MONTPELIER -- Vermont’s substance abuse treatment programs could see added stress due to a greater number of people having health insurance after key parts of the federal health overhaul take effect, mental health and substance abuse experts said Tuesday.
The comments from state human services officials and treatment professionals came as The Associated Press released a national report showing new demand from newly insured people seeking substance abuse treatment could overwhelm existing programs in many areas.
It’s expected that nationwide, between 3 million and 5 million people could become newly eligible to receive addiction treatment under provisions of the Affordable Care Act that take effect in 2014. But Vermont officials and professionals involved offered mixed opinions about whether the influx of new patients will present a serious problem in the state.
Julie Tessler, executive director of the Vermont Council of Developmental and Mental Health Services, said the state has two factors working in its favor -- the high percentage of residents, about 94 percent -- who are covered by insurance now, and Vermont’s mental health parity law, which requires insurers to provide equal coverage for mental health and substance abuse treatment that they do for physical health.
But Vermont already is facing a shortage of professionals in some fields, said Floyd Nease, director of services integration at the state Agency of Human Services. "There’s a 700-person waiting list in Chittenden County" of people seeking treatment for abuse of heroin and other opiates, said Nease, a former lawmaker who also served as executive director of the Vermont Association for Mental Health and Addiction Recovery.
National statistics examined by the AP indicated that about 53,000 Vermonters, out of an overall population of about 626,000, need substance abuse treatment; about 5,000 are getting it now. Many of those not getting treatment simply have not made the decision to seek it, professionals said. The figures indicated that about 3,350 newly insured people were likely to seek substance abuse treatment in the state next year.
The state’s 278 treatment center beds had an occupancy rate of 87 percent, according to the most recent data, which were gathered from the Center for Behavioral Health Statistics and Quality.
At the Valley Vista substance abuse treatment center in Bradford, Rick DiStefano, vice president for clinical services, said his facility currently has no waiting list for women and adolescents, while men typically have to wait three to four weeks to be offered a bed. He said most of the facility’s patients are funded by the state, through Medicaid or expanded Medicaid programs, and that the most common diagnosis is alcoholism.
DiStefano said a bigger worry for him than the availability of treatment beds and therapists is the availability of funding to support treatment for the publicly funded patients. He said his center is currently limited by the state to 15,400 patient-days per year that can be funded by Medicaid. If it goes over that limit, it is providing free care, he said.
"I believe it really is more of a funding issue than a need issue," DiStefano said.