Members of two legislative committees heard more details Thursday about a plan to expand treatment for opioid addiction to several hundred more Mainers. The surge in overdoses last year to an average of one death a day helped drive the proposal.
Appearing before a joint meeting of the Legislature’s Appropriations Committee, and the Health and Human Services Committee, Commissioner Mary Mayhew of the Department of Health and Human Services said the $4.8 million plan would provide treatment services for about 400 additional Mainers. It was developed after Democrats insisted more funding to address the drug crisis be included in the emergency budget now before the Appropriations Committee.
Mayhew emphasized that the proposal is built on a model of care already approved by federal officials, one that involves primary care providers.
“It is not residential treatment, so I want to be crystal clear about that. Many of you are familiar with patient-centered medical homes. It is about building up on a primary care role,” she says.
Mayhew says other states like Vermont have successfully received federal waivers to provide treatment services based on the primary care model. Implementing the plan will require emergency state rulemaking as well as federal approval since the plan relies on some federal Medicaid dollars.
“This is a model not only are they familiar with but this is a model they have been encouraging states to adopt,” she says.
The proposal is being presented to the committees in the form of an amendment to the supplemental budget for this year. If approved, it’s expected to take several months to get services in place. But Democratic state Sen. Cathy Breen of Falmouth says she sponsored the amendment as one more step toward helping to expand treatment for opioid addiction.
She says she understands it’s just that — a first step.
“The amendment would provide an additional $2 million in state funding for treatment, including medication-assisted therapy for uninsured Mainers, the population least able to access treatment at this time,” she says.
The proposal is focused on medication-assisted treatment, considered the gold standard and the only evidence-based treatment for patients with heroin and opioid addiction when combined with behavioral therapy.
Some lawmakers, such as Republican state Rep. Stedman Seavey of Kennebunkport, say they will support the proposal in the emergency budget, but Seavey remains skeptical of certain types of drug treatment unless it includes a residential component.
“I think behavior modification is very, very hard to do for any particular individual. Otherwise, if it were so, I would be 30 pounds thinner. But, particularly with drugs, I think you need to take that sort of person right out of the environment and put them in a different environment,” he says.
One of the challenges facing lawmakers is getting a handle on how many Mainers need treatment. DHHS statistics show that last year there were more than 8,600 Mainers who received medication-assisted treatment, but many providers say there are long waitlists for services.
According to the national Substance Abuse and Mental Health Services Administration, only 11 percent of those with an addiction in this country are getting treatment for it.
In December, DHHS announced it was shifting funding to create 359 slots for the uninsured to receive drug treatment. The department now pegs the current statewide waitlist for treatment at just 234.