Quarterly Meeting Agenda
Tuesday, February 3, 1998
White House Conference Center
Please note: a picture I.D. is required for admittance.
Quarterly Meeting Summary
February 3, 1998
The Coordinating Council on Juvenile Justice and Delinquency Prevention held its quarterly meeting on February 3, 1998. In attendance were representatives from Federal agencies and community programs. The Council considered a number of agenda items and their relation to the area of juvenile justice and delinquency prevention. Specifically, the Council focused on the incidence of child maltreatment and its link to the occurrence of juvenile delinquency. The Council also heard a number of presentations concerning the problem of youth substance abuse.
Mr. Shay Bilchik, Administrator, Office of Juvenile Justice and Delinquency Prevention (OJJDP), and Vice Chair, Coordinating Council, called the meeting to order at 2 p.m. at the White House Conference Center, Truman Room. A list of those who attended the meeting is included at the end of this summary.
Mr. Bilchik welcomed the participants and asked that the members seated at the head table introduce themselves. He also welcomed Mr. Raymond Fisher, the newly appointed Associate Attorney General. Mr. Fisher served as the chair for the meeting, due to the absence of Attorney General Janet Reno, who was attending the funeral of an Immigration and Naturalization Services agent killed in the line of duty. Mr. Bilchik noted Mr. Fisher's previous work as a trial lawyer in private practice in Los Angeles and his participation in that community's activities. Mr. Fisher's extensive public service work included serving as president of the Los Angeles Police Commission of the Los Angeles Police Department. He was instrumental in the formation of the Greater Los Angeles Youth Initiative. Mr. Fisher is especially interested in Los Angeles' youth-focused community policing project.
Mr. Fisher stated the goal of the Coordinating Council is to bring the Federal agencies and practitioner members together to reduce juvenile delinquency and victimization. The National Juvenile Justice Action Plan identified two key objectives for the Council: breaking the cycle of violence and victimization and reducing drug abuse among juveniles. Mr. Fisher said the work of those addressing the Council at this meeting speaks directly to these objectives. The Council needs to examine how it can support their initiatives.
Mr. Fisher welcomed the Council's newest members, Ms. Kitty Higgins, Deputy Secretary of Labor, who was representing the National Endowment for the Arts (NEA); Mr. Ted Mastroianni, U.S. Department of Labor; and Ms. Deborah Vincent, U.S. Department of Housing and Urban Development (HUD).
Mr. Fisher expressed the Attorney General's appreciation for the work of all the practitioners. He echoed her message regarding the importance of collaboration among Federal agencies and those at the State and local levels. "You can bring to us the knowledge of what you are doing and share amongst all of us the best practices. This, in turn, will bring about constructive results for the Nation's youth." He thanked Mr. Bilchik and Ms. Gina Wood, Staff Director, Coordinating Council, for providing the opportunity to discuss these issues so the daily work of the various members can be linked in order to address these issues.
Mr. Fisher noted the Nation is in a period of great challenge and opportunity regarding youth crime and victimization. Young people are experiencing increased problems in their lives, whether from abuse or neglect or as victims of or witnesses to violence. According to the Carnegie Corporation Report, young adolescents across all economic strata find themselves alone in communities with few adults and no safe places to go. One of President Clinton's chief priorities, as stated in his State of the Union address, is the establishment of afterschool programs. Today's youth are pressured to use alcohol, cigarettes, and other drugs at earlier ages. Many have problems with depression; suicide is the third leading cause of death for young people aged 15-24. Many youngsters cannot handle interpersonal conflict without resorting to violence. By age 17, one-quarter have engaged in behavior harmful to themselves or others. These behaviors include getting pregnant, using drugs, engaging in antisocial activities, and failing in school. Nearly half of the Nation's young people are estimated to be at risk for damaging their life chances. "Wherever we go in America, too many of our youth are afraid, alone, and angry, and this is a crisis which is a call to action," Mr. Fisher said. Those who work with children must form a protective safety net around them. Some of the work begun in the Council can help accomplish this, but more must be done to break through barriers and turf issues to support youth and their families and create safer communities. Mr. Fisher recalled that when he worked on the L.A. Police Commission, one of his first priorities was to bring the resources of the public school system, the juvenile division of the LAPD, community agencies, and nonprofit organizations together for the same purpose that defines the Council's work: "Not to compete for dollars, not to compete for turf, but to talk to each other."
