition for a Drug-Free Hawaii

1130 North Nimitz Highway, Suite A259

Honolulu, HI 96817

Judith S. Tellerman, Ph.D.

Clinical Professor

University of Illinois

College of Medicine

2020 Lincoln Park West #38J

Chicago, IL 60614

[Ex Officio Members]{.underline}

Charles G. Curie, M.A., A.C.S.W.

Administrator

Substance Abuse and Mental Health

Services Administration

1 Choke Cherry Road

Rockville, MD 20857

[C O N T E N T S]{.underline}

PAGE

Welcome and Opening Remarks

Dennis O. Romero, M.A.

Acting Director, CSAP 5

Discussion and Follow-Up from Day 1 5

Office/Division Updates

Donna M. Bush, Ph.D., D-ABFT

Acting Division Director

Division of Workplace Programs, CSAP 19

Discussion 48

SAMHSA Administrator\'s Remarks

Charles G. Curie, M.A., A.C.S.W.

Administrator, SAMHSA 49

Discussion 61

Office/Division Updates

Mike Lowther

Director

Division of State Programs, CSAP 67

Discussion 75

Kevin Mulvey, Ph.D.

Acting Director

Division of Systems Development, CSAP 83

Discussion 91

Council Roundtable Discussion 96

Closing Remarks

Dennis O. Romero, M.A. 131

[P R O C E E D I N G S]{.underline} (9:05 a.m.)

MR. ROMERO: Good morning, folks. I\'d like to officially bring this
meeting to order. It\'s 9:05.

I would like to welcome back the council on our second day of the CSAP
National Advisory Council meeting. I hope you had a good evening last
night and hope you had a chance to network, share some food, and have
some good discussions.

I\'d like to ask the council if there are any questions from
yesterday\'s proceedings that you would like some additional information
that we can work on throughout the day to provide that information.

MR. DeWISPELAERE: I wanted again to clarify with the SPF SIG states that
were move forward and the tribes. Do they all receive the same amount of
money?

MR. ROMERO: The funding issue has not yet been determined right now, but
that is a programmatic decision that will take place. The ultimate goal
is to ensure that there\'s a level of equity and fairness in the
distribution of the funds across states, territories, and tribal
organizations. That exact amount has not been determined. The Deputy
Administrator and the Administrator have not yet concurred with the
recommendations.

MR. DeWISPELAERE: Well, the reason I bring that forward is I travel all
over and I\'m always looking at SAMHSA\'s image, and what we say, we
should do. I\'ve heard the Administrator same numerous times that we\'re
going to be at 40 states this budget year. I\'m not very sure of the
math. That\'s why I have a finance manager. But my numbers that I looked
at certainly didn\'t indicate, as a matter of fact, with the states
anything close. I just think that that\'s going to come back to haunt
not only SAMHSA\'s image but what you guys have done such a good job of
doing over the past three or four years, doing what you say you\'re
going to do, and I have major concerns with that.

And maybe that\'s something that we won\'t be able to determine until
the programmatic issues are settled, but I felt like, as I thought about
this last night and I work so close with the states and I know how these
folks are counting on certain things, that this is going to be a real
issue for the organization.

MR. ROMERO: Jay, I will assure you that we\'re going to do everything we
can to reach our goal of 40 SPF SIGs in states across the nation.

MR. DeWISPELAERE: For this budget year?

MR. ROMERO: Well, that\'s what we\'ve been proposing and that is our
intention and that is our goal. If there\'s additional happy news, I
will personally call you.

MR. DeWISPELAERE: Thank you. I can see as soon as word on the street
hits about this ‑‑

MR. ROMERO: We\'re going to try.

MR. DeWISPELAERE: I know Alan can understand that too coming from that
area. These folks right now really need this money.

MR. ROMERO: Absolutely.

MR. DeWISPELAERE: The population that they\'re serving is so critical.
Most of the states that we work with are experiencing real issues at the
state level on funding, and it\'s going to hurt the field.

MR. ROMERO: I cannot agree with you more.

In the internal performance evaluation process that\'s held internally
for staff and for myself, that is the target that I\'ve given myself to
be measured with respect to my performance for this year, is to ensure
that we reach the 40-state SPF SIG target. So, believe me, I\'ve got
personal interests, as well as the commitment to get it done from
several fronts.

MR. DeWISPELAERE: Thank you, Dennis.

MR. ROMERO: But I will be more than happy to make that call to anyone
else who would like to get that call from me. I make that available.

MR. DeWISPELAERE: Well, you\'ve got my cell phone. Call me any time of
the day or night.

MR. ROMERO: For the record, I have your Blackberry because that\'s how
we\'ve been communicating.

MR. DeWISPELAERE: Right.

MR. ROMERO: Are there any other questions? Yes, Mitch?

MR. SAHN: I just wanted to amplify what a great session we had yesterday
with the grant review. I felt that we added a level of transparency, and
we were able to really take a hard look and go beyond our fiduciary
responsibility and ask some difficult questions. What I\'m terribly
happy about is the answers and the level of candor and honesty that the
staff provided in answering some of these questions. What I particularly
admire is if you didn\'t know something, you went and found out. You
didn\'t give a half answer or, for lack of a better phrase, an
artificially created answer. You gave what you knew and if you didn\'t
know, you went out and found out. I think that that\'s very impressive.
So thank you.

MR. ROMERO: Thank you, Mitch.

I\'m of the opinion that you\'re only as good as the people you surround
yourself with, and I am surrounded by very talented, well-seasoned
individuals within CSAP and certainly within the senior leadership team.
I look to them for advice.

As I said both in my confirmation speech and also in my remarks to the
Administrator when I first came on board, I acknowledge that no one has
to teach me about prevention. No one has to teach me about mental
health, and no one has to teach me about substance abuse treatment. What
I do need help with, less now than before, is how to navigate through
the federal systems and understanding the protocols and procedures to
ensure that we\'re on time, that we don\'t fall through the cracks on
issues that will impact the day-to-day operation of the center.

So to that end, I commend the senior staff who really have provided me
with wonderful information with great insight to the process. So this is
the only way that I know how to do business and I expect to continue
following that format.

Any other questions, comments?

MR. SHINN: I just want to go back to Peggy Quigg\'s excellent
presentation of the Division of Community Programs that we had
yesterday, the follow-up with CADCA and whether the council was in favor
of inviting CADCA to come and present on their training institute, and
also the evaluation part of the drug-free communities would be of
interest to me. Is it Battelle that has the evaluation? Okay. Something
where we could learn more about how all this works together.

MR. ROMERO: Sure. Yesterday I had an opportunity to talk to Alan a
little more about this, and I encouraged him to make his request known.
Though he did it privately with me, I wanted him to also make it public
for the rest of the council and for the public at large. This is your
meeting. Although I\'m getting into my speech for this afternoon, this
is your meeting and, therefore, you guide the direction of this meeting.

I think from a programmatic standpoint, Alan\'s recommendations I think
are very valuable ‑‑ and I would hope that the rest of the council sees
it in the same light ‑‑ that at the next face-to-face council meeting,
that you have a presentation from some of our prevention partners so
that you can also hear where our prevention partners are from and what
they\'re doing and how that really further supports, enhances, and
encourages the field of prevention, CSAP, and the community at large.

One recommendation that Alan mentioned was maybe having a presentation
from CADCA who is a major prevention partner of CSAP, and I think
another point of interest for Alan was the drug-free communities
initiative which is now overseen, to some extent, here at CSAP, but it
is a collaborative, joint effort with ONDCP from an administrative
standpoint. So we can certainly do those two, which are two large ‑‑ I
would consider them to be large ‑‑ presence here with CSAP.

I encourage the council to think of other ideas, recommendations, items
to add to the list. Certainly if time does not permit to be able to
fulfill all of your requests, we can certainly add them to the list for
future council meetings so that we always have not just updates from
CSAP ‑‑ but also there\'s a balance between updates from CSAP ‑‑ but
also updates from the field as well. I think that would certainly
enhance your end strength and your position as NAC members to learn what
else is going on in other parts of the country with respect to
prevention. I would hope that that would further strengthen your toolbox
as you make recommendations to me.

MR. DeWISPELAERE: I would really like to see one of our states that are
in the SPF SIG process come in and share with us because I hear all
kinds of war stories when I\'m out there about some that are doing real
well and others that are really struggling. I\'d kind of like one in
between that\'s working hard because if that works like it\'s designed
to work, it\'s the best thing to come to prevention in 30 years. So I\'d
be interested in hearing from one of them how is that process truly
going, not coming in here blowing smoke. But I\'d be really interested
in that.

MR. ROMERO: Absolutely. Thank you, Jay. That\'s a wonderful
recommendation.

I\'m of the opinion that we do not have the resources anymore or the
time to keep reinventing the wheel across this nation. We need to learn
from our best practices, take the approach of lessons learned from those
states that have done well, those communities that have done well with
the SPF to come in here and report to us and tell us how they struggled,
how they identified the problems, how they overcame their problems, and
how they are now succeeding. This could be a way to also encourage other
newly established SPF SIG states and communities to really look at those
who have already gone before them and struggled to get to the point
where they are. So that\'s a great recommendation, Jay.

MR. DeWISPELAERE: Thank you.

MR. ROMERO: Sue?

MS. RUSCHE: To that end, I don\'t know a lot about this, but I know just
enough to want to know more, and that is that there\'s a gentleman named
Ken Stark in the State of Washington. I don\'t know if that\'s a SPF SIG
state or not. But he has convinced the state legislature to consolidate
a great deal of funding, hundreds of millions of dollars, into a
prevention and treatment effort. He\'s going to come and present at the
Addiction Studies Program for state legislators in September. I think he
might be a very interesting and to come before the council as well and
begin to pay off on the investment of the SPF SIGs. There\'s a model
there we need to know more about.

MR. ROMERO: First of all, yes, there is a SPF SIG in Washington. I would
encourage, if you think of other folks also, this is not the only time.
We have been sharing emails. You have my number. I certainly have your
numbers, and if we can share any ideas you have of what else we could
add, we\'ll add this to the list as well.

Mitch?

MR. SAHN: Is this the appropriate time to talk about things that might
be helpful in our review of contracts, the types of, I guess, variables
that might be ‑‑

MR. ROMERO: Can we table that for this afternoon, if that\'s okay,
because that\'s one we really will be able to address a lot of issues. I
will make sure that this is the first thing we discuss.

MR. SAHN: Okay, thanks.

MR. ROMERO: Any other questions or thoughts?

DR. ANDREW: I\'ll wait until the afternoon.

MR. ROMERO: Great.

I\'d like to provide you with a bit of information. Per yesterday\'s
comments and discussions, Sue Rusche made a comment and a request, if
she could see a copy of the PRNS budget. To that end, you are getting
now for the whole council a copy of the PRNS, which is the Programs of
Regional and National Significance.

MR. DeWISPELAERE: Well, the budget is pretty small.

MR. ROMERO: It\'s a one-pager. We try to keep it down here.

MR. DeWISPELAERE: I thought Peggy had a tough job. This looks pretty
easy.

(Laughter.)

MR. SAHN: It\'s the minuses, Jay. Minuses always make it easier.

PARTICIPANT: Making things simple is always harder than making things
difficult.

MR. DeWISPELAERE: I like how she operates.

MR. ROMERO: And then the second item that was brought up yesterday was
some request of some particular publications. So I would like to just go
over the names of those publications and let you know that you will be
getting them. Every one on the council will be receiving them very
shortly.

The first is a publication called \"Three Curricula on Cultural
Competency,\" \"Risk and Protective Factors by Gender,\" and
\"Sensitivity of CMI Measures to Ethnic and Gender Differences.\" Those
were the three.

Are there any other requests?

MS. RUSCHE: You had mentioned I think when we were having lunch ‑‑ I\'m
not sure when it was ‑‑ the letters that you sent out to the states that
you thought the council had gotten a copy of that we had not.

MR. ROMERO: Yes.

MS. RUSCHE: Could you add that to the list?

MR. ROMERO: Sure. Who did not get the copy of the letter that I sent out
to all the SSAs?

MR. DeWISPELAERE: I didn\'t get it.

MR. ROMERO: We\'ll make a copy. There are two letters actually. One is
an introductory letter from me to all of the SSAs and NPNs, as well as
our prevention partners, and the second letter was a letter from me to
all of the SSAs further clarifying the revised NREPP status.

MR. DeWISPELAERE: That\'s a very important letter.

MS. RUSCHE: Yes, it is. I\'d like to see that.

MR. ROMERO: Sure.

MR. DeWISPELAERE: Your other one is important too.

MS. RUSCHE: Thank you for the budget.

MR. ROMERO: Your welcome.

Jay, I truly got your number. Okay? Just for the record.

(Laughter.)

MR. SAHN: Jay, I think you should switch your number now. Go unlisted.

(Laughter.)

MR. ROMERO: I am the one who should go unlisted actually.

(Laughter.)

DR. TELLERMAN: I don\'t know if this is the right time to bring it up,
but one of the prevention partners, when we used to have that, told me
that they used to get an invitation and a notification from us saying to
please come to the public part of our NAC meeting and they haven\'t been
getting those. That just would alert them, to remind them to drop by for
opportunities to network. So I wasn\'t aware that they used to actually
get a separate either letter or some sort of invitation.

MR. ROMERO: Yes. This was brought to my attention I think it was either
yesterday or the day before. To that end, I\'ve met with both Peggy
Thompson and Tia in the Office of OPAC where issues for the NAC are
involved. Moving forward, we will certainly do that. It will be my
responsibility to update both Peggy Thompson and Tia Haynes on the list
of either new prevention partners that I make in my travels, as well as
those prevention partners we\'ve had well-established relationships with
prior, to ensure that they also get sort of a reminder notice, a \"save
the date\" kind of thing, and let them know when we\'re having council
meetings. We\'ll make sure that we do that.

DR. TELLERMAN: The other thing that has lapsed is that we used to have a
meeting for the prevention partners that would be attached to one of our
meetings, like if we were at CADCA, then we would also have an extra
session with the prevention partners. It used to be that two of us were
assigned to that. They were like subcommittees, and two of us would be
assigned to that meeting. Wherever that was held, we\'d go to that.

MR. ROMERO: Let me look into that as well and see how we might be able
to coordinate that second piece. The first piece, I assure you, we will
make sure that all of our prevention partners learn and are aware when
we\'re hosting and when we\'re having a national advisory council
meeting.

MR. DeWISPELAERE: I would be glad to host that partners meeting at our
conference in April, or you can host it somewhere else. That\'s just an
offer on the table for you.

MR. ROMERO: Well, thank you.

MR. DeWISPELAERE: We\'ve done it before. I think it was about three
years ago. I\'d be glad to do it again.

MR. ROMERO: Thank you, Jay. Then we\'ll need to have some conversations
and look at the logistics of that. That\'s great.

This is what the council is about, what just transpired, getting
suggestions, giving direction, and also throwing in recommendations as
to how to facilitate the process. So it\'s got to be a give and take
from the council, and I appreciate that. We truly are headed in the
direction that I believe will continue to strengthen the role of
prevention and CSAP.

A point of housekeeping. I would like to just remind you that for the
rest of this day you are going to be hearing from the rest of our
division directors. I hope that you find them interesting and that you
ask questions. If you don\'t have a question, come up with a question.
Grill them. Just make them sweat because they\'re so good at what they
do.

MR. DeWISPELAERE: Especially Mike.

MR. ROMERO: Especially since they know their stuff so well. I can\'t
grill them anymore. So I am asking your help to help me grill them.

MR. SAHN: Can we bring back the people that presented yesterday?

(Laughter.)

MR. DeWISPELAERE: We were being nice yesterday.

MR. ROMERO: We were just warming up.

But in all seriousness, there\'s a lot of information that they will be
providing you today. It\'s very important for me ‑‑ it\'s extremely
important for me ‑‑ that you know what we are about and what we do
because that\'s how you make your decisions. So I\'ve asked all of the
division directors, including Peggy Quigg and Peggy Thompson who
presented yesterday. I gave them the things that I thought were the
highlights and then asked them to include anything else that they felt
was appropriate. Obviously, they both did yesterday, and I know that
folks today will also do the same. So this should be a very interesting
day.

I would like to invite first Dr. Donna Bush, who will be presenting on
behalf of Bob Stephenson, who is the Director of the Division of
Workplace Programs. Bob Stephenson could not be here today for personal
reasons, in fact, yesterday or today. So luckily we have the Acting
Director who is able to present to us. Donna?

DR. BUSH: Thank you so much, Dennis.

Good morning. I\'m very happy to be here with you this morning and share
the updates and information with you about DWP, where we are, what
we\'re about, what we\'re doing these days.

We\'ll start with the organizational changes. As you know, it\'s been a
very successful process and everybody is looking forward to it. Except,
we don\'t want to lose our cartographer because, see, Charles Reynolds
is the guy who does all our map-making, all our geographical information
system. He\'s moving from DWP and taking the entire geographical
information system function to DSD, Division of Systems Development. We
hope he\'s happy there, but he is quite the resource. I want to point
him out by name because he has done so much so many times, and he\'s
always looking to make a new map. So any information you need charted,
grants, contracts, things like that, he can do anything. Especially
during Hurricane Katrina, he spent many long days and weekends here
working with the SERC to plot things and to help provide data to anybody
who needed to know.

