Executive perry moore. I am also the cochair of the City County Task force on opioids that was done across the u. S. We had 20 elected officials at the city and county levels, ten city officials, ten county officials, the mayor of little rock arkansas was the cochair of the city side and i was the cochair on the county side. You will be hearing from one of those Panel Members today. When greg speaks. But our work that was done, was done it seems like ages ago. So much has happened since then we will be talking abed about that. The panel will be today. I want to thank those of you who are here in person as well as those of you that are here virtually. We know this is being broadcast live stream in a special thank you to arc for your partnership. What we do in county government is all about partnership. We partner with each other, we partner with various agencies, especially great partners like aoc. We are thankful for them. This event is the combination of a yearlong partnership to strengthen local response on the Opioid Epidemic across the 13 states of the appalachian region. Arc is a unique federal, state, and local partnership. And we at nacos feel its our privilege to work alongside it. Appellation region is one of the hardest hardest hit regions in the country. County leaders in the region need the help and support of partnerships like the ones that arc has provided. And the resources that are needed to serve our citizens. Today, we are focusing on the Opioid Crisis but we know that the issue reaches beyond that. It goes to Substance Abuse in a broader scale. Many local leaders from all sectors are working together to address Substance Abuse, and we see the impact that Substance Abuse is having on counties across the entire region. Countiesvi deal with these pressing issues every day on the front lines. Think about some of these numbers. County support over 900 hospitals, county owned, county supported hospitals. They oversee sheriffs departments, other local Law Enforcement, emts, firefighters, other first responders. Investing over 100 billion in justice and Public Safety services each year. I want to repeat that. 100billion in Public Safety services each year. Counties provide Child Protective Services and foster care. And they need to deal with increases in caseloads when parents are impacted by Substance Abuse. Counties are also heavily involved in the criminal Justice System. Supporting 91 of all local jails. 91 of all local jails and investing over 20 billion in courts and Legal Services annually. We cannot forget the way that Behavioral Health and Mental Health are aggravating the Substance Abuse crisis and the resources counties are investing style precedents in this area. Unfortunately two, County Corners and medical examiners end up being the ones who need to process the dead bodies and in some cases, like us in kentucky, counties are providing the funding with those indigent burials. Indigent burials is a line item in my county budget. Nacos and arc therefore are focusing on solutions. So many times this workk is done and you ask later what were the outcomes. The outcomes from this work is really focusing on solutions. And im excited to see that. We see the impact of Substance Abuse on counties and the residence and we are focused on making a positive change with this work. We are very proud of what weve been able to accomplish this partnership. Together we have produced a robust guiding document with findings, recommendations, and case studies for appellation county officials. We partnered with the 13 appellation state associations of counties to bring direct resources to the county leaders in the states through ten educational sessions. We also gathered feedback from attendees and fostered. Discussions through the live polling on many of these sessions. This event today brings together all of these efforts. We are proud to showcase what we have learned and to look forward to the future of appellation together. So we have two great Panel Discussions that are going to take place here today. Our first panel will focus on key solutions. Key solutions that county leaders have been implementing across appalachia to address the opioidss misuse i what types of solutions have been working the best. Following that discussion, our second panel will look to the future and focus on how we can help appellation communities move beyond thewi Opioid Epidemic, looking long term, focusing on solutions to re vitalize appalachia. Well have time for questions for all four of the panelists after the second panel finishes. After the questions, and after the panels, were excited to have u. S. Senator Shelley Moore ouppercaseletter join us at the 430 session two comments on the Opioid Epidemic of West Virginia and the key role for leaders to play on this work. So right on cue, im going to introduce a special guest we have with us today. Tim thomas, tim serves as a federal cochair of arc. As federal cochair he works directly with arcs 13 member governors their alternates, and Program Managers with a network of local development districts. Together they helped create Economic Development opportunities and address Opioid Crisis across appalachia. Tim has more than 20 years of experience in the Public Infrastructure workforce, training and regulatory issues. He most recently served with u. S. Senator Mitch Mcconnell staff from 2015 to 2018 where he fostered partnerships with state and local officials, Community Leaders, and constituent groups to support economic and community developmentst initiatives. Tim has a bachelor science degree from Murray State University and a law degree from the university of louisville. Please join me in welcoming the cochair of arc, tim thomas. [applause] will thank you their for that kind introduction and the good work you are doing back in northern kentucky. We have known each other for number of years. And welcome to all of you to this capstone event for year of collaborative efforts for the commission and the National Association of counties. Im very pleased to be here with mr. Morton chase chase who is been a great partner for us. And who runs an Excellent Organization i might add. It speaks for county leaders across the country and it works to broaden understanding of common issues among its members and enhance leadership capacity. This latter part of developing inlocal leadership is an overlap in the mission of our tour torganizations. It is been a pleasure to collaborate with you and nacos as a whole, matt. Thank you so much. I also want to thank any Congressional Staff here at this today. And certainly a thankan you to sanders surely capital from West Virginia who you will hear from later on today at the conclusion of our event. Certainly congress has made significant contributions to our finding and finding solutions. I also want to recognize my colleagues arcs North Carolina alternate mr. Class key over here who represents representative roy cooper on the commission and hell be participating in a panel a bit later. We will have some excellent discussions this afternoon on the state of the Substance Abuse act and the appellation region and the steps that are being taken and can be taken to address it in a comprehensive and most importantly and a localn way. They arc makeover reports, opioids and appalachia, released this past may shows that the death rate resulting from opioid overdoses was 72 higher in appellation counties compared to non appellation counties. Overdose death rates in several states in the region are among the highest in the nation. This is a tragedy on a human level that impacts in one way or another every person living in our communities throughout the region. But another thing i noticed from the moment i took office as the federal cochairman of arc, was the told these grim statistics take not only in lives lost, but also the impact on economic opportunity. Substance abuse robs our workforce of ready healthy workers, deprives our local governments of resources, and generally saps our populations hope. Arc is an Economic Development entity. That is our congressionally mandated mission. But i realized early on in my tenure that we couldnt address the economic challenges faced by many in the appellation region without giving attention to the Substance Abuse challenge. It was the elephant in the room, requiring us to think hard about how we as arc could respond. Unities our partnership with nacos is a part of that. And in the may report, it yielded recommendations. The most essential being local