Does the U.S. Secretary of Health and Human Services, Alex Azar, have a greater sense of urgency to combat the opioid crisis after his visit to a treatment center in Ohio this month?
Secretary Azar was asked that question by a reporter last week during a press conference at a Kettering treatment center in which he spoke about the federal government’s plans to address and combat the opioid addiction problem. Ohio saw a 30 percent increase in drug overdose deaths between 2015 and 2016.
The day before Azar’s visit to Kettering, an opioid summit was held at the White House March 1 during which Azar said the President and First Lady directed the administration to make efforts to address the crisis.
In response to the question, Azar said,“It couldn’t give me a greater sense of urgency than I already have but today’s work and seeing individuals and meeting with the individuals I’ve seen today has reinforced in me, and what I have heard from the President, what I’ve heard from the First Lady, what the entire administration is feeling. Which is that this is a crisis impacting every corner of the United States and has the full dedication of the U.S. government to drive ahead, and that’s where this historic package is looking at all of our regulatory authorities and what we can to do be supportive from the national level. We work with our state partners here in Ohio as they look at regulatory mechanisms to try to tackle this crisis also.”
The “historic package” is what Azar said is $13 billion the federal government has promised to make available for prevention and treatment to combat the crisis and mental illness in the United States. The money is expected to be distributed over six years beginning in 2018.
“We are devoting hundreds and hundreds of millions of dollars of research at our National Institutes of Health as part of the historic $13 billion opioid and serious mental illness program that the President and Congress are funding. So $750 million for just 2019 alone is going to be dedicated towards the National Institutes of Health, working in a public-private partnership to try to develop the next generation of pain therapies that are not opioids, as well as to develop the best evidence around alternative ways of treating pain that do not involve opioids. So that’s where our focus is,” said Azar.
What will the historic $13 billion funding package look like?
“The first $3 billion is dependent on Congress passing what they call the ‘omnibus appropriation,’ which is the funded deal that was struck between the President and Congress. I’m certainly hopeful that will be in March, and then we will work to get that money out to states and all of the other grantees and programs as quickly as possible,” said Azar.“I need to go look at the Medicaid funding issues, but as part of this $13 billion that the President and the Congress has negotiated for the opioid crisis as well as serious mental illness, there will be $3 billion in 2018, followed by another $3 billion in 2019, and then $7 billion over the following four years devoted around these critical issues. And so part of that will actually involve a doubling of the money that goes to states for these state-targeted response grants, which is a bedrock of funding for the opioid crisis and enables the state of Ohio to address these issues and then fund the providers and other organizations for treatment. So, our focus is on prevention, how do we keep people from getting in this trap of addiction in the first place, through often legal prescription opioids? How do we stop them from progressing forward by having appropriate treatment for those who are trapped, who have already gotten into addictions, having adequate treatment resources and medically-assisted treatment for those individuals so they can get out of that; and then how do we support them in their ongoing recovery and preventing relapse as they go forward in their lives? It will be for many a lifetime of working to fight against any re-occurrence or relapse,” said Azar.
Is there a Medicaid expansion that is going to to provide more coverage of services and treatment?
“It is so important that I have gotten to learn today about the challenges here of reimbursement, and of course Medicaid is a program run by the states that we fund our share of at the end of the day, so at the end of the day, the state does decide its priorities for funding different types of programs, but we certainly would want to work with the states to ensure that the money we have to offer is available to help with proven programs that can work to help on healthcare throughout this crisis. We’ve got, for instance, a program right now for inpatient opioid addiction treatment where there’s a statute dating back decades that was part of a well-meaning effort to try to keep from putting individuals with mental illness into these big institutions. And so it’s said that we can’t pay for any mental healthcare inside of an institution that has more than 15 beds. Well, that is a barrier to the substance abuse disorder treatment that we need, that needs to be available for inpatients, so we have actually offered waivers to states to allow and expand the use of Medicaid funds in those institutions for substance abuse disorder and treatment. We’re working with the states to progress on that,” said Azar.
Will Medicaid funding be available for facilities like Brigid’s Path in Kettering, which is currently privately-funded, an inpatient treatment center for babies born addicted to heroin?
“I want to go back to Washington, now that I’ve heard about this, and seen the unbelievable impact of this organization. I want to go back to Washington to look at our programs to see what we can do to be supportive and helpful, but at the end of the day, states do decide what their Medicaid programs fund and we work with them on that,” said Azar. “Congressman Turner did bring up the CRIB Act and of course we have Governor Christie’s opioid commission work that was done at the request of President Trump. And as Kellyanne Conway is coordinating our opioid efforts across the Administration and has made clear yesterday (March 1) at the Opioid Summit that the First Lady and the President hosted at the White House, the full slate of recommendations of the Christie commission are ones that the President has endorsed and we as an administration are all working for and driving forward on that agenda.”
