Category: News

Opioid crisis: State targets drug abuse problem

MassLive – With opioid overdoses becoming a growing problem in Massachusetts, state officials have established three task forces to look at the issues surrounding opioid addiction.

“The idea is eventually we’re all going to merge each other’s work and put a plan together and have an actual piece of legislation for this session,” said state Sen. Eric Lesser, D-Longmeadow, a member of a Special Senate Committee on Opioid Addiction Prevention, Treatment, and Recovery Options.

Last year, as overdose deaths spiked, then-Gov. Deval Patrick signed a law reforming insurance policy and creating new reporting requirements related to substance abuse. The law requires insurers to pay for 14 days of inpatient care for acute treatment for addiction without prior authorization. It requires a commission to prepare a list of drugs that can be substituted for opiates and requires pharmacists to dispense and insurers to cover abuse deterrent drugs. Several of the insurance provisions go into effect in October.

This year, under Gov. Charlie Baker, the state has continued to make combating opioid addiction a priority.

The most visible task force is one formed by Baker and chaired by Secretary of Health and Human Services Marylou Sudders. The task force, which includes Attorney General Maura Healey and experts in health care, drug addiction and law enforcement, has held four public hearings around the state, heard from 1,100 people and reviewed thousands of pages of documents. Recovering addicts and bereaved family members told heartbreaking stories as they asked for more treatment beds, better insurance coverage and more education.

The task force is expected to release results by early June.

“We’ll be definitely focusing on prevention, intervention, treatment and recovery recommendations for the governor,” Sudders said. Sudders said will not prejudge the task force’s findings, but she hopes to make recommendations relating to increasing access to treatment and not requiring people to fail at lower levels of care before accessing treatment they need.

“The overall goal is to reduce opioid deaths in the commonwealth of Massachusetts and make sure people get the treatment they need,” Sudders said.

Senate President Stan Rosenberg, D-Amherst, has convened a separate legislative special committee, chaired by Sen. Jennifer Flanagan, D-Leominster. The committee is tasked with overseeing implementation of the law signed in August and with making additional recommendations to address opioid abuse through prevention, intervention, treatment and recovery.

There are also several bills addressing substance abuse already pending in the Legislature.

One, sponsored by Sen. John Keenan, D-Quincy, would create a drug stewardship program in which a fee is added to the price of addictive narcotics, and that money is used to buy back excess drugs if, for example, someone is prescribed 50 pills but only takes 10.

Lesser wrote a bill to amend a prescription drug monitoring program to require pharmacies to report filling prescriptions for addictive narcotics within a day, rather than within a week. The goal would be to stop people from “pharmacy shopping,” filling one prescription multiple places.

Another bill filed by Lesser would let the state purchase the anti-overdose drug Narcan in bulk, so it could get cheaper prices, then distribute the drug to local police or ambulance departments.

In addition to those two committees, Healey has formed a working group of lawyers and investigators within her office to look at what the attorney general can do.

In an April interview, Healey said she is a looking at strengthening the state’s prescription drug monitoring program and cracking down on “problematic prescribing and dispensing practices.” She wants to focus on education and outreach to young people and families to prevent drug addiction, and to work with insurers and health care providers to ensure access to treatment.

Healey’s office has particularly been working in enforcement. In one case, Healey sued the North Andover-based Center for Psychiatric Medicine for allegedly charging MassHealth patients hundreds of dollars in cash fees for the anti-addiction drug Suboxone, when the medication would have been covered by MassHealth. The center allegedly allowed patients to pay cash to skip therapy sessions and physician visits.

Healey’s office has investigated and prosecuted criminal cases related to heroin trafficking and to people writing fake prescriptions. She requested information from the manufacturer and distributors of Narcan about recent price spikes. She has requested information from insurers about why Boston area drug rehabilitation patients who were affected by the Long Island bridge closure saw claims for treatment beds denied. A division of her office has been researching issues related to insurance coverage, cost trends and parity for physical and behavioral health treatment.

“Everyone needs to be at the table, because every day people are dying here in this state…and if we don’t come together now, it’s just going to continue to get worse and worse,” Healey said.

