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limited to a maximum of five, and the total number of committed alcoholics was limited to 25. This pilot project was continued for two and one-half years, and financial reasons then made necessary its discontinuance.

Treatment was provided to these patients only while they were incarcerated in the Workhouse for a 90-day period. Some 32% of the patients treated in this manner showed improvement, even though upon release there were no residential facilities or supportive programs to continue their rehabilitative treatment other than the small outpatient Clinic. It was also felt that more effective treatment could be undertaken in a non-penal inpatient facility completely separated from the usual jail setting.

In April 1956 Chief Judge Bolitha J. Laws of the United States District Court for the District of Columbia, the Chairman of the American Bar Association Committee for the Improvement in the Administration of Justice in the District of Columbia, appointed a special Subcommittee on Alcoholic Problems. The Subcommittee submitted an Interim Report on May 31, 1956, which was published in the July 1956 issue of the Journal of the Bar Association of the District of Columbia. The Subcommittee "agreed that alcoholism is a public health problem as much as tuberculosis," and that "penal measures reach only the homeless, social misfit group of drinkers and others whose alcoholism is far advanced." It therefore

“... concluded that the attempt to arrest alcoholism by means of punitive measures has been a total failure. The penal approach has been fully discredited as expensive, proffitless, and inapplicable to the problem. ***

"Judge Walsh estimates that the subjects of more than 90% of the intoxication cases were repeaters. ***

"We have not yet obtained figures from the police department as to the cost to it in money and precious manpower in dealing with alcoholics but preliminary estimates reveal that it is almost overwhelming.

"Today, we are immersed in a system that offers no help to the individual and costs the taxpayer large amounts of money which in effect are thrown down the drain in terms of solving the problem." Pages 429-430.

The Subcommittee unanimously recommended "that the District of Columbia embark upon an entirely new approach to the problem," using public health techniques. With regard to the public intoxication criminal statute, the Subcommittee recommended:

"Consistent with our belief that alcoholism is a health problem, specifically, we recommend that the penal statute prescribing fines and/or imprisonment for the offense of intoxication be repealed. This will not involve any change in existing law where other offenses are committed while a person is intoxicated." Page 431.

Thus, more than ten years ago this Subcommittee recommended that the problem of public intoxication be taken out of the criminal law and handled on a public health basis. H.R. 6143 adopts this approach.

The Final Report of this Subcommittee was submitted to Judge Laws on November 29, 1956. The Final Report elaborated upon the Interim Report, and concentrated upon three approaches. First, the Subcommittee recommended that the conflict between the statute handling public intoxication as a criminal offense and the statute handling alcoholism as a disease "be resolved by repealing the penal version of the law and implementing the enlightened version, which defines the case as a disease," since "the difficulties generated by the penal law tend to perpetuated themselves, and little improvement can be expected until it is repealed." Page 5. The Subcommittee concluded that "the first stage toward solving the problem is acceptance of the principle that alcoholism, in its compulsive form, is an illness-mental as well as physical; and that to relieve the burden on the taxpayer, it will be necessary to approach the issue as a public health problem, and treat or control the alcoholic as a patient." Page 7. Third, the Subcommittee recommended "a program of public information to stimulate community support," and that "the direct support and assistance of all organizations concerned" be enlisted to furnish volunteer workers and to carry the story to the public. Page 2.

The work of the Subcommittee continued after this Final Report. A further Progress Report submitted to Chief Judge Laws on March 14, 1957 noted that

District of Columbia Department of Public Health Alcoholic Rehabilitation Division Fact Sheet (October 1960).

Report of the Subcommittee on Alcoholic Problems, 23 Journal of the Bar Association of the District of Columbia 428 (July 1956).

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the approximately 40,000 drunkenness arrests per year cost the District of Columbia at least $1,700,000, and concluded that "if we take even a part of this money to finance the operation, and make a start toward the real solution, we are saving the taxpayer money." Page 10. The Subcommittee recommended that this money be devoted primarily to new alcoholism treatment facilities of the type that were then, and still are now, non-existent in the District of Columbia.

