Loading...
HomeMy WebLinkAboutLife's Choices Kauai-Drug Response, DEPARTMENTAL BUDGET CALL-BACKS FY 2014-15 4/21/2014 DEPARTMENTAL BUDGET CALL-BACKS FY 2014-15 • LIFE'S CHOICES KAUAI - DRUG RESPONSE PLAN April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 1 There being no objections, the Committee was called back to order at 1:49 p.m. and proceeded as follows: Life's Choices Kauai—Drug Response Plan Honorable Tim Bynum Honorable Mason K. Chock, Sr. Honorable Gary L. Hooser Honorable JoAnn A. Yukimura Honorable Jay Furfaro, Council Chair Excused: Honorable Ross Kagawa Honorable Mel Rapozo Chair Furfaro: Okay. We are back from our recess. We are accordingly going to focus ourselves now on Life's Choices and in particular the Drug Response Plan. I would like to remind everybody that the Response Plan is for discussion today for the next hour and that the actual item on the future use of the treatment facility and/or how do we get to a treatment facility is actually scheduled for July 23rd. This is a review of the current plan, its accomplishments and shortfalls and that is what our focus will be on for the next hour. On that note the rules are suspended. Theresa, along with Nadine, I believe you are coming up. You passed out this particular piece at the recess? Okay. Do you have a PowerPoint that you are going to be doing? The floor is yours. There being no objections, the rules were suspended. THERESA KOKI, Life's Choices Kaua`i Coordinator: Sorry. Good afternoon Chair and members of the Council, Theresa Koki, for the record. Chair Furfaro: Good afternoon. Ms. Koki: Good afternoon. Today I would like to present our Kaua`i Community Drug Response Plan for 2008-2013 and this is an update of our goals. Just a little bit of history about our program in February of 2003 the County Council here authored by Mel Rapozo introduced a resolution to have a community-based effort to deal with the island wide drug problem. Then our Office was created. Then we had our first Drug Plan for 2004-2009. Here we are today, with our Drug Plan that was from 2008- 2013. This Drug Plan was dedicated in memory to Mayor Bryan Baptiste for his leadership in initiating this effort. So we will start with prevention. Our prevention vision is to engage and empower our youth, adults, and families to make the choice to be drug-free. Our first goal for prevention was to develop the structure of the Drug Plan to provide effective coordination and implementation of prevention programs for youth and families on Kauai. So here are a few measures of success. We had consistent attendance at meetings. Our prevention meetings have collective impact discussions for all of our prevention providers. We had three years' of consistent attendance from 2009 to 2011 and that was because we had a strategic prevention grant for our prevention providers. We increased representation by...we identified the missing agencies using the prevention community stakeholders wheel and extended invitations to our providers and gave them a meeting calendar to block off the date to make a commitment to be part of the prevention team. We are building prevention system infrastructure through the SPF process which is the Strategic Prevention Framework. Our new mission at that time was created, most recently, April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 2 actually and it was to engage and empower the community to promote positive outcomes in their Life's Choices. Funding was secured for coordination and support. The first phase of strategic prevention framework State incentive grant funds was $313,000 for assessment and capacity-building. That also included funds for personnel in our Office. Later in 2009 we were able to continue the Big Brothers, Big Sisters mentoring program on Kauai for an additional two years with funding from the Office of Youth Services and Title V community prevention grant efforts most recently in 2013 we were awarded again from the Office of Youth Services to provide a structured program for our suspended youth. Working with the Department of Education, we identified that when kids get suspended for drug use on school property, they get suspended for 90 days, leaving them without any supervision or structure to complete their school year. The service provider for that contract is Hale Kipa. Then also in 2009 we received $1.2 million in Phase II of the strategic prevention framework grant which allowed the County to award, through the request for proposal process nine prevention agencies with funding to provide evidence based programs in the schools and communities island wide. The programs that we are operating were eight new evidence-based programs in the schools and communities throughout the island. They were implementing strategies on the top substance-abuse issues that are identified by the State in its subcommittees and that was under aged drinking. Here is our strategic prevention framework subcontractors. We have Hale Opio, and the areas that they taught their program. They target 120 youth and they actually got 98% of that goal. Their contract time was from November 2010 to September 2011. Hale Kipa was another provider. Alu Like was another provider. They went way over the amount that they targeted at 174%. Hina Mauka targeted such a large amount that they only reached 15% of the goal. They did very good work, but they...the number...the targeted group area was just too much. They did not realize the effort that it would have taken to accomplish that 100%. We had the Boys and Girls Club of Kaua`i, Circles of Light and Hale Kipa II, meaning that they applied for an additional grant when the second request for proposal went out. Kaua`i Economic Opportunity and the YWCA which also exceeded their goal and did 184%. Based on the accomplishments of the providers, we were able to allow them a no-cost extension, four of our prevention providers continued their programs until the end of the grant in September of 2012. They were Alu Like, Boys and Girls Club, Circles of Light, and the YWCA. These are the evidenced based programs that were implemented in the school and in the community. There is All-Stars, life's skills training, positive action, project alert, sports, too good for drugs, and then that is prevention education. We also have our environmental strategies which was community mobilizing for change on alcohol called CMC and then an information dissemination program, called Stars for Families. This is where kids would bring home packets to interact with their parents. Again continuing with our programs continued and expanded, in 2012 Phase III of the SPF grant allowed prevention providers to apply directly for funding to the State of Hawai`i Department of Health Alcohol and Drug Abuse Division to continue again their evidence-based programs. As part of their sustainability plan, two of the programs continue to teach positive action, which is an evidence-based program until today with other funding and that was the YWCA and Hale Opio. Right now we are currently working with the Alcohol and Drug Abuse Division on a partnership for success grant to continue to address