Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111436

Katherine E. Laws, BA, Ryan D'Ambrosio, MA, and Dennis D. Deck, PhD. RMC Research Corporation, 522 SW 5th Avenue, Ste 1407, Portland, OR 97204, 503-223-8248, kathy_laws@rmccorp.com

The Oregon Health Plan (OHP) expanded Medicaid coverage to childless couples and single adults using managed care and limits on covered services. In 1995 substance abuse services, including methadone, were integrated into the benefit structure. In 2001, OHP eligibility was further expanded, incorporating more state control by instituting co-pays, premiums, and if costs increased, freezing enrollment and limiting benefits. A poor economy and huge state deficit prompted the legislature to remove coverage for outpatient substance abuse, mental health, and dental services from the expanded population in March 1, 2003. Advocacy groups, treatment professionals, researchers, and others provided documentation that eliminating these benefits would create a host of problems (increased emergency room visits, increased crime) and as a result, benefits were reinstated in August 1, 2004.

Based on findings from a NIDA funded study, this presentation will describe the impact OHP changes had on publicly funded methadone maintenance treatment (MMT) providers (e.g., loss of clientele and staff, inability to provide quality services) and on OHP patients (resorting to illegal means to find money for treatment; having to detox off methadone quickly if couldn't pay.) Interviews show MMT providers creatively financing treatment for those who had lost their benefits, e.g., providing a variety of payment options, partnering with hospitals and managed care plans to pay for those who lost benefits. Quantitative findings presented will show changes that occurred in service utilization patterns for OHP clients after the cuts compared to before the cuts. Washington's methadone treatment system will be used for contrast.

Learning Objectives: At the conclusion of the session, the particpant will be able to

• describe how the changes to the Oregon Health Plan's substance abuse treatment benefit has impacted access to and quality of methadone treatment services and describe how these changes have impacted methadone maintenance patients.
• identify the differences in access and service utilization between Oregon's publicly funded methadone maintenance treatment system as compared to Washington.

Keywords: Methadone Maintenance,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.