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—Nancy K. Young, Ph.D., and Sidney L. Gardner, M.P.A.

Welfare reform—another wave in a succession of national policies sweeping across State substance abuse agencies, or an opportunity for the substance abuse treatment field to establish much-needed allies? Those of us concerned about services for persons affected by substance abuse face both an opportunity and a risk in the implementation of welfare reform.

For years we have lamented a lack of partners at the table when decisions are made on substance abuse treatment budgets. Welfare reform presents an unmistakable opportunity to demonstrate how much substance abuse treatment can help other systems achieve their goals. If this opportunity is seized, State substance abuse agencies can gain support in Congress, State legislatures, and local governing boards for expanding treatment resources.

The risk is that substance abuse agencies will see welfare agencies as simply "out for our money" or as a new line item in their budget. With this mistaken outlook, substance abuse agencies might resist new offers to collaborate, operating as though there were no overlap between their clients and welfare recipient populations.

In the past several months, we have frequently heard from State substance abuse agencies that the large number of treatment service referrals from the criminal justice, primary health, welfare, and child welfare systems creates a barrier to clients who voluntarily seek help from the public treatment system. Let's be clear: Taxpayers who support the publicly funded substance abuse treatment system deserve accountability for results from that system. That means that substance abuse clients who are driving up State costs will and should receive priority status as a means of reducing Federal, State, and local government costs in an outcomes-based system. That is not a threat to State substance abuse agencies—it is an opportunity to expand the base for treatment services and recruit the partners we need to help us at budget time. Alone, each State substance abuse agency's funding sources are inadequate to do the job. But combined with resources from other agencies that share the same clients, a much larger impact can be achieved.

State substance abuse agencies can try to ignore each of the waves of national policy that come along—welfare reform, managed care, outcomes-based accountability, and child protective services reform—or they can view each narrowly as a marginal new funding system. But they could instead take a longer view and ask how the treatment-needing population affected by each of these reforms can be helped by treatment and support. Each of these other systems can be overwhelmed by the problems that we know best in the substance abuse treatment field. By sharing our strengths, rather than setting up new barriers to our services, we can establish the partnership between State substance abuse agencies and each of the State agencies charged with implementing other reforms. We and they all need such cooperation to succeed.

Dr. Young specializes in social policy issues affecting children of substance abusers. Mr. Gardner has held positions in Federal, State, and local government agencies focused on children's policy. Together, they founded Children and Family Futures, an Irvine, California-based nonprofit agency dedicated to improving outcomes for children and families by providing technical assistance to government agencies, community-based organizations, and schools. They are the authors of Implementing Welfare Reform: Solutions to the Substance Abuse Problem (1997), published jointly by Drug Strategies and Children and Family Futures.

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