Friday, February 25, 2011

Addiction treatment in limbo

By Jamey Dunn

Addiction treatment providers have some sense of relief now that members of Gov. Pat Quinn’s administration say they plan to scale back reductions to human services’ funding, but they continue to operate in a state of limbo until they get the specifics on the cuts.

Kelly Kraft, spokesperson for Quinn’s Office of Management and Budget, said human services would take a hit of about $100 million, as opposed to the $208 million that substance abuse treatment and prevention providers say the Department of Human services told them to prepare for last week. “On the surface, that’s a positive development, clearly,” said Sara Moscato Howe, chief executive officer of the Illinois Alcohol and Drug and Dependence Association [IADDA]. “However, there was not one detail given about where that $100 million would come from.”

Kraft said the reductions are not new. She says the cuts came when Quinn gave the Department of Human Services a $3.6 billion lump sum this year — which was a reduction from the $3.9 billion it got last year. “When everyone says these are new cuts, it really was something that was announced a while ago.” Kraft said added demand prevented the department from spreading the cuts throughout the current fiscal year, but now the reductions have to be made. She said the administration had hoped that the economy might pick up, creating more revenue to defer some cuts. But instead, it remains sluggish.

Even though the income tax increase passed in January has brought in about $3 billion in new revenue, Kraft says it’s not enough to address the state’s fiscal crisis and plug the hole in Human Services. “Three billion dollars in additional revenue definitely helps, but we also have $6 billion in overdue bills [to providers, contractors and schools],” she said. “The list of bills that the state owes goes on and on.”

Kraft added that the state also owes $1.1 billion because it did not make the full payment on the group health insurance plan for state workers last year, as well as failing to dole out corporate income tax returns. Altogether, Quinn Budget Director David Vaught estimated in a briefing on the fiscal year 2012 budget that the state actually owes $9 billion to $10 billion.

But Howe says the administration's plan is counter intuitive. “Because the economy is so bad, the demand for services is grater … and because the demand for services is greater, they are now going to need to cut more? ... Why, then would you turn around and say to your citizens, ‘We know you really need this, but we may have to cut?’” Addiction treatment providers say cuts to their programs will only shift costs to other areas such as corrections and health care.

Kraft said the state spends about 45 percent of its general revenue funds on human services, and while cutting is a difficult process, some reductions must be made. She said that those assembling the budget look at five considerations when deciding where to cut. They first ask whether a cut to a program would hurt the state’s ability to bring in federal dollars and whether it is required by law or a court order. They look at data and try to determine how effective a program is and how many people it helps. They also try to project how proposed cuts would affect “life and health and safety” in the state. “We value the commitment of all these providers. They serve Illinois' most vulnerable citizens,” Kraft said. “It’s a difficult balancing act.

Howe said the administration indicated that the cuts would likely still be targeted at addiction treatment. Kraft said the department is still working to determine where the cuts will be and plans to start notifying providers in about two weeks. “That’s a long time, considering in the past week our providers, have really begun a painful process of shutting down,” Howe said. Providers are afraid to take on new clients, she said, because they are concerned they may have to discharge them when the cuts are spelled out. “It is kind of an operate-at-your-own-risk. … There is obviously some ethics involved in taking somebody in and making sure that when you release them, that they’re ready.”

Howe said no matter what happens in two weeks, Quinn’s budget proposal for the next fiscal year still calls for cutting state funds to all addiction treatment that is not backed by federal Medicaid matching dollars. IADDA estimates that about 80 percent of the more than 69,000 people currently receiving treatment for addiction in the state are not covered by Medicaid. “You’re willing to review this now, [but] you’re still willing to put the system out of business come July 1,” Howe said.

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