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Md. official says state prepared to help addicts

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ANNAPOLIS, Md. (AP) — More than 41,000 drug and alcohol addicts in Maryland are estimated to be eligible for health insurance next year under the federal health overhaul, according to the federal Substance Abuse and Mental Health Services Administration, and Maryland's health secretary said the state is well-positioned to handle added numbers who seek treatment due to big state investments in recent years.

Maryland invested more than $100 million a year of state money to support drug treatment, on top of Medicaid money that many other states rely solely on to help pay for drug treatment, Dr. Joshua Sharfstein said in a recent interview with The Associated Press.

"There are tens of thousands of people in treatment, and a lot of them are supported through Medicaid. And then, on top of the Medicaid, there is state-supported treatment, which doesn't even exist in many other states," Sharfstein said.

The number of additional drug addicts who will be eligible for health insurance will increase by about 20,000 after Maryland expands Medicaid as planned under federal health care reform.

"Pressure on our substance abuse treatment system to serve more people is a problem I would like to have," said Sharfstein, who was the U.S. Food and Drug Administration's No. 2 official before becoming Maryland's health secretary in 2011. "We want people to get substance abuse treatment. It allows them to gain independence and transform their lives, and it leads to less criminal behavior, more employment and better outcomes for individuals and their families."

Maryland currently has an estimated 423,000 people who need treatment for substance abuse, about 9 percent of the population, the federal Substance Abuse and Mental Health Services Administration said. An estimated 58,000 of them are receiving treatment. Maryland also has 3,012 beds at treatment facilities, with about an 89 percent occupancy rate, the administration estimates.

Maryland has seen a big increase in spending on outpatient substance abuse treatment in recent years. For example, Medicaid spending for outpatient treatment increased by 165 percent from fiscal year 2009 to fiscal year 2011 in total funds, according to a report the state health department sent last year to lawmakers.

In January 2010, the health department expanded drug treatment goals through three initiatives, including an increase in service reimbursement rates to Medicaid providers. The department also expanded a benefit package of the Primary Adult Care program to include outpatient substance abuse treatment. It also improved the ability of enrollees to self-refer for services. The department paid for the expansion by annually transferring state-only funds from the Alcohol and Drug Abuse Administration grant program to the Medicaid program. That enabled Medicaid to draw down federal matching funds and expand total funding in the system.

Sharfstein sees any need to expand services as a positive development.

"I think the treatment system will be able to handle more people, and if the demand rises to the point that the treatment system has to grow, it should grow," the health secretary said.

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