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RE: FFY 2012-13 Substance Abuse Prevention and Treatment Block Grant Request for Public Comments

DHMAS (CT’s State Substance Abuse Agency) has asked CT stakeholders to offer public comments on their Substance Abuse Prevention and Treatment Block Grant Application.

CTYF is requesting that the CT Substance Abuse Block Grant plan be revised to target “youth with substance use disorders” as requested in the application from SAMHSA (Our Federal Substance Abuse Agency). With your help and your voice CT youth may have a better shot at staying alive and recovering if good and modern services existed to support them and their families’ needs.

DHMAS Contact Information and Grant Application

Below are the comments submitted by CTYF, feel free to use ours or submit your own in support of CT youth to DHMAS:

DHMAS Staff,

After review of DHMAS’s 2012-13 SAPT Block Grant Application it is alarming that our state continues to neglect prioritizing developmentally appropriate substance use treatment and recovery services for youth, especially adolescents. As a result of the bi-furcated structure of our state systems of care and the entrenched DCF Children’s Mental Health Block Grant structure, adolescents with substance use disorders continue to fall through the cracks in our systems.

Over the next three years the implementation of the new Mental Health Parity and Addictions Equity Act, as well as the new Affordable Care Act will have profound implications on how the treatment and recovery from substance use conditions are structured, insured, and paid for in Connecticut. We do respect and understand that DHMAS has a statuary obligation to serve those who are 18 and older, but as indicated by SAMHSA in the revised Block Grant application the purpose of the funds are to “fund those priority treatment and support services not covered by Medicaid, Medicare or private insurance offered through the exchanges and that demonstrate success in improving outcomes and/or supporting recovery.”

Within SAMHSA’s Revised FFY 2012-13 Block Grant application process there is an opportunity to purchase services that are not anticipated to be covered benefits by other payers. We request that DHMAS take bold new steps to reform our state’s services for youth with alcohol or drug problems. The State of Connecticut and DHMAS has the potential to save millions of dollars in direct and indirect costs through forming a new partnership with DCF to use FFY 2012-13 SAPT Block Grant funds specifically for substance use treatment, advocacy, and recovery supports services for our most resilient population.

“Over 90% of people with abuse/dependence started using under the age of 18 and met criteria by age 20. Treatment and recovery supports in the first 10 years of use (basically adolescents & young adult hood) is associated with cutting the years of use by decades and key to reducing long term costs to society (Dennis, M. – Chestnut).”

As part of the new Block Grant application process DHMAS has been requested by SAMHSA to prioritize “youth with substance use disorders,” according to the Federal Register, Vol. 76, No. 117, from June 17, 2011. This population remains noticeable in need (see problem analysis section pages 62-74), but visibly absent in CT’s current SAPT application. As reported by SAMHSA in the Federal Register two of the most frequent public comments from around the country in support of their revised Block Grant application focused on the following areas:

*“Commending SAMHSA on including adolescents as a target group that States can include in their needs assessment and State Plan.”

“Inclusion of family involvement, tribal consultation and a focus on the provision of recovery support services.”

In this application DHMAS has neglected this request from SAMHSA and has overlooked the possibility of making an investment in this population that will provide tremendous future dividends for CT state systems.*

Youth and families stakeholders from around the State believe strongly that CT’s SAPT Block Grant Application should be revised to fill the following critical unmet service needs:

1) Families and adolescents currently do not have accessible substance abuse treatment or recovery services in CT. Within the next two years new data regarding adolescent substance use specific treatment and recovery support needs will quickly emerge as DCF implements new evidence-based Global Appraisal of Individual Needs Gain Short Screen (GAIN) for Children/Adolescents with Co-Occurring Mental Health and Substance Use Disorders in the Enhanced Care Clinics. There will be an increased demand to provide Detoxification, Residential Treatment, Housing, and Recovery Support Service options for adolescents and young adults now that they will be screened appropriately.

2) CT desperately needs an initial public investment for peer recovery support services for youth with substance use disorders and their families in order to bring these recovery support services to scale. Our adult system took this leap over ten years ago and is now nationally recognized as a purveyor of publicly supported community recovery organizations. Making this same investment for youth has the potential to position a long-term strategy in our State to have these services brought to scale and ultimately purchased by Medicaid and private insurers.

3) As indicated in DHMAS’s 2010 Priority Setting Process, potential solutions to many challenges our system faces can be found through “advocacy such as educating decision makers on the efficacy of treatment, and reducing stigma through community education.” The Children’s Mental Health Block Grant funds a great deal of advocacy around mental health issues children face, but these funds have never specified or initiated advocacy efforts for youth facing drug and alcohol problems. This is clearly evidenced by the glaring 5 Substance Abuse Consumer/Family vacancies as voting members on the planning council (Page 46). If youth and families in recovery are not there to vote on behalf of substance abuse service planning for adolescents than DCF will continue to neglect this population, while DHMAS will continue to see a greater number of 18 to 25 year olds entering the substance abuse system in need of high levels of services.

We understand Connecticut faces tremendous budget deficits and funding new types of services might seem out of the question. But funding the above services using the FFY 2012-13 SAPT BG will support youth recovery at home while decreasing the demands put on the system as young people age, allowing us to accomplish more with less and put CT in a position to maximize heath reform opportunities. At times of crisis “when all the cards are in the air” a unique set of circumstances and opportunities exists for realignment and reform.

Thank you in advance for your time and we hope DHMAS takes into consideration these public comments on behalf of our youth and family stakeholders. We are not the only CT stakeholders who want to see the above changes implemented, we anticipate that DHMAS will receive many public comments to this regard similar to the experience SAMHSA encountered during their public comment period just a few months ago.

Contact Information:

Greg Williams, Co-Director, Connecticut Turning To Youth and Families, Inc.

Email: gregw@ctyouthandfamilies.org
Mobile: 203.733.8326
www.ctyouthandfamilies.org