On June 14, 2010, Health & Medicine Policy Research group (HMPRG) hosted a forum, “The State’s Fiscal Crisis: Changing Our Collective Response.” With over 70 attendees, the forum explored the impact of the State’s budget and recent cuts on health and human services in Illinois. Participants heard from panel speakers about how we might collectively respond to the crisis and ensure responsible and adequate funding for education, health, and human services in Illinois. Materials from the forum can be found on the HMPRG website (www.hmprg.org)

1. STATE’
THE STATE’S FISCAL CRISIS:
CHANGING OUR COLLECTIVE
RESPONSE
Human Services Impact: Substance Abuse
June 14, 2010
Kathye Gorosh, MBA
CEO
New Age Services
kgorosh@newageservices.org

2. WHAT’
WHAT’S IN A NAME??
SUBSTANCE USE AB US E
CE
BS TAN
SU TION
SUB
STA ADDIC
DISO NCE
RDE USE BEHAVIO OPIOIDS:
RS RAL
HEALTH OMT
MAT
MMT
COV ERY DRUG
OTP
RE ATOD
TREATMENT

3. DASA: SERVICES PROVIDED
Case Management
Child Care Residential
Community Intervention
Detoxification
HIV Testing and Counseling
Intensive Outpatient Services
DASA Early Intervention
Outpatient Services
Residential Rehabilitation
Rehabilitation--
--Extended
Residential Rehabilitation--Extended
Toxicology

4. TREATMENT
NETWORK
DASA administers a network of community-
based alcohol and other drug treatment
programs.
All treatment programs must be licensed by
DASA
893 Licenses for Treatment and DUI.
494 Licenses held by 147 funded corporations.
399 licenses held by 283 unfunded
corporations.

5. LEVELS OF CARE
Illinois Substance Use Treatment Levels of Care
LEVEL DESCRIPTION
Level I (Outpatient) Outpatient treatment, individual and/or
group services, frequency determined by
assessment. Services average less than 9
hours/week.
Opioid Maintenance Therapy Outpatient treatment; methadone
maintenance; individual and/or group
services.
Level II (Intensive Outpatient) Outpatient treatment, individual and/or
group services, frequency determined by
assessment. Services average 9 hours/week
at a minimum.
Level III.2 (Detoxification) Monitored process of withdrawal from a
specific psychoactive substance.
Level III.3 (Residential Extended Residential extended aftercare (recovery
Care) homes), most often used as a step down
from residential treatment.

6. Minimum Unit of
S e r v i c e
S e r v i c e Code Rate
Admission and Quarter Hour AAS $63.36 - per hour
Discharge Assessment $15.84 - per quarter hour
Reimbursement Rates FY 2010
Level I (Individual) Quarter Hour OP $60.32 - per hour
$15.08 - per quarter hour
Level I (Group) Quarter Hour OP $22.80 - per hour
$5.70 - per quarter hour
Level II(Individual) Quarter Hour OR $60.32 - per hour
$15.08 - per quarter hour
$22.80 - per hour
Level II (Group) Quarter Hour OR $5.70 - per quarter hour
Level III.1 Daily HH $64.86
Level III (Detoxification) Daily DX Provider Specific
Level III.5 Daily RR Provider Specific
Recovery Home - Adult Daily RH $46.65
Recovery Home - Adolescent Daily RH $118.45
Case Management Quarter Hour CM $46.68 - per hour
$11.67 - per quarter hour
Psychiatric/Diagnostic Per Encounter/Per - $78.94
Opioid Maintenance Therapy Day
Weekly OP $85.35
(less than 105 patients)
Opioid Maintenance Therapy Weekly OP $68.28
(more than 104 patients)
Early Intervention (Individual) Quarter Hour EI $60.32 - per hour
$15.08 - per quarter hour
Early Intervention (Group) Quarter Hour EI $22.80 - per hour
$5.70 - per quarter hour
Community Intervention Quarter Hour CIH $45.56 - per staff hour
$11.39 - per quarter staff hour
Child Domiciliary support Daily CRD $48.71
Toxicology Per Test TOX As specified in exhibit
$56.24 - per hour
HIV Counseling and Testing Quarter Hour HIV $14.06 - per quarter hour

7. SUPPORTED TREATMENT
SERVICES SFY 2009
90,373 Includes All DASA
funded services
Individuals
60,267 Male
30,106 Female 1,403
Pregnant
13%
Youth
86%
Adults
1%
Seniors

8. S T I G M A

9. ALCOHOLISM AND SUBSTANCE
ABUSE
General Revenue Funds (Dollars in millions)
FY08 Appropriation Request = $164.5M
FY09 Appropriation Request = $109.5M
FY10 Appropriation Request = $109.3M
FY11 Appropriation Request = $140.3M

10. ALCOHOLISM AND SUBSTANCE
ABUSE
DASA: All funds SFY 2008 to SFY2010

11. ALCOHOLISM AND SUBSTANCE
ABUSE
DASA Medicaid SFY 2008 to SFY2010

12. New Age Services:
OMT Clients funded/Year
“budget relief”
Actual: 3/09
Revised –
retro to 7/1
l
TBD
na
gi
ri
O

13. THE GREAT SILO
EFFECT
HEALTH HUMAN
SERVICES
OTHER
SUPPORT
SERVICES

14. STATUS: DHS/DASA FUNDING TO
DATE
Contracts: Decreasing – since SFY 2008
Payment: Time from Billing to Payment
SLOW SLOW SLOW
3 months to 6 months and even 10/09 [IL Partners]
FFS Rates: unchanged since SFY 2002 (3% COLA in SFY 2006)
This amounts to a “cut” due to increased costs
Consequences of untreated Substance use/abuse
Clients/Patients admin detox
Programs Close; Intake Doors Slam Shut
Increased Waiting Lists
Decrease Access to Many Services

15. Addiction Healthcare Cuts
Yield Increased Costs:
Additional Cuts in FY 11 to Addiction Prevention and
Treatment Services Result in $280 million in Related Costs
Failure by the State to adequately fund alcohol and drug prevention, treatment
and recovery services results in the State paying out billions in costs associated
with untreated addiction. Annually, the State of Illinois spends only $1 on
addiction healthcare services for every $33 that is allocated to pay for the
consequences of substance use disorders and addiction.
Of the estimated $4.85 billion spent annually in Illinois on issues related
to substance use and addiction, only $147 million is actually spent
on the prevention and treatment of alcohol and drug use and
addiction.
By cutting Addiction Prevention and Treatment state funding by 8% in
FY11, on top of cuts already imposed in FY10, the State will need to add an
additional $280 million to cover the expenses that will be incurred in
Criminal Justice, Education, Healthcare, Child Welfare, and Public Safety as
a result of untreated addictions.
Illinois Alcoholism and Drug Dependence Association
www.iadda.org

16. WHAT’S NEXT???
Reality at the agency level:
Inability for Board to pass FY 2011 Budget
(varies based on %age of State Dollars that comprise the
agency’s budget)
Given the “state of the state” – prepare staff and
clients/patients for layoffs and admin detox
Look for additional places to cut expenses – not likely
since that has been ongoing since FY 2009
Verify Line of Credit still available [NOTE: may be
harder this year w/ the State as the source of the
Account Receivable balance]
Finding the best way to have a voice for our needs