A change in the way the state is funneling federal money to county addictions boards and local providers is creating a $20 million shortfall over the next year.
The plan by the Department of Mental Health and Addiction Services to distribute $63 million in federal money over 18 months instead of a single year is meant to address cash flow problems that at times have left addiction services providers scrambling to cover payroll. Federal money approved last fall, for example, wasn’t available until March this year.
The agency’s director has said that once implemented on July 1 the plan will ensure a more stable funding stream for local boards helping treat Ohioans with substance abuse problems.
Tracy Plouck, Mental Health and Addiction Services director, has also said Gov. John Kasich’s upcoming budget may help cover part of the gap, and Ohio’s decision to expand Medicaid eligibility for more poor Ohioans should help ease the blow.
“The challenge is if we don’t address this (financial) problem, providers will have no predictability with the money from the feds and we’re just perpetuating the issue in the system,” Plouck said.
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Butler County has seen a 139 percent increase in drug overdose deaths in the first part of 2014 compared to last year. Of the 21 drug overdose deaths attributed to heroin, 11 were a mixture of heroin and fentanyl.
John Bohley, executive director of Butler County Alcohol and Drug Addiction Services Board, isn’t sold that the proposed plan is the best way to go during the heroin epidemic because the SAPT grant “is money that’s pretty stable that we can count on.” Butler and Warren counties stand to lose nearly $1 million through the funding change.
“It’s true that the expansion of Medicaid results in more outpatient services being covered. What happened as a result of Medicaid expanding, providers in Butler County have increased their capacity for outpatient services, but they’ve also increased their capacity for residential services,” Bohley said.
As more people come into residential services, Medicaid only pays for part of the bill, he said. It does not pay for room and board and supervision — “and those costs have increased,” Bohley said. “(Medicaid expansion) is creating new demand for residential services and other services for childcare.”
He also feels local addiction and mental health boards “are facing a double loss” with the $47.5 million the General Assembly appropriated for clinical services support. But Ohio MHAS spokesman Eric Wandersleben said Medicaid expansion will cover those services, “creating an opportunity to re-prioritize the one-time state subsidy to address other unmet needs, like community based prevention and housing.”
Wandersleben said the Kasich administration “has made an unprecedented investment in mental health and addiction services” and the mid-biennium budget review proposals are “focusing on significant gaps in the continuum of care post-Medicaid expansion.”
Gubernatorial contender Ed FitzGerald and attorney general candidate David Pepper questioned the timing of the decision at a Thursday news conference in Columbus, saying the shortfall hampers the effort to combat Ohio’s painkiller and heroin epidemic.
“This was not a decision that had to be made,” FitzGerald said. “They made a bureaucratic decision without realizing that there could be an interruption in services or treatment, and that’s a foolish decision.”
“There is already far too little treatment for heroin addiction in this state, and the waiting lists are already far too long,” Pepper said. “To make dramatic cuts to treatment providers all across Ohio — as the crisis continues to explode — makes no sense.”
Sojourner Recovery Services serves about 700 patients each year, which includes 350 patients in the residential-only programs. About 89 percent of those patients are for heroin or some other opiate addiction, according to the non-profit agency that provides substance abuse treatment to women, men and adolescents.
“Leaders in Butler and Warren counties are working hard to address the crisis. So it’s a real shame to see the state pull the rug out from under them by dramatically reducing treatment,” Pepper said. “This will only result in more lost lives and more crime.”
The state saw a record 1,914 drug overdose deaths in 2012, according to Department of Health data. Heroin-related deaths soared 60 percent to 680 in 2012, the most recent year of available data, the Health Department found.
Ahead of Thursday’s news conference, health care and mental health advocates released a letter on the issue that they said was sent weeks ago to all statewide contenders and those running for the General Assembly. In it, they urge candidates not to politicize drug abuse and addiction.
“All too often we have seen the polarizing, trivializing effect that heated campaign rhetoric can have on serious issues,” wrote the groups, which include the Drug Free Action Alliance.
The Associated Press contributed to this report.