Op-Ed

Improving drug treatment key part of Medicaid reform

McClatchy-Tribune

Addiction is devastating Eastern and Central Kentucky. Our region has suffered from one of the worst prescription-drug abuse problems in the nation. Now, we see overdoses increasing as heroin and fentanyl flood into the mountains.

This is personal to me. This December, I will be clean and sober for 10 years.

Since November 2008, Addiction Recovery Care has been an organization that has served all clients, regardless of financial resources. That’s why we worked hard to become the first Medicaid service provider to get a behavioral-health services organization license in Kentucky. We admitted the first Medicaid adult residential patients in January 2015.

In the last two years, we have admitted over 800 patients into our residential treatment centers — 85 percent of these were Medicaid patients.

We currently operate four residential treatment centers and have three new centers opening this year, including a pregnant women’s center in Louisa.

We have served people from 49 of the 54 counties identified by the Centers for Disease Control as the most vulnerable for an HIV or hepatitis C outbreak as a result of intravenous drug use.

We are also working to expand vocational rehabilitation and job training. Addiction treatment is a necessary first step, but job training is important to so many individuals recovering from substance abuse.

Because of our experience in treating Medicaid patients, we are excited about Gov. Matt Bevin’s recent proposal on substance-abuse treatment in his Kentucky HEALTH plan.

Currently, residential treatment centers are limited to 16 beds because of the federal rule that governs such facilities. Bevin has proposed a pilot program to allow treatment centers serving 10 to 20 of the most vulnerable counties listed in the CDC study to increase capacity beyond 16 beds.

We applaud this proposal because it will greatly increase access to treatment for our most vulnerable citizens.

In addition, ARC has submitted comments supporting increasing telehealth services for Medicaid recipients with substance-abuse problems. We currently are able to provide online counseling and behavioral-health support services to those with private insurance, but Medicaid patients do not have access to those services except in limited situations.

Allowing access to these services will increase access to treatment in rural areas where transportation is difficult and often limited.

ARC also requested the waiver allow increased access for addiction treatment for pregnant women. In some counties, more than 70 percent of babies are born to drug-addicted mothers. These babies endure painful and dangerous withdrawal. This is a crisis. Extending care for addicted pregnant women should be a priority.

The proposal that Bevin has made to increase access to treatment is not surprising. Those of us on the front lines of battling addiction have seen that our governor has a pattern of addressing issues on behalf of those struggling with substance abuse and those in recovery.

He recently signed legislation that gives addicts a second chance by allowing their criminal records to be expunged. This is good public policy because it allows recovering addicts a path to employment. The governor also has recently created the Criminal Justice Reform Council, signaling an emphasis on treating addicts instead of incarcerating them.

Addiction providers in Eastern Kentucky, like ARC, see the work that our governor has done with our congressman, Hal Rogers, with the SOAR initiative. We applaud these efforts and the support of our governor for access to addiction treatment in Kentucky.

Eastern Kentucky has a lot of challenges. From a public-health standpoint, addiction is at the top. But, as someone who is native to these mountains and is a great grandson of pioneers who chopped down trees and built settlements here, I believe our best days are ahead of us.

There is hope when it comes to addiction and we have local folks taking responsibility to open centers and create programs and services, not only for addiction treatment, but also vocational rehabilitation.

We support all the governor’s efforts aimed at getting more people access to substance-abuse treatment and the help they need to become productive citizens. The changes proposed in the Kentucky HEALTH waiver application are outstanding public policy.

Tim Robinson is CEO of Addiction Recovery Care LLC, a Louisa-based network of drug and alcohol treatment centers.

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