Landmark U.S. Surgeon General Report Lends Medical Weight to Addiction Fight as Illinois Retreats from Battlefield

spr_capitol_v2(Springfield, IL) – While a new, groundbreaking Surgeon General’s report finds alcohol and drug misuse and severe substance use disorders, commonly called addiction, to be one of America’s most pressing public health fights, Illinois is in a full financial retreat from the addiction battlefield.

“It’s time to change how we view addiction,” said U.S. Surgeon General Dr. Vivek Murthy on November 17, 2016. “Not as a moral failing but as a chronic illness that must be treated with skill, urgency and compassion. The way we address this crisis is a test for America.”

Nearly 21 million Americans – more than the number of people who have all cancers combined – suffer from substance use disorders. Of those, approximately 845,201 are in Illinois.

The report, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, marks the first time a U.S. Surgeon General has dedicated a report to substance misuse and related disorders.

By issuing the first-ever report on addiction, the Surgeon General has lent the weight of “medical opinion” to the classification of substance use disorders as a health care issue, according to a top Illinois behavioral healthcare advocacy group.

“The Office of Surgeon General has for the first time recognized that addiction is a chronic health care issue whose treatment must be addressed on an equal footing with other chronic health care issues, such as diabetes, hypertension, etc.,” said Illinois Association of Behavioral Health CEO Sara Moscato Howe. “Unfortunately, in Illinois, the state’s financial commitment to fight addiction has floundered.”


Quinn Acts on Obamacare Fix to Bolster Illinois Substance Abuse Treatment Care

Governor Pat Quinn

Governor Pat Quinn

(Springfield, IL) – Quinn Administration officials have agreed to a state-level fix of an Obamacare loophole that has stymied the vast majority of Illinois’ residential substance abuse providers from serving new Medicaid enrollees.

A federal Medicaid law, which predates the Affordable Care Act, prohibits Medicaid certification of residential treatment providers with more than 16 beds, a measure intended to prevent the warehousing of individuals struggling to recover from substance abuse.

But Obamacare provides a new, guaranteed benefit of substance abuse treatment through Medicaid, and residential treatment is a key benefit. The situation of federal laws working at cross-purposes has bedeviled Illinois officials and those in other states, according to the chief of Illinois’ top advocate group.

“It’s a tale of two federal laws in conflict with each other creating havoc across the county and an ineffective Congress unwilling to fix the problem,” Illinois Alcoholism and Drug Dependence Association CEO Sara Moscato Howe. “The Affordable Care Act authorizes residential treatment in the benefits package, but the bill’s architects failed to reconcile it with the older law”.

Howe said that the problem has been festering in Illinois for more than a year, but state officials, realizing that Washington gridlock made a federal solution impossible, have been forced to design their own plan.

Earlier this summer, State Senator Heather Steans (D-Chicago), State Rep. Greg Harris (D-Chicago), Illinois House and Senate staff, Governor’s Office of Management and Budget officials, Healthcare & Family Services Director Julie Hamos, Department of Human Services Secretary Michelle Saddler, and DHS Division of Alcoholism & Substance Abuse Director Theodora Binion met with representatives of IADDA, the Community Behavioral Healthcare Association, and the Illinois Association of Rehabilitation Facilities to discuss options to solve the problem.

On Friday, August 22, the advocates and lawmakers learned that the Quinn Administration had met on Thursday, last week, with the CEOs of Illinois’ Medicaid Managed Care Organizations, which are gradually assuming responsibility for all Illinois Medicaid patients, and instructed them to begin covering medically-necessary residential treatment services and room and board costs at both Medicaid and Non-Medicaid certified facilities.

“This order includes already-existing Medicaid patient populations, as well as the expanded ACA patient population,” said Howe. “Additionally, the Department of Healthcare & Family Services is now working with an actuary to determine if the rate currently paid to the managed care providers adequately covers residential services”.

Howe noted that Quinn Administration officials reminded community-based treatment advocates that the managed care companies would remain as the decision makers regarding patient residential placement, not the providers.

The managed care organizations will not be, however, the only group slated for a rate review, Howe said.

“It was also acknowledged by Quinn Administration officials that the state’s current rates for all levels of addiction treatment care are inadequate,” Howe stated. “A state rate review for community based providers will also be undertaken”.

IADDA recently commissioned an actuarial report comparing current state treatment service rates to known cost indices and that study revealed that from 1990-2013, medical costs in Illinois rose 162% while addiction treatment reimbursement rose by only 21% during the same 23-year time period, a circumstance that strictly limits the number of people served.

“The state’s current rates are relic of the early 1990s,” said Howe. “Obsolete funding is preventing Illinois from confront modern addiction challenges, such as the heroin and prescription drug epidemics raging in Illinois and tightly limits the number of people that we can help.”

