Pubdate: Wed, 18 Sep 2002
Source: Washington Post (DC)
Page: A29
Copyright: 2002 The Washington Post Company
Contact:  http://www.washingtonpost.com/
Details: http://www.mapinc.org/media/491
Author: Joseph A. Califano Jr.
Note: The writer is president of the National Center on Addiction and 
Substance Abuse at Columbia University. He was secretary of health, 
education and welfare from 1977 to 1979.

TO REFORM WELFARE, TREAT DRUG ABUSE

The welfare reform bills passed by the House and reported out of the Senate 
Finance Committee consign most of the women and children remaining on 
welfare to a cruel Catch-22: forcing them off the rolls without giving them 
the tools they need to stand on their own feet.

We have come a long way since 1968, when Lyndon Johnson called the welfare 
system in America "outmoded and in need of a major change" and pressed 
Congress to create "a work incentive program, incentives for earning, day 
care for children, [and] child and maternal health services." With such 
reforms finally put in place a quarter century later, we have reduced the 
number of women and children on welfare from a peak of more than 14 million 
in 1994 to 5.3 million last year.

But in the process, the character of the welfare population has 
fundamentally changed. In 1994 at least half the mothers (largely 
temporarily unemployed) and children on welfare were there for less than a 
year. Moving and keeping them off public assistance in a booming economy 
was relatively easy.

Now comes the hard part: Today the bulk of mothers on welfare -- perhaps 
most -- are drug and alcohol abusers and addicts, often suffering from 
serious mental illness and other ailments. Most have been on welfare for 
several years. Moreover, women in the 1994 welfare population had an 
average of two children; those now on the rolls have an average of four 
children.

The National Center on Addiction and Substance Abuse at Columbia University 
(CASA) has been testing CASAWORKS for Families, a demonstration program 
involving 700 such women at seven sites (one each in California, Oklahoma, 
Maryland, Missouri, North Carolina, Tennessee and New York). The program 
provides integrated services such as treatment; literacy, job and parenting 
skills training; mental health and medical care; and assistance with 
housing and employment.

CASAWORKS women are representative of the mothers with substance abuse 
problems remaining on welfare. On average, they have been heavy drinkers 
for five years and illegal drug users for eight. Most have been abused: 70 
percent physically and 51 percent sexually. Seven of 10 suffer from 
depression and almost a third have attempted suicide. Three-fourths of 
these women have children younger than 6 and a third have children with 
serious medical, learning and behavioral problems. All confront the 
problems of poverty, such as inadequate housing, homelessness and despair.

The administration bill passed by the House would provide just three months 
for substance abuse treatment and training for these women before they 
could be pushed off the rolls. The Senate committee bill, only marginally 
better, would provide six months. These women need at least a year, perhaps 
two, of concentrated substance abuse treatment and literacy, job and 
parenting skills training. With such help, and with their benefits 
conditioned on staying in treatment, a significant number will achieve 
economic self-sufficiency and become responsible parents.

Preliminary evaluation of women in the program at the end of the first year 
is encouraging. Eighty percent have not used any illicit drug and 78 
percent have not done any heavy drinking in the past month. At entry, only 
16 percent were working part or full time; at the end of the first year, 
that figure had jumped to 41 percent, and the average amount earned had 
climbed from $50 a week to $250.

The next round of welfare reform should not be an unrealistic exercise in 
self-congratulation by members of Congress, serving up more of the same and 
ignoring the salient differences and greater vulnerability of the 
population remaining on the rolls. To offer these women a few months of 
treatment is a penny-wise, pound-foolish gesture that denies them the 
ability to become taxpaying workers and responsible parents and condemns 
them and their children to more years of dependency, ill health and crime 
with enormous public costs.

Several states, among them California, New Jersey, North Carolina, 
Tennessee and New York, are struggling to make the investment required to 
help these families by providing such treatment and training. Others are 
likely to follow if the president and Congress put resources behind their 
rhetoric -- and give these woman a decent chance to be self-sufficient.

The writer is president of the National Center on Addiction and Substance 
Abuse at Columbia University. He was secretary of health, education and 
welfare from 1977 to 1979.
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MAP posted-by: Beth