Among others, Chief of Police Robert V. Murray was consulted on these problems. The minutes of the April 4, 1957, meeting of the Subcommittee reflect that "Chief Murray said he recognized fully that alcoholism was a disease, rather than a crime, and should be approached from this point of view." Chief Murray was primarily concerned that any new law should protect the Police against charges of false arrest. H.R. 6143 will afford this necessary protection to the Police.

The recommendation of the Subcommittee for repeal of the public intoxication statute and substitution of a new public health approach were forwarded on July 1, 1957 by Chief Judge Laws to the President of the Board of Commissioners, David B. Karrick. Unfortunately, it appears that no action whatever was taken on these recommendations. H.R. 6143 will now carry through with those recommendations, made ten years ago.

In October 1956 the Board of Commissioners appointed a Committee on Prisons, Probation and Parole in the District of Columbia, chaired by Commissioner David B. Karrick.' Mr. Karrick was the Commissioner responsible for health, welfare, and corrections. The Report of the Committee was released in April, 1957.

This Report immediately recognized that "the 'skid-row chronic alcoholic' is the individual who now burdens the police, clogs the courts, and over-crowds the prisons." Page 86. It was estimated that the chronic alcoholic costs the District almost $2 million per year, and that the present criminal procedures have "very little effect" as a deterrent to public intoxication. Pages 84, 92. Moreover, many other misdemeanor offenses frequently grow out of intoxication, so that the true burden of this problem upon the District is undoubtedly even greater. Page 99. About 85% of all commitments to the Workhouse were attributed to intoxication, and the vast majority of the approximately 14,000 intoxicants committed each year to the Workhouse are chronic skid row alcoholics. Pages 102, 103.

In light of this information, the Committee concluded that:

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"... anything more futile than this process of getting drunk, being arrested, receiving 10, 15, or 30-day sentences, going to the jail and to the Workhouse, serving time, going out and getting drunk again, can scarcely be imagined. The rate of recidivism, moreover, is the best evidence that existing procedures are failing to rehabilitate the alcoholic." Page 102.

It further concluded that "the District is making no headway at all in reducing the problem of the skid-row alcoholic," using a criminal procedure “which neither benefits them nor the community," and which fails to meet "the real judicial concern, i.c., not a specific offense of intoxication, but the chronic condition of human deterioration." Pages 109, 123, 131.

The Committee therefore made the following recommendations, at pages 132137. First, the police should send persons who are simply intoxicated directly to their homes, and should avoid, where possible, arrest and detention. Second, facilities for inpatient treatment of alcoholics at D.C. General Hospital should be placed under the management of the Alcoholic Rehabilitation Division. Third, the building then housing the phychiatric service of D.C. General Hospital should be assigned to the Alcoholic Rehabilitation Division for purposes of inpatient treatment. Fourth, halfway facilities should be provided on an experimental basis for the chronic Skid Row alcoholic group. Fifth, additional funds should be provided for the implementation of the 1947 Act. And finally, an individual should be assigned to the Executive Offices of the Board of Commissioners to co

7 Included on this Committee were Chief Judge Laws of the United States District Court for the District of Columbia, Chief Judge Walsh of the Municipal Court for the District of Columbia, Chief of Police Murray. Judge Cockrill of the Juvenile Court for the District of Columbia, Chairman Johnson of the Board of Parole for the District of Columbia, Director Clemmer of the Department of Corrections for the District of Columbia, Chief Probation Officer Garrett for the United States District Court for the District of Columbia, Director of Probation Cooper for the Municipal Court for the District of Columbia, Director of Social Work Larkin for the Juvenile Court of the District of Columbia, and General Counsel Gasque of the Subcommittee on Improvements in the Federal Criminal Code of the Committee on the Judiciary, United States Senate.

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ordinate all efforts for dealing with the alcoholic problem in the District of Columbia.

