Front Page  Archives Search

Program changes underway to improve drug treatment
(Published November 14, 2005)

By LAURA PETERSEN
Staff Writer

Thirty percent of the beds at the detoxification center on the D.C. General campus were out of commission because of a caved-in, leaky roof when D.C. City Councilmen David Catania and Marion Barry toured the facility in April.

Seven months and $300,000 later, the roof has been patched, the walls have been brightened with yellow, purple and teal paint, the kitchen has been revamped to serve hot meals. A recreation room offers the chance to play ping pong, air hockey and foosball.

"These renovations do not suggest this is the best it gets," said Catania, chairman of the council's Committee on Health, during a public oversight hearing on the Department of Health's Addiction Prevention and Recovery Administration (APRA) held Nov. 9 at the detoxification center.

In addition to these physical improvements at the center, several program changes are underway that are intended to improve the quality of substance abuse treatment services provided by the D.C. government.

A voucher program that allows individuals to choose where they will receive drug treatment has been streamlined by legislation passed by the city council in July. Providers of services, such as outpatient care or transitional housing, now need only one certification from APRA, not two. Before, providers were required to secure certification to provide substance abuse treatment and to accept vouchers, which is basically the same thing, Catania said.

The at-large councilman said he expects that this change will mean more qualified providers will be certified, creating more choice for persons seeking treatment.

The voucher program was started in 2000, but has been slowed down by the certification process, which is overseen by the Office of Contracts and Procurement, Catania said. To get the voucher program operating at full capacity – at a cost of up to $7 million this fiscal year – APRA will soon be overseeing its own contracts.

Currently, the Office of Contracts and Procurement negotiates all of APRA's contracts with service providers. The process would often "grind to a halt," not only for the voucher program, but for other provider agreements, Catania said.

But lack of speed was just one part of the problem, said Tori Fernandez-Whitney, the Committee on Health policy director. Negotiators at the Office of Contracts and Procurement did not always understand the nuances of health-related projects and the services being provided, she said.

"It was a recipe for disaster," Fernandez-Whitney said.

APRA was expected to have an approved template for provider contracts by Nov. 11.

Substance abuse treatment services also will be expanded once Medicaid funding for the services begins next year. For every dollar spent by the District, the federal government will match 70 cents, Fernandez-Whitney said, freeing up local money to expand treatment services.

APRA applied to the federal Center for Medicare and Medicaid Services for the Medicaid reimbursements in September, and is expecting to get a response by the end of the year.

"We have every reason to believe it will be approved," Catania said.

However, several providers and clients of the treatment services testified during the council hearing that more needs to be done, especially in making it easier to receive mental health and substance abuse treatment together. A mental health counselor works at the detoxification center, but Catania agreed that it is necessary to treat the underlying problems that lead to substance abuse.

"Most people use drugs and alcohol to self-medicate," he said.

The D.C. Department of Mental Health was awarded a $3 million grant by the federal Substance Abuse and Mental Health Services Administration, so Fernandez-Whitney said there should be greater investment in concurrent treatment of mental health and substance abuse.

Other issues raised at the hearing included language barriers, ease of being admitted to a program and lack of coordination between providers, some of which turn away clients because all of their beds are filled, while others are operating at only half capacity.