under aged drinking. Problem ages 12-20 and the prescription drug misuse and abuse among individuals 12-25. Here is another program that was continued and expanded through money from the Kaua`i County Council, we were able to give funding through the Hawai`i Community Foundation for pre-school and after-school pilot programs. So the first-round of funding was awarded to six organizations and their second round will be available in May of this year. So here are the six organizations that got funding. Circles of Light, Aloha School Early Learning April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 3 Center, Hanalei School PTSA, Island School, Koloa Early School, and Hale Opio Kaua`i. The measures of success was the final one was decrease in first drug use among Kauai middle and high school students as shown on the Department of Health youth behaviors surveillance survey. Here we are, where we did good in some areas and not so well in other areas. So if we look...this is a school survey that taken in school every three years and they are trying to implement it every year. Goal number two for prevention was to promote the availability of public and other transportation for youth to and from activities. One measure was the number of transportation partnerships formed with providers and clients. We had the Big Brothers and Big Sisters Program partner with Kamehameha Schools and they offered seven children to go to a mentoring program through Kamehameha Schools. The County of Kauai also partnered with Hina Mauka in three fifteen passenger vans and the County Transportation Agency worked together with the prevention providers and 112 participants were riding the bus to go to these evidence-based programs. Extended bus coverage was one of the other measures. The committee worked on a survey to assess the need for late evening and weekend support services. We submitted that to our County Transportation Department and with the Administration and County Council working together, they funded extended routes / hours and youth were better ability to access the programs that they attend. For our treatment and community integration part, whose mission is local access to an affordable, effective drug treatment and support that offers all a hope for a happy, productive life without drugs. These are two themes that in the beginning in 2003 started separately, but realized that they are were related and formed one team. Their first goal was to establish additional residential treatment services and facilities for youth and adults. Our measures of success would be that on-island treatment is available and we have clean and sober homes that have been established for adults on Kauai. We recently completed the feasibility study for the adolescent drug treatment center. Community acceptance of treatment facilities, the majority of the community has accepted the need for treatment facilities, but we still need to put more outreach for the community's acceptance and education. The majority of provider outcomes achieved in 2011 the State Department of Health ADAD partnered with Kaua`i, utilizing the access to recovery grant called ATR and the State was awarded $11 million for four years and Kaua`i has a fee for service contract with ADAD and treatment providers including the County Transportation Agency. I am not sure that you know, but today is the day that people can go to the park over here and get their bus pass for free. They get an assessment and the need is evaluated and they get their bus passes. Chair Furfaro: Excuse me, you are talking about the park in front of the Historical Society? Ms. Koki: Yes. Chair Furfaro: It looks like it is a success. There are a lot of people. Ms. Koki: They actually go to where their clients are and that is unusual, instead of expecting them to come to an Office. Chair Furfaro: Very unique, thank you. April 21, 2014 Budget Call-Backs (Life's Choices Kauai— Drug Response Plan)(ss) Page 4 Ms. Koki: We have a coordinated assessment of treatment system that is ongoing and in the back of the Drug Plan and it is a continuum of care and we do need to update that. For number four measures of success, we had beds allocated for Kaua`i clients. We currently eight beds allocated on Oahu through Child and Adolescent Mental Health Services for our youth. Adult bed space on the other islands are on a first- come, first-served basis. Funds secured to support beds when empty or insurance not available...we had a grant secured for adult residential treatment in 2008-2011. It was contracted with Hina Mauka. At that time at least 53 adults received grant-in-aid for off- island treatment. On the satisfaction of referring agencies with the process, we know we have referrals made by supporting agencies which is the Department of Education, Office the Prosecuting Attorney, KPD, Drug Court, Family Court, and Hope Probation, and the Veterans Administration. To-date a satisfaction survey has not been completed. We know that referrals are not being made, but we are not sure how satisfied that they are with the process. Goal two of the Drug Plan was changed. It was establishing an on-island therapeutic living facility and then it was changed to establishing on-island clean and sober living homes. The positive community response to facilities in this case was a plan was created for community outreach and education to minimize resistance. We facilitated ten island wide meetings in 2010-2013 to provide that community outreach and education. We currently have six clean and sober homes for adults on the island and that is a new facility established. Referrals made by supporting agencies, agencies continue to refer youth and adults off-island for residential treatment. Goal number three for treatment and community integration was to expand drug treatment services within the Kaua`i Community Correctional Center to support the recovery of prisoners. In KCCC, the treatment in-house is the Salvation Army curriculum, freedom to change a level II substance-abuse rehabilitation program that provides inmates the highest level of treatment available here on the island. KCCC has allowed for other agencies to come into the facility and assist with treatment services. The number of people receiving treatment services right now in the program includes about 42 participants and that offers in-facility counseling, support groups, and transitional services after inmates are released. About 80 more inmates need in-house treatment. The number referred to community treatment services upon release, all who attend the program are referred to continuous treatment and wrap around services. All inmates have an exit plan six months prior to their release through the re-entry program. This is a program recently worked on with our treatment and community integration team. They did an excellent job to work with people in KCCC and our Workforce Investment Act, Office of Economic Development for the re-entry, reinvestment act for the workers that includes people from getting released from KCCC as well as other incarcerated facilities that we contract with. And also Drug Court clients who are in