Mr. Bilchik then introduced Mr. Michael Petit, Deputy Director, Child Welfare League of America, and Ms. Ruth S. Massinga, Chief Executive Officer, The Casey Family Program, whom he acknowledged as preeminent experts in the area of child maltreatment and its link to juvenile delinquency. Mr. Petit and Ms. Massinga have both policy and real practice experience in this field. Mr. Bilchik referred to a national poll taken 11 years ago that indicated that 26 percent of Americans thought that child abuse and neglect were serious national concerns. A similar poll taken this past year showed that only 2 percent believe that today. The misperception about the impact and importance of this issue illustrates that attention must be refocused on the problem.
Breaking the Link Between Child Maltreatment and Juvenile Delinquency
Mr. Petit thanked the Council for allowing the Child Welfare League to be represented. The League comprises 900 member organizations that serve more than 2.5 million families, through 49 of the 50 State child welfare agencies. After 30 years in this field, Mr. Petit is convinced that an unequivocal relationship and clear link exist between child abuse and neglect and juvenile crime. He recommended to the Council the book Ghosts From the Nursery: Tracing the Roots of Violence, which documents 10 years of infant brain research and its relationship to child abuse and neglect.
Professionals can identify early on those children who will commit crimes or pose problems to the culture later in life. This identification can occur in some cases as early as in utero, sometimes right after birth, and certainly by the age of 5 or 6. Mr. Petit highlighted a Sacramento County, California, study that illustrates three of the factors that contribute to this behavior: alcohol and other drugs, parental incarceration, and child sexual abuse. The Sacramento study was performed because of an increase in teen homicides, from approximately 7 in 1990 to more than 30 in 1995. A judge wanted to know what these teenagers were like at an earlier age.
Mr. Petit said it is likely the child will commit future offenses if a child has appeared for a third offense by age 10. The likelihood in such a case is 96 percent. Of the 75,000 youngsters ages 9 through 12 in Sacramento County, 1.5 percent, or 1,100, are involved with child welfare. Approximately 250 of these 1,100 commit three-quarters of the crime. These youngsters have identifiable risk factors such as a history of physical abuse, neglect, sexual abuse, and parental incarceration. Disturbingly, these 9- to 12-year-olds also have striking similarities to the 15- to 20-year-olds placed in the California Youth Authority, which is a very high level placement. For example, nearly half of both groups have incarcerated parents.
Substance abuse by caretakers is also very prevalent. School-related problems show up very early with this population. Escalating behavior results in escalating intervention, which, in turn, results in escalating costs. Without intervention, the system spends $471,000 per youngster through age 25. With the community intervention program designed for Sacramento County, the cost drops to $40,000 per youngster over a 5-year period.
Mr. Petit then shared with the Council the results of a survey that revealed a deficiency in the States' ability to deal with these problems. Forty-seven of the 51 States took part in the survey. When asked whether substance-abusing families are more likely to see their children return to the child welfare system once these children have been taken away, 69 percent said yes. When asked what percentage require substance abuse treatment services and what percentage the State is able to serve, only 11 of the 47 States could provide answers. These 11 States are only able to serve one-third of the parents who need treatment.
When asked what percentage of children in out-of-home care have substance abuse problems in their families, 39 of 47 could not answer. Forty-four of 47 could not say how many children have substance abuse problems themselves. Only 12 of the 47 States could identify an appropriation for drug treatment services in their budgets. Thirty-five either did not have an appropriation or did not know if they have one.
Currently, 1.5 million children have a parent who is incarcerated or who has a history of incarceration. This number has increased by five-fold within a single generation. Yet when asked how many children in their system have a parent with this history, only three States knew. Asked if they have policies that address these children and their problems, only six responded affirmatively.
Mr. Petit then cited a study in North Dakota, which he believes reflects the situation in all 50 States and Washington, D.C. Rampant substance abuse results in reality-based depression. Much of this depression can also be traced to sexual abuse at a young age. Many children who have suffered sexual abuse are not only not receiving care, some are still living with the perpetrator of the abuse. Virtually no record keeping exists regarding the relationship between the child welfare system and the criminal justice system. The only two ways to protect a child are to remove the child or the perpetrator from the home. Mr. Petit stated, "I can tell you what happens in most cases. The kids are yanked from the home. An 8-year-old girl is pulled 75 miles from her school district, and she internalizes this belief that somehow she is responsible for ruining her family. She is now away from them, and she is 80 miles away from her school. The kid accepts that verdict, and there is not a finding of guilt against the individual." He cited one case in which a father who sexually abused his 5-year-old daughter is still living in the home with her. No guilty plea, no prosecution, and the court thought this was the best way to deal with the problem.
