HOUSE BILL REPORT

RESSB 5897

BYSenate Committee on Health Care & Corrections (originally sponsored by Senators West, Kreidler and McDonald)

Regarding alcohol and drug treatment.

House Committe on Appropriations

Majority Report:  Do pass with amendments. (16)

      Signed by Representatives Locke, Chair; Grant, Vice Chair; Silver, Ranking Republican Member; Youngsman, Assistant Ranking Republican Member; Appelwick, Braddock, Bristow, Ferguson, Hine, Holland, May, McLean, Peery, Spanel, Wang and Wineberry.

Minority Report:  Do not pass.  (3)

      Signed by Representatives Brekke, Rust and Valle.

House Staff:Sandi Gray (786-7136)

AS PASSED HOUSE MAY 8, 1989

BACKGROUND:

In 1987, the state general assistance program (GAU) was revised to remove persons disabled solely because of drug or alcohol abuse. The Legislature enacted the Alcoholism and Drug Addiction Treatment and Support Act (ADATSA) to provide treatment or shelter services for low income disabled alcoholics and drug addicts.  The size of the program was limited by appropriated funds.  Under the original design, program participants would be offered inpatient or outpatient treatment or shelter. Those not entering treatment would receive room and board through contracted housing in a supervised living arrangement, normally in a group or dormitory setting.

The supervised group housing was legally challenged and declared a violation of privacy.  As a result, shelter clients receive cash grants through a protective payee to pay for their choice of housing.  Clients may also enter directly into outpatient treatment without first receiving inpatient care.  The program rapidly expanded, particularly in outpatient treatment (which includes shelter). There is concern that clients receiving the cash grants through protective payees are not getting necessary treatment and supervision and use the shelter money to maintain their addiction rather than to overcome it.

The rapid expansion drew the program beyond its financial means.  In order to bring projected expenditures back within budget, the Governor proposed, effective February 1, elimination of outpatient programs and limiting shelter to those already in the ADATSA program.  A superior court restraining order prohibited this limit on shelter, but allowed the elimination of treatment.  Most of the successful legal actions were based on these provisions or other income assistance statutes.

A supplemental appropriation of $5.4 million was passed for the remainder of the biennium to save the outpatient treatment program.  The supplemental appropriation was in addition to $38.9 million already appropriated for the program.

A supplemental appropriation of $10.2 million, including $5.4 million in state funds was passed in February, 1989.  The conditions of that appropriation required the department to manage treatment and shelter services so that the funds would last through June 30, 1989.  Subsequent Superior Court injunctions have precluded the department from limiting entry into the ADATSA shelter program, and caused placement of shelter clients in the state general assistance-unemployable program.

SUMMARY:

The Legislature recognizes that alcoholism and substance abuse are treatable diseases and that a range of treatment services are needed.  It further recognizes that for people whose disease has caused physiological, organic, or cognitive damage, shelter services may be appropriate, and that treatment or shelter services should be appropriate for the particular needs of alcoholics and drug addicts.

Specific eligibility standards are established for treatment and shelter services.  Persons are eligible for treatment if they are financially needy and unable to work.  Pregnant women and parents of young children receive first priority for treatment.

Persons are eligible for shelter services if they are financially needy, incapacitated from employment for at least sixty days, and have active addiction to alcohol or drugs which has caused physiological or organic damage, or cognitive impairment. Documented evidence by a qualified physician, psychologist or alcohol or drug treatment professional is required.

Shelter services must be provided through contracted room and board programs, normally in group or dormitory settings.  When such services are not available, shelter may be provided through an intensive protective payee program.  The department may by exception allow less intensive supervision.

Rules for the program must conform to any appropriation limitations.

The department is required to monitor treatment and shelter programs, collect demographic data on persons receiving treatment and shelter services, and report to the Legislature in December of 1989 and 1990.

Fiscal Note:      Requested April 18, 1989.

House Committee ‑ Testified For:    Len McComb, Director, Office of Financial Management.

House Committee - Testified Against:      None Presented.

House Committee - Testimony For:    Concern was expressed that the proposed striking amendment definition of persons eligible for general assistance is too broad. More restrictive language was proposed.

House Committee - Testimony Against:      None Presented.

VOTE ON FINAL PASSAGE:

      Yeas 80; Nays 17; Excused 1 - April 19, 1989 (ESSB 5897)

Voting Nay: Representatives Anderson, Appelwick, Brekke, Cole, R. Fisher, Heavey, Jacobsen, R. King, Leonard, Nealey, Nelson, Nutley, Phillips, Rust, Sayan, Valle and Wineberry

Excused:    Representative Gallagher