recovery. Goal number four was to ensure that transportation options are available to those seeking services for substance-abuse. Again with transportation available to clients at hours and in locations needed, we had conducted a survey in 2009 with the providers and treatment clients and our findings was that bus services were not available after sessions were completed and some bus stops were too far away from treatment services. So the week day extended hours of service proposed by the Administration and approved by the County Council had greatly assisted the clients. Treatment providers now use access to bus stops as criteria for selecting their facilities. Clients utilize expanded routes. In 2011, Kaua`i received the Access to Recovery Grant from the Department of Health, which is $11 million for four years and Access to Recovery gives out vouchers for people who need transportation. Four agencies report frequent use of the Kaua`i Bus as the only mode of transportation for their clients participating. Agencies include Positive Parenting, Women in Need, Love the Journey, and Hoola Lahui Hawai`i. This is our expanded routes as of April 16th, last week and how many people on that grant are April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 5 receiving vouchers for their bus passes. In February, it was 44. In March it was 194. And as of April 16th, which is just halfway through the month, there was 324 vouchers that were issued. Goal number five of the treatment and community integration goal was to participate in the legislative process to ensure needed funding and services for drug treatment and community integration. The measures of success was needed legislation passed and signed. Kaua`i's voice heard statewide on substance-abuse issues and due to the limited resources, this goal has not been pursued. For our enforcement group whose vision is to work together to interdict drugs and prosecute drug users and dealers and reduce crime. Their first goal was to improve communications with the community. The measures of success was the quantity of projects initiated following from community problems and one of the accomplishments were the neighborhood watch program increased from 6 to 15 active communities. In the Summer of 2012, we were able to grant KPD $24,000 to conduct 17 under aged drinking surveillance and park sweeps resulting in 7 citations, 1 arrest, and five detainments. The other measure of success was a decrease in overall crime statistics in areas where projects were initiated. It is difficult to compare a decrease in crime because now there are more accessible ways to report crime. Using the 411 crime mapping and all the anonymous tips, more crime is being reported. It shows that there is an increase and the neighborhood watch program there is another way for them to report crimes. Here are some of our drug statistics that were available up until 2011. It went down in some areas and it went up in others. Goal number two for enforcement was to secure funding and other resources needed to support law enforcement and intervention programs. Our measures of success, number one was to fill vacancies at the Police Department and the recruitment and retention of personnel, especially sworn Officers remains a high priority for the Kauai Police Department. The training resource and development in personnel sections are taking lead roles in addressing this County critical area. With that in the last five years we had 63 Officers fill vacancies. Chair Furfaro: Theresa on that slide, do you have anything that shows what the attrition of departing Officers was for the same period? Ms. Koki: No, I do not. I am sorry. I know one of the goals was to have a three-year retention and we found a few for various reasons did not stay, whether it was because of an evaluation or they decided it was not for them. We could work better and closer with the Police Department to get the statistics. Chair Furfaro: I will send the question over to the Police Department. I just wanted it for comparison. Ms. Koki: So the number of vacancies filled again, they received...the Police received the COPS grant, which is community-oriented policing grant from the U.S. Department of Justice to hire six additional Police Officers. Here is the retention of...the retention of newly trained Officers for three years. With subsidized vehicles and Collective Bargaining Unit pay increases that serves as incentives to retain current Officers and attract new Officers. Goal number three was to expand the demand reduction programs. One of the ways that Chief Perry decided to do that was to have the Citizens Police Academy. It was established in 2012 as an interactive program designated to educate the public about KPD's policies and the criminal justice system and the Academy is prepared to hold a third class this spring and graduated 19 citizens thus far. Another demand reduction program is the Kaua`i Police Activities League and today we were able to support KPAL with grant funding again for their Sea Scouts, wrestling, basketball, boxing, and flag football. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 6 Chair Furfaro: Is there money in this year's budget for KPAL? Ms. Koki: I am not sure. NADINE K. NAKAMURA, Managing Director: I believe there was funding for a position for KPAL this year in the budget as a re-described position. So that there could be one full-time staff person dedicated to KPAL, overseeing KPAL activities. Chair Furfaro: Thank you, Nadine. Ms. Yukimura: Is that an Officer position or a civilian position? Ms. Nakamura: It is an Officer position. Ms. Koki: The reason why we could support this with our grant funding, it was part of the environmental strategy...it was not evidence-based, but it was our environmental strategy. The number of collaborative cases accomplished was difficult to measure. Number of suspects and clients integrated was also difficult to measure. The number of presentations given within the last five years was 624 presentations. The number of actionable leads from the presentations, again, that is unknown. Goal number four is continue to strengthen working relationships among all County, State, and Federal law enforcement agencies. The number of Federal cases for prosecution is unknown and the number of cases for State prosecution is also unknown. Finally our Drug Action Team, whose vision is uniting the community to resist drug use, support the enforcement of anti-drug laws, and provide caring treatment and support for those affected by drug use. Their first goal was to identify and secure sustainable funding for drug programs. I am sorry on the Drug Action Team we have our chairs of all of our committees. So I am the leader of the Drug Action Team. I facilitate those meetings and our prevention chairs for these next two years is Melinda Montgomery of Hale Kipa and Maile Murray of Child and Family Services. For treatment and community integration, we have Merrilee Worrell who is retired and used to work in mental health, kokua, and family guidance center. Her Vice Chair is Jack Vile who works at KCCC. For enforcement we have Tina