The substance abuse addiction crisis touches every corner and resident of Butler County. We cannot beat addiction with a one-size fits-all approach. What has become very clear, however, is that we must recognize and treat behavioral health and addiction as a chronic disease and that we must address basic physical, mental, and spiritual needs in prevention, intervention, treatment, and life-long recovery.

Years ago, under the old fee-for-service behavioral health model, doctors and treatment providers were reimbursed according to the service provided, which encouraged more units of treatment in what was an acute response model. We treated behavioral health and addiction as though they were “short-term” illnesses. We learned the hard way that behavioral health and addiction are chronic challenges, much like diabetes, where long-term management and lifestyle changes can avoid repeated and very costly hospitalizations, where quality becomes more important than quantity.

In 1997, the Commonwealth of Pennsylvania instituted HealthChoices, a more flexible payment model that allowed counties to take responsibility for the behavioral health care of their constituents. Counties are closest to the consumer geographically and are uniquely situated to work with criminal justice, physical health care, education, and faith-based partners. Butler County was able to provide behavioral health care to its residents directly by contracting with Value Behavioral Health of PA, a licensed managed care organization. VBH-PA created a network of providers to meet both the mandated services created by statute, as well as the unique services designed locally.

This approach focused on quality versus quantity of treatment, saving millions of dollars that have been reinvested in programs addressing the chronic nature of behavioral health and addiction, such as Center for Community Resources, the local Crisis and Information & Referral program, the Bette Peoples Transitional Care Center at the VA, and the Assertive Community Treatment Team at Butler Memorial Hospital.

HealthChoices, along with Medicaid expansion, provided an additional $4.3 million this year alone for Drug and Alcohol treatment in Butler County undoubtedly saving many lives. In addition, Butler County used reinvestment funds to provide rental assistance for individuals coming out of residential rehabilitation to avoid a return to unsafe housing conditions and expanded the number of beds for treatment. The most recent initiative, substance abuse case coordination, helps find appropriate treatment for those seeking it and provides supports while they are waiting for an opening. HealthChoices curbed the escalating cost of acute treatment and hospitalization, with more than half of residents receiving care now doing so in outpatient, home-based, school-based or ambulatory settings.

While we recognize that we have a long way to go in combating the opioid crisis and that we have differing opinions on how to get there, we acknowledge the need for many hands, hearts, and tools to drive change. A long-term commitment on multiple levels is necessary to managing behavioral health and addiction with any level of effectiveness and efficiency. It doesn’t just go away. As we celebrate the 20th Anniversary of HealthChoices, we are ever cognizant of the need to continually measure its value and outcomes. We thank the Governor and Legislature and more importantly the citizens of this Commonwealth for their support and are committed to working with them to address this epidemic.

Leslie Osche is the chairman of the Butler County Board of Commissioners, and the former executive director of United Way of Butler County.