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91–830 PDF 2004

S. HRG. 108–372

AN EXAMINATION OF S. 1194, THE MENTALLY

ILL OFFENDER TREATMENT AND CRIME REDUCTION ACT OF 2003

HEARING

BEFORE THE

COMMITTEE ON THE JUDICIARY 

UNITED STATES SENATE

ONE HUNDRED EIGHTH CONGRESS

FIRST SESSION

JULY 30, 2003

Serial No. J–108–32

Printed for the use of the Committee on the Judiciary

(

(II)

COMMITTEE ON THE JUDICIARY 

ORRIN G. HATCH, Utah, Chairman 

CHARLES E. GRASSLEY, Iowa 

ARLEN SPECTER, Pennsylvania 

JON KYL, Arizona 

MIKE DEWINE, Ohio 

JEFF SESSIONS, Alabama 

LINDSEY O. GRAHAM, South Carolina 

LARRY E. CRAIG, Idaho 

SAXBY CHAMBLISS, Georgia 

JOHN CORNYN, Texas 

PATRICK J. LEAHY, Vermont 

EDWARD M. KENNEDY, Massachusetts 

JOSEPH R. BIDEN, JR., Delaware 

HERBERT KOHL, Wisconsin 

DIANNE FEINSTEIN, California 

RUSSELL D. FEINGOLD, Wisconsin 

CHARLES E. SCHUMER, New York 

RICHARD J. DURBIN, Illinois 

JOHN EDWARDS, North Carolina 

BRUCE ARTIM, Chief Counsel and Staff Director 

BRUCE A. COHEN, Democratic Chief Counsel and Staff Director 

(III)

C O N T E N T S 

STATEMENTS OF COMMITTEE MEMBERS 

Page

DeWine, Hon. Mike, a U.S. Senator from the State of Ohio ................................ 1

Durbin, Hon. Richard J., a U.S. Senator from the State of Illinois .................... 23

Grassley, Hon. Charles E., a U.S. Senator from the State of Iowa, prepared 

statement .............................................................................................................. 115

Hatch, Hon. Orrin G., a U.S. Senator from the State of Utah, prepared 

statement .............................................................................................................. 119

Leahy, Hon. Patrick J., a U.S. Senator from the State of Vermont .................... 3

prepared statement .......................................................................................... 130

WITNESSES 

Atkins, Rhonda, Sarasota, Florida ......................................................................... 13

Campbell, Hon. John F., Member, Vermont State Senate, Quechee, Vermont .. 9

Eslinger, Donald F., Sheriff, Seminole County, Sanford, Florida ........................ 7

Honberg, Ron, Legal Director, National Alliance for the Mentally Ill, on 

behalf of the Campaign for Mental Health Reform, Arlington, Virginia ........ 5

Stratton, Hon. Evelyn Lundberg, Justice, Supreme Court of Ohio, Columbus, 

Ohio ....................................................................................................................... 15

Wilkinson, Reginald A., Director, Ohio Department of Rehabilitation and 

Correction, on behalf of the Association of State Correctional Administrators, Columbus, Ohio ........................................................................................... 11

QUESTIONS AND ANSWERS 

Responses of Reggie Wilkinson to questions submitted by Senator Durbin ....... 29

Responses of Evelyn Stratton to questions submitted by Senator Durbin ......... 39

SUBMISSIONS FOR THE RECORD 

American Psychological Association, Judge Maurice H. Richardson (Ret.), Director, Massachusetts Mental Health Diversion Program, Law and Psychiatry Program, University of Massachusetts Medical School, Worcester, Massachusetts, statement .......................................................................................... 63

Art for a Child’s Safe America Foundation, Columbus, Ohio .............................. 69

Atkins, Rhonda, Sarasota, Florida, prepared statement ...................................... 76

Campbell, Hon. John F., Member, Vermont State Senate, Quechee, Vermont, 

prepared statement .............................................................................................. 80

Columbus Dispatch, Randy Ludlow, articles: 

Critical Care, August 24, 2003 ........................................................................ 84

Prison doctors aren’t top shelf; some come with big problems, August 

24, 2003 .......................................................................................................... 91

Lives Lost and Damaged, August 25, 2003 .................................................... 94

When co-pay plan started, clinic visits started falling, August 25, 2003 .... 101

Taft Focuses on Inmate Care; August 28, 2003 ............................................. 103

Panel To Review Health Care for Inmates, September 5, 2003 ................... 106

Eslinger, Donald F., Sheriff, Seminole County, Sanford, Florida, prepared 

statement .............................................................................................................. 108

Honberg, Ron, Legal Director, National Alliance for the Mentally Ill, on 

behalf of the Campaign for Mental Health Reform, Arlington, Virginia, 

prepared statement .............................................................................................. 121

Hogan, Michael F., Director, Ohio Department of Mental Health, Chair, President’s New Freedom Commission on Mental Health, Columbus, Ohio, statement and attachment ........................................................................................... 132

Page

IV

Stratton, Hon. Evelyn Lundberg, Justice, Supreme Court of Ohio, Columbus, 

Ohio, prepared statement .................................................................................... 145

Wilkinson, Reginald A., Director, Ohio Department of Rehabilitation and 

Correction, on behalf of the Association of State Correctional Administrators, Columbus, Ohio, prepared statement ........................................................ 153

Women, Girls & Criminal Justice, June/July 2002, article .................................. 163

(1)

AN EXAMINATION OF S. 1194, THE MENTALLY 

ILL OFFENDER TREATMENT AND CRIME 

REDUCTION ACT OF 2003

WEDNESDAY, JULY 30, 2003

UNITED STATES SENATE, 

COMMITTEE ON THE JUDICIARY, 

Washington, D.C. 

The Committee met, pursuant to notice, at 2:08 p.m., in room 

SD–226, Dirksen Senate Office Building, Hon. Mike DeWine presiding. 

Present: Senators DeWine, Leahy, and Durbin. 

OPENING STATEMENT OF HON. MIKE DEWINE, A U.S. 

SENATORFROM THE STATE OF OHIO 

Senator DEWINE. Welcome to the Judiciary Committee hearing 

on Senate bill 1194, the Mentally Ill Offender Treatment and 

Crime Reduction Act of 2003. Let me thank the Chairman of the 

Judiciary Committee, Senator Hatch, for scheduling this important 

hearing today, as well as cosponsoring this legislation. 

Let me also thank the Ranking Member of the Judiciary Committee, Senator Leahy, for all of his hard work and for his leadership in this area, and also for his cosponsorship of the bill and for 

his hard work in preparing for our hearing today. Let me also 

thank our original cosponsors, Senator Grassley, Senator Domenici, 

and Senator Cantwell, for their efforts and their hard work. 

Those who suffer from mental illness face great challenges in 

their lives, and when those with mental illness come into contact 

with our criminal justice system, the challenges become even greater. I learned this firsthand approximately 30 years ago when I was 

a county prosecuting attorney in Greene County, Ohio. I learned 

how important it is that our mental health community and our law 

enforcement community work together to deal with mentally ill offenders. 

This kind of coordination is vital because people afflicted with 

mental illness are incarcerated at significantly higher rates than 

the general population. Specifically, approximately 5 percent of the 

American population has a mental illness, but about 16 percent of 

the State prison population in this country has such an illness. The 

Los Angeles County Jail, for example, at any one time typically has 

more mentally ill inmates than any hospital in the country. 

Unfortunately, however, the reality of our criminal justice system 

is that jails and prisons are not equipped to provide a therapeutic 

environment for the mentally ill. In fact, mentally ill inmates often 

2

become even sicker in jail. Once released from jail or prison, many 

mentally ill people end up on the streets. With limited resources 

and little or no ability to handle their illness alone, they often commit additional offenses, resulting in their re-arrest and re-incarceration. This revolving door is costly and is disruptive for all involved, worst of all for the person suffering from a mental illness 

and his or her family. 

Although these problems manifest themselves most clearly within the prison system, the problem is also rooted in the mental 

health system and its failure to provide sufficient community-based 

treatment solutions. Accordingly, the key to any solution of these 

problems will be collaboration—collaboration between the mental 

health system and the criminal justice system. 

In fact, because many mentally ill offenders have a drug or alcohol problem, in addition to their mental illness, solving this problem also will require greater collaboration between the substance 

abuse treatment and mental health treatment communities. That, 

in a nutshell, is what our bill does. 

The entire goal of the mentally ill offender treatment bill is to 

foster exactly this type of collaboration at the Federal level, the 

State level, and most particularly at the local level. The bill provides funding for the criminal justice system, for the juvenile system, and for the mental health and substance abuse treatment systems all to work together at each level of government to establish 

a network of services for offenders with mental illness. 

The bill would promote public safety by helping decrease the 

number of repeat offenders, and also would promote public health 

by ensuring that those with a serious mental illness are treated as 

soon as possible and as efficiently and effectively as possible. 

The way this bill works is that it sets up a grant program, establishing a pool of money which would be used to fund State and 

local programs to address the problem of mentally ill offenders. 

Most importantly, to ensure that these programs are collaborative, 

the bill would require that two organizations, such as sheriff’s office and a mental health care agency, would have to jointly submit 

a single grant application on behalf of their community. So the bill 

would require that you would have to have a mental health organization as well as a law enforcement organization both applying together for the grant. 

These funds could be used for a variety of purposes as long as 

the program would further the goal of collaboration to help the 

mentally ill. For example, grant funds may be used to establish 

courts with specialized dockets for offenders who have a serious 

mental illness or a co-occurring mental illness and drug or alcohol 

problem. 

