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A
It
review
subcommittee
on
Justice
and
Judiciary
for
the
2023
interim
today
we're
going
to
hear
from
the
justice
and
Public
Safety
cabinet
on
substance
abuse,
treatment
programs.
The
current
budget
required
both
the
annual
report
describing
the
funding
and
the
programs
administered
by
the
cabinet,
as
well
as
the
external
performance
reviews
of
substance
abuse
programs,
which
there
was
one
million
dollars
appropriated
for
this
purpose.
So
any
meeting
materials
received
by
the
deadline
were
posted
online
earlier
in
the
week
and
made
available
for
downloading
and
I
believe
you'll
be
presenting
that
today
on
the
big
screen.
A
Thank
you
at
this
time.
I
think
it'll
be
helpful
with
this
great
background,
noise,
perfect
setting,
let's
hear
from
our
guest
today
and
thank
you
again
for
coming
van
and
TK,
we'll
look
forward
to
hearing
your
presentation
and
then
we'll
hold
any
questions
until
the
end.
So
if
you
would,
please
introduce
yourself
and
remember
to
press
the
green
button.
C
C
We
are
also
further
in
statute
required
to
provide
fundings
to
the
Department
of
Corrections
to
provide
treatment
services
in
jails
and
prisons.
There
are
already
two
evaluations
that
existed
the
Kentucky
treatment
outcome.
Studies
is
an
annual
study
that
looks
at
Community,
Mental,
Health
Centers
and
the
criminal
justice
treatment
outcome,
study
or
CJ
Catos
evaluates
Department
of
Corrections
those
criminal
justice
involved
treatment
programs.
C
So,
with
those
two
things
in
mind,
we
approached
the
center
for
drug
and
alcohol
research
at
the
University
of
Kentucky
and
ask
them
with
this
million
dollars.
Could
they
enhance
the
efforts
that
we're
already
doing
to
get
a
more
a
better
profile
so
for
the
amount
of
297
492
dollars?
They
proposed
presented
us
with
a
proposal
of
what
they
could
do
to
improve
upon
the
two
programs
that
already
existed,
and
my
friend
from
University
of
Kentucky
Center
for
drug
and
household
research,
TK
Logan
is
here
to
describe
that
process.
D
Good
morning,
thank
you
for
having
us
come
we're
excited
to
be
here
to
talk
about
all
the
hard
work
we
did
in
about
six
month
time
period.
Can
you
hear
me?
Okay,
also
I
wanted
to
introduce
the
team,
since
we
worked
so
hard,
they
wanted
to
come
as
well.
Dr
Michelle,
Staton,
Dr,
Jennifer,
Cole
and
Casey
Baker
and
Hope
Tevis
are
here
as
well,
so.
D
We
know
that
substance
use
is
continuing
or
actually
increasing
over
time
in
in
Kentucky
as
well,
but
we
also
know
that
substance
use
disorder.
Programs
can
and
do
make
a
big
difference
for
people
helping
people,
and
we
know
that
in
Kentucky
and
I
have
evidence
of
that.
That
I'll
show
you,
because
we
do
have
these
evaluation
programs,
so
I'll
show
you
that
in
a
minute,
but
we
also
know
that
there
are
people
who
are
still
falling
through
the
cracks.
D
So
we
saw
this
funding
as
an
opportunity
to
sort
of
better
understand
what
are
those
barriers
for
some
of
those
people
to
engaging
in
substance
abuse
treatment.
One
of
the
the
research
has
shown
that
it's
most
helpful,
the
longer
you're
in
a
program,
the
better
you're
going
to
do
so.
The
threshold
that's
been
identified
is
at
least
three
months,
but
again
longer
is
better.
D
There
are
studies
that
have
suggested
that
from
the
first
phone
call
to
30
days
in
treatment
about
80
percent
of
people
drop
out
of
that
process.
So
these
are
just
some
things
that
we
wanted
to
take
as
we
went
through
in
mind,
and
on
top
of
that,
when
we
look
to
see
what
barriers
are
in
the
literature,
what
we
found
is
that
many
of
those
barriers
focus
on
personal
characteristics
or
individual
characteristics,
but
what
we
really
wanted
to
do
is
look
at
those
barriers
that
were
plausibly
addressable
through
policy
changes
potentially
or
maybe
targeted
funding.
D
So
with
that
in
mind,
our
three
objectives
were
to
look
at
program
performance
indicators,
and
this
also
came
from
the
language
that
was
written
in
the
budget.
We
tried
to
to
to
interpret
what
was
being
looked
for,
but
these
program
indicators
sort
of
help.
