States spend millions to drug test the poor, turn up few positive results

CREDIT: Diana Ofosu/ThinkProgress

Low-income Americans who need to enroll in the country’s only cash assistance program—the Temporary Assistance for Needy Families (TANF)—face an onerous process. It typically requires extensive paperwork, visits to welfare offices, and sometimes even upfront job searches. Despite these hurdles, the chances of success are slim: out of every 100 families living in poverty, less than a quarter are enrolled in the TANF welfare program.

But some states have made the process of getting help even more difficult.

At least 15 state legislatures have enacted laws that require drug testing TANF applicants or beneficiaries. Last year, 13 of those testing programs were up and running. That means poor people who try to get assistance in these 13 states have to be screened for potential drug use and, if they are deemed suspicious, must come back to pee in a cup in order to receive benefits. While some states offer treatment programs to those who test positive, in essence, if you can’t prove you’re drug-free, you lose all benefits.

Some states test applicants, some just test beneficiaries. All states use some sort of screening to determine who has a reasonable suspicion of abusing drugs. Some states pay a lot for this screening, some pay next to nothing. Those different methodologies and rules lead to wide disparity in how many people were tested and how much they cost.

For the third straight year, ThinkProgress reached out to each of these states to ask how many applied for their TANF programs and how many were approved; how many of those were given drug tests; how many tested positive and negative; how many were rejected because they refused or did not show up for a required drug test; and the total cost of the program for 2016.

The states’ own data shows the costs were high, yet the positive tests were few.

All told, these 13 states tested 2,826 people out of about 250,000 applicants and recipients in 2016. Of those tested, just 369 came back positive. In four states, drug testing uncovered exactly zero positive tests for the whole year. The positive drug test rate out of all applicants, in states where people tested positive, ranged from 0.07 percent in Arkansas to 2.14 percent in Utah; none of them came anywhere close to the national drug use rate of 9.4 percent for the general population.

Those rates don’t account for those who were told to take a test but didn’t, which came to at least 767 people last year (two states didn’t track the figure). Some may abuse drugs, but there are lots of other reasons that people fail to take a test. Following through means an additional visit to a case worker’s office, which requires arranging transportation, time off of work, childcare, and other considerations. “People have complicated lives,” explained Liz Schott, senior fellow at the Center on Budget and Policy Priorities. “There’s very little evidence that it has anything to do with their concerns about [passing] the drug test.”

For all of this, states collectively spent more than $1.3 million on drug testing for TANF in 2016. Add that to the nearly $2 million states spent in the prior two years. That’s money that could instead be going to cash benefits or work supports for the recipients themselves.

CREDIT: Diana Ofosu/ThinkProgress

Alabama started testing last year. The public information manager for the state Department of Human Resources told ThinkProgress that there were 28,447 applications between October 2015 and December 2016 for Family Assistance, the state’s TANF program. They noted that about 50 percent of caseloads were children with no adults, and so only “approximately 14,224 of these applications would be subject to the drug screening policy.” With an comparatively tight screening process, just three were required to take a drug test, at a cost of about $50 a piece. Zero applicants tested positive in that time, while two didn’t follow through on the drug test.

CREDIT: Diana Ofosu/ThinkProgress

Arkansas also began to implement its testing law in 2016. According to an end-of-year report provided by the Arkansas Department of Workforce Services, out of 3,040 applicants for the state’s Transitional Employment Assistance and Work Pays program, just six were actually given drug tests and two came back positive. Another 11 did not take the test. The cost to the state: $30,243. Still, in January the state legislature enacted a new bill to make the testing policy permanent.

CREDIT: Diana Ofosu/ThinkProgress

Arizona’s drug testing requirements apply only to adult recipients, rather than all applicants. A public information officer for the state’s Department of Economic Security told ThinkProgress that while the division considered the eligibility of 91,976 applicants in 2016 (19,806 people, on average, were recipients each month), zero were actually tested. Another three were told to take a test but didn’t, and the state reported no expenditures for the process.

CREDIT: Diana Ofosu/ThinkProgress

In Kansas, state law requires drug tests for all applicants and recipients of TANF if a “reasonable suspicion exists” that they might be illegally using drugs. A Kansas Department for Children and Families spokeswoman told ThinkProgress that out of 24,536 applicants in 2016, 287 were tested and 77 tested positive, while 56 refused the test. Between staff time, lab expenses, and other costs, the state paid out $94,480.25.

The cost is particularly striking given the budget problems that the state is currently going through, with a shortfall of $1.1 billion through June 2019 that has led to deep cuts across government programs.

CREDIT: Diana Ofosu/ThinkProgress

The general counsel for Maine’s Department of Human Services told ThinkProgress only its 8,259 recipients, not applicants, can be screened under the state statute, which applies only to those previously convicted of drug felonies, and that very few actually were subjected to it. Since the end of 2015, just six were tested and none came back positive. About 10 more did not take the test and, at $62 per test, the state paid $372.

CREDIT: Diana Ofosu/ThinkProgress

Michigan’s Department of Health and Human Services public information officer told ThinkProgress that the state’s testing regime cost $700 over its year-long, three-county pilot. Out of 443 applicants covered by the pilot program, he wrote, none were actually given a drug test. “This is a result of court decisions that limited the ability of our department to administer substance use tests.” He added that while one person met the criteria for a reasonable suspicion of use of a controlled substance and consented to a test, the case was closed “for an unrelated reason prior to the submission of the test.” The legislature will now have to decide whether this pilot program’s results merit a new law.

