CHAIRMEN: Senator Harp

Representative Geragosian

VICE CHAIRMEN: Representative Bartlett


SENATORS: Debicella, Harris

REPRESENTATIVES: Candelaria, Clemons, Esty, Gonzalez, Ritter,

Roy, Saywer, Schofield,

Thompson, Walker,


SENATOR HARP: Come forward, please. Welcome.

Can you hear me now? Does that sound like a Verizon commercial?

ELLEN WEBER LACHANCE: Good afternoon, Senator Harp and distinguished members of the Appropriations Committee. I'm Ellen Weber Lachance, Executive Director of the Psychiatric Security Review Board, and I'm here to speak in favor of the governor's recommended budget for our agency.

You have my testimony before you, so I won't read it verbatim. I will make a few comments, and if you have any questions, I'll certainly be happy to answer any questions.

Excuse me? You don't have a copy of the testimony? I have a few copies in my packet. I understood you had some, but I'm happy to give you what I have.

SENATOR HARP: The Psychiatric Security Review Board testimony?

ELLLEN WEBER LACHANCE: I will read it for you.

SENATOR HARP: Okay. That will be good.

ELLLEN WEBER LACHANCE: The Psychiatric Security Review Board has jurisdiction over all persons found not guilty of a crime by reason of mental disease or defect. Individuals are committed to the board by Superior Court from all across Connecticut.

Over 90 percent of the times for which individuals are committed are for violent offenses. Murder accounts for 30 percent of those felonies, so we're looking at a serious constellation of crimes for people under our jurisdiction.

The board, in turn, orders the confinement of these individuals to either the Department of Mental Health and Addiction Services at CVH or a facility determined by the Department of Development Services.

The PSRB is composed of six members chosen for their expertise and appointed by the Governor to serve four-year terms. Board members meet every two weeks throughout the year. As you can see, that's a significant public service commitment. Last year the board conducted 225 hearings and issued 800 -- excuse me, 188 memoranda of decisions.

The board's statutory mandate is the protection of society. That goal is accomplished through board-ordered treatment and placement of those individuals committed to its jurisdiction. I am pleased to report that over the last 14 years, since the board has kept statistics regarding arrests, the board has had a zero percent criminal recidivism rate for those individuals discharged from the hospital who are residing in the community under board-ordered supervision.

At the close of the fiscal year in 2008, there were 152 individuals under the board's jurisdiction, 85 of percent of those individuals were residing in a hospital setting, 15 in the community.

The PSRB is a small agency, but we have a significant role in safeguarding Connecticut citizens, while at the same time ensuring appropriate treatment services for those under its jurisdiction.

The Governor's recommended budget provides the PSRB with the minimum resources necessary to carry out its public service mandate -- excuse me, public safety mandate.

Favorable actions by the Appropriations Committee on the Governor's recommended budget will ensure that the board can continue to effectively monitor insanity acquitees in order to ensure public safety.

I'm happy to take any questions you have.

SENATOR HARP: Thank you very much.

Are there questions? When I look at the budget, it doesn't appear that much happened to reduce your budget. Small recisions were carried forward.

ELLLEN WEBER LACHANCE: Small correct. We are an administrative agency that the primary cost of servicing our acquittees belongs to the Department of Mental Health and Addiction Services where most of our acquittees are confined.

SENATOR HARP: And I guess the other question that I have, you are one of the SMART agencies?

ELLLEN WEBER LACHANCE: No, we actually are attached to the Department of Mental Health and Addiction Services for administrative services.

SENATOR HARP: Okay, great. Very good.

Are there further questions? If not, thank you very much.


SENATOR HARP: And see you next year.


SENATOR HARP: Our next speaker is from the office of the medical examiner. Dr. Carver.

WAYNE CARVER: Yes, ma'am. Unfortunately, Senator, if you ask for a medical examiner, you get me.

Senator Harp and representatives -- I'm about to give you a display of head trauma here.

My name is Wayne Carver. I'm the chief medical examiner. This is Dr. Edward McDonough, who is our deputy chief medical examiner. I'm going to try to be brief, one, because you are probably very fatigued at this point; two, because my doctor has not been able to fix what's wrong with my lungs; and three, I didn't bring any pictures.

Short and sweet, this -- this is a lean budget, but you've heard that before. We can function with it. There is one problem I would like to bring to your attention, not because you are the definitive way to solve the problem; but if you're going to fund this agency and oversee us from a funding point of view, I think I owe it to you to know what kind of situation we're in.

This budget contains funding for replacement of a position who retired during the last budget year. We have now five. We have traditionally functioned with six. And what we don't have at this point is authority to hire that person.

Just three points on this: We are basically a medical service delivery outfit. We need to put doctors on problems, doctors on dead people. And our caseload is not so much on autopsies, it's been steady over the years, but the total number of cases we need to deal with, the number of death certificates we need to deal with continues to go up.

We currently have one physician per 660,000 population. Recommendations are one for 400,000. I will not pretend to want that, but I want the sixth.

Second, these individuals are very difficult to find. There's only probably 15 really qualified people coming out of the training programs in any given year, and they come out July 1st, so there's no way we can hire anybody until then anyway.

The good ones usually have positions locked up six months in advance. New York City and Chicago, where I trained, frequently offers people positions when they accept them for training.

And finally, just so you have some perspective, we have three -- two physicians right now who are eligible to retire, a third who would become eligible July 1st. The [inaudible] just adds to that.

And at some point, I got to bring some young people into this outfit for continuity sake.

Other than that, you know, I'll stop talking. I know in an email I promised you I wouldn't beg. But if you have any questions, please.

SENATOR HARP: Thank you.

So you have a sixth position that you need in your budget, but you haven't been able to hire the position?

WAYNE CARVER: We haven't been given the authority to operate.

SENATOR HARP: How can we help with that?

WAYNE CARVER: I don't know, okay?


WAYNE CARVER: But I think you need to be aware of it.

SENATOR HARP: Okay. All right. We'll see what we can do to allow you to do that.

Now, do you get any residents -- are you a resident [inaudible] at all for any of our medical schools?

WAYNE CARVER: We -- there's two levels to that, okay? One is that residency programs in anatomic pathology, which is the basic -- what most pathologists do, okay, and this is the case -- if you had a surgeon remove something from you or from your loved one, that's where it would go. They practice in hospitals.

They must offer rotations in subspecialties, things that when you become an anatomic pathologist, then you go -- you may choose to go and train in some subspecialty. They must offer rotations in subspecialties, and we do do that.

But they don't really -- it's very rare that a resident rotating per month actually gives you positive labor. They keep us sharp. They're wonderful people, and I've actually had three of them go on to be chief medical examiners over the years, and I'm tremendously proud of that.

But it's an obligation as physicians we take to teach others. Socrates said teach the sons of those colleagues who are found worthy. We've expanded, the criteria.

DR. McDONOUGH: The American Board of Pathology did grant us a fellowship program many years ago, but the state wouldn't fund it, and neither would --

WAYNE CARVER: The schools.

DR. McDONOUGH: -- UConn or Yale, singly or jointly, so we were never able to get [inaudible].

WAYNE CARVER: The fellow is the guy for the whole year. And I've seen other medical examiner's offices split a full-time position to get a fellow.

The problem is, you don't know if you're going to get another fellow the next year. By then, you're funded at half-mast, and it's not a good thing to do for the long-term health of the office if you have to sacrifice a full-time position to get a fellow.

SENATOR HARP: Well, it seems to me we have to work with you on -- when you meet with the subcommittee, could you bring in some proposals to deal with, you know, like filling your office --

I think we need to be proactive. We can't turn around and have you lose four people -- well, three more plus the other one. We will not have a program.

And it's very important that we -- as you know, your work is very important.

WAYNE CARVER: Well, I hope so. But I -- you know -- my son would kill me if we moved out of Avon before he graduates, but -- so would his track coach.

But, you know, there are realities to life. And my at my age, despite best intentions, you get sick. Maybe I sort of overemphasized that because of my position, but --

And we have a few -- I've been watching you all on the Internet, and I know we have a few minor ideas to maybe generate some revenue. But it might be the subcommittee, the appropriate place to discuss that.

SENATOR HARP: I think that would be great.

Is there a question? Yes, Representative Esty.

REP. ESTY: I take it you're one of those who's eligible to retire?

WAYNE CARVER: I have been for two years.

SENATOR HARP: Yes, it's not looking good.


SENATOR HARP: Yes. I think we've really got to figure out what to do about that.

Any other questions?

Because you're critically important, making sure that you maintain your independence. Just so you know, I read your email, it's also very important, and we have got to figure out how to make your program work.

So the subcommittee is charged with working with you on that.

Just to show you, you know, we're physicians. We're sworn to do whatever we can for our patient population and will continue to do that. But it's easy to when you're alone.

SENATOR HARP: All right. We understand, and we will work with you.

WAYNE CARVER: Thank you very much. All good to see you.

SENATOR HARP: Good seeing you.

The Department of Veteran Affairs.

Commissioner Schwartz.

LINDA S. SCWHARTZ: Good afternoon, Senator Harp and members of the committee. I would like to introduce Mr. Michael Clark, who is also my chief financial officer.

I'm always glad to come to represent over the 277,000 veterans that we have across the state, and I'm especially proud again to come before you to say for the fourth year in a row that the Department of Veterans Affairs has achieved its goal of being at a zero-cost agency for the tax patience.

And FY '08, we brought into the general fund more than $1.5 million, more than our total agency expenses. And we are on track again this fiscal year to increase that this year to nearly $1.7 million.

We've done this with the help of -- we were able to attract and actually get permission to -- for Medicaid reimbursement for our veterans at the home.

Now, because this money goes directly into the general fund, we just draw down on the state grant. We are not matched by the grant.

So we've also because we did a -- actually did qualify for the [inaudible], $352 million that was not expected.

We've really had to work at this, and I guess that's why we're proud to stand before you today, because we -- it takes almost -- a great deal of effort on the part of my staff. And because Rocky Hill is such a large complex, we have a new facility, we have the old building, we still see that we have over 500 veterans today at Rocky Hill. The majority of them have no other home, and many of them with complex medical and mental health issues. That also brings up difficulties with the, of course, the unknown energy and food expenses.

We have been working very hard. We believe that because of the proposal of the Governor's budget, obviously not only are we making our expenses -- and we do appreciate it is up front -- but we have a myriad of things. It's not just the home at Rocky Hill.

I probably am the only person in the State of Connecticut that has to run two cemeteries, too. And I am charged by statute to be sure that any veteran who dies not having enough money to be buried, it is my job to bury them.

And I will tell you in these hard economic times, we are doing that, and it's important for you to know that we can do that. We've been helping families who just can't afford funerals.

In our budget, which I will just call your attention to the slides that we have, I know you probably go cross-eyed when you see all these numbers, but you can see that our appropriations over the several years for the biennium budget, I think one of the things that maybe is a little difficult --

I'm trying to hedge and let you know that the reason we have burial expenses there is because we do actually bury people.

Also, we are tasked by statute to be sure that any veteran who dies and applies for a federal headstone, it's my job no matter where they're buried to make sure that their headstone is set. And that, as you can see, is a lot of money, but it does come from the Soldiers', Sailors' and Marine's Fund.

The Veterans' Support Services is like the first-time allocation for this department since I became the commissioner that we actually have money to assist veterans outside of Rocky Hill.

So this money goes for things like our standdown, which last year served over a thousand homeless and needy veterans that came to Rocky Hill. And we expect even more this year.

The -- actually, I want to just say that with the proposed budget, we have what we need for the essential operation without sacrificing the quality of care. And there is actually no effort to reduce the number of staff that we are allocated. No one in a central position has been touched.

We will be continuing to look for cost-savings measures to offset the inflationary index factors. And I have actually shown you on these slides the income that we have -- and one of the things I want to say to you is the fact that we do generate a lot of revenue, but it is not in any budgetary or anyplace attributed to us.

If you look at the slide, you can see that we bring over $7.3 million in VA per diem. That's why we were able to cover our costs. But that amount of money is attributed in the budget -- in the line items to DSF. We are the providers. We do the paperwork, and this money is earmarked for veterans.

And I know that this is a custom of the state to do this, and I don't -- please understand that I'm not saying I disagree with the money going into the general fund, but I think when you look at our budget and you see that we cost $33 million and you see no income, it's not a fair reflection of the work that we do.

I think also, looking forward, when you look at this budget, one of the things we want to say is that we will be able to maintain a special services. Governor Rell has given me a charge not to turn any eligible veteran away that we can take care of. And I will tell you right now that we get 15 to 20 applications each and every week to come to our residential program.

And the fact that the returning -- we have had over 16,000 veterans returning from Iraq and Afghanistan. Their real needs remain to be seen because of the multiple deployments.

The other thing that we also wanted to say is that when we look into the future, you can see on our budget that we are tasked with raising $3.1 million from private contributions, and I can tell you right now that as a budget item is certainly going to change with the economic climate that we have right now.

So that concludes my statement, and if there's anything I can answer, any questions that you have.

SENATOR HARP: Thank you very much.

I just want to tell you that I think that you do a fantastic job with your department and that you have really -- you've brought it into the 21st century, which is wonderful, you know, and it was really, frankly, due to your leadership, and I'm really quite proud of the job that you're doing.

You should get credit for your federal [inaudible], so thank you for bringing that to our attention.

I believe that Senator Harris has a question.

LINDA S. SCWHARTZ: Well, thank you, Senator Harp, because a lot of you have helped me with the support to do just that, bring this into the 21st century.

I'm sorry, Senator Harp.

REP. HARRIS: Thank you, Commissioner. I want to echo the kudos given to you and your department by the chairman.

A couple of questions. On the support services, '09 we have $190,000 amount, and then you requested what looks to be 140, 150 percent increase to $450,000.

What were those support services for that you request that?

LINDA S. SCWHARTZ: Well, if you recall, when the governor first made her budget proposal last year, she was going to give us $250,000 for outreach to the veterans in our state. And that was not allocated, so that's where the difference comes.

We had -- we had been operating with an allocation of over $200,000. That was added to our budget because we saved so much money in personal service contracts and bringing really -- transforming our caseload from private providers to VA providers, so we saved the state a lot of money on that.

So that's what the difference is. It was -- we were expecting the Governor's budget suggestion would have been taken.

That's -- you want to know what the services are?

REP. HARRIS: Yes. So it's not actual care? It's just outreach to try to get veterans to services?

LINDA S. SCWHARTZ: Well, let me just say this: We do the standdown, but we also have -- for example, the general assembly allocated several unfunded mandates, such as the wartime service medal.

Although we were tasked with the distribution of this medal, we were never given any money to administer that program, so we take that money from there.

Some the -- the Veterans' Hall of Fame. Some of these funded mandates are the services that we provide. The other thing that we've been doing is we have been joined with the Department of Labor to sponsor job fairs for veterans across the state.

And also, let me be very frank, sometimes the expenses of veterans that do not meet the criteria for the Soldiers', Sailors' and Marine's Fund and/or the Military Relief Fund, when there's no one else, some of these stories are very sad, and that's where we get the money to do that.

So it is more of a support for services off campus in the community.

REP. HARRIS: Thank you.

If you can follow up on that so we can move along today for the workgroup. Present to the subcommittee sort of a breakdown of what you described to me, an explanation of each of the services.

Similarly, on the equipment line item that was zero, you requested an additional 570,000 or so, and of course there's going to be 100 off balance in that account.

Can you describe what that equipment was for?

And you don't even have to do it now if you want to give us a listing, and in the interest of time, so that we can see what you needed and what we will be foregoing [inaudible].

LINDA S. SCWHARTZ: The short answer is that that money is going to be bonded, and we'll see it in a capital equipment purchase funds. It will be in a different line item.

MR. CLARK: Okay. If you can get us that information?

LINDA S. SCWHARTZ: I think I want to say that because we have the responsibility of cemeteries, we have been contracting that work out. We have taken a look at the pros and cons of acquiring our own equipment to do that procedure for both the Rocky Hill, Colonel Gates and for the cemetery in Middletown.

Those are some of the things -- you must -- I'm sure you realize that for years there was never anything in the budget for capital equipment for this department.


LINDA S. SCWHARTZ: So we're kind of just getting our bearings and seeing where we can do a better job to be more cost-effective, but we will be glad to get that for you.

REP. HARRIS: And then finally, just to match that with your estimates of demand going forward given the circumstances in our nation now and the war so we can kind of balance off what your needs are, what the veterans -- of course what their needs are and what's being budgeted, that will be helpful, too.

LINDA S. SCWHARTZ: I can tell you, with the advent of our new facility, it is 125-bed facility, and we -- two-thirds of it was funded by the federal government.

But we had a census of 184, so there's a big difference between the 184 that we had and the 125 that we now have.

And we see a need, and we are exploring this right now, to look between our residential program, which is fairly -- people are fairly active, but then there are some who need a very structured environment. We are looking at what can we do with our present resources so that we can --

Many people want to come. For the first time in I would say 25 years, we have a waiting list for people that want to come to the healthcare facility at Rocky Hill, and we see that we need to really look at our utilization so that we will be able to have --

We have a waiting list. It sometimes takes a very long time to even get in. We want to expedite that by creating an intermediate level of care so that we are aging in place.

REP. HARRIS: Great. So if you can get us all that you're doing so well, we appreciate it. Thank you.

SENATOR HARP: Thank you very much.

Representative Bartlett, did you have a question?

REP. BARTLETT: Thank you, Madam Chair.

I just wanted to know, on the headstones and the burial expenses, is that unique to Connecticut or is that like a nationwide thing that --

LINDA S. SCWHARTZ: No, it's actually nationwide, through the federal VA, Connecticut and the under the leadership of Governor O'Neill.

In the late '80s, we acquired funding. It was a 50-50 match then with the state, and that's he how we had the cemetery.

But long before that, because Connecticut was absolutely the first state in the union to have a veterans' home, we had cemetery in Darien.

So no, it's not -- from the time that they had a veterans' home, the commandant, and now me, the commissioner, has been tasked to be sure that no veteran who served and cannot afford a burial, that it is our job to bury them.

So that's how Colonel Gates and Rocky Hill became a cemetery.

REP. BARTLETT: And how did they get the information that this is -- how did families -- do they know some -- because I'm just thinking -- because I had a family situation, and I'm just wondering. Nobody knew that.

LINDA S. SCWHARTZ: Well, actually, I want to -- we have it on our website, and it is well known to funeral directors. I think one thing that is not well known to funeral directors, and it has caused a hardship for several veterans and their families this year, is the fact that if they don't have the money to bury their veteran, that they can come to us and we will help them with that.

But the way it works is anyone who has served -- has anything but a dishonorable discharge -- dishonorable discharge really prevents you from accessing any veterans' benefits.

So a veteran and their spouse are eligible for burial at the state cemetery. And due to I think it was the legislature -- before we were only doing wartime veterans. Now it has been expanded through the generosity of the legislature to all veterans who served, not just in wartime, and their wives.

So if you didn't know about it, I think most funeral directors do know about it and can offer that to folks that don't have [inaudible.]

REP. BARTLETT: Thank you.

SENATOR HARP: Thank you very much.

I was wondering if you're get any of the federal stimulus, if any of the dollars for veterans' services are coming to your department or do you know or --

LINDA S. SCWHARTZ: From the stimulus package?


LINDA S. SCWHARTZ: Well, I'm very excited, because -- well, as you know, our residential area is not totally air conditioned. We've been working on it. So three floors have.

We had had a grant into the federal government for several years. Our residential area was built in 1938, and the bathrooms are 1938 vintage. Also, the fact that we did not have air conditioning and some of the things that you would find anywhere, handicapped accessible, all that, that is in a proposal presently before the VA.

We are number three on the list. And because the stimulus packaged authorized another $210 million to state homes, I'm thinking that we would be eligible to receive that.

It would be another matching grant, but it would also take into consideration that we have put a great deal of money -- state money into moving the safety upgrades, that it would be actually -- I think we have almost $1.2 million over the last five years that would be matched by $2 for every Connecticut dollar.

SENATOR HARP: That is correct.

Are there further questions?

Yes, Representative Esty.

REP. ESTY: Thank you, Madam Chair.

Just a quick question. Did you say 3 million you are expected to raise from private funds? Did I have that right?

LINDA S. SCWHARTZ: That's -- that is the --

REP. ESTY: What will you do if in the current economic climate you're not able to raise that? Would you come back to us? How would you plan to triage that if you're not able to raise those funds?

LINDA S. SCWHARTZ: We are required by the VA in order to get that $7 million to provide all kinds of services, including dental services and so forth.

We would just have to cut the costs. We would really have to look at -- we would have to look at some of the things that we do.

I don't want to ever give up standdown, ever. And we often have to rely on the generosity of the veterans' service organizations for such things as -- we do provide clothes. We do provide anything that anyone can possibly want, up to and including haircuts.

So we would just have to start whittling down, like anybody else, with that. I can't say that we would stop any individual program, but you can see that $3 million -- we've been fairly successful due to the generosity of many of the veterans' organizations. I want to be sure that you know that.

But in these hard economic times, people are very careful where they're giving their money.

REP. ESTY: Thank you.

SENATOR HARP: Thank you very much.

Are there further questions? If not, you know, as we think about it, Daphne, the given questions that we will ask you to bring to the working session, so thank you very much and have a great weekend.

LINDA S. SCWHARTZ: Thank you, Senator. Thank you very much, members of the committee.

SENATOR HARP: We are now about to begin the public hearing portion on the health and hospitals budget. And what we are going to do, just so that you know, we have a lot of people who are going to want to speak tonight, so instead of doing everyone in one room, we're going to split the committee into two, and half of you will be in this room, which is 2C, and other half will be in the room next to you, which is 2D.

And I'm going to read the names of the legislators who are going to remain in this room and the name of legislators who are going to go into 2D.

In this room, Chairman Geragosian will be here. Representative Thompson will be here. Senator Harris will be here. Representative Bartlett will be in 2C. Representative Esty will be in 2C. Representative O'Neill will be in 2C. Representative Ritter will be in 2C, and Representative Schofield.

In 2D, I will be in 2D. Representative Ryan will be in 2D. Representative Candelaria will be in 2D. Representative Gonzalez will be in 2D. Representative Hovey will be in 2D. Representative Tercyak will be in 2D, and Representative Winfield will also be in 2D with us.

