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.

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Sheriff Tom Dart, Bill O’Donnell Receive TASC Leadership Awards; Access to Healthcare and Recovery Highlighted at Annual Event

(Chicago) – TASC held its 2015 Leadership Awards Luncheon on December 10, honoring Cook County Sheriff Tom Dart and entrepreneur Bill O’Donnell for their advocacy on behalf of people with mental health and substance use disorders.

“Sheriff Dart has called national attention to the injustice of using county jails to house people with mental health conditions,” said TASC President Pam Rodriguez in presenting TASC’s Justice Leadership Award. “He has supported Medicaid enrollment and other activities to ensure continuity of care for people detained at the Cook County Jail.”

To the applause of more than 300 guests at the Westin Michigan Avenue in Chicago, Dart reported that 12,000 people have successfully signed up for insurance at the jail via the Affordable Care Act (ACA). “People who never had insurance now have insurance,” he said. “It is absolutely amazing what this collective work has done.”

Since 2013, the Cook County Sheriff’s Office, working with TASC and the Cook County Health and Hospitals System, has enabled individuals detained at the jail to apply for health insurance. Prior to the expansion of Medicaid under the ACA, the vast majority of people entering U.S. jails lacked insurance, hindering their access to treatment for chronic substance use and mental health conditions that often contribute to rearrest.

The prevalence of these conditions in the justice system is not new, Dart observed. “These are issues that have been around for a while. And it’s with partnerships, working with TASC, that we’ve been able to make incredible change.”

TASC Public Voice Award Recipient Bill O’Donnell noted that he might well have gone to jail for his behavior while he was in the throes of addiction. Coming from a family driven to “achieve, achieve, achieve,” O’Donnell was a successful businessman who became addicted to alcohol and cocaine in the 1970s.

“It wasn’t until I got into treatment the second or third time… that I ever asked myself the question, ‘Why is it that I even need the marijuana, the booze, the coke, to change the way I felt?’” O’Donnell recalled. “Recovery and life and awareness is an inside job. You get can get help, you can get direction, you can get love, you can get guidance—but it’s an inside job.”

O’Donnell went on to found Sierra Tucson in 1983, an internationally-recognized treatment center that was among the first to involve family members in the recovery process.

TASC Executive Vice President Peter Palanca praised O’Donnell for his openness and high-profile voice for recovery. “Twenty-three million are in long-term recovery in this country and it’s still the most stigmatized illness,” said Palanca. “Bill was one of the first corporate leaders to speak openly about his addiction. He is a powerful voice for recovery.”

The value of helping one another was highlighted in two videos accompanying speakers’ remarks. Dart introduced a video depicting personal stories of people who now have health insurance thanks to enrollment efforts at the jail, and Rodriguez presented a video featuring participants in Winners’ Circles, which are peer-led recovery support groups for people who have been involved in the justice system.

TASC has been engaged in initiatives at the intersection of health and social justice since 1976, explained TASC Board Chair Cecil Curtwright. “I believe that our highest human calling is to help others—directly, if possible, and if not possible, to support those who do, with whatever means and talents available to us,” said Curtwright, who is the associate vice provost for academic and enrollment services at the University of Illinois at Chicago.

Among other dignitaries attending TASC’s event were previous honorees, including Gino DiVito, retired appellate court justice; Melody Heaps, TASC founder and president emeritus; and Toni Preckwinkle, president of the Cook County Board of Commissioners.

Chairing TASC’s 2015 event committee was John Zielinski, vice president and financial advisor at William Blair, who, along with other volunteers and generous donors, guided TASC’s most successful fundraising campaign to date. Zielinski extended special thanks to Blue Cross and Blue Shield of Illinois, the presenting sponsor of the event, along with numerous other generous sponsors and raffle prize donors.

“TASC is successful because we work together,” said Rodriguez. “Thanks to science and treatment parity, thanks to the Affordable Care Act and the efforts of TASC and our community partners, and especially thanks to all of you, more and more men and women are finding the treatment, the support, and the hope and tenacity needed to build and strengthen those delicate roots into lifetimes of recovery.”

TASC 2015 Leadership Awards Luncheon. Left to right: TASC Board Chair Cecil Curtwright, Justice Leadership Award Honoree Tom Dart, Public Voice Leadership Award Honoree Bill O'Donnell, TASC President Pam Rodriguez. Photo by Uk Studio.