A 1996 study in Riverside, CA showed that of 47 reports of child sex abuse, 10 cases were received by the district attorney, and only 4 resulted in charges being filed. Unfortunately, in 1 of 10 cases, the perpetrator see a courtroom. In one jurisdiction, 4,000 cases were received in a year, but only 50 to 100 were opened. Typically, district attorneys will only prosecute if there is a confession, and judges will only open a dependency proceeding if a criminal hearing is started by the district attorney.
Many children are left unprotected. Substance abuse, child abuse, and maltreatment result in angry children. As indicated by the book Mr. Petit referred to earlier, by age 2 or 3, brain patterns are formed, and it is almost impossible to break the formation of these negative patterns of thinking, along with the anger and hostility.
Mr. Petit noted the States and localities have a great deal of willingness to address these problems. However, a great deal of frustration exists because the information available regarding these problems has not always been shared adequately.
Ms. Massinga told the Council The Casey Family Program is a private foster care agency that has been in operation for 31 years. A member agency of the Child Welfare League, it is active in 13 States, primarily in the West. The data presented by Mr. Petit is very familiar to Ms. Massinga's agency from a practitioner perspective. For the past 30 years, more than 80 percent of the children who entered foster care did so because of parental substance abuse and the complicating factors of mental health problems and abuse and neglect issues. The past decade has seen an increase in the number of such children who come into foster care. As these children enter adolescence, little hope remains of sorting out these problems so their families can take care of them. These children experience many interruptions in their schooling and have mental health problems themselves. A better job must be done in determining the intensity and duration of treatment needed for these youngsters and for their parents. This determination must be made much earlier. Each year, 25,000 children leave foster care. Few resources exist to help them become successful adults.
The Casey Family Program joined with the North Dakota Department of Human Services, Juvenile Services Division, to discover effective intervention strategies, especially for adolescents who have been adjudicated delinquent and who have no probability of returning to the parental home. With the right interventions, appropriate foster families can be found for these youngsters, which can increase their chances for a better future. Recently, The Casey Family Program joined the Substance Abuse and Mental Health Services Administration (SAMHSA) to promote Staring Early, Starting Smart. This intervention strategy gives early treatment to young families with substance abuse and mental health problems. Its aims are to avoid issues of abuse, mitigate issues of neglect, and avoid interruptions of family life.
Ms. Massinga has found that the array of community partners that Mr. Petit referred to is available in many communities. This provides the cross-disciplinary, cross-agency involvement that allows a holistic approach to these issues to be taken for youngsters and young families. Yet a lack of treatment resources still exists throughout the United States, and the situation is getting worse. In particular, not enough treatment opportunities exist for young parents who may be faced with early removal of children. Ms. Massinga believes the recent law passed by Congress that seeks to speed up adoptions and terminate parental rights does not provide adequate local, cross-disciplinary services and will leave more children at risk, thus increasing the connection between dependency and delinquency. Organizations such as The Casey Family Program want to assemble facts that will provide information on the community level and that will ascertain the aspects of intervention that have the greatest long-term effects for children and their families.
A number of questions were taken from the participants. Mr. Jack Calhoun, National Crime Prevention Council, noted some youngsters have the same profile of incarcerated parents, drug abuse, and history of sexual abuse, but do not enter the system. He asked Mr. Petit and Ms. Massinga what insulates these children. Mr. Petit said if enough risk factors are present, few children escape the system. However, the children who fare best do so because of some positive model of intervention, whether that model is a boys' club, a teacher, a grandparent, or family therapy, that provides sustained attention to children's needs. The mix of services needed is as different as the children and families who need these services. Mr. Petit pointed out that millions of children do not receive early intervention and treatment services because of an overburdened child welfare system. Ms. Massinga said the ability to read, adequate, uninterrupted schooling, and the presence of a key person in their lives who gives them consistent attention help children to succeed. She also said belief in themselves, the sense of "I can make it," is especially important. She noted many children do not receive discipline from their environment and so do not have an internal sense of discipline.
