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Originally published Friday, March 11, 2011 at 5:15 PM

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Guest columnist

Savings of the state Disability Lifeline program should be preserved

Guest columnists Daniel Lessler and Nick Metz argue that the state Disability Lifeline program actually saves the state money. The Legislature should preserve this program that provides cash and medical assistance to disabled people unable to work who don't qualify for federal disability.

Special to The Times

The Great Recession has hit our community hard, but for 6,000 people, it has been brutal. These people are on the Disability Lifeline program, which provides cash and medical assistance to disabled people unable to work who don't qualify for federal disability programs. They suffer from severe injuries, chronic medical and mental illness, and substance abuse; many are also homeless.

Unfortunately, things may get even worse if the Disability Lifeline program is eliminated, which the governor proposed and the Legislature is currently debating.

Disability Lifeline is truly a lifeline. The small cash grant is the difference between housing and homelessness. Medical benefits mean treatment, including medications, for crippling mental illness and chronic conditions like diabetes. Substance abuse treatment and vocational training create a path to self-sufficiency.

Historically, Disability Lifeline patients didn't have access to a mental health benefit, even though half of them were disabled because of mental illness. Patients had to find a health-care provider who would care for them; some never got the needed care, and many got care that was uncoordinated. In either case, the program didn't reliably lead to improvements in health or employability.

To get better value for the money, Washington started a pilot program in 2008 in King and Pierce counties. In King, five community health centers, Seattle-King County Public Health, Harborview Medical Center, and the Regional Support Network teamed with Community Health Plan of Washington and the UW to create an evidence-based health care model for Disability Lifeline clients.

Each client was assigned a primary care provider who treated their chronic conditions and referred them to an onsite care manager if they had mental health or other challenges. Care managers provided mental health services, and helped patients access substance abuse treatment and job training. Some clients were referred for more focused treatment to a specialty mental health clinic such as Harborview.

A recent study of this model's first 21 months, conducted by the University of Washington, Washington State University and the state Department of Social and Health Services found that Disability Lifeline patients in King and Pierce counties who received care under this model consistently fared better than patients in non-pilot counties.

The program helped contain homelessness even as the great recession hit — King and Pierce Counties saw half the increase in homelessness among Disability Lifeline clients. Arrests among people who received services in pilot counties dropped by 24 percent, compared to an increase of 2 percent in non-pilot counties. Inpatient hospital admissions dropped by 17 percent and inpatient psychiatric costs were contained significantly better than in non-pilot counties.

We have learned that providing the right care for people in a primary care setting can save money in other parts of the system — hospital emergency rooms, homeless shelters and jails. We can free up emergency rooms for true emergencies, and free up police officers to focus on preventive policing

This study should be good news in a bleak budget year, especially because in 2009 the state expanded this new Disability Lifeline model statewide. Instead the program's future hangs in the balance.

Daniel Lessler is associate medical director at Harborview Medical Center and a University of Washington professor of medicine. Nick Metz, is deputy chief of operations for the Seattle Police Department.

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