PRO-A Recovery Advocates - Policy Issues
Pennsylvania Recovery Organizations Alliance, Inc.
Drug and Alcohol Service Providers Organization of Pennsylvania(DASPOP)
GOVERNOR CORBETT’S
BUDGET PROPOSAL
FY 2011-2012
Gov. Corbett delivered his first budget address on March 8, holding to his promise to balance the budget with existing revenues and no new taxes or fees. The total spending number of $27.3 billion anticipates a number of cost-saving mechanisms, including layoffs of state employees, broad-based cost containment initiatives, and smart purchasing proposals, among others.
The budget proposal also contains cuts of $4.16 billion from the current fiscal year, which is an overall reduction of 3.1 percent, with 103 line items eliminated. There were no Marcellus Shale severance taxes or impact fees, while business tax reductions are back on track with the restored phase-out of the Capital Stock and Franchise fee. In addition, Corbett proposed to maintain several tax credit programs.
Alcohol, Tobacco and Other Drugs: Funding through the Department of Health (DOH), including the federal block grant and the base allocation, remains stable. The Department of Public Welfare (DPW) has reduced the total allocation for the Behavioral Health Services Initiative (BHSI) by a total of $1.01 million, or 1.9 percent, which is shared between mental health and drug and alcohol programs. DPW also plans to move the Act 152 funding from the Single County Authorities (SCAs) to the Managed Care Organizations; this will represent a significant loss in case management funds for the SCAs. It will also impact the access points to the system for individuals who are not yet eligible for Medical Assistance or not yet enrolled in managed care.
The funds for drug and alcohol intermediate punishment have been increased back to the original 2009-2010 level. Funding for smoking prevention and cessation activities remains funded at the same level as last year, $14.7 million. SCAs will continue to receive a $3 million allocation from gaming revenue for assessments and residential drug and alcohol services. The Governor chose to maintain control of substance abuse programs within DOH rather than fund the Department of Drug and Alcohol Programs.
***PRELIMINARY***
FY2011-2012 PA STATE BUDGET
PENNSYLVANIA DRUG AND ALCOHOL ABUSE PREVENTION
AND ADDICTION TREATMENT BUDGET
(Dollar amounts in thousands)
Governor’s
Proposed
DEPARTMENT OF HEALTH FY09-10FY10-11FY11-12
Bureau of Drug & Alcohol Programs
State Assistance $41,750 $41,698 $41,698
Liquor Control Board $ 1,377$ 1,050 $ 1,050
Gaming Fund – Assessment & Treatment $ 3,000$ 3,000 $ 3,000
Compulsive & Problem Gambling Treatment $ 1,934 $ 5,756 $ 4,800
Drug & Alcohol Block Grant (F)* $56,474 $54,123$54,188
DEPARTMENT OF PUBLIC WELFARE
Behavioral Health Services Initiative (BHSI) $55,331 $53,231 $52,220
(Drug & Alcohol = 60% of this line)
Act 152 $16,227 $14,727 **
PA COMMISSION ON CRIME & DELINQUENCY
Intermediate Punishment, D&A Treatment $16,000 $15,643 $15,643
*F – Federal funding, state projected
**Act 152 numbers are not identified at this time
Note: Act 50 of 2010, converting the Bureau of Drug and Alcohol Programs to the Department of Drug and Alcohol Programs goes into effect July 1, 2011.The Governor’s proposed budget for state Fiscal Year 2011-12 discusses Act 50 of 2010 – “This budget proposes to maintain the program within the Department of Health in an effort to preserve the state’s limited resources for treatment services as opposed to new administrative costs.”
State Budget Plan Worries Drug, Alcohol Managers
A state plan to transfer $14 million for uninsured people to control of regional drug and alcohol managed care organizations is worrying many drug and alcohol treatment, prevention, and recovery advocates.
This transfer is included in Gov. Tom Corbett's proposed budget for FY 2011-2012 but otherwise no other major changes were made to the 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 across the state have been able to use Act 152 money to get such uninsured people into non-hospital, inpatient 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."
Critics fear this policy change will cause unnecessary delays, barriers to accessing care, and other challenges that could have hinder the treatment and recovery process. Please check the next edition of the PRO-A newsletter for future updates on this proposed policy change.
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Legislative Updates
DiGirolamo to Chair New House Committee
Rep. Gene DiGirolamo (R-Bucks) has been named by Speaker of the House Sam Smith (R-Jefferson/Indiana/Armstrong) to be the new chairman of the House Human Services Committee for the 2011-12 legislative session, a position where he can effectively continue his advocacy of issues relating to drug and alcohol treatment and prevention, as well as mental health, and to help Pennsylvanians in need.
The committee was formerly part of the House Health and Human Services Committee. Due to the overwhelming number of bills and resolutions assigned to the committee in recent years, House leadership decided to restructure and split the committee for greater efficiency.
“Human services are near to my heart and I am pleased that I have been selected to lead this new committee,” said DiGirolamo, who has spearheaded drug and alcohol and mental health treatment issues throughout his tenure in the state House. “As a member of the House Health and Human Services Committee for several years, I am already well versed in the human service aspects of state government and have voted on numerous changes and improvements to the way state and county governments deliver human services. I am excited to take on this new role.”
The committee will have oversight of issues within the Department of Public Welfare and the new Department of Drug and Alcohol Programs, the latter of which was created earlier this year through legislation DiGirolamo sponsored.
