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ND drug treatment vouchers could run out of money next week

Mark Schaefer, clinic manager of Community Medical Services in Minot, N.D., the state's first methadone clinic, is pictured Thursday, March 16, 2017. About 40 percent of clients there use a state-funded vouncher program, which would receive less funding under a legislative proposal. Amy Dalrymple / Forum News Service

MINOT, N.D. — At North Dakota's first methadone clinic, about 40 percent of clients rely on a state-funded voucher program to help them pay for treatment.

"It's serving a huge need," said Mark Schaefer, clinic manager for Community Medical Services in Minot, which opened last August and serves 60 clients.

But the substance use disorder voucher program, established by the Legislature in 2015, is set to run out of money as early as next week, according to the Department of Human Services.

In addition, the level of funding proposed by legislators for 2017-19 would provide vouchers for less than four months before it would run out of money, the department said.

Schaefer and others who participated in a recent discussion on combatting North Dakota's opioid crisis advocated for Senate lawmakers to restore funding to the voucher program, which had $1.5 million in the executive budget but legislators propose cutting to $375,000.

"There's a whole range of services that it's covering and filling the gap for people," Schaefer said. "Many of them would not be able to pay that. They would just slowly run out of money and options."

The Department of Human Services launched the voucher program last July after spending a year developing it, said Pamela Sagness, director of the Behavioral Health Division.

So far, 118 individuals have been approved to receive vouchers, which became available last September and cover services such as therapy, outpatient treatment and recovery coaching.

"It was the one real big effort that came out of last session in trying to tackle the behavioral health issues of the state," Sagness said.

The vouchers began with $750,000 in funding for 2016-17, but budget cuts to address the state's revenue shortfall reduced that to $375,000. More than 95 percent of the funding had been allocated as of March 13 and the funds are expected to be depleted any day, Sagness said. Funding for next biennium would become available in July.

The loss of vouchers will have a big impact on the St. Thomas Counseling Center in Jamestown, where about 30 percent of clients use the assistance to access outpatient addiction services, said CEO and psychologist Stacey Hunt.

"I hate to have to tell people, 'Hey come back in July when we get this funding back if it runs out next week,'" Hunt said.

The facility, which opened last November, aims to provide early intervention for people who likely won't qualify for other programs, Hunt said.

Many travel to Jamestown from surrounding rural areas. One client would not have been able to attend the recommended group therapy three times a week without transportation assistance from the voucher program, she said.

"We have to still help our rural folks and not just center our services in Bismarck and Fargo," Hunt said. "I hope the Legislature responds to that."

Eight providers are approved to participate in the voucher program. The other programs participating are in Fargo, Bismarck and Cando. Another nine providers have applied to participate with locations in Fargo, Grand Forks, Dickinson, Bismarck, Minot, Williston and Devils Lake.

A subcommittee of Senate Appropriations is expected to discuss House Bill 1012, which includes funding for the vouchers, on Tuesday, March 21. Sen. Tim Mathern, D-Fargo, a member of the subcommittee, said he thinks it's important to add money for the vouchers, but he doesn't know if it can be fully restored.

"It's the only creative thing we've done in the last few years to address behavioral health," Mathern said. "The funding is woefully inadequate. I believe we can add some more dollars back into that."

In North Dakota, opioid-induced fatalities increased by 125 percent from 2013 to 2014, according to the Centers for Disease Control.

U.S. Sen. Heidi Heitkamp, D-N.D., joined others at a discussion in Minot this week in calling for people to contact their state legislators about the funding.

"I can't imagine that in the state of North Dakota, we couldn't find a few more dollars to help families," Heitkamp said.