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Cleaning Up

Federal money is expanding drug treatment in Baltimore--and causing providers headaches.

Photographs By Christopher Myers
Baltimore substance abuse system's Greg Warren: "We're now about to do something that we've never had to do before, which is start an advocacy campaign."

By Edward Ericson Jr. | Posted 6/23/2010

The first of a four-part series

Read part 2, part 3, and part 4

Page 1 of 4.   1  2  3  4  

Correction: City Paper erroneously reported that the state's Primary Adult Care insurance program does not cover buprenorphine treatment, when in fact it does.

Greg Warren has good news.

"For the first time, we have open methadone slots," the president and CEO of Baltimore Substance Abuse Systems, the quasi-public nonprofit agency that coordinates the city's drug treatment industry, tells the board at its May 27 meeting. "We're now about to do something that we've never had to do before, which is start an advocacy campaign."

Radio, billboard, and newspaper advertising will start later this summer, according to Carlos Hardy, director of public affairs at Baltimore Substance Abuse Systems, known as bSAS. Already this spring, he has brought church leaders the good news that drug treatment is--or will soon be--available to virtually anyone who needs it. "We're hoping to make this a pulpit issue, if you will," Hardy tells the board, which oversees the disbursement of about $1 million per week for Baltimore City drug treatment and includes prominent researchers, a judge, Police Commissioner Frederick Bealefeld, City Council President Bernard C. "Jack" Young, and other civic heavyweights.

The announcement surprises no one at the table. Everyone here has anticipated the news that drug treatment--for years plagued by months-long waiting lists--is now becoming more available through the magic of federal money. But outside of this conference room on the 16th floor of 1 N. Charles St., the new paradigm is already changing lives--and not always for the better.

To get the new federal money, local drug treatment providers have to conform precisely to a 36-page billing instruction booklet, and they must give up some of the money bSAS used to give them. The federal money is strictly apportioned according to "billable hours," meaning treatment providers may no longer have the time to give clients the extra services they get now. And the federal money is targeted to the types of drug treatment that have been shown statistically to be least effective--particularly in Baltimore City.

Still, bSAS officials are celebrating the new paradigm, and they say they're working hard to resolve the challenges their treatment providers are facing.

BSAS disburses nearly $50 million in state grant funds to more than 50 treatment providers, and millions more are expended by health insurance plans, both public and private, to uncounted drug treatment service providers in and outside of the bSAS network. Millions more on top of that--much of it taxpayer dollars--go toward housing and other services to those in recovery.

Baltimore's drug treatment industry is a significant player in the city's economic, social, and political life. It is also changing rapidly and radically, growing and becoming more decentralized, and possibly more effective, as new theories about addiction and new techniques of treatment meet expanding funding sources. This story and three more in the coming weeks will examine Baltimore's drug treatment industry and try to analyze it in terms of its history, efficiency, and efficacy.

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