With an aggressive new mandate, the Human Resources Administration is officially telling tens of thousands of substance abusers that they have to clean up or get out–fast.
The agency has informed the private agencies that provide substance abuse treatment to people on welfare that they will no longer receive referrals of clients unless they sign an agreement obligating them to report their clients’ progress to HRA. Welfare recipients who fail to keep pace with HRA’s timetables for recovery may be cut off from their benefits and their access to city-sponsored drug treatment.
Complying with those guidelines will be extremely tough, say substance abuse counselors. Under the new rules, a recovering addict has to sober up within 31 days, with no relapses. Health care professionals say these rules go against prevailing drug rehab practices and are just asking for trouble. “It is not unusual for there to be an episode of relapse when someone’s working on their recovery,” said John Coppola, executive director of the New York Association of Alcoholism and Substance Abuse Providers, which advocates for treatment providers. “It’s part of the recovery process.”
The city now requires the treatment centers, which work with clients referred from HRA’s welfare offices, to send the agency weekly drug test reports on its clients in methadone and outpatient treatment programs. About 10 percent of city adults on public assistance participate in a drug program, according to HRA.
But the providers aren’t having it. “A number of the protocols are contradictory to good clinical practice,” Coppola said. “These regulations simply don’t make sense.” Treatment agencies are also concerned they could get in trouble for following them: Last week, Coppola sent out a letter advising the city’s 173 drug treatment agencies to hold off on signing the agreement until HRA can assure them that they won’t have to divert staff from other programs to handle off the new paperwork.
There’s another problem. The state Office of Alcoholism and Substance Abuse Services, which creates the standards for New York’s substance abuse treatment programs, says the city does not have the power to dictate how substance abusers are treated. “HRA does not have the legal authority to mandate clinical standards,” said Gwenn Lee, an OASAS spokesperson. Unlike the city, the state does not recommend timetables for recovery from substance abuse, on the premise that everyone progresses at a different rate. And OASAS recommends keeping clients in treatment unless they have successfully recovered or have another program to go into.
“I think we’ll see more and more people losing their benefits as a result of this,” said Corinne Carey, director of the Harm Reduction Law Project at the Urban Justice Center. Some clinics have voluntarily complied with the city’s treatment rules since they were implemented last year, and clients of Carey’s have already felt the heat, including a recovering heroin addict who now faces losing his Medicaid benefits.
Both Coppola’s trade group and the Urban Justice Center say they are exploring their legal options. At the state substance abuse treatment agency, Lee says, “we’re working on it.”