Medicaid asks for funding for substance-abuse treatment

bmusgrave@herald-leader.comFebruary 6, 2012 

FRANKFORT — If the legislature approves, nearly 6,000 people could be treated for substance abuse under the state-federal program for the poor and disabled.

Kentucky is one of only seven states that does not offer substance-abuse treatment in its Medicaid program.

With the number of Kentuckians with substance-abuse problems on the rise, treating more people with addiction will improve people's health and the state's bottom line, said Stephen Hall, commissioner of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

The average cost of intensive outpatient drug addiction services is $2,500. An adult who is not treated costs the taxpayers more than $23,000 in prison and other costs, Hall said.

Studies of Kentucky drug treatment programs show dramatic increases in the level of employment of people who successfully complete treatment, Hall said.

He testified Monday before a House budget subcommittee on health and human services. The expansion of the state's drug addiction services in the Medicaid program is one of several new spending items Gov. Steve Beshear has proposed in his two-year budget. Beshear has said that expanding drug treatment is key to tackling the state's drug epidemic.

Beshear, at a news conference Monday, said that during the past 10 years, the number of people seeking treatment for addiction to pain killers has gone up 900 percent. According to federal statistics, more than 25,428 people were admitted to Kentucky drug and alcohol rehab programs in 2010.

Beshear is asking for $11.6 million in the first year of the budget to serve about 4,500 people. He is asking for $14.9 million in the second year of the budget to serve an additional 1,300 people.

"All of the research shows that this is a smart thing to do," Hall said of the return on the investment.

He said Medicaid-eligible Kentuckians who have a mental illness and substance-abuse problems or who have substance abuse problems and custody of a minor child will have priority in the program. Those with serious addiction problems also will be treated.

Teresa James, acting commissioner for the Department for Community Based Services, has said that the additional money for substance-abuse treatment would be key to helping fight child abuse. The state has too few drug treatment programs for parents accused of child abuse or neglect, James has told legislators.

Hall said the state's community mental health centers already have community-based drug treatment programs that can be expanded to treat substance abuse if the legislature agrees to the funding increase.

Many on the House budget committee applauded the move, saying it was long overdue. However, the state is facing one of its leanest budgets in a decade. Most state agencies will have to absorb an 8.4 percent cut under Beshear's proposed two-year budget. That's on top of four years of cuts. Many state agencies' budgets have been cut more than 30 percent during the past few years.

Sen. Robert Leeper, chairman of the Senate Appropriations and Revenue Committee, said Monday that with so many state agencies facing deep cuts, any additional spending in new areas would receive scrutiny.

"It's a difficult time to start any new programs," said Leeper.

Beshear is also asking for money to fund a new residential program for the severely mentally ill. Currently, there is no money for residential and support services for that population.

Beshear is asking for $2 million for the next fiscal year and $4 million in the following year for 400 additional placements for people with severe mental illness who need additional services.

Kathy Dobbins is executive director of Wellspring, which provides residential and support services for the severely mentally ill in Louisville. Wellspring, through a combination of state, federal and private money, is one of only two providers in Kentucky that offer community support and residential services for the severely mentally ill.

It costs about $700 a day to serve someone in a psychiatric hospital, compared to $1,000 to $2,000 to provide residential services for someone for a month.

"It's not just the financial savings," Dobbins said. "This is the right thing to do."

The legislature has until April 15 to pass a two-year budget.

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