Higashi from the judiciary and her Vice Chair is Tim Tobin from the Prosecutor's Office. We are very grateful for all of the community hours that they put in for free and the respect that their supervisors let them come to these meetings that are an hour and a half once a month. Sustainable funding to secure program was the first measure of success and although grant funds are not sustainable funding Kaua`i continues to receive Federal and State grant funding for treatment and prevention providers. I am not sure how much the amount of funds raised at this time are, as individual agencies can apply for dollars directly themselves. New and continuing funding secured by providers, the information from the providers are not available at this time. Goal number two is to sustain a management system to support and coordinate implementation of the plan over the next five years and maintain timely communications for all involved. The measure of success number one was funding for anti-drug office secured. In 2008, we had one full-time and one part-time employee that was General Funded. In 2009, we had one full-time employee, General Funded and three grant-funded positions. From September 2012, when the grant ended we have one full-time employee. Here is our operational budget that we had in 2009 we had $40,000. 2010 the same. 2011 we had to start cutting our funding with $31,000. 2012, $31,000 and this current fiscal year I only have $19,000. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 7 Chair Furfaro: Going back to those positions that were funded, we funded one position and the other positions were funded by grants? Ms. Koki: Yes. Chair Furfaro: Going forward, we are still funding our position, but there was no money for grants? Ms. Koki: Not for personnel, no. Chair Furfaro: So that was a change in the grant policies? Ms. Koki: The grant ended in 2012. Chair Furfaro: Thank you. Ms. Koki: So measures of success number two was management systems in place. What we did was reorganize our teams. When I was with the Office of Boards and Commissions we tried to make it more in line with the Boards and Commissions especially since one of the staff members there was taking my minutes from my teams, as well as Boards and Commissions teams. So in order to streamline some of the things they have to do, we tried to reorganize our teams. We have new leadership for each team. We had Officers from 2003 that were still participating in 2010. That was a little bit too much years. So we kind of thanked them and had nominations opened. Mason is smiling. Nominations for officers now are every two years. This is for them to avoid burnout and to have other people who have been part of the team to step up and be the Chair or Co-Chair. Our committee satisfaction we had increased participation at meetings and planned updates and ongoing activities. The Life's Choices committee is currently working on a survey instrument to make sure we gather that satisfaction and measure it within six months and one year. Goal number three was to develop and make available information on community resources to help individuals and families. We had distributed over five years an average of 1,500 packets per year at various offices, events, and activities. A resource directory is given now to any inmate leaving Kaua`i Correctional Facility and that is where you can get food, where you can get support, where you can get prevention program for your children, and all kinds of resources that we have put together. Our Life's Choices website is updated with links directly to service providers. If you go online and you click on "love the journey," it goes directly to their website to show the hours. Our visitors especially like the part to look up where is an NA or AA Meeting where they are staying. So that is very helpful for them. Not everybody shows up and says that I got this resource packet and I am here to get help, but we continue to refer people to services and other referrals may come from Hina Mauka Teen Care, the Department of Education, the court, Kaua`i Drug Court, Family Court, Kaua`i Police Department, Adult Probation, Hope Probation, and the Veterans Affairs, and the Kaua`i Community Correctional Facility. Goal number four for the Drug Action Team was to coordinate messages to the public to heighten awareness on the goals, activities, and outcomes of the Kaua`i Community Drug Response Plan. So here we are out in the community, we have an annual health and wellness fair. We have alcohol awareness month, which we do high school and community presentations. This year we hosted a Drug Summit, where 80 of our County supervisors and managers received training in mandatory reasonable suspicion and drug recognition. That is mandated by Bargaining Units and they needed four hours, but they got six continuing education credits. We also had continuing education credits for April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 8 certified substance-abuse counselors and certified prevention specialists. Measures of success, the number of times messages are in the media, newspaper and we had a monthly column with The Garden Island newspaper and publicity spots. A number of positive comments received by Anti-Drug Departments are difficult to measure. The number of drug-related arrested is difficult to measure and that is the end. Chair Furfaro: Thank you, Theresa for a pretty complete presentation. Let me ask you, did we not solicit any comments from anti-drug partners that we have? Do you have any kind of feedback from slide 75, your last slide? Ms. Koki: Regarding the coordinated messages to the public, the measure was positive comments received by Anti-Drug Office. We do surveys when we have events. So we definitely do surveys from the Drug Summit that we recently got. Most of the comments were positive. At our health and wellness fair we also had surveys, but they critiqued the booths. They did not critique the anti-drug programs. They critique the vendors. Chair Furfaro: On page 21 of your slide, I will ask them to put that slide back up. You went very quickly through that slide, but could you walk us through one of our least favorable agenda items for feedback? Ms. Koki: I am sorry? Chair Furfaro: Slide 21, page 21, whichever it is. Would you walk us through one or two examples? Ms. Koki: Sure. Like I said this survey is distributed from the Department of Health to the schools every three years. We are trying to get better than that. The information being compiled in the year after they hand it in. For example, drank alcohol for the first time before age 13 other than a few sips, on Kaua`i, 20.5 response in 2007...it looks like it went higher in 2011. So in that area we know we did not do very well. I am sorry...0.4, sorry. Had at least one drink of alcohol at least one day in the past 30 days. It looks like we went down there by 9.9. Chair Furfaro: I guess the one I am interested in is the second to the bottom. Ever taken prescription drugs without a doctor's prescription? Ms. Koki: I think with the rise of prescription drug uses we have been getting education out there and the doctors are being very good at educating. Before you got a drug prescription it would last a year and now the doctors say in three days your prescription is expired. I think with the education that parents are getting they are not too quick to offer their children Vicodin for pain from a sports injury and so doctors and parents are being better at that. Chair Furfaro: Could I ask to you work with the transportation vouchers, you keep track of who is riding and so forth. But to us, in reaching out to give access to some transportation, do you know what the value of those transportation vouchers are? Ms. Koki: I think it is a one-month pass every time they get it. