Local treatment options are needed

I’m concerned about the article from Kaiser Health News (Kalispell addiction treatment facility under scrutiny, Dec. 28) scrutinizing services of a local treatment facility because I think it promotes two major misunderstandings of addiction and the needs of those providing these services in our community.

The first misunderstanding is about evidence-based research that improves recovery outcomes. The second is that we have a crisis of underfunding our Medicaid reimbursement in Montana that is forcing locals to seek even more expensive services out of State on the taxpayers’ dime which the Legislature can fix in this session.

This first problem of the article is how it frames incentive programs. It doesn’t highlight that clients are staying sober and testing. Sometimes these clients are fighting addictions and have gotten into legal, financial and personal troubles. There is solid evidence that incentive programs work, especially for those early in programs who need assistance to get through the struggle.

Structured incentives in programs work because they are working with an addicted mindset. Many sobriety testing programs surprisingly punish the individual because of how they withhold services when regular testing isn’t completed — this leads people to fail programs, going back into a life of addiction and waiting for their troubles to boil over again into a future intervention.

Some of these programs and funding models are new, or less than 20 years old, but they are founded in research and success. The clinical science around addiction has moved from treating addiction as a one-off occurrence that can be treated in a six-week boot camp to a more holistic approach that understands the strong likelihood of relapse and that addiction is sometimes just hardwired into an individual's brain chemistry. These programs work with measured successful outcomes to help individuals live sober lives, in our community and close to their family and home.

The second issue the article skews is about what Medicaid funding looks like in Montana. Medicaid funding is available for those living below the poverty line to seek services that they cannot afford.

Right now, state rules limit this funding for Montana providers and facilities struggling to make ends meet. This underfunding is affecting all Medicaid funded facilities from rehab facilities, to nursing homes, to group homes and all the way to the state hospital. Each of these programs are understaffed, and many are at risk of closing entirely not only in the Flathead but across Montana.

This critical underfunding is such a large crisis that the Governor's Office signed off on our 2021 legislative sessions request to do a Medicaid rate study in the interim session. Over $2 million was paid for this rate study and it was reviewed by an interim legislative committee — and it concluded that we are detrimentally underfunding this sector to the point where we cannot recruit the professionals to fill positions and to keep facilities open.

These recommendations are coming to the Legislature this year when there in fact is funding available to address this funding gap. This funding opportunity comes in the form of a billion-dollar surplus coming from sustainable sin tax sources like recreational marijuana, alcohol and tobacco sales.

What I am afraid the article misses (while scrutinizing a local program, providing successful recovery to local treatment) is that we don’t have enough Medicaid eligible programs available in the Flathead. It misses that we seriously need more publicly assisted treatment options given our elevated levels of addiction rates and of individuals living below the poverty line. To get to the level of service we need, the Legislature needs to properly fund providers as their rate study recommends and people should be contacting their local legislators to ask them to help get more support for these successful local programs.

This does sound like I am arguing to pay more into Medicaid and I am. But if we don’t pay these providers now then we will keep paying for the consequences of not having a local solution. And when we don’t have local solutions, then families and taxpayers must pay for these solutions in our penitentiary system, in other communities and out of State. Primarily right now, Montana is sending wards of the State to rehab facilities in Utah. This is costing the State more and costing more for the families who need to travel and seek service.

This is what the article about the local addition facility really misses — it is better to have a local option, trying something new, than it is for us to throw Montana lives and resources away by not investing enough into local services.

Kyle Waterman is a former Kalispell city councilor. He lives in Kalispell.