CUTBACKS THREATEN DETOX PROGRAMS FOR ALCOHOLICS, ADDICTS

PITTSFIELD -- Cuts to state programs that pay for substance abuse treatment
will mean hundreds of Berkshire County residents will be unable to pay for
inpatient detox stays and psychological counseling, according to local
health officials.

Gov. Mitt Romney has announced sweeping cuts from a number of state programs
in his efforts to erase a $650 million budget shortfall. A host of Medicaid
plans that offer health coverage to the state's poor and disabled are being
scaled back or eliminated entirely, and medical providers fear the effect on
substance abuse programs will be devastating.

In Berkshire County, the Thomas McGee Unit of the Berkshire Recovery Center
provides the county's sole inpatient detoxification facility where drug
addicts and alcoholics can stay while going through painful and sometimes
dangerous withdrawal symptoms. From there, patients graduate to Level B
care, a six- to 10-day stay in McGee where they undergo addiction
counseling. Often, patients are discharged from there to a halfway house.

Under Romney's emergency cuts, the state will no longer pay for the
inpatient detox visits for a large number of patients, eliminating a program
that had covered people who do not have private insurance and weren't
eligible for MassHealth, the state's Medicaid program. At the McGee Unit,
approximately 310 patients, or 25 percent of its 1,240 admissions each year,
are paid for by this program.

As well, a decision made by former acting Gov. Jane Swift to eliminate
MassHealth Basic on April 1, which would erase the state's only health plan
for long-term unemployed adults who are not disabled, means some of the
state's neediest people, including many who are homeless, will no longer be
eligible for any substance abuse treatment. MassHealth Basic currently
covers 16 percent of all admissions to the McGee unit.

And Romney's cuts will eliminate all state coverage of Level B treatment,
the six to 10 days spent in the hospital after detoxification, meaning
almost 60 percent of McGee's patients will no longer have their Level B stay
paid for. Level B is also the only treatment that had been offered to crack
cocaine addicts, who otherwise don't qualify for detox because the symptoms
of crack withdrawal do not dictate that level of care.

Providers in Berkshire County believe these cuts are threatening the fragile
network of substance abuse treatment that connects counselors, clinics and
halfway houses. Without the state coverage, they fear addicts will have no
means to pay for their own treatment and nowhere to turn, with a consequent
rise in emergency room visits, crime and overdoses.

"We see people being put back on the streets without treatment," said Eugene
Dellea, president of Fairview Hospital in Great Barrington, as well as of
Berkshire Medical Center's Hillcrest campus, where the McGee unit is housed.
"These people won't have a shot. Is our treatment successful 100 percent of
the time? No, but at least there is an opportunity to work with these
people. Now we won't even have that."

Statistics from the Massachusetts Bureau of Substance Abuse Services show
that inpatient treatment after detox is successful, and that participants
have a 36 percent increased rate of employment; a 42 percent reduction in
the use of alcohol or other drugs, a 24 percent reduction in further arrests
and a 12 percent reduction in their use of hospital emergency rooms.

MassHealth programs have been a popular target of cuts made by Romney and
Swift: they have capped the Children's Medical Security Plan and eliminated
its emergency room coverage, shrunk Medicaid reimbursement rates to
hospitals and tightened the income guidelines for other MassHealth plans so
that fewer people will qualify for coverage.

Hospitals and doctors say the broad range of MassHealth cuts will force them
to rely upon the state's beleaguered free-care pool to pay for treatment.
That plan, a combination of funds from hospitals, private insurance
companies and the state, is projected to lose $165 million this year. While
insurance companies and the state contributions to the pool are capped, the
hospitals' contributions are not, so they could be asked to foot the entire
cost of unpaid-for care if the state doesn't take special action to restore
money.

Edward Perlac, vice president of the Hillcrest Hospital campus, said
inpatient admissions to McGee are up 15 percent this year. "When the economy
goes down, people turn toward alcohol and drugs. This is a real problem and
there are going to be hidden consequences. With all the other cuts -- the
homeless shelter is being cut, services for abused victims -- you just go
right down the line and see a domino effect."

Calls to Gov. Romney's office on Friday were returned by a spokeswoman for
the state's Executive Office of Health and Human Services who had little
information about how many people the cuts will affect and where they could
turn for care. Subsequent calls to Romney's office for more information were
not returned on Friday or yesterday.

The elimination of the emergency detox program and the inpatient, Level B
postdetox treatment will save a total of roughly $1.3 million, the Executive
Office of Health and Human Services spokeswoman said. She did not know how
much the MassHealth Basic cuts would save.

Dr. Alex Sabo, Berkshire Medical Center's director of psychiatry and
behavioral sciences, fears the state's actions will shift much of the burden
of these costs onto hospitals, half of which in Massachusetts lost money
last year and cannot afford to bear the extra burden.

"At what point by making that shift does the actual treatment organization
ultimately go bankrupt and become unable to provide the service?" Sabo said.

In addition to shifting costs into emergency rooms and intensive care wards,
Sabo said the burden will move to the criminal justice system, where
incarcerating drug addicts is more expensive than treating them.

"What is the net impact of behaving this way?" Sabo said. "It is a statement
about your society and the way you are thinking about your people. It
threatens those not-for-profits that are trying to provide the care and it
is ultimately raising the cost of government because these problems don't go
away."