In order for you to tell where you're going to testify, there will be a sign out in front of 2C. Look there and when you -- where you find your name, it will say whether you're testifying here in 2C or in 2D.

So if you're here, come back into this room and wait for your name to be called. If you're in 2D, please go to 2D, and your name will be called there, but it won't be called in both places.

So make sure that you look to see where you're going to be.

I'm going to recess this hearing for about five minutes while we all check to see where we're going to be going and we meet in our appointed places.

So in about five minutes we'll start our public hearing. Thank you.


REP. BARTLETT: Okay, if everybody would take their seats, we'd like to get started. We want to welcome everybody here today. We have three lists, essentially, that we're going to go through. First is young people. Second is folks with special needs, and the -- there's a general list, so we're going to go in that order.

And if folks are up here together, we welcome you to come up here together to testify if you want to.

So the first person on the list is Maia Talmor, Taja Shelton, and Erin Walker.

Are they here? Okay.

Are you together? Okay. Just come up one at a time. Push the button for the microphone. There's a light there if you need it.

MAIA TALMORE: Good afternoon. My name is Maia Talmore, and I'm a senior at Hamden High School, and I'm here to ask -- I'm here to ask for your continued support for prevention programs so that our young people can grow and thrive in nurturing families and communities and find themselves ready and prepared to take their place as well educated adults in the Connecticut workforce.

I have seen firsthand how these programs benefit the youth of Connecticut, and I'm committed to helping their cause grow in the future.

About a year ago I started participating in compliance checks with the Governor's Prevention Partnership and the Connecticut Liquor Control. It was our job to ensure that the law enforcing the drinking age was being followed and to attend to those individuals who did not comply. These operations have showed me how important it is to have a strong bond between youth and law enforcement because after each offender is caught, teens all over Connecticut are one store safer to being drug and alcohol-free.

The Governor's Prevention Partnership is a valuable endowment because it saves Connecticut money; nearly ten dollars is returned for every dollar invested in prevention. The Partnership provides the expertise to help prevention programs grow and enlist businesses in prevention.

In the days ahead, please continue to support their tireless commitment, work and energy as they tackle the serious issues affecting our children and their futures, from underage drinking and drug abuse to violence prevention and bullying to mastering the skills and schooling needed to succeed. We need the Governor's Prevention Partnership to protect our future workforce.

REP. GERAGOSIAN: Thank you, Maia.

Any questions? Thank you for coming up.

MAIA TALMORE: Thank you.

REP. GERAGOSIAN: Taja Shelton, followed by Erin Walker.

ERIN WALKER: Paige is not here.

REP. GERAGOSIAN: Okay. Who is taking her place?


REP. GERAGOSIAN: Okay. So just let us know what you need when it's time for you -- okay? Thank you.

ERIN WALKER: Good evening, Senator Harp, Representative Geragosian, Senator Harris [inaudible] and distinguished members of the Appropriations Committee.

And I'm here today to ask for your support for the prevention program. My name is Erin Walker. I'm a freshman honor statute at Central Magnet High School in Bridgeport, Connecticut.

And by participating in the Home Neighborhood Health Program, I was able to learn life skills, mentoring and was able to receive information on HIV, AIDS and substance abuse. And I feel it's really important for the program to have a strong partnership and thank you for allowing me to speak.


VIALA PEARCE: Good afternoon, Representative Geragosian, Representative Bartlett, Representative Ritter, Representative Thompson and Representative Esty and other Appropriations Committee. I'm also here today to ask for your support for the Prevention Program.

REP. GERAGOSIAN: Just what's your name?

VIALA PEARCE: My name is Viala Pearce, and I am in the ninth grade currently attending Southland High School.

In my spare time I like to create beautiful work -- artwork, for me and on behalf of my friends. While participating at home neighborhood house, I had the opportunity to learn more about myself, gather with friends and attend fun activities.

I believe it is very important for the government prevention program to continue, because I have received so much information and resources.

Thank you for the opportunity to speak to you. God bless Connecticut and have a joyous day.

REP. GERAGOSIAN: Thank you. Are there any questions from members of the committee?

Representative Debicella.

REP. DEBICELLA: I just wanted to add [inaudible] I wanted you to know how proud we are of you for coming up here and testifying today. Thank you so much.

VIALA PEARCE: You're welcome.

REP. GERAGOSIAN: And if everybody can stay as brief as they are, we'll get out of here at a reasonable hour.

The next speaker is Carolyn Wysocki. Is Carolyn here? Okay, Hi, Carol.

CAROLYN WYSOCKI: Co-chair, Representative Geragosian and members of the Appropriations Committee, thank you for the opportunity to speak to you today.

My name is Carolyn Wysocki, and I live in Berlin, Connecticut. I wear several hats. I wear a respirator, but I also wear several hats, and one of them is I'm on the Central Connecticut Health District Board of Health and I'm also a board member of the National Association of Local Boards of Health, also referred to as NALBOH in my presentation, okay.

And today I'm presenting testimony as the New England regional director for the National Association of Local Boards of Health.

And this testimony is on the Governor's budget Bill 847 which would decrease the per capita money to local health department an effort to regionalize public health departments.

NALBOH represents the grassroots foundation of public health in America, and it's the only organization in America that's dedicated to preparing and strengthening boards of health to promote and protect the health of their communities through education, training and technical assistance.

As advocates of public health and boards of health, we are concerned that any decrease in funding to local health departments will limit their ability to fulfill the operational definition of what a local health department does and will limit their ability -- and to fulfill the ten essential functions of public health services that any community can reasonably expect to receive no matter where they are.

This definition also serves as the framework for the National Public Health Performance standards and the governing state and local health department standards and the voluntary National Accreditation Program that is targeted to start in 2011.

These ten essential functions of public health service include:

1. Monitor health status to identify community health problems.

2. Diagnose and investigate health problems and health hazards in the community.

3. Inform, educate and, empower people about health issues.

4. Mobilize community partnerships and action to identify and solve health problems.

5. Develop policies and plans that support individual and community health efforts.

6. Enforce laws and regulations that protect health and ensure safety.

7. Link people to needed personal health services.

8. Maintain a competent public workforce.

9. Evaluate and improve programs and intervention; and

10. Research for new insights and innovative solutions to health problems.

So how can local health departments be expected to provide these services without the necessary funding to support them?

Decreasing the per capita funds is most likely to result in staffing layoffs, reduction in programs and services to the public.

This may not be the only -- this may not be the most constructive course of action to take to protect the public health or to accomplish efficiency, effectiveness and cost-savings that regionalization can potentially bring about.

These are some questions I think that need to be asked:

Could our state and local health departments meet the public health performance standards and expectations that I have just outlined?

Will local health departments be able to become accredited when accreditation becomes a reality?

And is there a cost-savings by eliminating prevention services on one end of the spectrum only to have it appear in healthcare and treatment costs?

Regionalization of health departments is a challenge and an opportunity that needs careful planning, discussion and negotiating on various levels with input from those affected by the change.

Perhaps a public health regionalization task force can be formed. Expecting regionalization to become effective July 1, 2009, by legislation seems unrealistic without the maintenance or increase in funding to the regional district health department.

Public health needs a predictable, stable and viable funding stream for core public health functions and community-based prevention. An investment in prevention of a disease, injury or condition leads to a reduction in prevalence or severity of that condition and reductions in healthcare costs in the long run.

What we're looking at is our mission as a public health mission is having healthy people in healthy communities.

Thank you for listening, and I and NALBOH would be glad to help in any way that we can.

REP. GERAGOSIAN: Thank you, Carol. I was going to ask you if you have any ideas. And I think the Governor's proposal punishes towns that are already doing it and doesn't recognize some of the bigger places that I represent that, you know, have different issues.

So whatever help you can give us or -- I don't know if we're going to be able to get you a task force, but I'd like to try to address this some way through the budget process, so we appreciate any input you'd like it give us.

Any questions from the members of the committee? Thank you very much.

Before we go on to the next speaker I don't know if the committee members know and the folks at home know that all the testimony is online. They're not going handing out packets, so you can go to the appropriation committee website on the webpage and look at all the testimony of people testifying here today.

Next person for us is Susan Maxwell, followed by Ted Davis, followed by Janet Auster.

SUSAN MAXWELL: Hi. Good afternoon. My name is Susan Maxwell, and I'm a member at the Independence Center in Waterbury. I am here today to ask you not to cut any in funding to the DHMAS budget.

I've been going to the Independence Center because I get my support there. The IC is very important to the other members because it keeps them out of the hospital and is cost-effective. The first time I was hospitalized was 19. I'm doing very well now, and I've been out of hospital for quite some time.

I work in Macy's, and I've been there for four and a half years. Working is good for me because it keeps me in my apartment, and I get a paycheck.

The IC has good programs, like the WRAP Group and the Pathways to Recovery Group. Years ago patients hospitalized for a very long time. Now when someone goes to BTU or CTU in one of the hospitals, they're there for a very short time.

Grandview has helped tons of patients. I've still known most of the counselors there I've known since I was very young. If they put copays on our medications, a lot of patients would stop taking medication, be hospitalized and start at square one.

Again, please don't cut any funds and take away our programs, because it would be detrimental to everyone. Thank you.

REP. GERAGOSIAN: Thank you, Susan.

Any questions from the members of the. Committee?





THEODUS DAVIS: Good afternoon. My name is Theodus Davis. I am concerned about budget cuts, and I'm asking that you not take any cuts to the DMHAS budget.

I'm from the Independence Center. I need the clubhouse. I've been there for 20 years. If it weren't for the independence center, I would isolate myself. The reason why I need it is so I can motivate myself without being in the hospital.

Choices Work Services help me keep my job and hold onto my job. I've been working at Burger King for eight years. Choices has tried to help me get my driver's license and go to culinary school for cooking.

If it weren't for the Choices program I would probably be stuck somewhere, so please keep the program open for me. Thank you very much.

St. Vincent help me a lot for the past 20 years. They have helped me get better. Other people may need it, too, besides me. It has helped me with shopping, cooking, outings, games and sometimes groups.

Please, we need these program. If it weren't for this program, what will happen? Thank you again.

REP. GERAGOSIAN: Thank you, Ted.

Any questions? Thank you.

Janet Auster, followed by Michael Mitchell, followed by Ted Drake.

JANET AUSTER: Can you hear me?

Dear Senators, Congressmen and Congresswomen and all who care about us:

Committed social services counselors start stating as clear fact that we have to cut back in all care for persons with psychiatric disabilities. We, the persons in recovery, have to prepare for fresh -- a fresh and new cruelty that almost completely sabotages everything we stand for.

I use the word "almost," because we, the people in recovery, are so true, wise and imaginative and with such a vision how great our lives can be that we have to speak out to defy and peaceably fight that one day our voices and visions will be heard.

If Social Services gets negative, people that could be out in the community living happy, healthy lives would instead live emotionally crippling lives in barely functioning hospitals, stripped of their hope and identity. They would be forced to give us -- this is just a joke. They would be forced to give up cigarettes and not eat carbohydrates and having the joy of seeing their loved ones and fulfilling their innermost needs.

When we ask for help, we are not being selfish. We are being honest and brave. If everyone would ask for help, we would have a better world. How many more years do we have to wait for our ship to come in?

Thank you.


Are there any questions? Thank you, Janet.

I inadvertently skipped over Robbyn Sibley, so she'll be next.

JANET AUSTER: Oh, I'm sorry.

REP. GERAGOSIAN: It's okay. It's my fault.

JANET AUSTER: I think a lot of things [inaudible]. I think it's my fault and I find out it's not my fault.

REP. GERAGOSIAN: No, it was totally my fault.

JANET AUSTER: Does anybody have a question for me?

REP. GERAGOSIAN: I don't think so.

JANET AUSTER: I have so much more to talk about. This is just touching on the surface.


REP. GERAGOSIAN: Thanks for coming to see us.

So it will be Robbyn Sibley, followed by Michael Mitchell, followed by Ted Drake.

ROBBYN SIBLEY: Good afternoon, distinguished Chairs and members of the committee.

My name is Robbyn Sibley, and I'm from Oakdale. I'm here today to ask you to please ask the Governor if she is going to close Cedarcrest Hospital, to please give us 150 units of supported housing that we were promised two years ago.

This way, we can transition some of these people into the community as well as other homeless people, people with disabilities and families with children who greatly need this housing. These 150 units are shovel-ready and can really benefit these people.

Supportive housing costs $54 a day. Inpatient psychiatric costs $1,187 per day. And prison costs $183 per day. So going by the numbers, anyone can see supportive housing is the only way to go. It benefits everyone in the long run.

Just moving these clients from one hospital to another may not be the best move for all of them or their families, but giving them a chance to live in their own home may be a wonderful opportunity for some of these people.

Think about it. People who have been hospitalized for a long time transitioning into the community, to be given a chance to contribute to society and actually live their own lives with all the support they need to live full and productive lives.

In the long run these 150 units of supportive housing will benefit the state, too. Thank you.


Are there any questions from members of the committee? Thank you for coming up.

MR. MITCHELL: Representative Geragosian and members of the committee, I thank you for the opportunity to testify before you today.

My name is Michael Foy Mitchell. I'm from Plantsville, Connecticut, and I represent a generation of individuals whose lives were lost struggling to overcome three potentially overwhelming forces: Bigotry, apathy and ignorance. These are the weapons of my enemy. Human immunodeficiency virus. Compassion and will are my shield and weapon against these foes.

Not everyone understands the enormity of the Governor's proposal to undermine the Department of Public Health's ability to assist people living with HIV or AIDS, and I wonder how many advocates and people living with HIV or AIDS were consulted on the impact of these cuts.

I know from my personal experience in calling the Governor's office and the Commissioner's office that my calls were not returned. And in the case of the Governor, her staff would not even take my name or phone number.

Five times I called her office, and five times I was brushed off. It was only through your compassion passion and will that advocates of Connecticut have been able to piece together a continuum of care that assures the protection of those less fortunate than I.

HIV destroys lives in ways one would never anticipate. I have seen the helplessness of a mother infected with HIV [inaudible] wondering how she will raise her children and face the seemingly insurmountable objects, to seeing them graduate high school, elementary school or the prom.

I've sat with my friends as they have drawn their last breath in pain and in relief, and I have had friends and known people who, when faced with a diagnosis of HIV or AIDS, turn their lives over to drugs and alcohol in an effort to erase it from their minds and distance themselves from their all-too-real destiny.

I have seen the desperation and despondency with which people affected by this virus view their world and the roads they must walk in order to ensure their survival. One more barrier can lead them rapidly counsel a spiraling path toward their own death.

Medical case management, mental and emotional health services, transportation to necessary medical appointments and perhaps even more importantly, a compassionate voice on the other end of the phone call or a loaf of bread can mean the difference between living your life and accepting defeat.

You all may not have noticed, but I'm not originally from Connecticut. Some folks say it's my accent, while others say it's my life experience that gives me away.

You see, I grew up on a farm in Mossy Grove, Alabama, in the same house my daddy grew up in. I graduated from high school in 1982 and college in 1985. I heard about the gay cancer from my relatives up north, but had no idea that within ten years of my graduation, that half of my gay friends would be dead and all of my gay African-American friends I knew while attending college would be dead.

Living with HIV and watching my loved ones die or lose themselves to the traps of bigotry, apathy and ignorance has not been easy. I've been deeply affected. Sometimes my armor is not enough, and I'm left scarred by what I see happening to people I know and those I have yet to meet.

When I needed someone to talk to and when I needed a loaf of bread to get me through to my next paycheck so I could afford to keep buying my medications, I knew that compassionate people like you had stood up for what is right and had the will to say it is not acceptable to allow those affected by HIV to live their lives in despair. I will do something.

Today I ask you to show that will again and repute the Governor's proposition to drastically erode the safety net so many people in our state rely on every day. Thank you.

REP. GERAGOSIAN: Thank you, Michael.

Are there any questions from members of the committee?

Seeing none, Tao Drake, following by Nelson Ferguson, followed by Steve Young.

TAO DRAKE: I greatly appreciate the opportunity to be heard today.

There's no one in this room who does not understand that these economic times call for sacrifice. What I'm here to ask is that any cuts be just cuts made in whole awareness of the reality of life with HIV and AIDS and the consequences for those of us living with this virus.

My name is Tao. I've lived with HIV for over 13 years and with an AIDS diagnosis for the past eight. Almost all of my adult life has been lived in the shadow of this terrifying illness.

As my friends are starting their careers and starting their families, I was struggling to figure out how to survive. As they bought houses, I searched for drug trials. I don't testify here easily. I'm actually terrified.

Very rarely do I disclose my HIV status for fear of the stigma that it still carries. Not all that long ago my father, actually, who I know loves me without a doubt, told me one of the reasons he and my mom don't disclose my HIV status and my illness to folks is because he's afraid they won't come for holiday dinner. And he's a good guy, a really nice guy, but that's his fear and that's mine, too.

I don't come here to ask for your pity. It's really not necessary. What I want you to understand is the isolation that living with HIV carries every day. If you choose to impose the devastating cuts to the HIV care system, there's no other ready support for people like me. I'm still alive today because of the services that this funding provides.

Every month for 12 years, Freddie Close, my case manager, came to my house. Everybody who knows Freddie understands what that meant. She helped me to find the drug trials that eventually led to medications that I take today.

Six years ago I had 33 T-cells, and the virus was wild in my system. Eight million [inaudible.] She helped me access the funding for medications that neither Medicare nor CADA would provide. Those medications are often expensive antibiotics that I need to fight infection. If you get an infection every eight weeks for 13 years, the cheap drugs are bound to be useless.

It was Freddie that I called early in the morning this past October when it looked like the infection that nearly cost me my leg had returned. I was paralyzed with fear, and Freddie was my lifeline.

I'm going to leave the numbers and the statistics to the policy [inaudible] not because I'm not capable, but that's what they live for. I don't want to take away their joy. But I want you to understand what those numbers mean to me.

In 2007-2008, my average drug costs per year were in the neighborhood of 20 to $25,000. My out-of-pocket expenses after Medicare and CADA, if there was not funding from the federal government and the state, would be in the neighborhood of $2,300 in 2007 and $1,200 in 2008. That's not including over-the-counter and supplements.

To give you a comparison, I get a check from Social Security for $1,100 a month. If I didn't have the gap funding that this coverage provides, I would have to make life-endangering choices.

Most of the people here will -- who testified today will tell you that the Governor's own language asserted that we must care for our most vulnerable. And I stand here today as one of the most vulnerable, but I'm not the most vulnerable.

I have a roof over my head, although in this economy that's never a certainty. I've been blessed to remain sober for over 18 years, and I've had a good opportunity to heal some of the wounds that put me in the path of HIV in the first place.

Our most vulnerable are those who still feel unwanted and unwelcome at the table. Those who cannot see the light at the end of the tunnel of addiction, of shame and isolation and of grinding poverty. The funds that we're asking to be reinstated provides services that light the way.

I can tell you from personal experience, if a human being feels disposable, without any hope, it is nearly impossible to make life choices that reflect any other reality.

Providing quality medical treatment, substance abuse, mental health treatment and stable housing saves lives without a doubt. It also allows those receiving this help to begin to act from a place of dignity and self-care.

There was a time when I didn't care if I lived or died. Now I wake up every day grateful when my feet hit the floor. I need your help if I'm ever to see a future that I have fought tooth and nail to be here for.

This morning I was reading that Buddhists taught that our fear is great, but our connectedness is greater still. I appreciate your time. Thank you.

REP. BARTLETT: Thank you, Ted. Any questions from the committee? Thank you, Ted. Thank you for your courage and personal story.

Alice Ferguson and then Steve Young.

ALICE FERGUSON: Good afternoon. I was diagnosed with full-blown AIDS in 1989. I was working in a lucrative career for Aetna Life & Casualty that was abruptly ended due to complications from a disease I didn't know I had. I contracted the disease from my husband that died six months after I found out I was infected.

Six months following that, my complications began. And then the last 20 years, they have run the gamut from simple infections to the replacement of both my hips. I now live on Social Security. My career and everything as I knew it was ended once I got an AIDS diagnosis

One of the most important problems that arose for me was that my family could not accept it. So I was there, an achiever previously, reduced to someone who no one spoke of.

In came AIDS Service Organization that I've accessed in all these years. I can't possibly tell you how horrible and depressing and without any element of light when you're given an AIDS diagnosis, especially when you're not living with any kind of terms that you might think would [inaudible.]

And then to have your family -- and I don't want to belittle them, but to have them totally not understand, this is the plight of [inaudible] with HIV. We're left out there with nothing. Many of us are not able to work, not able to provide for ourselves. By God's grace, I have [inaudible] by my children. My Social Security pays my rent, pays my light and gas, and that's it.

The state program of Connecticut pays for my medication. I don't have to tell you they -- I'm sitting here 20 years after the fact, so I am going to plead. Understand any cuts to HIV and AIDS programs would be [inaudible] elimination of any sort for many people. Consumer some of us often have to nowhere else to go.

I heard Governor Rell on the news make mention of we all need to make sacrifices. We have lived with sacrifices forever. It's a way of life for all of us. We're told that [inaudible] are supposed to be of last resource. They're the last option you're supposed to when seeking any assistance when you have no other resort.

There is no priority needed. There is no other source for many of us. I really would love to sit face to face with Governor Rell and just recount some of my experiences. And believe me, I'm sure I can make her understand this is not just a sacrifice. It is our only chance to live.

Please, on behalf of all the consumers, and I know I [inaudible], because I've been [inaudible] years of sacrificing and years of complications, but for those who haven't who are facing so very much, please understand. Eliminate the cuts. Thank you.

REP. BARTLETT: Thank you, Alice. Any questions?

Any questions from the committee? Thank you. And don't give up on trying to influence Governor Rell, okay? Thank you.

Steve Young and then Nick Glomb and Walter Glomb.

STEVE YOUNG: Hello, and thank you for an opportunity to be heard publicly.

I could tell you stories about deprivation and mental anguish that might impression you. I feel my suffering credentials are adequate, and I prefer to spare you the details.

The need for change in our world seems obvious. Our healthcare system is too expensive. We can no longer afford to wait for illness to become a crisis and then attempt to play the hero. We know what makes people sick. We know that it is stress, and most illnesses are stress-related.

We all play a part in creating the stress, the food we eat, the way we live, the way we treat each other, wait we pollute the air and the water. We all pay for illness. We all play a role in creating it.

