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COMBATING DRUG ABUSE AND DRUG-RELATED

CRIME: WHAT IS WORKING IN BALTIMORE?

HEARING

BEFORE THE

SUBCOMMITTEE ON DOMESTIC POLICY

OF THE

COMMITTEE ON OVERSIGHT

AND GOVERNMENT REFORM

HOUSE OF REPRESENTATIVES

ONE HUNDRED TENTH CONGRESS

FIRST SESSION

OCTOBER 1, 2007

Serial No. 110–69

Printed for the use of the Committee on Oversight and Government Reform

(

Available via the World Wide Web: http://www.gpoaccess.gov/congress/index.html

http://www.oversight.house.gov

(II)

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM

HENRY A. WAXMAN, California, Chairman

TOM LANTOS, California

EDOLPHUS TOWNS, New York

PAUL E. KANJORSKI, Pennsylvania

CAROLYN B. MALONEY, New York

ELIJAH E. CUMMINGS, Maryland

DENNIS J. KUCINICH, Ohio

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

WM. LACY CLAY, Missouri

DIANE E. WATSON, California

STEPHEN F. LYNCH, Massachusetts

BRIAN HIGGINS, New York

JOHN A. YARMUTH, Kentucky

BRUCE L. BRALEY, Iowa

ELEANOR HOLMES NORTON, District of

Columbia

BETTY MCCOLLUM, Minnesota

JIM COOPER, Tennessee

CHRIS VAN HOLLEN, Maryland

PAUL W. HODES, New Hampshire

CHRISTOPHER S. MURPHY, Connecticut

JOHN P. SARBANES, Maryland

PETER WELCH, Vermont

TOM DAVIS, Virginia

DAN BURTON, Indiana

CHRISTOPHER SHAYS, Connecticut

JOHN M. MCHUGH, New York

JOHN L. MICA, Florida

MARK E. SOUDER, Indiana

TODD RUSSELL PLATTS, Pennsylvania

CHRIS CANNON, Utah

JOHN J. DUNCAN, JR., Tennessee

MICHAEL R. TURNER, Ohio

DARRELL E. ISSA, California

KENNY MARCHANT, Texas

LYNN A. WESTMORELAND, Georgia

PATRICK T. MCHENRY, North Carolina

VIRGINIA FOXX, North Carolina

BRIAN P. BILBRAY, California

BILL SALI, Idaho

JIM JORDAN, Ohio

PHIL SCHILIRO, Chief of Staff

PHIL BARNETT, Staff Director

EARLEY GREEN, Chief Clerk

DAVID MARIN, Minority Staff Director

SUBCOMMITTEE ON DOMESTIC POLICY

DENNIS J. KUCINICH, Ohio, Chairman

TOM LANTOS, California

ELIJAH E. CUMMINGS, Maryland

DIANE E. WATSON, California

CHRISTOPHER S. MURPHY, Connecticut

DANNY K. DAVIS, Illinois

JOHN F. TIERNEY, Massachusetts

BRIAN HIGGINS, New York

BRUCE L. BRALEY, Iowa

DARRELL E. ISSA, California

DAN BURTON, Indiana

CHRISTOPHER SHAYS, Connecticut

JOHN L. MICA, Florida

MARK E. SOUDER, Indiana

CHRIS CANNON, Utah

BRIAN P. BILBRAY, California

JARON R. BOURKE, Staff Director

(III)

C O N T E N T S

Page

Hearing held on October 1, 2007 ............................................................................ 1

Statement of:

Franklin, Lena M., director of Recovery in Community; Rita C. Fayall,

program coordinator Meet Me Half Way Village Center; Leon Faruq,

program director of Operation Safe Streets East; and Sheryl Goldstein,

director mayor’s Office on Criminal Justice ............................................... 12

Faruq, Leon ................................................................................................ 20

Fayall, Rita C. ........................................................................................... 15

Franklin, Lena M. ..................................................................................... 12

Goldstein, Sheryl ....................................................................................... 25

Heller, Ellen M., Circuit Court Administrative Judge, president of the

American Jewish Joint Distribution Committee; Jamey H. Weitzman,

Associate Judge, District Court of Baltimore City; David W. Young,

Associate Judge, Baltimore City Circuit Court; Dr. Joshua Sharfstein,

Commissioner of Health of Baltimore City; and Dr. Philip J. Leaf,

professor, Johns Hopkins Bloomberg School of Public Health .................. 45

Heller, Ellen M. ......................................................................................... 45

Leaf, Dr. Philip J. ...................................................................................... 68

Sharfstein, Dr. Joshua .............................................................................. 61

Weitzman, Jamey H. ................................................................................. 51

Young, David W. ........................................................................................ 60

Letters, statements, etc., submitted for the record by:

Faruq, Leon, program director of Operation Safe Streets East, prepared

statement of ................................................................................................... 22

Fayall, Rita C., program coordinator Meet Me Half Way Village Center,

prepared statement of ................................................................................... 17

Franklin, Lena M., director of Recovery in Community, prepared statement of ........................................................................................................... 14

Goldstein, Sheryl, director mayor’s Office on Criminal Justice, prepared

statement of ................................................................................................... 28

Heller, Ellen M., Circuit Court Administrative Judge, president of the

American Jewish Joint Distribution Committee, prepared statement

of ..................................................................................................................... 48

Kucinich, Hon. Dennis J., a Representative in Congress from the State

of Ohio, prepared statement of .................................................................... 4

Leaf, Dr. Philip J., professor, Johns Hopkins Bloomberg School of Public

Health, prepared statement of ..................................................................... 70

Sharfstein, Dr. Joshua, Commissioner of Health of Baltimore City, prepared statement of ........................................................................................ 64

Weitzman, Jamey H., Associate Judge, District Court of Baltimore City,

prepared statement of ................................................................................... 53

(1)

COMBATING DRUG ABUSE AND DRUG-RELATED CRIME: WHAT IS WORKING IN BALTIMORE?

MONDAY, OCTOBER 1, 2007

HOUSE OF REPRESENTATIVES,

SUBCOMMITTEE ON DOMESTIC POLICY,

COMMITTEE ON OVERSIGHT AND GOVERNMENT REFORM,

Baltimore, MD.

The subcommittee met, pursuant to notice, at 9 a.m., in Ceremonial Moot Court Room, University of Maryland School of Law, 500

West Baltimore Street, Baltimore, Maryland, Hon. Dennis J.

Kucinich (chairman of the subcommittee) presiding.

Present: Representatives Kucinich and Cummings.

Staff present: Jaron R. Bourke, staff director; Charles Honig,

counsel; and Jean Gosa, clerk.

Mr. KUCINICH. Good morning. The Domestic Policy Subcommittee

of the Committee on Oversight and Government Reform will now

come to order.

Today’s hearing will examine innovative approaches to combating

drug abuse and drug related crime in Baltimore.

Now, without objection, the Chair and other Members will have

the opportunity to make opening statements, followed by statements of the witnesses not to exceed 5 minutes.

Without objection, Members and witnesses have 5 legislative

days to submit a written statement or extraneous materials for the

record.

And without objection, we will be joined on the dais by Members

not on our committee for the purpose of participating in this hearing and asking questions of our witnesses.

I want to begin by recognizing the considerable contributions of

Congressman Cummings in organizing this hearing. Congressman

Cummings’ commitment to his home city of Baltimore, as you

know, is profound.

This is only the most recent of field hearings on the city’s efforts

to combat drugs and crime that he has helped this committee to

convene. These hearings continue to be important, both because of

the pressing issues facing Baltimore and what this city’s experience

tells us about national drug control and violence prevention efforts.

As we all know, the levels of drug abuse and drug related violence in Baltimore are unacceptably high. It is estimated that

60,000 of Baltimore’s 650,000 residents are drug dependent, mostly

abusing heroin and cocaine. By many metrics, Baltimore is the

most violent major city in the country and recent indicators are

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troubling. Non-fatal shootings and juvenile shootings are up and,

most tragic, homicides have been creeping upwards since 2002. The

city is on pace for more than 300 murders for the first time since

1999.

Five years ago our predecessor subcommittee held a field hearing

in the War Memorial Building to examine what is termed Baltimore’s innovative drug demand reduction strategy. Since then,

‘‘The Wire’’ has allowed a larger audience to learn about some versions of the Baltimore drug and crime problems.

In some respects, this hearing involves the same themes as the

earlier hearing. It looks at city-led and community-wide efforts to

provide effective drug treatment and in particular the role of drug

treatment courts in this process.

It also highlights how crime reduction efforts are part of the solution. Back then it was methadone provision. Now it is

buprenorphine.

By focusing here on drug treatment, the coordinated provision of

services and community-based violence prevention, I do not want

to suggest that law enforcement and policing strategies are not crucially important; they are even if they are not the main subject of

this particular hearing.

In this subcommittee, we will look at the ways in which Federal

policies, including the Tiahrt amendment and inadequate gun ownership registration, are stalling the efforts of local law enforcement

to remove illegal drugs from the streets. In addition, criminal justice is not just policing. As the highest criminal court coordinator

will explain, there are many other effective strategies. Nonetheless,

drug abuse is largely a public health problem, and combating drug

abuse is dependent on a coordinated strategy to offer at risk individuals multiple services.

Put another way, because drug abuse and drug related violence

have multiple causes, programs and strategies to combat them

must be multifaceted and provide multiple services in a coordinated fashion. Not just drug treatment, but job training, financial

assistance, and referrals to mental health facilities when needed.

Similarly, to combat gangs and prevent violence it is not enough

to place people behind bars. Instead we need to develop programs

that ensure that youths stay in school, learn to resolve their differences peacefully, stay off drugs, and plan for a career.

That is the insight behind what our witnesses will variously term

wrap around services or provision of a spectrum of services. A

panel of witnesses will introduce a lot of these programs today.

And they will discuss initiatives operated by community groups

and faith groups.

This committee will also hear from a panel of judges who together have been most instrumental in Baltimore’s successful implementation of drug treatment courts. Drug courts have been an

effective route for coordinating criminal justice agencies, mental

health, social agencies, and treatment communities to provide multiple services. Drug courts demand accountability from their participants and are sophisticated about monitoring outcomes and ensuring best practices as to how to operate.

The judges will describe efforts to improve these courts by providing more rapid evaluation and treatment referrals, a wider

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array of participants and expanded services. They will also explain

how the problem-solving court model is being applied to children

and families in juvenile drug courts, teen courts, truancy reduction

courts and family courts.

Important questions are raised by the simultaneous development

of judicially led problem-solving courts and non-judicial programs

that aim to provide a similar spectrum of services.

They are working at now to coordinate existing services in order

to prevent wasteful replication. Further demands of collaboration

and coordination have been reflected in institutional changes, and

there are other challenges specially for the Federal Government.

Does the government adequately fund drug treatment and types of

institutions like drug courts that have been shown to be effective?

Does the Federal funding process hinder the development of programs that provide multiple services because these programs naturally need grants from multiple Federal funding sources?

Breaking the cycle of drug addiction and violence in Baltimore or

in any other city, for that matter, is an immense, but not an insurmountable task.

Understandable frustration about the persistence of these problems should not blind us to the fact that those who care passionately about this city, church members, social workers, judges, public policy advocates alike, and Congressman Elijah Cummings,

have made progress identifying types of interventions that work.

To help, the Federal Government must be attentive to what is

working. That is what we are going to hear about today.

At this time, I am pleased to introduce the gentleman who, in

so many ways, has brought to the forefront matters of great concern to this community. He has brought them to the U.S. Congress

and he has demanded that Congress pay attention. Whether it is

health matters, housing matters or matters that relate to criminal

justice and drug treatment and prevention, Congressman Elijah

Cummings has been there and I am so grateful to Congressman

Cummings, Elijah, to be with you here today in your home area,

about this community you love so much about the matters that you

are so concerned about. So the Chair recognizes Congressman

Cummings.

[The prepared statement of Hon. Dennis J. Kucinich follows:]

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Mr. CUMMINGS. Thank you very much Mr. Chairman. And I want

to thank you and I am sure the audience is well aware that you

were the former mayor of Cleveland, OH, so you are familiar with

many of these problems.

I want to thank you for holding this vitally important hearing to

seek out the best practices for combating drug abuse and drug related violence.

I also want to thank the University of Maryland Law School.

Dean, I thank you for hosting us this morning.

As you already know, violent crime is on the rise nationwide. According to a report recently released by the FBI’s Uniform Crime

Reporting Program, robberies surged in 2006 by 7.2 percent, homicides rose by 1.8 percent and violent crime, overall, rose 1.9 percent. Taken together, 2005 and 2006 represent the first steady increase in violent crime since 1993.

