Officials with a handful of local nonprofits aiming to assist those who struggle with drug and alcohol addiction by providing residential treatment let out a sigh of relief as they could finally receive some much needed support from both the county and federal governments.
The San Mateo County Board of Supervisors will vote Tuesday whether to allocate a total of $5 million to support treatment facilities struggling to maintain their properties or leases due in part to the area’s high cost of living.
Furthermore, after years of waiting, California received federal approval for its waiver to the Affordable Care Act that could allow some of these specialty treatment centers to draw Medi-Cal dollars for the first time.
For those who run Our Common Ground and Project 90, nonprofit providers with several facilities throughout the county, news of the multi-million dollar show of support is a comfort — particularly as timing is of the essence when it comes to treating those who struggle with substance abuse.
“We need this to stay in business, to serve and support clients,” said Ray Rosenthal, president emeritus of the OCG Board of Directors. “We cannot ignore the problem, this is something that’s not going away. Unfortunately, drug and alcohol abuse is just rampant.”
OCG and Project 90 have struggled to provide residential services in an attempt to break one’s addiction cycle through a sober living environment and therapy. But funding sources have dried up as many thought the ACA would kick in and assist. Exacerbated by an increasing population, rising cost of doing business in the Bay Area and Proposition 47 that reduced many drug crimes to misdemeanors, officials feared services would soon be lost if the county didn’t provide more support.
The Board of Supervisors had stayed a decision on how to assist until a comprehensive study of the local providers’ finances was completed, said Steve Kaplan, director of the county’s Department of Behavioral Health and Recovery Services.
“We did two things, one was to look at what the existing balances that were on any of the facilities that providers had mortgages on and then concurrently, try to get a sense of their overall financial stability,” Kaplan said. “As we expected, a number of them are pretty on the edge in terms of finances. So the strategy is to stabilize two things; one is the actual treatment capacity so none of the properties are lost, and then secondly, by doing so, improving the overall fiscal health of the organization.”
With the OCG board considering having to sell its Redwood City facility to make ends meet and Project 90 soon needing to relocate from its main intake building on Ninth Avenue in San Mateo, the county agreed to extend an emergency $1 million last month. Now, the additional $4 million — sourced from Measure A half-cent sales tax funds — will provide longer-term assistance in the form of a low-interest 30-year loan for providers to pay off mortgages and secure their vulnerable properties.
But with the extensive application process and funds from the ACA waiver not expected to trickle down for months, if not years, some worry the time lapse will result in more addicts being turned away.
“They’re trying to come up with a program to help us with assistance. But I don’t know that they get the depth of the problem,” said Project 90 Executive Director Jim Stansberry. “My fear is that even with the money they’ve allocated with the best intentions, that process might take several months. And every month that goes by, we’re sinking further and we’ve got the scars of being in limbo over the last two or three years.”
While grateful for the support, Stansberry said he plans to share information about the number of people seeking treatment who’ve dropped off the wait list as treatment beds throughout the county disappear.
“Everyone that falls off the wait list is probably going to be impacting other people — their families or the community. The cost of not giving them services is probably far greater than any cost of helping them,” Stansberry said.
Project 90 must move out of two San Mateo properties as the owners plan a major redevelopment along Ninth Avenue. Stansberry said he hopes the county will assist in finding a suitable alternative, particularly as finding a facility with residential and office amenities is difficult.
Federal assistance to trickle down
Eventually, the county and providers can opt in to the state’s ACA waiver, which would assist local centers by providing insurance funds for the treatment portion of their work. However, Medi-Cal will never reimburse for the expensive residential costs associated with in-patient substance abuse treatment. The waiver will also will provide for a cost of living adjustment to providers with more than 16 beds that are critical to the Bay Area.
“I think it’s going to be a very stable funding source once it gets up and running,” OCG Executive Director Orville Roache said about the waiver. “But always the question not just for us, but for any other residential provider, is can you survive the time until it gets up and running?”
Kaplan said the county must now develop an implementation plan that needs approval from California and federal health officials. As notice of the waiver took months longer than anticipated, Kaplan said he couldn’t be sure when the county would be able to begin doling out Medi-Cal funds to local providers.
Eventually, Kaplan said he’s hopeful the insurance funds will help not only ensure there’s options for those seeking treatment to address substance abuse, but alleviate some of the county’s funds to provide other intervention or preventative programs as well as housing assistance.
“Over the years, we know that the capacity really hasn’t addressed the full demand and we’ve lost beds,” Kaplan said. “At minimum, we don’t want to have any further reductions in that part of our continuum [of care]. We may need to build more, but we all know that trying to start a residential treatment center in San Mateo, well it’s an understatement to say it’s a challenge. So we want to make sure the ones that are open stay open.”
Rosenthal said he’s thankful progress is being made both on the county supervisors front as well as toward further the federal and state aid. However, he added people should recognize providing treatment is better for the community at large.
“If we leave these people without services or any kind of help, they’ll end up in prison and as you know, our prisons are way overpopulated. Judges are having to release people because it’s overcrowded,” Rosenthal said. “Then what do we have? We have a society that is in chaos. So this gives us the ability to provide a program and support.”
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