Government-funded programs provide most of the addiction treatment and prevention services in the U.S., and states are in the forefront of efforts to prevent and treat alcohol and other drug abuse. Who should lead this fight at the state level, how government entities and services can best be structured, and which state criminal-justice policies can serve as models for others are among the issues under consideration by the new State Systems Policy Panel convened by Join Together.

The national Blueprint for the States Policy Panel held its first meeting on Dec. 15, 2005, and has begun gathering public testimony in anticipation of releasing a set of key recommendations in June 2006. Public hearings will be convened in Santa Fe, New Mexico on Jan. 30 and in Washington, D.C., on Feb. 13 during the annual meeting of Community Anti-Drug Coalitions of America. New Mexico Gov. Richardson is slated to provide the lead testimony at the New Mexico hearing.

"We hope to hear from other people who have had success in their own states, so we can develop policies that all 50 states can incorporate to prevent substance abuse," said panel member Pat George, a Republican member of the Kansas House of Representatives. George added that lawmakers need to hear the economic arguments in favor of investing in addiction treatment and prevention: "The savings over the long haul will far outweigh the short-term appropriations to provide substance-abuse treatment," he said.

Testimony also may be submitted electronically via e-mail (PDF of guidelines on how to submit testimony).

"States are on the front lines of the fight against substance abuse; state governments and legislatures have to lead, and I don't think that's happening," said former Massachusetts governor and presidential candidate Michael S. Dukakis, who chairs the policy panel. "I'd love for us to put together an agenda so that both previous and newly elected governors have a blueprint in front of them."

Dukakis said his work on the panel stems in part from frustration that drug prevention efforts undertaken by him and other state lawmakers in the 1980s seem to have fallen by the wayside in recent years. "That bothers me; nor do we see particularly impressive leadership nationally," he said. "It's all enforcement oriented, with very little focus on prevention and education, but I believe states can have an impact on changing that."

Strengthening State Leadership, Systems

The panel's recommendations will largely be driven by the public testimony received, but the group's early work has already revealed some guiding themes and areas of concern. For example, panel members have expressed an interest in defining the appropriate role and structure of the single state agencies (SSAs) that have primary responsibility for administering drug and alcohol programs. "We have an important opportunity to make recommendations that will provide guidance to improve state substance-abuse systems," said panel member Barbara Cimaglio, deputy commissioner of the Division of Alcohol and Drug Abuse Programs for the state of Vermont. "Strengthening state leadership is critical to building quality services throughout the country."

Other potential topics include the role of governors and other senior government leaders, sentencing policies, statewide collaboration, treatment integration, proper funding levels for addiction-related services, workforce development, and data collection and outcomes measurement.

"As a manager and advocate for quality alcohol and drug services, I am concerned that the national focus has shifted away from outcomes to evidence-based practices as the goal," said Ken Stark, director of the Mental-Health Transformation Project and former director of the Washington Division of Alcohol and Substance Abuse and another panel member. "While evidence based practices are a means to the end (of good outcomes), evidence-based practices themselves are not the outcomes. Too many legislative bodies are now requiring use of evidence-based practices with little attention to monitoring whether these practices have actually improved the outcomes previously being achieved. Hopefully, through these public hearings some attention will be focused on the outcomes themselves."

Other panel members include Sidney L. Gardner, president of the group Children and Family Futures; Diana Bonta, vice president of public affairs for Kaiser Permanente's Southern (California) Region; Judge Karen Freeman-Wilson (ret.), CEO of the National Association of Drug Court Professionals and chair of the Governor's Commission for Drug Free Indiana; Patricia Kempthorne, First Lady of the state of Idaho; Tom McHale, work family representative for the United Auto Workers-General Motors Commercial Truck Center and board member of Faces and Voices of Recovery; Katie McQueen, M.D., assistant professor at the Baylor College of Medicine and University of Texas Health Science Center in Houston and medical director of the Harris County Hospital District Screening, Brief Intervention, Referral and Treatment Program; and Paul Roman, director of the Center for Research on Behavioral Health and Human Services Delivery's Institute for Behavioral Health Research.

"The work of the policy panel is addressing some of the most critical issues facing state government at a time of many changes in the field of treatment and prevention services," said Gardner. "We are looking forward to Join Together raising these issues and the panel's findings to higher national visibility. The cross-section of national viewpoints assembled for the panel promises to offer an excellent scan of the policy environment in state policymaking in the years ahead."

Editor's note: Please view more information on how to submit written testimony via email (PDF).