Here in Baltimore we have seen incidents of violence and gang

activity increase at a record breaking pace. As of now, more people

have been killed in Baltimore this year than at this time last year.

We will not know for sure what has caused this national spike in

crime until a full analysis is conducted, however, there are many

things that we do know from the decades we have spent working

to bring peace to our community. However, in Baltimore’s inner

city, the inner-inner city, I have seen the young men in my neighborhood lured into prison instead of college by illegal drug traffickers. I’ve also seen the young women seduced by addiction into selling their bodies on our streets. It is almost impossible for me to express how deeply I am troubled by this waste of human life.

Drug abuse and drug related violence have destroyed whole generations in our community and in so many communities across the

country. Not only has it destroyed communities, but it has brought

a lot of pain.

As you know, Congressman Kucinich has stood for several years

as ranking Democrat in the predecessor committee to this committee, the Subcommittee on Criminal Justice, Drug Policy, and

Human Resources. We are all acquainted with Representative Congressman Souder, who was the Chair then, and of course Congressman Souder is from Indiana. And we tried to identify the best practices in our national effort to stamp out the scourge of illicit drugs.

You would assume that a Congressman from a rural Indiana town

would have little in common with a Congressman from the inner

city of Baltimore, and in many ways that would be correct. However, Congressman Souder, a Republican, and I were able to find

common ground in our efforts to identify drug treatment and prevention strategies that work.

Congressman Souder’s community is plagued mostly by methamphetamine addiction, whereas cocaine and heroin addiction are

more common here, but the result is still the same. Drug abuse and

drug related violence know no boundaries. They are equally destructive to all communities, Black, White, rural and urban.

In our past oversight investigations, we have frequently turned

to Baltimore City, historically a leader in implementing innovating

drug treatment and prevention strategies. Chairman Kucinich, I

sincerely appreciate your willingness to continue that tradition

today.

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This morning we will hear from the individuals on the ground

who are responsible for providing drug treatment and services. We

will hear testimony regarding a highly effective drug treatment

court model for which the State of Maryland has been a national

leader.

Providing comprehensive drug treatment to non-violent offenders

has been shown to stop drug related violence before it even starts.

In this process we will also examine the emergence of other problem-solving courts, such as truancy courts and teen courts, which

are aimed to address the needs of at risk youth. Finally, we will

hear from city leaders on the identification and implementation of

best practices, with such groundbreaking efforts as the Baltimore

Substance Abuse System [bSAS]. Since it was established in 1990,

bSAS has been in the forefront of harm reduction efforts. I applaud

its recent efforts to widely distribute the highly effective, low risk

opiate dependency treatment, buprenorphine.

Baltimore’s Mayor Sheila Dixon has long been a leader in our

shared fight against illegal drugs. I fully expect that the Mayor will

continue to implement an aggressive drug control strategy that

builds on the success of the past while meeting the new challenges

we face. And I look forward to learning more about that strategy

today.

I find it unconscionable that we are spending billions of taxpayer

dollars to fight terrorism overseas while failing to address the terrorism right here in our own backyards. That, Mr. Chairman, is

why it is so critically important that we hold hearings like this one.

Again, I agree with you that the programs that we have found

in the past are the most effective and efficient of those that provide

holistic treatment and services to our constituents.

I thank you again for holding this vitally important hearing. And

I thank all of our witnesses for being with us today.

And it’s my understanding, Mr. Chairman, that many of the law

student friends will have to be leaving us to go to class at 10. So

I hope that everybody will understand that these are the future

lawyers of America and we want them to get every bit of knowledge that they possibly get, as much as we would love to have them

with us.

And I want to thank all of you for taking your time to be with

this morning.

With that, Mr. Chairman, I yield back.

Mr. KUCINICH. Thank you very much, Congressman Cummings.

And to those who are scheduled to go to a class, thank you for

being here for the beginning of this hearing.

Are we going to have all the lights turned off? That is not the

way I work. OK.

So as people are filing out, we will give you a chance to file out

and then we will start with the introduction of the witnesses.

By the way, as you are leaving, this committee meeting is being

taped and it will be on our committee Web site. So you will have

a chance to watch it if you are on your way to class and can’t be

here for today.

I am going to begin by introducing our first panel.

Is it Lena or Lena?

Ms. FRANKLIN. Lena.

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Mr. KUCINICH. Lena Franklin is director of Recovery in Community, a Baltimore substance abuse treating center that provides

multiple services to its patients. She received a fellowship from the

Weinberg Foundation 2007 for her work. Recovery in Community

is one of three grassroots centers that makes up Baltimore city’s

Threshold to Recovery Program. Threshold centers offer a nontraditional holistic approach to substance abuse recovery with a range

of options including all night 12 step meetings, acupunture, mediation, tai chi and buprenorphine.

Rita Fayall, welcome. Currently works as program coordinator

for the Meet Me Half Way Village Center, a program founded by

her husband which provides mentoring and family support services

for students and families of Garrison Middle and Forest Park High

Schools. Mr. Fayall is a long time grassroots community organizer

and activist in northwest Baltimore where she has worked to help

residents and stakeholders organize and take action to improve the

quality of life for themselves and their families. Meet Me Half Way

is part of Project Garrison, a faith-based, community-based nonprofit dedicated to advancing public safety faith-based and economic development initiatives in northwest Baltimore.

Leon Faruq, welcome, is currently the program director of Operation Safe Streets East, a shooting and homicide reduction initiative in east Baltimore. He also serves as the director of reentry

services for the Living Classrooms Foundation where he oversees

pre-release and post-release services for juvenile and adult ex-offenders. Mr. Faruq was founding director of Respect Outreach Center, a community-based ex-offender run reentry organization. He’s

a member of the mayor’s Ex-Offender Steering Committee, Maryland Division of Corrections Useful Offender Initiative Task Force

and Baltimore City’s Ex-Offender Employment Steering Committee, and is an Open Society Institute fellow.

Sheryl Goldstein, is that correct? Was appointed director of the

Mayor’s Office on Criminal Justice in February 2007. Welcome.

Prior to her appointment she worked for the Center for Court Innovation, a public/private partnership with the New York State Unified Court System that focuses on problem solving initiatives. At

the center she created and operated a community-based mediation

center in Crown Heights, Brooklyn, helped develop community justice centers in Red Hook and Harlem and assisted criminal justice

agencies, governments, NGO’s and community groups. She has also

served as criminal justice coordinator to the Baltimore County Executive Jim Smith, worked on legal reform in Kosovo and litigated

criminal cases for 6 years.

I wanted to thank all of the witness for being here, and thank

those who are in attendance in the audience.

It is the policy of the committee on Oversight and Government

Reform to swear in all witnesses before they testify. I would ask

that you would rise and raise your right hands.

[Witnesses sworn.]

Mr. KUCINICH. Thank you.

Let the record reflect that the witnesses answered in the affirmative.

And I will ask that the witnesses now give a brief summary of

your testimony. I want you to keep in mind that this summary

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should be kept 5 minutes or under in duration, but also your complete written statement will be included in the record of this hearing.

Ms. Franklin, let us begin with you. And again, thank you so

much for your presence here today. You may proceed.

STATEMENTS OF LENA M. FRANKLIN, DIRECTOR OF RECOVERY IN COMMUNITY; RITA C. FAYALL, PROGRAM COORDINATOR MEET ME HALF WAY VILLAGE CENTER; LEON FARUQ,

PROGRAM DIRECTOR OF OPERATION SAFE STREETS EAST;

AND SHERYL GOLDSTEIN, DIRECTOR MAYOR’S OFFICE ON

CRIMINAL JUSTICE

STATEMENT OF LENA M. FRANKLIN

Ms. FRANKLIN. Thank you.

Recovery in Community, Inc., is a program that started in Baltimore City with funding from the Abell Foundation and Weinberg

Foundation in 1999 in three of the oldest southwest Baltimore

neighborhoods in southwest Baltimore, which was Franklin Square

Fayette Street Outreach and Boyd Booth.

The program was designed with input from the community as

well as representatives from Health, Human Service and law enforcement agencies. After locating to its permanent site in 1999, it

began to offer services to the community itself.

Recovery in Community differs significantly from the major existing drug treatment outpatient programs in that it provided from

the beginning a street outreach component as well as transitional

housing. Because one of the things that was found in, I guess we

would call needs assessment prior to the program opening, was

that traditional outpatient when looking at 3 to 6 month involvement that did not address all of the other barriers, a lot of the barriers in terms of treatment, that it was not useful. The community

did not see it as useful. And also our experience tells us, that is,

people are involved in treatment that if we do not address the barriers, then it sets up the likelihood that they are going to be continuing to recidivate or, you know, keep coming in and out because

all of the things that they need are not being addressed.

So a big part of what we do at Recovery in Community is the

piece where we do concentrate on comprehensive case management

in addition to the outreach, in addition to the transitional housing

and nontraditional kinds of services inclusive of acupunture, as

was talked about before.

The process is also an ongoing thing in that we do not look at

finite level or finite times that people are in treatment. Recovery

in Community expects that when folks walk through the door they

make a commitment, as we make a commitment to them, they

make a commitment to us for at least 1 year. So as a part of our

service we see that the graduation that we do at the end of 1 year

being enrolled in treatment as well as whatever time it takes them

to achieve 9 consecutive months of clean urines, that we do a huge

graduation where we do the dedicated speaker, the dinner inviting

the family, community everybody. Because we see that it’s a great

accomplishment to so many of our folks, you know not having ever

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finished something and to be able to be allowed to celebrate it with

their family, friends and community.

As a part of the concept of Recovery in Community also we’re not

just looking at the individuals that are identified or effected with

the substance abuse problem. Because, as we know, substance

abuse effects everybody not just the individual, but the families as

well as the community. So it’s always one of my things that if I

ever forget, or start to forget, what it is that I’m doing all I have

to do is remember the name Recovery in Community. Because unless we are addressing all of the community in terms of families,

individuals and the neighborhoods themselves, then we’re really

not doing a good job I don’t feel in dealing with the problems as

we see them.

We have had since we began treatment in 1999, 257 folks that

have completed the 1-year minimum and 9 months of consecutive

clean urines. And of those 257, 203 of them were in traditional

housing. And so it just kind of indicates to us how important transitional housing is as a part of this process.

As you talked about it in my introduction, we’re also involved in

the Threshold to Recovery project. And we see that as a natural extension of what we do. We don’t see our involvement with our client, again, is just in these increments of 3, 6 months that kind of

thing. We truly believe that in order for people to continue that

continuum of recovery in being and getting the support, that we

can’t just talk about the treatment part of it. We also have to talk

about the recovery part of it. Because as you know, with all of the

difficulties that people experience as a result of their substance

use; employment, housing, family support, all those kinds of things

that, again, we have to address that it takes time for folks to be

able to get back on the level ground and the footing that allows

them to maintain recovery in the long run.

So we design our program, as we continue to develop our program and to bring in other initiatives or to be involved in other initiatives as a Threshold to Recovery, then it’s very apparent to us

that we have to continue our efforts in developing programs with

community input with other agencies, social services agencies within our community. We have collaboratives with employment services, with legal services, with the family treatment or the family

health center that is located in our community as well.

Did I do 5 minutes. OK. But I think that in a nutshell kind of

gives you an overview of what it is that we do.

[The prepared statement of Ms. Franklin follows:]

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Mr. KUCINICH. Thank you very much for your testimony, Ms.

Franklin.

Ms. Fayall.

STATEMENT OF RITA C. FAYALL

Ms. FAYALL. Meet Me Half Way Village Center is a school-based

mentoring and family support program run by community residents. Operating from the basements of Garrison Middle and Forest Park High School in northwest Baltimore, center staff mentors

students and coordinate wraparound services for the students,

their families and neighbors.

Meet Me Half Way operates full time during the school day. The

Program impacts youth, drug abuse and violence prevention by providing mentoring, career exploration and other positive alternatives

and provides interventions through counseling, referral and support services.

Center staff conduct conflict resolution sessions and lunchtime

conversation circles. There is a kinship support group for grandparents and other relative care givers, individual and family counseling, grief support groups and GED classes.

Welding, printing and carpentry equipment has been purchased

or denoted to introduce youth to trades and career exploration. Licensed community professionals volunteer their time to perform the

services or classes for the students.

According to the director, 90 percent of what the staff does is listen.

