Pubdate: Fri, 27 Feb 2015
Source: Baltimore Sun (MD)
Copyright: 2015 The Baltimore Sun Company
Contact:  http://www.baltimoresun.com/
Details: http://www.mapinc.org/media/37
Authors: Ellen Weber and Nancy Rosen-Cohen
Note: Ellen Weber is a professor at the University of Maryland Carey 
School of Law. Dr. Nancy Rosen-Cohen is executive director of the 
National Council on Alcoholism and Drug Dependence.

REVERSING THE OVERDOSE EPIDEMIC

We commend Maryland officials for highlighting the serious health 
crisis that heroin use poses for all Marylanders and promising 
immediate action to respond to our state's overdose epidemic.

Now is the time to invest wisely in the health care strategies that 
will prevent and treat opiate and other substance use disorders, even 
in a time of budget constraints.

While the state's investment in substance use treatment has never met 
the need for care, Maryland is building a solid public health and 
health care financing system that can be mobilized to address our 
overdose epidemic.

The state, through its implementation of health care reform, requires 
private health insurance carriers to offer a comprehensive substance 
use disorder benefit that covers all levels of care from outpatient 
to residential treatment.

With the state's Medicaid expansion, over 1.2 million children and 
adults have access to a wide range of substance use and other health services.

The state has also implemented harm reduction strategies that allow 
trained individuals to administer naloxone to reverse an opioid 
overdose. Counties across the state are making the medication 
available to families and friends of those at risk of overdose, and 
police officers who carry the medication are playing a critical role 
in saving the lives of individuals.

The state can turn the corner on the tragic loss of life by taking 
full advantage of its health care system.

By enforcing laws that are already on the books and protecting our 
current infrastructure, we can improve access to treatment and reduce 
overdose deaths.

We recommend three policy initiatives to make substance use treatment 
more readily available.

First, ensure state grant funds are available to provide care to all 
individuals who seek treatment but have lost insurance coverage, are 
under-insured or fall through the cracks.

Any reduction in grant funds will prevent adults from accessing 
residential treatment, which is not covered by Medicaid, and will 
prevent our senior citizens from continuing outpatient methadone 
treatment and other cost-effective, community-based treatments not 
covered by Medicare. Grant funds provide the safety net for those who 
need immediate services to prevent overdose deaths.

Second, enroll incarcerated individuals in health insurance before 
they leave jail or prison and connect them to a health care provider. 
The state's data show that the risk of overdose for persons leaving 
prisons and jails is over eight times greater in the first week 
following release compared to the period of three months to a year 
after release.

The Departments of Public Safety and Correctional Services and Health 
and Mental Hygiene must implement a plan to ensure that individuals 
leaving jails and prisons are enrolled in both Medicaid and linked to 
a health care provider on the date of their release and that re-entry 
planning provides an immediate path to substance use treatment.

County jails and detention centers can enroll individuals at the time 
of booking so that persons with substance use problems can be 
diverted immediately to treatment as an alternative to incarceration. 
Many other states have tackled this problem, and Maryland's citizens 
can wait no longer for the implementation of this humane and fiscally 
sound policy.

Finally, ensure that consumers with private insurance policies get 
the substance use treatment they are paying for. Benefit coverage is 
meaningless if carriers deny care that is recommended by the 
patient's clinician or limit access by offering inadequate networks 
of substance use providers.

The Mental Health Parity and Addiction Equity Act requires carriers 
to sell policies that meet non-discrimination standards for care 
coverage and provider networks, but consumers have no way of knowing 
which plans are actually delivering on that promise.

The Maryland Insurance Administration must do what other state 
insurance departments have begun to do - review all plans for 
compliance with the Parity Act and allow only those that can 
demonstrate equitable coverage and reimbursement of substance use and 
mental health services to be sold in the state.

History has demonstrated that policies that punish people for their 
drug use will do little more than increase the state's criminal justice costs.

Luckily for its citizens, Maryland has put all the right health care 
pieces in place to address this epidemic as the public health crisis 
it is. Our political, business and health leaders can save lives by 
maximizing public and private resources at their disposal.
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MAP posted-by: Jay Bergstrom