State sees need for Franklin County detox beds
The detox gap in Franklin County could be filled, and insurers could face official scrutiny of the criteria they use to determine who is eligible for addiction treatment.
These are among the 36 recommendations released this week by the state panel charged by the governor with generating recommendations to deal with the epidemic of opioid abuse, providing a snapshot of that panel’s final recommendations.
Department of Public Health Commissioner Cheryl Bartlett, who chairs the group, said the recommendations released were generated by focus groups around the state, and will be prioritized and submitted to Gov. Deval Patrick by the end of next week.
“This is what we heard out in the community, we had 18 focus groups with different sectors of our communities — providers, family members, people in recovery, people not in recovery, providers, hospitals, public safety,” Bartlett said. “Our intention is to analyze these recommendations and put some specifics as to what it would take to implement them, from the financial and feasibility perspective, and then we would prioritize them based on what we already have; some of the things that were recommended we’re doing already.”
The detox recommendation is one of the few in the list with an attached location — “Add one detoxification program in Franklin County,” estimated cost: $550,000.
Earlier this month in Greenfield, Patrick told attendees of a campaign fundraiser for Franklin County Sheriff Christopher Donelan that there will be a detox facility in Franklin County before he leaves office. Patrick’s term ends in 2015.
Bartlett suggested that this recommendation will fare well in the prioritization.
“There has been a recommendation for the addition of a detox program in Franklin County. We’ve heard that that’s a gap in addressing the continuum of care there, and that’s something that we have already been prioritizing, so it seems like that’s aligned with what we think is needed out there,” Bartlett said.
The DPH Bureau of Substance Abuse Services had previously not identified a lack of detoxification beds — short-term placements for medically supervised withdrawal, usually over the course of five to seven days in the case of heroin and other opioids — in the county, viewing the area as a broader region with detox facilities in Springfield, Holyoke and Pittsfield.
The only detox in the immediate area closed in 2003, when Baystate Franklin Medical Center, citing state budget cuts, ended the program. Neither detox nor intermediate or transitional care are available locally. There are now four long-term sober living houses, three in Greenfield and one in Orange.
Bartlett also spoke of expanding service at existing facilities, potentially including the methadone and Suboxone clinics in Greenfield and expanding hours at the peer-to-peer RECOVER Project in Greenfield.
Most other recommendations apply to the broader system, a review by the DPH and Division of Insurance of the medical necessity criteria for opiate abuse and treatment developed by insurance providers. Health care parity laws require Massachusetts insurers to provide benefits for medically necessary mental and behavioral health care at the same level as other medical care. Medical necessity standards are, however, commissioned by insurers and many addicts and families describe difficulty in navigating the system and meeting the criteria. One father interviewed this year said he had difficulty finding help for his son when the young man was struggling with painkiller abuse, but things got easier once he slipped into heroin.
Recommendations on the list carried estimated price tags ranging from $25,000 per regional training for a suggested education and training program to help nurses and other professionals in courts, schools and elsewhere to identify high risk individuals to $10 million for a statewide community-based management service to support addicts in treatment and their families, while in treatment and in moving between stages of care. Total, the requests reach about $23 million.
Patrick tasked the Interagency Council on Substance Abuse and Prevention with gathering recommendations in declaring a public health emergency in March, also setting aside $20 million to bolster substance abuse treatment.
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