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New Obamacare Money for Health Centers Will Treat Substance Abuse

Heroin use among young adults has doubled in the last decade.

As the na­tion’s at­ten­tion in­creas­ingly turns to a sub­stance-ab­use epi­dem­ic and a surge of over­dose deaths, the Obama ad­min­is­tra­tion is pump­ing $500 mil­lion in­to com­munity health cen­ters in part to bet­ter equip them to help pa­tients with al­co­hol and drug prob­lems.

Us­ing fund­ing au­thor­ized by the Af­ford­able Care Act, the Health and Hu­man Ser­vices De­part­ment an­nounced Tues­day that it was award­ing $350 mil­lion in grants to nearly 1,200 com­munity health cen­ters across the coun­try to ex­pand their ser­vices. An­oth­er $150 mil­lion is be­ing giv­en to 160 cen­ters to pay for con­struc­tion and renov­a­tion.

The ex­pan­ded-ser­vices grants could pay for a vari­ety of ser­vices, from or­al health to phar­macy care, help­ing cen­ters stay open longer and hire more staff. But a par­tic­u­lar aim is to bol­ster their abil­ity to treat people with al­co­hol and sub­stance-ab­use prob­lems, said Jim Mac­rae, act­ing ad­min­is­trat­or at the Health Re­sources and Ser­vices Ad­min­is­tra­tion with­in HHS, in an in­ter­view.

About 1.4 mil­lion of the 23 mil­lion Amer­ic­ans that health cen­ters see an­nu­ally have some kind of al­co­hol or drug prob­lem. The num­bers have been im­prov­ing, but nearly 40 per­cent of the 1,300 health cen­ters still don’t provide sub­stance-ab­use ser­vices, ac­cord­ing to HHS.

“The abil­ity to provide some re­sources to help sup­port that kind of care and treat­ment on site in a primary-care set­ting, we think will be in­valu­able for the pa­tients at the health cen­ters,” he said.

Do­ing something about the na­tion’s drug prob­lem has be­come a fo­cus for both parties in re­cent years, amid grow­ing evid­ence that the prob­lem is get­ting worse. Heroin in par­tic­u­lar is seen as a scourge, and the Cen­ters for Dis­ease Con­trol and Pre­ven­tion has called it an epi­dem­ic. Heroin use among young adults has doubled in the last dec­ade, ac­cord­ing to the CDC, and the num­ber of over­all over­dose-re­lated deaths quad­rupled over roughly the same peri­od.

The White House an­nounced in Au­gust a new ini­ti­at­ive to fight opioid ab­use, fun­nel­ing $2.5 mil­lion to hire pub­lic-health staff in five areas plagued by the nar­cot­ic. Sen­ate Ma­jor­ity Lead­er Mitch Mc­Con­nell has urged the sur­geon gen­er­al to pro­duce a re­port on the is­sue, and Mc­Con­nell co-sponsored bi­par­tis­an le­gis­la­tion on pren­at­al opioid ad­dic­tion. Demo­crat­ic pres­id­en­tial can­did­ate Hil­lary Clin­ton made men­tal health and sub­stance ab­use one of the first policy areas for which she re­leased a de­tailed plan dur­ing her cam­paign.

“This crisis of opioid-re­lated over­doses strikes without re­gard to geo­graphy, age, race, or so­cioeco­nom­ic status, and it re­quires an im­me­di­ate and sus­tained re­sponse,” Mc­Con­nell said in a May state­ment.

Mac­rae por­trayed the new Obama­care fund­ing as part of an over­all na­tion­al strategy to com­bat drug ab­use. His agency has also star­ted to co­ordin­ate with the Sub­stance Ab­use and Men­tal Health Ad­min­is­tra­tion, an­oth­er branch of HHS, to help train and of­fer tech­nic­al as­sist­ance to health care pro­viders.

One trend that he re­por­ted see­ing is more primary-care cen­ters want­ing to add men­tal-health and sub­stance-ab­use ser­vices, and men­tal-health pro­viders want­ing to add primary-care ser­vices. One men­tal-health fa­cil­ity in In­di­ana, which saw an HIV out­break earli­er this year be­cause of shared-needle use, ap­plied for and re­ceived an Obama­care health-cen­ter grant in May, for ex­ample.

“We’re see­ing this in­ter­est­ing phe­nomen­on where we have be­ha­vi­or­al-health pro­viders, sub­stance-ab­use pro­viders say­ing, ‘We really re­cog­nize we need to provide primary care in ad­di­tion to what we tra­di­tion­ally provide,’” Mac­rae said. “And then on the oth­er side, you’re see­ing from the health-cen­ter side, tra­di­tion­al primary-care pro­viders re­cog­niz­ing, ‘We really need to add or­al-health ser­vices, we need to add be­ha­vi­or­al ser­vices, we now need to add ser­vices that will ad­dress sub­stance ab­use.’

“We’re see­ing more and more de­mand for those types of re­sources,” he ad­ded.

(Image via GraCon Design/