leadership. Every community is different, each with a unique array of resources and assets. Some may have assets that may not be readily apparent is having a bearing on this challenge. We do know that topdown national approaches are not going to fit universally if at all. It is critical and it is the basis for this partnership that local leaders have the tools and facts in hand because they are the ones making the policy decisions and directing the resources that are most impactful on this issue. In many instances, positive results are being realized in communities whereo local officials have taken on a more active role in leading the response, ensuring more of these officials have the tools to of effective leadership ensuring best practices to be implemented on the local level will be critical in helping communities impacted by the Substance Abuse epidemic. Also, we need to recognize that those individuals in our communities struggling need help and realize the negative impact an individuals longterm recovery and community n efforts to address this challenge. While people in recovery can ultimately help their communities too often stigma can serve as a roadblock that hurts us as well as them. In an effort to provide local leaders with the information and best practices they need, nacos has held educational sessions in ten appellation states, based on the report and has submitted articles to statewide leadership publications in other states. Discussing key recommendations for local action and showcasing case studies and effective initiatives. Many communities in thed appellation communities are leading by looking at multiple angles. And we hope with the efforts of this partnership and others appellation communities can continue to be out front and fighting this crisis. One that impacts the nation as a whole. Now unfortunately the Opioid Epidemic phone assured itself and the appellation region. And i believe appellation committees can also lead the way in finding solutions to the problem. At arc we are also taking action and focusing on facilitating the difficult transition from Substance Abuse recovery to the workforce. Last year we held listening sessions in sixix appellation states, conveninger leaders from state and local governments, treat Recovery Services and employers, among others to better understand effective strategies and the pitfalls that can hamstring wellmeaning efforts. We learn from those who have been dealing with this issue on the ground for a number of years now. And then we compiledmo that data, from those sessions and gave a tour Substance AbuseAdvisory Council with the members appointed by the appellation governors and myself. This is an august group including state cabinet members, Law Enforcement, treatment experts, Employment Specialist and the like. The council met several times and worked very hard to produce 14 recommendations for creating communitybased recovery ecosystems designed to help individuals navigate the process from the beginning of treatment, and ultimately to work. Employment in fact supports and sustains recovery. We have been told time and time again. The report has been approved by the commission, released publicly and serves as a basis for arcs implementation efforts for Substance Abuse and Building Local recovery ecosystems. Now there are no easy or Quick Solutions to this epidemic but that does not mean we should not confront its head on, use the tools at our disposal, and combine forces. The partnership we are showing today gives us hard data Improvement Strategies for approaches that the whole societyeg approach better requires folks working a morer at comprehensive way to form innovative partnerships including treatment providers, non profits, universities and comedic colleges, civic groups, and others often y working with people and organizations they do not have a history of working within the past. Local officials are in a key position to convene these entities and develop the myriad of players into a structured approach fitting their community. Now i want to thank everyone for being here today and i look forward to hearing what our expert panelists have to say. More importantly, my hope is that this report will serve as a helpful resource for local leaders like you, as you work to address this challenge in your own communities. And i want to thinke nacos for partnering with arc in this important effort. Thank you very much. Pleasure to be here. [applause] as tim said he really cant talk about Economic Development without talking about workforce and you cant talk workforce without talking about Substance Abuse, addiction, and the things that we are confronted with. Counties are onno the front line and i think were going to have a great discussion today talking about some solutions and some ideas and the results of the work that is taken place. So to facilitate, moderate the first panel i am going to bring up heidi said naughty. Heidi is i said bring up buddies get into it from there. Heidi was we worked very closely together, he was the staff person with nacos that really staff the city county y Opiate Task Force work, and has been involved in this now for a number of years. Im going to turn over to you thank you. Thank you judge moore in cochair thomas for your remarks and your leadership of this project throughout the lastst year. Its my pleasure to introduce my panelists into moderate this first conversation about candy solutionsad and how county leaders throughout appellation stepped up to lead the charge in reversing the tide of the Opioid Epidemic. Before doing that, a couple of quick housekeeping items. Well hold off im q a until after the second panel and take all questions at once. Andco also, we are Live Streaming this event is judge moore mention, soso please make sure to wait for a microphone speaking or asking questions so those following virtually can also hear you all. So with that is my pleasure to introduce two great appellation county leaders who will help lead this first conversation. Commissioner pockets who needs no introduction amongst the nacos audience, but is a native southern West Virginia and he was elected as a Mercer County commissioner in november 2014. Alongside and serving as a county commissioner he also serves as executive director of Community Connections, which is Mercer Countys Family Resource network where he continually reaches across county and state lines to help guide the a prevention and Community Building process. Commissioner pocket has been a key partner with nacos for a lot of our work around addressing opioid misuse and along with judge moore, i think have been a really key champions in this effort over the last several years. His county is featured as a case study in the opioids and appellation report, which nichol published with nacos airch ca in which we have many copies of outside as well as on the nato nar c websites. He is also served on the nacos task force on the Opioid Epidemic. Represent in the great state pennsylvania, we are glad to have commissioner schneider, Clinton County commissioner since january of 2012, commissioner2. Snyder currently serves as president of the county Commissioners Association of pennsylvania earthsea cap and he has five priorities as president. Behavior Health Funding solutions to the ms crisis, county property tax reform, Rural Broadband expansion and adult probation funding. In his or her opening speakers commented, all of these issues are part of the discussion today. And lastly prior to the election commissioner schneider owned and operated the chatham run feed mill for 33 years and was a member of the Keystone Central School board for 20 years. So please join me in welcoming our great panelists. [applause] and with that our first question about panelists is a broad one. Can you speak to how the Opioid Epidemic has affected your county and your state as a whole . Ands why is it important for county leaders in particular to be on the front lines of your efforts . Commissioner pocket. Thank you before we begin i want to think cochair thomas as well, judge moore, matt chase, and i certainly want to thank all of the amazing staff at nacos. With any Good Organization it all comes from the staff and so its a Job Well Done for putting this together. For us its really about everybody working together. And i think as long as you got a Good Community collaboration, you can have Great Solutions but without that its just the opposite. So from our standpoint working together with their local Community Coalition and working