U.S. GOVERNMENT PUBLISHING OFFICE

31–572 PDF WASHINGTON : 2018

THE ROLE OF FEDERAL HOUSING AND 

COMMUNITY DEVELOPMENT PROGRAMS 

TO SUPPORT OPIOID AND SUBSTANCE 

USE DISORDER TREATMENT AND RECOVERY 

HEARING 

BEFORE THE

SUBCOMMITTEE ON 

HOUSING AND INSURANCE 

OF THE

COMMITTEE ON FINANCIAL SERVICES 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED FIFTEENTH CONGRESS 

SECOND SESSION 

AUGUST 16, 2018 

Printed for the use of the Committee on Financial Services 

Serial No. 115–112 

( 

nshattuck on FSR297 with DISTILLER

(II) 

HOUSE COMMITTEE ON FINANCIAL SERVICES 

JEB HENSARLING, Texas, Chairman 

PATRICK T. MCHENRY, North Carolina, 

Vice Chairman 

PETER T. KING, New York 

EDWARD R. ROYCE, California 

FRANK D. LUCAS, Oklahoma 

STEVAN PEARCE, New Mexico 

BILL POSEY, Florida 

BLAINE LUETKEMEYER, Missouri 

BILL HUIZENGA, Michigan 

SEAN P. DUFFY, Wisconsin 

STEVE STIVERS, Ohio 

RANDY HULTGREN, Illinois 

DENNIS A. ROSS, Florida 

ROBERT PITTENGER, North Carolina 

ANN WAGNER, Missouri 

ANDY BARR, Kentucky 

KEITH J. ROTHFUS, Pennsylvania 

LUKE MESSER, Indiana 

SCOTT TIPTON, Colorado 

ROGER WILLIAMS, Texas 

BRUCE POLIQUIN, Maine 

MIA LOVE, Utah 

FRENCH HILL, Arkansas 

TOM EMMER, Minnesota 

LEE M. ZELDIN, New York 

DAVID A. TROTT, Michigan 

BARRY LOUDERMILK, Georgia 

ALEXANDER X. MOONEY, West Virginia 

THOMAS MACARTHUR, New Jersey 

WARREN DAVIDSON, Ohio 

TED BUDD, North Carolina 

DAVID KUSTOFF, Tennessee 

CLAUDIA TENNEY, New York 

TREY HOLLINGSWORTH, Indiana 

MAXINE WATERS, California, Ranking 

Member 

CAROLYN B. MALONEY, New York 

NYDIA M. VELA ́ ZQUEZ, New York 

BRAD SHERMAN, California 

GREGORY W. MEEKS, New York 

MICHAEL E. CAPUANO, Massachusetts 

WM. LACY CLAY, Missouri 

STEPHEN F. LYNCH, Massachusetts 

DAVID SCOTT, Georgia 

AL GREEN, Texas 

EMANUEL CLEAVER, Missouri 

GWEN MOORE, Wisconsin 

KEITH ELLISON, Minnesota 

ED PERLMUTTER, Colorado 

JAMES A. HIMES, Connecticut 

BILL FOSTER, Illinois 

DANIEL T. KILDEE, Michigan 

JOHN K. DELANEY, Maryland 

KYRSTEN SINEMA, Arizona 

JOYCE BEATTY, Ohio 

DENNY HECK, Washington 

JUAN VARGAS, California 

JOSH GOTTHEIMER, New Jersey 

VICENTE GONZALEZ, Texas 

CHARLIE CRIST, Florida 

RUBEN KIHUEN, Nevada 

SHANNON MCGAHN, Staff Director 

nshattuck on FSR297 with DISTILLER

(III) 

SUBCOMMITTEE ON HOUSING AND INSURANCE

SEAN P. DUFFY, Wisconsin, Chairman 

DENNIS A. ROSS, Florida, Vice Chairman 

EDWARD R. ROYCE, California 

STEVAN PEARCE, New Mexico 

BILL POSEY, Florida 

BLAINE LUETKEMEYER, Missouri 

STEVE STIVERS, Ohio 

RANDY HULTGREN, Illinois 

KEITH J. ROTHFUS, Pennsylvania 

LEE M. ZELDIN, New York 

DAVID A. TROTT, Michigan 

THOMAS MACARTHUR, New Jersey 

TED BUDD, North Carolina 

EMANUEL CLEAVER, Missouri, Ranking 

Member 

NYDIA M. VELA ́ ZQUEZ, New York 

MICHAEL E. CAPUANO, Massachusetts 

WM. LACY CLAY, Missouri 

BRAD SHERMAN, California 

STEPHEN F. LYNCH, Massachusetts 

JOYCE BEATTY, Ohio 

DANIEL T. KILDEE, Michigan 

JOHN K. DELANEY, Maryland 

RUBEN KIHUEN, Nevada 

nshattuck on FSR297 with DISTILLER

nshattuck on FSR297 with DISTILLER

(V) 

C O N T E N T S 

Page 

Hearing held on: 

August 16, 2018 ................................................................................................ 1 

Appendix: 

August 16, 2018 ................................................................................................ 35 

WITNESSES 

THURSDAY, AUGUST 16, 2018 

Boggs, David, President and Chief Executive Officer, Opportunity for Work 

and Learning ........................................................................................................ 8 

Fletcher, Hon. Ernie, Former Governor of Kentucky, and Founder of Recovery 

Kentucky ............................................................................................................... 5 

King, Edwin, Executive Director and Chief Executive Officer, Kentucky Housing Corporation .................................................................................................... 10 

Minton, Lisa, Executive Director, Chrysalis House .............................................. 12 

Robinson, Tim, Founder and Chief Executive Officer, Addiction Recovery 

Care ....................................................................................................................... 13 

Thomas, Jerod, President and Chief Executive Officer, Shepherd’s House ........ 15 

Walsh, Sharon L., Director of the Center on Drug and Alcohol Research 

and Professor, Behavioral Science and Psychiatry, University of Kentucky .. 17 

APPENDIX 

Prepared statements: 

Boggs, David ..................................................................................................... 36 

Fletcher, Hon. Ernie ......................................................................................... 40 

King, Edwin ...................................................................................................... 49 

Minton, Lisa ...................................................................................................... 52 

Robinson, Tim ................................................................................................... 55 

Thomas, Jerod ................................................................................................... 59 

Walsh, Sharon L. .............................................................................................. 64 

nshattuck on FSR297 with DISTILLER

nshattuck on FSR297 with DISTILLER

(1) 

THE ROLE OF FEDERAL HOUSING AND 

COMMUNITY DEVELOPMENT PROGRAMS TO 

SUPPORT OPIOID AND SUBSTANCE USE 

DISORDER TREATMENT AND RECOVERY 

Thursday, August 16, 2018 

U.S. HOUSE OF REPRESENTATIVES, 

SUBCOMMITTEE ON HOUSING

AND INSURANCE, 

COMMITTEE ON FINANCIAL SERVICES, 

Washington, D.C. 

The subcommittee met, pursuant to notice, at 9:10 a.m., in 

Courtroom A, U.S. District Court of the Eastern District of Kentucky, 101 Barr Street, Lexington, Kentucky, Hon. Sean P. Duffy 

presiding. 

Present: Representative Duffy 

[presiding]. 

Also present: Representatives Barr and Guthrie. 

Mr. DUFFY. The Subcommittee on Housing and Insurance will 

come to order. Today’s hearing is entitled, ‘‘The Role of Federal 

Housing and Community Development Programs to Support Opioid 

and Substance Use Disorder Treatment and Recovery.’’ Without objection, the Chair is authorized to declare a recess of the Subcommittee at any time. Without objection, all Members will have 

5 legislative days within which to submit extraneous materials to 

the Chair for inclusion in the record. Without objection, Members 

who are not Members of this Subcommittee may participate in today’s hearing for the purpose of making an opening statement and 

questioning the witnesses. 

The Chair now recognizes himself for an opening statement. 

I want to thank our witnesses for joining us as we continue to 

look at how existing Federal Government programs can be utilized 

to combat opioid addiction and substance abuse. Today, we will be 

focused on programs run by HUD (U.S. Department of Housing 

and Urban Development) that help low-income families and the 

poverty stricken. 

I want to thank Mr. Barr for hosting us in the fine city of Lexington and commend his leadership on the issue of opioid addiction 

and substance abuse, something that impacts the entire Nation. 

This crisis is not going away and it is only getting worse in some 

areas of our country. According to a 2016 report by the U.S. Surgeon General, 1 in 7 Americans will face substance addiction. 

Opioids are now at the forefront of the fight against substance 

abuse. 

nshattuck on FSR297 with DISTILLER

2 

On March 29 of last year President Trump signed an Executive 

Order to establish the President’s Commission on Combating Drug 

Addiction and the Opioid Crisis and the House began its work by 

moving legislation. We have passed 50 bills related to addressing 

the opioid crisis ranging from treatment and recovery, to prevention, to the THRIVE (Transitional Housing for Recovery in Viable 

Environments) Act, championed by Chairman Barr. 

Mr. Barr’s bill recognizes that sometimes you have to use resources outside of traditional rehab programs to treat addicts and 

help them prepare for becoming a productive member of society. 

The THRIVE Act would create a program setting aside 10,000 

housing choice vouchers for individuals suffering from addiction. 

Those people would be able to use vouchers with transitional housing nonprofits that focus on maintaining sobriety, teaching valuable skills for jobs, and obtaining employment as they transition 

back into society. They’ll have 24 months to complete the treatment 

program but most importantly are able to do so in a drug- and alcohol-free, clean, safe, and supportive structured environment. 

I know some of you will be commenting on how this bill would 

work in implementation but Mr. Barr’s bill is just one idea. You are 

the ones out there dealing with this through your organizations. 

We want to hear your ideas. 

Mr. King, you mention in your testimony needing the flexibility 

to meet specific needs at the local level by addressing the 20 percent limitation on tenant-based rental assistance for specific properties. 

Ms. Minton, you mentioned Continuum of Care and the reallocation process to create new projects. 

Mr. Thomas, you talk about a limited expansion of vouchers for 

graduates of THRIVE-based programs. 

Dr. Walsh, your testimony describes what you are doing with the 

First Bridge Clinic and the PATHWAYS programs. 

These are the ideas we need to hear about that can help us to 

combat the opioid epidemic with government programs already in 

place. 

I look forward to today’s discussion as it’s one of the most important issues we should be addressing today. 

I now recognize the gentleman from Kentucky, Mr. Barr, the 

Chairman of the Subcommittee on Monetary Policy and Trade, for 

an opening statement. 

Mr. BARR. Thank you, Chairman Duffy, and thank you to the 

Housing and Insurance Subcommittee for calling this hearing today 

in my home State of Kentucky, which is truly on the front lines of 

the opioid crisis. 

I’d also like to thank my colleague from the Kentucky delegation, 

Congressman Brett Guthrie for joining our Financial Services hearing today. Mr. Guthrie has been a leader on opioid issues on the 

House Energy and Commerce Committee and we are fortunate to 

have him here today to offer his insight. 

We all know that the opioid epidemic is a major health crisis 

that has impacted every community and every congressional district. Kentucky has the third highest overdose mortality rate in the 

country. Last fall, President Trump declared a National Public 

Health Emergency and Congress recently passed a historic package 

nshattuck on FSR297 with DISTILLER

3 

of legislation to address the opioid epidemic through research, 

treatment, and prevention. 

H.R. 6, the SUPPORT (Substance Use-Disorder Prevention that 

Promotes Opioid Recovery and Treatment) for Patients and Communities Act that was passed in the House this summer, builds 

upon past resources authorized and funded by Congress including 

the 21st Century Cures Act and the Comprehensive Addiction and 

Recovery Act. I was also proud to support the Consolidated Appropriations Act earlier this year that appropriated $4 billion, the 

largest Federal investment to date, to address the opioid epidemic. 

But there is more work to be done. Over 115 Americans continue 

to die every day from opioid overdoses. We cannot continue to focus 

our Federal efforts on prevention and treatment without looking toward long-term recovery through housing, job placement, financial 

literacy, and life skills training. 

Too many individuals find themselves with limited housing 

choices after completing in-patient rehabilitation and are forced 

into housing situations where they are surrounded by people using 

the same illegal substances that they went to rehab to stop using. 

This perpetuates the cycle of addiction and prevents individuals 

from rising above substance abuse. 

The opioid epidemic has also presented a major issue for workforce development and job placement. Local employers I meet with 

regularly in Kentucky are struggling to find workers to fill even 

low-skill jobs. According to the CDC, the opioid epidemic’s cost to 

our economy now exceeds $1 trillion. 

I was proud that H.R. 6, the opioid package which passed the 

House earlier this year, included my legislation, H.R. 5735 the 

Transitional Housing for Recovery in Viable Environments or the 

THRIVE Act. This bill would allow a limited number of Section 8 

Housing Choice Vouchers to be allocated directly to transitional 

housing non-profits that have evidence-based models of recovery 

and life skills training. I am hopeful that the Senate will act swiftly to pass this critical legislation. 

I have also introduced H.R. 5736 the Comprehensive Addiction 

Recovery through Effective Employment and Reentry, or CAREER 

(Comprehensive Addiction Recovery through Effective Employment 

and Reentry) Act, which would address the decline in workforce 

participation as a result of the opioid epidemic by encouraging local 

businesses and treatment centers to form partnerships to secure 

job training, employment, and housing options for individuals in recovery. This legislation would also give States more flexibility to direct Federal funds through the Community Development Block 

Grant (CDBG) to local recovery initiatives. I am grateful to Leader 

McConnell for introducing the Senate companion to this legislation. 

Meaningful employment and a safe place to live are key to helping individuals maintain sobriety and rise above poverty. Today 

you will hear from several non-profit, government, and academic 

experts who are on the frontlines of the opioid epidemic in Kentucky. They will offer their unique perspectives on ways our Federal housing and community development programs could be improved or further utilized to fight the opioid epidemic. 

Reforms to these programs and greater investment in long-term 

recovery would save American lives as well as taxpayer funds in 

nshattuck on FSR297 with DISTILLER

4 

the long run by helping more individuals rise above addiction and 

poverty. 

Thank you and I yield back. 

Mr. DUFFY. Thank you Mr. Barr. 

I now recognize Mr. Guthrie for an opening statement. 

Mr. GUTHRIE. Thank you Mr. Duffy, and thank you all for being 

here today. I have heard countless stories of the awful effects the 

opioid epidemic has had on families, communities, and the overall 

workforce. I have been working hard in my committee, the Energy 

and Commerce Committee, to pass meaningful legislation that will 

stop this awful epidemic. The SUPPORT bill, H.R. 6 which includes 

over 50 pieces of legislation is currently pending before the Senate. 

I am hopeful the Senate will act quickly to provide relief to so 

many suffering Americans. Most of the 50-something bills have 

come through our committee. And a lot of it comes from hearing 

from people like you, the witnesses here today. 

I wish there was one single bill we could pass and it would make 

the problem go away. It is just not that simple. I wish that it was. 

It is very complicated. And when we hear from people like you— 

and I have heard over the last several days even stuff we need to 

improve in legislation that has already been passed out of the 

House and into the Senate. We do hear the insights because you 

all are the experts, you all are the ones on the frontlines dealing 

with it, and we are trying to—where there are roadblocks, we are 

trying to get flexibility, we are trying to move things forward. 

And it is very appropriate we are having this hearing in this 

community today. I was in Elizabethtown about 3 or 4 days ago 

going through a recovery center, and the person who was walking 

me through said basically we get them here in residence for 30 

days, and we can control that environment. Some of them leave 

and whatever, but for the most part, we can get them through our 

30-day program because we have control. They are in our environment. 

He said the biggest gap is the sober-living piece, and so it really 

struck me. I said, well, we are having a hearing on something that 

Congressman Barr has made great efforts and great strides to 

make sure the sober living piece is, one, known throughout—the 

issue needs to be dealt with and, one, hopefully given the tools 

using money that is already going to be spent by the Federal Government in housing to give people an opportunity and have that 

full—not just the in-residence service but another piece of the bigger wraparound service. But it was stated to me that the biggest 

loss of people in recovery is when they get the sober-living part. 

So I appreciate your leadership on this, Congressman Barr. I certainly appreciate the Chairman coming to our wonderful Commonwealth, and I appreciate having the Governor here as well. We got 

to serve together in Frankfurt when I was in the legislature, and 

I am pleased to have you here and all of our witnesses. So thank 

you, and I yield back. 

Mr. DUFFY. The gentleman yields back. 

Again, I want to now welcome our witnesses. Our first witness, 

who actually is the Governor who I didn’t recognize in my opening 

statement, Governor Fletcher, former Governor of Kentucky and 

the Founder of Recovery Kentucky, welcome; our second witness, 

nshattuck on FSR297 with DISTILLER

5 

Mr. David Boggs, President and CEO of Opportunity for Work and 

Learning, also known as OWL; Mr. King, our third witness, Executive Director and CEO of the Kentucky Housing Corporation; Ms. 

Minton, Executive Director of the Chrysalis House. Our fifth witness is Mr. Tim Robinson, Founder and CEO of Addiction Recovery 

Care. Our sixth witness today is Mr. Jerod Thomas, President and 

CEO of Shepherd’s House. And our final witness, but not least, is 

Dr. Sharon Walsh, Director of the Center on Drug and Alcohol Research and Professor of Behavioral Science and Psychiatry at the 

University of Kentucky. 

To all of you, welcome. Thank you for giving us your time today. 

Again, this is important for us to get out of the bubble of Washington, D.C., and come and take the testimony and insights from 

those around the country who are on the frontline dealing with 

these issues so we can take that insight back to Washington to our 

colleagues. 

The witnesses in a moment will be recognized for 5 minutes to 

give an oral presentation of their written testimony. Without objection, the witnesses’ written statements will be made part of the 

record following their oral remarks. Once the witnesses have finished presenting their testimony, each Member of the subcommittee will have a length of time within which to ask the panel 

questions. 

With that, Governor Fletcher, you are now recognized for 5 minutes. 

STATEMENT OF HON. ERNIE FLETCHER 

Mr. FLETCHER. Chairman Duffy and other Members, Congressmen Barr and Guthrie, thank you for this opportunity. And, Chairman Duffy, welcome to Kentucky. I hope you do get to spend some 

time and see what a wonderful State it is. 

You have my testimony there, but let me just speak a little bit 

from the heart. It is obviously a public health crisis. It is a very 

challenging, complex crisis that we face. There is not a simple solution, as has already been noted. And even with the reports yesterday, every 7 minutes someone dies of overdose, if we look at combining that with alcohol where every 6–1/2 minutes someone dies 

from alcohol abuse and its consequences, and then if you combine 

that with about every 12 minutes someone dies from suicide, many 

of those suicides are related to substance abuse disorder, you can 

see the complexity of the problem of addiction that plagues this Nation. 