Funds could be used also, for example, to enhance training of 

mental health and criminal justice system personnel so that they 

could better handle situations that might arise with a mentally ill 

offender. Funds also could be devoted to programs that would divert non-violent offenders into treatment instead of prison, or correctional facilities could use grant funds to promote the treatment 

of mentally ill inmates and ease their transition back into the community upon release from jail or prison. 

3

Now, some of this may sound a little bit familiar to some of you 

because this legislation does, in fact, build on legislation that I introduced two years ago with my friend and colleague from Ohio, 

Congressman Ted Strickland. That bill, which many of my colleagues on this Committee joined with me in working on, did, in 

fact, become law and it authorized the establishment of more mental health courts. 

I have long supported mental health courts, which enable the 

criminal justice system to provide an individualized treatment solution for a mentally ill offender, while also requiring accountability 

of the offender. The legislation we are discussing today builds on 

that law and would make possible the creation or expansion of 

mental health courts. It also would promote the funding of treatment services that support such courts. 

There are a number of other important provisions in our legislation and we will discuss them today, but the real essence of this 

bill is that it would provide the funding and the incentive for law 

enforcement and mental health providers to work together to provide real help to those who are suffering from mental illness. The 

bill would help advance the community interest in promoting public safety and the human interest that we all have in helping people suffering from mental illness. 

Now, let me turn to my friend and my colleague on this Committee, Senator Leahy. 

STATEMENT OF HON. PATRICK J. LEAHY, A U.S. SENATOR 

FROM THE STATE OF VERMONT 

Senator LEAHY. Thank you very much, Mr. Chairman, and before 

we even start I want to commend your longstanding and well-demonstrated support of this concept. Like me, you have had experience as a prosecutor. And, of course, you have seen it from State 

government as lieutenant governor, so you know how important it 

is. It is not something that we talk about out of the abstract. 

This is a good, bipartisan bill. There are far more examples than 

not of legislation in this Congress that are put together by members on both sides of the aisle, and not surprisingly they are the 

ones that have the best chance of being passed. 

It is a good bill. It is going to help State and local governments 

with a problem that sometimes is overlooked—the extent to which 

mentally ill individuals commit crimes and then they are sent out 

again without ever receiving appropriate attention from the mental 

health, law enforcement, or correction systems, and commit crimes 

again. 

I welcome all the witnesses today, and I hope none of you among 

the witnesses will feel at all slighted if I give a special welcome to 

my fellow Vermonter, Senator John Campbell, who is here. He is 

going to testify about how our State has worked on this. 

Senator Campbell is the majority leader of our Vermont Senate. 

He is a member of the Judiciary Committee. He is a former law 

enforcement officer. But even more importantly, of the things that 

we share—we are both Vermonters, both been in law enforcement—we both married nurses and that is the best part of our 

lives. In his work as a legislator, as a lawyer, and as a law enforceVerDate 0ct 09 2002 12:48 Mar 09, 2004 Jkt 091830 PO 00000 Frm 00007 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\91830.TXT SJUD4 PsN: CMORC
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ment officer, he has seen this issue from policy perspectives, but 

also right up close and personal, as so many of you have. 

Too often, people with mental illness rotate repeatedly; they go 

back and forth between the criminal justice system and the streets 

of our communities. They go back on the streets and they commit 

a number of crimes. Yet, we have fewer law enforcement officers 

available to deal with this. They are being occupied by very important things, very urgent things, but they get diverted many times 

by lesser offenders. 

Then these offenders find themselves in jails or elsewhere, where 

there is no attempt made to take care of the mental illness problems they have. So what we are trying to do is give the State and 

local governments a tool to break the cycle. If we do, it helps law 

enforcement, it helps corrections officers, it helps the safety of all 

of us, but it also helps those who are mentally ill. It really is a winwin-win-win. 

When I held a Judiciary hearing last June, we heard from the 

members of the criminal justice system. We heard from State mental health officials, law enforcement officers, corrections officials, 

and representatives of counties around our Nation, and they all 

agreed that people with untreated mental illness are more likely to 

commit crimes and that our State mental health systems, prisons 

and jails don’t have the resources they need to treat the mentally 

ill and prevent recidivism. 

We know that more than 16 percent of adults in U.S. jails and 

prisons have a mental illness, that about 20 percent of the youth 

in our juvenile justice system have serious mental health problems, 

and that up to 40 percent of adults who suffer from a serious mental illness are going to come in contact with the American criminal 

justice system at some point in their lives. We know all these 

things, but we have done very little to help at the Federal level. 

This bill could change all that. 

It is not a one-size-fits-all approach. It gives grantees the ability 

to use the funds authorized under the bill for mental health courts 

or other court-based programs, for training mental health system 

personnel for mental health treatment. It makes a real difference 

in funding—$100 million authorized each year for the next two 

years. Actually spending this money could save a great deal of 

money in the long run. 

I am glad—and, Mr. Chairman, you have seen this from all the 

people you have talked with, as I have—that it brings the mental 

health experts together with law enforcement, something where 

they both see a chance to win. So I applaud you for holding the 

hearing, and I am hoping this is something that we can get out and 

get passed. 

[The prepared statement of Senator Leahy appears as a submission for the record.] 

Senator DEWINE. Senator Leahy, thank you very much. 

Let me introduce the panel very briefly. 

Mr. Ron Honberg is the National Director of Policy and Legal Affairs for NAMI, the National Alliance for the Mentally Ill. He has 

worked extensively to promote diversion programs and improve 

treatment for people with mental illness. 

5

Sheriff Donald Eslinger is the Sheriff of Seminole County, Florida. He has worked in the Seminole County Sheriff’s Office for the 

past 25 years. For 12 of those years, he has served as the sheriff. 

Additionally, the sheriff has worked with Florida’s Behavioral 

Health Services Integration Work Group. 

Senator John Campbell is the majority leader in the Vermont 

Legislature. In addition to his work in the Vermont Legislature, he 

is a former law enforcement officer and has been practicing law for 

the past 20 years. 

Dr. Reggie Wilkinson is the Director of the Ohio Department of 

Rehabilitation and Correction, and has been with the Department 

since 1973. He was first appointed Director in 1991 by then–Governor George Voinovich. He was reappointed eight years later by 

current Government Robert Taft. The Department oversees more 

than 30 prisons and is responsible for 45,000 inmates. 

Rhonda Atkins is from Sarasota, Florida. She has firsthand experience as a mother of a mentally ill child. Her daughter got involved in a criminal justice system that was inadequately prepared 

to offer her the services that she needed. 

Justice Evelyn Stratton, of the Ohio Supreme Court, chairs the 

Supreme Court Advisory Committee on the Mentally Ill in the 

Courts in Ohio. This committee has been instrumental in providing 

training for law enforcement officers to better handle mentally ill 

offenders in the justice system. 

Mr. Honberg, you will be the first witness. Let me say that we 

will set the clock at five minutes for each one of you. We have your 

written testimony, which we appreciate and will be made a part of 

the record. When you see the yellow light, that means you are 

down for a minute. We would like for you to conclude your comments then, and that will enable us to have some time, we hope, 

for some questions. 

You may begin. 

STATEMENT OF RON HONBERG, LEGAL DIRECTOR, NATIONAL 

ALLIANCE FOR THE MENTALLY ILL, ARLINGTON, VIRGINIA, 

ON BEHALF OF THE CAMPAIGN FOR MENTAL HEALTH REFORM 

Mr. HONBERG. Thank you. Senator DeWine, Senator Leahy, I am 

deeply honored to have this opportunity to testify at this very important hearing. My name is Ron Honberg and I am the Legal Director for NAMI, the National Alliance for the Mentally Ill. But I 

am also here testifying today on behalf of the Campaign for Mental 

Health Reform, which is a collaboration among 15 leading national 

mental health organizations, including consumers, family members, 

providers, and other advocates. 

The recent report that was released by President Bush’s new 

Freedom Commission on Mental Health emphasizes what certainly 

the two of you know so well that our Nation’s jails and prisons 

have become de facto psychiatric treatment facilities. Having been 

in many of those facilities myself, I know that they are not treatment facilities at all, that they are environments that are not at 

all conducive to treating people who are experiencing severe psychiatric symptoms. 

6

Sheriffs and police officers throughout the country, as I am sure 

you will hear today, will tell you that they frequently respond to 

people who are experiencing psychiatric crises. In view of this, the 

impressive line-up at this hearing, present witness excluded, reflects the reality that the criminal justice community has become 

the strongest ally of the mental health field, and in some cases, 

frankly, the leaders behind efforts to promote better mental health 

treatment and programs to reduce unnecessary criminalization of 

people with mental illnesses. 

The landmark Criminal Justice/Mental Health Consensus 

Project, which was convened by the Council of State Governments, 

is an illustration of just how important these issues have become. 

While compassion for a particularly vulnerable segment of our society is certainly evident in these efforts, the significant involvement 

of the criminal justice community reflects something more—recognition that reducing involvement of people with mental illnesses 

with criminal justice systems benefits not only those individuals 

themselves, but the criminal justice systems and society as a 

whole. 

Most people with mental illnesses who come into contact with 

law enforcement or criminal justice are not violent criminals. Most 

would never have ended up in these systems at all if they had received appropriate treatment in the first place. 

Yet, mental illness is the leading cause of disability in the world, 

but fewer than half of all people with these illnesses have access 

to even minimally adequate treatment and services. I want to emphasize that with treatment, recovery is very, very possible, but 

without treatment, the consequences are frequently horrendous. 

It is frankly unfair and very poor public policy to saddle criminal 

justice systems with responsibility for responding to people with 

mental illnesses in crisis, but that is the reality in America today. 

