Snohomish County’s only publicly funded in-patient detox center says it might have to close, and outpatient drug and alcohol programs could be cut, because of a drop in how much the state pays for treatment.
Everett-based Evergreen Manor’s in-patient detox program, which treats about 1,000 people a year, could shut down in two months unless legislators take action, said Linda Grant, the organization’s chief executive. Lawmakers would have to act quickly. This year’s legislative session is scheduled to end Thursday.
“It’s a huge crisis,” said Ken Stark, the county’s human services director. Stark said he’s hopeful that a last-minute solution can be found in Olympia.
Outpatient programs also could be affected, he said. “If there can’t be a fix, you will likely see the larger programs be able to hang on longer … and the smaller programs, without a lot of cash reserves, will be the first to go,” Stark said.
The problem arose in January as parts of the federal Affordable Care Act took effect. An expansion of Medicaid has allowed tens of thousands of the state’s low-income adults to get health care.
An unforeseen consequence of that shift meant that organizations providing drug and alcohol services to low-income patients would be paid at Medicaid reimbursement rates, which are lower than what the state previously paid.
At Evergreen Manor, the overhead cost of housing and caring for someone in an in-patient detoxification unit is $252 a day, Grant said. Since January, under the Medicaid payment system, that’s dropped to $150 a day, she said. The nonprofit lost $8,300 in the first month of the new payment system, she said.
If lawmakers take no action, Grant said, the program can’t continue. “I can’t drain the resources I have to keep a program going that can’t survive,” she said.
Jane Beyer, an administrator for the state Department of Social and Health Services, said that the Medicaid payment rates in Washington are lower than in a lot of other states.
To fix the problem for newly enrolled Medicaid patients needing detox services, the Legislature would have to instruct the federal government to increase payments, she said.
The annual cost for fixing the problem for detox patients who were enrolled in Medicaid prior to January is estimated at $200,000, according to DSHS officials.
State Rep. Ruth Kagi, D-Seattle, became aware of the funding problem from Grant. Since then, Kagi has worked with DSHS to figure out how many service providers are affected and what lawmakers can do to help them before the legislative session ends.
She’s concerned the closure of Evergreen Manor or any other center reduces services to people in need.
“Everyone knows this is a problem and we have to address it,” said Kagi, who is chairwoman of the House Early Learning and Human Services Committee. “We do not want to lose capacity. I know we would lose some capacity, but I don’t know how much.”
If money is needed, it will have to be added into the budget that House and Senate leaders are now negotiating. That won’t be easy this late in the session, Kagi said.
“We’re truly at the end of the budget negotiations, and it means trying to figure out what to give up,” she said. “We will address it. The question is if we will address the lower rate enough to get them through the year.”
Before the change in reimbursement, state and local governments chipped in money to help pay for local uninsured detox patients, and only about 25 percent of patients were on Medicaid.
Now, about 95 percent of Evergreen’s detox patients are on Medicaid, said Cammy Hart-Anderson, a manager in the county’s human services department.
Studies have shown that treating people in such units is far less costly than having patients admitted to a hospital for treatment, Stark said.
Evergreen also provides outpatient drug and alcohol services to about 500 patients a month. “We certainly would be curtailing services because we would be losing a significant amount of money,” Grant said.
Evergreen isn’t the only program that’s facing these issues. Local outpatient drug and alcohol services also are provided by Catholic Community Services, the Stillaguamish Tribe, the Center for Human Services, Sea Mar Community Health Centers, and Therapeutic Health Services, Hart-Anderson said.
Last year, 3,613 Snohomish County residents were treated in publicly funded outpatient drug and alcohol treatment programs — 524 of whom were 18 or under, she said.
The Center for Human Services provides outpatient treatment to people 18 and younger in Snohomish County. Without an increase in payment rates, the organization may have to close programs or provide fewer group programs, said Beratta Gomillion, the organization’s executive director.
Gomillion said she believes that the payment issue is an unintended consequence of the federal health care law.
“With any kind of new, major change in the system, there are going to be problems that come out of it,” she said. “Unfortunately, with nonprofits, we don’t have the reserves to allow us to last through a lot of the time it would take to solve these problems,” she said.
Sharon Salyer: 425-339-3486; salyer@heraldnet.com.
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