Still, last week’s announcement was a “big win” for Illinois residents working to overcome addiction and key officials warranted advocates’ “gratitude”, Howe noted.

“For those who seek and need residential treatment, the Quinn Administration’s announcement is a big win,” said Howe. “And Rep. Harris, Senator Steans, Secretary Saddler, Director Hamos, and Director Binion deserve our deepest gratitude for their work and commitment to find a solution.”

Sara Moscato Howe,

Advocates Welcome Quinn OK of Illinois Heroin Study, But Criticize Drug Treatment, Prevention Budget Cuts

Governor Pat Quinn signing legislation earlier this month.

Governor Pat Quinn signing legislation earlier this month.

(Springfield, IL) – Advocates today welcomed a new heroin research initiative approved by Gov. Pat Quinn, but criticized budget cuts to Illinois drug treatment and prevention under the governor’s watch.

Quinn on Tuesday signed legislation to fight heroin use in communities across Illinois through a new law that will expand the scope of a special task force created last year to study heroin use in Illinois and make recommendations to increase awareness and prevention.

“Today’s action is part of Governor Quinn’s agenda to strengthen drug prevention efforts and save lives,” according to the governor’s press statement.

The legislation, House Bill 4542, sponsored by State Rep. Natalie Manley (D-Joliet) and State Senator Thomas Cullerton (D-Villa Park), expands the age range to be studied by the Young Adult Heroin Use Task Force to students in grades six through 12.


Illinois Medicaid Budget Cuts Would Hurt Illinois Economy, Study Says

(Springfield, IL) – Two health-care advocacy groups are predicting thousands of job losses and billions of dollars in economic damage to Illinois, if Gov. Pat Quinn’s plan to conjure $2.7 billion in savings from the Medicaid program is implemented.

Quinn’s plan would jeopardize 25,615 jobs and cost the state’s economy $3.2 billion, according to a report released Wednesday by the Illinois Hospital Association, which lobbies for Illinois hospitals, and the Campaign for Better Health Care, an organization that advocates for health-care access

“Drastic Medicaid cuts hurt everyone, not just the Medicaid patients. Hospitals will be forced to reduce jobs. Local businesses will be impacted,” Illinois Hospital Association President Maryjane Wurth said.

“And hospitals will be forced to cut or eliminate medical services that everyone uses — there is not a separate set of staff, equipment and facilities just for Medicaid patients.”

Quinn’s proposal reduces the amount Medicaid providers get paid by $675 million, accounting for 25 percent of the $2.7 billion in savings.


Governor Pat Quinn Wants Illinois Budget to “Protect Core Priorities”

(Springfield, IL) — Illinois’ new budget may spend less than Gov. Pat Quinn’s original proposal, but it is higher than this past year’s budget and was balanced by delaying the payment of billions of dollars in unpaid bills until this current fiscal year.

“The governor has been clear … that while we put our fiscal house in order, we must continue to protect core priorities,” said Kelly Kraft, Quinn’s budget spokeswoman.

Quinn is “reviewing” the budget’s impact on human services and schools statewide, Kraft said, which were among those items lawmakers trimmed to reduce spending from Quinn’s $36 billion to $33.2 billion.

House Democratic budget architect Frank Mautino, D-Spring Valley, said the new spending priorities include Illinois’ $4 billion pension payment.

The budget “for the first time doesn’t hide the true costs of state government by taking the pensions off budget,” said Mautino. “We’re making all of our pension payments, which for the past three years we’ve had to borrow” to fund.

But pension payments are one piece of Illinois’ astronomical debt. In the proposed budget, lawmakers did not reduce the $4 billion in old bills on the desk of Illinois Comptroller Judy Baar Topinka. Instead, the state will take longer to pay these bills, including Medicaid payments

State Sen. Donne Trotter, D-Chicago, said lawmakers are spending as much as Illinois is expected to take in from taxpayers.

“This is a revenue-driven budget … versus a program-driven budget, which we’ve had in the past where we created programs and then tried to find money,” Trotter said.

State Rep. David Harris, R-Arlington Heights, said that if Illinois brings in more than $33.2 billion in tax revenue, that extra money will pay for past-due bills.

Benjamin Yount, Illinois Statehouse News

Illinois Lawmakers Reprioritize Gov. Pat Quinn’s Illinois Human Services Budget

(Springfield, IL) — Democratic Gov. Pat Quinn and former Republican Gov. Jim Edgar may have different political views, but Quinn is dealing with a similar, but bigger, challenge than Edgar tackled during his tenure as governor.

Edgar faced a nearly $2 billion deficit in 1991. Quinn assumed office in 2009, inheriting a more than $13 billion deficit. Edgar left office in 1999 with a $1.5 billion surplus, crediting his success to raising the temporary tax which later became permanent, cutting state spending and saying “no” to new programs.

