美国国家公共电台 NPR States Seek More Federal Funding For Opioid Treatment, Not More Promises（在线收听）

RACHEL MARTIN, HOST:

President Trump is going to try to refocus on opioids today. He's gathering Cabinet members, health experts and advocates for what's being billed as a White House summit on the opioid crisis. President Trump declared opioids a public health emergency back in October, and that brought more attention to state anti-drug programs, but not federal money. Congress recently authorized new funds, but those dollars aren't flowing yet, and many states are struggling. In a moment, we're going to hear how all this is affecting the state of Colorado. But first, Jackie Fortier from StateImpact Oklahoma reports that treatment programs there are bracing for budget cuts.

JACKIE FORTIER: The Oklahoma agency in charge of substance abuse needs to cut more than $2 million from this fiscal year's budget, and that has opioid treatment providers on edge.

RANDY TATE: Treatment dollars are scarce.

FORTIER: That's Randy Tate. He's the president of the Oklahoma Behavioral Health Association, which represents addiction treatment providers. He says it's like dominoes - cut state funding for treatment, and federal safety net programs feel the strain.

TATE: Any cuts to our overall contract really diminish our ability to provide the case management necessary to advocate for homes, food, shelter, clothing, primary health care and all the other things that someone needs to really be successful at tackling their addiction.

FORTIER: In just three years, the agency in charge of funding opioid treatment has seen more than $27 million chipped away from its budget. That's due to low oil prices, slashed state taxes and legislative gridlock. Jeff Dismukes, with the state department of Mental Health and Substance Abuse Services, says the already-lean agency has few cost-cutting options left.

JEFF DISMUKES: We always cut first to administration, but there's a point where you just can't cut that anymore.

FORTIER: The agency may push payments to treatment providers into July, and Tate says that could be devastating.

TATE: Some very thinly financed small, rural providers probably are at risk of going out of business entirely.

FORTIER: Getting treatment providers to open up shop in rural areas is really hard even in good times. And more financial uncertainty will make it worse. In the meantime, just 10 percent of Oklahomans who need addiction treatment are getting it. For NPR News, I'm Jackie Fortier in Norman, Okla.

JOHN DALEY, BYLINE: And I'm John Daley in Denver. That 1-in-10 statistic is similar in Colorado, and as 2018 began, Colorado's runaway opioid crisis got worse. The state's largest drug and alcohol treatment provider, Arapahoe House, shut its doors. Denise Vincioni, who directs another treatment center, says other facilities have scrambled to take on new patients.

DENISE VINCIONI: It's always difficult to get somebody in residential. It's just going to enhance that problem.

DALEY: Arapahoe House provided recovery treatment to 5,000 people a year. Most of its clients were on Medicaid. Autumn Haggard-Wolfe, a two-time Arapahoe House patient, now in recovery, worries the closing will have dire consequences, especially for people like her who needed inpatient care.

AUTUMN HAGGARD-WOLFE: I feel like the only other option right now for - in therapy would be jail for people, and people die in there from withdrawing.

DALEY: Arapahoe House's CEO blamed the closure on the high cost of care and poor government reimbursement for services. Lawmaker Brittany Pettersen is a Democrat whose mother battled addiction. She says treatment centers rely on a crazy quilt of funding sources and are chronically underfunded, often leaving people with no treatment options.

BRITTANY PETTERSEN: We have a huge gap in Colorado, and that was before Arapahoe House closed.

DALEY: She's pushing legislation to increase funding. But to get tens of millions in federal matching funds, lawmakers need to OK at least $34 million a year in new spending. It may not happen. Even if it does, Pettersen says...

PETTERSEN: It's going to take a lot to climb out of where we are.

DALEY: Colorado did get new federal funds to fight the opioid crisis last year, but it was just $8 million a year for two years, divvied up among a long list of programs. For NPR News, I'm John Daley.

MARTIN: That story is part of a reporting partnership with Kaiser Health News.