Paul Pacheco: Cutbacks strangling human services care

By Paul Pacheco
September 25, 2004

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For the second year in a row, alcohol and drug abuse treatment programs face severe cuts by county government.

In 2004, $358,000 was taken from local alcohol and other drug treatment programs. According to County Executive Kathleen Falk's proposed budget, an additional $333,000 will be cut in 2005.

For over 15 years county funding for human services has been well below the cost of living. Alcohol/drug treatment agencies have coped with this slow strangulation by downsizing.

Some smaller agencies have consolidated with larger ones. Most agencies have been forced to give minimal salary increases to their staffs, or no increases at all. As a result, some key staff have left public service for better-paying jobs in private agencies, or have left human service careers altogether.

Recently Dane County officials have informed the Hope Haven program, which provides halfway house and residential treatment services for people with advanced addictions, that it will be phased out over the next three years. Hope Haven has been a key treatment program since 1974.

In the last three years PICADA, a respected prevention and early intervention service, had its county funding reduced to the point that it can now provide only a fraction of the services it once did. It faces additional county cuts next year.

The Tellurian Program, which runs the county's detoxification facility, is struggling to provide services to the many citizens who require medically monitored detoxification; it has hinted it may need to reconsider its role in overseeing civil commitments for alcohol and drug-induced dangerousness - all because of underfunding.

There is a waiting list of more than 200 citizens trying to get counseling at the alcohol and drug treatment program of Mental Health Center of Dane County Inc. They must wait 15 weeks before they can get the help they need today. Mothers and children who need immediate service are becoming more difficult to enroll systemwide. At least one person is known to have died while stuck on a waiting list.

Many of these citizens have mental health problems in addition to substance abuse. Both problems will get worse while they wait. Some will end up in hospitals at a cost of $800 to $1,000 per day. Some will cause domestic problems. Some will drive drunk or commit other crimes and end up in our already clogged jail.

What we are witnessing is the unraveling of the alcohol/drug treatment system's continuum of care, a once nationally recognized model created over the past 35 years to keep people out of expensive institutions by intervening early when we can, and by providing stabilization for those with far advanced problems when we can't.

In between those two extremes is the system's centerpiece, outpatient treatment. But outpatient care cannot be all things to all impaired people.

Our system is unable to offer prevention services when addiction problems are less serious and relatively inexpensive to treat, and soon we will be unable to stabilize people with chronic addiction problems, meaning they will swell the ranks of the homeless and the incarcerated. These are serious matters.

County cutbacks are forcing our continuum of care model to become a treatment system of so-called mandated care, where increasingly the only people able to get treatment are those "mandated" to get help under court order or other legal requirements. Excluded from this model are Dane County's uninsured voluntary clients. In other words, people of modest means who want help will be turned away, while those who are forced to seek help are prioritized. That is a backward system detrimental to the quality of life in Dane County.

Iurge the Dane County Board to consider ways to restore our depleted alcohol/drug treatment system by supporting changes to the county executive's levy formula and by aggressively pursuing new Medicaid funding initiatives.

I urge Dane County citizens to contact their County Board supervisors to ask them to support a better-funded human services system in Dane County. We deserve no less.

Paul Pacheco is chairman of the Dane County Chemical Dependencies Consortium.

Published: 6:32 AM 9/25/04