TASC 2015 Leadership Awards Luncheon in Chicago. Left to right: TASC Board Chair Cecil Curtwright, Justice Leadership Honoree Tom Dart, Public Voice Leadership Honoree Bill O’Donnell, TASC President Pam Rodriguez.

Supporters filled the Westin Michigan Avenue ballroom for TASC's 2015 Leadership Awards Luncheon. Photo by Uk Studio.

Supporters filled the Westin Michigan Avenue ballroom for TASC’s 2015 Leadership Awards Luncheon. Photos by Uk Studio.

Anthony Harden, TASC Youth Services Administrator, Receives IADDA Award for Distinguished Service

Anthony Harden, recipient of IADDA’s 2014 C. Vincent Bakeman Memorial Award, is congratulated by his wife, Gloria, and TASC team members. Left to right: Alisa Montgomery-Webb, Gloria Harden, Anthony Harden, Maxie Knighten, Alicia Kusiak, and Janelle Prueter.

Anthony Harden, recipient of IADDA’s 2014 Dr. C. Vincent Bakeman Memorial Award, with (left to right): Alisa Montgomery-Webb, TASC Youth Reentry Services Administrator; Gloria Harden; Maxie Knighten, TASC Juvenile Justice Services Team Leader; Alicia Kusiak, TASC Director of Cook County Services; and Janelle Prueter, TASC Vice President of Operations.

(Chicago) – Recognized for his tireless advocacy on behalf of youth and families in need of health services, TASC Youth Services Administrator Anthony Harden was honored September 4 by the Illinois Alcoholism and Drug Dependence Association (IADDA).

Harden received the 2014 Dr. C. Vincent Bakeman Memorial Award at the association’s annual conference in Lisle. IADDA presents the award each year in memory of Dr. Bakeman, a pioneer in the field of addiction prevention and treatment who envisioned a society where all people have equal access to these essential health services.

“Just to be nominated for the Dr. C. Vincent Bakeman Memorial Award is an honor,” said Harden, “but to be selected is humbling and overwhelming.”

Paying tribute to the award’s namesake, he said, “Dr. Bakeman’s vision and legacy are consistent with our mission at TASC, as well as with our partners here at IADDA – to educate the public that substance abuse is a health issue.”

Harden offered that Dr. Bakeman’s commitment to equal access to substance use treatment is closer to being realized, thanks to the Affordable Care Act. For example, TASC provides application assistance for individuals detained at the Cook County Jail, which “not only for the first time gives many access to health insurance for their general well-being, but also access to treatment for substance abuse and mental health issues,” said Harden. “This is how we honor the leadership and legacy of Dr. Bakeman – by advocating, not just treatment for those who could afford it, but also treatment for everyone in need.”

He added that he would be remiss not to mention Dr. Bakeman’s insistence in advocating for all cultures, in particular for people of color.

“Years ago I heard Vince speak in Springfield at the Black Caucus convention,” recalled Harden. “He stated that one of the best models to address substance abuse is the 12-step program – but that it was designed for white, middle class, employed men. He advocated for communities of color to develop their own culturally-specific approaches and provide treatment and services to their own within their own communities. In other words, we need to make 12 steps inclusive; we need to make them fit who we’re serving – the unemployed, females, the homeless, the uninsured and the disfranchised. I think Dr. Bakeman would be proud of how far we have come today. But the work is not finished and I have no doubt my colleagues will not rest until it is so.”

TASC President Pamela Rodriguez presented the award to Harden, honoring his dedicated service and compassion for clients and staff.

“We are so proud to recognize your work, Anthony,” said Rodriguez. “Your heart goes into everything you do, and we see that in your quiet leadership and steady purpose in giving kids in the justice system a fair chance to succeed.”

“As Anthony’s colleague and friend, it is a pleasure to recognize his many achievements,” added TASC Executive Vice President Peter Palanca, who served as IADDA board chair from 2010 to 2012. “Anthony cares profoundly about creating opportunities for youth so they can grow up safely and participate in society in healthy and meaningful ways.”

