Experts: Latest opioid bill good-hearted but needs tweaks
An opioid-related bill that tackles treatment, training and overdose prevention is good-hearted but should be tweaked, public and private sector experts said during a Public Health Committee hearing Monday.
As it has done for three straight years, the committee analyzed a plethora of bills aimed at the crisis and included the most feasible suggestions in Senate Bill No. 1057.
State Sen. Heather Somers, a ranking member of the committee, said legislators created the “placeholder” bill knowing it would need to be adjusted before it could move forward.
Overdoses killed 1,017 people in Connecticut in 2018, per data from the state Office of the Chief Medical Examiner.
Somers said Tuesday morning that members of the committee soon would meet to discuss the feedback they got Monday.
“There were a lot of good points brought up,” she said.
The first section of the bill requires colleges and universities to stock the overdose-reversal drug naloxone in a central and accessible location. It further requires the institutions to notify a local emergency medical services provider each time the drug is used.
Most of those who spoke at the hearing Monday were in favor of the provision, because having naloxone on hand can prevent fatal overdoses.
Testifying on behalf of the state Department of Consumer Protection, Commissioner Michelle Seagull said institutions of higher education, if they are going to purchase, store and distribute naloxone, should be required to designate a medical professional to do so.
The bill asks the state Department of Mental Health and Addiction Services, or DMHAS, to study whether Connecticut could partner with at least one home health agency to bring treatment directly to some people who struggle with addiction.
Ideally, physicians would alert the home health agency to Medicaid recipients who were hospitalized because of a suspected drug overdose and/or are likely to relapse.
The agency then would bring medication-assisted treatment — or the combination of therapy and medications that reduce withdrawal symptoms — to the patients’ homes.
In her testimony, DMHAS Commissioner Miriam Delphin-Rittmon said DMHAS doesn’t have the resources to do a comprehensive study but could do a literature review on the topic.
Heidi Pugliese, vice president of behavioral health services for Elara Caring – New England Home Care, said the proposal likely would increase the number of people in treatment.
“By providing this service in the comfort of one’s home, it addresses the barrier of stigma, which prevents some individuals from seeking care,” said Pugliese, who said her agency could step up if the bill became law.
Mental health first aid
Another provision of the bill would require prospective paramedics to complete mental health first aid training beginning Jan. 1, 2020.
Michael Zacchara, chairman of the Connecticut Emergency Medical Services Education and Training Committee, opposed the idea. He said little research exists on the benefits of the first aid training, which hardly touches on addiction.
If the training were mandated for emergency medical responders, he said, it would take up eight of the 40 hours allotted to cover everything from childbirth and traumatic injuries to heart attacks and strokes.
In part because it costs $2,000 to become a mental health first aid instructor, Zacchara also said there might not be enough instructors to meet the demand should the training become required in Connecticut.
He said he would rather see the training offered as continuing education.
“I don’t want us to get to a point that we have our entire curriculum legislated to us,” Zacchara said.
Mental health screenings
The bill also says hospitals that treat patients for nonfatal overdoses should assess the mental health of those patients.
Though some who spoke Monday applauded the emphasis on mental health in relation to substance use disorders, the Connecticut Hospital Association objected to the provision.
The association listed nine major steps it has taken to combat the opioid crisis, including making recovery coaches, who help people navigate the complex process of getting and staying sober, available to emergency departments.
The association said health care providers should continue to be allowed to determine whether a person needs a mental health screening.
“Legislating the specific steps of care or treatment that a licensed health care provider must give creates an environment of defensive medicine, and is not patient-centric,” the association said.
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