Lesser secures manufacturing training funds

Chris Maza, The Reminder

BOSTON – The state Senate recently unanimously approved additional funding for Massachusetts Precision Manufacturing Pilot Program proposed by state Sen. Eric Lesser.

Making his maiden address on the Senate floor, Lesser advocated for an extra $500,000 to bump total funding for the program to close to $1.5 million. A portion of that funding will be utilized to continue the program in Western Massachusetts.

“Every member of the Senate voted for it, 39 to 0, so that was a good feeling, certainly,” Lesser told Reminder Publications. “My hope is this is really just the start because we have a big opportunity here and this is just one small program. If this is the only thing we do, it’s going to help quite a lot of people, but the challenge for us now is to continue that and turn this program into a wider series of proposals for Western Massachusetts.”

Lesser said the purpose of the funding was to address the challenge of training a workforce that is able to fit the needs of the precision manufacturers with a foothold in the region. In his speech, Lesser said there would be an estimated 44,000 vacancies in advanced manufacturing in the next 10 years.

“There’s actually quite a lot; there’s actually several thousand vacant jobs in the manufacturing field just in the Pioneer Valley,” he said. “The problem is we don’t have enough people with the skills to take them, so a gap has emerged.”

“I think one of the most important ways for us to grow our economy here, create more prosperity and more opportunity, is to close that gap by investing in training programs and get people up to speed on the latest technology so they can go get jobs where the demand is,” he continued.

Part of a statewide initiative, the local manufacturing pilot program is a collaboration between the Regional Employment Board of Hampden County and a national trade group for those in the industry.

“You want to make sure the training is very current to what the industry is demanding,” Lesser said.

He added the program, featuring 10 to 15 weeklong courses would target unemployed and underemployed people, as well as veterans in need of jobs upon returning home from overseas. Those in the program would have access to mentors, training and job placement assistance.

In his speech Lesser celebrated the region’s strong history of manufacturing and stressed the need for support in bringing those jobs, which can provide livable wages, benefits and employment security, to help an area “left out of the red-hot economy that developed in the eastern part of the state.”

“We have a history and with that an expertise as a result and all that experience and a lot of families that have been involved in trades and in manufacturing for generations,” he said. “There was a period when a lot of those jobs left our area, but where we really established ourselves is in really specialized, really high-tech manufacturing … Those are very, very good jobs and high-paying jobs. The average salary can approach $75,000.”

Massachusetts Senate agrees to state study of Boston-Springfield rail

Shira Schoenberg, MassLive

The Massachusetts Senate has adopted an amendment that would require the state to study the feasibility of developing high-speed rail between Boston and Springfield.

“This study will be a first step toward establishing a rail link between Boston and Springfield,” said State Sen. Eric Lesser, D-Longmeadow, who sponsored the amendment. “For our economy in the Pioneer Valley to grow, we need to connect ourselves to the red-hot growth we’ve seen in other parts of the state. Rail will help make that happen.”

The amendment was adopted on voice vote on Thursday as the Senate finished debating its $38.1 billion budget. The budget must still go through a committee of House and Senate negotiators.

The amendment would require the Department of Transportation to look at the costs and economic opportunities related to developing high-speed rail between Springfield and Boston. The study must look at capital costs, operating costs and revenue estimates, projected ridership, required upgrades, environmental impacts, availability of outside funding sources and general benefits to Springfield and the state. The report would be due Dec. 1, 2016.

The amendment was based on a similar bill that Lesser sponsored, which was backed by several Western Massachusetts lawmakers.

Senate adopts Lesser’s anti-pharmacy shopping amendment

Shira Schoenberg, MassLive

The Massachusetts Senate on Thursday unanimously adopted a proposal by State Sen. Eric Lesser, D-Longmeadow, that would require pharmacies to report opioid drug purchases to a statewide Prescription Monitoring Program within a day, rather than a week.

The goal is to prevent drug addicts from pharmacy shopping, fulfilling one prescription at multiple pharmacies.

“This measure is a crucial step in our overall efforts to fight the opioid crisis here in Massachusetts, which has led to the destruction of families, communities and hundreds of lives,” Lesser said in a statement.

