Changes in State Technical Assistance Priorities and Block Grant Funds for Addiction After ACA Implementation

• Abraham, Amanda J. ^[1] ; Smith, Bikki Tran ^[2] ; Andrews, Christina M. ^[3] ; Bersamira, Clifford S. ^[5] ; Grogan, Colleen M. ^[2] ; Pollack, Harold A. ^[2] ; Friedmann, Peter D. ^[4]
  1. [1] University of Georgia

     University of Georgia

     Estados Unidos

     
  2. [2] University of Chicago

     University of Chicago

     City of Chicago, Estados Unidos

     
  3. [3] University of South Carolina

     University of South Carolina

     Estados Unidos

     
  4. [4] University of Massachusetts Medical School

     University of Massachusetts Medical School

     City of Worcester, Estados Unidos

     
  5. [5] Myron B. Thompson School of Social Work, University of Hawai’i at Mānoa, Honolulu

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• Localización: American journal of public health, ISSN 0090-0036, Vol. 109, Nº. 6, 2019, págs. 885-891
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Objectives. To assess states? provision of technical assistance and allocation of block grants for treatment, prevention, and outreach after the expansion of health insurance coverage for addiction treatment in the United States under the Affordable Care Act (ACA).Methods. We used 2 waves of survey data collected from Single State Agencies in 2014 and 2017 as part of the National Drug Abuse Treatment System Survey.Results. The percentage of states providing technical assistance for cross-sector collaboration and workforce development increased. States also shifted funds from outpatient to residential treatment services. However, resources for opioid use disorder medications changed little. Subanalyses indicated that technical assistance priorities and allocation of funds for treatment services differed between Medicaid expansion and nonexpansion states.Public Health Implications. The ACA?s infusion of new public and private funds enabled states to reallocate funds to residential services, which are not as likely to be covered by health insurance. The limited allocation of block grant funds for effective opioid medications is concerning in light of the opioid crisis, especially in states that did not implement the ACA?s Medicaid expansion.