Senators Endorse the Irresponsible and Recalcitrant

While I would have difficulty finding in the constitution provisions granting the Congress power to appropriate funds for state efforts for substance abuse treatment, the Senate Appropriations Committee has found a way to make bad things worse. The Bush Administration had proposed that states adopt outcome measures for their substance abuse treatment programs. This proposal carried with it a 5% reduction in state grants for states that did not adopt such measures or report the results. Sadly this was too much oversight of federal spending for the committee. In their committee report on the appropriations bill for the Department of Health, Education and Welfare, the good senators had this to say about these limited measures to establish some accountability for the nearly 1.8 BILLION dollars to be appropriated for the Substance Abuse Block Grant.

"The committee has not included bill language requested by the administration to withhold at least 5% of the block grant funds from States unable to submit National Outcome Measures [NOMs] data. The Committee strongly opposes this proposal and believes that punitive policies could threaten or interrupt service delivery."

NOMs is a project of the Substance Abuse and Mental Health Administration to implement continuous quality improvement techniques. If we have to spend money without constitutional authority surely we would want to do it in a way that ensures the services purchased are not measured or improved. Holding states accountable for the use of grant funds is "punitive" and really bad mojo if it interrupts the delivery of services for which no outcome measures have been adopted. Way to go Senate Appropriations.