together with the resources in our communities on really what sets us apart. We start different programs different objectives, but we try to be as diverseha as possible. Wh one of the things that i think weve been able to do is really focus on understanding where our statistics are, not being so good, but alsot trying to come at it from the other side and saying okay we are understand where we are, we understand how bad the situation is. But yet weve started Quick Response team that go in and addresses overdoses individually. Weve also gonevi back into her schoolbased systems and worked with our prevention based programs to work with our Law Enforcement to startam lead and we really try to focus on getting into those hardtoreach areas of our Rural Communities and do as much education as possible. Even getting out into our local Convenience Stores or try to capture as many in this peoples possible. So again i think its all about partnerships and i think partnerships exude from everywhere from the local level, state level and certainly at the national level. Thank you all for being here today. Clinton county pennsylvania, most people ask they were clean county is. We are between Center County which is penn state which most bulb recognized, and coming county which Little League most people recognize. We are right in the middle of population of about 40000 people pretty rural, we have one precinct for 12 people live. So to get Voting Machines there and get them to vote sometimes is a little bit difficult. The Opioid Crisis has hit hard in our community, just like it has everyone elses community. We got on the ball real quick. Part of the problems with the rural county is funding. So i want to thank our governor, tom wolfe, he took this Opioid Epidemic very seriously. He got together o and put out 110 million worth of grant money. So, its helping filter down. We have a local group called the ill come back to that. I am not an expert, i will tell you. We have a local drug and alcohol a commission, west branch, thank you rest branch drug and alcohol commission. They are so vital. Unfortunately, most of the people that we deal with that have problems with Substance Abuse and up in our local prison. But you know thats not always a bad thing, because 60 to 70 of the 567 individuals that went to the system last year, also had Mental Health illness issues. So while they were interfacility, not only did we get a chance to help them with the opioid issues, the Substance Abuse issues, and unfortunately is not always the opioids. We have a big problem in our county with alcohol. And unfortunately, were now seeing a swing away from the opioids to meth. Bath salts. In some things i cant even pronounce. Weve got to look at the whole picture, and weve got to Work Together with the teams that we have. We are very fortunate. Our courts, our president judge, has under his umbrella the probation department. We work with our probation department, wedges to branch drug and alcohol commission, children and youth, you know one of the things of legislation that the governor wolfe pass that i thought was a saddest of all is for grandparents to have the ability to raise their grandchildren because the parents were incarcerated Substance Abuse. But we have put some really good teams together of all the entities, and thats why county government is so important. It brings the teams together to get treatment for these individuals whether its opioids, alcoholism, bath salts, and i spent a lot of time as an advocate with the children and youth. They are our most important. Weve got to educate, and were doing that in our elementary schools. Weve got to educate and work harder on prevention. And then maybe we wont have so much trouble with the cure. Thank you commissioner schneider and thats actually a perfect segue to the next question for commissioner pocket. Broadly speaking, we have broken down the roles for county leaders to prevention and education treatment and recovery. And Economic Development and employment. Can you speak to that first piece r prevention education and specifically how youve worked with youth in Mercer County to advance efforts . Sure, first of all i think one of the things that we have discovered is a county elected officials is that we not only have an, opportunity to lead we have an obligation to read. And in doing so we have to put all the different sectors together and part of the prevention strategy is workingt with our coalition. We have 12 different sectors to work on certain strategies to make sure they work on the individual but the environment for that individual. I think thats more we can do is a county commissioner is focus on that environmental strategy. We know if we do a lot of education upfront, we do that health fairs, we can get out and do curriculum in the schools, thats fine, the fact that its the environment that dictates their personality. We know that without that good positive environment, were not going to be able to change society. We may be able to change this individual but not the entire community. So we focus a lot of different ways. We focus not only on the programming for what other policies we need within our community. We look at the data. We decide what are the alcohol policies where we reaching out to young people and get them to effective opportunities not just for them but their families. If you have a society of addiction, how do you change that addiction so that everybody benefits . Again Economic Development everything goes along the same way. One of our congressional members evango jenkins our former congressman once said you can change a lot of social ills byal good job and thats very true. A good job can change a lot, but unfortunately we have to provide the environment where those jobs can effectively come in. Especially the Rural Communities. Steve got to be able to do both simultaneously not one before the other at the same time. One of the things were doing and prevention is where really looking at thatab community in doing this assessments and saying okay are we having that access to treatment . Are we having it accessed anything . Is it Grocery Stores . Where are we going so young people can have a goodquality source of life. And its those types of issues that we are working on that are extremely important. I also think part of that prevention site is really focusing on if you people an active addition how do you get them to treatment and the help they need . Within the state of West Virginia in thehe last three years weve had a Great Program called help and hope. Thats a website you go the resources throughout the entire state, not just my community. We also have a website called sigmare free wv and is cochair thomas alluded do we have to destigmatize issues around addiction. Which is again we dont have a drug problem we have an addiction problem. So we have to focus on addiction as a whole and if we can do that collectively as a community we are can have way to solve the problems. So we have to find ways to help them get past that. They are out there wondering where they start so with the businesses in our communities that will hire these individuals if its a housing problem we do it to the Housing Authorityty to find affordable rent for them in one of the things we work very hard in ourha county we do not have Public Transportation and tell over a year ago. That has helped usa tremendously but if the person who needs the treatment doesnt have the support of the family there is a program the commission started called be a loving here it is webbased curriculum designed to bring families hope and to help them regain their peace and calm despite is what is going on around them. And to contribute to be the best chance at recovery when a familyly gets well and sees the loved ones have a better chance to stay well. One of the comprehensive program are principles with facetoface family recovery certified coaches to facilitate the course it has been held in both counties and has been very successful. Same question. Jobs are so critical to this conversation. As with any community it is a challenge one of the things we try to do is to reach out to the Housing Authority not only have adequate housing but how they are associated. With the Housing Authoritys we have to educate them as much as possible so to look at policies to make sure whatever we can do for this protection we do that the best. It comes into understanding how raw you can get the economy like ours which unfortunately in West Virginia we dont have a lot