In 10 states, someone who applies for welfare cash assistance through the Temporary Assistance for Needy Families (TANF) program doesn’t just have to deal with complicated paperwork at a time when there’s a good chance she’s already in a state of financial crisis. She also has to be screened and possibly tested for substance abuse. And if she tests positive, she won’t receive benefits.
Proponents of these programs argue that they’re implemented not just to save money, but to help people who may be struggling with substance abuse. But the data tells a different story.
In 2015, despite lack of evidence that programs in other states accomplished their goals, three more states have implemented similar regimes. And a ThinkProgress survey of the 10 states that now have these programs in place found that they continue to be expensive and not especially effective. All told, states spent another $850,909.25 on the testing regimes in 2015 to uncover just 321 positive tests — in more than one state, none at all.
This came after a February 2015 ThinkProgress examination of the seven states that had implemented drug testing programs for TANF applicants and/or recipients. At that time, those states had spent about $1 million to create and implement a complicated system of screening and urine testing — and found just 407 drug users.
At least 13 state legislatures have enacted laws to drug test TANF applicants or beneficiaries. But a Florida law that required all applicants — regardless of suspicion — to pass a drug test was blocked by the federal courts, citing a lack of evidence that TANF applicants were more likely to abuse illegal drugs. Georgia shelved plans to implement a similar law, noting the 11th Circuit Court of Appeals ruling in Florida.
But several other states have passed laws to screen all applicants or beneficiaries and to test those for whom they determine a “reasonable suspicion,” most recently Arkansas last April. Neither that state’s nor Alabama’s 2014 testing requirements have yet been implemented, but, with earlier laws going into effect for the first time in 2015, 10 states now require at least some drug testing for TANF beneficiaries.
“If the issue were addressing substance abuse and providing treatment, this is not the approach,” said Liz Schott, senior fellow at the Center on Budget and Policy Priorities. “This is not a policy-based or evidence-based approach or use of resources.”
Arizona’s drug testing requirements apply only to Cash Assistance adult recipients, rather than applicants. A public information officer for the state’s Department of Economic Security told ThinkProgress that the monthly average of adult recipients in 2015 was 5,683. In 2015, just six recipients were required to submit to a drug test and none resulted in a positive test. Two beneficiaries tested negative, one tested positive for a medication prescribed by a physician, and three failed to complete the requested tests. The three tests cost Arizona $84.53.
Kansas law requires drug tests for all applicants and recipients of TANF if a “reasonable suspicion exists” that they might be illegally using “a controlled substance or controlled substance analog.”
A spokeswoman for the Kansas Department for Children and Families told ThinkProgress that between January and September of 2015, on average 5,541 adults were subject to that requirement. Over that time, 260 people were drug tested — and 66 tested positive. The full-year cost of the program was $97,000.
Since the testing was implemented last March, just 34 of the 705 opened cases were identified as “convicted drug felons,” according to a Maine Department of Health and Human Services spokeswoman. She told ThinkProgress that these 34 were screened with a Substance Abuse Subtle Screening Inventory (SASSI-3) and seven of those were then required to take a drug test. Two tested positive, five skipped their urine tests. The drug tests cost $62 each and the SASSI-3 cost the state $200.
Michigan’s pilot program began in October 2015 in three counties.
A public information officer for the Michigan Department of Health and Human Services told ThinkProgress that the testing program has begun in Allegan, Clinton, and Marquette counties and has thus far cost just $150. Of the 58 applicants, none were actually tested in 2015. He said the department “is working to remove obstacles to self-sufficiency through this pilot. The department is committed to helping MDHHS customers find jobs and removing barriers to employment. The aim is to remove any barrier related to substance use disorder without harming the family so that the family can ultimately achieve successful outcomes.”
The Missouri Department of Human Services publishes a monthly report that includes the number of TANF applicants and drug testing statistics. In 2015, 293 of the 31,336 applicants were tested for drugs. Just 38 of those 293 tested positive.
A spokeswoman for the department told ThinkProgress that “for fiscal year 2015, $336,297 was appropriated to the Family Support Division for drug testing and system tracking.”
Editor’s note: ThinkProgress requested the total cost for this program. At the time, the Missouri Department of Social Services responded to this inquiry by providing the $336,297 appropriated total. In March 2019, in the course of reporting on the 2018 data, ThinkProgress asked why the state’s costs were so much higher than other comparable states. At that point, Department informed ThinkProgress that the actual amount spent in Fiscal Year 2015 was $71,304, not the appropriated $336,297 previously provided. The totals and graphics in this story reflect the appropriated total.
Though Mississippi’s Department of Human Services Division of Human Resources refused to answer a ThinkProgress media inquiry about its TANF drug testing results, the information was ultimately obtained through a public records request. Of 12,074 applicants screened using a Substance Abuse Subtle Screening Inventory (SASSI), 175 were given a drug test. Just 10 of those tested positive, at a cost of $7,525.
In 2013, the GOP-controlled North Carolina legislature overrode a veto by Republican Gov. Pat McCrory to institute drug testing for TANF applicants. The law said that for those with a “reasonable suspicion” of drug use, they would not only have to pass a drug test to qualify for benefits, but would have to pay for it themselves.
