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million. The county drug program is provided almost entirely through contract with private community-based agencies.

The county plan provides for a system of services that is comprehensive in scope that includes prevention, early intervention, detoxification, methadone maintenance, residential and outpatient services.

In fiscal year 1985-86 there were 136 contracts which provided for over 4,800 treatment slots and approximately 112,000 units of service in prevention or early intervention.

One of the tables which I have provided you shows graphically the 36 percent decline in the available treatment slots since fiscal year 1981. Loss of Federal and county funding, reallocation of outpatient treatment funding to prevention services and the ever-increasing costs of providing human services have each contributed to that decline.

Last year it was estimated that at least $8 million of new dollars would be needed in this county to replace the treatment slots that have been lost since 1980-81. Programs are overutilized and they are unable to meet the growing demands for service.

A recent survey has shown that the waiting time to enter a residential program varies from one to 8 months; for methadone maintenance, 1 to 12 months.

The demand for services is especially acute for intravenous drug users at risk for AIDS; for pregnant addicts or drug abusing women; for youth, who require a range of services from prevention and early intervention to residential services; incarcerated drug abusers requesting residential treatment who can not be released until beds are available; young adults with dual diagnoses of mental illness in conjunction with drug abuse; and homeless drug abusers who have basically no place to go if residential drug treatment is not available.

The treatment system has never fully recovered since the 1981 Omnibus Block Grant bill. It is understood that the intention of the Federal Government was to turn program management and funding issues over to the state and local governments.

In California, concurrent with this transfer, was the passage of Proposition 13. Local government has been unable since then to respond to the escalating drug problem with expanded funding for services. The local treatment system adapted as best it could by increasing client fees and through greater use of federal medical dollars.

The Federal block grant system identifies prevention and women's services as priorities for the use of federal block grant funds.

While the intention of this earmarking is laudable, we discourage the use of special allocations to other underserved target groups, and recommend that local or state response to national program priorities can best be achieved by requiring states to address these priorities when submitting their annual federal block grant plans for services.

In Los Angeles County this earmarking has not been a hardship because Los Angeles has been in the vanguard of responding to the service needs of special target groups.

For example, our county plan identifies prevention, primary prevention, as a No. 1 priority and 33 percent of any new dollars allocated this county, as a minimum, automatically go toward prevention.

With regard to services for pregnant addicted women or homeless or those with problems of mental illness together with drug abuse, again we have been able to allocate scarce resources to those programs and continue to consider those target groups as high priorities; also minority groups, the homeless, the wide range of citizens in this county who do not have access to treatment at the time that they are ready and motivated to participate in it.

In terms of our recommendations to the Federal Government for strong leadership and assistance to the States and to the localities, we address several areas.

The first has to do with planning, and with regard to enhancing planning activities at the local level: we believe that it would be appropriate to ensure that all States and all publicly funded programs participate in a client data system which will provide information to the localities, the States and the Nation, with regard to the profiles of clients receiving services and their outcome at discharge.

There should also be assistance to the States and local jurisdictions in developing and utilizing a system of drug indicator data. Los Angeles County, San Diego, and San Francisco are three metropolitan areas in California that belong to a national community correspondents group and meet biannually and share information relating to drug trends.

There are, however, countless other metropolitan areas and medium-sized counties across the Nation and in California that have not yet developed the expertise to do their own forecasting and do their own responding to the drug problem.

With regard to services, we believe that the quality of services that is being provided throughout the Nation could be enhanced by increased training and technical assistance to the State and local governments in specialized areas such as accreditation or certification of drug counselors, treatment methods for special client groups, and prevention and counseling methods adapted for different minority groups.

With the Federal Government developing and sharing modules of these types, we believe that cost effectiveness and efficiency will be addressed.

We would also like to see a computerized information and resource network or clearinghouse set up so that at the local level we could rapidly access the latest information regarding research and evaluation, prevention and treatment resources, and trends.

An organization known as the Drug Abuse Resource and Communication Network, which provides quality prevention and educational materials, audiovisual and printed, needs to be updated in its budget so that materials can been obtained in sufficient quantity and in a timely manner at the local level.

With regard to third party payment systems, we believe that the Federal Government should require through legislation that standard health insurance coverage be included and be offered nationwide for drug abuse treatment.

Cost effective models of treatment are available which de-emphasize hospital care in favor of longer term residential and outpatient services.

Only five percent of the clients entering publicly funded treatment programs carry health insurance which is applicable to their

care.

At least as many clients come to the public drug programs following costly inpatient treatment which has been subsidized by private insurance but their available coverage has been utilized to the maximum within a period of three to four weeks.

We believe that by requiring such coverage and basic health care packages offered by the insurance industry, more people will have access to treatment and more cost effective models will be used.

It appears that the antidrug bill which was signed by the President this week contains a significant augmentation for drug abuse treatment services in Fiscal Year 1987.

Upon receipt of its local allocation, Los Angeles County will have moved rapidly to expand treatment services to all ethnic groups. It is imperative that the increased level of funding continue to be available for the next several years so that new programs will not founder in a second or third year because of lack of continued financial support.

Thank you again for providing me with this opportunity to share the county's concerns regarding key issues and the prevention and treatment of drug abuse.

Mr. RANGEL. Thank you.

[The statement of Irma Strantz appears on p. 169.]

Mr. RANGEL. Dr. Silbert from the Delancey Street Foundation.

TESTIMONY OF MIMI SILBERT, PH.D., DELANCEY STREET

FOUNDATION, INC.