We have the power to change this. We are powerful beyond measure. The shift would be in our priorities. Until now it seems that our priorities have been to make money. We have learned that this approach to life can be very expensive. We're having a rude awakening. The enemy here is really stress.

What I'm asking for is a total restructuring of society. I'm asking for humankind to make wellness its goal. We are like Humpty Dumpty, who has lived on the edge and has now had his great fall. Wouldn't it be better to teach him to reside on a patch of moss somewhere?

Life does not have to be so stressful. We can see now that prosperity is wellness-dependent. It is possible to have a world in which every thought, deed and action is focused on promoting life, good health, piece and prosperity for all beings. We can do it, and there's no better time than now. Thank you for listening. Thank you again for listening.

REP. BARTLETT: Thank you, sir.

Any questions from the committee? All right.

Nick Glomb and Walter Glomb, and then or Janine Nodine, and then Scott Richie.

NICK GLOMB: [Inaudible]. Hi, I'm Nick Glomb. I am a client of DDS. I do work at Big Y Supermarket in Ellington and South Windsor Ten Pin. I also go to class at Manchester Community College. I also take English 66. I'm also a coach of a high school hockey team, Tri-Town Hockey. I am living proof of DDS services. [Inaudible].

Today I'm going to tell you about the budget of DDS. Please don't cut it. If you do, I'm not going to have my two jobs much longer, because all DDS clients if you cut the budgets, all DDS clients are not going to have their jobs.

Please [inaudible] that. [Inaudible] now we're not going to have this problem again. And that's it [inaudible] Congress [inaudible] DDS clients as well. This is why [inaudible] I don't want DDS budget be cut. This is [inaudible] money back now to DDS. If we do, I hope and I pray for all of you committee to do that. Thank you very much.

WALTER GLOMB: Good afternoon, committee. My name is Walter Glomb. I'm Nick's dad. I'm a resident of Ellington, Connecticut. I'm also the president of the Connecticut [inaudible] Council in Congress.

What Nick was just telling you is that he and his peers all depend on funding that you have in the Department of Developmental Services to enable them to work and to live in the community. And without that funding, Nick and his peers will be unable to work. He wouldn't have the transportation. He wouldn't have the supports, and many lives would be wasted. I can't say it any better than Nick does.

The Governor's proposed essentially a flat budget for DDS this year. Under the circumstance, I have to say we're thankful that that's the case, although I hope you all realize that the private providers who do these services for Nick and his friends have been suffering under chronic undercutting for at least a decade. So as much as we're grateful for the flat funding, this is going to continue to be a challenge to provide the services even under those circumstances.

Budget cuts will be devastating. So the budget has been presented. Now it's up to you to see that there aren't any cuts.

I have to emphasize again, these really are discretionary programs. The individuals who depend on these services don't disappear because the budget isn't there. And in the absence of these -- these supports, they're going to be relying on something else.

The costs are not going to go away. They're just going to be shifted.

I want to thank Senator Debicella for his comments this morning about privatization. We understanding that the budget's tight. We understand that all the agencies are going to have to work to make the most use of their money, and I think that's all about efficiency.

So when you do come to look at the budget, if you have to make any changes, I hope that you'll look seriously at structural changes to the department that would shift more of the services to the more coast-effective side, and I think you know where that is. The senator made the point this morning.

I would also remind you that these services -- by the way, these are the home- and community-based services I'm talking about, the employment, [inaudible], transportation [inaudible] are provided under the home- and community-based waiver and Medicaid.

So Connecticut receives more than 50 percent under the new stimulus bill, will get more than 50 percent reimbursement from the federal government for all these services. That means, of course, if you cut any of these services, that's income that the state would be losing from Washington.

So in conclusion, we simply want to say please provide DDS with the budget they need to provide the services. Thank you.

REP. BARTLETT: Thank you, gentlemen, for your advocacy.

Any questions from the committee or comments? Thank you.

Janine Nodine. Scott Richie would be next and then Kevin Leniart.

JANINE NODINE: Good evening, representatives, senators and members of the Appropriations Committee. First, I want to let you know I'm really scared doing this. This is my first time ever advocating.

I would like you to be aware of how the budget cuts in AIDS service organizations are going to affect my life. I am living with this virus and have been for the last ten years. I do receive Ryan White services through several agencies in Hartford, something of them being AIDS Project Hartford, Latino Community Services and MANA out in Manchester.

Without these services from these places, I would not be able to get my individual therapy sessions for mental health problems and substance abuse treatment. I have been working with counselors at MANA for both of those issues.

I receive transportation from Latino Community Services and med adherence, case management and nurse care through AIDS Project Hartford. I also feel as a whole that these budget cuts that are being proposed this year will have an adverse affect on my life.

I will not be able to continue my treatment for substance abuse and/or mental health. This will cause me to possibly take a turn for the worse and go back to abuse and unhealthy behaviors.

My transportation needs are great, and I do feel with these cuts I would not be able to access the transportation to get me to my appointments to keep me alive. I will not have trained professionals to ensure that I stay adherent to my medications, and personally I feel if the Wellness Centers that provide many essential services to clients on a daily basis are forced to be closed this year, we will not have enough service.

I do benefit from these services and pray that they continue to be offered, because they are critical in assisting us in these troublesome times. Please consider the need of people living with HIV and/or AIDS when making these decisions. We are, after all, human and deserve to live. And we are asking basically for basic needs to be met to keep us alive.

And again, please do not cut any funds to the HIV/AIDS funding this year. It could be my life that you're cutting. And also right now, this virus is in my home, and it could be in yours the next time we meet. Thank you.

REP. BARTLETT: Thank you. Any questions?

Scott Richie and then Kevin Leniart and then Maggie McCaroll.

SCOTT RICHIE: I'm reading this for Joseph Alabierti. Good afternoon, Chairperson, and fellow legislators. My name is Joseph Alabierti, and I'm a duly diagnosed patient in the Department of Mental Health and Addiction Services of Waterbury.

I'm also an advocate, council member of the Discovery Drop-In, which is a social club. The club is affiliated with DMHAS. This is a state-funded facility, and we need funds to keep it going. Without these funds, we lose out. When I say "we," I mean people with psychiatric disabilities. And there are many more state-funded clubhouses throughout the state.

Without the funds, there will be more people just wandering the streets, in or out of jail, or even in the hospitals. We don't need this. We don't want this. So please give us the funds that we need. Don't get me wrong. I'm not just talking about the clubhouses. I'm talking about DMHAS who helps with housing, medical, nursing, psychiatric and even transportation.

Programs and services work. Such programs as group homes, support groups, AA, NA, work service agencies, social clubs, Advocacy Unlimited, [inaudible], WRAP, which stands for the Wellness Recovery Action Plan, regional health boards and case management.

Remember, keep the promise. We want people out in the community.

Thank you for taking the time to listen.

REP. BARTLETT: Thank you, Kevin.

Any questions or comments from the committee? Thank you, sir.

Maggie McCarroll. Kevin's next.

MAGGIE McCARROLL: Hi, my name is Maggie McCarroll, and I want to thank you for the opportunity to testify today.

As far as I understand it, the mental health system will lose $8 million in funding over the next two years. I know this budget needs to be balanced, however I suggest the governor cut money in areas other than mental health.

Mental health systems helps some of the most disadvantaged members of our society to survive and to strife. One of the most difficult issues in the lives of the mentally ill is housing. It is often hard for the mentally ill to find and maintain a decent place to live. This could be partially solved by opening up different types of housing and giving the mentally ill more choices than they currently have.

I was diagnosed as bipolar seven years ago. I mention this because during my slow process of recovery, I have spent time in both hospitals and group homes. Long-term hospital stays are sometimes necessary. Doctors and nurses try as hard as they can to make inpatient consumers feel comfortable in a home.

When I have been inpatient I always remember that I am in an institutional setting. Patients are barred from leaving the unit, and so they oftentimes feel like prisoners. Once again, the doctors and nurses try their best to make patients feel as home. The reality is that making a hospital feel like a home is unrealistic.

Instead, the number of alternative housing options such as group homes and halfway houses should be increased. Instead of increasing the options for housing, the budget is proposing to continue building institutions.

The Governor has proposed closing Cedarcrest Hospital. Sixty-four of the patients there would be transferred to CDH. There are 30 more patients that would be put into two smaller institutions of 15.

Instead of perpetuating institutions by building two more, why not try to have patients transferred to group homes or halfway houses? When I lived in a group home, there were about seven people living in the house. This number was manageable. I knew everyone very well, and we often gave each other support.

A building with 15 is too big to be intimate or give the people the feeling of being in a home. Group homes allow people to be more free than large institutions. People can come and go as they please as long as they're back by a certain time. Institutions cannot allow patients to come and go because of insurance company rules.

Being mentally ill can be difficult. Not having somewhere appropriate to live is a huge problem for the mentally ill. Instead of cutting spending and building new institutions, the Governor should be sending people to alternative housing. In fact, instead of cutting spending to the mental health community, the Governor should be spending money to build more alternative housing units. Thank you very much.

REP. BARTLETT: Thank you so much. Are there any questions or comments from the committee?

Thank you, ma'am.

Kevin Leniart. Sorry, Kevin, for skipping you before.

KEVIN LENIART: Good afternoon to the Appropriations Committee and my fellow advocates and guests of the DMHAS budget hearing.

Hello, my name is Kevin Leniart. I'm from the Second Wind Clubhouse in Enfield, Connecticut. I'm also an Advocacy Unlimited advocate. I would also like to thank the Keep the Promise Coalition for their help and support.

There is not just one factor which promotes recovery for people with psychiatric disabilities. There are quite a few of them. I will just scratch the surface today and talk about some of the factors that comprise recovery.

Access to medications is a good place to start, because the meds provide a sense of stability which, for me, helps organize my thoughts and get good rest. Without meds, my life would be chaotic and disorganized.

Psychosocial clubhouses promote rehabilitation and community integration. Activities for an average day and structure are another integral part of recovery. People like me need a place to work, find recreation and regain confidence and skills to get our lives together.

A third factor is available hospital beds. For me, the road to recovery started in 1992 after a brief stay at Cedarcrest Hospital in Newington, Connecticut. It was very difficult time in my life, as I was extremely withdrawn and very paranoid, but I knew that I could trust the people at Cedarcrest.

One of the caseworkers there went with me to apply for SSDI benefits. That was a process which made my life considerably more manageable, with for a financial comfort that allowed me to progress slowly through the mental system.

At the time I wasn't very appreciative and simply did not want to be in the hospital, but as it turns out, it was a place I needed to be. I can testify that the system works and would sincerely recommend that the members of the Appropriations Committee reexamine the closing of Cedarcrest Hospital.

Places like Cedarcrest Hospital save our lives and the people that work there provide a cornerstone of recovery from psychiatric disabilities. Money for meds, clubhouses and Cedarcrest are a few of the keys to recovery for people like me.

Please reconsider and revisit the cuts to the state mental health services. Thank you for the opportunity to speak to you today. Thank you.

REP. BARTLETT: Thank you so much, sir.

Any questions or comments from the committee? Thank you for your advocacy.

Dan Gaines. And after Dan, Pamela Mautte.

DAN GAINES: Greetings, Senators and Representatives.

My name is Dan Gaines, and I'm a registered voter from Waterbury. I'm also have a mental illness. I am speaking today because I believe we should be expanding community services instead of removing services.

I've utilized community services to help me remain out of hospitalized services for most of my life. I would hate to think that because of budget cutbacks, these services won't be available to others who might fall into my category, because if not for these services, I would have had at least three admissions into the hospital, whereas I have zero.

Nonprofit agencies like Independence Center, St. Vincent DePaul and others, have kept me out of the hospital and kept me stable. Cutting their funding would be like cutting a lifeline for me. I have a hard time trusting people, and it takes time for me to build the confidence in someone who is there to help me.

Counselors come and go, because there isn't enough money available now to pay them what they're really worth. It will only get worse if the cuts are made to the budget and nonprofits.

We should be working on funding community solutions and not create new institutions. People can survive and thrive out in the community with the proper supports, and that means not cutting funding for community programs and not making the same mistakes that were made when Norwich and Fairfield hills were closed. Funding needs to follow the ones who leave the hospitals that you're planning to close into the community. Thank you.

REP. BARTLETT: Thank you, sir. Any questions or comments? Thank you very much.

Next, Pamela, and I apologize, Mautte or Mautte. Thank you, Pamela. And then Sheila Amdur and Giana Livingston.

PAMELA MAUTTE: Good afternoon, members of the Appropriations Committee. My name is Pamela Mautte, and I'm the director of the Valley Substance Abuse Action Council, and today I'm here asking you to support restoring level funding for the Regional Action Council, which are very efficient and effective.

The proposed budget does not include full funding for the regional action council, and the funding used by the RAC is core funding dollars that is crucial to the state and local communities.

The RACs utilize the state funds to leverage and match additional federal and local funding. In the past four years, we've collectively enhanced prevention services in the state by obtaining 6.5 million in federal and over 8 million in local dollars. These dollars would not be available to us if we do not have the state dollars to leverage or match them.

They directly impact the communities you serve, because we have the -- we have been able to invest in local prevention activities. I ask you to remember your return on investment is for every one state dollar you allocate to the Regional Action Councils, we bring in over $4 in our funds, including federal and local.

However, it is important to remember we need the state dollars to match these federal dollars, and federal substance abuse grant dollars cannot be used to match additional federal dollars.

Our system is very effective, and it's beneficial to our communities as well as the State of Connecticut. Studies have shown that as economic decline prevails, substance abuse increases. Therefore, we need to continue to be in the front lines of our communities providing this valuable prevention programming.

Insufficient funding will jeopardize the prevention infrastructure Connecticut has worked 20 years to build. In addition, the RAC infrastructure is held up as a model by other states and the federal government.

Again, I remind you about the return on investment and provide. We recognize that this budget proposal is impacting many services and agencies in Connecticut. The Governor's proposed budget has eliminated the RAC line item and other state funds of approximately $600,000 and includes a transfer from the pretrial account of $600,000.

However, previously in the past 500,000 has also been transferred from the pretrial account to the RAC. Therefore, we're at about a 50 percent decrease in funding.

However, this transfer is not included in the Governor's budget. We ask you to reinstate the additional 500 from the pretrial account as in previous years.

Again I remind you of your return on investment we provide. I urge you to remember that the Regional Action Councils are a good investment of state dollars. And for every dollar you spend, 11 is saved in societal cost and therefore is an investment that should not be overlooked.

Thank for your time. Are there any questions?

REP. BARTLETT: Thank you, Pamela.

Any questions? Senator Debicella.

SENATOR DEBICELLA: Just a comment as we're going into committees, is one of the proposals that the Governor had submitted which is not going forward is to combine some of the RACs and regionalize it, and that might have been part of the rationale in the lower appropriation.

So I think the comment that you're making is absolutely right, is organizations like these have a tremendous return on investment, not just in dollars but we talk about results-based accountability up here. The results that you have delivered have been outstanding.

So this is an area where -- you don't hear me say this very often, but this is actually an area where we do want to consider adding some money back in. I know, look at that. I think that's the first time I've said that this year, but this is an area we need to consider adding some money back.

PAMELA MAUTTE: Thank you, Dan.

SENATOR DEBICELLA: That should make you feel good.

PAMELA MAUTTE: Are there any other questions?



REP. BARTLETT: Thank you. Sheila Amdur.

SHEILA AMDUR: Good afternoon, members of the committee. My name is Sheila Amdur, and I'm testifying today on behalf of the National Alliance of Mental Illness of Connecticut.

You have my testimony, and I just wanted to give you some highlights. I don't envy the position that you are in in terms of the serious economic situation that the state is facing; but I'd ask that as we go through this exercise that is going to be very painful, that the first maxim should be do no harm. And especially do no harm to the state's most vulnerable citizens.

You see I'm wearing a blue ribbon that you've seen on lots of people. The Keep the Promise campaign grew out of the closing of the state hospitals. When we wanted to see those state hospitals closed, we wanted to see people in the community, but we didn't want to see that money put back into the general fund and not reinvested in community solutions. And now we're reaping the whirlwind for well over a decade and a half of not investing in the community.

The Governor's proposing closing Cedarcrest Hospital, and essentially transinstitutionalizing people from the hospital, spending $6.2 million at CVH to renovate wards, and we think this is a very bad idea.

I don't want to -- I don't want to disappoint some of my friends here. I don't know whether the hospital should be closed or not. We need immediate beds. We have to have an examination of how many beds.

We should be looking at how we can be getting potentially Medicaid dollars for paying for some of those beds by providing some of it in the private sector.

Our state workers were extraordinarily critical in the deinstitutionalization that occurred when the two large state hospitals were closed. State workers were very important in providing the community services. So I'm not suggesting getting rid of state workers, because they were critical in terms of community programs.

That 6.2 million could go to replace some of the capital costs that we've done by -- that the Governor has done by wiping out 150 units of supportive housing.

I've given you -- we've given you -- this isn't just mine. This is a group effort. Saving money, saving lives. We're documenting in this how, number one, you can maximize federal revenue while strengthening the community system of housing and support. You can reduce alliance on long-term institutional settings like nursing homes. We're also suggesting in this we need to increase the home- and community-based services waiver for nursing homes.

Why are we paying $90,000 a year to put someone with a serious mental illness into a nursing home, increasing -- keeps being an increasing number of people, when those folks could be in the community and the federal government allows us to use that money to provide the community services.

And lastly, we have given you in this position paper how we can promote community integration.

So I'd be happy to answer questions. We'd be happy to follow up with meetings with any of you. This is something obviously that we have talked about for many, many years in terms of maximizing federal revenue, increasing community solutions and reinvesting in the community.

If you just -- if -- we just need to use -- I mean, if at no other time when we're facing this kind of economic situation, if we don't use this time to look at how do we invest state dollars and how can we be doing it better and how can we be saving money and saving lives?

So I thank you, and I really again implore you that times of crisis are times to find ways to do things better and not just times to really hurt those who are the most vulnerable.

REP. BARTLETT: We appreciate that, Ms. Amdur, and thank you for bringing the light to the mentally challenged, the "help" part into nursing homes. It's definitely not something you should be doing.

Any questions or comments? Yes.

REP. ESTY: Thank you.

If you can bring forward anything, especially I know through the National Alliance, on the Medicaid portion in the stimulus as quickly as possible, because we really are working very hard on, as you say, restructuring in a smart way, making the best decisions we can to provide services for people.

So any assistance you could give us in that would be very helpful. We're scrambling trying to get the figures on how that Medicaid funding is going to play out.

SHEILA AMDUR: This is in terms of the national -- the federal stimulus?

REP. ESTY: Some of the federal stimulus so we are making intelligent decisions that maximize our ability to --

SHEILA AMDUR: All right. I think I can get more information from our national office.

REP. ESTY: Exactly. That would be helpful. Thank you.

REP. BARTLETT: Representative Schofield.

REP. SCHOFIELD: Hi, Sheila, nice to see you and thank you for your testimony. Following up on Representative Esty, if you have -- something we asked the department for as well this morning, any suggestions on how we could take advantage of the rehab option prior to the case management, other things that might be available through Medicaid to do federal revenue maximization that then could allow us to sustain funding in DHMAS at a higher level, particularly supportive housing.

SHEILA AMDUR: Attached to my testimony is this position paper, Savings Money, Saving Lives. So we essentially quote the studies that have been done in the state, they're four years old, that showed -- it was close to $30 million of new federal money, which at this point would be much more, both because of the stimulus and because of the growth in Medicaid.

The state invested money and the community provided assistance to bring -- to have community providers develop the billing capability and the treatment planning documentation capability.

I know this isn't a popular subject for medical providers, it does require people to do much more documentation. But -- and, you know, it is more work. I know. I used to run community health centers.

But what is very important with that money is the state just doesn't take it and run and say, okay, we'll use that to displace grant funding. Because it would be then a zero-sum gain that does not in any way improve the community system.

So we -- we have done -- that's from a state study that was done. The state stopped doing it. They only implemented one option under the Medicaid rehab option which was for group home billing.

They stopped at -- I suspect you could ask -- there's some folks here from OPM, but I think they stopped it because they were concerned about what they thought would be increasing the number of people who would use the services.

But really, you know, there's a finite number of people who have serious mental illness. It's not something that there's a -- can be expanded because you put an option in.

So we have documented that. There's studies that document it, but we'd be happy to -- and we documented the kinds of services that could be provided, but perhaps we can follow up with you.

REP. SCHOFIELD: Thank you, Sheila.

SHEILA AMDUR: Okay, thank you.

Thank you. Giana Livingston, followed by Dominique Thornton.

GIANA LIVINGSTON: Hi, my name is Giana Livingston. I'm a member of the Connecticut Commission for [inaudible] in the Asthma Speaker Bureau in Bridgeport, Connecticut.

I'm a single mother of two sons with asthma. Bridgeport, Connecticut has the second highest number of emergency department visits due to asthma in the state and the third highest number of hospital admissions. Because of this, it has empowered me to learn more about asthma, about the risk factors, triggers, indoor and outdoor asthma.

The Asthma Speaker Bureau -- we did presentations at schools, health fairs, community events and public meetings. Asthma is the leading cause of missed days from school and work. African-American age 15 or 24 or six times more likely to die from asthma. African-Americans and the Spanish are more likely to die as a result of asthma than any other population.

Fourteen people a day die from asthma. Asthma left untreated can lead to death. In children, boys are more likely to have asthma. In add adults, women are more likely to have asthma. New England is the only region in the US where asthma is increasing. That's why funding is needed.

Thank you for giving me the opportunity to speak.

REP. BARTLETT: Thank you. Any questions or comments from the committee? Thank you for coming forward.

GIANA LIVINGSTON: All right, thank you.

REP. BARTLETT: Dominique Thornton, followed by Kim Streater.

MS. THORNTON: Good afternoon, members of the Appropriations Committee. My name is Dominique Thornton, and I work for the Mental Health Association of Connecticut, a 100-year-old nonprofit organization dedicated to service, education and advocacy for people with mental health disabilities.

I'm also here today as a member of the Connecticut Association of Nonprofits to speak in opposition to the cuts to the Department of Mental Health and Addiction Services.

The Governor declared in her budget address that she did not propose across-the-board reductions to private provider funding but instead recognizes the need to maintain as much continuity as possible in these areas in order to benefit those in need of assistance from the state during these trying times.

