Pubdate: Sun, 28 Dec 2003 Source: Lexington Herald-Leader (KY) Copyright: 2003 Lexington Herald-Leader Contact: http://www.kentucky.com/mld/heraldleader/ Details: http://www.mapinc.org/media/240 Author: Bill Estep DRUG TREATMENT IS COSTLY; LACK OF IT MAY COST MORE Programs Might Pay Off By Reducing Crime Later On As Medicaid faces a $500 million projected shortfall, 2004 may not be the year for Kentucky to try to find millions of dollars to pay for drug treatment through the program. But if it doesn't, some say the state will lose even more money. A study by the University of Kentucky Center on Drug and Alcohol Research this year said reports from former addicts suggested that every dollar spent on drug treatment produced a benefit of $4.16 in avoided crime. The study, based on follow-up interviews with people who received state-financed substance-abuse treatment in 2000, found a 27 percent increase in the number who reported working full time in the first year after treatment. There was also a 66 percent drop in the number of clients who reported being arrested. Medicaid could be a key piece of the treatment effort because a significant number of recipients have substance-abuse problems. "It would make a critical difference," both in access to treatment and the sophistication of services available, said Louise Howell, executive director of Kentucky River Community Care. Howell and others say the treatment options available in Eastern and Southern Kentucky right now are not equal to the region's drug problem. There aren't enough detox centers, residential-treatment beds, intensive outpatient programs or other measures. Financing drug treatment through Medicaid would allow the state to stretch its money, because Medicaid is a matching program. For every $3 Kentucky puts in, the federal government puts in $7. But adding substance-abuse treatment to Medicaid could be tough sell, with other worthwhile health services also wanting money and serious budget problems facing Medicaid and the state. Mike Robinson, commissioner of the Department for Medicaid Services, said he thinks the agency will be able to balance its books in the current fiscal year, which ends June 30. But the projected deficit for the next fiscal year is $500 million, he said. It would be premature to speculate on whether drug treatment should be added to Medicaid, Robinson said, "especially when most people feel that we've got some very tough decisions to make going forward." But the idea of paying for more treatment has supporters among a somewhat unexpected constituency: police and prosecutors, who say treatment, education and enforcement are all essential in stemming drug-related crime. "It's a terrible time to ask for money, but I think it would pay for itself when it got right down to it," said Allen Trimble, commonwealth's attorney for Whitley and McCreary counties. - --- MAP posted-by: Perry Stripling