Drug funding cuts decried

Critics fear decrease in treatment subsidy will overburden jail

July 06, 1999|By TaNoah Morgan | TaNoah Morgan,SUN STAFF

An innovative countywide program that subsidized treatment for nearly 800 substance abusers last year has fallen victim to a budget cut that critics fear will leave many of the sickest and most needy without care and ultimately overburden the jail system.

The $1.5 million drug treatment initiative for people referred by the criminal justice system, launched by former County Executive John G. Gary in 1998 and financed by a $12 million budget surplus, lost more than $1 million under the current budget, which focuses heavily on education. Budget planners said the cuts eliminated overlapping drug services.

Although the program's administration remains -- counselors, assessors and court-appointed monitors -- only $450,000 in county money is left to reimburse private clinics for detoxification, inpatient programs and outpatient counseling. State and federal grants add another $70,000, county officials said.

That money will be spread among 15 private health providers who say that even with the larger budget, they operated at a loss by treating the referrals. Administrators at Pathways, a drug rehabilitation clinic sponsored by Anne Arundel Medical Center and one of two clinics in the county that offers detoxification, recently decided that the county's reimbursement rate is too low for them to accept referrals for inpatient and long-term programs.

"It's going to be a big loss for the criminal populations," said Marti Potter, an administrator at Pathways, on Riva Road in Annapolis. "A lot of the people who were eligible last year are not this year. Nobody doubts that treatment works -- [the problem is] getting it funded."

Under Gary's program, criminal suspects are evaluated during the intake process at the jails and courts. Those with substance abuse problems are referred to one of 15 private clinics. Those unable to pay all or part of the costs are subsidized by county funds. The county health department acts as the health management organization, providing some reimbursement for the clinics for their services, clinic managers say.

Last year, the health department reimbursed $1.1 million to clinics that cared for 779 patients, according to county health officer Frances Phillips. Most of the money went to facilities offering inpatient care, which is a more intensive and more costly service.

This year's budget calls for health officials to shift the program's focus, allowing county subsidies only for juvenile defendants and those eligible to go through the county's pre-trial services who have been released on bond or on their own recognizance.

Those groups are likely to have the highest success rate of continuing and completing treatment, Phillips said, because the counselors catch youths at the beginning of their substance abuse problems, and pre-trial counselors monitor defendants to ensure that they show up for drug treatment. They also can test defendants for drug use.

The budget cuts, which also dismantled the health department's Office of Prevention Service, trimmed overlapping drug programs offered through the police department, state's attorney's office, department of aging, health department and courts, said budget analyst Marc Burford. The county will disperse nearly $9 million this year for drug prevention and treatment through those departments' budgets, he said.

But critics fear the cuts in the county subsidy will force addicted defendants into crowded jails, lengthen waiting lists at drug treatment facilities and compel clinics to turn away the worst-case addicts.

Because of the subsidy cut, effective July 1, Hope House in Crownsville reduced the number of available beds from 21 to 18. The clinic already had a four-week waiting period for patient screening. The nursing staff may be cut, said executive director Ruth Hudicek. With fewer nurses, she said, the clinic could no longer operate its detoxification program or handle patients with both psychiatric and addiction problems.

"We've literally had people die here because they desperately needed [detoxification] treatment and tried to do it themselves," said Barry Wiles, chairman of the Substance Abuse Treatment Council of Anne Arundel and executive director of Alcohol and Drug Recovery, one of the area's largest clinics.

Wiles was instrumental in persuading Gary in late 1997 to initiate the program and helped lead the lobbying in May against County Executive Janet S. Owens' proposal to cut the reimbursement program entirely.

Other key elements of the program, such as the drug counseling program at the county detention center on Ordnance Road in Glen Burnie, haven't been affected because the counselors' salaries have been absorbed in the health department budget.

But that could spell trouble for jails, Wiles said. Patients turned away for treatment probably will get into trouble again and be incarcerated, Wiles said. Or judges might sentence defendants just so they can be treated by the jail's free drug treatment program, overburdening it.

"I don't want the judges sending people here that they normally would not incarcerate to get drug treatment," said Jim O'Neill, an Ordnance Road facility administrator.

The jail is already full of criminals with short sentences who need treatment, O'Neill said. About 240 inmates annually participate in a six-week drug treatment program there.

Another concern is that the money will be gone before the year is through.

"Five hundred thousand is just not enough money, because some of these people are going to be inpatient and that sucks up a great deal of money," Wiles said.

He criticized what he considers Owens' single-minded focus on education. "You can't shut down these programs because one area needs all the money," he said. "It's not doing any good if we educate a bunch of drunks."

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