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State budget plan worries drug, alcohol managers

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Saturday, March 12, 2011

A state plan to transfer $14 million for uninsured people to control of regional drug and alcohol managed care organizations is worrying some Alle-Kiski drug and alcohol prevention advocates.

The transfer is included in the budget proposed by Gov. Tom Corbett's that includes the transfer but otherwise no other major changes to overall drug and alcohol treatment funding.

State Act 152 money has helped uninsured people who are waiting to become eligible for medical assistance. Once they are eligible, they qualify for drug and alcohol treatment through managed care organizations (MCOs).

Critics of the policy change think the change would add unnecessary time for uninsured addicts to get care.

For about two decades, local drug and alcohol commissions in the Alle-Kiski Valley and across the state have been able to use Act 152 money to get such uninsured people into non-hospital, in-patient treatment quickly instead of waiting for them to be accepted into the medical assistance -- Medicaid -- program for which they qualify.

But the state wants to change that.

"The county offices are simply redundant to the regional offices," said Ann Bale, a spokeswoman for the Pennsylvania Office on Mental Health and Substance Abuse that handles Act 152 and related programs. "They're doing the same things. And to us, the transfer to the regional offices is working toward efficiency."

Dave McAdoo, who is executive director of Charleroi-based Southwestern Pennsylvania Behavioral Health, said he is concerned by that reasoning. The MCOs and local commissions have systems that mirror each other, but they take care of different groups of people, he said.

SPBH, which serves people in Westmoreland and three other counties and other managed care organizations serve people who are receiving assistance. But Act 152 helps uninsured people waiting for assistance.

If the transfer becomes law, the initial intake of addicts would be switched to MCOs, such as SPBH, Community Care Behavioral Health of Pittsburgh and Value Behavioral Health, which has an area office in Trafford. Community Care handles programs for Allegheny County, while Value Behavioral is the regional manager for Armstrong, Westmoreland and four other counties.

A spokeswoman for Virginia-based Value Behavioral Health said the company is studying the proposal and can't yet comment. No one was available to comment for Community Care on Friday.

Colleen Hughes, who directs the Westmoreland Drug and Alcohol Commission, Inc., said her office and most other county drug and alcohol offices have a good relationship with Value Behavioral and other managed care organizations.

However, she is concerned that some of the MCOs might not have staff trained to do client assessment in addition to financial review. The assessment includes helping clients complete paperwork to get assistance and it gets them into treatment sooner.

"We enjoy a very good relationship with Community Care, but such a fund transfer causes us some concern," said Patricia Valentine, deputy director of behavioral health for Allegheny County. Case management at the local offices is needed to help clients before their paperwork arrives at the MCOs, she said.

Waiting for medical assistance approval "can take days or even longer" and "Medical Assistance has 30 days to act on an application," Valentine said.

"We're seeing a lot more substance abuse," said Kami Anderson, who directs the joint Armstrong-Indiana County commission.

The demand for treatment is increasing and so is the time that it takes for people without private insurance to get non-hospital, in-patient care.

According to the Alle-Kiski Valley's drug and alcohol commissions, the number of people needing this help is about 8,000 in Allegheny County, 1,200 in Butler County, 1,000 in the combined Armstrong-Indiana county commission, and 400 in Westmoreland County.

Time can mean lives, said Donna Jenerski, who directs the Butler County Drug and Alcohol Program.

"When people come into our offices, they are ready to go into treatment that day," Jenerski said. "We make every attempt to help them.

"If we tell them they will be put on a waiting list, we'd probably not see them again."

Timing is important, agreed Hughes.

Alcohol and drug addicts seldom admit that they have a problem.

"When an addict says they want help, its important for them to get it as quick as possible," she said.

It's too easy for someone waiting to get into treatment to slip back into theft or burglary to get money or even die from an overdose, Hughes said,



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