Miller's proposal (Click here
for a copy of Attorney General Miller's Proposal) calls for $29 million
of new spending on drug treatment and prevention. He also called for $15
million in increased spending for anti-tobacco programs.
Miller said the overwhelming linkage between drugs and crime is what
makes the program so important. "The number one thing we can do to fight
crime is fight drugs, and the number one thing we can do to fight drugs
is to do a better job with drug treatment. This is a crucial public safety
measure," he said.
"Drug treatment reduces crime more than any other single thing we can
do," he said. "It's proven to succeed and pay off." Miller cited a federal
study showing that various criminal activity declined sharply among those
who completed treatment: selling drugs dropped 78%, shoplifting declined
almost 82%, arrest for drug possession dropped 51%, and arrests for any
crime dropped 64%. Research by the University of Iowa shows that clients
reporting "no arrests" increased by 51%, and clients responding to "1-3
arrests" decreased by 51 %.
"We need a three-prong approach to deal with drugs and crime: prosecution,
prevention, and treatment," Miller said. "Overall, Iowa is doing a good
job with prosecution and a pretty good job with prevention, but we must
do much more work on treatment." He said that most law enforcement officers
and prosecutors agree that prosecution alone will not solve the drug problem.
Miller conducted news conferences Thursday in Des Moines, the Quad Cities,
Cedar Rapids, Mason City, and Sioux City. He was joined by law enforcement
and drug treatment officials.
"Law enforcement and prosecutors in Iowa are doing a fine job dealing
with an almost intractable problem," he said. "Drug shipments crossing
our Interstate highways are being intercepted. Meth labs are being discovered.
Drug dealers and users are being arrested and prosecuted." He noted that
there has been a 34.8% increase in the number of drug charges adjudicated
by the Iowa District Court from 1999 to 2001. Drug
cases constitute about 20% of the court docket in Iowa.
"Tough prosecution is very important," Miller said, "but it will only
work when it's used in conjunction with effective drug and alcohol treatment.
Increasing the money available for substance abuse treatment will reduce
crime and make Iowans safer."
About 80% of persons in prison have been identified as having a substance
abuse problem. In Des Moines, 57% of persons arrested tested positive
for drugs, and 35% were at risk for alcohol dependence. The Iowa Department
of Corrections reports that 75-80% of all correctional clients admit to
a history of substance abuse. A federal study shows that one-third of
state prison inmates reported being under the influence of drugs at the
time of their offense.
"The top goal of the proposal is public safety, but it also will help
Iowa's economy and workforce," Miller said. "All Iowans benefit from having
more productive employees in our workforce, and we must be able to offer
a positive alternative to drugs including a decent job."
Miller said that the economic benefits of substance abuse are much greater
than its costs. "Drug treatment saves money," he said. Studies show that
a dollar spent on drug treatment pays a $4-7 dollar return, mostly in
health care savings and increased productivity.
Miller said it was important not to stigmatize addiction. "It is important
to understand substance abuse addiction as a disease instead of a result
of personal weakness and moral failing," he said. "Addiction is an ongoing
health problem that is not easy to cure." He said 6.7 million Americans
are affected by drug addiction and 13.8 million by alcoholism -- about
equivalent to the the number of Americans affected by heart disease (21
The Attorney General proposes that resources for substance abuse treatment
and related programs should be increased by about $44 million. The funds
would be used to get more people into treatment, and let them stay in
treatment long enough to get the maximum benefit.
Details of the Increased Drug Treatment Program:
Estimated Funding Outline:
Community Based Treatment - $10 million
Correction Treatment - $5 million
Other Programs - $12 million, including:
Drug Courts, $3 million
Diversion Programs, $1 million
Jail Programs, $4 million
Knoxville Program, $4 million
Increased tobacco control funding to CDC minimum - $15 million
Total: $44 million
A Community-based Treatment. (Estimated $10 million
The State Capacities Work Group in 2001 was given the task of determining
capacity and estimating costs for increased capacity. The most effective
scenario recommended by the group called for an increase in both the number
of beds and the length of stay. The increased cost for that maximum scenario
was $13.9 million. We believe that the current system could not absorb
that size of increase in a single year because of workforce issues and
so we recommend $10 million in the first year, $10 million in the second,
and $15 million by the third.
B Prison Treatment. (Estimated $5 million increase)
The current estimated expenditure for licensed substance abuse treatment
in Iowa prisons is $4.3 million. This provides "residential" level of
care treatment for about 1,100 offenders and "outpatient" level of care
for about 575 offenders. A $9 million annual budget targeted for licensed
substance abuse treatment could adequately address the need for treatment
within the prisons. An additional $300,000 could be used to reinstate
a centralized substance abuse treatment needs assessment process at the
Oakdale reception center.
C Adult and Juvenile Drug Courts. (Estimated $3 million)
Drug Courts for adults, juvenile or both exist in Des Moines, Sioux City,
Mason City, Marshalltown, and the in the Fourth Judicial District. These
programs are funded primarily through federal grants and they are proving
their effectiveness. The state should ensure their continuation and expansion.
