July 9 represented an important milestone for the Maine Legislature when it gave overwhelming bipartisan support to LD 925, a bill that included $6.7 million for the much-needed treatment of Mainers with opioid use disorder.
Appropriating these funds was a key recommendation of the Opioid Task Force that met in 2017. For once, a task force report will not just sit on a shelf collecting dust – instead, it will translate into saved lives.
This funding is particularly important to those healthcare providers providing treatment to uninsured Mainers struggling with opioid use disorder.
Two years ago, faced with the alarming crisis of a growing number of Mainers caught in the grips of the opioid epidemic, MaineHealth brought clinical and executive leaders from across Maine’s largest healthcare system together and asked that they do more to address it.
The issue was and remains daunting. Since 2009, 2,114 people have died of a drug overdose in this state. That’s more people than live in the York County town of Dayton (2,014), the Cumberland County town of Sebago (1,781) or the Sagadahoc County town of West Bath (1,893). Imagine losing everyone in any one of those towns?
As alarming as that is, equally challenging has been the misinformation and stigma associated with this disease and a lack of resources dedicated to treating those who suffer from it.
MaineHealth’s vision is “Working together so our communities are the healthiest in America.” Yet we knew that there was much more we could do to address this growing crisis.
So, healthcare professionals from MaineHealth’s members and affiliates came together in the summer of 2016 with both a sense of urgency and of great challenge. What became the MaineHealth Opioid Work Group looked at how we could do a better job of prevention through things like consistent prescribing of opioid pain medications. We brought people together who were on the front lines of treating babies born to mothers with opioid use disorder. We sought to educate our communities as well as our clinical staff about what needed to be done to combat the epidemic. And we created a “hub and spoke” treatment model to provide a range of care across our system, from intensive inpatient and outpatient services through Maine Behavioral Healthcare to ongoing medication maintenance for stable patients through primary care practices.
As a result, since Oct. 1 of last year, MaineHealth’s hub and spoke model has treated more than 900 people with opioid use disorder. That’s the good news. The bad news is the need is much greater than that, and the cost of delivering high-quality treatment far exceeds the reimbursement from most payers. Add to that the fact that more than 25 percent of our patients are uninsured, and the result is an unsustainable treatment model.
It is true that as a nonprofit healthcare provider, we provide care regardless of ability to pay, but a lack of funding limits our ability to expand treatment programs in a sustainable way. And even when we provide treatment to uninsured patients, there remains the issue of paying for prescription medication. There is nothing more heartbreaking than a patient desperately trying to address her illness who cannot afford the medication that research tells us will be her best shot at recovery. The funds provided in LD 925 will help address that problem.
Expanding Medicaid (Maine Care) in Maine under the federal Affordable Care Act would also help many get needed treatment, but the need is urgent, and unfortunately lives will be lost waiting for the Medicaid expansion issue to be resolved here.
Funding treatment, however, is not the only challenge. In our rural state, there is a tremendous need for transportation so that patients can receive treatment, which can involve up to five appointments per week. There is also a need for financial support for recovery coaching and patient navigation that will help patients and families find needed services and the support networks.
There is, too, a need for greater education to lift the stigma so more people will come forward for help. Meanwhile, law enforcement has an important role to play stemming the tide of illegal drugs coming to our state.
And within the medical community, we face a shortage of providers, especially psychiatrists specializing in substance abuse disorders.
But passage of LD 925 was an important step in our progress toward combating this epidemic. It was a wonderful show of leaders coming together in bipartisan fashion for the betterment of Maine people.
Send questions/comments to the editors.