And we know that the private nonprofit providers have received actually zero in the last few years, and every year that they receive a zero cost of living increase, and actual costs do rise, they actually get a cut. And it will be worse next year. We know that.

Services provided will be -- to consumers will be substantially less. So we must speak out when the reality of the budget does not match the promise of the words in its presentation.

The proposed budget reduces mental health case management services by $3.5 million over the next two years, and this process will be accomplished through rebidding current services contracts for less money.

Ask yourself if you reduced your current service contract by a total of $3.5 million over the next two years, could you reasonably expect to receive the same level of service?

Considering that the private nonprofit providers are already stretched paper thin, is it reasonable to believe that the state's most vulnerable citizens can expect equivalent services for $3.5 million less? A rose is by any other name still a rose and a cut is a cut.

Converting case management service to different service delivery model called community support program still cuts case management. The budge details show that community support services will be enhanced to save the department money. Ask yourself, how can services be enhanced and also save money. Services will be rebid, repackaged, shuffle and ultimately less service provided.

The budget describes community support service will take the place of some community assertive -- assertive community treatment teams and thereby reducing the total number of teams in the state to only three, saving the state another $3.36 million over the biennial.

Instead of requiring all the [inaudible] teams to follow the model faithfully, people in crisis in the state can expect to receive the services that they received will be less than those who do follow the model. Also, mobile crisis and other services are going to be reduced $1.4 million less.

And then I just talk about redirecting the -- going back into the institution and how that costs more to reinstitutionalize people at CVH and not -- not putting more money back into the community, which is far more effective economically.

REP. BARTLETT: Thank you for coming forward. Appreciate your time.

Any questions for the committee?

MS. THORNTON: Thank you.

REP. BARTLETT: Thank you.

Kim Streater, followed by Elizabeth Civitello.

KIM STREATER: Good afternoon. My name is Kim Streater.

Supportive housing has brought my children and me out of deplorable living conditions. The apartment we came from before receiving help from New Haven Home Recovery [inaudible] and Neighbor Works New Horizon was almost unlivable.

When it rained outside, we knew it because it also rained inside. We had mold that would form in the hole in the bathroom every time it rained. My two-year-old spent most of the time at the hospital because of asthma attacks caused by mold than she spent at home. When the weather conditions became extremely cold outside, it felt the same inside.

My children always tried to spend nights out to get away from the horrible conditions we lived in.

I was referred to New Haven Home Recovery from Bill Heinrich, who works in the office of Rosa Delauro. He referred me to New Haven Home Recovery. New Haven Home Recovery verified the living conditions and other problems we were having, and within a few months we were moved to new affordable apartment.

If it wasn't for supportive housing, this would never have been possible. Supportive housing doesn't just give you a place to call home. They continuously support you [inaudible] food, clothes, help with a resume or just someone to talk to. I still receive help from New Haven Home Recovery.

Without supportive housing, there will be families that would just give up like I almost did. Without supportive housing, you'll begin to see more homeless families, families breaking up and crime rate will elevate.

So when you think about budget cuts, if you don't plan on breaking up families, then don't cut -- excuse me -- supportive housing. Sustain funding for services for homelessness and DSS housing and homelessness line item. Thank you.

REP. BARTLETT: Thank you.

Any questions or comments from the committee? Thank you so much.

Elizabeth Civitello and then Claire Phelan.

ELIZABETH CIVITELLO: Good afternoon, distinguished members of the Appropriations Committee. Thank you for this opportunity testify today against the Governor's proposal to shut down Cedarcrest Hospital.

My name is Elizabeth Civitello, and I have a grandson at Cedarcrest who is 28 years old with a pervasive mental illness disorder. He's also autistic.

My grandson has come along very well. He's made a lot of progress, but he needs more time at Cedarcrest. Cedarcrest is his family. He has such ties to the staff members there. Not just the caring staff, but also the doctors.

I can sleep well knowing he's well taken care of. What's the alternative to keep him out of harm's way? It scares me to think of him going somewhere with more hostile residents. Right now isn't the time to cut services. We're all taxpayers, and it doesn't seem right to pick on the weakest people in our society, people that need Cedarcrest.

Please keep Cedarcrest open and available for patients who need help from professionals, qualified doctors and caring staff. Cedarcrest provides not only the services but also the attention that people like my grandson need. They make sure patients get everything they need. It's a caring facility, not somewhere where you're concerned for the safety of your family members.

The goal of the hospital is to allow patients to live their potential, with the goal of eventually being in the community. The staff there helps him. You can see that they really get to know their patients.

My grandson is not just another number. If he doesn't like certain things, they take care of him and give him something good to eat. It would be a hardship for so many families in Connecticut if Cedarcrest closed down.

I don't agree with privatizing any beds, because I don't feel the private sector has adequate resources to provide the type of care Cedarcrest provides. We have no idea where our family members would be housed, and they're in such a good place right now.

It's a very frightening idea. The patients at Cedarcrest need stability and support so they can go on and have a good life.

There are so many aspects of what the hospital provides. How can you consider closing down a hospital like Cedarcrest? When someone is ill, they need a medical facility, a hospital. That's what Cedarcrest is with extended services as well.

We have a responsibility to provide for the people who have the greatest needs, and as a grandmother and conservator, I urge you not to close down such an important hospital.

Thank you so much for listening to me today.

REP. BARTLETT: Thank you, ma'am.

Claire Phelan and then Jesse White-Frese.

CLAIRE PHELAN: Good afternoon. My name is Claire Phelan. I'm a resident of Milford, and I'm the chairperson of the board of directors of Bridges.

Bridges is a healthcare agency. It's very important to Milford and the surrounding communities. I am here today to talk to you about the DMHAS budget and what it means to our area residents and our constituents -- and your constituents.

Bridges provides comprehensive mental health and addiction services for children, adolescents, adults and families. It is the DMHAS-designated local mental health authority. It offers outpatient mental health and addiction services in Milford, Orange, and West Haven.

We are the lead Kid Care agency for DCF, providing a similar range of services for children and families.

We are a grant-funded agency under contract with DCF, DMHAS and DDS to provide behavioral health services in residents in 22 towns. In 2008, over 7,000 individuals and families accessed our services.

Bridges has been serving our local communities for over 50 years through partnerships not only with the state but with local sources such as the City of Milford, the Town of Orange and the Milford United Way.

I mention all of this because our board of directors and our many community supportive volunteers are now deeply concerned with the current fiscal crisis and its potential to erode, if not severely damage, all that our community has built.

As hard working residents and volunteers of our local communities, we are aware of the difficult job you have. Even so, I am here today to urge you to strengthen state support for these vital services, even in the face of the fiscal crisis before all of us.

Sometimes crisis can be the vehicle that brings about and drives a positive change. Many of us have had family members who have used these services, and we know well what would happen if they were not available.

One of our past board members and my friend spoke last night to this committee of her own family experience and how the wonderful recovery services of Bridges has enabled one of her family members to live independently. It is one of her many examples that our board and community are so supportive of bridges.

During these very widespread difficult times, more people are seeking our services. In the first seven months of this fiscal year, over 2300 calls came into Bridges asking for help, but we've only been able to do intakes and evaluations for about 530.

We've had to -- we've had -- underfunding has forced us to cut back in so many areas. We had to -- we have six full-time positions that are frozen. One of our concerns is our frustration in not being able to serve these people, all of them that do need our help.

And when we hear about the residential and hospital beds costing Connecticut 250,000 to $800,000 a year, my board members question why the state would not invest even in more community services, knowing that it would keep the people out of the institutions.

The cost of those beds represents 2500 to 6,000 treatment sessions at Bridgeport.

REP. BARTLETT: Ma'am, I have to cut you off. I have your testimony. I was reading it with you. And we're all able to read it here, and I appreciate it.

CLAIRE PHELAN: Okay. I have done that for you, and thank you for your attention.

REP. BARTLETT: Thank you for coming forward.

Jesse White-Frese and Leslie Balch.

JESSE WHITE-FRESE: Good afternoon, members of the committee. My name is Jesse White-Frese, executive director of the Connecticut Association of School-based Health Centers.

And with your permission, I have asked Joann Eaccarino, the president of our board of directors, to sit with me. For the sake of time, she has forfeited her number 166, I believe, but she will be here if you have questions so that we can be efficient with time.

The school-based health center model is a cost-effective efficient delivery system of medical mental health and dental services to Connecticut's children.

You understand the benefits of bringing health services to children in their schools and have demonstrated that through your investment in school-based health centers.

Currently there are 19 Connecticut communities that benefit from these services in more than 70 school sites. And annually 44,000 children and adolescents utilize these services in 131,000 visits.

At least 28 percent of those students are uninsured, and those numbers are now climbing higher.

The Governor's public health budget proposes to cut $1.47 million from school-based health centers. This will have a devastating impact on Connecticut's children, potentially affecting nearly 7,000 students that will not have access to needed medical care.

School-based health centers are safety net providers for children and adolescents. By definition, a safety net provider maintains an open door, offering access to patients regardless of their ability to pay.

A substantial share of their patient mix is uninsured, Medicaid and other vulnerable patients. This clearly describes the school-based health centers that you have funded.

As families are experiencing the loss of employment and employer-sponsored health insurance, students are turning to the centers for needed medical care and help with family stress. Parents are grateful that the centers provide a safe environment for their children to express their concerns.

Our military families tell us that when they are deployed, their most important concern is that their children will receive the care they need while they are gone.

School-based health centers provide affordable healthcare. Students have immediate access to care provided by staff with expertise in child and adolescent health. When they receive care in the early stages of the medical or mental health problem, they avoid the costly care that results from delaying treatment.

In most cases, the healthcare provider in the centers keep students in school and out of the emergency room. If school-based health center services are reduced, families will have no option but to seek care in the emergency room for nonurgent issues, and this drives the cost higher.

In my testimony, you see that we did a comparison of an asthma visit in a school-based health center costing approximately $22 to provide that service compared to $350 for that same child to go to the emergency department.

If the child is uninsured, the state bears that cost and the cost-savings are much -- or rather the cost is much higher. So the cost-savings are clear this way, and it makes fiscal sense. Numerous studies have shown that school-based health centers reduce inappropriate emergency room use.

You know that school-based health centers keep children healthy and keep them in school, and our families need these services now more than ever. We know these cuts always impact vulnerable families. And when family stress increases, we see an increase in substance abuse and domestic violence that impacts our children.

These reductions in funding translate into reductions in staffing, early closure of centers, less days of week per service and a loss of the health lifeline that is critical for so many of our children.

This has happened before. We hope that you will help avoid this again. We strongly urge you not to cut this vitally important safety net for our most important and vulnerable citizens. Thank you.

REP. BARTLETT: Thank you.

You kind of said it at the end, but I just want to go over, the cut, will that close a certain number of health centers? What is the direct impact of the proposed cut?

JESSE WHITE-FRESE: Joann, would you like to talk to that?

JOANN EACCARINO: More than likely what it will do is cut some, because again, there was a stipulation that that be from expansion funding. And the way that some centers were expanded from part time to full time, those services would then go back to part time or may necessarily be cut all together.

REP. BARTLETT: So going back like a year? Because I know we expanded from part time to full time.

JOANN EACCARINO: Right, right.

REP. BARTLETT: And who gets to make that determination? Is that DPH or who does that?

JOANN EACCARINO: Apparently that's -- that -- that's what was noted in the bill, was that it would be from expansion money.


JOANN EACCARINO: Or in the budget notes.

REP. BARTLETT: There was a question this morning as to billing, and over lunch I was talking to another state representative, and she seemed to indicate or seemed to think that we were not getting full reimbursement for Medicare and Medicaid. I think the commissioner testified to 20 percent, about.

And I was wondering if you could address that, because I think some people have the opinion that the blame lies with the school-based health center that we don't get full reimbursements, and I was wondering if you could shed some light on, you know, how do we improve that, if you have any suggestions and really where that -- why aren't we getting it.

JOANN EACCARINO: Well, first of all, there certainly were inaccuracies in the testimony this morning about how school-based health centers bill. Every single one of us in all 18 communities have contracts with [inaudible] Medicaid providers, Aetna, AmeriChoice and CHM, so we all have contracts with them.

The issue is sometimes the reimbursement is less than you would get in a private provider's office, because instead of paying for individual facets of the visit, like not only to get reimbursed for the visit but also for what's done during that visit, so say a strep test or an asthma treatment, they just pay for the visit, and I --

REP. BARTLETT: The insurance company just pays for the visit?

JOANN EACCARINO: Right, right, and that's Medicaid.

So we do have contracts. We do submit, you know, bills for what we do. But the reimbursement issue is sometimes the problem.

REP. BARTLETT: So if a child went to a doctor's office and he had a strep test and he went back to the healthcare -- the insurance company, would the insurance company pay for that under the physician's office?

JOANN EACCARINO: We think so. Again, that's something we have to investigate, but it -- it would seem that any of us who have gone to our own private provider, when you get your explanation of benefits, it lists those things that were done.

REP. BARTLETT: Okay. I'd like to work with you on that so that we can --

JOANN EACCARINO: Yes, definitely.

REP. BARTLETT: -- see how that works, so if there's a problem in the system...

Are there any other questions? Yes, Representative Thompson.

REP. THOMPSON: Good afternoon. The only thing that amazes me is that there are only 18 right now. Some years ago, the legislature had a statewide town meeting. We asked the individuals attending that to go back to their communities and create town plans, the idea that everything begins and can end and be successful on a community basis.

And one of our neighboring communities, East Hartford, went back, and they decided that the most important thing that they could do for their children was to establish a school-based health center.

And today, what they started really, they now have connections with the Eastern Connecticut Health Network which operates three hospitals now. In our community what was created was a health clinic and a dental clinic, and a dental service that coordinates its work with the board of education.

And through the East Hartford community, dental services are being provided to schools in I think East Hartford, Manchester and so on.

And it just seems such a natural to have the school-based health centers coordinating with the federal [inaudible] health centers. And we asked the commissioner this morning, Commissioner of Health, about his suggestion that private physicians and dentists and so forth might be more willing to provide services if they could relieve to some of the primary care responsibilities, including referring for specialists and so on. And he's going to agree that that's a good idea.

It was a loaded question, because he answered that question for me at an earlier meeting and answered pretty much the same way.

But there is a mention with the economic conditions we're in, it seems such a natural to me, behavioral, health, dental and so on. So whatever you can do to promote the concept of the school-based health center would be wonderful, and I hope you'll join us in expanding this program instead of cutting it. It doesn't make sense.

JOANN EACCARINO: And in these days, too, it's really so much about access. And, I mean, you can have partnerships with private providers with the community health centers, but if you're right there where the child spends at least a third of their day every day except for the weekend and holidays, you're -- their chances of getting the healthcare are just so much better.

REP. THOMPSON: That reminds me, speaking of hours and so on, as I understand there is a movement to extend hours at least at the federal centers and also the school programs so that they're able to be responsible for kids during vacation periods and so on, wherever possible.

JOANN EACCARINO: Right. Some of us are already open during summers and school vacations. But we'd like that to be the general operational expectation.

REP. BARTLETT: Thank you so much for coming forward.

Leslie Balch and then Kent Donovan. Dorayne Carter.

LESLIE BALCH: Good afternoon. Thank you for being here to hear us.

My name is Leslie Balch, and I'm the director of health for the Quinnipiac Valley Health District, a regional health department that serves approximately 97,000 people in Hamden, Bethany, North Haven and Woodbridge.

I applaud the state's consideration of regionalization for financial incentive. As a strategy to contain costs in these hard economic times, it's a great idea.

Operating a health district for over 17 years, I have witnessed the cost-effectiveness of a centralized regional authority to provide public health services to our residents. The member towns benefit from the economy of scale, coordinated services, shared expertise, and decreased administrative costs, just to name a few.

The Governor's proposed budget in Bill number 847 lessens the financial incentive of belonging to a health district. It decreases the per capita funding from the current $2.08 to $1.25.

It threatens to disband seven out of 20 currently operating regional health districts because of a new definition, requiring a minimum number of residents to be served and more than two cost participating towns.

It pulls funds away totally from municipal health departments, whether full or part time, without giving them any initiative to join or to build a regional health department. And it decreases the reimbursement to already struggling health districts by a minimum of 60 percent, a level which threatens our very existence.

I am disheartened by these disincentives for public health. This proposal represents the lowest state subsidy to local health districts in Connecticut since 1984 and will discourage regionalization and decrease the quality and the quantity of public health services throughout the state.

The projected savings in the governor's budget attributed to this regionalized health department is not the functioning of restructuring, but it is the direct result of funding and service cuts. It saddens me to see a well-intentioned idea of regionalization so twisted that it discourages support from the public health community, it cuts municipal funding, it disregards diversity throughout our state, and it ignores the protection and the prevention for the populations that we serve. Thank you.

Are there any questions?

REP. BARTLETT: I get to ask.


REP. BARTLETT: Any questions from the committee? [inaudible].

REP. THOMPSON: You heard me mentioning the federally qualify health --


REP. THOMPSON: Do you have any centers in your region?

LESLIE BALCH: No, I do not.

REP. THOMPSON: Would it be a welcome addition to your work?

LESLIE BALCH: Actually, in our area, I do not believe that we have the -- the [inaudible] for federally -- that we would need to [inaudible] federally qualified center.

REP. THOMPSON: I remember as a major of Manchester, one of the services we provided through our local health department was when a person was in need, and we didn't have access to a district qualified health center at that time, but we had the involvement of the community positions and dentists.

And if a person was unable to provide care and it wasn't of a nature going through an emergency department, although I'm sure many did, they would go to our local health department. And they did have service where in cooperation with doctors and dentists in the community, there's always somebody on call.

The person would come in and have a bad tooth or something, didn't have access to a dentist, they would call a dentist. And the cooperation between the providers and the health department, which was great [inaudible] and so on, was very healthy, and I think progressive.

It would seem to me that as part of your -- not your responsibility but as part of your operation working closely with healthcare providers would be a positive thing and would of course identify needs for people seeking or have some idea of the needs of your population and might be a healthy thing. So you might take a look at that.

LESLIE BALCH: I think that's a very good idea, and I will mention that in my district we do own a school-based health center, so we are providing services.

However, the public health services for which this money is being cut are actually the actually the preventive services, the protection services, the environmental health, the department's --

And I'm not only speaking about my department but the municipal department such as New Haven that has the AIDS programs in them. But it is the preventive programs, the prevention of chronic illness, getting the information out there.

I'm not a particularly underserved population as far as medical care goes. I know that that is different throughout the state, and that is the needs and the diversity that I speak about that this does not recognize by making us all do exactly the same thing across the State of Connecticut.

But I certainly do appreciate involving providers that are around and providing that last source of care when it's needed through the health department. Thank you.

REP. BARTLETT: Any other questions?

Thank you very much.

LESLIE BALCH: Thank you.

REP. BARTLETT: Kent Donovan, followed by Dorayne Carter.

MR. DONOVAN: Okay. Good evening, members of the Appropriations Committee. My name is Kent Donovan, and I'm a student at the University of Connecticut working on my master's degree in social work.

I am doing my internship at AIDS Project Hartford. I am here before you this evening to request that you do not support the proposed cuts to the budget for funding for AIDS and am requesting that you restore the 2.5 million to the AIDS service line.

Among my many job assignments at AIDS Project Hartford, one of my assignments has me working at AIDS Project Hartford's Connection's Wellness Center, which offers psychosocial support services and support groups for straight men, gay and bi men, women and individuals who are struggling with addiction.

Members can also receive medical examinations, mental health and substance use counseling, advocacy, acupuncture and a meals program.

For members of Connection's to lose their funding would be devastating for them. Daily I meet people who are homeless, struggling with addiction and who on top of all of this are HIV positive and Connection's Wellness Center offers them hope, someone to talk to, a nurse to confer with, and possibly their only warm and nourishing meal for the day.

Here they can also meet with their peers who can offer them encouragement and guidance and tactics to survive their illness. Also to be affected are the medical case managers who are placed strategically throughout the Hartford area and throughout surrounding towns.

For many of our HIV-positive clients, their case managers are their lifeline to living, and for many this collaboration helps to improve their lives, prolong their lives, and many of the clients have assured me that they have a reason to live and will not give up.

I don't believe that these cuts are fair and just, to punish a population who has suffered enough. AIDS can happen to anyone. Let's show them that yes, we can do more and we do care and will do what we can do to support you, help you to continue to survive and thrive.

I thank you for your time.

REP. BARTLETT: Thank you, sir. Any questions from the committee?

Never know. All right. You guys, got to wait to see if we have questions.

Dorayne Carter and then David Boone.

DORAYNE CARTER: Good evening, members of the Appropriations Committee. My name is Dorayne Carter, and I coordinate a case management program for adults with chronic mental illness, and that's at United Services, which is a nonprofit comprehensive behavior health center that's located in northeastern Connecticut. I'm also a member of New England Healthcare Employees District 1199.

I'm here today to advocate for people who are suffering from severe mental illness, who cannot speak for themselves. Over the course of the 20 years that I've worked for United Services, I have witnessed a severe erosion of services and resources for the disabled.

Disabled people who cannot work or take care of themselves are made to wait long periods of time before they are granted Social Security.

During this process, which can take several years, the disabled are only eligible for a maximum monthly assistance of $200 from the Department of Social Services.

We have a record number of people living in tents in winter because they can't afford housing. Frequently homeless shelters are not an option for this population, because their psychiatric symptoms make it difficult for them to interact with people or to follow shelter rules.

The following is a partial list of challenges people with severe mental illness face every day: Lack of respite care, no long-term residential programs for those too disabled to live safely on their own. Large Title 19 spenddowns make it impossible to pay for medical treatment or for psychiatric or medical medication, a limited transportation system that makes it difficult to access treatment and other resources. Not enough substance abuse treatment programs for people with co-occurring disorders, long waiting lists for subsidized housing and few payees for assistance with finances.

Although these are universal issues, they are extremely critical they are extremely critical for many disabled people who are living in extremely unhealthy and marginalized and are suffering because our poor rural communities do not have the resources to address direct me problems.

I understand that we need to be fiscally responsible during this economic crisis; however, I believe that we have a morale responsibility to care for those who cannot care for themselves.

In northeastern Connecticut, people with severe mental illness have been hurting for some time and cannot sustain further cuts in programs and resources.

