Gov. Says No to Viagra for Sex Offenders

Under pressure from the Bush administration, Gov. Arnold Schwarzenegger on Thursday ordered California health officials to not provide Viagra and other erectile dysfunction drugs to convicted sex offenders.

Schwarzenegger said he issued the emergency order “to protect all Californians” until permanent regulations can be written to “target the sex offenders who pose a threat to innocent citizens with these drugs.”

About 63,000 registered sex offenders live in California. The state does not know how many -- if any -- are getting impotency drugs through state health programs because California is prohibited from using the Megan’s Law registry for such purposes.

Schwarzenegger’s order came two days after the Bush administration threatened to impose sanctions against states that provide erectile dysfunction drugs through Medicaid, which funds California’s Medi-Cal program for low-income and uninsured patients.

About $38 million a year is spent nationwide on Viagra and other such drugs through the federal Medicaid program. A small portion of that has gone to sex offenders, the administration has said.

The practice was revealed in a recent audit by New York State Comptroller Alan Hevesi, who found that 198 offenders in New York had received Medicaid-reimbursed Viagra from January 2000 to March. Tabloid newspapers in New York splashed the audit across their pages.

In 1998, health officials under the Clinton administration ordered Medicaid to provide impotency drugs for medical necessities such as if a man is recovering from prostate surgery or suffering from diabetes. That directive did not prohibit such drugs from being dispensed to registered sex offenders.

“Requiring that convicted sex offenders be provided Viagra for sexual dysfunction, paid for by the taxpayers, is one of the worst policies ever developed by the politicians in Washington,” Schwarzenegger said in a statement.

The Bush administration warned this week that providing erectile-dysfunction drugs to sex offenders “could constitute fraud, abuse or inappropriate use” of government funds. That may lead the federal government to withhold healthcare funds from states that don’t comply, the Centers for Medicare and Medicaid Services said.

The governor’s order bans Medi-Cal from reimbursing hospitals and doctors that dispense the drugs to convicted sex offenders and stops government treatment programs from issuing the drugs.

Until the law changes, hospitals, doctors or treatment programs will have to know whether the person receiving erectile-dysfunction drugs is a sex offender and, if he is, stop dispending the drugs.

Schwarzenegger may sponsor legislation to establish a mechanism to determine if a sex offender is getting Viagra through a government health program, aides said.

Kimberly Belshe, the governor’s health and welfare secretary, said California already has “strict controls” to ensure that erectile dysfunction drugs given to Medi-Cal patients are prescribed with a doctor’s order stating that it is medically necessary. She said the number of pills is limited.

“Gov. Schwarzenegger’s directive restores some sanity to our government,” said Assembly Republican leader Kevin McCarthy of Bakersfield.

California’s prison system does not provide Viagra or other erectile-dysfunction drugs such as Cialis and Levitra to prisoners, a spokeswoman said.

A new California law requires HMOs and other health groups to cover all medically necessary drugs for patients. The state now is writing regulations for that law, and may add impotency drugs to the list.

Therapists who work with sex offenders said taking away erectile-dysfunction drugs would not necessarily remove the impulse to commit another crime.

Many sex offenders do not require an erection to commit their abuses, while others go through complex rituals, including grooming their victims, that would not change because they get an erection for a relatively brief period.

“It’s psychological. The whole sexual response is in your brain,” said Robert Lark, a therapist who runs the Star Program in Downey. “I can’t imagine that just because somebody gets an erection that he will want to go out and re-offend.”

Robert Weiss, clinical director of the Sexual Recovery Institute in Los Angeles, said “like a drug addict who gets excited about a new drug they have never taken, someone who is compulsive sexually may get aroused or more excited about the possibility of an enhanced sexual experience,” by taking Viagra.

But, Weiss added: “I haven’t heard anyone say if this drug wasn’t on the market, I would not be offending.”