OP-ED: Revamping of Health Law Could Be Costly to Illinois

As Congress prepares to replace the Affordable Care Act, it is essential that the Medicaid expansion provision of the law be protected.

Any rollback of federal Medicaid coverage would be particularly harmful to Illinois, especially as our state grapples with budget deficits, an opioid epidemic, and an overburdened criminal justice system.

Under the ACA, Illinois was among the majority of states that expanded Medicaid, which provides federally-funded health insurance for low-income people. In a January letter to congressional leaders, the Rauner administration expressed concern about potential changes to Medicaid, pointing out that 3.2 million Illinoisans—almost one-quarter of the state’s population—are enrolled in coverage. 

Reducing Medicaid coverage would deprive Illinois of millions of dollars per year in federal support. As an example, in behavioral health services alone, the state would have to replace an estimated $80 million per year in federal Medicaid resources to pay for community-based substance use and mental health services that would support alternatives to incarceration and reentry initiatives.

Second, such changes would fly in the face of efforts to address the opioid epidemic that is devastating Illinois communities. Nineteen Illinois sheriffs, prosecutors, and police chiefs recently signed a letter to Congress urging action against any policy changes that would make it even harder for low-income individuals to access addiction and/or mental health treatment. Lack of treatment access impairs law enforcement’s ability to prevent overdose deaths and to make our communities safer.  

Finally, rolling back Medicaid coverage would hamstring Illinois’ successful bipartisan progress toward reforming the criminal justice system. Coverage for addiction and mental health services is essential to the state’s strategy for preventing crime, reducing recidivism, and avoiding the $41,000 per person annual average cost of incarceration for those whose non-violent offenses stem from untreated health conditions.

It is well recognized that there are aspects of the Affordable Care Act that must be overhauled. However, as changes are made, and to expound on what the Governor’s administration and criminal justice experts have written, it would be foolhardy and counter-productive if those changes include an attack on Medicaid coverage. Illinois can ill afford such a loss.

Pamela F. Rodriguez, President & CEO of TASC

TASC President Pam Rodriguez


Pamela F .Rodriguez is president and CEO of Treatment Alternatives for Safe Communities (TASC, Inc.) and a member of Governor Rauner’s Illinois State Commission on Criminal Justice and Sentencing Reform.

TASC Releases Medicaid Policy Briefs, Offers Financing Strategies to Improve Community-Based Healthcare Access for Criminal Justice Populations

(Chicago) – Recent Medicaid policy reforms present new opportunities to improve community-based healthcare access for people under justice and corrections supervision. Access to care is critical to reducing recidivism, given high rates of substance use, mental illness, and chronic medical … Continue reading

Fundamentals of Alternatives to Incarceration

(Chicago) – In the United States, the majority of people who come into the criminal justice system have a substance use problem, which is a treatable health condition. As a response to non-violent offenses related to drug use and addiction, there are many alternatives to incarceration that are more effective and less expensive than keeping people behind bars.

“Program models are not enough,” said TASC President Pam Rodriguez. “What’s much harder to sustain—but what’s necessary if we want to achieve real impact—are whole systems where justice partners and health services in the community work together by design.

“Too often,” she added, “the justice system is the first place where people have a chance to get drug treatment and other health services. Adequate health services must be available in the community far before people reach the point of incarceration.”

For cash-strained governments, overburdened justice systems, and communities and families suffering the consequences of addiction, alternative sanctions for non-violent, drug-related offenses make sense.

First, incarceration is costly. In Illinois, it costs an average of $38,000 to keep someone in prison for a year. A single day in the Cook County Jail costs an average of $143, and even more in the segment of the jail that detains people with serious mental illness.

To borrow a term from the medical field, incarceration is iatrogenic, meaning that in and of itself it is harmful. Incarceration usually leaves people worse off—in terms of recidivism risk, job and family disruption, financial destabilization, and more—than when they went in. Even three days in jail has deleterious consequences.

Furthermore, without intervene early on, there are costs and consequences of a criminal conviction that last far beyond the period of incarceration or probation. The American Bar Association keeps a record of these consequences in each state.

Like other chronic health conditions, substance use disorders are treatable. It is estimated that 23 million people in the United States once had an alcohol or drug problem and no longer do.