As I said, police officers around the country spend many hours 

transporting people to hospitals, and sit for hours in emergency 

rooms, only to see the same people back out again on the streets 

in a matter of a few hours. The time these officers spend in doing 

so is time they are unable to spend fighting crime. 

In 2000, this Committee demonstrated its commitment by enacting America’s Law Enforcement and Mental Health Project, as Senator DeWine said, a bill that authorized funding for mental health 

courts, and this bill indeed represents the next logical step forward. 

Senator DeWine and Senator Leahy, we applaud you for scheduling a hearing to tackle these troubling problems. Senator 

DeWine, we are deeply grateful for your introduction of the legislation and, Senator Leahy, for your cosponsorship, that provides an 

important approach to badly needed community reform. 

This legislation wisely recognizes that solutions will ultimately 

be found in communities, and what the Federal Government can do 

and what good legislation must do is provide support for a wide 

range of collaborative community programs that provide avenues 

for effective and appropriate treatment. 

I would like to use the remaining few minutes to make the following five points. 

First, it is critically important that collaboration occur among all 

elements of the criminal justice and mental health systems if efVerDate 0ct 09 2002 12:48 Mar 09, 2004 Jkt 091830 PO 00000 Frm 00010 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\91830.TXT SJUD4 PsN: CMORC
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forts to reduce criminalization of people with mental illnesses are 

to succeed. And I might add that this collaboration is also necessary at the Federal level between the Department of Justice, the 

Department of Health and Human Services, and other key Federal 

agencies. 

Second, jail diversion and community reentry programs will succeed only when mental health services and supports are available 

to address the needs of individuals in these programs. A more thorough explanation of the types of services needed is contained in my 

written testimony. 

Third, the best form of jail diversion is that which occurs prior 

to arrest and incarceration. For example, different approaches to 

pre-booking diversion have emerged, such as the nationally-renowned Memphis, Tennessee, Police Crisis Intervention Team program, which has now been replicated, I am very pleased to say, in 

over 50 communities across the country. 

Fourth, a wide range of post-booking diversion strategies exist, 

tailored to local needs and systems. Most notable, of course, among 

these are mental health courts, which NAMI is very pleased to report have been now adopted in approximately 70 communities 

across the country, many in Ohio, several in Vermont. But there 

are other successful models, as well. 

Finally, discharge planning and reentry services for individuals 

with mental illnesses reentering the community are critically important. Successful reintegration is frequently hampered by lack of 

services and the failure to restore benefits lost or suspended during 

incarceration. The Campaign applauds the sponsors of S. 1194 for 

recognizing this and ensuring that grant funds can be used to support vital community reentry services. 

Once again, I thank you and am very grateful that I have had 

this opportunity to testify. I look forward to any questions you 

might have. 

[The prepared statement of Mr. Honberg appears as a submission for the record.] 

Senator DEWINE. Thank you very much. 

Sheriff? 

STATEMENT OF DONALD F. ESLINGER, SHERIFF, SEMINOLE, 

COUNTY, FLORIDA, SANFORD, FLORIDA 

Sheriff ESLINGER. Thank you, Mr. Chairman. I, too, would like 

to congratulate you and commend you on your leadership concerning this very important piece of legislation. 

Senator Leahy, thank you very much for your leadership as well. 

I am the Sheriff of Seminole County, and based on my experience 

I can assure you that the provisions contained in this bill are clearly needed to stem the ever-growing tide of the mentally ill within 

the criminal justice system. 

Ironically, it was five years ago this month that Seminole County 

lost Deputy Sheriff Eugene Gregory in a tragic incident that is emblematic of the crisis of untreated mental illness. Deputy Gregory, 

responding to a disturbance call, ended up in a confrontation with 

Alan Singletary, a man whose schizophrenia went untreated for 

years, despite his family’s efforts to get him to accept treatment. 

8

Alan killed Deputy Gregory, wounded two other deputies, and himself was killed in the ensuing 13-hour standoff. 

It was that tragedy that made me recognize the inescapable conclusion that we have to shift the focus of intervention for people 

with untreated mental illness away from law enforcement and the 

criminal justice system back to professionals who are trained to 

provide care and treatment for individuals with severe mental illness. 

The Senate bill provides critically needed resources for alternatives to incarceration, including training of law enforcement officers and mental health providers, and fostering collaboration 

among community stakeholders. 

With these resources, we have a greater hope of accomplishing 

really three main goals: number one, preventing fatal encounters 

involving law enforcement officers and those who are suffering 

from mental illness, as well as preventing unnecessary injuries 

that often occur during these crisis situations; number two, responding to the intense fiscal pressures in our counties throughout 

America, as well as making better use of public safety resources by 

not just treating symptoms of the problem, but looking at the underlying causation and addressing it. 

The loss of Deputy Gregory and Alan Singletary were far from 

an isolated incident and is not unique to Florida. Just since that 

tragedy in July of 1998, at least 175 other people with mental illness and 28 law enforcement officers have been killed in altercations across this Nation, 6 in D.C. and Maryland alone. This 

month, five mentally ill people have been killed in encounters with 

law enforcement. We now know that mental illness is a factor in 

many police shootings. In fact, people with mental illnesses are 

four times more likely to be killed in these encounters than the 

general population. 

It is critical to train officers to deescalate crisis situations. Seminole County has fully implemented the Memphis Model for CIT, a 

proven approach that fosters partnerships between law enforcement and the community. CIT has been shown to reduce officer injury rates five-fold. 

Equally as important is to prevent these incidents from ever occurring, because even the best training is no substitute for having 

medical professionals handle medical crises. The most effective way 

to prevent these violent episodes and deadly encounters is to prevent them by providing earlier intervention and treatment. This is 

not only the safest approach, but it is the most cost-effective. 

Lack of treatment impacts county budgets significantly in costs 

of personnel, incarceration, treatment within the system, emergency care, and even lawsuits. I am aware of at least seven lawsuits stemming from police shootings filed or settled since April of 

this year, some in excess of $1 million. 

When there are no alternatives to incarceration, the mentally ill 

begin to swell inmate populations in local jails and prisons. 

Mr. Chairman, as you alluded to, we now have over 300,000 incarcerated mentally ill in county and State prisons throughout this 

country, nearly six times the number in State psychiatric hospitals. 

These individuals are ill and most don’t belong in jail. 

9

I will abridge my comments, Mr. Chairman, for the sake of moving on. I would be delighted to answer any questions, but I must 

say again, to reiterate what you had conveyed, fostering community 

collaboration is a vital component of this bill. The deaths of Deputy 

Gregory and Alan Singletary inspired our community to collaborate 

to prevent such tragedies and improve the lives of people with severe mental illness. It is my hope that Senate bill 1194 will be a 

part of Gene and Alan’s legacy, making certain that people with 

mental illness get treatment before tragedy. 

Thank you, Mr. Chairman. 

[The prepared statement of Sheriff Eslinger appears as a submission for the record.] 

Senator DEWINE. Sheriff, thank you very much. 

Senator Campbell.

STATEMENT OF HON. JOHN F. CAMPBELL, MEMBER, 

VERMONT STATE SENATE, QUECHEE, VERMONT 

Mr. CAMPBELL. Thank you, Mr. Chairman. Let’s make sure we 

get this on. 

Senator DEWINE. You have to have those really close, is what we 

have learned here. 

Mr. CAMPBELL. My children will like that, also. 

Senator LEAHY. What happened, John, is we had too many 

snippets on the evening news with open mikes, everything from 

planning golf games to sometimes a little bit stronger. So we are 

being a little more careful around here. 

Mr. CAMPBELL. Well, Don and I were planning our golf game before, but we will hold off until after the hearing. 

Good afternoon, Mr. Chairman, Senator Leahy. My name is John 

Campbell. I am a member of the Vermont State Senate, where I 

serve as the majority leader, and also serve on the Judiciary and 

the Appropriations Committee. 

First, I would like to thank you for inviting me here today to 

speak in support of S. 1194, the Mentally Offender Treatment and 

Crime Reduction Act of 2003. As a former law enforcement officer 

and attorney for over 20 years and a current State legislator, I believe I have a unique perspective on the issues that we are discussing here today. 

During my time as a police officer, I frequently found myself 

called to scenes involving petty thefts, disturbances, and public intoxication. It was not uncommon to find the suspects of these 

crimes to be acting paranoid or behaving erratically. 

While I was quite able to handle the criminal aspect of the situation, I was not trained to deal with the complex underlying issues 

of mental illness and substance abuse. Although there were times 

that it was necessary to arrest and incarcerate certain individuals 

with mental illnesses in order to protect the public, others who had 

committed low-level crimes, non-violent, as a result of their mental 

illness should have been referred to a mental health agency. Unfortunately, such care was rarely available, which left us with no 

other option other than to transport them to the county jail, not a 

fine place for someone who is suffering from mental illness. 

Police officers today are better trained to recognize and deal with 

these situations. However, they still find the process of securing diVerDate 0ct 09 2002 12:48 Mar 09, 2004 Jkt 091830 PO 00000 Frm 00013 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\91830.TXT SJUD4 PsN: CMORC
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agnosis and treatment extremely frustrating. They find that the 

treatment providers may refuse to accept an individual for several 

reasons—lack of health care coverage, acuity of the illness, denying 

responsibility for the treatment of that person’s specific diagnosis. 

In cases where an individual is eligible for services, the officer 

may find themselves waiting hours before that person is admitted. 

