New report charts practical steps to tackle Montana’s substance abuse problems.
Helena, Mont., Mar 21, 2017 – Montana can take practical and cost-effective steps to address its growing substance abuse crisis, according to a new report released today by the Montana Healthcare Foundation and the Montana Department of Public Health and Human Services, and authored by national experts at Manatt Health. The report finds that Montana’s current treatment system is severely under capacity as it struggles to address high rates of alcohol and drug abuse. Montana’s 2015 expansion of Medicaid creates an important opportunity to strengthen the state’s substance use disorder (SUD) prevention and treatment system; a federal rollback of the Medicaid expansion could put many of these opportunities at risk.
“Hospitals and public health departments around Montana tell us that substance abuse is one of the most serious health problems facing their communities,” said Montana Healthcare Foundation CEO Dr. Aaron Wernham. “The toll in terms of human lives, economic costs, and the drain on our healthcare, child welfare, and criminal justice systems is simply too high: we can’t wait any longer to tackle this problem.”
In looking at the state’s SUD crisis, researchers learned that:
- The number of children in foster care related to parental SUD in Montana has doubled since 2010. Only six percent of state-approved facilities report any programming for pregnant women.
- Drug overdoses account for nearly 250 deaths and 2,500 emergency room and inpatient admissions each year.
- Only 32 state-approved facilities provide inpatient and outpatient SUD treatment, along with a small number of community health centers and tribally-run programs.
- Only seven percent of Montanans with a SUD are receiving treatment, and 4,000 adults are actively seeking care without success.
- Only 43 percent of state-approved facilities report any services for people with co-occurring SUD and mental illness.
“There are practical, cost-effective solutions that we can begin working on right away,” said Mary Dalton, Medicaid and Health Services Branch Manager at DPHHS. “We are committed to doing all we can on this issue, and this report will be our starting point.”
The report provides an extensive list of options for DPHHS, many of which can be implemented at little cost or even in ways that generate cost savings for the state. For example:
- Integrating SUD treatment into primary care practices: Research now shows that SUD is best managed as a chronic illness (like diabetes, for example). DPHHS could facilitate expanded treatment capacity by implementing a reimbursement structure that facilitates routine screening for SUD and supports integrating SUD counseling into primary care practices.
- Supporting greater use of medication-assisted treatment (MAT) for opioid and alcohol use disorders: The report found that Montana has among the nation’s lowest usage of MAT, a cost-effective approach that can be used in primary care as well as specialized treatment centers.
- Utilization management to ensure the appropriate level of care: The state could improve treatment outcomes and ensure that people are getting the appropriate level of care by revising its utilization management system. This would also ensure that Medicaid is using its resources in the wisest possible manner to serve the greatest number of people.
- Using savings from the Medicaid expansion to strengthen prevention and offer peer supports: Montana’s HELP Act extended Medicaid eligibility to many low-income adults, giving many people with SUD access to insurance for the first time. The state currently pays for most SUD treatment out of general fund and grant dollars: with the Medicaid expansion, the state can now bring in $9 in federal funds for every $1 spent on SUD treatment. With the savings in state dollars, Montana could invest in cost-effective prevention and peer support programs.
- Targeting outreach and enrollment to justice-involved populations: Specific attention to treatment in this population could reduce criminal justice costs related to arrests and recidivism.
DPHHS and MHCF will work with stakeholders throughout Montana to identify immediate opportunities and next steps to address the problem.
The Department of Public Health and Human Services (DPHHS) strives to improve and protect the health, well-being, and self-reliance of all Montanans. Through various public health programs, DPHHS monitors and responds to disease outbreaks, works with businesses to ensure food safety, assures clean indoor air and safe drinking water, and provides community programs to support healthy living. Agency human service programs help children, families, seniors, and people with disabilities. These programs ensure families in need have adequate food and health coverage, keep children and adults are safe, and help heat and weatherize homes.
About Manatt Health
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