He\'s also working and loving working on the HAY tool, Helping
America\'s Youth, the First Lady\'s initiative, and quite frankly, he
for SAMHSA is quite a presence in that and making presentations in
Indianapolis and wherever they need him to be and represents us well and
takes good information with him and brings good information back. So we
will miss him, but I want to make sure that you know that\'s our one
organizational change based on Dennis\' adventurous and successful
reorganization.

MR. DeWISPELAERE: You said that one too many times at meetings. Now you
lost him.

DR. BUSH: Yes, I know. Again, see what happens. That\'s exactly right.
Exactly. We\'ll just make sure that Kevin Mulvey treats him well. We\'ll
watch.

So that leaves DWP. We\'re just a very small powerhouse of a division.
We\'re down to eight people. Bob Stephenson is the Director, me as the
Deputy, and then the drug testing team leader, with three other staffers
on the drug testing team, and Bob\'s Secretary and then our grant
person, Dr. Deborah Galvin. So we\'re small, efficient, energy-filled,
and lots of information-driven, and that\'s what I want to share more
with you. We\'re one down, but not to worry.

So we are the lucky division and the lucky group to have and own and be
responsible for the National Laboratory Certification Program. This is
the program run under contract, full and open kind of bid contract, that
certifies laboratories for federal employee workplace drug testing
programs. And lucky us. We ran such a wonderful program that the
Department of Transportation, under separate law and authority, is
required to use these forensic laboratories for their workplace drug
testing.

So over the course of a year, we test about 6.8 million specimens in our
certified laboratories. Each one we ensure is an accurate and reliable
test. But only about 200,000 to 400,000 of those are actually specimens
from federal employees or job applicants.

So we have a lot going on with that program run under contract. We\'re
in the third year of five years, a one-year contract with four option
years kind of deal. We\'re finishing up the third year of that.

In addition to doing the urine drug testing side of things, which is
what the public law and executive order started with back in 1986 and
\'87, we have out an additional proposal looking at including
alternative specimens and matrices, different ways of testing biological
specimens from workplace drug testing. That\'s still out there and
we\'ll just keep updating you as the committee meets just to let you
know what\'s going on with that.

MR. ROMERO: Excuse me, Donna. Just for a point of clarification, is the
laboratory certification program just for federally recognized programs
or is it also for the private sector?

DR. BUSH: At the very beginning with then-President Reagan\'s executive
order, he established this program especially, certainly, and
exclusively for federal employees, but then finished his sentence
saying, this should be a model for the rest of the nation. And so it has
become.

That\'s how the Department of Transportation, looking at a program ‑‑
you prepare, present, and deliver an accurate and reliable drug testing
program. Congress took note of this and constructed Department of
Transportation\'s law that covers the regulated industries like airline
pilots and 18-wheeler truck drivers and school bus drivers and trains
and Coast Guard and all and required those industries to use the
services of these certified laboratories, but then the rest of the
country and the private sector also took advantage of this program.

So that was a long answer to your question, but yes, initially prepared
and presented for the federal employees, expanded to federally regulated
industries, and then expanded even more and continues to expand today to
private sector companies.

Yes, ma\'am?

MS. RUSCHE: So when we do our pre-employment drug testing in our shop,
are your laboratories what see those specimens and decide whether
they\'re positive or negative?

DR. BUSH: Well, that depends.

MS. RUSCHE: It depends on where our company sends them.

DR. BUSH: Yes, exactly. That\'s exactly right and that\'s exactly how
that entire process is determined, what labs are chosen, what contract
requirements are included in testing programs such as you reference.

MS. RUSCHE: Thank you.

DR. BUSH: All right. In addition to that, another part of our division,
another prong of the division, is again to focus on the federal
employees and the federal agencies and the federal Drug-Free Workplace
Program. Now, we coordinate requests from federal agencies to modify
their plans. At the beginning of time of this program, every agency was
to put forth a plan, and then Congress had to get a report on that plan
and is updated on these routinely.

So when you look at employers who use this program for drug testing,
these labs certified for drug testing, we have essentially 120
employers. That\'s approximately 120 federal agencies, and each agency
has to have a plan that covers many things in addition to drug testing.
But we are in touch with them all the time. Again, we\'re on speed dial
for a lot of them and have primary agency liaisons that we work through
and with and answer their questions because that\'s literally the first
line in all of our performance appraisals, to work with the federal
agencies.

In particular, we\'re working with the Department of Homeland Security
to plan and implement their Drug-Free Workplace Program. This is a big
agency, and this is a plan that\'s going to cover about 180,000
employees. These employees come from different agencies that had their
different plans in place. So this is an ongoing, developing major
project to get a plan together that covers so many individuals. And
that\'s a prime example of a lot of time and energy that we put into
working with the agencies and their plans.

Then we\'re not just available by speed dial and telephone and Internet,
but we also do plan and visit federal agencies to review the operations
of their Drug-Free Workplace Programs because we want hands on. We want
to evaluate. We do this every few year. We can\'t do all, nor do we want
to, nor do they want us in their shop every year, and that\'s not
necessary, but rather to put it on a several-year kind of cycle where we
select certain agencies and then go in and take a look at their plans
and evaluate them, provide any training and assistance and teaching and
help that we can do and also recommendations for what they need to do
both from an Office of Personnel Management level and get Department of
Justice involved if they have questions about testing designated
positions, how their agencies are changing shape.

Not everyone in every federal agency is drug-tested. So while everyone
is subject to the Drug-Free Workplace plan, there are individuals
designated to be in drug testing positions, and that changes as
agencies\' missions change. So we are available to help them with that.

Now, we have our Workplace Helpline, 1-800-WORKPLACE. This is an
in-house contract individual who works in our division so that he can
gather answers to any questions and information necessary to move on to
the inquirer, and he\'s just there pretty much. He\'s got a lot of
background in substance abuse over the course of his previous
experiences in life, what he did before he became the helpline guy of
the moment under contract. And he provides information and teaching and
training and assistance to employers, as well as any other information
he can then gate people to as they need it.

Certainly small businesses call up. People from states call up curious
about state laws. We can, many times, gate them back to the person in
their state who can help answer their questions. Many of them have some
legal and statutory intersection that they really do have to go back to
their state for, but we try to point them in the right direction if we
can\'t provide them the absolute perfect answer. So that\'s about 25
communications per day that we get on that.

MR. DeWISPELAERE: I have a question for you there. Do you want me to
wait until the end?

DR. BUSH: No. Please ask as we go through them.

MR. DeWISPELAERE: We work with a lot of different states and we work
with their workplace divisions within their states. How connected are
you to them?

DR. BUSH: What we use is pretty much a master book that\'s put together
by the ‑‑ let me just think about this ‑‑ Institute for a Drug-Free
Workplace. This is a set of two large books that they update every
couple of years. That lists state liaisons and points of contracts in
the states and Departments of Commerce because many times this is
commerce issues. So if your folks ‑‑ and I don\'t know if every one of
those is listed in those state books, but if they are, then we certainly
have those names and numbers.

MR. DeWISPELAERE: My question was more at the state agencies that run
workplace ‑‑ in a couple of the states we work in and one in particular,
they\'re doing great work in the area of drug testing and being familiar
with this. The other one ‑‑ and I\'m not going to name states ‑‑ is
doing hardly anything, and I think it\'s because of lack of information,
not lack of desire. I just wondered how you connect the dots to those
agencies in the state to improve that to get them more on board with all
the other things that we\'re doing.

DR. BUSH: When you say state testing, do you mean for state employees?

MR. DeWISPELAERE: State government.

DR. BUSH: State governments?

MR. DeWISPELAERE: Which would be both, similar to what you\'re doing
here.

DR. BUSH: We rely on call-ins to us and we get them not just through the
Helpline, but many times there will be a state law on the table that
they want to talk about.

MR. DeWISPELAERE: So you wait for them to call you.

DR. BUSH: Yes.

MR. DeWISPELAERE: You don\'t call them necessarily.

DR. BUSH: Right, not necessarily. But we\'d be more than happy to take
any intersection, any list of folks that we could network with. We\'d be
more than happy to take that.

Yes, sir?

MR. COYHIS: Do any of the tribes use the service, do you know?

DR. BUSH: We get calls from tribes and we have worked with tribes. I can
guarantee you it\'s not every one because we\'re not set up to outreach
to everyone.

But I am confident that we are very well known. This program has been
around for a long time. We have a very large Internet presence, which
I\'ll talk to you about later, and we\'re easy to reach once somebody
even has an idea about a drug-free workplace. If you Google \"drug-free
workplace,\" you will find that SAMHSA\'s website, DWP, and CSAP, comes
up very high at the top of those lists. So we\'re very happy with that.
I think a lot of it is because our website presence that is so navigable
and so full of information.

MR. SAHN: I\'ve heard that you also do a fair amount of retesting or
appeal work, you know, when somebody contests a positive outcome.

DR. BUSH: For a federal employee now, this where our authority lies. But
it\'s spelled out in great detail what opportunities an individual does
have to have their specimen retested at another certified lab because
we\'re talking about a single specimen collected in time, not one two
weeks later, but that one collected at that moment. There\'s a lot of
detail in our mandatory guidelines that was published in the Federal
Register. That\'s our rule book, and then every agency has a plan based
on that. So, yes, we do.

MR. SAHN: Right, and I was impressed with that, with the protocol for
appeal. I think that adds a lot of validity to the test procedure.

Where do you stand with hair testing now or is that ‑‑

DR. BUSH: No, no. That\'s further back actually. That was a part of the
proposal that was put out April 13th, 2004, that slide I referenced back
to the proposed revisions published in the Federal Register. It\'s been
an ongoing process to evaluate the public comments that came in and then
to continue to evaluate the science as it has evolved. This is a
burgeoning area. I think our Federal Register notice stimulated a lot of
interest in the science behind the interpretation of the drug test
result.

Quite honestly, it\'s very easy for us to get an accurate and reliable
drug test result. We\'re fairly good at this. We\'ve been doing it since
1988. We\'ve been to the Supreme Court on various challenges many times.
We\'ve been used as a model, and it\'s a system of checks and balances
and a systematic approach to each and every specimen, whether it\'s a
negative or positive result, be just that and stand on its own from
every laboratory.

We can get you that result on pretty much any specimen you want to
collect, but how do you then interpret that result? Is there an
alternative medical explanation for the presence of a drug in a
specimen?

I\'m presuming you all know the poppy seed issue, looking at opiates.
One example in particular, our federal program was designed to look at
illicit, illegal substances, they being cannabinoids, cocaine,
phencyclidine, PCP, opiates focused on heroin, and amphetamines.

But the opiate class of compounds has been very challenging, the most
challenging to us, over the years because we\'re looking at morphine and
codeine and the heroin marker that\'s called 6-acetyl morphine. Just let
it be known as the heroin marker. But morphine and codeine don\'t just
come from ingesting heroin, but the little opiate poppy plant also
provides those infamous little poppy seeds. So those same poppy seeds
that come out of the poppy plant that\'s used to make the heroin are in
our foodstuffs, and not all poppy seeds are created equal when it comes
to the concentration of these compounds in them. Who knew? Little did I
know I\'d ever have to study that, but nevertheless, we\'ve got to
exclude poppy seeds as the reason why a drug test is positive.

We also have to look at medications containing codeine like your Tylenol
No. 3, Tylenol No. 4, Fiorinal with codeine. So we have a whole lot of
other things going on below the radar. We need to make sure they stay
below the radar because we\'re looking at heroin. That\'s what we\'re
interested in. And then morphine and codeine when in it\'s in
exorbitantly high concentrations and no one has a reason why it got into
my urine. Then we have to also take action.

So other drugs are fairly straightforward, marijuana, cocaine, PCP,
usually very straightforward. But the opiates are difficult.

So we can analyze here for you and we can find the morphine and codeine,
but we want to make sure that we know what that means. Could that be
poppy seed?

MR. SAHN: I have to tell you the poppy seed example seems like it should
be a \"Seinfeld\" sketch.

DR. BUSH: It was and we can talk offline about that.

MR. SAHN: Really?

DR. BUSH: Elaine and poppy seeds, yes.

DR. TELLERMAN: Are you saying that the same people that export poppy
seeds are exporting heroin?

DR. BUSH: Not at all, not at all. Poppy seeds come in your little
McCormick\'s jar, your spice jars, whatever.

DR. TELLERMAN: They come in bagels. But the thing is like if they\'re
from the same poppy, then isn\'t that poppy also being used for heroin?

DR. BUSH: Other poppy plants in other parts of the world are being
harvested exclusively to make heroin. They\'re not interested in the
poppy seed commercial market. They\'re interested in the illicit drug
market.

DR. TELLERMAN: So the heroin comes from a different part of the plant.

DR. BUSH: Yes, it does. This is merely just the little seeds of the
plant. The rest of the plant is used. The flower is used.

I didn\'t mean to take this down this road, but here we are.

(Laughter.)

MR. DeWISPELAERE: You lost me at the poppy seed thing.

MS. RUSCHE: Do the drug tests also screen for other opiate derivatives
like Oxycontin, which is a big problem now in our country?

DR. BUSH: No, they do not. Our federal program is looking at illicit,
illegal drugs. Really, a urine drug testing program is difficult, if not
impossible, to set up for medication compliance. Our executive order and
public law at the beginning ‑‑ remember, this was a program whose
authority is based back in 1986. Oxycodone and Oxycontin wasn\'t even
thought about back then. So that\'s a prescription drug and that\'s
really not covered. That\'s not the authority under which this program
operates. We don\'t look at diversion of prescription medications or
taking three or four times too much of the drug. A urine drug program is
not going to get you there easily.

Yes, ma\'am?

DR. TELLERMAN: Does your program cover the U.S. Post Office?

DR. BUSH: The U.S. Post Office is a quasi- governmental agency. They\'re
not a federal agency, but they\'re under the auspices ‑‑ they report
somewhere to some other part of the government that doesn\'t make it a
federal agency. But the happy news is, yes, they do use our program.

MR. SAHN: Are you getting a lot of other people\'s mail?

(Laughter.)

DR. BUSH: Well, I guess that was good.

MR. ROMERO: Absolutely. Anything to clarify and educate and further
raise the bar of our elite council is a plus.

MR. DeWISPELAERE: That will teach you guys to ask any more questions,
won\'t it?

DR. TELLERMAN: I\'m concerned that when I eat poppy seeds, I\'m getting
high. Now I\'m going to worry about it.

DR. BUSH: Actually, believe it or not, a study was done on that because
we had to find out. Years and years ago this was done by the military
who also has a very aggressive and very similar drug testing program.
The civilian program was modeled on that. They say that there\'s no free
lunch, but actually the military lab director at the Tripler Army
Medical Center did buy many different poppy seed products from poppy
seed bagels to poppy seed strudel where you\'re going to have an awful
lot more poppy seeds and asked his lab staff, do you want to volunteer
for a free breakfast, free lunch for a couple of days, and they did. And
nobody got high no matter what they ate.

MR. SAHN: So the strudel connection is ‑‑

DR. BUSH: No strudel connection.

MR. ROMERO: I am so glad that the technical language and the concern
that I\'ve had for a long time is now resolved.

MR. SAHN: And I have to comment the world is now safe from strudel.

MR. DeWISPELAERE: I want to hear Mike get into the science aspect of
things when he does his report.

DR. BUSH: Now I want to get into our Young Adults in the Workplace
grants. I think you\'ll really find this very interesting, and this is a
great update.

It\'s a multi-site, multi-protocol kind of project, collaborative among
multidisciplinary teams studying the effectiveness of workplace-based
substance abuse prevention for young adults in the workplace, aged 16 to
24, and is completing a phase I which was over a two-year period, and
covered approximately 22,300 employees. This was a group of 13 workplace
grants.

We\'re moving into phase II. This is a continuation phase. It will begin
at the beginning of October and we\'ll scale down a bit. It will be four
to six grantees covering approximately 4,000 employees, that will be
funded under this phase II part of the program. Each will be funded to
the tune of about \$300,000 per year for a three-year period.

I can\'t identify for you by name the group yet because the larger group
has been evaluated and winnowed down, evaluated by this cross-site
evaluation team. So they have independently peer-reviewed the larger
group and they\'ve rated them and winnowed them down to the best small
group of grantees, employers with workplaces who are willing to share
completely all the data that we\'re going to need to gather to get a
good evaluation, to have a substantial research design, and set this
small group up for success in the NREPP evaluation project. So we want
the most amount of data and structured in the best way that we can to
succeed through the rest of the process.

Now, the problem is ‑‑ well, I guess you\'ve heard this from others too
‑‑ we have had a reduction of funding, from close to \$2 million per
year on this cross-site evaluation team, who met with these grantees and
shared more current knowledge and helped with the T&A of the group, to
approximately \$180,000 per year, which will reduce the level of work
significantly. But I guess what we need to do best is more with less, or
at least as much with less. So that\'s how we\'re approaching this.

This program really has a great impact because it\'s not just these
employees in the workplace, but rather, this program reaches out into
the community. These are not just the employees, it\'s their family, and
then it\'s the families that are spread across the community. So really,
we get a very big bang for the buck for a small amount of money, and I
think this is going to bear well in the end as the process progresses.