People
understand
how
many
people
are
being
served.
How
long
are
people
staying
quality
of
the
programs?
The
second
thing
we
wanted
to
do
was
understand
staff
barriers,
because
staff
are
the
program.
D
They
are
the
most
important
resource
when
engaging
consumers
or
clients
in
these
programs,
and
so
we
have
to
figure
out
how
to
support
them,
so
they
can
best
do
their
job
and
then
finally,
we
wanted
to
understand
who
has
the
unmet
treatment
needs
and
then
from
voices
of
people
who
are
being
impacted,
so
people
who
thought
about
going
to
treatment
but
didn't
or
people
who
had
recently
dropped
out
of
treatment?
What
did
they
say?
Their
barriers
are.
D
So.
As
van
said,
we
had
around
three
hundred
thousand
dollars.
We
did
four
projects
and
in
a
six
month,
time
period.
So
this
is
all
we
basically
did
for
six
months
and
we
have
five
reports.
So
the
first
project
we
did,
which
was
led
by
Jennifer
Cole,
was
looking
at.
What
does
the
literature
say?
Those
program
performance
indicators
are
that
should
be
collected.
D
Looking
at
what
Kentucky
has
to
some
extent,
I'm,
not
sure
I,
understand
fully
everything.
Kentucky
has,
but
we
know
some
things
and
then
looking
at
overlap
between
the
evaluations
we
have
and
one
of
the
things
Dr
Cole
did
in
this
report,
for
this
particular
project
is
profile.
D
We
did
the
consumer
survey
project
and
Michelle
did
those
LED
this
project.
So
we
talked
to
62,
very
in-depth
interviews
with
consumers
who
either
thought
about
treatment,
that's
but
did
not
enter.
That
was
about
40
percent
and
then
those
who
had
dropped
out
in
the
in
the
past
year,
that
was
about
60
percent,
and
then
we
did
the
secret
shopper
project
to
and
I
led
those
to
the
provider
survey
and
the
secret
shopper
project.
D
So
we
trained
students
to
a
scenario
of
a
consumer,
a
substance
use
user
who
was
trying
to
get
into
treatment.
Half
were
pregnant
and
half
were
opioid
users,
and
so
we
mixed
things
up
and
then
we
just
kind
of
had
the
callers
document.
What
happened,
how
it
felt
that
kind
of
thing?
D
And
then,
in
that
particular
report,
each
region
that
we
talked
with
there's
a
profile
there,
just
kind
of
explaining
what
happened,
and
then
we
did
a
final
overall
because
nobody's
going
to
read
all
of
these
Pages
for
these
four
reports
that
just
kind
of
summarize
what
we
did
and
then
integrated
the
conclusions
and
recommendations.
So
most
of
what
I'm
going
to
say
comes
from
that
final
report,
we
integrated
everything
into
these
five
main
questions
and
I'll
just
go
through
each
question.
D
So
why
does
that?
First
phone
call
matter
for
program
engagement
so
that
same
study?
That
said,
80
percent
of
people
drop
out
from
that
first
phone
call
to
within
30
days
of
treatment.
45
do
not
show
up
for
that
first
appointment,
so
that's
a
first
place
that
we're
losing
some
people
for
some
reason
and
we
feel
like
that
might
be
the
most
one
of
the
most
important
steps
in
in
engaging
clients.
And
this
is
just
what
the
profiles
look
like
for
each
region.
D
And
asking
about
scheduling,
preferences
and
providing
information
like
where
to
get
where
to
go
to
the
program,
what
to
bring
and
what
to
expect.
We
feel
like
that,
will
help
people
better
be
prepared
to
show
up
to
the
program
and
then
to
talk
to
Consumers
about
the
different
program
approaches,
so
some
programs
that
you
call
they
and
I
should
say
I
forgot
to
say
this
before
we
also
called
for
prenatal
programs,
but
so
some
of
the
programs,
what
you
call
they
offer
a
variety
of
approaches.
D
We
also
thought:
maybe
this
first
phone
call
because
people
are
dropping
out
what
we
want
is
you
know,
no
matter
what
you
do,
there's
probably
still
going
to
people
be
people
that
don't
show
up,
but
hopefully
they'll
re-engage
later
and
re-engage
quicker
or
take
some
of
the
resources
that
they
need
right
then
to
support
them,
so
they
can
do
better
when
they
get.
You
know
be
more
ready
to
engage
in
that
program,
so
we
thought
that
the
first
phone
call
might
be
an
opportunity
to
quickly
assess
some
risks.