I urge you to increase revenues rather than cutting essential services and resources. An increase in taxes for those making over 200,000 is a fair way to raise revenue and to balance the budget. I urge you not to make cuts and balance the budgets on the backs of vulnerable people. Thank you.

REP. BARTLETT: Thank you, Dorayne. Any questions or comments from the committee?

David Boone, followed by Martha Roy.

DAVID BOONE: Thank you for the opportunity to speak to you today. I want to say a few words about the Governor's proposal to cut per capita funding to local health departments and the concept of the regional health departments.

My name is David Boone. I'm the director of health for the down of Glastonbury, and we're speaking here tonight on behalf the Connecticut Environmental Health Association. We call it CEHA for short.

And CEHA's members include a variety of environmental and public health professionals but the majority of our membership are local health department sanitariums.

CEHA is opposed to the proposed changes in per capita funding to local health departments and the restructuring of district health departments. I don't need to remind you folks that municipalities are struggling to continue to provide necessary programs and services for the residents. And elimination of all state funding from municipal health departments and smaller health districts obviously will severely impact staffing and the ability to perform the functions necessary to protect our citizens.

The case of district funding is no less critical. Districts need to depend on fees, per capita funding, and greens to survive.

And as has the recession has led to reduced fee collection 40 percent cut in the per capita funding could be disastrous for the districts.

Local health departments, and I'm sure you're probably aware of this, are the underground presence in the area of sewage disposal, restaurant inspection, childhood lead poisoning investigation, well water matters, outbreak investigation, to name a few of the local responsibilities.

And the question I hear my colleagues asking is what responsibility can we not deliver as a result of insufficient funding? Keep in mind that local health departments to a large extent are enforcers of the state public health code.

And in spite of the absence of state funding, our responsibilities on the local level under law remain unchanged. The proposed changes to the per capita funding will impact every single local health department in the state, specifically provide no funding -- and people viewing at home missed the Commissioner this morning. Let me say that again. No funding to 28 part-time health departments, 32 full-time health departments and seven current health districts.

Local health departments should not be asked to sustain the largest percentage cut in the state health department's budget. On the matter of the creation of regional health departments, it's clear that over the years local health departments have been on the forefront of regionalization.

Take a look at the larger health districts that exist. The Torrington area health district, Farmington Valley, north central and northeast district are examples of how regionalized public health services have been delivered in Connecticut for decades.

The large recent growth in some the newer districts, the Chatham district, the Uncas district, Eastern Highlands, to name a few, proves that municipalities are clearly interested in obtaining regional services.

I don't feel that -- I don't understand the rational for the three towns and 50,000 population is coming from. I don't understand the basis of why that is an advantage over what we currently have. And I appreciate the opportunity to speak to you tonight. Thank you.

REP. BARTLETT: Thank you, sir.

Do you have a suggestion in terms of how you would go about, what factors you would suggest if we were to go down this road instead of just doing a population type of approach, what kinds of factors would you offer?

DAVID BOONE: I think I would look at it through a different pair of binoculars.

I'm not really convinced that the regional approach is the best one in all circumstances. I think that the -- there's many examples of municipal health departments that are providing all the services that a region is providing.

I think there is a benefit there for smaller towns to join the region, but I don't think that is fair to essentially penalize the smaller districts or the municipalities.

REP. BARTLETT: I would ask you to accept for a moment the fact that we are going to consolidate, and I would ask you to follow up with me personally and members of the committee on what kinds of factors you think should be considered in that.

It's kind of like probate, you know? Something is going to happen. And we want to get it -- at least I want to get it right. I think the legislators want to get it right. And so, you know, if we're going to go down that road, then we should know, you know, how you would do it, you know, what kinds of factors.

And I understand -- you know, I understand what everyone's doing and how good the services are, but if this is something that's going to be looked at, we want it to be looked at right, and I can appreciate the binoculars, but give me something to focus on.

DAVID BOONE: I would certainly say that CEHA would be more than willing to engage in that sort of discussion.

REP. BARTLETT: Yes, okay.

Any other questions or comments? Thank you very much.

DAVID BOONE: Thank you.

REP. BARTLETT: Martha Roy, followed by Judith Shaw.

MARTHA ROY: Good afternoon, and thank you for the opportunity. My name is Martha Roy. I'm from Enfield, Connecticut. And as the sister and conservator of a person in the state to a 49-year-old with lifelong mental illness, thank you for considering my remarks.

Seven different psychiatric diagnoses caused my brother to do things that are harmful to himself and potentially others. Only since he has been at Cedarcrest for the last three years has there been any improved stability.

A bit of history. For the first 44 years of my brother's life, my parents were his sole caretakers. Despite having no professional help other than brief group medication sessions and a requisite quarterly visit to the psychiatrist they managed not only his diseases and symptoms but also his medication regime.

At age 42, the mental health district center where he was a client banned him from their own social activities because of his increasingly harmful behavior, yet he continued to live in the community with my parents because it was the most fiscally attractive thing for the state to do.

For the next two years, I watched his diseases escalate to the point of my parents' total exhaustion and ultimately became his conservator. Energy was needed to navigate the system, and I promised my brother I would give it all to keep everyone safe.

He knew he was a danger but had no idea how to manage it, and no one else did either. Eighteen months, four nursing homes, three acute care settings and finally 11 straight days in the St. Francis Hospital emergency department when no one in the state mental health community would take him in led us to Cedarcrest, the only place with talent, dedication, medical resources and 24/7 support he needed.

It was disconcerting to feel glad that my brother was sick enough to be admitted. If he hadn't been, he would have ended up in jail, given the antisocial predilections of his illness and the complete and total lack of community support for my family.

He has been at Cedarcrest for three years and it's time for him to go no matter what. Community and recovery is not an option for him. He won't benefit from the hospital saying open, but it is important for me and my commitment to him to be here today on behalf of folks just like him.

At Cedarcrest, clients learn to ask for and receive professional help when symptoms arise. It is understood that diseases are diseases and the clients are treated as such. They will be going from a safe, secure medically controlled residential setting to where? No one seems to know where the clients who are ultimately bumped are going to go.

Remember the numbers that others have spoken of so well. And somewhere between discharge from Cedarcrest and the inevitable reentry into the system by some of these clients, someone will be hurt. It will not be the client's intent. Just -- I ask that you allow me to finish, please.

It will not be the client's intent. Just their illnesses showing their predilections that cause emotional, mental or physical pain to themselves, their family members and the community. So let me throw out this idea. There are 56 people on this community -- on this committee. Each of you need only volunteer one week a year to be on call to all the people who are inappropriately based in the community so that clients and law enforcement officials can call you when their diseases escalate and you can come care for them.

But because caring for such folks is a 24/7 proposition and Cedarcrest will be closed, the short respites you would receive as their caretakers will not be enough and other arrangements with need to be made, it appears that within this budget, the state has the answer.

There is an increase in prison budgets and beds, and it's clear that the state's intent is to have mentally ill people go to prison where it is less expensive to care for them.

It has been estimated by experts that nearly 20 percent of the current prison population is mentally ill. This provision in your budget will accommodate an even larger percentage of many people guilty only of having a disease. Only of having a disease. Imagine having cardiac problems and being brought to jail instead of an appropriate hospital.

Keeping Cedarcrest open will allow appropriate clients the treatment, medication and support they need to safely live with their diseases. We all wish hospitals like Cedarcrest weren't necessary, but that thought is a fallacy.

Closing Cedarcrest doesn't seem like a very safe thing to do to either people with diseases for which no other treatment is available and the community in which they are suddenly expected to live.


MARTHA ROY: Please, reject the recommended budget and restore funding to appropriate levels to deal with critical mental illness.

Thank you for your consideration and your additional time.

REP. BARTLETT: Thank you, ma'am.

I just wanted to say -- we're supposed to wait and see. I just did want to say that, you know, you're the second testifier on this particular issue, and I personally have not looked into Cedarcrest and what the issues are around it, so you got my attention.

MARTHA ROY: That's all I ask. Thank you so much, Representative Bartlett.

REP. BARTLETT: Thank you. Judith Shaw and then Cheri Bragg.

JUDITH SHAW: Good afternoon, representatives. My name is Judith Shaw. I'm a resident of Wethersfield, Connecticut. I'm a person in recovery from mental illness and I'm currently employed by the North Central Regional Mental Health Board.

For the past year and a half, I have been project director of the unique perhaps first of its kind in the United States special interview research project called A Day In The Life.

My employment is special, because I was told 19 years ago by a neuropsychologist that I would never work again, became totally debilitated. For 25 years I barely spoke. I struggled with psychiatric problems, sometimes extremely disabling, since the age of 12. I have experienced unthinkable loss and suffering because of my illness.

I began to finally reenter life when I met -- moved to Wethersfield and joined up with the [inaudible] Area Council in that community that serves several communities in that area.

I began to finally reenter life when I moved to that town, and I'm hear today to speak on behalf of taking care -- great care with the decisions about the mental health -- Department of Mental Health budget. I'm sorry, excuse me.

The department has done some wonderful things. Most notably, adapting a recovery model for people who felt hopeless, lost, poor and immobilized and without a map to go forward. The Day In The Life project started as a project designed started by the North Central Regional Mental Health Board in conjunction with Yale University Program for Recovery and Community Health.

[inaudible] Davidson, Ph.D., was our teacher and taught eight interviewers who were chosen from the [inaudible] area council's local mental health agencies, an interview and narrative summary skills.

All and all, we gleaned 80 interviews from 80 people in the [inaudible] system about their day in the life.

What is your day in the life like? What do you do every day? Where do you go every day? How would you change your life? How would you change your mental health services?

This project is representation of people's life stories and feelings. The interview team works with dedication, pride, empathy and courage. Keep in mind that they're all in recovery. There were artists we discovered later, poets, electronic engineers, a lawyer and parents and grandparents and hard workers.

We wanted to know about their agonies and the support that DHMAS has been able to give them.

I just want to see something very quickly. As a native of Atlanta, Georgia, I've always been an activist in the civil rights movement and other social justice movements. To me, this is the most important movement of all of them put together because it crosses all boundaries and all cultures and eliminates the words that we don't like that are just as awful as the N word. Mental, crazy, coocoo.

Last night I attended a concert at Manchester Community College in honor of Black History Month. We sang the song We Shall Overcome, which is an advocacy song which many of you may know.

The advocacy is different now, and as the commissioner wrote in his last report to us, putting quoting our new president, "We can change." And we can change. Changes in the budget need to be careful, well thought about, move ahead carefully and with very great care towards humanity and [inaudible]wonderful human beings.

REP. BARTLETT: Thank you, ma'am. Thank you for those words.

JUDITH SHAW: Thank you.

REP. BARTLETT: Judith Shaw and Cheri Bragg.

CHERI BRAGG: Good evening, distinguished chairs and members of the Appropriations Committee. My name is Cheri Bragg, coordinator of the statewide Keep the Promise Coalition, dedicated to advocating for the Blue Ribbon Solutions necessary to maintain and expand critical community mental health services.

We first want to thank the governor for recognizing the great need for young adult services in the DHMAS project for promoting funding in caseload growth, and we continue to strongly advocate for the planned and meaningful transition services between DCS and DMHAS.

SAMHSA estimates that 29 percent of young adults with serious mental illness age 18 to 26 are parents, further underlining the need to support young adults and their families.

You heard Sheila Amdur earlier speak about the number of adults living with mental illness in nursing homes. Connecticut must ensure that the proposed mental illness waiver dollars are used specifically to increase the number of available community waiver slots.

The state recently lost approximately $7.5 million in federal Medicaid payments because they exceeded the number of allowable percentage of residents with psychiatric illnesses.

So that -- with the April rollout of Money Follows the person as well as the pending lawsuit, it only makes fiscal sense to increase these community waiver slots.

In respect to the government Governor's proposal to close Cedarcrest Hospital, the coalition wants to ensure that any plans first include assessing the number of people who can be better served in the community.

DHMAS has stated that there are a number of young adults at Cedarcrest who are only waiting for housing. We would not be in favor of the two proposed 15-bed housing units, as these are truly too large to be community integration. They definitely stand out.

Keep the Promise coalition urges legislators to look at cost-effective community solutions first before investing dollars in bricks and mortar at CVH.

These solutions would begin to alleviate the gridlock problem and open up short-term crisis level beds for those who need them. It's a continuum. So failure to address the need for a community-based service options is a failure to address system paralysis.

For this very reason, we also urge you to reject the proposed $3.2 million cut to the housing support services line item that would fund 150 units of shovel-ready permanent supportive housing.

This coalition has members who are currently homeless. They've shared stories, and we heard some today, about education, families, postgraduate degrees, many people working until they became ill. No one chooses to have a mental illness and no one dreams about being homeless.

Finally, I would like to say that it's been a decade, ten years, since the Keep the Promise Coalition was formed, and the passage of the Homestead Act. Yet even seasoned advocates this year have been affected by the urgency of the stories we've heard. People talking about eating out of garbage cans to stay alive and living in their tents, living in their cars while working on their recovery. These are not wants. They are core, basic services.

Any cuts to an already-starved community mental health system will result in further spillover in emergency care and institutional costs, which only gets worse in these tough economic times.

Now is the time to work together on fiscally sound community solutions. It's time to keep the promise to people with mental illness, families and taxpayers. Community solutions, not institutions. Thank you.

REP. BARTLETT: Thank you. Appreciate the words. Any questions or comments? Thank you.

Linda Lentini and then Kathleen Donlon.

LINDA LENTINI: Good evening. My name is Linda Lentini, and I live in Plainville, Connecticut. I'm a person in recovery from co-occuring disorders, and I'm here to talk about making sure that DHMAS funds are not cut.

Wikipedia defines a traumatic event as involving a single experience or enduring a repeating event or events that completely overwhelm the individuals' ability to cope or integrate the ideas and emotions involved with that experience.

How many events lead to a person just giving up? How events led to a person on 84 giving up on Monday and pulling over and said he had enough? How many events would it take for you to pull over and say that you've had enough and would services be available for you if you needed them?

My situation is not uncommon to many people that I work with today at Advocacy Unlimited. My childhood was interrupted at the age of four by a traumatic event, and I started to self-medicate when I was six.

My parents were unaware of places and programs available to help me. And I was able to get treatment in my early 20s, but unfortunately it was too late to stop addiction from enveloping my life.

My lost childhood led me to getting lost in an addiction world that caused me to want to die and want to give up, and I did give up. The trauma of my early life did not allow me the luxury of avoiding the judicial system and incarceration ended up being my recovery.

I was able to put my life back together because I had housing, employment and relapse prevention services. And DHMAS was one of the services that allowed me to help me get my life back together.

What about the person in recovery that doesn't have housing, employment or community-based services available due to the lack of funding? How can we ignore the lives of so many people that want to have a home, a job, an opportunity, services, a life?

I'm not sure how my life would have ended up if I did not get the help that I needed. My hope for the future is to move forward with supporting houses -- supportive housing, person-centered care, person-centered discharge planning, recovery supportive services and employment and educational resources.

We need to help people like myself who want their life back and need to get them back on their feet.

Thanks for your time and patience in this matter.

REP. BARTLETT: Thank you, ma'am.

Any questions or comments from the committee? Thank you for coming forward.

Kathleen Donlon and then Betsy Chadwick.

KATHLEEN DONLON: Good evening. My name is Kathleen Donlon. I have been my brother's conservator and primary caregiver for the last decade. I am here to speak on behalf of my brother, Steven Donlon, regarding the closing of Cedarcrest Hospital.

Steven was inducted in 1980 into the Unification Church, a cult run by Reverend Sun Myung Moon, where he endured mental trauma and mind control until he was forcibly rescued by my family and deprogrammed by professionals.

At 27, Steve was diagnosed with schizoaffective disorder. In the last 20 years, Steve has been admitted on 12 separate occasions into Cedarcrest Hospital.

And in the last five years, in addition to cedar crest hospital, Steven has also lived at two convalescent homes, a group home, three hospitals and currently lives in the locked psychiatric unit at Whittenbury Convalescent Home in Bloomfield, Connecticut.

In 2005, he was admitted to Manchester Memorial Hospital from West Side Convalescent Home with induced psychosis.

During the three months he was there, his condition became progressively worse, and at one point he was on 17 different medications. At the point, I would have been completely out of treatment options for Steven in Cedarcrest Hospital had not been available. It was still difficult to get him admitted into Cedarcrest, and I needed the help of Manchester's president -- Manchester Hospital's president, State Representative Ryan Berry and Cedarcrest psychiatrist Dr. Pierro to do so.

At Cedarcrest, over the next several months with the collaboration of Dr. Pierro and other psychiatrists and the neurologist, Steven recovered from the damage done by the multiple medications and eventually achieved a healthy baseline and was able to return to the community. Dr. Pierro and others listened to Steven and me and worked to get him on the right medications and dosages.

I don't know of any other facility where it would be possible for Steve to receive this type of care when he is in crisis. I believe that the lack of investment in community-based services and housing, small hospitals and group homes have led them to often fail those with the most severe mental illnesses.

In all of these settings, psychiatric care is minimal. Sometimes a brief visit once a week, if at all. Psychiatrists often don't have the time to attend care meetings or even discuss treatment with family members.

My brother's had a difficult life which has been much improved by his treatment at Cedarcrest Hospital. Because of the nature of his severe illness and the level of care provided to him in other facilities, it is likely that he will again need the type of treatment that only a facility like Cedarcrest can provide.

Without quality and adequate community-based mental health system, it is critical that the state maintain this option. Community housing and convalescent homes are not really equipped to deal with someone like Steve when he is in crisis.

Steven deserves to get the treatment he needs to improve the quality of his life, and I believe the closing of Cedarcrest would deprive him of that opportunity.

Please considerate needs of my brother and others like him. Please do in the remove any dollars or capacity from a system that is already starving. Thank you for this opportunity to speak.

REP. BARTLETT: Thank you, and thank you for standing by your brother.


REP. BARTLETT: Betsy Chadwick and then Selina Welborn.

BETSY CHADWICK: Representative Geragosian, members of committee, my name is Betsy Chadwick, director of the Middlesex County Substance Abuse Action Council.

MCSAAC is one of 14 Regional Action Council, or RACs, that provide prevention services to every town in Connecticut. We are here to request that $500,000 in funding be returned to the RACs system. This is the kind of follow-up to Pamela Mautte's testimony that you heard a little bit earlier.

Considering our troubled economy, we think it ill-advised to ignore the fact that people turn to alcohol, tobacco, illegal drugs and prescription drug abuse more often in times of stress. RACs work at the grassroots level, tracking drug abuse trends and working with community volunteers to keep people, especially youth, from falling into addiction.

Let me begin with one important statistic, and you've heard this from Pam as well. For every one dollar spent on substance abuse prevention, the government saves an average of $11 in law enforcement, rehabilitation and health costs. I want to give you a few examples of how this is working in Connecticut.

We've all read and seen stories in the local media about the disturbing trend of prescription painkiller dependence that too easily leads to heroin addiction. The northeast region RAC facilitated the Connecticut Prescription Drug Abuse Task Force which developed some of the first statewide educational material alerting the public to this danger.

All of the RACs have been monitoring the opiate problem in their communities and developing coalitions and strategies to combat it, my own group included.

Or consider alcohol abuse. Every day in this country more than 20,000 people go to the emergency room for alcohol-related injuries and illnesses. The greater Stamford area RAC is leading an initiative to promote alcohol screening, grief intervention and referral to treatment.

Emergency room doctors are trained to observe and ask a series of questions that reveal alcohol problems and take steps to get patients into treatment. The long-term cost saving of this program is obvious.

Up in Meriden and Wallingford, the RAC launched -- the RAC there launched an inhalant task force where the problem of kids using household chemicals and aerosols to get high was emerging.

The tremendous response of parents, teachers, paramedics, police, poison control specialists and even the Office of Consumer Protection was proof that this RAC had tapped into an issue of great concern. Since then, the RAC has educated hundreds of adults and thousands of children.

Finally, I want to mention the work of another RAC in greater Bridgeport that has prepared its community for major change in the juvenile justice system.

More than 75 percent of young offenders abuse drugs and alcohol. The need for substance abuse services is clear, but right now only those who are 15 and younger receive any treatment. Older youth don't.

When the [inaudible] jurisdiction for the juvenile court system rises, communities will have to develop treatment and prevention services for 16- to 18-year-olds. Greater Bridgeport is prepared for that challenge because of their local RAC.

This kind of head-of-the-curve cost-saving prevention work has been performed by 14 RACs at an annual cost to the state of only $1,077,000 a year. This year the Governor's budget eliminates our line item of $325,000 and state funds of 252,000. That money is replaced by 600,000 from the pretrial substance abuse account.

However, the Governor's budget neglected to reinstate our original pretrial amount of 500,000. Therefore, we do not have a budget neutral situation, as Commissioner Clerk recently claimed. We lacked the 500,000 critical to our survival, and with all respect we ask that this oversight be corrected. Thank you.

REP. BARTLETT: Thank you. Any comments from the committee? Thank you, ma'am.

Selina Welborn and then Jill Spineti.

SELINA WELBORN: Good evening, members of the Appropriations Committee. Thank you for the opportunity to speak with you this evening. My name is Selina Welborn. I'm a resident of the town of Bloomfield, and I am also an Advocacy Unlimited advocate, founder and chapter leader of the Depression and Bipolar Support Alliance of Greater Hartford.

Four years ago I sat before you in support of Wrap around services for Medicare Part D. A few months after that, I was hired as a VISTA member, and from 2005 to 2008 I served AU as a VISTA member so I could not testify on matters of concern to me as a person in recovery from a psychiatric disability.

In January of this year, I began working full time as an advocate and educator for Advocacy Unlimited, and currently there are no such restrictions. So it is with great pleasure and pride that I speak with you today to share some of my reflections over the past four years concerning the need for DHMAS services and especially supportive housing.

Coincidentally, the past four years coincide with what I consider to be my recovery from a very serious mental illness, even though I have lived with it for more than 11 years. In 1998, I was first diagnosed with bipolar disorder and was fortunate enough to have a full-time job and private insurance from '98 to 2003, and so I could choose from a list of private doctors and therapists.

By 2003, however, my illness had taken its toll on me, and I found myself in a position of being unable to work any longer. Unlike many, I applied for Social Security disability and was granted it with the first application.

After many hospitalizations, a change in diagnosis and a move back to Connecticut, I found myself a recipient of services at a DHMAS-funded counseling agency in Enfield, Connecticut.