That is what is unique about Meet Me Half Way. Students say

this is the one place where adults actually listen to children. Until

very recently the staff did not even realize the impact the program

has relative to drug usage, drug related crime or gang violence

until one student shared that she spends so much time in the basement because it is one of the few places where she is not being recruited by gang members. Other then admitted that there are recruiters in the building and that this is a serious issue for students.

Last week when a girl was beaten by several girls, she returned

2 days later with nine girls to attack her own cousin because she

did not join in to help the fight. The cousin was reluctant to have

staff call her mother because she said her mother would make her

fight each of the 10 girls individually while the mother stood guard

to make sure it was fair fight. The cousin is the young lady who

is trying to resist gang involvement.

Last summer, four youth workers returned from lunch admittedly under the influence of marijuana and were sent home for the

day. Rather than terminate the young men ages 15 to 17, program

staff decided unanimously to give them the option to undergo drug

testing and treatment for the duration of the summer work assignment as a condition of their continued employment. Program staff

collaborated with a nearby treatment facility and each youth accepted the offer.

One was reluctant to submit to the test because he was already

on probation through the courts and because he believed the treatment was not really going to make a difference because he said all

the people in his house smoke marijuana.

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Sometimes it is the parents who seek help from Meet Me Half

Way. In two separate runaway cases within the past few months

program staff have helped parents to secure residential placement

and treatment for the students on the very day they were located.

All these cases are fairly representative of issues faced by Meet

Me Half Way staff and clearly illustrate the need for a comprehensive approach that involves family and community stakeholders.

To maximize the impact in combating youth drug and gang involvement, the program’s parent organization Project Garrison, Inc.

coordinated a drug-free community coalition following the guidelines set forth by SAMHSA. On this past Saturday a Recovery

Walk was held on Park Heights Avenue in Baltimore to celebrate

recovery. Over 350 people participated in the walk sharing their

support and appreciation for the support of those in recovery.

Meet Me Half Way has just started its fifth school year and conflict resolutions are down from 61 in September 2005 to 17 this

September. Out of school suspensions are down by over 83 percent.

Last year student attendance improved and an unexpected result,

teacher attendance also improved.

Thank you.

[The prepared statement of Ms. Fayall follows:]

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Mr. KUCINICH. Thank you very much for your testimony.

Mr. Faruq.

STATEMENT OF LEON FARUQ

Mr. FARUQ. Thank you.

Operation Safe Streets is based on the CeaseFire model to reduce

shootings and homicides in high risk neighborhoods. The model has

five core components: Community coalition building, street outreach, public education, clergy involvement and law enforcement

collaboration.

The program seeks to create behavior change and shift the social

norm that violence is acceptable through repetitive prevention messages and concrete services that support and give credibility to the

message.

The key message is that shooting is not acceptable in our communities. Operation Safe Streets site focus on Police Post 221 in

the southeast police district. This area is selected based on its high

rate of violence including homicides and shootings. We deliver stop

shooting messages through our outreach workers, community leaders, posters and flyers. We also emphasize that this message at

Safe Streets events. Our workers are on the streets Tuesdays and

Wednesdays from 2 p.m. until 10 p.m. and on Thursdays, Fridays

and Saturdays they’re on the streets from 6 p.m. until 2 a.m.

Our outreach workers are hired from the community. They are

working with similar backgrounds to those who they are trying to

reach. These are individuals who are respected n the community.

The outreach workers both deliver the message that shooting is not

OK and are able to interrupt and de-escalate volatile situations before they lead to violence. We have four outreach workers in our

site, four full time and one part time.

The workers identify at risk individuals, they canvas the neighborhoods, they case manage clients, they work with youth and they

identify and they mediate conflicts in the community.

An example of a conflict mediation one of the outreach workers

recently mediated a conflict between two groups related to a theft

of a drug stash. The situation escalated to the point where friends

were involved and violence was threatened. The outreach worker

was able to bring both subjects away from their friends and engaged them in mediation where they discussed the situation and

talked about the issues and misunderstanding relating to the conflict. And the situation would have likely ended in violence was resolved in a peaceful manner.

We have over 20 conflict these kind of mediations, and most of

them in my opinion I believe they would have led to violence.

Workers continue to monitor situations and are prepared to intervene again if needed.

We organize a response to shootings in our area. The response

emphasize the message that shootings is unacceptable and bring

the community together and heals community spirit. Responses can

be a vigil, a march or some other kind of activity.

We also conduct community events such as midnight barbecue,

movie nights and basketball tournaments. Our most recent event,

Peace Night Out, included a community resource area, free drinks

non-acholic, free food, a dance contest and musical performances.

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The event drew a crowd of approximately 250 community members

and stressed the importance of reducing shootings and homicides

in the targeted area.

The community oriented events promote confidence in the program and allow community members to take ownership of the program and its message.

Operation Safe Streets have been operating in the east side of

Baltimore in this part of McElderry Park since June 2007. At that

time there had been five shootings in that targeted area, and Operation Safe Street had responded to each shooting by galvanizing

community members to deliver the message that shooting is not

OK.

There have been between 65 and 200 community members at

each of these shooting responses. In addition, Operation Safe

Streets have held four community events in a targeted area since

June with between 175 and 300 residents attending these events.

The program has handed out over 5,000 public education materials.

Outreach workers have mediated over 20 conflicts and assure that

these conflicts did not result in shootings and homicide.

We are optimistic that this program, we have an impact in reducing homicides and shootings in Baltimore.

And thank you for your time and attention to this important

issue.

[The prepared statement of Mr. Faruq follows:]

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Mr. KUCINICH. Thank you very much for your testimony.

Our next witness is Ms. Goldstein.

STATEMENT OF SHERYL GOLDSTEIN

Ms. GOLDSTEIN. Thank you. Good morning, Mr. Chairman and

Congressman Cummings.

I appreciate the subcommittee’s desire to help cities like Baltimore reduce violence, and I thank you very much for the opportunity to testify here today.

Baltimore is a city with many strengths, but we also have some

serious challenges. Gang culture and criminal activity are threats

to the many law abiding citizens of our city and they create some

long term challenges because gangs recruit young, and young people who commit crimes often spend their entire lives on the wrong

side of the law. Many never could finish school, many have very

limited employment options. And unfortunately, all too many end

up in jail or becoming the victims of violence.

Preventing juvenile crime, combating gang activity and reducing

youth violence in Baltimore City requires a citywide effort, including local, State and Federal agencies, social service providers, community-based organizations, faith-based groups, neighborhood associations, community leaders, residents and youths. And it is really

my privilege to sit on a panel with three people who represent community-based organizations that are in the trenches doing this

work. Because without partnerships with people like you who have

been out there and are working with the people, the city could

never be successful, or nearly as successful in combating violence

and helping the people in our community. So I thank you and applaud what you are doing.

We must all work together to address health concerns, substance

abuse, criminal justice, recreation, employment and other socio-economic issues confronting Baltimore’s youth.

What we see in Baltimore today is that youth involvement in

gangs and violence is a growing concern. Police estimate that we

have over 50 known criminal street gangs with over 1,500 adult

members. This number is an interesting number in that last year

we had 170 known criminal street gangs. We are not losing criminal street gangs, they are just becoming more organized in identifying themselves as Blood sets and Crip sets. And so while the numbers are growing, the gangs are actually become more organized.

School policy estimate that we have 600 high school involved in

60 gangs. Six hundred youth involved in gangs in middle schools

and elementary schools.

Juvenile violence and juvenile crime is also on the rise. Last year

9,000 young people were arrested and put in the juvenile justice

system. A third of those young people were arrested for substance

abuse related crimes.

Juveniles account for nearly 20 percent of all people charged

with adult felony gun charges this year. And even more disturbing

is that Baltimore City has experienced a 64 percent increase in juvenile shooting victims and juvenile shooting suspects from last

year.

Mayor Dixon has adopted a multifaceted approach to combat

gangs and youth violence. The strategy includes law enforcement

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and prosecution components which are not the focus of this hearing, but recognizing the police and prosecutors cannot do this

alone.

Mayor Dixon’s administration supports gang and juvenile crime

reduction through outreach, community partnership and providing

opportunities to those who choose to take positive steps toward realizing their full potential. The goal is to create a full continuum

of services and supports, starting at creating opportunities for

young people and others to keep them out of the system entirely,

keep their lives free of crime, engage in positive opportunities as

well as programs and systems that will intervene with young people who get in trouble with the law at all points in the system.

In my written testimony I have presented a number of different

programs, and I wanted to highlight a few of the really promising

programs that we have research and data on for the committee.

One of the main initiatives under Mayor Dixon starting in January of this year was to create more outreach opportunities. One of

the things that we find is that there are many people who want

to access opportunities and services but can’t get connected, don’t

know about those opportunities.

Mr. Faruq just testified about Operation Safe Streets. With the

support of Federal funding, Baltimore City has been able to launch

two Operation Safe Streets sites. The east side site started in July

and we have just funded a site on the west side of town as well.

This program is modeled on Chicago’s CeaseFire, which is an

outreach program to prevent and reduce homicides and shootings.

It is a program that really focuses on having people who have

street credibility, who are either ex-offenders or who have been involved in gangs in the past out on the streets at nontraditional

times when most people are out on the streets and conducting outreach to try to get people to make different choices and to link

them with different support, such as substance abuse treatment,

job training, job opportunities so that they change their lifestyle.

In Chicago, CeaseFire achieved reductions in shootings of between 25 and 67 percent in different communities. And we are optimistic that we will see these same results here in Baltimore.

Baltimore is also partnering with grassroots organizations that

have been working on the ground and have been successful just on

their own reaching out to people to try to get them out of the lifestyle and connected with positive supports. So far the city has

partnered with and has funded programs such as Reclaiming Our

Children & Community Project, Precision Youth Power, On Our

Shoulders and New Vision Youth Services. These four programs

are an example of programs that were started by people who used

to be in gangs or were in the criminal justice system who wanted

to change their lives and change other people’s lives. And we are

continuing to build those partnerships, investment in those programs to help people to change their lives.

Another program that I want to talk about is the Health Department’s Office of Youth Violence Prevention runs a program called

Operation Safe Kids.

Operation Safe Kids was developed in response to young people

who were at risk of violence. The program really seeks to engage

young people who are in the juvenile justice system as an alterVerDate 11-MAY-2000 14:42 Sep 15, 2008 Jkt 000000 PO 00000 Frm 00030 Fmt 6633 Sfmt 6633 C:\DOCS\44006.TXT KATIE PsN: KATIE
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native to placement or detention, and it is focused on young people

who are either likely to be victims or perpetrators of violence.

What we find in these young people is that many of them have

multiple prior arrests, five or six for CDS and other types of offenses. And many of them have their first arrest as young as age

13.

The outcomes of this program are promising. The total arrests

for young people in the program after their first year dropped by

32.9 percent. Arrest for drug crimes dropped 41.2 percent. And arrest for violent crimes dropped 44 percent.

One of our other lessons learned by that program is that for

every 10 percent increase in employment of participating youth

was associated with a 20 percent drop in arrests, which takes me

next to looking at our Mayor’s Office of Employment Development.

The Mayor’s Office of Employment Development has really taken

a leading role on providing opportunities for young people who are

at risk of not completing school or out of school. The Youth Opportunity Centers have reconnected over 1,000 youth each year who

have dropped out of school to a broad menu of academic, personal

growth and employment opportunities. Our Futures program

serves nearly a 1,000 young people each year who are at risk of

dropping out of school and keeps them in school. And 5,000 city

teens are employed each summer through the Mayor’s Office of

Employment Development’s Youth Work Summer Jobs Program.

These programs all have proven to reduce dropout rates and to

reduce arrests.

So I see that my time is up. And if there are any questions, I

would be happy to answer them.

Thank you.

[The prepared statement of Ms. Goldstein follows:]

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Mr. KUCINICH. I want to thank Ms. Goldstein for her testimony.

And maybe what I could do is to begin with questions of you.

What percentage of at risk children in Baltimore do you estimate

are served by the more aggressive multi-service intervention, be it

in Teen Court or Operation Safe Kids, and has these saturation

services reached the point where you can see an improvement in

overall social indicators like school attendance, new drug indication, gang affiliation, level of violence?

Ms. GOLDSTEIN. Sir, these programs reach a very small number

of children. Operation Safe Kids reaches about 100/150 kids a year,

our Teen Court service about 200 kids a year. So while they are

programs that are successful with the young people they intervene

with, it is a very small number of young people who are receiving

those services. And so in terms of saturation services, absolutely

not. We would certainly need more support and funding for that.

