In 2017, the West Virginia Department of Health and Human Resources (DHHR) launched a three-year pilot program that screened drug use among recipients of Temporary Assistance for Needy Families (TANF). Otherwise known as WV WORKS, TANF provides cash assistance for low-income families and helps with child care, skills training, and job searching. As the pilot program ends, state legislators have proposed a bill to make the pilot program — which included about 30 percent of TANF recipients — into a long-term fixture that would expand across TANF. Extending drug screening across the program is an egregious policy choice that has negative implications reaching beyond the scope of its intent, especially as West Virginia continues to grapple with an enduring opioid epidemic.
The pilot program, which included about 2,200 recipients in Fiscal Year 2020, has proven both inefficient and costly. In the last year, the testing cost West Virginia $4,300. And since the ongoing pandemic required the program to pause, this number is quite conservative relative to estimates published in the 2016 bill. The initial cost of the program was roughly $50,100 in 2017. In subsequent years (excluding Fiscal Year 2020), lawmakers estimated the pilot program would cost $22,100 annually.
The fiscal note detailing these costs indicates that if the screening program tested all new applicants, the maximum annual cost is nearly $270,000. However, the fiscal note fails to consider additional potential costs associated with the program, including hearings and appeals for recipients who challenge test results, litigation costs, and treatment and job skills programs. In the three years before and after implementing the drug screening pilot program, TANF enrollment steadily decreased. The plan appears to have no impact on this trend in either direction; such evidence implies that its extension lacks empirical justification.
Drug screening and testing in TANF has proven ineffective in West Virginia. There are no returns on such an investment — not to taxpayers, the state, nor, most importantly, TANF enrollees. In Fiscal Year 2020, the pilot program included 2,221 people. Just seven of them tested positive for any substance. That ratio equals about 0.33 percent. This trend is consistent with numbers from even before the pandemic: in 2017, about 0.49 percent of TANF recipients tested positive. Notably, 65 tests are pending since the program paused due to the pandemic. Even if every person returned a positive drug test, the positive rate would still equal just 3 percent, below many drug use estimates across TANF nationally.
West Virginia’s results mirror those found in other states that implement drug screening for TANF applications. A Think Progress investigation of states with these laws found that of more than 263,000 applicants, less than 1 percent were rejected from TANF for positive drug tests, while the total cost of screening and testing surpassed $200,000.
Rendering benefits contingent on passing a drug test for individuals otherwise eligible for cash assistance does not meaningfully address substance use problems. Instead, it does quite the opposite — drug screening creates barriers for those who may otherwise seek treatment. Those who fear losing their benefits or custody of their children may be less likely to disclose their substance abuse, making treatment less accessible to the most vulnerable population. In 2019, West Virginia spent just roughly 22 percent of TANF dollars on basic assistance, a proportion that has shrunk significantly over the past several decades. Furthermore, less than 10 percent of TANF dollars go toward child care. As West Virginia continues to cope with the ongoing opioid pandemic — of which it remains the epicenter — such policies ultimately penalize individuals for systemic problems.
In a state already riddled with budget shortfalls, dedicating resources to an initiative that further stigmatizes individuals with low incomes — while worsening their material conditions — contradicts the core mission of TANF and other social programs, as well as best practices for public health. Rather than punishing TANF recipients by extending the drug screening program, West Virginia must recommit to providing basic assistance to families. Redirecting funds toward these initiatives would better serve low-income families and help create a healthier West Virginia.
 West Virginia Department of Health and Human Resources Annual Report: Drug Testing for TANF Program, fiscal year 2020.
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