Op Ed - Historic Moment For Heroin Epidemic

The Beginning of the End? Historic Moment for Heroin Epidemic

Maureen Ledden Rossi

Family members and anti drug advocate Maureen Rossi joined by Legislators Cilmi and Trotta celebrate the singing of NYS legislation to help those dealing with addiction.History was made in Albany on Wednesday June 18^th when Governor Cuomo signed a series of critical bills designed to help combat the state’s burgeoning youth heroin crisis.  Those of us on the front line of the Movement; families of the addicted, those in recovery, treatment providers and grassroots civic organizations applaud these bills.  However, there were a few critical things left on a table in the Capital, things that must still get done if we are going to beat this thing and it’s incumbent upon all of us to beat this thing.

Unfortunately, what the Governor calls the greatest health crisis of our time and the C.D.C calls an epidemic is now a statewide problem.  No stranger to Long Island; we have been grappling with this youth epidemic for a decade.  Thousands of families have been affected in Nassau and Suffolk County; thousands of parents have buried a child and become part of a club no parent ever wants to join.  The loss of young life on Long Island in unquantifiable.     National experts in the field say Long Island was Ground Zero, however, despite numerous experts weighing in; hard numbers for both counties are very difficult to find.  The gaggle of reporters covering the epidemic at the Capital kept asking for those numbers.   Unfortunately, neither Suffolk nor Nassau County Health Departments have configured or published this data.  In 2010 the Long Island Council for Alcoholism and Drug Dependence (LICADD) reported two hundred and forty-two deaths from opiates and in 2011 they reported three hundred and forty seven with an anticipation of a higher number in 2012.  

During Cuomo’s press conference with leaders of the Senate and Assembly at his side, he spoke first the most critical bill of all, the Insurance bill.   He said there has been a lot of confusion with regard to ascertaining treatment.   However, for those of us trying to ascertain a bed for a young addict, there was never any confusion.  It was abysmally apparent that blatant discriminatory practices were at play.   They were told they are not high enough or don’t use enough heroin for detox, opiate withdrawal wasn’t lethal or they must fail at outpatient therapy prior to being provided inpatient services.   The profiteers, the big insurance company executives, have been playing Russian Roulette with the precious lives of Long Islanders and young people all over the state.  There is nothing confusing about that.  We watched helplessly as kids as young as eighteen and nineteen who overdosed two or three times were denied the proper medical treatment for their life-threatening disease.

The passage of the Insurance Bill appears to be an enormous victory but there are provisions missing that leave people with knowledge of the inner workings of Insurance companies worried and skeptical    The Insurance bill is supposed to remove obstacles to treatment by providing a more rapid appeals process if someone is denied.  It also ensures care will be provided while the appeals process is underway.  This is a win.  It is supposed to hold the hand of the Insurance companies to make sure they use recognized, evidence-based and peer-reviewed clinical review criteria, approved by the State Office of Alcoholism and Substance Abuse Services (OASAS), when making decisions regarding the medical necessity of treatment.  Unfortunately , it turns out that this verbose phraseology might not be enough because the bill doesn’t require plans to cancel out or change their ability to have their own medical necessity criteria.  Ideally the definitions of the Insurance term medical necessity would have been standardized and transparent to beneficiaries with the exact same language for every carrier.  On the upside, the bill does ensure that these medical necessity decisions are made by medical professionals who specialize in behavioral health and substance use.   Elected officials on both sides of the isle believe these measure will make a palpable difference.   Critics remain cautiously optimistic.

The passage of this compromised bill that still has merit did not come about with ease.  Hundreds of Long Islanders made numerous trips to Albany in the last two months where parents of those lost told their excruciating tales of these Insurance denials to lawmakers.   They also shared their stories in the eighteen hearings around the state hosted by the Senate Joint Task Force on Heron & Opioid Addiction.  A bi-partisan effort, it was headed by Long Island’s own Senator Phil Boyle as its Chairman.  Those hearings played an integral part of the historic passage of bills that Boyle says will be the beginning of the end for this epidemic.

As the minutes of the last week in Albany ticked down, there were vigorous negotiations back and forth between the Assembly and the Governor’s office with lobbyists for the Movement.   The Senate was on board from the beginning, at the end of the day the Assembly and the Governor held the final cards.  They wanted the law to sunset in three years, it will not sunset.  They were pushing for a January 2016 start, we wanted it to be effective immediately – it will now go into effect until April 2015.   There was great pushback about the oversight, about the audits to be done by the Department of Financial Services (DFS).   We wanted enhanced DFS oversight of carriers with random audits to ensure the proper protocol was being followed.   However, it seems that it will be business as usual because they agreed to continue to do an audit every three years.  This is the current practice – this has not worked, from this vantage point, it appears we did not win this battle.

Sadly, in addition, there were two critical bills that were left on the table.  One was originally the other half of the I-stop bill; it required doctors to receive three hour training on prescribing opiates biennially.  Although basking in the light of victory for the cumulative package, Long Island families and activists will be back in Albany in the fall to fight the education bill.  Too many young people have been prescribed into their addiction by well-meaning doctors who quite simply did not know enough about opiates.  Many addictions started as a result of treatment for; migraines, surgeries due to sports injuries, car accidents and dental procedures.   

The other bill that needs to be reexamined in the fall is the Sober Home Bill requiring the oversight and regulation of Sober Homes.    If run properly, these homes have the potential to play a critical role in maintaining and enhancing recovery when people phase out of inpatient.  Public awareness campaigns, prevention education and doubling the size of the state’s Narcotic Enforcement team were all a win.  Withstate representatives up for election in the fall in both counties, it’s game on.   Long Islander’s must report any difficulties they encounter when seeking treatment for their child immediately to their Senators and their Assemblymen.  These elected officials must be held accountable and this absolutely must be the beginning of the end.