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October 23, 2003

Host: Michael Grant
Topics:
· New audit of CPS;
· Medical marijuana;
· ASU Technopolis, a new initiative amied at stimulating technology in Arizona.
In-Studio Guests:
· David Berns, Director, Arizona Department of Economic Security;
· Dr. Jeffery Singer, who been involved in ballot measures for legalizing medical marijuana in Arizona;
· Dr. Rob Melnick, Director, ASU Morrison Institute for Public Policy

>> Michael Grant: Tonight on "Horizon," a new audit states that CPS caseloads are at or below national standards. We'll talk to the man in charge of CPS about those findings.

>>> Michael Grant: Recent Supreme Court inaction allows doctors in some states to recommend medical marijuana. We'll tell about the impact in Arizona. And ASU has a new initiative aimed at stimulating technology in the valley. It is called "Technopolis". The Arizona Office of the Arizona Auditor General has released a report on Child Protective Services. That was done at the request of the legislature, and covers caseloads averages. We'll talk to the director. But first, here's more about its findings.

>>Michael Sauceda: In the area of case management, the audit found that CPS's case manager loads were at 12 or below in 2001 and 2003 in Arizona. However caseloads in the investigative unit were at an average of 15 per case worker because of an increase in caseloads and several unfilled CPS manager positions. Since June 2001, the division's total overall caseload had increased 30%. The audit reveals that only 68% of case managers were able to make monthly face-to-face visits. Concerning training hours, the audit said a new training program has increased the amount of training new staff receives but is still not working at the level envisioned. The new training program has expanded topics but some case managers were not able to complete training because they had to stop to work on cases. The audit revealed insufficient supervision of case managers and showed in one review that supervisors had failed to fill out the proper case record review guide in 42% to 71% cases. The Audit reveals that although CPS is using concurrent case planning to help speed children through the foster care system, that needs to be improved. And current planning allows for family reunification and an alternate plan to be worked on at the same time.

>> Michael Grant: With me now to give us his reaction to the audit is David Berns Director of the Arizona Department of Economic Security. I note that we invited the auditor general tonight but the auditor general declined. Good to see you again.

>> David Berns: It's good to be here.

>> Michael: I think clearly the most controversial aspect of the audit is its statement that the caseloads are at or below the national average which is contrary to the statement being made by the Governor's office and CPS. What's your reaction to that?

>> David Berns: Well, you are right that most of the audit we do agree with. They have identified a number of areas that were also identified in the Governor's plan to be addressed. We know that there is a lot of issues in children's protective services that need improvement. That's why we have the plan. Much of that improvement is related to the amount of staff that we have and what it takes to actually do an adequate job. We believe that the auditors misinterpreted the standards,is interpreted the amount of work in cases that we have to work on, and made some erroneous judgments in the size of our caseloads.

>> Michael Grant: I think one of your points is they took snapshots in June of 2001 and in June of 2003 to reach the conclusion that caseloads were at or below the national standard. What's wrong with doing it that way in your opinion?

>> David Berns: Well, traditionally, June is our lowest month of caseloads because school is out. We're not getting new reports from school teachers or bus drivers or many of the people that see children on a day-to-day basis because it's the summer time and so if you use January, we might have more than a thousand additional complaints or cases that are coming in. June is just a time, if you select a time, that's going to show the lowest caseloads.

>> Michael Grant: Now one of the things that occurs, though, and you just indicated it, it seems to me that the caseload normally will be longer than, for example, a 30-day period.

>> David Berns: Right.

>> Michael Grant: So that number would be picking up caseloads from earlier months that are being supervised. How much would it impact the number just by focusing on June?

>> David Berns: Well, like I say, it might be as many as a difference of close to a thousand cases that are --

>> Michael Grant: How many workers are we dealing with here?

