Our June 25, 2017 Letter to Broome County Executive Jason Garnar

We are tired of waiting for the county to take action. It is long past time for them to be responsible in their roles to protect the public. See our letter to County Executive Jason Garnar below. Be sure to click the news links to see what he thought should be done PRIOR to being elected.

We have been calling on the county to track and report overdose deaths and reversals since August of 2015. Here we are, nearly two years later, still waiting.

Call County Executive Garnar today and ask him when he’ll start doing all the things he was demanding of the last administration.

June 25, 2017

Jason Garnar
Broome County Executive
60 Hawley Street
Binghamton, NY 13901

Dear County Executive Jason Garnar,

On June 24, 2017 the Village of Johnson City Police issued a warning about a surge in heroin overdoses, including three fatalities. We thanked them for their proactive approach in alerting their community. Due to their proactive approach, Truth Pharm and STAP worked together to immediately respond by advertising, promoting and handing out life-saving Naloxone kits during a three-hour time-slot on Sunday. Twenty-four people were trained and obtained kits.

This is what the response to a public health emergency looks like.

Also, due to their proactive approach, the news media published stories about the overdoses and the handing out of Naloxone kits, which caused hundreds of people in Broome County to engage in conversations about the opioid epidemic. In addition, hundreds of people were educated about: the dangers of using alone; the need to call 911; a particularly strong or ‘bad’ batch of heroin that was circulating; harm reduction practices they could use to reduce overdoses; and the lifesaving medication Naloxone. Conversations that our community desperately needs. In addition, two people reached out to Truth Pharm and will be placed into inpatient treatment tomorrow.

On February 23, 2017 you attended our in-depth presentation to local elected officials outlining the dire need for both care and harm reduction approaches in Broome County. We also made it clear that tracking of overdose data – both deaths and successful revivals – is the responsibility of our county government and needs to be done accurately, consistently and actively reported to the public.

We have seen zero progress on this front. We have been making requests for this information since August of 2015, we are approaching two years since then, over one hundred deaths and thousands of overdoses with no change to the system.

Prior to being elected as County Executive, you agreed that the community should be notified. We have communications from you to us directly stating so and ridiculing the prior administration for not being responsible in doing so. And you made your opinion public to the media.  On August 12, 2016, WICZ started a report about overdoses with this line: “Broome County Executive Candidate Jason Garnar called for a public health warning on heroin overdoses Thursday night.” And later in the article included this as well, “Jason Garnar says it is a health risk when the public isn’t notified.” Garnar Calls for Public Health Warning   Garnar Wants Better Accounting by the County

On August 11, 2016, in an article published by the Press & Sun Bulletin: “First and foremost, Broome County needs to declare a public health emergency,” said Garnar, the Democrat challenging Preston in the November election. But “what I’m more concerned about is it seems our county executive is not saying anything about this. We should be doing everything possible to get the word out there that something is out there that is killing people left and right.” The website for that article includes a video of you stating how important it is for the County Executive to release CURRENT information to the public in order to save lives.  Garnar calls on Broome to Declare Opioid Emergency

It is nearly one year since you made those strong statements and you’ve been in office for six months. But, where is your action? Why aren’t you releasing notices to the public? You are now the one responsible to ensure the public is notified.

As we have in the past, we could provide multiple examples of other counties in New York State who are actively tracking and releasing overdose data, but we trust you can google and immediately find plenty of results just as easily as we can.

We also know this data already exists for the county. We recently learned that the county is planning to participate in a program to release all overdose data (deaths and reversals) to a mapping program run by the DEA. That mapped data will not be accessible by the public, but is utilized in drug investigations. We are beyond sickened to learn that the county is choosing to participate in an enforcement and further criminalization program as their priority over participating in issuing public health warnings and participating in harm reduction practices with data you ALREADY HAVE.

Your goal must be to save lives.

We are again requesting that the County Health Department immediately begin to take responsibility for counting the deaths of our loved ones due to substance use related causes and issuing that information to the public. This responsibility does not belong to the District Attorney, this is a health issue and belongs to our county health department.

We also want to remind you that funding from the state and federal government depends on accurately reporting both overdose and death data to state officials. We are being bypassed for funding, new programs and attention because our issues are not accurately reported.

Though it seems much of what was written in our letter of February 23, 2017, including working together cooperatively, has been ignored, we’ll attach the letter as a reminder of what we called for four months ago, please be sure to review request #3 which we’ll include below. The optimism we expressed in our letter is waning, but we as an organization continue to do the work necessary to save lives. You, as the County Executive, declared this opioid crisis a Public Health Emergency. With that declaration comes serious responsibility on your part.

