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President Promotes "Access to Recovery"

By Rebecca A. Clay

President George W. Bush making announcement

(White House Photo by Eric Draper)

SAMHSA expects that a new initiative proposed by President George W. Bush will soon make treatment available for an additional 100,000 people a year. In this year's State of the Union address, the President proposed a 3-year, $600 million program designed to increase treatment capacity. The first $200 million installment is included in his budget proposal for Fiscal Year 2004. Called "Access to Recovery," the initiative will establish a voucher system to ensure that a comprehensive continuum of effective treatment and support service options, including faith-based and community-based programs, becomes more readily available and accessible.

"SAMHSA recognizes that the process of recovery is very personal and can take many pathways, including physical, mental, emotional, and spiritual," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "A voucher will allow recovery to be pursued in an individualized manner."

He added, "To provide treatment services for people who have substance abuse problems, SAMHSA currently funds the Substance Abuse Prevention and Treatment Block Grant and the Targeted Capacity Expansion Grant. The former will continue to support the treatment infrastructure that exists in all states. The latter will continue to enable states and local governments to respond to new and emerging substance abuse trends by enhancing treatment capacity before problems compound. The President's Access to Recovery initiative provides a third funding mechanism to expand substance abuse treatment capacity."

SAMHSA will oversee the initiative through a new grant program. The governor's office in each state will be eligible to apply for funds competitively. The program will give states the flexibility to work out the details of their proposals as they see fit.

As currently envisioned, the voucher initiative would work basically like this: When someone seeks treatment, professionals at that site will assess the individual's needs, offer a voucher for the level of care required, and refer the person to a variety of providers who could offer such services. The individual will then select a provider and "pay" for treatment with the voucher, which will probably have no face value. The provider will then redeem the voucher through the organization administering the state's program.

To assure high quality, SAMHSA will require states to develop certain safeguards. For example, states will have to create a plan to ensure that participating providers offer treatment that actually works. They will have to comply with SAMHSA standards and also will have to establish standards for participating providers. In addition, they will have to establish protocols for screening, assessing, and referring clients.

SAMHSA's Three Objectives

According to Mr. Curie, the President's proposal will help SAMHSA fulfill three objectives that substance abuse treatment professionals, policymakers, and consumers themselves have identified as key. First, the program will increase the Nation's treatment capacity. As part of their applications, states must include detailed plans for broadening the base of providers. States also must agree to use this new funding to supplement rather than supplant current funding.

. . . financial incentives not only will encourage providers to use proven treatment approaches, but also will increase accountability.

Second, the program will expand consumer choice. Nonprofit, proprietary, community-based, and faith-based programs that are licensed/certified by the states will all be eligible for the program, allowing individuals to choose the approach that best meets their needs.

Finally, the program will reward performance. States will use data on past costs to set cost ranges for each type of service. They also will consider providers' success in getting clients off drugs and alcohol, and in getting them out of the criminal justice system and into jobs. These financial incentives not only will encourage providers to use proven treatment approaches, but also will increase accountability.

"As the President said, 'Our Nation is blessed with recovery programs that do amazing work,' " Mr. Curie said. "Now we must connect people in need with people who provide the services. We look forward to working with Congress and our Federal, state, and local partners to make this program successful for the people we all serve."