Looking to the Future – Areas That Need Improvement

Provide coverage for those coming out of prison. If you or someone you love is exiting the corrections system and is in need of on-going substance abuse treatment, know that efforts are being made to bridge the gap in coverage for this population. CMS’s Technical Assistance Brief “Coverage and Delivery of Adult Substance Abuse Services in Medicaid Managed Care” explains which states are making strides in helping these oft-neglected individuals and points out that there is still room for progress.

Increase knowledge of early identification programs. It is important for parents to know about the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Benefit. As part of EPSDT, children who receive health care coverage via a government-sponsored plan are eligible for age-appropriate mental health and substance use health screenings.
Repeal bed-limit law. The ACA mandated that insurance plans cover mental health and substance abuse treatment. However, a recent New York Times article explains that a 50-year-old law still on the books restricts the kinds of places where beneficiaries can get treatment. It limits coverage to only community-based facilities with 16 or fewer beds.

Increase the number of providers. An article from The Pew Charitable Trusts addresses a key barrier to receiving adequate substance abuse treatment–a lack of providers. As the article notes, because these services weren’t covered by insurance plans, behavioral health providers were paid less than other medical professionals. As result, many have ended up in “more lucrative specialties.” However, the passing of the ACA means it’s time for the industry to take steps to meet the new demand.

Improve prevention efforts. The Office of Disease Prevention and Health Promotion’s Healthy People 2020 provides “science-based, national objectives for improving the health of all Americans.” One topic it addresses is how to reduce substance abuse. It provides statistics-supported information:



●Interventions & Resources

●National Snapshots

Continue to expand distribution of TIPs. SAMHSA produces Treatment Improvement Protocols (TIPs), which provide guidelines for improving substance abuse treatment. The National Center for Biotechnology Information explains that TIPs are distributed to a growing number of facilities and individuals across the country. Examples include:

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