Hailed by the LePage administration as an answer to the shortcomings it saw in many drug treatment programs, and by a bipartisan group of legislators as at least a step in the right direction, the opioid health homes funded last February provided hope that Maine was finally taking seriously, in some small way, the state’s dearth of treatment options.
Almost a year later, the Portland Press Herald reported last week, the health homes have served only a fraction of the Mainers planned, and only a handful of the uninsured who so desperately need help, leaving us to wonder when the state will meet the opioid epidemic with anything approaching a proportionate response.
As presented early last year, the plan was to use $4.8 million in state and federal money to provide comprehensive addiction treatment to more than 400 Maine residents, including about 170 who do not have insurance and thus have trouble accessing health care services, a problem that worsened when the governor cut the state’s Medicaid program.
The opioid health home model delivers treatment through primary care providers, who the administration feels are better equipped to care for people with addiction than traditional providers of the medication-assisted treatment provided by methadone clinics.
The idea is that these medical offices can provide the medication Suboxone along with counseling, mental health care and peer recovery services and other forms of treatment under one roof.
But it appears that the model is asking a lot from doctors. The complicated structure of the opioid health homes, along with their cumbersome regulations and low reimbursement rates for the services provided, have kept many away.
According to a Feb. 6 memo from the Department of Health and Human Services, less than $60,000 has been spent on the program, and just five uninsured Mainers and fewer than 50 Medicaid recipients have been enrolled.
With so much riding on the opioid health home model, that is a failure, and it is disappointing.
The approval of funding for the initiative came just a few months after the Department of Health and Human Services pledged to spend $2.4 million to create 359 new treatment slots for the uninsured, seen as a signal that the LePage administration was finally embracing medication-assisted treatment, which has been shown to be the most effective strategy for treating opioid addiction.
But perhaps the celebration came too soon. Even if they were all filled, the 700 or so new treatment slots did not match the need, which treatment providers and anti-addiction advocates put in the thousands, but which DHHS continues to assert is much, much lower.
And providers recognized early on the problems with the health home model, shooting through the optimism of the moment and predicting what has happened so far.
DHHS did not respond to the Press Herald’s questions about the program’s underwhelming performance thus far. Officials should say whether they believe the program can be salvaged, and what we can expect over the next few months.
With an average of one person a day dying from a drug overdose, and thousands more in need of help, we need to know where they will go from here. It can’t be their best and final answer.
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