D
Some
key
risks
recent
incarceration,
because
if
they
haven't
used
for
a
while,
they
might
be
more
at
risk
for
overdose
if
they
use
just
talking
to
people
quickly
about
overdose
risk,
suicidality,
domestic
violence
or
other
personal
safety
risk
they
might
have
going
on
in
pregnancy,
and
you
could
share
some
quick
information
depending
on
their
risks
where
to
obtain
Narcan
or
just
educating
them
asking
if
they
have
prenatal
services.
That
kind
of
thing
and
everything
I'm
saying
is
in
that
handout.
D
I
gave
you
as
well
I,
know,
I
talk
really
fast,
but,
and
the
second
question
is
sort
of
what
can
programs
do
to
make
that
recovery,
Journey,
more
successful
for
clients
and
across
all
of
the
things
that
we
looked
at
all
the
data
we
collected?
These
were
kind
of
the
three
that
stood
out
to
us.
D
The
other
thing
that
sort
of
came
out
is
just
just
how
restrictive
some
of
these
programs
are
and
then
trying
to
think
about
allowing
as
much
choice
for
clients
as
possible.
So
maybe
it's
a
scheduling,
Choice.
Maybe
it's
a
harm
reduction
choice
I,
just
even
if
it's
small
working
within
that
program,
curriculum
can
help
with
motivation
and
then
addressing
staff
barriers
like
I,
talked
about
before
making
sure
they
have
the
tools
to
be
able
to
do.
D
Women
and
postpartum,
particularly
pregnant
and
postpartum
women,
can
be
difficult
to
engage
in
treatment.
People
with
co-occurring
vulnerabilities,
marginalized
individuals,
individuals
with
limited
personal
resources,
which
I've
already
sort
of
talked
about.
They
tend
to
do
worse
in
in
programs,
individuals
involved
in
the
criminal
justice
system.
D
The
other
interesting
thing
with
for
me
is
that
this
older
group
about
50
plus
I,
don't
know
where
they're
going
to
treatment.
There's
a
small
group
that
are
coming
into
the
cmhcs
and
the
recovery
centers,
so
I'm,
not
sure
where
they're
and
that
actually
came
out
as
well,
that
both
staff
understand
that
that
group
is
also
not
being
served
as
well.
I
think
the
one
that
surprised
me
is
the
the
veterans,
the
persons
on
active
duty
and
their
families
were
really
brought
up.
D
And
that
so
what
happens
is
that
people
who
are
involved
in
the
criminal
justice
system
like
on
supervision
or
certain
programs,
so
they
have
additional
requirements
on
top
of
treatment
requirements
and
those
things
sometimes
don't
always
mesh
super
well,
and
it
just
creates
a
lot
of
juggling
for
the
clients
to
do
and
relapse.
Then
it's
not
necessarily
the
program
policy,
it
might
be
the
criminal
justice
system
policies,
and
so
those
things
just
got
brought
up
as
being
particularly
difficult
for
these
clients.
D
There's
increased
stigma
with
that
and
increased
risk
of
relapse
and
overdose
potentially.
D
D
So
you
can
see
there's
five
main
kind
of
clusters
of
these
performance
indicators.
The
last
two
we
have
again
through
our
longitudinal
evaluations
of
substance
use
disorder,
programs
that
we
have
so
we
have
some
information
about
what
clients
think
about
these
indicators
and
outcomes.
D
So
just
this
is
an
example
of
what
we
have
for
the
cmhc
clients
from
2017
to
2023,
and
you
can
see,
there's
quite
a
drop
so
around
42
percent
and
it's
pretty
stable
over
time
and
around
42
percent
report.
Any
illicit
drug
use
or
problem
alcohol
use
that
intake
and
or
at
follow-up
I
mean
so
that
means
60
did
not.
D
This
is
for
the
recovery
centers
that
we
look
at
and
you
can
see
again
and
these
this
group
of
people
they
target
people
who
are
homeless
or
transitioning
out
of
jail
or
prison,
and
you
have
to
live
in
the
program
for
about
seven
and
a
half
months,
so
their
outcomes
are
much
better
because
just
being
removed
and
supported,
all
those
basic
needs
are
supported,
and
then
they
live
there
for
seven
and
a
half
months.
D
So
again,
just
supporting
those
recognizing
the
potency
of
those
systemic
and
program
barriers
that
to
ask
asking
staff,
maybe
to
think
about
what
could
be
these
barriers
instead
of
always
thinking
it's
just
the
lack
of
motivation,
staff
media,
all
of
us
kind
of
need
to
think
about.
