DASPOP Organized For Advocacy Drug & Alcohol Service Providers Organization of Pennsylvania PENNSYLVANIA HOUSE OF REPRESENTATIVES HUMAN SERVICES COMMITTEE PUBLIC HEARING MEDICAID EXPANSION JUNE 6, 2013 Submitted by: Deb Beck, President DASPOP dasdbeck@hotmail.com 717-657-7702
Good morning Representative DiGirolamo, Representative Cruz and members of the Committee. Thank you for providing this opportunity to speak with you about Medicaid Expansion under the Affordable Care Act. My name is Deb Beck and I am here on behalf of the Drug and Alcohol Service Providers Organization of Pennsylvania. We are a statewide coalition of addiction treatment and alcohol and drug abuse prevention, education and addiction treatment programs, practitioners, employee assistance programs and drug and alcohol associations representing more than 365 organizations, programs and clinics, 1,200 student assistance professionals, prevention specialists, counselors and other addiction professionals and others throughout the state. We have programs in every county in the state, serving every legislative district. We urge the Commonwealth to move forward with implementation of the Medicaid Expansion provisions of the Affordable Care Act. Let me frame the issue for you from our perspective. We have programs in every one of your communities and unfortunately, we can confirm for you that the alcohol and other drug problem is epidemic in our state. 1 in 4 families in our state are struggling to help a loved one with an untreated addiction. These families, our families, struggle often heroically, first with shock about their loved one's addiction. Next, they struggle with the denial of the problem by their loved one. Finally, they struggle to get their loved one into treatment. DASPOP 1
This is a hellish journey for our families. From the moment the drug and alcohol problem takes hold, their whole lives change and the families are pulled into a nightmare from which there seems no escape. Alcohol and other drug addictions are progressive, always fatal illnesses if they go untreated. 1 in 4 families have this illness. This is a killer illness that if untreated, lays waste to whole families and whole communities. The PA Department of Health certifies that over 800,000 Pennsylvanians have a drug and alcohol problem. (Federal SAPT Grant Application, FFY2011) Currently, we are treating less than 70,000 people a year and over the last 3 to 4 years, we have lost over $7.5 million in addiction treatment funding. As a result, every day after charity care is exhausted, people are turned away from life-saving help. If the family has no insurance and is not eligible for traditional Medicaid, getting help is very, very difficult. In fact, in the early spring of each year, counties are forced to ration treatment for addiction and can no longer place people in treatment at the level they need. Medicaid Expansion will help narrow Pennsylvania's current burgeoning addiction treatment gap. Medicaid Expansion will assist people who are low income wage earners who have no insurance and by the very virtue of their work, are not eligible for traditional Medicaid coverage. Let me restate, they are ineligible for traditional Medicaid because they are wage earners. something that we should support, not penalize. Medicaid Expansion is a jobs bill and is projected to create over 35,000 tax-generating new jobs in health care and in its support systems alone. In addition, it will provide health care coverage for wage earners working in low DASPOP 2
income industries such as food services, including cooks, waiters and waitresses, housekeeping, hotel staff, grocery stores, landscaping, etc. It is also a job preserving initiative in that workers with drug and alcohol problems of their own (or with family members) will be able to obtain treatment and maintain employment. These low income jobs are often jobs that are gratefully embraced by people in early recovery from drug and alcohol addictions as they work their way back into gainful employment. In addition, the Medicaid Expansion will surely have a helpful impact on the criminal justice system and crime. Untreated addiction is involved