AUGUSTA, Maine (AP) - A $2 million effort to combat the opioid crisis has helped 108 uninsured Mainers access drug treatment and other addiction services, Republican Gov. Paul LePage’s administration told The Associated Press, citing figures from treatment providers.
That’s short of the administration’s goal of 170 uninsured individuals. But it’s up from just five uninsured Mainers in 2017, when lawmakers mid-year funded the Opioid Health Home program.
Former Department of Health and Human Services commissioner and new federal Medicaid chief Mary Mayhew championed the program.
Since then, the state approved two dozen sites across the state, including Greater Portland Health, Discovery House and Hope House shelter in Bangor, according to Department of Health and Human Services spokeswoman Emily Spencer.
The effort has funded medication-assisted treatment for 64 uninsured Mainers at Groups: Recover Together, which has at least eight participating sites across the state. The for-profit organization’s executive director Cooper Zelnick said 94 percent of those participants are still in treatment at three months - a rate he touted as much higher than national figures.
“Most treatment is enormously expensive,” Zelnick said, whose organization provides individuals with weekly mandatory group therapy, opioid treatment medication, nurse care managers, peer recovery coaches and if necessary, walk-in counseling.
Other treatment providers have told the state the program was too complex, and didn’t provide enough reimbursement for all required services.
Noah Nesin, chief medical officer at Penobscot Community Health Care, said it’s been “too challenging” for nonprofits like the federally qualified health center to meet the program’s requirements. The center will treat roughly 600 Mainers for opioid use this year, with Opioid Health Home funding going toward fewer than 20 of the quarter who are uninsured.
Maine should instead reduce opioid-related overdoses and deaths by making it easier to prescribe suboxone and methadone, and treating opioid use disorder like other diseases, Nesin said.
“There aren’t going to be enough addiction specialists, or for-profit chains, to do it any other way,” he said.
The leader of a nonprofit organization of treatment providers says the state has wasted time by failing to work closely with providers from the start on efforts to combat the opioid crisis.
“We’ve seen a number of programs come out that just are not functional,” said Malory Shaughnessy, executive director of the non-profit membership organization Alliance for Addiction and Mental Health Services. “And so they take longer to implement than one would want, especially in the midst of an opioid epidemic of people dying every day.”
The number of Maine residents who died from drug-induced deaths jumped to 418 in 2017, according to the state attorney general’s office. That’s up from 376 in 2016 and 272 in 2015.
Zelnick said he’s found Maine to be “very, very responsive” to treatment providers. “With all new programs, there’s a period of learning and development and transition that occurs,” he said.
LePage’s administration for months failed to provide lawmakers with several required updates on the program, including how much money was spent to provide Opioid Health Home Services to the uninsured.
The Department of Health and Human Services finally sent such reports to lawmakers Tuesday, following inquiries from The Associated Press. An update dated Tuesday said 643 Medicaid members are also authorized to receive Opioid Health Home services next month.
But the LePage administration’s recent reports don’t state, as required, how much the state spent on the uninsured and Medicaid members.
It’s unclear how the program will end up overlapping with the latest legislative effort to target the opioid crisis.
Lawmakers recently appropriated $6.6 million to create a new a “hub-and-spoke” model to cover intensive, intermediate and long-term opioid treatment. The idea is modelled after a similar effort in Vermont.
The LePage administration is working on emergency rules to update the Opioid Health Home program’s reimbursement structure in light of the “hub-and-spoke” model and concerns from providers.
Democratic Rep. Patty Hymanson, House chair of the Legislature’s health and human services committee, said lawmakers should work with the new administration on figuring out such details. The term-limited governor’s leaves office early next year.
“Our opiate treatment is not serving as many people are should be given the crisis we have,” she said.
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