Wolf’s $34M drug treatment plan gains momentum

April 23--Gov. Tom Wolf has a $34 million proposal to expand access to drug treatment facilities and curtail heroin and prescription painkiller addiction, and now he has to convince state legislators to keep it in the next fiscal year's budget.

A Wolf spokesman says the governor has taken a bipartisan approach in building support for the funding proposal, one that would increase treatment access to an additional 11,250 addicted Pennsylvanians.

Press secretary Jeffrey Sheridan said Wolf continues to engage legislators, emergency responders, local officials, health care professionals and others to learn about the scope of heroin and opioid addiction and to gain suggestions on how to address it.

"The governor is confident members from both parties will work with him to provide adequate funding to holistically address this issue," Sheridan said.

The bulk of funding will be used to establish 50 opioid use disorder Centers of Excellence to treat Medicaid recipients. An estimated 11,250 additional addicted Pennsylvanians will enroll in treatment, the Wolf administration predicts.

The Department of Human Services is offering $500,000 to each facility either to expand or establish medication-assisted treatment at behavioral health or primary care practices, including buprenorphine, more commonly known as Suboxone, as well as methadone and naltrexone.

A minimum 300 additional patients must be enrolled within a year, according to the Centers of Excellence program application.

The theory of "warm handoffs" would be employed, encouraging hospitals, corrections facilities, physicians and in-patient treatment centers to steer people to a Center of Excellence. Each facility's care management team would be tasked to engage addicts and recovering addicts in their physical and behavioral health care and also assist in finding stable housing and employment and repairing fractured relationships.

Cost and availability of treatment services are identified as barriers to recovery, both of which Wolf's proposal seeks to address.

A study on addiction by the Center for Rural Pennsylvania found just 1 in 8 Pennsylvanians can afford treatment services and estimated that more than 35,000 beds are needed for 60-day inpatient stays but just 6,800 are available.

Geisinger Health System's latest needs assessment says lack of insurance, cost of care and transportation all are treatment barriers and found there simply aren't enough providers to meet demand.

More than meds

Twenty-five facilities already licensed by the state's Department of Drug and Alcohol Programs would implement the measures proposed in Wolf's Centers of Excellence plan by Oct. 1.

An additional 25 facilities incorporated into the state's HealthChoices mandatory managed care program for Medicaid recipients would begin implementation Jan. 1, including 20 primary care providers.

In the Susquehanna Valley, the nearest methadone clinic is in Watsontown. A handful of buprenorphine sites are scattered around the Valley, including in Shamokin, Coal Township, Mount Carmel, Danville and Lewisburg, according to a provider locator.

Wraparound services would complement the medication-assisted treatment, Sheridan said, such as counseling or referrals to in-patient treatment centers.

No one enrolled in Medicaid would be charged cash when receiving treatment, according to the Department of Human Services.

The department would oversee implementation of the Centers of Excellence initiative with assistance from county drug and alcohol programs in selecting facilities and managing funding, according to deputy press secretary Rachel Kostelac.

The application period ends May 6. The department wouldn't reveal how many applications have been received. Final selections will be made by June 17.

Information sought

State Sen. Gene Yaw, R-23, of Williamsport, is chairman of the Center for Rural Pennsylvania, a bipartisan legislative agency of the General Assembly. In 2014, the agency began releasing reports and hosting public hearings on the impact of heroin and opioid abuse in rural communities.

"The concept is a good one because throughout all our hearings we heard that a warm handoff is critical and integral to the whole continuum of care," Yaw said after attending a hearing in Lewistown.

More information is needed, however, before Republicans support the Democratic governor's plan, Yaw said. He said questions remain not only about implementation but about how the 50 facilities would be chosen, especially in rural counties.

"We don't have the details, and I can't foresee the Republicans approving an expenditure of this magnitude without knowing the specifics of the program -- as related to structure, implementation and coordination," Yaw said.

Expects support

State Rep. Kurt Masser, R-107, of Elysburg, said there hasn't been a complete line item dissection of Wolf's budget proposal yet. The addiction crisis, what some are calling an epidemic, however, reaches all legislative districts and he expects Republicans and Democrats will meet in the middle on the issue.

"This is one item that I think every person in the Legislature can back. I think you'll see bipartisan support to go along with the governor's proposal," Masser said.

Northumberland County Coroner James F. Kelley, who works in a county that's had 11 confirmed or suspected drug overdose deaths this year, is hopeful whatever state funding is made available finds its way to the Susquehanna Valley. He suggested incorporating a standalone treatment facility on the grounds of the Northwestern Academy in Coal Township, where Northumberland County is planning to establish its county prison.

"I think it's excellent news," Kelley said of Wolf's proposal. "I hope we have people apply that we may be able to have (more options) here in Northumberland County."

Some concern

Like Yaw, state Rep. Lynda Schlegel Culver, R-108, of Sunbury, was cautious, saying it's too early to commit to an exact dollar amount to allocate. She also expressed reservations about Wolf's plan, specific to its focus on medication-assisted therapy. She referred to a town hall meeting held this month in the Northumberland County Courthouse and how the topic of Suboxone divided many in the audience.

"We want to use evidence-based outcomes. We're looking for results and success stories. We're in that stage of the game right now, making sure we're not just offering treatment and it's not resulting in good outcomes," she said.

Sheridan said the Wolf administration is cognizant of the potential abuse of therapeutic medications like Suboxone, but he also called its positive results "evidenced-based."

However, the administration is open to many options to expand access throughout the substance use disorder treatment continuum, he said.

"We are confident that building a comprehensive system that treats each individual based on the patient's unique needs is the best path forward for Pennsylvania in combating this epidemic," Sheridan said.

Email comments to [email protected]. Follow Scicchitano on Twitter @ericshick11.

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