The department was established to elevate the Bureau of Drug and Alcohol Programs from the Department of Health and all of its statutory functions to a cabinet-level department. Experts believe that, with a better focus on drug and alcohol treatment, the department has the potential to reduce crime, bring healing to families struggling to get help for addicted love ones and ultimately save taxpayer money.
“This assignment is one that comes with many new challenges, including ensuring that every dollar sent to the Department of Public Welfare is used to its maximum benefit and to get the new Department of Drug and Alcohol Programs off the ground,” DiGirolamo said. The new committee replaces the House Intergovernmental Affairs Committee. This session marks the first time that DiGirolamo has served as majority committee chairman.
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New Department Taking Shape
by Kari Andren
The Patriot News
Former state Rep. Milton Berkes, right, testifies Thursday before the state House Human Services Committee in Harrisburg about the state Department of Drug and Alcohol Programs. Listening to Berkes is Deb Beck, left, president of the Drug and Alcohol Service Providers Organization of Pennsylvania, and Gaudenzia Inc. President and CEO Michael Harle, center.
Cheryl Floyd would be dead if her mother didn't have the patience to call every number she could find in the phone book to get her drug-addicted daughter help. Floyd nearly died at age 29 after more than a decade of drug use, but her mother's determination to find treatment services helped her overcome her addictions and stay clean for 19 years and counting.
Now Floyd, executive director of the Pennsylvania Recovery Organizations Alliance, hopes a newly created state Department of Drug and Alcohol Programs will serve as the only call parents have to make to get information about addiction treatment and other services.
The new Cabinet-level department, created by the Legislature last summer, will officially be up and running July 1. Gov. Tom Corbett is charged with appointing a secretary and working with that person to shape the overall scope and direction of the new department.
The law, crafted by Rep. Gene DiGirolamo, R-Bucks County, elevates the Bureau of Drug and Alcohol Programs, its duties and personnel to a Cabinet-level department. As a department, rather than a bureau in the state Department of Health, officials can more aggressively go after federal funding and have a seat at the table making decisions with Corbett and other state departments, DiGirolamo said. Advocates have pushed for years to create a department to deal with drug and alcohol programs, but some, including state Sen. Pat Vance, R-Cumberland County, raised concerns over whether adding more state bureaucracy would ultimately help those in need. Others worried about the increased cost.
A legislative analysis done last summer found that elevating the bureau to a department would cost about $2.1 million more per year because more staff, office space and equipment would be needed. Last year, lawmakers approved transferring $3 million a year in gambling revenue to the Health Department for drug and alcohol addiction treatment services, which could help defray the additional costs of the new department.
Now that the plan is state law, the focus has shifted to how the Drug and Alcohol Programs Department will function.
"I talk about saving lives, which to me is the No. 1 priority," said DiGirolamo, whose oldest son is a recovering heroin addict. He said the common thread among every family's story is that they are desperately trying to find the help they need.
"I think this new department is going to be revolutionary when it comes to the way we look at addictions, how we treat addictions," DiGirolamo said. "I think it's going to go a long way to help the criminal justice system keep people out of prison." Untreated addictions cost the state Department of Corrections $1.4 billion per year because 70 percent of the state's prison population has a drug or alcohol problem, said Deb Beck, president of Drug & Alcohol Service Providers, Organization of Pennsylvania. In Chester County, for example, a drug treatment court and jail-based treatment services have reversed prison growth to the extent that the county now sells prison beds to the state, said Kim Bowman, executive director of the county's department of drug and alcohol services.
She said the new state department could have a similar ability to work with other agencies to stem prison growth on the state level.
Advocates hope the department will consolidate drug and alcohol programs from a variety of state agencies, including the departments of Health, Public Welfare, Education and Corrections, as well as the Pennsylvania Liquor Control Board. They see the new department as a one-stop source of information and programs that address drug and alcohol needs, from prevention and intervention to treatment and recovery. And they hope the department will educate families and enforce current laws, such as one that requires insurance companies to pay for at least 30 days of rehabilitation and 30 days of outpatient treatment per year as well as seven days per admission into detoxification.
Health Care Reform
Residential Addiction Treatment/ Health Care Reform
The Affordable Care Act (ACA) – the new health care reform law – requires inclusion of treatment of alcohol and other drug addiction as one of the “Essential Benefits” that must be part of health insurance plans that are subject to the Act.
Design of the actual benefit package to be required for addiction treatment is the responsibility of the Substance Abuse and Mental Health Services Administration (SAMHSA) and ultimately, the U.S. Department of Health and Human Services.
SAMHSA is leading discussions on the benefit design and although the continuum of care tentatively proposed for addiction treatment includes acute care and outpatient, a debate has ensued in D.C. over whether residential addiction treatment should be included.
Proper design of the full continuum of addiction treatment benefits – including residential treatment – in the Essential Benefits package is critical for many reasons. To give just one example, under the new health care reform law, businesses will be able to pay a small penalty and drop health coverage for employees. These employees are likely to obtain coverage through health insurance plans subject to the ACA and the Essential Benefits design.
The Drug and Alcohol Service Providers Organization of PA (DASPOP) is examining the inclusion of residential addiction treatment in the Essential Benefits package. Please check the next edition of our newsletter for updates on this issue.
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