In other cases, the person is admitted for treatment, but often discharged shortly thereafter, and sometimes is back on the street before the police officer even makes it back to finish his report. 

Requiring police officers to act as quasi-mental health care providers places an unreasonable burden on them, the department, 

and their communities. The time required to facilitate treatment 

for individuals keeps the officers from performing their normal patrol functions and forces departments to either hire additional personnel or expose the community to a lack of police coverage. This 

is especially troublesome in rural communities, such as Vermont, 

as reduced police presence there sometimes means the difference 

between having one officer and having none at all. 

While the initial responsibility for finding placement for these individuals often falls upon law enforcement, a burden felt by the 

communities, the ones who really suffer, the ones who truly suffer 

are those who are afflicted, and also their families. They simply 

have no place to go. 

This disjoined spectrum of responsibility is never more evident 

than when dealing with co-occurrence disorder. Individuals who 

suffer from co-occurrence find themselves the proverbial hot potato, 

tossed among the mental health agencies, substance abuse facilities, and the criminal justice system. 

These agencies and organizations have good intentions. All of 

them seek to break that cycle. However, unless there is a collaborative effort, it is inevitable that the individual will find themselves 

interacting with the criminal justice system. 

The systemic dysfunction is not isolated to any one area. From 

large urban areas to small communities such as my own in 

Quechee, Vermont, people are in dire need of integrated services. 

I often represent families in crisis, and in the majority of these 

cases you will find an underlying mental health problem. 

It is extremely frustrating to search for a solution for these families. Too often, we come up short as a result of fragmented and insufficient resources to deal with the issues. It is devastating to 

watch families implode over issues that, if treated, could be managed. Mothers and fathers have to stand by as their children selfmedicate themselves with alcohol and drugs in order to escape the 

personal horrors of their mental illness. 

Passage of S. 1194 will promote the types of integrated treatment 

and collaborative efforts between the criminal justice system and 

the mental health organizations that could spare many of these 

families those agonies. 

As an elected official, I appreciate more than ever the fiscal implications of the existing problem. Having to provide mental health 

treatment in an incarcerated setting is neither cost-effective nor 

clinically sound. A community-based approach would provide more 

complex services at a far greater service to the taxpayers. 

11

Many States have implemented programs for just these reasons. 

Vermont is one of them. One of our more effective programs is taking place in two of our largest communities, Burlington and 

Brattleboro. It is called the Co–Occurring Disorders Treatment 

Project, which promotes public safety and health by offering comprehensive, integrated mental health and substance abuse services 

to those individuals with both psychiatric and substance abuse disorders and who have ongoing involvement in the criminal justice 

system. 

Quite simply, as everyone has said so far, we can’t do this without you. There is no way that we are going to bring collaborative 

services to our communities without your help, and therefore I 

would ask that anything we can do to help you support and pass 

S. 1194. 

If there are any questions, I would be more than happy to answer them later. 

[The prepared statement of Mr. Campbell appears as a submission for the record.] 

Senator DEWINE. Senator, thank you very much. 

Director Wilkinson. 

STATEMENT OF REGINALD A. WILKINSON, DIRECTOR, OHIO 

DEPARTMENT OF REHABILITATION AND CORRECTION, COLUMBUS, OHIO, ON BEHALF OF THE ASSOCIATION OF STATE 

CORRECTIONAL ADMINISTRATORS 

Mr. WILKINSON. Good afternoon. Thank you, Senator DeWine, 

Chairman Hatch, and Ranking Member Leahy, for inviting me to 

testify regarding Senate bill 1194. My name is Reggie Wilkinson 

and I am the Director of the Ohio Department of Rehabilitation 

and Correction. ODRC comprises more than 30 prisons and on any 

given day our agency supervises 45,000 prisoners housed in our 

correctional institutions. Moreover, we supervise another 30,000 

persons on parole and probation. 

Today, I not only represent the great State of Ohio that is so ably 

represented by Senator DeWine, but also the Association of State 

Correctional Administrators. ASCA is the national organization 

that represents persons who serve in my position in each of the 50 

States and several other jurisdictions in this country. I am the current president of ASCA. 

I would also like to provide testimony on behalf of the Council 

of State Governments. They recently undertook a major initiative 

dealing with the mentally ill offender. Their work culminated in 

the publishing of a landmark report entitled ‘‘Criminal Justice/

Mental Health Consensus Project.’’ This bipartisan initiative 

brought together 100 leading law enforcement and mental health 

officials in the United States. 

A brief history. In 1993, following a prison riot at the Southern 

Ohio Correctional Facility where one correctional officer and nine 

inmates were killed, a Federal lawsuit was filed in Ohio entitled 

Dunn v. Voinovich, challenging the constitutionality of Ohio’s mental health delivery system in our prisons. 

We agreed, however, to a five-year consent decree in 1995 and 

decided to concentrate on, with the oversight of the Federal court, 

improving our mental health services for the mentally ill prisoner. 

12

Throughout the life of this lawsuit—the case was terminated per 

the settlement in the year 2000—all parties, including the plaintiff’s counsel, the court monitor, State’s attorneys, correctional administrators, and health care administrators, agreed to manage 

points of contention privately. 

Consequently, I am extremely proud of the mental health delivery system that currently exists in the State of Ohio. I consider the 

current system to be a national benchmark as it relates to prison 

mental health care. However, I know that it is very difficult, with 

the budget constraints, that we continue along the current path 

that I am so proud of today. 

I think this legislation, Senate bill 1194, can be the single most 

important positive legislative development for correction and mental health workers to occur in Congress in recent memory. It is 

gratifying to see a group of leaders in the Senate rally as they have 

under Senator DeWine’s and others’ leadership around a bill that 

practitioners and policymakers alike will agree can save lives, increase public safety, and reduce State and local government spending. 

First, save lives. Our Nation’s prisons, where more than 1.3 million persons are incarcerated on any given day, and our jails, which 

book about 10 million people annually, house more people with 

mental illness than do our country’s mental health institutions. In 

fact, I often claim that correctional administrators are de facto 

mental health directors. That is enormously frustrating for us in 

the corrections community. Our principal job is to incapacitate and 

rehabilitate persons who are dangerous to the community, not to 

hospitalize sick people. 

Although we believe criminals with a mental illness should be 

punished, we also know that a correctional environment is hardly 

conducive to recovery for a person with mental health problems, especially a seriously mentally ill person or a person with an Axis 1 

diagnosis. Not surprisingly, inmates with untreated mental illness 

are at a high risk of committing suicide or being victimized by 

predatory inmates. 

Public safety. The growing involvement of persons with mental 

illness in the criminal justice system has enormous public safety 

implications. Many offenders with mental illness have committed a 

crime that makes their incarceration necessary and appropriate. 

Still, nearly all inmates with a mental illness will be released from 

prison at some point. 

Unless we provide these offenders with the services and treatment they need while they are incarcerated, we are virtually guaranteeing that they will commit new crimes when they return to the 

community. Nevertheless, few corrections systems are able to prepare inmates for adequate release following their incarceration. 

Not surprisingly, studies have shown that rates of recidivism for 

persons with a mental illness should concern all elected officials. 

Senate bill 1194 can promote effective reentry planning for persons with a mental illness through efforts such as encouraging 

mental health providers to come into correctional facilities and connect with the offender prior to release and ensuring inmates have 

an adequate supply of medication upon their release. Typically, two 

13

weeks of psychotropic medication is provided to offenders once they 

are released from our custody. 

Reduced spending. Nearly every State in the Nation now knows 

that it is extremely expensive to manage persons with a mental illness. We have found out in the corrections business that we are no 

longer recession-proof, that we have enormous responsibilities and 

great fiscal burdens. Speaking on behalf of persons in my capacity, 

we are hoping that Senate bill 1194 will continue with its current 

path in due speed. 

[The prepared statement of Mr. Wilkinson appears as a submission for the record.] 

Senator DEWINE. Thank you very much. 

Ms. Atkins.

STATEMENT OF RHONDA ATKINS, SARASOTA, FLORIDA 

Ms. ATKINS. Chairman DeWine, I am very grateful to be here 

today in support of Senate bill 1194, the Mentally Ill Offender 

Treatment and Crime Reduction Act of 2003. 

My name is Rhonda Atkins. I am the mother of a 25-year-old 

mentally ill daughter from Sarasota, Florida. My daughter would 

have been spared a great deal of torment, as well as our entire 

family, had these things been in place ten years ago. 

My daughter suffers from a severe mental illness, bipolar disorder, and for much of these last ten years she has cycled in and 

out of psychiatric hospitals—rather, ping-ponged from psychiatric 

hospitals to substance abuse treatment centers—inconsistent treatment, and her condition has steadily grown worse over the years. 

She is presently in treatment, after struggling for literally most of 

these last ten years to have her in long-term treatment. 

I will never forget what it is like when she is not in treatment. 

When she is not on her proper medication, she becomes very symptomatic, with mania. Some of the symptoms of that would be extreme irrationality, hyper speech to the point where she can hardly 

be understood. She doesn’t think the way that you or I do when 

she is suffering from one of these episodes. 

She can become paranoid, thinking that those of us who are trying to help her, who love her, who want to get assistance for her, 

are trying to make her think that she is crazy, that it is we who 

have the problem and she is fine. She becomes delusional, very 

poor judgment, very dangerous to herself. 

There have been many, many nights, countless nights when I 

have not known where my beautiful daughter was, sometimes for 

a night, sometimes for a week, up to three months at one time. 

Like many people with mental illness, she sometimes doesn’t think 

that she is ill and doesn’t want to take her medication. She had 

not been consistently in treatment long enough to really gain the 

insight to understand that she indeed is ill and it would behoove 

her to stay in treatment or stay on medication. 