Mr. KUCINICH. You have broad experience in New York and

other localities. Can you tell us how Baltimore compares to the

other localities in criminal justice strategies and the services it offers? And does it offer more programs that have been shown to

work?

Ms. GOLDSTEIN. I think it is hard to make those types of comparison. I think that Baltimore has a number of programs. It has

actually recently started a number of programs that are successful

for the small populations that it serves.

New York City, you know which is probably my best basis of

comparison, has a broader scale and scope of programs. It serves

a larger number of people.

I think Baltimore has faced many challenges in terms of trying

to serve these populations. And the more support that we could obtain from Federal sources would be greatly appreciated.

Mr. KUCINICH. Let me go to that then. What can the Federal

Government do better to help support criminal justice and public

health strategies that work?

Ms. GOLDSTEIN. I think a few things. First, you know, I think as

Congressman Cummings began at the hearing, you know it’s really

a holistic approach. And we need more after-school opportunities

for young people. You know the data shows that by the time these

kids are 13 it is almost too late in terms of trying to intercede. So

we need more opportunities for young people, more early intervention and prevention program, more opportunities earlier on.

And then as you can see even from my description, the programs

that we have developed here are intervention programs for kids

who are already in the system. We have not had the resources to

do real prevention programs for the young person who is first

stopped by police. You know, for the very first time they should not

even be arrested, but could be referred to a service program to

meet their needs. So certainly early intervention and more opportunities are needed.

Mr. KUCINICH. Thank you.

Mr. Faruq——

Mr. FARUQ. Yes, sir.

Mr. KUCINICH [continuing]. I can see from background that you

spend time out on the street.

Mr. FARUQ. Right.

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Mr. KUCINICH. And you are talking to these young people.

Mr. FARUQ. Yes, sir.

Mr. KUCINICH. Can you relate to us what are they thinking?

What is it that draws them into the violent crimes and the drug

abuse? If you could characterize it in a few minutes, how would you

characterize what is going on in the street with these kids?

Mr. FARUQ. You know, they characterize it that they are trying

to eat. Their characterization is that they are trying to eat. They

do not see a lot of opportunities in trying to negotiate the system

to come for some success with a meaningful lifestyle. So they think

that they do what they do best or know best.

So, hopefully, some of the things that we want to do is to partner

with them to show them there is something different. And to take

their hand and partner with them to get to negotiate the system

to try to unveil opportunities. To show that there’s hope.

And, you know, them seeing the outreach workers, used to sharing their lifestyle and that outreach workers having turned their

lives around and doing something different, then that is an example of hope. If he can do it, I can do it. So there is hope presented

in the outreach worker who used to be on that side of it.

And for many of them, do not have hope, you know. So also with

the hope is the possibilities that it is possible for me, too.

But their characterization is that they are trying eat, so they are

trying to make a living. You know, they are trying to get money.

But, you know, the thing that we want to do is that they can this

without risk, without going to jail.

Mr. KUCINICH. My time has just about expired and I am going

to go to Mr. Cummings for questions. We are going to have one

more round of this panel, Mr. Cummings, so we can get all the witnesses’ reflections.

I just want to say that while your testimony focuses on what you

are doing to try to help deal with the situation with drug abuse

and violent crimes, I think it is important for us to try to get under

it and ask some questions about why. Because we may learn something from that as well, and you are the ones that are dealing with

these young people every day. I think you have some reflection,

and that is why I asked those questions.

The Chair recognizes the gentleman from Maryland, Mr.

Cummings.

Mr. CUMMINGS. Thank you very much, Mr. Chairman.

As I was listening you, Mr. Faruq, a lot of people do not know

this but I met Mr. Faruq many, many years ago in prison when

I was teaching a course for Compton State many years ago. And

I thought about something that is in the movie ‘‘Sicko’’. And going

back to what you just said, Mr. Chairman, and in that movie by

Michael Moore a parliamentarian from England said something

that is so profound. They were trying to figure out why, for example, do we have universal health care, some form of it, in France

and in England but not America. And he said something to this effect. He said, first of all, the people would rise up if they didn’t

have it. But then he said if you keep people sick, unhealthy, if you

keep them uneducated and if you keep them hopeless and helpless,

they will not rise up.

38

And when I think about all that you are saying, this whole thing

of holistic, I want you to talk about the holistic piece. I think you

have talked about, Ms. Franklin, and I think all of you hit on it

to a degree.

One of the things that I have noticed is that you can get—it

seems like even when we pull, that we are able to folk saying not

to use drugs. You have to have something to replace that. And

going back to what you said, Mr. Faruq, one of the things you got

to establish is hope. Because when people are not hopeful, that is

a real problem.

So going back to, Ms. Franklin, how do you or Ms. Fayall, how

do you all get to that piece? You know, how do you get that piece

where a person perhaps has fallen or is falling and then you are

able to get them at least hold the falling, stop the falling for a moment, but then get them back on the right track? Because you

talked about 257 people who I think you said has successfully

stayed clean for a whole.

Ms. FRANKLIN. Completed the program.

Mr. CUMMINGS. And you said 203 were in transitional housing.

Ms. FRANKLIN. Yes.

Mr. CUMMINGS. Housing is one thing. I mean, we are talking

about basics.

Ms. FRANKLIN. Right.

Mr. CUMMINGS. So go ahead.

Ms. FRANKLIN. And that is what we’re talking about, we are talking about basics. But the real basic that we are talking about in

Recovery in Community is providing a community of support so

that the program does not just stop just because you have completed your 12 months or whatever, however long it takes you to

get to that point. It is about providing a place where people can be

if they pass or fail in success or failure so that, you know, understanding that as a part of the process of recovery that is a process.

I look at it as any other chronic illness, chronic disease, diabetes,

hypertension all those kinds of things. We do not beat people up

because they do not stick to their dietary regiment in diabetes. We

understand. Very clearly we understand that once you got it under

control, then what happens with is that we make a decision well

I am doing good now, I can just go back to my old habits. We do

not beat people up for that. But we beat people up for that in terms

of substance abuse, in terms of relapse and that kind of thing.

Now that is not to say that relapse has to be a part of it, but

we need to understand that relapse sometimes is a part of it. And

what we do, what we can do in that process in terms of support

or we can make them feel even worse than they already feel and

alienate them from the treatment process or we can help them to

stay in the process and understand that you are not failure just because that happened.

The whole thing of, you know, looking at all the things that are

impacted. We also know that a number of our folks are impacted

with mental health issues. That we have gone out into the community and gotten folks that are interested and willing to provide

mental health services to our folks who do not have insurance or

who are eligible for insurance under the gray zone, whatever, with

the mental health services. But again——

39

Mr. CUMMINGS. I see my time is running out. Yes.

Ms. FRANKLIN. Yes.

Mr. CUMMINGS. But let me just ask this question. The other

thing I am very concerned about, you know one of the things that

has always concerned me and we have seen it in Washington when

people come just doing some investigations that we have done, we

have seen sometimes people providing services, services like drug

treatment and in some instances the drug treatment is not what

it ought to be. And people are making a profit. The addict is not

getting properly treated.

And in talking to addicts that I have known, they tell me that

if they go into something that they find to be false or they think

it is just not the real deal, that it sets them even further back. Yes.

Ms. FRANKLIN. Yes.

Mr. CUMMINGS. Maybe in the future answering of questions you

all can get into that a little bit.

And the other piece that I am concerned about is how do we

interact with the various agencies? I mean, sometimes I think that

what we do is we set up situations, we almost set ourselves up for

failure. In other words, if I have an agency that is doing this and

doing well, how much interaction with, say, the job component do

I work with; the health community, do I work with? I mean things

that are already in place for people who are experts. I am not saying that you do this, but sometimes I think that what happens is

we are trying to do so much but if we zeroed in and a better interaction and like a web of services coming to truly wraparound the

people who are experts on these things, so if somebody needs I can

send them to somebody that is all they do is find people job and

train them. If they got health thing—you know, you hate to be

sending people to different places. But if they are got to help them,

perhaps if they are suffering from some chronic disease, sending

them to the appropriate place for that.

Again, going back to what the parliamentarian said in ‘‘Sicko’’,

uneducated, unhealthy, hopeless and helpless. And I think if we

can get, going back to what you were saying Mr. Chairman, to

some of those things and truly provide a safety net for them, I

think you can get to the bottom of some of this.

Mr. KUCINICH. We will take one more round of questions for this

panel.

I would like to go back to a discussion that you started with Ms.

Franklin relating to the mental health issues. These young people

we are talking about, they are living in an environment where

there is a lot of violence, where the violence might be inside the

home as well as outside the home, while people in the home may

not have a secure sense of economic vitality, may not have jobs,

right?

Ms. FRANKLIN. Yes.

Mr. KUCINICH. They are likely not to have health care, right?

Ms. FRANKLIN. Yes.

Mr. KUCINICH. That kind of an environment is really ripe for

mental health problems for anyone.

Ms. FRANKLIN. Yes.

Mr. KUCINICH. And would you agree with that?

Ms. FRANKLIN. Yes, I would, absolutely.

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Mr. KUCINICH. So these young people if we are looking at looking

at young people in situations where they could become at risk, one

of the areas that we should be looking to and we’re seeing is access

to mental health.

Ms. FRANKLIN. Yes. Absolutely.

Mr. KUCINICH. Tell me more about your experience in that, I

mean if you can think of any cases in particular.

Ms. FRANKLIN. Well, we do not treat young adults.

Mr. KUCINICH. I understand.

Ms. FRANKLIN. OK. But one of the issues, what we do with that

is that we work within the community, within the community

where we are. And, you know, there are a couple of hospitals and

community mental health centers that are right there that we take

advantage of that we have our clients to be able to go there without

having to go through a bunch of barriers to access and treatment,

as well as providing space in the facility for those community folks

to come in and provide mental health services to our people, as

well as to the families, the children the other folks that are impacted that are associated with our clients that are involved in

treatment at our program. And we see that working very well.

As a matter of fact, we have been fortunate that we have been

able to raise some funds to develop a community mental health

center right across the street from where we are. And one of the

providers that has been coming in to see our clients has agreed to

set up an office there that is not only going to treat and be available for the folks that we see, but for the folks in the surrounding

community. So it’s not going to be just for adults, but it’s going to

be for children and anybody who is in need of mental health services and they have the ability to be able to find out their eligibility

for coverage for their mental health services medications as well as

treatment. So that is one of the outcomes that we have had that

has been very successful with having mental health as an integral

part of what we do. Because we know that people are in need of

those services just because of the circumstances in which you have

so elegantly describes: You know, in just living in a situation like

that will set you up for——

Mr. KUCINICH. Right. It is a tough society out there for a lot of

people, particularly for children.

Ms. FRANKLIN. I am sorry?

Mr. KUCINICH. I said it is a tough society out there for a lot of

people, particularly for children.

Ms. FRANKLIN. Absolutely. Absolutely.

Mr. KUCINICH. And these programs that you are setting up

where it is a sense of prevention and then referral become——

Ms. FRANKLIN. Right.

Mr. KUCINICH [continuing]. Life savers for young people.

Ms. FRANKLIN. Yes, we are.

Mr. KUCINICH. Congressman Cummings and I have had this discussion about looking at drug addiction as, first, a health problem.

It can be a physical and emotional health problem. And if it is delegated, it ends up being a criminal justice problem. Would you agree

with that?

Ms. FRANKLIN. Yes, I would. Absolutely.

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Mr. KUCINICH. I have a minute for another question here. I

wanted to Ms. Fayall how do students end up in your program? Is

it voluntary or——

Ms. FAYALL. It is voluntary. They also can be recommended or

referred by administration. We have a membership of 1,100 students who have voluntarily come down and joined the center. And

it is just not for troubled youth. We help them with anything that

is on their minds. It could be something like starting a new club,

a dance group; anything that they want to do, anything that they

are having issues with. It can be health related. We help families

to meet their basic needs. We do perform the wrap around services.

We have outreach to all kinds of agencies. We have a retired social

worker who is on staff who provides the resources that the students need to get what they want.

Mr. KUCINICH. Now in your written testimony you state that suspensions are down 83 percent after the implementation of your program. Do you attribute this decrease to improvements in student

behavior or the provision of alternative sanctions to your program?

Ms. FAYALL. The first year that we were there the policy was in

force yet. But the students were able to come down. The one thing

we do, we offer in-house suspension so that instead of sending the

children home or out on the streets, they come downstairs. They’re

out of the student population. And while we have them down there,

we work on the issues that led to the behavior in the first place

rather than punishing the behavior or trying to find out specifically

what is going on, meet the need where the student is and literally

meet them halfway.

