252294 Receipt of earmarked public funding and the provision of charity care in substance abuse treatment facilities

Wednesday, November 2, 2011

Bettye Apenteng , College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE
Preethy Nayar, MBBS, MS (ENT), MPhil, PhD , College of Public Health, Department of Health Services Research & Administration, University of Nebraska Medical Center, Omaha, NE
Background: Mental health and substance abuse treatment facilities receive earmarked public funds to expand mental health and substance abuse treatment services. The aims of this study are to examine the association between the receipt of earmarks and provision of charity care in substance abuse treatment facilities (SATFs) and to assess if this association is modified by ownership type. Methods: This is a cross-sectional study of 9735 SATFs in the United States. Data was obtained from the 2009 National Survey of Substance Abuse Treatment Services (N-SSATS) and analyzed using multivariate logistic regression. Results: Compared to facilities not receiving earmarks, facilities receiving earmarks were 3.06 times more likely to provide charity care (p<0.001). There was no interaction between ownership type and receipt of earmarks (p =0.320). Organizational factors increasing the likelihood of charity care provision included affiliation with religious institution (OR = 1.44 p<0.001); acceptance of Medicaid (OR = 1.24, p<0.001); acceptance of Medicare (OR = 1.14, p=0.025) and licensed status (OR = 1.14, p=0.009). For-profit status (OR = 0.33; p<0.001), accredited status (OR =0.84; p<0.001), hospital affiliation (OR = 0.74; p =0.001) and acceptance of private insurance (OR =0.67; p <0.001) decreased the likelihood of providing charity care. Rural location was not associated with the provision of charity care. Conclusions: Findings suggest that awarding earmarks to substance abuse treatment facilities may be an effective means of expanding community access to mental health services.

Learning Areas:
Other professions or practice related to public health
Provision of health care to the public
Public health or related public policy
Public health or related research

Learning Objectives:
Identify organizational correlates of charity care provision in US Substance Abuse Facilities. Assess the association between charity care provision and the receipt of earmarked public funds by US substance abuse facilities Discuss policy implications relating to the distribution of earmarked public funds.

Keywords: Mental Health Services, Substance Abuse Treatment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I independently designed this study and analyzed the data for the study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.