Island County was identified as one of several Washington state counties that are at imminent or critical risk of losing their chemical dependency programs.

“We’re losing money,” said Jackie Henderson, Island County’s human services director.

Last year, the program, now run by Sea Mar, was able to bill patients at both Medicaid rates and higher private pay rates.

With most patients now on Medicaid as a result of the Affordable Care Act, the program is now getting less money to provide the same service, Henderson said.

Sea Mar is currently supplementing the programs in smaller counties with income from profitable programs in larger counties and urban areas.

But it is unlikely they will want to do that forever, Henderson said.

“They agree that they shouldn’t have to be taking money form other parts of the state to supplement our programs here,” Henderson said.

Island County’s Sea Mar Health Center works closely with the county’s drug court system to provide drug and alcohol assessments, intensive outpatient treatment for addicts, relapse prevention, offender monitoring and assists with deferred prosecution if they seek treatment.

Henderson said the loss of the county’s chemical dependency treatment program would have a “huge impact on the local court system and our medical system.”

For that reason, struggling counties are banding together to ask the state to fund the programs or find a solution.

During the Association of County Human Services meeting in May, representatives identified Island, San Juan, Grant, Lincoln, Stevens/Ferry and Skamania counties as being being at “imminent” risk of losing chemical dependency programs by the end of the year.

Kittitas, Pend Oreille and Walla Walla counties were identified as being at “critical” risk of losing programs any day.

If the reimbursement rate structure for chemical dependency is not fixed, there is a possibility of these types of service providers pulling out of rural communities, said Island County Commissioner Jill Johnson.

“It is unrealistic to expect a business to serve a community where they are losing money,” Johnson said. “It is also unrealistic to assume that individuals with chemical dependency issues will somehow manage to get to a service providers in other counties.”

The association identified a number of possible solutions they have already begun to pitch to legislators.

Among those possible solutions are providing a local funding match, allowing for secondary insurance, increasing the Medicaid reimbursement rates for this type of service and identifying other allowable services that providers can bill for to offset the costs.

Johnson, who serves on the North Sound Mental Health Administration board, contacted all of the county’s state and federal representatives asking them to intervene before Sea Mar is forced to stop providing services.

“This is an important issue to me, and to our county,” Johnson wrote legislators.

“This is an issue that will need advocates coming from all directions, and the more informed you can be on the topic, the better you can serve our rural communities.”