We are visiting Albany to advocate for policy change on May 3rd, May 10th and May 11th.
It is very important that our political leaders hear from us and the struggles we face with finding treatment and having it be affordable and/or approved by our insurance.
Here is our agenda for advocacy for 2016:
Advocacy Agenda for 2016
New York State is not immune to the opioid and heroin epidemic plaguing our country which has progressed now to a crisis. While we have been ahead of the curve on implementation of some important issues such as the Good Samaritan Law and Naloxone access, we remain behind in health parity and treatment access.
As an advocacy organization, we are reminded daily of the many obstacles people seeking help encounter. Here is the typical sequence of events experienced by an individual who has said “I want help”:
- They don’t know where to turn and often go to the Emergency Room. Emergency Rooms do not admit for detox, do not transfer patients to detox, rarely line up treatment appointments and often do not give information regarding access to treatment or evaluations.
- The individual attempts to schedule an evaluation. The wait time for evaluation appointments in NY varies widely, from 2 days to 5 weeks.
- They are most often referred to outpatient treatment, which is known to have a 90% relapse rate.
- Co-pays for outpatient treatment are a huge financial burden. One mother recently reported her son was remanded to intensive outpatient treatment 5 days per week. With private insurance, the co-pay is $40 per visit. At $200/week the bill is higher than her mortgage and electric bill combined.
- If the person goes to inpatient treatment, there is little information about what the facility offers or provides. Many people report arriving at a facility only to be told ‘you need to detox first’ or the opposite ‘you don’t have enough drugs in your system’. One family said a treatment facility employee suggested the parents take their son to make a purchase so he could shoot up and then he could be admitted.
- If they are admitted for detox, few facilities are offering medically assisted humane detox. Even those that are providing it are often saying the person is ‘done detoxing’ after 2-3 days. We had one gentleman told he was ‘done’ less than 48 hours after being admitted.
- If the treatment center finds out Medicaid or the insurance will not pay for the stay, the person is immediately asked to leave with no taper from the Suboxone they were started on and no direct link to their next service provider.
- For inpatient treatment, insurers in New York are typically only approving 7-14 days of treatment. The average seems to hover around 9 to 10 days. We have not heard of a single family with private insurance or Medicaid that has been provided over 21 days at an inpatient facility.
- There are families losing loved ones while they wait for treatment.
Though we believe a multi-faceted approach will ultimately be necessary to conquer this epidemic, nothing is more important than saving those who are desperate for help now. We need our state government to take emergency measures to address those suffering and asking for help now.
Thank you for your time and also offer our help. If you need someone to speak at a hearing, provide testimony or advocate to your colleagues, please call on us. We will help.
We need the following emergency measures:
- Same day evaluations for those seeking help.
- A treatment protocol for persons taken to the emergency room after an overdose. Attached as “Best Practices for Medical Providers.
- Immediate access to treatment or a hospital stay until treatment is available.
- Humane, medical detox.
- Insurers MUST be required to pay for the type and length of treatment known to be effective. Anyone seeking opioid addiction treatment should be granted 90 days of inpatient treatment at a minimum.
- New York State must increase the reimbursement rates so that treatment centers can open and operate here.
- A one call system.
These bills would offer a high impact with low cost to New York and are non-controversial:
- Require all first responders, fire and police to carry Naloxone.
- Require hospitals to provide persons who have overdosed and any support person with them with Naloxone training as well as a kit to take home.
- Require all treatment facilities, outpatient clinics and residential facilities:
- to have all staff trained in the administration of Naloxone and to have Naloxone on premises;
- to follow up after discharge at 14, 30, 60 and 90 days to determine relapse rates and report these statistics to OASAS;
- to provide patient and support persons with Naloxone training as well as a kit to take home upon discharge.
The following bills will have a significant impact on the epidemic:
|S6478A/ A9211||Requires insurance companies to provide at least ninety days of rehabilitation services to an insured upon a doctor’s prescription||Senator Ritchie/ Assemblyman Stirpe|
|S651||Relates to continuing medical education requirements for doctors, nurses and pharmacists; requires three hours of training on the prevention, treatment and mitigation of opiate analgesics and psychotropic drug addiction.||Senator Kennedy|
|S647||Requires the department to draft guidelines for the transition of patients from substances with a high risk of addiction to those with a low risk.||Senator Kennedy|
|S660||Requires disclosure of addiction risks for certain prescription drugs; requires physicians, nurses and pharmacists to provide information on prevention, mitigation and treatment of prescription drug addiction and to have the patient sign a form acknowledging education of such risks.||Senator Kennedy|