D
How
can
we
address
those
barriers
to
support
that
engagement,
again
supporting
program
and
staff
quality,
so
some
of
the
biggest
problems
were
lack
of
choice,
not
feeling
valued
or
respected,
feeling
that
there's
some
favoritism
going
on
and
having
some
ways
for
clients
to
express
that
feedback
or
concerns
during
the
program
in
a
way
that
protects
them
and
another
one
that
came
out
are
just
clients
not
taking
the
program
seriously
and
that's
one.
We
don't
really
have
context
for
that's
something
we
would
like
to
dive
into
more.
D
Maybe
the
in
the
next
study
that
we
did
or
something
and
then
policies
regarding
that
the
sanctions
and
termination.
So
a
lot
of
what
came
up
is
like:
if
there's
one
relapse,
then
they
either
get
kicked
out
of
the
program
or
get
sent
back
so
far
back
and
it
can
just
be
really
demotivating
for
people.
D
But
at
the
same
time,
then,
you
have
other
people
in
the
program
who
are
working
the
program
and
not
relapsing
so
a
way
to
kind
of
balance,
those
things,
but
most
of
the
people
brought
up
that
that
is
a
huge
barrier,
just
when
you
relapse,
which
is
part
of
the
Journey
of
recovery
and
and
if
it's,
if
it
sets
you
so
far
back,
that
can
be
a
problem.
D
So
again,
our
main
recommendations
is
really
looking
at
that
first
phone
call:
how
can
we
make
that
more
supportive
to
increase
that
engagement?
There's
a
piece
of
the
barriers
that
we
were
not
able
to
investigate
in
this
six-month
period,
and
that
is
all
right.
Well
now
the
the
person
has
shown
up
for
their
employee
at
their
appointment.
What
is
that
first,
what
is
the
intake
process
like?
D
What
is
the
you
know,
the
education
process,
and
how
does
that
work
for
clients
and
just
documenting
those
barriers
is
kind
of
another
area
capitalizing
on
that
science
of
Engagement
and
motivation,
which
is
again
autonomy,
competence
and
belonging.
So
just
those
three
kind
of
things
which
I've
already
sort
of
talked
about
making
sure
that
clients
and
consumers
can
provide
feedback,
particularly
for
those
specialized
needs.
So
if
you've
got
somebody
who's
marginalized
or
somebody
who's
having
those
unmet
treatment
needs
and
they're
making
program,
adaptions
talking
with
them
about
what
would
be
helpful
to
them.
D
Investing
time
and
resources
for
a
peer
support
workers
again
such
a
valuable
resource?
Both
the
program
staff
talked
about
the
peer
support
workers
help
them
in
the
program
they
can
relate
to
clients
in
a
way
they're
unable
to
for
a
variety
of
reasons
and
the
consumers
talking
about
how
important
this
these
people
were
for
their
supporting
their
recovery,
but
they
need
that
trade.
E
Thank
you,
madam
chairman,
and
thank
you
for
your
presentation.
I,
don't
have
any
questions.
I
just
have
a
comment,
several
comments,
because
I
think
I
have
a
responsibility
to
my
constituents
and
the
people
I
I,
represent
to
represent
their
point
of
view
on
this
subject.
So
there's
just
a
few
things.
I
I
like
to
say
about
it.
E
First
of
all,
I
guess:
I
basically
disagree
with
the
whole
philosophy
that
you're
coming
to
this
problem
with
my
friend
John
Tilly,
former
Secretary
of
Justice,
was
the
first
person
I
ever
heard,
use
the
term
substance
abuse
disorder.
E
The
inference
was
that
this
is
something
like
breast
cancer
or
covet
or
some
other
disease
that
that
somehow
we,
if
treated
properly,
we
can
manage,
but
I'd
like
to
remind
the
committee
and
the
public
watching
that
this
is
a
subcommittee
on
Judiciary,
not
Health
and
Welfare.
This
is
a
subcommittee
on
judiciary
and
what
was
formerly
called
substance
abuse
or
which
we
now
call
substance.
Abuse
disorder
is
a
felony
in
the
Commonwealth
of
Kentucky
with
certain
drugs.
E
Mere
possession
is
a
felony
and
somehow
that,
in
this,
in
judicial
has
somehow
that's
been
lost
and
I
know
that
you
have
a
lot
of
Statistics
saying
how
well
your
programs
work,
but
the
reality
of
the
matter
is
is
we're
spending
more
money
than
we
ever
have
had
on
treatment,
and
we
have
more
a
drug
addiction
than
ever.
