Pubdate: Mon, 20 Sep 1999
Source: Milwaukee Journal Sentinel (WI)
Copyright: 1999, Milwaukee Journal Sentinel.
Contact:  414-224-8280
Website: http://www.jsonline.com/
Forum: http://www.jsonline.com/cgi-bin/ubb/ultimate.cgi
Author: Tom Held, of the Journal Sentinel staff

CUTBACKS LEAVE COUNTY'S POOREST ADDICTS ON STREETS

They Face Waiting Lists For Treatment Programs

The scene offered a street-level assessment of drug and alcohol treatment
for Milwaukee County's poorest addicts.

The day's expert, Edward, leaned up against a house on N. Hopkins St., just
two doors away from Gladney's Beer & Liquor. While he talked about drugs
and alcohol, Edward kept his left hand tucked between his hip and the
house. The hand held a paper bag; the bag held a bottle.

His assessment of the treatment situation: It's hopeless.

He talked about a friend, a woman, an addict, who wanted to get off drugs.
At Edward's urging, she went to one of the two county-funded central intake
units for addicts and alcoholics.

An intake worker told the woman her name would be put on a waiting list.
They would contact her when a slot opened in a treatment program.

"People like her, they'll just say, 'What the heck, I might as well just
keep doin' what I'm doin',' " Edward said. "She didn't feel like there was
any hope."

Treatment providers and people who work with addicts fear that scenario is
being repeated over and over again as a lack of money creates waiting lists
for drug and alcohol treatment programs in the county.

Instead of directing addicts to an agency for treatment, the workers at the
two intake centers are frequently only able to take names and addresses,
then wait for treatment slots to become available. The wait can last weeks,
and sometimes more than a month.

The "don't call us, we'll call you" message can be devastating for someone
who needs help, said the advocates.

James Marr, who runs a counseling program through Cross Lutheran Church,
said: "When they walk out that door, they run into another type of
counselor, a friend with a 40-ouncer."

Marr sees the addicts regularly in his outreach work through the church.
The women sell their bodies to buy food for their children and drugs for
themselves; the men beg or steal to maintain their habit. All slowly
destroy themselves, making their treatment more difficult as time passes.

The problem, county officials said, is that there isn't enough money
available to help everyone who needs it.

In 1992, the county received nearly $13.7 million from the state and
federal government to provide drug and alcohol treatment for the poor. By
this year, the flow of revenue had dropped to $7.1 million. Trying to
maintain programs in the face of those cutbacks has been a strain on county
budgeting.

In 1998, the county spent more than $6 million to treat addicts and
alcoholics just through a voucher treatment program, which covers people
with no insurance or other means to find help. The vouchers cover three
types of services: day treatment, outpatient treatment and 90-day stays in
residential treatment centers. That $6 million was almost $4 million more
than the county had budgeted.

Thus, the edict for 1999: Keep the spending within the $3,660,355 budget.
And that means strict limits on how many people receive help.

From January to June in 1998, 4,730 people received some type of treatment
through the voucher program. The number for the same period this year was
2,019. Throughout the year, people seeking treatment have been on waiting
lists. In late August, the number hit 175, and it has hovered above 100
much of the year.

More recently, better coordination between the county and other social
service programs has helped reduce the numbers on the lists. As of Sept.
14, 26 people were waiting to start outpatient treatment. Another 13 people
were waiting for a bed to open in a residential treatment center; six more
were waiting to get into treatment involving methadone or the drug
Antabuse, which if mixed with alcohol makes a person violently ill; and
four others were waiting to receive daily counseling.

Easter Dethrow sees those numbers as people, the ones who appear every day
at Reformation Lutheran Church, 2201 N. 35th St.

Dethrow runs a group counseling session at the church every Monday and
Wednesday, and he cruises the streets regularly to keep in touch with the
people who need more help than he can give. Those are the people with no
money or insurance to cover their treatment, waiting for a slot to open in
a county-funded program.

"I check on them every day," Dethrow said. "They're living in different
smokehouses, or in cars. They want to get clean, but there's no place to go
with them."

