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After watching "Finding and Paying for Addiction Treatment in Your Community" you will have many questions such as:
You can ask these questions and more as part of a "live" online discussion with SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., on Wednesday, August 20, 2003 from 3 to 4 p.m. EST. Be a part of this lively exchange and mark your calendar today and post your questions in advance in the form below. Chat Transcript MODERATOR: The Web chat will begin in 5 minutes. Welcome to the Recovery Month 2003 Web chat. Our host today is Mr. Charles G. Curie, M.A., A.C.S.W., Administrator, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Our topic today is Finding and Paying for Addiction Treatment in Your Community. This online discussion will identify various barriers to receiving treatment and highlight innovative approaches to locating and funding substance abuse treatment. Mr. Curie, before we take questions from the public, do you want to give a thumbnail sketch of your views on financing addiction treatment? Charles Curie: Yes. My views on financing addiction treatment are based on the funding streams that finance drug and alcohol treatment services. Currently, the substance abuse prevention and treatment block grant is the primary Federal funding stream that, along with the required State match, provides the foundation for the substance abuse treatment infrastructure for the Nation. The substance abuse prevention and treatment block grant and the State match is approximately $3.6 billion. Along with the block grant, SAMHSA provides funding for a range of targeted capacity expansion grants. The targeted capacity expansion grants address emerging needs and new trends identified in different parts of the country. In other words, the TCE grants provide us agility and flexibility in meeting needs as they are identified. TCE grants total approximately $320 million on an annual basis. Medicaid provides only a small amount of funding for substance abuse services, and that is one difference between the drug and alcohol arena and mental health-Medicaid is the major public funder for mental health treatment services. Currently, the President has proposed a third avenue or funding stream for substance abuse services. This program is called Access to Recovery, and is a proposed $600 million program over a 3-year period. The first $200 million installment on this program is in the President and Secretary Thompson's '04 budget, which is now before Congress. This program will be based upon the whole notion of recovery. States will be able to compete for this funding. The program's intent is to expand treatment and support capacity to better ensure individuals with addictive disorders realize outcomes in their lives that demonstrate recovery. Those outcomes include abstinence, or not using; employment; a stable housing situation; connectedness to the community, families, and friends; and lack of involvement or no involvement with the criminal justice system. In other words, those things that demonstrate the individual is truly attaining a quality of life in the community. Access to Recovery will utilize vouchers issued to an individual once he or she has been assessed and the needed level of treatment and service is determined. The clients will then have a choice of providers qualified to provide the needed service. It is anticipated that Access to Recovery will help expand treatment capacity with current providers as well as give a wider range of providers an opportunity to be part of the publicly-financed drug and alcohol system. The basic premise of Access to Recovery is that there are many pathways to recovery including medical interventions, inpatient and outpatient treatment modalities, self-help, relapse prevention, case management, and faith-based programs. MODERATOR: This question was previously submitted. What are the private-sector treatment options? What are the public-sector treatment options? Public-sector treatment options can be found in the SAMHSA treatment facility locator. This is a searchable directory of drug and alcohol treatment programs that shows the location of facilities around the country that treat alcohol and drug abuse problems. The locator includes more than 11,000 addiction treatment programs including residential treatment centers, outpatient treatment programs, and hospital inpatient programs. Listings include treatment programs for marijuana, cocaine, heroin, alcohol, and other illicit drugs for adolescents and adults. The facility locator can be found at our Web site, www.samhsa.gov. Also, SAMHSA's CSAT [Center for Substance Abuse Treatment] provides a national helpline that is toll-free and available 24 hours to help you locate treatment options near you. The number for the hotline is 1-800-662-HELP. We also have nonprofit support services such as Alanon, Alateen, and NA, which offer fellowship and resource information for people in the public sector arena. And hospitals and clinics are excellent resources for finding and paying for treatment. Many offer low-cost or free substance abuse treatment programs, and many are willing to set up payment plans to ensure patients get the help they need. Clinics such as NY Human Services Center, Inc. are based in communities plagued by substance abuse and offer free substance abuse treatment in conjunction with family, individual, or group counseling. MODERATOR: This question was previously submitted. As an individual recovering from a substance use disorder, it's frustrating to know that there are no treatment centers in my community. Everyone has this "not in my community" mentality. What can I do to raise awareness about the benefits of addiction treatment? Right now, you have an opportunity to raise this issue because September is National Alcohol and Drug Addiction Recovery Month. During this month, we highlight the societal benefits of substance abuse treatment, recognize the contribution of treatment