>> David Berns: He will well, if you said 15 workers per case or -- it depends on whether it's an investigation or an ongoing or a foster care case. But the different standards apply to each of those. Roughly, that might make a difference of 40 or 50 workers with those kinds of numbers, but that's not the biggest issue. The auditors used what they thought were the interpretations of the Child Welfare League of America to do their caseload analysis. When I first saw what they were doing, I advised them that they were not interpreting those standards correctly. They went back to Child Welfare League, got a clarification that indeed they should be counting the number of investigations that are done in a month, rather than the number that are open at any given time on a computer system. They said they didn't have time to recompute that data and used their original analysis.

>> Michael Grant: Was one of the other arguments that CPS has with the audit, the fact that supervisory people and other support staff were rolled into the case worker devise sore?

>> David Berns: That's right. They said, well, you've assigned case work duties to supervisor or to specialists or to people who are doing foster care licensing, those kinds of jobs, and we did assign some of the cases to those people because we didn't have enough of the regular staff to assign it to, and somebody had to do the investigation, somebody had to provide the services, but they used those in the divisor, so it would be similar to saying that the principle is a licensed teacher so you can count them in the pupil-teacher ratios.

>> Michael Grant: What is wrong, though, necessarily with -- I mean, obviously you would not want to have a supervisor perhaps have a full caseload because you want the supervisor to be supervising, but it's not unusual, I don't think, for a supervisor to have a reduced amount of line duties. Is there anything problematic with that?

>> David Berns: There certainly is because we need to have the supervisors doing the work with their staff, the professional staff to make sure the work is done, to get -- as the audit identified, to fill out the appropriate case reviews and to help train new staff, and we have assigned work to supervisors that we don't want to do but in order to get the investigations done, and in order to protect children, we've had to assign it to somebody. They were the only ones around that we had to assign the work to.

>> Michael Grant: David, I think the basic point being made by some, certainly by the county attorney, Rick Romley, and I think many over at the legislature, and I assume this audit is going to be used to fuel that, is we don't want to throw more money at a system we are not certain is the right kind of system. How do you respond to that?

>> David Berns: Well, the attorney Romley has done his own study which identifies that we do need more staff in order to carry on with these functions. As a matter of fact there has been numerous studies. This is the only one that's been done that even comes close to suggesting that we're adequately staffed in the child welfare system. But I agree with attorney Romley on the fact that we do have a system that's in grave danger of failing, that we really need to make systems changes. The Governor has made her recommendations, including legislature changes and programmatic changes that is will improve the system. We need to improve those services but in order to do that, we have to have appropriate and adequate staff in order to carry that out.

>> Michael Grant: The audit also found that those in the investigation unit had higher caseloads. Now why is that?

>> David Berns: Well, I would say that because there's no control over how many complaints or calls come into the hotline. We have a certain number investigators and we get more calls. We just keep assigning and assigning investigators because we have to. We have to go out and investigate and make sure that those kids are safe.

>> Michael: And there isn't time, though -- there is a certain number of complaints that are given a low priority and are not investigated at all; is that the way --

>> David Berns: That's right. That's led to considerable difficulties because they are assigned to community groups that have no legal authority to go out and do a set of assessment if those families say we don't want you to see the kids or to provide any services, there's no safety check. We had a legitimate complaint of child abuse and neglect and nobody responds to it. We need considerable number of staff in order to be able to investigate all of those complaints that are currently going uninvestigated.

>> Michael Grant: In your opinion, how many additional personnel are necessary for Child Protective Services to bring it to the national average?

>> David Berns: Right now, we need 155 additional staff, and it's an easy calculation, I don't think even the auditor could quibble with it very much. We had a certain number of complaints or investigations that we have to do. You can just divide that by the number of investigations one worker can do per year, and that tells you how many staff we need. Same thing with, we know exactly how many kids are in foster care. We divide that by 15 cases per worker. That tells us exactly how many staff we need.

>> Michael Grant: And which portion of the additional supplemental budget request is going to that, the 154 or 155 additional work centers

>> David Berns: Of the $27 million that's going just to keep the staff that we have right now, only $8.5 million is in the Governor's plan to add additional staff we need and to make the other systems changes. So we're talking $8.5 million for the staff and the other programmatic changes for this year neared to come into compliance with national standards and to provide appropriate services.

>> Michael: David Berns, DES director, thank you very much.

