Butler County’s $3.6 million Opiate Business Plan will be getting another infusion of cash, lessening the amount of taxpayer levy funds that will be needed to fight the opiate epidemic.
Butler County Prosecutor Mike Gmoser recently determined that mental health levy dollars can be used to support addiction services, reversing a previous opinion that would’ve negated the use of those funds for opioid-related efforts.
He said addictions are a form of mental illness and therefore qualify for some of those levy funds, which total about $10 million.
“If we haven’t learned anything from the opioid crisis over the past several years, we have at least learned that it is one hell of a mental problem for the people that are suffering with that addiction,” Gmoser said. “Consequently in a review of the law and the language of the law I felt that it was appropriate to interpret it the way I have.”
In the throes of the crisis, the Butler County Mental Health and Addiction Recovery Services Board devised a plan to combat the problem. The price tag in April 2016 was estimated at $3.6 million annually, but the only funding source has been $660,000 in federal 21st Century Cure funds.
MHARS Executive Director Scott Rasmus said that since that time — with a massive overhaul of the behavioral health system in the works — the organization is now projecting Medicaid dollars will cover about $525,600 for detox services, $350,000 for post-treatment recovery services and $60,000 for medication assisted treatment.
With the infusion of levy funding, the MHARS board is gradually ramping up the plan, spending about $500,000 between now and July, an additional $1.25 million for fiscal year 2018-2019 and $2 million the year after.
Julie Payton, senior director of alcohol and drug addiction services, said the board will be expanding detox services from about 30 to roughly 50 to 60 people who need detoxification, with new contracts with Lumiere Healing Center and Beckett Springs in West Chester Twp.
Recovery housing is another major piece to the complete healing process. Currently in the county, there are 28 units, operated by the board’s provider Sojourner Recovery Services, and at least one private facility for men. Sojourner CEO Scott Gehring said the group is in the process of purchasing an apartment building that can house 14 to 16 people.
Gehring said in a perfect world his agency could probably use about 100 units, just for the people they treat, but there are also many recovering addicts who find each other during treatment and decide to co-habitat to keep each other clean.
“Recovery housing is a really great asset because most of the folks that are coming to us are coming without a safe, sober living environment,” Gehring said. “When you take somebody out of that living environment and put them in treatment and they get sober and they’re doing really well, to then turn them back into that unhealthy, unsafe environment really just lessens their chances of long-term success.”
Special attention, about $200,000, is being given to a new treatment pod at the county jail that can serve 36 women at a time. Rasmus said the treatment they already provide to men at the jail has a success rate, 74 percent of 466 inmates served last year not being arrested again.
There are many more initiatives in the business plan that will be stepped up with the newfound money. Even innovative things like a possible pilot program testing the effectiveness of a new devise call the Bridge, a small electrical nerve stimulator placed behind the patient’s ear, that reduces opiate withdrawal symptoms.
The levy money will help move the opiate plan forward, but Rasmus and Payton warned there are forces outside the county’s control that could have a negative impact. The 21st Century Cure money runs out in April, and unless the federal government extends that avenue, the MHARS board will need to plug that $660,000 hole.
Eric R. Wandersleben, director of media relations for the Ohio Department of Mental Health & Addiction Services, the agency that disbursed the $26 million across the state, said future funding is uncertain.
“We are in the process of submitting an application for continuation funding now and continue to hold discussions around the potential amount and use of said funds,” Wandersleben told the Journal-News. “I hesitate to speculate.”
The future of Medicaid expansion is also in limbo now both at the federal and state levels. The expansion, championed by Gov. John Kasich, opened up Medicaid coverage to a larger population in 2014. Payton said the potential disappearance of Medicaid expansion would be devastating.
“If Medicaid expansion goes away, we’re going to be hurting,” she said. “It is a very significant risk for the addicted population and for services for addicted individuals if Medicaid expansion is modified, reduced or eliminated.”
Rasmus said the elimination is a very real possibility, they just don’t know for sure if and or when it might happen. He said it couldn’t come at a worse time.
“Obviously with an opiate epidemic in this state and obviously Medicaid expansion supporting the treatment and prevention aspects to reduce the impact of that epidemic, hopefully it will be challenging for legislators to support repealing that,” Rasmus said.
Butler County Overdose Deaths
Year /# of deaths
* There are still some outstanding cases pending tox results.
Source: Butler County Coroner’s Office