Taking a look at a sample of the early process used in the workplace
findings, looking at those 13 grantees, here are some big picture
findings.

The work culture of the employer is important to new or increased use of
alcohol and other drugs in that hourly workers frequently have intense
social relationships with each other. We found that out through polling
and evaluating what was reported back from those workplaces.

For those 16 to 24, there\'s a high risk of alcohol and other drug use
and involvement, as well as prescription drugs, tobacco, and caffeine.

The young ones have difficulty managing work-life boundaries. Young
adults do not know how to prioritize, too distracted, and don\'t know
when to turn off their cell phones. That could be us too.

Many stress-related symptoms were identified in that Youth in the
Workplace group, some of which were reports of headaches, lack of sleep,
the idea of presenteeism, and the call in sick phenomenon more for a
mental health day as opposed to being really sick.

So what we find is there\'s going to be a need for more training and
education, including healthy lifestyle and financial and time
management, for those youth coming into the workplace.

MR. DeWISPELAERE: I don\'t think any of us fit that age group, but
maybe.

MR. SAHN: Emotionally maybe.

MR. DeWISPELAERE: Maybe Sue or Judith does or Sylvia.

DR. BUSH: Another action that we\'re involved in is our Workplace
website, and I referred to that earlier. We\'re definitely going to have
a reduction in funding, to keep supporting it and updating it and all of
that. We had over 76,000 visitors to the website from February 2006
through June 2006, and the most frequently used pages were the drug
testing and the Drug-Free Workplace.

There are several others. I printed out a copy of it. Just to let you
know, we\'ve got prevention research and interventions. We\'ve got
workplace health, wellness, and safety, and lots of information on the
Young Adults in the Workplace and how to contact us ‑‑ we\'re easy to
get to ‑‑ and then FAQ sheets, e-briefings, Get Fit, lots of
high-powered information on this website.

So we\'re happy and we\'re glad to see it\'s very well used. Like I
said, you put drug-free workplace into Google, and we\'re right up
there. We\'re very happy with that.

I want to show you a copy of this. The bullet says, \"Workplace Online
Kit should be ready in draft form by the end of August.\" Well, okay.
Let\'s go to the next slide because we\'ll talk about that Workplace
Kit.

Now, this is the kit.

MR. ROMERO: Excuse me, Donna. Just for clarification purposes, the CSAP
website, which is within the SAMHSA website ‑‑ DWP is in that section.
Correct?

DR. BUSH: Yes, it is. Absolutely.

MR. ROMERO: So when you say that there\'s a reduction of 40 percent in
funding for the site, that\'s for your portion of the site?

DR. BUSH: It\'s for our maintenance. Actually this is separate and
apart. One of the ways you can get into this Workplace site is
dwp.samhsa.gov. This is separate. It\'s workplace resources is where
you\'ll end up. If you click on workplace resources on the SAMHSA
website or on the CSAP larger home page, this is where you\'ll drill
down to. So this is very much the subset and library of workplace tools.

MR. ROMERO: Just for a point of clarification, one of the things that
we\'re doing, both within SAMHSA and within the federal government, is
we have an intranet, as many of you know, and we have an Internet. On
July 5th, we launched the new SAMHSA website and it\'s moving in stages
of updating. As I said, July 5th was the home page of the new samhsa.gov
site, and it\'s going to go through, I believe, September before it\'s
all complete.

One of the bigger challenges, within SAMHSA, we have many, many websites
and we\'re trying to pull them all together under one that you can go to
basically one site, though you can Google and you can get to the
different portions if you want as well.

So to make it as accessible as possible, one of the challenges for CSAP
in my opinion is I want us to have it again following the same format as
the SAMHSA website so within CSAP you can go to anywhere you want to go,
or you can just Google it and you will get there as well.

So there\'s a number of things that we need to do, but I think if you
get a chance to go to the SAMHSA site, you will see a new look to it. I
think it\'s quite appealing and it\'s been well researched as we
branched out into that one. So just a point of clarification.

MR. DeWISPELAERE: Though necessarily, when their part is cut, it
doesn\'t mean the CSAP Web money has been necessarily cut.

MR. ROMERO: What I don\'t want to do is to completely make one division
be wholeheartedly affected. I\'m of the opinion that we need to share
the wealth and spread the burden. So if we have to reduce in one area, I
want to make sure that it\'s reduced ‑‑

MR. DeWISPELAERE: Equally.

MR. ROMERO: ‑‑ equally so that there\'s no huge impact for one area
alone.

DR. BUSH: Thank you, Dennis.

Let\'s get back to this Drug-Free Workplace Kit. This Drug-Free
Workplace Kit has been around ‑‑ and I picked up a Spanish version on my
way down here ‑‑

MR. ROMERO: Gracias, for the record.

DR. BUSH: ‑‑ in hard copy, in paper copy. This kit has been around for
15-plus years, and it has been a best seller so to speak. Whenever we
go, we take them and they\'re always gone. These take-aways are amazing.
They have an awful lot of information in them, looking at a model plan
for implementing a drug-free workplace. They\'re going to have very
basic employer policies. They\'re going to have flyers on custody and
control forms, on drug testing. There are posters to be posted in the
workplace concerning a drug-free workplace and little stickers and all
kinds of information, pamphlets to be shared with employees. It\'s
really a very complete how-to kit.

We\'ve had tremendous success with it in English for so many years, and
then we translated the paper copy into Spanish. So we have those. And we
have both of those paper documents that have stood so well for so long
on our Internet now, on our website, the DWP website at Workplace
Resources. Click right on it. And we are updating this now in an
electronic way. Certainly there are going to be paper copies that are
going to have updated information, but the wealth of information,
additional, more, better, statistics, additional information, and more
links are going to be included on our Web version that\'s going to be
coming out, we hope, in draft for us to keep working on it by the end of
July 2006 and then post that on the Web. They\'ll have paper copies so
that we can hand them out as take-aways and stimulate interest whenever
we get out and go to places. So we\'ve had great success with it and are
going to continue. We\'re going to make it flower and succeed even more
with our efforts. We\'re going to include a whole lot more stuff.

MR. ROMERO: Donna, would you mind passing it around so that folks could
see that as well? I know they all read and speak Spanish.

DR. BUSH: I apologize. I picked that up on the way down. I meant to stop
by and pick up another one, and I\'ll get one. I\'ll bring one down for
you to see at the break.

MR. ROMERO: And if you would like a copy to take with you, we will
arrange that.

DR. BUSH: Not a problem.

MR. SAHN: This is in Spanish.

DR. BUSH: Yes, it is.

MR. ROMERO: We will certainly get that to you.

DR. BUSH: I\'ll bring them down after we have the break.

It will be much easier for us to keep this whole product and process
updated as we move to the online base.

We\'ve got some research report findings. DWP and PIRE are in the final
phases of publishing a paper related to substance abuse issues of
uninsured and telecommuting workers.

Under review, we\'ve got impact of alcohol testing on fatal impaired
driving crashes of heavy truck drivers, the costs of alcohol-involved
injuries to employers, relationship of workplace substance abuse
prevention programs and injury rates.

MR. DeWISPELAERE: When will that be due?

DR. BUSH: I don\'t know. It\'s in the review process, but we will update
you.

DWP, Econometrics, and PIRE are analyzing older worker alcohol and
tobacco use with measures of quality of life and health. Early findings
indicate that although fewer older workers drink, those who use alcohol
tend to drink more frequently and in larger amounts than might be
expected. So we\'re going to keep going with these projects.

In addition to all of that work that we do do at our desks, we get out
and participate in as many things as we can. Again, Charles Reynolds. I
want to bring that Helping America\'s Youth Conference in Indianapolis
to the front. He did a great job on that.

And then Bob Stephenson has done an awful lot in the spirit of recovery
in New Orleans, Louisiana. He\'s been an active participant and takes a
lot to those conferences and brings a lot back to us.

We have our National Drug-Testing Advisory Board meetings that are
scheduled to be four times a year. We\'ve had two, and again because of
some funding issues, we\'re going to learn how to do electronic meetings
and video conferences. We\'re going to take the next step. The new
SAMHSA building has the capabilities. We\'re going to use them. So
that\'s how we\'re going to learn to convene meetings. Face-to-face is
always good because of all the interaction, the cross-talk and the
networking that can be done, but you\'ve got to do what you\'ve got to
do. It will also allow us to convene meetings sooner in a more
expeditious manner. When issues come up, we can announce them in the
Federal Register and convene them then without the difficulties that
travel just imposes.

MR. ROMERO: I would also like to just bring to your attention that the
Division of Workplace Programs is the only division that we have a
separate advisory council outside of the NAC, and that is because of the
unique role and leadership that the Division of Workplace Programs
presents at the national level.

The decision to reduce the frequency of the meetings was a budgetary
decision based on what the budget looked like when I first came on board
in the beginning part of this year.

But one recommendation that both Bob and I came to agreement on was,
well, we can reduce the amount of face-to-face, but that does not mean
we have to reduce the amount of communication. Therefore, having
teleconferencing or videoconferencing will continue. We will actually
enhance that. Therefore, when we do have the face-to-face meetings, they
will be very clearly orchestrated so that they are addressing the points
that have been addressed throughout the teleconferencing and
videoconferencing sessions so that it could be a more robust and,
hopefully, a very enthusiastic and productive session.

Thank you.

MR. DeWISPELAERE: Thank you, Dr. Bush.

DR. BUSH: We\'re looking forward to doing all of that.

The charter for our Drug-Testing Advisory Board is up on our website. We
have an interesting group because this is all techie types, lab
directors, forensic experts, academicians, those of us who do real
forensic science. And I\'ll just leave it there.

So we have a commitment to get out and do well for CSAP when we get out.
We have lots of opportunities and we\'re happy to do that. So there\'s
your list and plenty more if you want to talk about it.

MR. SHINN: I just had a comment. I like the translation. I don\'t read
Spanish, but certainly I would recommend that you look at Asian
languages because we know that especially immigrant Asian Pacific
Islanders are small business owners, probably under 50 employees. While
they all say, well, we speak English and they do, when they get together
in their own cliques or with their own people, they revert back to
speaking their native language. That\'s Korean Americans, Filipino
Americans, Cambodian Americans. So I think having that information
available to them in their native language would be a great asset,
although I keep seeing that 40 percent cutback in your budget. I\'m sure
Dennis can do something about that.

DR. BUSH: He does the best he can. I promise.

MR. SHINN: But I think that issue should be looked at, that at least
select materials be translated and be made available.

MR. ROMERO: Absolutely. We cannot forget who our targeted audience is,
number one. Number two, if we truly are serious about prevention, we
need to make sure that it\'s culturally sound, culturally specific, and
that it targets the population that we\'re trying to reach. So I take
your recommendation as a confirmation to really pursue that even more
so.

DR. BUSH: Well, that\'s all I have.

MR. ROMERO: Are there any questions or clarifications? Sue?

MS. RUSCHE: I do have a quick question. There\'s increasing interest in
school drug testing programs. Do your laboratories and does your
division have anything to do with school drug testing or is that a
different creature altogether?

DR. BUSH: It\'s a different creature altogether, but certainly the
laboratories that we certify for workplace drug testing do extend over
and do school drug testing. They\'re definitely involved. They have
technical expertise and they do take it to the schools for the school
drug testing.

MS. RUSCHE: Is there a list somewhere of all the laboratories that you
certify?

DR. BUSH: There is. There are 49 labs and it\'s on our website.

MS. RUSCHE: Great. Thank you very much.

DR. BUSH: And it\'s updated monthly as we publish that list in the
Federal Register.

MS. RUSCHE: Fabulous. Thank you.

MR. ROMERO: One more question, Judith.

DR. TELLERMAN: Just thank you very much.

MR. ROMERO: Thank you, Donna. You did wonderful.

If there aren\'t any comments or questions, on our agenda, we will break
for 15 minutes. I ask that everybody please be here. I\'m sorry. Let me
clarify. It\'s 10 minutes. I ask that everybody be here on time. We will
have an opportunity to hear from our Administrator, Charlie Curie.

(Recess.)

MR. ROMERO: For the record, we should officially reconvene. It\'s now
10:40 and we\'ll officially open up the session again.

It is my pleasure and privilege to introduce to you of the council Mr.
Charles Curie, our Administrator here at SAMHSA. He will present and
offer a few remarks and we\'ll have an opportunity for a couple of
questions at the end of his remarks.

MR. CURIE: Thank you, Dennis. I appreciate you stepping into that role
of Acting Director of CSAP. That\'s always difficult. I think being
interim or acting is one of the most challenging things, to be in that
type of position. But I appreciate you stepping into it. Obviously, we
brought Dennis aboard as the Deputy Director of CSAP and he hasn\'t been
able to be in that position a lot because he stepped into this role. But
I want to thank you for that and for your work.

MR. ROMERO: Thank you.

MR. CURIE: Of course, Rose is in the Deputy slot and the leadership is
in her very capable hands. I appreciate your efforts.

First of all, I think too often individuals who volunteer and
participate on national advisory councils ‑‑ and of course, I know most
of you from your day jobs as well and what you do day in and day out for
prevention ‑‑ aren\'t recognized or given thanks and credit for really
helping create a healthier America. Clearly, the efforts of CSAP and the
programs supported by CSAP and the Parent Corps, PRIDE, the coalitions
throughout this country represented by CADCA, the on-the-ground White
Bison ‑‑ I just see so many great programs just represented here.

We should feel very good about the fact that there\'s been a 19 percent
reduction in illicit drug use in this country over the past four years
because it\'s because of the efforts put forth by the field that\'s
contributed to that. I think we need to make sure that that credit is
given in the right places, that it\'s recognized that it\'s the efforts
of many people, and if it wasn\'t for the front-line work going on and
if it wasn\'t for the efforts of the many organizations supported by
CSAP and the hard work of families and schools and parents and
communities and faith-based organizations, we wouldn\'t see this type of
progress.

But we also recognize, while we can celebrate for a moment, that it\'s
critical that we continue to advocate for prevention, continue to make
its effectiveness known, continue to make the case, especially on the
Hill.

I\'m pleased to see the matrix is here in full force. Clearly, the
matrix articulates initially our vision of a life in the community for
everyone. Prevention is absolutely essential for that life to be
realized in the community, a fulfilling life, a life with all the
rewards we all look for, and we\'d recognize that children and youth at
risk need an opportunity for that life. We recognize that people who
have been trapped in addiction need that life and people with mental
illness need the opportunity for that life. CSAP is critical for us
realizing that.

It was interesting. Benjamin Zander, who is the conductor of the Boston
Philharmonic and wrote the book \"The Art of Possibility,\" spoke.
Several in this room had the opportunity to hear him speak a couple days
ago to a SAMHSA constituency group on leadership around addictions. He
talked about vision, and the one thing he said about a vision is it
needs to apply to everyone. I\'m pleased that everyone is mentioned in
our vision. After I heard that, it was very affirming.

I think it\'s important that a vision articulates the ultimate outcome
you\'re looking for in the lives of the people you\'re serving. In order
to realize that vision, of course, there are two elements we
specifically mention in our mission. To realize that vision, we have to
accomplish a mission and our mission is to build resilience and
facilitate recovery. While CSAP is probably the one center that\'s
focused more on the resilience side, it\'s still focused on recovery and
understanding that resilience is part of recovery. I\'m pleased that all
three centers have a critical role in accomplishing that overall
mission.

CSAP has, I think, been able to take advantage of the frame that\'s been
set by the vision and the mission and, again, played a critical role in
helping influence. And you have all helped influence the matrix. The
matrix is our leadership tool that defines the priorities and making
sure we\'re doing the right things, and that\'s what leadership is all
about. Cost-cutting principles is our management focus. Management is
doing things right. So we have both reflected on the matrix, doing the
right things and doing things right. We want to make sure we do the
right things the right way.

Clearly, the Strategic Prevention Framework is the major priority
articulated that is really laid at the very feet of CSAP in terms of
assuring that we have, for the first time, a risk-protective factor
approach based on the science that\'s available to communities
ultimately through the states.

The great news for SAMHSA and for CSAP is that we\'ve been able to be in
the right place at the right time when it comes to being aligned with ‑‑
and, of course, it\'s no accident. My job was always to make sure we\'re
all aligned with the President\'s agenda. When we take a look at the
First Lady\'s initiative of Helping America\'s Youth being an umbrella
program in which federal prevention programs are fit under that, the
Strategic Prevention Framework clearly has been embraced by the HAY
initiative.

SPF is putting into place ‑‑ again, ultimately our plan is to see, by
the time that the \'06 awards are made, that Strategic Prevention
Framework will be in place in over 40 states, also several more tribal
organizations and territories. Again, I\'m a firm believer that SPF will
only work if we give the states and communities the flexibility that
they need, though we need to have clear guidance in terms of overall
what we\'re expecting and we need to give clear guidance in terms of the
outcomes we\'re going to be measuring. Again, those outcomes need to
reflect resilience and recovery. Otherwise, they\'re outcomes that are
irrelevant to our mission.

Again, the framework\'s premise is making sure local people are
empowered to solve the local problems at the same time that they\'re
supported and undergirded with information, state of the science, state
of the art, technical assistance, what our CAPTs and clearinghouses can
provide in terms of supports and in terms of critical types of
information.

