ADMS Block Grant:

Women's Set-Aside Does Not Assure Drug Treatment for Pregnant Women

HRD-91-80: Published: May 6, 1991. Publicly Released: Jun 21, 1991.

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Pursuant to a congressional request, GAO reviewed the availability of drug abuse treatment for women, particularly pregnant women, focusing on: (1) the barriers pregnant women and mothers faced when seeking treatment; (2) whether Congress had the information it needed to oversee state use of the women's set-aside to meet women's treatment needs; (3) whether the states used the women's set-aside to provide for the specific treatment of drug-abusing women, pregnant women, and mothers with young children; and (4) available drug treatment for such women in seven states.

GAO found that: (1) despite recent national attention regarding maternal drug use effects on infants and dependent children, many pregnant women and women with children did not receive adequate drug treatment services; (2) many of those women needed such services as prenatal care, child care, and parenting skills training in conjunction with drug treatment; (3) the Alcohol, Drug Abuse, and Mental Health Services (ADMS) women's set-aside increased almost 500 percent between fiscal years 1988 and 1990; (4) despite that increase, Congress lacked adequate information to determine whether the set-aside effectively reduced treatment barriers and addressed such treatment needs, since the Department of Health and Human Services (HHS) did not clearly specify reporting requirements to states; (5) the women's set-aside did not ensure that states provided appropriate treatment services to women, since the set-aside encouraged, but did not require, states to fund specifically designed treatment; and (6) of the seven states, two did not use the women's set-aside funds to provide for women's specific treatment needs.

Matters for Congressional Consideration

  1. Status: Closed - Implemented

    Comments: The ADAMHA reorganization legislation, recently passed, specifies amounts to be expended by states.

    Matter: Should Congress decide that pregnant women and mothers with young children need special funding priority for drug treatment, it may wish to consider amending the ADMS women's set-aside so that states are required to spend a certain percentage of the set-aside exclusively on treatment services for pregnant women and mothers with young children.

  2. Status: Closed - Implemented

    Comments: The ADAMHA reorganization legislation defines such services.

    Matter: Should Congress decide that pregnant women and mothers with young children need special funding priority for drug treatment, it may wish to consider defining what constitutes a program on service specifically designed for women, pregnant women, or mothers with young children.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: This recommendation is addressed by the ADAMHA Reorganization Act, Public Law 102-321.

    Recommendation: To better ensure that Congress is given a clear picture of how the funds for the ADMS Block Grant women's set-aside are used, the Secretary of Health and Human Services should direct the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration and the Director of the Office for Treatment Improvement to specify annual reporting requirements for the states in a manner that allows for the national aggregation of reported data. States should be required to report on: (1) all treatment programs for pregnant women and women with children and new or expanded treatment programs or services for women, whether women in general, pregnant women, or women with dependent children; and (2) the number of drug-abusing pregnant women and women with dependent children.

    Agency Affected: Department of Health and Human Services

 

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