MEMO: Governor Wolf Makes the Fight Against Opioid Abuse Top Priority

April 29, 2016

SUBJECT: Governor Wolf Makes the Fight Against Opioid Abuse Top Priority
TO: Interested Parties
FROM: Jeff Sheridan, Press Secretary
DATE: April 29, 2016

The Wolf Administration has made the fight against the opioid abuse and heroin use crisis a top priority.

The Wolf Administration hopes that the following steps and actions, as well as a series of statewide roundtable discussions, are just the beginning of a larger conversation with both Republicans and Democrats in the House and Senate as well as local officials, law enforcement, emergency responders and health care professionals. And, while we know that avoiding the upcoming fiscal cliff is critical to fixing our structural budget deficit and having the resources necessary to do even more, we look forward to working collaboratively with the General Assembly and community leaders to ensure Pennsylvania leads the nation in the fight to combat the opioid abuse and heroin use epidemic.

The magnitude of the addiction and overdose death epidemic in this state is astounding — at least seven Pennsylvanians die every day from a drug overdose. With nearly 2,500 overdose deaths in Pennsylvania in 2014 and estimates that the 2015 total will be higher, a collaborative effort on the federal, state, and local levels is crucial in combatting this crisis.

Some of the Wolf Administration’s current and ongoing initiatives include:

Drug Take-Back Boxes:
  • The Wolf Administration, through DDAP, in partnership with the Pennsylvania Commission on Crime and Delinquency (PCCD) and the Pennsylvania District Attorney’s Association (PDAA), developed a statewide drug take-back system to address the problem of excess prescription drugs.
  • This is funded through grants managed by PDAA.
  • The program has placed over 400 boxes resulting in the collection of over 40,000 pounds of prescription drugs in 2015.
Naloxone Distribution:
  • The Physician General, Dr. Rachel Levine, signed two standing orders to make naloxone, a drug that temporarily reverses the symptoms of an opioid overdose, available.
  • The first standing order made naloxone available to all first responders.
  • The second, subsequently, made it available to all Pennsylvanians.
  • Thanks to those orders, the Pennsylvania State Police and more than 300 municipal police departments have started ubiquitously carrying naloxone.
  • To date, police departments have made over 740 reversals.
  • Additionally, the Wolf Administration has partnered with Adapt Pharma to offer free naloxone to schools.
Expedited Behavioral Health Coverage:

Behavioral Health Managed Care Organizations (BHMCOs) provide behavioral health, SUD, and recovery-oriented supplemental services in the Medicaid System.

  • DHS and DDAP are collaborating to ensure that individuals in need of SUD treatment are able to access those services immediately through an expedited enrollment process.
  • This means persons have BHMCO coverage as soon as their Medicaid is approved.
  • A particular emphasis is placed on facilitating immediate BHMCO coverage for individuals being released from state and county correctional institutions and transferring directly to Residential Drug and Alcohol Treatment Facilities to ensure Medicaid covers the cost of care.
Warm Handoff Policy:

“Warm handoffs” refer to health care professionals are transitioning patients from primary physician care to specialized drug and alcohol treatment programs.

  • DDAP developed the warm hand-off policy, which mandates that Single County Authorities create and execute a process whereby overdose survivors are taken from the emergency department directly to treatment. These facilitated referrals support individuals with SUD and increase the odds of a successful recovery.
Behind-the-Walls Treatment:
  • The Department of Corrections (DOC) is working to reduce criminal behaviors through individualized SUD treatment and education for inmates.
  • This will result in successful community reintegration.
  • DOC provides comprehensive drug and alcohol treatment to inmates through a variety of services, including assessment, outpatient care, inpatient care or aftercare.
  • As part of this ongoing mission, DOC is also conducting a pilot program using Vivitrol, a long-acting injectable form of naltrexone that blocks certain receptors to prevent a ‘high.’

Some of the Wolf Administration’s plans and ideas for moving forward include:

Continuing Medical Education:
  • DOH, DDAP, the Department of State (DOS), and the PA Medical Society are working on developing and offering continuing medical education (CME) credits for physicians on SUD.
  • The educational modules are broken into 4 sessions.
  • Currently, modules on naloxone and prescribing guidelines are available on the PA Medical Society’s website.
  • Still under development are modules on the ABC-MAP program and warm handoffs.
Substance Use Disorder Medical School Curricula:
  • Physician General, Dr. Rachel Levine, and DDAP are working with the deans of Pennsylvania medical schools to incorporate SUD courses into their curricula required for graduation from the program.
  • This effort was successfully accomplished in Massachusetts and has been advocated by the Obama Administration and the Department of Health and Human Services.
Opioid Prescribing Guidelines:
  • DOH and DDAP have been working collaboratively to create a set of specialized opioid prescribing guidelines in an effort to curtail the excess supply of drugs.
  • The departments have completed multiple guidelines, including emergency department providers, chronic non-cancer pain, obstetrics and gynecology, pharmacists, geriatrics and dental pain.
  • In development still are pediatrics, neurology and sports medicine.
  • The departments are working to get the guidelines affirmed by the appropriate medical boards.
Syringe Services Program:
  • Syringe services programs can reduce the spread of disease and assist in connecting those with SUD with treatment professionals.
  • In addition, these programs provide opportunities for program staff to share treatment options and assistance to intravenous drug users in a safe environment.
$34M for Opioid Use Disorder Centers of Excellence (aka “Health Homes”):
  • Governor Wolf’s proposed 2016-17 budget provides more than $34 million to treat more than 11,250 new individuals with substance use disorder.
  • The Department of Human Services (DHS) will provide 50 new Centers of Excellence for individuals with substance use disorder, providing medication-assisted treatment and appropriate wraparound services, such as cognitive-based therapies.
  • Opioid Use Disorder Centers of Excellence will focus on whole-person care and will treat all of the health care needs of an individual through a collaborative approach that consists of physical and behavioral health care and links to appropriate community supports that can increase chances of recovery and reduce expensive health care costs.
Increasing the Number of Providers in the Medicaid System:

BHMCOs use local needs assessments in the development of new services, including the expansion of the provider networks and development of additional supplemental services to address the needs identified within the local community.

  • DHS continues to use these local assessments to inform and pursue recruitment and retention of additional providers to meet the increasing needs of Pennsylvanians affected by the opioid epidemic.
Prescription Drug Monitoring Program (PDMP):
  • Pennsylvania’s PDMP, implemented by DOH, is the Achieving Better Care by Monitoring All Prescriptions (ABC-MAP) program.
  • Recently, DOH named Meghna Patel the PDMP director.
  • Pharmacies and health care professionals who dispense Schedule II through V controlled substances will be required to electronically report prescription dispensing information to the ABC-MAP system within 72-hours.
  • ABC-MAP will aid regulatory and law enforcement agencies in detecting and preventing fraud and abuse, as well as, helping individuals with SUD get into treatment.

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