Ms. Mary Ann Murphy, Casey Family Partners, said that 25 percent of abused children become abusers as adults. Not enough information has been gathered as to why the other 75 percent do not continue this cycle. Underreporting and underresponse contribute to this lack of knowledge. Ms. Murphy also pointed out that referrals to child welfare agencies often come from family members or neighbors, rather than professionals. Such referrals are less likely to be responded to.
Mr. Mastroianni asked how the system can ensure that those involved in the child welfare system are not victims of discrimination later in life. Mr. Petit replied that our society is very tough on 12- to 14-year-olds who have engaged in criminal behavior. The key to preventing discrimination is to identify these children early so that they do not amass a set of records or undesirable characteristics. Mr. Petit said it is ironic that referrals from neighbors are minimized, while referrals from law enforcement receive more attention. However, by that time, less chance exists for curbing the behavior. Unfortunately, an adequate way to avoid stigmatization does not exist.
Ms. Higgins asked if communities have model programs for early intervention. Mr. Petit responded that numerous worthwhile programs exist, but they do not have the desirable penetration rate. "The question is, are they getting to 5 of the 100 kids, or 40 of the 100 kids, or 100 of the 100 kids? It is no consolation to the one kid who is hungry that 99 are not. At some point, it comes down to one kid a time." Ms. Massinga again pointed to the need to know the nature and duration of intervention required so that these successes can be transferred more easily to other situations.
Mr. Fisher asked for a working group to be formed from the Council to address this problem. He directed that an action plan be drafted for the next meeting. Ms. Murphy and Ms. Rose Washington, Berkshire Farms Center, will cochair this group. Mr. Fisher called the empirical data presented by Mr. Petit and Ms. Massinga "impressive and depressive."
HHS Secretarial Initiative on Youth Substance Abuse Prevention
Mr. Fisher introduced the Honorable Donna E. Shalala, Ph.D., Secretary, U.S. Department of Health and Human Services (HHS). Secretary Shalala reported that the 1999 budget calls for an 11-percent increase in substance abuse grants to the States, with an emphasis on getting users into treatment programs. She said this budget reflects President Clinton's leadership and a genuinely caring attitude about the children no one else seems to care about.
Secretary Shalala outlined the Child Care Initiative, which is the largest investment in child care in the history of the country. It features an afterschool care component that includes adolescents. The Federal Government hopes to see innovative approaches in this area emerge from community-based organizations and schools since it has no desire to dictate what these programs should look like. The Secretary wants activities planned not only for afterschool hours but also for the weekends. Although teenagers are on a different time rhythm, they still need caring adults to be with them. She pointed to the need to leverage the resources she believes Congress will approve with local funds because the States have a great deal of money. Putting enough money and ideas into play in substance abuse and afterschool programs will allow practitioners to work with the Administration and Congress to shape a set of dramatically different programs for young people.
Secretary Shalala then spoke about another set of programs for younger children, including infants. Very little infant care currently exists in the Nation. Parents who are going to work or entering a treatment program have no place to put a new baby. This initiative seeks to develop quality child care for younger and younger children. Currently, most parents place their children with a friend. Family daycare needs to be upgraded. A number of networks are being developed to train these daycare providers, even if these providers take care of only a few children. These jobs need to be upgraded, with workers who have more skills and who are paid on a regular basis. Such initiatives represent a fundamental, multibillion-dollar investment in children.
Noting that research investments are also very important, Secretary Shalala said, "Our understanding of why young people do what they do is quite limited. We know more about basic science than we do about behavioral science. We need to invest in prevention and understand why some kids are involved in risky behavior. The explanation cannot simply be poverty all the time." By investing in social science and clinical research, a better sense of the strategies that should be developed will emerge.
Secretary Shalala said, because not enough money is available for substance abuse treatment, the States need to leverage the money they are "sitting on." Republicans have asked the Secretary if the money from the tobacco industry can be applied to a more integrative approach regarding risky behavior. Rather than isolating tobacco, they want to look at alcohol and drug abuse also. She said this will be considered so that more careful and more strategic investments can be made.
