REHAB CENTERS BRACE FOR AUSTERITY

Rendell's proposed budget would cut $66 million from 2 substance-abuse
programs, affecting 30,000 people.

Directors of drug- and alcohol-treatment centers across the region said
yesterday they would have to turn away half their clients if the state
budget proposed by Gov. Rendell is approved by the legislature.

Rendell on Tuesday proposed cutting $66 million from two programs that pay
for substance-abuse treatment for people who are not eligible for medical
assistance, about 30,000 of the most vulnerable Pennsylvanians, according
to supporters of these programs. These programs also pay for treatment of
people with behavioral problems.

The proposal also trims another $6.2 million that pays for treatment
programs for nonviolent offenders as an alternative to prison.

"They're ripping the bottom out of drug and alcohol treatment in
Pennsylvania," said Terence McSherry, who runs NorthEast Treatment Centers
in Philadelphia. The centers serve about 375 patients.

Rendell said yesterday that he believed in drug and alcohol treatment. Last
fall, when one of his aides was arrested on a misdemeanor heroin charge,
Rendell said, "we should all hope for his rehabilitation and recovery, just
like we should for everyone else with a problem."

But as governor, he's had to make broad budget cuts, and substance abuse
treatment did not escape the knife.

"The governor agrees it's not only undesirable, but that he hates it," said
Ken Snyder, a spokesman for Rendell. "He inherited a bad fiscal situation
and there's not a lot he can do about it."

Pennsylvania and other states have faced budget crises as a faltering
economy has cut into revenues, and on Tuesday Rendell proposed a $21
billion spending plan for the 2003-04 fiscal year that makes cuts affecting
virtually every aspect of state government. Its fate is uncertain in a
Republican-controlled legislature.

Rendell has also said he would return to the legislature with an updated
budget plan that would call for new programs, but probably with tax
increases attached.

For now, the bare-bones budget proposal worries people such as Toni M., a
beneficiary of publicly funded rehabilitation.

"I wouldn't have had the opportunity to get my life back if it hadn't been
for treatment, and if it hadn't been for public funding," said Toni, 46,
who requested that her last name be withheld. "Now I'm executive assistant
to the president of the largest nonprofit drug- and alcohol-treatment
facility in Pennsylvania."

Toni, employed by Gaudenzia rehabilitation centers in Norristown, said her
downward spiral began when she tried drugs as a student at Morgan State
University in Baltimore, and ended with her walking the streets of
Philadelphia in search of drugs, crashing in abandoned drug houses.

"My one desire was not to die like that," Toni said.

But now she and others in the treatment community are worried others may
die just like that.

"We are looking at 40 percent reduction in funding for these programs, and
I do not see any alternatives other than eliminating programs," said George
Kimes, who runs an association of 180 drug and behavioral-health programs
in the state.

Rendell's budget cuts $47.9 million from behavioral-health services
initiatives, which are used to fund rehabilitation for people who don't
qualify for welfare or medical assistance, usually young males. It also
cuts another $18 million from a program that supplements nonhospital
detoxification centers. That leaves just $40 million available in state
funding for drug rehabilitation.

Philadelphia stands to lose the most at $6.1 million. Elsewhere, Bucks
County will lose $708,000; Chester County will lose $609,000; Delaware
County, $528,000; and Montgomery County, more than $1 million.

Snyder said there would continue to be drug and alcohol programs available
to the poorest Pennsylvanians and people with health care through
medical-assistance programs.

For those who fall in between, he said, there is still $40 million from the
Department of Health, which pulls in another $56 million from the federal
government. The two programs cut garnered no matching federal funds.

He also said there are many county-funded drug- and alcohol-treatment programs.

"It's cut this, or make decisions like cutting health care to children or
cutting so far into higher education that we would block access," Snyder
said. "Children did not get thrown off health care."

W. Charles Folks, the clinical director of Eagleville Hospital's treatment
program in Montgomery County, said the cuts came at a difficult time, given
recent increases in insurance, regulatory compliance and pharmaceutical costs.

"One-third of our revenue, or about $2 million, comes from those funds,"
Folks said. "... There are 50 people in my program alone who wouldn't be
here without that funding."

But Folks and others said that taxpayers stood to lose much more.

"These programs return many times their investment in terms of overall
public benefit," said Dr. Robert Field, the director of the health-policy
program at the University of the Sciences in Philadelphia.

Failure to treat addicts will result in costs elsewhere in society, experts
said, in the forms of health-care and emergency-room costs and increased
crime rates, Kimes said.

"That's not rocket science," he said. "This is a very shortsighted
strategy. We know treatment works."

Ask Toni. After being arrested for a series of drug-related offenses, she
had a choice: jail time or treatment. She chose treatment.

She had no health insurance, so she was admitted to a six-month inpatient
program at Interim House in Germantown, where her stay was covered by
public funds.

"That inpatient six-months' stay turned my whole life around," she said. "I
didn't have to worry about funding, and that was a blessing."

Toni spent six more months in an outpatient program, went through job
training, and started a new career. Now she is studying for a master's
degree in nonprofit administration.

Toni remembered seeing fellow addicts die out on the streets. She credited
drug treatment with saving her life.

"I recall very clearly this one woman dying as a result of her addiction,"
she said. "I remember me and another addict crying. But for the grace of
God... I really didn't want to die like that. And that prayer has been
answered."