“That took time, and it took discipline,” Edgar said. “The governor, I think, has to provide that leadership. It’s hard for the legislature to do that.”

Quinn’s administration isn’t hoping for a budget surplus, but is expecting fiscal stability following proposed spending reductions and recent personal and corporate income tax increases.

Quinn’s proposed $35.4 billion spending plan for fiscal year 2012 aggressively slashes the overall human services budget by about $412 million, or 11 percent, one of the deepest reductions compared to other areas. For instance, the state’s transportation budget saw a 86 percent reduction, or $67 million, according to Quinn’s proposed agency funding figures.

However, other departments saw state funding increases, including:


As Other States Health Cut Care for the Poor, Gov. Pat Quinn Embraces Illinois Medicaid Reform, Patient Care Safeguards

(Springfield, IL) — States across the nation are ratcheting down Medicaid services and eligibility to hold down costs, but Illinois officials are standing by Medicaid reforms passed in January that Republicans claim just skim the surface.

The $14 billion state-federal program offers health insurance for mostly low-income children, pregnant women, parents with young children, senior citizens and the disabled. Chief among the reforms passed in January were a requirement to move 50 percent of the state’s 2.8 million Medicaid participants to a “medical home” within the next four years through “coordinated” or managed care, and to move residents from nursing homes and other institutional care into community-based settings.

Illinois Senate Republicans believe the state can do better than the $800 million in savings expected from the reforms during the next five years.

“That was a good step one,” said state Sen. Pam Althoff, R- Crystal Lake, who served on the Medicaid reform task force. “But there’s now a step two.”

Julie Hamos, director of the Illinois Department of Healthcare and Family Services, noted the reforms are intended to keep people healthy and thereby hold down costs.


Gov. Pat Quinn Rescinds Proposed Elimination of Illinois Alcohol, Drug Treatment Funding

(Springfield, IL) – March 10, 2011. Governor Pat Quinn’s Administration yesterday announced that it had rescinded the proposed elimination of all state funding for non-Medicaid substance abuse prevention and treatment services.

“This afternoon, I received a call from Illinois Department of Human Services Secretary Michelle Saddler informing me that the Governor’s Office of Management and Budget has recommended no additional state revenue reductions from addiction treatment in FY11, leaving all provider contracts unchanged for the rest of the year,” said Illinois Alcoholism and Drug Dependence Association CEO Sara Moscato Howe.

Secretary Saddler stressed, however, that this recommendation does include the projected savings of $7 million of Medicaid funding that DASA believes they can achieve through the implementation of Utilization Management, according to Howe.

“This funding decision means that providers who had frozen admissions for DASA-funded clients should be able to starting accepting new clients as early as today,” said Howe.

On the prevention front, the Secretary indicated that the ‘addiction prevention’ line will not be cut any further in FY11, but that the governor’s budget office is still looking at possible reductions in the Methamphetamine Awareness line, says Howe.

“The Secretary will update me once a decision has been made,” said Howe.

“As an Association, we have successfully educated legislators and the news media alike on the impact of the full elimination of state GRF funding for our services,” said Howe.

“Nevertheless, we still have much work to do on Governor Quinn’s FY12 budget, which also calls for elimination of state funding for prevention and treatment services.”

“In the meantime, we must thank State Representative Sara Feigenholtz, Senator Mattie Hunter and other lawmakers who were crucial to the restoration of funding for addiction health care.”

Uncertainty over Gov. Pat Quinn’s Mid-Year Budget Cuts Freezes Drug Treatment for New Clients around Illinois

State Reps. Sara Feigenholtz (D-Chicago) and Greg Harris (D-Chicago) announced at a press conference last week that they are sponsoring House Resolution 106 that calls on Governor Pat Quinn to halt the elimination of funding for substance abuse treatment services.

(Springfield, IL) — Despite Governor Pat Quinn’s statement last week that mid-year budget cuts announced earlier by the Illinois Department of Human Services (DHS) would be reduced to avoid a complete elimination of state funded substance abuse prevention and treatment services, the uncertainly of the actual amount to be cut in the next two weeks has prompted some treatment providers to refuse new clients.

“While we appreciate Governor Quinn’s good intentions,” said Illinois Alcoholism and Drug Dependence Association CEO Sara Moscato Howe. “We are not out of the woods yet, because multiple providers around Illinois, who are fearful of the magnitude of still unspecified cuts, have frozen treatment services for new, non-Medicaid eligible clients.”

On Friday, February 18, DHS Secretary Michelle Saddler suddenly informed Howe that all state funding for non-Medicaid alcohol and drug treatment services would be eliminated by March 15 as part of an effort of the Quinn Administration to cut $208 million from the department’s budget, prompting providers to halt the intake of new clients.

