For many senior citizens who need treatment for addiction to drugs or alcohol, one big stumbling block is that Medicare will only provide coverage for hospital-based, inpatient care. It does does not cover outpatient treatment. As a result, expensive inpatient treatment is the only option for some seniors, and beyond the financial reach of many.
In the Twin Cities suburb of Stillwater, Minn., two business partners – both recovering alcoholics – have created a low-cost outpatient treatment program for seniors, called Silver Sobriety.
Co-founder Peter Oesterreich was director of recovery services at a treatment program for seniors in the Twin Cities when he became aware of “this Medicare gap.”
“We were tired of insurance companies dictating what treatment centers can do,” Oesterreich told The Influence. “We knew there was a better model.” Oesterreich and co-founder Win Miller created their program to offer affordable, non-residential recovery services designed for older adults.
Last year, one of the largest treatment programs in Minnesota shut down its senior program because Medicare reimbursement was inadequate, Oesterreich notes. “The director there told me that, to change Medicare, it would take an act of Congress.”
Medicare red tape can also be a problem. To qualify for Medicare-reimbursed inpatient treatment, seniors “have to meet with a psychologist, then be referred to a clinical social worker, and then can talk to chemical dependency (treatment) people. Then you have to be admitted to a hospital and the treatment plan has to be supervised by a physician. That’s what Medicare requires.
As a treatment provider, “I’m not going to put someone who has been in treatment before through two hours of assessment to find out if they need treatment,” he says.
The average client age at some urban treatment centers is about 25, and opiates are often the drug of choice, Oesterreich points out. “Seniors just can’t relate to that, so a program like that is not a good fit for them.”
Oesterreich and Miller opened their program in early 2015. For the first year, neither men took a salary. Rather than focusing on making a profit, their venture is based on “a passion to try to fill this gap; so seniors have some place to go,” Oesterreich says.
The standard price Silver Sobriety charges is $4,500 for six months of treatment, which includes three group sessions per week, and a weekly one-on-one meeting with a counselor.
Many clients pay less, based on their ability to pay. “Because we are a non-profit, we have a very aggressive sliding fee schedule.” Some clients pay the minimum charge of $100 per month for six months of outpatient treatment.
For seniors, one major contributing factor to developing a dependence on alcohol or drugs is social isolation. “A lot of the people who come in to our program are isolated,” Oesterreich says. “Their social circles have declined as spouses and friends have passed away, and their work circles.”
Accordingly, one of the important things Silver Sobriety gives clients is a place to connect with other people, he says. The program uses strategies designed to address emotional issues such as loneliness, depression and grief.
After they complete the program, clients are given the opportunity to participate in continuing care, free of charge; Silver Sobriety has relapse prevention groups that meet several times a week. “It’s really important that people remain connected so they can stay sober,” Oesterreich says. “We’re really trying to create a recovery community for seniors.”