December 11, 2019
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After Democratic push, LePage offers plan to expand addiction treatment

Troy R. Bennett | BDN
Troy R. Bennett | BDN
A "finger" of heroin is carefully unwrapped from its paper backing at the state drug testing lab in Augusta in this August 2015 file photo.

AUGUSTA, Maine — Motivated by a push from legislative Democrats, Gov. Paul LePage’s administration floated a plan on Wednesday that would leverage up to $8 million to expand opiate addiction treatment to as many as 700 Mainers this year.

It’s a continuation of LePage’s recent embrace of medication-assisted treatment — a subject on which he has clashed with addiction experts in the past — and a sign that new relationships between the Republican governor and Democrats can bear policy fruit.

Assistant Senate Minority Leader Nate Libby, D-Lewiston, said that while Democratic leaders “are supportive of the concept” rolled out in a meeting with administration officials on Wednesday, it’s not “a deal” and the idea will face legislative hearings as part of talk around LePage’s supplemental budget proposal.

Perhaps no issue in Maine demands more attention: The state saw 378 drug overdose deaths in 2016 — more than one per day — setting a record for the third-straight year driven by a 127 percent rise in deaths attributed to fentanyl and a 15 percent increase in heroin-related deaths.

Maine Department of Health and Human Services Commissioner Mary Mayhew said the plan would use up to $8 million in state and federal funds to expand opiate addiction treatment to as many as 700 insured and uninsured Mainers through an integrated model providing medication, counseling and other services.

She said this “opiate health home” model would likely be run by existing providers and mostly serve patients enrolled in MaineCare, the state’s version of Medicaid, the federal health care program for low-income people, although 6 percent of money would be devoted to uninsured patients. It would need federal approval.

“What we know is that we have to improve access to medication-assisted treatment and that we see a great opportunity in primary care so that we can support a comprehensive approach to the care that’s being provided,” Mayhew said.

The plan came out of negotiations between LePage and Senate Minority Leader Troy Jackson, D-Allagash, who the governor mentioned repeatedly in Tuesday’s State of the State speech as a negotiating partner. Jackson approached the administration about doing something in short order to fight opiate addiction.

Medication-assisted treatment — in which patients are given drugs including methadone and Suboxone — is the best way to do it, but nationally, one-fifth of people who could benefit from it aren’t getting it, according to a 2015 study from Johns Hopkins University.

The state said in December 2016 that just over 8,600 people got medication-assisted treatment in the 2016 fiscal year. However, there were only 215 beds for people without insurance until DHHS funded another 359 starting in January, a move that won universal praise.

LePage been at the center of clashes on this before. In 2015, he proposed eliminating funding for methadone and shifting it to Suboxone, which was criticized by experts. Last year, the governor said he wanted to eliminate funding to methadone clinics without a counseling component.

Recent legislative efforts on this front also have failed, including a 2016 push to restore methadone reimbursement rates that fell from $80 to $60 per week between 2010 and 2012 to 2010 levels. Their key funding bill around opiate addiction last year provided $3.7 million split between funding drug agents and services that didn’t include medication-assisted treatment.

“Not knowing what the governor’s thinking, I’d suggest probably we’re all getting a little bit better educated on what some effective solutions to this problem are,” Libby said.

 



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