  1. County Departments that responsibly track and publicize data in a timely manner including:
  • Naloxone uses by all departments and the number of doses required
  • Overdose deaths
  • Deaths by other causes, but linked to substance use
  • Criminal acts related to substance use disorders
  • Incarceration rates related to substance use disorders
  • Success rates of various forms of treatment
  • A public calendar of all events offered by providers, support groups and grassroots organizations
  • A comprehensive list of treatment options, modalities and services within our region, allowing individual organizations to add their information and website links

Sincerely,

Alexis Pleus
Founder and Executive Director

cc: Governor Andrew Cuomo, NYS Attorney General Eric Schneiderman, NYS Commissioner of Health Howard Zucker

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6/1/16 – Our Letter to NY Assembly Ways and Means Committee regarding A9211 – the 90 Day Bill

Greetings,

I understand Bill A9211 is on the Ways and Means schedule for 6/1/16 (probably today as you read this). This bill would require insurance companies to pay for 90 days of inpatient addiction treatment when a physician says it is necessary.

I lost my son to a heroin overdose and there is no doubt in my mind his life would have been spared if it were not for insurance denial after insurance denial for the treatment he desperately needed.

But, it’s not just about my son. As I’m sure you are aware, many lives have been lost and we are losing more lives every single day.

We are a non-profit grassroots organization that works to reduce the stigma associated with addiction, educate about the disease of addiction and this health crisis and advocate for policy change.

We have thousands of members and unfortunately they come with thousands of stories of being denied treatment by their insurance carrier.

Our organization researched all of the bills related to heroin, opioids and addiction at the start of this session to find the bills that would have the greatest impact on the epidemic now – or basically, save the most lives. Of all the bills reviewed, the 90 Day Bill was the clear winner for having the greatest impact on this epidemic and in saving the most lives.

I, along with many of our volunteers, have met with many of you. Today I provided oral testimony at the Governor’s Heroin Task Force Forum in Binghamton, NY. In February I provided testimony in Penn Yan at the Senate’s Heroin Task Force. in April, one of our board members, Penny Stringfield provided testimony at the Senate Heroin Task Force in Binghamton, NY. We have read both reports produced by the Assembly and both reports produced by the Senate along with the 22 bills the Senate passed recently.

And will still say, little legislation has been presented that addresses the health needs of those addicted and who voluntarily ask for help. This 90 Day Bill stands out as being our greatest hope this session.

As far as budgetary concerns, we must consider the real cost of this epidemic and the costs to society and the tax payer now. We must find ways to require the medical industry who created this epidemic to respond responsibly, we must find ways to make the pharmaceutical industry pay for the damage they’ve caused and we must require insurers to cover the treatment for this life threatening illness no different than they do any other illness. These solutions will take the burden off of the New York State tax payer.

Some of the costs we must consider in NOT providing treatment are probation, incarceration, family court, criminal court, parole, rising crime rates, Hepatitis C treatment, foster care, adoption, family services, child protective services, family court, accidents, police enforcement, coroners and funerals. We are paying dearly, we are just not paying on the right end of this epidemic.

Furthermore, the cost of not providing effective treatment from the start, likely costs insurance carriers more. We know people who have gone through outpatient and short term stays 5-10 times and with a proven success rate of only 10%, it is no wonder. Add to that the toll it takes on the family and their health. And Hepatitis C treatments at $100k each.

Providing the type and length of treatment known to be effective from the onset makes sense. It makes sense because their lives are worth saving. It makes sense because it is how we treat all other illnesses. And it makes economic sense.

I’m attaching our Advocacy Agenda we have used for this session. The first page provides a snap shot of what happens when a person asks for help. The second page lists our asks.

We have worked very hard spending many days in Albany letting people know we are hoping for the passage of this bill this session. We request that you consider the positive impact this bill can have on families facing this addiction crisis as well as in protecting the tax payers of New York.

Feel free to contact us for any reason or if you have any questions.

Sincerely,
Alexis Pleus
Founder and Director

And all of the Rainmakers at Truth Pharm

Alexis Pleus
Founder
Truth Pharm

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Join us to Advocate for Policy Changes in Albany!

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”:

  1. 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.
  2. The individual attempts to schedule an evaluation. The wait time for evaluation appointments in NY varies widely, from 2 days to 5 weeks.
  3. They are most often referred to outpatient treatment, which is known to have a 90% relapse rate.
  4. 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.
  5. 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.
  6. 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.
  7. 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.
  8. 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.
  9. 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:

  1. Same day evaluations for those seeking help.
  2. A treatment protocol for persons taken to the emergency room after an overdose. Attached as “Best Practices for Medical Providers.
  3. Immediate access to treatment or a hospital stay until treatment is available.
  4. Humane, medical detox.
  5. 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.
  6. New York State must increase the reimbursement rates so that treatment centers can open and operate here.
  7. A one call system.

These bills would offer a high impact with low cost to New York and are non-controversial:

  1. Require all first responders, fire and police to carry Naloxone.
  2. 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.
  3. Require all treatment facilities, outpatient clinics and residential facilities:
    1. to have all staff trained in the administration of Naloxone and to have Naloxone on premises;
    2. to follow up after discharge at 14, 30, 60 and 90 days to determine relapse rates and report these statistics to OASAS;
    3. 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:

Bill # Description Sponsor
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
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