Going back 10 years, we looked at models that worked in a residential program out of The Healing Place in Louisville and the 

Hope Center in Lexington, Kentucky. It is a residential program 

where folks come in. We use a peer-support 12-step model, and we 

had fairly good efficacy from that. I will say that it is not for everyone, and we think we can improve on that model. 

But we took that model, we developed some very creative funding. This was done by an individual by the name of Don Ball. Don 

Ball is a builder/philanthropist here who had worked with the 

Hope Center. I appointed him as Chair of Housing Corporation, 

and he brought together several funding streams to fund the expansion of centers modeled after the Hope Center. Now, we have 

nshattuck on FSR297 with DISTILLER

6 

18 of those. We have 2,100 beds at any one time. University of 

Kentucky’s Drug and Alcohol Research Center does our surveys. 

Eighty-four percent are drug-free at 1 year. Seventy-five percent 

are gainfully employed at the end of that program. Recidivism rate, 

as the criminal justice system, is very low, and so it is an effective 

program. 

I will give you the caveat that at the beginning, 30 percent of 

folks, as a voluntary program, walk away and it is not for them, 

and I think that would address the need for medication-assisted 

treatment and more of a comprehensive approach than just onesize-fits-all. 

The bottom line is we have 18 centers here that are working very 

effectively and transforming lives, and we are taking and expanding that nationally. As you look at what we face expanding that nationally, let’s look at the funding streams. We use low-income housing tax credits, we use some other Federal home-loan moneys for 

the capital construction of these facilities. That runs about $5–6 

million. 

We use Section 8 vouchers, food stamps, per diems from corrections because up to 70 percent of our residents come out of corrections, whether it is parole, probation, or diversion from drug courts. 

And these are nonviolent offenders. It is a good investment for 

them. They pay a per diem, and as I mentioned, the recidivism rate 

is very, very low for these individuals, so it works for the benefit 

of the recipient, as well as for the Department of Corrections in 

saving money substantially. 

As we are taking this nationally, though, what we find is that 

Section 8 housing is a little more challenging to get in the operational side of things, and for that reason, we are very supportive 

of the THRIVE Act, Congressman Barr, that you have put forward, 

because it sets aside some of these moneys for this type of program. 

And there are two advantages of that. One, we think it recognizes 

that these programs, when they are evidence-based or have some 

outcomes that show that they work, they help make sure that we 

are not funding programs that don’t work. Unfortunately, in the recovery industry, let’s face it; there are some scams out there and 

a lot of families spend a lot of money on recovery only to find that 

their loved one comes back and is not truly recovered or treated. 

Folks end up financially broke trying to get their loved ones the 

treatment they need. So this Act, making a stipulation, focuses on 

making sure that only quality programs are funded. So, thank you, 

Congressman, for that insight. 

As you look at some of our other funding, we are working with 

the Department of Corrections. We have worked with Secretary 

Ben Carson. He has been here to Kentucky. We have met with him 

here, and Congressman Barr was in that meeting. We also met 

with him at his office, and they are very supportive looking at how 

can we work with HUD to make sure that we expand these programs and make it available. We are working in other States now, 

and Georgia is one of our first States that we are working. We 

want to expand them in Kentucky because we still have a need 

here. We are also working with other programs. Tim Robinson is 

here, and we are glad to collaborate with other programs to make 

nshattuck on FSR297 with DISTILLER

7 

sure that we provide as many people as possible with this type of 

recovery. 

The other thing that I want to say about the congressional funding, you have nearly $6 billion that is coming, funding to fight this 

opioid crisis, much of that is going to medication-assisted treatment 

because it is the gold standard of treatment. Dr. Walsh will address a lot of this. 

In our recovery program, what we find—and we are expanding 

because we see that it doesn’t fit everyone. We have 30 percent at 

the beginning that may drop out, and they would likely, very likely 

benefit from MAT, or medication-assisted treatment. 

We also have some folks that end up relapsing as they leave, so 

a program that combines the best of these I think is something 

that Congress needs to make sure that, as you are looking at the 

funding, as you—final passage of these bills, that you recognize 

this full continuum of care. 

These vouchers that are set aside in Section 8, I think are very 

important. Congressman Guthrie, your bill, the Comprehensive 

Opioid Recovery Centers Act, I think is important and recognizes 

the issue we have talked about, so I appreciate and hope we can 

pass that. 

I have a few specific recommendations, and I will close with that. 

One, I would like to recommend obviously passage of the THRIVE 

Act through the Senate as it becomes a part of this larger package 

to fight this public health crisis. There is always a challenging— 

and I think some of the criticism is that, well, you may be taking 

some money from some other folks that need it. Let me say there 

is no greater need than these folks that are held captive by addiction. If you look at the sequelae of their life, it is abysmal without 

some kind of treatment, so there is no greater need. 

I would like you to consider to take some of the $6 billion that 

you are looking at and making sure that it might be allocated toward more of these because we have a proven model. It is not the 

only model, but we have a proven model that we can take nationally, collaborating with MAT and collaborating with other centers 

to expand the treatment, and so let me ask you to take a look at 

that. 

I would like to—part of our funding is Community Development 

Block Grants. That is always threatened. The President’s budget 

usually cuts those. And when I was in Congress, and you all—usually, we have to put them back. But I would like you to take a look 

at a similar program. 

You will find that part of what we are doing—and according to 

the CAREER Act is we want to be able to provide the skills that 

an individual needs in order to enter the workforce. What is important in recovery is having meaning and purpose, and a good job 

and a purpose in life with a skill is extremely important in preventing relapse. And so I think that is important as you look going 

forward at where you are putting the funding. And Community Development Block Grants, this is community development, so I 

would like you to take a look at that and see if there is not some 

other way that you can make that funding a little more assured 

and sustainable because, right now, our funding for these programs 

is sustainable, and that is what makes them strong. 

nshattuck on FSR297 with DISTILLER

8 

Last, I will recommend—and this is just probably out of nowhere 

and you all don’t have the jurisdiction except for—or maybe Guthrie in that second-best committee. But this is a public health crisis. 

We have the EOC, Emergency Operations Center, activated at the 

CDC right now for polio. It is affecting three countries right now, 

and they are: Pakistan, Congo, and I think Nigeria. It is not activated for this. I think it is a perfect center. This is an epidemiological problem. It is a public health problem, and I just encourage 

you to take a look at activating the Emergency Operations Center 

out of CDC for this. It will allow them to bring a lot of the silos 

that we have with NIDA (National Institute on Drug Abuse), NIH 

(National Institute of Health), SAMHSA (Substance Abuse and 

Mental Health Services Administration), other parts of HHS together. 

So let me close with that and say thank you for this opportunity. 

[The prepared statement of Mr. Fletcher can be found on page 

40 of the Appendix.] 

Mr. DUFFY. Thank you, Governor Fletcher. 

Mr. Boggs, you are now recognized for 5 minutes. 

STATEMENT OF DAVID BOGGS 

Mr. BOGGS. Thank you very much. Good morning, Chairman 

Duffy, Congressman Barr and Congressman Guthrie, and other 

guests. It is an honor to address this committee this morning in regards to the epidemic of opioid addiction in our Nation and the serious housing challenges that this population faces. Since housing 

is a vital step in the recovery and reentry process, the Acts that 

we have already talked about that have been introduced by Congressman Guthrie and Congressman Barr, THRIVE and CAREER 

Act and others, will have a major impact on abolishing this crisis 

that we are facing across our Nation. 

Considering that this epidemic touches every family in our Nation, something needs to be done in the seriousness of it. Just this 

morning on our national news it was announced that the national 

lifespan for individuals has dropped because of a leading factor of 

drugs, and that is tragic for us to reach that point in our Nation 

today. 

I would like to share with you the role of Opportunity for Work 

and Learning and how it plays with the topic at hand and some 

views of how the Federal Government, through our organization, 

can use existing housing and our community development program 

to complement community efforts to treat individuals experiencing 

the opioid epidemic. OWL provides key elements in the transitional 

path to self-sufficiency through job training and employment services. 

Housing and employment definitely go hand-in-hand, so it is difficult to successfully maintain one without the other. And yet, too 

often, our offender reentry population, whom we work with a great 

deal, have at least one of these or both of these once they are released from incarceration. Consistent housing cannot be obtained 

without employment that will provide enough income to meet the 

demands of either renting or owning in the long term. Many of 

these individuals lose their employment due to the challenges faced 

through inconsistent living through a term that we often hear 

nshattuck on FSR297 with DISTILLER

9 

called ‘‘couch surfing,’’ and that is very real for this population that 

we all serve, along with the homelessness. 

Individuals come to OWL from many different paths. Some of 

them are coming from incarceration, some of them are coming from 

short- or long-term recovery programs, and there are a lot of people 

entering our program that are still struggling with the opioid addiction but yet trying to maintain employment. The struggle is 

overwhelming and often leads to more serious consequences for 

these. 

The mission of OWL is, simply, OWL partners with communities 

to help individuals overcome barriers to achieve personal and professional growth. We have been doing that since 1961. But in our 

Nation there is—annually, 600,000 people are being released every 

year from incarceration, and the number of people at risk of falling 

back into this lifestyle that led them there in the first place continues to climb because of inadequate housing or the lack of employment. In addition to the criminal record preventing these individuals from finding jobs, statistics show that ex-offenders far too 

often have limited education and work experience and therefore do 

not have the skills necessary to enter today’s workforce with the 

adequate skills. 

The Lexington Manufacturing Center (LMC), which is a wholly 

owned subsidiary of OWL, is an on-site advanced manufacturing 

center that provides training in the essential skills that are so desperately needed and demanded by today’s employers in every job 

sector. LMC employees earn more than minimum wage, and while 

they are there, they get benefits, the opportunity for bonuses, and 

they have the opportunity to work for other companies and earn a 

greater income because we are just a training facility in many aspects. 

The various training programs that we provide such as our forklift certification, our manufacturing certification and material handling, third-party inspection, kitting, assembly, woodworking, all of 

these offer new opportunities for these individuals to reenter into 

the workplace and become successful. The programs that OWL and 

LMC have in place have proven to be successful as a researchbased program in the path to self-sufficiency and attainment of stable housing and employment. 

OWL has maintained a strong partnership with the Kentucky 

Office of Vocational Rehabilitation since its beginning in 1961. 

Over these years, our organization has successfully provided services for 23,000 individuals in central Kentucky. Through OWL’s 

services and programs in Fiscal Year 2018 alone, over 74 individuals found full-time employment, not temp service or not part-time 

but full-time employment with job benefits. Yet while this is successful numbers, over 60 percent of them had some type of opioid 

and substance abuse while they entered our program. 

OWL completely adheres to the work being done with WIOA, the 

Work Innovation Opportunity Act, and we support all the mandates of community rehabilitation programs required in that 

through our youth grant, out-of-school youth grant. 

Paul, a good example of our work, came to OWL as a result of 

an ongoing opioid addiction that cost him his home, his family, and 

also some incarceration time. Fortunately, after a period of time, 

nshattuck on FSR297 with DISTILLER

10 

Paul became involved at a drug court diversion program, and they 

opened their doors to him instead of the long-term incarceration. 

Today, he is reunited with his family. He now has adequate funding and support through his job at OWL, and now he has homeownership. This is what we are all striving to reach together 

through this funding mechanism. 

James came to us after serving 24 years in our Federal and State 

judiciary systems and still struggled with opioid addiction time 

after time. But thanks to our partnership with community housing 

agencies that we work with within our community, many of them 

represented here today, James was able to begin his pathway to a 

new life. Today, he has been fully employed at OWL for over 5 

years and lives independently. 

Paul and James are just two examples of individuals who have 

struggled because of the impact of the opioid addiction on their 

lives. Sadly, they are not alone, as we have already heard here 

today. There is an overwhelming need for housing and employment 

services for others trying to escape the opioid crisis in their life. 

Funding must be accessible—it is not an option—it must be accessible for research-based programs like OWL and others represented 

here today and have a proven track record of employment training, 

job placement, and housing. Programs that can easily be replicated 

and expanded upon in our individual communities must be provided oversight and guidance to establish consistency in collaboration among agencies to maximize resources and human capital. 

Yes, we applaud the work being done by this committee and the 

leadership of our local Congressmen in Kentucky through bills that 

have already been sponsored and passed, but the battle against the 

housing and opioid crisis is not just a Kentucky epidemic but a national pandemic that has no borders. 

Thank you again for this opportunity to share with you this 

morning. 

[The prepared statement of Mr. Boggs can be found on page 36 

of the Appendix.] 

Mr. DUFFY. Thank you, Mr. Boggs. And it has no borders; you 

are right. 

Mr. King, you are recognized for 5 minutes if we can figure out 

the microphone situation. 

STATEMENT OF EDWIN KING 

Mr. KING. Hopefully, you can hear me. Chairman Duffy, Congressman Barr, Congressman Guthrie, thank you all for holding 

this hearing. As you said, I am the Executive Director of the Kentucky Housing Corporation, the Commonwealth’s housing finance 

agency. And on behalf of KHC’s board of directors and staff, again, 

we thank you for conducting this hearing and affording me the opportunity to speak with you today. 

I want to thank Congressman Barr and Congressman Guthrie 

publicly for bringing attention to the problem of the opioid addiction in the Sixth and the Second Districts. Thank you all. Congressman Barr, the passage of your bill, the Transitional Housing 

for Recovery in Viable Environments, the THRIVE Act, demonstrates your commitment to housing solutions for those on the 

road to recovery, so thank you for that. 

nshattuck on FSR297 with DISTILLER

11 

It is my pleasure to share information about Kentucky’s accomplishments through leveraging housing resources to help our citizens on the path of recovery from substance use disorders. There 

are multiple effective recovery strategies depending on the personal 

circumstances of those that are caught in the grip of addiction, as 

Governor Fletcher has alluded to. Access to stable housing is a 

basic human need and one of the primary social indicators of public 

health. 

One of the most successful recovery strategies that we have seen 

here in Kentucky is of course the Recovery Kentucky model. In 

2004, the late Don Ball took the helm as the Chair of Kentucky 

Housing Corporation under Governor Fletcher’s administration. 

Mr. Ball brought with him a personal commitment, a strong will, 

and a solid plan to establish a network of recovery centers across 

Kentucky. Because of Mr. Ball’s vision, Kentucky now has 14 recovery centers that have helped thousands of our residents start a new 

life of recovery from addictive substances. These 14 centers are in 

addition to the other four centers, two in Louisville—The Healing 

Place—and then the two Hope Centers here in Lexington. Today, 

these 18 recovery centers serve and help over 2,000 men and 

women daily. 

The Recovery Kentucky Centers follow a peer-to-peer education 

and self-help model to provide sustained addiction recovery services. Peer mentors model behaviors and spiritual principles that 

focus on providing life skills to residents by following the spiritual 

principles of the 12 steps of Alcoholics Anonymous. Information 

from U.K.’s Center for Drug and Alcohol Research points to the significant successes that we have seen here in Kentucky, and I mention those in my written testimony. 

Additionally, the program has saved taxpayer dollars through 

avoided cost to society or costs that would have been expected 

based on the rates of drug and alcohol use, and that can’t be understated. For every dollar we spend on these recovery centers, we 

save $2.60. 

Recovery Kentucky would not have been possible without housing program dollars appropriated by Congress and administered by 

the Kentucky Housing Corporation (KHC). The recovery centers 

rely on a complex array of Federal funds for construction and operation, including the following: The bricks and mortar are built with 

the low-income tax credits and also HOME dollars and some affordable housing trust fund dollars that we have here in the State of 

Kentucky. There is also CDBG funds that are used, as well as Section 8 Housing Choice Vouchers for rent subsidies for the residents 

at these facilities, and also, as has been mentioned, food stamps. 

It has become increasingly difficult to develop more of these recovery centers for two primary reasons. The first is of course less 

funding in Federal housing programs, but the second I really want 

to draw attention to, and that is red tape that surrounds certain 

Federal programs. For example, KHC has experienced significant 

challenges recruiting landlords to participate in the Section 8 

Housing Choice Voucher tenant-based program, with many citing 

programmatic red tape as an obstacle. Additionally, Federal statutes restrict the amount of tenant-based rental assistance that may 

be used for a specific property to 20 percent of a public housing 

nshattuck on FSR297 with DISTILLER

12 

authority’s housing choice vouchers. One useful reform would be to 

raise that 20 percent cap and allow public housing authorities like 

KHC to project-base more housing choice vouchers to meet our specific needs here in the Commonwealth. 

I sit on the board of directors of the National Council of State 

Housing Agencies, so I have the opportunity to speak with many 

of my colleagues across the country, including my distinguished colleague in Wisconsin—Mr. Winston does great work in Wisconsin— 

and I can tell you that, nationally, this would be accepted on a bipartisan basis. It is an option that allows housing choice vouchers 

to be project-based, but each State doesn’t necessarily have to do 

that. So it would be a significant reform to potentially look at 

building more recovery-type models, regardless of treatment methods. 

I will conclude my remarks with these key statements: Recovery 

Kentucky is a housing-based model that has produced remarkable 

outcomes and has proven to be highly cost-effective; housing is a 

key component of successful recovery programs and essential for 

long-term recovery; and greater flexibility with Federal housing 

program regulations will provide States with more control of the 

resources needed to achieve the goals of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. 

Thank you for taking on this difficult but important work to help 

ensure access to effective recovery programs. Kentucky Housing 

Corporation led the way more than a decade ago, and we stand 

ready as a dedicated partner in the continuing effort. Thank you. 

[The prepared statement of Mr. King can be found on page 49 

of the Appendix.] 

Mr. DUFFY. Thank you, Mr. King. 

The Chair now recognizes Ms. Minton for 5 minutes. 

STATEMENT OF LISA MINTON 

Ms. MINTON. Thank you, Chairman Duffy, Congressman Barr, 

and Congressman Guthrie. I am the Executive Director of Chrysalis House, and I am very pleased to be with you today. And I 

would be remiss if I did not introduce our wonderful board president, Lindy Karns, who is also here today. That just shows what 

a wonderful program Chrysalis House is. Our board, our staff, our 

community partners, and everybody that we work with, we come 

together to do the best that we can for the women and children 

that we serve. 

And we have been saving lives for over 40 years. We are Kentucky’s oldest and largest licensed substance abuse treatment program for women. And the chrysalis is the protected stage just before the beautiful butterfly emerges, and that is what we want for 

the 200 women and babies that we serve every year. 

As reported in the Herald Leader this past weekend, the CDC report recently stated that Kentucky had one of the highest rates in 

the Nation of pregnant women using opioids, and that is another 

example of the State’s struggle with abuse of pain-killing drugs. 

At Chrysalis House, we prioritize pregnant and parenting 

women, and we are one of the few programs in the Nation that 

allow women to bring their babies with them into treatment. We 

nshattuck on FSR297 with DISTILLER

13 

believe the opportunity for our clients to be with their babies and 

young children is a powerful incentive for recovery. 

