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Addiction in Franklin County

State officials see need for more addiction rehab

BOSTON — Leaders across the branches of state government are in broad agreement that the state needs to increase access to mental health and substance abuse treatment, with many saying there is a deficit of services and a lack of insurance coverage to pay for treatment.

“We treat someone who has a cardiac problem due to a lifetime of unhealthy habits better than we treat someone who has an addiction problem, and it could have started from something as simple as a back surgery,” said Sen. Jen Flanagan, who is chairing a new commission looking into the issue.

“I could not agree with you more,” Health and Human Services Secretary John Polanowicz told Flanagan at a budget hearing in Watertown last week after she said she was “disheartened” that so much substance abuse treatment takes place in correctional facilities rather than health care settings.

Massachusetts residents are open to “rethinking how drug crimes are treated,” according to the results of a new statewide poll conducted by The MassINC Polling Group for MassINC and The Massachusetts Criminal Justice Reform Coalition. The poll results were released Thursday by MassINC.

By more than a 2-to-1 margin, the poll showed residents are “more likely to perceive drug use as a health problem (64 percent) than a crime (24 percent).” Seventy-eight percent “would consider early release for drug users, and 83 percent think sending drug users to treatment instead of prison would be effective at reducing crime.”

Franklin County

The county has three long-term treatment houses run by private social service agency ServiceNet, and a fourth on the way. The existing houses typically operate at capacity, with long waiting lists, and there are none of the intermediate steps: detox or stabilization beds.

Local legislators Rep. Stephen Kulik and Sen. Stan Rosenberg have supported initial funding for a paid staffer to support a home-grown organization, the Opioid Education and Awareness Task Force, working to identify and address the extent of the heroin and prescription pill problem in Franklin and Hampshire counties and the North Quabbin Region.

That money, $40,000, is included in a supplemental budget awaiting the governor’s approval.

Kulik has also advocated longer-term state financial support to address the issue.

“Definitely this is not a short-term problem,” Kulik said last week. “I’m hopeful that as we are now working on preparing the fiscal year ’15 budget we’ll be able to continue this work. So yes, I’ll be looking to do that as we look at the next fiscal year.”

Rosenberg presented the problem as beat able and pointed to budding efforts to combat it.

On Tuesday, the Committee on Mental Health and Substance Abuse advanced a bill (H 3825) that would establish three commissions investigating the use of drug treatment in lieu of incarceration, cutting down on a state prison population where officials estimate 80 percent of inmates have a substance abuse problem.

“We have to address this. It’s a public health emergency, so we need some better treatment long-term,” said committee co-chairwoman Rep. Elizabeth Malia, a Jamaica Plain Democrat.

Insurance

Bill sponsor Rep. Randy Hunt, a Sandwich Republican, said the goal is to move people with drug and alcohol problems out of prisons and into treatment, and said the commissions should determine the proper course “so that, when we’re dealing with health insurance companies, that there is a standard of treatment that we would encourage them to support with health insurance dollars from their subscribers.”

Public Safety and Security Secretary Andrea Cabral has discussed the need for recovery treatment to begin during incarceration and extend after release, and Trial Court Administrator Harry Spence said the court’s plans for more drug courts require funding for treatment as well.

“Within three years, every person who needs it and for whom it is appropriate, will have access to a drug court in Massachusetts. That’s our goal,” Spence told a budget panel in Fitchburg.

Later he said, “We could have come to you with a specialty courts request for $700,000 by leaving out any treatment, any clinical supports. We could have just set up a judge and a probation officer and called it a specialty court. It’s clear to us that to do so would be irresponsible. Secondly, not to include the treatment beds just means the court becomes a way of somebody jumping the line for an already desperately limited resource.”

While some have said insurance policies are not accommodating enough for drug treatment, an official with the state’s health insurance association said insurers follow national guidelines for coverage.

“Plans already cover a wide range of services for substance abuse and chemical dependency issues,” said Eric Linzer, senior vice president of public affairs and operations for the Massachusetts Association of Health Plans. Saying MAHP is willing to sit down with advocates on the issue, Linzer said, “This needs to be a discussion that focuses on data and the facts.”

Treatment rose

Linzer said Division of Insurance statistics show coverage of inpatient and outpatient treatment for chemical dependency increased from 2011 to 2012, the last year of available data.

“I was talking to a gentleman in detox last week, where he’s literally sat – I believe he was drunk – waiting for the insurance company to approve his care. Now if you’re someone who has a drug problem, or an alcohol problem, and you’re looking for treatment, are you really going to wait six hours?” Flanagan asked the News Service. She said, “There’s a lot of times when providers will say, ‘We’ve done everything we can, and the insurance companies will only approve three days.’”

The Department of Public Health says the Bureau of Substance Abuse Services has licensed 869 detox beds for adults, 284 clinical stabilization service beds, 291 transitional support service beds, and 2,211 recovery home beds, along with beds for youths and families.

Gov. Deval Patrick’s budget would add 32 detox beds and 32 beds for clinical stabilization service.

“I think it’s going to create the kind of system where people who need access to rehabilitation can get that access and not handle them in our DOC system,” Polanowicz said of the 64 new beds in the budget.

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