The already precarious status of Idaho’s nine community recovery centers — including those in Boise, Caldwell and Emmett — isn’t likely to improve during the first year of Gov. Brad Little’s tenure.
Unlike the crisis centers that opened in recent years, with much support from the Otter administration, the recovery centers are a place where patients work on their addiction and mental health recovery and receive peer-group support. The nine centers are located in Boise, Caldwell, Coeur d’Alene, Emmett, Idaho Falls, Lewiston, Moscow, Pocatello and Twin Falls.
Collectively, the centers applied for $893,400 from the Idaho Millennium Fund next year, both to shore up their shaky finances and to enhance outreach efforts in surrounding rural communities.
Little, however, didn’t include the request in his fiscal 2020 budget recommendation. That’s because he wants to use the Millennium Fund to pay for the Medicaid expansion initiative that voters approved in November.
Norma Jaeger, executive director of Recovery Idaho, which submitted the Millennium Fund application on behalf of the centers, questioned whether any of them can remain open long-term without some level of state support.
“Their continued survival has been something of a miracle already,” she said. “Hopefully, a better funding solution is on the horizon.”
‘An unfortunate view’
Mental health and substance abuse have historically been state responsibilities, Jaeger said. For the governor to suggest that local governments and private donors should finance the recovery centers goes against the grain, she noted.
“It’s an unfortunate view of the state’s responsibilities,” she said.
Except for Twin Falls, which opened in 2017 with donations and private dollars, the centers have each received about $175,000 in state support. The Millennium Fund provided $125,000 in start-up funding for the first four in fiscal 2016; over the following two years, they and the remaining centers received another $900,000.
Nevertheless, Rep. Fred Wood, R-Burley, said the recovery centers were always expected to be self-supporting.
“We’ve always told them, as far as the Millennium Fund goes, they were on their own after a year or two. This was never supposed to be an ongoing source of funding,” said Wood, who is co-chairman of the Joint Millennium Fund Committee.
The joint committee is tasked with recommending how to spend Millennium Fund monies. Although it has supported a few ongoing programs in the past, such as Project Filter or other tobacco cessation efforts, it traditionally resists efforts to tap the account permanently.
Yet that’s exactly what Little wants to do. His budget would honor Project Filter and the other ongoing commitments, but beginning in 2020, any remaining Millennium Fund monies — roughly $14 million per year — would go toward Medicaid expansion.
Is the Millennium Fund meant for this?
That doesn’t sit well with Sen. Dan Johnson, R-Lewiston, who also is on the Millennium Fund Committee.
“If we’re going to do that, why have a committee?” he asked.
Johnson sees the recovery centers as a critical component of the state’s behavioral health system. He’s open to considering their 2020 funding request but, like Wood, he doesn’t think the Millennium Fund is an appropriate source of ongoing support.
“When someone comes to the Millennium Fund for money, they’re supposed to submit a sustainability plan,” he said. “Absent that, it makes it hard to keep supporting the request. The fund has been an important source of seed money for local, home-grown solutions to substance abuse or tobacco use, and I’m concerned about taking those dollars out of circulation (on a permanent basis).”
Return on investment
Whatever funding source might be available, supporters say the recovery centers offer great “bang for the buck.”
Darrell Keim, one of three part-time employees at the Latah Recovery Center, noted that the Moscow facility has about 6,000 client contacts per year. That includes people attending Narcotics or Alcoholics Anonymous meetings, taking recovery classes or who simply come by to hang out with their friends in a healthy, safe environment.
“Recovery centers are a great way for the state to engage citizens in healthy behavior,” he said. “We are an excellent value.”
Keim and the other part-time managers are the only paid employees. The center is staffed primarily by volunteers. They contribute about 400 hours each month; in many cases, they’ve had their own struggles with substance abuse and addiction, and volunteering is part of their personal path to recovery.
That’s actually one of the main benefits of the recovery centers, Keim said. Like any social support group, these peer interactions help reinforce good habits and behaviors and forestall relapse.
The centers also provide a continuum of care, he said. While emergency rooms will treat someone who’s in the midst of a crisis, recovery centers provide long-term support.
“You might go to a crisis center for 24 hours to de-escalate, but the long-term issue that caused the crisis hasn’t been taken care of,” Keim said. “You go to a recovery center for life, for the sense of community and the support of your peers.”
Wood, who is also chairman of the House Health and Welfare Committee, agreed that recovery centers are an important part of the state’s substance abuse and addiction treatment services.
“They are very valuable. There is no doubt about that,” he said.
Lawmakers skeptical that they work
But other lawmakers aren’t so sure. Although every center has “feel-good” stories about the people they’ve helped, they typically lack hard data regarding the fiscal and social impact of their services. For example, they can’t prove that they helped lower crime rates or reduced emergency room visits, and they don’t track clients to make sure they stay on the straight-and-narrow.
Absent such “return on investment” data, it may be difficult to convince a fiscally conservative Legislature to permanently fund the recovery centers.
Rep. Mike Kingsley, R-Lewiston, hopes to introduce legislation this session that could help overcome that resistance.
Kingsley ran for office specifically to push for increased state funding for substance abuse and addiction treatment services. He tried to create a permanent funding source for the recovery centers last year, by imposing a small tax on opioid drug distributors. However, the measure died in committee.
This year, he’s proposing a pilot project involving the Moscow and Lewiston centers. Each center would get $200,000 in state funding. He would then work with them over the course of the coming year, to track and demonstrate the savings that can be realized with that investment.
“Then I can come back to the Legislature and say here’s what can be accomplished,” Kingsley said. “Look at the amount of money we can save. We’re spending $30,000 to house one state prisoner. To me, (recovery centers) should be the first place we spend money.”
The Joint Millennium Fund Committee is scheduled to meet Tuesday to discuss the governor’s funding proposal, as well as the recovery centers and other funding requests. However, the joint budget committee will make the final decision on how to use any Millennium Fund monies.