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Delaware counties' review of substance use treatment system reveals scale of need

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Delaware Public Media
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A review of Delaware’s substance use treatment network found state service providers currently meet only a fraction of the demand for its services — a challenge particularly acute for those needing the highest levels of care, including inpatient treatment.

New Castle, Kent and Sussex Counties commissioned the study last year in hopes of identifying what elements of the state’s crisis response are working. By the end of 2021, overdose deaths reached an all-time annual high.

Health Management Associates, a Michigan-based research organization, found the state only meets 15 percent of current treatment need – and only 5 percent for the highest-intensity services, including inpatient treatment. Researchers underscore that while that gap is not unusual nationally, nowhere in Delaware adequately provides access to treatment services.

Division of Substance Abuse and Mental Health Director Joanna Champney says the discrepancy between treatment demand and availability may not reflect a shortage of space for inpatient or outpatient care.

“It’s not necessarily that there’s this giant waiting list or that we don’t have the beds for inpatient or spaces for outpatient," she said, "but that there’s a disconnect with people understanding how to access publicly funded treatment.”

One of the researchers, Muriel Kramer, says healthcare providers can better meet demand if they – and their patients – have clearer information about how to efficiently access the right level of care.

“Sometimes, we hear that providers are reluctant to initiate treatment because they don’t know where they’re going to send a person next," she said. "Every provider in your system needs to know the system that’s out there and where they’re going to send people.”

In addition to efforts to improve coordination and awareness between stakeholders in the treatment system, Champney notes her agency plans to direct additional dollars toward expanding publicly funded inpatient and outpatient treatment capacity.

Meanwhile, Delaware’s Department of Health and Social Services is proposing an increase in the Medicaid reimbursement rate for substance use treatment – part of a broader plan to retain and attract more staff to meet Delaware’s rising demand.

Paul Kiefer comes to Delaware from Seattle, where he covered policing, prisons and public safety for the local news site PubliCola.