Methadone transportation costs rack up huge tab for taxpayers

SEATTLE-- Roberto Hernandez looks down at his foot in a cast. He could have lost it to amputation. He is passed that challenge. Now it's fighting the need for drugs and finding a way to get to a clinic for help.

Hernandez is one of the thousands of Washington state drug addicts trying to turn their lives around. But it comes at a cost. The state is on the hook for millions of dollars to shuttle patients to methadone clinics in vans, by bus and even by taxi cab -- and taxpayers pick up the tab.

Federal law requires states to pay to help poor addicts get to clinics six days a week, and the costs for us all are jumping at an unheard of rate.

Hernandez travels from Renton to a treatment center in gritty SoDo six days a week. He doesn't want to go back to the life of looking for drugs to help his aching back.

"I was sick, I was in pain. You'd almost do anything," he said.

Hernandez is just one of an estimated 7,000 patients receiving methadone assistance from the state through Medicaid. The state says the controlled substance methadone can help wean patients off heroin and other addictions, which are on the rise.

"This is considered a full flown epidemic according to the CDC," said Molly Carney with Evergreen Treatment Centers, which help disadvantaged patients who use Medicaid to pay for treatment and transportation. "These are patients who deserve access to treatment."

The federal government demands that states pay to get Medicaid patients to clinics six days a week. Whether it's a bus pass, gas vouchers or a regular taxi cab, taxpayers foot the bill.

"The medical transportation is the safety net used to ensure that people can get to their health care appointments," said Paul Meury, a supervisor with the Health Care Authority's transportation division.

The costs for rides is rising. In 2011, approximately 587,000 trips cost a little more than $8,800,000. In 2012, the trips jumped to 638,000 and the cost went along with it to $9,300,000.

The state says it is on pace for 700,000 trips and more than $10,000,000 in costs. Part of the problem is Washington itself.

"We are responsible for 100 percent of the geography of the state," Meury said.

Washington has only 13 clinics in the state that allow Medicaid to pay for methadone. For-profit clinics do not take Medicaid in most cases, so taxpayers have to shell out money to drive patients right by a methadone clinic that's closer all because of rules and regulations.

Hernandez says it's maddening.

"Time out of your life and money we don't have," he said.

In King County, transit passes and short trips help keep the costs to around $22 round trip. Some on the Kitsap peninsula have to take ferries to Sodo. Walla Walla patients have to drive to Yakima and back every day. In north central Washington, it costs $336 and up to an 8 hour round trip each day to Spokane to get a thirty second appointment for that little bit of blue liquid.

More clinics could help, but the state says cities and neighbors often stand in the way because they do not want patients lingering nearby. That is why Hernandez is in SoDo, close to the highway. It is one of the few places he can go to get help. And the costs keep rising.

"There's times where you can't get down here or your car breaks. There's stuff that happens. It's like a losing battle to me," he said.