We
kind
of
have
adopted
the
European
model
personally,
I.
Think
it's
a
big
mistake,
because
at
one
time
the
Republican
party
was
the
party
of
personal
responsibility
and
I
don't
see
any
personal
responsibility.
E
Treatment
has
its
place,
but
for
someone
to
go
to
treatment
after
committing
a
felony
without
any
consequences
from
the
criminal
justice
system-
and
you
you
act
like
contact
with
the
criminal
justice
system
is
a
bad
thing
for
someone
who
has
substance,
abuse
disorder.
I
would
say
that
if
someone
is
committing
a
felony
in
the
Commonwealth
of
Kentucky,
they
ought
to
have
some
contact
with
the
criminal
justice
system
before
they
go
to
treatment,
and
then
maybe
they
will
take
what's
going
on
seriously.
A
F
D
F
Okay,
do
you
know
any
of
the
private
funding
for
the
center.
D
I
do
not
have
like
guys
it's
the
center.
It
seems
like
a
cohesive
like
under
one
building,
but
there
are
lots
of
people
that
are
associated
with
that
Center
they're
at
all
different
locations
and
and
there's
a
lot
of
work
being
done
at
all
different
kind
of
levels.
So
I
was
not
prepared
for
that
question.
I
could
have
gotten
it,
but
I
do
not
have
it
at
my
disposal.
F
Okay,
thank
you
next
question,
part
of
I
believe
it
was
number
four
discusses:
quality
of
a
sud
program
as
an
attorney
and
someone
who
was
an
elected
prosecutor
and
has
been
involved
in
the
criminal
justice
system.
I
guess
on
multiple
sides.
F
I
believe
treatment
can
work,
I'm
not
opposed
to
treatment.
I've
been
an
advocate
for
it,
but
I
guess
what
I
have
learned
from
my
observations
and
experiences
that
all
the
providers
are
not
created
equal
right.
There
are
some
that
do
an
excellent
job
and
truly
provide
good
care.
There
are
others
that
are
really
bad
actors
in
this
space
and
what's
becoming
I
guess
most
defensive
to
me
is
I
mean
they
are
using
tax
dollars.
They
are
being
funded
for
Medicaid
and
I.
F
Don't
have
a
problem
with
that
if
they're
providing
good
quality
Care,
but
there
are
a
lot
of
private
providers
that
are
not
providing
good
quality
care
and
and
I
think
that's
something
we
really
need
to
take.
A
look
at
we've
got
a
big
debate
on
a
certificate
of
need
in
the
health
care
space.
One
thing
that
I've
noticed
and
this
particular
space
is
that
there
doesn't
seem
to
be
any
sort
of
certificate
needs
for
any
sort
of
private
addiction
provider.
Could
you
help
me
maybe
understand
a
little
bit
more?
C
F
F
What
what
I
guess
there
are
certain
recommendations
that
are
listed
in
your
own
presentation
as
to
Quality
what
other,
currently
what
what
is
looked
at,
whether
it's
a
cmhc
or
whether
it's
a
private
provider
as
to
how
do
you
measure
success?
How
do
you
measure
quality
of
services
what's
currently
being
used
to,
regardless
of
whether
it's
a
cmhc
or
a
private
provider,
to
try
to
figure
out
hey?
Is
this
organization
doing
a
good
job
and
helping
people
that
that
need
treatment.
C
I
have
an
employee,
that's
liaison
to
my
office
from
the
Q
from
the
Cabinet
for
Health
and
Family
Services,
and
she
does
site
visits
and
monitoring
of
all
the
programs
we
fund.
Okay,.
G
Thank
you,
madam
chair
I.
Just
have
a
couple
of
quick
questions.
Thank
you
all
for
your
comprehensive
presentation.
G
I
wanted
to
ask
if
you
could
quickly
and
I
apologize
for
coming
in
a
few
minutes
late
summarize
some
of
the
results
that
you've
seen
I
know
you
had
a
few
slides
in
terms
of
relapse
rates,
rates
of
return
or
incidences
with
the
criminal
justice
system.
If
you
could
just
quickly
summarize
the
drops
in
those
rates
for
us
in
terms
of
results
from
from
these
types
of
programs,
so.
D
But,
for
example,
you
know
40
to
50
percent,
do
have
return
to
use,
but
that
means
then
50
to
60
percent.
Do
not
in
in
our
measures,
usually
once
people
leave
treatment.