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 9 Chair Furfaro: So how many have we given out? Ms. Koki: This month, just halfway through the month, 300 something, yes. Chair Furfaro: So that is a pretty substantial increase and it is basically a complimentary pass? Ms. Koki: Yes it is. It is an access to recovery grant and keep in mind, the transportation is an access to their treatment provider. They have recreational activities that they can participate in as part of their recovery or just the basic daily needs such as going to the store to take care of their families and themselves. We have made a commitment, the Department of Transportation has to give me the stats on an ongoing basis. Chair Furfaro: Could you ask if they could expand that to say what they gave in the way of vouchers, but also what the value of those vouchers were? Ms. Koki: Okay. Chair Furfaro: Go right ahead, Mr. Hooser. Mr. Hooser: The access to recovery grant, is that funds that are paid to the Department of Transportation for the bus pass? Ms. Koki: We have worked out a way we can do it on consignment and so they have X amount of vouchers that they get from the Transportation Department. It is like a fee-for-service. They pay them. Mr. Hooser: So the County actually receives income from this grant? Ms. Koki: Yes. Mr. Hooser: That is the point I wanted to make that the County is not offering free bus trips. Ms. Koki: No, we are not. We had a long discussion because we did not want to take away from the bus. So we had...first we looked at their Ordinance to see what we could work with. It was a long transformation between Celia and myself, Kalawaia, and the access to recovery lady from the Alcohol and Drug Abuse Division. So we had several meetings before we came to the conclusion of what we exactly could do. It seems to be working out. Mr. Hooser: Thank you. Chair Furfaro: But I still want to know the value of those? Ms. Koki: Yes, I will get that for you. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 10 Chair Furfaro: That is covered by grant money as Mr. Hooser is pointing out, right? But we should be keeping clear track on the value of those vouchers. I think that is all of my questions. JoAnn. Ms. Yukimura: Thank you, Theresa and Nadine. This is the first time that I have seen in a report the actual drug use statistics that were put up there on page 21. So thank you very much for doing that. You know, it is good when we have people attending meetings sustainably and so forth, but the real bottom line is are our young people using less drugs? Are they not starting early? You know, those kinds of things. So it is good to get a report back like this and it is also really good to hear that they might be doing these surveys every year. That would give us much better indication or feedback as to whether our efforts are working. So this list, there is actually five places where it is gone down and the rest have actually gone up in different degrees. So I mean, for example, look at the "tried marijuana for the first time before age 13." It was 11.7 in 2007 and 16.4 in 2011. Ms. Nakamura: If you compare the Kaua`i numbers, in 2007 it was 8.1 and went up to 16.4, three years later. Ms. Yukimura: Thank you. It went down for a couple of years and then it went up. Ms. Nakamura: The first two columns are the Hawai`i Statewide numbers and the next two columns are the County's comparison. Ms. Yukimura: Thank you. Ms. Nakamura: So this is one where we have doubled. Ms. Yukimura: Yes. Thank you. Ms. Koki: To address that, we concentrated a lot on under aged drinking and we are trying to find ways with our teams when we discuss...to find ways when we have a grant specified for a certain drug, we really have to cover everything. We cannot do just under aged drinking and marijuana starts going up, but we have to have education on all the substances. Ms. Yukimura: If you fund programs that actually help kids make good choices, it does not matter what the drug is. So that is the power of really getting clear what cause-and-effect is in terms of kids making choices? I know that in the Life's Skill Program, that is the crux of the effort, to help kids understand how to analyze the consequences of their choices? Where to go for help? To get engaged in really positive activities that really meet their needs for confidence and self-esteem. So that is one way to address it. So for example, this is only an example, I think there are other ways of showing it...when you go to your...I am looking at slide 67 or even 69. Where you measure success by number of packets distributed. How do you know that the packets are actually having the impact you want to have in terms of people's choices? Because if it is not having an impact, no matter how many packets you distribute, it is not going to really make a difference in what you want to make a difference. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 11 Ms. Koki: This measure of success was included in the drug plan as that. Ms. Yukimura: Well, but then maybe it is not the proper measure of success. Ms. Koki: Perhaps it is not, I agree. Ms. Nakamura: That is why, this Drug Plan, the most updated one, this discussion is based on is for the period of 2008-2013. So last year the Administration included funds to update this Drug Plan, because of the expiration date of this Plan and it was not approved. This year, while we wanted to have funding to update the Plan, because of our fiscal situation, it was not included in the budget. Ms. Yukimura: We gave money for this Plan and this Plan has measures that to me are not really the real measures to look at. So to fund something else that is going to update it and come back with measures that do not make a difference that would be one of my concerns. Ms. Nakamura: So if there was a good process where maybe the measures were more pertinent or something that is actually measurable or something that will actually change outcomes. Ms. Yukimura: Right. Ms. Nakamura: That is really where we would need to go. Ms. Yukimura: Right. Ms. Nakamura: It is very clear that for some of these measurements, they were not good indicators of success. Ms. Yukimura: Right. Ms. Koki: When we were going through this eight years or five years' worth of accomplishments in the last two weeks, we noted that we were stuck to a certain measure, but we did so much more, but it was not the measurement that we were addressing. Ms. Yukimura: Even if you did so much more, what does