Fund­ing cut to Whit­sitt, other treat­ment cen­ters

Record Observer - - News - By PETER HECK pheck@thekent­coun­tynews.com

CH­ESTER­TOWN — The A. F. Whit­sitt Cen­ter and sev­eral other Mary­land in­pa­tient drug treat­ment cen­ters are about to lose state fund­ing.

In a phone in­ter­view Jan. 12, Dr. Le­land Spencer, Kent County health of­fi­cer, said the Whit­sitt Cen­ter will be mov­ing to a “fee for ser­vices” struc­ture rather than be­ing grant funded by the state. This means the fa­cil­ity, along with oth­ers through­out the state, will have to get pre-ap­proval for pa­tients’ in­sur­ance cover­age.

Spencer said Mary­land has re­ceived a waiver from the fed­eral gov­ern­ment that would al­low Medi­care and Med­ic­aid to pay for those ser­vices. “We’re not clos­ing the cen­ter, it’s just a dif­fer­ent fund­ing model,” he said.

Spencer said the ben­e­fit to the state would be that some of the cost of the cen­ter’s ser­vices would be borne by the fed­eral gov­ern­ment in­stead of the state car­ry­ing the whole load. “I don’t think (the state) thinks it will im­pact ac­cess to care,” he said.

As de­scribed on the health de­part­ment web­site, “The A. F. Whit­sitt Cen­ter is a 24-hour, seven-day-aweek res­i­den­tial treat­ment fa­cil­ity of­fer­ing treat­ment to adults ages 18 and over suf­fer­ing from chem­i­cal de­pen­dency and co-oc­cur­ring dis­or­ders.”

The cen­ter also of­fers med­i­cally mon­i­tored detox­i­fi­ca­tion for al­co­hol-, opi­ate- and ben­zo­di­azepinede­pen­dent in­di­vid­u­als, the web­site said.

Tim Dove, out­pa­tient ad­dic­tion di­rec­tor at the Whit­sitt Cen­ter, said in a phone in­ter­view Tues­day, “It’s go­ing to be a ma­jor task to ad­just our billing process,” he said.“We’re look­ing at var­i­ous mod­els, try­ing to fig­ure out how to steam­line the process.”

Pre­vi­ously, Dove said, state fa­cil­i­ties did not bill pa­tients. He said the state treat­ment cen­ters, in­clud­ing the Whit­sitt Cen­ter, will be look­ing at how hos­pi­tals and other pri­vate providers han­dle billing and in­sur­ance.

Un­der the state-sup­ported sys­tem, Dove said, the Whit­sitt Cen­ter was able to keep pa­tients as long as it needed to detox­ify them, then move them to half­way houses and other fa­cil­i­ties to com­plete their trea­ment. But, he said, in­sur­ance com­pa­nies don’t want to pay for longer stays in treat­ment. He gave the ex­am­ple of child­birth, where a mother and child are en­cour­aged to leave the hospi­tal as soon after de­liv­ery as they can safely do so.

Dove said the fee-for-ser­vices model would prob­a­bly lead to sim­i­lar poli­cies. One ap­proach could be for the Whit­sitt Cen­ter to sta­bi­lize pa­tients be­fore send­ing them to pri­vate prac­ti­tion­ers to com­plete their re­ha­bil­i­ta­tion, he said. “We’re do­ing our very best to make sure the ser­vices don’t go away,” he said.

“It’s a sad thing,” Dove said. “Here we are in a (drug) epi­demic.” He said there were more than 1,400 over­dose deaths, from all kinds of drugs, in Mary­land last year.

In ad­di­tion to chang­ing the fund­ing model for the Whit­sitt Cen­ter, Spencer said the state de­funded out­pa­tient re­ha­bili­ti­a­tion ser­vices at the be­gin­ning of Jan­uary. “Luck­ily, we had some pri­vate providers move in,” he said.

His­tor­i­cally, the Whit­sitt Cen­ter served an av­er­age of 140 out­pa­tients at any given time, Dove said. With the elim­i­na­tion of state fund­ing for out­pa­tient treat­ment, that case load is now shifted to pri­vate providers, he said.

Dove said Kent County res­i­dents have bet­ter ac­cess to pri­vate providers than those in other Mary­land coun­ties. He men­tioned Healthy Con­nec­tions, which opened a Ch­ester­town branch in De­cem­ber. Part of a mid-At­lantic chain of ad­dic­tion cen­ters, it of­fers sub­ox­one treat­ment for ad­dicted in­di­vid­u­als.

Opi­ate an­tag­o­nist drugs like sub­ox­one or viv­it­rol can go a long way to­ward help­ing ad­dicts re­cover, Dove said. Viv­it­rol, which is in­jected once a month, and sub­ox­one block the plea­sure­able ef­fect of heroin and other opi­ates. In ad­di­tion to th­ese an­tag­o­nist drugs, coun­sel­ing is usu­ally part of an ef­fec­tive re­cov­ery pro­gram.

“We don’t know what the fi­nal im­pact of the fund­ing change will be,” Spencer said. “We may need to do some belt tight­en­ing or re­struc­tur­ing. But we’ll have some­thing there.” He said he would have a bet­ter idea of the ex­act ef­fect of the new model in March, when in­for­ma­tion on the new rates is re­leased by the state.

PHOTO BY PETER HECK

The A.F. Whit­sitt Cen­ter in Ch­ester­town, a treat­ment cen­ter for drug and al­co­hol de­pen­dency, is fac­ing changes in its fund­ing model due to statewide bud­get cuts.

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