Drug centers assessed by city

Program aims to give treatment facilities credibility, funding

October 29, 2001|By Caitlin Francke | Caitlin Francke,SUN STAFF

It's Friday morning, and Dr. Peter L. Beilenson, Baltimore's health commissioner, is sitting at the head of a conference table, flipping through pages of statistics. Nervous directors of city drug treatment programs sit around the table and wait for the interrogation.

Today's first target is Total Health Care Inc., an outpatient program near Charles Street and North Avenue. Beilenson wants to know why the program's retention rate - how long people stay in treatment - has dropped. Six months ago, 94 percent of the people were still there after the first month of treatment, now 83 percent are.

"What's going on?" Beilenson asks.

Director Wendy Merrick attempts to explain, knowing her funding depends on whether her answers satisfy Beilenson.

Since the city's drug treatment accountability program, known as DrugStat, started about 18 months ago, one program has lost its funding and another had its funding reduced, because they were not performing well.

DrugStat is part of Mayor Martin O'Malley's high-tech accountability approach to city management, which he based on the New York Police Department's crime program CompStat. It seems to be establishing credibility for the city's drug treatment programs.

For years, city and state leaders doubted the efficacy of city drug treatment programs, making requests for funding in Annapolis a hard sell. In April 2000, a spokesman for Gov. Parris N. Glendening criticized the city programs, saying that the governor "has no confidence ... [that] funding will be spent effectively and efficiently."

State Sen. Barbara A. Hoffman, chairwoman of the Senate budget committee, said lawmakers could not understand why the number of city addicts never seemed to decline despite millions of dollars in state funding. Since DrugStat started she has felt more comfortable funding city programs, because she has been able to see which ones perform well and which do not.

"Until they kept track of successes and failures, you would be putting money into a program and not know if it was any good," said Hoffman, a Baltimore Democrat. "It helped rehabilitate the reputation of the city Health Department in my mind."

State Sen. Christopher Van Hollen Jr., vice chairman of the Senate budget committee and a Montgomery County Democrat, said the state wants to know if its money is being invested well, and DrugStat allows lawmakers to inspect results.

"This has provided more confidence in the program," Van Hollen said. "It's definitely seen as an important step in bringing accountability" to Baltimore drug treatment.

All city programs are funded by Baltimore Substance Abuse Systems (BSAS), a quasi-public entity under the city Health Department. BSAS has a $45 million budget made up of state, federal, local and grant money and funds 53 treatment and 22 prevention programs.

Beilenson said DrugStat gives him the statistics he needs to make his case for funding in Annapolis.

In Glendening's budget this year, for the second year in a row, he included an $8 million increase in funding for the city's treatment programs.

Nearly every Friday, different treatment providers appear before Beilenson. They are measured on five basic areas: how many people are in treatment; how long they stay; how many patients test positive for drugs while in treatment; how many leave treatment with a job; and how many are arrested after treatment.

Since DrugStat began, two of the city's drug treatment programs have seen their funding cut or reduced. In the past, programs have had money taken away during BSAS' annual review process, said Bonnie L. Cypull, acting president of BSAS.

She said the New Fayette House Inc. program lost its funding last year, because it did not have adequate fiscal controls. Since then, she said the program has made changes, and she hopes BSAS will begin funding the program again. The other, Northwest Baltimore Youth Services Inc., was not treating enough addicts, so its funding was cut.

Beilenson said all programs have improved. The percentage of unemployed addicts who left treatment with a job or a skill has increased by more than 30 percent. Methadone centers are holding onto patients longer - a sign that the treatment will stick, according to statistics provided by Beilenson.

But on this Friday, Total Health Care is under the gun. Beilenson wants to know why addicts are dropping out of the program more often.

Merrick, the director, tells Beilenson that she is trying to increase the number of people the program treats - but that means some people who are not ready to kick the habit end up accepted. They back out quickly, she says.

She says she used to screen potential patients by having them return for three or four interviews, but now she accepts them into the program on their first or second interview.

Beilenson conducts a quick poll of the table, asking other agencies when they accept new patients. Most of them say on the second interview.

So he kicks it back to Merrick.

"I don't buy that argument," he says.

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