A brief snapshot of the women that we are currently serving: 

Their average age is 26 to 30, 41 percent are pregnant, 61 percent 

report their primary substance abuse is heroin or other opioid, 85 

percent have had one or more prior treatment episodes, 98 percent 

are unemployed, and 60 percent meet the homeless criteria for 

transitional housing. This population needs additional recovery 

supports. Housing and employment are imperative to long-term sobriety. 

Chrysalis House received our first HUD Transitional Housing 

Grant in 1990, and we’ve received HUD permanent housing funding for over 20 years. In 2016, our $200,000 grant was cut by our 

continuum of care due to the change in HUD’s vision for moving 

forward and serving the chronically homeless and housing first, 

which we agree with, but we do think that there is room for transitional housing because our women and their children, after they go 

through 3-to-6 months of treatment at Chrysalis House, need sober, 

stable living in order to achieve long-term sobriety. The next year, we lost our $93,000 scattered-site apartment funding and our $60,000 permanent-housing bonus apartments, so 

we have gone from $360,000 a year in HUD funding to zero. And 

so this shift in HUD’s view, I can see that, but we also think that 

there is room for transitional housing. And so we look forward to 

working with you all on the CAREER Act and the THRIVE Act and 

any other ways to help the women and children that we serve at 

Chrysalis House. 

So I thank you for allowing me to speak today, and I am glad 

to take any questions. 

[The prepared statement of Ms. Minton can be found on page 52 

of the Appendix.] 

Mr. DUFFY. Thank you, Ms. Minton. 

Mr. Robinson, you are recognized for 5 minutes. 

STATEMENT OF TIM ROBINSON 

Mr. ROBINSON. Good morning, Chairman Duffy, Congressman 

Guthrie, Congressman Barr. My name is Tim Robinson. I am the 

CEO of Addiction Recovery Care. More people died from overdoses 

than car accidents last year, making addiction a national public 

health crisis that is taking too many lives and threatening our economic security, as employers struggle to find and retain employees. 

Last year, our Kentucky Chamber of Commerce CEO wrote in an 

op-editorial and he called addiction the number one economic concern in our State. 

Everyone is looking for a silver bullet to address the addiction 

crisis. The reality is there isn’t a silver bullet. Addiction recovery 

requires a whole-person approach, which starts with intervening 

with treatment, investing in someone’s economic future by providing access to transitional housing, vocational rehabilitation, 

workforce development, and inspiring them from day one that 

there is hope to go from their crisis to a career. 

I am thankful for the opportunity to speak to you because recovery is personal to me. I started drinking in my first year of law 

school at the University of Kentucky to cope with my mom passing 

nshattuck on FSR297 with DISTILLER

14 

away during finals. For the next 8 years, I almost drank myself to 

death. Eleven years ago while I was a prosecuting attorney in Lawrence County, Kentucky, a court bailiff, who was a recovering alcoholic and pastor, led me to a spiritual awakening at my desk. He 

became my sponsor and my pastor. And addiction recovery is personal to me because I am a survivor. 

Two years later in 2008, I resigned as prosecutor and in 2010 

opened a residential center for women in rural eastern Kentucky. 

Today, we have 350 residential clients and 500 outpatient clients 

and centers across 12 counties in Kentucky. Our experience has 

taught us that addiction is a disease that devastates all aspects of 

a person’s life, impacting someone’s mind, their body, their spirit, 

and their purpose. And we have been determined to treat addiction 

holistically, medically, clinically, spiritually, and vocationally. 

Our centers are led by an addictionologist and are nationally accredited. We have developed a spirituality program that inspires 

hope and offers redemption. Much like hospice centers, we employ 

chaplains who work alongside our clinical staff, and though we consider the spiritual aspect of our centers to be the heart of our success, our spirituality program does not replace medical and evidence-based clinical practices. It is in addition to them and makes 

our care more comprehensive. 

Treating the whole person has led to great success. One of our 

payers recently reported to us that our centers reduced their members’ healthcare costs by 33 percent during the 6 months after they 

completed our program. 

We created an internship program with the promise that everyone who completes the program would be guaranteed a job. Today, 

190 of our 380 employees are in recovery, and of those 380 employees, 130 are graduates of our programs. 

We are a State-certified peer-support training program. A peersupport specialist is a Medicaid-billable professional who has 1 

year of sobriety and completes a certification program. 

We partnered with a workforce board, Eastern Kentucky CEP, 

and with Sullivan University to expand our internship into a 6- 

month career academy. Our graduates earn State certification and 

college credit. In just 1 year, a person in addiction can go from an 

IV heroin user to supporting themselves, literally going from their 

crisis to a career. 

To date, 41 of our 46—or 85 percent—of our academy graduates 

are clean and sober, working full-time, paying taxes, and 

transitioning off public assistance. Some of the graduates have 

been promoted to management, and others are continuing their 

education for careers such as counseling. Prior to the academy, 40 

percent of our clients chose to continue treatment beyond detox in 

residential care. After giving folks an opportunity to go from crisis 

to career, 70 percent of our clients now choose to continue treatment, doubling treatment motivation. 

Vocational education that leads to a meaningful career that provides the dignity of work gives those reentering the workforce the 

confidence necessary to establish career goals and plan for their future. Because of this success, we are adding other programs such 

as an auto mechanics academy. 

nshattuck on FSR297 with DISTILLER

15 

Kentucky may be leading the Nation when it comes to our drug 

crisis, but Kentucky is also leading the way in access to treatment 

because of the national leader on this issue, Congressman Hal Rogers, who has been working on this issue for more than a decade, 

and the efforts of our Governor Matt Bevin, who is making Kentucky a second-chance State. 

But the two biggest challenges preventing us from taking more 

people from crisis to career is a lack of funding for workforce development and transitional housing. That is why I am so excited 

about Congressman Andy Barr’s bill, the THRIVE Act, and our 

Senate Majority Leader Mitch McConnell’s CAREER Act, and that 

Congressman Guthrie has convened joint committee hearings on 

the issue of helping people in addiction who are in recovery get the 

workforce development they need. And these two historic pieces of 

legislation have the potential to transform the national effort to 

combat the drug epidemic. 

In closing, the hope of America is not merely surviving. The hope 

of America is an opportunity to flourish. That is what our brothers 

and sisters in addiction need. They need an opportunity, an opportunity for treatment, transitional housing, and workforce development that leads to a meaningful career path. And when the opportunity is given, I have seen not just survive but thrive. Our current 

human capital and labor shortage can be solved at the same time 

we combat the drug epidemic as we take those struggling with addiction from their crisis to a career. 

[The prepared statement of Mr. Robinson can be found on page 

55 of the Appendix.] 

Mr. DUFFY. Thank you, Mr. Robinson. 

Mr. Thomas, you are recognized for 5 minutes. 

STATEMENT OF JEROD THOMAS 

Mr. THOMAS. First, let me thank you for including me today. It 

really is an honor. My name is Jerod Thomas. I am the President 

and CEO of the Shepherd’s House. The Shepherd’s House is a nonprofit, long-term transitional living home for men 18 years and 

older that have a drug or alcohol addiction. We have been providing this treatment for 29 years, since 1989. We are one of the 

few transitional-living houses that offer recovery care for our clients 24/7. We offer a lot more than just a roof over your head. 

Our long-term residential recovery program is very similar to the 

model of the THRIVE Act. We are a therapeutic community, and 

our primary focus is on helping these men acquire daily living 

skills. In our day, we offer individual counseling, group counseling, 

conflict resolution, anger management classes, parenting classes, 

education programs, money management classes, and art therapy. 

We also feature a one-of-a-kind jobs program in which 90 percent 

of our clients get a job within 3 weeks of entering our transitionalliving house. 

Employment is mandatory at the Shepherd’s House. To prepare 

our clients for employment, we provide professional assistance with 

resume building, interview skills training, personal presentation, 

employment goalsetting, and teambuilding. We partner with DVA 

Kitchen, Employment Solutions, Vocational Rehab of Lexington, 

and OWL. 

nshattuck on FSR297 with DISTILLER

16 

The Shepherd’s House has never received any Federal grant 

money for any of our programs, but we have received grant money 

from Federal Home Loan Bank and Kentucky Housing Corporation 

in the form of brick-and-mortar grants, which require income and 

special-needs verifications, which are similar to the Section 8 rental assistance voucher program, so we are very familiar with the 

process. 

Under our transitional housing model, clients pay a portion of 

their income as rent. That does not cover my utilities, my food, and 

my professional therapies cost. The bulk of our expenses are funded by the donations the Shepherd’s House receives, so basically 

what I am telling you all today is the good people of Lexington, 

Kentucky, keep my doors open. Because we have had so much success, the donations have increased. I believe the THRIVE Act will 

have similar results. The financial support the THRIVE Act could 

provide would ensure our continued success, as well as allowing us 

to serve more people. 

And I really wanted you guys to hear me today, but I thought 

it was more important that you feel me today, so I brought Donna 

Schuler with me today. Donna, could you stand up? Thank you, 

Donna. 

Donna is a great friend of mine and a wonderful mother. Her 28- 

year-old son Luke Andrew Schuler died of a drug overdose on December 9, 2016. Luke was on my waiting list at the Shepherd’s 

House. He was 2 weeks away from his bed date. We live with that 

every day, knowing a life was lost because we didn’t have room. 

There are perhaps countless others who are waiting that we don’t 

know about. Luke’s mother Donna, in spite of her unimaginable 

grief, rose to the challenge and has worked tirelessly to get contributions to grow the Shepherd’s House so that no other parents 

have to bury their son because a bed wasn’t available. 

The Shepherd’s House currently has a 6-month waiting list. The 

funding the THRIVE model facilities will receive would allow us to 

expand our current bed capacity and offer more services to more 

individuals. The housing cost burden will be significantly reduced, 

and these precious funds will be freed up to provide more services 

and more beds. 

We currently follow all the Section 8 housing rules but with more 

restrictions and services for the client. Like Section 8, we require 

our clients to stay drug-, alcohol-, and crime-free, but unlike Section 8, we provide the programs and support to help them do so. 

We provide a 24-hour-a-day, 7-day-a-week therapeutic community 

that gives you access to the daily living skills necessary to stay 

sober and participate in the game of life. Our focus is on the whole 

person. Our aim is to meet all the client’s needs while they are in 

our safe and drug-free environment. The THRIVE-based model includes programs like the Shepherd’s House that have proven results of long-term sobriety. Most of our clients are either incomeeligible for Section 8 or qualify as homeless, so the reallocation of 

these vouchers still meets the letter and spirit of Section 8. 

In preparing to give testimony today, I have looked at the support offered by Section 8 vouchers, and I am excited that we may 

be able to use those funds for people who want to live sober, but 

the Section 8 voucher in and of itself is not the end game. There 

nshattuck on FSR297 with DISTILLER

17 

are more pieces to this puzzle of life than the housing issue. The 

THRIVE Act takes the intent of Section 8 to provide safe and stable housing and partners that with the very best treatment model 

we know of today. The union of these three things—a treatment 

model with daily living skills incorporated, job placement and education to secure a financial future, and stable and adequate housing—that is the end game. Through those relationships and funds, 

the THRIVE Act will give drug addicts and alcoholics tools for 

change and solutions for life. 

Let me leave you with the sobering facts we live with here in 

Kentucky. By the end of the day today, five more Kentuckians will 

have died of a drug overdose. That means five more sets of parents 

will bury kids, and five more kids will lose their parents. Kentucky 

is always in the top five in overdose death. At the end of our day 

today, let’s use the THRIVE Act and the CAREER pilot program 

in Kentucky to save those five lives. Thank you. 

[The prepared statement of Mr. Thomas can be found on page 59 

of the Appendix.] 

Mr. DUFFY. Thank you, Mr. Thomas. And, Donna, thank you for 

being here today, and we are sorry for the loss of your son Luke. 

Thank you. 

Dr. Walsh, you are recognized for 5 minutes. 

STATEMENT OF DR. SHARON L. WALSH 

Dr. WALSH. Thank you. Chairman Duffy and distinguished Members of the committee, thank you for the opportunity to appear 

today to discuss the role of Federal housing and community-development programs to support opioid and substance use disorder 

treatment and recovery. I want to thank Congressman Andy Barr 

from Kentucky’s Sixth congressional District for inviting the committee to Lexington—I wish that the weather was better for you— 

to discuss the Nation’s opioid crisis and how Kentucky leaders are 

responding. 

My name is Sharon Walsh, and I am the Director of the Center 

on Drug and Alcohol Research at the University of Kentucky, and 

for the past 25 years, I have been engaged in conducting research 

on opioid misuse, dependence, its medical complications, best practices, and the development of novel treatments for opioid use disorder. I have been fortunate to have had funding throughout my 

career from the National Institute on Drug Abuse, along with other 

sources, including SAMHSA and the FDA (U.S. Food and Drug Administration). I am here today representing the University of Kentucky. 

The University of Kentucky has launched many initiatives to increase access to care and accelerate the discovery of novel approaches to address the opioid crisis in the Commonwealth and the 

Nation. I will highlight only a few with my limited time today. 

The University of Kentucky Hospital emergency rooms see approximately 1,000 non-fatal opioid overdoses in a given year with 

approximately 50-plus cases of fatal overdoses. This does not include those patients who present with significant and life-threatening medical complications from injecting drug use behavior who 

present virtually every day, nor does it include all of those individuals who never make it to the emergency department. Historically, 

nshattuck on FSR297 with DISTILLER

18 

emergency departments in our region would treat the presenting 

problem and return the patient to the street without attempting referral or linking patients to care for their opioid addiction. 

With the support from the CURES funds, through SAMHSA and 

the State of Kentucky and the Cabinet for Health and Family Services, a new service has been developed to address this critical gap 

in care. The First Bridge Clinic is a new initiative that allows our 

emergency departments to directly refer individuals at high risk for 

fatal overdose and link them to care. Patients can quickly begin receiving evidence-based care, including medication-assisted treatment and start on the path to remission and recovery. However, 

these patients often have many other psychosocial problems that 

are barriers to treatment success and retention in treatment. For 

example, a criminal record is a barrier to employment, and unemployment is a barrier to housing. Linking all patients to the requisite supportive services is essential for long-term recovery, especially housing when needed. 

Another U.K. program that is having a profound impact that 

Congressman Barr mentioned earlier is PATHWAYS, a program 

designed specifically for the care of pregnant women suffering from 

opioid use disorder. PATHWAYS opened in 2014 and has treated 

more than 200 women and their newborns. Women are able to receive evidence-based care, medication-assisted treatment, and good 

prenatal care. The large majority of women achieve abstinence and 

deliver their babies with no illicit opioids in their systems. And the 

incidence of babies suffering from neonatal abstinence withdrawal 

has been reduced by more than half. U.K. just opened a specialized 

NACU unit that is an eight-bed unit that is specifically for the care 

of babies born with drug exposure. Our postpartum program for the 

support of new mothers, Beyond Birth, is also expanding with the 

help of Medicaid assistance. 

Young mothers with new babies may be the most vulnerable of 

all the patients that we see. This is a high-risk group that may require housing services, housing that allows infants and other children in order to promote retention in care and sustained remission. 

In Kentucky, there was little to no opioid abuse before the current prescription opioid epidemic began. There was no heroine historically. Most existing treatment facilities and housing services 

were not designed to address the unique issues associated with 

opioid use disorder that set it apart from other substance use disorders. This is a very unforgiving disorder. A single lapse or relapse can lead to the immediate death of a person who is striving 

to sustain their recovery. A single mistake ends a life. 

Federal agencies, including the FDA, SAMHSA, and NIH, all 

agree that the most effective approach to the treatment of opioid 

use disorder is pharmacotherapy, also known as medication-assisted treatment, including buprenorphine, methadone, and 

naltrexone, and all are calling for its expanded use. These medications effectively reduce drug use, improve health, reduce the transmission of infectious disease, and, most importantly, protect individuals from fatal overdose. 

It is commonly recommended that part of the path of recovery is 

to change the people, places, and things that are associated with 

one’s past drug-using lifestyle. This may involve moving into resinshattuck on FSR297 with DISTILLER

19 

dential care or recovery housing. Unfortunately, many of these facilities prohibit or exclude patients who are receiving all or specific 

FDA-approved medications under the supervision of a trained physician. Providing healthy- and safe-living housing environments for 

all patients seeking recovery is essential, and programs receiving 

government support should not only allow but should also promote 

the use of all evidence-based practices in treatment and housing 

programs. 

The University of Kentucky looks forward to working with Congress and other leaders to leverage the expertise and resources of 

the Federal Government in a strategic and coordinated manner. As 

a historic land-grant and flagship research university, the University of Kentucky was founded for the people of Kentucky 150 years 

ago. That is why we are here, to keep a deep and abiding promise 

of better tomorrows for our community, our region, and the Commonwealth. 

I sincerely appreciate the opportunity to present testimony before 

the subcommittee, and I am happy to address any questions. 

Thank you. 

[The prepared statement of Dr. Walsh can be found on page 64 

of the Appendix.] 

Mr. DUFFY. Thank you, Dr. Walsh. I want to thank our panel for 

their insights and their testimony. The Chair now recognizes himself for roughly 5 minutes for questioning. 

First, I neglected to mention how grateful I am for the warm welcome that you have given me in Kentucky, especially after Wisconsin ended your undefeated season in 2015 in the Final Four. 

Mr. Guthrie was at that game. 

With that said, listen, this is a heart-ripping conversation. I was 

a prosecutor for 10 years, and over 10 years ago in my small county 

we saw more deaths from opioids than anything else in our community. And there was really no national conversation or even a 

Statewide conversation at that time, and so we put together a community taskforce. That is what we do, right? We try to go, how do 

we help our other community members when we see a crisis that 

burns? We don’t always look up the food chain; we look to ourselves 

to try to address the problem. 

And I was the prosecutor, so I had the D.A., I had the judge, we 

had the school, law enforcement, the pharmacist, everyone was getting involved, and one of the problems that we had was—if we have 

any doctors in the room, I am sorry—but the doctors were the ones 

where, again, they were the flow of the OxyContin, which was our 

issue of opioids. They were the flow-out, and we couldn’t get their 

participation early on to even deal with random pill counts, to do 

random testing. And when someone comes in on a Friday afternoon 

and says that the dog ate their Oxy and they want another 30-day 

supply and they were getting it, this was insane stuff. 

And so no wonder we have a crisis on our hands that was made 

not by the drug dealers, but whether we want to talk about pharmaceuticals or whether we want to talk about doctors and hospitals, and it has absolutely ravaged all of our communities across 

America. 