Harden extended appreciation to his colleagues, many of whom were in attendance to celebrate his accomplishments, and his wife, Gloria, for her unwavering support. Thanking IADDA board members and CEO, Sara Howe, as well as TASC’s executive team for their advocacy on behalf of clients, families, and staff, Harden offered special appreciation for his juvenile services team, led by Maxie Knighten. “They are the true frontline soldiers and without them none of this is possible.”

With more than 20 years of dedicated service at TASC, Harden leads the agency’s services for the Juvenile Drug Court in Cook County, as well as TASC’s programs in partnership with the Cook County State’s Attorney’s Office. He serves on several committees and boards, including the Juvenile Detention Alternatives Executive Committee, the Austin Community Coalition for Healthy Lifestyles, and the UIC PHAT (Preventing HIV/AIDS Among Teens) Community Advisory Board.

Established in 1967, IADDA is a statewide advocacy organization that represents more than 50 organizations across Illinois that provide substance use disorder prevention, treatment, and recovery services. TASC is a member agency of IADDA.

 

Researchers to Study Impact of Affordable Care Act on Public Safety; Cook County Key Research Site

(New York)Laura and John Arnold Foundation (LAJF) has announced a grant to a team of researchers at Johns Hopkins Bloomberg School of Public Health and Harvard Medical School to study the Affordable Care Act’s (ACA) impact on public safety.

The project will examine innovative programs focused on providing formerly incarcerated individuals with access to medical, behavioral health, and social services under the Affordable Care Act (ACA).

“Our aim is to identify possible links that may help to explain whether improved access to health care can contribute to a reduction in crime,” said Haiden Huskamp, a professor in the Department of Health Care Policy at Harvard Medical School. Dr. Huskamp is leading the study along with Colleen Barry, an associate professor and associate chair for Research and Practice at Johns Hopkins Bloomberg School of Public Health.

An inventory will be produced as part of the overall Hopkins/Harvard study and will be available at the end of the calendar year. The research will include an in-depth study of a unique partnership in Illinois between the Cook County Health and Hospitals System, the Cook County Sheriff’s Office, and TASC (Treatment Alternatives for Safe Communities), with the location being inside the Cook County Jail where thousands of individuals who are exiting the jail have been signed up for Medicaid coverage.

People involved in the criminal justice system often have extensive health care needs. More than two thirds of jail detainees meet clinical criteria for substance dependence or abuse, and 14.5 percent of men and 31 percent of women entering jail have a serious mental illness. Yet, studies find that the overwhelming majority of people leaving jail – 80-90 percent – do not have health insurance. New health care options under the ACA will allow many of these individuals to receive coverage.

“The goal of this project is to learn everything we can about how the ACA is being used nationally to make our communities safer and to improve public health,” said LJAF Vice President of Criminal Justice Anne Milgram.

Dr. Barry emphasized the importance of conducting in-depth studies of earlier innovator programs that are currently enrolling individuals exiting jails and prisons in Medicaid under the ACA, and developing ways to connect them to mental health, addiction, and other medical and social services in their communities.

“Early programs like the Cook County partnership have the potential to improve population health and may lower crime, so it is essential to learn lessons from their experiences and to share insights with jurisdictions in other areas of the country considering initiating similar efforts,” said Dr. Barry.

Research findings will be published in a peer-reviewed journal within the next year.

342,000 Low-Income Illinois Citizens to Have Access to Medical Care, Treatment for Substance Use and Mental Health Conditions, Beginning January 1

(Chicago) – In 90 days, 342,000 low-income Illinois citizens will have access to health care, including many of those involved in the Illinois criminal justice system who require treatment for mental health, substance use, and medical conditions.

On July 22, Governor Pat Quinn signed legislation, Senate Bill 26, that authorized Illinois’ participation in the new national health reform law called the Affordable Care Act.

As one of the outcomes of this legislation, starting on January 1, 2014, adults aged 19 through 64 with incomes below 138 percent of the Federal Poverty Level (about $15,400 per year for an individual and $20,000 per year for a couple) will gain access to Illinois Medicaid coverage.

What this means is that uninsured, low-income adults—describing the majority of individuals in Illinois jails and prisons—will have greater access to treatment for substance use and mental health conditions that often contribute to their criminal behavior. Eighty-six percent of male arrestees in Cook County, for example, test positive for illicit drugs. Nationally, about a quarter of people in jail convicted of property and drug offenses had committed their crimes to get money for drugs.