The amendment was co-sponsored by State Sen. Jennifer Flanagan, D-Leominster, who chairs the Joint Committee on Mental Health and Substance Abuse and has been a long-time advocate for addressing issues related to drug abuse.

Changing the reporting time was a recommendation of a February report by the Department of Public Health’s Drug Control Program.

The $38 billion budget passed by the state Senate late Thursday also adopted another provision based on a bill filed by Lesser that would allow for the creation of a bulk purchasing system for the anti-overdose drug, Narcan.

In the state budget, senators took numerous steps to address the growing number of opioid overdose deaths in Massachusetts. They proposed earmarking money to create two new recovery high schools to support teenagers in recovery, and to add 150 new post-detox treatment beds. The budget would put $10 million into a substance abuse trust fund, which focuses on a range of treatment services.

The House also stressed substance abuse prevention in its budget, though in slightly different ways.

According to state statistics, more than 1,000 Massachusetts residents died of opioid overdoses in 2014 compared to 668 in 2012.

The House and Senate versions of the budget will now go to a committee of House-Senate negotiators to iron out the differences.

Uneven state funding leaves WMass homeless shelters out in the cold

By Shira Schoenberg, MassLive

Friends of the Homeless runs an overnight shelter for homeless individuals in Springfield and has case managers available during the day. Last year, it got paid $25 per bed per day from a state contract, according to state data. Friends of the Homeless Executive Director Bill Miller said the shelter got an extra $7 per bed from a budget earmark, but it is still struggling to pay basic bills.

Shelters run by ServiceNet in Northampton, Greenfield and Pittsfield got $28 per bed per day.

At the same time, the Pine Street Inn in Boston had state contracts that paid up to $61 per bed per day. A handful of other shelters have contracts paying more than $40.

“There’s no formula,” Miller said. “It is a significant disadvantage to Springfield to be trying to provide adequate services while receiving among the lowest bed rates in the commonwealth.”

The struggle faced by the Springfield shelter highlights a funding process that creates disparities between shelters and appears to have little rationale behind it. Each year, the state spends around $40 million on shelters for homeless individuals. The state funding for the shelters is not competitively bid and has no set formula. There is no process for new shelters to apply for money. Rather, money that was at one time awarded by legislator’s requested earmark has become a permanent line item in the state budget, with the same shelters getting the same contracts year after year, with occasional increases to the lowest paid shelters. Previous legislative attempts to create a standardized bid process failed, although that could change with support from the new administration of Gov. Charlie Baker.

“As the administration works to improve efforts around prevention, addressing Massachusetts’ homelessness crisis requires using our resources as effectively as possible,” said Baker spokesman Billy Pitman. “Governor Baker’s budget proposal introduces an intention to transparently and competitively award, for the first time, individual homelessness services and shelter contracts to better serve a vulnerable population in need and get them back on their feet.”

Joe Finn, executive director of the Massachusetts Housing and Shelter Alliance, a non-profit advocacy group dedicated to ending homelessness, said the budget line item providing the shelter assistance has existed for decades.

“It emerged essentially as emergency programs years ago and rather than going through a formal bidding process, the state was simply negotiating with different communities,” Finn said. “Usually, the state develops specifications, which they entertain bids on. That was never quite done with this.”

The result, Finn said, is a system where an “eclectic mix” of community-based shelters are funded, with no one taking a comprehensive look at what kinds of services each shelter provides, who the shelters accept, and whether the shelters are receiving comparable amounts of money for comparable programs and costs.

“Usually, a rate is based on some kind of logic around what it is the commonwealth wants to purchase. That process has never taken place here,” Finn said.

Paul McMorrow, a spokesman for the Executive Office of Housing and Economic Development, confirmed that the program has not been procured competitively. “The rates had basically been set by earmark in the budget,” McMorrow said. “So lawmakers who were working with advocates who were providing services would put in a request for certain funding to cover their caseload. There was little price transparency and there was not a lot of consistency from provider to provider.”

McMorrow said the department, through Baker’s fiscal year 2016 budget, wants to institute competitive bidding.