that so much more lead to? Because you are having kind of an internal measurement when you say "so much more." But what did that lead to is the question? I mean, when we first started this out in 2003, we had the communities that care model and they were highly...they used the survey, the Department of Health survey, page 21 that we were looking at. But somewhere along the line, we lost track of those measures. So the question is what happened there? How did we lose track? So if there is a proposal to update this Plan, that would be one of my questions, how are we going to really do a Plan that gets us to where we want to go? How do we know whether we are getting there or not? I really believe that a plan should be flexible. So if it is not working, like if the measures are not good measures, how do we change it and stay on-track? April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 12 Ms. Koki: You know, I realize that these indicators and these measurements and all the numbers and surveys are so crucial to assess all of this, but it is again as you saw on the slide, it is just me. So in order to implement this Drug Plan, it did say it called for some staffing, which we did not get. Ms. Yukimura: Well, I just know that now there is this whole Keiki to Career effort and that is an effort to look at more than just drug use of kids. So one of my questions is how does that integrate? If there is what Keiki to Career says it is doing and if it is supporting our young people in becoming confident, competent, caring and healthy, which all four of those adjectives, confident, confident, confident, means that drug use is not the option really. How are we getting there? Through Keiki to Career or through a Drug Plan? Ms. Koki: Well, we have discussed that with Stacy, some of our members in our prevention team, Stacy Gillette from Kaua`i Planning and Action Alliance, who spearheads the...along with all of us, Mason has a part in there and JoAnn, that we talked about even including that in the prevention parts of our plan. She comes to our prevention meetings and presented the plan and got other members to participate in her prevention...I mean her Life's Skills and Parenting section. So that is up for more discussion. Just to clarify, last year when I put in the budget, it was not for a new Drug Plan, because I only asked for $25,000. A Drug Plan usually costs anywhere from $40,000 to $50,000. It was to assess the Plan that is what I was asking for, to do all of these. Because I am sure there are more things to report here for agencies that succeeded in helping us do it, but they might no longer come to a meeting or they have changed. I mean, with this Plan in the middle of it was the economic downturn and offices that had four or five people are now down to one or two and sometimes they are not able to come to all of the meetings. We keep sending them the minutes and they keep in touch, but not all the time that they can participate. So there might be a lot of other things that we did not have. Ms. Yukimura: You know there is a place where you mentioned doing a survey, putting that together. That is a future action, do you remember where that is? A satisfaction survey. I see one on page 67. Ms. Nakamura: Page 67. Ms. Koki: 67 was the part that we are going to be working on a survey instrument. Ms. Yukimura: I do not know that committees know how to put really good surveys together. Ms. Koki: Actually we are going to ask our boss, who is a planner to help us. She has several surveys she has used for years in her company. So we are going to try and see. Would you like to help us, too? Ms. Yukimura: No, no, I am not a survey expert, but I mean, I am really asking a legitimate question. Surveys take a particular skill and art, if you want to get the right information. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 13 Ms. Koki: Exactly. We had a public relations firm a couple of years back, who came up with a survey tool, but it did not really assess what the teams wanted to have in. So we still need to work in that area. Ms. Nakamura: I would like to add too, that I think that the questions that you are asking about the satisfaction that current participants have in this pretty comprehensive program and then the whole discussion with Keiki to Career, which the County also funds, you know, I think it is a good time to have the discussion, open it up for possibilities and then see what is the best way to reorganize, if we need to, moving forward? But really take into account, that there are other initiatives going on and if it makes sense to dovetail or to coordinate further, we should be doing that. Ms. Yukimura: Committee satisfaction with management systems, I am not even sure that is where we should be focusing on. It seems to me we should be focusing on are we getting the results in community with our youth in terms of drug use, drug prevention, drug treatment, and drug enforcement? You know, I think that issue came up with the Liquor Commission and doing their...what do you call it Theresa? Ms. Koki: The compliance checks. Ms. Yukimura: The compliance checks. They are not showing that much compliance you know? We do it over and over every year and we are not making really big strides. But I am convinced that there are ways to make strides in this, but we have not yet found the effective ways to do it and partly, maybe that we are not measuring what we need to measure. Thank you. Chair Furfaro: Mr. Chock, do you wanted to add to that? Mr. Chock: Thank you. I think what I heard from Nadine is that it is a good time for us to kind of take a step back, now that we have come to this place and looking back at the Plan and seeing it for its merits and its faults. There is a lot of opportunity here and what I would look at is how do we restructure? What does it look like moving forward? Maybe we do not take on the measurement part or maybe we do? Whatever it is, this Plan is so big, it tried to accomplish so much and the resources at times were not there. So there are a lot of community efforts out there as you mentioned, as you said Keiki to Career. I love some of the things that you talked about where they are integrated into our other Departments that were very successful. The Transportation Agency and those things that I thought they are a win-win for us. They are easy to implement. But we need to really refocus and that is what I want to hear from you Theresa, because you are the one leading it. What does it look like for you in the areas that are going to be most productive for our participation from the County standpoint? Because you know you cannot do it all. There are efforts out there in the community that we can plug into just to make it much more solid. Ms. Koki: Well, I think using the resources that we have existing in the County, like the Workforce Investment Act, and what about prisoners? We looked at that we were so lucky to have a probation officer go to Hope Probation to KCCC and he partnered and was willing to be our Vice Chair on our enforcement group. There is only one day on the island that you would actually starve, because there