Disagreements continue over policy on how to address NY’s opioid epidemic

A few weeks ago, Capital Tonight discussed why advocates are pushing Gov. Kathy Hochul to declare addiction a state of public health emergency. Since then, calls for him to do so have only grown stronger as hundreds of providers, families and members of the Legislature from across the state rallied at the Empire State Plaza on Monday.

Capital Tonight asked the Hochul administration about his position in calling for such a state of emergency. While spokesman Avi Small did not directly answer the question, he pointed out that the governor is personally familiar with the tragedies behind the epidemic.

As one of the millions of Americans who have lost a loved one to an overdose, Gov. Hochul is committed to aggressively tackling the Opioid crisis and has invested a historic $2.8 billion in addiction services since taking office. Governor Hochul will continue to make smart, responsible investments to address the extraordinary scale of this crisis and bring support to those who need it,” Small said.

In a separate email statement, Evan Frost, a spokesman for the state’s Office of Addiction Services and Supports (OASAS), wrote that the agency recognizes that we are in the midst of the worst overdose epidemic in history, and continues to work with our providers and stakeholders in a series of initiatives to support individuals, families, and communities affected by this crisis.

According to Robert Kent, president of Kent Strategic Advisors, former general counsel for the Biden administration’s White House of National Drug Control Policy and former general counsel for OASAS, New York has the resources to deal with the opioid epidemic, but preventing it.

New York has the most robust treatment system in the United States, Kent said Capital Tonight. But the network of providers is struggling.

According to Kent, providers cannot hire or retain staff, which means they cannot safely serve the number of people they are approved to serve.

Kent also questioned why the state only buys one brand of naloxone when, he said, there are now multiple versions of the drug on the market, all approved by the FDA.

But OASAS argued that currently, Narcan is the only FDA-approved naloxone nasal spray for over-the-counter distribution.

OASAS spokesperson Evan Frost continued:

New York makes several formulations available through our partnership with NEXT Distro, including intramuscular naloxone. Earlier this year, OASAS launched a new ordering system for New Yorkers to get free naloxone. To date, approximately 70,000 naloxone kits have been ordered through this system, along with 3.2 million fentanyl test strips and 2.9 million xylazine test strips.

The most important change Kent is seeking involves the state’s 30 or more recovery centers urging OASAS and Hochul to certify them so the centers can bill for peer services.

Outpatient treatment facilities like Hope House are required to have peers on site, and they can bill Medicaid, Medicare and other insurance for the work those peers do.

Community recovery centers cannot.

We have nine peers on staff, according to Kellie Roe, of Second Chance Opportunities, a non-for-profit organization in Albany that offers people in recovery a range of wraparound services. Every single person who walks through our doors is assigned a recovery coach. Each person in the housing has a recovery coach. Each of our employment contracts has one. They are professional cheerleaders.

OASAS certification will create another revenue stream for organizations like Second Chance Opportunities.

When we moved addiction treatment services into Medicaid Managed Care, it opened up the opportunity to license entities, such as recovery community centers, that would allow them to bill for services provided by their Certified Peer Recovery Advocates, said Kent, who works with Second Chances.

In the same email reply to Capital tonight, OASAS said there are ways in which certified recovery centers can be paid for peer counseling, even though certification is not currently available under current regulations.

No regulation exists to certify recovery centers. However, recovery centers can now be designated to charge for Community Oriented Recovery and Empowerment (CORE) services, which include peer services for people covered under the Health and Recovery Plan (HARP), the paper wrote. by OASAS spokesperson Evan Frost.

But Kent maintains that HARP is a very limited program that only offers services to those most in need who are already engaged in treatment.

OASAS may choose to create a regulation to certify recovery centers that would open the door to serving more people and saving more lives, he said. Capital Tonight by email.

Another recommendation that Kent says will prevent overdoses is an investment in Overdose Prevention Centers (OPCs), also called Safe Injection Sites.

The Opioid Settlement Board pushed to have some of the settlement cash fund OPCs, but OASAS rejected that recommendation because the centers are illegal under federal law.

Kent responded by saying, They ignored the federal law for marijuana! States, such as Rhode Island, are promoting OPCs and are using opioid rehabilitation funds to support the work. If they were challenged with the legal argument that this violated federal law, they would argue that they exercised their police power which is protected by the US Constitution as a power reserved to the states and would likely win any such challenge.

The legislative session begins in two weeks.

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