Heroin in Illinois: A State of Emergency
CUTS TO SAMHSA FUNDING THREATENS HEALTH, COMMUNITIES
FEATURING: Allen Sandusky, President and CEO, South Suburban Council on Alcoholism and Substance Abuse, East Hazel Crest, Illinois
The Oasis in the Desert
For more than 30 years, the South Suburban Council on Alcoholism and Substance Abuse has provided affordable and effective chemical dependency treatment and rehabilitation to residents of the greater Chicago Southland community. It is the largest such program in the far south suburbs of Chicago, serving more than 45 towns and communities.
“We serve those without adequate resources for treatment,” said Allen Sandusky, the President and CEO of the South Suburban Council. “We are mainly funded by the state through federal block grant dollars.
The Substance Abuse Prevention and Treatment block grant—funded by the federal Substance Abuse and Mental Health Services Administration (SAMHSA)—provides funds to all 50 states. It is considered the “safety net” for substance abuse treatment, intended to help those who have no other resources. In Illinois, the amount of the block grant decreased by over 10 percent in 2013, in part due to sequestration. Some of that cut was restored in 2014, yet last year’s block grant funding was still almost 5 percent below the 2012 level. SAMHSA also disperses discretionary funds to the states, and in 2014, Illinois received $20.9 million for substance abuse prevention and treatment. The previous year, the state received $22.9 million. The year before that, it was $24 million. That’s a 13 percent decrease in just two years.
The timing could not be worse. Heroin use and addiction is at crisis levels nationally and in Illinois—so much so the state legislature is considering a resolution that would declare a “Heroin emergency.” The problem, long thought to be one limited to urban areas, is as widespread as any other health issue. Heroin-related deaths in DuPage County increased 55 percent in 2012. In Will County, such deaths increased 80 percent. McHenry County reported a 77 percent increase. Finally, in Kane County, heroin deaths increased 200 percent in just one year.ii
The Incredible Shrinking Treatment Center
There is an economic impact to these cuts as well, and much of the brunt is bourn by the workforce. Inside of five years, South Suburban Council reports that it has lost more than $1 million dollars, or 21 percent, in funding, forcing it to shrink its staff from 155 to 98 employees. In the last year, 11 positions were eliminated. They have also been forced to terminate a joint staff contract with a nearby domestic violence shelter.
Because of budget cuts, our rates for service in Illinois have not changed in seven or eight years. The rates of reimbursement are so poor, we cannot sustain our rate of services,” explained Allen. “When the rates of reimbursement don’t keep up, we have to compromise.
Remaining employees must deal with reduced benefits, including increased employee contributions for medical insurance and the elimination of employer contributions to employees’ 401K service reductions. It is estimated that 600 jobs in addiction health care services have been lost across the state since 2012.iii
Cuts Hurt Those Most In Need
Of course, the budget cuts have the greatest impact on those most in need—the consumers. As Allen explained:
We get ongoing referrals from the courts. We get ongoing referrals from jails. We get ongoing referrals from people in crisis. If we are not available to hospitals to take people on, they go to hospital beds. If we are not available to the courts, patients take up jail cells. These are repercussions that are far more costly than the cost of providing treatment.
Not only has South Suburban Council seen the number of people they treat annually drop from 3,600 to under 2,000, the services received by those remaining are being compromised. Even worse, the services they currently provide are not adequate to meet growing demand. Core services such as treatment are in tact, but ancillary services, such as case management and outreach, have all but been eliminated. It is these ancillary services that guarantee good outcomes for recovery. According to Allen:
Our ancillary and supportive services have suffered. These services are linked to good outcomes. When our budget is cut, we can’t cut core services. So we cut ancillary services. All we hear from government is that they want good outcomes. But based on the funding scenario, it’s become a self-defeating system.
The South Suburban Council is currently operating at a deficit of close to $60,000 a month. By the end of 2014, there is no guarantee that they will still be in operation.
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International Certification & Reciprocity Consortium
i Illinois House Resolution HR 883, Illinois General Assembly. March 4, 2014
ii Lawrence J. Ouellet, Drug Abuse Patterns and Trends in Chicago—Update: January 2014 (Division of Epidemiology and Biostatistics, School of Public Health, The University of Illinois at Chicago. Compiled for the National Institute on Drug Abuse, Community Epidemiology Work Group, 2014)
iii “FY ’12 Cuts Slash Life-Saving Addiction Healthcare Services,” Illinois Alcoholism and Drug Dependence Association, 2013 https://www2.illinois.gov/hsc/Documents/Springfield/Illinois%20Alcoholism%20and%20Drug%20Dependence%20Association%20Budget%20Cuts%20Fact%20Sheet.pdf