Calling the city on costly drug service

Referrals: Agency's willingness to pay $55 for addicts' calls shows little regard for common sense.

July 07, 1999

WOULD YOU use an answering service that charges $55 a call?

Baltimore's drug treatment organization did for an entire month -- and paid with your money.

The organization's board members didn't question the arrangement, which guaranteed a flat rate regardless of the number of after-hours calls from addicts. They didn't wince when 44 of the 54 callers were simply told to call back during regular business hours. Only 10 were referred to treatment programs.

It's an extreme example. But just as $1,000 toilets and hammers once exposed the Pentagon's loose spending, the pricey phone calls show how the quasi-governmental Baltimore Substance Abuse Systems Inc. (BSAS), flush with $33 million in taxpayer money, is spending without regard for common sense.

Since Baltimore Mayor Kurt L. Schmoke doubled its budget three years ago, BSAS has been among America's biggest taxpayer-financed local treatment agencies. Yet it is operating with inadequate internal controls.

It's time to overhaul the organization and pare down its 30-member board, many of whose members don't even show up for meetings.

BSAS doesn't evaluate its 44 drug programs. Providers have no uniform admission or performance criteria. The very contractors who devour public dollars that flow through BSAS have almost complete control over operational matters, such as frequency of drug tests.

Not surprisingly, completion rates in BSAS-financed programs are abysmal -- just 7 percent for heroin addicts on methadone, for example.

BSAS's board bears much of the responsibility by not insisting on accountability. Its meetings are casual affairs, where parliamentary procedures are seldom observed. Concerns that are raised receive little follow-up.

Indeed, for much of last winter, the board dithered over whether it was an executive board or an advisory panel.

Board members are hand-picked by Health Commissioner Peter Beilenson. Many do not take their duty seriously. They attend meetings sporadically, and that seems to be the expectation: If all the board members showed up, the small meeting room could not accommodate them.

On paper, the BSAS board includes viewpoints of a range of people, from the lieutenant governor and city department heads to representatives of the Greater Baltimore Committee and major foundations to recovering addicts. In practice, though, that diversity is not evident at its sparsely attended meetings. Instead, the board is run by a clique that seldom challenges Dr. Beilenson, the chairman.

As a result, the board puts little pressure on BSAS to improve.

Some members fear open criticism might erode public support for drug treatment. Others -- including city elected officials -- worry that tighter standards could shut down anti-drug programs operated by politically influential community organizations. These groups, in turn, employ many recovering addicts as counselors.

As for members from organizations such as the Abell Foundation and George Soros' Open Society Institute, they have invested substantial grant money in BSAS and do not want to cast doubt on their judgment.

BSAS is at a crossroads.

With Mayor Schmoke leaving office in December and the city facing large budget deficits, current funding could be threatened unless the agency can prove success in providing treatment for Baltimore's estimated 60,000 addicts.

Meanwhile, the board is about to adopt a new strategic plan.

An outside consultant has amazingly recommended enlarging the already unworkable BSAS board to 36 members. This would be a mistake that would likely lead to more ridiculous spending and even less accountability.

At its meeting tomorrow, the BSAS board should reject its consultant's misguided plan and shrink the board to just 10 or 12 members.

A carefully selected, compact and more focused governing body would make BSAS's success more likely and give taxpayers some assurance that the tens of millions spent on treatment are not wasted.

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