of zoning and unfortunately a lot of times thats not seen as something our Community Wants although we understand it something we desperately need so as we look at that coalition we need to look at whatever we can do not only perfect our communities zoning is a perfect example if you have a trailer park next to a milliondollar housing edevelopment with major metropolitan areas its difficult to protect them. Has to be a protection standpoint not the punitive standpoint over the next two years thats what im working o on. So that comes with the introductory remarks in the report that we publish speaking about t county officials in ways that for the recovery for those in the community. Can you all speak to your position as elected commissioners to chip away at that stigma . We have three courts, we have a treatment court, v. A. Treatment court and the most recent is a Behavioral Court that deals mostly with mental illness. These courts are structured so these individuals have structure and they need structure. At and the judge in the beginning was not an advocate for the first court that we formed with the treatment court. He was one of the judges, and he will tell you this that heh m thought there was not a lot of hope. But you ought to hear him talk today. I am smiling because i really like what the judge has done for this program. He works them through, they have wristbands of different colors that they work through and the thing that he says to them every time they show up in court, they have to tell what they have been doing and they cannot lie. No matter what, even if they went backwards, they cannot lie. Because if someone does not have self value what do they have . He makes them feel like they should what he does through the treatment courts and the has beenate phenomenal we are turning these individuals back into productive citizens and im very proud of what Clinton County is doing through the treatment courts. I agree when you talk about stigma going back to my earlier comment treated as a brain disease so as long as we can understand that we have a hgreater opportunity to overcome those stigma one of the programs thats very unique is camp mariposa put out by the foundation only 13 nationwide children ages nine through 12 to understand and dealing with addiction it doesnt necessarily have to be them could be a family friend , but allows the young people to come forward to understand is not their problem. Its a cultural problem they in. Living that is working very well for us and we constantly try to perpetuate that to move forward also there was a program called keith mercer clean if they feel a certain way and will act a certain way so on a volunteer basis march 3h they can come out and clean up their community and take ownership. The only way the community will changes through ownership so by having them volunteer cleanup their own properties that is what will make a community change. Looking to the future of appalachian on appellation Community Leaders would you prepare them for future growth and development . It never stops moving. We are not just dealing with a crisis now. These drugs are everchanging. So the best thing we canan do to keep in mind with the partnerships to never give up i dont know what else to say about that because it is everchanging and we have to be flexible and then to stay ahead and those that are a lot smarter than me and tell them that everyday. And to help these individuals get back on the path but i am absolutely committed, still recovering from that but 20 years on the schoole board. It is an education. Thats where it lies is in education the sooner we get into those schools with a new superintendent we are working with she is absolutely fantastic to get that at earliest stage as we can that is where it is. I truly believe that. I concur over the last two administrations we have seen a dramatic shift this problem did not spark ten years ago but 24 yearsif ago when it first came into West Virginia we didnt know how to deal with the problem. Thankfully confronting resources we have really started to see a shift to work on the policy to help protect our communities. There are four basic things. Work on prevention, Early Education as well as policy development. Second, adequate treatment we cannot get people who in active addiction now into treatment we cannot solve the problems. If you do treatment that they will relapse in the same desired result. But research to focus on thein data within a particular community. Know where the overdoses are handling. And start putting resources to communities. Law enforcement should be your veoverdoses. And the last thing is hope. If you cannot provide hope to your community do not need to be elected official that is your number one goal of resources to make sure your Community Knows that you care, youre out there working as hard as you can to solve the problem. One thing i remember being discussed and to avoid an epidemicic and it could hit any community at any time. Outside of appalachia who have that epidemic of Substance Use and addiction as they look forward . Look at not only what you have now but what is coming. Especially appellation next its hiv epidemic and all the other problems with hepatitis c in the Public Health crisis we have following the opioid wiisis in my state alone we have 28 communities to 20 identified by the cdc at risk for hiv outbreak one of those is mine. We are not testing enough to not getting out there ahead of this so to the administration and those in between focus on what is coming and not what is. Were dealing with opioids we are shifting to math and heroin and the Public Health crisis so deal with it and know what is coming. Looking at the benefit is the fact all the different communities that are working together to combat this issue. And how i feel i dont think it is the end all it give someone a Second Chance but we have to move past that. But what has happened is all the agencies, police , schools, or county village have come together to be prepared for an event if it happens there. So they are training and communicating and collaborating. The words thatle i used when i was running for reelection. But thats what its all about. People in your Community Working together. If that is any benefit to the Opioid Crisis people come together. One more thing i want to tell you because people in recovery need support and i really want to mention this certified recovery specialists. They are individuals and longterm recovery of Substance Abuse trained to provide i support and i know the commissioner talked about that , you really need to support thoserm individuals. To get behind each other and support each other to go a long way. And then to Work Together so on a broad base level reaching out to all emsit personnel in any way shape or form it doesnt matter if you are trained or not you deal withh addiction you need ems. One Major Community said absolutely not he will not have in our cars we will not deal with it. After about one year of really talking about the issues and from the standpoint this could help an officer or your drug dog are all these other people. Just have it in the car. One month later all of a sudden i got a text from the city manager who said it just saved one of our officers. He pulled somebody over with exposure and went into cardiac nearrest at that moment it saved his life prick i got a call from the city chief. Sorry we did not listen sooner. You have to be more diligent and open. If there is a solution and be open to understanding it. I make myself available to the community i want to get to a christmas right dont get a phone call from a grandparent. Thats what i want to go. I think as commissioners is not just me right now i thank you have got to care to be in the communities you cannot be disconnect onow dash disconnected but youct have to care you have to get dirty and solve the problem. Their resources there the federal government put a lot of money out there. They are providing resources and education to understand where you can get it. Find those resources and make it available in your community. Thank you for your passion and to exhibit why we work with officials please give me a round of applause for the commissioners. [applause]e before we moved to our next panel this is a culmination of our partnership we encourage you all to read it also to all county leaders you can always reach out to us with any questions Research Related or not. And resources are available to you. We will wait to take questions until after