Among individuals with a drug problem who were sent to TASC’s court and probation services, there was a 71 percent reduction in arrests for drug and property crimes over a two-year period after program enrollment.

“We know that addiction is treatable,” said Rodriguez. “We know that incarceration is expensive and iatrogenic. We also know that there are effective alternatives to incarceration. For these reasons and more, it makes sense to divert eligible individuals with substance use problems out of the justice system and into treatment and recovery support services in the community.”

There are numerous evidence-based practices and policies for preventing and stopping cycles of drug use and crime. The National Institute on Drug Abuse, the Institute of Behavioral Research at Texas Christian University, and TASC’s Center for Health and Justice are among many entities that publish and promote what works.

“What we know from extensive research and experience is that interventions must be matched to individuals’ risks for reoffending and their clinical needs,” said Rodriguez. “Mismatched interventions—such as the wrong level of care or supervision—not only waste resources, but actually can have the opposite of the intended effect.”

Sept. 14-16, 2016: TASC and partners welcomed guests from international agencies for a three-day site visit focused on diversion initiatives, jail interventions, and sentencing alternatives in Cook and Lake counties. Left to right: Antonio Lomba, Organization of American States; Chritharth Palli, India judiciary; Melody M Heaps, MMH & Associates; Pamela F. Rodriguez, TASC; Charlotte Sisson, U.S. State Dept.; Richard Baum, White House Office of National Drug Control Policy

Sept. 14-16, 2016: TASC and partners welcomed guests from international agencies for a three-day site visit focused on diversion initiatives, jail interventions, and sentencing alternatives in Cook and Lake counties. Left to right: Antonio Lomba, Organization of American States; Chritharth Palli, India judiciary; Melody M. Heaps, MMH & Associates; Pam Rodriguez, TASC; Charlotte Sisson, U.S. State Dept.; Richard Baum, White House Office of National Drug Control Policy.

TASC Joins Partners in West Side Heroin Task Force to Address Chicago’s Opiate Epidemic

(Chicago) – TASC Vice President of Community and Government Affairs George Williams joined other members of the new West Side Heroin Task Force assembled on International Overdose Awareness Day to announce findings of a study on the impact of heroin in Chicago’s west side neighborhoods.

The Roosevelt University study, “Hidden in Plain Sight: Heroin’s Impact on Chicago’s West Side,” found that while media coverage of the current epidemic has focused on “the new face of heroin”—white, suburban or rural users—the west side for many years has been ground zero of the crisis and its consequences.

“To continue to ignore the west side of Chicago is like a firefighter putting out a fire in part of the house and leaving the house burning,” said State Rep. La Shawn Ford (D-8) at the August 31 press conference. The task force, led by Ford and comprised of dozens of partners and organizations, including TASC, will support and intensify existing efforts in the fight against heroin.

Long considered to be a place where people with heroin addictions travel from the suburbs and other parts of Chicago to get their drugs and leave, “the city’s west side actually is a hotbed for heroin hospitalizations, arrests and deaths,” Roosevelt University’s news announced.

State Rep. Camille Y. Lilly, (D-78), vice president of external affairs at Loretto Hospital, highlighted broader community issues related to the heroin crisis. “The overdosing is the outcome of other factors and issues that are going on in our society. People are using drugs to deal with life, lack of jobs, lack of money, lack of housing, lack of healthcare,” she said. “Policy is what’s going to make the difference, and how we fund the policies that are enhancing the lives of individuals.”

Task force member Kathie Kane-Willis, director of the Illinois Consortium on Drug Policy at Roosevelt University, authored the study, which found that opioid-related hospital admissions of Chicagoans on the west side constitute almost one in four such hospitalizations across Illinois. Additionally, heroin possession arrest rates in these neighborhoods continue to exceed those in other parts of the city, even increasing during times of overall citywide decline.

Further, the study indicated that the Chicago metro area experienced the second greatest decline in publicly funded drug treatment admissions among all state metro areas, falling by 61 percent over the past 5 years.

The study found that recent heroin overdose rates were higher in Chicago than in suburban Cook, Will, Lake, McHenry, DuPage, and Kane counties, and the overdose mortality rate across the state was significantly higher for African Americans (8.94 per 100,000 population) than for whites (5.86).