This would not be the first time the idea was raised. The 2011 budget passed by the Legislature required the state to develop recommendations to standardize contract rates. In fiscal year 2014, the budget directed then-governor Deval Patrick’s administration to undertake a competitive procurement process “to the extent feasible.”

McMorrow, who was hired by Baker, said Housing and Economic Development officials were advised by Patrick administration officials that a competitive procurement process was not feasible. A reporter was unsuccessful in contacting former housing undersecretary Aaron Gornstein through a housing non-profit where he will become president in June.

Jay Sacchetti, vice president of shelter and housing services for ServiceNet, said ServiceNet’s shelters are all running deficits. Sometimes, they have only one staff member on duty. He is frustrated that the state has no formula to take into account the shelters’ costs. “There is no funding formula. It’s like ‘Here’s what you get,'” he said.

The shelters are vastly different from one another.

Mark Alston-Follansbee, executive director of the Somerville Homeless Coalition, said his shelter is a sober shelter in a church basement with significant staff and support for guests. It was given a contract in 1986, based on its staffing needs, and the contract has continued annually. The contract specifies that the coalition gets $78 a night for eight beds, although the shelter now uses that money to pay for 16 beds. “I have no idea how it was determined,” Alston-Follansbee said.

Alston-Follansbee worries that a competitive bidding process could disadvantage smaller shelters.

The Pine Street Inn in Boston, which has hundreds of shelter beds across three locations, has some of the highest pay under state contracts. A call to the Pine Street Inn was returned by a spokesman for The Coalition of Homeless Individuals, an umbrella group of shelters and homelessness programs. The coalition provided a statement from Karen LaFrazia, executive director of St. Francis House, on behalf of the coalition, which addressed the need for more funding but not the funding disparity between shelters.

“The most significant and urgent issue that all organizations that serve the homeless individual population face is the lack of state funding for providers, and the Coalition is focused on addressing that issue,” LaFrazia said.

With the lack of a solid formula, the shelters are still being funded partially by earmark, requests submitted by individual lawmakers. Last year, Friends of the Homeless brought their rate to $32 per bed through a budget earmark. Western Massachusetts lawmakers are trying to again amend this year’s budget to maintain that rate.

The current process does not allow new shelters to get state contracts without being earmarked. So, for example, Craig’s Doors in Amherst has only been able to get state funding through an earmark. This year, one was introduced by Senate President Stan Rosenberg, D-Amherst. “It’s very precarious,” said executive director Rebekah Wilder. “Shelters able to get into that specific source of funding, they at least have some guarantee of year after year having funding to operate. We’re not part of that.”

The disparity is not entirely regional. Shelters run by the Boston Public Health Commission as well as poor cities like Lawrence, Lynn and Brockton are all getting just $25 per bed per night, the lowest daily rate.

But there are regional implications. Data from the Massachusetts Housing and Shelter Alliance found that in 2013, 45 percent of homeless individuals lived in Boston, Cambridge and Somerville. Those cities received 70 percent of the individual shelter money. In comparision, cities and towns west of Worcester had 13 percent of the individual homeless population and 7 percent of the money. The worst hit were areas south of Boston that had 18 percent of the population but only 6 percent of the money.

“We often hear about the talk of Western Massachusetts getting the short end and eastern Massachusetts getting more resources,” said Sen. Eric Lesser, D-Longmeadow. “This is living proof, factual evidence, of just how broad that funding disparity is. I think it’s very important for us to get parity.”

Lesser is working with Sen. Jim Welch, D-West Springfield, to get Friends of the Homeless more money this year. Long term, both senators say they want to make the funding fairer.

“The funding is so out of whack, whatever formula they are using doesn’t make any sense,” Lesser said. “The potential would be to create a rational formula, because right now, there clearly isn’t one.”

Rosenberg said he does not know exactly what change should be made, but he agrees there should be change. “There are different costs across the state, but the range is way too big,” Rosenberg said. “Many of the places outside of the metropolitan Boston area are simply not getting the rates they need in order to support the programs to serve the people they’re supposed to serve.”