Many state and local officials and health care providers agree – the opiate epidemic is overwhelming Ohio’s mental health and drug treatment systems. Last year, the Republican-led Ohio House allocated additional resources to tackle it – an extra 48 million dollars in each of the next two years.
But that was before Governor Kasich maneuvered around the legislature to expand Medicaid. Republican lawmakers opposed the expansion. Now, they’ve decided that since Medicaid covers mental health and addiction, their earlier allocation needs rethinking.
"And so the question is what do we do with the original $47.5m that was appropriated, now that we have the Medicaid expansion? Because that money is effectively freed up," said Representative Robert Sprague, a Republican from Findlay.
He sponsored legislation that both houses have now approved. It reallocates the second year of funding to what he says are more strategic uses in the fight against opiate abuse, such as more transitional housing for people getting out of inpatient facilities, which improves the odds of making their recovery stick. More will go into school drug use prevention programs, and into a court program that makes drug treatment part of sentencing.
"We’ve got to be agile enough as a state, to be able to begin to fill these gaps, make these investments quickly, to help people," Sprague said.
Local treatment agencies agree some of these programs are needed. But they complain that changing course midstream with what they thought would be two years of funding throws their budgets into disarray, and threatens programs they just started.
For example, Lorain County Alcohol and Drug Abuse Services, a private nonprofit, created an ambulatory detox program. That allows some clients to go through the first phase of kicking an addiction on an outpatient basis. The agency’s chief, Tom Stuber, said it has gotten more people into treatment and reduced the wait for inpatient detox, too.
Under Sprague’s legislation, the state funding goes away a year earlier than Stuber expected. Stuber said the agency will find a way to keep it going, but there will be an impact.
"What it will mean is there will probably be reduced slots available for rehabilitation," he said.
Stuber said the notion that Medicaid will now cover the costs of treatment for the poor is only partially true. It doesn’t pay for all the non-medical services his agency provides that help keep people clean.
Besides, Stuber said, all that Medicaid money is somewhat hypothetical this early in the program. Expanded coverage only began January 1st, and there’s a big backlog in the process of getting people signed up so that his agency can start getting paid for treating them.
While Sprague said the funding adjustment aims for big-picture investments in the system, Stuber and officials with other local treatment agencies say they need more money now to treat the rising tide of patients faster.