OP-ED: Trumpcare Plan Would Sink Illinois Mental Health Care, Addiction Treatment for 27,000

OP-ED: Obamacare, coupled with Medicaid expansion, has transformed access to behavioral health care for Illinois residents with mental illness and addiction disorders. Since the inception of the Affordable Care Act, almost 66,000 Illinois residents have accessed care that they otherwise would not have obtained.

Today, however, tens of thousands risk losing behavioral health care in Illinois. A survey by the Illinois Association for Behavioral Health of its members estimated that 26,490 Illinois citizens would lose behavioral health services if the Medicaid expansion component is rescinded under proposed Trumpcare. Financially, in fiscal year 2019, the president’s health plan would cut Illinois’ share of Medicaid funding by $1.4 billion.

Overall, according to the non-partisan Congressional Budget Office, the Trumpcare plan would cut coverage for 975,700 Medicaid beneficiaries; cause 301,600 Illinoisans to lose employer-sponsored health insurance; cut 62,000 from the Illinois insurance exchange; and cut coverage for 55,000 elderly residents, totaling more than 1.3 million Illinoisans who would lose health insurance under the federal legislation currently under consideration.

Moreover, roughly 2,038,000 individuals in Illinois, who have pre-existing health conditions, are at risk of having their coverage rescinded, being denied coverage, or being charged significantly more for coverage if the Congress approves the proposed American Health Care Act.

The loss of addiction treatment and mental health care services would cut not only care to 26,490, but also it would inflame the heroin and opioid epidemic that is convulsing the state.

In Illinois, heroin-related overdose deaths increased 22 percent from 2013 to 2014 and the opioid-related death rate rose 120 percent from 2014 from 2015. In 2016, Illinois Criminal Justice Information Authority researchers surveyed police chiefs and sheriffs for its Illinois Drug Threat Assessment and more than half of respondents identified heroin as the greatest drug threat in the state.

For example, in 2015, Will County registered 53 overdose deaths linked to heroin and fentanyl, which is more than the 51 deaths caused by traffic accidents. In Cook County, there were 526 heroin and fentanyl deaths in 2015 compared to 240 traffic deaths.

Critically, in the current opioid epidemic fight, Medicaid pays for 15.4% of addiction treatment medication in Illinois.

Additionally, Governor Bruce Rauner’s signature criminal justice reform goal to reduce the Illinois prison system by 25% would be jeopardized with the loss of federal money from the rollback of Medicaid expansion.

Without Medicaid expansion, Illinois will need to spend tens of millions of its general revenue fund dollars—an estimated $84.5 million—to pay for critical community-based behavioral healthcare services in support of the Commission on Criminal Justice and Sentencing Reform’s goal to reduce the state’s prison population 25% by 2025. That’s money that Illinois does not have.

The health legislation being considered currently by Congress would unleash a health care crisis, in general, and a behavioral health care crisis, in particular, in Illinois on a staggering financial and human scale if approved by federal lawmakers.

Illinois’ congressional delegation – which has a healthy interest in its constituents’ behavioral health well-being and their own – has a clear choice.

sara@ilabh.org

Drug Treatment Center Collapses; Exasperated Advocates Point Finger of “Moral Culpability” at Illinois Elected Officials

IABH CEO Sara Moscato Howe

(Springfield, IL) – The slated closure of a Central Illinois addiction treatment center because of Illinois’ budget crisis has pushed exasperated behavioral health advocates to demand that Illinois’ top elected leaders “do their job” or face “moral culpability” for “abetting heroin crisis.”

The Jacksonville-based Wells Center, which provides a 32-inpatient and outpatient addiction treatment program, announced on Friday that it will close in April and layoff all 33 employees.

Wells Center, which serves 500 clients annually, is owed approximately $1.4 million from the state, which provides 70 percent of its funding.

“The Wells Center closure is an another self-inflected wound in a long list of self-inflicted wounds committed by the state’s elected leaders,” said Illinois Association for Behavioral Health CEO Sara Moscato Howe. “We ask our elected leaders to stop marching in parades; stop schmoozing at political fundraisers; stop working the rubber-chicken circuit and, instead, focus like a laser on a budget deal. Period. Nothing else matters.”

