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.
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MAP posted-by: Perry Stripling