Thursday, December 2, 2010

Substance abuse treatment programs weather funding crisis - Medill Reports: Chicago

Everyone who is paying attention knows that the state is in financial trouble. And many of the stories chronicling how that plays out on a granular level are aware of program cuts and unpaid bills.
But not as many people are aware that some of the most critical cuts are coming out of the budgets of the state’s substance abuse treatment agencies. That means that some of the state’s most fragile residents – drug addicts and alcoholics – are on the front lines of the suffering.
And when you learn that the state saves $7 in costs such as welfare and unemployment for every dollar it spends on substance abuse programs, the problem comes into stark focus.
In the last three years, Illinois has decreased state funding for substance abuse prevention and treatment agencies by 8.6 percent. The Division of Alcohol and Substance Abuse, housed within the Illinois Department of Human Services, has endured a 30 percent cut since fiscal year 2008.
Sara Howe, CEO of the Illinois Alcoholism and Drug Dependence Association, estimates that 10 to 15 percent fewer people are getting drug and alcohol treatment services.
And now, Illinois owes millions to those same agencies.
According to a survey conducted by the Illinois Alcoholism and Drug Dependence Association, for fiscal years 2010 and 2011, Illinois owes community-based agencies $46 million as of November. Many have been forced to end programs. Others have had to decide between paying vendors or paying employees.
“You don’t necessarily see that an agency has completely shut down, but there are programs that have gone away,” Howe said. “There have been numerous layoffs and people are working without their paychecks,” she said.
Unlike other social service agencies, substance abuse treatment providers don’t get flat grants from the state. Instead, DHS requires an agency to provide services first and then submit a bill, much the way doctors bill insurance companies.
Tom Green, spokesman for the Illinois Department of Human Services, said the last several years have been challenging without additional state resources. “The state just doesn’t have enough money in its treasury to write the checks,” Green said.
Pamela Rodriguez, president of Treatment Alternatives for Safe Communities, a non-profit organization that provides case management services to individuals suffering from substance abuse in and out of the Illinois court system, said that while rural communities have been hit hardest, urban cities like Chicago have come up with more resources to fill the funding gap.
“We’ve been working that much harder to take advantage of some of the federal money,” she said. But even federal money, including stimulus money, is starting to disappear.
The South East Alcohol and Drug Abuse Center, a Chicago organization that provides drug treatment on the South Side, is one of the agencies that wasn’t able to fill the gap.
Valerie Pitts is the director of SEADAC’s youth treatment program – which was forced to shut down in July. She retained her job, but her title no longer accurately describes her position.
Before the youth treatment program closed, SEADAC counseled about 2,000 young people a year, ages 13 to 20. It focused on prevention in neighborhood schools and helped students who struggle with addictions to marijuana and alcohol.
“We just have to say ‘We’re sorry, we don’t have a youth treatment program anymore,’” Pitts said.
Pitts said SEADAC tries to refer teens to other agencies, but very few agencies deal with teenagers. “It’s a big injustice mainly because there aren’t a lot of residential outpatient treatment centers that service youth,” Pitts said.
Many of the teens either forgo treatment entirely or are forced to commute long distances to get help, which can cause other problems like parole violation and absence from school.
“People are generally not overly motivated to participate in substance abuse treatment,” Rodriguez said, “and this is particularly true for youth.”
Long-term effects
Howe said drug treatment and prevention services are needed now more than ever. On one hand, she said, as unemployment rises during the recession, more people will turn to drugs and alcohol. On the other hand, crime will escalate.
“Crime and addiction go hand in hand,” Howe said. By spending more money now, the state could actually save money in the long run.
Studies have shown that in Illinois, at least $3,200 is generated for the state in employment earnings and health care costs for each person treated for substance abuse. Other studies have consistently shown that for every dollar spent on substance abuse treatment and prevention, the state saves $7 in other costs, like the costs of corrections, welfare and unemployment.
“If you invest $1 and save in costs in corrections, why wouldn’t you do it?” Rodriguez said. “If you’re going to cut that dollar, you better build your budget to add $7 more somewhere else.”
Howe said she is concerned that the current lack of funding will have long-term consequences that will cost the state even more money.
“Overtime, everything is cyclical,” Howe said. “You can’t just start a program back up. You can’t just open a building again. It’s not like if they just gave us our money back we’d be all set,” she said.
As for the 2012 fiscal year budget, which will be introduced in January, Howe and Rodriguez aren’t optimistic.
Green said that DHS will not comment on the budget until it’s introduced. But Rodriguez said she’s concerned that the state will make hard decisions based on short-term goals and overlook the bigger picture.
“It’s the shortsighted nature of political decisions,” she said.
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