Secretary Shalala expressed some disagreement over the concerns voiced by speakers earlier regarding the effects of the new adoption bill. While very supportive of substance abuse treatment for natural parents, she still believes that children cannot bounce around in foster care. "We have some responsibility to make these decisions quicker and, I think, ultimately fairer because 2 or 3 years in the life of a child is a lifetime." She believes that the new adoption bill establishes the balance needed between parental rights and the welfare of children. She went on to say, "What we have now is simply a disaster for a whole generation of young people, and we're coming down now on their side to see if we can find a way to get them into a much more stable situation much quicker."
On the issue of substance abuse, Secretary Shalala said marijuana continues to be a very serious problem. Some success has occurred in slowing down the use of drugs among younger children. "The question is," according to the Secretary, "how do we sustain that conversation? Somehow, when we turn the kids over to the larger society and they no longer have babysitters or if the parents pull away from them a little as they enter adolescence, we lose them to a larger culture and to a different kind of message. We have to figure out a way in which the messages and the expectations stay together for these young people." She believes afterschool and weekend programs will address with this need.
Secretary Shalala ended her remarks by pointing out that, in every fairy tale across cultures, "kids are always saved by caring adults. In the end, that is what we have to do." This must be done with the tools available, whether they be new legislation or investments in substance abuse education and treatment.
Mr. Fisher thanked Secretary Shalala and noted the powerful alliance that she has formed with Attorney General Reno in bringing together the efforts of HHS and the Justice Department.
Secretary Shalala was asked if there are alternative educational programs for children with discipline problems so they do not have to be removed from school. She said that HHS and the Departments of Justice and Education encourage localities to develop alternatives that will foster safer kids and safer schools. Performance partnerships encourage mixing of funds on the local level, so that the needed components, such as alternative schools, schools-within-schools, or special support programs, are present in innovative programs. Secretary Shalala believes barriers are being removed to empower agencies to work together.
National Drug Control Strategy
Mr. Bilchik welcomed the Honorable Barry R. McCaffrey, Director, Office of National Drug Control Policy. General McCaffrey said 14 other Cabinet officers work together on the Administration's drug strategy and that a special coalition exists among the Attorney General, Secretary Shalala, U.S. Secretary of Education Richard Riley, and himself. He praised the Attorney General for her work as a child advocate and a community coalition builder.
The focus of the drug strategy is prevention programs for adolescent American youngsters, particularly those in the middle school years. According to General McCaffrey, if youngsters from the ages of 9 to 19 do not smoke cigarettes, abuse alcohol, or use pot, they are "home free."
Only a small number of Americans are compulsive, drug and alcohol addicted users. However, this group of 4.1 million is larger than the number of persons in the active armed forces. This group is involved in almost every social problem the country faces, accounting for 16,000 deaths per year and $70 billion in damages. They represent one-third of all AIDS cases and one-third of all industrial accident victims. They also drive the criminal justice system. Of the 1.7 million persons behind bars, Columbia University estimates 80 percent have drug or alcohol-related problems. The National Institute of Justice puts this figure at 54 percent. Whatever the number, the number is going up, with perhaps a 25 percent-increase expected in the next 5 years.
Five years ago, the Nation had seven drug courts. Currently, 200 are in operation and, by the turn of century, there may be 1,000. These courts place the nonviolent, drug-using offender in a treatment program supervised by the criminal justice system. This approach has been shown to work at least one-third of the time. Under this approach, if a person is arrested, that person will be tested for drug use. If the test is positive, the person goes into treatment. The person either cooperates with the treatment or goes back to jail.
General McCaffrey told the Council 80 percent of the drug effort is dedicated to prevention for adolescents and treatment programs that are linked to the criminal justice system in an effort to alter the compulsive drug-using behavior of those 4.1 million Americans. On other fronts, the Nation needs to work in cooperation with the international community to stop the drug supply. Americans accept modest constraints on their behavior in order to travel safely. General McCaffrey wants to see an analog to air travel developed for the 39 border crossings in the Southwest. Within 5 years, a similar system could be set up for the border crossings, using unintrusive technology. Since the technology exists, this challenge is a matter of organization and resource allocation.
To illustrate the point that the drug supply sometimes grossly exceeds the demand, General McCaffrey said addicts in this Nation use 13 metric tons of heroin, while 390 metric tons are produced in the world. The United Nations reports the United States accounts for 11 percent of the world demand, but it is the preferred customer because Americans pay more for illegal drugs. The country spends spend $67 billion a year on illegal products and thus fuels an international crime syndicate.
