The PCPA Drug & Alcohol Committee met on June 14 and learned of some of the liability requirements the Bureau of Drug and Alcohol Programs (BDAP) has included in the new five-year contracts with the Single County Authroities (SCA). An urgent work group of PCPA members has been convened to assess the potential impact on providers and clients and prepare a response. After an initial review, PCPA members are extremely concerned about the negative impact on access to care the new liability requirements will create. The difficulty in obtaining the required documentation from clients, the collection process as outlined, and the refusal to pay for clients with past due balances are just a few of the problems that have been identified thus far.
PCPA sent a letter to Gene Boyle, Director of BDAP, June 20 on behalf of members requesting a delay in the implementation of the liability process as written in the contract until concerns can be addressed. The new liability requirements as written are detrimental to clients served in the drug and alcohol system and, if implemented, will lead to significant obstacles to treatment, even ineligibility. The primary concerns include:
1. The new liability process requires that a private collection agency be hired and that a client with unpaid debt no longer receive BDAP funds. Many clients have unpaid debt and refusing to provide services is inhumane and not good public health policy.
2. The new requirements for documentation to be provided by clients are difficult for many clients in drug and alcohol treatment to present.
3. Information about spouse’s income is often not available or irrelevant due to confidentiality issues and/or separation.
4. Many clients being served in the current system do not qualify for Medical Assistance, do not have health insurance, and have no other means of receiving services. If they are employed, they are often making minimum wage or little more than minimum wage. The new scale is far too restrictive and will make many clients ineligible for BDAP funding. Some providers currently use the federal poverty guidelines for annual income (200% of poverty) which are appropriate for the population. Also, the scale should not be uniform across the commonwealth because it does not take into consideration the extreme differences in local/regional economies.
5. The new process does not take into consideration the rent, utilities, food, and clothing for families. This factor alone will make many clients ineligible for BDAP funds.
6. The new monthly co-pay is another significant obstacle to treatment. Individual and group co-pay for each service is much more appropriate and is in line with prevailing practices.
Many elements of the new liability requirements are foreign to providers and more time is needed to learn the new process, get clarification where needed, provide consistent training, and negotiate reconsideration of several aspects. PCPA hopes to hear soon about a possible delay. Questions may be directed to Lynn Cooper at the association.
