Bernard Gyebi-Foster had a problem this year that underscored the challenge facing public health officials battling the opioid epidemic nationwide. Gyebi-Foster, director of a Baltimore drug treatment program, had 44 beds at his center for detox patients. Amid a crisis that’s killing more than two city residents a day, he had funding for only two thirds of those recovery slots, the Baltimore Sun reports. “That left 15 beds unoccupied,” said Gyebi-Foster, who runs Tuerk House, one of the city’s best-known treatment facilities. A federal initiative being tested in Maryland is showing some early signs of increasing treatment capacity by changing how care is paid for. President Trump, in declaring the opioid crisis a national health emergency, said his administration will expand that change to other states that request it.
Maryland, where overdose deaths are surging, is one of seven states that have been approved to allow large residential centers to bill Medicaid for substance abuse treatment, reversing a prohibition that dates to President Lyndon B. Johnson. Under the new structure, treatment centers receive reimbursement for each patient rather than a set grant. Many drug treatment providers say it’s too early to declare the change a success. The federal money comes with new billing and staffing requirements that smaller treatment centers might struggle to meet. In expanding the initiative, the Trump administration said new states taking part must not increase federal Medicaid spending, which could prove difficult. Baltimore reported 694 overdose deaths last year, more than twice its 318 homicides. Another 393 died in the first half of 2017, up 29 percent compared to the same period last year.