The partial hospital, psychiatric services, adult outpatient therapy and clubhouse proved therapeutically effective and played a significant role in my resultant recovery.

Today I continue to utilize both medication management and adult outpatient therapy along with the aforementioned support group and work as part of my daily, weekly and bimonthly recovery regimen.

So I ask you to please consider my story. And there are many other people like me whose lives have been saved or greatly improved by the services they receive from DHMAS-funded agencies, and more importantly, its treatment providers.

I appreciate the difficult task you are faced with over the upcoming weeks concerning the budget, and I am here today to also ask you to remember the people who sat before you and me, because I was an audience member over the past four years, and especially two years ago when advocates around the state asked you to fund safe and affordable housing.

Like others have already said, and I will repeat, the governor committed to fund 150 units of supportive housing. We ask you to hold her to that commitment. I know I don't need to tell those of you, who are our supporters, how important it is to people who are veterans, families with children and people with disabilities who are homeless, because you know. You know. We simply ask that you remember when making the tough choices you must make over the upcoming weeks.

Thank you for your time and consideration.

REP. BARTLETT: Thank you. Any questions from the committee? Thank you, ma'am.

Jill Spineti, followed by Sheri Neely and Janine Sullivan-Wiley.

JILL SPINETI: Good evening, Senator Harris and members of the Appropriations Subcommittee. My name is Jill Spineti, and I am the president of the governor's Prevention Partnership.

Governor Rell is the fourth governor who has been our chair. We were started by Governor O'Neill, and our nonprofit organization is now recognizing its 20th anniversary this year. Our work is to support young people in the state so that they can grow up free from substance abuse, underage drinking, violence and bullying and be able take their place in our future workforce.

I am here today to ask for your continued support for prevention programs through funding from DHMAS so that our young people can grow and thrive in nurturing families and communities.

I'm joined here by several of our partners groups and individuals, as well as my colleagues in the Regional Action Councils, as you've already heard.

I have three key messages that I'd like to provide this evening. First of all, prevention is cost-effective and saves the state money. We know that over $10 is returned for every dollar invested in prevention. And at the Governor's Prevention Partnership, our public-private partnership model has been working for over 20 years, and in that time we have leveraged over $14 million in private funding from businesses and corporations. And I provided a list of 115 businesses along with my written testimony that currently are mentoring and providing resources right here in the State of Connecticut.

My second key message is that threats continue to occur. Right now, prescription drug abuse is prevalent among teens and communities across the state. The partnership, along with DHMAS, DEA and many others, formed a task force last year to look at the problem. In partnership with the RACs, we've disseminated information warning parents to safeguard their medicine cabinets.

Whether it's cyberbullying, underage drinking or prescription or over-the-counter drug abuse, these threats are constant.

In my ten and a half years with the partnership, I've seen waves of similar threats come and go, but the constant is that the prevention community remain poised and ready to attack the problem as the first line of defense.

And my third key point is during times of economic stress, we must remain vigilant. As families face uncertain times, an investment in prevention now will net a tremendous return in costs saved in treatment and incarceration, to name two.

In the days ahead, I ask for your continued support. And just to name a few of our initiatives this year, we are launching a new effort to prevent bullying in schools. We're working on federal grants to strengthen mental health prevention efforts in schools along with CREC and UConn Health Center. We're working on a federal grant to prevent gang violence as a follow-up to a statewide Urban Youth Violence Summit that was held last fall.

We're developing new tools for mentors on prevention of smoking and obesity. We're getting messages out through the media to raise awareness about drugs and underage drinking. We're supporting over 100 chapters of Students Against Destructive Decisions and over two mentoring programs in the state, including school-based mentoring programs in West Hartford and Manchester.

I urge you to protect critical resources for prevention in the budget. Thank you, and I appreciate your support.

REP. BARTLETT: Thank you very much. Questions? Thank you. I think I missed Porsia. Porsia? I don't have your last name, so I need you to tell us. You have to tell us the whole thing. [Inaudible].

PORSIA BROWN: Yes, [inaudible]. Good afternoon, good evening. In my hand I have a photo of myself before I started going to recovery and also getting help through the Department of Mental Health Services. I would like to say that please let this message not fall on deaf years.

Recovery, reclaiming what was lost, is a noble task. Rebirth is a natural process of life. Harvesting the seed of empowerment, being clean and sober, recovery for you, for your family and friends, for the community, for society, legislature-appointed.

Hello, my name is Porsia Brown. Being a citizen and a voter in the Willimantic area has been and still is an eye-opener as my first arrival to reside in a sober house for my recovery status to grow stronger.

September the 11th of 2008 was my new beginning of life, free from misleading, mood-altering substances. I came here to make a representation of myself in a productive field. Attending Windham Recovery Community Center helps me gain a more understanding of my past and recovering social skills. Family support, education and giving back.

CCAR, Connecticut Community for Addiction Recovery, is -- I believe is going to become global. One state as an event. So the need for our support to continue funding for our services will create progress for you, for your family and friends, for the community, as well as the Department of Mental Health's services is really needed for our funding. Please support us. And as well, to come visit CCAR in Willimantic, Connecticut. Thank you very much.

REP. BARTLETT: Romantic Willimantic. Thank you. Sheri Neely.

SHERI NEELY: Good evening, my name is Sheri Neely, and I'm the community organizer for the Connecticut Coalition for Environmental Justice in Bridgeport, and I will be giving the testimony of Mark A. Mitchell, MD, MPH, president of the Connecticut Coalition for Environmental Justice in support of asthma funding. He's out of town now.

My name is Mark Mitchell -- my name is Dr. Mark Mitchell, and I am president of the Connecticut Coalition for Environmental Justice. I would like to speak in favor of restoring the $150,000 in funding for the Community Asthma Outreach, an education program of the Connecticut Coalition for Environmental Justice.

The Community Asthma Outreach and Education program identifies the people who are most likely to end up in the emergency room or admitted to the hospital due to asthma and encourages them to seek help before they are hospitalized or rushed to the emergency room.

Specifically, we aim to educate low-income people, people on medication, blacks and latinos and the uninsured to identify uncontrolled asthma symptoms in their family and friends and encourage them to seek medical care before the symptoms become severe.

The program has several components. One is the Asthma Speakers Bureau, a grassroots group of trained laypeople who give presentations in churches, schools, public housing projects and homeless shelters, explaining the symptoms and triggers of asthma to large numbers of people who either have or are likely to know of someone with undiagnosed asthma.

The speakers also explain how to avoid asthma attacks that can result in emergency room visits or hospitalization by avoiding asthma triggers and seeking out medical assistance early. The Asthma Speakers Bureaus are based in Bridgeport, New Haven and Hartford.

In addition to the Speakers Bureau, other components of the Community Asthma Outreach and Education campaign include radio and TV promotion statewide, posters in Bridgeport and New Haven, as well as bus placards and billboards in Bridgeport.

This effectiveness of the Asthma Outreach and Education Program has been borne out by a recent random telephone survey of 300 Bridgeport residents. Two-thirds of the respondents indicated that they had heard of the Asthma Speakers Bureau. Sixty percent of those who had heard of the program stated that they acted on the information they had received, mostly talking to their friends and family about asthma if they had no symptoms themselves. Or if they did have symptoms of asthma, they sought out more information or medical assistance for asthma.

This is a remarkable response for a community outreach and education initiative and shows us that tens of thousands of people are responding to the program in Bridgeport alone.

The Asthma Outreach and Education Program saves the state money when we refer to people who have symptoms of asthma to health professionals and avoid hospitalization or emergency room visits. If through our outreach education work we are able to reduce emergency visits by only one half of one percent, we will have saved the state more than the cost of the program. That's why it is so important to keep this prevention program.

Thank you for your consideration of the people with asthma and their families.

REP. BARTLETT: Thank you, ma'am. Thank you for your advocacy.

SHERI NEELY: Thank you.

REP. BARTLETT: Questions? Michael Fox and then Janine Sullivan-Wiley.

MICHAEL FOX: Hello. Good evening. My name is Michael Fox, I'm the mentor coordinator for the New Haven Public School Foundation.

I'm here today to ask for your continued support for the prevention programs so that our young people can grow and thrive in nurturing families and communities and one day take their place in Connecticut's workforce.

I'm dedicated to the cause, because I have experienced firsthand how prevention programs can impact life choices. The Governor's Prevention Partnership provided a grant that enabled our organization to hire staff. As a result, our program grew from 50 to 145 mentors in the past year. We are well on our way to reaching our goal of 200 mentors by the end of the school year.

The greatest challenge for me was that as a retired law enforcement officer and a volunteer mentor, I did not have the experience to organize a mentor program. However, our organization maintains a close working relationship with the Governor's Prevention Partnership.

They provided me with the basic training and then additional training in the areas of recruitment, mentor training and best practices. They also assist us by providing high-quality recruitment material and ongoing support. We look forward to continuing our relationship with the Governor's Prevention Partnership.

The Governor's Prevention Partnership saves Connecticut money. We know that nearly $10 is returned for every dollar invested in prevention. The partnership provides the expertise to help prevention programs grow and enlists businesses to invest in prevention.

In the days ahead, please continue to support the tireless commitment, work and energy as they tackle the serious issues affecting our children and their futures from underage drinking and drug abuse to violence prevention and bullying to mastering the skills and schooling needed to succeed.

We need the Governor's Prevention Partnership to protect our future workforce. Thank you for your time.

REP. BARTLETT: Thank you, Mr. Fox.

Any questions? Thank you. Janine Sullivan-Wiley, and then Venus Jawad and Amy Greer [phonetic].

JANINE SULLIVAN-WILEY: Good evening, Senator Harris, Representative Bartlett and members of the committee. And, Representative Bartlett, it's nice to see a compassionate face from our neck of the state.

My name is Janine Sullivan-Wiley, and I'm the executive director of the Northwest Regional Mental Health Board, and I appreciate this opportunity to speak to you this evening.

The regional boards [inaudible] all-stakeholder citizen-based entity with responsibility for determining what the mental health needs are and do planning to address identified needs and evaluate programs funded by the Department of Mental Health and Addiction Services.

From the viewpoint of the needs that we've seen, the Governor's proposed budget has some strengths. The increases for young adult services recognizes the numbers of young people coming into the DHMAS system, most of whom have very complex needs.

This money is very well spent in terms of prevention of future needs and getting or returning these young people to the lives they deserve as productive members of our communities. Every enhancement to community services is important and a good investment in our state.

Now, I recognize the enormous challenges in the current fiscal situation, but there are some proposals that I've heard that concern me very deeply. In the northwest portion of the state, the 42 towns up there, including Bethel, the private not-for-profits provide the majority of mental health and substance abuse services. The zero increases for the private nonprofits really translates to a cut, as their funds cover all of the operating expenses, not just staff salaries, and those cannot be controlled. The result is chronically underpaid staff, high turnover. And this has gone on for years, and they really need your help.

What is the face of that? Consumers and family members have said again and again that continuity in the relationship with staff is essential to gaining and maintaining recovery. With each change of the staff person, the consumer and their family starts all over again. The private nonprofits need to be made whole in order to have that continuity of care.

And historically, this kind of turnover has not been an issue on the state employee side. But that is endangered by the proposals that I've heard for early retirement incentives or if there would be large layoffs. Please do not use retirements or layoffs to control costs in any of the state-operated DHMAS services.

Now, this may be a terrible analogy, but I would like using mass retirements and layoffs to cut this cost as trying to use shrapnel to lose weight. You could lose mass, but you could lose essential parts, and it would leave a bloody mess. And I really think they're a very comparable process.

Just as for the private nonprofits, when state employees are removed, consumers lose the stable relationships. And the bumping -- and the -- and in the state system, the bumping that then ensues means that it just gets -- it gets made worse. It's like a domino effect across the system.

And I don't actually know the solution, but I know that staff reduction that way would not be it.

Through DHMAS, Connecticut has developed an effective system of services that enable people with mental illness and substances disorders to recover and lead productive, meaningful lives in the community, and that is a good thing for those consumers, their families and for the community.

And I urge you to seek ways to address the deficit without hurting people, and I have every faith that it can be done. Thank you.

REP. BARTLETT: Thank you, Janine. Questions? Thank you for coming forward. And that was quite the visual.

JANINE SULLIVAN-WILEY: Not a nice one, but really it fits. Thank you.

REP. BARTLETT: Thank you. Venus Jawad and then Amy Greer.

VENUS JAWAD: Hi, my name is Venus Jawad, and I am a board member of the Connecticut Coalition for Environmental Justice of Bridgeport, and I am also a member of the Bridgeport Asthma Speaker Bureau.

I joined the Asthma Speaker Bureau because of how many people who have asthma and how so many don't even know they have it. Part of the reason is they're not educated about asthma.

As I learned about asthma, I thought what creative way could we reach the children and adults about asthma. The Bridgeport Asthma Speaker Bureau got together and did an asthma skit with puppets. Even children will hold the information of asthma because of the fun-filled puppets being used.

Myself have learned and become very educated about asthma. Because of this, a month ago I was able to help my doctor diagnose me with asthma, because I knew the symptoms and what to look for. As you can see, the Bridgeport Asthma Speaker Bureau is important, because not only can I help others be educated about asthma, it saved me from not knowing.

I want to continue with the Bridgeport Asthma Speaker Bureau, helping others to learn about asthma. Thank you.

REP. BARTLETT: Thank you, Venus. Any questions? Thank you so much. Amy Greer and then Pamella Reid.

Okay. Thank you. Pamella Reid and then Lynn Stokes.

PAMELLA REID: Good evening, senators and representatives and other members of the committee.

My name is Pamella Reid. I'm a member of the District 1199 Healthcare Workers Union, and I work at a day program in Seymour, Connecticut, for Oak Hill School, which is a private, nonprofit agency that provides services for people with developmental disabilities.

I want to thank you for this opportunity to tell you a little about what I do and my struggles to support myself and care for my clients -- I want to thank you for this opportunity to tell you a little about what I do and my struggles to support myself and care for my clients, who are elderly people with mental retardation.

I have been employed with Oak Hill for nine years. After all that time, I now make only $16.31 an hour. Fortunately, I am able to receive my employer's medical plan. However, in this case, over half of 900 coworkers throughout the state who is employed by Oak Hill are denied access to medical insurance for themselves their family. Why?

This is not acceptable. And for those of us who do have medical benefits, our employer has told us that at our contract negotiation this year, they are going to seek to shift the cost of the medical plan onto employees like myself.

We already agreed to increases in our medical and copays just a year and a half ago, which took up most of our 30 cent raise we received at that time.

If I were working directly for the state in a DDS group home, I would be making more than $24 an hour and paying just $8.13 a month for insurance. Family insurance would cost me about $100 a month. We do the same work as our counterparts in DDS, for the same client population, but for half the wages.

At one time, direct caregivers at private agencies were almost at parity with the state workers, but we keep falling further and further behind. This is just one example of how the state has shifted burden of the cost of care to the private agencies through underfunding.

In turn, the agencies shift costs to the employees. The result is high turnovers, massive burnout, people working multiple jobs and disruption to the quality and continuity for care for our clients. Private agencies have been starved of the funding they need to provide services by the State of Connecticut and those agencies are now starving us.

For this coming year, Governor Rell has put zero funding -- no additional money -- into the budget for private provider agencies for this year and next year. This was on top of the zero in the budget for us last year. That is three years of zeros. This is a cut to our funding.

And while the Governor's proposed zeros, even though it hasn't actually gone into effect, my employer, Oak Hill, has already transferred the cut from the zero increase from last year into a cut in the services me and my coworkers provide.

All of our agency, which covers 80 group homes and about 113 day programs like mine, management has already cut workers' schedules. Individuals who once were working 40 or 38 hours per week are now working 36 or less hours because of the underfunding.

This has meant clients are less able to go out into the community for engaging and stimulation activities, because there are not enough staff around, and we are constantly reminded to reduce our driving to cut back costs. Thank you.

REP. GERAGOSIAN: Thank you very much. We'll have Lynn Stokes, followed by Ingrid Gillespie, followed by Mark Greenstein.

A VOICE: Thank you for the opportunity to speak to you today. My name [inaudible] and I'm a person in recovery.

I would like to congratulate Governor Rell and Commissioner Kirk for their hard work on the state's budget and the foresight to allocating $18 million to the DHMAS young adult [inaudible].

Young adults are the key to the future of DHMAS's system of care. Recovery is facilitated by a meaningful role in life. Education and discovering passions are the keys to recovery in the young adult population. Young adults have tremendous amounts of inner gifts to offer to a recovering community.

As an educator in the DHMAS system of care, I have met many talented young adults who work hard to spread the message of recovery through their gifts. The passion of using their talents on others is inspiring. They are proud of who they are and excited about what is happening in life.

The young adults are conscientious of the fact that to keep their recovery, they must give it away. The support of the DHMAS young adult population of the State of Connecticut is critical to the long-term recovery. I have learned so much from working with this population. Young adults have taught me that whatever the obstacles are in our lives, we can overcome them by perseverance and initiative.

The young adults I have worked with have their -- worked with have discovered creative solutions to life's daily puzzles and make it a joy to get up in the morning.

They radiate hope with each learning lesson they encounter. Without the support and guidance and education from the DHMAS system of care from these young adults, our future would be lost. There is a window of opportunity in a young adult age group as concerns begin to emerge when most [inaudible] are either ignored, end up in the criminal justice system, put into a drug treatment program or committed to a psychiatric hospital without their needs being met.

Services to young adults must not be on a Band-Aid type basis. These opportunities must never be lost. Education must be universal. A recent personal experience with one of the state's large emergency rooms shows that young adults are often misunderstood and mistreated.

To overhear a medical professional inform a young adult he was "chronic" and "would never get well" and "must just deal with his chronic conditioning" was heart breaking. After hearing this declaration, it was clear that the young adult began to feel chronic about his condition and began losing hope.

These types of incidents must be stopped. It is through education at all points of service for young adults that hope and understanding and recovery becomes automatic.

Young adults deserve to be treated with acceptance, dignity and social inclusion to be able to recover. We must facilitate the process of exploring and educating the issues of mental health and substance abuse concerns.

The young adult must be guided on identifying the tools of recovery and how to utilize them. These kinds of opportunities would further educate everyone through the fact that there is a meaningful life full of hope and joy and a passion in recovery that we all deserve. Thank you for your time.

REP. GERAGOSIAN: Thank you for your testimony. Any questions from the members of the committee? Thank you very much?

Ingrid Gillespie.

INGRID GILLESPIE: Hi. Good evening, Representative Geragosian and other members of the committee.

My name's Ingrid Gillespie, and I'm a member of the Regional Action Council for lower Fairfield-Stanford area, Greenwich, [inaudible] and Darien. Basically I'm here today to support previous testimony from Pam Mautte and Betsy from [inaudible].

I just want to highlight the Regional Action Councils are mandated under Connecticut statute to develop and implement plans that include looking at the needs and gaps of our regions and then developing resources and designing the programs to address such.

That continuum that they often refer to that we use includes prevention, intervention, treatment and aftercare. So to meet that, we collect data, consumption and consequential, and then we develop the plans to address this. And today I just want to talk about some of the work we did around tobacco.

According to Campaign for Tobacco-free Kids, smoking rates for high school students in Connecticut are 21 percent, slightly higher than the national average of 2.5. However, these state rates do not necessarily reflect what we're seeing subregionally, as noted by the RACs.

In addition, they really do not incorporate the increase in the number of incidents as reported by RACs on the increasing use of smokeless tobacco.

However, based on the interventions that we've been using, we've been able to show that the smoking rates for youth in our regions have decreased due to the correlative relationship with these strategies, some of which include coordinating anti-tobacco campaigns, organizing education opportunities for youth and parents at all school levels, collaborating with DHMAS and local police to implement tobacco compliance checks and then publicly acknowledging those merchants who do not sell to youth, also providing technical assistance to local prevention councils who really want to address this issue at the local level. And working with retailers to reduce the size of tobacco advertising on their storefronts.

RACs are really known for working with youth and convention, but we also deal to work around tobacco in special populations.

I can speak for that, but I'm an active member of a formed group called the Smoking Cessation Support Initiative, and our focus is really prevalent, smoking rates with persons living with mental illness and those with substance abuse [inaudible].

We've been in -- operating since October 2005, and recently some of you may have heard that we were successful in advocating $1.2 million from the Tobacco and Health Trust Fund for Smoking Cessation support for persons with serious mental illness.

We do work across the board, across populations with tobacco. And based on the work that we do, and we have been able to show an impact on the rates, we're really asking that you consider allocating the $500,000 set aside in Senate Bill 847 for prevention programs to the Regional Action Councils.

And as noted earlier, it's not an increase in our budget but it's rather making up for the reduction of the RAC funding in the Governor's budget. Thank you.


Are there any questions? Thank you for coming: Mark Greenstein, followed by Steve Huleatt, followed by John Hamilton.

Is Mark not here? Steve Huleatt.

STEVE HULEATT: Thank you, Representative Geragosian, members of the committee and members across the hall, including Senator Harp, I presume. Thank you very much.

My name is Steve Huleatt. I'm the director of health for the West Hartford-Bloomfield Health District. We're a district serving 81,117 people, by the last estimate from the Department of Public Health, roughly 40-odd square miles. And I've been the health director there and for West Hartford for 21 years.

I'm also the immediate past president of the Connecticut Association of Directors of Health, a member of the National Association of County and City Health Officials board of directors, and I serve as the affiliate to the American Public Health Governing Council, for Connecticut Public Health Association.

I offer my testimony in opposition to the Governor's proposed cuts to the local public health funding. The proposal is simply a budget cut poorly disguised as a regional initiative.

The story I'm going to tell, not necessarily go to my notes, is really the one of West Hartford. Back in 2005, the town of West Hartford, which we know takes its fiscal studies very seriously, was asked by the Office of Policy and Management to do an analysis of how well or what had happened in ten years since the formation of health district between the towns of West Hartford and Bloomfield.

We were able to do that because had we formed the district. We had done some serious analysis at that point in time and projected out five years on sort of a pro-forma-based budget. So really we just need to extend it five more years to see what would have happened if our assumptions stayed correct.

West Hartford's Financial Services conducted that assessment, and what they found was really quite stunning. They found that the Town of West Hartford had saved over $1 million in ten years; and that, in fact, the service levels that the health districts had provided had increased by 44 percent over what our business had planned it had done. We literally did more with less.

