In an act that potentially heralds a more aggressive and confrontational strategy to gain greater funding for drug treatment, an array of powerful state and local groups--many not traditionally associated with drug treatment--formally told Governor Gary Locke in a November 20 letter that they believe Washington State is violating federal law by significantly under-funding methadone programs.

The letter, addressed to the governor and Dennis Braddock, head of the Department of Social and Health Services (DSHS), describes as "shocking" the fact that, because of limited funding, hundreds of Medicaid-eligible heroin addicts who seek treatment are instead placed on waiting lists "sometimes for years, even where there are clinics with the capacity to accept new clients."

Generated under the auspices of the Drug Policy Project of the King County Bar Association (KCBA), the letter is signed by such politically mainstream organizations as the Washington State Bar Association, the Washington State Medical Association, the Washington State Pharmacy Association, the King County Medical Society, the Seattle League of Women Voters, and other state medical groups.

Arguing that expanded treatment reduces social costs and saves the state law-enforcement and incarceration expenses, the letter points out that federal law requires that all medical services, including methadone treatment provided under the state's Medicaid plan, which receives half its funding from the federal government, "must be provided promptly." It points out that in response to a 1994 lawsuit, a federal court issued an injunction ordering California to comply with this requirement, which resulted in the expansion of methadone treatment there.

Roger Goodman, head of the KCBA project, says local waiting lists reached 18 months or longer recently, and only $2 million more in state funding would ameliorate the situation. He states that government officials have yet to respond to the letter, and confirms that the state's failure to comply would likely result in a California-style lawsuit. He adds that several local law firms are "poised and ready" to bring such a suit.

Don Stark, head of DSHS' treatment division, concedes that lengthy waiting lists are a problem, but says methadone treatment, on which the state currently spends $5 million annually, is already expanding despite severe budget constraints and pockets of local opposition. He cautions that a lawsuit may backfire, prompting the state to drop methadone altogether from the Medicaid program.

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