With heroin and other drug use at epidemic levels across the country and here in Washington, local addiction recovery centers are scrambling to keep their doors open. A sudden and unintended consequence of the Affordable Care Act (ACA) is threatening outpatient programs for those who are poor and in recovery for alcohol and drugs.
This month, executives of the dozens of publically funded addiction recovery centers around the state found out the immensity the impact on their budgets as federal payments now foot the bill for these services under the ACA. Prior to 2014, the state chipped in additional dollars to meet the funding gap.
At the Seattle based nonprofit, Recovery Centers of King County alone they spent $21,000 of their scarce reserve money in January to cover the difference.
"I was horrified and instantly terrified. How are we going to survive this year?" said CEO Pat Knox, Ph.D.
“I was anticipating a reduction in fees but I didn’t know the magnitude. When we pulled together the numbers for January my heart dropped. I got a sick feeling in my stomach,” said Norm Redberg, Director of Alcohol Drug Dependency Services in Ellensburg.
Emily Scheving of Kent attends weekly group counseling sessions at the Seattle location of Recovery Centers of King County. Scheving is a recovering alcoholic who began drinking at age 12. Four years ago the disease had progressed to the point where she lost her children, boyfriend and apartment. Now she attends school and has joint custody of her three kids. She says the outpatient program provides the support she needs.
“The program is important, especially because (they provide) childcare. For a mother it’s really hard to try to work a job and do outpatient and not have childcare. I don’t know what I would do without it,” said Scheving.
Dallas Redlin of West Seattle is recovering from 22 years of heroin addiction. He began using at age 14 when a relative introduced him to the drug. Last year he hit bottom. Redlin was homeless, living under a bridge in downtown Seattle and was stealing to pay for drugs.
"I would accomplish my goal three times a day so I felt like I was achieving. And achieving was getting better (scoring drugs),” said Redlin.
Redlin has been sober for four-and-a-half months and attends outpatient meetings and counseling sessions several times a week.
"Outpatient keeps you accountable. That's when the work starts when you're out on your own," said Redlin. “(Without it) it would be like releasing someone from jail and putting them out on the street with no support and saying ‘good luck.’”
The nonprofits KING 5 contacted say if the legislature doesn't make a budget fix in the next two weeks, outpatient services for thousands of people will be scrapped. The Recovery Centers of King County is considering selling their Seattle building or closing down one of their two locations altogether.
“It certainly is (a crisis) and no one seems to care at DSHS and the legislature doesn't know that this is happening," said Knox.
Top DSHS managers who oversee chemical dependency programs in the state told KING 5 they “absolutely care” about these patients and “understand the ramifications” of losing outpatient services. But, that it is out of the Department’s hands and up to the legislature to authorize DSHS to pay the same rates they were paying in the past.
“It’s the legislature’s decision at this point,” said Jane Beyer, Asst. Secretary of Behavioral Health and Service Integration Administration at DSHS. “Our concern needs to be with everyone that needs chemical dependency treatment. We’re doing the best that we can with the resources available to us.”
“Smaller agencies will go out of business. The patients will not go away,” said Knox. “They will be on long waiting lists to receive treatment and they will fill the hospitals and jails. More of them will be living on the streets of Seattle and surrounding neighborhoods as their addiction progresses."