MAYOR AIMS TO ABOLISH METHADONE PROGRAMS; TREATMENT EXPERTS ARE ANGERED

As Mayor Rudolph W. Giuliani outlined plans to dramatically expand his
workfare program to include drug addicts, he veered unexpectedly from his
prepared speech Monday and announced his desire to abolish all methadone
treatment programs for heroin addicts in New York City.

Giuliani, who criticized the programs for substituting a dependency on
methadone for a dependency on heroin, conceded that he could not
unilaterally take such action. Federal and state officials provide about 92
percent of the financing for methadone treatment in New York, Federal
officials say. But Giuliani said he would still lobby to reduce the role of
the programs in the city, which has the largest concentration of recovering
heroin addicts in the country.

"Over a period of time, hopefully within the next two, three or four years,
we will phase out and do away with methadone maintenance programs in the
City of New York," Giuliani said.

His comments quickly created a furor in the drug-treatment community.

Methadone treatment has been embraced by the National Institutes of Health,
Gen. Barry R. McCaffrey, the White House's top drug official, and other
drug rehabilitation experts who have all called for an expansion of the
program, which they describe as the best hope for recovering heroin
addicts.

"He said what?" asked Don Des Jarlais, the director of research for the
Chemical Dependency Institute of Beth Israel Medical Center and an expert
on heroin addiction. "From a public health standpoint, that has to be one
of the more ridiculous things for any public official to have said over the
past 30 years.

"It implies that he was either misunderstood or misspoke, or he does not
have much of an understanding of drug abuse treatment for heroin
addiction," Des Jarlais said.

Federal drug officials also expressed astonishment. "The Mayor of New York
City said that?" said one official, who spoke on condition of anonymity.
"Does he realize this is scientifically considered to be the best treatment
for heroin?"

The Mayor caught even some of his own city officials by surprise as he
strayed from the prepared text of a speech that focused on his plan to
require virtually all adults on welfare to work for their benefits by the
year 2000.

Under the new policy, only the most severely disabled people will continue
to receive cash assistance without working. The rest -- currently about
340,000 adults -- will be required to participate in workfare or to find
private-sector jobs. The initiative, which is modeled after a similar
policy in Wisconsin, would create the largest welfare program in the
country to have a universal work requirement.

But Giuliani, who has been promising to enforce a universal work
requirement for months, received the most sustained applause from
supporters and welfare officials when he announced his plan to end the
methadone treatment program. He described drug addiction as the most
serious stumbling block on the road to putting most people on welfare to
work, but he emphasized that drug addicts should learn to recover the hard
way, without the help of medication.

"What we should be teaching in drug-treatment programs is the more
difficult, but the much more loving and caring, attempt to try to
reintegrate into a person the ability to take care of their own life,"
Giuliani said.

Giuliani, who revolutionized the city's welfare system by creating a
workfare program that has sharply reduced the welfare rolls, has already
pushed hundreds of the disabled and the drug-addicted into workfare.
Additionally, welfare officials have begun to discourage the poor from
applying for welfare, urging them to rely on relatives, charity and work.
And this year, the number of people on public assistance plunged to its
lowest point since 1967.

But putting the universal work requirement into practice will be a much
more daunting feat, and the problems posed by welfare recipients suffering
from drug addiction is only one of many obstacles ahead.

Only about 22 percent of adult welfare recipients are working, and city
officials must now confront the task of moving about 260,000 people into
workfare or private-sector jobs over the next 18 months.

Some welfare caseworkers, union officials and advocates for the poor doubt
the city can develop enough workfare positions, private-sector jobs or
child care slots to support such a transition. A similar plan announced in
1996, in which Giuliani promised to create a workfare force of 100,000 over
two years, never materialized. Today, about 36,000 people participate in
workfare, and city officials say that number is expected to increase by
only about 4,000 over the next year.

But Giuliani dismissed doubts about his plan Monday, saying he was
confident that New York City's strong economy and workfare program could
easily absorb thousands of welfare recipients.

"We're going to end welfare by the end of this century completely,"
Giuliani said during a news conference in Manhattan. "Everybody in this
city will work, with the possible exception of people who are truly
disabled or, for some short period of time, are unable to work.

About 30,000 people on public assistance have been excused from working, he
said, because they were participating in drug-treatment programs. Under the
new plan, he said, drug addicts will work and receive treatment. Since
March of this year, 1,139 drug addicts have been assigned to workfare
slots, city officials said. They did not have estimates for the number
expected to be working in the next 12 months.

Ideally, welfare recipients will find private-sector jobs, Giuliani said.
But he emphasized that the workfare program could easily absorb those who
are not able to find work.

But union officials are wary. Earlier this year, they sued the city,
asserting that it used welfare workers to replace civil servants in
hospitals. The city responded by pulling all welfare workers out of the
city hospitals. Stanley Hill, executive director of District Council 37,
said his group would carefully monitor any workfare expansion.

Advocates for the poor also fear the city will not spend enough money on
support services for welfare recipients moving into the work force.
Wisconsin increased spending on each welfare recipient by about 60 percent,
expanding child care and other services.

But city officials said Monday that there were no plans to substantially
increase the investment in day care even though the city suffers from a
severe child-care shortage. Nor are there plans to determine whether the
people who leave welfare or who do not apply after expressing interest
actually find jobs or simply languish in poverty.

"I think the Mayor is right to emphasize work, but it's important to know
what's happened to people who are denied assistance initially or leave the
rolls later," said Jack Krauskopf, the dean of the Graduate School of
Management and Urban Policy at the New School for Social Research.

Krauskopf, who ran the city's department of social services in the 1980's,
said the Mayor's universal work requirement was a worthy goal. "But it's a
very difficult goal to get to," he said.

Copyright 1998 The New York Times

Checked-by: (Joel W. Johnson)