When I first came aboard, one of the hallmarks of CSAP was the
clearinghouse. I\'m pleased that today I would say SAMHSA\'s
clearinghouse effort overall ‑‑ and CSAP being a critical element of
that ‑‑ is stronger than ever. We\'re disseminating more information
than ever before. It\'s still user-friendly. People are still able to
draw down. I always turn to people like Sue and to Jay and Don, and also
I turn to folks, Art Dean, for example, and his membership, asking them,
are you still drawing down information you need? I hear from small shops
around this country, so to speak, people in the nonprofit, almost
family-driven types of services and supports of this country, that the
clearinghouse materials are their lifeblood because they don\'t have to
buy them. They don\'t have to create them. They don\'t have to be
looking for them, but we\'re making them available. I think it\'s one of
the best uses of the taxpayer dollar. I always felt it was.

The reason I\'m putting a major plug in it now for the record with this
advisory council and encouraging all of you is it\'s something you need
to continually keep your eye on in the budget process because various
entities such as OMB and appropriations subcommittees ask questions
about things like clearinghouses and question if we have to have to take
budget reductions, where are places you can take them. That always seems
to appear on a list for consideration.

The good news is we\'ve worked hard to make a vigorous defense about how
this is one of the essential, critical roles of the federal government.
If the clearinghouses are cut back or eliminated, we\'re going to see a
lot of services around this country and outreach dry up. I would have
major concerns. So I think it\'s something we want to keep at the
forefront of consideration and be prepared and not take it for granted,
make sure that the case can be made.

As I think all of you around the table know now and everyone in the
room, I have resigned my position as SAMHSA Administrator. As I\'ve
shared before, it was not an easy decision to make. It was one which
took some time evaluating what time is the right time. Again, I\'ve
always viewed myself as a temporary steward in this position. My major
goal has been that when I leave, that hopefully things are going to be
in place that are going to last and have a lasting impact and that will
continue to move forward.

I think what\'s critical ‑‑ and the matrix is one of the tools we use ‑‑
to understand is that the priorities which were established in this
process are not my priorities. They\'re your priorities. They\'re the
field\'s priorities. They\'re priorities on behalf of people whom we
serve. There\'s ownership of these priorities because these weren\'t
things that I just made up out of my mind one day saying, I\'m
Administrator, by golly, this is what I want to see done regardless of
what anyone else thinks, and then for five years staff at SAMHSA has
placated me. It doesn\'t work that way. These priorities are rooted in
terms of data, reality, clear input from leaders such as you represented
in this room. The national advisory councils all leaned in and gave
feedback. When we presented this matrix, we got ideas. I think the
matrix has been a process that has represented a true consensus in the
field around what\'s truly important. That\'s the critical thing.

It\'s not that the priorities on the matrix have anything to do with me
as SAMHSA Administrator and they\'re valid only as long as I\'m here.
They weren\'t valid because I was here. They were valid because they
came of you and from you and they\'re part of you. As has always been
the case, it\'s up to each of us in this room as advocates and each of
the groups represented to press on with making the case for those
priorities and supporting those priorities.

The exciting thing is I do think what we\'ve been able to do these past
five years is gain that clear consensus, to be able to communicate what
truly are the important priorities that help leverage change and that
will help make a difference in the outcomes we\'re able to measure.

As I leave, too, I\'m pleased that we\'ve been able to raise suicide
prevention to the level of the matrix and specifically talk about
suicide prevention. I think suicide prevention is also a great example
of how all three centers collaborate, in particular, CSAP and CMHS.
Again, those centers historically never necessarily locked arm in arm
with issues. Mental health has always struggled with a prevention agenda
for years for a variety of reasons. The good news is I think there\'s a
clear prevention and early intervention agenda in the mental health
arena than ever before. I think CMHS\'s leadership and its partnership
with CSAP has helped shape that. I think CSAP has helped, indeed,
contribute to the mental health field.

I also am pleased that we were able to put workforce development on the
matrix, and I\'m also pleased to reinforce the fact that there are those
of us who have made it very clear that workforce development applies
just as much to the prevention arena, if not more, than to the treatment
arena because many times workforce development takes on more of a flavor
of treatment providers being concerned about their future, legitimate
concerns. That\'s why we have it on the matrix. But we do have a
prevention focus is the good news when it comes to workforce development
and I\'m very pleased that I think we have a structure in place to
finally get real about workforce development.

We just had a conference last week, the first of its kind, that involved
all three centers. If you want to say there are three fields, all three
fields were there with their professional associations, trade
associations, and individual providers. I\'m confident from those
efforts we\'re going to influence academia. We\'re going to influence
the training that goes on. We\'re going to make an impact ultimately on
retention and recruitment.

Also, I\'m pleased that SAMHSA has put forth ‑‑ again, the topic I\'m
going to mention has controversy around it, and when I first came
aboard, it was a topic which SAMHSA and CSAP, in particular, tried to
address years before but got clobbered with getting, I think, about \$50
million taken out of its budget overnight because some folks were
threatened by the position that was being taken. I think it made, to be
honest, folks gun-shy about taking this issue on.

But we took it on anyway, beginning about five years ago, to the point
that now, for the first time, we have an Interagency Coordinating
Committee on Prevention of Underage Drinking. We have I think a real
strategy around addressing underage drinking and plan that\'s a
collaboration of all the federal agencies who touch that issue. And we
have the strong support of the advocacy community that\'s more united, I
think, than ever before on this issue.

I would say one of the critical elements is that we also have the
industry at the table of accountability, as I call it. I know that
that\'s fraught with some of the controversy because there are people
who are leery of the industry. I\'m not shocking the industry by saying
this. I think they sense this from advocates.

But I think the critical thing we have done is we have taken the stand
that all parties, no matter how uncomfortable it is or the recognition
there isn\'t full trust and there might even be mistrust ‑‑ and there is
mistrust ‑‑ at that table, that all parties need to be at that table if
we\'re to make progress in pressing this issue and that we need to take
everyone\'s word at that table to be able to move things forward.

I think the fact that we had the first national conference that the
Secretary kicked off and had the support of Secretary Leavitt on this
very critical issue also helped further unite. I know there\'s a Call to
Action in the works out of the Surgeon General\'s office. That hopefully
will be coming out in the near future. I think all those things combined
together are going to help us finally see the needle move, so to speak,
in terms of underage drinking going in the right direction.

Another reason we\'ve pressed the issue is ‑‑ of course, we celebrated
briefly the 19 percent decrease in illicit drug use. As we all know,
underage drinking has remained stubbornly and persistently about the
same. Binge and heavy drinking, in fact, have gone up among youth. So we
know we need to push back hard on it. That\'s why I\'m pleased that
SAMHSA has been at the forefront in CSAP.

Prevention\'s path I think has been paved. I feel that we\'re actually
at a tipping point to where we\'re not on the defensive as much with
prevention. I think back to my testimonies in front of the
appropriations subcommittee and various forums on the Hill. Five years
ago, the question was consistently asked, does prevention work? And
there are still those who ask that question but more and more the
question isn\'t asked, does prevention work, we\'re making the case it
does work. It\'s like, so what are you doing about it? Which is really
progress.

If we can get members of Congress and we can get, again, the budget
offices and OMB not to just ask the question, well, does prevention
really work, if we can make the case and continue to make the case and
show prevention does work, the question should be, all right, are you
doing the right things? Are you doing what works? Again, those are tough
questions. They\'re questions of accountability, but that\'s, I think,
the next phase we\'re hoping for and I\'m hoping for in terms of
questions.

Then eventually we get to the point of, okay, you\'ve been doing what
works, that\'s great. The outcomes look great. How can we do it better?

Those are some of my thoughts and reflections. Again, I want to thank
you. I want to thank this advisory council for its wise counsel and
support in moving the agenda ahead for CSAP and being there as we\'ve
pressed these issues. Your support, your leadership has been critical.
So thank you.

(Applause.)

MR. DeWISPELAERE: Charlie, as you know, I represent over 20,000 young
people across the country in my day job. And I don\'t have the
reputation of being the most mushy guy out there as well, but I think
it\'s appropriate that I say how well respected you are in the field.
Your leadership has been stellar. There\'s no question about that. Your
results speak for themselves, not just with the 19 percent, but
everything that you put in place. I too believe that a lot of that will
stay in place, and that takes brave leadership.

It\'s been a long, long time on the underage drinking. You and I have
had many, many conversations about that, and I\'ll continue to carry
that torch across the country.

But I know I speak for the thousands of youth when I say you have come
to know them, they have come to know you, and not only do they know you,
but they respect you. I know in the field how important that is. We
don\'t just do this for a paycheck, and I know I simply say on their
behalf thanks for everything you did and you\'re going to be missed.

Thank you, Chairman.

(Applause.)

MR. COYHIS: In our culture in our language, we don\'t have a word for
boss, we don\'t have a word for manager, we don\'t have that. But if you
translate how we describe that, the literal translation says how
strongly this person is respected in the circle in which they walk.
That\'s how in our language we would say boss or leader.

I think in your time here you have opened doors in Indian Country that
we have not seen before. Our people call this \"the basket.\" It has
really strong significance for us because it makes sense. It\'s easy to
explain in our culture. I watched you on the native communities that
some of these doors have been opened since you were here. It\'s very
significant. It\'s kind of like a bridge. You\'ve got to do something on
one side and then from the other side, if the understanding isn\'t
there. But you opened up that door. All of those things include our
culture. It\'s very easy to explain that to our people what is going on
back here.

The second word for a higher-level manager, what they say is not only
that you have been respected in the circle in which you walk, but they
say you\'ve been tested and still maintain the respect. So that\'s how
you\'d say like a senior manager or a leader.

I think that you have left a legacy under some very trying times, and I
think for a long time, people will say your time here will be referred
to as ‑‑ I think more important that you position things that will allow
things to continue and bloom and grow. So on behalf of Indian Country, I
really thank you for all that you did for us. You will always be welcome
to Indian Country. Thank you.

MR. CURIE: Thank you, Don. That means a lot.

(Applause.)

MR. SAHN: Hi, Charlie. My name is Mitchell Sahn. As a former public
official, I want to thank you for making our burden a little bit easier.
Your ability to market the concept of mental health and substance
treatment and prevention has made funding decisions at the county and
state level a lot easier.

I think that you also have taken a fragmented industry, which we
oftentimes are our own worst enemy as we compete for dollars, and built
a framework around it and it has brought people together and developed a
common goal or common outcomes. How we get there will always be a
problem because we\'re basically rebels and unmanageable people in the
field. However, you put us in a box and gave us a structure.

You also in many ways became a mediator. You will able to split the
difference and see through the weeds and focus on the long-term
objective. And I think that that\'s very commendable, and I want to
thank you both on behalf of the field and on behalf of the people who
are public officials.

One last thing. You really motivated me to think about knowledge
management and what you said about the clearinghouse. Knowledge
management is a key to a successful organization, and the clearinghouse
is a good example. But I think it really can be built upon. It\'s
demand-driven, so you\'re getting feedback from the field. It\'s cost
effective. It\'s able, if run properly, to take the science, which we
have plenty of, and translate it into common actionable, salable
knowledge.

I would suggest that the center or SAMHSA consider hiring a chief
knowledge officer or create the position ‑‑

MR. CURIE: And interesting thought.

MR. SAHN: ‑‑ which would combine both the external facing and the
internal knowledge that we\'re able to assimilate, pass on, and market.
So I\'ll put my resume in for that position.

(Laughter.)

MR. CURIE: It sounds like a fun position.

MR. SAHN: Thank you.

MR. CURIE: Thank you, Mitchell. Thank you so much.

MR. ROMERO: Thank you.

Are there any other questions? Judy?

DR. TELLERMAN: Well, I would just like to say ‑‑ hi, Charlie ‑‑ thank
you for everything. Some of the comments here are more knowledgeable
than what I would be able to say at this point. So I\'ll just second
what everyone has said and thank you for everything that you\'ve done.

MR. CURIE: Thank you, Judy.

MS. RUSCHE: No one has spoken for the council, so I\'m going to be so
bold. On behalf of the council, we also want to thank you for all the
leadership you\'ve given our field and this agency.

MR. CURIE: Thank you. I want to say what you\'ve expressed here ‑‑
again, from Jay and Don, Mitchell, Sue, Judy, and all of you ‑‑ it means
a lot coming from you as well. The awesome responsibility that I also
feel ‑‑ feedback in terms of what you said about the youth means a lot,
Jay.

Again, I love the tribes. I love Indian Country and the people. It\'s
been just a major highlight. I\'ve said this time and time again. When
it comes to substance abuse and mental health, the needs are just so
apparent and great in Indian Country that for it not to be a priority of
SAMHSA, SAMHSA would be shirking its responsibility to the nation for
not addressing it. So I see what we\'ve done here as a beginning, to
keep working and working in partnership with IHS and making sure that
Indian Country is strong and healthy along with the rest of America.

Well, thank you. I also appreciate the opportunity one more time to
share the strategy and the matrix, and you guys always have been
patiently setting through those things. I appreciate the idea of the
basket too. That\'s very helpful. Thank you so much. I\'m sure our paths
will cross.

(Applause.)

MR. ROMERO: We will start in a couple of minutes.

(Recess.)

MR. ROMERO: I know that the remaining members will be here shortly, but
because of time, I would like to get started.

I am happy to introduce to you Mike Lowther, who is the Director of the
Division of State Programs. He will provide us with an overview of what
the new division looks like and its efforts as well. So, Mike?

MR. LOWTHER: Thank you. It\'s interesting. I won\'t beat this to death
because you all already know a lot about this. But I was going to
provide you a lens of the State Division.

The vision is a life in the community for everyone and we\'re about
building resilience and facilitating recovery. One of the major things
that I think is important to understand from the prevention perspective
is that the kind of communities that keep people healthy are also the
kind of communities that support people getting well and staying well
when they return from treatment. So it\'s about building communities
that do both things.

Our role in all of this in prevention then really is about being
accountable ‑‑ those are the strategic goals that we have ‑‑ accounting
for money, being accountable to you, accountable to Congress,
accountable to each other about how we spend our money and what we do in
the State Division, building capacity for states to support communities
and being successful and providing states with information they can then
provide to communities about what works and what doesn\'t work. That\'s
the lens through which we see the SAMHSA strategic plan within the State
Division.

So if you think about it in that context, the idea about a life in the
community for everyone is about each individual enjoying a life. What we
really think about in prevention, what we\'re thinking about in the
State Division is it\'s about creating communities in which people have
healthy lives. Our job is building state systems in a way that they will
support communities in creating opportunities for people to have healthy
environments that work in the schools, supportive communities and
neighborhoods, places where people are connected to families and
friends. There\'s no crime. There\'s no ATOD. It\'s a community that
does, indeed, support recovery and foster resilience.

So with that in mind ‑‑ this is sort of context ‑‑ if you think about
it, substance abuse is local. It\'s all local. It\'s like politics. It
really is all local. I don\'t prevent any substance abuse in my office
here in this building. In fact, if you ask the staff, they might suggest
that I create ‑‑

(Laughter.)

MR. DeWISPELAERE: I\'ve heard that.

MR. LOWTHER: Thank you, Jay.

MR. SAHN: Do you have an outcome measure for that?

(Laughter.)

MR. LOWTHER: Yes, but we don\'t want to get into it.

And that\'s true for many of us and many folks at the state level. It
really is what happens at the community that matters and it is about
getting states to figure out how to drive change and support change in
communities so that we get the outcomes that we need.

In that regard, we believe, through the State Division, that every
community needs a comprehensive plan, and it is the state\'s job to
build a prevention system that helps communities develop those
comprehensive plans at the community level. Otherwise, the state won\'t
succeed and we won\'t succeed because it\'s all about outcomes and those
outcomes all come from communities. They don\'t come from my office and
they don\'t come from the state-level office. So that\'s the context for
where we are.

So what we would say to states is that we want the state and us to play
a servant-leadership role together, that is that we lead a little and we
serve a little and they lead a little and we serve a little. It\'s not
top-down. It\'s not bottom-up. It\'s both, that we learn from each other
and we work together to build systems that in a state will create a
prevention system that provides resources, capacities, and tools to
communities to generate the change and reduce problems in substance
abuse.

So our focus then really is we think that gets done best through the
Strategic Prevention Framework, and that\'s a very straightforward
community development, strategic planning process. You all have heard a
lot about all of this. In a very fundamental way, it really is the
answer to five questions. What\'s the problem? What have you got to work
with? What are you going to do about it? What have you done? And did it
work? Those are the five fundamental steps with the five fundamental
questions. I have been known to go on for hours about it, so I\'m not
going to. That really is what we are driving and pushing, that states
use this framework to create their system and that they teach
communities how to use this framework to create their plans so that we
actually wind up reducing substance abuse throughout this country.

So for us then, we\'re asking communities and states to look at and
prevent problems associated with consumption and the consequences of
use. We\'re looking across the life span, not just at youth, but with
the elderly, as well as young people. We\'re asking them to do things
that they know work, and we\'re trying to create change at the community
level.