Relapse
occurs
within
that
first,
three
months
after
treatment,
so
we
are
capturing
that,
but
if
we
went
out
longer,
I
don't
know
so,
as
I
said
before,
Kentucky
is
helping.
Our
programs
are
helping
a
lot
of
people,
but
there
are
people
that
are
falling
through
the
cracks.
I
mean
this
is
any
program.
D
There
are
always
strengths
and
there
are
always
places
for
improvement
and
I.
Don't
know
that
we've
spent
a
whole
lot
of
time
on
these
programs.
Looking
for
those
places
for
improvement
and
working
on
those
with
maybe
policy
changes
or
targeted
funding
in
a
systematic
way,
I
know
at
the
individual
program
level
or
the
cmhc
level
I
believe
they
take
measures
within
their
own
program
and
it.
You
know
it
varies.
If
you're
serving
more
of
a
rural
population,
there
are
certain
needs
there
that
you
might
not
see
in
a
more
urban
population.
D
So
it's
also
at
the
program
level.
So
it
is
really
hard
to
kind
of
do
it
at
that
program
level
or
at
that
microcosm,
especially
without
more
specific
funding
for
their
research
and
a
lot
of
the
funding
goes
for
the
services
as
it
should
I.
Don't
know
if
that
answers
your
question,
but
we
have
we
do
extensive
reports
every
single
year.
D
We
have
the
longitudinal
data,
we
have
feedback
data
from
the
clients,
we
have
mental
health
data,
we
have
victimization
data
and
we
report
that
every
single
year
and
it's
out
on
our
website
for
the
public.
We
keep
two
years
out.
We
also
have
fact
sheets,
so
you
don't
have
to
read
through
the
150
page
report.
I
mean
we
work
very,
very
hard
to
represent
what
data
we're,
collecting
and
feed
that
back
for
everyone
to
see,
so
that
stuff
is
out
there.
For
anyone
who
wants
to
thank.
G
You
and
to
that
point
in
terms
of
populations
falling
through
the
cracks
and
not
getting
the
care
that
they
need.
G
Specifically,
you
know
you've
listed
here,
individuals
with
physical
developmental
learning,
disabilities,
I'm
specifically
interested
in
those
with
developmental
or
learning
disabilities,
who
may
not
know
or
be
able
to
consent
to
certain
things
or
just
know
where
to
find
these
resources.
That
seems
to
me
a
very
difficult
population
to
reach
an
expensive
and
time
consuming.
So
I
wanted
to
just
hear
your.
D
Comments
so
again,
I'm
just
reflecting
what
from
the
833
staff
that
we
surveyed.
This
is
one
of
the
themes
that
came
up,
that
that
is
particularly
challenging
and
they
feel
like
these
are
a
group
of
people
that
we
need
extra
eyes
brains
on
how
to
better
serve
that
all
all
we're
doing
is
kind
of
reflecting
back
that
that
is
an
area
that
came
up
and
documenting
that
barrier.
D
C
Representative
I've
been
in
contact
with
commissioner
Marx,
with
the
division
of
Behavioral,
Health
and
individuals
with
intellectual
developmental
intellectual
disabilities,
we're
going
to
put
together
a
training
for
all
the
folks
that
receive
this
funding,
probably
several
trainings
on
how
to
better
do
what
we
improve
upon.
What
we've
been
doing,
I
think
TK
has
highlighted
some
things
that
we
can
do
better
at
and
we're
certainly
going
to
try
to
do
better
at
it.
A
I
think
you
were
there
any
other
questions,
I'd
like
to
pose
a
few
myself
in
in,
and
thank
you
for
this
and
I.
Often
in
committee
meetings,
admit
that
I'm,
a
I'm,
a
new
state
senator
so
barely
250
days
on
the
job,
but
who's
really
counting
so
recognizing
as
Senator
schickel
shared
we,
we
do
have
a
criminal
Behavior
behind
those
that
are
now
coming
for
treatment
and
pursuing
treatment.
A
When
I
look
at
part
of
the
objective
that
we
were
trying
to
achieve
with
the
one
million
dollars
appropriated
as
well,
the
external
performance
reviews
of
substance,
abuse
programs,
I'm
unclear
as
to
the
the
array
of
programs
available
within
Kentucky
and
are
there
actual
overlaps
that
were
identified
in
this
or
potential
for
coordination
to
achieve
a
better
result
and
I'm
still
unclear
about?
What's
the
review?
C
This
is
not
a
Kentucky
problem.
This
is
a
nationwide
problem.
It's
how
to
evaluate
substance,
use
disorder,
treatment,
programs,
there's
a
lot
of
discussion
on
a
lot
of
of
effort.
