Aid for Substance Abusers a Target of Welfare Foes

Out behind the Mission Homeless Shelter, past a parking lot and over an old stone wall lies the historic Old Gray Cemetery, the final resting place for many of Knoxville’s early settlers.

Today, it is also a campground and final way station for alcoholics and drug addicts who are barred from the mission because they cannot stay sober.

Every month, they emerge from their plastic lean-tos and soggy sleeping bags so that a man they know as Brother Blue can bring them the money they use for their drink, drugs, cigarettes and food--$458 Supplemental Security Income payments from the federal government. They call the payments “drunk checks.”

As part of his self-styled ministry to homeless people in this mid-size Southern city, Brother Blue--the Rev. Alan Reynolds--receives SSI checks for 63 people. He helps them rent cheap apartments but 20 still live in the cemetery.

“Overall, it’s helped me help a lot of these people,” said Reynolds, who wore a camouflage jacket and a black Vietnam-veteran baseball cap with “Try God” pins attached.

“They have not all quit drinking but at least they’re not on the streets anymore. They buy booze with the checks but they also buy food and their physical health is better.”

But if the version of welfare reform approved by the House becomes law, the SSI checks will stop coming to Brother Blue’s flock and about 100,000 other people.

While many provisions of the GOP proposal for overhauling the welfare system have been hotly debated in Congress and the media, the elimination of SSI checks to people disabled by long-term alcohol and drug dependence has raised hardly a murmur.

More starkly than any other feature of welfare reform, the acceptance of a simple cutoff of such aid reveals the magnitude of the change in attitudes toward social problems in general that has swept Washington--the rising political power and appeal of what have long been regarded as traditional moral values.

If the federal “drunk checks” are cut off, so far as federal law is concerned, alcohol and drug abuse would be viewed primarily as issues of personal will and character. Responsibility for dealing with them would fall upon the individual, not society. Though the underlying assumption of welfare policy for decades has been that society should assist those who are down and out, the new policy would leave them on their own.

“You’ve seen a shift in attitude that was reflected in the last election,” said Irv Shandler, chief executive officer of Philadelphia’s Diagnostic and Rehabilitation Center, which treats substance abusers. “ ‘It is the individual’s fault. They’re bringing it on themselves.’ There’s a very negative overtone.”

Paradoxically, this shift in welfare policy would come at a time when the previous approach seemed to be more broadly accepted among the middle class. From company-sponsored counseling programs and health insurance coverage, to the attitudes of neighbors and families, many Americans now appear to view drinking and drug problems as subjects for treatment more than for censure.

This has been underscored by a growing belief among doctors,psychologists and other health professionals that substance abuse is often tied to genetic or physiological conditions, rather than solely the result of moral weakness. Thus, those afflicted would seem to be viewed more sympathetically.

But when it comes to welfare, the consensus in Washington is that the alcoholics and drug addicts now getting checks no longer should receive any benefits.

Recipients here--those undergoing treatment and those still pursuing their habits--say society will pay a higher price if the government stops the checks.

Crime and street violence could increase. And middle-class society would probably find the problems more visible and closer at hand than under the present system.

Standing beneath a stretch of elevated highway, not far from where he once slept in a wrecked Volkswagen, Leo Townsend, one of those in Brother Blue’s group, spoke of how the steady check enabled him to move into an apartment and begin pulling his life together after 15 years on heroin.

Without SSI money, those who would change the traditional approach and those who defend it agree, Townsend and many others would be back on the streets. Even more than they do now, drunks and addicts would haunt public parks and business districts, suffering more and suffering more visibly.

“The checks have helped a lot of people,” said Townsend, 39, a former Hells Angel with a prison record and no work history. “I know for a fact they have helped me.”

Counselors and professionals who treat substance abusers are sharply split over the tough new approach. Some support a cutoff of the cash, arguing that it contributes to the addicts’ self-destruction by giving them money to buy drugs and liquor. Others make a passionate case that the cash provides the only opportunity for addicts to pick themselves up, get treatment and rejoin society.

No one makes the latter case better than Charles Ryan, 59, who spent most of his adult life as a town drunk. His was a familiar face--panhandling or passed out--in historic downtown Knoxville. When he was not carted off to spend nights in drunk tanks, he slept under bridges or in the cemetery--until a relative helped him sign up for SSI benefits two years ago.

“I was on the street, drinking every day. I did everything I had to to survive--stealing mostly. The judge called me a professional shoplifter.”

But one day, after one of many visits to a detox unit, he took some of his SSI money and checked into a motel. Later he moved into a halfway house for recovering alcoholics, where he has now lived--sober--for two years.

