ADMS Block Grant:

Drug Treatment Services Could Be Improved by New Accountability Program

HRD-92-27: Published: Oct 17, 1991. Publicly Released: Oct 28, 1991.

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Pursuant to a congressional request, GAO reviewed: (1) how states have implemented the 1988 legislative requirement to assess the quality and appropriateness of drug treatment services supported by the Alcohol, Drug Abuse, and Mental Health Services (ADMS) Block Grant; (2) whether states are providing pertinent information for Congress to know the effect of the federal investment in drug treatment services; and (3) how the Department of Health and Human Services (HHS) plans to hold states more accountable for the use of ADMS funds.

GAO found that: (1) Congress receives limited information on the results of federal investment in drug treatment services; (2) although most of the 10 states reviewed monitor administrative processes, their review activities have not provided information on the quality and appropriateness of drug treatment; (3) state annual reports vary significantly in the information provided on drug treatment services, making comparisons or assessments of federally supported drug treatment services difficult; (4) the Office for Treatment Improvement (OTI) has developed a program to develop federal drug treatment program guidelines, institute federal performance reviews of state substance abuse agencies and drug treatment programs, provide technical assistance to states and providers as part of those reviews, and collect more detailed information on what states will do and have done with ADMS Block Grant funds; and (5) under HHS policy, states are not required to undertake any of the proposed OTI program elements, which may limit the program's success.

Recommendations for Executive Action

  1. Status: Closed - Implemented

    Comments: The ADAMHA State Systems Development Program (SSDP) is a comprehensive program designed to enhance federal oversight and state accountability for use of ADAMHA block grant funds. Provisions of the ADAMHA Reorganization Act, Public Law 102-321, will serve to achieve the purpose of this recommendation.

    Recommendation: To provide Congress with information necessary to assess the impact of ADMS-supported drug abuse programs, the Secretary of Health and Human Services should establish reporting requirements for the states that will provide HHS with information to determine whether states are providing drug treatment programs and services that are effective.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Implemented

    Comments: On February 2, 1996, the Secretary of HHS submitted a report to Congress on the states' activities under block grants administered by SAMHSA. The report discusses activities as part of SSDP, but does not fully address the recommendation.

    Recommendation: To provide Congress with information necessary to assess the impact of ADMS-supported drug abuse treatment services, the Secretary of Health and Human Services should report to Congress by 1995 on the progress of the OTI State Systems Development program (SSDP). The report should include information on: (1) which states have implemented HHS treatment improvement protocols; (2) which states have participated in a federal technical performance review and the type of problems or weaknesses identified by the reviews; (3) the extent to which the states have implemented OTI developmental action plans to correct identified weaknesses; and (4) if applicable, the reasons why states have not participated or implemented each aspect of SSDP.

    Agency Affected: Department of Health and Human Services

 

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