Thursday, February 18, 2010

Employment rates among GCASA's 2009 admissions

It is interesting that one of the indicators which OASAS (New York State Office Of Alcoholism and Substance Abuse) measures on its program Score Card is employment of people under treatment in OASAS licensed programs.

The rationale seems to be that if people deal with their substance issues they will be capable of maintaining or improving their employment. In the current economy and for many other reasons this is a dubious assumption, but nonetheless, it is one of the indicators which OASAS has chosen to track.

Of the 606 admissions to the Genesee County Clinic in 2009, 223 were employed either full time or part time. That's 37%.

Of the 341 admissions to the Orleans County Clinic in 2009, 118 were employed either full or part time which is 35%.

The other 2/3rds were involved in child care, disabled, retired, students, or looking for work. 25% of people admitted in Genesee County, and 30% of people admitted in Orleans County said they were unemployed and looking for work.

What does are this mean?

1. Most people don't have employer sponsored health insurance to pay for their care. The percentage is only about 17%. Most of the people getting care at GCASA are on Medicaid for a variety of reasons: they are poor, disabled, or caring for children.

2. A quarter to a a third of GCASA's patients indicate that they would like to work if they could find work. Many of GCASA's patients are poorly educated, involved with the criminal justice system, and have poor work histories due to their substance abuse disorders, and are not perceived as reliable and desirable employees making it very difficult for them to find employment.

3. GCASA counselors are being held accountable for producing a social benefit which they have little if no control over, the employability of their patients, which seems to be an inappropriate expectation.

4. While substance abuse disorders cut across all social classes, it hits the lower classes the hardest because they have so few resources to cope with the disease. When Lindsey Lohan, Brittany Spears, Robert Downey, Jr., Rush Limbaugh, Betty Ford, and other members of the elite run into trouble with substance abuse, they not only can pay for their expensive rehabs, but they have the income to tide them over their illness. Poor people suffer much worse and occasionally die.

5. Many people who have problems with alcohol and other subtances are referred to as "functional alcoholics" and many patients use their employment as a denial for the severity of their illness. "I go to work every day!" is a common rebuttal when they are questioned about their substance abuse. Indeed, going to work hung over or in withdrawal may be admirable and reduces absentism for the employer, but a substance abuser while even making it to work is more likely to have workplace errors, accidents, and interpersonal problems.

This is article #7 in a series on 2009 GCASA Admissions Data.

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