the second daniels mom panel so now we handed over to our close partner over the last year. And that q aec time lets give him and the panel are round of applause. [applause] i had not planned on giving any opening remarks of the last the panel to come to the stage and we will jump right in. Thank you everybody for the introduction also thank you again for coming out today chief of staff to the federal cochair at the fl nation regional cochair i have been fortunatee enough to work on some of these issues in the past and to see the impact it really is rewarding to have this important conversation. Thank you all again for being here today. So to talk beyond opioids and fortifying communities to sustain future growth to look to the future and the commissioners did a really good job to lead off on thatin conversation but the things we need to think about and then to address this issue and the that work very closely with local communities to ensure the challenges and the Substance Abuse and is a significant challenge. Serving as director North Carolina office in this role to work and collaborate on behalf of the state of North Carolina and also serves as governor coopers representative on the commission as well and then directly we have david connor who serves as executive director with the services association. Thank you for joining us again. We will jump right into it. So talk about your role in your respective states and the root causes of the epidemic that local leadership think about moving forward . Thanks to nato and to the arc team to bring us together for the work this report represents. I am a child of the appellation mountains on both sides of my family going back to the days before North Carolina i have come to know how to deep the roots run ive also been honored to serve and im thess longestserving alternate through the arc did san entity near and dear to my heart we call ourselves the arc family we it means we know each other well and like each other anyway. Taking this issue on but so far it is showing promise because we are not there yet and thats the spirit of this event i appreciate this is a capstone but we are in the middle of thene crisis because they all want to give us hope we appreciate our leaders comments here today. My dad is retired in the Methodist Church if you dont like them just wait you get a different one but one of the churches that daddy served in high school and North Carolina and this was 40 years ago, we are a little deeper into this crisis manufacturing was strong and textiles to a degree certainly agriculture Northwestern Bank we had some strong employers that gave people the way to go to get married and then get a job and inth that order or close to it and there were issues than in a said this with these listening sessions this listening tour i that we put together. So and i have been back since for other reasons talking about what was different 40 years ago he was really talking the Economic Development realm jobs are kstrong folks had a place to go but its always been a moonshine county kids were eating quaaludes and there was that was serious so when we talk about root causes talk about significant foundation support around the. Rdiseases that these chemicals are different and you know better than me. Im not an expert, that they change your brain and how you process and then you dont get the drugs again. Is not to get out of work but to keep your life functional. That is wicked problem. It was described as a wicked problem and all the ways it changes people approach their lives so the root causes close is not headquartered there anymore it was Employee Owned one of the early Stock Ownership but now they are not there anymore. The furniture is gone. Its a very different place to make a living and have stuff to do in good folks are working hard on that. But that is all over the region we are talking about. So jobs with a sense of purpose and connectivity are cruciall and in the absence of those so the governor was on the president s commission on opioids that did its work in 2017 and early 2018. We heard powerful testimony from a range of different perspectives in that process. But the medical communities combined with the biochemistry of opiates and opioids, i know our friends and colleagues are upstairs asking what the third branch has to say about this but the fact that companies were marketing the way they were aware is just completely out of whack. And here we are. But we are behind we are trying to catch up i was on the phone earlier today and the root causes are that complex of issues and it has always been with meaning and purpose and the chemistry is a deep cause. So lets all just take a moment for faces and friends that struggle with pain and loss with this right now. Remember the heroes who get up and try to stay clean every day right now. My dear friend of mine lost a brother on christmas day. We are in the middle of it and i dont pretend to have answers but i appreciate you are all here and we are all here together to make a difference. I apologize for taking so long. Working for the state association of county officials i get the privilege for thosese who have the passion for those communitiess they are trying to turn their Community Around to get jobs and keep kids off of. Drugs and in some ways i get to sit back and look at the 30000foot view. So many officials have their down so as this crisis begins hitting everywhere they did not realize the nationaltr affect. So we tried to do with our associationst and programs to raise awareness. You are not the only place but so many comments. But a couple of things that both commissioners spoke about earlieras is its not an opioid problem because we are the same way in our communities because we had math task force now its a Dangerous Drug Task force. To deal with things like fentanyl and to mention these chemicals that could kill a 200pound man it so much easier to overdose. But the counties are dealing with addiction one way or another. Ed the first is a bad one the second is good but and i talked to the rule county mayors and having a general discussion and then at some point of whats happening in your county what are the Biggest Challenges are what are the problems you are facing . And he said the biggest problem is the people who live here. And my first thought that you got elected . [laughter] he did not get elected the next cycle but he said we have employers here we try to expand to movein industry and they tell me all they want is someone to do eighthgrade math and show up on time and pass a drug test. They could not do too out of those three and he was frustrated. Whats goingme on . Ifid you look at Mental Health issues, as far as depression and all of that we see higher levels of suicide and addiction. Its not a true opportunity but there is a perception. To do a lot of work on the economic recovery some places it took off in other places were stuck in the depth of the economy more than 25 percent that got hammered and it took them forever to come back from that. But there are opportunities they saw themselves falling behind on the Information Age and the dialogue so how do we go there quex we have to have different strategies but more positive county official local politics is easy that they want to raise a kid in a safe environmentt and they want their kids to stay there and raise their kids. That has strengths and weaknesses but in some ways your parents of kids have a lot of accountability and they are scared of education. And then to get a good job because they think they cannot get it here. Is a place where the rule communities the strength is the weakness at the same time. That could be a wonderful strength but there is also the fear we dont want to lose our kids. But i think there are opportunities to take those different strategies. So something is happening theres been everything that you mentioned earlier and they change. We have to figure out why people feel they dont have other solutions and turn to something. I think one of the Silver Linings of the Opioid Crisis is that it didnt discriminate. Not a drug problem in that community. This is not an addiction proble problem. This farmer fell off his tractor and has prescription pain now cannot get off or the former College Athlete and then they start on things they trusted the doctors and the pharmacists to say this will help you then the next thing you know they areto addicted. It head across racial lines and socioeconomic lines. And toud change peoples attitudes toward addiction