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Health law expands treatment for addicts

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POSTED April 15, 2013 8:41 p.m.

 

 

 

 

SAN FRANCISCO (AP) — The number of drug and alcohol addicts eligible for health insurance that will cover substance abuse treatment will rise by 1.5 times when federal health care reforms kick in next year.

Throughout the state, and particularly in Los Angeles County where the largest share of people get treated for substance abuse through the public health system, providers are scrambling for ways to serve the wave of expected patients. Officials remain uncertain how the new programs will be funded under the Affordable Care Act.

"Today, an enormous amount of people don't qualify for Medi-Cal so they aren't tapping that system," said Albert Senella, president of the Tarzana-based California Association of Alcohol and Drug Program Executives. "But if we don't build up our capacity to treat them once they become eligible, we will end up with crowded ER rooms and more people in urgent care."

More than 95,000 people with drug and alcohol problems get treatment through Medi-Cal, California's version of the Medicaid health care program for the poor. At least 146,000 more are projected to become eligible for insurance coverage if Medi-Cal expands to cover people who make less than 138 percent of the federal poverty rate under the health care overhaul, according to figures from the California Department of Health Care Services.

The largest number of patients getting taxpayer-funded treatment for alcohol and drugs was in Los Angeles County, according to the state's figures from fiscal year 2011-12. Once the newly insured show up, the state projects that number will balloon from the current 42,000 alcoholics and drug addicts who get public support to about 87,000 patients.

That is in part due to demographics: more than one-third of all Californians enrolled in Medi-Cal live in Los Angeles County.

It also is due to the county's historic willingness to provide addiction treatment to those in need, where some other California counties have resisted letting community-based nonprofits contract for addiction treatment services, Senella said.

After several rounds of funding cuts in recent years, many providers say they are not receiving enough government money to serve all the addicts they are supposed to be treating, let alone to prepare for a new population needing addiction treatment.

"Historically, many counties either ideologically or philosophically have decided they don't like offering methadone maintenance in the community so they say 'No, we have enough of you in our county,'" Senella said. "But now, many counties are considering applying to get certified to offer those services because they see they have to expand their capacity to take on the new patients."

The Department of Health Care Services certifies any facilities that offer day treatment, outpatient or residential services to people recovering from alcohol or drug abuse through the Medi-Cal system, as well as clinics that offer methadone maintenance.

Substance use disorder services are one of the mandated essential health benefits that are required to be provided under the part of the Affordable Care Act that expands Medicaid, a provision that California has accepted.

Nationwide, anywhere from 3 million to 5 million people with drug and alcohol problems will become eligible for insurance coverage under the federal health care reforms, according to an Associated Press analysis of government data. Yet treatment clinics already are at or approaching capacity in more than two-thirds of the states.

California has yet to decide what, exactly, will be included in its substance abuse benefits package, said Anthony Cava, a department spokesman.

 

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