>>> Michael Grant: United States Supreme Court recently let stand a ruling by a lower court that allows doctors in some states to recommend medical marijuana. That will impact us in Arizona. We will talk to our medical marijuana advocate more about how that will affect the state, but first, Mike Sauceda tells us how one medical marijuana user views the Supreme Court's inaction.

>>Michael Sauceda: For 8 years Josh burner has had two prescriptions allowing him one ounce of marijuana. He got the prescription from his doctor because of nausea due to mouth cancer treatments. His prescription were based on an old law which is expired. He says the prescription protect him from prosecution.

>> Josh Burner: I've been told by the U.S. attorney or whatever, that I'm immune to prosecution. Rick Romley would think not, but I invite Rick Romley to bust my butt any time he chooses. Because I am protected by my prescriptions, and it's not a matter to smoke dope or do a joint or any of that. It has to do with nausea and health and attitude and appetite, and the fact that after 8 years, I'm still alive with the cancer that was supposed to kill me a long time ago.

>>Mike Sauceda: Burner's prescription as well as the issue of medical marijuana have been clouded even though Arizona twice passed laws allowing medical marijuana. Recently the United States Supreme Court refused to take up a medical marijuana case out of the 9th Circuit Court of Appeals. Doctors can give several patients a recommendation to use medical marijuana. In Arizona, however, the wording of the law requires a prescription. Burner thinks the Supreme Court inaction can help those needing medical marijuana.

>> Josh Burner: Now, if my doctor or your doctor or whoever else wants it, your doctor can say, get yourself some marijuana and you'll feel better, because it takes care of your nausea, takes care of your pain, and it'll make you feel better, but there's one little problem, just like we've had with all of the propositions. Distribution. Where do you get it? But there is still a lot of sick people, and when I can share my medical marijuana with an old veteran, who walked from Normandy to Berlin and today is 83 years sold, and he couldn't eat, and he sees me for the first time after I share my medicine with him and he says, hey, Josh, I ate a whole meet love yesterday and that to me, it makes my heart soar like a hawk and it's good, and whether you are young or old, if it's medicine, it's medicine, and it should not be run by the federal government.

>> Michael Grant: Dr. Jeffery Singer has been involved in three ballot measures aimed at getting medical marijuana legalized in Arizona. Dr. Singer is here to give us his reaction to the Supreme Court's not taking up the case. Case out of California in the 9th Circuit and I want you to fill in some of the background, but as I understand it, a doctor had recommended medical marijuana and law enforcement authorities came after him for that. Fill in the rest of those blanks.

>> Jeffrey Singer: That's correct. Back in the mid-90s, Arizona and about eight other states passed medical marijuana laws. Now in order to deal with the fact that it is a federal prohibition on marijuana, the way they did it was they said if a law enforcement official sees someone possessing marijuana and they provide in the case of Arizona a doctor prescriptions as proof or in other states proof of a doctor's recommendation, then law enforcement officials in that state will walk away from that, will not arrest the person. That's the way they deal with the federal prohibition on marijuana without contradicting federal law, because federal law always Trumps state law.

>> Michael Grant: It is a prohibited schedule 1 substance that's illegal?

>> Jeffrey Singer: Right. So the feds responded to that by saying, obviously it's bad public relations to arrest a terminal cancer patient using marijuana, so instead they threaten doctors with sanctions. They said if we find a doctor who has recommended or prescribed marijuana to a person, we would ban them from participation in any federal medical programs, such as Medicare or Medicaid and will deny them a narcotics prescription license which is given by the federal government. So in effect, they'll shut them down. They will not be able to practice. And that cast a chilling effect, which was intended.

>> Michael: Now, a doctor in California recommended --

>>Jeffrey Singer: A doctor in California recommended medical marijuana.

>> Michael: They came after him.

>> Jeffrey Singer: They came after him and he said are you telling me I can't tell someone what my opinion is? I can't give my opinion as to what's a good form of treatment for your problem? Isn't that interfering with my right to free speech and with the free exchange of scientific information with a patient? And it went up the ladder and the U.S. district court -- I'm sorry U.S. court appeals for the 9th Circuit affirmed the lower court's decisions, because it got appealed all the way up to the Court of Appeals that the doctor is right and the federal government cannot sanction shun doctors for recommending marijuana because it's their free speech right.

