Despite the fact that people with disabilities often need substance abuse treatment, there is little research about whether substance abuse treatment models are tailored to meet the complex needs of this population. Funded by the Robert Wood Johnson Substance Abuse Policy Research Program, we examined eight states and the substance abuse treatment services they offer to the SSI disabled population through Medicaid managed care arrangements. Our results suggest that there is wide variation in how states are using managed care strategies to provide substance abuse treatment services to the SSI disabled population. In fact, multiple managed care strategies are often implemented within a single state. In addition, the specific methods that are used to provide substance abuse services to people with disabilities within these multiple models are sometimes difficult to identify.
Our work resulted in several important findings related to the importance of substance abuse treatment for people with disabilities. Our work has clarified that people with disabilities often experience substance abuse problems. Substance abuse treatment may cause their health care to become more expensive and complicated. The state Medicaid program often absorbs these costs. However, when we contacted both states and managed care plans to talk about substance abuse treatment services for people with disabilities, many of our key contacts knew relatively little about these needs, or or limited to only people who use wheelchairs. Alternatively, when we explained that we were thinking more broadly and focusing on substance abuse services for people with all types of disabilities, respondents typically focused on people with serious mental illness. We hope that the results of this project will help key policymakers and managed care plans think more broadly about disability and substance abuse treatment needs, recognizing both the range of conditions that affect people with disabilities as well as how important substance abuse treatment is for persons with disabilities.