Regrettably, none of these recommendations was implemented. As shown by the arrest records, the police have increased arrests for drunkenness in the past 10 years. No significant inpatient or halfway house facilities were made available to the Alcoholic Rehabilitation Division of the Health Department. Additional funds to implement the 1947 statute were never provided. And the Board of Commissioners failed to designate anyone to work with it to coordinate all efforts within the District of Columbia to deal with the alcoholic problem. H.R. 6143 will, some 10 years later, provide effective implementation of these recommendations.

In January 1958 Dr. Marvin Perkins, Director of the Bureau of Mental Health, issued a report to the Director of Public Health emphasizing the need to coordinate the alcoholic rehabilitation activities of D.C. General Hospital with those of the Alcoholic Rehabilitation Division. Dr. Perkins recommended additional staff and facilities for increasing the inpatient alcoholism treatment program at D.C. General Hospital as contemplated by the 1947 statute. These recommendations were never implemented.

In January 1960 the Council on Rehabilitation of the area's Medical Societies issued a report which ranked resources for the treatment of alcoholism as second among the four problems of greatest concern. General practitioners who were consulted ranked alcoholism as the number one disabling condition needing additional services and facilities, and all physicians as a group ranked it second in importance.

In December 1960 the Washington D.C. Area Council on Alcoholism attempted to spearhead a new movement to stimulate a public health approach to the problem of drunkenness and intoxication, by inviting community leaders to a “Workshop on Unmet Needs of the Washington Area in Alcoholism Control." The Report developed from this Workshop recommended that the District amend the law "to eliminate intoxication as a misdemeanor, as well as vagrancy and disorderly conduct when those offenses are clearly the result of undue intoxication," that facilities be developed "for drying out and diagnosis, with a full professional staff," that a professional staff be developed for "outpatient treatment in terms of vocational training and placement, deep individual psychological therapy and all other known helpful approaches," and that facilities be created "such as hostels or farms for longer-term treatment of cases requiring daily supervision." Page 21-22. The educational approach of this Workshop was, however, insufficient to obtain direct community action. H.R. 6143 will now implement these recommendations.

In February 1961 the Public Health Advisory Council of the District of Columbia suggested that the mental health programs of the Department of Public Health be evaluated, particularly in light of the surveys submitted by authorities since 1946. Dr. Wolfgang Schwarz, an experienced clinical psychologist, was employed to undertake this survey. The Department of Public Health then prepared a report in February 1962 entitled "Some Highlights on Mental Health Facilities in the District of Columbia." based upon Dr. Schwarz' survey.

This report noted that, of the recommendations contained in 7 prior reports made between 1946 and 1961, change in the law relating to commitment of alcoholics was mentioned 5 times, better integration of existing alcoholic programs was mentioned 3 times, and more facilities for the treatment of alcoholic patients was mentioned 2 times. In discussing the Alcoholic Rehabilitation Division outpatient Clinic located at 1400 Q Street, N.W.-the very Clinic that is in operation today-this report said that "there is a very srong need for additional medical and psychiatric service in this Division, and the physical plant leaves much to be desired." Page 3a.

During this time, the Court of General Sessions has continued to use the services of the outpatient Alcoholic Rehabilitation Clinic for a limited number of persons charged with public intoxication. About 1300 patients were referred from the Court to the Clinic during the period 1950-1963. In 1963, the Court discontinued use of the Clinic and relied completely upon its own Alcoholic Rehabilitation Unit of the Probation Department. (This Alcoholic Rehabilitation Unit was severely criticized by the D.C. Crime Commission, and has now been abandoned.) In a May 2, 1966 letter to the D.C. Crime Commission the Director of Public Health suggested that "the Court's reaction to the limited extent of services they felt were being provided may have been a factor" in discontinuing use of the Clinic in 1963.