are six opportunities for you to go to a soup kitchen and what we would like to make sure when someone is incarcerated their family already knows about those resources. I could get April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 14 excited about a whole lot of things but our reentry plan was done based on the visits that the Mayor and I went to the KCCC to visit the lifetime stand program and the inmates inside. The information that they told us. One of the things that came up was the cycle of incarceration and grandpa, son, and grandson at KCCC and it is one of the things that we are trying to break the chain, so to speak and we are looking into that. The re-entry program on the Big Island was funded through a grant from Public Safety and we did ours for free just working with the people that we had and we are going to start measuring our success there, because it is a new program for us. But there is another opportunity, like with...I agree with Councilmember Yukimura about Life's Skills in the schools. We have got to start going to our target audience and cannot just keep hosting events and we have to go to where the kids are. I think Vice Chair Chock you are familiar with that. You were hands-on directly to Kapa'a School and implemented your leadership program there. So working cohesively again with the Department of Education, I know their hands are tied with the curriculum and standards that they have to implement themselves, but I am sure if we all got together and talked about that, we could do great things. The other, we have to keep in mind that we just do not work with children and we work with families and we also work with kupuna. I have been working on a couple of things with Kealoha Takahashi and we do our kupuna educational thing where we have a lot of grandparents taking care of the grandchildren because the parents are incarcerated because of drugs. Chair Furfaro: Mr. Hooser. Mr. Hooser: Thank you for your very in-depth presentation. I agree with the Life's Choices broad concept in terms of teaching and supporting people to make the right choices. Young people and old people. But I believe that there is a different...some choices are worse than others, and looking at the survey the Department of Health did the survey, is that it? Ms. Koki: That is correct. Mr. Hooser: Okay. I noticed a lot of attention paid to alcohol and marijuana and very little paid to methamphetamine or Oxycontin. When I am out in the community, those two topics come up over and over again in terms of the most destructive of the substances that are being abused. One could argue that alcohol is more destructive, but in terms of other drugs it would be Oxycontin and meth. My question, are you able to work on those particular issues and things like...Oxycontin is prescribed by physicians and often it is my understanding that there are some physicians, perhaps abuse their prescriptive authority. Is there any kind of activity or focus on what I consider the really worst of the worst? Ms. Koki: Well, recently we have started this prescription drug campaign and we had youth do commercials on it about prescription drugs, and I can send you the script, if you want. They created it themselves about how you should not be sharing your medication. It was done by two students, who actually attend Kamehameha Schools, but in the summers they come back and help me with whatever. It was really interesting and we paid for it to run a month on the air, for the station, they usually listen to Pandora and not radio stations, but even to educate people in our age bracket, we went through Hits 99 and they did our commercials. We work with the Hawaiian Meth Project not directly, but they have youth leaders in all of the schools. At our recent drug summits one of the evening sessions was for the youth to come and plan their future with us and cocaine use is coming up as you mentioned and methammphetamine, which is very scary April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 15 because some of them mentioned about their aunties and uncles and parents and they started to spearhead peer education programs in schools. I think the only school that I do not have and currently working on is St. Theresa, but I have Island School youth leaders and Kaua`i High School and we will have to start going younger to middle schools as well. Mr. Hooser: I was not able to attend the drug summit, but from reading the literature, it looked like it was marijuana-focused and begged the question why it was not or maybe there was more focus on the Oxycontin and meth, and that kind of thing. Ms. Koki: Based on the Legislative bills going through the House and Senate, there was over 100, either medical marijuana changing laws or recreational use for marijuana. We had an opportunity to partner with the Smart Approaches to Marijuana and the Coalition for a Drug-Free Hawai`i called me and the morning session on Thursday was about marijuana. We looked at all of our bills and which ones were alive, which was only four at the time. And was called smart approaches to marijuana. We also had some nurses and a physician work on the medical marijuana part with the guy... Chair Furfaro: Excuse me, I have to stop you right there. I let it go as long as I could without a tape change. We are going to take a five-minute tape change here. Why do not we take ten minutes and do the caption break at the same time? There being no objections, the Committee recessed at 2:52 p.m. There being no objections, the Committee was called back to order at 3:06 p.m. and proceeded as follows: Chair Furfaro: We are back from our recess and tape change and I would like to do some summary and start with you, Mr. Hooser, we have ten minutes. Mr. Hooser: Just a follow-up question. What is cost of the recent Drug Summit to the County? Ms. Koki: The recent Drug Summit cost $14,000. Mr. Hooser: And those were operating funds, General Funds? Ms. Koki: That is General Funds, correct. Mr. Hooser: Okay and you had mentioned one of the reasons that the topic was selected was because of the Legislative agenda. Who determines the position on the County on those items? Is it the Mayor or your committee? I mean the point in case, medical marijuana, there were several bills, and I personally felt that several of them were deserving of support, that right now people who have legitimate needs for medical marijuana, do not have a legal way to get it. So I was support something of those measures and was the County opposing those measures? Ms. Koki: No, actually we have realized for years that our medical marijuana laws are flawed. The first thing, where do you get your legal plants from? So the Mayor did say he supports the medical part of it, that is to help our sick April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 16 people and that we needed to work on that. There was a press conference as well that he talked about it. We have also been saying that for years. He has worked closely with the Police and DEA regarding marijuana. I know the DEA right now is actually helping the family get a permit for their child who has seizures to extract