Monday, August 17, 2020

A NEED FOR A DRUG CZAR ?

 Would the struggle against the crippling effects of addictive behavioral disorders benefit from a consolidating of initiatives coordinated by one person or office? Does the Garden State need a Drug Czar (my term)? There are three bills pending in the state Legislature that would significantly center addiction prevention, treatment and recovery services under one roof. All three are presently receiving committee consideration.

 

* Assembly Bill 2124 and Senate Bill 2170 would establish an Office of Alcohol and Drug Use Disorders Policy to oversee, direct and coordinate resources, funding and data tracking with all State Departments with regard to the prevention and treatment of alcohol and drug disorders. The Office would be allocated within the Dept. of the Treasury but would be independent of the Dept. and would report directly to the Governor. It would review County Annual Alliance Plans and distribute grants. It would evaluate provider performance and enforce contract compliance. The Office would take over most of the functions of the Governor’s Council on Alcoholism and Drug Abuse. An Executive Director would be appointed by the Governor with the consent of the Senate.

 

* Assembly Bill 3364 would create an Office of Alcohol, Drug and Tobacco Use Control Policy in the Dept. of Health. It would develop a strategic plan to reduce use, oversee the collection of data related to youth use, identify the best municipal youth programs, and develop recommendations to improve the safety and effectiveness of acute pain treatment. The Office would apply for grants to fund itself.

 

* Senate Bill 2079 would create the Office of Coordinated Substance Use Control Policy and Planning in, but not of, the Dept. of Human Services. It is intended that it would be independent of DHS control. The Governor would appoint the Executive Director and his/her Deputy, with Senate consent. The Office would develop a strategic plan, coordinate and oversee all substance use control activities in all state Departments, law enforcement, and local governments, make compliance recommendations, provide agency budget recommendations, audit and evaluate agency performance, biennially review existing laws and regulations to determine consistency with the Strategic Plan, serve as spokesperson for Executive Branch substance use policies, administer appropriate grant programs, assume some of the responsibilities of the current Governor’s Council on Alcohol and Drug Abuse including review of County Annual Alliance Plans, examine extant statutes and make recommendations, hire, appoint, transfer agency staff to implement the Strategic Plan, assign funds among agencies, control the use of agency monies, and operate a hotline to assist the public.

 

Even if it is determined that either of these proposals (or some combination thereof) would improve on the present state of things, would New Jersey government have the will to make it happen? Would the monies be found to carry out this reform in a meaningful way? An argument could be made that every state department should be ready to engage in activities, within its bailiwick, that would help the cause. However, in the world of turf politics, how much authority and funding can it be reasonably expected that extant bureaucracies would voluntarily surrender? And can’t you just hear the howl that would be emitted from the hallowed halls of county and municipal governments when the big toe of state government is seen to be encroaching on its territory?

 

If this organizational shuffling makes effective sense, then like so many meaningful changes, it will have to be a priority of people seeking long-term recovery and their allies in order to get it enacted.

 

Ed Martone

Policy Analyst

Tuesday, August 11, 2020

ON MY MIND

 We are now one quarter through the 2020/21 state Legislative Term and a number of bills have been introduced to deal with the struggle of people seeking to attain, and maintain, long-term sobriety. There was hope that we were beginning to realize a modicum of success in 2019 that could be built upon in the New Year. A number of significant reforms were enacted; the Governor and most in  the Legislature were supportive of our recommendations; $100m had been pledged in the next Fiscal Year for addiction services; and overdose deaths had been reduced three percent below the previous year (for the first time in years). Then COVID-19 hit hard. The virus, and the resulting lockdown exacerbated problems of depression, anxiety, drug misuse, and overdose deaths. At a time when more folks needed treatment, many providers had to place limits on the number of patients admitted, or closed their doors altogether. Additionally, the state Budget is hemorrhaging billions of dollars and monies for addiction services have been largely frozen. Politically, attention has been rightly focused on the viral outbreak.

 

The challenge before us is to re-aim the spotlight on solutions to mitigate the damage left in addiction’s wake, that impedes recovery. Concentrating on public policies that can contribute to securing a path to wellness is one way in which people seeking healing, and their allies, can make a needed difference.

 

The following are some pending proposals being followed in the NJ Senate and Assembly:

 

A.970/S.2259 – Requires public schools to administer written student screenings for depression and other behavioral issues

AJR178/SJR85 – Recognize August 31 of each year as “Overdose Awareness Day”

A.4221 – Mandates that the Office of Information Technology establish a centralized, one-stop website resource guide to assist people in navigating the State’s mental health and substance use disorder service systems

S.805/A.3004 – Permits individuals with drug distribution, or intent to distribute, convictions to be eligible for General Assistance (welfare) benefits

S.1109 and S.1753 – Examines the issue of health insurers’ network adequacy

A.683 – Creates the office of Behavioral Health Ombudsperson

S.151/A.672 – Limits the release of a patient’s private information to insurance carriers

A.275/S.1112 – Reduces court-ordered fines owed by a drug or alcohol-dependent person upon the completion of a treatment program

A.2684/S.1073 – Authorizes public libraries to maintain a supply of opioid antidotes and permits emergency administration of an opioid antidote by a librarian or another trained library employee

A.3364 and S.2079 and S.2170/A.2124 – Creates the Office of Alcohol, Drug, and Tobacco Use Control Policy (Drug Czar)

S.1763/A.2280 – Prohibits certain substance use disorder treatment facilities from paying fees, commissions, or rebates to any person to refer patients to a particular facility (patient brokering)

S.1788/A.2642 – Requires hospitals to inquire whether patients have a substance use disorder and establishes protocols for providing or referring to treatment

S.508/A.3158 – Mandates that public and nonpublic secondary schools annually conduct written or verbal substance use screening on all students using a particular screening program (SBIRT)

S.892/A.2649 – Requires nursing homes to provide training to staff in behavioral health issues

A.3284 – Requires pharmacies to maintain a minimum stock of opioid antidotes

A.271 – Changes the name of “Drug Court” to “Recovery Court”

A.3295/S.1121 – Increases Medicaid reimbursement rates for certain evidence-based behavioral health services to Medicare levels

S.1731/A.2295 – Mandates the curriculum in medical schools include instruction in the treatment and management of opiate-dependent patients that meets the minimum training requirements established for physicians to be authorized to prescribe narcotic drugs

A.2269/S.1844 – Requires hospitals to include a warning in patient discharge papers concerning the risks of addiction and overdose associated with opioid medications

A.1059 – Requires institutions of higher education to maintain a supply of opioid antidotes and permits the emergency administration of an opioid antidote by a campus medical professional or trained employee

A.677 – Authorizes Overdose Prevention Centers (safe injection sites)

S.877/A.809 – Mandates state and county correctional facilities to develop strategic plans to provide peer counseling and peer health navigators to support the treatment of substance use disorders

S.1968 – Provides tax credits to employers who hire people in recovery from substance use disorder

S.1969 – Includes substance use disorder on a list of disabilities that qualify a student for state special education and related services

A.3941 – Provides for funds received from opioid litigation or settlements to be dedicated for use in financing substance use disorder prevention and treatment services

S.2323/A.3869 – Requires the issuance of a prescription for an opioid antidote to anyone receiving a prescription for an opioid medication

 

Ed Martone

Policy Analyst