Mr. KUCINICH. Thank you very much.

Mr. Cummings.

Mr. CUMMINGS. Yes. Ms. Goldstein, the gang situation. You were

talking about one of the programs and you were saying in answer

to the chairman’s question that there was a limited number of

young people that you could help, is that right?

Ms. GOLDSTEIN. Yes.

Mr. CUMMINGS. And so that means that there are probably a lot

of people who need the services but do not get them.

Ms. GOLDSTEIN. Absolutely.

Mr. CUMMINGS. Do you have any idea what kind of numbers we

are talking about? I think you said it was a hundred and something that you are. What program was that?

Ms. GOLDSTEIN. I think we were talking—if you look at just the

school dropout rates, for example. You know in Baltimore City, as

we know, our graduation rate is about 50–60 percent. And when

we look at our programs that serve our out-of-school youth in terms

of education and employment opportunities, we are serving 500,000

young people a year. So just looking at that universe there are so

many young people who are out of school and who are susceptible

to those types of opportunities, as Mr. Faruq said, because they do

not have other opportunities or hope. That is a huge number.

Mr. CUMMINGS. What would you all like to see us do on the Federal level to help you address these problems?

Ms. GOLDSTEIN. I think we need more resources to create what

you have talked about, which is a seamless web of services so that

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we can catch young people early and provide them opportunities to

stay on the right path.

And I think one of the struggles that you were talking about is

you have different people who have different areas of expertise and

they need to be connected up. But research also shows that if you

send people to five different places, they don’t often get there. And

so the challenge is sort of creating one stops. You know, one stop

shops where you can colocate people who have that expertise so

that they can provide the maximum services to that group of folks.

And I would say that really what we need is more funding opportunities to support those types of initiatives so that we can help

people before to keep them in school, to keep them out of trouble

and then to catch young people at all places along the system to

give the supports and services they need in a holistic fashion.

Mr. CUMMINGS. Mr. Faruq, with regard to mediation, you talked

about trying to get to folk before they get into some very violent

situations. Do you find folk open to that? It seems like that would

be very difficult at times?

Mr. FARUQ. Actually, when you got the right people it is very

easy.

The guys that we choose have a lot of credibility with the population that we are targeting. They have a lot of influence. In some

cases, they even have command.

So when issues erupt and they present themselves, they are in

a situation where, first, they already got the respect. So they are

in a strategic position where they can mediate from all sides because all sides respect them, you know. And they take their word

at heart.

And I think this has emerged as a real cornerstone in our approach. Because it is preventive. You know, in most of the incidents

that we have mediated, you know that come out with peaceful resolution, even to the extent where we have mediation where guys

hugged and shook hands after they was threatening each other.

Mr. CUMMINGS. Yes.

Mr. FARUQ. You know, I would also like to add that with this approach is a public health approach. And what it does is to try to

sift a behavior norm. You know, violence is a learned behavior. You

know, so with credible messages, with a credible message we try

to change the behavior. You know, in the same way that the smoker who was changed by having this credible message, dominated

the person with the message and then all of a sudden the expectations about smoking changed. You know, drunk driving the same

thing.

And so it is with violence, you know, that we can change how

people look at violence. That people can begin to see that they can

have another outcome and there are other options other than violence.

You know, when we have people that they used respect representing that, talking that, pushing that and we dominate environment with this message, that we can bring about a change. It’s

so evident in Chicago.

Mr. CUMMINGS. And so you take them to a bigger picture?

Mr. FARUQ. Yes, sir. Yes, sir.

Mr. CUMMINGS. All right. Well, I thank all of you.

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And, Mr. Chairman, I just say that there were a number of people who wanted to testify, but the limitations of these hearings limited it. So I am hoping that we will be able to get some of their

written testimony and get it into the record.

Mr. KUCINICH. Thank you, Mr. Cummings.

We certainly want to invite the testimony of those who are interested in this. And we have 5 days to do that. So ordered.

I want to just make a brief comment before we dismiss this first

panel.

Mr. Faruq, you started to talk about violence being learned and

nonviolence can also be learned. I mean, that is what Dr. King’s

life was about, that is what the teachings of Christ and Gandhi

were about.

There’s a proposal in the Congress, H.R. 808, to create a Cabinet

level department of peace and nonviolence. And it directs itself to

these domestic issues of domestic violence, spousal abuse, child

abuse, violence in the schools, gang violence, gun violence, racial violence, violence against gays, police/community clashes. And I

would just recommend for your interest a bill which I’m the author

of, and I believe Mr. Cummings is one of the co-sponsors of. Because it really reflects the deep understanding that you have about

how you can teach nonviolence just as people learn violence. That

is a very important observation. I think everyone here on the panel

understands that, and I just wanted to share that with you.

On behalf of the committee, I want to thank the witnesses. Not

only for their testimony, but for the service which they give to the

people of this community in providing a path for hope and recovery.

So thank you.

And at this point we will dismiss the first panel. Staff will prepare for the second panel. We are going to actually combine the

second and third panels to facilitate the testimony of some of our

witnesses.

I would ask all those in the audience to please join me in expressing appreciation for the first panel.

[Recess.]

Mr. KUCINICH. The committee will come to order, please. Thank

you.

I want to welcome our second and third panel of witnesses for

coming forward. And I would like to begin with the introduction of

this panel, so those who are in the audience can understand the

significance of having this distinguished group of people here to

testify.

I will begin by introducing the Honorable Ellen M. Heller. She

was appointed as a Circuit Court Judge for Baltimore City in December 1986. She became the Judge in charge of the civil docket

in 1993 and served in that position until 1999. She became the first

woman in Maryland to be appointed as the Circuit Administrative

Judge overseeing the entire court, that was in 1999. Although

Judge Heller retired in December 2003 she continues to sit parttime as a trial judge and coordinates and sits on the Felony Drug

Diversion Initiative. Prior to her appointment on the bench she

served as an Assistant Attorney General of Maryland and was Deputy Chief of the Educational Affairs Division. Judge Heller is currently president of the American Jewish Joint Distribution ComVerDate 11-MAY-2000 14:42 Sep 15, 2008 Jkt 000000 PO 00000 Frm 00047 Fmt 6633 Sfmt 6633 C:\DOCS\44006.TXT KATIE PsN: KATIE
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mittee which provides humanitarian assistance to both Jewish and

non-Jewish communities globally.

The Honorable Jamey H. Weitzman has served as Associate

Judge of the District Court of Baltimore City since 1991. She

founded the first drug treatment court in Maryland in 1994 and

continues to serve as its supervising judge and developed Teen

Court, which provides alternative sentencing for troubled youth.

Judge Weitzman designed and chaired Maryland’s Drug Treatment

Court Commission and serves as Chair of Maryland’s Problem

Solving Courts Committee. She’s the author of Drug Courts: A

Manual for Planning and Implementation. Serves on the faculty of

the National Judicial College. And has lectured nationally and

abroad regarding therapeutic justice and drug courts.

The Honorable David W. Young has been Associate Judge of the

Baltimore City Circuit Court since 1996 where he presides over the

Baltimore City Juvenile Drug Court and has worked on developing

the city’s Family Dependency Drug Courts. He’s Vice Chair of the

Foster Care Court Improvement Implementation Committee. Prior

to his current appointed Judge Young served as Associate Judge

with District of Court of Maryland and Assistant City Solicitor to

Baltimore. He’s taught at the University of Baltimore School of

Law. Has been a long time trustee of the Bethal AME Church and

member of the Board of Directors of the YMCA of Greater Baltimore.

Dr. Joshua Sharfstein has served as commissioner of Health of

Baltimore City since December 2005. From 2001 to 2005 he worked

on the Democratic Staff of the Government Reform Committee of

the House of Representatives for Congressman Henry A. Waxman.

So, just want you to know there’s a future after this.

Dr. Sharfstein is a graduate of Harvard Medical School, trained

in pediatrics at the Boston Medical Center and Children’s Hospital

and completed a fellowship in general academic pediatrics at Boston University.

Dr. Philip J. Leaf is a professor in the Johns Hopkins Bloomberg

School of Public Health with joint appointments in the School of

Medicine, the School of Professional Studies in Business and Education and the Kennedy Krieger Institute. At Johns Hopkins he is

director of the Center for Prevention of Youth Violence, co-director

of the Center for Prevention and Intervention, senior associate director of the Urban Health Institute. For two decades Dr. Leaf has

worked with community groups, schools systems, law enforcement

officers, ex-offender groups and the faith community of strengthening families and communities and buffering the effects of violence

over neighborhoods. In 1995 he received the Johns Hopkins University Martin Luther King, Jr. Award for community service for his

work in Baltimore.

I want to thank members of this panel. This is, indeed, a distinguished panel. And we are eager to hear your testimony.

It is the policy of the Committee on Oversight and Government

Reform to swear in all of our witnesses before they testify. So I

would ask, if you will, to rise and raise your right hands.

[Witnesses sworn.]

Mr. KUCINICH. Thank you very much.

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Let the record reflect that the witnesses have answered in the

affirmative.

As with the first panel, I asked that each witness give an oral

summary of his or her testimony, bearing in mind to keep the summary to 5 minutes or under in duration. But your entire written

statement will be included in the record of this hearing. And,

again, our gratitude.

We are going to begin with Dr. Sharfstein. We are going to begin

with Judge Heller. OK. Go ahead, Your Honor.

STATEMENTS OF ELLEN M. HELLER, CIRCUIT COURT ADMINISTRATIVE JUDGE, PRESIDENT OF THE AMERICAN JEWISH

JOINT DISTRIBUTION COMMITTEE; JAMEY H. WEITZMAN, ASSOCIATE JUDGE, DISTRICT COURT OF BALTIMORE CITY;

DAVID W. YOUNG, ASSOCIATE JUDGE, BALTIMORE CITY CIRCUIT COURT; DR. JOSHUA SHARFSTEIN, COMMISSIONER OF

HEALTH OF BALTIMORE CITY; AND DR. PHILIP J. LEAF, PROFESSOR, JOHNS HOPKINS BLOOMBERG SCHOOL OF PUBLIC

HEALTH

STATEMENT OF ELLEN M. HELLER

Judge HELLER. Thank you.

Good morning, Chairman Kucinich and Congressman Cummings.

I am very appreciative of the opportunity to address you today on

behalf of the Circuit Court for Baltimore City, which is in Maryland the State trial court in Baltimore, a court of unlimited jurisdiction with civil, family, juvenile and Judge Young has been a long

time Judge in the Juvenile Court, as well as the criminal docket.

My testimony today is going to focus on the Felony Drug Diversion Program, a special initiative that was begun in 2003 with

great assistance, indeed I would say 100 percent assistance, from

Congressman Cummings in response to a crises at that time that

had hit the city. There had been a horrific murder of a family that

had been reporting drug crimes in their neighborhood. But in addition, there were many drug arrests. The dockets were clogged. And

there was a need to tweak what we already had in order to see

what we could do.

And out of the crises that occurred at that time, and unfortunately and the testimony today will indicate it is still there. For example in 2006 I got statistics and I was told there were 3,358 new

felony drug offenses in the Circuit Court for Baltimore City alone.

That doesn’t include the misdemeanor drug offenses that Judge

Weitzman will talk about, a high percent not abating. But we were

looking for a model that would get the felony drug offenders, those

not violent offenders who faced 5 to 20 years real time into a different situation that incarceration, where I am sure you are aware

there is very little drug treatment especially in the State prisons,

and there has been as long as I’ve been on the bench there has

been almost no drug treatment for the incarcerated community,

and where people were released with almost no support services,

only to re-enter once again.

So we worked as a team. And I heard this morning Congressman

Cummings talk about the need just a few moments ago to work as

a team. This court couldn’t have been developed without them and

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continuing now a positive relationship between the partners in the

criminal justice system, the Office of the Public Defender, the Office of the State’s Attorney, the Division of Parole and Probation,

the Division of Corrections, Baltimore Substance Abuse systems

just all the way down the line to come up with a new variation on

the umbrella drug treatment court. And let me tell you quickly the

features.

We wanted to make sure within a month of arrest we were going

to have an individual into treatment. And, again, these are people

who have long records, felony charges who faced 5 to 20 years incarceration. We were able to do that.

We found, although we had thought we were going to have a continuum of services that the population we were addressing needed

long term residential structured placements. And they had to be

quality of placements. We didn’t want to set people up to fail and

go back into the system. We were able to do that with the assistance of Baltimore Substance Abuse Systems. We only used placements that they have certified as adequate and appropriate.

