Under Section 6-1404, which incidentally in the bill has a typographical error, stating 6-1401, in Subsection (c) (p. 9), the bill states that in case involving a chronic alcoholic in which a medical officer recommends that the Corporation Counsel that a criminal charge be filed against an individual in order to institute civil commitment proceedings under Section 6-1407, a decision not to follow the recommendation of the medical officer "may be made only by the Corporation Counsel and may not be delegated." (p. 10) The Commissioners believe that requiring the Corporation Counsel himself to review every such recommendation made by a medical officer is an undue burden on that official, and they recommend the striking of the sentence beginning in line 23 on page 9 and ending in line 2 on page 10. In subsections (c) and (d) of Section 6-1404 (pp. 9-10), use is made of the term "summons" in connection with a person's being charged with the offense of intoxication. The use of this term imports a further proceeding against the individual to whom it is issued, in the nature of a hearing, rather than a trial. If this be the intent, then police officers would be spending more of their time in connection with the prosecution of cases of intoxication than under the present procedure. If, however, the term "summons" is intended to mean "violation notice," allowing the person to whom it is issued to forfeit collateral rather than to appear in court, there would be less demand on the part of the police officer. The Commissioners recommend, therefore, that the term "violation notice" be substituted for the word "summons" wherever it appears in Section 6-1404: page 9, line 15; page 10, lines 4 and 7; and page 11, line 1. Subsection (d) of Section 6-1404 (p. 10) makes it mandatory that a person "charged with violation of any criminal provision other than Section 25-128 of the D.C. Code and who appears to be intoxicated shall first be brought by the police to a de-toxification center where he shall be admitted as a patient for an immediate medical evaluation of his condition. This language requires apparently intoxicated persons charged with the gravest of crimes, such as homicide, rape, or robbery, to be taken to a detoxification center. The Chief of Police is of the view that this procedure would create serious problems of security in detaining the prisoners. Accordingly, the Commissioners recommend that in this subsection the phrase "shall first be brought" be changed to "may be taken", and that the word "shall" where it appears on page 10, lines 13 and 17, be changed to "may". Mr. FUQUA. This is a valuable point in the bill, that they must be cared for in the center. As this reads now, does it mean that if somebody is apprehended for a homicide charge, hit and run, or something like that, he has to be carried through the center as the bill is now written? Mr. ROBINSON. The Commissioners feel that that language would require in all cases that they will be taken to this center. They feel those charged with serious crimes should be first charged with that and taken to an appropriate facility where there could be better security measures taken over that type of person. They don't object completely to some persons going to the detoxification center but they think this language is mandatory and requires it. They want to give the Chief of Police some discretion as to how to handle individual cases. Subsection (e) of Section 6-1404 provides that the police "shall be available to assist a detoxification center whenever such help (to protect the health and safety of an intoxicated person) shall be required." The Chief of Police suggests that that requirement may be unnecessary. They recommend that the comma, page 11, line 5, be changed to a period and that the balance of the first sentence of subsection (e) be deleted. Subsection (e) of Section 6-1404 (p. 11) limits the disclosure of information available in a detoxification center to medical personnel for purposes of diagnosis, treatment, and court testimony, and then only at the request of the patient. The Chief of Police feels in this instance that the limitation prevents the disclosure of registration and other records of the detoxification center to police personnel for purposes of investigation of criminal offenses and of complaints against police actions. Accordingly the Commissioners recommend that the last sentence of subsection (e) of Section 6-1404, appearing on page 11, lines 10 through 14, be amended to read as follows: "The registration and other records of a detoxification center shall remain confidential, and may be disclosed only to medical personnel for purposes of diagnosis, treatment, and court testimony, to police personnel for purposes of investigation of criminal offenses and of complaints against police actions, and to no one else." With respect to Section 6-1406 (p. 13), the Commissioners believe the requirement contained in subsection (a) that there be a central out-patient treatment office open 24 hours every day to coordinate operations of all out-patient facilities is unnecessary and a duplication of services which would be provided in the mental health centers and detoxification units. They would delete that requirement that such a center remain open 24 hours a day. Subsection (d) of Section 6-1407 (p. 14) provides that a committed person may not apply for a writ of habeas corpus except once during any six months period. The Commissioners feel that any restriction on seeking the writ of habeas corpus might perhaps be unconstitutional and they would recommend deleting that phraseology. The Commissioners question the provisions of Section 6-1411 (p. 19) which prohibit any punishment or penalization of employees of the District of Columbia who are afflicted with alcoholism. While the Commissioners do not believe that any employee of the government of the District of Columbia should be deprived of the beneficial aspects of alcoholism rehabilitation programs, they nevertheless question the advisability of prohibiting by statute the punishment or penalization of District of Columbia employees who may, by reason of alcoholism, fail to perform their duties in the manner required of them. Rather the Commissioners believe that this section should be revised in such a manner as to indicate a Congressional policy on the question of alcoholism among the employees of the District of Columbia, leaving the administration of that policy to the discretion of the Commissioners. Finally, Section 6-1415 (p. 21) requires an advisory committee to be appointed by the Commissioners. As Dr. Grant has testified, the Commissioners also feel that there should be established an alcoholism advisory committee working within the Public Health Advisory Council, and reporting to that Council, which in turn would report to the Department of Public Health Director rather than to the Commissioners. Also, as Dr. Grant has pointed out, the bill does not authorize appropriations to carry it out and, as he has indicated, it is estimated that the bill would require some $15 million in capital outlay and some $3.8 million in annual operations. The Commissioners do believe the principles and the objectives of this bill to be excellent and that it is necessary and essential that some effective program be established to deal with this problem in the