The aspects from that enabled us to increase our services and all the services -- you've heard my colleagues speak before us -- from food service to everything else that we had done.

From that, that point of view, the Governor's proposal really punishes the existing regional public health structure. Seven health districts, including mine, which I just stated, put together an outstanding performance over a ten-year period and was reported to OPM was doing so has been eliminated.

The other seven, because I don't think they've really been read into this part of the room, they have eliminated our Bristol-Burlington Health District, the Connecticut River Area Health District, which only just formed, the Newtown Health District, the Pomperaug Health District, the Trumbull-Monroe Health District, West Hartford-Bloomfield, as I mentioned, and the original and first health district in the State of Connecticut, the Westport-Weston Health District.

All seven are eliminated. They're not just eliminated, but they were surgically, actually, cut out by definition. We are no longer considered governmental entities if this language were to pass.

What does that mean not to be a governmental entity? That means that all my -- all my pension plans and everything else cease to exist.

In conclusion, I just repeat that this is simply a budget that is poorly disguised as a regional initiative. The Governor has reported that regionalization helps cities.

I have shared with you that this did and has, in fact, helped the cities that I serve. These cuts are not equitable, as they provide state funding to only 13 local health departments and do not fund 67 others. Thank you very much.

REP. GERAGOSIAN: Thank you. I appreciate your testimony. As I said earlier, too, if you'd like join us in any solutions you might have on this particular issue, along with Representative Hartley, and members of his committee, he's working on those issues.

STEVE HULEATT: We'd be happy to do so. On behalf of the various organizations I'm associated with, I know that I'll be very happy to work with you to come up with a long-term solution.

REP. GERAGOSIAN: We certainly shouldn't penalize entities that have already done a good job already and do so -- we have to move in that direction in a way that's smart.

Are there any questions from the members of the committee? Thank you.


REP. GERAGOSIAN: John Hamilton, followed by Martha Dale and Daniel Hall.

JOHN HAMILTON: Good evening, members of the Appropriations Committee. My name is John Hamilton. I am CEO of Regional Network of Programs. Regional is a nonprofit behavioral health organization serving over 3500 clients and families per year in all towns of the greater Bridgeport area. I'm speaking to you today representing all of the nonprofit methadone providers of Connecticut, CCPA and CAN.

I would first like to commend Commissioner Kirk for his visionary leadership of DHMAS. I sit on several national committees, and I take great pride to know that the Connecticut Recovery System of Care is actually the model for the rest of the country.

I only have one objection to the DHMAS-proposed budget reduction. It is regarding a tiered system for methadone maintenance. This proposal is both clinically and fiscally flawed; but the most serious concern is if this budget option goes through, people may die.

Here in Connecticut we are experiencing a heroin and OxyContin epidemic. In my agency alone, we admitted over a thousand new clients in the past two years on these substances. Last year Bridgeport had the dubious distinction of having the highest purity of heroin confiscated by the DEA, 91 percent pure. This is not the time to consider cutting back on methadone services and transferring clients to physicians for their medication.

The vast majority of methadone overdoses last year, in fact, were not from diverted methadone clinics but prescribed by physicians and pain clinics in the community. This tiered system is predicated on seeing methadone treatment as only a medication: Methadone and buprenorphine are the best evidence-based medications for opiate addiction. However, they're only part of the recovery process.

Our agency provides individual counseling, group counseling, crisis intervention, mental health services, case management, housing, peer support through CCAR and family counseling, because we believe family members deserve support as well as their loved ones.

This proposed tier system punishes programs and clients for doing the right thing. The program that works on providing the client whatever it takes to support their recovery efforts get penalized for these efforts with a reduction in rate. In the same manner, a client who finally has a program that works for them is told they should cut back on their treatment.

I can tell you there is no evidence that a tiered methadone program improves outcomes. In fact, Tom McClellen, the newly appointed deputy drug czar who spoke here last year at Connecticut legislation, suggested that we should do just the opposite of what this tier system proposes.

Dr. McClellen recommended treating addiction as a chronic relapsing disease requiring continuous care and suggested we should create incentives for programs that provide the best outcomes in stabilizing our clients, and we should measure these outcomes both on the public health and public safety domain.

We urge the committee to reexamine these funding cuts to services that are part of the core mission of state government. Thank you for your time and consideration.


Are there questions from members of the committee? Thank you very much for your testimony.

JOHN HAMILTON: You're welcome [inaudible].

MARTHA DALE: Good evening, co-chair, Representative Geragosian. I'm Martha Dale from [inaudible], and with me is Nicki Cutler, who is an intern at Leeway. She has the more important thing to say. I was here Wednesday night and spoke about pretty much the same issues, but I feel like I'm speaking --

REP. GERAGOSIAN: Speak into the microphone so we can hear you.

MARTHA DALE: Yes. I feel like I'm preaching to the choir a little bit, because all of you understand the issues of -- concerning the AIDS population that we represent at Leeway, but we're here really on behalf of all of the other individuals who have spoken in front of us who represent their one piece of the social services safety net, that they entrust their future viability to you and the other government funders that they need to support.

My two pieces that I just want to speak to are to restore the $2.5 million cut in the AIDS service line at DPH. Very important. We've heard lots of prior speakers to that. The second is to restore the $3.2 million cut to housing and supportive services for the Next Steps Round III program, of which Leeway has a shovel-ready project, but let me hand it over to Nicki.

NICKI CUTLER: Good evening, my name is Nicki Cutler, and I am a student from the [inaudible] School of Social Work.

I've been interning at Leeway since September of 2008, and I have been working very closely with Leeway Alumni Society. Leeway Alumni Society consists of members from Leeway who have transitioned successfully back into the community. Together they work to be supports for one another, advocate for HIV/AIDS, and find opportunities to educate themselves and others in current issues in the community.

While working with the alumni society, I have seen firsthand the importance and needs for services provided by the Ryan White funding. The Ryan White funding has continued to provide case management services to our members, transport them to doctor appointments, provide mental health and substance abuse treatment, provide meal and food vouchers, housing and copays for medication.

These services continue to help members maintain a healthy lifestyle and prevent them from cycling back into hospitals and returning to Leeway. Most importantly, these services have helped members to sustain housing, which is a major barrier the community faces on a daily basis.

If the DPH funding budget is cut by $2.5 million, the state will have to face repercussions financially by the increase of homelessness, increase of risk of hospitalization and most importantly death.

HIV/AIDS no longer has to be a death sentence for those living with the disease. But if it is not properly treated, it is. The Ryan -- the services Ryan White funding provides is the closest thing these individuals have as a family support. The members of the alumni society don't have positive family lives, like many of us are so fortunate to have.

When they are not feeling good, they don't have the family to take care of them. When they get into financial trouble, they do not have the family to lend them a hand. If they need a ride to an appointment, many of them have no reliable transportation.

The necessary tasks many of us need to survive, the Ryan White funding makes sure these necessities are taken care of.

These members are a fragile part of our community and cannot risk losing any more services. Ryan White has and continues to be available to help our members and many other individuals within our community in their time of need.

The decision to cut funding around the state is a very difficult task at hand and not one anyone is taking lightly. But I ask you out of all the state agencies that are having their funding cut by ten percent, why is DPH facing an astounding 40 percent cut?

These are human beings with homes and dreams that deserve to be given a chance to live. I ask you to reconsider the DPH budget cut and bring a quality to the [inaudible]. Thank you.


Any questions from the members of the committee? Thank you for your testimony.

Daniel Hall.

DANIEL HALL: Thank you. First of all, you guys have been sitting for a long time, so I won't mind if you want to get up and stretch. Everybody can do that.

I do want to say thank you, and I appreciate the fact that you, the members of this body, are here and present now and the ones in the other room. And the senate 46 members, I appreciate the ones who are present now.

Good afternoon. My name is Daniel Hall, and I am a mental health assistant at Cedarcrest Hospital. I'm here to speak on behalf of District 1199 and in particular at Cedarcrest Hospital to talk about the unique services that we provide to greater Hartford.

We want this committee to know that closure would harm not only the patients but the greater Hartford area, which is already reeling from the economic downturn. Each patient is an individual member of the community, and what affects them has a ripple effect on their spouses, their coworkers, their fellow parishioners or congregants.

Hilary Rodham Clinton once equipped "It takes a village to raise a child." Well, we at Cedarcrest believe that it takes a village to treat or heal the mentally ill.

Cedarcrest is an inpatient state-run psychiatric facility for adults on two separate campuses, Cedar Ridge and Blue Hills. And since -- we're opposed to the closure because there is no other state-run facility of this size serving the greater Hartford area, and there's consistently waiting list for those in need of these services.

Economic impact of such a move would go beyond the 400-or-so employees and their families, but to the hundreds of other jobs that are directly or indirectly supported by the hospital.

My testimony here today will focus on the Cedarcrest -- Cedar Ridge campus, because that's the one that's marked for closure. After reviewing Governor Rell's proposed budget, it is obvious to me and to my coworkers that whomever drafted it had little, if any, idea about the services that we provide at Cedar Ridge and to whom these services go.

Cedar Ridge has three specialty units. Its young adults program provides age-specific services to those who've aged out of children's services, that is, that they are between the ages of 18 and 25. Clearly a very at-risk population. The Latino monolingual mental health services provides a range of services to Spanish speakers. The transitional supervised living program offers intensive rehabilitation services for individuals facing serious obstacles to community reentry.

Cedar Ridge provides acute and subacute care to individuals suffering from a variety of psychiatric and mental health ailments, including anxiety disorders, schizophrenia, anorexia nervosa, bulimia, borderline personality disorder, traumatic brain injury, acquired brain injury, drug and alcohol addictions, dementia due to illness and/or injury, pervasive developmental disability, obsessive-compulsive disorder, oppositional defines disorder, varying degrees of mental retardation, posttraumatic stress disorder, some of whom are veterans of recent and ongoing conflicts in the Middle East.

We have people with severe behavioral issues as well as antisocial and sociopathic tendencies. We care for people at varying ends of the autistic spectrum and differing developmental stages.

In closing, I want to reiterate that the importance of keeping Cedar Ridge campus open in order to facilitate the care that is so desperately needed in the greater Hartford area. These beds need to stay in the greater Hartford area. Cedar Ridge is for many in our community the last best bastion of hope.

It is my fervent desire that our message resonates in the hearts and minds of this committee and that we're not seen as merely a pontification in some perverse horse and pony show. This means something. These are real people. Thank you very much for your time.


DANIEL HALL: Any questions?

REP. GERAGOSIAN: I'm glad you focused on the issue of jobs, because I read the other day, every billion dollars that's cut out of this budget not only affects state employees but 7,000 private sector for employees when we cut this budget, so --

Any questions from the members of the committee? Thank you for your testimony.

DANIEL HALL: Thank you.

REP. GERAGOSIAN: Bob Davidson, followed by Bill Blitz, followed by Bob Brex.

BOB DAVIDSON: Good evening, Representative Geragosian and members of the Appropriations Committee, especially Representative [inaudible] from my area.

Thank you for your endurance. I know this has been a long week for you. After speaking with the DSS budget on Wednesday, it is a pleasure to be here about DHMAS. The Eastern Regional Mental Health Board believes that DHMAS is a progressive and well-managed agency that has promoted recovery, person-centered planning, evidence-based practices, the treatment of trauma and co-occurring substance abuse disorders.

Obviously, the Governor agrees at least with the management part since she has cut this budget less than others. She has also added a caseload growth fund for the people who will get worse from the cuts she has made to the DSS budget.

But the proposal to close Cedarcrest, as you have heard, raises issues that you need to monitor. The commissioner has said repeatedly that he doesn't want to close beds. He wants to reallocate them.

And so two-thirds of these beds will go to CVH, presumably with the special programs that Mr. Hall mentioned going with them. One-third will go to two 15-bed facilities to be built in the community. I agree with the earlier speakers that 15 beds is too big, that 15 beds is another institution.

It's also inviting a difficult and unpleasant and stigma-aggravating zoning [inaudible] in each of those two towns. It will cost money to build these buildings when there are plenty of houses available for smaller five-bed facilities that don't require special zoning in most towns that you have heard this evening, are more homelike and more conducive to recovery and reintegration into the community.

I commend DHMAS for acknowledging that people are in the hospital who no longer need a hospital level of care. That's the criteria. It's not that hospitals are too expensive, although they are. It's that people -- some people need a hospital level of care and others don't. And those who don't should be in the community.

Second, in the -- DHMAS has embraced rebidding as a way to modernize services. And, again, we support that, but we are concerned that the total amount for the rebid services will be less than the current services, which means that you have to improve services at the same time that you're cutting funds.

Especially with a case management model they're going to, community support program, which is a good way to do things. It's also a more staff-intensive way, and so you're going to be hiring more people with less money, and that's taking -- doing more with less beyond reason.

Finally, and quickly, I support the people who have called for the -- for reinstituting the funding for supportive housing. We -- if we don't build shovel-ready projects for people who need support, we will have shovel-ready people who may die from a lack of it. Thank you for your attention.

REP. GERAGOSIAN: Are there any questions? Thank you very much.

BILL BLITZ: Good evening. My name is Bill Blitz, and I'm the public health director for the largest population district in Connecticut, serving over 162,000 people in the eight towns of East Windsor, Ellington, Enfield, Stafford, Suffield, Vernon, Windham, Windsor Locks. And also we are in charge of all the food service at Bradley Airport as well.

Our department's also one of the lowest cost to towns in this state, based particularly on economy of scale being somewhat larger than most others. But there is a limit to that, too, and I could talk a little bit about that later.

I applaud the Governor's proposal to encourage regional health departments but find that something went radically wrong from the proposal to the proposed legislation. Instead of encouraging regionalization, the proposal does the opposite and discourages regionalization because of the proposed radical cut in funding districts.

The $2.08 we currently receive is one of the lowest levels of funding of health departments in the United States, putting us around 42nd of all states. And I think with more recent information, probably even closer to the bottom.

One of the reasons for this is that most states are funded from state and county monies. And of course Connecticut does not have functional county government, so they place the burden squarely on the local towns.

If the proposed reduction goes through, we certainly could not afford to take in any towns. It's a disincentive. And the question of whether we can continue to serve our existing towns consistently with expanding mandates that the state health department and that the legislature continue to place on us is a real question.

Having said that, I believe every citizen in Connecticut is entitled to some equal level of protection wherever they live. Prevention and health education alone have the effect of reducing chronic disease. Our presence as a health district, although quiet and unnoticed in most times, prevents costly disease outbreaks and the spread of diseases as well, all which are translatable into huge savings on the part of the state for medical curative care.

I feel that big cities like Hartford, New Haven, Bridgeport and the like have unique needs and complex departments and that they should not be considered to be regionalized. They should remain independent health departments and not be placed in districts or regions.

But in summary, I am asking you to attempt to restore the $2.08 so that we do have an incentive to bring other towns into our district, and if that's impossible, hopefully something close to that. But we feel that we really are going to be crippled from a reduction of the $2.08. I'm open for any questions.

REP. GERAGOSIAN: Thank you. Any questions? Thank you. Appreciate your testimony.

Bob Brex, followed by Michael Merriam, followed by Ron Fleming.

BOB BREX: Representative Geragosian and members of the Appropriations Committee, my name is Bob Brex, and I'm the executive director of Northeast Communities Against Substance Abuse, which is a Regional Action Council for the 21 towns in northeast Connecticut.

I'm going to abbreviate for the sake of time, because I know there are people here that still need to speak.

Northeast Communities Against Substance Abuse has three direct federal grants. A drug-free community support grant, a drug-free mentoring grant, which allowed us to help the Town of Putnam and the Town of Windham both get their own drug-free community grants, and we have a federal underage drinking grant. We use our state and local funding to help match these grants. So our state and local funding is extremely important.

NECASA has the data to prove the reduction in use of alcohol, tobacco and marijuana in the northeast corner. The Consultation Center at Yale University analyzed data from nine years of NECASA's student surveys, and the comparison between the first round, 2000-2004, and the second round, which is 2005 to now, showed a reduction in lifetime use, 30-day use and an older age of initiation by ninth and tenth grade students. I am not going to read you the data. I know you have that in front of you.

NECASA has also recently funded eight school systems in our region to evidence-based prevention curriculums, so they have moved away from those curriculums that did not work to those that are proven scientifically to work with our funding.

We also have 15 middle school projects going across the region dealing with access in the home to drugs where actually students are teaching their parents why to limit access to them.

NECASA is a prime example of how RACs do a lot for their communities. We run programs, we fund programs, and we assist all levels of our community in their response to substance misuse and abuse.

I ask that you restart funding, as others have done before me, to its level -- to its flat level. And then also I want to say that I support all of the prevention infrastructure of this state.

Every one of us from GPP to the RACs to the others in the infrastructure work very, very hard to prevent substance abuse in this state, and we are working all together to do that, and I support all of you.

REP. GERAGOSIAN: Thank you very much for your testimony.

Questions from the members of the committee? Thank you. Michael Merriam.

MICHAEL MERRIAM: Good evening. It is evening, I guess, yes.

REP. GERAGOSIAN: Yes, it is.

MICHAEL MERRIAM: Members of the Appropriations Committee, my name is Michael Merriam. This is my wife, Ruthann, and we want to thank you for the opportunity to -- for us to tell you about our daughter so you'll support funding for the Department of Developmental Services.

Our daughter is Millie Merriam. Millie is a 28-year-old resident of the 8 Card Street group home in Willimantic, which is operated by the state and staffed by state employees.

My daughter lives in this group home because she has cerebral palsy and mental retardation. Millie is nonverbal, but she can speak with her eyes and with her facial expressions and body expressions, and she's in a wheelchair. She requires nursing 24/7 along with five other clients who live with her.

Any cuts or changes in services would drastically affect Millie's quality of life. Millie's current care caregivers know her, understand her and can meet her special medical problems, the same as they do for all the clients living at Card Street.

My wife Ruthann and I know and trust these caregivers with our daughter's care. We are very happy about the attention she gets in this state-run group home. It's a loving, Christianly run home and clean, where Millie can live with dignity and a great quality of life. We feel welcome to visit her at any time.

Please, don't cut funding for this group home or state caregivers. And thank you for letting me talk about my daughter today.


Do you wish to say anything?

RUTHANN MERRIAM: Yes, I was just going to say that I [inaudible] --

REP. GERAGOSIAN: Let me move the microphone over to you.


REP. GERAGOSIAN: That's all right.

RUTHANN MERRIAM: I was responsible for Millie's care for almost 13 years practically by myself, and so I know what a hardship it can be and how stressful it can be. And I just love these people that can take care of her, and there's not very many people in this world like that anymore, as you probably well know.

And Millie lights up the room. Everybody calls her their angel. And at certain times, especially when she's sleeping, they share the glow all around her. So most of her caregivers have told me that if they have a bad day or if they lost a loved one of their own, they just walk in the room and they see her with that big smile and they say, Hello, Millie, we're here. And she just lights up the whole room. And they actually forget about their problems for a few hours until they go back home to their own life.

So I have to say the same thing my husband said. Please don't cut my daughter's care, because right now she's in a good place where there's not going to be any harm to her, because everybody there is in a wheelchair, and so we don't have to worry about that, as previous years we did because there were other people that could harm her. But right now she's protected. And thank you for listening to me.

REP. GERAGOSIAN: Thank you for coming.

Are there any questions? Thank you very much.

Ron Fleming, followed by Rosalyn Beckham, followed by Steve Woke [phonetic].

RON FLEMING: Good evening, members of the committee. I appreciate the opportunity to provide testimony. You have my written testimony, so I'll use this time to emphasize some what I think of as key points.

And I would add that in the context of the current budget issues the state faces, I'm grateful that the DHMAS budget is as stable as it is at the moment.

I'm here actually to advocate on behalf of maintaining DHMAS's ability to operate in an existing network of services that are provided by private, not-for-profit agencies.

These agencies provide care to thousands of Connecticut residents effectively and at low taxpayer cost. At the same time, I'm here to point out the vulnerabilities of these same agencies should the DHMAS grant, fee-for-service or administrative budgets be subject to any further reductions.

Some of these items have already been mentioned by other speakers. As an example, human resource issue costs. Based on the current budget, my colleagues and I throughout the state must plan a no COLA and no rate relief for what will be three consecutive years.

Due to inconsistently available rate relief or COLAs in the past, most agencies have not been able to keep up with escalating costs. At my own agency, as a for instance, my recent health insurance costs have reached the point where they now exceed a million dollars annually. I employ 200 people. About a third of them are part time.

Anticipating two more years without COLA or rate relief proposes substantial hardship on vulnerable agencies, including my own, and will in fact result in reductions in personnel even without a budget cut.

I would mention physical plant issues, as unromantic as it is. All of these services are provided in buildings ranging from residential care to outpatient care, and the cost of maintaining these structures and facilities, particularly when you have to maintain them to maintain licensing from the Department of Public Health or comparable agencies, represents an ongoing and persistent cost and a burden to agencies in light of short funds.

Most importantly, service demand. For most agencies, including my own, demand for care is constant and unrelenting, most agencies anticipate due to the times we're in. If anything, our service demand will go up; but due to our funding structure and tenuous supports, we clearly cannot accommodate additional loss of funding.

And like I said, the current budget actually over the three years will represent what amounts to a loss of funding.

My agency alone serves 32 -- over 3225 people a year. To summarize, by the end of 2011, private nonprofits similar to my own will be faced with trying to operate without rate relief or COLAs for three consecutive years. We will be operating in a time when it's reasonable to expect demand to remain constant, if not increase.

Clearly budget cuts beyond what's already been proposed would create a crisis. But it must also be understood that the currently proposed budget actually ultimately does result in reductions in services and loss of jobs.

There's no agency I know of that can withstand three years of no COLA and no rate relief.

As a for instance, and I'll close with this, my own agency started this year, because we had no COLA and no rate relief this year, with layoffs. And we anticipate that over the next two years, we will face a similar set of decisions. Thank you.


I just have to warn you, as I've done each night during these hearings, that this budget if we pass it tomorrow would be $3 billion out of balance. So for those of you that are happy with not being cut or only being cut a little bit, are facing, you know -- this committee is going to have to deal with that $3 billion in some way.

So any questions from the members of the committee? Welcome back, Representative Ryan. Thank you very much for your testimony.

REP. GERAGOSIAN: Good evening.