We wanted to have in-court assessors. Never in the history of

Maryland have we put accessors in the court so that right there

and then we could have people brought over within 30 days. They

were literally assessed in the morning. If found appropriate,

brought down in the afternoon before the judge. Entered the program the very next morning because of the cooperation with the

Division of Corrections actually transported by the division into a

residential placement where they stayed for a minimum of 6

months. Twenty-four hour turnaround within a month of arrest.

And we are still doing it.

We have structured after care. We learned soon into the program

that we needed more services as people succeeded.

I also heard this morning there had to be hope and something

to replace the drugs. And we did that with job training and liaisons

with job opportunities.

We started to evaluate and we continue each month to look at

our statistics and have a meeting of that whole team. There is a

very positive, cooperative nice to see environment with the State’s

Attorney and the Public Defenders talking with each other. The Division of Parole and Probation agents who are specially trained

take a special interest in each of their clients.

What are the achievements? In 2004 we had the largest number

of people. Seventy-three percent successfully completed treatment,

86 percent of those who did complied with their conditions of probations.

In 2007, 4 years down the line, 68 percent of our people, that’s

almost 70 percent, of either successfully completed the entire program or in successful good standing in drug treatment. That’s a

really fine statistic that we work on.

Cost saving. In contrast to the $25,000 noncapital expense of incarceration. This, again, we are talking about residential long term

care for a minimum of 6 months, our average cost for diversion is

$6,535. So that is quite good.

Are there needs? Yes. Needs for quality drug treatment programs.

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Need for job opportunities and employment for felony and criminal offenders so that they can qualify for them. Need for what we

call dual diagnoses programs. Chairman Kucinich, mental health

issues are a very large part of adult offenders. There is a shortage

of programs. I have actually kept people incarcerated for months

while we try to search a program that would take these so called

dual diagnoses individuals. They almost do not exist.

We need housing. I have a man right now who is almost finished

our program, was in from the beginning. He is confined to a wheelchair. He has been drug free for 3 years. He has a job, notwithstanding his paralysis. He has no housing. He no longer qualifies

because of his felony conviction. And he needs supportive housing.

So I want to end. I think my time is up. But saying I thank Congressman Cummings for the chance to work with the team at the

court. I think this is a program that can be replicated. And we are

actually this year expanding it in the Circuit Court. It could be replicated across the country.

And I also think that the services you talked about, not only help

the offender, help the clogged dockets. They introduced back into

the community productive, self-sufficient participants in our society.

Thank you.

[The prepared statement of Judge Heller follows:]

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Mr. KUCINICH. Thank you, Judge.

Judge Weitzman.

STATEMENT OF JUDGE JAMEY H. WEITZMAN

Judge WEITZMAN. Good morning, Chairman Kucinich and Congressman Cummings. I am honored to be able to testify and show

off a little bit about what we’re doing here in Baltimore City. Judge

Heller has already elegantly spoke about Drug Court. It is one of

my babies, too.

Started it in 1994 and it is one of the first in the country. And

the hallmarks of Drug Court are clear. It’s immediate, intensive

treatment and collaboration, intensive monitoring. And that famous word that I find to be of biblical proportions to me is holistic

support systems.

But I would also like you to consider some other programs. So

by way of illustration, consider Alese, who was a 14 year old who

was arrested for fighting in schools. And she already has a distinguished criminal history of thefts and disorderly conducts, and

fighting, and five suspensions under her belt already, poor grades.

So we’ve diverted her into Teen Court, which is a program that is

run by children, staffed by children, all of the criminal justice positions are by the children and then the jury of their peers sentences.

It provides a holistic sentence that tried to address the needs of the

child, such as mandatory jury sentences, jury duty, peer mediation,

anger management.

We also have a social worker that is on staff to triage services

to Alese and her family so that we can get to the underlying problems that are contributing to the criminal behavior.

Teen Court has been running for the last 7 years in Baltimore

City. Unfortunately, we can only handle 250 people so far, children.

Just a drop in the bucket. But so far the statistics show tremendous success.

How about the child named Alex? He already has 24 absentees

in the last previous two quarters of school and 18 days of being

tardy. He doesn’t wear uniforms when he comes to school. He has

an attitude. We find out that when he doesn’t come to school, his

little sister doesn’t get to school either. So enter the truancy program which tries to provide support services to the child to try to

find out why, what is causing this truancy. And then, of course,

there is collaboration with the school system.

So these three programs highlight just three of the problem solving programs in Baltimore City, but they really attempt to try to

meaningfully effect children’s lives by getting them away from the

maelstrom and the cycle of violence and crime. But they are all significant because of the extreme collaboration, the wonderful collaboration of criminal justice and non-criminal justice partners

such as business community, social clubs.

I am proud to say in Drug Court, for example, we have a wonderful partnership with Goodwill Industries where they actually provide job training and placement for our folks so that they can get

a meaningful wage and living. And it’s so successful in Baltimore

City that Goodwill is now trying to market this throughout the

country.

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But do not make no mistake: These programs are not easy. This

is not hug-a-thug justice, as Judge Young likes to say. It requires

intense work and a lot of judicial monitoring and accountability of

the defendants and the team members as well. But my passionate

assertion of the effectiveness of these programs are really supported by numerous evaluations of Drug Court which show its success. We are making taxpayers. We are having drug free babies

born to our folks. And so there’s numerous, wonderful intended and

unintended consequences to Drug Courts as well as the Teen

Courts which we have.

Truancy courts are a little young, but I have every reason to believe and do believe that they will benefit from the same success.

The sum is definitely greater than the parts, and it costs money

to run these. Nothing comes for free. And so if anything, I would

ask that the Federal Government partner with us to provide more

of these programs to the community.

Thank you.

[The prepared statement of Judge Weitzman follows:]

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Mr. KUCINICH. Thank you, Your Honor.

Judge Young.

STATEMENT OF DAVID W. YOUNG

Judge YOUNG. Good morning, Chairman Kucinich and Congressman Cummings.

If I might just, I believe you said that I was a graduate of the

University of Baltimore. I am actually a graduate of this fine institution where my classmate was Judge Heller, and one of our predecessors was Congressman Cummings.

Mr. KUCINICH. I thank the gentleman. And the record will be corrected to reflect that. Thank you.

Judge YOUNG. Thank you.

Since 1998 the Baltimore City Juvenile Drug Treatment Court

has offered comprehensive intensive outpatient drug treatment to

juvenile offenders between the ages of 15 and 18. The exciting

thing about Drug Treatment Court is it works. As Judge Weitzman

said, we have a hard time explaining to people that Drug Treatment Court is not hug-a-thug, it is intensive. The participants in

Drug Treatment Court in the initial phase of the three phase program are required to attend 5 days a week. They have an individual counselor. They are required to participate. They have an addiction counselor. Additionally, they are required to undergo random urine analyses, breathalyzers and to attend NA and AA.

As if that’s not enough, they are required to go to school. Each

one of them is given an educational assessment. If they are in

school, they are required to go to school. If they are not in school,

they are required to go to either the YO program, the Youth Opportunities Program which is operated through the Mayor’s Office of

Employment Development or to the Baltimore City Community

College.

We also provide intensive services to families in the way of functional family therapy. And the one thing about Juvenile Court is

there is a device called the Order Controlling Conduct. So if your

child is court involved, the court does have within its authority

that we can require the families to also receive services.

We are also fortunate to have family intervention specialists who

come to us through the Johns Hopkins University. And their job is

to do a family assessment and to identify ongoing family needs. As

was said earlier, addiction is a family disorder.

We also have discovered that many of the youth participating in

Juvenile Drug Treatment Court have mental health problems and

they are, in fact, self-medicating. So we have a relationship with

the University of Maryland Hospital. As a matter of fact, our drug

treatment is conducted through the Harambee Drug Treatment

Program, the addiction counselors.

We also have a relationship with the Johns Hopkins University.

Many of our participants do suffer from depression. Many of them

have been diagnosed with ADHD. And so we take a comprehensive

approach to addressing their needs. This is a collaborative effort.

We have a dedicated State’s Attorney, Prosecutor, a dedicated Public Defender. They always see the same judge, yours truly, but they

have the same counselor.

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In addition, we do recommend them if they are in need of vocational training to one of the programs in the community. Judge

Weitzman mentioned the Goodwill. We were fortunate to get a

grant through the Administrative Office of the Courts that allows

us to refer teenagers to the Goodwill Industries for job readiness.

And quite a few of them have now actually been transferred into

full time positions.

There are needs. What they need? We need more inpatient treatment. Many times we refer youngsters to inpatient treatment, but

there are only one or two programs that will take them. Additionally, even when they go they are released after, as short a period

is 3 to 7 days.

We need independent living programs so that they can be referred to independent living. Many of them are 18. They have no

family or a fractured family to go home to.

We need professionals who are college educated who have backgrounds in juvenile justice who want to work with young people

rather than hiring people for whom it’s not a calling, it’s just a job.

We need advocates at the national level, such as yourself and

Congressman Cummings to say that children count and that drug

treatment courts work.

And finally, we do need more resources for after care. When

youngsters graduate from the Juvenile Drug Court or they get a

certificate of completion we need after care. It costs, I’m told,

$68,000 a year for an out of home placement. And so we just need

some resources to keep these people at home.

I thank you for the opportunity address you.

Mr. KUCINICH. Thank you very much for your testimony, Your

Honor.

Dr. Sharfstein.

STATEMENT OF DR. JOSHUA M. SHARFSTEIN

Dr. SHARFSTEIN. Thank you. Thank you very much, Chairman

Kucinich and Congressman Cummings. I really appreciate the opportunity to be here. And I am also pleased that you heard about

the Safe Streets program earlier today, which is run out of the

Health Department.

I am testifying as the health commissioner. And I think to look

at some of these issues from a public health perspective, meaning

across the whole city and looking at the whole need, I think the

key word is capacity. How do you have the capacity to serve the

people who need to be served so as many people as possible can

turn their lives around? How do you wind up not just talking about

individual programs that are making a difference for the people

they are serving, but overall what is the need and are we meeting

that need over.

And I think when you think about capacity there are two ways

to go. One is that there need to be more resources. No question

about it. One of the ways that I think would make a difference,

particularly for drug treatment in Baltimore, is if the State of

Maryland passes the Medicaid expansion that’s been proposed. Because Medicaid will cover at least outpatient substance abuse treatment. And there would be tens of thousands of more people in Baltimore who would qualify for drug treatment through Medicaid.

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There is also, you know, additional resources for drug courts,

other things that would be extremely helpful. But what I am going

to talk about in the next 3 minutes is an approach to capacity that

does not necessarily require additional funding. It is using funding

already in the system. It is using a new technology called

buprenorphine that is available to provide highly effective treatment for heroin addiction, but necessarily in the substance abuse

system, but actually in the medical systems. And Congressman

Cummings has been a national leader in this because of the legislation that he sponsored.

It used to be that every hospital could have 30 patients receiving

buprenorphine. And then it became every doctor 30 patients. And

then it became 30 patients per year, and then up to a 100. This

is any licensed physician in the city of Baltimore.

So if you are thinking about capacity when you have all these

limits to drug treatment; funding and locations in the drug treatment system. If you can tap into the medical system in Baltimore

as a sponge to soak in patients, giving them very high quality

treatment where the evidence is 6 months of treatment, 75 percent

of them may be absent from drugs, from illicit drugs. It’s just a

huge potential impact of the city.

So just briefly, we have been embarked for about the last year

on a big effort to try to make this work in Baltimore. And, you

know, if you can do that, that frees up resources in other places.

I agree there are deficiency. We need more residential care. If we

can shift some of our nonresidential care into the medical system,

then we can free up resources to do that or for more people to come

into the system.

Buprenorphine is similar methadone in the sense that it stimulates the same receptors in the brain as heroin and can keep people

without getting a high from really craving heroin. But it is different in the sense that at high doses it antagonizes itself. So it is

very hard to overdose. In fact, if you give buprenorphine to someone high on heroin, it precipitates withdrawal. So the risk of abuse

is much less. The risk of diversion is much less. And that’s why

they consider it safe for doctors in the substance abuse system to

prescribe.

In November last year we became the first city to pay for any

doctors in training buprenorphine. And we have over 110 physicians who have signed up for training around the city, and over 50

of them have completed through that effort.

We have basically broken it into three parts. The first thing is

the patient calls us needing help. They go into the substance abuse

system as they did before for 3 or 4 months to intensely receive

buprenorphine, counseling and other services.