In Wausau, Wisconsin, I did a roundtable with many of my sheriffs and our attorney general, and what you see is how it is even 

nshattuck on FSR297 with DISTILLER

20 

addressing our kids, parents that are doing heroin in the car outside the drug house and the kids are in the back seat in the 

carseats as the parents are strung out in the front or what is happening inside homes of cereal being dumped on the floor for kids 

to eat for a couple days as the parents are on a drug binge. 

And some of the sheriffs were talking about how some of their 

deputies have started to drink more to cope with what they are 

seeing in our community, so you have seen drug use that translates 

even to some of our law enforcement deputies starting to consume 

more alcohol to deal with the pain of what they are seeing in their 

community with kids and with adults. And there is no silver-bullet 

answer here I don’t think, but trying to find bright spots that can 

help our communities deal with these issues is incredibly important. 

Just to the panel, I don’t know if you guys have this scenario. 

Are you seeing more out-of-home placements for children in your 

community because of this epidemic? Is that a fair assessment, 

Governor? 

Mr. FLETCHER. Yes, we are involved with the group in Georgia, 

Rome, Georgia, and up to 70 percent of foster home placements are 

related to substance use disorder. And a lot of the data across the 

country shows increase in foster care, and we don’t have near the 

adequate number of foster parents or volunteers to accommodate 

that, so we are facing—one of the consequences of opioid use disorder is going to be a tremendous impact on the children going forward, and the NAS that Dr. Walsh mentioned as well. 

Mr. DUFFY. And just for my smaller counties, we don’t come from 

a wealthy area in America or in Wisconsin. We have some pretty 

poor counties. The counties don’t have the resources to actually 

fund the out-of-home placements, which you want money to address addiction, but then you are spending money to address the 

consequences of it with the out-of-home placement for children, 

which a lot of our counties are struggling to go, how do we deal 

with this? It is a financial problem; is that fair to say, Governor? 

Mr. FLETCHER. Yes. One of the things that I think as we put this 

in the context of other works being done with NIH and the healing 

communities and NIDA is—and we are starting a project in Rome, 

Georgia, where we are looking at a group that handles foster care 

in addressing women. It is going to have to be a community-wide 

program of having a community that addresses these issues comprehensively, similar to what you started off with, your effort with 

the taskforce on opioids in your community. 

But I do think the healing community and having part of MAT, 

residential continuum of care that even addresses to reduce the incidence or the need of foster care by addressing these generally single moms early on or maybe both parents that are under substance 

use, but getting them into recovery so that you can reunify that 

family, which has historically been the best impact on a child’s 

well-being is reunification. 

Mr. DUFFY. Yes. Mr. King? 

Mr. KING. And what we are seeing in housing, we are really focused on two populations: Seniors and children. And you are seeing 

this spillover effect among youth and youth who are aging out of 

foster care. We have dedicated our resources to try to alleviate 

nshattuck on FSR297 with DISTILLER

21 

some of the issues with seniors, grandparents housing, having to 

house or find the resources to house their grandchildren. 

Mr. DUFFY. Yes. 

Mr. KING. I talk often about a holistic approach to housing. 

When you are looking at the spillover of an increasing population 

of youth and youth aging out of foster care, another housing approach that we have introduced in Kentucky is the Scholar House 

model, which helps single parents go to college or technical school 

and receive a degree and become a participating member of society. 

We are now over the next year going to be introducing a Scholar 

House model for youth who have aged out of foster care. But we 

are definitely seeing an uptick in housing resources going specifically for seniors who are caring for their grandchildren. 

Mr. DUFFY. Anyone else want to comment? 

Ms. MINTON. Well, I want to say that is one of the great things 

about Chrysalis House is that we allow the babies and children 

under 2 to live with their mothers while in treatment and older 

children come and spend the night on the weekends. Then the 

whole family reunites when they move into transitional housing. 

And so we can help them all along the way. And here in Kentucky 

the DCBS has a specialized team called START, which stands for 

sobriety, treatment, and recovery teams. And Chrysalis House 

works closely with the START team and with the court system because a lot of times the judges would take the children away, put 

them in out-of-home placement. But if the woman is at Chrysalis 

House and is doing well and working on her treatment plan, then 

they will allow the children to stay with the mother, and so that 

does save our citizens a lot of tax money. 

Mr. DUFFY. I don’t know if anyone knows the answer to this 

question. In regard to how we treat pain in America and if you 

have been to the doctor—my wife and I, we have eight kids, so at 

least every 2 years I have been to the doctor dealing with pain in 

childbirth, not my pain but my wife’s pain, and the little smiley 

faces to the grimacing frown of the little face in the doctor’s office. 

And anyone have any comment about the reimbursement method 

as it is tied to pain treatment with people in hospitals? And if your 

assessment of pain is low and doctors get a benefit for that, don’t 

we start pushing drugs on people when we should say, well, we 

don’t want to actually push some of these high-octane, highly addictive drugs on folks to necessarily manage pain. Maybe a little 

bit of pain might be beneficial instead of the possibility of getting 

hooked on a very powerful drug. Am I off base, Dr. Walsh? Am I 

crazy up here? 

Dr. WALSH. You are not crazy. So I think the contingencies are 

a little bit different, though, than what you have described, so the 

contingencies aren’t really about reimbursement. Where the requirement came for physicians to treat pain came out of JCAHO, 

the Joint Commission on Accreditation of Hospitals, when they 

adopted the policy that pain was going to be a vital sign— 

Mr. DUFFY. Right. 

Dr. WALSH. And that initiative was I think unknowingly pushed 

by groups that appeared to be legitimate scientific and medical societies, but they were actually funded by the pharmaceutical industry. 

nshattuck on FSR297 with DISTILLER

22 

Mr. DUFFY. That is right. 

Dr. WALSH. So they were able to persuade the accreditation, 

which every hospital needs to maintain in order to operate, that 

pain was going to need to be treated well. And then the other thing 

that drives it are patient satisfaction scores because that is another 

thing that hospitals pay attention to and that doctors are held accountable for. 

Mr. DUFFY. Have we changed that model now? 

Dr. WALSH. So JCAHO certainly is reevaluating things, and at 

the national level, there are a lot of physician organizations that 

are really trying to do a better job with coming up with guidelines. 

The CDC, I am certain, released new pain treatment guidelines, 

but they are guidelines so they are not mandatory. So we see some 

of the same bad practices continuing both in hospital settings, outpatient settings, dentist, mid-level providers. So while there is a lot 

of popular news about this, you cannot possibly not know that this 

is the biggest crisis that we are facing. 

We still see a lot of bad prescribing practices. And just as an example, in our State, the State Government changed the law so that 

you could only have a 3-day prescription for a Schedule II agent, 

and so what a responsible doctor would do would give a 3-day prescription. What some who don’t want to get called on the weekends 

do instead, they will give a 3-day prescription for 4 times as much 

as they would have prescribed for a 3-day prescription so that there 

is more available so that they are not getting patients calling up 

and saying that they are in pain. 

So I think that is really important when we are thinking also 

about how we do both regulations around this, guidelines, what is 

it that we are incentivizing because sometimes we are missing the 

mark a little bit and— 

Mr. DUFFY. And we want to manage pain. We don’t want people 

not to be able to get medicine to manage their pain, but also we 

don’t want to push that pendulum too far over, which I think you 

have mentioned, Dr. Walsh, that we have and it has to be reevaluated. And frankly, we are not done with that process. It is a little 

bit shocking based on the crisis that we are seeing across America. 

I have to end in one moment, but you all agree that housing is 

a key component to recovery. We are all agreeing on that. Good. 

We are on the same page. And just I thought that, Mr. Boggs, you 

made an interesting point. When we are talking about, you are 

dealing with those that have been convicted of crimes who have 

served sentences, I don’t know if you have the same problem in 

Kentucky, but in Wisconsin, we don’t have enough workers to fill 

our jobs, and if we can move people, whether it is from incarceration with skill sets into jobs or from those who have drug abuse 

issues to skills sets to meaningful jobs that give purpose in life, not 

only does it help the individual, their family, but it helps our 

broader economy because they are filling places in our workforce 

that aren’t being filled right now. 

You talk about a—this is a holistic issue that we face as a community and as a country. Mr. Thomas? 

Mr. THOMAS. That is a perfect example. What better place to get 

your employees than living at our facility where they are being 

drug-tested 3 days a week, and if you are positive, we will not send 

nshattuck on FSR297 with DISTILLER

23 

a guy that is under the influence of drugs or alcohol to work. We 

will simply call the employer and say he is not going to be available today, but we have a guy that we can send to you and you 

can start training today. 

So we are actually doing that for you, so we take the cost of the 

drug test and we monitor, so if you are in our facilities or any of 

our facilities getting drug tests, you have a safe and sober employee. That also saves money on the other end almost like an employee assistance program would. There are not as many workplace 

accidents when nobody is drunk or high. 

Mr. DUFFY. That makes sense. I am going to pass it over in a 

second to Mr. Barr, but again, we are talking about 10,000 vouchers out of 2.1, 2.2 million as a demonstration project to see if this 

works. Again, this is how the government should work to say let’s 

take a little sliver and see if we can have a real impact, and if it 

works, we can expand it, but it is only 10,000 vouchers, again, out 

of 2.2 million. I think that point needs to be made also. 

The fact that we are trying to address an opioid crisis is different 

than—we have all dealt with alcohol and alcohol abuse in many of 

our families. This is a new animal we are trying to get our hands 

around and how we address addiction. I know we are not talking 

about meth today, but that is a whole other problem as well, and 

it is going to be all of us partnering together. And I want to thank 

you all for the work that you do to make Kentucky a healthier 

place, to help families, individuals who are going through this incredibly difficult time, helping them get to a place of health. And 

to hear stories like Donna’s, to make sure we don’t have those five 

people today, Mr. Thomas, go through what she had to go through 

in her family, it is heartbreaking, and I appreciate her strength 

and willingness to help other families and have her and her son’s 

story be told. 

So with that, my time is expired, and I recognize the gentleman 

from Kentucky, Mr. Barr, for as much time as he may consume. 

Mr. BARR. Thank you, Mr. Chairman. And again, thank you, Mr. 

Chairman, for coming to Kentucky and listening to our constituents 

about models of hope, about models of recovery. Wisconsin has a 

crisis, Kentucky has a crisis, the whole country is dealing with an 

opioid addiction crisis, an overdose crisis. And the fact that you 

have spent the time and the willingness to come to Kentucky and 

hear from people on the frontlines who are offering solutions and 

taking our testimony is something that I really appreciate. 

Mr. Chairman, since you did mention the 2015 NCAA tournament, I just respectfully remind the Chairman about 2014 and 

the 30-foot shot with 2 seconds left by Aaron Harrison that 

knocked out your Badgers, so just for the record. I can say that to 

the Chairman because— 

Mr. DUFFY. Duly noted. 

Mr. BARR. —he is a good friend of mine. 

On a more serious note, I do just want to make note of the fact 

that it is altogether appropriate that this field hearing is taking 

place in the United States District Courthouse. In my conversations with members of the Federal judiciary, the criminal docket 

here in the Eastern District is disproportionately inundated with 

nshattuck on FSR297 with DISTILLER

24 

criminal cases that are connected in some way or another to the 

opioid addiction crisis. 

Well, all of you have made very good points today, but let me 

start my questions with Governor Fletcher. Thank you for your testimony. Thank you for your leadership. Thank you for your innovation with Mr. Ball a decade ago and for your continued work in trying to take the Recovery Kentucky model nationwide. It is a unique 

model. We know it works. My question to you is besides the 

THRIVE Act—and we thank you for your words of support for 

more Section 8 vouchers for addiction recovery, but you mention 

the CDBG program, the Community Development Block Grant, and 

I fully agree with you that recovery is community development because of the connection to the workforce development issue. 

What statutory changes does the Congress need to make, continue to make besides the THRIVE Act to provide more CDBG 

funds or other resources to take the Recovery Kentucky model nationwide? 

Mr. FLETCHER. That is a tough question. Congressman, let me 

say this. As I have thought about the CDBG grants, 15 percent of 

those are available for service, and we are using those, but they are 

very competitive because most of the communities out around the 

State, knowing that these funds are controlled primarily by the 

Governor, make it very difficult to direct some of these moneys to 

a recovery effort. 

I do think, maybe similar to what you are doing in the THRIVE 

Act under the CDBG funding, is looking at considering setting 

aside, taking some of that $6 billion that is going and set aside for 

community development similar to the CAREER Act but making 

sure there is a funding stream available that is sustainable, that 

helps us address directly that particular need. That could be tied 

with the quality measures that you have already done in the 

THRIVE Act. It could be tied with making sure that they have job 

training, that they are involved with the local economic development, all part of this healing community effort. 

What particular piece of legislation? I think the CAREER Act 

might be a place, but looking also at the—I guess the appropriations for CDBG but the authorization for CDBG and where those 

come from and looking at the language in that authorization bill 

to see if we couldn’t specify, as you have done in the THRIVE Act, 

some moneys for that particular development effort. 

Mr. BARR. Thank you. That is helpful. 

Mr. Boggs, I appreciate all the good work that you all do at OWL 

to take people from a period of incarceration into sustainable employment. Do you have any specific suggestions for how Federal 

housing programs can work more closely with nonprofits like yours 

to help residents find jobs and rise above poverty? And the question is animated by my own personal experience traveling the central Kentucky area and talking to employers. 

And, Mr. Thomas, you made a great point about providing sober 

workers. It is ubiquitous. Every single employer in central Kentucky, whether it is a farm, whether it is a manufacturing firm, 

whether it is a healthcare-related business, whatever the business 

is, the hiring manager, the H.R. manager, the plant manager, they 

all tell me the same thing, which is we have job openings we can’t 

nshattuck on FSR297 with DISTILLER

25 

fill because people can’t pass a drug test. How can Federal programs partner more with organizations like you to provide that 

labor supply? 

Mr. BOGGS. Yes. As I mentioned several times, the correlation 

between housing and employment is so critical because of—simply 

for the fact if people do not have a place to stay, they do not feel 

like getting up and going to work in the morning. They are not capable of getting up to work in the morning. So if they have stable 

housing, then that provides them a place, a residence, a place of 

safety that enables them to go to a place like OWL and receive the 

necessary job training. 

And you are correct; every individual that comes through our 

doors that wants to work, we can find employment for them. The 

big issue is so many times they come to work and then the next 

day they don’t show up. That is because they don’t have transportation. That is another big barrier that goes in this whole piece 

that none of us have mentioned today. So getting back and forth 

to work and having that stable place to live brings that full circle 

together. 

And when we do have partnerships like I stressed earlier, that 

makes it so meaningful to connect it all together, and the collaboration is going to be the ultimate key for all this among agencies and 

maximum utilization of dollars. 

Mr. BARR. Mr. King, can you expand on how the current cap on 

project-based vouchers—you mentioned the 20-percent cap—has 

limited specifically here in Kentucky. How has that limited the 

Kentucky Housing Corporation’s ability to invest in housing programs that serve those who are recovering from opioid addiction? 

Mr. KING. Yes, and when I—thank you. When I mentioned that 

earlier, there are PHAs throughout the Nation who have done some 

demonstration projects where they can exceed that 20-percent cap. 

However, Kentucky Housing Corporation is not one of those. What 

you have seen in Kentucky is 14 recovery centers that do great 

work, but they all use housing choice vouchers that are projectbased to those centers, so you have those 14 recovery centers. You 

also have, I believe, 13 Scholar Houses, which I just mentioned a 

little bit earlier where, again, those vouchers are attached to those 

projects. 

So these have been very innovative approaches to address a particular issue like the opioid epidemic and like education and workforce training. However, because of those efforts, we have hit that 

cap. And so allowing us more flexibility, maybe increasing that 20- 

percent cap to potentially 40 percent or greater, to me it presents 

an option for States to utilize those resources. I think we have to 

take—as a country, I think we have to take a holistic approach to 

housing, and we can’t just look at providing a roof over somebody’s 

head. We have to address the things that lead to chronic homelessness like the opioid addiction epidemic and like educational opportunities for parents. So by raising that cap, we are allowed to target individuals into particular housing models. 

The purpose of the housing choice voucher was a good purpose, 

to give people choice in where they want to live. That is a good and 

noble goal. The problem is that you have a lot of landlords who are 

not willing to take tenants. So someone might get a voucher and 

nshattuck on FSR297 with DISTILLER

26 

they might not be able to find a house to live in because there are 

no landlords that will take them. So by increasing that, you are 

guiding them into a particular project. 

We administer at Kentucky Housing approximately 4,600 vouchers, Housing Choice Vouchers. There is a waiting list of 5,600. So 

while the increase in cap, the 20-percent cap would be beneficial, 

vouchers are the single most effective resource to address a homelessness issue, so obviously increasing those would certainly help. 

Mr. BARR. Thank you for your testimony, Mr. King, and I look 

forward to working with you and the Kentucky Housing Corporation to address that arbitrary statutory cap and looking forward to 

working with Chairman Duffy to achieve that once we get the 

THRIVE Act signed into law. 

Ms. Minton, you talked a lot about—and we applaud the great 

work of the Chrysalis House and what you do for women and 

newborns suffering from neonatal abstinence syndrome. And we 

want to work with you on the problems that you described with 

HUD. We want to fix those problems, so I look forward to working 

with you on that. That is precisely why we introduced the THRIVE 

Act, to provide alternative resources to replace some of the funding 

that you lost. And I think your respectful pushback of the Housing 

First program I think is appropriate for us to take into consideration as we exercise oversight over HUD and encourage HUD to reevaluate the priorities and the need for more transitional housing 

services. 

But my question to you, Ms. Minton, is because you are at the 

frontlines of the neonatal abstinence syndrome issue, could you just 

describe for the record, at least here in central and eastern Kentucky, the dimension of the problem of women who come to you 

with newborns who are suffering from this problem? 

Ms. MINTON. Well, Chrysalis House prioritizes pregnant women, 

so we try to get the women in before the baby is born, and that 

we are working with U.K. PATHWAYS and Beyond Birth to ameliorate the effects so that the baby is born healthy or as healthy 

as possible. And so we are working closely with the doctors. 

And Lindy left, but we have our board meeting tonight at 6 

o’clock to officially vote on opening a new 16-bed facility on the 

grounds of Eastern State Hospital for 16 pregnant and postpartum 

women, working very closely with U.K. PATHWAYS and Beyond 

Birth, and so we will have access to MAT services—the buildings 

are right next door on the campus—and hep C services because 

that is another problem with many of the women that we work 

with, and just trying to partner as best we can to help the women 

and their babies because they do recover and they do get better. 

I think that one of the things that Dr. Walsh alluded to is the 

number of women in rural Kentucky who do come to Lexington for 

services but are often reluctant to enter into treatment, especially 

long-term treatment. And so that is one of our obstacles that we 

are working on, and trying to do the telehealth I think is making 

great strides for our State. 