the oils. Mr. Hooser: Excuse me, if you could take your conversation outside, it is probably better. Thank you. I apologize. Ms. Koki: That is okay. We do work closely with the DEA and Police Department and feel that the medical marijuana law is flawed and needs to be worked on. Mr. Hooser: So the policy comes from the Mayor's Office and not from the committee? Ms. Koki: Our committee is the Mayor's Advisory Committee and they provide the education and we all talk about it and see where the Mayor is going to come up on this. I know he has sent in testimony to some of the bills. Mr. Hooser: Thank you. Thank you, Chair. Chair Furfaro: Mr. Bynum. Mr. Bynum: I want to follow-up on that. Chair Furfaro: Your mic. Mr. Bynum: You do not have to answer now, but I want to know as a follow-up, you mentioned the organization Smart Alternatives to Marijuana. Ms. Koki: Smart Approaches. Mr. Bynum: Was there any funds expended directed at that organization? Ms. Koki: No. They came on their own. We did pay for the two speakers that came on Friday to discuss all other drugs and to train our County managers, our substance-abuse counselors and certified prevention specialists. Mr. Bynum: You said that the medical marijuana laws are flawed and what law are you proposing to repair it? Ms. Koki: I cannot think what the number is right now. We want to make sure that the first transaction is legal, where they can get their prescription from. We want to make sure that the caregiver part with the amount of plants that they can have is more regulated. Mr. Bynum: So I will follow-up later. Thank you. Chair Furfaro: JoAnn, we are on the last four minutes of the ten-minute session for them. Go ahead. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 17 Ms. Yukimura: Page 29, where you talk about the ADAD giving us...the State getting $11 million for four years to provide transportation. Is this just...so this is four years, what is that? $2 million. $2.75 million a year to the State, divided among four Counties. How much is Kaua`i getting? Do you know? Ms. Koki: It is not divided within four Counties, but it is for Oahu and they did a pilot program and we put in for Kaua`i to be the pilot program. It is based on a fee for service for Kaua`i, so there is no set amount. It is not just for transportation, but for treatment providers including transportation. I think I mentioned earlier they can get recreational use and their treatment covered and all of that. Ms. Yukimura: Well, if they get a bus pass for a month that covers all of their needs actually. Ms. Koki: Access to their needs. Ms. Yukimura: Right. Clients of treatment providers. So I would like to know how much money is coming to Kaua`i for this? And who is eligible? Is it just drug-related or do mental health people get qualified for transportation? Ms. Koki: This is for drug treatment services. However, a lot of people have dual diagnoses. Ms. Yukimura: If they only have a mental health and not a drug- related disorder then they do not qualify? Ms. Koki: I believe it started with drug treatment. I am not sure. Ms. Yukimura: It is coming through ADAD, so you would guess that. I would like to get a copy of the contract, the fee-for-service contract. Ms. Koki: With all the provider's contracts or of the transportation? Ms. Yukimura: If we could, I would like to see them all. You said that we are looking at slide 29, by the way. Coordinated assessment of treatment system is ongoing. Or it needs to be updated? Ms. Koki: It is ongoing. We did not make a new one yet, but we have been taking the information. Ms. Yukimura: Well if you are talking about a new one, what does the old one look like? Is it a document? Ms. Koki: It is a document that was crafted by the people who helped with the Drug Plan and it is attached in the back. Ms. Yukimura: It is attached to the Drug Plan? April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 18 Ms. Koki: Yes. Ms. Yukimura: Or is it attached to the PowerPoint? Ms. Koki: No it is attached to the Drug Plan. Ms. Yukimura: I do not have mines here but I will look at it. There is one that has a date when it was accepted or whatever and it needs to be updated now. What are our plans for updating it? Is that part of the update for the Plan or is there a separate track by which it is being updated? Ms. Koki: We update it at every meeting that we have. Ms. Yukimura: This is the treatment committee? Ms. Koki: Treatment and community integration. Ms. Yukimura: Treatment and community integration committee. You update it every meeting that you have? Ms. Koki: Every time we have something new or a new provider or new service. Ms. Yukimura: I see. Ms. Koki: We do a roundtable and we take that information from whatever information they give. Ms. Yukimura: So the update is actually like you say here ongoing. Ms. Koki: Yes. Ms. Yukimura: It is just that you said in your oral presentation "needs to be updated" so I was wondering what that was. Maybe is the latest copy, the updated copy then available through the Drug Plan? Or can you make that available to us? Ms. Koki: I cannot make it available right now. Ms. Yukimura: No, no. Ms. Koki: It is in minutes of every meeting, I am going to have to extract that information and start typing it into a document. Ms. Yukimura: Well, it probably needs to be done, if it is a document that people refer to. Okay. If we could have that, that would be useful. As a follow-up, not right now. Ms. Koki: Again, I am a party of one, so I do not know how long it will give me to do that, but I am really not ready to hand it over right now. April 21, 2014 Budget Call-Backs (Life's Choices Kaua`i— Drug Response Plan)(ss) Page 19 Ms. Yukimura: Okay. Chair Furfaro: Let me make a suggestion. Would you be able to have it ready by July 27th when we are talking further in the Council session as related to the Adolescent Drug Treatment Center? Would that be fair enough to say by July 27th? Ms. Koki: I will have the information updated as best as I can by that time. Chair Furfaro: Okay. To the best of your ability, so we will look forward to July 27th. Ms. Koki: Extracting information from people can sometimes be difficult, but I can certainly do my best. Ms. Yukimura: I know that the Adolescent Drug Treatment Center there was talk about it being parts of the continuum of care. So it would be timely. Thank you. That is it. Thank you. Chair Furfaro: Okay. Ladies, I just want to say thank you very much for your presentation. We will visit more on this on July 27th, but for the discussion here, I would say that is all there is. I do want to point out after the review of the Police budget, there is the $50,000 in KPAL in the budget line for Police. So I would be very interested in how your working with them on extracting staff support will be mutually beneficial for all. Thank you very much. Okay. We are going to go now into the Public Works, Solid Waste Division and I am going to ask Mr. Dill to come up and Paula thank you very much for being here with the Drug Treatment Facility of the Life's Choices program. Thank you. There being no objections, the Committee recessed at 3:16 p.m.