State health officials this week urged lawmakers to nix a proposal to transfer the state substance abuse office to a different department of state government. They said the move would divert time and money away from treating addiction.
Sen. Jane Kitchel, D-Caledonia, who proposed the transfer, said it is the first step toward breaking up the mammoth Agency of Human Services and will make state substance abuse treatment programs more efficient and accountable.
Rep. Ann Pugh, D-South Burlington, chair of the House Human Services Committee, said Friday the idea is worth considering but it is too late in the session to mandate the transfer this year.
“We all walked into this yesterday,” Pugh said.
Kitchel’s proposal would transfer the Office of Alcohol and Drug Abuse Programs (ADAP) from within the Department of Health to the Department of Vermont Health Access (DVHA).
Kitchel, D-Caledonia, the chairwoman of the Senate Appropriations Committee, Friday explained her plan to the House Human Services Committee. That committee plans to weigh in with a recommendation about the proposal as money committees conference over next year’s budget.
Health Commissioner Harry Chen and DVHA Commissioner Mark Larson Thursday told the committee the move is a bad idea. They were not consulted, they said.
“It’s the wrong decision at the wrong time,” Chen said. The agencies already work together, he said.
“It splits the prevention and treatment in a way that would become a new problem,” Larson said.
Kitchel said her committee did not hear testimony from proponents of the idea. They based the decision on a series of reports and memos from state health officials, she said.
Kitchel pointed to an estimated $6.7 million in savings DVHA expects next year as a result of using the hub and spoke addiction treatment system which the department would reinvest in the system.
It was hard to understand exactly how officials plan to spend that money, Kitchel said.
The committee wrestled with whether medication-assisted therapy is always the best way to treat patients with an addiction or whether that would simply “substitute one drug dependence or another.”
“It just got into a very hard discussion around what would the money be used for, how would it be used along that continuum, because we didn’t even have a good measurement of where the need was the greatest,” she said.
Kitchel’s proposal would leave substance abuse prevention efforts within the Department of Health but move treatment programs into DVHA, which handles Medicaid for the state.
Both DVHA and the Department of Health are within the Agency of Human Services. That agency also encompasses the Department of Corrections, the Department for Children and Families and others.
Kitchel said the switch makes sense as the state works toward universal health care.
There are always logistical reasons not to make the switch, but concerns about moving offices and people pale in comparison to the benefit of streamlining government, she said.
“It’s not to say that something is broken,” Kitchel said.
Committee members said it’s a good idea to study whether existing bureaucratic structures make sense. But they said the suggestion comes too late in the session, with only a week remaining.
“I understand her rationale that no one likes change but if it is such a good idea, it would seem as though there would be someone who would testify and say yes, this is a good idea,” said Rep. Patsy French, D-Randolph.
Rep. Anne Donahue, R-Northfield, suggested that the Agency of Human Services present a plan next year to move the ADAP addiction and mental health treatment programs from the Department of Health and into DVHA by fiscal year 2016.