By 1964 the Washington, D.C. Area Council on Alcoholism had concluded that traditional educational methods would not result in any change in the community's handling of drunkenness and alcoholism in the near future, and it was therefore concluded to institute legal action, with the cooperation of the National Capital Area Civil Liberties Union, to force the necessary changes. On four occasions, beginning in July 1964, pleas of "not guilty by reason of chronic alcoholism" were entered on behalf of derelict alcoholics charged with public intoxication in the Court of General Sessions. On all four occasions, Corporation Counsel entered a nolle prosequi solely in order to avoid the legal issue raised. On the the fifth occasion the Court refused to permit Corporation Counsel to drop the prosecution, and the case of Easter v. District of Columbia went to trial in September 1964.

The trial court found Mr. Easter guilty, and an appeal was taken to the Disthe need for immediate development of facilities and programs within the Distion on April 29, 1965. A further appeal was taken to the United States Court of Appeals for the District of Columbia Circuit, and that Court, by a vote of 8-0, reversed Mr. Easter's conviction and held that chronic alcoholism is an absolute defense to a charge of public intoxication in the District of Columbia." The effect of this ruling was to prohibit the conviction of any chronic alcoholic in the District of Columbia for simple public intoxication or for any other activity directly caused by his alcoholism.10

Both the majority and the concurring opinions in the Easter case emphasized the need for immediate development of facilities and programs within the District of Columbia for the handling of derelict alcoholics through public health techniques. Since over 90% of the defendants who appear in the Court of General Sessions on intoxication charges are derelict alcoholics, this decision required the immediate change of the criminal procedures that had been in use for such a long time, and that had been severely criticized in all of the reports already described above. H.R. 6143 will carry through with the work begun in the Easter decision.

The outcome of the Easter case was widely anticipated among community leaders, although the District of Columbia Government took no steps to prepare for it. The Subcommittee on Alcoholism, Drug Addiction, and Correctional Facilities of the Mental Health Committee of the District of Columbia Public Health Advisory Council was fully aware of the implications of the case, and repeatedly advised on the need for development of adeqaute alcoholism treatment facilities. The minutes of the June 18, 1964 meeting of the Subcommittee show its opinion that “adequate facilities do not exist" for alcoholism treatment. Dr. John Schultz, Associate Director for Mental Health and Retardation for the Department of Public Health, remarked that the Department "probably could not certify adequate facilities" because the only beds available are for emergency use. He stated that the alcoholic patient "seems adverse to being considered mentally ill," and that he should be treated in separate facilities rather than in mental health facilities. The minutes of the September 28, 1964 meeting of the Mental Health Committee state that the Subcommittee on Alcoholism (1) recommended that serious effort be given to developing a "substantial program of treatment services for alcoholics in contrast to the 'drying out' service currently offered," (2) had made recommendations to the Judicial Conference "for the repeal of penal sanctions in the disposition of those charged with chronic intoxication," and (3) "recommended the establishment of a District-wide facility for the inpatient treatment of alcoholics" under the 1947 Act.

In a May 27, 1965 memorandum to the Chairman of the Mental Health Committee, the Chairman of the Subcommittee on Alcoholism raised several questions about the Final Draft of the Report on Comprehensive Mental Health Services in the District of Columbia. The memorandum specifically questioned whether planning should be based on the assumption that a chronic alcoholic can be put in jail as a criminal, in view of the test case, In view of the many deficiencies in this Final Draft the Subcommittee on Alcoholism prepared 28 pages of comments suggesting extensive revision and submitted them to the Department of Public Health in June 1965. Of primary importance, the Subcommittee pointed out that the section of the Report on "Making A Start" ignored the prob

8 Easter v. District of Columbia, 209 A.2d 625 (D.C. Ct. App. 1965). Easter v. District of Columbia, 361 F.2d 50 (D.C. Cir. 1966 (en banc).