That is, it is wonderful and important to be able to document that a
program has improved the knowledge and prevented a classroom full of
eighth-graders to keep from using drugs. What we understand is if
that\'s the only tying that goes on in that community, when those
eighth-graders are tenth-graders, they\'re likely to be right back where
they started. It is about a community plan that has multiple programs,
multiple policies, and multiple strategies in it that really grounds the
community in a way that people, individuals, are able to stay sober and
stay healthy and recover health. So that\'s what we where we\'re trying
to move things.

Now, what do we have to work with inside the State Division to try to
realize this view? Well, we have three or four major functions and some
mechanisms. The three functions basically are prevention systems
development work, strategy implementation, program policy and practice
effectiveness. We are a liaison to NASADAD, the National Association of
State Alcohol and Drug Abuse Directors, the NPN, state NPNs, and tribes
as well. It\'s a task that we\'re going to begin to take on with the SPF
SIGs.

The major mechanisms. There really are essentially three in this
division. One is the substance abuse block grant, the other one is the
Strategic Prevention Framework State Incentive Grant Program, and then
the Synar amendment, which is a part of the block grant.

Specifically, my number on the block grant, you\'ll see varying numbers
because it all is based on the budget. I was hoping for the high end.
But roughly speaking, our 20 percent of the block grant is somewhere
between \$350 million and \$370 million. As you all know, that goes out
in a block to the states. They send us block grant applications every
year, which we approve. They\'ve all submitted for this year, and
they\'re all approved.

As a part of that is the Synar amendment, which requires that every
state report their youth access rates, and I\'m pleased to report that
every state this year made it under the 20 percent mark. I think that\'s
happened maybe once or twice. There\'s usually one state who doesn\'t.
This year that\'s not true. They\'re all in and everyone got under the
20 percent mark, which is a very good thing.

The division has put together a lot of materials and a lot of
information to help folks do Synar. We have done a really good job, I
think, in supporting states in being able to reach the less than 20
percent mark.

Then there\'s the SPF SIG grant program, the new SPF SIGs. There are 26
out there, roughly \$85 million. We funded 21 grants the first cohort,
2004. That included two territories. And then last year, we funded five,
if you will, off the shelf. You all had approved more than the number we
awarded the first year, and we went back and awarded five additional
ones. Then you reviewed scores for this year. So those are the 26 SPF
SIG grants, 24 states, in place at the moment.

In terms of other resources, the staff. There\'s a division director.
That would be me. A division Secretary; a Synar lead, who is Lee Wilson;
two team leaders. Bettina Scott will be leading the eastern team. Debbie
Castell will be leading the western team. And then 10 state project
officers, all of whom have experience in this field. We have one vacancy
at the moment. We lost one of our really good folks who got a promotion
and moved into CSAT. So we\'ll be recruiting for a replacement. That\'s
the staffing of the division.

We roughly have about \$450 million to manage out of some \$600
million-\$650 million budget for the agency. So we\'re a small group,
but we have a lot of responsibility to manage those dollars and to work
with the states.

I\'ll end by saying that the SPF SIG is the change driver. What we would
like to do to achieve the visions I talked about earlier is to use the
SPF SIG as a way for states to learn to do the Strategic Prevention
Framework and incorporate it into their block grant so that they begin
to think this way about all of their resources, and in fact, that state
education departments, justice departments, public health, public
safety, all of the agencies in states begin to think systematically and
begin to use the SPF as a planning tool. There is some evidence that
we\'re having some success at that, that the SPF is beginning to be
picked up and being applied more broadly than just within the SPF SIG.
And I can talk about that later, if you want.

What we really believe is that when states develop and support community
capacity to put together a really local system, that communities wind up
with the right set of programs, policies, and practices so that people
can have a life in the community.

I hurried through that because I think you all have more questions and
maybe I can stop talking and answer questions.

MR. ROMERO: Questions?

MR. DeWISPELAERE: Yes.

MR. ROMERO: Jay.

MR. DeWISPELAERE: I have several. No, I don\'t.

Number one, Mike, I think you know how much we respect the work that you
do in the states and your staff. I think it\'s gaining. When I started
on the advisory council, I really believed that the states felt that the
block grant money was their money, not federal money, and by the time it
filtered down to the locals, that was really in question. And we\'ve
talked about that before, and I think you\'ve done a great job as the
leadership here at CSAP.

I have two main questions. My first question is one of the things I
found out over the past year is that if a community doesn\'t agree with
a decision made by the state or the regional body that coordinates their
block grant dollars, there appears to be no method to test that. Why is
that when it\'s all federal dollars that they\'re using?

MR. LOWTHER: Well, when it comes to the Strategic Prevention Framework
State Incentive Grant, that\'s a grant and it\'s a cooperative
agreement. We have some ability to negotiate, discuss, and talk, as you
know. I think your question really pertains to the block grant more than
anything else.

MR. DeWISPELAERE: Absolutely. The first question, yes.

MR. LOWTHER: The reality is that the block grant legislation and the
statutes regarding that really do not provide us with a great deal of
ability to demand and require or question. They have to fill out a block
grant application that tells us how they spend the money and give us a
general plan. We have wonderful TA providers that go out and ask
questions and try to prompt and move, and we\'re using the SPF to try to
drive it. But we really actually don\'t have direct authority to be able
to say you can\'t do that or you can do that because in that sense,
it\'s a block grant and it simply goes to them. As long as they\'ve
gotten their materials in on time and have described what they\'re doing
and have reported appropriately, we don\'t have as much authority to say
yes or no. So, yes, in a very real way that\'s correct, what you\'ve
said. It\'s because of the statutory limitations, regulatory
limitations.

MR. DeWISPELAERE: My second question is we had our meetings yesterday,
and I keep coming back to this and I think it\'s so important. I was
glad that Charlie alluded to it today. In the budget year \'06/\'07,
Charlie said CSAP has said that\'s a goal. We want to be at 40 states.
Clarify for me that we don\'t mean 40 states and tribal bodies. When
they said 40 states, you truly meant SPF SIGs in 40 states. And how are
we going to get to that point without saying how many are going to be
funded and how many aren\'t?

MR. ROMERO: Jay, the goal is for CSAP to reach the goal of 40 SPF SIGs
in states. That\'s the goal.

MR. DeWISPELAERE: So that\'s separate from the ‑‑

MR. ROMERO: So if tribes also compete or territories also compete, then
they would also be considered. But the initial goal or the initial
direction was a commitment from CSAP and from SAMHSA to reach 40 states
at the completion of the awards in \'06.

MR. DeWISPELAERE: Thank you. That answers my question. See how easy that
was?

MR. ROMERO: I think the other piece, Jay, to your earlier question. One
of the things in Mike\'s area ‑‑ and actually really this is impacting
on the rest of the center ‑‑ is that the SPF as a framework, the
Strategic Prevention Framework, is in fact now being operationalized
across the center so that really the way we think and the way we\'re
challenging the states and communities to think is based on the
framework. So all of our activities mirror, follow the thinking, the
logic of the SPF. In that respect, Mike\'s area does have and does
provide additional support and guidance for the rest of the center in
terms of following that model, that approach.

MR. LOWTHER: Well, and I would add that in the field, we\'re seeing some
evidence that the Strategic Prevention Framework is expanding beyond the
SPF SIG.

MR. DeWISPELAERE: Absolutely it is.

MR. LOWTHER: That\'s really useful because if you don\'t have the power
to make people do things a certain way, then you try to educate and
persuade. I would suggest that the education and persuasion process is
having some impact. We\'ve done a brief survey. It\'s not completed yet.
But there are six states out there that are using the Strategic
Prevention Framework to allocate block grant monies.

MR. DeWISPELAERE: I know they are.

MR. LOWTHER: They\'re not required to do that. We can\'t require them.
They\'ve used it. They\'ve looked at it. They\'ve paid attention to it,
and they\'ve decided this is a good way to think about this process.

My hope is that that will continue to happen, and I believe that it will
over time. So we may not need the power to go, you have to do this,
because we\'re beginning to educate. People are beginning to buy into
this idea and do it because they think it\'s a good idea, which is even
better than doing it because I made them.

MR. DeWISPELAERE: And that\'s what partnerships are about.

MR. LOWTHER: Right.

MR. DeWISPELAERE: And that\'s why I keep coming back to if we say we\'re
going to do it, then we need to do everything in our power and make that
happen so that we can continue to see the progress because I\'ve seen it
out there and it is working.

MR. ROMERO: Don?

MR. COYHIS: I have a comment and then a question. It really is nice to
see the recognition of the tribes for their sovereign status that we
have and start to see that really, really honored in that respect. I
think there will be a lot of excitement in Indian Country when this is
communicated out as my comment.

The suggestion would be I think it would really be significant to
communicate this through the National Congress of American Indians and
through the National Indian Health Board, in addition to IHS in your
normal communications. But I think President Garcia, who\'s the new
president of the Congress, would be very, very supportive of getting
this as a main presentation at the National Congress of American
Indians, which is where the majority of the tribal chairpersons are
gathered at a gathering. They have two sessions. They have a national
session; they have a midwinter session also. So if you need any help in
doing that.

The second is when that communication is really ready to get out, with
our database, we\'re able to distribute to almost 35,000 native
communities. So when it\'s time to get the word out, feel free. We would
offer that.

MR. LOWTHER: Thank you very much, Don. Those are great ideas.

MR. ROMERO: Thank you, Don.

Alan?

MR. SHINN: Mike, thank you for your presentation.

I just had a question about this SPF SIG and the relationship that the
federal government will have now with the states. That\'s going to
change. It\'s going to be like you\'re going to live in our house.
That\'s a tough assignment coming out to Hawaii I know.

MR. DeWISPELAERE: Dennis is doing that one.

MR. SHINN: Right. Dennis is always welcome.

I just wanted you to maybe comment on that, that there\'s going to be a
little more involvement on the federal part on the SPF SIGs.

MR. LOWTHER: Yes, that\'s the nature. It is a cooperative agreement,
which means that we\'re partners, which means we have a right to sit at
the table and go, wait just a minute, let\'s talk about this, as opposed
to simply looking, going, okay, it\'s a block grant, you can do the way
you want. Here\'s our advice, but you don\'t have to take it. So we
really do begin to work together around what it looks like and how it\'s
shaped.

The traditional way this happens is that the grant is funded. They hire
project staff. They begin to put together the Governor\'s advisory
council immediately, and we come out and say, these are the
expectations. This grant went to the Governor of the state, and with the
charge that the Governor has agreed to assemble a group that will put
together the state agencies in that state to put together a prevention
system that will support communities in reducing problems related to
substance abuse, reducing substance use, and building an infrastructure
to support prevention, and we\'ll be at that table with the state
agencies to help make that real. And we have some substantial training
and technical assistance that can be brought to bear as well. So we\'ll
be active participants.

Alan, is that ‑‑

MR. SHINN: Yes, Mike. Thank you.

MR. ROMERO: Any other questions?

(No response.)

MR. DeWISPELAERE: Period. See how easy that was? That\'s too easy.

MR. ROMERO: We were bracing ourselves for even more.

Thank you, Mike.

We will reconvene at 1:15 for the continued presentations from our
Division of Systems Development. We will head over for lunch at this
time. Thank you very much.

(Whereupon, at 11:35 a.m., the meeting was recessed for lunch, to
reconvene at 1:15 p.m.)

[AFTERNOON SESSION]{.underline} (1:28 p.m.)

MR. ROMERO: For the purpose and the aim of being on time and ending on
time ‑‑ and I do apologize to Kevin for not starting at 1:15 as planned.
But we will just adjust our schedule accordingly.

It\'s my pleasure now to introduce to you Dr. Kevin Mulvey, who has
assumed the role of Acting Director for the Division of Systems
Development. Kevin?

DR. MULVEY: Good afternoon, everyone. I\'ve been in this position for
three days ‑‑ two and a half.

(Laughter.)

MR. ROMERO: A veteran in my opinion, but go on.

DR. MULVEY: As you all remember from various documents you\'ve been
receiving from your work on the council before, we have the \"Life in
the Community for Everyone,\" building resilience and facilitating
recovery, using a framework of accountability, capacity, and
effectiveness. This slide really demonstrates in my mind what the
Division of Systems Development is planning to do within CSAP by
facilitating the support within each of the divisions for their staff,
as well as their programs and the individual grantees.

Just by a quick organizational chart, the Division of Systems
Development is one of the divisions which has developed out of a merge
between the Division of Public Education and the Division of Knowledge
Application and Systems Improvement.

The organizational functions for the division are primarily twofold.
It\'s to provide leadership and guidance in planning and developing and
implementing the programs and the prevention concept, such as the
Strategic Prevention Framework, across the center, and is responsible
for carrying out the center\'s health promotion and public education
activities and information dissemination activities. As I mentioned
earlier, we\'re doing this through providing, in my mind, facilitation
activities with the other divisions in terms of facilitating the
implementation and development of tools, guidance documents, data
activities, which would involve training and TA components, along with
GPRA performance measurement and PART.

There are divisional responsibilities. The division is made up of a
branch, the Performance and Technical Assistance Branch, and a team, the
Materials Development Team.

A very wise man once sat me down in a conference room once at a meeting
and taught me about circles and wheels. So I\'ve purposely designed the
graph in terms of looking at it as a holistic approach and the
intersection between the circles and the wheels. There are, in fact,
three particular teams, if you will, if not organizationally structured
that way. Technical assistance and training is a major component, along
with data, performance monitoring and measurement, which would include a
cross-site evaluation from the National Institute on Drug Abuse, and
then the materials development component.

The division really is, as I mentioned earlier, looking at our work as a
support function for the center, for the Office of the Director, for the
Office of Program Analysis and Coordination, for the Division of State,
and the Division of Community Programs. Their staff, their programs,
their grantees, whether the grantees are at the state level, community
level, really is trying to provide support and technical assistance,
training, as well as again thinking about that vision, the
accountability and the effectiveness component of the ACE framework.

As I mentioned earlier already, we\'re going to be engendering and have
continuously been doing this. Because the Division of Knowledge
Applications and Systems Improvement functions remained in the division,
we have already been doing a variety of learning communities across the
divisions, as well as working with providing guidance, data systems, and
evaluation tools for the use of those grantees.

Again, thinking about the circles and the wheels, really the
intersection is of both DCP community programs and state programs, and
there\'s also an intersection across those programs where we also might
be involved. Then, of course, there\'s the Division of Workplace
Programs where we have a variety of programs that we\'ll be linking with
such as Get Fit, the Youth in Transition Program, Youth in the Workplace
Transition, that we\'re attempting to facilitate more interaction and
coordination across all the divisions, but particularly focusing with
the Division of Workplace Programs, which we have not necessarily done
so.

Within the Division of Systems Development, the activities include ‑‑
and this is just a short list. There are many subtasks and matrix
workgroups as well that we are involved with. We are, as I mentioned
already earlier, responsible for GPRA, the Government Performance and
Results Act; the PART, the Program Assessment Rating Tool, which is
OMB-required; the National Registry of Effective Programs and Practices.
Prevention Fellows is a major component of our work. The State
Epidemiological Workgroups. These are the subcontracts to the non-SPF
SIG states to develop SEOWs or the State Epidemiological Workgroups. The
CAPTs are in our division, as well as, I mentioned earlier, the health
promotion and health promotion dissemination activities. Geospatial
mapping is in our division. Again, thinking of these activities,
they\'re really for the entire center, not just for one division. We
also are working with and responsible for the underage drinking
initiatives, publication clearance, the workforce, and a variety of data
analysis activities.

One program that you may have been aware of is last year SAMHSA
purchased CTC. What we\'re doing with regard to CTC is next week we\'re
developing a training of trainers for the CAPTs because the CAPTs will
become the training arm for CSAP. The CAPTs will be trained in this
tool, but it\'s important to understand the CTC is one of many tools
that are available to empower communities, grantees in looking at risk
and protective factors in the broad sense when trying to develop the
first step or first stage of the SPF. The CTC materials and the CTC
survey have already been available for download from the Web.

As I mentioned earlier, we\'re doing a training next week, August 1st to
August 4th, in Denver, Colorado for the CAPTs. The idea is that we\'re
not planning to train the communities. The CAPTs are going to train the
states, and the states then should train those communities in which they
wish to implement the CTC. Again, we\'re not requiring the states to use
the CTC. Again, it\'s a tool, an additional tool in a toolbox, if you
will, for them to use if that\'s what they choose to use, and we\'re
just making available training at the state level.

MR. SAHN: Where do counties and municipalities fit into that mix?
Because from my experience, so much of the funds flow through to
localities and it would be great to have everybody, more or less, on the
same system, if not the same page.

DR. MULVEY: What we\'re trying to do within the SPF process ‑‑ and
you\'ve probably heard it from Mike and Peggy Quigg as well ‑‑ is trying
to move the field and help or work with the states to work with their
local communities and not the federal government get in the business of
getting down into the local community, except through discretionary
grant programs. But in terms of working with the SPF, which is why it\'s
a SPF SIG, State Incentive Grant, we\'re working with them.

Now, we\'re making available a variety of different technical assistance
components for the states to utilize that. I believe the State Division
will be working with their project officers, the SPOs, to facilitate
that transition from the state system or the state level down into the
county and into the city or towns.

