Drug and alcohol treatment centers across the state are looking to the legislature to fix a last minute, gaping hole as some of their most basic services for thousands of recovering addicts are on the chopping block.
The KING 5 Investigators at KREM 2's sister station first exposed on Monday that because of the implementation of the Affordable Care Act, federal dollars from Medicaid are now paying for outpatient chemical dependency treatments for low income citizens. The Medicaid rates aren’t high enough to cover the actual costs. The state Department of Social and Health Services (DSHS) was supplementing payments to fill the funding gap, but those payments stopped on January 1.
Late Friday a staffer for the Ways and Means Chairman, Sen. Andy Hill, said the issue is now “on the radar” of Sen. Hill and that a solution could be a possibility during budget negotiations.
DSHS could have included the additional funding in the department’s new budget in anticipation of the Affordable Care Act, but that didn’t happen. That inaction has put the issue on the legislature’s plate with only a few weeks left in the session.
“Theoretically state agencies have the ability to change rates (increase the amount of federal dollars to pay for a service), but the changes must be approved by the Legislature if they cost more than what was originally appropriated in the 2013-15 biennial budget,” wrote Jane Beyer, Asst. Secretary for Behavioral Health and Service Integration at DSHS, in a statement to KING 5. “We have effectively committed the biennial budget funding for treatment services.”
Now the directors of publically funded clinics from Seattle to Spokane say they cannot afford to sustain the vital outpatient services with their scarce reserves.
In January the non-profit Recovery Centers of King County had to pay $21,000 to cover the difference for outpatient services. At Evergreen Manor, a non-profit treatment center headquartered in Everett, they were out $14,000 for outpatient treatments.
“We can’t continue with that level of loss. We’d probably have to refuse Medicaid patients or put them on a waiting list,” said Linda Grant, CEO of Evergreen Manor. “It’s awful. It’s like choosing between which baby you can keep and which one you have to give away, like ‘Sophie’s Choice.’ To turn people away who are desperate to get in, it’s really hard.”
Beyer, of DSHS, said the state would increase the Medicaid payments if lawmakers can find the money.
“We believe that Medicaid payment rates should fairly reimburse chemical dependency agencies for the high quality services they provide,” said Beyer. “Our Medicaid reimbursement rates are relatively low for some chemical dependency services. The department will increase the rates if the legislature provides additional resources.
The former director of the Division of Alcohol and Substance Abuse at DSHS said he’s “astonished” the funding problem has come down to a last minute scramble. Ken Stark is now the Director of Human Services for Snohomish County.
“This issue has been brought up to the state (DSHS) time and time again by many people, including me,” said Stark.
Stark says people’s lives and millions of tax dollars are at stake. He pointed to one study after another authored by the state’s own DSHS experts which found when drug and alcohol treatments are reduced, the move backfires on society. The research shows that a population, without access to insurance or treatment, ends up committing crimes, filling up jails, emergency rooms, and nursing homes.
"Those services aren’t free. You and I as taxpayers pay for all of that stuff. Monies don't fall from heaven. The taxpayers cover these costs," said Stark. “We want the most effective service with the most value. The one way to get that is to follow what the research says works and the state’s own research shows chemical dependency treatment works and if you don’t fund it, we will pay for it in other ways.”
Shelley Stewart of Mill Creek says she is a perfect example of how society can benefit when a person gets off drugs and the lifestyle that comes with the abuse. She began using crack cocaine at age 15 and added heroin use in her 20s. In 23 years of active addiction, she stole to buy drugs, was on welfare, spent time in jail, served prison sentences and couldn’t take care of her child. After in-patient treatment and outpatient services afterward, she’s led a productive, drug-free life for four years.
"I no longer am breaking the law. I no longer am in prison where taxpayers have to pay for me to be in prison. My child is not in CPS custody where taxpayers are paying for that - for someone to take care of my child. (And now) I pay taxes," said Stewart.