Lawmakers Question Performance Of $5 Million Opioid Treatment Program

Feb 28, 2018

A state program aimed at expanding access to treatment for opioid addiction came under scrutiny by lawmakers Tuesday. The Opioid Health Home Project was on the agenda before the Health and Human Services Committee, whose members, as well as state officials, expressed frustration that the program has fallen far short of its goals.

The Opioid Health Home project, or OHH, launched about a year ago with nearly $5 million in funding. At the time, the Maine Department of Health and Human Services predicted that it would serve 400 MaineCare and uninsured patients using a team-based model of care. Those enrolled would receive medication-assisted treatment, counseling, peer support and other services.

Office for MaineCare Services Director Stephanie Nadeau reported Tuesday that the program has fallen short of that 400 patient goal.

“There are 18 sites and we have served about 70 individuals,” she said.

Nadeau was joined by the medical director for MaineCare Services, Dr. Christopher Pezzullo, who told the committee that OHH is modeled after other health homes that treat chronic diseases. But he said the department has realized that opioid addiction is much more complex than other chronic diseases.

“There really seems to be an intensity that we didn’t prepare for and that we’d like to be able to confront in OHH 2.0, for lack of a better term,” he said.

That response didn’t pass muster with the co-chair of the committee, Democratic state Rep. Patty Hymanson.

“I could have told you, and the stakeholders could have told you at the beginning of this Opioid Health Home what the problems were, that people were sicker than you thought, that there wasn’t the infrastructure,” she said.

Hymanson and other lawmakers admonished DHHS for failing to work with stakeholders to create an effective model. Some providers have complained that the staffing criteria are too strict and that reimbursement rates are too low.

Democratic state Rep. Dale Denno noted that the state’s two largest health providers, MaineHealth and Eastern Maine Healthcare System, don’t participate in the program.

“They’re the big fish. If they’re not buying into what we’re doing, then probably we’re not going to be effective,” he said.

Committee members asked Nadeau and Pezzullo whether DHHS should abandon OHH for a different model that’s better equipped to help people in the beginning, more intense stage of treatment. But Pezzullo insisted that the model is good and just needs to be refined.

“It’s so frustrating that we’ve been told that we’re not playing and that we created a system that doesn’t work, when the system is ultimately so flexible, and we just want to make it work with you,” he said.

After about an hour of discussion, the committee decided to send a formal letter to DHHS to ask for a remediation plan to accompany the department’s quarterly report, due in late April. Then Hymanson asked a final question about MaineCare expansion, which is now at the center of a political standoff in Augusta.

“If we were to have MaineCare expansion, how would that affect [OHH], or these population of people who are not incarcerated, who don’t have insurance?” she said.

Nadeau said that she was “not in a position to answer the question.”

Meanwhile, MaineCare expansion is supposed to take effect in July, after it passed in a ballot initiative last year. But Gov. Paul LePage won’t allow it to move forward until the Legislature finds about $50 million in funding without raising taxes or using savings.

This story was originally published Feb. 26, 2018 at 5:46 p.m. ET.