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Recovery in the News
32-day wait for help is deadly for drug addicts
Greg Cima
Pantagraph
August 4, 2007
Bloomington — Adam Hearon asked his family for help with his heroin addiction when he was 19.
When he was 20, he spent three months on a waiting list for a drug treatment program, only to drop out after one day in November 2005. He began outpatient counseling late last year after he couldn’t get admitted to a treatment center.
After an arrest for driving without a license because of his prior drug use, Hearon spent three months in jail. He was ordered to get treatment for his addiction.
But the treatment center he was assigned to was full, and there was no indication when he’d get in. He walked out of the DeWitt County Jail at noon April 10. He died of an overdose less than 24 hours later at the age of 22.
Tammy Hearon said her son would have returned to treatment earlier if it had been immediately available. But the jobs he worked didn’t provide insurance, and he was too old for coverage through his mother, who is a nurse at a Twin City hospital.
“When they’re at their worst and they’re going on a downward spiral, that’s when they need help,” she said. “And that’s usually when it’s (treatment) not available.”
Her son was one of about 6,100 people statewide waiting to get substance abuse treatment this spring, and there were another 370 waiting for a higher level of care, according to a recent University of Illinois at Chicago survey commissioned by the Illinois Alcoholism and Drug Dependence Association, or IADDA.
Illinois residents without insurance or the means to pay for treatment are forced to wait an average of 32.4 days, according to the study.
About 250 people were waiting to get into Bloomington’s Chestnut Health Systems facilities at that time, said Alan Sender, Chestnut’s chief operating officer.
“When you have people on a waiting list for substance abuse treatment, nothing good happens to them,” said Sender, because most continue using, driving, committing crimes, neglecting or abusing children and running into the law.
Sara Moscato Howe, CEO of the IADDA, said the average delay in receiving treatment is “an extremely long waiting time, especially for an illness like addiction.”
“You want to get people right in the door when you can, and sometimes one day alone is not going to be enough,” she said. “They’re ready today. Tomorrow, they might say, ‘Well, yeah, I’m not interested anymore.’”
Lack of funding causes delay
Administrators of treatment centers in Bloomington, Springfield and Peoria say the delay is largely a money issue.
“The rates that the state provides for us do not cover the actual cost of treatment for indigents,” said Steve Knox, CEO of Triangle Center, a Springfield-based treatment facility.
The reimbursement rate given to providers for indigent clients has gone up just 3 percent in the last seven years, Sender said. “There are a lot of decision makers who would rather engage in new and flashy programs, not tending to the very sophisticated infrastructure in the substance abuse arena,” he said.
Knox wants lawmakers to update the state’s formula for reimbursing treatment centers. If nothing is done, “Will the result be a reduction in service and a longer wait list? The answer is yes,” he said.
Treatment costs vs. jail costs
State Rep. Dan Brady, R-Bloomington, agreed the state isn’t investing in treatment services with the same effort it invests in jailing people.
He cited a report by the National Center on Addiction and Substance Abuse that shows Illinois spends 12 percent of its budget, or nearly $3 billion, addressing the consequences of substance abuse, such as costs associated with the criminal justice system and child/family assistance.
He and other lawmakers have tried working with the Blagojevich administration to get more money for drug treatment centers.
The facilities, Brady said, are among the agencies held hostage during state budget negotiations, and there is no indication of any significant increase in the negotiations that have, so far, failed to produce a new state budget for fiscal 2008. Because of the impasse, it’s not known what they will get.
A spokesman for the Illinois Department Of Human Services, which administers state funding of treatment centers, didn’t respond to a request for information last week.
At Chestnut, Sender said adults admitted to the Bloomington facility in March waited an average of 29 days. There were 21 youths and 228 adults in the area waiting for assessments or treatment at Chestnut.
“There’s always been something of a waiting list, but it has become worse the last several years,” Sender said. “And I think it’s worsened by the fact there’s no new funding to deal with what is a burgeoning problem.”
More heroin, meth patients
Mike Boyle, president and CEO of the Peoria-based Fayette Companies, said his company’s treatment facility has been seeing more people for heroin and methamphetamine in the last five years, and fewer people with addictions to alcohol.
