"Welfare Options: Substance Abuse"
Welfare Reform Options
Set #6 -- Substance Abuse
WORKGROUP #3 SUPPORT SERVICES
ISSUE: Given the shortage of substance abuse treatment
programs for the existing eligible population, should TANF
recipients be given priority to receive treatment or should
the number of programs be increased?
OPTION TITLE: Increase the availability of substance abuse
programs.
OPTION DESCRIPTION: The state must ensure reasonably
speedy access to an appropriate level of substance abuse
treatment for adults who have a drug addiction which is
identified as a barrier to employment and/or self-
sufficiency.
BACKGROUND: It would be difficult to give priority to the
TANF adult population compared to those who already have
priority. Currently, those who have priority are pregnant
women and IV drug users. Other populations who could be
displaced include: parents participating in family
preservation or family reunification activities, those who
are already self-sufficient but need treatment in order to
maintain their status, and those being diverted from the
criminal justice system. Alcohol/Drug treatment providers
have the ability to expand services with an increase in
financial resources.
WORKGROUP #3 SUPPORT SERVICES
ISSUE: Should the state or the county assume responsibility
for substance abuse treatment program expansion?
OPTION: The state should assume the responsibility for
increasing the number of treatment placements available for
TANF adult recipients.
OPTION DESCRIPTION: The state shall, through the use of
TANF block grant funds, increase the amount of money
available for substance abuse treatment. In addition, the
state shall explore the possibilities of obtaining a waiver
from the federal government which will allow residential and
day substance abuse treatment services to be provided to
parenting women through Medicaid.
BACKGROUND: The federal act allows the TANF block grant to
be used for alcohol and drug treatment as long as it is not
a medical service. Most of the treatment strategies which
are available in California are non-medical.
WORKSHOP #3 SUPPORT SERVICES
ISSUE: Should the state of the county assume
responsibility for substance abuse treatment program
expansion?
OPTION: A state/county sharing ratio (using county TANF
block grant funds) should be developed to fund the expansion
of substance abuse treatment programs.
OPTION DESCRIPTION: The state and counties shall develop a
state/county sharing ratio to cover the cost of expanding
substance abuse treatment programs. This option shall only
be operative if county TANF funding is provided through
block grants which are not based on current caseloads.
BACKGROUND: The viability of this option depends on the
mechanism which is chosen to fund programs at the county
level. If the state transferred the TANF funds to the
counties through a block grant, based on the formula used
by the federal government in determining California's block
grant, counties may have a small amount of discretionary
funds to apply to support services depending on legislative
decisions on work requirements and time limits, among other
things. In most cases, case loads currently are lower
than in the base years used in the federal/state block grant
formula and if this block grant approach was used most
counties would benefit from the federal block grant to the
same extent that the state benefited. If, however, the
counties are funded based on the grant amount of their
current caseload there would be no additional monies
available to apply to support services.
WORKSHOP #3 SUPPORT SERVICES
ISSUE: Given the predominance of women in the TANF
population, should there be an emphasis on the development
of substance abuse programs designed to treat women with
children?
OPTION TITLE: The state should expand existing women-
specific substance abuse programs and create new programs
where needed.
OPTION DESCRIPTION: Substance abuse treatment programs
designed to serve parenting women shall be expanded and new
programs created where necessary.
BACKGROUND: The competency in providing woman-specific
services varies from county to county. Some women's
programs have the ability to increase their capacity;
however, in some communities new programs may need to be
created.
Women with severe addiction really need the intensive
intervention that comes from residential treatment programs
which focus on the specific problems which affect women
users. These programs are in short supply and are
expensive because of their duration (12 to 18 months) and
the need to make alternative child care arrangements.
Nonetheless, for a small percentage of women and their
children this may be the only solution. Some women
will not enter these programs because it means separating
from their children for an extensive period of time.
Because of this, intensive day treatment programs have been
developed and are the best alternative in many cases.
Women with less severe addictions can benefit from day
treatment programs which are, of course, the least
expensive and for many women will provide the support they
need. Women participating in these programs will have
other issues which they are also addressing which may
include: family preservation/reunification services,
domestic violence issues, medical and mental health
services.
WORKGROUP #3 SUPPORT SERVICES
ISSUE: Should individuals be exempt from the work
participation requirements of TANF during the time they are
receiving treatment for substance abuse?
OPTION TITLE: County flexibility to determine exemptions
from work participation requirements for individuals
undergoing treatment for substance abuse.
OPTION DESCRIPTION: The state will allow the counties the
flexibility to develop, in consultation with drug abuse
providers, the extent and duration of any exemption from
work participation activities on a case by case basis.
BACKGROUND: In many treatment programs, participation in
job search activities and job training programs are part of
the treatment
program. In other programs, such as the intensive,
residential programs, isolation from outside contacts and
pressures are vital to the participants' success.
Therefore, a blanket exemption is neither appropriate nor
desirable and county welfare departments and service
providers will need to make these decisions on a case by
case basis.
WORKGROUP #3 SUPPORT SERVICES
ISSUE: Should the family of an individual who has been
convicted of a drug felony be denied TANF benefits.
OPTION TITLE: The family of an individual who has been
convicted of a drug felony should not be denied TANF
benefits under specified conditions.
OPTION DESCRIPTION: Any person who has been convicted of a
drug felony but who has either successfully undergone drug
abuse treatment, or is willing to enter a drug abuse
treatment program shall not be denied TANF benefits. The
county may remove the person from the family grant if, at
any time, it is determined that the person has resumed
using drugs and is unwilling to undergo further treatment.
BACKGROUND: Even the most conservative estimates of drug
abuse in the TANF population suggest a percentage between
15.5% and 39%. The Department of Alcohol and Drug
Programs, using national research statistics, estimates
that 20% of the TANF population has alcohol/drug problems.
Given the statistics on drug use in the TANF population,
the workgroup felt that the state should give parents the
chance to rehabilitate themselves and take advantage of the
new opportunities to train for and obtain work through the
TANF program before assessing any sanctions for past
behavior. The impact of denying benefits to drug felons
outright has the potential for impacting a significant
number of children and provides their parents with no
incentive to change their life styles.
WORKGROUP 3# SUPPORT SERVICES
ISSUE: Should all TANF recipients be tested for drug and
alcohol abuse to determine their ability to meet TANF work
participation requirements?
OPTION TITLE: Substance abuse screening should be part of
all job training and job readiness assessments.
OPTION DESCRIPTION: Drug and Alcohol screening shall be
part of all job readiness and job training evaluations.
Any person determined to have drug or alcohol problems shall
be referred to the appropriate agency for an assessment.
BACKGROUND: Drug testing is a very expensive process. The
cost of drug testing for eligibility (and the necessary
administration for due process) would outweigh the
benefits. Drug/alcohol addiction is a health issue which
impacts an individual's ability to become self-sufficient.
Therefore, it is appropriate to conduct drug and alcohol
screening as part of job assessment and to provide treatment
where necessary.