Durbin Introduces Bill to Expand Access to Substance Abuse Treatment Under Medicaid

Source: http://www.durbin.senate.gov

2.29.16 – U.S. Senator Dick Durbin (D-IL) today joined doctors (including those from Gateway Alcohol & Drug Treatment Centers) and substance abuse treatment clients at Haymarket Center to discuss legislation he is introducing this week that will expand access to treatment for vulnerable populations who currently are not receiving the addiction care they need while the heroin and opioid prescription drug abuse epidemic continues to grow. The Medicaid Coverage for Addiction Recovery Expansion (Medicaid CARE) Act would modify the Medicaid Institutions for Mental Disease (IMD) Exclusion policy—a decades-old Medicaid policy that has had the unintended consequence of limiting treatment for our most at-risk populations.  The measure would allow more than 2,000 additional Illinois Medicaid recipients in Illinois to receive care annually.

 “Too many substance abuse centers do not qualify for Medicaid because of an outdated understanding of addiction, which restricts access to care. Less than 12 percent of Illinoisans in need of substance abuse treatment actually receive it.  That unacceptable treatment rate is hindering our ability to help these individuals turn their lives around and start curtailing this public health epidemic that’s feeding on our state’s youth,” Durbin said. “That’s why I am introducing a bill to change this outdated and ill-advised policy to ensure that patients in need of substance abuse care can get it.”

 Currently, the IMD Exclusion prohibits the use of federal Medicaid financing for care provided to most patients in residential mental health and substance use disorder residential treatment facilities larger than 16 beds. Illinois has 585 residential addiction treatment beds across 15 facilities that are larger than the 16-bed threshold and thus ineligible for Medicaid payments.

Under the Medicaid CARE Act, residential addiction treatment facilities across the nation and here in Illinois would qualify if they:

  • Provide substance use disorder treatment services;
  • Are accredited by a national agency;
  • Have less than 40 beds; and
  • Provide services to adults for up to 60 consecutive days

The legislation also establishes a new $50 million youth grant program to fund inpatient substance abuse treatment to Medicaid beneficiaries younger than 21 in underserved, high-risk and rural communities.

Durbin is introducing the Medicaid CARE Act as the Senate this week begins debate on the Comprehensive Addiction and Recovery Act (CARA) of 2015—of which Durbin is a cosponsor.  The CARA legislation authorizes grants to help states adopt a comprehensive approach to the opiate crisis that involves law enforcement, the criminal justice system, the public health system and the recovery support community

The bill would:

  • Require the establishment of a federal interagency task force to develop best practices for pain management and pain medication prescribing;
  • Require a national drug awareness campaign on the risks of opioid abuse;
  • Authorize the Justice Department, in coordination with other federal agencies like the Office of National Drug Control Policy and the U.S. Department of Health and Human Services to make grants to states, locals, and non-profits to:
    • expand education campaigns and prevention strategies to combat opiate abuse;
    • fund treatment alternatives to incarceration for addicts;
    • provide training for first responders for naloxone use;
    • make grants to help develop disposal sites for unwanted prescription drugs;
    • fund heroin and methamphetamine law enforcement task forces
    • implement medication-assisted treatment programs;
    • provide for school-based programs to support recovery from substance abuse;
    • expand education opportunities for offenders in jails or juvenile detention facilities
    • expand family-based substance abuse treatment programs, and expand services for pregnant substance abusers and those with young children;
    • support veterans treatment courts

Illinois experienced 1,652 overdose deaths in 2014 – a nearly 30 percent increase since 2010. Forty percent of those deaths were associated with heroin. Illinois is ranked number one in the nation for a decline in treatment capacity between 2007 and 2012 – and is now ranked the third worst in the country for state-funded treatment capacity.

Nationally, the number of deaths from heroin overdoses more than tripled since 2010. Yet according to the Substance Abuse and Mental Health Services Administration, less than 12 percent of the 21.5 million Americans suffering with a substance use disorder received specialty treatment in 2014.

Durbin was joined at today’s announcement by doctors from the Haymarket Center and the Gateway Foundation.  The Haymarket Center is the largest substance use and mental health disorder treatment facility in Chicago.  Founded in 1975, it is one of the only treatment centers in the state that offers all levels of care as defined by the American Society of Addictions Medicine.  Gateway Alcohol & Drug Treatment was founded in 1968 and is the largest provider of substance abuse treatment in Illinois, with locations throughout the state. 

HEROIN USE SPIKES AMONG 18-22 YEAR OLDS

Today’s portrait of a typical heroin user probably isn’t what most people imagine. The growth in heroin use is primarily among white, middle and upper class 18-22 year olds, living in America’s suburbs and rural areas.

The heroin concern is an unfortunate outcome of another sweeping drug abuse trend among affluent teens: abuse of prescription pain medications, such as Vicodin and Oxycontin. According to Partnership for Drug Free America, 24 % of high school students have abused addictive prescription drugs, a 33% increase in 5 years. 

However, prescription opioids have become harder to obtain and more expensive, therefore opioid abusers are migrating to a cheaper, stronger alternative to prescription pills: heroin.

It’s important to recognize the physical signs and symptoms of heroin use, which include:

  • Shallow breathing and shortness of breath.
  • Clouded mental functioning.
  • Decreased pain from either physical conditions or emotional challenges.
  • Uncontrollable feelings of itching.
  • Constricted pupils.

As well as behavioral signs of heroin abuse, such as:

  • Lying or other deceptive behavior.
  • Substantial increase in time spent sleeping.
  • Increase in slurred or incoherent speech.
  • Poor performance in school or work, including expulsion or loss of jobs.
  • Decreasing attention to hygiene and physical appearance.
  • Loss of motivation and apathy toward future goals and interests.
  • Withdrawal from friends and family, instead spending time with new friends with no natural tie.
  • Repeatedly stealing or borrowing money from loved ones, or unexplained absence of valuables.
  • Wearing long pants or long sleeves to hide needle marks, even in very warm weather.

If you know someone who needs help breaking free from opioids, Gateway Foundation can help. For a free and confidential consultation, please call 877-505-4673.

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