IOWA FACES LOSS OF FUNDS AS TEENS EASILY BUY CIGARETTES

STORM LAKE, Iowa - Because Iowa teen-agers still find it easy to buy
cigarettes, the state's prevention and treatment programs may be
scrapped.

On Oct. 1, the state will lose $5 million in federal funding for
substance abuse prevention and treatment.

"This will be a devastating blow," Kermit Dahlen, president and CEO
of Gordon Recovery Centers of Sioux City, told lawmakers who met
Wednesday in Storm Lake with providers. "This will impact and perhaps
close programs that likely will never reopen."

The federal funding is the result of the Synar Amendment which
required states to implement tobacco sale prevention and compliance
checks. Ten states, including Iowa, were found not in compliance with
the federal standards. Each of those states faces a 40 percent loss
in federal funds for prevention and treatment programs.

Providers say it's not fair to cut prevention and treatment programs
because teen-agers can buy cigarettes - after all, they are working
to change that.

Programs might be unable to reopen because of the requirements of the
Americans with Disabilities Act. Current facilities, many of which
are in older houses, would have to comply with the ADA from the time
they opened, which would be prohibitively expensive, Dahlen said.

Federal lawmakers including Rep. Tom Latham, R-Iowa, and Sens. Tom
Harkin, D-Iowa, and Charles Grassley, R-Iowa, are working together to
delay or prevent U.S. Secretary of Health and Human Services Donna
Shalala from implementing the penalty.

If federal lawmakers are unsuccessful, treatment providers need help
from the state. The Iowa Department of Health can shift funds to help
keep the programs funded, but only until January. Then lawmakers will
have to act rapidly during the first weeks of the next session of the
Iowa Legislature to provide additional money for the programs, said
Rep. Steve Warnstadt, D-Sioux City.

Closing the programs won't save the state any money.

"If our treatment system is dismantled, the cost to our communities
will be immeasurable," Dahlen said.

He said if residential and outpatient programs are eliminated, the
patients currently being served will seek services in other ways.
Among the impacts is likely to be an increase in the number of people
seeking treatment for substance abuse in hospital emergency rooms, he
added.

"If you talk to hospitals, the number one uncompensated care problem
they have is substance abuse," Dahlen added.

"There is going to be cost shifting," said Mary Sloan of the
Northwest Iowa Alcoholism and Drug Treatment Unit Inc. in Storm Lake.
"There will be increased crime."

Part of the reason that states like Iowa don't comply may be because
the state has done a good job of checking whether or not underage
children are able to buy cigarettes and alcohol. Iowa has a
compliance rate of 36 percent overall with north central Iowa at 49
percent and Northwest Iowa at 35 percent. The target was 20 percent.

Rep. Greg Stevens, D-Milford, said a student told him 75 percent of
high school students at his school, especially girls, are smoking.

"That's a real issue, a life-and-death issue," Stevens said.

Rep. Dwayne Alons, R-Hull, said he has heard parents say they are
glad their children are "only" using cigarettes instead of other
drugs or having other problems.

"Kids who smoke are at high risk of other problems," Dahlen said.

Sloan showed a survey of sixth-, eighth-, 10th- and 12th-grade high
school students in Iowa which indicated that 71 percent of students
who use cigarettes also are frequent alcohol drinkers; 50 percent use
other drugs.

"If you don't tackle the cigarette problem, you are going to have a
bigger meth(amphetamine) problem," said Sloan.

Dahlen added that it is essential that the state pass a substance
abuse parity bill for health insurance that will require insurance
companies to treat substance abuse like any other health problem.

"I know the insurance companies will lobby you," he said. "But
outside, nonbiased numbers show that it will result in only a 0.2 (of
a) percent increase in premiums."

The problem concerns employers as well as those who are involved in
substance abuse, Dahlen said. He pointed out that 70 percent of all
substance abusers, not including those who abuse alcohol, are
currently employed.