New Initiatives to Expand Access to Medication Assisted Treatment in NYS OASAS

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1 New Initiatives to Expand Access to Medication Assisted Treatment in NYS OASAS Charles W. Morgan, MD, DFASAM, FAAFP Medical Director New York State Office of Alcoholism and Substance Abuse Services February 16, 2017

2 February 16, What is OASAS? Certify over 1,300 treatment and prevention programs. Operate 12 Inpatient Addiction Treatment Centers Treat more than 240,000 New Yorkers on an annual basis. Fund more than 1,100 treatment and prevention programs which serve all who seek their help. OASAS system has more than 12,000 treatment beds. OASAS system has more than 40,000 individuals in Opioid Treatment Programs.

3 February 16, What are we doing? Ends Prior Insurance Authorization to Allow for Immediate Access to Inpatient Treatment as Long as Such Treatment is Needed. Ends Prior Insurance Authorization to Allow for Greater Access to Medication Assisted Treatment. Requires All Insurers Use Objective State Approved Criteria to Determine the Level of Care for Individuals Suffering from SUD. Mandatory consultation for prescribers for the PMP. Expand Wraparound Services to Support Long Term Recovery.

4 February 16, What are we doing? Reduce Prescription Limits for Opioids from 30 days to Seven Days. Require Ongoing Education on Addiction & Pain Management for All Physicians and Prescribers. Mandate Pharmacists Provide Easy to Understand Information on Risks Associated with Drug Addiction and Abuse. Collect and disseminate data on Overdoses and Prescriptions to Assist the State in Providing Additional Protections to Combat this Epidemic.

5 February 16, New Supports and Connections to Treatment Family Support Navigator Peer Engagement Recovery Centers Adolescent Clubhouses Vivitrol in local jails Tele-health In Community Services Regional 24/7 Crisis Access Centers

6 February 16, Opioid Treatment Program Expansion Expanded Capacity 2,300 New Treatment Slots Increasing Access: NP, PA Prescribing Federal Buprenorphine Regs Free MAT Training for Physicians:

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10 February 16, Recovery Oriented Health Management Strategies Substance Use disorder must be treated on par with other health conditions. It is a chronic illness with acute states and remissions. It requires a long term management strategy. Identifying risky use (SBIRT) intervening early when a disorder exists and managing more severe forms of the illness through partnership with a robust treatment delivery system with the full continuum of care will make all of health care stronger and will help to achieve the triple aim.

11 February 16, Better Continuity of Care We need to make better connections between acute levels of care Emergency Department, Detox, Inpatient and Community Based Services. Follow up after an acute admission within 14 days is below 40% we can do better. Warm Hand offs and peer engagement have been shown to be effective in connecting between levels of care. From hospital to community based treatment is especially important.

12 February 16, In Community Services OASAS has federal Medicaid and Regulatory authority to allow for reimbursement of services outside of the four walls of the clinic or in community. This will allow for innovation clinic services including counseling services, peer services, and medication evaluation and management can be billed when provided by the clinic anywhere in the community at the government APG rate (for Medicaid). Many programs are beginning to innovate under this new opportunity to provide better integration with health care and better transitions between levels of care.

13 February 16, Access, Integration, Quality In the coming year OASAS will focus on Access new treatment availability tool, provider groups forming to create urgent and emergency 7 day (24 hour) assessment and linkage to care. DSRIP projects and Value Based Payment preparation create opportunities for integration. Partnerships between SUD and PH providers, hospitals and community based organizations, health providers and social service and housing providers to integrate the system of care. Quality of care needs to rise to standards expected by payers where services are provided because they add value.

14 February 16, Resources Print Materials Websites Information for Discussions with families, individuals Prevention The Progression Kitchen Table Toolkit Navigating the Substance Use Disorder System of Care Video Series Real Stories

15 February 16, OASAS Main Website page

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19 February 16, 2017 PART D, Section 1. Section of the mental hygiene law Effective October 22, 2016 Pharmacies registered in New York State must educate individuals at the time of dispensing a prescribed controlled substance medication. The dangers of misuse and the potential risk for addiction to prescription controlled substances. The physical and behavioral warning signs of addiction. Available alcohol and drug addiction treatment resources. Proper disposal guidelines for unused prescription controlled substances. 19

20 February 16, Combat Heroin and Prescription Drug Abuse Kitchen Table Toolkit n-table-toolkit 2 videos 2 guidance documents

21 February 16, New York State Navigating the Substance Abuse Disorder System of Care SERIES 1. You Think Your Loved One Has a Substance Use Disorder Issue and Needs Help 2. Introduction to Treatment 3. Inpatient Detox 4. Outpatient Treatment 5. Inpatient Rehab 6. When Family and/or Loved one wants to help 7. Relapse Prevention: What a Family and/or Loved One Needs to Know 8. Appeals Process 9. Communicating with Your Health Care Provider 10. Patient Safety

22 February 16, Resources NYS OASAS oasas.ny.gov Talk2Prevent talk2prevent.ny.gov Combat Heroin combatheroin.ny.gov Kitchen Table Toolkit combatheroin.ny.gov/kitchen-table-toolkit Good Samaritan Law combatheroin.ny.gov/prevention Spotlight on Synthetics oasas.ny.gov/admed/drugs/synthetics Download Materials from the websites combatheroin.ny.gov/resources Order Combat Heroin Materials Reach out to YOUR LOCAL PREVENTION/TREATMENT PROVIDER!!!

23 February 16, Thank you 2/16/