Mr. BARR. Thank you. Mr. Robinson, thanks for your powerful 

personal testimony, and I wanted to ask you from your experience, 

do the program participants that you contemplate coming into your 

program, how will they have success finding work, and how will 

nshattuck on FSR297 with DISTILLER

27 

they have success moving out of government assistance? What are 

some of the factors that will, in your judgment, lead to hope and 

thriving as you say, as opposed to just getting by? 

Mr. ROBINSON. Well, there has been a big effort for reentry programs, whether that is helping people transition out of prison or 

transition out of 30-day treatment programs or detox facilities. We 

have put a lot of effort there. And the problem is that often when 

that person leaves jail, if they leave a 30-day treatment program, 

there is a big gap from that moment when they walk out the jail 

cell, they walk out the treatment center until they are able to even 

be employed. And there are some things on the life skills side; 

there are some things on financial literacy. Those things have to 

be a part of that gap between when they come in crisis to putting 

them in a career. 

The other thing is you have to get them on a path where they 

can see a career path that is better than a petty drug dealer because we compete in their mindset with why should I go work a 

minimum wage job when I can do one petty drug deal. And so the 

hope has to be a real hope. It has to be a real economic opportunity. It has to be that you can become somebody who can support 

yourself, support your family, and we are not competing with that. 

And so I think having wraparound services like what the Shepherd House is doing, what we are doing, what others are doing, Recovery Kentucky, to get people in that zone where we lose most of 

them and make sure they have peer support, make sure they have 

counseling, make sure that they have people that really are reparenting them because a lot of the things that we do we take for 

granted, getting up every morning, knowing what is appropriate to 

wear to work. If we leave that to them when they have never done 

that, we are setting them up to fail. So our efforts, whether it is 

MAT, whether it is abstinence, whether it is whatever, all of those 

are going to require us to have transitional housing, workforce development. 

One of the things in the CAREER Act is not only giving more 

targeted project-based vouchers, not only giving more targetedbased community block grants, but giving targeted workforce development, that the WIOA funds have a certain amount that are targeted for people coming out of addiction because I have seen time 

and time again if somebody doesn’t have that hope, then they are 

going to go right back to petty drug dealing, and it is not going to 

be long before they are going to relapse and they are going to be 

right back in the mess that we have already once rescued them out 

of. Instead, if we will make the investment with a whole-person approach, we can see them succeed. 

Mr. BARR. Thank you for that. And, Mr. Thomas, first of all, let 

me just address Donna and express my condolences to you for the 

loss of your son Luke, and that is exactly why we are here today. 

Luke is exactly why we are holding this hearing, and we want to 

make sure that we bring every resource to bear from Congress to 

prevent this happening to any other family. 

And the Shepherd’s House is a wonderful program that needs resources, and Congress has responded to this epidemic with billions 

of dollars in appropriations, but guess what? Not all of the resources that we have appropriated are actually addressing the 

nshattuck on FSR297 with DISTILLER

28 

transitional housing need. And so I fully, fully agree with Mr. 

Thomas’ testimony that we need to make sure that there are no 

shortages of beds, and we need to rethink all of the priorities within the context of these appropriations so that organizations, not-forprofits like Shepherd’s House, are eligible to receive some of the resources. And again, that is what is motivating the THRIVE Act. 

So, Mr. Thomas, you mentioned no Federal funding to the Shepherd’s House outside of some Federal Home Loan Bank and KHC 

funds. How would the THRIVE Act specifically help Shepherd’s 

House and similar programs? 

Mr. THOMAS. Point-blank, it is a game-changer. I spent a ton of 

time reading it and researching it. We made a joke in getting ready 

for this. We are at the Shepherd’s House, we are the forgettables. 

And by that I mean, my clientele falls through the cracks. We don’t 

qualify for anything. I understand why pregnant ladies will go 

first. It makes absolute sense to me. But again, we are getting left 

behind. We are the forgettables. So our guys fall through the 

cracks. 

But what I love about it, what I love about the THRIVE Act, I 

think it was the fact that it ties it all together as the whole person 

as opposed to just addressing one issue because that is what always happens to a drug addict now. It is always one issue that 

takes them out, so you get them sober, but then they don’t have 

anywhere to live so they get high. Well, you get them sober and 

then it turns out they are bipolar and you didn’t provide them any 

mental health services, so they relapse. You get them sober and 

they get fired from their job and they can’t get another job, so they 

get high. 

The thing I love about the THRIVE Act is it ties it all together 

and it allows us to work as a team on this panel with the THRIVE 

Act. So now, when you are putting them and giving them vouchers 

for a place to live, you are not just saying here is your money, good 

luck. You are saying here is your money, here is peer support, here 

is job training, here is mental health counseling, here is individual 

counseling, here is group therapy. Well, now, you have provided 

them with all the tools they need to take that voucher. 

And eventually the endgame always has to be—I would honestly 

say this and hope not to offend, but if I had a guy that was 10 

years’ sober still living in Section 8, I would be extremely upset because the endgame has to be move them on in life. And I think that 

gives them the start that they need. And I thought it was genius. 

I am so excited about it, so thank you. 

Mr. BARR. Well, thank you for the testimony. 

And, Dr. Walsh, we want to get to Congressman Guthrie here, 

so just a quick comment and a quick question. The comment is a 

follow up from Chairman Duffy’s exchange with you about pain 

management reimbursement and narcotics avoidance. The American Society of Anesthesiologists and some anesthesiologists in 

Kentucky are doing some groundbreaking work on enhanced recovery after surgery. We need to pursue that. I think Congress needs 

to appropriate funding to tie narcotics avoidance to pain management, and we need to work with our physician community to do 

that. So I appreciate the fact that the accreditation standards may 

nshattuck on FSR297 with DISTILLER

29 

be revisiting that issue, and I want to work with you and U.K. and 

other healthcare facilities to achieve that. 

The question is, following their treatment at the University of 

Kentucky—and the PATHWAYS program is a wonderful program; 

I had the privilege of visiting with the fine people there at U.K.— 

are there currently sufficient housing options for these women and 

their babies to have a safe place to live in a sober environment? 

Dr. WALSH. So I think that, overall, hearing from the other panelists that there are insufficient opportunities for housing, when we 

hear about waitlists and the need for an additional, what was it, 

over 4,000 vouchers to meet the needs. And so we really need expanded access, but we need expanded access to meet people where 

they are. 

So, for example Chrysalis House, which is an outstanding program, allows women with their children. Many programs don’t 

allow that. As I said in my testimony, many programs will not 

allow people who medication is part of their recovery to participate 

in their programs. And I think that we need to align what it is that 

we know from the evidence that works. 

Let me be clear: My position is not that medication is the sole 

answer, but it is an important component. And so I think that for 

places to actually make a decision and say we are going to exclude 

this evidence-based practice that has been endorsed by the Federal 

Government and not allow that in their setting I think is a disservice to the patients that we are trying to reach. So I think that 

we need additional resources, but we also need to have a more integrated approach. 

And so Mr. Thomas just talked about integrating and everyone 

is talking about holistic, but I think that we really need to think 

about who the patients are, where they are, and then what unique 

things they bring and then loosening up some of the reins around 

some of the restrictions that we put on some of the programs. And 

some of them are from within. 

Mr. BARR. Thank you, Dr. Walsh. And my time is more than expired, but again, as I yield back, I want to thank Chairman Duffy 

for coming all the way from Wisconsin to be with us in Kentucky, 

for your leadership on this issue, for helping as you chair the subcommittee, moving the THRIVE Act through the markup process 

and off the House floor over to the Senate. Thank you for your continued dedication and commitment to this very important issue. 

And, Congressman Guthrie, thank you as well for your leadership and for joining us here today in Lexington. 

I yield back. 

Mr. DUFFY. The gentleman yields back. 

The Chair now recognizes the other gentleman from Kentucky 

from the Energy and Commerce Committee, a Ranking Member on 

the Health Committee, also the author of the Comprehensive 

Opioid Recovery Centers Act, which passed the House almost 

unanimously, but like many other bills, is still waiting action I believe in the Senate. 

Mr. GUTHRIE. Right. 

Mr. DUFFY. That is the story of our life. 

With that, the gentleman from Kentucky, Mr. Guthrie, is recognized for as much time as he may consume. 

nshattuck on FSR297 with DISTILLER

30 

Mr. GUTHRIE. Thank you very much. I appreciate it. I guess I 

should take back all my nice comments about Wisconsin after your 

comment about that ballgame, but, no, it is great. It is a great rivalry. It is a great rivalry. 

So I was going to ask my first question, and I think it has really 

been answered. But I think, Mr. King, since you are in the housing 

world more than the recovery world really, just what specifically 

the THRIVE Act was empowering you to do that you can’t do now. 

I know a lot of people—so we come to the agreement, we all agree, 

and then I said earlier that leaving inpatient care and going into 

sober living is vital. So what specifically does the THRIVE Act 

allow you to do that you can’t do now? 

Mr. KING. Well, I think the THRIVE Act goes directly to the participants. It is a set-aside of the Housing Choice Vouchers, and it 

goes directly to the nonprofits. 

Mr. GUTHRIE. The Section 8 isn’t administered to you at all? 

Mr. KING. It is a portion, I believe, the funds. And I— 

Mr. GUTHRIE. OK. So I thought Section 8 probably went through 

you guys as well, but it doesn’t, so— 

Mr. KING. No, it— 

Mr. GUTHRIE. I am not on this committee so— 

Mr. KING. It— 

Mr. GUTHRIE. —I don’t know how Section 8 was administered 

through— 

Mr. KING. Yes. But I think it is good in the fact that it targets 

a need for housing in recovery services. And again, it goes back to 

my suggestion that we increase that cap of 20 percent because we 

need to target specifically those individuals in recovery. 

Mr. GUTHRIE. So it would help your specific role to do it more 

than this specifically? 

Mr. KING. Yes. And I would say that by increasing that cap, I 

can do more at KHC in line with the THRIVE Act. 

Mr. GUTHRIE. Oh, perfect. Great. 

So, Dr. Walsh, I am interested in the First Bridge Clinic you 

were talking about earlier. So I am on the Healthcare Subcommittee of Energy and Commerce, and we had a group of 10 parents that came in that had lost a child and one that specifically 

just—so when you talk about 50 bills, well, what are you doing in 

50 bills instead of one big bill? But there are a lot of different 

things we found were roadblocks. 

And we had one family from New Jersey that specifically said 

they got a phone call that their son had overdosed and passed 

away. They didn’t get the phone call from the emergency room 

until they came to pick up his body. That was actually his eighth 

trip to the emergency room, and he was over 18. He was a college 

student. They were paying his bills. He was on their insurance. 

The parents were still completely responsible for him, but by law, 

he was an adult. 

So because of HIPAA (Health Insurance Portability and Accountability Act), that is what we are trying—some privacy. We understand the privacy side, but we also understand that parents are 

wanting the information, too, of their child. And I don’t know the 

specifics of every trip to the emergency room, but you leave yourself going, if somebody has been there 8 times, is there not some 

nshattuck on FSR297 with DISTILLER

31 

connection between the emergency care and getting them into care? 

So exactly—if you want to further talk about First Bridge, I would 

love to hear a little more. 

Dr. WALSH. Sure. I am happy to talk about that. But if you don’t 

mind, I will just reflect on what you just described because what 

you are describing is exactly what is happening all over the country. So people come in and out; it is a revolving door. The emergency department staffs are completely overwhelmed, and in many 

places they have absolutely nothing to offer to people, so they really are just treating them and then getting them out the door. People will come, they will be reversed with their overdose in the ambulance. They won’t even come in the door. They don’t want to be 

at the hospital. So we are not really making that connection at that 

very critical time when we have identified someone who is at high 

risk. 

I can tell you it is actually even very difficult for us to count accurately the number of overdoses that are occurring within any 

hospital system because we are not even necessarily testing people’s urine to determine that they have opioids and that is the 

cause of the overdose because if you give them naloxone and it 

works, then you know that is what it is, and they just send them 

back out. So at every level this has just been an incredible challenge. 

And what we are trying to do with the First Bridge Clinic is really provide an immediate warm handoff, and that way, within an 

integrated system, the physician can identify that this person has 

either an overdose or maybe they have an ulcer from injecting drug 

use or some other thing that alerts them to the fact that the person 

has an opioid issue. They can do a pulldown on the computer to 

do an electronic referral directly to us. If they reach out to us from 

the emergency department, we have actually spoken to patients 

from their beds in the emergency room. We can get hospital transportation to bring them to our clinic, and we can try to start them 

on treatment right away. 

We have just started the clinic in January. We now have 5-daya-week coverage. We are working on having some walk-in hours so 

people don’t have to deal with making an appointment even; they 

can just show up. 

I can tell you the issue that you are raising about adult children 

whose parents are still really the caretakers, a lot of patients we 

have are brought in by their parents. They are adults, but they are 

brought in by their parents, and they sit in the waiting room and 

they have an argument about things, and then the person with the 

disorder leaves. They don’t want to be there. They feel like they are 

being coerced, and the parents really have no influence. 

And the HIPAA issue is not just that the systems aren’t connecting. This area of medicine is so completely separate from everything else. If someone is in a methadone program, we don’t have 

any way of knowing that in our program because that is also siloed 

by Federal law. So I think that we need to come up with some creative solutions for figuring out how we can move forward to actually empowering people to get the help that they need for their 

family members. 

nshattuck on FSR297 with DISTILLER

32 

I know Massachusetts is working on a law that would actually 

require people to be forced into care. I am not one personally who 

agrees with that, but I think people are looking at innovative solutions so that we can try to help people who either are failing to recognize that they need help but really are on the verge of a complete 

crisis or death. 

Mr. GUTHRIE. Yes, trying to get that information where emergency rooms will have that information because you are right; it is 

siloed. If you are in treatment or have drug issues, it is not in the 

medical records by law. 

Dr. WALSH. Even if it is in the same health system. 

Mr. GUTHRIE. Exactly. And so actually what is interesting, one 

of these 50 bills is on specifically—and you couldn’t have two different Members of Congress. There is one gentleman from Portland, Oregon, who would be more you would describe to the left, 

another from Oklahoma would certainly be described more conservative, to the right, and those two together—and the debate was not 

really Republican/Democrat, left/right. It was more different groups 

on privacy versus practicality of having this done. And that bill did 

pass. It is in the Senate. So it is interesting. I think a lot of people 

outside of Washington think everything is just always a battle, but 

there are groups of people who have different opinions on other 

things that come together and they have common solutions. And 

that bill has passed. 

And I guess I am going along, but what is interesting as I walk 

into every—so I told you the last couple of weeks I have been going 

to recovery centers, and you hear the patients there, the people 

talking, it just seems like everything is working well. 

I did bring up the—you talked about the 16 beds. That is by 

Medicaid law, and we are looking for opioids, expanding that, because I saw one place that had an eight-bed room and an eight-bed 

room and a different administration so they could have—or that is 

eight beds, 16—or eight rooms had two to a room, so they essentially had 32, but they were trying to get around the law. We need 

to fix that so people aren’t having to game it to get things done. 

But the point we were talking about opening that 16-bed exclusion or limit for opioid, and it should be for more but it is just funding I guess we get back to. But one person when I said that, well, 

if you do that, people just create these big warehouses that have 

100 beds. They will have people in them and not get the treatment. 

So the question—and in those—so, Dr. Walsh, this is for you. In 

those 10 families we had, there was one specific family. They had 

different issues they were trying to address. And one family, typically from high-income families, I will spend anything it takes to 

get my child—so they were from New Jersey as well, suburban 

New York, and they were very high-income family, and whatever 

it takes, and so they sent their child to Florida, had passed away. 

It is everywhere, not just Florida, but it seemed to be an industry 

down particularly in southern Florida where it was like patient 

brokering, which was new to me where the intent didn’t seem—this 

parent said that. I am not saying it because I don’t know, but the 

parent said the intent didn’t seem for their son to get out, but son 

just to go from one to the other to the other as long as they were 

paying. 

nshattuck on FSR297 with DISTILLER

33 

And so I guess to get into if we are going to warehouse—the ones 

I have seen I have been impressed with, but how do we know a 

good one? I have a bill called the Comprehensive Opioid Recovery 

Centers to try to sort out how do we—what kind of evaluations 

they do in placement, be longer than a few-minute answer. But 

kind of in just—the THRIVE program, the THRIVE Act, because 

it is demonstration, how should we judge these things and test 

them and evaluate them? 

Dr. WALSH. That is a very important question, and there really 

isn’t a standard. And I can tell you that the American Society of 

Addiction Medicine does have standards of care, and they have different levels of care that they define that may be needed depending 

on the severity of the disorder. And you could use that framework, 

and people have talked about using that framework to try and 

grade treatment facilities. 

However, the problem at least here in Kentucky is that we only 

have a few of those levels of care. We don’t have the whole complement based on what the ideal circumstance would be. We are 

not the only ones, though, so I do think that there are evidencebased practices that have been defined and they are on the website 

for SAMHSA. We know what they are. I think that we can start 

by developing guidelines that check off those boxes and that actually are doing the monitoring that is necessary. 

So when somebody is saying that people are successfully abstaining, then I want to see your drug screen results from that. I don’t 

want to see just self-report. So, like Mr. Thomas said, when they 

are linking with an employer, they are testing people 3 times a 

week, they know exactly what is happening. That is not occurring 

in all settings. 

In some of the treatment programs, there is a lot of drug use 

that goes on. And I am not talking about anybody that is at this 

table. I am just saying that there are places where, as you described, they are in it for the profit, and they are less concerned 

about the well-being of people as long as they are getting care. 

There was a big expose ́ about some of those programs in southern Florida, and there is some suggestion that those same places 

that were pill mills before have been shut down, and now this is 

a different business model for them. We know that there are a lot 

of overdoses, fatal overdoses that take place in some of these programs. They are not publicized. That is not a good outcome when 

that happens. But oftentimes, people are not made aware of it. 

So I think that we can take what we know from the scientific literature about how one would do a study to assess the efficacy of 

a treatment and borrow those same types of monitoring practices 

and implement them and customize them for recovery houses and 

for treatment programs for residential because we know what the 

goals are. If the goals are to get jobs, if the goals are to get somebody so that they are surviving, these are really objective markers. 

But I think then you want some external source doing that evaluation. You don’t want to necessarily have people reporting on their 

own without some external evaluation. 

Mr. GUTHRIE. Thank you. And I am not going to ask another 

question, but I just want to say I know Mr. Robinson has been to 

nshattuck on FSR297 with DISTILLER

34 

Washington to testify. Mr. Boggs, I appreciate what you guys do 

specifically, and all of you. 

