Impact of Illinois state cuts - substance abuse

STATE’ THE STATE’S FISCAL CRISIS: CHANGING OUR COLLECTIVE RESPONSE Human Services Impact: Substance Abuse June 14, 2010 Kathye Gorosh, MBA CEO New Age Services kgorosh@newageservices.org

WHAT’ WHAT’S IN A NAME?? SUBSTANCE USE AB US E CE BS TAN SU TION SUB STA ADDIC DISO NCE RDE USE BEHAVIO OPIOIDS: RS RAL HEALTH OMT MAT MMT COV ERY DRUG OTP RE ATOD TREATMENT

DASA: SERVICES PROVIDED Case Management Child Care Residential Community Intervention Detoxification HIV Testing and Counseling Intensive Outpatient Services DASA Early Intervention Outpatient Services Residential Rehabilitation Rehabilitation-- --Extended Residential Rehabilitation--Extended Toxicology

TREATMENT NETWORK DASA administers a network of community- based alcohol and other drug treatment programs. All treatment programs must be licensed by DASA 893 Licenses for Treatment and DUI. 494 Licenses held by 147 funded corporations. 399 licenses held by 283 unfunded corporations.

LEVELS OF CARE Illinois Substance Use Treatment Levels of Care LEVEL DESCRIPTION Level I (Outpatient) Outpatient treatment, individual and/or group services, frequency determined by assessment. Services average less than 9 hours/week. Opioid Maintenance Therapy Outpatient treatment; methadone maintenance; individual and/or group services. Level II (Intensive Outpatient) Outpatient treatment, individual and/or group services, frequency determined by assessment. Services average 9 hours/week at a minimum. Level III.2 (Detoxification) Monitored process of withdrawal from a specific psychoactive substance. Level III.3 (Residential Extended Residential extended aftercare (recovery Care) homes), most often used as a step down from residential treatment.

Minimum Unit of S e r v i c e S e r v i c e Code Rate Admission and Quarter Hour AAS $63.36 - per hour Discharge Assessment $15.84 - per quarter hour Reimbursement Rates FY 2010 Level I (Individual) Quarter Hour OP $60.32 - per hour $15.08 - per quarter hour Level I (Group) Quarter Hour OP $22.80 - per hour $5.70 - per quarter hour Level II(Individual) Quarter Hour OR $60.32 - per hour $15.08 - per quarter hour $22.80 - per hour Level II (Group) Quarter Hour OR $5.70 - per quarter hour Level III.1 Daily HH $64.86 Level III (Detoxification) Daily DX Provider Specific Level III.5 Daily RR Provider Specific Recovery Home - Adult Daily RH $46.65 Recovery Home - Adolescent Daily RH $118.45 Case Management Quarter Hour CM $46.68 - per hour $11.67 - per quarter hour Psychiatric/Diagnostic Per Encounter/Per - $78.94 Opioid Maintenance Therapy Day Weekly OP $85.35 (less than 105 patients) Opioid Maintenance Therapy Weekly OP $68.28 (more than 104 patients) Early Intervention (Individual) Quarter Hour EI $60.32 - per hour $15.08 - per quarter hour Early Intervention (Group) Quarter Hour EI $22.80 - per hour $5.70 - per quarter hour Community Intervention Quarter Hour CIH $45.56 - per staff hour $11.39 - per quarter staff hour Child Domiciliary support Daily CRD $48.71 Toxicology Per Test TOX As specified in exhibit $56.24 - per hour HIV Counseling and Testing Quarter Hour HIV $14.06 - per quarter hour

SUPPORTED TREATMENT SERVICES SFY 2009 90,373 Includes All DASA funded services Individuals 60,267 Male 30,106 Female 1,403 Pregnant 13% Youth 86% Adults 1% Seniors

S T I G M A

ALCOHOLISM AND SUBSTANCE ABUSE General Revenue Funds (Dollars in millions) FY08 Appropriation Request = $164.5M FY09 Appropriation Request = $109.5M FY10 Appropriation Request = $109.3M FY11 Appropriation Request = $140.3M

ALCOHOLISM AND SUBSTANCE ABUSE DASA: All funds SFY 2008 to SFY2010

ALCOHOLISM AND SUBSTANCE ABUSE DASA Medicaid SFY 2008 to SFY2010

New Age Services: OMT Clients funded/Year “budget relief” Actual: 3/09 Revised – retro to 7/1 l TBD na gi ri O

THE GREAT SILO EFFECT HEALTH HUMAN SERVICES OTHER SUPPORT SERVICES

STATUS: DHS/DASA FUNDING TO DATE Contracts: Decreasing – since SFY 2008 Payment: Time from Billing to Payment SLOW SLOW SLOW 3 months to 6 months and even 10/09 [IL Partners] FFS Rates: unchanged since SFY 2002 (3% COLA in SFY 2006) This amounts to a “cut” due to increased costs Consequences of untreated Substance use/abuse Clients/Patients admin detox Programs Close; Intake Doors Slam Shut Increased Waiting Lists Decrease Access to Many Services

Addiction Healthcare Cuts Yield Increased Costs: Additional Cuts in FY 11 to Addiction Prevention and Treatment Services Result in $280 million in Related Costs Failure by the State to adequately fund alcohol and drug prevention, treatment and recovery services results in the State paying out billions in costs associated with untreated addiction. Annually, the State of Illinois spends only $1 on addiction healthcare services for every $33 that is allocated to pay for the consequences of substance use disorders and addiction. Of the estimated $4.85 billion spent annually in Illinois on issues related to substance use and addiction, only $147 million is actually spent on the prevention and treatment of alcohol and drug use and addiction. By cutting Addiction Prevention and Treatment state funding by 8% in FY11, on top of cuts already imposed in FY10, the State will need to add an additional $280 million to cover the expenses that will be incurred in Criminal Justice, Education, Healthcare, Child Welfare, and Public Safety as a result of untreated addictions. Illinois Alcoholism and Drug Dependence Association www.iadda.org

WHAT’S NEXT??? Reality at the agency level: Inability for Board to pass FY 2011 Budget (varies based on %age of State Dollars that comprise the agency’s budget) Given the “state of the state” – prepare staff and clients/patients for layoffs and admin detox Look for additional places to cut expenses – not likely since that has been ongoing since FY 2009 Verify Line of Credit still available [NOTE: may be harder this year w/ the State as the source of the Account Receivable balance] Finding the best way to have a voice for our needs

Impact of Illinois state cuts - substance abuse

by Health & Medicine Policy Research Group on Jun 22, 2010

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Impact of Illinois state cuts - substance abuse — Presentation Transcript