Read the full post »

Affordable Care Act Repeal Would Cost Illinois 114,000 Jobs

(Springfield, IL) – Pledges by President Donald Trump and U.S. congressional leaders to repeal the Affordable Care Act would deal an economic blow to Illinois, costing the state 114,000 jobs, says a new report.

A new report by Health Care for America Now shows the impact that repealing the Affordable Care Act would have on Illinois. It says more than a million people in the state would lose health coverage.

The fallout also includes $1.2 billion in new uncompensated care, 114,000 lost jobs, and $2.7 billion in lost income for hospitals and physicians. In Illinois, 260,000 people receive subsidies to help pay for their coverage, and the report says repeal would cost each of them over $4,300 in 2019.

Lynda DeLaforgue, the co-director of Citizen Action Illinois thinks without a good replacement plan, a repeal is irresponsible and dangerous.

“When people can get medical care at the front end, then we prevent a lot of catastrophic illness at the back end,” she said. “And so, the whole system is benefited through this, not to mention all of the lives that are saved when people have access to health care at the front end.”

sara@ilabh.org

66,000 Illinois Citizens Got Mental Health, Drug Treatment Thanks to Obamacare Advocates Tell Durbin

spr_capitol_v2(Springfield, IL) ­– In a letter to U.S. Senator Dick Durbin (D-IL), a top Illinois behavioral health advocacy group claims that Obamacare has provided 66,000 Illinois citizens treatment for mental illness and substance abuse that “they otherwise would not have obtained.”

The letter to Durbin, dated January 2, 2017 from the Illinois Association for Behavioral Health CEO Sara Howe, heralded the Affordable Care Act impact in Illinois.

“The ACA, coupled with Medicaid expansion, has made a tremendous positive difference in access to services for those with mental illness and substance use disorders,” Howe wrote. “Since the inception of the ACA, IABH members have provided almost 66,000 Illinois citizens services they otherwise would not have obtained.”

Howe warned Illinois’ senior senator that “thousands” risk losing behavioral health care in Illinois if the U.S. Congress repeals the federal health insurance plan.

“The loss of services under the auspices of the ACA would not only lead to thousands of clients losing services, it would exacerbate the all too common occurrence of those with mental illness and substance use disorders being incarcerated due to actions taken as a result of their lack of access to care,” Howe stated.

A survey of its members by the group estimated that 26,490 Illinois citizens would lose behavioral health services if the Medicaid expansion component of the ACA is rescinded.

Read the full post »

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.”

Read the full post »

IL Mental Health, Addiction Treatment Advocates Want “Quick, Responsible” Budget Resolution

(Springfield, IL) – Illinois Association for Behavioral Health CEO Sara Moscato Howe today issued a statement calling on Governor Bruce Rauner and the four legislative leaders to act “quickly and responsibly” in order to produce a full Fiscal Year 2017 state budget.

“With the FY 2017 stop gap budget expiring at the end of December, the Illinois Association for Behavioral Health urges both the legislative leaders and the governor to approve quickly and responsibly a full-year state budget that reverses the budget cuts that have been imposed on mental health care and addiction prevention and treatment in recent years,” Howe said.

showe@ilabh.org

$1.3 Million from Feds Will Help IL Bolster Mental Health, Drug Treatment Parity

IABH CEO Sara Moscato Howe

IABH CEO Sara Moscato Howe

(Springfield, IL) – The Illinois Department of Insurance has received a $1.3 million federal grant to improve consumer and healthcare provider outreach, focusing on parity in mental health & substance use disorder benefits, and preventative health services.

“This is a tremendous opportunity to further our Administration’s coordinated efforts on mental health,” Acting Director of DOI Anne Melissa Dowling said. “These funds will help extend our outreach.”

Illinois Association Behavioral Healthcare CEO Sara Moscato Howe echoed Dowling comments.

“The grant does present an important outreach opportunity to help individuals struggling mental health or substance use disorders to get the care that they need, but otherwise may forgo by being unaware of insurance benefits to which they are entitled,” Howe said.

A portion of the grant will be directed to the Office of Consumer Health Insurance to improve data tracking and consumer complaint analysis. It will also help in increasing awareness of the internal and external appeals processes for health insurance consumers.  The grant will allow the state insurance department to develop community-focused health insurance consumer education for Illinois residents.

The state agency will also work with health plans, consumers and providers to ensure that mental health parity compliance is understood.

