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Gaps Seen in Md. Drug Treatment

In Montgomery, adult addiction services manager Richard Kunkel said the county offers a robust continuum of care but receives far less in state funding than other large Maryland counties.

He said bottlenecks and waiting lists occur for service.

The county receives less funding, he said, because of its perceived wealth.

"Even though the need may be low in comparison, the reality is we get very little in state funding," he said, noting that the smaller city of Baltimore receives 10 times more funding.

Researchers found that Baltimore had the highest substance abuse need, but also admitted more than 3,600 patients for treatment per 100,000 residents. That left it with a far smaller treatment gap than Prince George's or Montgomery.

Members of the Prince George's County Council voiced concern about the lack of inpatient beds at a meeting this week. They also questioned Shell about the amount of funding returned to the state each year.

Prince George's is one of several Maryland counties that has returned hundreds of thousands in state substance abuse treatment funds each of the last four years. In fiscal 2007, Prince George's returned more than $700,000 -- more than 6 percent of its overall funding -- to the state. Baltimore County returned almost 10 percent of its money.

"I don't understand how we consistently give money back when there is such great need," council member Camille Exum (D-Seat Pleasant) told Shell at the hearing.

Shell said funds sometimes arrive at the end of the fiscal year, making it more difficult to spend dollars before the department is required to send money back. In 2007, a hiring freeze made bringing new staff on board to spend funds difficult.

But he acknowledged that the county must speed the process for approving the transfer of state funds to the health department and that the department must become more efficient in spending the treatment dollars.

"The loud message to the health department is that if we want the help of the county and the state, we have to get our house in order," Shell said.

The county might get some help -- and more oversight -- from the state.

Kathleen Rebbert-Franklin, acting director of the Maryland Alcohol and Drug Abuse Administration, said state figures are looking at the problem and trying to come up with ways to ensure that counties spend more state funding on treating addiction. She plans to report suggestions to lawmakers in December.

Del. Peter A. Hammen (D-Baltimore), chairman of the Health and Government Operations Committee, said he hopes to introduce state legislation this year that could address the issue and also work to start closing the treatment gap statewide.

"We know in those jurisdictions that the need is high," he said. "If there's money that's not being spent on services, it's a huge problem."

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