Drug testing for welfare faces hurdles Addiction treatment programs in short supply, experts say

Churches are opposed

Md. would deny benefits under Assembly proposal

December 08, 1996|By Kathy Lally and Jonathan Bor | Kathy Lally and Jonathan Bor,SUN STAFF

A legislative proposal to test welfare applicants for drugs has quickly encountered serious obstacles: Not only are treatment programs filled up, with long waiting lists, but the plan depends on the participation of religious leaders who are infuriated by it.

As if that weren't trouble enough, the idea took state and city health and welfare officials by surprise. They first heard about it Tuesday, when the General Assembly's Joint Committee on Welfare Reform said it would recommend something no other state has done: testing all welfare applicants for drug use and denying them benefits if they refuse treatment or return to drugs.

"I'm afraid the program is moot from the beginning," Dr. Peter Beilenson, Baltimore's health commissioner, said. "We have 5,700 slots, and we could only estimate how many people are trying to get in.

"My guess is it's probably 30,000 in a given year."

The Rev. Douglas Miles, pastor of Koinonia Baptist Church in Baltimore, called the proposal the "height of social engineering" because if a parent refused treatment, it would cut off her portion of the welfare payment and require a third party such as a church to accept the child's portion and spend it for the family.

"It assumes that just because you're poor means you're taking drugs," he said. "To ask the church to be part of this despicable effort is outrageous. The church community will stand united and opposed to it."

Legislators, hearing the complaints about shortages of treatment, promised to push to expand treatment programs.

"I would not support a change in law unless we have appropriate treatment available," said Del. Samuel I. Rosenberg, a Baltimore Democrat and co-chairman of the welfare reform committee. "The whole point is to help people."

If Maryland does require drug testing, it will be setting foot on terrain that until now has been considered risky, an area written off as promising too little return for too much investment.

But state Sen. Martin G. Madden, a Howard County Republican, says there is no choice if the state is to comply with the five-year limit on welfare benefits imposed by the federal government. He hopes the state can expand treatment as it moves welfare recipients into managed-care health plans.

Others are doubtful that sufficient treatment can be found. "Unless Maryland is in a different country than any other state," said Michael Laracy, who studies welfare reform for the Baltimore-based Casey Foundation, "treatment is woefully inadequate."

About 87,000 people throughout Maryland received drug-abuse treatment at public and private facilities last year, according to the state health department. That's about one-third the number thought to need services.

Beilenson calls drug abuse the biggest public health problem in the state and the goal of requiring treatment in return for a welfare check a laudable one. "Appropriate treatment does work, and it's not money wasted," he said. "The problem is, statewide, we do not have enough treatment slots."

The city has about 50 treatment programs. Half of the 5,700 slots -- which serve about 17,000 people because of turnover -- are in methadone programs. Methadone satisfies the craving for heroin but does not cure the addiction. The other half are in "drug-free" programs that attempt to get people off drugs through counseling.

A small number of patients are in residential treatment programs.

Karen Ostrich, director of the Man Alive methadone program in South Charles Village, said the program was always at capacity.

"Once you tell people there's a six- to eight-week waiting list they very often hang up the phone," she said. "The minute they want treatment, they want it that day. You should be able to offer them treatment right away."

In Maryland, under what has been Aid to Families with Dependent Children, about 63,000 adults and 140,000 children receive monthly benefits totaling $23.6 million. Legislators estimate that about 10 percent of applicants would test positive for drugs and about 5 percent would accept treatment, which they expect would come through managed care.

"One of the concerns, however, is the level of treatment that will be authorized," said Thomas Davis, director of the state's Alcohol and Drug Abuse Administration. Managed-care groups have been criticized for paring down substance abuse programs. "If it is not sufficient, people will still be left with a drug problem that must still be attended to."

Other states have rejected drug testing, either because it's not cost-effective or because of philosophical aversions.

One of those is Oregon, which Maryland welfare officials plan to consult because it is considered a national leader in reform, having reduced its caseload by 35 percent in the past two years.

"We made a conscious decision not to test everyone for drugs," said April Lackey, Oregon coordinator for drug and alcohol services. "It wasn't because it was too expensive. It was because we're here to help families."

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