“I am committed to furthering this collaboration to achieve mental health parity in the commercial health care system by collaborating with my colleagues as well as with the provider community in Illinois,” said Dowling.

showe@ilabh.org

Top Advocates Launch 1st of 3 Illinois Mental Health Policy Forums on August 30

(Springfield, IL) – As Governor Bruce Rauner’s Administration embarks on a “transformation” of the state’s of health and human services programs, Illinois’ top behavioral health care advocates will roll out the first of three mental health policy forums at the end of August that will aim to help shape state policies.

The Community Behavioral Healthcare Association (CBHA), the Illinois Association of Rehabilitation Facilities (IARF), and the Illinois Association for Behavioral Health (IABH), in partnership with the Behavioral Health + Economics Network (BHECON) led by the National Council for Behavioral Health, will host the first of the series of behavioral health forums on August 30 in Normal.

“The state’s planned ‘transformation’ of Illinois’ health care system prioritizes behavioral health services, which promote overall health and lower health costs,” said IABH CEO Sara Moscato Howe. “The state’s effort will align with our behavioral health policy forums, forums that we expect will provide a platform to help shape’s the Administration’s policies going forward.”

The August 30 forum in Normal, “Illinois Behavioral Health Pre-Transformation: Where Are We Now and Where Are We Going?,” will provide a scan of the current system in Illinois. Presenters will discuss Illinois’ current system of care along with future considerations, such as:

  • Range of treatment options and care settings for individuals with acute, chronic and mild needs;
  • Specialized services available to children and adolescents;
  • Services for co-occurring mental health and addiction disorders;
  • Financing and payment reforms; and
  • Policy reforms that ensure individuals access to care at all stages, including prevention and early intervention.

Speakers from a diverse array of industries will also discuss creative approaches to integrating care, the impact and cost savings of a housing-first approach, how early intervention and prevention programs could be implemented across the state, and how available resources drive capacity, according to Howe.

“In Illinois, the burden of untreated mental health conditions and lack of access to substance use prevention and treatment falls on hospital emergency departments, jails, prisons, child welfare systems, schools, communities, and families,” said Howe. “That burden and the policy solutions will be the centerpiece of the forum series.”

This initial forum is expected to lead discussion towards fundamental questions:

  • What is our vision for a comprehensive, high-performing delivery system in Illinois?
  • Where are current gaps in care that create poor health outcomes and increase expenditures in the system?

The next planned forum in Normal will be on October 6.

“Throughout the three forums, participants will hear from experienced executives and clinicians from community clinics, state agency representatives, legislators, and educators,” said Howe. “They will share innovative approaches to address the continuum of care and share data from economic research on the impact of community-based care.”

The date of the third forum in Normal remains to be determined.

sara@ilabh.org

BHECON Logo Banner

Cash Reserves Exhausted, Hispanic Drug Treatment Agency Closure Looms

Illinois’ budget impasse is driving a suburban non-for-profit substance abuse treatment agency, which serves mostly Hispanic residents, to close all offices by July 1.

Without payment from the state on the $59,326 owed, the Elgin-based Latino Treatment Agency will begin to shut down two agency facilities by June 15 and the final office by July 1.

“Given the State’s inability to release the $59,326 owed to the Latino Treatment Agency from our state grant, we will be unable to provide services to our clients, mostly from the Hispanic community, if we do not receive these State funds by July 1,” said agency executive director Adriana Trino. “More than 160 clients will be terminated from services by July 1.”

Trino says that the agency, which has been in operation for more than 30-years, has cut salaries and exhausted bank lines of credit and cash reserves in order to maintain services to its 160 Hispanic clients spread through out Cook, DuPage, and Kane counties.

“We have cut our expenses; we have accumulated debt; and we have reduced salaries of every staff member,” Trino said. “We have exhausted cash reserves and our line of credit in order to remain afloat.”

The $59,326 owed to agency is on top of $60,690 cut from the group’s $273,008 budget by the Rauner Administration in August 2015.

Read the full post »

Op-Ed: Proposed Rauner Budget Fails to Meet Mental Health, Addiction Health Care Needs

OP-ED: Illinois has a staggering behavioral healthcare challenge and it needs a budget to meet that challenge.

Recent data from the federal Substance Abuse and Mental Health Services Administration underscores the need for a strong, well-funded community-based system of addiction and mental health services in Illinois.

