Heroin users seeking help face funding issues


A lot can stand in the way of a heroin user who wants to get clean.

People often have to make several phone calls and "jump through hurdles" as they navigate the path to funding their treatment, said Adriane Shultz, director of inpatient treatment for Colonial House Inc. in West Manchester Township.

"The thing that's really frustrating is, when you have somebody who makes the decision to go into treatment, you have a very small window of opportunity that you're working with" because addicts often change their minds, she said.

The rehab's bed count fluctuates — sometimes it has open beds, sometimes a waiting list — but "it often seems that lack of funding for treatment is what impacts our bed count the most," Shultz said.

Funding sources: Quite a few White Deer Run of York residents are on public funding, but the rehab has a wide variety of populations, said campus director Sarah Hawkins.

Their treatment, including their length of stay, is contingent on their funding, Hawkins said.

With the Affordable Care Act and Pennsylvania's alternative to Medicaid expansion, the insurance landscape has been changing for a few years now, she said.

"Now is better, in some respects, than it was with the medical assistance population," Hawkins said, as more people are eligible.

One of the first things White Deer Run offers clients is help applying for medical assistance so they have access to treatment, she said.

Those on medical assistance can get great coverage, especially for outpatient and intensive outpatient levels of care, said Donna Wampole, a licensed clinical social worker at WellSpan Behavioral Health in Spring Garden Township.

Behavioral health benefits can be very "touch and go," Wampole said, but name-brand insurance companies usually cover much of the cost to the patient.

Even though more individuals are getting insurance, they're not necessarily able to access their treatment benefits because of high deductibles and co-pays, Hawkins said.

Extra help: If someone doesn't qualify for medical assistance and doesn't have insurance, treatment funding is difficult to get, Shultz said.

"It's very limited — not even just in York," she said.

The York/Adams Drug & Alcohol Commission, the counties' drug and alcohol program, is a "last resort" payer that contracts with many treatment providers throughout the state and helps fund treatment for those who are eligible.

The commission funds prevention, intervention and treatment, including both inpatient and outpatient services, said administrator Audrey Gladfelter. Funding is a mix of federal, state and county dollars, she said.

In fiscal year 2013-14, the commission referred 639 people to detox; 558 people to inpatient rehab; five people to halfway houses; and 1,447 people to outpatient care, reports show.

About 106 requests for inpatient funding were denied for reasons such as residency requirements, funding limitations and existing coverage through private insurance, Gladfelter said.

Heroin problem: The commission sees varying drug trends: Rarely does it see cocaine anymore, but heroin and prescription drugs have been a "significant problem" for at least five years, she said.

"It definitely ebbs and flows," Gladfelter said.

Data show that 68.5 percent of people the commission served in fiscal year 2013-14 were IV drug users, an increase from 66.1 percent the previous year, she said.

Reports that would show exactly how many heroin users the commission serves are currently unavailable because of changes to the state reporting system, Gladfelter said.

As of Feb. 24, the commission made 422 detox referrals; 435 short-term rehab referrals; and four halfway house referrals for the 2014-15 fiscal year, reports show.

"We're definitely continuing to see an increased need for services," Gladfelter said.

Limitations: This fiscal year, the commission has had to deny rehab funding for 24 people because of funding limitations, but it has also made 25 exceptions, she said.

In fiscal year 2012-13, the commission saw a 10 percent cut in state funding, and it hasn't received any money to bump its budget back up, she said.

"Because of that and the incredible amount of individuals seeking services, we put funding limitations into place," Gladfelter said.

Priority is given to pregnant substance abusers, IV drug users, those with recent drug overdoses and those who have had multiple detox episodes, she said.

The commission used to only fund two detox episodes per year but opened up to unlimited detox access in the past year, Gladfelter said.

Often, those who go through detox don't want to stay for rehab, but the commission stays in contact and tries to encourage them to continue treatment, she said.

"We really try to stay on top of them and recognize them as individuals who would be at increased risk of overdose," Gladfelter said.

— Reach Mollie Durkin at mdurkin@yorkdispatch.com.