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Clients involved in Kansas Works, a welfare reform project of the State's Department of Social and Rehabilitation Services (SRS), are automatically screened for alcohol and drug problems. For no matter how much job readiness training welfare recipients get, they will be unlikely to obtain or keep a job if alcohol and drug abuse issues are not addressed. They won't pass the employer's drug screening test. Or they won't show up for work on time. Or they won't perform well once hired.

"The Kansas Works Program gives people the best opportunity to find and retain employment," according to Dalyn Schmitt, Project Director for two of Kansas' five Regional Alcohol and Drug Assessment Centers (RADACs). Schmitt trains intake staff at SRS, which provides employment services to cash assistance and Food Stamp recipients, to recognize when clients may have drug or alcohol abuse problems. An alcohol and drug component has been built into the employability assessment required for participation in the State's work programs.

Upon meeting the client, Kansas Works intake staff note whether a

client seems drunk or high. Case managers may use the CAGE questionnaire, a brief screening instrument that identifies covert substance abuse problems. A positive CAGE score alerts the case manager to refer the client to a RADAC for further assessment. Or case managers may ask clients directly whether drug or alcohol use has ever affected their work.

Clients often acknowledge that substance abuse has been a problem in the past. But regardless of whether a client openly self-reports substance abuse difficulties, the client's medical record, employment history, and interview responses may contain information that signals a problem. When a client has been fired from previous jobs for addiction problems, has addiction-related legal problems (e.g., an arrest for drunk driving, domestic abuse, or fighting in a bar), or has had a previous positive drug screening, the red flag goes up. SRS intake staff know that these patterns indicate that the client needs help.

The RADACs use the SASSI instrument to assess the problem and the Kansas Client Placement Criteria to determine the appropriate level of care and to assign the client to a treatment provider. In addition, at the Hays and Chanute area offices, the SRS is piloting the use of SASSI when clients enter the employment services program. According to Katie Evans, Public Service Executive and an expert on welfare reform, case managers at these two locales administer the SASSI to all work program participants up front, at intake. The results are then sent to the RADACs for evaluation, so that substance abuse treatment professionals can recommend appropriate treatment. The RADACs also monitor client progress for discharge and the need for continuing care.

The assessment instruments make it easier for case managers to raise the issue of substance abuse with clients, Evans noted. "The case managers were very insecure about this at first," Evans said. " They were worried about being too intrusive and confronting clients with drug abuse." But since the program began, Evans reported, few clients have refused to go for treatment, a result that surprised her. "In the Chanute office, of 194 people referred by SRS, 50 (25 percent) went into treatment. I thought for sure people would appeal," she said. Instead, if clients don't want to enter treatment, or if they are already working and treatment interferes with unreported employment, they request that their cases be closed.

Evans is proud of Kansas' treatment-oriented approach. "We didn't want to just test people for drug use and close their cases punitively if they had a positive urinalysis," she said. Rather, substance abuse treatment providers use the Addiction Screening Instrument (ASI) to assess treatment needs, to develop a treatment plan, and to collect data so results can be evaluated. Once the client is in recovery, job-related activities resume.

The substance abuse screening component of the Kansas Works program, in operation since November 1, 1996, was established by a mandate of the Kansas Legislature as a pilot program. Legislators recognized that a significant minority of welfare clients had substance-abuse barriers to self-sufficiency, and that these barriers to employment had to be confronted head on.

CSAT, the Treatment Improvement Exchange, and the editors of the TIE Communiqué thank Andrew O'Donovan, Commissioner, Division of Alcohol and Drug Abuse Services, Kansas Department of Social and Rehabilitation Services, and his staff members for their assistance in the preparation of this article. Further information on the Kansas Works Program can be obtained from the Division of Alcohol and Drug Abuse Services, Kansas Department of Social and Rehabilitation Services, Credit Union 1, 2nd Floor, 610 Southwest 10th St., Topeka, KS 66612; telephone: 785-296-3925; fax: 785-296-0494.

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