From: Raye Silvers
To: Legislative Fiscal Analyst Office Dropbox,
Subject: Comments regarding Utah Cares Plus
Date: Thu Oct 08 15:37:48 MDT 2015

My name is Raye Silvers. I’m the Admissions Manager for First Step House, a non-profit treatment center in Salt Lake City serving low-income and indigent men with substance use and mental health disorders. We also have been selected as the lead agency for Salt Lake County’s Criminal Justice Recidivism Pay for Success Project, and in 2016 will implement programming to support the long-term stability of offenders re-entering the community after incarceration.

For nearly 10 years, I’ve been the primary point of contact here for men and their families seeking help. I have heard every story of desperation and despair one can imagine, and I invite anyone on this committee to discuss these stories with me personally if they wish. For me, they have all become one story, of families who’ve heard that help is available if they’ll only reach out, but because they have no money and no insurance, the help they need isnot available. True, there is County funding available for SL County residents, but the wait for that can be several weeks to several months for outpatient services, and up to six months or more for residential services. There is also some specialty funding available for criminal justice diversion programs, but it is very, very limited.

Proponents of the current proposed plan assert that the cost of our portion of Medicaid expansion plan is unsustainable, that we cannot afford to burden future generations with it. I maintain that Medicaid expansion costs far less than what I call the revolving door services of law enforcement interventions, incarceration, DCFS involvement,` homeless services, and unfunded emergency room visits and hospitalizations. It’s not uncommon for our patients to have more, often much more, than $50,000 in outstanding medical debt. This is especially true for individuals who, in addition to a substance use disorder, also struggle with a serious, chronic mental illness.

The costs of revolving door services can all be calculated with surprising accuracy, but the cost to families and to our society of fathers, sons, partners and brothers incapacitated by or lost to addiction and/or mental illness is incalculable. I regularly talk with grandparents and even great-grandparents who are raising young children in their retirement years because the parents of these children are stuck in the revolving door or have died from their treatable illnesses, as a direct result of the lack of affordable, accessible treatment services. These are the costs that we cannot afford to burden future generations with.

I attended the Health Reform Task Force meeting on Tuesday, and wasn’t called to testify before I had to leave. I am extremely disappointed in the Utah Cares Plus plan, and truly appalled by the proposed plan to finance it. I will simply say that I oppose this plan entirely, and support Governor Herbert’s Healthy Utah plan, a very reasonable alternative to full Medicaid expansion. The majority of Utahns support it, and many, many Utahns, not just the individuals we serve, need it to save their lives.

Raye Silvers, ASUDC
Admissions Manager

Phone 801-359-8862, ext. 2113
Direct 801-410-5217

Fax 801-359-8510

We help build lives of meaning, purpose, and recovery.

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