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The article below depicts the beginning of worse times for addicts. Mandated treatment in the name of helping addicts, much like Joseph Califano's plan to mandate treatment for incarcerated addicts, makes real the concept of hypoic genocide discussed in my book. Mind control is a useful technique used by fascists to rid society of those people it hates. Hiding a bad motive under "good" one is the essence of corticolimbic dissociation. The general public will go along with this program because of their irrational fear and demonization of addicts. The next step will be mandated "medication," much as in the case of schizophrenics. This administrative behavior is blatantly unconstitutional and persecutory. I predict that unless we oppose this policy strongly this kind of societal persecution will become commonplace for addicts in the future. There is no doubt that breaking the confidentiality of medical records and mandated treatment in conjunction with financial retribution among addicts whether on welfare or not will keep more and more addicts away from the help they need, the exact opposite of the supposed real benefit of such so-called help. This is and will always be the result of the wrong premise (the current P/R paradigm) behind addiction etiology. The addictionology community has much to gain in power and money from Giuliani's plan. Let's observe whether or not they oppose this obviously discriminatory proposal or just sit back and take advantage of it to the detriment of all addicts. Note: There is no advocacy for the addicts mentioned in the article, only for the state and the treatment centers. If the N4A gets going, we will be there for the addicts. But, that takes your support. Welfare Officials to Search Records on Drug Treatment, NYTimes 9/25/99 By NINA BERNSTEIN The Giuliani administration is planning to search thousands of medical billing records for evidence it can use to place welfare applicants in mandatory drug and alcohol treatment programs as a condition of receiving public assistance, city welfare officials say. The information will be culled from computerized Medicaid insurance bills submitted in the past on behalf of applicants who have voluntarily sought treatment for drug and alcohol problems. The record search is for the applicants' own good, welfare officials said this week, and will be used to push them to finish treatment and to get jobs faster. Officials say that record checks are needed because the city's current system of drug screening and testing is finding unrealistically low rates of substance abuse among welfare mothers who need help. But privacy experts and lawyers for the poor say the record search may violate a Federal law protecting the confidentiality of drug and alcohol treatment records. They contend that the city's plan will frighten poor people from seeking treatment or benefits and will send a chilling message to anyone considering help for drug or alcohol problems. The issue, privacy experts say, is a classic example of the conflict between public concern over the loss of privacy, especially in health care records, and public support for using computer databases to monitor or track suspect groups, like welfare recipients, illegal immigrants and parents who fail to pay child support. Federal officials said they had no official notification of the plan. "But there are confidentiality provisions in New York's Medicaid plan, and we expect them to be followed," said Christopher H. Peacock, spokesman for the Federal Health Care Financing Administration, which oversees Medicaid records. Jason A. Turner, Commissioner of the city's Human Resources Administration, said no breach of confidentiality would be involved because the billing records to be checked are submitted by drug and alcohol treatment providers to the city's Medicaid office, and both Medicaid and public assistance fall under his agency. "These are our own records," he said. 'We are not interfering with the doctor-patient relationship. We're helping poor people here." But advocates of the poor who support treatment as a condition of aid say the record search crosses the line. "If people go into treatment thinking their records are confidential and then, lo and behold, the information is illegally disclosed, that will upset just about everybody," said Paul N. Samuels, a lawyer and the director of the Legal Action Center, a nonprofit advocacy organization that specializes in substance abuse issues and has offices in New York and Washington. "Violating confidentiality is an ambush that will drive many people away from treatment." No date has been set to start searching applicants' records. The plan is one of several new measures introduced by Turner to meet a deadline set by Mayor Rudolph W. Giuliani, who vowed last year that by the year 2000, "New York will be the first city in the nation, on its own, to end welfare." Giuliani, whose welfare overhaul is expected to be a centerpiece of his likely campaign for the United States Senate, did not mean an end to public assistance, Turner said. The Mayor meant that all adult recipients would be moving from welfare to work through a variety of assignments, including treatment for drug and alcohol abuse that is a barrier to employment, Turner said. The Mayor has cited one estimate that 20 percent of all people on public aid have such substance abuse problems. Ten percent is the figure more commonly accepted by substance abuse experts. But among mothers, who are the bulk of adult recipients, only 2 percent have been identified as substance abusers through a system of screening and testing put in place two years ago, Turner said. In several other jurisdictions around the country, including Florida and Los Angeles County, officials have also identified lower-than-expected rates of welfare mothers as substance abusers, for reasons that remain unclear. But no other state is known to be contemplating a record search like New York's, according to the Washington office of the Legal Action Center, which represents many treatment centers nationwide. Brian J. Wing, Commissioner of the State Office of Temporary and Disability Assistance, which oversees city and county welfare operations, approved the city's record search plan, said Daniel D. Hogan, his deputy. Hogan added that some upstate counties have already conducted such searches case by case. Marc Rotenberg, executive director of the Electronic Privacy Information Center, a civil liberties advocacy group based in Washington, said:" Welfare recipients are among the first to lose their privacy. But the unfortunate consequences of these tracking and matching technologies tend to make their way up the line." A Federal law passed in the 1970's makes it a crime, with few exceptions, to disclose information about patients in drug and alcohol treatment programs without the patients' narrowly defined written consent. That consent does not allow redisclosure for any other purposes. Experts on privacy law call the measure unique and exemplary, and contrast it to the blanket consent forms allowed in the gathering of other types of health care information. Corinne Carey, a lawyer who has studied drug testing and welfare reform nationwide, said that instead of searching records, the city should be asking why more mothers on public assistance are not being identified by the city's current screening system for substance abuse. As tougher rules and a strong economy have combined to shrink New York City's welfare rolls to about 670,000 from 1.1 million in 1994, including children, fewer substance abusers are applying for public assistance because they cannot deal with the hurdles or meet the work requirements, said Ms. Carey, who works for the Urban Justice Center, an advocacy organization opposed to the record search. Others hide their problems from caseworkers because they fear losing their children. And some advocates suggest drug use may actually be lower than experts thought in the younger generation of poor mothers who saw crack devastate parents or older siblings. A different kind of explanation was offered by Bill Panepinto, an administrator in the State Office of Alcohol and Substance Abuse Services. The substance abuse screening form used by the city was intended to be the framework for a personal interview by a trained worker, he said, but for the last two years it has instead been handed out to welfare applicants as a nine-question paper test. Those who answer yes to two or more questions are referred to certified alcohol and substance abuse counselors for further assessment, including a drug test. Seven out of 10 welfare applicants referred to mandatory residential treatment end up cut from all assistance, said Michael Kink, legislative counsel to Housing Works, one of about 30 advocacy, legal services and provider organizations that met yesterday because of concern about the city's plan. "The sanction rate shows that this program is designed more to drive people off the rolls than to get people help," he said. Turner vigorously defends the program's intentions. Now, he said, mothers are known to coach each other in the waiting room on how to answer the questionnaire to avoid being assigned to mandatory treatment. But treatment billing records may show they have been in and out of care many times, he said. "If you're sick and your children are at risk because you're a substance abuser," he said, "we believe it's not compassionate to ignore that fact." Like most states, New York considered but rejected a requirement that all public assistance applicants submit to drug tests. Instead, it asks drug-use questions of all applicants, but uses physical tests only on those whose answers or behavior raise a reasonable suspicion of abuse. Universal testing is permitted under the Federal welfare overhaul, but only Michigan is planning to use that approach, which has been widely criticized as expensive, ineffective and vulnerable to constitutional challenge. | |||||||