MR. SAHN: Right. So basically we\'re relying on the states to put the
news out to the counties as opposed to us sending material over to NACO,
National Association of Counties, the U.S. Conference of Mayors, just
informing people that if you have an issue, call the state.

DR. MULVEY: The direct answer is yes because our primary responsibility
or conduit is the NPN for prevention or the SSA for the treatment side
of the house. But, of course, there are obviously the state associations
for alcohol and drug directors that are often in many meetings and hear
the same messages that NASADAD might hear or NASMHPD might hear or NPN
might hear.

MR. SAHN: Thank you.

MR. ROMERO: If I could also just add to that piece. Though the direction
of CSAP has to be to develop stronger partnerships, as well as
collaborate with the states, there\'s no question that because we
internally have both a States and a Community Division, we do see the
communities as playing an important role. So there will be a
partnership, but as Kevin mentioned, our direct support or activities
under Kevin\'s area will be directed to states who will then empower,
support, and it will filter down to the community level. But there will
be opportunities for the federal government to collaborate at the
community level through our Division of Community Programs and State
Programs. But our goal is to increase the accountability, as well as the
ownership at the state level.

MR. DeWISPELAERE: One of the examples of that is the county I come from.
The coalition wanted to do coalition capacity-building. So they\'re
aware of the CAPTs\' ability to teach that or to train in that. So they
requested to the state that the state allow that. The state did allow
that and the CAPTs came in with the state\'s approval and did this whole
training for free.

The same concept with CTC and the others stands true. So if you have a
cooperative state, which hopefully most of them are, the state has
ownership in the training and the Feds paid for the training. The CAPTs
got to do the training, and it\'s win/win for everybody. It really was a
great experience for them.

DR. MULVEY: And basically my last few points are that we\'re conducting
the TOT within Denver, as I mentioned already, in terms of a CTC update.
We expect that we\'ll be making an announcement or Dennis will be making
an announcement at the NPN conference at the end of August, that this is
yet another tool that\'s available, yet another training packet that\'s
in the CAPTs toolbox, if you will, to send out to the states.

MR. DeWISPELAERE: Great tool.

DR. MULVEY: I kept it brief based on Jay\'s comments at the beginning.

(Laughter.)

DR. MULVEY: I\'ll be happy to take any questions.

MR. ROMERO: Sylvia?

DR. ANDREW: On slide 9 under \"Programs and Activities,\" you have a
bullet there called emerging substance abuse issues. Can you elaborate a
little bit on what that is?

DR. MULVEY: It\'s my understanding that, for example, the block grant is
a stagnant mechanism in the sense that they have to deliver the services
that they\'ve outlined. But there may be at times certain activities or
certain new emerging issues that develop, and my understanding of
putting this label, if you will, in the organizational statement is to
enable us as a unit to respond to it and still having it appear within
our organizational statements during the reorganization that there is a
location and a place for this to occur. It, by its nature, facilitates
collaboration across the state and the community because they\'d be
implementing and executing whatever the issue might have been.

DR. ANDREW: Is that the expectation, that they would naturally flow from
the states, or could they surface, say, from the field in general?

DR. MULVEY: It could be both.

DR. ANDREW: Great.

DR. MULVEY: It could surface from the field as well as from the state.

DR. ANDREW: That\'s wonderful.

MR. SAHN: You touched on an issue we discussed last night, to be able to
react to changes in the field and then pilot up solutions. But what we
were discussing is, is there a separate funding stream, almost like an
incubator type operation where these ideas percolate up and then we look
at them and have the ability to be proactive and fund them in terms of a
pilot?

DR. MULVEY: There is not currently a fundable mechanism for that.

MR. ROMERO: Historically there had been a small amount of money sent
aside for emerging kinds of issues, but it is my understanding that we
stopped funding it because we weren\'t getting any requests to explore.
It\'s an item that I do know that Sue Rusche mentioned and that we will
be discussing as a group later in our next piece. But if that\'s
something that the council feels would be helpful, then we can explore
that. We can certainly explore that.

DR. TELLERMAN: Dennis, last evening we spent quite a bit of time at
dinner discussing this issue, and we were all in agreement ‑‑ well, I
shouldn\'t speak for Jay and Don because they weren\'t there, but I
think they\'ll go along with this. But we were all in agreement that
this is very important, and we want to really, really stress it. I\'ll
bring it up at the appropriate time, but I want to really explore this
and see what we could do. We even have a dollar amount that we\'re going
to suggest.

MR. SAHN: We didn\'t agree on the dollar amount.

DR. TELLERMAN: Well, it\'s just a suggestion.

MR. ROMERO: Well, we can talk about that, and if that\'s something that
the council feels that\'s the direction that they want to take, we will
certainly take that into consideration and explore the options there.

Don.

MR. COYHIS: Just for clarity. The Native American. Is that the One Sky
Center?

DR. MULVEY: No, it\'s not. There is an idea that we would want to have a
particular component for this population.

MR. DeWISPELAERE: So it doesn\'t exist now.

MR. ROMERO: The goal is, as we\'re moving forward with the SPF and other
initiatives, we need to make sure that if CSAP is funding programs or
awarding funds to groups of people, whoever they are, whether they are
tribes, whether they\'re territories, or whether they\'re states, that
we\'re setting them up to succeed and not to fail. So to simply just
give them the funding and then just wash our hands of our role is not
fair, I don\'t believe.

So to that end, I have suggested that we also begin to proactively think
about what is the safety net we\'re going to create if we\'re going to
be funding, as an example, Don, tribes in the SPF. Let\'s make sure that
we\'re also thinking what are the safety nets we\'re putting into place
to ensure that they succeed and not fail.

Ideally, I would like to see us have a national center that would
address American Indian/Alaska Natives. I know that we\'ve used One Sky
in the past. There\'s a current contract, I believe, that\'s actually
ending very soon with the work that they were targeted to do.

Certainly we will need to explore. I want to see us have a safety net
within CSAP for not just American Indian and Alaska Natives ‑‑ I happen
to have a soft spot for that ‑‑ but also for other groups who are
marginalized or disadvantaged to ensure that they\'re able to be given
the opportunity to succeed after the funding is awarded.

MR. COYHIS: Great. Thank you.

MR. DeWISPELAERE: Kevin, being that you\'ve only been here three days,
you know, the NREPP process alone has taken several of these meetings
half the time. So you\'re a lucky man. Maybe next time we\'ll get you,
buddy. Thank you.

MR. SAHN: A great job.

DR. MULVEY: Thanks.

MR. DeWISPELAERE: Short and sweet.

MR. ROMERO: Thank you.

Any other questions?

MR. COYHIS: I\'d just say we\'re really glad that Kevin is heading this
up. I\'ve known him for a long time and I think there\'s a match to his
knowledge and skills and energy, and he\'s very responsive. I just wish
you best of luck.

MR. DeWISPELAERE: You need to do more of Rose\'s work so she can do
less.

(Laughter.)

MR. ROMERO: That will be on the record.

DR. MULVEY: Thank you. I look forward to working with you all.

MR. ROMERO: Thank you, Kevin.

Since we\'re doing so well on our agenda, I would propose that we
continue and not slow down in order to stay on top of our scheduled
plan. Do I have any objection to that?

MR. DeWISPELAERE: No, sir.

MR. ROMERO: Wonderful.

This portion of the council is focused on roundtable discussions. For
any items that I have asked since the beginning of yesterday to table,
this is the time to bring it up for discussion and for a decision or a
vote on it. There are a couple of other topics that I also want to cover
and I\'m just going to mention it, but we will go through them.

The first thing is to talk about the possible dates for the next council
meeting.

I also want to have a brief discussion regarding what you feel the role
of the NAC member group is or should be.

I certainly want to explore more of the option of you being an extension
of CSAP, as ambassadors of CSAP in your current professional roles, but
also in activities that you may be assigned by me to go out. So
ambassadorship is another topic for us to discuss. Also under the notion
of ambassadorship, I want to have us talk a little bit about the notion
of representing CSAP at some of our national events, i.e., NASADAD, the
conference with CADCA, NPN, where you might have a role with your
presence and your affiliation with CSAP.

Also, I want to challenge you ‑‑ and we will talk about this a little
bit more ‑‑ about how to strengthen the council. We need to have 110
percent participation of the council, but we also need to have 110
percent representation of the people we serve. So we need to strike a
balance in that area. So I am challenging you to really think about who
would you recommend to come on our board. We have a stellar list of
council members. I just want to make sure, again, that we are truly
representing the people that we aim to serve.

So those are the topics for our discussion. If you would allow me, I\'d
like to just go down that list, unless there are other items. Please
bring them up.

Actually for due reverence, why don\'t we start with the topic that
both, Mitch and Judy, you just brought up a few minutes ago. It\'s the
suggestion of developing some kind of an initiated grant process.

DR. TELLERMAN: This would be like for emerging practices or emerging
programs, if you want to consider it R&D for CSAP. We don\'t seem to
have a vehicle to support innovation in the field. It\'s extremely
difficult to innovate without support, and we know that there are other
federal agencies that have put in place a vehicle for doing this. For
example, NIDA, and I think NIMH.

Now, for example, if we went to any of our community groups and said,
well, why don\'t you approach NIDA, they just wouldn\'t do it. They have
a promising practice or program that they\'re using. It would be too
formidable, too intimidating to them to try to go through the NIDA
process. But if we had our own process at CSAP, then I think it would be
something that they could perceive as doable. They\'re coming in from
the field. They don\'t have a lot of resources, but they could handle
this.

If we don\'t innovate, then really, we will remain stagnant. So I think
that it\'s important for us to have an ongoing encouragement of
innovation.

Of course, we would be talking about money that would be going into an
outcome evaluation of a program. It would be, I guess, service to
science is what we would be talking about. So whether we call it
emerging or cutting edge or incubator or R&D, those are all possible
ways of thinking about it. We had sort of thrown out the concept of \$5
million set aside for a small fund for competitive ‑‑

MR. ROMERO: A small fund.

(Laughter.)

MR. SAHN: Meth only got four, Judy.

DR. TELLERMAN: Oh, meth only got four. Sorry. Well, this is all subject
to scrutiny, but an amount of money that would be set aside that would
be all-phase and people could apply competitively to have an outcome
evaluation done of a new emerging program.

MR. ROMERO: Kevin?

DR. MULVEY: Actually, there\'s already an initiative in the Senate for
science to service and service to science. In fact, the science to
service component is, in fact, to do that, in which there is a
competitive process as mini-subcontracts, that is, a subcontract to a
prime contractor.

So, for example, there\'s a nice graphic I can show you, but essentially
the CAPTs have regional academies. The attendees of the regional
academies, by virtue of having attended an academy, are in the applicant
pool. They can then apply for these mini-subcontracts, and the
mini-subcontracts are \$30,000 each. We have currently awarded 25 of
them.

The idea is that they use these small pots of money to, in fact, work on
moving them from wherever they are, taking them where they came in, and
moving them, in terms of evaluation, at least one step or two steps
closer to a more rigorous state. It varies across the applicant because,
again, we\'re taking them where they came in.

We are planning to reissue that particular mini-subcontract process
again this year, again with an applicant pool coming from the five
regional CAPTs. We had about 42 applicants, of which 25 received small
mini-subcontracts.

DR. TELLERMAN: As you probably know, \$30,000 will absolutely not pay
for any kind of outcome evaluation of any decent sort.

DR. MULVEY: And the intent is not to do outcome evaluation. It really is
to work with the programs in improving their evaluation capabilities.

DR. TELLERMAN: See, that\'s a completely different thing than what I\'m
talking about. I\'m not talking about improving someone\'s ability to do
an outcome evaluation. I\'m talking about you\'ve got a program and you
want to bring it to more of a science-based level and you evaluate it.
You implement it. You evaluate it. That costs money. That\'s what the
grant is for.

MR. ROMERO: Mitch?

MR. SAHN: Yes. I think that there are really two parts to this. One is
an operational part. The other one is an intelligence part.

The intelligence part is, first of all, we have direct connectivity with
people in the field, unfiltered, unvarnished, bubbling up of, A,
emerging threats, which would add to the DAWN reports, which are
excellent, but we\'re able to now see it in a multidimensional frame. So
we have intelligence coming up from the field. We have solutions coming
up from the field unfiltered by the state, by the CAPT, by anything
else. So we have that direct flow.

We also have to create a truncated process for this. I think the intent
was to provide a proactive funding mechanism which would not have to
wait for the yearly cycle to get funded and we could create an
actionable plan with a streamlined process so we can deal with things as
they emerge as opposed to ‑‑ you know, I can only say the Ecstasy
example. We were a bit behind the curve. The meth also. If we had this
in place as a trip wire, I believe that we could have, A, gotten an
early indication from the field because it was bubbling up in certain
demographic pockets, found a solution, and then pilot up a couple of
programs so when the funding opportunity came up on a macro level, we
would have had, theoretically ‑‑ I hate using the phrase ‑‑ but people
on the ground, boots on the ground.

MR. ROMERO: Sure. Thank you, Kevin.

If I understand the initial concept, the idea is that if there are some
wonderful ideas, some wonderful practices that are going on at the
community level, at the field level, and if they could somehow be able
to contact us and say, can you support us so that we can magnify our
efforts or provide the necessary due diligence so that we could
ultimately be able to take this nationally, if it works.

MR. SAHN: If we see a specific problem and it\'s causing us concern and,
therefore, we\'re going to ask to pilot up this program.

MR. ROMERO: Correct.

So along this line of thinking, we do a little bit of that already. We
do get requests. I think they\'re considered unsolicited requests for
funding for a particular activity at a local level. Peggy and Rose may
correct me. I believe that it\'s at my discretion with some concurrence
from some folks. But usually it\'s at the center director\'s discretion.
And we have done that in the past. I have no intention of not continuing
that if there are programs that are doing well.

I\'ll give one example. I won\'t mention the program by name
specifically, but one program asked for some funding to help pilot an
idea. It was a good idea, and they piloted the program at the local
level. They came back and they requested some additional funding to keep
it at the local level but just expand it at the local level. It was our
understanding and it was our goal that they would pilot the program and
then be ready to come back with the results and be ready to say, now
we\'re ready to take this nationally. So we have to be careful about
that. We don\'t want to just be able to fund a small, really good
program if it\'s only going to stay at the local level because that\'s
not what our role is.

But at the same time, we need to strike a balance. So if there are good
ideas that are coming from the field, I think that it\'s incumbent upon
us to get that kind of feedback and that information. If it\'s
appropriate, if it meets our guidelines, ethical, programmatic
guidelines, then yes, I think we need to try them out because ideas
cannot just be coming from top down. It\'s been said a few times
already. Ideas have to come from the bottom and from the top and meet
somewhere halfway.

MR. SAHN: I think you hit the nail right on the head. This is a low-cost
way to evaluate a program and create a template that can be exported
with some modification, depending on cultural sensitivity, to others. So
it\'s like the software business. You put all the money into R&D and
then every copy you sell after that has minimal cost.

MS. KITTRELL: May I just say this? Because it sounds like, for those of
us who have been around a while, the old demonstration program because
at that time NIDA, the Prevention Branch, put out a lot of money, I
think about \$20 million and some, to the field to find out what type of
innovative programs were out there that could help drive down the
numbers. And that was back in the late \'80s.

What happened along the way ‑‑ and it might be the time for us to have
some new innovations because a whole generation of people have come and
gone now, and there\'s a new generation that\'s coming up now. We have a
lot of technology, and there\'s another generation of people that we
have to reach.

In order to do this, some policies need to be changed about how we are
going about doing business here. So I think that you can make a
recommendation and this could be taken under advisement by policy
officers and the Administrator, but that\'s what it sounds like you want
to do, a demonstration program. Those grants were funded anywhere
between \$300,000 and \$500,000 a pop.

DR. TELLERMAN: That\'s what we\'re talking about.

MS. KITTRELL: I thought that\'s what you said.

MR. SAHN: Would it be possible, Rose, for the next meeting to have some
understanding of what policies and procedures would need to be changed?
This way we could actually weigh out the cost-benefit analysis.

MS. KITTRELL: Well, what you may want to do ‑‑ and, Dennis, you just
chime in ‑‑ is for you all to articulate what it is that you want in
writing to us and then we can take it forth. But if you don\'t put it in
writing, it\'s us saying this is what we want, and we\'re supposed to be
taking what it is that you\'re asking for.

MR. ROMERO: I think just the other piece is then that affords us the
opportunity to be able to respond back and provide the information that
you\'re requesting, Mitch, which is potentially what would the
guidelines be and how much effort it would require.

DR. TELLERMAN: Would you have a template or anything in writing from
those demonstration models that we could work off of? Do you still have
those files left from 26 years ago?

MS. KITTRELL: I just threw them away in this last move, when I moved to
the Acting Deputy position. But I can look in some of my old files.
Sandy Stephens may have them back there. Sandy, you were around back in
those days.

MS. STEPHENS: I just threw mine out when we moved from Parklawn.

MS. KITTRELL: See, that\'s what it is. People started throwing things
away. We finally gave up and said, we\'re not ever going back there
again. I need to throw this stuff away. That\'s just what I did.

DR. TELLERMAN: That\'s okay. We\'ll figure it out somehow.

MR. ROMERO: Jay?