The report includes recommendations to increase community-based treatment, reclassify drug possession related to small amounts as a misdemeanor offense, and provide medication-assisted treatment to individuals incarcerated in Cook County jail, among others.

Joining fellow task force members to release the report, Williams noted that the world is moving to a platform of public health, and not a criminal justice response to heroin addiction.

“Everyone deserves the right to their life and to live,” said Williams. “That’s why we need the necessary services that our state reps, particularly Representative Lilly and Representative Ford have fought for… to continue to make sure that the west side does not continue to be the epicenter, but the west side becomes the model of how the community has gathered together and interrupted men and women and families and communities losing their lives when it’s not necessary.”

Ford advocated that resources, services, and cutting-edge programs be directed to residents, and also encouraged funding for House Bill 1, a comprehensive measure to fight heroin.

In addition to Ford, Willis, and Williams, speakers at the press conference included Dr. Sonia Mehta, CEO of Loretto Hospital; Jacqui Colyer, regional administrator of the Illinois Department of Children and Family Services; Dr. Dan Lustig, vice president of clinical services at Haymarket Center; Jamelia Hand, overdose prevention advocate; Marianne Schiavone, chairperson of West Suburban Hospital; Doris Davenport, president of the Center of Community Connections; and Chelsea Laliberte, executive director of Live4Lali.

George A. H. Williams, TASC vice president of community and government affairs.

George A. H. Williams, TASC vice president of community and government affairs, speaking at the August 31, 2016 press conference.

Addiction Policy Forum and National Criminal Justice Association Partner to Translate Opioid Research to Practice

[On Monday, August 8 from 1:45-3:15 PM EDT (12:45-2:15 PM Central), the National Forum on Criminal Justice will livestream a panel discussion on Strategies for Combating the Opioid Epidemic. TASC President Pam Rodriguez is among the speakers. Register for livestream.]

The Addiction Policy Forum and the National Criminal Justice Association have announced a new partnership, the Translating Science into Practice Project, which will focus on translating the current research on opioid addiction and treatment into policy and practice in the field.

TASC is an active partner with the Addiction Policy Forum, which is comprised of organizations, policymakers, and stakeholders committed to comprehensive approaches to addiction prevention, treatment, recovery, and criminal justice reform.

The first step in the Translating Science into Practice Project is a livestream session on alternatives to incarceration during the National Forum on Criminal Justice in Philadelphia on August 8.  TASC President Pam Rodriguez, a leading voice in advancing front-end criminal justice diversion strategies, is among the expert panelists in this session. TASC has been involved in both studying diversion and in implementing innovative programming nationally as well as in its home state of Illinois.

The forum will be followed by a five-webinar series in the fall of 2016 that will provide policymakers and practitioners with details about policies that are working to reduce and treat addiction, including to prescription drugs, heroin and other opioids.

The Addiction Policy Forum has identified 11 practices across six key elements of addressing addiction: prevention, treatment, overdose reversal, recovery, law enforcement, and criminal justice reform. The state criminal justice administering agencies represented by the National Criminal Justice Association conduct comprehensive statewide planning and fund innovative, data-driven criminal justice policies and practices. They are engaged in finding and funding solutions to the opioid epidemic.

In collaboration with the Addiction Policy Forum, the Center for Health and Justice at TASC served as a partner in planning and facilitating briefings on addiction treatment and recovery, which contributed to the Comprehensive Addiction and Recovery Act, introduced originally in 2014 by U.S. Senators Sheldon Whitehouse (D-RI) and Rob Portman (R-OH), and signed into law on July 22 by President Barack Obama.

 (Source: Addiction Policy Forum)

U.S. Senate Passes Comprehensive Addiction and Recovery Act (CARA), Bipartisan Bill Moves to House of Representatives

On March 10, the U.S. Senate overwhelmingly approved the Comprehensive Addiction and Recovery Act (CARA). The legislation embodies a comprehensive response to addiction and the opioid crisis, earning the support of over 130 organizations—including TASC—in the fields of prevention, treatment, recovery, law enforcement, and state and local governments.

