FARGO — North Dakota legislators are mulling a recommendation to double funding for a program that is a “payer of last resort” for substance use disorder treatment — a program that ran out of money because of high demand for services.
Gov. Doug Burgum’s budget recommendations would boost funding for the program to $17 million for the upcoming two-year budget, up from the current $8 million.
Funding for the program, which has served 4,200 clients since 2016, ran out, forcing the program to freeze enrollment June 30, 2020.
The voucher program, which serves people who lack health insurance or other means to pay for treatment, is continuing with support from the Coronavirus Relief Fund, which provided $1.7 million for community-based behavioral health care, which ends June 30.
Treatment center administrators report that demand for addiction treatment is soaring as the opioid crisis is compounded by the strains of the ongoing coronavirus pandemic.
“There’s a lot of gaps that need to be filled around access to care,” said Kurt Snyder, executive director of Heartview Foundation in Bismarck. “Our patients are reporting more issues around substance abuse,” with cases compounded by joblessness or other problems stemming from the pandemic.
Ty Hegland, chief executive officer of ShareHouse in Fargo, which provides residential addiction treatment, said the population served by the voucher program — almost 75% are unemployed and 26% are homeless — will show up in jails or hospital emergency rooms, where they are more expensive to care for.
“These patients, whether we like it or not, are going to get served somewhere,” he said. If they end up in the emergency room, the cost is 10 times higher, and if they end up in the corrections system, the cost is six times higher, Hegland said.
“This is saving money in a lot of other areas of the state budget,” he said.
Addicts who can’t get treatment are at risk, Hegland said. “We’re talking about patient access and life and death,” he said.
Fargo police recently reported that they responded to 91 drug overdoses last year, triple the number in 2019, and recorded 18 overdose deaths last year.
Inadequate voucher funding has meant Prairie St. John’s in Fargo has been forced to increase its charity care by more than $1 million, the behavioral health hospital’s president said.
“It really increased our bad debts substantially,” said Jeff Herman.
Officials in Bismarck seem to have been stunned by the level of demand for addiction services, Hegland and Herman said. The voucher program is addressing a need that has gone underserved for decades, they said.
“They seem to be complaining that providers are providing too much care,” Herman said. “But all it did was open a floodgate to reality,” he added, referring to the establishment of the voucher program several years ago. “We didn’t create these patients.”
Brenda Owen of Summit Prairie Recovery Center in Raleigh said steps can be taken to ensure the voucher program is tapped only after other payment sources have been exhausted.
“It could definitely be built into the process,” she told the House Appropriations Committee.
Also, granting Medicaid waivers to enable access to addiction services would be a major help, Owen and Snyder said.
Pamela Sagness, director of behavioral health for the North Dakota Department of Human Services, which manages the substance use disorder voucher program, agrees that treating addiction can save money.
“They’re able to avoid hopefully that higher level of care,” she said. Addicts who can’t afford private treatment can access services at state human service centers, although those might not be as convenient, especially for those who lack transportation, she said.
Mike Nowatzki, Burgum’s spokesman, said expanding access to treatment services is a priority for the administration, and can be done in a way that is friendly to taxpayers.
“The governor’s budget proposal included the substance use disorder voucher program to match funding to the increased demand for the program without raising taxes,” he said.