Little new money in budget to fight drugs locally

While the House and Senate volley back and forth over health care legislation, the federal budget plan announced last week allows at least a glimmer of hope for some communities battling an opioid crisis, despite some ongoing department cuts.

Ohio Senators Sherrod Brown and Rob Portman both issued statements following the bipartisan agreement that would include $160 million to combat the opioid epidemic and to fully support the Comprehensive Addiction and Recovery Act (CARA) and the 21st Century Cures Act. The budget would appropriate $10 million for anti-heroin task forces.

“This is good news for Ohio, and will help our efforts to combat the heroin and prescription drug epidemic gripping our state,” Portman said in a statement. “Over the last year, I have worked hard to address this crisis by passing my CARA legislation and helping to pass CURES, and I am pleased that we are providing additional resources that will help save lives. In order to reverse the tide of addiction, I will continue to do my part at the federal level to work with the new administration and make the federal government a better partner to those who are on the frontlines of this epidemic and need our help.”

CARA establishes a comprehensive, coordinated, balanced strategy through enhanced grant programs that would expand prevention and education efforts while also promoting treatment and recovery. It was signed into law by President Obama in 2016. The 21st Century Cures Act was enacted in December 2016 and authorized $6.3 billion in funding, mostly for the National Institutes of Health.

However, according to David Browne, executive director of the Washington County Behavioral Health Board, the new budget may still leave the county in the lurch.

“The $26 million that (the Department of Health and Human Services) released, none of it is coming to Washington County,” he said. “It was allocated to counties with higher rates of overdoses and deaths. The ‘new’ money sounds like it is being split between a number of entities. I am glad the state may use the $10 million for a statewide campaign, but what it may look like, I don’t know.”

Project DAWN is a community-based overdose education and naloxone distribution program throughout the state of Ohio. Val Betkoski, director of nursing for the Washington County Health Department, said that because nothing has really been taken away, the program and others like it will be able to continue in both the county and city health departments. Naloxone is a medication used to counter the effects of opioid overdose.

First responders, EMS personnel and even friends and family members can administer the drug, commonly called Narcan. Locally, pharmacies offer Narcan without a prescription.

“We will train local law enforcement, EMTs and even individuals in the county who feel the need to know how to administer Naloxone,” Betkoski said. “Our funding is through House Bill 64 and is for half a million dollars through Jan. 1, 2018. Right now I haven’t heard that anything has changed. But I can’t see the future. We’ll cross that bridge when we come to it.”

The $1 trillion spending bill will keep the government operating through September. Among other items approved were an additional $15 billion in military spending, $1.5 billion for border security, and funding for programs like the Environmental Protection Agency and arts and economic development grants were kept in place. The bill passed in the House with a vote of 309 to 118 and the Senate approved it 79 to 18. President Trump signed the bill on Friday.

More recently, however, Senators Brown and Portman took issue with the president’s proposed cuts to the Office of National Drug Control Policy (ONDCP). Portman said that he has known and worked with drug czars for more than 20 years and he authored a bipartisan law in 1997 called the Drug Free Communities Act, which is now in jeopardy.

Brown said in a statement, “If these reports are true, President Trump will need to explain himself to the families whose loved ones have been taken by this epidemic and to the Ohio county morgues who’ve had to bring in extra refrigerated trucks to keep up with the overdose deaths in our state.”

The House of Representatives also passed their version of a health care bill intended to replace the Affordable Care Act last week, which would limit funding for Medicaid expansion, a program that insures roughly 900,000 people in Ohio. It provides substance abuse treatment coverage for as many as 200,000 in the state. The legislation also removes the requirement that insurers must cover behavioral health and substance abuse services.

Browne said the rollback of Medicaid expansion and enrollment will be “detrimental” to those currently receiving services.

“Many individuals are now receiving those services at local provider agencies that are being reimbursed by the Medicaid program,” Browne said. “Not only are we talking about helping people with mental health or addiction issues, we are also talking about the jobs created through Medicaid expansion. To roll back the program now would have a negative effect on our county.”

Until the Senate decides what it’s going to do, it’s just a waiting game, according to Browne.

“I have been here going on 20 years and have learned to wait until everything is finalized, then deal with it,” he said. “There are always so many things proposed, but we have to wait for the back room deals to be struck. So, the final bill usually looks nothing like what was originally proposed . until our local communities realize it is up to us to take on the crisis ourselves, the opioid crisis in Washington County will still be here. A statewide campaign that focuses on the more populated counties will have little effect for us here.”

By the numbers

¯ Federal budget bill includes more than $160 million in federal resources for the opioid epidemic in Ohio.

¯ $10 million is for anti-heroin task forces.

¯ According to the Ohio Department of Health, fentanyl-related overdose deaths climbed from 503 in 2014 to 1,155 in 2015.

¯ Between 2008 and 2013, Washington County had 10.8 overdoses per 100,000 people, according to ODH.

¯ Ohio counties with the highest overdose death counts (2010-2015): Lucas, Stark, Lorain, Cuyahoga, Summit, Trumbull, Lawrence, Scioto, Adams, Brown, Clermont, Hamilton, Butler, Warren, Clinton, Greene, Montgomery, Clark, Madison and Franklin.

Source: Times research.