Substance-abuse treatment claims don’t add up, auditor finds

"MN Agencies"

02/23/2006

A legislative auditor’s report said broad claims about the effectiveness of state treatment programs are misleading.

Mark Brunswick,
Star Tribune
Last update: February 23, 2006 – 7:14 AM

The legislative auditor’s office said Wednesday that broad claims about the effectiveness of substance abuse treatment are “misleading,” the state’s oversight of county practices is inadequate and prison inmates are provided less treatment than is needed.

The audit also found that levels of service for drug and alcoholism treatment varies from county to county and recommends that the Department of Human Services strengthen its oversight of county programs.

It suggested that the Corrections Department study why some offenders fail to succeed in prison-run treatment programs, and how that might be linked to committing new crimes.

The audit released Wednesday recognized the problems associated with documenting substance abuse programs and their effect on the state. It makes no recommendations about increasing funding.

Substance abuse treatment has a significant effect in Minnesota. The state will spend $63 million this fiscal year in its main source of public funding for treatment. The corrections system will spend $3.6 million in its 2006 budget for chemical dependency services.

In 2004 there were 42,000 admissions of Minnesota residents to substance abuse treatment, and 56 percent of those were publicly funded.

Prisoners incarcerated for drug-related offenses now make up 25 percent of the state’s prison population, up from 9 percent in 1990. Among chemically dependent inmates released in 2002, a majority had new arrests or convictions within three years.

The audit found what it called a “considerable variation” in counties’ admission rates for treatment, suggesting uneven access to services. In 2003 and 2004, for instance, the rate of admission to publicly funded treatment in Mahnomen County was 168 admissions for every 1,000 people. It was 22 admissions for every 1,000 in Kittson County.

The report suggests that officials in most agencies are dissatisfied with the availability of prison-based treatments. It also said a large majority of chemically dependent inmates did not participate in prison treatment or postrelease programs.

It did note that prisoners who completed the Challenge Incarceration Program, a boot camp with a chemical dependency component, had lower recidivism than those who failed treatment or completed shorter programs but it was unclear about what factors might contribute to the difference.

Responding to the audit, Health and Human Services Commissioner Kevin Goodno said the variety in county response rates was driven by demographics such as ethnicity and what it called “co-occurring” disorders such as drunken driving and drug arrests and detox admissions. The county with the highest placement rate, Mahnomen County, for instance, had the highest rates of drunken driving incidents and the largest percentage of Indian population (a group that Human Services said has a demonstrably higher treatment need).

Corrections Commissioner Joan Fabian said the department has several programs in the works to strengthen coordination between the state and community-based organizations. The department also has begun a program to improve assessments and case planning for each offender.