Drug Courts are one of the most effective things we can do in part because
of the intersection that is created between the criminal justice system
and the treatment system. The Court serves as a particularly effective
incentive for requiring treatment. Defendants hear the message that failure
to comply will result in sanctions. Because of this feature, judicial
cooperation is crucial to success.
D Diversion to Treatment Pilot Projects. (Estimated
The idea of this program is to use a screening tool to identify treatment-ready
offenders immediately after arrest so that diversion to treatment occurs
prior to the expenditure of legal and correctional resources. Eligible
offenders accused of non-violent drug and property crimes would plead
guilty enabling them to go the front of the line for full evaluation,
treatment, and CBC supervision.
There are two keys to success: first, the use of a treatment-eligibility
screening tool by pre-trial release interviewers; and second, priorities
set by the prosecutors, public defenders, judges, DCS, and treatment programs
to "fast track" these cases.
E Jail-based Treatment Programs. (Estimated $4 million)
The programs that provide treatment within the confined are effective
and reliable in part because of the benefits of treating a confined population.
This program is currently being implemented in Polk County and has potential
for other of the states larger counties. The Polk County program budget
is $400,000 and serves 30-40 men and 10 women. Placing such a program
in ten of the larger counties of the state would cost $4 million.
F Knoxville Secure Drug Treatment Program for Probationers. (Estimated
This funding would establish a secure drug treatment program at Knoxville
probationers who also have a substance abuse problem. The program would
provide specialized treatment in a secure setting without increasing demands
on the prison system.
G Statewide Comprehensive Prevention Programming
Grants. (Estimated $2 million increase)
Additional funding for the Iowa Department of Public Health's Statewide
Comprehensive Programming Grant Program will provide an important complement
to the increased emphasis on treatment. Under this program 23 grantees
provide drug prevention services to all 99 counties of the state on a
per capita basis. The programs engage in local
alcohol and drug prevention activities such as working to reduce college
binge drinking habits, or the strengthening families to discourage the
use of alcohol and drugs. Current funding for the program is $2.8
The Proposal to Increase Funding for Tobacco Control
-- $15 million increase:
In addition to dedicating most of the 25-cent cigarette tax increase
to substance abuse treatment, Miller said a portion of the proceeds -
about $15 million - should be used to strengthen Iowa's efforts to reduce
tobacco use, addiction and disease.
Even though the settlement with the tobacco industry resulted in payments
of hundreds of millions of dollars to Iowa, current funding for the program
is only $5 million (down from $9.3 million last year.) The U.S. Centers
for Disease Control has set a targeted range for what each state should
spend for an effective and comprehensive program -- and Iowa's recommended
spending level is a minimum of $19.3 to $48.7 million.
An additional $15 million would bring Iowa to roughly to the CDC recommendation.
"This is an especially appropriate use of money from the state tobacco
tax," Miller said. "As a state, we should commit ourselves to spending
the money necessary to prevent the loss of more than 5,000 Iowa lives
per year from tobacco," he said.
"Our most effective tool to fight the addictive effects of nicotine in
tobacco is a comprehensive program with counter-marketing, community programs,
youth programs, enforcement and cessation. In proper combination, these
programs save lives. We should fund the program at least to the minimum
level recommended by the CDC," Miller said.
Funding the Program by Raising the Tobacco Excise
Miller said a 25-cent tobacco tax increase would raise approximately
$50 million in new state revenue. He noted that others are proposing higher
increases, and that he supports such increases because it is well-documented
that lives are saved because people reduce smoking or quit when prices
Economists estimate that a 10% increase in the price of cigarettes would
reduce teenage smoking by 7% and overall consumption by 4-6%. Such a decline
would help reduce the loss of life each year from tobacco. Smoking related
disease claims an estimated 440,000 American lives each year including
more than 5,000 Iowans.
The current Iowa cigarette
tax is 36 cents. It has not increased since 1991 when it was
increased 5 cents. Sixteen states raised cigarette taxes in 2002. Iowa
is currently 29th in the nation regarding cigarette tax level.
A number of neighboring states raised their tobacco tax in 2002. Illinois
raised its tax 40 cents to 98 cents per pack. Nebraska raised its tax
30 cents to 64 cents per pack and Kansas raised its 55 cents to 70 cents
per pack. Three other neighboring states considered such increases: Minnesota
(48 cents currently), Wisconsin (77 cents currently) and Missouri (17
Each pack of cigarettes sold in this county costs the economy $7.18 in
health care and related expenditures. Smoking costs the U.S. approximately
$150 billion each year in health-care costs and lost productivity. In
Iowa the estimated cost is $1,618,000,000.
"Cigarettes and tobacco impose a huge drain on our nation's health and
economy," Miller said. "It is only fitting that tobacco should pay more
of the costs for solving our most important problems."
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