Treatment crisis: Providers of addiction services make plea for critical funding

Medicaid-funded providers say financial shortfall due to low reimbursement rates will mean cuts in service.

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CONCORD, NH – Representing the vast majority of in-patient substance abuse care accessible through Medicaid, a coalition of treatment providers urged New Hampshire lawmakers on Tuesday to revisit state funding for treatment before they are forced to make deep and painful cuts to available treatment statewide.

The state reimburses area substance abuse treatment providers through the program, but the payments are woefully below the true cost of care, leaving a growing and irreversible gap between funds and services. The estimated shortfall is $10 million per year.  If the rate isn’t increased by the end of 2018, all local providers face reduced services for their patients, eliminating jobs and cutting available beds, halting planned expansions and longer wait times for Medicaid-based patients seeking access to care.

“New Hampshire has the third highest rate of overdose deaths in the nation, the problem here is real and it is urgent,” explained Larry Gammon, President & CEO of Easterseals NH.  “We ask HHS Commissioner Jeff Meyers to negotiate with the various managed care organizations to set higher rates and move forward to help us avoid service cuts in January.”

Providers say they have met with the Governor and state officials to explain the urgency and asked for help in figuring out solutions that will preserve current programs statewide.

Here is a sample of what various providers said the impact would be if Medicaid reimbursement rates are not increased by January 1:

“At the current pace, Farnum will have to reduce our available beds by 49 by January if we do not get financial help,” says Cheryl Wilkie, COO of Farnum, the largest provider of treatment beds in the state’s Medicaid system. “We are millions of dollars short of what we need from the state to cover basic costs and break even in providing care to our Medicaid clients.”

“In Keene, we have 15 residential beds and on any given day, 30 percent of our residential patients and 60 percent of our out patients are Premium Assistance Medicaid patients,” says Amelie Gooding, Program Director for Phoenix House, with locations in Dublin and Keene. “We are the only treatment facility in the Monadnock Region and If we don’t raise the Medicaid rates, it will significantly impact our ability to provide care at current levels.”

“Keystone Hall has 40 beds, with 18 beds specifically provided to pregnant women; we are one of only two facilities in the state that serves this population,” says MaryBeth Lavalley, of Keystone Hall. “If we don’t raise Medicaid reimbursement rates, we will struggle to maintain our current level of care. It will force us to limit the number of available beds.”

“We have 28 beds, 16 are “high intensity” beds which is where the impact would be felt,” says Sharon Drake, CEO of Southeastern NH Alcohol and Drug Abuse Services. “We could lose all 16 beds.  On average, 89 percent of all high intensity,residential clients are Medicaid eligible. This would deeply impact our ability to continue providing the help we offer right now.”

“At the rates we are talking about today, it adds up to a financial shortage of $99 per day, per person in our Intensive Outpatient Program,” says Stephanie Savard, Chief Operating Officer of Families in Transition, New Horizons.  “We recently expanded this program by adding a second IOP for women with substance use and trauma histories.  If these rates don’t change, we will be forced to cancel our expansion of this service, which we know is needed in our community.  The demand is there, but the supply is woefully short.”

Manchester Fire Chief Dan Goonan says this financial shortfall threatens the future of the highly successful Safe Station program in the state’s largest city.

“If current Medicaid rates are not adjusted, the decrease in treatment beds and the limiting of outpatient services for Safe Station partners will affect people from across the state,” says Manchester Mayor Joyce Craig. “I am willing to work with state and federal leaders to find a solution for New Hampshire residents who so desperately need our help.”

Providers pledge to work closely with state lawmakers and regulators to explore ways to close the funding gap and keep current services from being cut or eliminated. “This rate increase is being requested so we can simply protect the status quo, this is not about expanding the services our state desperately needs in this crisis,” says Gammon.

Lawmakers recently completed a full review of the state’s Medicaid program and cited higher reimbursement rates for substance abuse and mental health treatment as a priority action item.

“We deeply appreciate that lawmakers understand the challenges facing the provider community,” says Gammon.  “We just need them to take action as soon as possible so that none of us are forced to make the terrible choice of making someone in need wait for available services through Medicaid.”

For more information, go to the New HampshireProviders Association,