General McCaffrey believes the most dangerous substance abuser in America is a 12-year-old who smokes a lot of pot. This youngster probably started by smoking cigarettes and abusing beer or wine coolers. An addicted youngster costs $2 million over the course of his or lifetime. Yet a child-at-risk program like the one cited in Miami only costs $2,000 a year per child. This represents an excellent, cost-effective tradeoff.
After going through the budget appeal process, General McCaffrey, Secretary Shalala, and Secretary Riley secured $17.1 billion for drug programs. Although the Nation will continue to pay for law enforcement incarceration, the largest increase in the 1999 budget (14.5 percent) will go toward prevention programs for young Americans.
General McCaffrey also outlined two new initiatives, the Drug-Free Community Support program and the National Youth Media Strategy. Over the next 5 years, $140 million will be used as seed money to build more antidrug community coalitions. These groups sprang up in the 1970's and early 1980's as a reaction to the prevalence of drug abuse, which peaked in 1979. Since then, the Nation has experienced a 50-percent reduction in use. These coalitions played a big part in that downturn. Currently, more than 4,300 coalitions operate throughout the Nation. DHHS will administer the program, and 14,000 coalitions will be built in 5 years. This effort represents a modest investment of money by Federal Government standards.
The second initiative is the National Youth Media Strategy, which began through the Partnership for Drug-Free America. The advertising community will develop television, radio, and print advertisements, and then air them as public service announcements (PSA's). Congress appropriated $195 million for a 5-year effort. These ads will appear in 12 test cities for a 3-month test. The program will be evaluated and then go nationwide in June. The initiative will also create four interactive sites on the Internet. The National Institute of Justice (NIJ) has said America does not have a national drug problem but a series of local drug epidemics, so these ads will target local markets with local messages, which will appear four times a week with a 90-percent market penetration. General McCaffrey believes that both these initiatives will help parents, educators, health professionals, law enforcement, and communities, which are the heart and soul of drug prevention efforts.
Mr. Petit asked General McCaffrey if resources could be expanded to help substance-abusing mothers with babies. Due to the lack of available treatment programs for this population, their children are often taken from them. Mr. Petit does not think advertising will affect this group. General McCaffrey agreed that this aspect of the drug problem needs attention. However, he stressed this $195 million will not come at the expense of any other program. He reminded participants money cannot be transferred from one program to another. For example, the money spent to fly an aircraft on a counterdrug mission over Peru cannot be applied to drug treatment as a tradeoff.
General McCaffrey went on to say saturating the market with these ads will create a demand and will make people realize the system does not currently have the capacity to respond. By deliberately overloading the system and creating the demand, the public will force Congress to respond. Two-thirds of the ads will be aimed at youngsters and one-third at adults. In the future, 60 percent of the ads will target parents and 40 percent will target youngsters. General McCaffrey believes a niche market could be created for parents who are drug abusers.
General McCaffrey told the Council, "All of us would like to believe that drug abuse is a problem of the dual-diagnosed, drug abuse is a problem of the dysfunctional family, drug abuse is a problem of the economically deprived, drug abuse is a problem of anybody but me and my family." He stated Americans believe 97 percent of compulsive drug users are black. Yet 7 out of 10 drug abusers are employed, and users are overwhelmingly white, not black or Hispanic. Drug abuse is not a poor person's problem. The highest incidence occurs among health professionals, particularly anesthesiologists, 10 percent of whom have problems with alcohol, legal narcotics, or illegal drugs. Black teens have a markedly lower incidence of drug abuse than any other ethnic group. On a per capita basis, crack use by whites is double that of blacks. The drug use problem exists across the board in America. "If you want to worry about somebody's kids, worry about your own," General McCaffrey said.
National Substance Abuse Coalition
Mr. Bilchik then introduced Mr. R. William Ide, Chair, American Bar Association (ABA) Standing Committee on Substance Abuse, and Dr. Percy Wootton, President, American Medical Association (AMA). Their organizations have formed a multidisciplinary coalition to address the problem of substance abuse. Mr. Ide shared with the Council his pride in the partnership the ABA and AMA have forged with one another. The ABA has been working on the drug problem for the past 7 years. One of its accomplishments in this area is the unified family court system, which Mr. Ide believes will ultimately reinvent the court system in this country by providing one judge for each family. While Mr. Ide has observed some successes in the workplace, he has also met with frustration in dealing with business leaders. He believes politicians are the most difficult to deal with because they do not truly understand the problem of drug abuse and only want to build more correctional facilities.
