“Combating Opioid Abuse: A Report to Governor Scott Walker”
Last week the Governor’s Task Force on Opioid Abuse met to release recommendations to address the opioid epidemic in our state. The link above is the full document regarding the issues at hand as well as their recommendations. I am also listing some of their recommendations here (along with my 2 cents) for ease of reference…
To develop these recommendations, task force meetings were held all across the state of Wisconsin. In collaboration with health care providers, law enforcement, public health officials, the tribes, and our state agencies, the task force listened to experts, looked at best practices from across the country and across Wisconsin, and heard from the people and families impacted by this crisis of Opioid Abuse.
LEGISLATION AND STATUTES
We recommend legislation permitting school personnel such as school nurses to administer an opioid antagonist such as Naloxone to a student on school premises if a student overdoses while at school.
We recommend permitting UW’s Office of Educational Opportunity to charter a recovery school so that students who need in-patient care can receive it without missing a semester or year of school.
My 2₵-This is an invaluable idea. If we can offer help and yet support their education, some students may actually succeed where otherwise they would have failed and lost everything. Of course not all will accept this option, many will fail, but for those who succeed the benefits to society are huge.
We recommend amending the state statutes to permit relatives to commit a drug-addicted family member in the same fashion we currently allow for alcoholism.
FUNDING AND PROGRAMS
We recommend spending $150,000 to fund two additional fellowships to train addiction physicians.
We suggest a “Recovery Corps”. For $60,000, we could annually train 20 recovery specialists to serve at substance abuse and peer support sites.
We also recommend a grant program to allow up to 25 hospitals with high rates of drug overdose care to hire in-house recovery coaches. These coaches would be responsible for ensuring a smooth hand-off from in-patient care for an overdose to in or out-patient care for addiction. We propose dedicating $2,000,000 to begin this program with the hope that hospitals will find value and consider continuing it after the pilot phase.
We recommend $500,000 to support recovery coaches and peer specialists in community corrections settings with high concentrations of addict offenders.
My 2₵ (for the last 3 items)-These are a no brainer. It is those who have gone through the same struggles that can best help the addict. There are things only addicted individuals can understand and having the support of someone who has been there is critical when working with addicts, in my opinion anyway.
We recommend $2,016,000 in funding to support the start-up of three new medically assisted treatment (MAT) centers that provide assessment, counseling, treatment, and intensive case management services to many individuals looking for addiction support, but also housing and employment, in underserved areas of the state.
My 2₵-It is the underserved that suffer the most. They often start out at a disadvantage, economically, socially etc, but they also lack the resources to show them a better way, or to help when they are ready to seek it. Other than jail and life on the street, their options are few. They need help, and I hope this will give them that.
An Addiction Treatment & Recovery Hotline at DHS. Staffed by trained counselors and peer specialists, the call center and website would connect people to resources in their region, help them navigate insurance or Medicaid, and be a listening ear in a difficult hour. We expect the hotline to require $400,000 annually to operate.
We recommend $1,000,000 to provide competitive community Innovation Grants to implement the best treatment ideas developed by community coalitions. The funds will focus on expanding MAT treatment, especially in conjunction with drug courts, and expanding recovery services.
DHS will expend $1,000,000 to support education, training, and access to Naloxone through non-profits that serve high-risk populations, including our veterans.
My 2₵-This is so important. Recently, legislation was passed to make Naloxone available without a prescription to communities and individuals in Wisconsin. There is not, however, current education for communities on who should have it handy and how and when to use it. I think this is critical to compliment the increased availability of Naloxone.
We propose $420,000 to hire additional Criminal Investigation Agents at DOJ to focus specifically on drug traffickers operating in Wisconsin.
My 2₵-Let’s focus our criminal investigation on the actual criminals. Good plan.
We recommend increasing funding for drug courts and other alternatives to incarceration for minor, drug-only offenses because social science and personal experience convince us that they work. The program was previously funded at $2 million per year in a one-time biennial transfer; we recommend continuing that funding and adding $150,000 to expand the program to more counties.
We recommend $261,000 to launch a pre-booking diversion pilot program to allow non-violent arrestees a treatment option that diverts them away from the criminal justice system and into support and healing in the community.
My 2₵-This is so important! We need alternatives to incarceration for addicts. It does not work to lock them up and forget about them. Without treatment, they will most likely return to the same behavior upon release. With treatment they have a shot at overcoming the addiction and staying out of jails and prisons. Is it expensive? Probably. But so is incarceration.
We propose appropriating $250,000 to fund three staff to operate a data analysis center. Working with our agencies, they will develop a dashboard for opioids data which will be used to develop our state needs assessment and statewide strategic plan.
To identify addicts and to better prepare people for the Wisconsin workforce, the Governor has ordered DHS to seek a federal waiver to conduct drug screening and testing for able-bodied adults without dependents who participate in FSET (FoodShare Employment and Training) as part of the supplemental nutrition program. Importantly, anyone who fails the drug screen will be provided treatment.
My 2₵-Not to punish those on food stamps who are addicts, but to get them help so they can one day join or rejoin the workforce and have a life.
DOC should consider developing a recovery housing unit within an institution where inmates would voluntarily commit to living clean after release, participating in an addiction program, and supporting their fellow inmates in their common battle for healing.
My 2₵-Yes, Yes, Yes!!!!
The Department of Safety and Professional Services should dedicate all necessary resources to ensuring the efficacy of the Prescription Drug Monitoring Program (PDMP). As the PDMP becomes mandatory for three years, we expect DSPS to see an increase in investigations and enforcement actions based on the data it makes available.
My 2₵-I have talked about the PDMP before. It is a great tool, but it must be reviewed! Requiring doctors and pharmacies to enter prescription information is only good if someone is reviewing the data for problems and following up on them when they are brought to light. I would like to see the investigations and enforcement actions publicized so we can be aware of the prevalence of the issues.
DVA (Department of Veteran’s Affairs) should ensure that its Division of Veterans Homes provides care in line with best practices for opioid prescription and pain management. In particular, home residents with opioid prescriptions should have individualized plans of care that may include non-pharmaceutical treatment options. Moreover, DVA medical and pharmaceutical staff should ensure that opioid prescribing is in line with best practices recommended by the Medical Examining Board.
DVA should promote public awareness among the veteran community of opioid related resources, for instance by ensuring that DVA and county veterans services staff, homeless veterans service providers, and DVA grantees and allies have information on opioid abuse.
My 2₵-Thank God Veterans are included in this task force’s recommendations. They are an underserved group and need much help. I hope this gives those Veterans who struggle the support they need.
BEST PRACTICES FOR INDUSTRIES AND COMMUNITIES
Because we intend for Medicaid to set the best practices for coverage, we encourage all other health insurance providers to bring their own policies in line with Medicaid to ensure all citizens in Wisconsin have access to appropriate treatment for both pain and addiction.
The task force offers these recommendations to ensure their consideration in the biennial state budget process. I will follow the progress of the task force and update you all as things, hopefully, progress. I think this is a good start.
I welcome your thoughts.