I am also on the Education and Workforce Committee, Chairman 

of the Higher Ed Subcommittee that has the jurisdiction of the 

Workforce Investment Act or WIOA Opportunity Act, and so it is 

all vital to tie together. And I think you are seeing all sides in 

Washington. As Chairman Duffy said, we are all agreeing that we 

need to put this together, and I think once we know we are paying 

for the good programs and the funding, we want to make sure we 

are, the funding is following, and so there is a lot of work to be 

done but a lot of effort is being done and a lot of—trying to understand it and trying to comprehend it and trying to move forward 

and getting—and I am left convinced, getting people into sober living is probably our most critical part now because we have a lot 

of residential treatment. There may be a waiting list for them but 

not a big control on the sober living side of it, and so I appreciate 

Congressman Barr’s leadership and appreciate everybody coming 

together to talk about that because this is important to highlight. 

Thank you, Mr. Chairman, and I yield back. 

Mr. DUFFY. The gentleman yields back. 

I want to again thank our panel for their participation in today’s 

hearing. I want to thank Chairman Barr for all the work he did 

in putting this hearing together, making sure we had a well-rounded panel, providing us excellent insights. 

If I could make one parting note, the best ideas for legislation 

come not from Washington, it comes from all of you who are on the 

frontlines doing this work. And there is a great partnership that 

happens. If you have an idea and you get it to Mr. Guthrie, Mr. 

Barr, or myself and we introduce it, one, we have stolen your idea 

and we look really smart; and two, you get your idea into legislation. But in the end we are helping people. We are getting the right 

bills, the right legislation that do the most to help the most vulnerable among us, and that is what is really critical here. 

And I just want to thank all of you for the work that you do, for 

taking the time out of your day to participate in this hearing so we 

can take the information garnered in this hearing back to our colleagues in Washington. So thank you for your time and your effort 

and your good work. 

Without objection, all members will have five legislative days 

within which to submit additional written questions to the chair, 

which will be forwarded to our witnesses. If we have any of those 

additional questions, I would ask the witnesses to respond as 

promptly as feasibly possible. 

With that, and without objection, this hearing is now adjourned. 

[Whereupon, at 11:05 a.m., the subcommittee was adjourned.] 

nshattuck on FSR297 with DISTILLER

(35) 

A P P E N D I X 

August 16, 2018 

nshattuck on FSR297 with DISTILLER

36 

nshattuck on FSR297 with DISTILLER


Testimony of David I. Boggs, 

President/CEO of Opportunity for Work and Learning 

Before the House Financial Services Subcommittee on 

Housing and Insurance 

Hearing on 

"The Role of Federal Housing and Community Development 

Programs to Support Opioid and Substance Use Disorder 

Treatment and Recovery" 

Thursday, August 16th, 2018 at 9:00AM 

Courtroom A, U.S. District Court of the Eastern District of 

Kentucky 

101, Barr Street, Lexington KY, 40507 

650 Kennedy Road I lexington, KY 40511 1 P: 859.254.0576 1 F: 859.254.0578 1 www.owiinc.net 
37 

nshattuck on FSR297 with DISTILLER


Good afternoon Chairman Duff, Ranking Member Cleaver, and other distinguished members. It 

is an honor to address this committee in regards to the epidemic of opioid addiction in our 

nation and the serious housing challenges this population faces. Since housing is a vital step in 

the recovery and reentry process, the THRIVE Act and CAREER Act can have a major impact on 

abolishing this crisis. Considering that this epidemic touches every family in our nation, 

establishing long term solutions should indeed be a top priority. 

I would like to share with you the role Opportunity for Work and Learning (OWL) plays in the 

topic at hand, and my views on how the Federal government can use existing housing and 

community development programs to complement community efforts to treat individuals 

experiencing opioid addiction. OWL provides key elements in the transitional path to selfsufficiency through job training and employment services. 

Housing and employment go hand-in-hand, so it is difficult to successfully maintain one without 

the other. And yeftoo often, ex-offenders are lacking at least one of these once they are 

released from prison. Consistent housing cannot be obtained without employment that will 

provide enough income to meet the demands of either renting or owning. Many of these 

individuals lose their employment due to the challenges faced through inconsistent living 

conditions such as "couch surfing". 

Individuals come to OWL from many different paths: returning citizens recently released from 

incarceration, a short or long-term recovery program, or someone struggling with opioid 

addiction while still trying to maintain employment. The struggle is overwhelming and often 

leads to more serious consequences. 

Page 1 of3 
38 

nshattuck on FSR297 with DISTILLER


OWL partners with communities to help individuals overcome barriers to achieve personal and 

professional growth. Annually, 600,000 people in our nation are being released from prison. 

The number of people at risk of falling back into the lifestyle that led them there in the first 

place continues to climb because of the lack of housing and employment. In addition to the 

criminal record preventing these individuals from finding jobs, statistics show that ex-offenders 

far too often have limited education and work experience, and therefore do not have the skills 

required to perform in the workforce. 

The Lexington Manufacturing Center (LMC), a wholly owned subsidiary of OWL, is an on-site 

advanced manufacturing center that provides training in the essential skills so desperately 

needed and demanded by today's employers in every job sector. LMC employees earn more 

than minimum wage and have the opportunity for increases every 90 days. Other benefits 

include production bonuses, health insurance options, matching retirement and other company 

benefits. The various trainings LMC provides include a manufacturing certification in forklift 

and material handling as well as third-party inspection, kitting, assembly, and woodworking. 

The programs OWL and LMC have in place have proven to be successful in the path to selfsufficiency and the attainment of stable housing and employment. 

OWL has maintained a strong partnership with the KY Office of Vocational Rehabilitation since 

1961. This relationship has led to the employment or related services being provided to over 

23, 000 individuals in central Kentucky. Through OWL's services and programs in FY18, over 74 

participants gained full-time employment while more than 60% of them had some type of 

opioid or other substance abuse history. We fully adhere to WIOA mandates for youth and 

adults with barriers that are mandated for Community Rehabilitation Programs. 

Page 2 of 3 
39 

nshattuck on FSR297 with DISTILLER


Paul came to OWL as a result of an on-going opioid addiction that cost him his home and family 

as well as jail time. Fortunately, a Drug Court diversion program opened their doors to him 

rather than long-term incarceration. Today, he is reunited with his family, whom he can now 

adequately support, and has home ownership. 

James came to OWL after he had served over 24 years in our state and federal judicial systems. 

Thanks to OWL's partnership with community housing agencies, James was able to begin his 

pathway to a new life. Today, he has been employed at OWL for over five years, has full 

employee benefits, and lives independently. 

Paul and James are just two examples of individuals who have struggled because of the impact 

the opioid addiction had on their lives. Sadly, they are not alone; there is an overwhelming 

need for housing and employment services for others trying to escape the opioid crisis in their 

life. Funding must be accessible for research based programs like OWL and others represented 

here today that have a proven track record of employment training, job placement and 

housing. Programs that can easily be replicated and expanded upon in our individual 

communities must be provided oversight and guidance to establish consistency and 

collaboration to maximize resources and human capitol. 

We applaud the work being done by this committee and the leadership Congressman Barr is 

providing in Congress and Kentucky through Bills he has sponsored. The battle against the 

housing and opioid crisis is not just a Kentucky epidemic but a national pandemic that has no 

borders. Thank you again for this opportunity to share with you the mission of OWL and our 

efforts to join with you in conquering this crisis. 

Page 3 of3 
40 

nshattuck on FSR297 with DISTILLER


Testimony for the Subcommittee on Housing an Insurance Hearing Entitled: 

"The Role of Federal Housing and Community Development Programs to Support Opioid and 

Substance Use Disorder Treatment and Recovery" 

August 16, 2018, 9-11am 

US District court of Eastern District of Kentucky 

101 Barr Street 

Lexington, KY 40507 

Ernie Fletcher, MD 

Former Governor, Commonwealth of Kentucky 

Chair, Fletcher Group, a not for profit corporation 

Good morning, Chairman Duffy and Ranking Member Cleaver. Let me welcome you to Kentucky and 

thank Congressman Barr for bringing this important hearing to the 6'h District. 

In America, every 8.5 minutes someone dies from a drug overdose with about 8o% due to opioids. 

Every 6.5 minutes someone dies from alcohol abuse. Every 12 minutes some dies of suicide·- many 

associated with substance use disorder (SUD). This is a public health emergency of the most 

challenging nature. In a conversation with NIDA Director, Dr. Nora Volkow, she reported an increase 

in methamphetamine use in areas where efforts have reduced opioid abuse, which points to the fact 

that most who abuse drugs do not use just one drug, they are likely to use two or more, as well as 

alcohol. 

One way of addressing this crisis is through programs like Recovery Kentucky that include transitional 

housing along with peer support based upon the 12-step model. We now have 18 centers in Kentucky 

with over 2100 recovery beds. Our outcomes are very good-at one year, 84% of individuals have not 

relapsed. I refer you to our outcomes at a glance attached to this testimony for a complete summary. 

Overall, Recovery Kentucky clients make significant strides in all targeted areas and have much more 

support for their recovery after participation. In addition, the Recovery Kentucky Program saves 

taxpayer dollars and adds value via workforce development as over 75% of graduates become 

gainfully employed. 

The recovery programs have been named "A Model That Works" by the U.S. Department of Health 

and Human Services and the Louisville Courier-Journal called the Recovery Kentucky Centers a 

"bright spot" for dealing with prescription-drug abuse. 

We are pleased with the outcomes but recognize that up to 30% drop out of this voluntary program 

and leave before entering the program. Those individuals may be better suited for medication 

assisted treatment or MAT. MAT is evidenced based, but it too does not work for everyone and it is 

primarily focused on opioid use disorder. 

One size does not fit all and a holistic approach that combines the recovery model and MAT may 

provide the best approach to meet individual needs. For that reason, as my organization seeks to 

expand this model to other states, we are partnering with MAT providers to offer program 

alternatives and provide effective intervention for a larger number of people. Congress has 

allocated nearly $6 billion for MAT based grants and research. Some of this may be directed toward 

residential recovery program efforts if they combine MAT, but most will not. 
41 

nshattuck on FSR297 with DISTILLER


Our program depends upon funding thru HUD and is consistent with the HUD Recovery Housing 

Policy Brief that defines Recovery Housing in an abstinence-focused and peer-supported community. 

Facility funding depends upon Low Income Housing Tax Credits and money from Federal Home Loan 

programs. Operational funding combines Section 8 vouchers, SNAP, Community Development Block 

Grants and per diems paid for by state Department of Corrections along with local fundraising. 

Nearly 70% of our residents are from Corrections-parole, probation or diversion from drug courts. 

For Corrections, it is a prudent use of tax dollars with a great ROI. Why? Because in large part we 

stop the cycle of poverty and criminal activity often associated with drug seeking behavior, as well as 

responding to the chronic health conditions represented by drug and alcohol addiction. Our 

recidivism rate is low because lives are transformed by engendering meaning and purpose and 

teaching skills necessary for self-sufficiency. 

This type of transformation is only possible when housing is incorporated in the program that 

extends beyond 28 days as often found in residential treatment programs. The controlled 

environment found in the Recovery Kentucky programs provides the discipline, training and support 

that overwhelmingly stops the cycle of poverty, homelessness and criminal activity by addressing 

root causes. With low rates of relapse, we reduce the risk of overdose as well--an important goal of 

your efforts. 

Given this backdrop, I want to thank Congressman Barr and each of you here today for the work you 

are doing to combat the opioid crisis. 

As part of the Fletcher Group we have established the Don Ball Foundation for Recovery Hope and 

are working to take our Recovery Model nationally in honor of Don, a local businessman and 

philanthropist who is responsible for founding Recovery Kentucky. 

We are establishing a Technical Assistance Center that will provide consultation, training and support 

to states for the establishment of similar programs, expanding capacity and building on best 

practices that enhance recovery efforts such as access to education, job training and skills 

development, and participation in program sponsored businesses. 

We currently utilize creative funding streams from HUD, USDA and the Department of Corrections. 

But as we take this model nationally, we face a challenge that section 8 housing is limited and 

competitive and when we apply for this type of housing there are those, well intended, who see this 

as taking from the allocation to help others who have real and valid housing needs. We believe that 

pitting those needs against the needs of those who have been held captive from addiction is not the 

best public policy. 

Congressman Barr's bill, the THRIVE Act, helps solve this problem by providing project-based 

vouchers, which will help foster residential recovery programs important to address the opioid crisis. 

Setting aside project vouchers in this way will make it easier to provide more effective recovery 

programs. Unfortunately, there are, as in every industry, those who run programs that are little 

more than scams. Thankfully, this legislation has stipulations to ensure the programs funded are 

effective and well run, like Recovery Kentucky and other well-run programs across the nation. 

Another of our funding sources is CDBG grants. These funds are always at risk and I would 

recommend that you look at making funds available for proven and effective residential recovery 

programs as well as traditional MAT. 
42 

nshattuck on FSR297 with DISTILLER


I also want to thank Congressman Guthrie and Green for their legislation, The Comprehensive Opioid 

Recovery Centers Act of 2018 which would award grants on a competitive basis to eligible entities to 

establish or operate Comprehensive Opioid Recovery Centers. I am hopeful those who want to establish 

recovery centers based upon the Recovery Kentucky model will be eligible. 

In summary to provide the best continuum of care to address this crisis, the Don Ball Foundation for 

Recovery Hope recommends: 

Passage of the THRIVE Act 

Recommend taking some of the already identified opioid budgeted funds to add additional 

funding for more of these project-based vouchers because of the pressing need and 

effectiveness of residential programs 

More allocation of the Opioid appropriations be directed toward proven recovery efforts in 

addition to MAT 

Provide funding that would offset cuts for CDBG grants recognizing that substance abuse 

treatment is an important part of community development 

• Lastly, I recommend that the CDC activate the Emergency Operations Center to help 

coordinate and oversee this fight. It is at the heart of CDC's purpose and it is the right agency 

to coordinate the epidemiological effort against this public health crisis 

Again, thank you for your work and coming to Kentucky. I will be glad to answer any questions. 
43 

nshattuck on FSR297 with DISTILLER

44 

nshattuck on FSR297 with DISTILLER


INTRODUCTION 

Recovery Kentucky was created to help Kentuckians recover from substance abuse, which often leads 

to chronic homelessness. There are 17 Recovery Kentucky centers across the Commonwealth, providing 

housing and recovery services for up to 2,100 persons simultaneously. Recovery Kentucky is a joint effort 

by the Kentucky Department for Local Government (DLG), the Department of Corrections, and Kentucky 

Housing Corporation. Local governments and communities at each Recovery Kentucky center location have 

also contributed greatly to making these centers a reality1 The overall program is composed of 4 main 

components through which clients advance: 

The Behavioral Health Outcome Studies team at the University of Kentucky Center on Drug and Alcohol 

Research (UK CDAR) independently conducts the Recovery Center Outcome Study (RCOS) which is an annual 

outcome evaluation that includes 15 of the Recovery Kentucky centers who participated in RCOS this fiscal 

Recovery center staff conduct an intake interview when clients enter Phase I after completing SOS and 

1 and 2 to assess behaviors and problems clients had prior to entering the recovery center. Follow-up 

interviews are then conducted over the telephone by an interviewer at UK CDAR with eligible, consenting 

RCOS clients 12 months after Phase 1 entry. A random sample of eligible clients, stratified by target month 

(based on the intake month), gender, and Department of Corrections (DOC) referral into the program, was 

selected. Client responses are kept confidential to help facilitate the honest evaluation of client outcomes 

and program services. 

This Findings at a Glance report summarizes outcomes for 300 men and women who participated in a 

Recovery Kentucky program, completed a Phase 1 intake interview between July 2015 and June 2016 and a 

follow-up interview between July 2016 and June 2017.' At intake, most clients included in this report were 

White (92%), not currently married (89%), predominately female (57%) and, on average, 34 years old. 

ror more inform.o;t!On <:bout Recovery Kentucky, contact KGCs Mike Town~prcJ toll-free in Ken~ucky at 300·635· 8896 or 502-564-7610, extenswn 715: TT':'711; 

til ema•~ t-1Townsfnd(t;;kyhmsng.org 

tn the .~ecovery Center Outcome Study between July 2015 and June 2016 and 
45 

nshattuck on FSR297 with DISTILLER


FACTORS EXAMINED AT INTAKE AND FOLLOW-UP 

PAST-6-MONTH SUBSTANCE USE3 

ANY ILLEGAL DRUG USE ANY ALCOHOL USE 

83% ••••• ofclients 

···~\· 

= 

= 

OPIOID USE4 

' reported heroin 

use at follow-up 

HOW MUCH HAS OPIOID AND HEROIN USE CHANGED OVER TIME? 

63% 

19% 

65% 

.... _ 

16% 

47% 49% 

13% METHADONE 13% 

FY 2010 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 

drug use,cl!ents who were incarcerated the entire period measured at 

• Hisuse of opioids other than heroin, including prescnptmn opiates, methadone,and lluprenorphine"naloxone. 

'On average, there were 1,200 intake surveys submitted each fiscal year_ 
46 

nshattuck on FSR297 with DISTILLER


PAST-6-MONTH MENTAL HEALTH AND STRESS 

88% , at Intake 

Clients meeting 11101 

study criteria for L.......-.J... /0 

DEPRESSION at follow-up 

74% 

at intake 

C!ients meeting 

study criteria for 

ANXIETY 

9% 

atfo!tow-up 

59% 

at intake 

Clients reporting L 201

anyuseof /( 0 

SUBSTANCES' atfollow-up 

to manage stress 

PAST-6-MONTH ECONOMIC INDICATORS -------------

48% 

at intake 

EMPLOYED AT L 

LEAST 1 MONTH 

EMPLOYMENT TRENDS CENDER 

in employment between men and women in the RCOS >ample 

Follow-up 

89% 

Intake 

60% 60% 

55% 

38% 38% 37% 37% 

FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 FY 2011 FY 2012 FY 2013 FY 2014 FY 2015 FY 2016 

--Men Women 

38% 

at intake 

CURRENTLY L_+ 2% 

HOMELESS 

at follow-up 

' lntludes atcohot, prescription drugs, .and illegal drugs. 

50% 

at intake 

Clients reporting L 180/ 

drfficulty + /0 

MEETING BASIC 

LIVING NEEDS at follow-up 

29% 

at intake 

Clients reporting L 50/ 

drfficulty /0 

MEETING HEALTH 

CARE NEEDS at follow-up 
47 

nshattuck on FSR297 with DISTILLER


TRENDS IN HOMELESSNESS 

In the past four fiscal years, the number of people reporting homelessness at intake has increased 

slightly and the number of people reporting homeless at fotlow·up has decreased. 

38% 38% 

11% 

FY 2013 FY 2014 fY 2015 FY 2016 

-Intake -Follow-Up 

PAST-6-MONTH CRIMINAL JUSTICE INVOLVEMENT---------

56% 

at intake 

. . L .. 3% Clients reportmg ANY ARREST at follow-up 

76% 

13% Clients reporting 

INCARCERATION atfollow-up 

TRENDS IN ARRESTS 

ho•nr"N"'''~ changed 

me and I'm now a peer 

mentor. I know about this 

disease better and I have 

the tools to stay sober. 