As soon as possible we get a social worker to meet with them and

try to get them access to a very basic kind of health insurance,

called the Primary Adult Care Program or Medicaid. So that they

then will have the capacity to transfer into the medical system.

This gets them health insurance that will at least provide for some

of their other needs and then the social worker can help with other

things to the extent possible.

Every single patient in our effort has been through this process

with the social worker.

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Then after 3 or 4 months they move to primary care or psychiatry where they can continue to receive a highly effective treatment

while receiving their counseling back at the drug treatment center.

At that point they become stable patients in primary care and you

can use that spot in the drug treatment system for another person.

So it is a cycle that brings more people into drug treatment and

then uses the medical system in Baltimore as the sponge. And it

is a collaboration between Baltimore Substance Abuse Systems,

Adam Brickner its president is here, Baltimore Health Care Access

which organizes the social workers and tracks every patient and

the Health Department, which has taken a lead in trying to enroll

people.

The data is in the written testimony. Over 500 patients have

come in. We have 91 patients now who have moved over into the

medical system. And all those patients have other medical conditions addressed. And we have over 100 doctors signed up, and two

residency programs in the city have committed to train all their

residents.

So there is a lot more to be done, but I think it is important for

you to know how the Federal effort on buprenorphine is really having a big impact here in Baltimore.

Thank you.

[The prepared statement of Dr. Sharfstein follows:]

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Mr. KUCINICH. Thank you very much, Doctor.

Dr. Leaf.

STATEMENT OF PHILIP J. LEAF

Mr. LEAF. Good morning, Chairman Kucinich and Congressman

Cummings. Thank you very much for inviting me today.

Before I run out of time, I want to highlight one of the things

that was mentioned today in passing numerous times, and that is

the role that Congressman Cummings played in the development

and support of programs. And I want to emphasize not simply the

funding that is available, but having a Congressman who comes

home every night to live in this city who has close ties with lots

of different kind of people here, and whose staff actually sits on

many of the planning efforts that you are hearing about today. I

think it has been one of the important implications, it is around

information exchange. It is being able to access information and access information not just for those of us at academic institutions or

on the city government, but in local community programs, the

church groups, other groups.

And I think one of the challenges is how to get information about

the opportunities that are out there, whether it is Federal funding

programs, whether it is best practices or whether it is things that

are working in your child’s school to people who really need to

know those things. And I think Congressman Cummings is a wonderful example.

We also benefit from having a Senator who lives in our city and

up until recently had two Senators living in our city. And I think,

again, at the information level, knowing what the problems are,

their staffs are really critical.

Increasingly, as you have heard, there is an agreement that we

require multifaceted response, a response involving not only governmental agencies but also local school systems, providers of substance abuse, the mental health services, the faith and business

communities, local institutions of high education, civic association,

ex-offender and ex-offender organizations and parents, families and

other caregivers. Local communities and States increasingly are

calling for systemic interventions rather than programs. We have

lots of programs. The issue is how to fund these in a systemic manner, how to sustain these and to expand the ones that are working

so they can meet, as you have raised to the previous panels, the

real needs that exist in these communities.

We have lots of things that work. Often people do not know

about them. Often the programs that work have difficulties sustaining themselves because sometimes they are funded by one time

Federal funds for 3 to 5 years. And as Dr. Sharfstein said, sometimes our normal funding procedures whether it is Medicaid, State

budgets or city budgets are not adopting as rapidly as possible and

as rapidly as necessary these proven practices.

So clearly we are talking about lots of different strategies. You

have heard a little bit about the need for community mobilization,

particularly by those living in the communities.

We need social intervention programs. Programs that are supporting the full range of needs.

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In Baltimore we have many youth who are essentially homeless.

Who move from different living circumstances 1 week to another

week. Maybe living with an aunt 1 week. Maybe living with a

friend another week.

We also have lots of children have to move through fairly violent

neighborhoods to get to school. And it is not irrational as our chief

executive officer of our school system said at the Board meeting

last week for youth having to move through some of these neighborhoods to be carrying a weapon. Not necessarily a gun, but a

knife, a scissor, something that is going to get them expelled from

school because it really is not safe for them to move to and from

school. And clearly, that is not an issue for the schools themselves.

That is going to require multiple government agencies, but also

multiple communities.

We do need service provision, but also we need opportunities provisions. We need employment opportunities. And has been mentioned, when we have individuals with multiple dual diagnoses,

substance abuse/mental health problems, we need to use those

strategies that have been shown effective for meeting those needs.

We obviously need also suppression activities, but also organizational change in development. We all need to change the way we

are working. And I think you have heard some very positive examples of how programs have organized themselves differently, have

structured their funding systems differently, have changed their

collaborations.

Increasingly in the Baltimore City Public School system we are

also focusing on the behavior of the adults. Essentially, as you have

heard several people talk about, behaviors are learned. Violence is

learned. Well, nonviolence is also learned. And we need to be training behavioral and problem solving skills in our schools, but we

also need to be supporting the people in our faith community. The

people in our neighborhoods who have traditionally taught nonviolence, who have taught problem solving, who have supported

those most in need.

Baltimore is paying increasing attention to the fact that many of

the individuals to be reached our communities suffer not from a

single problem, you have heard that today. In Baltimore we do not

encounter an individual who only has a drug problem and others

who have lots of assets and their deficiency is violence. We have

people who commit crimes or engage in violence, do not have a lot

of community supports and also have very limited aspirations. And,

again, I think the role models are particularly important.

It is essential that we think about how the Federal, State and

local governments can be organized. But also supporting families,

supporting neighborhoods, supporting communities.

You have heard a lot about voluntary work. Many of the programs you have heard about today were supported or if not innovated through help with University of Maryland Law School, University of Baltimore Law School. Again, we are fortunate in Baltimore because we have wonderful educational institutions, faith

communities, we have many city and State organizations. And I

think some of the successes you heard today because we really do

have the confluence of the multiple partners in this jurisdiction.

[The prepared statement of Mr. Leaf follows:]

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Mr. KUCINICH. Thank you very much, Doctor.

I would like to start the questions with the Commissioner. How

do you think the city’s buprenorphine initiative fits in with the

overall treatment philosophy? And is it a departure from programs

like methadone maintenance or abstinence-based treatment?

Dr. SHARFSTEIN. I think it’s a great option to have for patients.

That it is very well established that almost—I would say most heroin addicts will do just as well on buprenorphine as methadone.

There are some groups of people addicted to heroin who will probably better on methadone. It is very important to continue to have

methadone as part of the approach. But buprenorphine, some patients prefer it. It is better tolerated in some respects. And because

of the potential to engage the medical system, it creates this potential for really expanded capacity.

Mr. KUCINICH. Now you made free buprenorphine available,

right, to every doctor practicing in Baltimore since October? Are

you satisfied with the level of participation among doctors?

Dr. SHARFSTEIN. That is one of the areas, we made the pre-training available. And I think we would like to see more doctors training. Right now it is not limiting the number of patients who can

be seen. But I think we would like to see more doctors trained

around the city.

One of the ways we are hoping to do that is through the HIV program. The Ryan White money which comes in from the Federal

Government. The local planning council is putting some strings on

that money to try to make sure that it goes to clinics that really

do prescribe buprenorphine.

Mr. KUCINICH. So with this free training what percentage of doctors participated?

Dr. SHARFSTEIN. Well, there are probably—there have to be at

least a few thousand doctors in Baltimore City. And so far we have

had about hundred plus a few sign up for training. So as an overall

percentage of doctors, it is pretty low. We are looking particularly

at internists, family physicians and psychiatrist. I would say we

could definitely better.

Mr. KUCINICH. What kind of steps can the Health Department or

others like the Federal Government take to improve participation?

Dr. SHARFSTEIN. Well, I think particularly you look at where the

particular funding streams are. And I think the Ryan White funding stream, like I said, is a real opportunity. Because there is so

much money coming in for treatment of people with HIV. And the

evidence is that if people who are drug addicted and are also HIV

infected if they are getting their drug addiction taken care of, they

will stay on their HIV medicines better. They are less likely to infect someone else because they will not be sharing needles.

So if we can take—you know, and basically I would like to have

the expectation in Baltimore that it is like a required part of taking

care of an HIV patient to have this as an option for the right patient to prescribe buprenorphine.

Mr. KUCINICH. So how many of Baltimore’s drug addicted persons could benefit from buprenorphine?

Dr. SHARFSTEIN. Well we have, I think, the statistics I have seen

about 70 percent of the people seeking treatment of heroin problems. So certainly I think right now we have about 3,500 people in

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the publicly funded system on methadone everyday in Baltimore.

And I think easily we could double or triple that with

buprenorphine if we could get that kind of capacity.

Mr. KUCINICH. Thank you.

Now Judge Heller, prior to the development of the Circuit Drug

Courts and the Felony Drug Diversion Initiative would the individuals in the programs actually have served a substantial portion of

their felony sentences?

Judge HELLER. That is not up to the courts. That is up to the

Parole Boards. But I would say nonviolent offenders, about a third

of their sentence. These days I think it is up to a half of their sentence that they would serve. The problem is they would spend,

whether it is 2 years, 3 years, 6 years incarcerated time. And you

would think that merely being incarcerated when someone reentered, they would be drug free. But that is not true. And there is

virtually no drug treatment programs in the system.

This is a long answer. Today we are focusing even for those who

are in our programs like Felony Drug Diversion or Incarcerated

with reentry support.

Mr. KUCINICH. If there were more funding just in your court

based on demand and reasonable eligibility criteria, how much

could you envision participation expanding?

Judge HELLER. Oh, I think enormously. I think I gave the statistic that in my court alone there were 3,358 felony drug offenses.

This is nothing else. Pure drug offenses. So we are not talking

about the robberies, the homicides, the gun. Most of those people

in State court in contrast to the so called big traffickers and kingpins that are often in Federal court, are really addicted people who

have mainly nonviolent, although long records who could benefit

significantly diverting out of the system into a treatment program,

and once again reentering this time with support for their addiction into communities.

Mr. KUCINICH. Now the after care portion FDI is funded largely

through existing State, local and Federal funding. I assume that

the funding streams for this treatment are not specifically earmarked for drug court referrals. Should they be?

Judge HELLER. You are getting a little out of my expertise.

I think I would say yes. But I have to be honest. I have for 4

years, and this is one of the unfortunate challenges, you come with

a program that succeeds, initial funding ran out and then we have

been looking year after year, month after month, at every level city

and State for support services. I sometimes think it is magic when

the funding reappears. But it would be very nice if it was targeted

so we know it was there to help these people.

Mr. KUCINICH. Right. OK. Thank you very much, Judge.

Mr. Cummings and then we will have a second round of each

panel as well.

Mr. CUMMINGS. You know, Dr. Sharfstein, buprenorphine. When

one is treated with that if that is a person—and I am going back

to Judge Heller and I think Judge Weitzman was saying, that a lot

of times we have people who have a dual——

Judge HELLER. Dual diagnoses.

Mr. CUMMINGS. What do you call it?

Judge HELLER. Dual diagnoses.

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Mr. CUMMINGS. Yes, dual diagnoses. And we have talked about

that in our committee, in the Drug Committee when it existed

about how people have a drug problem, but they also there’s an underlying, and I guess it is the same thing, mental problem. too.

Probably going back to childhood in many instances.

So if we treat them with the buprenorphine, are we looking at

that dual piece, too? Because I am just wondering whether we are

just scratching the surface? You follow me?

Dr. SHARFSTEIN. Yes. And for some patients the answer is we are

scratching the surface. For some patients they do very well in

buprenorphine. They do not need a lot of intensive mental health

treatment. Nationally about 40 percent of people with substance

abuse have serious metal health problems and 15 percent of people

with mental disorders have substance abuse problems.

Here is one of the big problems that is facing us in Baltimore.

The system of funding for substance abuse and mental health are

completely and utterly separate. They are not just separate, they

are totally different types.

Mental health is like an insurance program. Substance abuse

comes in in grants. They have each of their own sets of requirements.

The Federal level you have SAMHSA, which is at least one agency. The State level you have the Mental Health Agency and the

Substance Abuse Agency.

And, you know, maybe about 18 months ago somebody came to

me from a different agency saying that their job was to coordinate

the two agencies at the State level, and could I help, you know.

And I mean I am not even at the State level. So I said ‘‘Yes, I will

do whatever it takes.’’ But it is very, very difficult.

I think just one of the ways we are seeing that is the frustration

of the judges are having for certain patients. But across the system

there is a real gap.

