After more than a decade of failing to stop gross abuses in an aid program for disabled drug addicts and alcoholics, the Social Security Administration is preparing to spend nearly $300 million on a crackdown ordered by Congress that will force thousands of chronic substance abusers off the rolls.
That's the estimated cost of enforcing a new law that aims to cut off payments to all addicts after three years -- a move triggered by reports from investigators that Social Security has failed to keep recipients from spending the money on drugs and alcohol.
In some cases, addicts have used their monthly checks to drink and drug themselves to death at taxpayers' expense, investigators found.
Critics have called the program "revenue-sharing for addicts" and "death on the installment plan." But addiction counselors say the drastic response by Congress will rob thousands of sick individuals of their only income and that it amounts to punishing the needy for Social Security's failure to run the program properly.
They say that the cutoff may cause a crisis in large cities such as Baltimore, where addicts will face long waiting lists for the publicly funded drug treatment programs that they would need to get themselves clean before they lose their monthly aid checks.
Meanwhile, Social Security officials said last week that they still do not know how many of the agency's 9 million physically and mentally disabled check recipients are addicts and alcoholics. Figuring that out, notifying addicts of the cutoff, and defending against legal challenges is likely to cost taxpayers $285 million over the next five years.
That much money would buy a year of intensive residential care for 15,000 of the hard-core addicts currently on the rolls, treatment experts say.
"It's an insane misapplication of public funds that can only make the situation worse," said Jack Gustafson, who represents state rehabilitation directors in Washington. "It's almost beyond dispute at this point that treatment is far less expensive than incarceration or welfare programs -- which is exactly where these people are going to wind up if the best we can do is shove them back out onto the street in 36 months."
Sen. William S. Cohen, the Maine Republican who is considered a prime mover behind the legislation, has called the current program "revenue-sharing for addicts." But he said Friday that he, too, is troubled by the final version of the cutoff he helped initiate.
Attached to a larger bill that will make Social Security an agency independent of the Health and Human Services Department, the measure would drop some addicts even if they can't find rehabilitation. The bill is expected to win final congressional approval this week.
"We can't have taxpayers' dollars going directly into the arms and stomachs of addicts," Mr. Cohen said Friday. "But it's also not fair to tell people you have 36 months to find treatment where treatment isn't available."
The current aid program cost taxpayers about $1.4 billion last year and provided monthly checks to as many as 250,000 addicts and alcoholics nationwide, congressional investigators estimate. The recipients, many of whom are unable to work solely because of their addictions, are supposed to spend the money on food, shelter and clothing.
Further, a third of them are supposed to be in mandatory rehabilitation as a condition of receiving $446 in monthly checks. But Social Security officials admitted at hearings earlier this year that they have failed to keep tabs on the vast majority of addicts to make sure they are in treatment.
Translation: Of the nearly 80,000 addicts supposed to be in treatment, the agency knew of fewer than 8,000 who actually were.
At the same time, tens of thousands of new recipients are entering the disability program every year, many as a direct result of outreach campaigns by Social Security and state welfare agencies.
100,000 on waiting lists
As the rolls have grown, treatment slots have dwindled in many )) cities. There are at least 100,000 addicts and alcoholics on waiting lists, according to federal, state and private estimates -- and there may be as many as 3.2 million who need help.
In Baltimore, a study by the non-profit Abell Foundation last year found that there were 62,000 addicts and alcoholics in the city in need of treatment, and that Baltimore's rate of heroin-related emergency room admissions was among the highest in the nation. The study also found that eight of every 10 inmates in the city jail were drug users.
Yet there were only 5,500 publicly financed, out-patient treatment slots available in the city. There were no in-patient slots for hard-core addicts, and the jail had almost no treatment programs for inmates.
Gwendolyn King, who served three years as Social Security commissioner in the Bush administration, said such wide gaps between treatment supply and demand further argue against the cutoff.