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Another View -- Cheryl Wilkie: Four steps to respond to the opioid crisis

April 15. 2018 10:00PM

I appreciate that President Donald Trump visited New Hampshire to unveil his plan for how to resolve the opioid epidemic. It affects all of us. Beyond the pipe and drape and national media and standing ovations and promises made, my sincere hope is that next steps include a quick and substantial influx of specific resources to New Hampshire.

The President’s promise that we would end the scourge of drug addiction in America once and for all by being tough, smart, kind and loving resonated with me and with my team. I hope he will follow through with the help we need at Farnum and throughout the state’s treatment community. The President highlighted the need to address treatment, prescription drug policy, stricter law enforcement, and enhancing deterrence efforts. We appreciate he is leading this conversation.

This isn’t a partisan issue; it’s not a political issue. This is an issue of humanity and it’s important to take action now. After listening to President Trump’s message, I respectfully suggest four areas where more resources could make an immediate impact.

Treatment Personnel and Training: Many substance abuse providers can’t afford to pay the salaries of the medical personnel who are essential to treatment. These men and women are essential, but they come with steep personnel costs.

And although jobs are available, finding qualified counselors and treatment experts is a challenge. We need a program to accelerate and fund training for treatment providers to meet growing public demand. We need to view this as a plan to address addiction with an investment that thinks long-term.

Narcan: This life-saving medication reverses the effects of an overdose. It saves lives, but at $150 per dose, it is prohibitively expensive. We applaud making Narcan available for free in schools and on college campuses and we support the proposal to federally fund Narcan for law enforcement. We should expand that approach to first responders and treatment providers like Farnum.

Increase Medicaid reimbursement: New Hampshire needs to protect this vital program and recognize that current reimbursement rates for substance abuse treatment are so low, they don’t come close to covering the actual cost of treatment. Facilities like Farnum must find other revenue streams because this current rate is unsustainable.

This is one major reason why so many treatment providers struggle to stay open. In January 2019, when all Medicaid clients are pulled off the exchange and placed in the full Medicaid population, the reimbursement rate for treatment will be $162.50. BDAS pays $140 a day. However, the cost to run a program is approximately $275 a day for residential and $425 a day for detox. The financial shortfall is enormous and unsustainable.

Increase financial aid for treatment: There is a constant struggle for those who need treatment but can’t afford it, many don’t qualify for state aid and have no insurance. We should provide financial aid to help fund treatment for men and women who would otherwise be turned away from care for lack of resources. Most treatment centers offer financial aid, but there are limits. We need resources to fund operations of all treatment centers around New Hampshire and beyond.

Hope for New Hampshire is a perfect example of a facility doing good work, while struggling to fund its operations. The state has stepped in, but we need sustainable funding.

Farnum is doing its part. In the last three years, Farnum has rapidly expanded its available beds, more than doubling space to 140 beds. Our administrators have opened and expanded a facility in Franklin. Farnum Center has expanded Suboxone treatment, with more providers and more client openings. Farnum has expanded hours to help families through the evening Intensive Outpatient Program. Our business model combines insurance coverage, state funds, private fundraising and collaboration. But costs are rising, demand is rising and assistance from the state and federal government is not rising to meet this demand. We need help and we need it right away. Treatment works, but it cannot be unattainable to those who need it if we are really going to respond to this epidemic.


Cheryl Wilkie is chief operating officer of Farnum in Manchester and Franklin.

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