In addition to improving treatment access for low-income populations, the new law also answers a resounding public call: A Cook County referendum on state funding for substance abuse treatment passed overwhelmingly in 2004, with more than one million voters saying the state should pay for drug and alcohol treatment for any Illinois resident who demands it.

A long time coming, the new health care law begins to answer this public demand by providing the means to fund treatment programs.

Under the legislation, the federal government will pay 100 percent of the costs of the new Illinois Medicaid enrollees from 2014 through 2016. Starting in 2017, the match rate gradually will be reduced: 95 percent in 2017; 94 percent in 2018; 93 percent in 2019; and 90 percent in 2020.

The share paid by the federal government for care in Illinois will never dip below a 90 percent.

Even if the federal government were to change the law’s financing terms, Illinois’ share would never be more than 10 cents on each dollar spent on new Medicaid recipients. The legislation signed by Quinn includes language that would discontinue coverage if the federal government’s share of Medicaid matching funds drops below 90 percent.

Illinois currently receives a 50 percent match from the federal government for health programs under terms of the existing Medicaid program.

For individuals involved in the Illinois criminal justice system, the Illinois Medicaid expansion is critical, because they will be able to access adequate medical care and, equally if not more importantly, behavioral health care such as substance use treatment and mental health care, many for the first time, according to TASC President Pamela Rodriguez.

“TASC strongly supported this legislation because rates of addiction and mental health disorders are disproportionately high in the criminal justice population. Access to care for these conditions can help break costly cycles of crime and recidivism,” said Rodriguez. “Additionally, the new health law will help save counties and the state of Illinois enormous sums of money on justice and uncompensated health care costs.”

Rodriguez pointed out that the national and Illinois record on Medicaid access has been solid, noting that “Illinois has received bonus payments totaling over $50 million over the past four years for meeting enrollment targets and having program simplifications in place for our Medicaid and Children’s Health Insurance Program.”

Additionally, Medicaid cost controls outperform both Medicare and private health insurance. Nationally, the per enrollee cost growth in Medicaid is 6.1 percent, which is lower than the per enrollee cost growth in comparable coverage under Medicare (6.9 percent), private health insurance (10.6 percent), and monthly premiums for employer-sponsored coverage (12.6 percent).

To help criminal justice organizations and agencies establish enrollment processes, the Substance Abuse and Mental Health Services Administration (SAMHSA) has launched an online toolkit entitled, “Getting Ready for the Health Insurance Marketplace.” This narrated presentation describes the health care law, explains how the Health Insurance Marketplace works, and provides communication ideas and materials from the Centers for Medicaid & Medicare Services (CMS) for use in increasing awareness and helping uninsured individuals apply for coverage.

Twitter @TASC_CHJ

TASC, Coalition for Whole Health Recommend Coverage of Mental Health and Substance Use Disorder Services in Essential Health Benefit Package

(Chicago, IL) — Substance use disorder and mental health services must receive equitable coverage in the implementation of health care reform, according to the Coalition for Whole Health, a group of national organizations that seek improved coverage for and access to prevention, treatment, rehabilitation, and recovery services. TASC is an active member of the Coalition.

Based the standards of the National Quality Forum and other extensively researched protocols and evidence-based practices, the Coalition recommends that under the Affordable Care Act (health care reform), the essential health benefits package must minimally include the benefits outlined below:

  • Mental health and substance use disorder assessment, placement, and treatment
  • Laboratory services, including drug testing
  • Emergency services, including crisis services and hospital-based detoxification services
  • Pharmacotherapy and medication-assisted treatment
  • Rehabilitative, habilitative, and recovery support services
  • Preventive and wellness services and chronic disease management
  • Maternal and newborn services, including screening and brief interventions for maternal depression and substance use disorders and referral to treatment
  • Pediatric services, including screening for substance use, suicide risk, and other mental health problems

As a significant step toward creating a healthy and just society, TASC supports these recommendations for improved coverage and access to care. To read the Coalition’s recommendations in full, please click here.

To find additional resources and webinars on the coverage of substance use disorder and mental health services under health care reform, please visit the Legal Action Center’s page on National Healthcare Reform.

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