The LePage administration is negotiating with legislative Democrats about funneling up to $8 million toward a new, comprehensive approach to opiate treatment in response to the state’s growing drug crisis.
The Maine Department of Health and Human Services has proposed earmarking an additional $3 million in state funds this year – and leveraging up to $5 million in federal funds – to serve about 600 additional people who are struggling with opiate addiction. Participating patients would receive a multifaceted approach to combating addiction that includes medication-assisted treatment, which uses medications such as Suboxone in combination with clinical therapy or counseling and primary medical care.
Part of that funding would be set aside for uninsured opiate addicts – a growing population that has struggled to gain access to treatment – while also serving MaineCare patients. DHHS Commissioner Mary Mayhew said she hopes that existing treatment or health centers will be able to provide the services.
Sen. Troy Jackson, a Democrat from Allagash who has been pressing Gov. Paul LePage for a share of the excess money in the current year’s budget, said providing treatment services for “600 to 700 lives” is a major step in the right direction. If successful, the “opiate health home” model could be incorporated or even expanded in the two-year budget that the Legislature will craft over the next five to six months.
“It’s not a done deal or set in stone, but so far we feel very good about this opportunity,” said Jackson, the Democratic minority leader in the Maine Senate.
The potential agreement indicates that the LePage administration and legislative Democrats are serious about working together on the opiate crisis, despite the sometimes harsh political rhetoric between the two sides. During his State of the State address Tuesday night, LePage said he and Jackson had “a very good conversation” and portrayed the Allagash Democrat – with whom he has had a contentious relationship in the past – as a willing partner on the issue.
“I think we are coming up with some ideas,” LePage said. “We have been discussing it with DHHS. We are trying to find programs that work because … we’ve spent over $80 million (on treatment) and it’s not working. Too many people are dying.”
Maine, like many states across the country, is in the midst of a worsening drug crisis stemming from the overprescription of addictive painkillers followed by a steady supply of cheap but deadly illegal opiates. Maine reported a record 378 drug overdose deaths in 2016, up from 272 in 2015. Heroin, fentanyl and prescription opioids accounted for 313 of the 378 deaths last year, according to statistics from the Maine Attorney General’s Office.
Democrats slowed down work on the supplemental budget for the current year in order to obtain additional funding for the heroin and opiate crisis. Mayhew, meanwhile, said the LePage administration wanted to make sure that any additional funds would be used for innovative models of treatment.
“Our intent is to make sure we are expanding access to medication-assisted therapy and to make sure it is in concert with effective health treatment, and that their care is coordinate,” said Mayhew, who met Wednesday with Senate and House Democratic leaders to discuss the idea. “We can be open to different approaches … that meet those criteria or objectives.”
LePage has clashed with legislative leaders over how to approach the opiate crisis. While the Republican governor has pressed for a stronger law enforcement approach to the problem – successfully pushing lawmakers to provide funding for additional drug enforcement agents – Democrats as well as substance abuse providers have called for substantial investments in additional addiction treatment. LePage also has sought to prioritize one form of medication-assisted treatment, favoring the use of Suboxone, or buprenorphine, over methadone, which is more common in Maine.
During his State of the State address, LePage said that “everything is on the table when it comes to opiates,” and that any approach must include a combination of treatment, law enforcement and prevention, beginning as early as middle school. LePage said he has discussed options with Maine Supreme Judicial Court Chief Justice Leigh Saufley and is looking for potential models in other states.
“The problem is this: We can’t just simply throw money at something that isn’t working because they are just going to die,” LePage said. “We need to try to find a solution.”
Late last year, DHHS announced plans to spend an additional $2.4 million in existing funds to create 359 slots for the uninsured in medication-assisted treatment programs. According to DHHS, 8,627 Mainers received medication-assisted treatment in fiscal year 2016. However, only 215 slots were available for those without insurance. The 359 additional slots announced in December were added to that total.
Mayhew said she was “incredibly optimistic” that, between the $2.4 million allocated in December and the additional $8 million, the state will be able to help address the demand for treatment.
“We’ll be evaluating how this addresses the unmet needs to make sure that all of the resources are being used efficiently and effectively,” Mayhew said.
Jackson said he hopes the 70 federally qualified health centers statewide could provide the comprehensive treatment, counseling and medical services paid for by the $8 million in additional potential funding. That would likely benefit residents of rural areas like his in Aroostook County, where people with opiate addictions have struggled to find placement in treatment programs.
Jackson said Democrats were “adamant” that the supplemental budget include additional funding for opiate treatment.
“We pushed for more money, but it’s $3 million in new money and it’s not coming out of any existing programs,” Jackson said.
The proposal will be the subject of a work session next week before the Appropriations and Financial Affairs Committee.
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