Community Input: Improving Substance Use Disorder Care in Illinois Medicaid
In June, the Illinois Department of Healthcare and Family Services (HFS) sought community input on improving substance use disorder care and treatment for individuals through Medicaid services. While Children’s Home & Aid is not a substance use provider, our programs often serve clients who may struggle with substance abuse issues. Our programs are a crucial community support for clients who are receiving substance use treatment. Children’s Home and Aid provided written public comment to HFS to help inform their improvement of substance use disorder care and treatment. Our public comment discusses barriers to accessing and completing treatment, the importance of maintaining community supports, and the importance of anti-racist practices in the training of providers.
Access to Child Care
One significant barrier for parents receiving both outpatient and inpatient treatment is their access to child care. Parents need to spend time in their treatment but if they can’t afford child care or don’t have child care that is open during their outpatient treatment hours, they struggle to access and complete treatment. Additionally, while there are inpatient treatment centers that allow children to reside with their parent, oftentimes there are restrictions on the number of children and on the children’s age. HFS should look at increasing the number of inpatient centers that serve families and outpatient treatment that provides child care options.
Supportive Services: Programs for Families Involved in Child Welfare System
Families with substance use issues that are also involved in the child welfare system face unique challenges when it comes to treatment and recovery. Therefore, it is crucial to maximize community supports that are available to this population. This may include programs like the Intact Family Recovery Programs that provide a substance use case manager to co-case manage with child welfare workers throughout their treatment and are an additional support for families. Furthermore, utilizing home visiting programs throughout treatment and recovery can provide crucial supports for families via home-based counseling from trained experts. Home visiting programs have been proven to prevent negative childhood experiences such as abuse and neglect and can decrease the risk of substance use later in life (Baizer, 2018). Medicaid substance use providers should utilize an efficient referral process and build strong working relationships with home visiting programs in their areas to utilize this crucial support more.
Anti-racist Practice
We know that implicit bias is a contributor to racial and ethnic inequities in the health care system. Training counselors and staff to be culturally competent isn’t enough when successful recovery is a life or death situation for many of the clients served in substance use treatment. It is crucial for staff (at all levels) involved in substance use treatment to be appropriately trained in anti-racist practices to ensure that their clients are receiving the care and treatment they deserve. It is also important for HFS to review contracts with providers to determine if policies are contributing to inequities for the clients their providers serve.
We thank the Illinois Department of Healthcare and Family Services for the opportunity to provide feedback and look forward to improvements that benefit individuals with substance use disorders. If you would like to view the public comment in its entirety you can find the document here. For more information regarding these comments, please contact Ali Schoon, Early Childhood and Child Welfare Policy Associate at aschoon@childrenshomeandaid.org.
___________________________________________________________________
Baizer, S., Isaacson, D., & Carpenter, T. (2018). Stopping the opioid crisis begins at home. Council for a Strong America. https://strongnation.s3.amazonaws.com/documents/409/8693f478-d803-4ce6-97d3-7a8cb7541b3a.pdf?1523649696&inline;%20filename=%222018-001FC_IL%20Opioid%20Report.pdf%22