providers, celebrate people in recovery, and promote the message that recovery from substance abuse in all its forms is possible. Each September, thousands of treatment programs celebrate their successes and accomplishments in an effort to educate the public about treatment, how it works, for whom it works, and why. Recovery Month also serves to educate the public on substance abuse as a national health crisis. Something we all can do is remind people that addiction is a treatable disease, and that recovery is possible. I would encourage you again to check out our Web site for the locations of Recovery Month activities across the country. You can find this more specifically at www.recoverymonth.gov. And get involved with your local efforts around Recovery Month. MODERATOR: This question was previously submitted. I heard something on the news about the President's voucher program. Can you explain what this program is? Charles Curie: The voucher program you heard about is the program called Access to Recovery, which I mentioned earlier. In addition to the fact that individuals will be assessed and receive a voucher for an appropriate level of treatment, I should also stress that this initiative is designed to assure that there are more portals of entry into treatment and recovery services. Though we also will be looking to States to demonstrate how they will assure that individuals who present themselves with a potential illicit drug and/or alcohol problem-whether that be in schools, emergency rooms, primary care settings, or the workplace-will have a clear and efficient pathway through the needed assessment, which would trigger the issuing of a voucher. Once again, Access to Recovery is the largest proposed expansion for alcohol and illicit drug treatment services currently being considered by any level of Government. MODERATOR: This question was previously submitted. I live in a very rural area where substance use is a dire problem that no one wants to address. Addiction treatment centers are few and far between. How would one go about trying to get funding for or starting a treatment center? Charles Curie: SAMHSA's Recovery Community Services Program (RCSPII). The goal of this grant program is to aid nonprofit entities in developing, designing, delivering, and documenting peer driver recovery support services that help prevent relapse and promote long-term recovery from alcohol and drug use disorders. RCSPII is targeted to people with a history of alcohol or illicit drug problems who are in recovery or seeking recovery. It also is targeted to family members, significant others, and supporters and allies who will be both the providers and recipients of recovery support services. This can be an excellent option for rural areas to pursue. MODERATOR: This question was previously submitted. How do Employee Assistance Programs help those in the workplace find substance abuse treatment? Charles Curie: EAP programs have proven themselves to be an effective vehicle for addressing an employee's poor performance that may stem from a wide range of problems or issues, including substance abuse and addiction. EAP services include counseling referrals to appropriate outside help, including alcohol and drug treatment, and follow-up for those identified as having a substance abuse problem. EAP services are provided confidentially, and workers and their family members can avail themselves to support without their employer's knowledge. EAP services also can help pay for the cost of some subsequent treatment. Such treatment may be covered by employer-provided health benefits. The data informs us that providing an EAP is a cost-effective benefit that clearly demonstrates an employer's commitment to a productive, drug-free workplace. EAPs save time and valuable resources by offering an alternative to dismissal, and thus can minimize risk and cost to employers as well as to employees. joe marmo: What is SAMHSA's position on the issue of "treatment on demand," that any person who wants treatment should not have to wait weeks to enter a program? Charles Curie: SAMHSA believes it is important to set up services and systems in such a way that when individuals come ready for help, help is ready to be rendered. This is critical because of the nature of addictive disease. Denial plays such a strong role in preventing people from recognizing they have a problem in the first place. When somebody reaches a point where they are asking for help and treatment, it is essential that we address that request and engage the individual to ensure they do not walk away. Too often, individuals do seek help and cannot find it. Thus, we miss an opportunity. In 2001, 5 million of the 6.1 million people needing treatment for an illicit drug problem never got help. Of the 5 million, only 377,000 reported they felt they needed help for their drug problem. This included 101,000 people who knew they needed treatment, got help, but were unable to find care. Those are the individuals we need to make sure get treatment and why it is necessary for us to expand treatment capacity. This would further underscore the importance of Access to Recovery, and the $200 million now proposed to expand capacity. Nathan: Will SAMHSA be publishing any grants next year to help communities establish treatment programs? Charles Curie: Yes. In fact, there will be a wide range of treatment programs. We will make sure they are posted on our Web site and they will include a wide variety of targeted capacity expansion grants addressing various needs identified by States and local communities. Again, these grants will be made available along with continuation funding of the block grant and Access to Recovery. andrea: States will be able to compete for Access to Recovery dollars. What criteria are used to determine the level of funding for a State? Charles Curie: Basically, we are going to be giving the Governor's offices the opportunity to apply for Access to Recovery funds. States will be responding to a request