Federal money set aside to help uninsured Mainers recover from substance abuse is sitting unused, with many addiction centers unaware of its existence.
Gov. Paul LePage referenced the funding in his July 29 radio address, saying the Maine Department of Health and Human Services “has money available for drug treatment, even for those who don’t have Medicaid or private insurance. In fact, we have hundreds of thousands of dollars left over every year in this program. We have the resources to help those who need it.”
The federal government has stepped up funding for substance abuse treatment over the last couple of years as the Medicaid program covers a smaller share of that care, according to David Sorensen, a spokesman for Maine DHHS.
In Maine, hundreds of residents were dropped from substance abuse treatment programs in 2014 after the state eliminated a group of people — nondisabled childless adults — from the Medicaid program, known as MaineCare. That left a pool of individuals without insurance who potentially would be eligible for the increased funding, but some substance abuse treatment providers say they’ve never heard of the program.
“This would be wonderful news if I actually knew of it and could have access to it,” said Brent Miller, program director at Discovery House in Bangor, an addiction treatment center.
Plenty of patients would benefit from the funding, he said.
“Almost on a weekly basis individuals are dropping out because they lost MaineCare or their financial situation has changed so that they can no longer afford it,” he said.
While anyone lacking insurance could benefit from the funds, federal guidelines prioritize some populations: pregnant intravenous drug users, followed by pregnant women, women with children, IV drug users, veterans and Native Americans.
After offering treatment to uninsured patients, providers such as Discovery House can bill DHHS to access the funds, made available through the Substance Abuse and Mental Health Services Administration, Sorensen said.
LePage said in his radio address that funding for substance abuse treatment has increased under his administration. General fund money for that care rose from $8 million in fiscal year 2014 to $9.5 million in 2015, according to Sorensen.
Summit on drug abuse
The governor announced Wednesday that he plans to convene a group of officials from state, local and federal law enforcement agencies, addiction treatment and recovery advocates and other experts this month to address Maine’s deadly drug crisis.
In a letter to legislative leadership, LePage chastised lawmakers for funding only half the law enforcement positions he sought in the budget to combat the state’s substance abuse problem.
“How many more Mainers must die before you commit the resources we need to fight this drug epidemic?” he wrote.
House Speaker Mark Eves, D-North Berwick, responded that lawmakers listened to medical experts and rejected the governor’s proposal to cut methadone treatment while expanding access to the overdose antidote Narcan over the governor’s objections.
“On the governor’s watch, we’ve seen more struggling families lose access to health care and we’ve seen substance abuse treatment centers close their doors for lack of funding,” Eves said in a statement. “The obituaries and news stories we’ve seen in recent weeks show the drug crisis in our state is a health care crisis, not just a matter of law enforcement. The longer the governor keeps the blinders on, the more Maine families will suffer.”
LePage and his administration have stressed law enforcement crackdown on drug dealers in responding to the drug crisis.
“The problem is not that the $16.4 million DHHS spends annually on addiction treatment for the uninsured is too low, but that many addicts who begin treatment never even complete it. … Indeed, uninsured intravenous heroin addicts are presently one of the most heavily prioritized of all the populations DHHS serves,” DHHS Commissioner Mary Mayhew said in a statement.
Only 36 percent of those seeking treatment complete it, Sorensen wrote, saying his figures are based on data DHHS collects from providers.
Jim Cohen, an attorney representing a coalition of Maine methadone providers, said clinics are struggling to keep patients in treatment in the wake of government reimbursement rates plummeting by 25 percent over the last five years. That has forced cutbacks in counseling sessions that accompany the medication and are critical to patients’ recovery, he said.
“Even if there’s more money available, it’s not immediately clear how that changes the math in terms of making services available to Maine people,” Cohen, whose group successfully fought the LePage administration’s plan to eliminate all state funding for methadone treatment, said.
He questioned how DHHS determined the completion rate for substance abuse treatment, saying the definition of success varies from patient to patient. The two-year cap the state imposes on methadone treatment leads some clients to stop before they’re ready, Cohen said. With statistics showing 80 to 90 percent of those who halt treatment prematurely will relapse, the state should do all it can to help patients continue their care, he said.
“Success is defined as helping the patient meet their goals in terms of getting back to work, achieving stability with their overall health needs, reuniting with family,” Cohen said.
The recent closure of the Mercy Recovery Center in Westbrook, one of the state’s largest addiction treatment centers, highlights the need for more funding for providers, he said.
He, too, was unaware of the funding for uninsured residents, saying he welcomed the news and his coalition would spread the word about its availability. But patients without MaineCare or other insurance coverage who can’t afford addiction treatment on their own often assume they’re out of luck, Cohen said.
“The uninsured folks might never show up at a clinic,” he said.