We have renewed energy on this. We have a new head of Baltimore Mental Health System who just started, who was an Assistant Commissioner in New York. Who is really an expert in how to

do better for people with dual diagnoses or co-occurring disorders.

But there is no question it is a big frustration.

In our report about buprenorphine initiative we identified, our

goal was to have patients be free from heroin in their urine and

able to move into primary care after 90 days. That was one of the

targets we did not meet. And one of the reasons it has taken so

long and why some patients have never been able to move over,

like I told you 500 patients have started and about 100 have moved

over into primary care, is we think that there are some patients

who because of their mental health issues have not been able to be

successful. So a big focus that we have now is to try to improve

that mental health part. But the system works against us, I think.

Mr. CUMMINGS. Judge Weitzman, in your written testimony you

talk about short term funding leads to short term results. What

does that mean? Does that mean you cannot plan? I mean what

does that mean?

Judge WEITZMAN. The problem is multifaceted.

Mr. CUMMINGS. And Judge Heller, you might want to chime in

on this also.

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Judge WEITZMAN. The problem is multifaceted and needs support

from many different areas. And so just bursts of funding does not

really get to the problem.

So dribs and drabs of treatment, for example, where we need

long term residential treatment for example does not help.

We have multiple problems with dual diagnoses bucks. And we

need mental health slots as well as substance abuse slots.

One of the long term goals for my program in Drug Court is to

have a community Drug Court haven, so to speak the one-stop shop

where the folks do not have to go to many different multiple places

to get their health. They are treatment and the courts, and the

support services are one place which will help facilitate their

wellness. Because they are not able to manage their lives as well.

Plus money.

Mr. CUMMINGS. Let’s say we know we need. We have somebody

who needs the dual treatment. And they are doing everything they

are supposed to do. Do they sort of just hang there until you get

them the treatment? You follow what I am saying? Could year? I

mean, years, months?

Judge HELLER. They can hang there and often with unsuccessful

results.

I have a woman that I was looking. She could not go in the community because she just could not make it. She had major psychiatric problems. We were looking for a dual diagnoses program.

I had no where to keep but over in the Baltimore City Detention

Center.

She said to me when she would come in for the monthly monitoring, ‘‘So I am incarcerated, Judge Heller, because you cannot find

a program, not because I violated—’’ well, originally she did or she

would not be under the system. And I had to say ‘‘That is right.’’

She was kept there for 5 months waiting for us to find a program.

On your other questions, Congressman Cummings, having short

term funding is so important for a startup and creating programs.

But here in Felony Drug Diversion we created a successful model

that was working, and then the funding ran out. And it would have

been very easy to say no. But we kept looking. I have to thank Dr.

Sharfstein helping in part in the interim for funding. But replicating and then expanding the programs that worked is difficult if you

only have short term funding.

Mr. CUMMINGS. Just one other question. You know, the interesting thing is, you know I am just sitting here and I am just thinking

it sure would be nice to be able to prevent some of this. Because

the cost to society is so great. I mean, and the individual. And I

was just thinking ways that you all could—I guess it is like with

witness protection. I mean, you would have thought that I was

talking about something that should have zero attention in the

Congress. And to me it goes to the very essence of our system of

justice.

So do you all have any recommendations, you all are dealing

with these things on a daily basis, how we get over what you all

are talking about to our colleagues. I know that it is a flip, but I

am just curious I mean why do you think folk do not see what you

all see or understand it? Judge? I am sorry. It is like we are walking down the hall in Washington and you got 30 Congressman and

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you just want to say ‘‘Congressman, Congressman,’’ and everybody

turns around.

Judge Young.

Judge YOUNG. I think that many times, Congressman, public

perception drives public policy. And we are seeing it especially in

the area of juvenile justice where because everything, the media is

saturated with gangs everywhere you go, we have noticed that

there has been a shift away from focusing on drug treatment and

intervention programs toward suppression even in our city. So one

of the things that I think is important is that our decisions be research based. That is why we are fortunate to have the University

of Maryland and University of Baltimore collaborate so that we are

making decisions based on research as opposed to what the media

tells us.

I think there is an additional problem, and that is many times

we go into communities and we tell communities what is best for

them rather than bringing them in at the front end and asking

them help us determine what you need through needs assessments.

And so one of my frustrations, if you will, with our approach to

juvenile justice is the 6 o’clock news determines what is a priority

versus what the young people in this city actually need.

Mr. KUCINICH. As I am listening to this testimony and to answers to the questions, and I am sure everyone involved in this

hearing whether you are at the panel or on this dias or whether

you are sitting in the audience has to be thinking about the connection between drug abuse, mental health and crime and how many

people are in our prisons are people who did not get mental health

treatment or treatment for an addiction. And so the prisons end up

being places where the people are just held because their whole reality is distorted. I mean in a sense if crime by definition is some

behavior that is anti-social, if someone goes through that labyrinth

of drug use and with the additional crippling factor of let’s say a

mental health problem, how would they know what social is? How

would anyone know what normal is?

Judge, would you like to comment on that?

Judge HELLER. I think they would not know. And I think your

observation brought to mind the following: One, we need different

models. Although drug abuse and mental health problems these

days in this country equate to incarceration, that is costly, it is ineffective and it is not working and it is clogging the courts; two,

I think something Judge Young just said, we are focusing as judges

when we already have a problem in the criminal justice system,

which is almost at the end of the road. All of us can focus much

early on.

I know that the Johns Hopkins Bloomberg School of Public

Health has just started an Urban Health Institute where we are

going to actually look, this sounds ridiculously, prenatally, early

childhood education and the wrap around support so that from the

very beginning perhaps we will not have a next generation here,

but we can try to make health——

Mr. KUCINICH. Well, yes, it actually makes sense. Because you

know we know from studies of prenatal that if a mother is taking

a lot of alcohol or drugs that has an effect on the developing fetus.

And so it is good to see that.

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You know, obviously, Congressman what we are looking at is a

system here. And to talk about it prenatally. But then you look at

all the societal influences that occur as well; does someone have a

roof over their head, is there food on the table, is there a job, is

there some kind of an education, are there goals out there that

children have aspirations? I mean, these things all come into play

in terms of whether there is enough social organization and stability to permit mental health, a healthy mental climate to develop

and whether or not conditions develop that would precipitate drug

use. I mean, even in the best homes where everything seems to be

stable you can have drug abuse. But, you know, as you are talking

I am just drawing kind of diagrams here. And you think about all

the factors that are involved are and you are actually dealing with

them as best you can, which has really said something about this

community and about your Congressman.

I just wanted to make that observation.

And let me, perhaps, ask one final question here of Judge

Weitzman. Did you think that the problem solving court should be

expanded to include individuals who have committed acts of violence? And could there be specific conditions on violent offenders

that address a monitor and attempt to rectify their violent actions?

Judge WEITZMAN. The research is out on that. There are some

schools of thought that feel that violent offenders should be in a

whole another category of themselves. That we are really trying to

target people that but for their substance abuse or other problems

such as mental health, that they would not be committing crimes.

Violence tends to be psychopathic and is higher on the risk scale.

So they need other kinds of support such as better monitoring perhaps.

Yes, any problem solving court I think can help criminal justice

issues. I think the complexity of it and the complexion of it will

look very different than the problem solving courts that deal with

the strictly social issues that we have.

Mr. KUCINICH. Thank you.

Congressman Cummings to you for any final questions.

Mr. CUMMINGS. Yes, just one question. Judge Heller, or all three

of you judges, the key I guess to the effectiveness of the Drug

Courts is having a hammer over the head sort of, so to speak, to

say that if you do not do this and you have the certain things that

they have to do. You say appear 5 days a week and get the treatment, and get the education and whatever; that they then may

very well end up serving the sentence. But then there are some

who do not do it. I think you said 76 percent, Judge?

Judge HELLER. In the beginning. Right now we have almost 70

percent success rate. But that means 30 percent do not make it.

Mr. CUMMINGS. Right. And what do you find? I mean, first of all

when you look at all programs, that is a phenomenal rate. But I

am just wondering about that other 30 percent or so percent that

are not.

I mean what seems to be the kind of things that you hear? Do

you think they are more the dual situation problems? Do you think

it family problems that you just cannot seem to get to? I am just

curious.

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Judge YOUNG. I can tell you with many of the juveniles who do

not succeed in Juvenile Drug Court it is because even after you get

them clean, and even after you get them coming to the program

every night they go back to the same environment. There is a great

need to be able to help families transition, not just the individual.

We had a young man who was almost murdered. He was shot

and even after he was in rehab and got himself together, his mother lost her Section 8 voucher. So she moved right back to the neighborhood where he had been shot. And so it’s just an ongoing need

to help people, not only move up but also to move out.

Mr. CUMMINGS. That reminds me of a story when I had an after

care program some years before I went to Congress. And we had

a young man who had come out of the Boot Camp program. The

mother of his child lived on the east side and the guys in the neighborhood had told him that if you come back on the east side, we’re

going to kill you. Remember that? Well, we have some people in

the audience who know about that case.

And he decided that he was going to do it anyway. You know,

he was not going to be—and we begged him not to do that, to find

a way. We told him we would help move her on the west side. But

his manhood and other—you know, he’s gone.

And I say that to say I guess some of the issues are so difficult

and they go so far back. I tell my staff that a lot of the problems

that we deal with are problems that were created, going back to

what you were saying, Mr. Chairman, when folks were little kids.

And trying to deal with that is very, very difficult.

And so, Mr. Leaf, you have something on that? You look like you

need to say something?

Mr. LEAF. Well I think, as you said, some of the people in the

courts who are going through that also have little kids. And so this

is an opportunity. Again people are talking about needing to support families, people do a lot of things for their family including the

illegal activities. And I think recognizing that some of the relief

won’t be effective unless it is also supporting the family needs besides the individual needs.

Mr. CUMMINGS. Right. Right.

Mr. LEAF. And your earlier question about how to convince some

of your colleagues. Unfortunately, ex-offenders and people in recovery and even people with mental disorders, there’s a certain

amount of stigma from being physical for some of them. And as

with any legislation, without having a consumer group, without

having a vested constituency who is actively advocating for their

own needs, it is probably very difficult to convince legislators who

have lots of demands on them where there are lots of organized

lobbying going on. And so how to support the efforts of the ex-offenders, the people in recovery who are successful. Some of them,

you know, are in recovery for life are very successful businessmen,

academics. You know, it’s the whole range of both those individuals

and ex-offenders. And you can have it support those efforts so that

they can be vocal and visible about their successes, not about their

problems. But about their successes and their identification of

where additional successes could come from I think are part of the

solution.

Mr. CUMMINGS. Yes?

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Judge HELLER. I think that there are some people that will not

make it because of their mental illness, their background, their age

or they just do not want to make it. I mean the reality is you can’t

have everyone succeed. But, having said that, every time we have

had people drop out we look to see what we could do better and

might have done differently and have kept that person in.

I do not really believe it is the Judge that is sitting there with

the gavel. I do not know that any of us actually use a gavel, or I

know as we are saying symbolically. I think what keeps people in

the program to succeed is quality care, quality drug treatment. I

think the structure is so important. And then I heard a word at

the previous hearing which I really must use, and it is hope. And

I think by letting people begin to think they actually can change;

these people have given up hope, you can make a change. You can

control our addiction. You can get a job. You can get an education.

You can actually move your housing. And we are going to structurally be there with you for the next few years while you do it.

I think it does help succeed.

Mr. CUMMINGS. Thank you. Thank you all very much.

Mr. KUCINICH. I want to thank the members of the panel for

their participation. And when you hear your testimony and your

answers, it is very clear that what your lives have been about is

saving other people’s lives. And there cannot be any higher service.

And so thank you for what you do, continue to do.

And this has been a hearing of the Oversight and Government

Reform Committee, the Subcommittee on Domestic Policy. I am

Dennis Kucinich, chairman of the committee.

We want to thank the University of Maryland School of Law for

letting us use their Ceremonial Moot Courtroom. I think we agree

these facilities are beautiful and have been conducive to this hearing.

The title of the hearing has been Combating Drug Abuse and

Drug-Related Crime: What is Working in Baltimore. We know what

is working and who is working at it, and we want to thank all of

you for making it happen.

Again, to Congressman Cummings. Thank you for suggesting

this hearing, for facilitating it. I look forward to continuing to work

with you on all these matters of importance to our communities

and to urban America.

This committee stands adjourned. Thank you all for being here.

[Whereupon, at 12:06 p.m., the subcommittee was adjourned.]

[Additional information submitted for the hearing record follows:]

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