Like so many other people with mental illness, she has tried to 

calm the chatter in her own mind with substance-abusing, which 

only makes her symptoms worse and the situation worse. She has 

often been uncontrollable and we have many times been afraid of 

what she would do to herself. She has indeed tried to harm herself 

14

on numerous occasions by wrist-cutting, overdosing, and things like 

that. 

When someone gets that sick and when the mental health system doesn’t respond, usually the first line of recourse is the police. 

There have been numerous times when we have had to have police 

officers come to our home. Some have been educated enough to 

know how to deescalate a situation. 

There were others. I will never forget the one who very roughly 

handled her and said that if you were my daughter, I would knock 

you across the room. As you can imagine, that can throw fire upon 

a very tense situation already and cause problems that would not 

have been necessary, They might have deescalated a situation and 

gotten her into a safe situation had they been better trained to deal 

with a mentally ill person. 

The first time my daughter was arrested was for a trespassing 

charge. Each time she brushed with the law, we would hope that 

then would be the moment that we would get some assistance that 

we needed to get her into treatment that we knew she needed. 

Sometimes, when we would get into a situation, there were no 

services for her to be diverted to, or if there were services, there 

were waiting lists for those services. Waiting lists are just—when 

you need the treatment, you need it now. Six months from now 

doesn’t serve someone who desperately needs to be in safe care in 

the moment. 

She has been arrested on a drug charge, which isn’t surprising 

because when she is self-medicating, it will just often lead to that. 

There was one occasion when she was arrested on a drug charge 

and actually went through a drug court, but even then there was 

no real understanding or integration of services for substance 

abuse and mentally ill offenders. 

So rather than having an integrated approach to working with 

my daughter, she was just in the drug treatment program. Actually, a social worker in the program had discouraged her from taking her medication, which was lithium, which resulted in her deescalating, becoming manic again, and an a series of hospitalizations 

occurred after that. 

I believe in a 3-year period, there were, I think, 20, 21 hospitalizations, which is very costly to the State. My statements to 

those in charge were it would be so much less expensive if you 

treated this on the front end rather than the repeated hospitalizations, the jail, all of those occurrences. 

The very tragic thing about so much of this is that my daughter 

is intelligent. She is a beautiful young woman, and while many of 

her friends were starting careers, getting married, having babies, 

my daughter spent years drifting through the streets, in and out 

of the jail system and emergency rooms, living among drug dealers. 

Within the last three years, she was sleeping in cat feces. She 

weighed 81 pounds at one point. Her body was covered with sores, 

and still we couldn’t get her in long-term care. This bill could have 

saved years of my daughter’s life. It could have saved us a great 

deal of heartache and grief early on, because this is an illness that 

doesn’t affect just the person who has the illness, but it affects the 

entire family. 

15

The reality under current law is that law enforcement officers 

often are the ones who are the first line of response for people with 

mental illness. I am deeply in support of this bill to encourage 

what is needed on every level of working with those with mental 

illness in all levels of the system. Nothing can be gained by putting 

a person on a waiting list. 

My daughter has a brain disease, and these people need help; 

they simply need help. I felt personally compelled to come here 

today to plead with you to pass this bill. There are many people 

suffering who will continue to suffer without its passage. I am here 

to speak on behalf of all of us, all the families across the State of 

Florida, where I am from, and across the Nation who suffer from 

this illness. Please pass this bill so that another mother won’t have 

to watch her daughter or her child deteriorate the way that my 

daughter has. Thank you. 

[The prepared statement of Ms. Atkins appears as a submission 

for the record.] 

Senator DEWINE. Thank you very much. 

Justice STRATTON.

STATEMENT OF HON. EVELYN LUNDBERG STRATTON, 

JUSTICE, SUPREME COURT OF OHIO, COLUMBUS, OHIO 

Justice STRATTON. Thank you very much, Senator Leahy and 

Senator DeWine, for allowing me the privilege of coming and sharing with you. 

You have heard much today about the problems that have 

brought us to this bill. I hope to share with you a little different 

focus on why this bill can be successful and why this bill can make 

a difference. 

My own story that brought me here is that about eight years ago 

I received a call from the governor’s office appointing me to the 

Ohio Supreme Court. As you can imagine, it was one of the most 

exciting moments of my life. That same week, my 12-year-old son 

ended up in a mental hospital seriously depressed and suicidal, and 

I went from the biggest highs during the day to the biggest lows 

at night, holding his hand, wondering if he was going to live. 

Then I went to court and sat on the bench and looked at the defendants in front of me who had absolutely no mental health care. 

If they were alcoholic and drug-addicted but had a mental health 

problem, Drug and Alcohol wouldn’t take them. If they were mentally ill but had a felony, the mental health system wouldn’t take 

them. So I put them in jail, often more for their protection than 

anything else. 

I felt a compelling need to do something. So two years ago I went 

to the chief and asked if I could establish a task force. He said we 

have no money. I said I will do it on my own. I called together 

some experts in the field and said I don’t know anything about 

this, but I want to make a difference, help me. 

We got people from Mental Health, from Drug and Alcohol, from 

Sheriff’s, from Probation, from NAMI, from the Ohio Advocates for 

the Mentally Ill. We put together a statewide task force and we 

started to try to find solutions. We have met every month for two 

years now, and every meeting our goal is to come forward with 

16

something positive, not a white paper, not a study, but something 

to move forward to make a difference in this State. 

We have now over 20 counties that have either a mental health 

court or some program specifically aimed at the mentally ill in the 

jails. Every major city in Ohio now has a CIT program. We have 

over 150 law enforcement officers that came to the last NAMI convention, something totally unprecedented. We are even now going 

to the campus police and offering training for campus police. 

Our goal is to get every single county to put together a collaborative task force. I have a waiting list a mile long of counties that 

want me to come, but I still have no staff, no resources. I make all 

my site visits myself. My law clerks type all my letters. We are 

doing it on our own, but we are still making a difference because 

collaboration is what works. 

I wish to give you an example of one county where it worked. 

Some people came to me from Franklin County and said, we have 

a serious problem. We have all these mentally ill. We know you are 

doing something. Can you come and help us? 

One of the advantages of my job is judges tend to return my 

phone calls. So I called some judges, I called some local people. We 

had ten people that met over a year-and-a-half ago, tried to put a 

little group together, and discovered the Department of Mental 

Health had funded a grant program for Franklin County, for the 

jails. The judges had never heard of it. We had 500 beds funded 

by the Community Shelter Board for the Mentally Ill and Homeless. The judges had never heard of it. We had a program that 

trained the mentally ill to work. The judges had never heard of it. 

That committee now has 55 people on it. It has started a mental 

health program in the Franklin County muni court and a drug 

court in the common pleas court. It has received two grants. One 

is from your mental health bill that you passed before. They are 

starting two CIT programs in the city of Columbus, and that program not only deals with the mentally ill in the jails, but they have 

started to find so many other ways to collaborate and work together outside of the jail system and not duplicate and waste resources. So it has been a tremendous success just in one county 

alone. 

A judge from Seneca County started this with the Juvenile 

Court, trying to deal with the juveniles in his court. He got together the schools, mental health, and drug and alcohol folks, and 

got them to work on the problem in their county. When he first met 

with them, they sat on opposite sides of the room, wouldn’t even 

talk to each other, Drug and Alcohol one side, Mental Health on 

the other. By the fourth meeting, they were intermingling. 

They are currently now having an intervention program that 

tries to identify kids before they even are declared a criminal defendant, before they are even arrested, to intervene and work with 

them. This program can further that type of collaboration. It can 

provide that key seed money. 

I have a staff attorney and she has a sister named Sheree. 

Sheree had a drug and alcohol problem, a mental health problem, 

and had been arrested several times. Last week, Sheree died of a 

drug overdose. To others, she was a statistic; she was a mentally 

ill, drug-addicted criminal defendant. But to us, she was a sister, 

17

a mother, a daughter, a wife. She left four children. She was 46. 

There was no mental health program in her community. 

We were too late to help Sheree and we may be too late to help 

others, but we can really make a difference with this bill, with the 

catalyst this funding can provide, to get that collaboration going 

that can make such a difference. 

Thank you. 

[The prepared statement of Justice Stratton appears as a submission for the record.] 

Senator DEWINE. Well, I want to thank all of our witnesses for 

some very compelling testimony. 

Let me turn now to Senator Leahy. 

Senator LEAHY. Thank you, Mr. Chairman. I think this has been 

a very good hearing. You know, there are a million things going on 

right now on the Hill. The Senate is in session and we are having 

votes and doing other things. That is why there are so few here. 

There are, however, a number of staff members of various Senators, key Senators on this on both sides of the aisle, and I have 

a feeling that a synopsis of all your testimony, the six of you, is 

going to be in the must-reading book for a lot of Senators tonight. 

Let me ask Senator Campbell this question, and I ask this not 

to be parochial, but I think probably the same question can be 

asked in any small State or any basically rural areas. 

Can you give me examples of what Federal funding provided 

under the Mentally Ill Offenders Treatment and Crime Reduction 

Act that we are talking about—what funding under that would 

allow a small State like Vermont to do that it wouldn’t otherwise 

be able to do? 

Mr. CAMPBELL. Senator, I think especially small States, but even 

some of the ones that maybe are not as far advanced in their State 

programs regarding mental illness—we are trying to start with the 

mental health court. We now have a pilot program for drug courts, 

and in coming up with the ideas for these programs we are following the lead of a lot of other States. 

