Facing a tough cut

Proposed state budget puts some drug and alcohol centers at risk
Sunday, February 27, 2005 | 12:00 a.m. CST; updated 6:38 p.m. CDT, Sunday, July 6, 2008

By 2003, John Pepper had abused drugs and alcohol for 41 years and spent 25 years in prison for a variety of crimes, from drug-dealing to burglary.

Pepper, 58, said he had struck bottom.

“I wasn’t a very nice person,” Pepper said of his demeanor before seeking treatment for his addiction.

Referred by Memorial Veterans Hospital, he received 70 days of treatment for substance abuse at Cedar Ridge Treatment Center in Linn Creek and came out clean.

These days, Pepper has a busy schedule: working a full-time job, attending church twice a week, speaking at a treatment center and volunteering at Truman Veterans Hospital. “I’m paying taxes. I’m giving back to the society,” Pepper said. “Now I have a life.”

Cedar Ridge Treatment Center, however, is in peril. Gov. Matt Blunt’s budget for fiscal year 2006 proposes cutting about $11.1 million from the Division of Alcohol and Drug Abuse. That would trigger a two-year loss of federal matching money: $12.9 million in 2006 and $16.5 million in 2007 respectively, according to the Missouri Department of Mental Health.

Area treatment programs would feel the impact: Cedar Ridge Treatment Center would close in 2006 or 2007. In Columbia, the McCambridge Center for Women, Daybreak Residential Center, Phoenix Programs and Drug and Research Development all would have to dramatically reduce their service.

“It’s interesting that Missouri has the reputation of being the No. 1 manufacturer of meth, and then we want to cut down drug and alcohol programs,” said David Veanes, director of Cedar Ridge Treatment Center. “That doesn’t make sense.”

At this moment, Veanes has a six-week waiting list for clients. Crowding has long been a problem for his center, which is the only agency of its kind in the Lake of the Ozarks area.

“We are still going to operate; however, we need to operate and continue to provide service” unless and until they’re forced to close, Veanes said. “There are men and women out there with active addictions. They need help.”

Pepper said he knew sometimes the center had to turn people away.

“And every time you turn a person away, you don’t know whether they may be back or not,” Pepper said. “They may die out there.”

Lawmakers in Jefferson City will review the proposed cuts as they develop a final budget before the legislative session ends in May. Lois Thomas of the Missouri Department of Mental Health said the potential impact of the cuts remains under study.

Substance-abuse treatment service providers said most of their patients are adult men who don’t receive Medicaid.

“They are fathers and husbands,” said Joel Putnam, education director for the Reality House, which is funded by the Missouri Department of Corrections and would not be affected by the cuts. “If we can get them clean and sober, they can help other members in their family become clean and sober and influence their children in prevention.”

In Boone County, 1,409 people received treatment in 2003 for substance dependency and abuse. Two-thirds of them were men.

Most treatment providers have waiting lists three to four weeks long.

“When people come to treatment, they start to change their lifestyle,” Veanes said. “They can get jobs; they will start paying taxes. The treatment is important both at the local and state level.”

In a two-story blue building in downtown Columbia, Daybreak Treatment Center houses 10 treatment beds. In 2004, it admitted more than 100 people for treatment of substance abuse. For several months, clients spend eight hours a day in group activities or individual counseling.

Along with the McCambridge and Cedar Ridge centers, the Daybreak program also falls under the supervision of the Family Counseling Center, a Central Missouri non-profit corporation based in Columbia. Seventy-five percent of the Family Counseling Center’s income comes from the state and federal government.

Half of all substance-abuse patients rid themselves of dependence after a single round of treatment, Tacker said. Overall, five of six clients eventually free themselves of addiction.

At present, most of the six men and four women being treated at Daybreak are covered by Medicaid, program director Monique Frazier said. Most addiction patients in Missouri are not, however, and their payments vary with income level. The poorest among them get treatment paid for by the state, Frazier said.

Tacker said his greatest concern is that the governor’s budget would exclude everyone but Medicaid patients from getting treatment for addictions. That situation would be compounded by Blunt’s proposed cuts to the larger Medicaid program, which would remove about 90,000 people from Medicaid.

Tacker estimates 5 percent of Family Counseling Center Medicaid clients would lose Medicaid benefits under Blunt’s plan. At the same time, state-funding cuts might limit their chance of getting free treatment.

“It’s a terrible idea,” Tacker said. “It will cost the state money and will increase the amount of crime and amount of people who go to jail.”

Mental-health funding continues to decline even as the county’s population grows, said Roland Meinert, chairman of the Boone County Mental Health Board of Trustees. The trustees have had discussions about asking Boone County voters for a mental-health tax.

“I’m not sure whether the system is going to collapse, but it’s certainly approaching a crisis,” he said, adding that budget cuts usually eliminate prevention efforts.

In Missouri, state spending related to substance abuse was as high as $1.3 billion in 1998. Only 3 percent of that went toward prevention; the other 97 percent was put toward “shouldering the burden of substance abuse,” according to a 2001 survey by the National Center on Addiction and Substance.

Missourian reporter Karla Wentzel contributed to this report.

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