That's
going
into
that
when
much
of
the
information
is
self-reported,
it's
really
hard
to
tell
how
accurate
it
is.
H
D
You
do
look
at
those
performance
indicators
that
literature
is
all
over
the
place.
I
mean
we
have
an
extensive
report
where
we
reviewed
that
and
I
think
the
next
step
would
be
if
Kentucky's
interested
in
pushing
that
further
I
mean
one
of
our
recommendations
was
that
we
have
to
get
together
with
his
key
stakeholders
to
decide
what
performance
indicators
do
we
want
to
look
at.
How
are
we
going
to
collect
it
in
a
systematic
and
reliable
way,
and
then
what
are
we
going
to
do
with
it?
Who
who's
going
to
have
access
to
this
information?
D
Is
it
going
to
be
us
key
stakeholders
will
be
consumers,
there's
nobody
in
the
nation
that
we
could
see
and
Jennifer
correct
me
if
I'm
wrong,
but
she's
the
one
that
spent
almost
six
months
diving
into
this
terrible
terrible
literature,
state
reports
from
other
states,
and
things
like
that,
because
we
were
looking
for
a
map,
we
didn't
find
a
map.
I
think
that's!
Okay,
Kentucky
can
make
their
own
map.
C
D
Yeah
so
which
indicators
and
what
you
know
for
me,
it's
like
what
truly
does
represent
quality
on
an
average,
because
quality
for
one
person,
as
we
saw,
doesn't
mean
quality
for
Van.
You
know,
I
am
a
different
person
than
van
I
have
different
needs.
I
have
different
addiction,
Journey
recovery,
Journeys
yeah,
so
it
gets
hard,
so
I
think
the
first
step
would
be
for
some
committee
or
group
or
person
to
sit
down
and
say
these
are
the
indicators
we
want
and
then
we'll
have
to
just
see.
D
But,
like
I
said,
we
looked
and
looked
and
looked,
who
in
the
nation
is
doing
this?
Who
is
tracking
these
and
there's
some
stuff
out
there?
But
it's
it's
still
we're
still
at
the
beginning
of
this.
It's
just
really
hard
to
quantify
quality,
and
what
does
that
mean?
And
again
we
have.
We
know
that
it's
helping
a
lot
of
people
because-
and
you
saw
those
longitudinal
Trends-
are
very
stable-
that's
across
studies
across
programs
across
time,
so
we
know
we're
doing
a
pretty
good
job
with
a
percent.
The
question
is:
can
we
improve
on
that?
H
You,
madam
chair
I,
have
a
thank
you
all
for
your
presentation
and
for
looking
into
these
barriers,
but
my
I
have
kind
of
a
comment
instead
of
a
question
that
is
just
a
kind
of
contemplation
of
I
tend
to
get
to
this
place
in
a
lot
of
the
hearings
we
have
here
in
the
legislature.
H
Your
very
first
comment
under
background
led
me
to
start
thinking
this
way.
You
say
that
there's
a
nationally
there's
a
substance,
substance
use
that's
increased
over
decades,
despite
the
efforts
to
make
it
drop
and
substance
use
disorders
have
increased
over
time.
So
then
we
hear
and
I
applaud
you
for
looking
at.
Why
is
our
treatment
not
working,
but
I
would
like
for
the
legislature
to
also
look
at.
Why
are
we
here?
Why
do
our?
Why?
Why
are
we
increasing
in
substance,
use
disorders,
I've
thought
of
this
all
throughout
the
summer?
H
At
various
hearings
we
hear
about
Behavioral,
Health
agencies
and
the
need
for
more
money.
For
that,
because
we
are
in
Behavioral
Health
crises,
we
need
more
money
for
school,
Mental,
Health
problems.
We
need
more
money
for
incarceration
for
crime,
for
increasing
crime,
increasing
drug
use
and
I
keep
wondering
what's
behind
all
this.
Why
are
we
here?
Well,
I,
keep
hearing
it
during
a
hearing
this
summer.
I
got
this
Vision.
In
my
mind,
it's
a
bad
analogy,
but
it's
the
best
I
can
come
up
with.
Is
that
it's
like
we
are
standing
outside
of
a
house.
H
All
these
different
people
are
standing
outside
of
a
house,
and
water
is
flooding
out
of
the
house
and
we're
saying
we
need
more
buckets
to
catch
this
water.
We
just
need
more
and
more
and
more
buckets
to
catch
this
water,
and
we
don't
ask
what
what
is
causing
the
water
to
leak
out
of
the
house,
what
is
causing
our
children
to
have
this
Mental
Health
crisis?
