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Lifeline Connections limits its state work

Nonprofit says it can't afford all the losses it's taken

By Marissa Harshman, Columbian Health Reporter
Published: July 10, 2011, 12:00am

Clark County’s only inpatient substance abuse treatment center is reducing the number of state-funded patient beds from 55 to no more than 25.

Beginning next month, Lifeline Connections will cut back the number of publicly funded beds it offers to people who are low-income, have Medicaid and come through the county’s drug court.

For the last several years, the inpatient unit has lost $20,000 to $50,000 per month as operating expenses climb and the state reimbursement rate remains stagnant.

The private nonprofit can no longer sustain such losses, said Lifeline Connections Chief Executive Officer Lynn Samuels.

“This will be a significant loss to the community. However, everybody understands this was not a decision we made lightly,” she said. “This was not an easy decision to come to.”

With statewide cuts in the millions of dollars to inpatient and outpatient chemical dependency services, nonprofit organizations and treatment centers across the state are being forced to alter their business models, said Cleve Thompson, Clark County’s alcohol and drug program manager.

“The pressure is going to come this biennium where these reductions, without any kind of increases, are putting a lot of pressure on these nonprofits and treatment facilities,” he said. “Even though your mission may be to provide some services, you can’t continue to operate at that great of loss.”

In the last two biennia, inpatient program reductions totaled $17 million. Funding for outpatient services was reduced by nearly $48 million in the same four years. This year, chemical dependency services were cut even more.

“It’s cost-shifting problems from the state to the county, to the local level,” Thompson said. “As they don’t increase rates and as a lot of state budget cuts get placed on chemical dependency, the impacts are going to be seen in your local hospitals, in your court system.”

Services at a loss

The state rate for all-inclusive inpatient treatment — including housing, food, transportation, counseling and medication — has been $90.18 per patient per day since 2007, when that amount covered about 80 to 85 percent of the actual cost of providing the treatment, Samuels said.

Lifeline now loses about $70-75 per patient per day. In the last 11 months, the nonprofit has lost $560,000, Samuels said.

As a result, Lifeline is reducing the number of publicly funded beds, restructuring its inpatient units and adding services.

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It will add day-treatment services for those who don’t need inpatient care but could benefit from more-intensive treatment than offered by outpatient programs. That program should be in place by early next year, Samuels said.

Lifeline has a 60-bed inpatient unit in which 55 beds are publicly funded, and another 16-bed inpatient unit with patients who pay out-of-pocket or have insurance, Samuels said.

The 60-bed unit will be restructured to two 16-bed units and one eight-bed unit, all comprising both publicly and privately funded beds.

The reduction and restructuring will occur as patients currently in the program complete treatment, Samuels said.

The larger units will be for chemical dependency inpatient programs. The eight-bed unit will offer a new program: inpatient treatment for patients with co-occurring disorders, who are seeking treatment for both mental illness and chemical dependency.

The specialized program, which should be up and running by November, will help reach a largely underserved population, Samuels said.

“We right now have a very, very difficult time placing those folks anywhere,” Thompson said. “They all have to go out of county.”

The loss of state-funded inpatient beds for chemical dependency programs will likely mean some Clark County residents will have to go out of town to receive treatment, Thompson said.

Lifeline’s current 60-bed unit is usually about 95 percent full. For the last few months, that rate has been closer to 97 percent, Samuels said.

“Absolutely when you lose 20 beds of capacity it has an impact on the community,” Thompson said. “And I anticipate more wait time for people to get access to beds and potentially — actually, in reality — more people having to go out of county to access publicly funded beds.”

Lifeline Connections is in the Center for Community Health, 1601 E. Fourth Plain Blvd.

Marissa Harshman: 360-735-4546 or marissa.harshman@columbian.com.

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Columbian Health Reporter