It is wonderful to start the programs, but unless we have the resources to actually treat the folks that are coming through the programs, we are not going to be successful here. Then we are just 

going to be again back here in a few years talking about other programs and trying to get other grants. 

I believe that with the Federal funds that this bill would suggest, 

we would be able to make sure that the drug courts and the mental 

health courts not only are implemented, but they are sustained. 

That is really the key here, is the sustainability of the programs. 

In addition to that, we need to make sure that we have the resources available to have the collaborative effect that you are seeking under this bill. 

So with that, with the funds that are provided here, I think we 

will be able to make a difference. Without them, I don’t see us fiscally being able to handle it in the State budgets. 

Senator LEAHY. Are there other things we see in a rural area? 

We have very small police departments. I suspect rural Ohio and 

rural Illinois, or any other State represented here also have very 

small police departments. Are these among the biggest problems? 

18

We have heard Ms. Atkins talk about a police officer reacting to 

her daughter. We have heard the sheriff speak and others speak 

about how you react when you go there. Is this an insurmountable 

problem? 

Mr. CAMPBELL. I don’t think it is, but I tell you the training of 

police officers is so important. I can understand Ms. Atkins’s dismay over something like that, and as a former law enforcement officer, I cringed when I heard that story. 

Especially in rural areas like we have, as you know, the State 

police do a wonderful job in Vermont. However, they are spread 

very thin. We are right now down 40 to 45 officers. Sometimes, in 

the rural areas, the only people we have actually patrolling are the 

sheriff’s department, which only has about two or three people, and 

most of those are part-time folks, or constables. The sheriff’s department in Vermont—a lot of the sheriffs, and also the constables, 

are not trained in these areas specifically. So we have that problem 

to deal with. 

In addition to that, we have an issue that when you are in such 

a rural area, everything is so spread out that it is very difficult to 

get the services and use the urban models that seem to be effective 

here in those rural areas because of the fact that there is not 

enough training. 

So this bill, I believe, would effectively enable the mental health 

communities, the corrections and the substance abuse communities, 

to train the folks within these smaller communities, train the police officers, and train the constables to make sure that they are 

available to help in crisis situations and to continue with the wraparound services, and also to make sure that it is not just a onetime shot, that they follow them all the way through until there 

is some type of recovery. 

Senator LEAHY. You have the obvious problem we have with juveniles; they get out and nobody does follow-up. I know it is one 

of the things that both Senator DeWine and I have talked about, 

and I would hope that this would allow us to do something in that 

kind of a follow-up. 

Mr. CAMPBELL. If I may read, this is from the Juvenile Justice 

Commission report of February 2003. I couldn’t sum it up better, 

but this kind of lets us know about how our juvenile justice is in 

Vermont. 

‘‘Vermont’s juvenile and youth justice response represents a fragmented array of programs and interventions. There is no clearly 

defined, consistent, or coordinated statewide response for juveniles 

and young offenders, nor are efforts woven into a large continuum 

of care for children and families. The State Agency of Health Services, working in partnership with the judiciary, communities, and 

families, need to bring these efforts together and create an integrated and coordinated system of care.’’

That sums it up right there, and we can have wonderful programs, but unless it is a collaborative and integrated affair, then 

we are not going to be successful. 

Senator LEAHY. Well, you know, I couldn’t agree with you more 

from my own experience, and certainly from the things that you 

have done and others have done in Vermont on this, but also from 

some of the other testimony Senator DeWine and I have heard. 

19

I would like to ask Dr. Wilkinson, what about law enforcement 

and corrections officers and mental health problems? I mean, you 

come from a much larger State than Senator Campbell and I do. 

Are they willing to work together? I am talking about law enforcement and corrections and mental health. Are there obstacles to coordinating? Are there things that could be done better? What is 

your general take on that? 

Mr. WILKINSON. I think the obstacle that exists more so than 

anything else has been the fact that people have not brought folks 

together that need to be in the same room, like Justice Stratton is 

currently doing. I think that is the first thing, and a lot of the problems that we can solve can be solved without a whole lot of money, 

which brings us to the second problem. 

Sometimes, money can’t be avoided when we are talking about 

the need to get persons who appear to be acting out, and sometimes that behavior is criminal and sometimes it is deviant behavior as a result of a psychosis, for example. If there are not crisis 

centers for police to refer persons to, if there is no crisis intervention training and first responders can’t adequately identify unusual 

behavior that might be a mental illness, then those persons are 

going to travel through the criminal justice system and cause taxpayers of all of our jurisdictions to spend multi-million dollars on 

something that could have been avoided at the very beginning of 

this process. 

Senator LEAHY. To say nothing about the risk to others, themselves, and everybody within the system. 

Mr. WILKINSON. That is exactly right, and it is very expensive 

once they are in the system. The cost of housing a person who is 

mentally ill is extremely more costly than it is to house a person 

without a mental illness. You take the statistic that Senator 

DeWine mentioned. About 16 percent of all the persons in prison 

have a mental illness, and half of them have an Axis 1 serious 

mental illness. We are talking about an awful lot of money. 

But on your original question of do we work together, the answer 

is unequivocally, absolutely yes, and it is happening. But part of 

the problem that relates to that is that we don’t tell those stories 

well enough. So I think part of the bill addresses that we not only 

need to give grant money to jurisdictions who apply for it; we need 

to dissect what is going on and share that with other jurisdictions 

across this country. 

Senator LEAHY. Thank you. Well, I think what Judge Stratton 

has said, as you have mentioned, is important there. 

Mr. Chairman, I will put my other questions in the record. 

I just might say, Ms. Atkins, obviously all of us who are parents 

up here feel for what you are going through and hope that someday 

the best solution will come of that. 

Sheriff, there is no way to bring back Deputy Gregory, but all of 

us, again, on this Committee share your sadness at his death. 

Thank you all for taking the time. It is not easy to work out time 

for people to come to testify and I appreciate it. 

Ms. Atkins, do you want to say something? 

Ms. ATKINS. I just wanted to say that it is wonderful to be at a 

table in a group with a cooperative spirit of everyone working together, because as my daughter shuffled through the system it has 

20

been so fragmented and to have everyone working together is just 

what I have prayed for for ten years. 

Senator LEAHY. Thank you. 

Senator DEWINE. Ms. Atkins, we just appreciate your testimony 

very much and the fact that you would come and share your story 

with us. I take it that your daughter is doing better today? 

Ms. ATKINS. She is doing better today. She was in residential 

treatment for a year and she is in a therapeutic community presently, still in treatment, but a step down from where she has been. 

And I can honestly tell you that a year-and-a-half ago, no one 

thought she would be alive today. Because she has been in treatment, we have hope that she is going to continue with her recovery. 

She is doing better presently than she has in the last ten years. 

Senator DEWINE. Good. Well, we wish her well and we wish you 

well. 

Ms. ATKINS. Thank you. 

Senator DEWINE. Sheriff, you gave in your written testimony 

some very alarming statistics and pointed out something, I think, 

that we should know and maybe we don’t think enough about, and 

that is how very dangerous it is for the police officer and how dangerous it is for the defendant, the criminal, when that criminal has 

a mental problem. 

You pointed out how many people just in the last month have 

been killed when that person had a mental problem. I mean, the 

sheriff or the deputy or the police officer goes in and tries to make 

an arrest. If that person whom he is arresting has a mental problem, that is a high-risk proposition for both of them. 

I guess it just points out maybe the need for this bill, but also 

points out the need for training. Ms. Atkins gave some testimony 

that would indicate sometimes maybe we don’t have enough training for those officers. I got a letter after I introduced this bill, a 

copy of a letter that was sent to some of my colleagues from another State from, again, a mother who had some similar experiences that Ms. Atkins had relating about her child, her experiences 

with officers. 

I think we are doing a better job today than we were probably 

when I was a county prosecutor 30 years ago. But how well are we 

doing? How often do we have these crisis intervention teams? How 

many jurisdictions have crisis intervention teams? Could you just 

kind of reflect on that for us? 

Sheriff ESLINGER. I do believe that law enforcement administrators throughout this country recognize that the mental health issue 

is not just a humanitarian issue or a public health issue, but it is 

also a public safety issue as well. I believe that a lot of agencies—

and NAMI can back us—have moved to CIT and much more can 

be done in the area of training. 

But what the bill also does, Mr. Chairman, is to provide earlier 

intervention. Law enforcement is called upon only during a crisis 

situation and we need to shift the focus of that intervention back 

to the mental health professionals. 

In the State of Florida, law enforcement conducts 34 percent 

more Baker Acts, which is our involuntary examination, than DUI 

arrests. We average over 115 a day of Florida’s Baker Act law. 

21

That is more than aggravated assault, that is more than burglary 

arrests that we make, and we need to shift the burden back. 

In fact, in half the counties in the State of Florida, nearly half 

of the counties, no mental health professional is involved in administering the Baker Act; it is law enforcement. What your bill will 

do is not only develop that collaboration, but it will also shift focus 

back to the mental health professional and provide greater assistance in community-based treatment. 

Senator DURBIN. But it is a safety issue, and it is a safety issue 

for the officer, it is a safety issue for the person they are going to 

arrest, and maybe a safety issue for innocent bystanders as well. 

Sheriff ESLINGER. As I mentioned earlier, Mr. Chairman, those 

who suffer from mental illness are four times more likely to be involved in a fatal police shooting. 

Senator DEWINE. A staggering statistic. 

I am going to have to move on. Let me ask Mr. Honberg and anybody else who wants to comment on what our experience has been 

with the mental health courts. They are of fairly recent origin. 