ROSALYN BECKHAM: I'm Rosalyn Beckham. I'm a member of the North Hartford Seniors in Action, and I'm here in opposition to the Governor's budget cuts for the Asthma Outreach Educational Program.

This program has been instrumental in reducing emergency room visits due to asthma attacks and also reducing hospitalization. Asthma is on the rise; however, this program has been most effective in addressing that issue.

The effectiveness will be lost without funding. Parents and grandparents have benefited greatly from lessons learned through the Asthma Speakers Bureau. Although there is no cure for asthma, we can do something environmentally.

In closing, I want to thank you, Representative Marie Kirkley-Bey, who has been one of our close sponsors, and Senator Eric Coleman for his continued support. And thank you, ladies and gentlemen, for listening.

REP. GERAGOSIAN: Thanks for coming up. Steve Wolf, followed by Art Romano, followed by John Quinlavin.

BOB ZIEGLER: Good evening. If I may, I'm not Stephen Wolf. Dr. Wolf was tied up at the hospital and can't make it, so I'm going to sit in for him.

REP. GERAGOSIAN: Sure. If you give your name for the panel?

BOB ZIEGLER: Sure. My name is Bob Ziegler, and I want to thank you for your time and your patience here this evening. I don't envy your jobs at all, and I appreciate your listening to our pleas for whatever it is that we're looking for for monies.

I've been active in the EMS world for 32 years. Twenty of those years I have had some exposure and some involvement in the local [inaudible] councils. I've held positions of vice president and president of various communities and councils, and so the importance of having those regional councils available to all the communities in the state I feel is critically important.

There are a lot of reasons why, and we can spend all night trying to plead our case to you, as to why they should be here. But one particular reason I'll just expound on is, as others may do later, one of the roles that I feel is an important aspect of the councils is to be able to hear needs of service applications from various communities or vendors wishing to do business as a particular need of their client core.

The councils take that application, they review it for completeness and thoroughness, and then they hold their regional hearings with the constituents in that region to discuss the merits and whether or not to approve favorably to the department public hearing officer on that application.

There are many times sitting on both sides of the table on those hearings where applications are reviewed, sometimes denied, sometimes told to go back, fix and come back with us, and sometimes that engagement goes a couple, three, four, five meetings.

I know in my case when I went before the committee for a licensure, it was an extensive, exhaustive process. The benefits to having the regional councils be the first-blush look at those applications is that, first off, it's very cost-effective. Most everybody except for the paid staff, director of those councils, all the members are volunteer staff. The committees are volunteer committees.

And so they are reviewing the applications and helping better the applications so that when they're brought to the hearing officer, it is thorough and complete.

Once it gets to the hearing officer, if it's found that there's information missing, you can't reintroduce that information unless it's asked of by the hearing officer. So there are checks and balances in that system, and I think it would be tragic to lose that system.

It also helps eliminate some of the, if you will, bureaucracy and quagmire in the system in trying to prevent a backlog of applications and paperwork that will go just directly to the hearing officer without any sort of vetting process prior to them seeing it.

So in sort of closing here, I think it would be a burden to the system, a burden to the office. It would be a burden to the EMS community to lose a valuable asset as the council, and it will certainly burden and hamper the system from that regulatory perspective. I would encourage you to help do something to save the councils.

REP. GERAGOSIAN: Thank you for your testimony.

Any questions from the members of the committee?

Seeing none, thank you.


ART ROMANO: Good evening. My name is Art Romano. I'm a paramedic. I work at Greenwich EMS. I also serve as a volunteer in my hometown. I'm a member of the Kent Volunteer Fire Department as well, and I'm also here to speak to you about the DPH proposal to completely eliminate all funding for the five regional EMS councils.

I'm going to speak to really one specific [inaudible] for you, one thing that the regions do, which is really indispensable. Many times I've been in various hearings here in LLB where the question has usually been if we reduce this or we cut that, is that really going to stop ambulances from rolling out the door and being able to answer calls? Well, this function I'm going to speak to you about, the regional councils, would, in fact, completely hamper our personnel from being able to go on ambulance calls.

What I'm speaking to here is every two years, as you probably know already, every emergency medical technician this state, every medical response technician, MRT, in the state must go through a recertification process.

All of that testing, the qualification of that exam, the vetting of that exam as being an appropriate testing instrument is done at the regional level, not at the state level. And those exams and the delivery of them is really performed largely on a volunteer basis.

Personally, I am a member of the Southwest Regions Training Committee, and we do formulate those exam questions on a pro bono basis. The delivery is then vetted through the regional office, and that is really a very user-friendly way to do things, part of your regionalization thought process in other areas of the state. We then can accommodate the needs of the small service who needs their personnel tested on a regular basis at their locale.

It also serves very well to the large municipal service where costs would be very burdensome for them to have entire platoons of firefighters or police officers having to travel to remote testing sites.

Those are cost-effectives way to do things. If you eliminate a regional council, there is no other way to deliver those services. If the DPH were to report to you today that they can supplement that and do it instead of the regions, be very cautious in how you hear that.

The regional EMS office -- excuse me. The state EMS office has exactly one educational coordinator for the entire state, and that person has one administrative assistant.

There is no way they have the funding to even formulate those exam questions, let alone deliver those exams effectively to the troops out in the field.

So that would see -- over a very short period of time, you would have large services and small services personnel with no ability to effectively requalify or be recredentialed as EMS and MRTs.

REP. GERAGOSIAN: Thank you very much for your testimony.

ART ROMANO: Thank you very much.

REP. GERAGOSIAN: Questions from the members the committee? Seeing none. Thank you.

John Quinlavin, followed by Karen Lang, followed by Jonathan Lillpopp.

CHARLOTTE JONES: John needed to leave. He chairs the Connecticut -- chairs our -- the Connecticut EMS advisory board. I'm the vice chair.

REP. GERAGOSIAN: Okay. What's your name?

CHARLOTTE JONES: Charlotte Jones.


CHARLOTTE JONES: I don't normally like to read, but this is John's testimony.

I am vice chair of a board that was created by you, the legislature, to provide expert consensus advice and guidance on all matters related to our state system.

There are 41 members of our board, which some people think is unwieldy, but there are so many constituents who represent EMS and are part of the EMS system in the State of Connecticut, all 41 of those people are extremely important.

I'm here today to address a proposed budget cut to the regional EMS councils which if enacted will force them to cease to exist. We are deeply concerned about the integrity of the entire EMS system which serves every resident of the State of Connecticut in a 911 [inaudible].

The advisory board's successful project management consists of 14 subject matter committees working closely with the conduit to the field providers and services available only through the regional councils.

As the Governor Rell suggested, regional approaches to our state and local needs is essential, and these regional councils have been ahead of the curve in this respect for many years. In fact, since 1974.

With 169 units [inaudible] facing EMS issues somewhat unique to their particular locale, we simply have no other mechanism available to provide the direct input, feedback and participation in the advancement of prehospital patient care.

These regional councils provide our state advisory board state committees with the regional expertise and guidance through which we're able to formulate uniform, statewide policy and practice which is to the benefit of our residents when they become our patients.

Some of the accomplishments to highlight our successes with this collaborative state [inaudible] approach we have, reduce the risk of injury or death from emergency medical vehicle crashes with our statewide guidelines for the use of lights and siren, provided for the health and well-being of participants of large-scale events with our EMS gatherings legislation, assisted with recruitment endeavors with the enactment of changes to our EMT reciprocity laws, created the medical guidelines for new treatments to be provided by EMTs, reduced unnecessary grief to family members with our statewide do-not-resuscitate determination of resuscitation guidelines.

The list can go on and on, and I'd love to go on and on, but I won't. Patient care is a collaborative consensus-driven entity to which all partners must have the opportunity to participate. The regional councils provide for this very important collaboration.

REP. GERAGOSIAN: Thank you very much for your testimony. Any questions from members of the committee? Thank you very much.


REP. GERAGOSIAN: Karen Lang here? Jonathan Lillpopp, followed by Joanne Eaccarino and Debbie Davis.

JONATHAN LILLPOPP: Good evening. Thank you for your time. I did submit some testimony. One was a sheet that has pretty colors so you can pick it out of the black-and-white ones, and it has certain sections on what we've done, where we want to be and our funding and productivity, so I'm not going to read that to you, but I would appreciate it if you could take a look at it.

My reason for being here is obviously the regional councils are being eliminated in the proposed budget, and I am here to give you the perspective of the paid employee.

I was on the regional council board of directors and a committee chairman for eight years before I became the regional director. I really didn't have a clue even after that long on the board what the staff does.

Today I heard the commissioner, who I think is the best commissioner we've had since I've been here, talk about how the DPH planning teams could take over the council functions that -- after they've been reduced, and I started going through my notes, and I came up with about three pages of things that are not planning things. They're planning teams can't take over what we have. There's not a plan to absorb all of the various functions we do.

I think the problem for me, a staff member, the most important thing that I do every day is I provide the services, the ability to get through the bureaucracy.

The [inaudible] here, even if their service chiefs do not have necessarily leadership training, they rely on somebody locally who can answer their questions. And so I have to provide them with the ability to do so.

Just give you a couple of points, and then I'll be done. Things like calling up for latex allergy management. Where do you go for that? There's not a book that these people can open up.

How do you follow TSA application? What are the minimum crew requirements? How can you assist me in terms of telling me what my paramedics can do and what they can't do? How are they allowed to help out in an emergency department? What's a management service? What's its function? How can I get authorized to provide this certain medication to the patients that I service?

All these things have nothing to do with planning. They're all direct administrative support, and I do this daily. I don't ever go and sit in the office and look at a plan. I spend my time mostly on the phone answering these folks' questions and trying to make sure that their life is as easy as possible, because our volunteers don't need to learn the statutes and the regulations so that they can pull out a book and quote them. They need to have a place that they can call as a resource. And that's what I do as a staff member.

And lastly, I'm a little confused. Again, not to disrespect the commissioner, but he seemed to think that they could absorb all of our council functions. And -- I'm done.

REP. GERAGOSIAN: You can finish your thought.

JONATHAN LILLPOPP: He seemed to think that he could absorb all of the functions that the councils do with their current DPH planning teams, but we know that he put in a proposal to the Governor's office to eliminate the regional councils and then ask for seven and a half FTEs to put in the field offices.

So it's difficult to say on one hand we're going to absorb all those, but we'll need seven and a half more people. So I'd like to -- for you to think about that. And thank you for your time. I know it's been a long day. I've been here watching you all. And unless there's questions --

REP. GERAGOSIAN: Thanks for coming up.

Any questions? Thank you very much.

REP. GERAGOSIAN: Thank you. Joanne Eaccarino. Is she here? Debbie Davis, followed by Tom Burr and Phyllis Harrison.

DEBBIE DAVIS: Good evening, Appropriation Committee. My name is Debbie Davis, and I am a member of District 1199, the Healthcare Workers Union. I live in Glastonbury and I also work in a group home in Glastonbury, Oak Hill.

Oak Hill is a private nonprofit agency that provides services to people with developmental disability. I'd like to take this opportunity just to tell you a little bit about what I do and a little about me.

I've been working in this agency for 18 years, and I currently make $17.97 an hour. And if I was working for the state in a DDS group home, I would be making more than $24 an hour for doing the same work as they do but for two-thirds of the wages.

At one time, direct caregivers in the private agencies were almost at parity with the state workers, but now we keep falling further behind. Just an example of how the state had shifted the burden of the costs to the care -- of care to the private agencies through underfunding, in turn the agency shift cost onto the employees as a result is a high turnover, massive burnout, people working multiple jobs and destructions to the quality and continual care of our clients.

Private agencies have been starved to the funding that they're providing the services by the state and those agencies are now starving us.

For this coming year, Governor Rell has completely left the private provider agency, like Oak Hill, out of her budget proposal. Unless the legislature funds our programs and ensures that all of the additional funding is dedicated to wages and benefits for direct caregivers, we will see our wages freeze, our insurance costs soar.

My clients have 100 percent insurance coverage at no cost to them or their families. It's wonderful that in this state we're committed to providing that care.

I happen to like where I work at and for the residents that I serve. Please help me to continue to help them who cannot always speak for themselves. And I don't feel like I should have to work an additional job that takes me away from my family so that I can provide the same services for those that I care for that are also in my home that need me as well.

And if I may say, I have been completely humbled by the testimony of those before me, and I pray that the governor will hear and listen to our cries. Thank you and be blessed.

REP. GERAGOSIAN: Thank you, Debbie. Tom Burr.

TOM BURR: Good evening, Representative Geragosian and Representative Bartlett and the esteemed members of the Appropriations Committee.

My name is Thomas Burr. I am the president of the Manchester [inaudible] National Alliance on Mental Illness, though tonight I come here just representing myself as a taxpayer here in Connecticut.

Simply said, I do support the work of DHMAS. You already have my testimony. I am not going to read it to you, but I just want to, you know, direct your attention to some of the numbers in there, which I think you've already heard tonight in other people's testimonies.

Certainly I echo what Sheila Amdur from [inaudible] Connecticut has stated earlier. I just want to kind of color some of what my testimony says in human terms. I want you to know that my son, who is an adult, was diagnosed with bipolar illness ten years ago, and that started an eight-year rollercoaster ride of hospitalizations, incarcerations and homelessness.

Thankfully, he is currently in recovery. He has been on his own now for over two years. He lives on his own, and he's doing very well. He works. He has a job. In fact, he called me up just a few weeks ago because he just did his taxes and he was mad because he owed the government a thousand dollars, the federal government. So I said, Join the club.

Anyway, the point of that story, just briefly, is just that people with mental illness can and do recover, and you should know that, and I think in some of the other people's testimony, you've seen that.

Having said that, I'm certainly well aware of the current financial situation the state is in, and I don't envy you folks having to make some very hard decisions this year.

Certainly -- again, the numbers are in my testimony. In my opinion and the opinion of some of the members of my affiliate, DHMAS is stretched too thin as it is. Connecticut's mental health system, quite honestly, is in gridlock. My members tell me repeatedly they have often a situation where one of their loved ones is stuck in an inappropriate and expensive setting, like a nursing home, an emergency room or a hospital.

The people there that are sick are good enough so that they don't have to be there anymore, but they literally have no place to go.

Specifically, as part of what DHMAS is trying to do, the monies they're trying to put together for the transitioning young adult services, that's critical, and that's certainly -- I'm glad to see that's going to hopefully remain in the budget. Certainly the governor seemed to think so.

Regarding Cedarcrest, I don't have an opinion one way or the other whether it should be closed or not. I don't know the situation there specifically well enough. I do know that if it is closed, the money saved should be put into the community for supportive housing, certainly the monies that were initially for funding the Next Step supportive housing initiative the Governor took out of the budget, which I was very disappointed to see, and I think that is very shortsighted.

Currently there are 14 shovel-ready projects ready to go for supportive housing, but it would create jobs in the short term, [inaudible] construction and certainly long-term would support staff and property management that's involved in running these things.

There was 150 units [inaudible] supportive housing are critical. The absence of those will cost the state about three times what they cost to build. The increases in homeless shelters, nursing homes, emergency rooms, jails and prisons. And you should know that the costs associated with not providing the supportive housing and funding these crisis-based services, you can't avoid that. That deal is going to come due.

So just to kind of, you know, summarize everything, folks with mental illness that have supportive housing can enter recovery faster. A large portion of them will be able to get employment, which, you know, puts money into the state revenue, and they will transform themselves from being a perceived burden to society to actually being an asset to the state and their communities.

And I think cutting the DHMAS budget will be counterproductive, and providing supportive housing is not only the morale thing to do to one of the most vulnerable segments of our society, but it is also the fiscally responsible thing to do for the taxpayers here in the great State of Connecticut.

And just to end, I'd like to quote John Fitzgerald Kennedy who stated, "The poet and the politician have this in common: Their greatness depends on the courage with which they face the challenges of life." Thank you. I'll gladly answer any questions you have.

REP. GERAGOSIAN: Thank you, sir.

In the supportive housing, were those rehabs or new construction.

TOM BURR: I think most of them were new construction. I could get you that information, though.

REP. GERAGOSIAN: Because I think that really -- some of the rehabs might be -- when you talk about shovel-ready, really available on smaller projects rather than some of the projects on the books.

TOM BURR: Well, I wouldn't use the term grandiose.

REP. GERAGOSIAN: No, I'm just saying in terms of infusing money into the economy, they're quicker to get money into the economy as opposed to, you know, building parking garages or large buildings or --

TOM BURR: I don't think many of them will really, really large, quite honestly.

REP. GERAGOSIAN: No, what I'm saying -- [inaudible] for dollars, we'd like to get the money into the economy as quickly as possible, so I think some of the smaller projects are better for that purpose.

TOM BURR: And they're ready to go. I mean, that's the other thing. Just need the funding approved.

REP. GERAGOSIAN: Sure. Thank you for your testimony.

Are there any questions? Senator Esty.

REP. ESTY: Just to follow up on that, this is the time to go to the Governor. She controls shovel-ready. She made a commitment to 150 supportive units. She can do it with shovel-ready. Have her do it that way, because we don't control that.

Those stimulus shovel-ready moneys go through the Governor's office in every state. I would urge you folks to besiege her with requests, because she can do it.

TOM BURR: I will certainly continue to do that. Ironically, I met with her staff the day before she announced her budget and did exactly that. It wasn't very effective, apparently, but I will continue to try.

Believe me, that was part of the discussion, was the fact that they were shovel-ready and they did create the jobs and I thought a made a good business case, but I will continue to besiege.

REP. GERAGOSIAN: We're trying to. Thank you.

TOM BURR: Thank you.

REP. GERAGOSIAN: Phyllis Harrison. Phyllis Harrison, following by Nicole Cater [phonetic]? Phyllis is not here? Nicole Cater? David Rich?

Lynn DeMarchi. Good evening.

LYNN DeMARCHI: Hi, my name is Lynn DiMarchi, and I am very grateful to all the services that has helped me in my recovery. I have gone through the intensive outpatient program at Natchaug Hospital. That's a [inaudible] program, Monday through Friday, 8:00 a.m. to 12:30 p.m. from June 23rd to August 8, 2008, and that's in Mansfield, Connecticut.

I did follow-up aftercare at United Services. I see my therapist once every two weeks, attend group relapse and prevention once weekly, medicine maintenance every three weeks, and I've also done posttraumatic stress disorder group and anger management classes at United Services in the past. I've managed to stay sober since June 2nd of 2008.

I also attend CCAR meetings weekly. I have completed 150 hours' community service at CCAR that has also played a huge part in my recovery. I also get weekly phone calls, TRS, which is telephone recovery support, from CCAR that helps to keep my recovery in check.

On Tuesdays 2:00 p.m. to 4:00 p.m. I attend the ROSE program. That program is very educational for helping people with job skills. These programs have helped me and many other recovery-involved people.

Without these programs available to me and other recovering addicts, I wouldn't want to even think of where I would be or what I would be doing. I know one thing for sure, I wouldn't have any interest in writing you this letter.

Thank you for everything to DHMAS and just all the funding and thank you for giving my life back and for giving my son his mother back. Sincerely, Lynn Marie DeMarchi.

REP. GERAGOSIAN: Thank you, Lynn.

LYNN DeMARCHI: Thank you for listening.

REP. GERAGOSIAN: Are there any questions? Thank you.

LYNN DeMARCHI: Have a good evening.

REP. GERAGOSIAN: Cheryl Martone.

CHERYL MARTONE: Good evening, Senator Harris. You saw me at the December 18th hearing, and you'll be seeing a lot of me. My name is Cheryl Martone, and I'm from Westbrook, and I'm going to be sending a letter to the Governor regarding these issues that I'm going to be talking about in correlation with DCF, and there's reason. And the reason why I'm here is talking about the correlation with DHMAS and DESS.

I'm a single parent who is responsible and was responsible [inaudible] for upbringing and loving nurturing of my child. The reason why I'm here is I'm a parent of DCF, and I organized a parent investigation team on DCF.

My story is one that really involves the agenda here of Department of Mental Health. I do not have any addictions or mental health problems, but the probably with DCF is that they are trying to push me and many parents and children that do not have mental health problems into services not needed.

And I support Bill Number 30, which [inaudible] brought up in mental health. This is where it starts in the schools. They -- it's an act. 5730 is an act concerning psychiatric and psychological testing of schoolchildren and procedural safeguards for parents, and this is where it starts, in schools. And we can have better mental health prevention, a strategy to contain costs to do preventive maintenance with DCF instead of spending a lot of money from the mental health department or mental health services and utilize the laws to keep children and parents safe and regulate and organize an overlook what DCF is doing.

I would like to see the budget to be spent on prevention of children and families to be shoved into mental health services, like I am trying to be shoved into and my child was unfortunately shoved into.

I agree with the Governor's prevention and partnership council about doing better by these agencies for children. The Westbrook Middle School principal, Mr. House, may have committed a hate crime on my child Justin and I, but making false reports to DCF and trying to make my child and I look like we have mental health problems.

School officials and teachers should have criminal and mental health screening regularly. Can I just finish my thoughts? I'm asking the Governor and Attorney General's Office to seriously look at the way DCF runs their business, about pushing parents and children into mental health programs.

Towns use this to throw everything into the mental health pot to avoid providing services for education that they may need if there is something wrongful with the classroom and not the child.

They get away with doing -- impeding and using services of the mental health department. It's easier for them to make -- to blame it on the mental health of the child and cause them to blame the child and not the school. It's cheaper for them to provide mental health services and get a pill to drug the child and make zombies out of them.

It's a diversion, instead of giving the child the proper education they need. The child needs education services that are expensive for the school, and it does not want -- they do not want to pay the bill.

We as taxpayers deserve the best education no matter what the disability, if there is a disability. And an IEP, the school is telling me in my child's IEP -- they are not telling me what was going on with my child and they're hiding things from me, and it's like a big secret because they want to push children into mental health services.

And this is the email address for parents of DCF that were wrongly accused and falsely accused and wronged by DCF. I formed a -- I'm trying to form a committee.

REP. GERAGOSIAN: Thank you very much for your testimony.

Are there any questions from the members of committee? Thank you very much.

Cheryl is the last one on the list. Is there anybody here who would like to --

CHERYL MARTONE: I appreciate you hearing me.

REP. GERAGOSIAN: Thank you. Is there anybody else who would like to testify tonight? Scene seeing none. I'll declare this public hearing closed. Have a good weekend, everybody.