In 2015, the law was implemented, though the state agreed to pay for the initial testing. As it stands now, only those who test positive are required to pay for future tests to prove that they are no longer using drugs. A North Carolina Department of Health and Human Services spokeswoman told ThinkProgress that between the program’s implementation (August 1) and the end of the year, about 7,600 North Carolinians were screened as part of the application or re-application process with the Drug Abuse Screening Test (DAST-10). Of those, 150 were referred for drug testing based on the screen or a criminal history. Just 21 tested positive — 0.3 percent of those screened. These tests cost the state $4,895, in addition to the startup costs of $125,750 (the legislature provided a total of $344,288 for implementation and the cost per test will be $55 going forward).
Though Oklahoma uses a Substance Abuse Subtle Screening Inventory (SASSI) for applicants to determine reasonable suspicion of drug use, it seemingly found a lot of false positives. Of the 3,864 applicants for TANF given that screening, 1,328 were then required to take a urine test — more than a third. But, an Oklahoma Department of Human Services spokesman told ThinkProgress, only 138 of those tested positive and nearly 90 percent tested negative. The annual cost of these tests (on a November to November basis) was $230,944 — $43,699 of which the state billed to Medicaid.
A 2013 newspaper story noted that while the makers of the SASSI tests claim a more than 90 percent accuracy rate, researchers have questioned those statistics.
Of the 24,471 applicants for Families First (Tennessee’s TANF program) in 2015, a Department of Human Services spokeswoman told ThinkProgress that 325 were administered drug tests. The state spent $19,377 on the testing and attained just 28 positives. A Tennessean story this month noted that since the program’s inception, it has detected just 65 drug users out of 39,121 people applying.
“When you add up the 116 (who refused to go through drug screening) to the 65 people (who failed a drug test), that’s 175 or 180 people no longer receiving taxpayer-funded support for illegal activities,” state Rep. Glen Casada (R), who voted for the law, told the paper. “It’s a good investment that those who receive support at the largesse of taxpayers should not be using it to fund illegal activities.”
Utah, which keeps statistics on an August to July fiscal year basis, screened 4,225 Family Employment Program applicants (Utah’s TANF program) with the Substance Abuse Subtle Screening Inventory between August 1, 2014 and July 31, 2015. Of those, 460 were given a urine test, a public information officer told ThinkProgress, and just 18 of those tested positive. The state paid $5,281.25 for the screening and $23,281 for the drug tests.
Beyond the high costs and few positive test results, there are a number of reasons why implementing screening and testing for welfare benefits doesn’t serve the main purpose lawmakers claim: helping people with substance abuse problems. One is that those who are most likely to be kicked off of benefits in states that have drug screening are not those who test positive, but those who don’t even take tests at all. “There’s actually more people who are denied benefits for not following through with a test than for failing,” Schott of the CBPP noted. “The impact is largely on people who don’t necessarily have any substance abuse issue.”
Good national data is hard to come by, but in Missouri, which publishes its figures, the number of people who actually get tested is dwarfed by the number of people who don’t complete the drug tests. In 2014, for example, 407 people were tested, while 627 either refused to take a test or didn’t follow up.
“What this is really doing is creating more of a roadblock, yet another hurdle to get over when you’re trying to get on benefits,” Schott said. “It’s more of an additional barrier… than it’s got anything to do with a particular issue of substance abuse.” And those hurdles already get between needy families and the benefits that might help keep them afloat in times of poverty — they constitute the most common reason someone is denied benefits. As it is, only about a quarter of eligible families are enrolled.
“The more hurdles you put in front of an applicant, the greater the share of people who won’t make it over all of those hurdles,” Schott said. “People have complicated lives, and they’re in crisis.”
If lawmakers are truly concerned about substance abuse among welfare recipients, there are more effective options than drug testing. Most states already have requirements for people on TANF to participate in substance abuse treatment programs if that’s identified as a barrier to their employment. “The sponsors [of drug testing bills] often don’t know what the state actually already does,” Schott said. “If that’s your goal, then why don’t you look at what you’ve got, maybe put some funding into making those programs available, maybe allow participation and treatment to count toward work requirements.”
Clearly some lawmakers are aware that these options exist and choose to ignore them. In North Carolina, which passed its law in 2013, the original bill crossed out the previous provision that required recipients to be screened for drug abuse and referred to a personalized treatment program and replaced it with the blanket TANF drug testing regime. “It was revealing,” Schott said. “It showed the blatant lie to that argument.”
What drug testing requirements do instead is divert already constrained funds. TANF funding hasn’t been increased by the federal government in 20 years, so it’s lost 28 percent of its value. The nearly $2 million states have spent on tests could have instead gone toward assisting people in poverty, including drug treatment programs. “It’s a waste of limited resources,” Schott said. “Resources are going to the administrative process and drug testing companies, and not treatment.”
This evidence may be having an impact on other states, if a slow one. Schott sees the trend toward proposing and passing these bills, which have come at a steady pace of one or two new ones each year for the last five or so, losing steam. “This year is actually a little slower,” she said. “It may be slowing down.” Even so, lawmakers in West Virginia are currently considering a drug testing bill, while a lawmaker in Congress wants to expand the ability to implement drug testing to food stamps.
This story has been updated with an editor’s note in the section about Missouri to reflect updated information from the state.