They are certainly of recent origin on the Federal level, but before 

our bill was enacted there were some mental health courts at the 

State level that had already been started. Ours didn’t start it. We 

were trying to add to that and put kind of the Federal seal of approval on them, and we were glad to be able to do that. 

What has been the experience at the local level? 

Mr. HONBERG. Well, you know, they are a relatively new phenomenon. 

Senator DEWINE. Yes, they are. That is why I asked. 

Mr. HONBERG. Yes, despite the fact that there are over 70, so 

they have certainly devolved like wildfire around the country. So, 

you know, in terms of formal data, it is just starting to come out. 

I think based on what we have heard today, first of all, the first 

point I would make is that it is pretty obvious that any mechanism 

that can link people with needed treatment and with treatment for 

co-occurring, for not only their mental illness but substance abuse, 

is good. 

I would say that the early data that I have seen, at least, in 

places like Broward County is very favorable. For example, the 

court has been successful in linking people with treatment. The 

court has been successful in preventing recidivism. Very few people 

who have been under the jurisdiction of the court have re-offended. 

Another intangible that is difficult to measure is sort of the experience of the individuals who have come through the court, by and 

large people who have reported that the experiences have been 

very positive. They have not been coercive. They have felt that the 

judge and the court were very supportive. 

One other point I would make is that the judges—I have met a 

number of judges and the judges, as is true for Justice Stratton, 

have come real advocates and sort of use their bench as a bully 

pulpit to advocate for services that don’t exist. 

Again, using Broward County as an example, where there is just 

a lack of community mental health services, lack of housing, the 

judge has been able to go before the legislature and actually lobby 

and get resources for housing and for treatment for mental illness 

and substance abuse. 

22

So, again, I would make the point that it is not the only approach, that there are a number of different approaches that need 

to be tried, and it is up to each community to decide to work best. 

Mental health courts certainly seem to me to be a very positive development and a very positive experience for those who have been 

through them. 

Senator DEWINE. Justice Stratton? 

Justice STRATTON. There are, in fact, not very many statistics because they are all relatively new, but the oldest one in Ohio is the 

Akron court, Judge Stormer. She had a drug court, started the 

mental health docket within her drug court, devoted two full days 

to just people who were mentally ill and also had a co-occurring 

disorder, helped put together the task force that started the CIT 

program. And not just because of the court, but because of the CIT 

diverting to the facility the community agreed on, her docket has 

dropped in half. She only has one day a week now for the people 

who are mentally ill. 

The anecdotal stories of the physical changes in appearance, people who started getting jobs who haven’t worked for years, people 

going back to college—the stories these judges tell of the difference 

in the lives of people from the first day they appeared to when they 

graduated from the program are just heart-warming. 

Senator DEWINE. The main emphasis, frankly, of this bill is the 

collaborative effort, and what we require is law enforcement has to 

be a part of it and the mental health community has to be a part 

of it. 

I am going to quote something that Justice Stratton wrote in her 

prepared testimony. She says, ‘‘Taxpayer dollars are paying for police officers to repeatedly arrest, transport, and process mentally ill 

defendants, as well as for jail costs associated with treatment, crisis intervention, salaries of judges, and, of course, staff prosecutors 

and defense attorneys and many more hidden costs. The question 

becomes would we rather spend these dollars to keep mentally ill 

citizens homeless, revolving in and out of our criminal justice system, or would we rather spend these dollars to help them become 

stable, productive citizens?’’

I guess the question then is, you know, why aren’t we doing this 

more? Senator Leahy asked Director Wilkinson that, and I would 

ask maybe some of the rest of you the question. Why haven’t we 

in the past been doing more of these collaborative efforts and what 

is it that has stopped us from doing that? Is it money? Is it culture, 

a culture that means that law enforcement doesn’t talk to treatment, treatment doesn’t talk to substance abuse people? We have 

all kind of seen that over the years. I think we are doing better, 

but what is it? 

Mr. WILKINSON. My first take is the squeaky wheel gets the 

grease. We have not squeaked loud enough, like law enforcement 

and like some other venues have. We are here squeaking today, 

Senator, that there are other ways that we can skin the public 

safety cat, that we can divert funds to. But we can’t forget about 

the public safety notion that we are currently doing. It has to be 

a gradual process. 

But probably more so than anything else, it is going to take leadership for people to have a bigger vision about tackling the mental 

23

health problem, the co-occurring disorder problem, the problem for 

people who have retardation. It is going to take people who can tie 

all of that together and see a bigger picture of answers rather than 

what we have seen before. Otherwise, it is going to be business as 

usual. 

Mr. CAMPBELL. Senator, if I could add, in fact, I was quite 

shocked. When I learned first about the co-occurrence about three 

years ago when I had a constituent that was going through this 

with her daughter, similar very much to Ms. Atkins, I was shocked. 

I couldn’t believe that they weren’t dealing with both issues at 

once. Everyone was trying to point the finger at someone else. 

It was like turf wars almost and people were concerned about 

who was going to get what funding, and if we don’t justify our position and our use here, then we are not going to get the funds. I 

find that to be abhorrent and I am glad that we are finally discussing it, and your bill here is going to force the States to make 

sure that they do work in a collaborative fashion. 

Senator DEWINE. Justice Stratton? 

Justice STRATTON. I think it has been a culture issue more than 

anything. I have found that groups just never talk to each other, 

like the experience I had with Franklin County. The trial courts 

are very isolated from the mental health community. Drug and Alcohol is very fixed with their funding. 

When I brought them to the table and said let’s talk together and 

they started talking, barriers came down and people found ways to 

work together. I have had almost no resistance to people working 

together. The Department of Corrections sits on our board, Probation sits on our board, and Mental Health. All these people started 

talking. That is what it makes a difference. 

Senator DEWINE. Everybody is well-intended, everybody wants to 

do the right thing. It is just that when you get up in the morning, 

that is not what you do. I mean, you just don’t work with the other 

group. You just go about and do your own business. I mean, we 

have all been in courthouses. We know how things work. You 

know, the mental health folks are over here and substance abuse 

is over here, and we are doing our thing—as a prosecutor, we did 

our thing in criminal justice and we just didn’t necessarily work together. 

Justice STRATTON. But where your bill can really make a difference is that sometimes funding is a galvanizing force; it is a catalyst. When communities say, okay, there is some funding available, but we have got to put a task force together and we have got 

to communicate and we have got to collaborate before we can get 

the funding, it is the catalyst that can get that to happen. So in 

that sense, it can really be important. 

Senator DEWINE. That is the idea. 

Senator Durbin.

STATEMENT OF HON. RICHARD J. DURBIN, A U.S. SENATOR 

FROM THE STATE OF ILLINOIS 

Senator DURBIN. Thank you, Mr. Chairman. Thank you for this 

hearing and this important legislation. I would be honored if you 

would add me as a cosponsor of this bill. 

Senator DEWINE. We appreciate that. Thank you very much. 

24

Senator DURBIN. Let me also thank the panel for your contributions. Though I wasn’t here for your actual testimony, I have reviewed your statements and I appreciate what you have added to 

this record. 

I also would like to note for the record that our former colleague, 

Paul Simon, now at Southern Illinois University in Carbondale, 

last year held a meeting with former Surgeon General David 

Satcher on this issue and wrote us all a letter. Obviously, if you 

didn’t get the letter, you were inspired by your own means, but I 

am glad to be able to tell Paul that—

Senator DEWINE. Paul has been a real leader in this area. Paul 

really gets it, gets the whole problem. 

Senator DURBIN. If it is permitted, I would like to add to the 

record the findings of his conference last year, which is relevant. 

Senator DEWINE. It will be made a part of the record. 

Senator DURBIN. I would like to ask a few questions based on 

some of his findings which I think might be interesting if this 

panel could address. 

Senator Simon as a result of this asked, or at least requested 

that all those incarcerated be screened for mental illness, developmental disabilities, and learning disabilities as part of the initial 

processing as they enter the correctional system. 

Is that done now or is that something that may or may not 

emerge during the entire criminal process and may, in fact, emerge 

later in some instances where it finally is realized that we are dealing with a situation with mental illness? 

Justice STRATTON. It is something that is not done. I don’t know 

about the prison system, but at the local jail system it is frequently 

not done and it is part of why we have very poor statistics. One 

of the things we urge in our collaboration effort is an intake process that even asks some basic questions about what mental health 

illnesses or treatment they have had to even help us identify it. 

That is one of the things we hope to have funding for. That is 

one of the things that does require funding, is somebody who can 

be trained, ask the questions, and deal with the intake process, because we just don’t even have any statistics because there is very 

little done. That is one of the things we are trying to put into the 

whole collaborative process. 

I know that the Department of Correction has done some things 

on that and I would like Reggie to speak to that. 

Senator DURBIN. Before Dr. Wilkinson or others respond, I am 

tempted to divert my questioning into another line as to how a person can go through a criminal trial, when one of us learned in law 

school that one of the first questions you asked is whether they had 

the criminal intent or whether they were capable of forming that 

criminal intent. If that person is, in fact, seriously mentally ill and 

it is not even discovered at the point when they are incarcerated, 

it appears to me that the important question was not asked at an 

earlier stage that might have related to the guilt of the defendant. 

Justice STRATTON. I can explain how that works. 

Senator DURBIN. Maybe that is for another hearing. I don’t know. 

Justice STRATTON. I can explain briefly how that works. At the 

felony level, most of the time you do catch them when they are 

screened. It is at the municipal level where they don’t. If you have 

25

a defendant and you know he has a mental problem, you can plead 

him out and get him three days and he is out of jail. Do you do 

that or do you let him go into the process, 30, 60, 90 days before 

he even gets a hearing and a psychiatric evaluation, sits in jail now 

30, 60, 90 days? 