Illinois Senate President John Cullerton (D-Chicago) opposed the cuts, saying, “It’s not the right move.”

Quinn later reduced the amount to $100 million after advocates protested and more than two-dozen lawmakers, lead by State Rep. Sara Feigenholtz (D-Chicago), introduced a House resolution calling on Quinn to cancel the cuts that would eliminate treatment services for 55,000 clients out of the 69,000 currently being served.

“Neither Governor Quinn nor Secretary Saddler have yet identified where the $100 million in cuts will fall,” said Howe. “As a result, the mid-year budget crisis remains unresolved and a freeze on accepting new clients is in place in various parts of the state, denying treatment for those desperately seeking it.”

Howe noted that the Haymarket Center in Chicago currently has a freeze on new, non-Medicaid eligible clients. The South Suburban Council in suburban East Hazel Crest is operating below capacity, accepting only a few new clients. Meanwhile, the Prairie Center in Urbana is also accepting only a trickle of new clients for residential treatment, leaving 12 of its 24 beds empty, until they learn the magnitude of the cuts to be announced within the next two weeks.

“The uncertainty is as harmful as the cuts themselves because of the disruption of services,” said Howe. “We need both predictable and adequate funding to keep treatment services flowing.”

Gov. Pat Quinn’s Sudden Mid-Year Budget Cuts Trigger Plans to Discharge 55,000 Drug Treatment Clients, 5,000 Layoffs

(Springfield, IL) – On Friday, Illinois’ alcohol and drug prevention and treatment providers learned from Governor Pat Quinn’s administration that Quinn is eliminating all state funding for non-Medicaid drug and alcohol prevention and treatment services beginning on Tuesday, February 22, triggering provider plans to discharge 55,000 out of 69,000 drug and alcohol treatment clients and to lay off more than 5,000 private sector workers.

“Department of Human Services Secretary Michelle Saddler telephoned me on Friday morning to say that all state non-Medicaid funding, which covers 80% of our clients, is being eliminated and providers would be notified on Tuesday,” said Sara Moscato Howe, CEO of the Illinois Alcoholism and Drug Dependence Association, whose group backed Quinn’s successful effort to increase the income tax to protect Illinois Human Services.

“Governor Quinn had pushed to increase the income tax to save Illinois human services,” said Howe. “The Governor’s pledge to protect the most vulnerable in Illinois has been a cruel hoax.”

Though the contract cut notifications from Quinn will have a March 15 effective date, Howe says that date is arbitrary.

“The notices will contain an amended contract amount and the state will not approve any bill above that amount, making the March 15 date meaningless,” said Howe.

“Thus, the cuts begin on Tuesday and it will start triggering layoff notices and client discharges, creating multiple medical risks involved in the sudden disruption of a client’s addiction treatment,” stated Howe.

Howe said prevention and treatment advocates will once again turn to the legislature to protect the vulnerable and fragile men, women, children, and communities served

“In past funding crises, the legislative leaders–Speaker Michael Madigan, Senate President John Cullerton, Leader Tom Cross and Leader Christine Radogno–have championed our clients and demonstrated bi-partisanship in our behalf,” said Howe.

“Additionally, many rank-and-file Democratic and Republican lawmakers have supported the work we do, lawmakers such as: Representatives Sara Feigenholtz, Greg Harris, Deb Mell, Chapin Rose, Rosemary Mulligan, Patti Bellock, Jim Watson, Dennis Reboletti, and Senators Mattie Hunter, Heather Steans, Terry Link, A.J. Wilhelmi, Maggie Crotty, Chris Lauzen, Carole Pankau, and Kirk Dillard, and we are calling upon them for help,” said Howe.

In addition to the fiscal year 201180% mid-year budget cut, Quinn’s newly unveiled fiscal year 2012 budget also eliminates $55 million or 55% of state funding from the Division of Alcoholism and Substance Abuse for prevention and treatment which will reduce the number people receiving treatment from 69,787 this year to 13,957 next year. As recently as fiscal year 2007, the state served 98,000 people.  Quinn’s proposed budget also eliminates addiction prevention services for 229,536 youth.

Currently, untreated addiction costs the State of Illinois $3.5 billion a year. Increases in health insurance rates, incarceration of non-violent drug offenders, domestic violence, on-the-job accidents, lost worker productivity, school drop-out rates, teen pregnancy, and traffic accidents and fatalities are all attributable to untreated addiction, says Howe.

“Crime rates, domestic violence incidents, and traffic accidents will explode across Illinois, starting next week,” said Howe. “Governor Quinn will have to answer for the consequences.”

“We urge the General Assembly to reverse Quinn’s callous cuts to the addiction healthcare system and prevent a doomsday that will decimate Illinois communities.”