Report: Access still limited for substance abuse sufferers
For those who need substance abuse treatment in Massachusetts, the system appears to be stacked against them in a couple of key ways, according to a new report by the Center for Health Information and Analysis (CHIA).
The report from the state agency, released last week, highlighted a “misalignment” in capacity among Massachusetts’ substance abuse treatment facilities, which include short-term drug and alcohol detox and residential facilities, as well as long-term residential treatment programs.
Aron Boros, CHIA’s executive director, explained that patients leaving the nearly 900 acute treatment, or detox, facilities face a backlog when they try to enter long-term residential treatment programs. There are only about 150 beds in the clinical support services field, which is the next step down for many patients leaving detox programs, making it a hard-to-reach service for most.
Boros said this creates a problem for those leaving detox who still need significant support on their path toward recovery.
“The lack of continuity between the services makes it hard to identify the right kind of treatment,” Boros said.
According to the report, a number of providers are seeking licensure for additional beds, both at detox facilities and long-term residential treatment facilities, which may increase access to care for some. But paying for the services is another significant challenge.
“Ultimately it consumes the life not only of (those people) struggling with substance issues but also their families who are helping them to get the care that need,” Boros said.
CHIA: 10 percent struggle with substance abuse
The CHIA report estimates that about 10 percent of Bay State residents suffer from substance abuse disorders. Those who are deemed indigent may require state funding for residential treatment services, and those who can afford it can seek treatment at facilities that serve private-pay clients only. But those in the middle, who have private health insurance and some assets, often don’t have the option of long-term residential treatment.
CHIA was required to compile the report under a 2014 state law aimed at increasing access to substance abuse treatment. It’s been filed with the Health Policy Commission, which will conduct a series of hearings with substance-abuse stakeholders across the state to find solutions to access problems.
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Interest from outside players?
While access to treatment remains limited, the picture improved slightly last year, according to Chuck Faris, CEO of Worcester-based Spectrum Health Systems Inc., when the Legislature passed a law requiring insurers to cover up to two weeks of detox and short-term care services for substance abuse patients. But Faris said that measure should just be the start of a push to require expanded coverage for services; most long-term residential treatment programs include stays of around a month or more.
Faris said the state is beginning to receive interest from out-of-state substance abuse treatment services providers who want to open facilities here in light of that law passed last year, without preauthorization. The Department of Public Health declined to identify the providers seeking to add licensed beds in the state, though the CHIA report said there are several applications pending.
But that won’t help those without insurance or the means to pay for services out of pocket, Faris said.
Those people qualify for treatment in publicly funded beds, and right now, the state only reimburses providers at a rate of $75 per day for services rendered. That’s hardly enough to justify the cost of expanding to include more publicly-funded beds, according to Faris.
“They’re paying more to put up a homeless individual in a hotel,” he mused.
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