CREDIT: Diana Ofosu/ThinkProgress

In Mississippi, 11,717 people applied for TANF in 2016, according to a Department of Human Services spokesman. Of the 222 tested, 16 came back positive. The state did not track the number who did not complete the test. This process cost Mississippi $31,776. Still, even those who pass the test may not all receive benefits: just 167 of the 11,1717 applicants were ultimately approved for TANF benefits — about 1.4 percent.

CREDIT: Diana Ofosu/ThinkProgress

Missouri’s Department of Social Services publishes a report each month that includes the number of TANF applicants and its drug testing statistics. In 2016, 28,281 applied and 187 were given drug tests. Just 23 tested positive, while 321 did not complete the test. A spokeswoman told ThinkProgress the cost was $336,297.

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 2016 was $28,211, not the appropriated $336,297 previously provided. The totals and graphics in this story reflect the appropriated total. 

CREDIT: Diana Ofosu/ThinkProgress

Work First, North Carolina’s TANF program, had 25,138 applicants in 2016, according to a Department of Health and Human Services spokesman. Three-hundred eighty nine applicants and recipients were required to take a drug test — 171 missed the test, 218 were tested, and 42 tests were positive. The cost of the tests was $11,990.

CREDIT: Diana Ofosu/ThinkProgress

In Oklahoma, 17,012 people applied for TANF benefits in 2016 and 3,858 were given a Substance Abuse Subtle Screening Inventory (SASSI) to determine reasonable suspicion of drug use, according to a Oklahoma Department of Human Services spokeswoman. As was the case in 2015, a high number of those screened by SASSI were selected for a urine test: 1,172, or nearly one in three were selected. Although the makers of the screening inventory have previously claimed more than a 90 percent accuracy rate, just 101 (less than 9 percent) of those given a urine test actually tested positive for an illegal substance. The state does not track how many people referred for testing failed to show up. The total cost of the testing regime was a lofty $668,818.48.

CREDIT: Diana Ofosu/ThinkProgress

The public information officer for the Tennessee Department of Human Services told ThinkProgress that of the estimated 18,390 applicants for Families First (the state’s TANF program) in 2016, 198 were given drug tests and 19 tested positive. One-hundred sixty three didn’t take the required test. The cost for the tests was approximately $8,768.50.

CREDIT: Diana Ofosu/ThinkProgress

Utah, which keeps statistics on an August to July fiscal year, had 3,746 people go through the application for its Family Employment Program (its TANF program) between 8/1/2015 and 7/31/2016, according to a Department of Workforce Service public information officer. She said that 515 people were required to take a drug test after completing an SASSI screening and all but 30 of them did so. Of those 485 people tested, 80 tested positive. The estimated staffing and testing costs was $129,675.75.

CREDIT: Diana Ofosu/ThinkProgress

Wisconsin’s drug testing policy went into effect in July 2016, according to a spokeswoman for the Department of Children and Families (DCF). “Under these rules, only a very small subset of TANF recipients in any programs administered by DCF are required to do a drug screening, and if they do not pass the screen then to submit to a drug test,” she said, and that only includes non-custodial parents. As of March 2017, 1,838 applicants have been screened, 42 tested, nine tested positive, and zero refused or didn’t show, at cost of somewhere between $1,050 to $4,200.

States keep testing despite questionable results

Despite these numbers, more states are eager to join in. Last year, West Virginia became the latest state to enact a law to screen applicants or beneficiaries and to test those for whom officials determine a “reasonable suspicion.” A West Virginia Department of Health and Human Resources spokeswoman said in an email that implementation of the testing had not yet begun in 2016.

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. That hasn’t stopped Florida lawmakers from recently proposing a new law to require drug screening — despite the $500,000 expense to start the policy and the untold legal fees likely required to defend it in court.

More than a dozen other state legislatures have considered TANF drug testing proposals in the past year.

Advocates for drug testing welfare applicants frequently claim that it will help reach those with abuse problems and therefore can help get them “work-ready.” Wisconsin Gov. Scott Walker (R) has pushed to drug test people on other government programs to erase the “barriers to employment related to substance abuse.” But that isn’t the way these programs operate.

“The number who test positive is very small,” Schott said. “The people who don’t complete [tests] is the bigger number of denials.” In 2016, at least 1.6 times as many people were denied benefits for failing to follow through on a drug test as those who tested positive. In Missouri, nearly 300 people were denied benefits because they didn’t take a test. Two states, Mississippi and Oklahoma, don’t even track how many people are being denied welfare this way.

“The drug testing is just one more reason people get procedurally denied,” Schott said.

That also means these drug testing programs could be missing the people who are supposed to get help. “It hasn’t been a policy choice to help people get drug treatment,” Schott said. One glaring example was North Carolina. In 2013, when the state passed its drug testing law, the bill crossed out a previous law that required recipients to be screened for drug abuse and referred to personalized drug treatment. Instead, it was replaced with blanket drug testing, minus the treatment provision. “They literally repealed their treatment [and] replaced it with testing and no treatment,” Schott said.

All states can include substance abuse treatment in a TANF recipient’s employment plan; that’s been the case since welfare reform passed 20 years ago.

Yet these punitive policies keep proliferating. “It sounds good very superficially,” Schott said. But “it’s part of beating up on TANF recipients, eroding support for TANF.”

This story has been updated with an editor’s note in the section about Missouri to reflect updated information from the state.