District of Columbia, and with the suggestions they have recommended they heartily give their support to the bill and recommend favorable enactment. Mr. DOWDY. Where is this habeas corpus provision in the bill which you mentioned? Mr. ROBINSON. Section 6-1407. It is at the top of page 17. Mr. Dowdy. With regard to filing one writ, the exception that no more than one such writ may be filed within any six month period is all right except I think there should be some provision with regard to new evidence. I don't like the idea of a person filing one writ after another. If there were some newly discovered evidence it would be something else. Anything we wrote in here would have no effect on that. Wouldn't that take care of the problem you were talking about rather than just leaving it open? Did I make myself clear? Mr. ROBINSON. I think so. The Commissioners were really concerned that the language says you may not file a writ of habeas corpus except once in every six-month period. They think it is quite possible that it could be held unconstitutional. As you know, many inmates do now file harbeas corpus writs one right after the other. Mr. DowDY. If some provision were written in here in place of this to make it clear newly discovered evidence would make it possible, coupled with what you are talking about, would it still protect the courts from being over-burdened with applications for writs? I assume they will still have a lot of them filed. Mr. ROBINSON. That is true. I think your suggestion would work just as well. Mr. DOWDY. Questions? Mr. FUQUA. I have no questions. Mr. DowDY. Thank you, Mr. Robinson. Next we have Dr. David Pittman, President, North American Association of Alcoholism Program and Director of the Social Science Institute of St. Louis, Missouri. STATEMENT OF DR. DAVID PITTMAN, PRESIDENT, NORTH AMERI- Dr. PITTMAN. I think the clerk has copies of my statement. Dr. PITTMAN. As president of the North American Association of Alcoholism Programs, it is indeed a privilege to offer testimony in support of Congressman Hagan's bill to provide a model alcoholism care and control program for the District of Columbia. Our organization is deeply gratified by the hearings scheduled by this subcommittee under the able chairmanship of Congressman John Dowdy and by the interest and enthusiasm shown by the members of the District of Columbia Committee. It is appropriate to note that approximately 20 years ago it was the District of Columbia Committee which originated the only other significant legislation to pass the Congress on the specific problem of alcoholism. In traveling throughout the United States in my capacity as president of the North American Association of Alcoholism Programs, Congressman Hagan is closely identified by masses of individuals as having an interest in this problem. His pioneer efforts in legislation for control of this medical-social problem area are sincerely appreciated by all groups, professional and lay-members of Alcoholics Anonymous, local voluntary councils on alcoholism, state and municipal programs for alcoholism care and control and professional disciplines such as medicine, psychiatry, sociology, education, nursing, social work, the ministry, judicial, law enforcement and others. It is my charge from the membership and officers of the North American Association of Alcoholism Programs to bring to you official endorsement as to the principles enunciated in Congressman Hagan's bill. Specifically, I am happy that the modern medical concepts of voluntary treatment rather than the primitive and punitive practices of repeated jailing of chronic alcoholics are to be used under the provisions of this bill. Since 1959 I have been consultant on alcoholism to the St. Louis Police Department, which, as you know from the prior testimony of Colonel Edward L. Dowd, has established the first detoxification unit in North America. Thus far, this unit has treated more than 600 latestage chronic alcoholics, more commonly known as skid-row derelicts. I am pleased to report that the acceptance of voluntary treatment by these individuals has far surpassed the most optimistic expectations of all of us involved in this new alcoholic treatment program. We are now in the ninth month of operation and at this point, more than ninety-seven percent of the patients have completed the entire prescribed treatment regimen. Fewer than three percent have left against medical advice. We feel that these figures are a result of the voluntary nature of the treatment program as well as the concept employed of handling these victims of disease as sick individuals rather than as criminals. Linked to the detoxification unit is the necessity for inpatient and after-care facilities. Extended inpatient care may be needed for alcoholic patients who suffer extensive dietary deficiencies such as malnutrition and liver cirrhosis. The greatest emphasis, however, must be placed on aftercare facilities which, in H.R. 6143, are described as clinics, social centers, vocational rehabilitation services and supportive residential facilities such as hostels and halfway houses. Our experience in St. Louis shows that a significant number of late stage alcoholics can be rehabilitated. Specifically, of those treated, twenty-one percent are totally abstinent from alcohol and fifty-six percent are now gainfully employed. The individuals who show the most marked improvement are those receiving adequate aftercare services. However, St. Louis, like most American cities, is grossly lacking in adequate aftercare facilities of the type called for in Congressman Hagan's bill. The attitude of those responsible for implementing an on-going operation of any alcoholism treatment program is the crucial factor in the success of such a program. In St. Louis, the Metropolitan Police Department saw the wisdom of treating chronic alcoholics as sick instead of criminal individuals, and this attitude has carried from top to bottom throughout its ranks as is indicated in the following. Several former patients are now civilian employees in the Police Department. Patrolmen who are responsible for bringing intoxicated persons to the detoxification unit frequently return to visit the patients and encourage these individuals on the road to recovery. As an aside, having worked closely with the law enforcement personnel in my own state over the last decade, I am much impressed by the humane compassion of police with regard to the problems of alcoholism. This stands in sharp contrast to the rigid attitudes of certain health interest groups who would tend to postpone action through contemplation and numerous surveys. The passage of this legislation will mark a significant breakthrough in the attack on one of this nation's leading medical-social problems. There are a number of other points I wish to discuss. The cost of the detoxification unit in St. Louis is much less than has been estimated here for the District of Columbia, basically because of the use of a private hospital which was going to be abandoned and torn down but a new use was found for it by establishment of a detoxification unit there. I believe Colonel Dowd did testify before you that the cost of the unit was approximately $300,000 yearly to handle 30 patients. Thus far it has handled approximately 600 patients. Mr. Dowdy. How many beds can you expand it to? |