The addicts' transient lifestyle makes the voucher program waiting lists
almost useless, according to Dethrow and others. By the time a slot opens,
the intake workers have little hope of finding the next addict on the list.

"You're back to that big gap in the system," said Linston Young, a former
addict who describes himself as a street-corner counselor. "The crack (in
the system) has become a canyon. I hate to say it, but most of these people
are going to wind up in the penitentiary. Maybe that's the plan."

The agencies that provide treatment paid for by the county are also
suffering because limiting the number of people in treatment also limits
the amount of revenue flowing in.

Earlier this summer, Behavioral Health Counseling Services Inc., which
provided outpatient counseling at 4122 W. Fond du Lac Ave., closed its
doors to county referrals around Aug. 20. (Patients already there are being
allowed to continue their treatment.) Dwain Berry, who operates the center
with his wife, Lorie, said the cutbacks in the voucher program cost him
$8,000 to $12,000 per month.

"We tried to stay in there and keep the doors open, but there wasn't enough
money coming in to pay the rent," Dwain Berry said. "We decided we'd have
to shut the business down."

The Meta House, a national model as a residential center for women, closed
one of its houses with 10 beds because of a cutback in clients and in money
from the county. And the Dennis C. Hill Harm Reduction Center, operated by
the AIDS Resource Center of Wisconsin, has suffered a sharp reduction in
both clients and revenue.

Doug Nelson, executive director of the AIDS Resource Center, said the
Dennis Hill facility had been receiving $2,000 per month from the county
for the clients it treated. That amount now has dropped to $200.

County officials recognize that the current situation is far from ideal,
but they say there is little the Department of Human Services, which
oversees the treatment programs, can do.

"The money's just not there," said Virgil Williams, who manages the
county's drug and alcohol treatment effort.

Budget figures provided by Williams' office show that the county spent just
over $14 million on drug treatment programs in 1992. The total amount
budgeted for 1999 is just under $8.5 million.

The reduction has come about because of a cut in state and federal dollars
to the county. County officials have kicked in more property tax revenue -
the amount devoted to treatment programs has gone from $346,365 in 1992 to
$1.37 million in 1999 - but it hasn't been enough to make up what they lost.

County and state officials said drug treatment programs that are part of
W-2 and the child welfare system should be helping the situation.Women with
children, in particular, should be able to receive drug treatment through
those other agencies and programs, rather than on the county dime.

"We've tried to get other entities that have an obligation, and that have
money, to pay for it (treatment)," said Roger Quindel, the county
supervisor who chairs the County Board Committee on Health and Human Needs.

Advocates working with the addicts on the street, however, say the services
provided through the W-2 and child welfare programs are full of barriers
and inadequate treatment.

Dr. Francine Feinberg, the executive director of Meta House, outlined this
likely scenario: A woman with four small children goes to the central
intake unit to kick a drug habit that prevents her from holding a job. The
intake worker directs her to the W-2 agency, so she bundles herself and her
children onto a bus and heads for the W-2 agency. There, she goes through
another assessment, in hopes of being referred to her health maintenance
organization. If she gets a referral, she applies to the HMO to receive
treatment, which may be nothing more than a few outpatient counseling
sessions.

At worst, the woman gives up; at best, she receives some treatment, but not
enough, Feinberg worries.

"I'm talking about a flawed system that doesn't allow a person to walk in
the door and ask for help and get that help," Feinberg said.

Williams and Geri Lyday, the administrator of the Adult Services Division
of the Department of Human Services, acknowledge the system is not optimal
for helping the poorest clients and those without insurance.

County officials, treatment providers, Dethrow and Marr and other advocates
all agreed that part of the crisis in the treatment system is caused by
public sentiment that demands drug addicts and alcoholics take personal
responsibility for their lives and find the willpower to quit on their own.

"People love to hate these people," Feinberg said. "There's very little
understanding of what's happening with these folks. These are not people
who are out there happily enjoying their lives. These are people who have
horrible lives . . . very, very sad lives."

The advocates also argue that paying for treatment and helping addicts
would save tax money in the long run, saying it's cheaper to pay for
treatment than for prisons.

"You pay one way or the other," Feinberg said.
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