and to say they want to claim they are an addict now most Everybody Knows somebody so it causes us to develop new compassion we did noted have before or the understanding slowly chipping away at that stigma thats a crucial part. T thank you for that. Director, arc is primarily an Economic Development agency. So from your perspective how has this impacted efforts at the local level and also what do local leaders think about to have economic the resilient communities in the context of this crisis . These are really important questions for the reason you just stated insidious and onpersistent and hard to come back from and availability changes but has fentanyl in it you could be dead. That is frightening. I dont have a nice neat answer but one thing that is happening is a shift in attitude the disease of addiction the polysubstance that the secretary of hhs next week on this question what you using the federal money on and what works . And that question is what were all struggling with. If part of thehe answer is meaningful jobs and we are in a region designated a region of special attention by the federal government, because of the need of meaningful jobs , and this is layered on top of it, that is the central question and to his credit he has challenge the commission and has successfully gone to thet congress the congress and the recent move shows the Commission Getting much more space andthe opioid we have decisions to make what that will mean and how that may work watch this space because shortly as a commission we will pick up proposals around making funding available for Creative Ideas from the field around and ecosystem. I highly encourage you to go to the website for what was accepted in the task force from the september meeting of the recommendations of a variety of experts because it is how we help folks to stay employed while in a Recovery Scenario thats a lifetime scenario. So parts of what it means, the North Carolina opioid sanction it is to your review and contemplation includes recommendations on what local officials are doing and employment support is part of that. So things that cost a lot of money and arc doesnt have a lot of money in transportation support a drivers license is a so when i was in high school did you get him . You can lose them also a lot ofm folks who are in recovery may not have their drivers license. But they have to get toy, work and home and to the daycare and the school. That is an interesting conundrum we will see ideas coming our way for that supportive transportation look like and be held in partnership to what degree . What about housing . That doesnt put those back andth helps them stay intentionally . Those are workforce issues and thats where we should be spending time and attention. But we are going to figure it out with you. We need ideas from the field. We fund public and nonprofit we love it when its together so watch this space. Did i go too far . You have anything you would like to add on . I do think its something that is critical doing a Little Research looking into insues one thing i will take a moment to say is to that i dont have an addiction problem that i have Mental Health issues. I take medication and i also see a counselor. But i have Good Health Insurance its easier for me to get to places if i have to go to a counseling appointment over lunch that was simple. If you live in a rural area lost the job maybe lost her licens license, you are stuck having to ask somebody for assistance. But you have to find someone to drive 90 minutes to another town. That is the ecosystem for can we definitely know we dont have broadband that were missing the Mental Health infrastructure. They estimate more than 90 percent of psychiatrist and psychologist licensed to practice with the social work its over 80 percent. They are not out thereat and we try to encourage teachers or get a chemistry your french teacher out there. As Mental Health practitioners they dont have it. But that is why that addiction has worse outcome in the communities they cannot get the resources they need telemedicine could play a role looking at those strategies a lot of times they say its best if you can integrate into a normal type of family practice. Because i can take off for lunch and drive to my Counselors Office not running into anybody that i know but if i go see my therapist in a Rural Community they will know whats going on. And the stigma around the breakthrough that is part of the culture and with the Community Support ive got friends that are in their sixties they are both recovering alcoholics and then they had some Health Issues and a number of Different Things kicked in after 15 years of sobriety he had as relapse and then had to go through residential treatment and said it is a longhaul issue not just we have to get them out there and they will be fine but recognize these problems they were burdened with thate have hit and change the way their brains work they have to struggle with that the rest of their lives. The thought that brings bac back, what we all here somebody to show up on time and pass a drug test. What about employers who are willing to hire people that are not . To these to use drugs . Thats how he is to think about this we had a panelist that is a big enough county but going to the prom with his cousin he is a businessman in town and operate the restaurant creamery and is in recovery. And a point to hire those who try to make it. Not everybody can do that we have been those other locations to see interesting hightech operations with a very different attitude on Substance Abuse. None of this is mandatory its coalition for the willing and for those who are in business to do business but i do believe this evolution of attitudee attitude, these are just good folks who need to be able to be good folks for all of our sake. Does that mean to provide the ecosystem that can support that is the challenge of our time in this space. I could spend the entire time that we will move on really quick so in addition with the Economic Impact and ysissues often there are two issues of significant concern for local leaders how does it strengthen appellation communities to address the root causes of Substance Abuse . We hear that linkage. We started earlier with Mental Health and to say the jails and correctional facilities are the largest in the country and to have an interesting story how a couple years ago at the International Airport a man in his forties walks in what do you do . You call the cops they arrest him and figure out something to charge him with he goes to county jail they hold him there they do a drug screen no alcohol or drugs in his system. Typically dont think a 40 yearold man will walk into the airport unless he is met at on mentallyt ill that the responses are thats messed up call the cops even in the urbanized area the Rural Community is even harder we have a lot of efforts to do crisis intervention training to help sort out recovery and addiction is it Something Else . But when youfo talk to Law Enforcement in rural communitie communities, the frustration is thats great you could help meee identify but now what do i do with that . Thats what we have to have a good integrated communication with Service Communities that may not be crossing lines the counselors and Law Enforcement thats partnership we really need to forge. Because if they already start off with that, maybe they have committed criminal behavior is a result putting them in jail would make it worse in some cases they may be dangerous maybe we are creating a worse problem by locking them up this isnt a choice i have to be making but not only is it growing and its overcrowded vet people show up at the front door they are in much worse shape they are so strong out there high they dont know whats going on. A lot of them are women and we need to be more equipped to dealal with that in our facilities. If you plan a jail you didnt plan on having an entire wing sor women but that is the Fastest Growing population of thee jail. To reconfigurees the structure to make sure they keep on the gender safe and secure but with female prisoners comes the fact they were a caregiver for children that comes your issue those that are raising the Second Generation because mom is in prison or jail. Those changes have been a huge burden on the criminal Justice System tennessee has been bad about incarcerating women with simple possession types of offenses because it has shown many time if they are caught up in criminal behavior probably has been a victim in the