Health reform could strain substance-abuse care

By Rebecca Keister
PBN Staff Writer

There are some things that don’t get better simply with time. More

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Health reform could strain substance-abuse care


By Rebecca Keister
PBN Staff Writer

Posted 5/20/13

There are some things that don’t get better simply with time.

A substance-abuse problem, says Dale Klatzker, president and CEO of the Providence Center, a nonprofit that provides inpatient and outpatient services, is definitely one of them.

The Providence Center operates two treatment facilities, in Burrillville and in Cranston, that together provide 75 inpatient beds that are, Klatzker said, pretty much always full and have “long, long waiting lists.”

He’s afraid those waiting lists are going to get even longer when new health care laws that will expand eligibility for Medicaid take effect Jan. 1, 2014, and give previously uninsured adults better access to health care.

“I have been ringing the bell for a while that we’re not prepared,” Klatzker said. “It’s not going to take too much time for people who haven’t accessed care to want to access care to find that there isn’t a lot of care to be had.”

According to the U.S. Department of Health and Human Services, 100,952, or 12 percent, of Rhode Island’s nonelderly residents are uninsured. About 91 percent of those residents may quality to purchase insurance coverage in a health-insurance marketplace established under the Affordable Care Act or for Medicaid under the expansion, for which the state will receive 100 percent federal funding in the expansion’s first three years.

According to data collected by the Substance Abuse and Mental Health Services Administration, a total of 29,267 Rhode Island residents with drug and alcohol problems would be eligible for insurance when the new laws take effect. Those already seeking treatment put the state at a 90-95 percent capacity rate for its 322 nonhospital beds, according to the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.

R.I. Health and Human Services Secretary Steven M. Costantino estimated that about half of those newly eligible for insurance would seek it out right away, which creates uncertainty about the impact the changes will have on the substance-abuse treatment system. But it’s better than the alternative of having people needing treatment but not seeking it, he said.

“You’re going from a whole bunch of individuals for whom one of the major barriers to seeking treatment or help [is not having] insurance or being underinsured.

“But we know that [not everyone] is going to walk in the door [immediately]. There will be a funding redesign in the state to be able to handle the gaps in treatment that Medicaid or commercial benefit is not covering,” Costantino said.

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