SAA Finances
Even when the necessary official operating licenses for the running of these treatment centers had been granted and the necessary funds provided, the financial bases for the operation were still sometimes insecure and a lack of floating capital made running SAA operations diffucult.
On a brighter note SAA was virtually debt-free and was able to remain so until 1983 when Vogur Hospital was built. In 1985 it became apparent that SAA was facing dire financial prospects. The building of Vogur Hospital had necessitated heavy financial commitments and SAA was forced to pay large instalments as well as substantial interest rates. The operating costs of Vogur Hospital and the treatment clinics at Sogn and Stadarfell were in no way commensurate with the actual overhead and The Icelandic State Social Security Iinstitute disbursed the operating losses with so-called daily overhead payments. This state of affairs made it necessary for SAA to obtain funds constantly for the payment of operating losses of tens millions of ISK. There was no financial basis for the running of an outpatient unit for alcoholics and SAA suffered a deficit because of the outpatient ward and the operating costs of SAA offices. The financial situation was rapidly growing worse because of the accumulation of debts. SAA found it increasingly difficult to finance operating costs and this situation caused many operational and financial problems for SAA. This state of affairs was most difficult from 1987 to 1988.
Getting Out of the Financial Struggles
In 1989 SAA was able to strengthen its financial operating base and the operating losses were curbed. SAA was further financially invigorated when the organization´s endeavors to become a socalled fixed feature in the national budget were successful in 1990. This arrangement of SAA management has remained very successful to this day. In present financial circumstances the operating costs of the medical clinics is now manageable and SAA was able to cover operating costs by degrees. By settling some of the debts and with cost-cutting measures in management SAA was able to reduce the operating costs of the medical clinics run by the organization. Since 1989 there has been a steady increase in other revenues than government funding. Funds raised independently by SAA amounted to 80 million ISK in 1995 and 97 million ISK in 1996, which constitutes 30% of SAA revenues. All these factors have been instrumental in strengthening the financial position of SAA and have enabled the organization to tackle new projects.
Operation and Financing of SÁÁ
Patients can undergo detoxification and enter the SÁÁ inpatient treatment program free of charge. The patients must, on the other hand, pay in part for the services in the treatment program and consultation in the outpatient ward. Friends and relatives must also bear a part of the cost of consultation services in the outpatient ward. The amount paid by the patients and their friends and families is in fact only a relatively small portion of the overall cost of running these programs.
SÁÁ constitutes an integral part of the Icelandic National Health Service in spite of the fact that it is a privately owned organization. The Icelandic state contributes roughly two thirds of the organization´s annual funds. The remaining third of the funds is raised privately by SÁÁ.
The contribution from the official state budget is allocated directly to detoxification and inpatient services. State contributions do not cover these costs completely. The remainder is financed with funds raised privately by SÁÁ. The main health care policy in Iceland has been that all citizen should benefit from equal access to health services, and these services be rendered to those who need inpatent treatment free of charge. SÁÁ hospital services, i.e. detoxification and inpatient treatments are therefore available to all Icelandic citizens for free.
There are waiting lists for those who wish to undergo detoxification and join the treatment program. Young people and those entering the treatment program for the first time are a priority in this regard and generally do not have to wait. On the whole, around 1.600 individuals are admitted each year to the detoxification program at Vogur, the SÁÁ Hospital. Around two thirds of these patients only undergo detoxification once p.a. Only in rare instances is the same patient admitted for detoxification on three or more occasions in the same year.
When the organization was founded in 1977, a general fund raising campaign was instigated by SÁÁ in order to meet the costs of running and housing this kind of operation. Early on the Icelandic state and the city of Reykjavík were financial contributors to SÁÁ.
In 1983 SÁÁ began construction work on Vogur Hospital. The building of Vogur was entirely financed with contributions from private companies and donations from the general public. At present SÁÁ bears all investment costs and and is solely responsible for financing the operation and running of SÁÁ facilities. The Icelandic state, on the other hand, contributes funding only for the services that are offered within the walls of these buildings, although state contributions do not cover these costs completely, as stated above. By the end of 1995 SÁÁ housed operations in ten different locations. Detoxification and treatment constitute a part of these operations and take place in three locations. These operations consist of three recovery houses, one social center and one office.
A large part of SÁÁ´s private funds derives from slot machines. In addition to SÁÁ, four other organizations participate in the running of these slot machinges: the Icelandic Red Cross and two organizations dedicated to rescue operations.
In addition, SÁÁ is funded by membership fees contributed by roughly 14.000 SÁÁ members. Some income is also generated by various fund-raising campaigns.
In 1991 government funding was considerably reduced in comparison to the funds that had been allocated to SÁÁ in previous years. The reason for this reduction was government cut-backs. These reductions have become a set feature and state funding has been reduced by 25% in recent years. In lieu of restricting services SÁÁ has been able face these reductions with increased private funding and by reorganizing the running of SÁÁ operations. Since 1990 privately raised funds have quadrupled. The overall amount of SÁÁ annual funds has remained stable over the last six years.
SÁÁ services have been dramatically expanded in this decade, e.g. three recovery houses have begun operations in only the last four years. In addition SÁÁ started a comprehensive substance abuse prevention unit in 1995. Education about alcohol and substance abuse has played an increasingly important role in SÁÁ activities in recent years.
The state of SAA's Treatment Program - an Overview, excerpted from the 1995 Annual Report SAA is a public institution in the sense that all the organization´s assets and profits are committed to offering treatment options and social services for Icelandic addicts and their families. The organization enjoys the good will and respect of the Icelandic government and one tenth of the adult population of Iceland are now members of SAA. If the organization were ever to be abolished its assets would be donated to organizations offering treatment for drug and alcohol addiction.
The cost of operating SAA
SAA members elect a Board of Directors every year and hire employees to run the treatment program. All SAA assests, evaluated at 350 million Icelandic kronur (ISK), are used to run the treatment program and implementing various preventive measures. The Icelandic Government contributed 208 million ISK to the SAA Treatment Program in 1995. Since 1992, public contributions alone have not covered the cost of running the SAA Treatment Clinics that have been officially sanctioned. In 1995 SAA contributed 24 million ISK from its own assets to the runnnig of these clinics. In addition, the organization channelled roughly 50 million ISK to meet the cost of treatment work, preventive measures, and support work for alcoholic and their families.