10 See Hutt & Merrill, Is the Alcoholic Immune From Criminal Prosecution? 6 Mun. Ct. Rev. 5 (1966), reprinted in 25 Legal Aid Briefcase 70 (1966) and in 113 Cong. Rec. A1524 (March 23, 1967) (daily ed.).

lem of alcoholism. The Subcommittee stated that "we strongly believe that the need for in-patient facilities for the treatment and rehabilitation of chronic alcoholics is urgent, and that a recommendation for immediate development of such facilities should be made." This recommendation was not followed by the Department of Public Health. When asked why this recommendation had not been followed, Dr. John Schultz replied in a letter dated October 27, 1965 that although an inpatient facility is "judged by us to be an essential element of a well-balanced alcoholism program" there was "uncertainty as to whether we can take immediate steps to develop such a facility." Dr. Schultz said that "top priority" had been placed on development of a detoxification center, because of the "sense of urgency provided by the pending Easter case." This "urgent" detoxification center is still, at this late date, apparently at least a year away

from realization.

The final Report on Comprehensive Mental Health Services in the District of Columbia was published by the Department of Public Health in September 1965. At least in part because of the urging of the Subcommittee, this Report does recognize that "chronic alcoholics should be treated in facilities and with programs that are separate and distinct from the facilities and programs used for mental patients," and therefore that "in-patient and halfway house facilities for the treatment of chronic alcoholics will not be located at the mental health centers." Page 39. The Report forthrightly stated that "outpatient treatment only is presently available through the D.C. Alcoholic Rehabilitation Clinic, and outpatient treatment is plainly incapable of rehabilitating the vast majority of these chronic alcoholics." Page 43. A variety of facilities were recommended in the Report: A detoxification center, a centralized in-patient facility, a rehabilitation farm, halfway house and hostel residential facilities in the heart of the District, and additional outpatient treatment services and clinics. Finally, the Report stated that, regardless of the outcome of the Easter case, "sufficient funds for the proper implementation of the 1947 statute should be provided." Page $7.

None of these recommendations were implemented prior to the Easter decision. And the only one of these recommendations implemented subsequent to the Easter decision was the establishment of an inpatient facility at the former Women's Reformatory at Occoquan. This new facility was provided only after intensive pressure had been brought to bear on the District of Columbia Government through the refusal of the courts to continue to convict chronic alcoholics for public intoxication. Without the public outcry against the failure of the District Government to provide treatment for derelict inebriates, none of these recommendations would have been implemented. H.R. 6143 will now implement all of these recommendations.

On January 22, 1966, the U.S. Court of Appeals for the Fourth Circuit handed down its decision in the case of Driver v. Hinnant, 356 F. 2d 761 (4th Cir. 1966), holding that the prohibition against cruel and unusual punishment in the Eighth Amendment to the United States Constitution precludes the conviction of a chronic alcoholic for simple public intoxication. In a memorandum dated February 1, 1966, Mr. Richard J. Tatham, Chief of the Office of Alcoholism and Drug Addiction Program Development in the Department of Public Health, recommended to Dr. Schultz that:

"Because of the great interest in the Driver and Easter cases, and because rather quick action may be called for, it would be well for the Health Department to proceed now to develop a long-range program planned for providing diagnostic, treatment, and rehabilitation services for an enlarged patient population which may include many patients now being handled through criminal procedures." Mr. Tatham emphasized that "the Department should recommend that its program of alcoholism treatment services not be administratively identified with either St. Elizabeths Hospital or the D.C. Workhouse." He recommended that "alcoholics found to be neither psychotic nor criminal should be treated by the Health Department within a range of treatment services which emphasize community-based activities," and said that "the vast majority of the alcoholics presently being handled through the criminal process is non-psychotic."

Mr. Tatham's memorandum set out a four-phase program. First, “a 200-300 bed comprehensive (in- and out-patient) Alcoholism Treatment Center would receive intoxicated male and female patients for short-term (one week or less) emergency medical treatment and, in some cases, longer term (one to three weeks) intensive care." Second, "a 200 bed Health Department facility could be located in the Lorton Reservation or at St. Elizabeths Hospital Campus" for "patients requiring long-term treatment or intensive rehabilitation services,"

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