Va. Substance-Abuse Funding Diverted in '06

Finding Gaps in System, Audit Says $18 Million Went to Undetermined Programs

Nearly $18 million earmarked for substance-abuse services in Virginia was diverted to other programs in 2006, a state audit has concluded.

The report, released by the Joint Legislative Audit and Review Commission, says that of the $73 million dedicated by the state for rehabilitation programs that year, about $55 million went to an array of services, including detoxification and counseling. The audit could not determine where the remaining $18 million went. The report says programs that could have benefited from that money included efforts to help prison inmates who needed substance-abuse services and those designed to hold local officials accountable for the funding they receive.

State funding for substance-abuse programs is taken from annual profits recorded by the Virginia Department of Alcoholic Beverage Control. The money is transferred into the state's general fund, not to the agencies that provide counseling, group therapy and other programs. But state officials said that although the transfer to the general fund is mandated by state law, there is no language that specifies what happens to the money.

"Once they've been allocated to the general fund, they become indistinguishable from any other state money," said Nathalie Molliet-Ribet, an analyst for the commission who led the research for the report. "I don't think anyone's been paying attention to this."

The audit illustrates how the system designed to fight substance abuse has gaps in service, funding and accountability.

The 182-page report says there are no systems to determine whether the state's programs are effective. It also says that Virginia could better use its resources by implementing more programs that have been tested in other states. In many cases, the audit concluded, people who need services are unable to access the state's programs, because of long waiting lists or because they have poor access to transportation or child care. There were about 6,000 people on waiting lists during the first quarter of last year, state records show.

Several lawmakers on the commission said that the report raises important questions but that they need to try to figure out where the money went before making any determinations.

"It really depends on what the money went for," said Del. M. Kirkland Cox (R-Colonial Heights), chairman of the commission. "I don't think we'll get an answer to that."

Del. Phillip A. Hamilton (R-Newport News) said that many state programs could be run better but that over the past several years, lawmakers have tried to address the funding gaps highlighted in the report.

"If you look under every rock, you can find something wrong," he said. "We've made some progress, and we'll have to continue to make tough decisions based on limited resources."

James Reinhard, commissioner of the Department of Mental Health, Mental Retardation and Substance Abuse Services, said the report acknowledges "the numerous barriers to enhancing the quantity, quality and accountability" of the state's substance-abuse services network.

The report says that substance abuse cost the state and local governments at least $613 million in 2006, mostly in public safety. It also says that $102 million was spent in Virginia to provide substance-abuse services that year, but few agencies evaluated those services. The audit recommends that the state pump more money into prevention programs.

The report also says that the state could do a better job of helping low-income residents gain access to services.

Last year, the state budgeted $9 million to pay for Medicaid patients to access substance-abuse programs. But the report found that the state had billed only about $120,000, or 1 percent of the projection, indicating that many addicts might not be accessing treatment they are eligible to receive. In some cases, state officials said, it's because many providers do not take Medicaid patients because payments do not cover the cost of services.