Knox said his facility is underwriting the cost above what the state is paying — a practice that can’t continue indefinitely.
“Yes, we have a waiting list. It’s about two months long, and it’s very hard to get people in,” said Knox, adding the wait has, at times, been as long as three months.
“When people summon the courage to come and help themselves, that courage can go away very quickly,” Knox said. “And it’s very troublesome to us.”
To Sender, abuse and addiction aren’t being treated as seriously as other medical problems. He likened it to a doctor saying, “You may have cancer and I know you want tests, but we’ll see you in 45 days.”
That’s Shelley Finfrock’s point, too. Hearon was her nephew. It was unfair, she said, that he was turned away for treatment when drunk drivers injured in crashes are served immediately and punished later.
“They don’t look at you and say, ‘I’m sorry, you have to wait because you don’t have insurance,’ ” Finfrock said.
In the end, Sender said, it’s “penny wise and pound foolish” not to make treatment available. The average treatment regiment costs $3,500, far less than incarceration or the societal costs of no help, he said.
Knox said costs not covered by the state are paid by people who have private insurance, people who can pay for their own treatment and the facility’s contracts with the federal government for programs such as post-incarceration care. There could still be a wait list even if the state covered the actual cost of treatment, Knox said, but the facility also could treat more people.
Even more may be waiting
Moscato Howe noted the study commissioned by her organization doesn’t count everyone who wants help — only those who didn’t hang up the phone when told they would have to wait. And Boyle said about half the people who call for treatment never make it to an initial assessment.
Michael Dennis, senior research psychologist for Chestnut, cited a study published in 1994, when he and three others studied the effect of increased funding and capacity on methadone treatment at a Pittsburgh facility. The number of applications for treatment skyrocketed when workers tried to reduce the wait time for treatment. Within three months of a grant program, the waiting list was longer than it was the year before.
People weren’t applying for treatment before because they knew they’d have a difficult time getting in or paying for it, Dennis said.
“When they increased the capacity and decreased the time to get in, the demand went up,” he said.
Moscato Howe argued more money spent on addiction treatment would pay for itself in reduced societal costs connected with health care, child welfare and crime and the criminal justice system.
“We spend so much money each year in corrections to just house people as a result of what is truly their addiction going untreated,” she said. “And when you treat somebody, the recidivism rate goes down.”
Her organization has requested about $41 million more for treatment providers in the coming year. That includes a 6 percent cost-of-business increase and additional money for prevention and treatment.
Tammy Hearon said it was never obvious to others that her son, who liked NASCAR, bowling and being outdoors, “had a problem with drugs.” But he sought help, and she hopes something changes because other young people avoid treatment because they have no way of paying for it.
“It is very difficult for these kids to get treatment in a timely fashion,” Hearon said. “Without our help, these youth could easily end up dealing with the penal system or death.
“If they end up in jail, we will be paying for them in some way or another.”
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The waiting game
An estimate of people waiting for treatment from the Illinois Department of Human Services’ Alcohol and Substance Abuse department’s services:
4,429: Illinoisans waiting for a full treatment assessment
1,670: Illinoisans assessed and waiting to start treatment
372: Illinoisans waiting to get the level of care their assessment suggested
6,467: Total people waiting for treatment last spring, including about 250 at Bloomington’s Chestnut Health Systems
SOURCE: “Waiting for Treatment: A Survey of DASA Funded Treatment Facilities,” April 2007, University of Illinois at Chicago
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As months go by
Average waiting times for treatment in facilities supported by the state’s Department of Alcohol and Substance Abuse, according to an April 2007 study from the University of Illinois at Chicago:
17 days: Waiting time between initial contact and treatment assessment
15 days: Wait between assessment and first treatment appointment
32 days total: Wait in state-supported facilities from first contact to treatment
SOURCE: “Waiting for Treatment: A Survey of DASA Funded Treatment Facilities,” April 2007, University of Illinois at Chicago
Copyright © 2007, Pantagraph Publishing Co. and Lee Enterprises. All rights reserved.