What
is
causing
all
of
this
and
I
don't
see
us
focusing
on
that.
H
I
applaud
you
for
focusing
on
what
is
the
problem
that
our
services
are
aren't
effective,
but
I
would
like
to
see
us.
Why
are
our
families
crumbling?
Why
why?
What
is
going
on
that
has
not
gone
on
before
that
is
leading
us
to
these?
So
that's
just
an
observation
I
have
in
general
about
all
of
this.
Thank
you
for
your
presentation.
A
Thank
you,
representative,
Decker
in
in
fact,
you're
articulating
what
I
couldn't
put
into
words:
I
I
believe
that
we're
describing
the
water
while
we're
drowning
and
and
that's
hard
to
sit
here
and
just
hear
the
description
without
a
life
raft
representing
cool
Carney,
okay,
okay,
thank
you.
I.
D
Just
I
just
want
to
say:
I
mean
that
is
the
million
dollar
question,
or
by
now
billion
dollar
I
don't
know
I
mean.
That
is
a
good
question.
There
are
lots
of
people
looking
at
that,
there's
no
simple
answer:
I
guess!
For
me,
the
reason
to
focus
on
treatment
is
when
people
look
for
help
I
want
to
say:
are
we
doing
a
good
job
of
helping
them
when
they
reach
that
handout?
C
There
is
a
body
research,
representative,
Decker
that
suggests
adverse
childhood
experiences
when
the
more
at
Aces
people
go
through
as
children,
the
higher
likelihood
they
are
of
becoming
having
a
substance
use
disorder.
So
things
like
food
insecurity,
violence
in
the
home,
a
difficult
divorce.
These
kind
of
things
are
Aces
that
we
see
in
the
history
of
people,
often
who
use
substances.
H
I,
don't
doubt
that
and
my
question
is:
why
are
we
having?
Why
are
we
increasing?
Well,
can
we
not
learn
and
decrease
and
and
I'm
not
meaning
to
imply
at
all?
You
should
not
focus
on
these
programs.
H
H
He
said
we
have
a
spiritual
crisis
in
our
country
and
the
things
you
just
described
are
caused
by
poor
spirit.
We
need
to
have
a
spiritual
Revival.
We
need
to
figure
out
what
is
wrong
with
our
spirit
in
America.
What
is
causing
all
of
this?
We
need
to
to
delve
into
that,
because
we're
spending,
as
you
say,
billions
to
treat
the
symptoms.
Thank
you.
I
And
thank
you,
madam
chairman.
I,
have
a
question
kind
of
going
along
these
lines.
It's
more
of
prevention.
So
my
my
question
is:
how
are
things
looking
from
the
prevention
side
when
we
talk
to
kids
because
I
think
if
we
focus
on
getting
into
the
the
schools
and
the
kids
like
the
Dare
program,
and
that
has
there
been
any
studies
on
the
effectiveness
of
the
Dare
program
or
other
prevention
programs.
D
There
has
been
a
lot
of
evaluation
work
with
the
Dare
program.
It's
not,
as
my
understanding
is
it's
not
as
great
as
we
would
like.
I
think
there
are
some
benefits
of
the
Dare
program
like
showing
police
officers
can
be
good,
guys,
they're,
okay,
to
go
to
because
sometimes
a
lot
of
kids
are
afraid,
but
in
terms
of
prevention
is
very
difficult
to
measure
because
you're
measuring
something
you
hope,
never
happens.
D
So
that's
a
it's
a
very
difficult
thing
to
measure.
Some
studies
show
some
success.
Other
studies,
don't
so
also
that's
a
whole
other
and
I.
Don't
think
I,
don't
know
that
we've
done
any
Recent
research.
C
C
A
program
called
too
good
for
drugs
that
currently
we
have
in
over
200
Kentucky
schools
that
is
evidence-based
and
researched.
There's
another
program
called
sources
of
strength.
That's
another
good
research
program,
that's
evidence-based
and
the
our
state
opioid
response
dollars.
We
get
from
from
Washington
pays
for
those
curriculum
for
any
school
that
wants
them.
I
I
A
That
concludes
what
is
our
formal
agenda?
Is
there
any
other
concerns
that
we
need
to
address?
Oh,
we
do
have.
Okay,
I
would
like
a
motion
to
approve
the
minutes
from
our
previous
two
meetings:
I
believe,
yes,
and
second
by
senator
schickel,
all
in
favor,
we
say
I,
okay,
we
are
adjourned.
Thank
you.