Monday, September 18, 2023

Family-based residential addiction treatment centers are successful, but the model struggles to be viable

Despite successes, these centers struggle.
(Photo by Jordan Whitt, Unsplash)
Even with higher success rates, family-based residential addiction treatment centers remain the exception; centers in rural areas are rarer still, with waiting lists ranging from two to six weeks, reports Christina Saint Louis of KFF Health News. Recovering Hope Treatment Center in eastern Minnesota's Kanabec County is the state's only rural residential treatment center and "one of only five providers in the state that offer family-based residential treatment, allowing women to enter the program while pregnant or to bring one of their children younger than 5 with them for the duration of their stay."

Research supports the success of family-centered approaches to addiction treatment, but costs, lack of funding and staffing struggles prevent the model from becoming the standard of care. "And because of that complexity, families in rural areas are less likely to find such a residential treatment program in their communities," Saint Louis writes. "Meanwhile, maternal opioid-related diagnoses have increased nationwide. From 2010 to 2017, the rates of women with those diagnoses at delivery increased by 131%, and babies born with withdrawal symptoms increased by 82%, according to the Centers for Disease Control and Prevention. The increases disproportionately affected rural areas."

Women receiving residential treatment tend to have Medicaid, which has lower provider reimbursement rates, contributing to centers limiting or reducing services to cut costs. Saint Louis adds, "Women in the center's residential program previously spent up to an average of 40 days in high-intensity care at the beginning of their treatment, but that time span is now closer to 30 days to contain costs due to those low reimbursement rates."

Family-based care allows children to stay at the center but adds child care and schooling limitations, according to Ashley Snyder, a licensed drug and alcohol counselor at Recovering Hope. Snyder told Saint Louis, "If you don't provide family services, the parents run the risk of losing their kids."

As an indicator of how tough establishing a residential addiction center is, North Dakota's state Department of Health and Human Services has been "trying to establish a family-based residential treatment option like Recovering Hope since 2020. The state has been without one since April 2019, when its lone provider shut down," Saint Louis reports. "The department has issued three requests for proposals seeking providers to offer a treatment model that allows children to live with a parent undergoing residential treatment but didn't receive any responses."

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