past maybe theyre getting high to get over the fact of who knows whatever else and then we lock them up and take them away from the children so unintentionally we create generational patterns that are difficult. Shifting in the pretrial and there is a lot of good work being done with Adverse Childhood Experiences and Law Enforcement is starting to understand. This is a good indication of thats not even going to work. So many different places on the criminal justice side they try to figure out how to work with those populations but it is a tremendous challenge that takes a big coordinated effort from a lot of different players. Some years ago before i joined the city i worked here as a local Government Advocate i worked for counties and cities trying to fix he got his dry cleaver guys that i have mayor smith coming to next week. He said bring them it gives people a chance to talk. That was brilliance. I really appreciate more and more over time the power of the elected official or leadership body is the power to convene to bring people together and talk about things. It plays out in so many ways that these listening sessions we have groups from hours away in North Carolina. But there were minutes apart who know each other and. So youre not just talking about running for reelection. Nothing happensr if they dont. Its easy for me to say and i deeply respect and admire and thank you for taking on public leadership and to stick with it. But bringing people together we had a listing session in madison county. And we decided to have the opioid conversation by and large they did know each other but they had a strong perspective from the courts. They dont have a drug court per se but the da office the sheriff s was terrific that he needs places to take places besides the jail. Because once they are there it probably wont go so well when they need the other alternatives. The Health Director is a pistol. But they have to get together regularly and dealing with pieces on the ongoing basis and with this complex of issues bring. Have you seen any best practice approaches in tennessee when it comes to the Justice System . Yes. We are hearing a lot of h. Stories. That is really rewarding to see that communities and then to start Reentry Programs we have been doing that for a while its the Law Enforcement and sheriff from the Grundy County and southeast tennessee one of the most rural you could get so so many other counties said they are embarrassed. With the resources they got. But we we have some counties that are specialized for those on women and to be successful one of the most encouraging things to me is counties have heard quite a lot fromlo people on Reentry Programs to say we have yet to go into a community where there was not a billet on a business willing to be a ready partner. May be the Recovery Community or they believe in Second Chances a redemption. But you were railing out and then you ask who has the Reentry Program . So that comes back to the fact they are trying to find people who are out that can pass a drug test and show upan to work. Im pretty sure they havent then on anything the last nine months i will take a chance on them. To make and to get folks attention it has been striking to me on the Power Initiative that partnerships for opportunity and revitalization about diversification but especially this last year and thenhe return to work is striking so the continuing relationship that and the little bit of money we can put in places to afford local leaders and spark plugs to make a difference so that is my message when it comes back to where we started. And we appreciate being with you today. Everybodys already passed off how much we spend on the jail if you say we will invest money to get more treatment for those people you are mad ot its tough and sometimes it takes keeping the faith then we start seeing the stories of those graduations and programs and they turn their lives around with the joy with those graduationss its the right thing to do but the hard thing to do we have been trying to work on gathering data to make it easy if your county wants to take that step youre not crazy heres how much it has reduce the recidivism rate and how we can get them and save up some money with the return to work program. It definitelyy takes courage as you mentioned convening to have those advocates and Faithbased Community to advocate to be the right thing for our community to do. This wasnt planned but so do you have suggestions or recommendations and when it comes to getting people in recovery overcoming this crisis back into the workforce. When you discuss this earlier we found out it is very underutilized but there is a felon bonding program. And then to cover any potential liability. With those recently convicted felons but there is a class for felons so i do think we need to be aware of things like that and help promote programs like that where you may have been reluctant but there are some programs out there and what we need to expand maybe not to convictions that can you get a tax credit for hiring someone in recovery . That is interesting. Just a couple of things i will mention these are earlystage in a few counties we hope to grow to other places as resources are available i think housing and Supportive Services to give an employer some sense there are other folks in this who will help an individual stick with it. And a couple of things i thought were interesting and then to provide housing thats interesting but we need Supportive Housing so it is a little bit about the training of Law Enforcement or judges as the offender per se to access resource. At hospitals and the program and that you have a better acronym but looking at the same people cycling to the criminal Justice System also in Emergency Rooms of hospitals so where there are hospitals across this country that if we can get them out of the emergency room maybe they wont keep coming back but they are trying to do a unique partnership with Blue Cross Blue Shield and the local hospitals and that is cycling through both systems with Wraparound Services and we can deliver that a heck of a lot cheaper than to treat and the Emergency Rooms are the jail cell. We talked about that earlier today about prevention and yes that is more effective money to spend overtime but its a trade off in real time when youre most experienced on dash but its life or death. Thats why you get paid the big bucks to make hard decisions. I will pose one more question to both of you. Looking forward to the future what would you consider for appellation leaders to fortify their communities to prepare for future growth and development . And the states cochair and thats because i was there so the theme was appellation strong. So what does that mean i think people are strong method i would say to anybody. And we have been through worse we can get through this to and to make something in this part of the country. And and to have incredible resources and Rural Counties trying to develop tourism and manufacturing we have to get employers and not have to hundred 50 people. You are 6 miles from the nearest interstate you dont have rail or barge so you dont make the cut off for those jobs so what do you have it doesnt have the broadband piece. And those in the Rural Community whether software or data entry employers can pay them much less than silicon valley. Instead of just trying to do solution so embrace you have a Strong Community traffic or noise you are five minutes away. Lots of people want to live there. Look at your strengths. We want to thank you for your contributions in your local communities in this and various other issues. We really appreciate your timeco today is a mask and eating the commissioner to come up on stage we will do q a later. I have to give a shout out to senatordo muppercaseletter from North Carolina but i love West Virginia thank you for your support and leadership for the appellation commission we appreciate you. [applause] thank you for the Great Questions so it is my great honor to introduce a senator from West Virginia i have known her longer than she was a member of the senate. But every single time i went to dc although i was not a constituent meeting me for all the different people to work with and to do a phenomenal job and there is a greater bipartisan support then luppercaseletter please give a round of applause. [applause] its great to be here today. Excuse my voice. Who else has had it . We had 11 people for dinner and eight of us got it. We are not sure. We think grand is zero