Medicaid Expansion

Before the Senate Medicaid Finance Subcommittee and the House Health & Aging Committee

May 2, 2013 (Senate) and March 7, 2013 (House)

Chairman Burke, Vice Chair Jones, Ranking Minority Member Cafaro and committee members, thank you for the opportunity to testify before you this morning.

My name is Marcie Seidel. I am the executive director of Drug Free Action Alliance, a statewide certified prevention agency in existence for more than 25 years with a mission to lead the way in promoting healthy lives through the prevention of substance abuse and its related problems.

Our agency and our numerous partners are strong advocates for the increasing Ohioans quality of life and strengthening the workforce by support every segment of the continuum of care from prevention, intervention, treatment through aftercare.

Drug Free Action Alliance works collaboratively in a science-based approach throughout the entire state to make environmental changes that result in reduced substance use and abuse. Our approach increases public awareness to promote change in attitudes and promote changes in our environment that discourage the use and abuse of substances.

We build Ohio’s prevention infrastructure by working more than 100 community coalitions; 50 colleges, universities, and community colleges; 35 family advocacy groups; 100 youth-led prevention organizations and many more sectors throughout Ohio.

Each year, we connect with more than 30,000 Ohioans who are leaders in their communities with evidence-based programs, trainings, resources, and technical support. We advocate for closing the gap between current knowledge of prevention science and local entities creating or adapting their own prevention programs that lack research which too often products marginal outcomes.

Prevention works.

In 2009, two Iowa State University researchers did a study showing that for every dollar spent on evidence-based substance abuse prevention programs, there was a nearly $10 return for that one dollar.

Comprehensive substance abuse prevention can be helpful in preventing many other problems, including undiagnosed/untreated mental disorders, child abuse and neglect, crime and violence, problem gambling, and other problems.

Too often prevention is dismissed in the essential continuum of care, but the primary prevention river parable puts it in perspective and I would like to repeat it:

Imagine a large river with a high waterfall. At the bottom of this waterfall hundreds of people are working frantically trying to save those who have fallen into the river and have fallen down the waterfall, many of them drowning. As the people along the shore are trying to rescue as many as possible, one individual looks up and sees a seemingly never-ending stream of people falling down the waterfall and begins to run upstream. One of the other rescuers yells, “Where are you going? There are so many people that need help here,” to which the man replied, “I’m going upstream to find out why so many people are falling into the river.”

Prevention works.

Our approach not only centers on informing and educating individuals and the public, but also changing the environment. There are four major environmental factors that significantly reduce use and abuse of substances:

  1. Changing individual and community attitudes to create a healthy, normative environment.
  2. Limiting access and availability.
  3. Restricting the promotion and marketing.
  4. Creating sound laws and policies and increasing their enforcement.

A great example of an effective environmental outcome came from the 129th General Assembly’s passage of House Bill 93. After the enactment of this legislation in Scioto County alone there were 1.5 million fewer opiate pills prescribed and 17 fewer people died. The legislation provided for the creation of public awareness campaigns, physician education, and massive closing of pain clinics, which significantly limited access and availability. Ohio was one of 10 states from 2010 to 2011 that reduced its opiate use. This is a major prevention accomplishment.

Prevention saves money and because prevention and all the needs within the behavioral healthcare systems are vital to keeping Ohio strong, we strongly support the expansion of Medicaid.

First, we believe it is the right thing to do. More individuals receiving health services not only benefit the quality of individual lives but also the collective whole of our communities.

Second, there are many individuals who need treatment but don’t have the access to healthcare services to receive it.

Drug Free Action Alliance works with family groups throughout Ohio consisting of family members whose lives have been forever altered through the death or tragedy of a loved one. They come together to provide support to individuals and families affected by addiction, advocate for effective policy changes, and mobilize their communities to affect their own change.

From these networks, we are told time after time that access to treatment is critical. Ms. Seidel, who is with me today, will tell the story.

Third, the expansion of Medicaid could free up resources to be redirected to help build the infrastructure to include the entire continuum of care, including prevention and more treatment facilities. Prevention can reduce the number needing services and providing more treatment facilities will reduce waiting lists that are in too many cases too long, shattering the hope for treatment and recovery.

Funding for alcohol and drug prevention has steadily declined in recent years and is threatened to the point of extinction. Studies consistently show a significant correlation between funding and adolescent drug use. Funding is up, drug use down. When funding is down, drug use is up.

A comprehensive approach to putting lives back on track, creating full employment, and helping Ohio to thrive should not just be an option. Resources are scarce, but Medicaid expansion is a viable option to keep our dollars here serving our citizens.

We respectfully ask you to consider this information and reconsider including Medicaid expansion in your complex decision-making process.

Thank you for allowing me to testify before you today.

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