Blending Perspectives and Building Common Ground. Assuring Timely Access to Comprehensive Substance Abuse Treatment Services


Parents must be provided with opportunities for treatment and recovery.  Addiction is a treatable disease.  With high quality care, many addicted parents can and will take control over their lives, enter recovery, and provide safe and loving homes for their children.  Unfortunately, however, few of the parents who come to the attention of the child welfare system ever receive such care.

There are currently several important opportunities for States and local communities to expand substance abuse treatment for child welfare clients.

The Fiscal Year 1999 appropriations includes a significant increase in substance abuse treatment funding, particularly an increase of $225 million over last year's funding level for the Substance Abuse Prevention and Treatment Block Grant, the Federal block grant to States that provides funds for substance abuse prevention and treatment services.

Treatment for women with children was last year and will again this year be a priority population for applications under SAMHSA's Targeted Capacity Expansion Program.  This program allows State and local government agencies to apply for funds to enhance treatment capacity for populations for which local treatment capacity is insufficient.  In Fiscal Year 1999, a total of $55 million will be available for the program, and $110 million has been requested for this program in the President's Budget for Fiscal Year 2000, doubling the size of the program with a significant investment of new resources.  SAMHSA's Center for Substance Abuse Treatment (CSAT) will also continue to support a number of long-term residential substance abuse treatment programs for women with children that enable women to bring their infants and children into treatment with them.

Further opportunities for States and local governments to improve treatment for parents include making increased use of Medicaid to fund substance abuse treatment services.  Many child welfare clients are Medicaid-eligible.  As described in Appendix A, most substance abuse treatment services for adults, with the exception of services provided in large residential facilities, can be paid for under Medicaid.  A number of States have expanded their provision of substance abuse treatment services through Medicaid in recent years, and additional States may wish to consider this option as a way of expanding treatment capacity.

Finally, many substance abuse services could be paid for under the Temporary Assistance For Needy Families (TANF) and Welfare-to-Work Programs.  Many families with substance abuse problems who come to the attention of the child welfare system are families receiving welfare benefits.  If these parents' substance abuse problems are interfering with their ability to care for their children, it is likely that the substance abuse is also compromising employment.  States and counties may wish to consider writing substance abuse treatment services into these clients' employment plans.  Under these circumstances, TANF funds, and funds under the Welfare-to-Work program, could be used for non-medical aspects of substance abuse treatment, if such treatment is not otherwise available to the participant.  Non-medical services include services performed by those not in the medical profession such as counselors, technicians, social workers and those services not provided in a hospital or clinic.  The Welfare-to-Work Program, operated by the U.S. Department of Labor and implemented through local Private Industry Councils (PICs) and/or State and local Workforce Investment Boards (WIBs), specifically targets individuals who require substance abuse treatment for employment and allows non-medical substance abuse treatment as an allowable activity under job retention and support services.

State and local leaders are urged to consider these options as they plan to address the treatment needs of child welfare clients.  It is essential that communities provide substance abuse treatment services to these clients so as to allow as many parents as possible to establish sobriety and provide safe homes for their children.  The availability of new resources can promote the building of capacity at the state and local levels to provide services in ways that promote safety and permanency for children and sobriety for families.  If the utilization of these resources can be shaped in a collaborative way that builds on the knowledge and expertise of both systems and the needs of families, the stage can be set for more effective use of future resources.