After decades of drinking, he said, his health is too poor, nerves too frazzled and police record too long to get a job. If the checks stop coming, “I’d probably go back to my old ways,” Ryan said. “I’d have to survive.”

Thousands of other SSI recipients make a less persuasive case for benefits, though, using the money to stay drunk and high and in some cases living on the street as well.

With conservative reformers demanding a crackdown on those living on the dole, the program’s beneficiaries make a prime target.

“There can be no clearer case that shows the terrible, perverse incentives of our welfare system today,” Rep. E. Clay Shaw Jr. (R-Fla.), chief author of the House bill, said earlier this year. “In effect, we say to addicts: ‘Drink or drug yourself into a stupor so you can’t work. Then the government will take tax money and give you a guaranteed income of over $450 per month and Medicaid coverage. Take that cash and buy yourself more booze or drugs.’ ”

With local and private agencies bracing to help the welfare mothers and children pushed out of other public support programs, no safety net is likely to be waiting for alcoholics and drug dependents.

“We can only take care of so many of society’s problems. Children get more sympathy than addicts,” said Susan Blacksher, executive director of the California Assn. of Alcohol Recovery Homes.

Ever since drug addicts and alcoholics became eligible for payments in 1974, when the government began its Supplemental Security Income program for needy aged, blind and disabled adults, authorities have been struggling to find a way to make sure that the money was used properly.

While payments for other recipients were sent directly to them, the checks for disabled alcoholics and drug addicts went to third-party “payees,” usually relatives, who could keep an eye on recipients and encourage treatment. Last year, Congress enacted restrictions intended to force recipients to get treatment and limiting benefits to three years.

Some officials still are skeptical. In a statement prepared for a congressional committee, Eloise Anderson, director of the California Department of Social Services, said: “California recommends the elimination of this cash incentive by excluding drug addiction or alcoholism from being considered in the disability determination.”

But many professionals who work with substance abusers, as well as a number of Democratic lawmakers, have said that they believe the policy approved last year by Congress could work if given the chance, and the National Governors Assn. has asked Congress for at least a trial period.

It is not clear whether the Senate, which has yet to take up welfare reform, will buck the trend against continued public support for such long-term recipients.

Complicating the issue is that the fiscal benefit of a cutoff seems to be growing all the time. Total annual SSI spending now is $400 million, far less than the $15 billion that goes to women receiving Aid to Families With Dependent Children.

But as a result of local efforts to shift poor people onto the federal rolls, the number of drug addicts and alcoholics getting SSI checks is mushrooming. Between 1990 and 1994, the number more than tripled. About a third of the recipients, 31,000, live in California, where the rolls are growing by 8,000 annually.

Social welfare advocates insist that the money saved by ending direct payments would be exceeded by the costs of law enforcement, jails and public health care for former recipients who would end up on the streets.

In Knoxville, whose streets collect the victims of hard lives spent in the mines that abound in the area or adrift on interstate highways, some of the alcoholics and addicts on SSI said that they understand why people might look askance at their drunk checks.

Louis McCroskey, 52, who lost his truck-driving job and his wife to his fondness for vodka, said that he received SSI money for two years without being told to obtain treatment. Finally, using his income, he checked himself into an inpatient program at East Tennessee Baptist Hospital and started the rocky road toward sobriety.

He said that the check meant the difference between life and death to him and should not be cut off for those trying to end addictions.

“What happens if they cut the check and I can’t work?” he asked. “What am I going to do? All I can say is they better get a whole bunch of jails ready. This is not a threat, but what are we going to do?”

Pat Cannon, who runs the treatment center at East Tennessee Baptist, said that other factors make the problem more serious.

As the government considers cutting off the SSI checks, managed-care companies are reducing the number of days for inpatient treatment for alcohol and drug abusers. Under TennCare, the plan that has replaced Medicaid in Tennessee, for example, the limit has been halved to 10 days and soon will be halved again to five.

Cannon, a recovering alcoholic himself, said that the new policies seriously underestimate the time it takes an alcoholic or drug addict to recover. For him, it took a 31-day inpatient program and then a full year in a halfway house.

For his part, Brother Blue said that he thinks the payments should continue, even for those who continue to drink. The reason, he said, is the alternative.

One often-drunk friend, he said, “can work when he’s sober. But for most of them, the effects of 15 to 35 years of constant alcohol consumption has hurt them so much, physically and mentally, that there’s no way they can get a job.”

The only thing left for them, he said, will be the cemetery.