for application (RFA), and the RFA will outline standards the State will need to meet in order to be awarded dollars. These standards will include a process for screening, assessment, referral, and placement. States may target the program of greatest need, [a program] in a high degree of readiness to implement such an effort, or to specific populations-including adolescents. Generally, a determination on the amount awarded to the State will depend on the scope of services described in their application and the documented need. Bridgett: What is SAMHSA's position on "recovery" being extended to family members' counseling, such as children and spouses recovering from their loved ones' addiction? Charles Curie: SAMHSA is extremely supportive of our family members being included in the recovery process. We recognize that each individual also needs to be progressing in their own recovery. In fact, SAMHSA does have a kit available to treatment providers outlining how the children who live in homes where one or more parents are addicted can be helped and engaged. Recognize that it is very important for children in such situations to be supportive as they are at high risk for developing an addictive disease. We worked on the kit with the National Coalition for Children of Alcoholics. andrea: What are the effects so far of the 2003 State Targeted Capacity Expansion Program? How many people have been helped with this program? Will this program continue in 2004? Charles Curie: We do not have a specific number right off hand. That information will be made publicly available. However, we do look to continue the program and expand it as it's critical for us to partner with States in expanding capacity in such a way as to strengthen and augment a State's plan for providing addiction treatment services. andrea: The voucher program will increase the availability of treatment to those who may not have previously been able to afford it. How will the program change the demand for treatment capacity? Charles Curie: One of the major goals of Access to Recovery is to assure there are more entry points to drug and alcohol treatment services. States will be asked to demonstrate that they have expanded the number of entry points for appropriate assessment. It is anticipated that at least an additional 100,000 individuals will be served in the course of a year because of Access to Recovery. That 100,000 number represents those individuals I discussed earlier who knew they needed treatment, sought it, and could not find it. Thus, Access to Recovery will play an important role in filling a gap that currently exists. Lee: What is SAMHSA's role in expanding office-based treatment (i.e., the Drug Addiction Treatment Act of 2000)? Charles Curie: This particular piece of legislation has offered people with addictive disorders (people with opiate addictions) an opportunity to obtain treatment from a primary care physician. SAMSHA's role is to provide both certifications and training to primary care physicians to assure that the medication Buprenorphine is appropriately prescribed and used in treatment along with other support services needed to obtain recovery. A physician needs 8 hours of education to treat patients addicted to narcotic pain medications or heroin. SAMHSA continues to work with medical groups, and we would like to continue to expand this very important treatment capacity. Charlene: What specifically is SAMHSA doing to get more churches and community -based groups involved in the treatment process? Charles Curie: SAMSHA's providing ongoing technical assistance to faith- church- and community-based groups as to how they can appropriately access funding for services as well as become part of the important array of support services and interventions in their local community for people with addictive disorders. SAMHSA also has just released a new manual on how to apply for SAMHSA grants designed specifically for faith- and community-based organizations. This manual is now available on SAMHSA's Web site, www.samhsa.gov. Bridgett: Will Access to Recovery make treatment available to everyone, including felons (who are usually excluded from public programming)? Charles Curie: Access to Recovery will be available to expand treatment capacity not only to the general population, but also to specific populations that the State may identify. This includes individuals coming out of the criminal justice system and into the community. We anticipate there will be some applications that States may specifically outline a partnership between State drug and alcohol authority and criminal justice authority. Access to Recovery funds will not be used to fund treatment services within prisons, but [they] can be used to treat those individuals who will be re-entering the community. MODERATOR: Our hour has concluded. For more information, visit CSAT's Recovery Month Web Site at http://www.recoverymonth.gov. Visit the multimedia area (http://www.recoverymonth.gov/2003/multimedia/) to see a list of upcoming Web chats and Webcasts on various topics. You can also watch the archived version of the Webcast that complements this Web chat at http://www.recoverymonth.gov/2003/multimedia/w.aspx?ID=211. Join us next month on Wednesday, September 3, 2003, from 3-4 p.m. EST for our next Webcast, "Helping the Justice and Child Welfare Systems Meet the Needs of Families Affected by Addiction." And tune into the follow-up Web chat on Wednesday, September 10, 2003. We would like to thank our host, Charles Curie, Administrator, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, for his participation in this online event. And we would like to thank our participants for their questions. This transcript will be available shortly so that others may benefit from the dialogue. The chat has now officially ended. Flier for Webcast on 8/6/03 and Web chat on 8/20/03: Finding and Paying For Addiction Treatment in Your Community | ||||||||||||||||||||||||
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