MS. SILBERT. I am the president of an organization called Delancey Street Foundation. We are a national organization. We do longterm residential treatment and prevention. We have about 600 people at any given time nationally.

I have included for you along with the statement a manila envelope that contains some pieces of information basically saying how good we are.

Delancey Street is in its 16th year. I would like to do several things with my remarks. First, of course, I would like to tell you something about this organization. It is different from just about everything else that I know that exists anywhere in the world. It is uniquely successful.

We have been studied by everyone. We have been called by Carl Menger-who is one of the few patriarchs in our field, who really is an expert-the best and most successful program in the world. We have been commended by Nancy Reagan, President Carter, etc. Along with telling you about Delancey Street-and I would like to do that because I think-I know this word is used all the time"model"-but I think we really are a model, and I would like to try to encourage you to think that along with me.

Along with doing that, I would like to take what I think is a different cut at the drug abuse problem. I do not think that additional

monies are the answer. I don't think that there is ever going to be a way to put enough money into the substance abuse treatment and prevention problem to ever handle it, and therefore, I think we had best come up with some answers that are not simply dependent upon more and more money, and I also think that it is insufficient to just say "no" to drugs.

Those of us who have been doing prevention for years and people who are abusing drugs for years will tell you, most people, including kids, are not unaware that drugs are harmful, and they abuse them anyway.

And if we are to make our prevention efforts really make a difference, then we better begin to taylor them to what I think are the problems.

There are many things that we need to teach people to say "yes" to. Drug abuse happens to be tied in with a lot of self-destructive things that need to be balanced in our society. If we don't start balancing them then we are not going to make a dent in the problem. I would like to take a minute of my extended five to "expert" myself, if I may, because I am saying things that I think are different from the general take on drugs. I would like to give myself a few credentials.

I have doctorate degrees in criminology and psychology. I have been in this field for 20 years, exclusively in substance abuse and criminal justice. I have taught college. I have done major research. I have evaluated programs for the National Institute of Mental Health Drug programs in over 30 cities. I have trained probation employees and sheriff departments in over 25 cities. I was appointed by President Carter to the National Institute of Justice. I have been appointed by Governor Deukmejian to the Board of Corrections. I serve on the California Post Commission Advisory Board. I have spend a long, long time, really my life, in this field, and I feel very strongly that we need to look in some other directions. Now I am going to try and tell you a little bit about Delancey Street with which I have been for 5 years.

Mr. RANGEL. Dr. Silbert, we do have a time problem, because the members have arranged their transportation schedules based on the number of witnesses we are having, and there is another panel. What I am afraid of is that they may have to leave before they hear all the people who have prepared their testimony.

The staff should have advised you of this restriction when you were invited to testify.

MS. SILBERT. They did, but I have come near to my five minutes, and with due respect to my colleagues, they have taken more than their five minutes.

If you have to leave, there is nothing I can do. I am not funded by the government, so I am not asking for more money. Mr. RANGEL. I think you made that clear.

Ms. SILBERT. I do think we have an interesting model.

Mr. HAWKINS. Mr. Chairman, could I suggest that she briefly describe this most wonderful program that she said is so different and unique. I think we can stipulate that her credentials are good, but we would like to find out what the program is.

Ms. SILBERT. I would like to, if I may.

Delancey Street has never taken any money, not only not government money, but not private monies. To make money we go back to the American style; we earn it.

We have 600 residents. A majority of them come in unskilled, functionally illiterate, and without any work experience.

We have 10 to 15 different training schools that provide vocational training at the same time as we pool the income from them to support the organization.

Mr. RANGEL. What is your annual budget?

Ms. SILBERT. Our annual budget is about $6.5 million.

Mr. RANGEL. This money comes from the income of the businesses that you operate?

MS. SILBERT. Yes, it does. They range from moving school and trucking through construction, automotive repair, national sales.

We sell imprinted items to the college book stores. We sell to businesses. We make everything-furniture, stained glass, crafted products. We sell them, as well. We teach people bookkeeping, etc. We also have no staff. The entire organization is run by the residents, and I think that that is a critical issue, because in my opinion, the people most targeted, highest risk for drug abuse, are the marginal people of our society.

It used to be the poor, because they were always on the outside. Now we have more and more groups being marginal in society, adolescents, etc.

Mr. RANGEL. How many people are involved in your program? Ms. SILBERT. Six hundred residents at any given time.

Mr. RANGEL. Do they ever leave?

Ms. SILBERT. Yes. The whole point of the program is to have them graduate. They stay an average of 4 years. We think of it comparable to a Harvard education. We have graduated literally thousands of people. Our success rate is upwards of 80 percent.

We have graduated-our graduates range from lawyers and people in the medical profession through construction-virtually every area of life.

During those four years everyone receives at least a high school equivalency. They are trained in three marketable skills. They learn interpersonal relationships, which are lacking.

They learn a great deal about self-esteem, which I do not believe can be taught quickly in an encounter group. I don't think it happens by me telling you that I think you are OK. I think it has to be learned slowly and over time.

Mr. RANGEL. Do you have a waiting list?

Ms. SILBERT. We don't, because we don't operate on a bed principle, and so we don't hold a traditional waiting list.

For example, if you were facing 50 years and really desperate to come in and it was our belief that you meant it, and that your choices were death or Delancey Street, we would take you in.

We certainly have-the demand for our services is by far greater. We get about 25 to 30 calls a day. Obviously, we can't take anywhere near that, so we do turn people away, only the last couple of years, because we have gotten so overcrowded and we don't have the money to expand.

But we don't take a traditional waiting list-excessive need comes in if they are desperate.

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