MR. DeWISPELAERE: I just want to caution that it\'s going in writing so
that if it goes in writing and it\'s going to be from the council, the
whole council has time to dialogue that before it moves forward.

MR. ROMERO: Absolutely.

MR. DeWISPELAERE: I understand what they\'re trying to do. I\'m somewhat
opposed to it because I think that\'s what\'s wrong with the NREPP
process right now, that it costs too much money for these programs to
make that list and so very few programs are going to have access to
whatever little money that might come up. But I understand in concept
what they\'re saying and support that part of it. So I would want more
time with something in writing to dialogue as a council and actually
talk about it more in the group.

MR. SAHN: I was hoping that you\'d write the letter, Jay.

MR. ROMERO: And just for clarification, the next council meeting will be
a teleconference. If we plan it right, we could have all that
information out to you before that meeting so we could use that
teleconference session to have more of this discussion.

DR. TELLERMAN: When will that be?

MR. ROMERO: I\'ve got a couple of dates that I want to bounce off you
and just leave them as tentative for now.

DR. TELLERMAN: So I guess we need to be able to communicate through
email with each other to firm up what we\'re going to write.

MR. ROMERO: That would be the first step.

DR. TELLERMAN: I don\'t think we have a vehicle for doing that right
now.

MR. DeWISPELAERE: Through Tia.

DR. TELLERMAN: Oh, through Tia.

MS. HAYNES: I can make sure everybody ‑‑

DR. TELLERMAN: Okay.

MR. SAHN: Our emails are on the roster.

MR. ROMERO: Alan?

MR. SHINN: I think this is an exciting discussion because I think we\'re
really crafting and shaping this incubator kind of concept that we have.
I was thinking of it as a much less formalized kind of initiative that
would come from the grassroots, as Mitch was saying, and it would be for
groups, organizations that really maybe don\'t even know about SAMHSA
and CSAP, but we\'re going to introduce them to the agency and to the
concept of trying to mature maybe some of their culturally based
programs which are working in their community to eventually, or maybe
never, become evidence-based programs. I don\'t think they have to be,
but I think the idea of replication and sharing those ideas with other
communities that might need those kind of programs and services would be
definitely a service that CSAP could render. So I see that as part of
it.

So the capacity-building, technical assistance, and even continuing what
CSAP used to do which was those workgroups, which I thought were very
good. We did it ethnically. We did it multi-ethnically,
multi-culturally. I think that needs to come back because that\'s how
CSAP really gained a lot of support in the communities. So I see this as
a vehicle.

MR. ROMERO: Great. Thank you, Alan.

Any other discussion?

(No response.)

MR. ROMERO: The next item is the potential dates for the next NAC
meeting, which will be held via teleconference. I\'d like to propose
November 6th, if that is a potentially doable date. I believe the 6th is
a Monday.

MR. DeWISPELAERE: What were the other date options?

DR. TELLERMAN: What are the other options?

MR. DeWISPELAERE: Or you don\'t have any?

MR. ROMERO: That is the date option right now. I wanted to see if we
could do it before Thanksgiving.

My thinking is to have two in-person conferences, two meetings where we
physically come together, and two where we could meet via
teleconference. This would serve several purposes for me. One is that it
would create a continuity, a dialogue year-round. We would have it four
times a year. The one in the summer and the one in the winter would be
in person. The one in the fall and the one in the spring would be a
teleconference. Hopefully that would again maintain a level of
continuity in our conversations and in our dialogue.

So I\'m suggesting anything before Thanksgiving. October is a tough
time. It\'s the beginning of our new budget cycle. Our year literally
starts on October 1st. So my proposal was the 6th, the first Monday, of
November. But it\'s open.

MR. DeWISPELAERE: The advantage of being chairman is you get to set the
dates, Mr. Chairman. As many that are missing today, I just hope that
it\'s more of a priority for the November meeting. And I\'m not throwing
stones at anybody. I\'m just saying that I hope we reiterate the
importance of the council and the work. If you get the word out by
setting it today, you can get the word out quicker and allow Tia that
opportunity to communicate that to the council members. So I\'d just set
it and be done with it.

MR. ROMERO: Sure.

MR. SAHN: I\'m good on the 6th.

DR. TELLERMAN: If we do it on the 6th, I have a commitment between 12:00
and 4:00. So if it could be done in the morning, that would help me.

MR. ROMERO: The only issue with that is that it may impact on those who
are on the west coast. They are three hours behind us.

What I was suggesting is between 1:00 and 3:00 p.m. Eastern Standard
Time.

DR. TELLERMAN: That\'s really bad for me.

MR. ROMERO: The other option is to look at the Monday, the 13th.

DR. TELLERMAN: All my Mondays are the same.

MR. ROMERO: Besides Judith\'s conflict, if there aren\'t any other
conflicts, I would like to, right now, propose the 6th from 1:00 to 3:00
p.m.

MR. DeWISPELAERE: Works for me.

MR. ROMERO: Then we will certainly make sure that a notice goes out to
everyone for November 6th.

We don\'t have a date yet, but sometime in February ‑‑ at least we hope
it\'s in February ‑‑ CADCA ‑‑ and I\'ve been speaking with General Art
Dean about cosponsoring another annual CADCA conference/Prevention Day
conference. Although I was literally just a few days into my job, I kind
of thought that it was a good activity, a good meeting of different
groups. So I am in discussions with General Art Dean to cosponsor an
event. It\'s going to be sometime in February. I don\'t have a date yet,
but during that time frame. The plan is that I would like to hold a
full, live, in vivo, face-to-face conference, meeting.

MR. DeWISPELAERE: One day?

MR. ROMERO: I think it\'s two days, depending on the agenda items that
we get from all of you.

MR. DeWISPELAERE: I want to caution you when you go either on the front
end or the rear end of a conference like that, not only the number of
staff from CSAP that\'s so involved in that event, but I know of three
at least, if not more, of the advisory board members are part of that
event too. So when you add two days either in the middle of it, which
doesn\'t work, or on either end, it makes for a long week, especially
down here. But on consensus, whatever the group wants to do.

MR. ROMERO: Well, one of the things that General Dean and I will be
looking at is what would the program look like.

MR. DeWISPELAERE: His program.

MR. ROMERO: His program. And then ensure that there\'s a balance and it
doesn\'t really siphon the whole week in such a way that it makes it
very difficult for folks to be present.

MR. DeWISPELAERE: It would be a Prevention Day that day like there was
last year too?

MR. ROMERO: That is part of the discussions we\'re having.

MR. DeWISPELAERE: That adds another day. I mean, you wouldn\'t want to
have your advisory council meeting on the day of Prevention Day because
then the council in town, you couldn\'t get to participate. I suppose
you can do anything you want, but it wouldn\'t make sense to me.

MR. SHINN: I think we did last year.

MR. SAHN: We did it right after the Prevention Day.

MR. DeWISPELAERE: But it wasn\'t for two days.

MR. ROMERO: No, it was not. It was one day.

MR. DeWISPELAERE: That\'s why I asked that, Alan. It wasn\'t for two
days.

MR. SAHN: Dennis, let me just ask you a question. What do we usually
spend to fund an event like that?

MR. ROMERO: What do you mean?

MR. SAHN: How much money do we spend on co-hosting the CADCA conference?

MR. ROMERO: It all depends to what extent the request comes to us and
based on our prior discussions of our involvement, our role. There are
several factors that go into play. Then based on that, we reach an
agreement as to what our level of contribution and involvement will be.

MR. SAHN: I was just curious. Maybe historically, what did we do last
year, do you know, in terms of ‑‑

MS. THOMPSON: Without my spreadsheets in front of me, it\'s a little
awkward for me to make a very accurate projection of what it was or
recollection of what it was. But if I had to make a very general guess
about what we spent on the conference, I would say \$35,000. There\'s an
extensive staff involvement. It does depend on the number of days, the
agenda items, and a lot of other factors.

MR. DeWISPELAERE: I don\'t think you can rent the space for that amount
of money.

MR. ROMERO: If I could also just remind folks this is an open session.

MS. THOMPSON: I\'m being very general. It\'s just a ball park, off the
top of my head memory.

MR. SAHN: Thank you. No further questions.

MS. THOMPSON: But I\'ll look into it if you really want to know.

MR. ROMERO: The goal is to really utilize because when CSAP hosts or
convenes a meeting, we could potentially bring a lot of folks there, NPN
folks from the National Prevention Network. So it would really enhance
the CADCA and the coalitions in such a way that it could really afford
the opportunity to really have a strong presence during that time. So
that\'s the thinking or the logic behind that.

MR. SAHN: And the point I was trying to make is we get a big bang for
the buck when we piggy-back on the infrastructure.

MR. ROMERO: Absolutely.

MR. SAHN: And that was my point.

MR. ROMERO: That is another item that helps in the decision-making
process.

MR. DeWISPELAERE: And in history, we used to have members that were
assigned to particular areas that you\'re going to talk about in a few
minutes. I know there was somebody assigned to CADCA, a couple I think,
maybe more. I don\'t know who it is now.

MR. ROMERO: So in any event, there\'s no date set, but as soon as we
know, we will certainly let you know. When the notice of the date of
that council meeting goes out to you, I will also at that point ask you
to submit any recommendations or ideas for the agenda for that time.

Just to plan ahead, in late July, we\'re thinking of having the next
face-to-face NAC meeting here. We need to ensure that the NAC meeting
falls at the right time with some of the other internal processes, i.e.,
the grants review and ensuring that our grants are in the right place at
the right time so that you have enough time to review them. I\'m
becoming more and more aware that that\'s a real challenge for me to
ensure that you get the paperwork within reasonable time frames. But the
reality is that there are a lot constraints that are outside of my
control. Therefore, one of the ways that I can remedy this is by trying
to move our meeting just a little bit further up.

So late July. No exact date has yet been scheduled. But we will try to
do it around the last week of July, and we will provide more
information, more details as we get closer to that time frame. Certainly
by the February meeting, we will have a better sense of that.

The role of the NAC. What is the role of the NAC? What do you see your
role ought to be? How can you further enhance and support CSAP?

MR. DeWISPELAERE: We\'re certainly a voice of the field; hopefully, a
representation of the field, and hopefully, those of us that are out
there representing the council, as we\'ve been asked to by previous
chair people, in different meetings throughout the country that we may
be at or specifically go and attend.

DR. ANDREW: I don\'t guess just following up on Jay\'s comment, I think
because of our relationship with the field in our own respective states,
I think our role is to also bring to the table any emerging issues that
perhaps have not risen on the radar screen even at the state level or at
the national level. Without dating myself, I\'m recalling the return of
heroin use in certain parts of our country. It started off. Remember?
Well, I\'m not saying Jay because he\'s so much younger than I.

MR. DeWISPELAERE: Hey, come on.

DR. ANDREW: But I remember that that was an issue in certain parts,
particularly the Southwest and some of those areas, and we were seeing
it bubble. Had we had a vehicle to be able to bring it forward, we could
have perhaps. Now in hindsight. But those are the kinds of issues that
we\'re seeing in the field, especially with kids getting more and more
creative in terms of their drug use, that we could bring that forward.

I think it\'s also our job to represent the good work of CSAP,
especially the mission and the direction that you\'re going. I think
that that\'s something we should do.

I think the other thing that I would like to see ‑‑ I think we\'ve only
done this once, which is we had more of a social opportunity. It didn\'t
give us the full flavor, but I think the CSAT advisory committee was
meeting at the same time that we were meeting. Even though it didn\'t
give us the full opportunity, it gave us a chance to perhaps come
together. I don\'t know whether that\'s your thinking, but just maybe
some thought be given to if those meetings are ever held at the same
time, that you could bring all advisory committees together and really
solidify what we can do together as different advisory committees.

MR. SAHN: I think our primary role, at least from my perspective, is to
be your trusted advisor, to be a sounding board that\'s impartial, that
really has no agenda or ax to grind except the betterment of, A, the
institution and, B, the services we render. I think that that trusted
advisory relationship encapsulates all of our different areas of
expertise, be it youth, be it Judy\'s work, Sue\'s work, advocacy, or
just government experience at a different level. When we become more
involved in the process, I think the benefits, based on our own areas of
expertise ‑‑ some of them might even be operational ‑‑ benefit the
cause.

I would hope as your level of comfortability with us and our various
skill sets grow, that we would have phone exchanges. When something
comes up, you could pick up the phone because you\'ve got people that
are experienced and that you can trust. So that\'s how I view it.

DR. TELLERMAN: What you were talking about before, Sylvia, we used to
have joint council meetings. There would be problems that would be
proposed, topics that were given out for us to discuss. We would be
broken up into small groups and then two people would be designated
co-chairs, and they were from different councils. Then they had to
present the finding of the small group to the entire joint council at
the end. So it was very vigorous because we had to come up with these
ideas and then make a presentation. It was very challenging. So that was
just something that used to occur a few years ago.

I wanted to say that you were talking about having people be
ambassadors, and I welcome that idea. I think it\'s a great idea. I do
think that we would have to have a carefully scripted or very careful
guidelines as to what we could say and how we should say it. We would
want to be really cautious about that because I know I\'m always getting
calls from the media.

The American Psychological Association recommends me to be one of their
spokespeople. They\'ll call me about all kinds of topics: groups of kids
killing kids, the kids who burned down the churches. I\'m always getting
things like that. I\'m speaking not representing APA, but speaking as a
professional giving my own professional opinions about what\'s
happening.

So that\'s a whole different way of doing it because I can just think on
the spot, okay, how do I interpret this, what do I think is going on
here, from the best of my clinical judgment. But if I\'m representing
SAMHSA or CSAP, then I really need to have the guidelines and the exact
parameters of what I can say and what I can\'t say.

MR. ROMERO: One of the things that I\'ve wanted to do ‑‑ in fact, I
asked Tia ‑‑ is to provide me with a spreadsheet of all of your names,
your areas of expertise. That will be my guiding post to ensure that
we\'re tapping the right person for the right task.

I see you, if you were to ask me how do I see your role in supporting
the work of CSAP, as an extension of the Office of the Director. I
happen to be in that seat today. Therefore, we would collaborate.

We need to ensure that there is a strong presence of prevention across
this nation. You would be part of that group to represent CSAP.
Certainly you would not go out cold. We would make sure that you were
getting the necessary background information, and if a PowerPoint or a
speech needs to be included, you would get that way in advance so that
you can edit it and work around it.

But that\'s what I see because Jay, Don, Alan ‑‑ I\'m just learning
about some of your efforts that you\'re doing. It would be more
appropriate that you go out and speak with the collaboration of my
office to ensure that we\'re getting the right message. But this goes to
all the council members. That\'s the role of the ambassadorship that I
see, and I want to work hard at making it come to fruition.

DR. TELLERMAN: Could I just add a little bit to that?

MR. ROMERO: Sure.

DR. TELLERMAN: When we were at the Workforce Development, I was assigned
to the research group, and Sue was in children and families. She was
telling me about how she felt that some of the groups just didn\'t
understand at all how prevention fit into anything, and they were
consumers. My suggestion to her was that ‑‑ I wrote some notes about
this ‑‑ when people are consumers and they have an ongoing, existing
problem such as a severely emotionally disturbed child, and they\'re
advocating and they\'re going out and being in an organization to try to
get help for those children, they\'re very much involved with their
personal pain and an ongoing problem that they\'re involved in. So when
you say prevention to them, it\'s like what planet are you from? How are
you going to help me? My child has a mental illness and you can\'t
prevent anything. Well, we couldn\'t prevent it. Here it is. What are
you going to do about it?

So I was suggesting to her that it would be good to position it from the
point of view of the continuum. For example, if you already have a child
with mental illness, how horrible would it be for that child to then
start using Ecstasy or something else, which might precipitate a
complete psychotic break or just make everything so much worse for the
family.

So what we\'re trying to do is reach out because they don\'t really
understand prevention. They just say, well, preventing. Okay, that\'s
like a one-shot thing. You prevent it or you don\'t prevent it. That\'s
it. But our concept, which we have to convey, is that it\'s a continuum
and that we can help these families and these people to make their lives
better and to prevent things from getting worse. My dad always says,
\"It could always be worse.\" So that was a concept that I was trying to
discuss with her.

I think it\'s important for us. As we think about reaching out and
getting the message of prevention out there, how do you approach?
Because I know with suicide prevention, a lot of the people that get
into that, already lost their loved one. Now they\'re trying to figure
out what could I do, what could I do, and they say, well, let\'s help
prevent this from happening to another family. So now they understand,
okay, prevention, prevent suicide. But for somebody that\'s got children
with severe mental illness or someone in the family, it\'s ongoing,
constantly ongoing. So they\'re not thinking, well, how can I go prevent
mental illness from happening for Family X. It\'s so different for them,
their mind set.

MR. ROMERO: Yes. I also think that part of the challenge for us, for
you, and for CSAP, and for SAMHSA as well, is to get the message out to
our own providers that prevention does work.

If our own field doesn\'t buy the message of prevention, it\'s very
difficult. It\'s challenging enough. So we have wonderful people,
wonderful providers out there who know about prevention very well, and
we need to ensure that we get the spotlight on them and use them and
their resources, their talents and skills to really get the message out
to the rest of the community, the prevention community, in turn, to the
other fields, whether it\'s treatment or mental health.