was material grandson. Welcome. Its good to be here he was the head of the arc to West Virginia where we did a swing on Economic Development issues that go handinhand with opioid addiction and health in general h. Thank you for your dedication. So we appreciate great attentionn for every single county as part of the arc. And what you do and they association of counties and my experience in westu virginia has been the best solutions for this problem are from the ground up. And from Mitch Mcconnells office and has been a great advocate from ohio to hit legislation going with 21st century cures. And also a bipartisan issue cutting across every single part of our stay in a tragic way. But i contend as a West Virginian that the solutions that are coming from our state that has deeply affected now have found their way into the support act of the Crisis Support team that originated where i live it there is a program called handle with care where the local police if the child has an intervention in their home if there is a Drug Overdose or somebody ishu a arrested for something tragic happens overnight and johnny has to go back to school and is behind is hungry and starts acting out which he would do if you were johnny that before he gets to the school the city place of called the principal to say hes had a rough night handle him with care. It doesnt cost anything but it can help but these are the solutions we seeha coming from our different counties. Leading Community Connections onprogram earlier also camp mariposa is located in Mercer County again working with children as an unfortunate byproduct of that addiction that we see. Also working with the Cultural Development corporation working with arc and others that are Economic Development for on the job training and treatment programs in the area to get people back to work you can treat people and they can be in recovery but if you cant get a job the likelihood of falling right back into it is clearing and in a lot of places its too much to cope and people repeat and repeat the senate and the house has done a lot in this area we did just pass a program this year or last year to help combat the Opioid Epidemic with dedicated funding to go towards that as well is not just the report but also the coordination and partnerships developing think of the whole breath and depth of the issue like the Drug Court Graduation it does work for some people it works well for some people. Our Health Systems are overrun but those that come into the emergency room zoar ems with the same people and then you have to talk about your Mental Health worker. We have varieties of those in job training when you advertise for foster parents that is a problem we are having we have 7000 more children in foster care. As a result of opioid addiction. Grandparents raising and sometimes great grandparents raising children i cant imagine trying to raise a new generation when most of our grandparents have planned for retirement or to have a high school child in their home everything that has been impacted but a lot of the programs we are looking at but the solutions to be expensive and expansive but also look i know arct does this its a big part of what the solution has got toso be if its not working get rid of it. Dont keep funding it or trying it or think it will be improved start on a solution from another community where youve got solutions that are working to see this tried and true and other areas. One of the other things i did impacting West Virginia more on the funding issue i found out the formula funding they said 7 million. Here is my guru i should introduce her. But when i found out sounds like a lot but its a drop in the bucket when you go through the healthcare Treatment Centers and transition and foster care. Because it was pushed by population smaller states like mine and New Hampshire the house one of the largest problems per capita we are number one the smaller states where it is ground zero we were losing out on the funding issue i thought was effective so to carve out the money to say ifif you have a highly effective state that is 15 percent that we carved out its about 15 more Million Dollars to myy state i asked rob portman do you have this problem in ohio . He said no its not as intense everywhere in our state but its not the whole population so he can work around it in North Carolina is the same with the population so the smaller states this is fair because if we dont solve the problem in appalachia and learn what works and what doesnt it will be coming to your state and you wont have the solution. Thats why its important to drive the funding where its needed the most. So statistics are improving but they are still high and scary. Funding comes from arc and hhs Law Enforcement, doj there is a lot of different funding drugfree communities, we decided because of that funding stream we need to make more flexibility is probably different than ohio so the Health System drives the funding to medication and the assisted treatment but it doesnt help the meth addict program not professional and it doesnt stop at overdose. And to thank you for everything you are doing. My kids went to school and high school in West Virginia my youngest child is our daughter and i was speaking in front of her and any conversation she tells me i always exaggerate. So i was trying to be very careful with her when i said my daughter is here and in her High School Class she can name at least ten people of 212 that has lost her life or has a sibling that has lost their life. That i went back and said is that right . She said its probably closer to 20. Thats 10 percent now they all didnt lose their life that somebody that they know that has been deeply affected. And is tragedy after tragedy its a big snowstorm here in dc which is a joke for us in appalachia but thank you for allowing me to be a part and for what arc does every day to help all of us to be a better place to live. Also when i ask what do you hear . He says Economic Development that comes with the arc has to go handinhand with the recoveryemi issue. If you dont have a job or see opportunity or not hopeful that you can do something with youran life after you have gone through all this, then again your propensity to fall back or remain hopeless is so much greater. That is where arc can help. Thank you all very much. Good luck with your snowstorm. [applause] why an exciting time to spend together unfortunately will have to forgo q a but i want to close at this time to say every time we get together i learned something. The work that has been done through the collaborative effort is remarkable. Thank you for all of the time and energy in getting us to this point today so back home as a recovery ecosystem that sums up what we heard. When the county officials and others spoke to convene others and it is a key to what we are talking about here. The passion just the heart that they have and across the country we know when youre elected by the people of your community whatever the issues may be so senator we may be cousins but thank you so much for your leadership for all of congress and the bipartisan way they have worked it is an issue that touches all aspects of our community and it is bipartisan. Arc, thank you for being with us today and for your work and a. Investment and your partnership and for the governors to thank them as well for your partnership. Focusing on solutions that key to what we are talking about and a key component. All of you for everything you do each and every day and bringing us together thank you and i wish you well and be safe in your winter weather. [laughter] [applause] we have a vote once the impeachment trial has begun to pass a resolution, is essentially the same, very similar to the 100 zero vote in the clinton trial. Stomach and the rules house manager and presents lawyers each had 24 hours to present their cases. Senators could ask questions for up to 15 hours before debating and voting whether to dismiss the case altogether or call witnesses. Once all the evidence was presented the senator celebrity behind closed doors leading to a final vote on each article. Chuck schumer responded. We have very different visions of what it means to conduct a fair trial. All the relevant facts come out and documents are part of that trial. Who ever heard of a trial with no witnesses or documents . Its unprecedented but if you are afraid of the facts or what would come out come if you want to cover it up and as serious as impeachment then you say no witnesses or documents