The history of cooperation between the ABA and AMA began with the domestic violence issue. Their first successful venture in the drug abuse area was similar to Drug Abuse Resistance Education (D.A.R.E.). Their partnership allows each organization to bring a piece of the answer to the drug abuse puzzle. For the past 2 years, the National Substance Abuse Coalition has brought together 30 national organizations that, in turn, are building a mosaic of perspectives. For example, corrections officials learn about the welfare system from those working in that area. By developing a mission statement that includes their guiding principles, the Coalition has been able to focus their efforts.
Dr. Wootton expressed his appreciation to the Attorney General for recognizing the importance of this partnership. He also thanked the Council for the invitation to speak to them on behalf of the AMA's 300,000 members. He outlined the coalition's approach to the problem, an approach that is somewhat different from others. The coalition wants to bring together America's public and private leaders to address the substance abuse problem as primarily a public health crisis. This public health crisis damages families, foments crime, drains the economy, and undermines that Nation's strength. Unlike many other public health problems, drug abuse is preventable, and treatment and rehabilitation opportunities already exist. By enlisting member organizations with grassroots support, the leaders of those organizations can educate their members regarding the abuse of alcohol and other drugs. These organizations can then harness their national lobbying capabilities to influence drug policies and legislation.
By recognizing the drug problem in America is fundamentally a public health problem, the criminal justice ramifications are then seen as symptoms of this public health crisis. The focus of national policies must shift to treatment. Dr. Wootton said when treatment is received, crime will decrease and the quality of Americans' health will increase.
The Coalition is working on the parity issue to ensure that those who seek drug treatment will have the same level of insurance coverage they would have for other illnesses. It also wants treatment expanded, especially for those who are clogging the Nation's criminal justice system. He emphasized prevention is the bottom line. Very often, preventing a disease is much easier than treating it.
Dr. Wootton said the key words that drive the Coalition are collaborate, cooperate, and participate. He believes partnerships like the National Substance Abuse Coalition are effective because they respond to the need for a national discussion on policy priorities and resource allocations. Such partnerships also bring together diverse approaches and fragmented perspectives from communities throughout the Nation. Public and private leaders can then work together without being derailed by partisan politics.
Dr. Wootton assured the Council the AMA and ABA are ready to work to end the scourge of substance abuse and improve the quality of life of all Americans and their families. The Federal Government can help best through their support of local efforts. Dr. Wootton quoted Martin Luther King, who said that service is contagious. Community service is a key principle among physicians. Giving back to one's community is the message Dr. Wootton has tried to promote across the country. This service to the community is essential since because all health care and all politics are local. This Coalition can serve as a national model for building partnerships that will provide the right kinds of services on a local level. Dr. Wootton also stressed that, if the system can reach juveniles, the cycle will be broken.
Mr. Bilchik acknowledged the shortage of treatment services. If the demand in the field is created as General McCaffrey suggested and linked with best practices, such as the Safe and Drug-Free Schools programs, perhaps additional support will be secured and concrete parameters established in partnership with Federal agencies.
Mr. Fisher observed Washington has the money to deal with this problem, but it must be designated and appropriated. He stressed the Federal Government needs to know what the demand for services is so that resources can be channeled. He reminded the Council the Attorney General is adamant that those in government listen, because all politics is local. Mr. Fisher said, "There is a lot 'inside the Beltway' can do if we are told what is needed out there. We need to know what your assessments are."
Mr. Bilchik asked that the Council focus on the child abuse and neglect area. Ms. Murphy and Ms. Washington will work with Ms. Wood's support in forming a working group and performing outreach to the other Federal representatives and practitioner members. He also requested Ms. Wood to crystallize the opportunities that may exist among the Federal agencies and practitioner members to connect with the ABA and AMA and to further support and participate in the National Substance Abuse Coalition. Mr. Bilchik closed the meeting at 4 p.m.
Coordinating Council on Juvenile Justice
Dr. Hoover Adger
Larry K. Brendtro, Ph.D.
John A. (Jack) Calhoun
Robert W. Denniston
The Honorable Gordon Martin
The Honorable Barry R. McCaffrey
The Honorable County and Youth Court of Forrest County
Mary Ann Murphy
The Honorable Donna E. Shalala, Ph.D.
Deborah L. Vincent
Gina E. Wood