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Towards A National Campaign Campaign’s Focus Increase awareness of this problem Make treatment as available for addiction disorders as it is for any other chronic health condition
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Securing Collateral Support for Whole Systems Change: Seeking Resources and
Key Stakeholder Support
Victor Capoccia, Program Director, Open Society InstituteJohn O’Brien, Legal Action Center Associate
What Do We Know About the Treatment Gap? Addiction to drugs and alcohol is a chronic
health condition affecting 22 million Americans
Proven treatments for this health condition exist
Ninety percent of those who need addiction treatment are unable to get it.
Towards A National Campaign
Campaign’s FocusIncrease awareness of this
problem Make treatment as available for
addiction disorders as it is for any other chronic health condition
The Barriers to Success
It’s a personal, moral or social problem, not a health condition
There is nothing that can be done, treatment doesn’t help
The economic, legal, and social side effects of addiction are more compelling than the condition itself
Campaign Strategy
Communication: Shape message to policy makers and publicChange Policy and Practice: Insurance—Addiction is a chronic health condition and should be
covered like diabetes by specific benefits in all existing and future public, semi-public and private health plans.
Appropriations— Where insurance is unavailable, government at all levels has a role to pay for treatment until universal health plan coverage reduces the need for special categorical funding.
Efficiency—Expediting the engagement, integration and retention of individuals into treatment is critical to using existing resources more effectively.
Advocacy: Drive policy message and policy change
Change Principles
It’s a Health IssueLeadership, ChampionClear and Persistent Public Presence
Payor EngagementChange LeaderAccess to and Facility with Datac
Towards A National Campaign
What Are the Goals? Increased number of consumers receiving
high quality care Increased resources available to pay for
treatment Effective practices or models for change
created by grantees that are applicable in other jurisdictions
What Are the Models?
Baltimore Developed a broad-based advocacy and communications to
increase appropriations Developed a new city-wide administrative entity to purchase and
monitor treatment services. Used data to track performance aggressively and improve the
efficiency and to effectiveness of individual programs. The results:
Funding for the treatment system increased from $20.3 million in 1997 to $52.9 million in 2005,
Number of people receiving drug treatment in publicly funded programs increased from 18,449 in 1997 to 28,672 in 2005.
What Are the Models?
FloridaNo clearly defined Medicaid SA benefit (> $10
million annually—redefined mental health coverage to include SA and created intensive TA for providers
Service gaps—initiated several new covered services for Medicaid recipients
Little new state funding—partnered with counties to identify local dollars and leverage federal funds
What Are The Models
Connecticut—Department of Mental Health and Addiction Services:
Three state agencies had different contractual requirements for similar SA services—created one contract
Had multiple and different monitoring processes for same SA providers—create a single monitoring process
Paid vastly different amounts for the same services to the same providers—reviewing opportunities for developing a consistent reimbursement methodology
Future Directions—Closing the Addiction Treatment Gap (CATG)Seeks to expand treatment by increasing public
funding, broadening insurance coverage and achieving greater program efficiency.
A $10 million national program of the Open Society Institute (OSI).
Demonstration sites across countryNational communication initiativeLearning Collaborative and technical Assistance Evaluation
CATG Summary
35 Applications were submitted in April8 sites recommended for participation:
ArkansasMilwaukeeNew HampshireNew JerseyNew YorkPuerto RicoRhode IslandTarrant County
Help Us with CATG
Financing, How do you: Increase the scope of benefits covered by
public payers (e.g. Medicaid, Medicaid contracted health plans and other state agencies)?
Shift expenditures from inpatient, emergency departments and corrections to community services?
Finance across systems and create purchasing efficiencies?
Proposed Strategies Increase state appropriations for AODA treatment services—several
different strategies proposed (general request for increased spending)
Add AODA community services to the state’s Medicaid plan Shifting spending from inpatient services to more effective
community treatment approaches Review and retool the purchasing practices among state agencies
that purchase substance abuse services. Increase the insurance coverage (through state’s Medicaid
program) for low-income uninsured individuals Increase the use of evidenced based and promising practices
offered by treatment providers and increase access and retention to addiction treatment services.
Help Us with CATG
Efficiency, How do you:Expand the use of proven interventions to improve
outcomes and reduce relapse?Develop recovery support systems?Use established system redesign and improvement
strategies to expand treatment access?
Help Us with CATG
Advocacy and Communication What is the message that you would use to
publicize the costs and consequences of the treatment gap?
Who would you involve in delivering the message?
Who would you target to receive the message?What data and analysis would you want to
make the case?
Thank you for your thoughts!
Track the CATG Initiative @
www.treatmentgap.org.