-RCOS FOLLOW-UP CLIENT 

4 years, over half of RCOS clients reported being arrested at least once in the past 6 

clients reported an arrest in the past 6 months. 

54% 56% 

FY 2013 FY 2014 FY 2015 FY 2016 

-Intake -Follow-Up 
48 

nshattuck on FSR297 with DISTILLER


RECOVERY SUPPORTS 

in 

at 1 

average number 

support at intake support at intake 

RETURN ON INVESTMENT IN RECOVERY CENTER SERVICES 

CONCLUSION 

Estimates of the cost per drug user and alcohol user were applied to the sample 

to examine the total costs of drug and alcohol abuse to society in relation to 

expenditures on the Recovery Kentucky program. The cost savings analysis suggests 

that for every dollar invested in recovery services there was an estimated $2.60 

return in avoided costs (i.e., costs to society that would have been expected given 

the costs associated with drug and alcohol use). 

Overall, Recovery Kentucky program clients made significant strides 

in all of the targeted areas and have much more support for their 

recovery after participating in program services.' In addition, the 

Recovery Kentucky Program saved taxpayer dollars through avoided 

costs to society or costs that would have been expected based on the 

rates of drug and alcohol use. 

truly, honestly cared 

me and want me 

to have a fruitful and 

productive future." 

-RCOS FOLLOW-UP CLIENT 

includes on!y clients who advanced to Phase 1 after completing the SOS and Motivational Tracks and 

months after entering Phase I. 
49 

nshattuck on FSR297 with DISTILLER


Testimony of Edwin King 

for the 

House Subcommittee on Housing and Insurance 

August 16, 2018- Field Hearing in lexington, KY 

Chairman Duffy, Members of the Subcommittee: 

I am Edwin King, executive director of Kentucky Housing Corporation (KHC), the Commonwealth's 

housing finance agency. On behalf of KHC's Board of Directors and staff, thank you for conducting this 

field hearing in lexington and affording me the opportunity to provide testimony. I want to thank 

Congressman Barr publicly for bringing attention to the problem of opioid addiction in the Sixth District 

and for working to implement common-sense solutions. The passage of his bill, the Transitional Housing 

for Recovery in Viable Environments (THRIVE) Act, demonstrates his commitment to housing solutions 

for those on the road to recovery. It is my pleasure to share information about Kentucky's 

accomplishments in leveraging housing resources to help our citizens on the path of recovery from 

substance use disorder. 

We all understand that opioid addiction is a major public health issue with significant personal and 

societal consequences. We have found that there are many effective recovery strategies, depending on 

the personal circumstances of those caught in the grip of addiction. Stable housing is a basic human 

need and one of the primary social indicators of public health. Access to stable housing is one common 

factor that is essential for all of these strategies to produce positive results. 

One of the most successful recovery strategies we have seen in Kentucky is the Recovery Kentucky 

model. In 2004, the late Don Ball took the helm as chair of the KHC Board of Directors. Mr. Ball brought 

with him a personal commitment, a strong will, and a solid plan to establish a network of recovery 

centers across Kentucky. Because of Mr. Ball's vision, Kentucky now has 14 recovery centers that have 

helped thousands of our residents start a new life of recovery from addictive substances. These 14 

centers are in addition to the four prototype recovery centers (two in louisville, The Healing Place for 

men and The Healing Place for Women, and two in lexington, The Hope Center for men and The Hope 

Center for women). Today, these 18 recovery programs serve over 2,000 men and women daily. 

The Recovery Kentucky Centers follow a peer-to-peer education and self-help model that uses mutual 

self-help, a "social model" approach, to provide sustained addiction recovery services. The centers are 

not licensed medical facilities and, thus, do not qualify for Medicaid reimbursement. All residents have 

Medicaid or private health insurance. Therefore, physical or mental health needs can be provided 

through licensed service providers in their local community. The recovery centers provide a highly 

structured program for residents. Peer Mentors model behaviors and spiritual principles that focus on 

providing life skills to residents by following the spiritual principles of the 12 steps of Alcoholics 

Anonymous. 

Information from the University of Kentucky Center for Drug and Alcohol Research points to the 

significant success of the Recovery Kentucky model: 

83% of all residents in the recovery programs used illegal drugs 6 months before entering a 

recovery center. Follow-up surveys of former residents showed that only 5 % had used illegal 

drugs within six months of having left a recovery center. 
50 

nshattuck on FSR297 with DISTILLER


Six months prior to entering a recovery center, 63% of residents reported opioid misuse. At 

follow-up one year later, only 2% reported opioid misuse since leaving the recovery center. 

38% of residents were homeless at intake; 2% were homeless at follow-up. 

• 56% had been arrested and 76% had been incarcerated six months before entering a recovery 

center. At follow-up, 3% had been arrested and 13% had been incarcerated. 

Cost savings analysis suggests that for every dollar invested in recovery services there has been 

an estimated $2.60 return in avoided costs. 

Overall, Recovery Kentucky program clients made significant strides in all the targeted areas and have 

much more support for their recovery after participating in the program. The program saves taxpayer 

dollars through avoided costs based on the rates of drug and alcohol use. 

Recovery Kentucky- and the tremendous impact this program has had on so many plagued by the 

scourge of drug addiction- would not have been possible without the housing program dollars 

appropriated by Congress. The Recovery Centers rely on a complex array of federal funds for 

construction and operation, including the following: 

Low Income Housing Tax Credits 

• HOME Investment Partnerships Program 

Community Development Block Grant (CDBG) Funding 

Section 8 Housing Choice Voucher Program 

Supplemental Nutrition Assistance Program (formerly Food Stamps) 

Other important sources of funding come from the Kentucky Affordable Housing Trust Fund and 

Department of Corrections, as well as the Federal Home loan Bank. 

It has become increasingly difficult to develop more Recovery Centers for two primary reasons: 

There is less funding in key federal programs. 

o HOME Program funds have contributed to constructing the Recovery Centers. The SO% 

reduction in HOME funds since the Recovery Kentucky initiative began has sharply 

limited the ability of developers to pull construction financing together to build more 

centers. 

o CDBG funding has been critical for the ongoing operation of the facilities. 

o The Section 8 Housing Choice Voucher program provides rental assistance that supports 

residential facility maintenance and operating costs. KHC currently has a three-year 

waiting list for our Housing Choice Voucher program. Additional funding would help 

meet the need for people in recovery in addition to the low-income residents of rural 

Kentucky who also receive assistance from these vouchers. 

These federal programs have stringent regulations that impede the effective use of the dollars. 

o KHC has experienced significant challenges recruiting landlords to participate in the 

Section 8 Housing Choice Voucher, tenant-based program, with many citing 

programmatic red tape as an obstacle. Additionally, federal statutes restrict the amount 

of tenant-based rental assistance that may be used for a specific property (pursuant to 

the project-based rental assistance option) to 20% of a public housing authority's 

Housing Choice Vouchers. While some urban public housing authorities have been 

permitted to exceed this limit under a demonstration program, many authorities, 
51 

nshattuck on FSR297 with DISTILLER


including KHC, are at or near the 20% limitation. One useful reform would be to raise 

the 20% cap and allow public housing authorities, like KHC, to use these vouchers to 

meet our specific needs at the local level to connect people to housing with services. 

This is an extremely important source of funding for developing supportive housing for 

individuals completing recovery and acute treatment programs to keep them on the 

path toward employment, self-sufficiency, and family reunification. I sit on the Board of 

Directors of the National Council of State Housing Agencies, and after speaking with my 

counterparts in other states, I can tell you that this policy change would be welcomed 

on a bipartisan basis across the country. 

o Many other states have expressed interest in replicating the Recovery Kentucky model 

because of its demonstrated effectiveness. However, many of these states report that 

they have not been able to access resources like CDBG for a Recovery Kentucky Model. 

The operations of almost all of the Recovery Kentucky centers are subsidized by CDBG 

funds. It would be helpful to have a dedicated source of funding for recovery centers 

outside of the CDBG funding, so that CDBG funds can be freed up for infrastructure and 

other community needs, while recovery centers receive their own dedicated source of 

funding. 

I will conclude my remarks with these key statements: 

• Recovery Kentucky is a housing-based model that has produced remarkable outcomes and has 

proven to be highly cost effective. 

Housing is a key component of successful recovery programs and is essential for long-term 

recovery. 

Greater flexibility with federal housing program regulations will provide states more control of 

the resources needed to achieve the goals of the President's Commission on Combating Drug 

Addiction and the Opioid Crisis. 

Thank you for taking on this difficult, but important, work to help ensure access to effective recovery 

programs. KHC led the way more than a decade ago and remains a dedicated partner to this effort. 
52 

nshattuck on FSR297 with DISTILLER


TESTIMONY OF LISA MINTON, EXECUTIVE DIRECTOR 

CHRYSALIS HOUSE, INC. 

FOR THE 

HOUSING AND INSURANCE SUBCOMMITTEE FIELD HEARING 

"THE ROLE OF FEDERAL HOUSING AND COMMUNITY DEVELOPMENT 

PROGRAMS TO SUPPORT OPIOID AND SUBSTANCE USE DISORDER 

TREATMENT AND RECOVERY" 

AUGUST 16,2018 

COURTROOM A, U.S. DISTRICT COURT OF EASTERN DISTRICT 

101 BARR ST. LEXINGTON, KENTUCKY 

Good morning Congressman Barr, Congressman Guthrie, Chairman Duffy, Ranking 

Member Cleaver, and other interested parties. 

I am Lisa Minton, Executive Director of Chrysalis House, a 501(c)(3) nonprofit agency 

located in Lexington, Kentucky. Chrysalis House was established in 1978. We have 

been saving lives for 40 years. We are Kentucky's oldest and largest licensed 

treatment program for women with substance use disorders. 

The Chrysalis is the protected stage just before the beautiful butterfly emerges. That is 

what we want for the 200 women and children we serve each year. 

Our mission to support women and their families in recovery from alcohol and other 

drugs led to our family-centered approach to treatment. We serve women from across 

the state. 

As reported in the Herald Leader on Sunday, the CDC report released on Friday cited, 

"Kentucky had one of the highest rates in the nation of pregnant women using 

opioids ... another example of the state's struggle with abuse of painkilling drugs." 

We prioritize pregnant and parenting women on our waitlist, which has a daily census of 

approximately 120 women. We are one of the few programs that allow babies to 

accompany their mothers to treatment. We believe the opportunity for our clients to be 

with their babies and young children is a powerful incentive to recovery. 
53 

nshattuck on FSR297 with DISTILLER


A brief snapshot of the women we are currently serving: 

average age is 26-30; 

41% are pregnant; 

61% report their primary substance of abuse is heroin or other opioid; 

85% have had one or more prior treatment episodes; 

98% are unemployed; and, 

60% meet the homeless criteria for transitional housing. 

This population needs additional recovery supports. Housing and employment are 

imperative to long-term sobriety. 

We received our first Department of Housing and Urban Development (HUD) 

Supportive Housing Program-Transitional Housing grant in 1990 and had received HUD 

Permanent Housing grants for over 20 years. 

In 2016, our Transitional Housing renewal $200,000 grant application for our Family 

Program and Serenity Place Apartments was not selected by our Continuum of Care 

(CoG). The funding ended June 30, 2017. 

This came as a surprise because a few months earlier in March 2016, our Family 

Program and Permanent Housing Bonus Program data tables were accepted for use in 

the Annual Homeless Assessment Report (AHAR). The AHAR is a report to the U.S. 

Congress on the extent and nature of homelessness in America. The report is prepared 

by HUD and provides nationwide estimates of homelessness. To my knowledge, the 

Lexington CoG had never had any data tables accepted for use in the AHAR until then. 

Our two permanent housing applications were selected for funding: $93,000 for 

scattered site apartments, and $60,000 for permanent housing bonus apartments. 

In 2017, we lost both of those grants as well. 

We have gone from about $360,000 a year in HUD funding to support homeless 

families with histories of substance abuse to 0. 

The loss of funding was due to a shift in HUD's funding priorities (FY17 NOFA): 

*CoGs should use the reallocation process to create new projects that improve their 

overall performance and better respond to their needs. 

Our CoC has done this; choosing new projects over existing projects. 

2 
54 

nshattuck on FSR297 with DISTILLER


*CoGs should use a Coordinated Entry process which measures average length of 

homeless episodes and rates of return to homelessness, prioritizing chronic 

homelessness. Each agency receiving HUD funding through the CoC must utilize a 

Coordinated Entry process which prioritizes chronic homelessness. 

Having been in residential treatment, the women we serve would not meet that 

definition. We phased families from residential/transitional housing into permanent 

housing funded by HUD. HUD's policies prioritize the chronically homeless who could 

be actively using over those seeking a supportive community dedicated to their sobriety, 

income, and family reunification. 

*CoGs should use a Housing First approach which does not have a service participation 

requirement or preconditions. 

This policy is strictly looking at if people stay in housing. For women, particularly those 

with children, housing represents more than just shelter; it is safety, a crucial support for 

recovery. They need supportive services. Transitional Housing is a place to learn the 

skills necessary to manage a disease, a job, transportation, childcare, etc. prior to 

managing a household. 

We did meet the HUD's old definition for transitional housing: having a lack of financial 

resources and support, efforts have been made to obtain housing, without assistance 

they would be living on the street or in a shelter or they have been discharged from an 

institution having lived there for a long time and no resources, no support, and no 

subsequent residence. All conditions that mitigate against sobriety. 

Policymakers are seeing a link between homelessness and substance use disorders. 

But the policy at HUD ignores that link and actually enables non-sober housing. 

Senate Majority Leader Mitch McConnell recognizes the needs for long-term success 

and we are grateful for his continued support and leadership. We are encouraged by the 

CAREER Act and the opportunity it provides for the women and families we serve as 

they work to rebuild their lives. 

Additionally, we look forward to the passage of Congressman Andy Barr's THRIVE Act. 

The Bill will create a demonstration program that allocates a limited number of Section 8 

Housing Vouchers to transitional housing nonprofits. 10,000 vouchers will be set aside, 

allowing nonprofits to directly report to HUD. 

The Thrive Act will show how crucial supportive services are to support those seeking 

sobriety break the cycle of addiction, poverty, and homelessness. It is an important 

means to re-connect the link between addiction and homelessness in HUD policy. 

Thank you for inviting me to share with you today. I am happy to take questions. 

3 
55 

nshattuck on FSR297 with DISTILLER


ADDICTION 

RECOVERY 

CARE 

NARRATIVE OF TESTIMONY BY TIM ROBINSON, 

CEO OF ADDICTION RECOVERY CARE 

FOR THE 

SUBCOMMITTEE ON HOUSING AND INSURANCE 

AUGUST 16,2018 IN FRANKFORT, KENTUCKY 

Good morning. My name is Tim Robinson, CEO of Addiction Recovery Care. 

More people died from overdoses than car accidents last year making addiction a national public 

health crisis that is taking too many lives and threatening our economic security as employers 

struggle to find and retain employees. Last year our Kentucky Chamber of Commerce CEO wrote 

an Op Editorial that called addiction the number one economic concern in our state. 

Everyone is looking for a silver bullet to address the addiction crisis. There isn't a silver bullet. 

Addiction recovery requires a whole-person approach which starts with intervening with treatment, 

investing in someone's economic future by providing access to transitional housing, vocational 

rehabilitation, workforce development, and inspiring them from day one that there is hope to go 

from crisis to a career. 
56 

nshattuck on FSR297 with DISTILLER


I am thankful for the opportunity to speak to you because recovery is personal to me. I started 

drinking in my first year of law school at the University of Kentucky to cope with my mom passing 

away during finals. For the next eight years, I almost drank myself to death. Eleven years ago, 

while I was a prosecuting attorney in Lawrence County, Kentucky, a court bailiff who was a 

recovering alcoholic and pastor, led me to a spiritual awakening at my desk. He became my 

sponsor and my pastor. Addiction recovery is personal to me because I am a survivor. 

Two years later in 2008, I resigned as prosecutor and in 2010 opened a residential center for 

women in rural Eastern Kentucky. Today we have 350 residential clients and 500 outpatient 

clients in centers across 12 counties in Kentucky. Our experience has taught us that addiction is 

a disease that devastates all aspects of a person's life impacting someone's mind, body, spirit, 

and purpose. We have been determined to treat addiction medically, clinically, spiritually, and 

vocationally. 

Our centers are led by an addictionologist and are nationally accredited. We have developed a 

spirituality program that inspires hope and offers redemption. Much like hospice centers, we 

employ chaplains who work alongside of our clinical staff. Though we consider the spiritual aspect 

of our centers to be the heart of our success - our spirituality program does not replace medical 

and evidence-based clinical practices - it is an addition to them and makes our care more 

comprehensive. 

Treating the whole person has led to great success. One of our payors recently reported to us 

that our centers reduced their members' healthcare costs by 33% during the 6 months after 

program completion. 
57 

nshattuck on FSR297 with DISTILLER


We created an internship with a promise that everyone who completes the program would be 

guaranteed a job. Today. 190 of our three hundred and eighty (380) employees are in recovery 

and 130 are graduates of our programs. 

We are a state-certified, Peer Support Specialist (PSS) training program. A Peer Support 

Specialist is a Medicaid-billable professional who has one year of sobriety and completes a 

certification program. 

We partnered with workforce board, Eastern Kentucky CEP. and with Sullivan University to 

expand our internship into a 6-month career academy. Our graduates earn state certification and 

college credit. In just one year. a person in addiction can go from an IV heroin user to supporting 

themselves. literally going from crisis to career. 

To date, 41 of our 46 or 85% of our academy graduates are clean and sober, working full time. 

paying taxes and transitioning off public assistance. Some of the graduates have even been 

promoted to management. and others are continuing their education for careers such as 

counseling. 

Prior to the Academy, 40% of our clients chose to continue treatment beyond detox and residential 

care. After starting the Academy, 70% of our clients now choose to continue treatment doubling 

treatment motivation. 

Vocational education that leads to a meaningful career that provides the dignity of work gives 

those reentering the workforce the confidence necessary to establish career goals and plan for 

their future. Because of this success we are adding other programs such as an auto mechanics 

academy. 
58 

nshattuck on FSR297 with DISTILLER


Kentucky is leading the way in access to treatment because of the national leader on this issue, 

Congressman Hal Rogers and the efforts of our Governor Matt Bevin. The two biggest challenges 

preventing us from taking more people from crisis to a career is a lack of funding for workforce 

development and transitional housing. That's why I am so excited about Congressman Andy 

Barr's bill, the T.H.R.I.V.E. Act and Senate Majority Leader Mitch McConnell's CAR.E.E.R. Act. 

These two historic pieces of legislation have the potential to transform the national effort to combat 

the drug epidemic. 

