Act to Save Lives

Maine Medical Association
Legislation 2017: Treatment for Opiate/Opioid Addiction
DRAFT: December 29, 2016

Title: An Act to Save Lives and Support People in Recovery from Opiate Use Disorder in Washington County

Fiscal Impact: $1,600,000 ($800,000 per year) for the FY18/19 biennium

Summary: This bill builds the infrastructure and systems needed in Washington County to ensure residents seeking treatment for opiate addiction can access the medicine, care, and recovery supports they need to be successful.  This bill funds a professional evaluation of this comprehensive approach to the treatment of substance use disorder and requires a report to the Maine Legislature on its effectiveness and ease of replication in other Maine communities that are being impacted by the opiate epidemic.

Overview:
The state of Maine is experiencing a crisis of opioid use as overdose deaths have reached an average of one person per day in 2016. Washington County has been particularly hard-hit, yet the region lacks infrastructure at almost every level of care and recovery. The need for treatment and recovery supports in Washington County is clear, but resources are limited or simply unavailable. Despite this financial reality, community members are eager to volunteer their help and this “sweat equity” can be a solid foundation upon which to build.

This bill will fund a comprehensive, evidence-based pilot project in Washington County that will allow residents seeking treatment for opiate use disorder to get the care and supports they need, when they need it.  The project will follow three phases: planning, implementation, and evaluation/reporting.  The planning phase will allow for the development of a best-practice approach that meets the unique needs of the region.  The implementation phase will fund the additional infrastructure and staffing needed to reduce wait times while leveraging other local state, and federal resources.  The evaluation/reporting phase will allow the Washington County project to be assessed, improved, and used as a model for other Maine communities.

Funding will be used for:

  1. Training non-health care entities that serve as points of entry to treatment and recovery (e.g. law enforcement, social service agencies)
  2. Training, comfort packs, and referral systems at emergency departments
  3. Adding detox beds (8 total – 2 per hospital plus 4 others TBD)
  4. Adding/incentivizing/training more Medication-Assisted Treatment (MAT) prescribers and pairing them with counselors (goal: 18 at FQHCs and 4 per hospital; total = 26)
  5. Providing MAT to people without insurance
  6. Adding partial hospitalization option for people without insurance
  7. Adding Intensive Out-Patient (IOP) capacity, including for people without insurance
  8. Adding low/no-cost prescription medicines for people without insurance
  9. Adding child care, transportation, and other barrier reductions for people in treatment and recovery
  10. Improving coordination, including the hand-off/referral systems, among all entities on the treatment/recovery continuum
  11. Adding residential rehab beds, including for women, youth, and other specialty populations
  12. Adding a re-entry house
  13. Adding treatment and recovery supports in county/local jails
  14. Adding more counseling capacity, including for people without insurance
  15. Adding peer mentoring/recovery programs, including training for Recovery Coaches
  16. Adding a peer recovery center (this could be embedded at an FQHC)
  17. Engaging community members in housing, employment, and other recovery supports
  18. Adding supports for families and friends
  19. Building and staffing a county-wide resource hub to compile and disseminate information about treatment and recovery opportunities
  20. Adding pain and chronic disease self-management classes
  21. Adding evidence-based school programs
  22. Convening regular community conversations to plan, implement, and improve the system