The fact that the three centers have embarked on a workforce development
initiative really speaks well for the field as a whole, the whole public
health field because we are saying very clearly with one voice that
there\'s a place for treatment, there\'s a place for mental health, and
there\'s a place for prevention.

For those of you who heard us speak last week, the three of us never sat
down and talked about what our speech was going to be, but we all said
pretty much the same thing, which to me spoke and reaffirmed for me that
we are really aiming to develop and strengthen a workforce that can
truly appreciate the role that the three fields have to offer. But it is
a challenge.

Going back to the issue of ambassadorship, you are that extension to
help raise awareness.

MR. SAHN: So Tia is going to send us out the spreadsheet for us to fill
in?

MR. ROMERO: No, no. We actually have that already. It\'s my
understanding that we have that.

MR. SAHN: Did anybody get it?

MR. ROMERO: No, no. It never went out. I asked that for me.

MS. HAYNES: It\'s your professional area breakdown, what you send in
when you first become members, all your areas of expertise. But if you
have more, if there\'s something that you have added on, please send it
to me so that I can get it to Dennis.

MR. SAHN: I\'m just saying, have they gone out yet?

MR. ROMERO: No. It would not go out. It\'s internal only.

MS. HAYNES: It\'s internal, yes.

MR. ROMERO: Again, it was for my use so that I know who tap in. But
it\'s not something that\'s going to go out.

MR. SAHN: Oh, no. I mean, have people received them already on this
panel?

MR. ROMERO: No.

MS. HAYNES: No. It was for Dennis\' use.

MR. DeWISPELAERE: You never would. It\'s something you put on when you
get on the commission and it\'s just going to Dennis.

MR. SAHN: Maybe I should say I never received one. I never filled one
out.

MS. HAYNES: Yes. It\'s in your papers that you first fill out when you
first become a member. You filled one out. You just don\'t remember. You
had to.

MR. ROMERO: Mitch, I encourage you to talk to Tia to make sure that the
information that we have is correct and accurate and up-to-date.

The last item that I wanted to talk about is ‑‑ well, two more items.
One is the role that you could potentially have whenever CSAP is
attending the NASADAD conference or the leadership conference. There\'s
a potential place for your presence there as well certainly to hear and
know some of the activities that are going on at a national level and
hear where CSAP is in those positions. That\'s also open to you to know
that we do attend the NASADAD conference, the NPN leadership conference.
I\'m of the opinion that knowledge is power. The more knowledge you
have, the better position you\'re in to make better informed decisions
and recommendations to me.

Yes, Judy.

DR. TELLERMAN: I have one other question. In the Workforce Development
group, we talked about including Homeland Security as part of our
outreach, especially in terms of suicide prevention. I was wondering if
it would be possible to have any interface with them because when you
talk about suicide prevention, there\'s also the issue of the suicide
bombers and how it\'s possible that some of the concepts that we\'ve
addressed about suicide ‑‑ that we might have some insight that we could
share or brainstorm about with some of the Homeland Security people. So
it\'s just a thought that I had about being able to share some
information or joint possible brainstorming.

MR. ROMERO: Okay, thank you.

Don?

MR. COYHIS: I think, too, there might be times when there would be a
role for us to attend certain parts of strategic planning or at least to
have the draft input from that planning so that something isn\'t missed
from that.

I think now what I notice in the field different than 5 years, 10 years
ago is acceleration. Whatever it is, if it\'s negative, it moves faster.
If it\'s positive, it moves faster. So you can\'t go with that old pace.

I think the role here that I would like to see on the board would be to
have a rotating youth representative to this from the field. Their world
is hard to imagine what is really going on there. We make issues without
that ear. They\'re very, very powerful.

The last thing I\'d like to see is to have a prevention elder. There are
some people who have been around in prevention who could really keep us
from making mistakes or knowing the history of things. I\'m not talking
about a troublemaker elder. That\'s an old person. I\'m talking about a
person who really knows what went on before you. They\'re very, very
valuable, like Ms. Rose was saying about the boxes of material that they
had. We think we\'re inventing something. It already was done at one
time. And to have that voice of stability here also. So I would see that
as a role too.

MR. ROMERO: Can I ask you just one question? I\'d like to get your
thoughts on this. With respect to a youth representative, would it be
helpful to have one or to have maybe just ‑‑ and some folks may not like
this ‑‑ but to have folks from different parts of the country, different
parts of the region? Because what happens out on the west coast is very
different than the way things happen on the east coast and north/south.

MR. COYHIS: I think that would be excellent. But one of the purposes
that I think that we\'ve got to pay attention to is a long time ago,
there was a wave of people that really got interested in this work. So
we end up doing this. We have to create that interest of the next wave
to get involved in this.

MR. ROMERO: Absolutely.

MR. COYHIS: This is like a passion for some of us. We cannot not do it
because something grabbed your insides, and you look around and you
don\'t see that. Some things have shifted. I notice like in Indian
Country, the powwows come along now. The dancers want to get paid to
dance at the powwows. There was a time it wasn\'t like that. I think
we\'ve got to be really aware that there are key people out there. Like
when we were younger, somebody spotted us, and they tricked us and
talked us into all kind of things until they grabbed your heart. We\'ve
got to be aware of bringing in those key community young ones, the ones
you can set a fire again, because they\'re kind of disappearing in a
sense.

MR. ROMERO: Well, I would challenge our CSAP staff and the division
directors, especially Peggy, to consider that. But I also want to make
that challenge to this council. In your travels, if you can identify,
please, by all means. I think those are two great suggestions, Don.

MR. COYHIS: Jay is getting old, so we\'ve got to look who is ‑‑

MR. DeWISPELAERE: Please, soon. I thought you were our representative
for elders, but I\'m not going there.

As far as the youth piece, there\'s been a recommendation from the Youth
Central group that met. We actually hosted that event at our conference
last year. I\'ve read the findings of the young people that were brought
together from all three of the centers to review that. One of the
recommendations I can remember ‑‑ I can\'t remember all of what was in
there ‑‑ was a youth advisory council.

From my experience ‑‑ and PRIDE is in 40 states now ‑‑ my advice would
be that we really look at that from a cross section, cross-involvement
of some age groups. The youth did that. It was a great start for a
recommendation. I think that would give the staff and certainly the
council some tools to work with.

MR. ROMERO: Great, wonderful.

MR. DeWISPELAERE: Hopefully, you\'ve seen that report, Dennis.

MR. ROMERO: Yes, I have.

Thank you very much. This has been very, very helpful.

One last item, just a point of reference. We have a packet of
information for you to take with you from some of the presentations. We
will order the publications that I mentioned earlier today and get them
out to you. We can\'t get them to you today, unfortunately. But we do
have packets. Before we close today, you\'ll get them.

I will now open the session for public comment.

MR. DeWISPELAERE: One of the things we talked about briefly and you were
going to bring up in this part was the council strengthening. That as
your words, not mine, or maybe what Don and I interpreted. Has that been
covered appropriately?

MR. ROMERO: I feel very good about it. I think you\'ve provided me with
some wonderful information. I want to see the council strengthened not
just in terms of the size, but also by the level of participation and to
ensure that we\'re representing the people that we serve. So to get some
elder prevention presence, some youth prevention presence, and then a
cross section from our community, that makes a whole lot of sense to me.
So I feel very satisfied.

MR. SAHN: Dennis, would you make them ex officio members, or would they
be voting members?

MR. ROMERO: Let me get back to that. I don\'t know the answer to that.
My initial feeling is I\'d like to make them members with the same
rights and privileges that you have. Now, I may need to look into ‑‑

MR. SAHN: There\'s an age requirement I think.

MR. ROMERO: I\'m sorry?

MR. SAHN: There might be an age requirement.

MR. ROMERO: We\'ll need to look at several things. But the important
thing for me is to ensure that we truly have a representative around the
table that can speak to the different groups.

MR. DeWISPELAERE: A voice.

MR. ROMERO: A voice, yes.

MS. VAUGHN: Dennis, the law requires that the council be composed of 12
members. There is no age limitation. For ex officios, the law states
that they would be federal officials. So you can only have 12 authorized
members on the council.

MR. ROMERO: Thanks.

MR. DeWISPELAERE: The sheriff has spoken. Madam Sheriff, excuse me.

MR. ROMERO: Thank you.

Is there any public comment?

(No response.)

MR. ROMERO: Great. Being that there\'s no public comment, then I will
have my closing remarks to make. I want to start off by first thanking
the council. Again, I want to thank you for the one-on-ones that I had
with you. It really was and is very beneficial to me.

I want to also review with you or reiterate to you what I think I shared
with you individually, and that is, when I am going around the country
talking about prevention and CSAP, I am reminding people ‑‑ and I want
to remind ourselves today and those that are here present ‑‑ that if we
are truly serious about prevention, we need to see prevention truly from
a collaborative standpoint. It has to be from a standpoint of
collaboration.

In 2004, we began the good work of thinking and planning for the
Strategic Prevention Framework to be implemented in every state, in all
the four corners of this great land. The goal is to get there by 2008,
the last time I checked. If we do that, I don\'t know how much we have
planned beyond 2008 with respect to the SPF. It\'s my belief that if we
do not start thinking strategically just like we\'re challenging the
states and communities to think strategically ‑‑ we at CSAP are now
thinking strategically. We are now challenging ourselves to think
strategically by initiating a retreat for senior staff to begin to help
me identify what is the direction of CSAP, what is the focus of
prevention. In turn, that will be brought over to the entire CSAP staff
for their input and feedback. Then I want to be able to present that to
you as well.

Of that, what I would like to see come out is a strategic plan. As I
said yesterday, we need to have a 1-, a 3-, a 5-year strategic plan. We
need to have a road map. Without a road map, it\'s very difficult to
move and to know where we\'re headed. So to that end, we are now
embarking on that quest, and I am personally excited to be part of that
quest. I am excited to have the people on board with me along this
quest.

Prevention, as I see it, has to be about collaboration, but it also
needs to be seen as a mechanism for collaboration through the SPF. Once
we have an SPF in every state and every community, that\'s not the end.
That\'s actually the beginning of the prevention effort because we will
then be able to identify what the problems are, be able to come through
the five-step process of ultimately assessing whether or not we\'re
doing a good job. And if we\'re not doing a good job, then we know
we\'ve got to pull out that plan and start a new plan, start a new
model.

Our work is really cut out for us moving forward. CSAP cannot do it
alone. It needs your support. It needs your experience and it needs your
input.

The SPF, as I see it, is truly an overarching piece. As an overarching
element, there are, as I believe, three constants, three unmovable,
unshakable constants that we need to stay focused no matter what time of
the day it is, what weather might be outside, what else may be going on
politically or socially or economically.

They are, first, we need to focus on our youth. We need to remain
constant, focusing on our youth, underage drinking. We cannot afford to
lose generations, as we have already, to alcoholism and other drugs. No
matter what data we read, alcoholism remains a very, very major player
impacting our young adults. We have the top five, as I go around the
country reminding people. We have alcohol, tobacco, marijuana,
stimulants, and opiates. But of them, we know the gateway drugs, who
they are, what they are. But alcoholism remains as well one of the major
intruders. Therefore, we need to stay focused on our youth.

So I am committed, we are committed to addressing the issue of underage
drinking, and we are going to be doing more efforts. We have done
tremendous work with the town hall meetings this past March. In some
instances, I heard as of last month, they were still holding town hall
meetings. That speaks so well for the efforts of underage drinking that
we\'re trying to address.

Secondly, on that continuum, we need to focus our attention on our older
Americans. We truly need to focus our attention on older Americans. Our
older generation is going to, if it hasn\'t already, begin to impact our
public health systems in such ways that it has never done so in the
history of public health. We need to be ready to address the unique
issues that our older generations present. From a public health
standpoint, from a medical, psychiatric, and a substance abuse
standpoint, their issues are very unique. We truly need to start
focusing more and more. At CSAP, we are. That is my goal. As we focus
attention, our resources and our efforts to underage and our youth, we
need to focus also simultaneously on older Americans.

I always get a bit of a laugh, especially with younger people, when I
tell them that the unique issues that older Americans are bringing to
the office, to counselors is not just sense of loneliness, isolation,
depression, anxiety, sense of loss because of their counterparts are
passing away, but also a sense of loss of independence. One. The other
piece is that many older Americans are using multi medications, and
therefore they are abusing or get hooked on other drugs. That\'s another
important issue.

But the reality is that older Americans are living longer and many of
them are also living healthier. But those that are not as healthy create
some serious problems from a public health standpoint. The issue of
dating, the issue of STDs, the issue of rape is very prevalent more and
more in older Americans. We need to be mindful of these issues. We need
to be thinking from a proactive, which in my opinion is prevention,
standpoint. We need to address these kinds of issues.

So young adults, our youth, older Americans, and then in the middle is
our workforce development. We won\'t be able to address these two groups
if we don\'t have a strong workforce. To that end, we are aiming towards
that by the collaboration of the three fields, prevention, treatment,
and mental health. We need to work collaboratively with the states, as
well as with the communities, to engage and bring people to the field.
We need to respect those that are in the field and pay them adequately,
provide them with the level of financial support, but a sense of
meaningfulness. That\'s also vitally important.

So those are the three constants that we cannot forget when we address
the issue of prevention, as I move forward. This sort of reminds me of a
quote that I once heard from a famous politician who said that \"You can
only measure the morality of a society based on how you treat your
citizens during the dawn of life, the dusk of life, and in the shadows
of life.\" I believe that our job is to work to ensure that fewer and
fewer people reside in the shadows of life.

So to that end, I want to thank you, council members, for your continued
investment in the health and the hope of this great nation. The work we
collaboratively do moving forward needs to be filled with passion. I
have seen that passion firsthand with 24-plus years of being in the
field and never working in the federal or the state government. I\'ve
only known one thing and that is to be on the front lines. I have
listened as prosecuting attorneys, defense attorneys, case workers, and
judges try to piece shattered lives back together by giving prevention
efforts a chance. I have witnessed the cycle of crime, arrest,
incarceration, release, and recidivism be broken when mental health and
substance abuse treatment and prevention are presented as options. In
essence, when you make those types of decisions and clear a path for
recovery, you are bringing the wires back up for people who are often
isolated, alone, and without hope.

General Douglas MacArthur once spoke about keeping the wires up. And in
closing, I would like to share his words with you as well because I
truly believe that they speak to the dedication that\'s behind your
efforts, your work, and your commitment to CSAP and the field of
prevention. MacArthur said, \"In the central place of every heart, there
is a recording chamber so long as it receives the message of beauty,
hope, cheer, and courage, so long as you are young. When the wires are
all down and your heart is covered with the snows of pessimism and the
ice of cynicism, then and only then are you grown old.\"

If those words are true, then the persons suffering with mental illness
or the individual trapped by addiction are the people who become more
and more cut off, more and more isolated, and truly do have all their
wires down. And in many ways, they do grow old before their time.

This then tells us that once treatment begins to take hold, once
medications have taken their effect, once symptoms are alleviated, once
the wires start to come up, we must do everything in our capacities as a
system and as a nation to ensure that messages are sent to that central
place in the heart, messages which convey beauty, hope, cheer, and
courage, for when these messages come through and ring loud and clear,
they melt away the snow of pessimism, they melt away the ice of
cynicism, they can melt away the glacier of despair. This then invites
recovery and prevention and it becomes the guiding post to ensure a
healthier life.

I thank you very much. I thank you for your participation in the last
two days, and if there is no other business, I ‑‑

MR. SAHN: Move to adjourn.

DR. TELLERMAN: Second.

MR. DeWISPELAERE: I abstain.

(Laughter.)

MR. SAHN: You love this, don\'t you? All the world is a stage.

MR. ROMERO: Before we do that, I do want to also thank a few people who
really helped make the last two days wonderful and constructive days.

First, I want to thank our transcriptionist, Alan Friedman, and Irene
Saunders Goldstein, our summary writer. Thank you for your tremendous
effort. I don\'t know how you kept all your stuff going here.

I also want to thank Rose Kittrell, Acting Deputy Director here at CSAP,
for her constant help, support, and advice to me.

Also, I want to thank Peggy Thompson and Tia Haynes for their efforts to
ensure that the NAC session was as successful as it has been.

I also want to thank the support staff who helped prepare who really are
involved day to day to ensure that everything was accommodating and that
the information was clear and concise. That\'s our support staff from
CSAP. They are Deadrae Nicholson, Eliza Jones, Mary Ewald, and Dee
Encarnacion. To our support staff, I thank you.

I also thank our senior staff for their presentations that they gave
within the last two days.

Also, I want to thank the CSAP staff who came at different times of the
last two days to learn a little bit about the NAC, but also to support
and be a source of comfort for the rest of us.

This is the beginning of a long relationship, in my opinion. I truly
believe that you are only a phone call away, and I hope that you believe
that I am only a phone call away. Please do not hesitate to call at any
time with questions, ideas, suggestions, recommendations, or if you want
to invite us to your event. I do want to acknowledge Jay. Thank you for
making the recommendation yesterday to possibly host, and I\'d like to
talk to you more about that after our meeting.

Thank you very much. It\'s officially 3:05. So to that end, I officially
adjourn our session.

(Whereupon, at 3:05 p.m., the meeting was adjourned.)