The hope of America is not merely surviving. The hope of America is an opportunity to flourish. 

That is what our brothers and sisters in addiction need; an opportunity. An opportunity for 

treatment, transitional housing, and workforce development that leads to a meaningful career 

path, and when the opportunity is given ... ! have seen us not just survive, but thrive. Our current 

human capital and labor shortage can be solved at the same time we combat the drug epidemic 

as we take those struggling with addiction from crisis to career. 
59 

nshattuck on FSR297 with DISTILLER


HOUSE FINANCIAL SERVICES COMMITTEE 

HOUSING AND INSURANCE SUBCOMMITTEE 

TESTIMONY OF JEROD M. THOMAS, CEO 

SHEPHERD'S HOUSE, INC. 

LONG-TERM TRANSITIONAL RECOVERY RESIDENCE FOR MEN 

"The Role of Federal Housing and Community Development Programs 

To Support Opioid and Substance Use Disorder Treatment and Recovery" 

AUGUST 16, 2018 

LADIES AND GENTLEMEN OF THE HOUSING AND INSURANCE SUBCOMMITTEE, 

CONGRESSMAN BARR, CHAIRMAN DUFFY, AND ESTEEMED GUESTS: 

There's a saying in recovery that "The Only Thing that Has to Change is Everything." 

At the Shepherd's House, we're in the business of helping drug addicts and alcoholics 

change everything about their lives, over the course of 18-24 months. We are a wholeperson, holistic model. Our treatment is multi-dimensional because life is multidimensional. The only life that is one-dimensional is that of the man in active addiction 

whose only need is to feed his heroin or alcohol addiction. That lifestyle must be unlearned. 

Our primary focus is the business of recovering from drug and alcohol addiction. But 

we know, after nearly 30 years of providing long-term transitional recovery residences in 

Central Kentucky, that long-term sustained sobriety is heavily reliant upon living in a 

safe, drug-free home, and learning daily living skills. It's a result of learning how to live 

and how to make choices -- on a daily basis in a way that doesn't cause harm to us or 

to others, but instead promotes and uplifts others, and as a result, ourselves. We learn 

self-support by supporting others. 

These facilities are not sober living houses where there is only a roof overhead, but no 

actual treatment. They are Transitional Housing for Recovery and provide recovery care 

and treatment 24 hours a day, 7 days a week. What our facilities offer is rare. But as 

you will hear today, they are proven methods of treatment with quantifiable data 

supporting their efficacy. 

THE SIGNIFICANCE OF SECTION 8 VOUCHERS 

FOR SAFE TRANSITIONAL HOUSING 

While the Shepherd's House doesn't currently use Section 8 vouchers, we do 

administer Federal Home Loan Bank funds and Kentucky Housing Corporation funds 

which require income and special needs verifications which are quite similar to the 

Section 8 rental assistance voucher program in the THRIVE Act. The Shepherd's House 

and other similar models have essentially adopted the tenets of Section 8 housing, but 

with additional restrictions. Under our transitional housing models clients pay a portion 

of their income as rent, and the rest is subsidized by the non-profit support the 
60 

nshattuck on FSR297 with DISTILLER


Shepherd's House receives. Like Section 8, you are required to remain drug and 

alcohol free and commit no crimes. But unlike section 8, you are residing in a 24-hour a 

day 17 -day a week therapeutic community where you are accountable for your lifestyle, 

your choices, and your self-care. The additional requirements for employment, 

workforce training, counseling, therapy, recovery, home management and maintenance, 

etc., are MANDATORY for continued residence. 

The significance of the THRIVE Act funding is that THRIVE-modeled facilities will be 

able to expand their client bases and offer more services to more individuals. There will 

be a significant reduction of the housing costs burden on the facilities and these funds 

will be freed up for more services and expanded facilities. Since most of the clients 

served are either income-eligible for Section 8 or qualify as "homeless," the resources 

are not misappropriated and will serve the double duty of providing housing and 

subsidizing treatment. It is a smart and efficient use of funds. 

With regard to life skills, many clients come to recovery from diverse backgrounds 

where self-care and daily living skills weren't emphasized. Perhaps our family of origin 

was not a family that created a budget, paid bills on time, developed good parenting 

skills, or learned how to resolve conflicts in a healthy way. The Shepherd's House, and 

the model outlined in the THRIVE ACT gives addicts and alcoholics a second chance at 

learning healthy living tools. Our clients learn skills that teach them how to live within 

the rules, within the laws, in society and in sobriety. These are the collateral supports of 

sustained recovery. 

In addition to our primary goal of learning to live sober, the Thrive and Career Acts 

support a complete recovery program. Some of the trainings under the Shepherd's 

House include: 

i. Education: Completing a GED; applying for technical schools or trade and 

vocational schools; attending or finishing undergraduate degrees; helping clients 

find opportunities for financial assistance and teaching them how to apply for it. 

2. Writing resumes and learning interviewing skills; 

3. Understanding how to be a good employee, including accountability and 

consequences when there is under-performance, or a job is lost; 

4. Creating a personal budget, sticking to it, and paying bills in a timely manner; 

5. Appreciating the personal, legal, and moral obligations of paying child support 

and becoming current on all outstanding child support obligations, and paying all 

court costs and fines before graduating from the program; 

6. Understanding the impact of drugs and alcohol on one's family and learning how 

to repair those relationships that can be supportive and healthy; 

7. Learning what healthy relationships look like through therapy and group work and 

removing oneself from toxic relationships and households; 

8. Learning healthy parenting skills and reunifying families; and 

9. Improving conflict management including how to resolve conflicts without 

emotional or physical harm. 

We know through experience and real-life examples that it is virtually impossible to 

sustain sobriety when daily living skills are lacking; when a person can't find or maintain 
61 

nshattuck on FSR297 with DISTILLER


employment; and where there is no safe housing. The challenges of daily living -- when 

the client has no skills to conquer these problems and when they are in a destructive 

living environment-- will inevitably lead back to active addiction. Independence 

acquired as a result of living in stable residences and maintaining stable employment is 

how the client will THRIVE. 

THE SIGNIFICANCE OF JOB TRAINING FOR THE RECOVERING PERSON 

The partnerships with employers which are fostered by the staff at the Shepherd's 

House and are supported in the CAREER Act allow our clients to work in safe and 

sober environments, foster mentoring relationships, and provide opportunities for 

advancement. 

The Commonwealth of Kentucky, with our skyrocketing addiction and unemployment 

rates, is the perfect slate for inclusion as one of the five states to be selected in the 

CAREER Act Pilot program. Facilities like ours have already generated statistics that 

the CAREER Act Pilot Program require, but in a non-funded setting. We can provide 

statistics for funded vs. non-funded programs through comparison of new data to our 

existing data. 

When the addict or alcoholic finally makes it to treatment, there is a universal 

brokenness. The hopes and dreams of yesterday have been crushed under the heavy 

shackles of addiction. Ambitions have been lost and the promise of a brighter future is 

as elusive as the freedom from addiction they are seeking. 

The THRIVE Act, and the facilities that follow that model, have the time and resources 

to nurture the clients back to life. Within their therapeutic community they learn, one 

day at a time, that good things will come to those who stay sober. They witness the 

metamorphosis of recovery in their peers as they live and grow together in a safe home. 

Often this is the first safe home the client has ever had. 

TIME is the recovering person's ally. We understand that a safe and nurturing living 

environment - for 18-24 months -- is critical if the recovering person is to set about 

cleaning up the wreckage of their past so that they can move forward with their head 

held high, meeting the new challenges a sober life presents. 

The THRIVE Program and the CAREER Act provide precisely the foundation for 

sustained recovery that we have seen succeed time and again at Shepherd's House. 

Our programs are abstinence based. Unfortunately, as advocates for abstinence-based 

recovery, we have watched millions and millions of dollars be distributed for medically 

assisted treatment within the state. Based upon our treatment model, we were and will 

remain ineligible for this funding. And yet we can boast success rates of our clients 

after graduating from long-term residential recovery residences that far exceeds those 

for individuals who only rely on one-dimensional treatment (in this instance, MAT) and 

are not provided with additional modalities like recovery programs, job training, 

employment assistance, or stable housing. 
62 

nshattuck on FSR297 with DISTILLER


We have also been ineligible for the millions of dollars that have been distributed to 

programs directed to mothers and pregnant women. In no way do we believe these 

funds for mothers programs are misappropriated. These programs are critical. But 

everyone deserves the chance to live sober. The massive distribution of funds excludes 

the type of programs THRIVE supports to non-mothers and others in abstinence-based 

treatment. There must also be adequate funding for those who have, quite frankly, 

fallen through the cracks. For the forgettables. For the men and women who want to 

learn to live sober, but who have no other options; who don't qualify for other 

government-funded programs. And so for those of us who know that a multi-faceted 

holistic model is a model of hope, we eagerly support these Acts. 

RECOMMENDATIONS FOR LIMITED EXPANSION OF SECTION 8 VOUCHERS 

PROGRAM FOR GRADUATES OF THRIVE-BASED TRANSITIONAL HOUSING 

PROGRAMS 

The THRIVE Act's Section 8 voucher program for transitional housing establishes rules 

for eligibility. The program excludes individuals with drug or alcohol addictions, or a 

history of criminal conduct from eligibility. As such, currently the recovering drug addict 

or alcoholic is not eligible for section 8 vouchers for safe and affordable housing after 

release from a transitional housing residence. The individual may be relegated to 

returning to destructive living environments. 

Attendant to the THRIVE Act, I recommend an expansion of the Section 8 eligibility be 

carved out specifically for those drug addicts and/or alcoholics (with or without criminal 

histories) who are graduates of a THRIVE-based program. The client would be deemed 

eligible for Section 8 housing for a defined period of time upon completion of a THRIVEbased program. For example, upon completion of an 18-24 month transitional housing 

program, the graduate is entitled to apply for Section 8 vouchers for safe and affordable 

housing for a period of 12-60 months. The goal would be for the client to transition from 

the voucher program within 1 to 5 years, when employment is achieved that provides 

adequate income for safe and affordable housing outside of the subsidy. 

The hope is that a person who graduates from a transitional housing program, who has 

remained sober; who has gotten his or her life back on track; who has maintained longterm employment who has learned how to pay bills and keep child support current, that 

because of this person's success, that they would be able to obtain safe and affordable 

housing where drugs and alcohol are not acceptable. This further supports their 

continued recovery and provides the accountability they have come to rely upon. It is 

yet another form of treatment through continued accountability 

IN CONCLUSION 

The THRIVE-based model, including existing facilities like the Shepherd's House, have 

proven results of long-term sobriety. But we are one small program in a sea of 

addiction. Replicating this Model will be a game-changer. It is sound and is the best 

and most successful tool not just for separating the addict from the drug; but for giving 

the addict an opportunity for a new life. There are simply not enough of them and so 

this funding is critical. The Programs will save lives. 
63 

nshattuck on FSR297 with DISTILLER


At some level, the Shepherd's House and similar models have been undertaking and 

accomplishing the goals of the CAREER and THRIVE acts since 1989. The difference 

is that we are facilities operating on a shoestring budget, without governmental support. 

We have struggled and scraped to put together the private funding to help these men 

change their lives. We have been blessed by our generous donors, many of whom are 

our graduates. But with the opioid epidemic and the addiction explosion in Kentucky. 

we can't keep up with the need. We're nowhere near meeting the needs of our addicted 

population. We have a six-month waiting list every single day of the year. 

As a result, too many families have buried their sons and daughters while they were 

waiting for a treatment bed or a spot at a transitional housing recovery residence that is 

safe and drug-free. A place where the addicted person could have not only survived but 

THRIVED. 

By the end of the day, nearly 5 more Kentuckians will have died of a drug overdose. 

The THRIVE programs and the CAREER Act Pilot Program will reduce those numbers. 

These programs are the infusion of hope that Kentuckians have been waiting for and 

praying for. 
64 

nshattuck on FSR297 with DISTILLER


Testimony of Sharon Walsh, Ph.D., Director, Center on Drug and Alcohol Research, 

Departments of Behavioral Science, Psychiatry, Pharmacology and Pharmaceutical Sciences, 

University Research Professor, College of Medicine, College of Pharmacy, University of 

Kentucky 

Chairman Duffy and distinguished members of the committee, thank you for the opportunity to 

appear today to discuss the role of federal housing and community development programs to 

support opioid and substance use disorder treatment and recovery. I want to thank Congressman 

Andy Barr from Kentucky's 6th Congressional District for inviting the conunittee to Lexington, 

Kentucky to discuss the nation's opioid crisis and how Kentucky leaders arc responding. 

My name is Sharon Walsh and I am the Director of the Center on Drug and Alcohol Research at 

the University of Kentucky. For the past 25 years, well before the present opioid epidemic took 

hold of the country, I have been engaged in conducting research and publishing the outcomes 

focused on opioid misuse, dependence, its medical complications and the development of novel 

pharmacotherapies for the treatment of those suffering from opioid use disorder. I have been 

fortunate to have had funding throughout my career from the National Institute on Drug Abuse 

along with other sources, including SAMHSA, the FDA, private foundations and pharmaceutical 

companies. I am here today representing the University of Kentucky. 

I want to begin by sharing with the committee some of the current initiatives and projects 

underway at the University of Kentucky and UKHealthcare to increase access to care and 

1 
65 

nshattuck on FSR297 with DISTILLER


accelerate the discovery of novel approaches to address the opioid crisis in the Commonwealth 

and nation. 

The emergency rooms at the University of Kentucky Hospitals are seeing approximately 1000 

non-fatal opioid overdose cases in a given year with approximately 50 fatal cases per year. This 

does not include the additional patients presenting with significant and life-threatening medical 

complications from injecting drug use behavior who present virtually every day. Nor does it 

include all of those individuals who never make it to the emergency room. Historically, our 

emergency department along with most others in the region would address the immediate 

concern, for example reversal of the overdose with naloxone, and return the patient to the street 

without attempting referral or linking these patients to care for their opioid addiction. 

With new support from SAMHSA through the CURES funds, the State of Kentucky and Cabinet 

for Health and Family Services, a new service has been developed at UK to address this critical 

gap in care. The First Bridge Clinic is a new initiative that allows the emergency department and 

the hospital to directly refer patients for treatment of their opioid use disorder. Here we are 

identifying those individuals at highest risk for fatal overdose and making a linkage to immediate 

care. Most patients can initiate evidence-based care, including medication-assisted treatment, 

within a day or two of referral and get onto the path of recovery; however, these patients often 

have many other psychosocial problems that are barriers to remaining in treatment and treatment 

success. For example, a criminal record is a barrier to employment, and unemployment is a 

barrier to housing. The First Bridge is offering wraparound services, such as counseling and 

2 
66 

nshattuck on FSR297 with DISTILLER


linkages to other social service programs. Linking all patients to the requisite supportive 

services is essential for long term recovery, especially housing when needed. 

Another UK Program that is having a significant impact on improving outcomes is the 

PATHWAYS program, a program designed for the care specifically of pregnant women with 

opioid use disorder. At PATHWAYS, which opened in 2014, women are able to enter the 

program and immediately begin receiving evidenced-based care, medication-assisted treatment, 

and prenatal care. The large majority of women achieve abstinence and deliver their babies with 

no illicit opioids in their system. Importantly, the incidence of babies suffering from neonatal 

abstinence syndrome has been cut by about half. UK has also opened a new special unit, the 

NACU, that is specifically designed for the care of babies born with opioid physical dependence. 

The NACU was opened in 2017 and has 8 dedicated beds with specialized staff trained to treat 

drug-exposed infants. PATHWAYS retains women until they give birth, at which point, they 

can transfer to a linked program, Beyond Birth, where these young women may continue their 

care. Young mothers with new babies who are early in their recovery may be some of the most 

vulnerable of all those suffering from opioid use disorder, and the health and welfare of their 

baby is intimately linked to the well-being and success of the mother. This is a high-risk group 

who also may require housing services- housing that allows infants and other children in order to 

promote retention in care and sustained remission. 

In Kentucky, prior to the current epidemic, there was little to no opioid abuse. Unlike the east 

and west coasts, heroin was historically unavailable in Kentucky. Therefore, Kentucky was only 

introduced to the scourge of opioid abuse once the pharmaceutical industry-driven epidemic of 

3 
67 

nshattuck on FSR297 with DISTILLER


prescription opioids began. Therefore, most of the existing treatment facilities and housing 

services for those affected by substance abuse were not designed to address the unique problems 

associated with opioid abuse when compared to other substances, such as alcohol or 

methamphetamine. Opioid use disorder is a very unforgiving disorder- a single lapse or relapse 

can lead to the immediate death of a person who may be striving to achieve remission or sustain 

their recovery. A single mistake ends a life. 

Every federal agency that plays a prominent role in supporting the treatment and research of 

opioid use disorder, The Food and Drug Administration, SAMHSA and the NIH, are all in firm 

agreement that the most effective approach to the treatment of opioid use disorder is the use of 

pharmacotherapies also known as medication-assisted treatment or MAT. There arc three 

medications presently approved for the treatment of opioid use disorder by the FDA, and these 

include buprenorphine, methadone and naltrexone. All federal agencies are calling for expansion 

of access to medication as the best strategy for turning the tide of the opioid epidemic. 

Approved medications have been demonstrated to reduce drug use, improve health, reduce the 

transmission of infectious disease and most importantly--- protect individuals against fatal 

overdose. 

Those of us in the treatment community frequently recommend that the path to remission and 

recovery for those addicted to opioids is to change the people, places and things associated with 

their past drug-using lifestyle. This may often involve moving into residential care or recovery 

housing. Unfortunately, the majority of these facilities explicitly prohibit or exclude patients 

who are receiving medication-assisted treatment from accessing these programs- creating 

4 
68 

Æ 

nshattuck on FSR297 with DISTILLER


additional barriers for those who are trying to sustain long-term recovery who are receiving 

evidence-based care under the supervision of a trained physician. 

Providing healthy and safe living housing environments for ALL patients seeking recovery from 

their drug use disorder is essential to promote long-term success and turn the tide on the opioid 

epidemic. All programs receiving government support should encourage rather than discourage 

engagement by patients, should include rather than exclude patients attempting to sustain 

recovery, and should not only allow but also promote the use of all evidence-based practices in 

both treatment and housing programs. 

The University of Kentucky looks forward to working with Congress, and other leaders here 

today, to provide an overarching framework to leverage the expertise and resources of the federal 

government in a strategic and coordinated mamier. As a historic land grant and flagship research 

university, the University of Kentucky was founded for the people of Kentucky. This is why we 

are here; to keep a deep and abiding promise of better tomorrows for the Commonwealth. We 

arc here, as we have been for more than !50 years, for our community, for our region, and for 

Kentucky. 

I sincerely appreciate the opportunity to present testimony before the Subcommittee and 

welcome the opportunity to address any question at this time. 

5