A lot of the criminal defense attorneys that I talked to said I 

think it is my duty to get him out of jail as quickly as possible. The 

problem is it doesn’t get at the underlying illness. So they often ignore the mental health problem, or they may be acting competent 

at that exact moment, but may not have been when they were arrested. 

There are a lot of factors, but the basic thing is a lot of them consider it better to move them through the system quickly than get 

them caught up in the mental health process. 

Senator DURBIN. Dr. Wilkinson? 

Mr. WILKINSON. Senator, there is an awful lot of mental health 

assessment taking place. We think we do it well. However, that 

varies across the country in both prisons and jails regarding how 

well it is done. It is not cheap to do initial assessments of thousands of people who come in and out of your correctional facilities 

on an annual basis. 

So we in some cases depend an awful lot on the sentencing 

courts to give us that information in pre-sentence investigation reports so that we don’t have to go back and do our own investigations regarding the pasts of these persons who are coming. Benchmark programs can help resolve that in a significant way. 

The other thing that we don’t do well, including in our system, 

is detecting those persons who either have a mental illness and deteriorate while they are in prison or the people who develop a mental illness while they are incarcerated. 

Senator DURBIN. So let me take it to the next step. Let’s now 

talk about the population that has now been discovered to be suffering from some form of mental illness and they are incarcerated, 

and that, I think, has been suggested 16 percent serious mental illness. At least that is our benchmark figure for this discussion. 

What percentage of those receive medication and treatment during incarceration? Does anyone know? 

Mr. WILKINSON. Senator, of the 16 percent, we guesstimate about 

half of those have a serious mental illness, which means that they 

require a lot more supervision, they require medication, they require in some cases hospitalization. Hospitalization is sometimes 

short. What we do is have intermediary housing areas where we 

can take the persons who have a very visible mental illness. 

A lot of people in our correctional institutions with a mental illness, you don’t know it if they are on their medication because they 

can behave normally with medication. But at least half of that 16 

percent is on some sort of psychopharmacology. 

Mr. HONBERG. Senator, if I just could quickly add, I know that 

in Ohio, in particular, Reggie Wilkinson has done some marvelous 

things in creating programs. But I have tell you, around the country, the way that people with mental illnesses who are incarcerated 

in jails and prisons are treated is frequently deplorable. 

I mean, people may have access to medication if they are overtly 

psychotic, at least for as long as they are psychotic. But I have seen 

26

it many times. People with mental illnesses tend to get sent to the 

worst units in the prison. There is excessive use of solitary confinement, there is excessive use of seclusion and restraints. It is a 

nightmare and it is oftentimes in circumstances that are only going 

to make the symptoms worse. 

That is why it is so important to have legislation like this and 

to have a movement like this that is designed to get at least lowlevel offenders out of these facilities and into community treatment. 

Senator DURBIN. I want to get to two more questions and I don’t 

know how much time I have remaining. 

Senator DEWINE. You have plenty of time. 

Senator DURBIN. Thank you. 

In the situation where you have someone who is mentally ill and 

incarcerated and has been diagnosed and is now being treated, who 

pays for the treatment? 

Mr. WILKINSON. The taxpayers of that State, sir. 

Senator DURBIN. Is the Federal Government involved at all? 

Mr. WILKINSON. No. 

Senator DURBIN. No Medicaid, no Medicare? 

Mr. WILKINSON. No. In fact, the law excludes persons who are in 

detention from receiving any Medicaid funds whatsoever. 

Senator DURBIN. Justice Stratton? 

Justice STRATTON. One of the problems we are struggling with in 

Ohio is if you are in jail, just even jail for a shorter-term sentence, 

after 30 days your Medicaid is cut off. That means now they have 

to go get a psychiatrist to do a new evaluation to give medications 

which may be different than what they are used to. 

If they get out of jail in 60 days, they may not even get the new 

medication by the time their other 30 days are up. The door is 

open, they walk out. Now, they have to re-apply for Medicaid. It 

may be months before they get it. They decompensate and they are 

back in prison before they ever get back on Medicaid. So it is a reentry problem that we are really having a struggle with as well. 

Senator DURBIN. You have taken me, Justice, to the point I 

wanted to get to, and this goes back to Senator Simon’s conference 

which he held. He recommended something which I hope Senator 

DeWine will consider as part of his legislation. He believes that 

there is a missing link in the current system which you have just 

noted—access to medication after mentally ill offenders are released. 

I would like to ask anyone on the panel to discuss the merits of 

providing Medicaid presumptive eligibility for mentally ill offenders 

upon release from incarceration. Under presumptive eligibility, 

mental health and health care providers would be able to grant 

mentally ill offenders immediate short-term Medicaid eligibility 

while a formal determination is being made. This presumptive eligibility would be intended to provide immediate access to mental 

health and health care services such as psychotherapy, medication, 

and rehab. 

I think you have just identified the problem. You have someone 

who, after a long period of time, is finally receiving some medication. Now, they are released, and that should be good news, but it 

may be the worst news because, being released, they are released 

27

without medication or help. Then they have to, if they can ever figure the process out, get into it, make application, and hope that 

they receive their medication in time before they do something that 

is harmful to themselves or others. 

Justice STRATTON. One of the things we are working on through 

both the reentry court and through my committee is trying to set 

up a process that hooks up a defendant before his sentence ends 

with the Medicaid process, get the applications in, and get the approval before he steps out the door because most of them—you 

know, they may be given a two-week supply and they are out the 

door. 

They don’t even know how to get to a Medicaid office. They don’t 

even know what a Medicaid office is, as you said, to even go 

through the process. So there is a huge link in there that is fixable. 

It is very fixable. It is a matter of finding the process to make it 

work and starting it before they walk out that door. 

I am delighted to hear you say that because my committee has 

been struggling with this issue and I am so excited to hear some 

focus on it because it is a huge problem we have all across the 

country. 

Senator DURBIN. I want to give my friend, Senator Simon, credit 

for it. 

I hope we can consider adding this as part of our conversation 

on this. 

If I could ask one last question, and that is it appears to me—

I spoke to our Illinois Director of Corrections a couple of years ago 

about what he was challenged with and he was telling me about 

the over-crowding situation and the complexity of the inmates, the 

challenges that they brought, and so forth and so on, and he talked 

about this issue of mental illness and what to do with it. It struck 

me that our profile of the qualifications of a corrections officer 

doesn’t reflect the reality of what the Department of Corrections 

faced today. 

When we talk about mental illness in the corrections system, for 

those who can address it, are there people who are being trained 

and recruited to deal with this new phenomenon so they can recognize the potential mental illness with an early screening or a developing situation and protect those inmates who may be potential 

suicide victims or victims themselves within the institution? Are 

we developing that expertise at a time when many States are saying we are out of money, we can barely house the people that are 

being sent to us, let alone provide any kind of special services? 

Dr. Wilkinson? 

Mr. WILKINSON. Senator, it is a great question. The issue relates 

to basic training for corrections officers. If the corrections system 

does not do training for first-line personnel such as a corrections 

officer and others regarding how to detect unusual behaviors—we 

are not wanting them to be clinicians. We just want them to be 

able to detect behavior that is unusual so that they can refer that 

to the proper staff person. 

A third-shift officer, for example, doesn’t have on his or her shift 

a person that they can immediately get to, other than maybe a 

third-shift nurse. But that is woefully inadequate when we are 

28

talking about a person who has got a serious psychiatric problem 

and that problem is manifesting itself in a security concern. 

So if we aren’t doing it—and some jurisdictions do it very adequately—if we aren’t doing it, then the Federal courts are going to 

intervene because it is going to manifest itself in a lot of other 

problems that we don’t want to deal with. 

Senator DURBIN. I want to thank the panel and thank you, Mr. 

Chairman. 

Senator DEWINE. Senator Durbin, thank you very much for very 

constructive comments. 

Let me thank our panel. This has been, I think, an excellent 

hearing. I appreciate the fact that you all are here. 

Ms. Atkins, thank you very much for coming here notice. 

Ms. ATKINS. Thank you. My pleasure. 

Senator DEWINE. We appreciate your making time to come here 

and we wish you and your daughter well. 

We have two statements that need to be entered into the record, 

which I am going to do. The statement of Chairman Hatch will be 

made a part of the record. Also, I would like to enter into this 

record of this hearing a letter from the Chairman of President 

Bush’s New Freedom Commission on Mental Health, Dr. Mike 

Hogan. Attached to Dr. Hogan’s letter are several pages from the 

commission’s July 2003 report that are directly relevant to S. 1194. 

Again, let me thank all of our witnesses. I would also like on a 

personal note to thank Evelyn Fortier, who is a member of my 

staff, who I know has been in contact with all of you. Unfortunately 

for me, at least, and I think for Congress, Evelyn will be leaving 

us, I hope, on a temporary basis, but she will be leaving us at the 

end of the week. We would not be here today on this hearing, and 

I don’t think we would be here with this bill without Evelyn’s help. 

So, Evelyn, thank you very much for your hard work. We appreciate it very much. 

[Applause.] 

Senator DEWINE. We hope Evelyn will be back with us in the not 

too distant future. 

Let me again thank all of you very much for your very, very good 

testimony. I think it has been an excellent panel, excellent testimony, and we hope to move this bill forward. 

Thank you very much. 

[Whereupon, at 3:37 p.m., the Committee was adjourned.] 

[Questions and answers and submissions for the record follow.]

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