CARA garnered strong, bipartisan support in the Senate, passing on a vote of 94-1. Among the bill’s strong leaders and supporters were Senators Sheldon Whitehouse (D-RI), Rob Portman (R-OH), Amy Klobuchar (D-MN), and Kelly Ayotte (R-NH), as well as both Illinois Senators, Dick Durbin (D-IL) and Mark Kirk (R-IL).

More people died in 2014 from drug overdoses than in any previous year on record, according to the Centers for Disease Control and Prevention. The vast majority of people who need addiction treatment do not receive it. The Substance Abuse and Mental Health Services Administration estimates that only 2.6 million of the 22.5 million people across the country who needed help with a substance use disorder got it in 2014. The treatment gap also exists for people in prisons and jails, where an estimated 85 percent have been found to be substance-involved, but only 11 percent received any kind of treatment.

CARA’s key provisions include:

  • Expanding the availability of naloxone—an overdose antidote—to law enforcement and first responders to help save lives.
  • Expanding resources to identify and treat incarcerated individuals with addiction disorders promptly by collaborating with criminal justice stakeholders and by providing evidence­based treatment.
  • Launching an evidence-­based opioid and heroin treatment and intervention program to expand best practices throughout the country.
  • Launching a medication-assisted treatment and intervention demonstration program.

Appropriations to implement the bill were not included in the legislation.

For more information about CARA, visit here, and to ask your U.S. Representative to support the bill, click here.

 

Preeminent Addiction Neuroscientist Named Advisor to TASC Center for Health and Justice

(Chicago)Timothy P. Condon, PhD, a distinguished expert in the neuroscience of addiction, has been named chief science advisor to the Center for Health and Justice (CHJ) at TASC.

With extensive experience in leadership roles for the National Institute on Drug Abuse (NIDA) and the White House Office of National Drug Control Policy (ONDCP), Condon specializes in the fundamental impact of drugs on human behavior and implications for clinical and criminal justice practice.

CHJ is a nonprofit public policy and consulting group that promotes criminal justice and health reform nationally through practical, evidence-based responses to mental health and substance use conditions. The Center grew out of the direct service experience of TASC (Treatment Alternatives for Safe Communities), a statewide organization that since 1976 has provided placement into addiction treatment, case management, and recovery support for hundreds of thousands of Illinoisans, primarily through alternatives to incarceration and reentry programs.

“Dr. Condon’s exceptional experience and knowledge will inform the delivery of our national training and consulting services as well as our internal program evaluation processes,” said TASC President Pamela Rodriguez. “We are honored to announce this partnership, especially at a time when justice and health reform efforts across the country are incorporating new understandings of brain science and research-based practices.”

Among his many accomplishments, Condon guided NIDA in building its research, training infrastructure, bringing science-based findings to community treatment programs, and establishing a national communications network for information sharing and research collaboration. He was instrumental in establishing the national NIDA Clinical Trials Network to conduct research in real-life treatment settings with diverse populations. In addition, he established the NIDA/Substance Abuse and Mental Health Services (SAMHSA) Blending Initiative to reduce the substantial lag time between research discoveries and the implementation of these finding into clinical practice.

At ONDCP, his expertise informed the development of the National Drug Control Strategy and the nation’s demand reduction activities, including the integration of primary and behavioral health delivery, the treatment of substance use disorders among criminal justice populations, evidence-based approaches to prescription drug abuse, and the implications of health care reform for policy, practice, and workforce development. Condon was one of the authors of the national Prescription Drug Abuse Prevention Plan released in 2011.

“I have been working with TASC and CHJ for a number of years as deputy director of NIDA and am honored to provide whatever expertise I can to TASC as it creates new opportunities to improve social justice for those in the criminal justice system and to ensure that those suffering from addiction and other behavioral health disorders get the treatment that they need,” Condon said.

“At TASC and our Center for Health and Justice, it is with both pride and humility that we have the opportunity to work with innovative thinkers and influential change agents across the country,” Rodriguez added. “Together we are committed to meaningful strategies, practices, and policies to improve health and justice. It is in this environment that we happily welcome Dr. Condon to our expansive team of dedicated partners and colleagues.”

Timothy P. Condon, PhD, Chief Science Advisor to the Center for Health and Justice at TASC

Timothy P. Condon, PhD, Chief Science Advisor to the Center for Health and Justice at TASC

Twitter: @TASC_CHJ