Between 2010 and 2014, the behavioral healthcare challenges, such as depression, suicide risk, drug and/or alcohol abuse, for Illinois men, women, and children have mounted.

  • About 105,000 adolescents’ ages 12-17 report having at least one major depressive episode, while only 38% received treatment for their depression.
  • 355,000 adults 18 and over report ‘serious thoughts of suicide’; while ~363,000 qualified for a Serious Mental Illness (SMI) diagnosis.
  • Of the 1.53 million Illinois adults having ‘any mental illness’ (AMI) in the previous year, more than 55% did not receive mental health treatment.
  • Similarly, only 11.7% of the estimated 267,000 individuals 12 and older dependent on or abusing illicit drugs received treatment for their substance use disorder.

While behavioral problems and needs are clear, funding for addiction and mental illness prevention and treatment has been continually reduced by the Illinois General Assembly. In the past five years, the legislature has slashed state funding for addiction prevention, cut addiction treatment by 40% and mental health treatment by nearly 25%.

Meanwhile, an epidemic of heroin and non-medical use of prescription drugs has exploded across the state, forcing Illinois’ jails and correctional centers to become ill-equipped triage centers for individuals with mental illnesses and/or substance use disorders. Cook County Sheriff Tom Dart has repeatedly stated that the Cook County Jail is now the ‘largest mental health institution in the country’, and a majority of the individuals under his care are also there as a result of untreated addiction.

Over the past several years, Illinois has witnessed an expansion of mental health and addiction parity, the implementation of the Affordable Care Act, and a shift from state General Revenue Funds and Medicaid funding to a system of Managed Care funding, all of which has been implemented by providers in the trenches. At the same time, providers have borne uncompensated, additional expenses associated with implementation of Electronic Health Records and electronic billing. These changes have occurred while the legislature has almost annually imposed funding reductions on community providers, refused to raise historically low reimbursement rates, and left unresolved a Fiscal Year 2016 budget impasse that threatens to undermine our system of community-based care at its core.

While the staggering challenges to Illinois behavioral healthcare community providers continue to bear down, the policy prescription in the form of Governor Bruce Rauner’s proposed FY 2017 falls, let us say, short. In fact, the Governor’s budget proposal continues to move Illinois in the wrong direction, threatening to decimate the already-weakened safety net for Illinois’ most vulnerable citizens.

At a time when the need to prioritize state dollars for the maximum return on investment, reductions to the community behavioral health system are short-sighted and ill-conceived.

Data from national studies have concluded that addiction and mental health treatment not only produces measurable, positive outcomes, but also yields substantial savings to states. A 2014 actuarial study by Milliman found that $26-$48 billion could be saved nationally through effective integration of medical and behavioral services.

Additionally, several studies underscore the positive impact of addiction and mental health services:

  • A 2004 randomized trial studying employer costs found that ‘consistently-employed patients in an enhanced depression management program had 8.2% greater productivity and 28.4% less absenteeism over two years than employees receiving ‘usual care’.
  • The reduction in absenteeism and increase in productivity had an estimated annual value of $2,601 per full-time equivalent employee.
  • The state of Washington compared disabled Medicaid enrollees receiving SU treatment with the untreated population, finding that average monthly medical costs were $414 higher for those not receiving treatment, and with the cost of the treatment added in, there was a net cost offset of $252 per month or $3,024 per year. For individuals with opiate-addiction, cost offsets rose to $899 per month for those who remain in methadone treatment for at least one year.
  • The same study also found that prior to their SUD treatment expansion initiative, healthcare costs for Medicaid disabled clients with SUD problems were rising at a rate of 11% per year. Under the SUD treatment expansion initiative, the growth in healthcare costs was slowed to just 2.8% per year.

The solution is clear.

The Illinois General Assembly and the Governor must prioritize funding for addiction and mental illness prevention, treatment, and recovery support. Lawmakers and the Governor need to end the funding reduction cycle. Now. Instead, Lawmakers and the Governor need to close the gap between those needing behavioral healthcare and those receiving it. Lawmakers and the Governor need to invest in behavioral healthcare.

The governor’s proposed FY 2017 budget fails to do that.

The budget needs a do over.

Sara Moscato Howe, CEO, Illinois Alcoholism and Drug Dependence Association

showe@iadda.org