OTDA Launches New Drug/Alcohol Policy

June 1, 2001

Author: Susan C. Antos

A joint project between the Office of Temporary and Disability Assistance (OTDA) and the Office of Alcohol and Substance Abuse Services (OASAS) has culminated in a new initiative which promises a more parent friendly approach to assessing and treating drug and alcohol abuse. This initiative was announced at a teleconference on May 3, which was broadcast across the state, and is part of a report by Mary Nakashian entitled, "Identifying Substance Abuse among TANF Families in New York State."(1)

The new policy is based on the recognition that addiction is a chronic and relapsing brain disease, and that every $1 spent in treatment saves $7 in other costs. The teleconference speakers cited data showing that the likelihood of drug and alcohol problems among public assistance recipients was between 6 - 30%, but only 1% of the current population was being identified through the current assessment process.

The Office of Alcohol and Substance Abuse Services held a series of focus groups in Rochester and New York City with recovering addicts, in an attempt to identify the barriers that kept recipients from stepping forward to self-identify needing treatment. First and foremost was a risk of losing their children; second is a risk of losing benefits; and third is a sense of shame. Most noted that they did not get into treatment until they lost their children or became involved with the criminal justice system. They also noted that when they picked up the phone to ask for help, they needed to talk to a person not a machine, and the focus group strongly recommended an 800 number. OASAS and OTDA began formulating a new policy, recognizing the need for more worker training and the fact that the blunt and direct questions of the current assessment instrument might not be the best vehicle for eliciting a positive response.

In response to the work done by the project, OTDA/OASAS now promises a new three pronged approach to those in need of drug and alcohol treatment, described in more detail below.

A Targeted Outreach Campaign to Women

This campaign will go out into the community, into health centers, and to other places. Both posters and brochures will be available throughout the community, and they will be available in English in July, and in Spanish in August. The theme will be that families can stay together while a parent is in drug treatment and that the addict does not have to be alone.

To make good on this promise, OTDA promises the use of more treatment options that allow families to stay together. Additionally, OTDA/OASAS is providing funding for peer outreach workers who will be stationed at a variety of places, including health centers and social services offices. These workers must be females who have been in recovery for at least one year with a high school education.

Training for Workers

Recognizing that addicts will not disclose unless they feel that they are talking to someone that they can trust, the agencies are embarking on a training effort that will attempt to change the "organizational culture" toward drug and alcohol treatment. The focus on this training includes developing new approaches, such as

• not punishing recipients for having a disease that the agency is encouraging them to talk about;
• providing necessary child care and mental health services. Recognizing that an addict may be unable to negotiate the different agencies and systems to obtain these services, 
• will be the job of the workers to assist in obtaining these services;
• identifying agency requirements that conflict with each other, and getting the agency's "internal act" together;
• not making promises unless the agency can deliver;
• creating an atmosphere of safety, providing the message that it is "safe to talk" to the welfare worker.

Training will begin with eligibility workers.

Revised Screening Instrument

Noting the reluctance of addicts to self-identify, the screening form has been revised to include both behavioral observation and observation from case records.(2) The observational checks include homelessness, involvement with the child welfare system, on assistance for more than 48 months, and "hyperactive, belligerent, argumentative." Currently, the applicant or recipient is permitted to fill out the form. This will no longer be permitted. Workers will be required to ask all the questions on the screening form. The screening process is currently mandated by the Social Services Law(3), and it is inconsistent with the tone of the new initiative which seems geared at self-identification and trust; the screening form suggests a "gotcha" approach more consistent with a sanction driven system.

Implementation

The initiative will be piloted in Albany County, and then it will go to the "big 10" districts, followed by seven regional training events. A separate model is being developed for the Human Resource Administration in New York City. David Kircher, who is directing the program in Albany, states that one of the goals of the program is not to penalize applicants and recipients at relapse, but to look at the reason for relapse. He also notes that there may not be enough Certified Alcohol and Substance Abuse Counselors or treatment space for identified families, and he hopes the program is successful enough that he can confront any such problems.

Conclusion

Although the new policy promises a number of positive steps in treating addiction, it seems to have an inherent internal contradiction that seems difficult to address. How does the local social services district inspire trust when its workers have the power to take an addict's children away and put them in the child protective system? How does the local social services district inspire trust when its workers can sanction non-compliant addicts and make them lose their benefits? Resolving these critical questions will be one of the keys to the success or failure of the new system.
________________________________________
1. Contact Susan Antos (santos@empirejustice.org) for a copy of the training tape.
2. The screening form is attached as an appendix to the Nakashian report which is referenced in footnote 1.
3. Social Services Law § 132(4).