Drug Screening Awaits Those on Welfare in O.C.

As tough welfare reform rules take effect early next year, the more than 30,000 adults who receive public assistance in Orange County will be questioned about any substance-abuse or mental health problems they might have.

Those who are found to be in need will be offered detox programs, counseling and even hospitalization that officials hope will help them better cope with the new welfare policies, which require that all able-bodied adults be shifted from welfare rolls to the labor force within two years.

But the program is shaping up to be one of the most controversial elements of the sweeping reform program. Some civil libertarians say that probing about alcohol and drug use violates the privacy of recipients.

On the other hand, advocates for the poor say the county’s program doesn’t go far enough.

“It’s great that they are trying to help people with these problems, but it has to be long-term,” said Felix Schwartz, executive director of the Health Care Council of Orange County. “What happens six months, nine months, a year down the road? Are they going to have the coping skills to deal with the pressure of a job? They are going to need help.”

The substance abuse and mental health screenings are designed to identify and get help for welfare recipients whose mental problems or drug dependency could prevent them from finding jobs. Other counties across the state are expected to create similar programs.

Experts agree that alcoholism, drug addiction and mental illness can be major barriers to getting and keeping a job. But it remains unclear how many welfare recipients in Orange County suffer from these problems.

A 1994 federal study found that about 15% of women on welfare use illicit drugs or drink too much. But the Center for Addiction and Substance Abuse at Columbia University estimates that a quarter of 4.2 million women on welfare fall into the category.

County officials said they won’t know exactly how many people will require counseling or other services until they begin interviewing welfare recipients, starting early next year at four welfare branch offices.

“For some people, drug use and alcohol prevent them from being self-sufficient,” said Angelo Doti, assistant director of the county’s Social Services Agency. “With welfare reform, they are going to have to stay employed for the long haul. This is an effort to help them do this.”

The county is preparing a questionnaire that will ask recipients about their general medical history and whether they believe that mental problems or drug dependency would make it difficult to work.

Bill Edelman, manager of alcohol and drug abuse services for the county, stressed that the questionnaire would be “non-offensive” and that all responses would be kept in strict confidence.

“There are no trick questions,” Edelman said. “If someone tells us they smoke a joint on Friday night to unwind, that’s not something we would report to the authorities.”

If a welfare recipient admits to problems during the initial interview, he or she would then be referred to a health professional who would conduct a more in-depth interview, Edelman said.

While all adult welfare recipients in the county will be surveyed, no one will be required to submit to any of the offered treatments, which range from mental-health counseling and self-help programs to a full detoxification and short-term residential care.

“No one is going to be forced into an environment they don’t want to enter,” Edelman said. “If workers smell alcohol on someone’s breath, they will probably urge them to get some help. But we can’t force anyone.”

Welfare guidelines signed this summer by Gov. Pete Wilson give most able-bodied adult recipients 18 months to two years to find work. The plan sets aside millions of dollars to pay for job training and child care that are supposed to make it easier for recipients to find and keep jobs.

Schwartz and other activists praise the screening and counseling programs as one more way of eliminating “barriers” to work. But they argue that people with mental troubles or substance abuse problems need long-term treatment.

“The trick is not just getting a job, but keeping it,” Schwartz said. “They need the life-coping skills needed to get up every day and go to work. That is going to require long-term medical care.”

Health care advocates point out that many of the service-industry jobs some welfare recipients will ultimately take do not include medical benefits that could pay for drug treatment or therapy.

However, others expressed concern that the surveys mark a highly intrusive step by government into the personal lives of welfare recipients.

“People on welfare know that they give up certain privacies when they receive aid. But this kind of privacy violation seems unprecedented,” said Nancy Rimshaw, an attorney with the Legal Aid Society of Orange County. “If the intent is to help people get treatment, that’s great. But it does seem like an invasion. It’s a fine line.”

Rimshaw said the new welfare policies make it harder to challenge such provisions. “With these reforms, welfare is no longer considered an entitlement. So the government is more free to place conditions on it,” she said.

Drug use among those who receive welfare has long been an emotional issue. A federal lawsuit is pending over Contra Costa County’s effort in 1995 to question--and in some cases actually test--certain aid recipients suspected of taking drugs.

But with welfare reform, counties will scrutinize the lives of recipients like never before, including checking the attendance records of children and reviewing the college class schedules of adults.