in 70o/o- 80% of crime in our state. However, many people involved in drug and alcohol related crime are ineligible for traditional Medicaid coverage. Drug courts and the criminal justice system have to compete with the working poor for limited treatment resources at the local county level. Under Medicaid Expansion, these same individuals will be eligible for health care coverage, thus providing badly needed addiction treatment resources to our state's Drug Courts and to Probation & Parole. We urge the Commonwealth to move forward with implementation of the Medicaid Expansion provisions of the Affordable Care Act. Thank you for your time. DASPOP 3
DASPOP Pennsylvania Profile 2012 Addiction Treatment PA POPULATION: 12.8 million ESTIMATED NUMBER IN NEED OF TREATMENT - 812,853 (Department of Health, SAPT Block Grant Application, FFY2011) ACTUAL NUMBER RECEIVING TREATMENT 67,736 (Department of Drug and Alcohol Programs, CIS Data, FY1 0-11) TREATMENT ADMISSIONS BY DRUG: FY06-07 FY07-08 FY08-09 FY09-10 FY10-11 ALCOHOL 33,554 31,174 26,725 27,139 25,381 HEROIN 17,593 15,715 11 '126 14,717 14,231 COG/CRACK 15,472 12,384 11,693 7,089 6,419 MARIJUANA 11,427 11,312 15,454 11,114 10,588 OTHER 8.446 8.121 121294 101132 11.117* TOTAL 86,492 78,706 77,292 70,191 67,376 ( -22% decrease) *Includes opiates/synthetics, amphetamines, barbiturates, benzodiazepines, other sedatives, PCP and other INMATE POPULATION IN STATE PRISON: (Department of Corrections) 2006-07 2007-08 2008-09 2009-1 0 2010-11 2011-12 42,446 46,028 49,133 51,281 50,530 51,757 (+21% increase) Drug and Alcohol Service Providers Organization of Pennsylvania 717-657-7702 dasdbeck@hotmail.com
CRIMINAL JUSTICE STATISTICS PRE-TREATMENT 80-90% of all crime in the United States is related to drug or alcohol addiction. 1 23% of the state prison population in 1995 and 60% of the Federal population in 1997 were incarcerated for drug offenses. 2 One of every 144 American adults is behind bars for a crime involving drugs and alcohol. 3 Taxpayers spent $30 billion in 1996 to incarcerate inmates for drug and alcohol involved crimes. 4 Crime related to untreated addiction costs the nation an estimated $57 billion per year (not including medical expenses). 5 POST-TREATMENT Every $1.00 spent on treatment leads to a $7.46 reduction in crime-related spending and lost productivity. 6 Cost savings during treatment alone more than recoup the cost of providing treatment, i.e., "Post-treatment gains are virtually an economic bonus." 7 Inmates who completed prison-based residential treatment program were 73% less likely to be re-arrested in the 6 months after release. Treatment completers were also 44% less likely to have evidence of post-release alcohol and drug use. 8 Post-treatment decreases in illegal income (73%) appear to track post-treatment decreases (71 %) in expenditures on drugs."... the implication is clear, that as drug abuse treatment suppresses demand for illicit drugs, less predatory crime is committed and income from that crime declines.. 9 $7.00 savings for every $1.00 spent on treatment during the period of treatment and in the first year following. These savings continue to accrue in subsequent 1 2 3 4 5 6 7 8 9 Drug Use Forecasting: Annual Report on Adult & Juvenile Arrestees", NationallnstiMe of Justice, 1995. Executive Office of the President, Office of National Drug Control Policy, Drug Policy Information Clearinghouse Factsheet, "Drug Treatment in the Criminal Justice System", August 1998 Behind Bars: Substance Abuse and America's Prison Population", The National Center on Addiction and Substance Abuse at Columbia University, 1996. Ibid. The Sense in Saving Drug Addicts", Alan Leshner, Boston Sunday Globe, September 5, 1999. Controlling Cocaine: Supply Versus Demand Program. Drug Policy Research", Santa Monica: RAND Corporation, 1994. The White House, President's Commission on Model State Drug Laws, "Treatment Volume", December 1993 Triad Drug Treatment Evaluation Six-Month Report Executive Summary", Federal Bureau of Prisons, U.S. Department of Justice, February 1998. The White House, President's Commission on Model State Drug Laws, "Treatment Volume", December 1993.