>> Michael: In Arizona, the law here, the medical marijuana law that was passed by voters, is not written that way. It requires a doctor to actually prescribe marijuana.

>> Jeffrey Singer: Right.

>> Michael: Not just recommend marijuana.

>> Jeffrey Singer: That's why I have sort of ambivalent feelings. On the one end I'm very happy with the Supreme Court's decision not to touch the 9th Circuit's decision, because I think the 9th Circuit is right. But in the wording of the 9th Circuit's decision regarding that doctor, they seemed to distinguish between recommending and prescribing. I'm not a lawyer, I'm just a simple doctor. To me, I've always thought of a prescription as a recommendation in writing. Sometimes I actually recommend it verbally, I'll phone in a prescription for patients. I fail to see the difference, but in wording they seem to draw a distinction. For that reason, there is like a little -- there is a little problem here. I can't -- if my colleagues contact me and say now is it safe for me to prescribe marijuana for my patients that need it without recommending sanctions I can't say. They may have to go up the legal ladder and fight that in court also.

>> Michael: Let me suggest this possible distinction to you and give me your reaction to it. Seems to me that every citizens of the United States is free to discuss whatever they want to discuss under the First Amendment. Pulling that down to the doctor level, you know, I've had consultations with doctors from time to time in which they would discuss various treatment modalities and that would be kind of a free exchange of ideas, but then at the end of that consultation, they write me out a prescription for what they actually prescribe in their professional capacity. Isn't that the distinction that the Ninth Circuit was trying to draw between in one capacity you are acting actually as a doctor, in another you're simply exercising your free speech rights.

>> Jeffrey Singer: They seem to see a distinction in that. I fail to see that because as a doctor who writes prescriptions, I know when I'm writing one, first of all, I'm not dispensing the medication. I'm not forcing the person to take that medication. That person could end up tearing up the prescription and getting a prescription from someone else that they think is better. It's just basically my recommendation in writing that they can then take with them to a pharmacist and show them what I recommended to the pharmacist will get it for them. In the other states where now it is safe for doctors to recommend, their laws say recommendation. So it's not just discussion. They are actively actual actively recommending.

>> Michael: Have you ever prescribed marijuana to a patient?

>> Jeffrey Singer: No, because I've been chilled.

>> Michael: What about generally in the state. Do you know of any doctors who are prescribing it?

>> Jeffrey Singer: I personally don't know of any doctors who are prescribing. I can think of a situation where a doctor would have no fear of prescribing, one who has retired but maintains an active practice, there are many who do that, they keep their license up and keep their education up but they are not in practice any more. They can write a prescription but it will not have an impact on their ability to practice because they are not practicing. That's kind of doctor right now who probably would not be intimidated by the federal threat.

>> Michael: So it sounds to me like this -- the actual issue we have here in Arizona may not reach a head because doctors are not doing it?

>>Jeffrey Singer: Right. And in my -- to my mind, it's all a semantic issue because that's why I advise my colleagues if they want to prescribe it, they may find themselves having to go to court like the doctor in court had to and I can't tell them the coast is clear.

>> Michael: Dr. Jeffrey Singer, thank you for joining us.

>>> Earlier I talked to Dr. Rob Melnick. About a new endeavor by the university. It is called Technopolis and it's name is to simulate the technology base economy.

>> Michael: Technopolis sounds like super man's home town. What is it in Phoenix Arizona?

>> Rob Melnick: Well, the name is taken not from super man, but it means technology city. That's in fact what we intend to do here is to try to help the region become more technology oriented in its business endeavors. Technopolis is a program which trains mentors and connects entrepreneurs in the technology businesses.

>> Michael: Give me an example of a candidate for the Technopolis program.

