HARRISBURG — Millions of dollars secured, in part, through legal settlements with opioid companies will alleviate student loan debt in a targeted program intended to boost the addiction treatment workforce.
The industry is beset, like others, by a shallow candidate pool, employee burnout and entry-level wages considered unattractive.
The Pennsylvania Department of Drug and Alcohol Programs, citing federal labor data, found that the commonwealth’s mental health and substance abuse workforce shrank by nearly 15% from 2018-19 through 2021-22.
An estimated 400 professionals will share in grants totaling $22 million distributed by DDAP. Grant maximums are $75,000 for full-time workers and $37,500 for those working part-time.
Eligible professions include certified counselors, case managers, licensed social workers, physicians and registered nurses.
It’s the latest round of funding for DDAP’s substance use disorder (SUD) student loan repayment program. According to the Shapiro Administration, the program has been funded since 2022 with more than $40 million to help offset loans for an estimated 675 workers.
A portion of the funding comes from settlements with opioid manufacturers and distributors blamed for fueling the ongoing opioid epidemic. Gov. Josh Shapiro pursued the settlements during his years as the Pennsylvania attorney general.
The commonwealth expects $2.2 billion across two decades. Payments began in 2022, with $209.4 million received and allocated for commonwealth programs, varied recovery efforts in all 67 counties as well as in certain municipalities deemed adversely impacted by the opioid epidemic.
“The supports are only as good as the staff and the team who are available to deliver them. One of the first issues we diagnosed was that we just didn’t have enough people doing this work. We were able to use a good portion of that money to provide loan forgiveness for people who were doing the important work in helping those in recovery, helping them on their road to recovery,” Shapiro said in a statement announcing the funding.
While fatal drug overdoses fell in 2023 for the first time since 2018, the nation’s death toll still topped 107,500, according to the Centers for Disease Control and Prevention. Deaths involving opioids — namely illicit fentanyl — exceeded 81,000 last year, down from nearly 84,200 in 2022.
DDAP surveyed addiction treatment providers in 2023, with 490 in varied aspects of the field participating. According to the results, 84% reported that the labor shortage was a moderate to serious problem for their organizations. The average job vacancy rate was 18%, according to the survey.
Deb Beck, president of the Drug and Alcohol Service Providers Organization of Pennsylvania, said Shapiro’s work to hold the pharmaceutical industry accountable shouldn’t be forgotten. Staffing problems are plaguing the recovery industry across the commonwealth, Beck said, and loan forgiveness will help.
But, Beck said, there’s no single solution.
Tuition reimbursement and funding to raise salaries for counselors is needed, she said, as are regulatory reforms to help make it easier for people, specifically those who’ve achieved sustained addiction recovery themselves, to enter the profession.
Legislation signed into law in 2023 provided staffing flexibility for Pennsylvania’s Licensed Addiction Treatment Programs during an opioid epidemic, expanding staff-to-client ratios to increase patient access and easing requirements to become a counselor.
A bill introduced in June by state Sen. Christine Tartaglione, D-Philadelphia, would build on the reforms. Senate Bill 1243 proposes to allow certain individuals including those in recovery to become counselors without college degrees provided that they have at least one year’s experience working in a licensed program under an individualized training plan.
“We don’t have enough staff and yet the patients keep pouring in,” Beck said. “It’s devastating. (Workers) rally at the front door when somebody shows up for help but they’re over-stressed, overworked and underpaid.”
Jason Snyder, director of Substance Use Disorder Treatment Services for Rehabilitation and Community Providers Association, also expressed gratitude for the loan repayment program. Like Beck, he said more efforts are needed — namely, increasing reimbursement rates for treatment services.
“People leave the field because their paychecks are too low and the administrative burden placed on them is too high. And those factors are a direct result of historically inadequate reimbursement rates that are becoming more acute in a time of skyrocketing operating costs and a regulatory and oversight system that is growing, not shrinking,” Snyder said.
“Until rates, administrative burden and 50-year-old regulations that are burdensome barriers to accessing treatment are urgently addressed in a meaningful way, our addiction treatment system will continue to struggle not only with workforce issues but with long-term sustainability as well,” he said.