> Rob Melnick: Sure, somebody who has a commitment to technology development, life science development, and maybe very expert in the technology or the field of endeavor but doesn't know how to bring that business to full bore, does not know how to bring a product to market. Someone would come to this program and be coached and trained in the kind of business of developing a technology business or taking that invention, widget idea, getting financed, getting commercialized, making it successful.

>> Michael: This is a person who says I'm a great inventor or maybe I even have an invention, but I don't know how to move that to market?

>> Rob Melnick: That would be one candidate. Another candidate would be somebody who is a business person and seeks to take their business skills and transfer them, if you will from the business they are in into the technology life science business and identify the kinds of people you just mentioned who have the inventions and the widgets who want to do that. It's for inventors, scientists, technologists, life scientists as well was as people who are in business who want to grow themselves into the technology/life-science game.

>> Michael: You've got seminars on one side of the equation that someone could attend. You could go back to college, I suppose and get your master's in business administration. Does this try to kind of fit in between those two alternatives for somebody who maybe doesn't have a year for an MBA and a day seminar is not quite enough?

>> Rob melnick: Precisely. It fits that space. That's the market we looked at. We found from a lot of things that we had been seeking that that's what the entrepreneurial community and the community that serves the entrepreneurs wanted. They wanted to see this middle ground filled. Short course, multiweeks, more than the kinds of seminars that are great information but just that, they are information and not really training programs can provide. That is, a lot of people don't have the time or the wherewithal or the capital to spend two years in an MBA program. On the other end of the continuum, the one-day things may not be quite enough. There are organizations in town, ones we're partnering with the chamber of commerce of the Arizona technology council. They do a wonderful job providing seminars, but ASU is an educational institution. This is a shorter course forum.

>> Michael: Who is the team?

>> Rob Melnick: We have a terrific team to deliver this. The actual instruction is delivered by Daniel O'Neil and Sharon Ballard. These people are both successful entrepreneurs in their own right. Dan is a lifelong Arizonan and committed to the place and Sharon is the foremost authority in the nation on helping small businesses get grants to the SBR, STR program and Julia Rosen also who is the director of the office of economic affairs here has a tremendous networking knowledge of the local entrepreneurial scene with regard to technology and life sciences. They form the core team to deliver these services. These are people who are very skilled.

>> Michael: One of the first project is launch pad? How does that work?

>> Rob Melnick: Launch pad is modeled after a program in San Diego called the connect program. That provides a similar kind of thing where people come to this program and are coached, one-on-one, and there are ideas for technology businesses or life science businesses are refined through this coaching or business plan is refined and the culminating activity of this coaching after 6 or 8 weeks is a kind of a final exam. What we do is bring in real live people who are in the business of venture capital, accounting, supporting through intellectual property law, the kinds of businesses that these young or experienced for that matter, entrepreneurs want to develop. And they pitch their plan, and they pitch their concept and pitch their business. And they get feedback, as if they were in a live situation.

>> Michael: It almost sounds like a doctoral dissertation, delivering it orally and getting beat up by a panel.

>> Rob Melnick: You get toughened up for the street this way. People who have gone through similar program in San Diego say is that this one thing prepares them remarkably well to be successful when they go realtime with these kinds of people.

>> Michael: Rob Melnick, thank you for joining us.

>> Rob Melnick: Good to be here.

>> Michael: For more information on Technopolis, go to the web site on the screen. To see a transcript of our show or find out about upcoming topics, please visit our web site at www.kaet.asu.edu, click on the word "Horizon." That'll lead you to transcripts, links and future show topics. Here's what's on "Horizon" tomorrow.

>> Reporter: State lawmakers convening this week to fix CPS and Arizona's prisons face a long and contentious session. A new statewide poll puts Howard Dean ahead of the pack, among Arizona Democrats. Also, will America West's high-flying performance on Wall Street last? Join us for our Journalists' Roundtable Friday night at 7:00 on "Horizon."

>> Michael Grant: And please stay tuned for "Horizonte" coming up next on channel 8. It gives you a look at Arizona issues as "Horizon" but through a Hispanic lens. Thanks for joining us on this Thursday evening. I'm Michael Grant. Have a great one, good night.

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