President Declares Opioid Crisis a National Emergency

President Trump has declared the opioid crisis a national emergency. This action was the primary recommendation of the President’s Commission on Combating Drug Addiction and the Opioid Crisis.

The Washington Post reports:

“It’s a national emergency. We’re going to spend a lot of time, a lot of effort and a lot of money on the opioid crisis,” Trump said, speaking to reporters outside a national security briefing at his golf club in Bedminster, N.J., where he is on a working vacation. “It is a serious problem, the likes of which we’ve never had. You know, when I was growing up, they had the LSD, and they had certain generations of drugs. There’s never been anything like what’s happened to this country over the last four or five years.”

Trump’s announcement is a change of course from earlier this week when the president stopped short of issuing such a declaration during a press conference about the commission’s report. The designation opens the opportunity for additional funding that could be used for treatment and prevention efforts. It also provides federal agencies with flexibility to allow waivers of certain rules and regulations that could help local government adapt programs to meet their needs.

The national emergency announcement is welcome news to many. Especially as NBC News notes a new report that has concluded that overdose deaths have been under-reported:

Nearly 35,000 people across America died of heroin or opioid overdoses in 2015, according to the National Institute on Drug Abuse. But a new University of Virginia study released on Monday concluded the mortality rates were 24 percent higher for opioids and 22 percent higher for heroin than had been previously reported.

For more information:

Trump declares opioid crisis is a national emergency, pledges more money and attention (The Washington Post)

Trump Declares Opioid Crisis National Emergency (NBC News)

Federal Commission Releases Opioid Report, President Declines Declaring National Emergency (Conduit Street)

Federal Commission Releases Opioid Report, President Declines Declaring National Emergency

Last week the President’s Commission on Combating Drug Addiction and the Opioid Crisis released a preliminary report proposing recommendations for addressing the nation’s opioid crisis. One of their top recommendations was for the president to declare the opioid crisis a national public health emergency.

At a news conference this week the president declined to declare such an emergency.

The Washington Post reports that following an update from his health officials on the report, the president held a press conference and made statements focused on the importance of preventing people, particularly the youth, from ever starting to use drugs. Additionally, Health and Human Services Secretary Tom Price provided background to the decision not to declare a national emergency but assured those in attendance that the crisis would still be treated as an emergency:

Health and Human Services Secretary Tom Price later told reporters that declaring a national emergency is a step usually reserved for “a time-limited problem,” like the Zika outbreak or problems caused by Hurricane Sandy in 2012. Declaring a state of emergency allows the government to quickly lift restrictions or waive rules so that states and local governments don’t have to wait to take action. Price said that the administration can do the same sorts of things without declaring an emergency, although he said Trump is keeping the option on the table.

“The president certainly believes that it is, that we will treat it as an emergency — and it is an emergency,” Price said during a news briefing held about eight miles from Trump’s golf club, where he is on a 17-day working vacation. “When you have the capacity of Yankee stadium or Dodger stadium dying every single year in this nation, that’s a crisis that has to be given incredible attention, and the president is giving it that attention.”

What does it mean to declare a public health emergency? Route Fifty reports on what a declaration of state of emergency on the opioid crisis would have meant. Generally a declaration would open the option for states to apply for additional funds from the Federal Emergency Management Agency, that could be used for treatment and prevention efforts. It would also provide flexibility to federal programs to allow for waivers of certain rules and regulations:

First, an emergency declaration would allow states that are declared disaster zones—areas that have been particularly hard-hit by the crisis—to receive funds from the federal Disaster Relief Fund, which as of June 30, 2017, had a balance of nearly $4.4 billion.

..

And, if the Trump administration declares an emergency under both the Stafford Act and Section 319 of the Public Health Service Act, it would allow temporary waivers on specific rules regarding federal programs like Medicare, Medicaid and CHIP. For example, Medicaid does not currently reimburse the costs of receiving drug treatment in facilities that have more than 16 beds. Many states have already applied for waivers on this rule, but an emergency declaration could give a blanket waiver to all 50 states.

An article in The Intercept decried the President’s focus on “just say no” and harsher sentences as a return to the 80’s war on drugs (that was ultimately found to be ineffective), but offers support for the Commission’s recommendation regarding Medication Assisted Treatment (MAT):

Even without the emergency declaration, at least one of the commission’s recommendations would transform the U.S. approach to the crisis and give those in its grip a real chance at recovery. It’s an approach that was embraced by the surgeon general in a report in November and consistently by the Office of National Drug Control Policy under Obama.

The recommendation is a direct shot at a drug-treatment industry that still relies on strict abstinence as the only form of true recovery, rejecting any intervention by medication. The stigma associated with what’s known as medication-assisted treatment is leading to unnecessary death and suffering across the country.

While much of the focus has been on the recommendation to declare a public health emergency, the report included a number of additional recommendations:

– Rapidly increase treatment capacity. Grant waiver approvals for all 50 states to quickly eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion within the Medicaid program. This will immediately open treatment to thousands of Americans in existing facilities in all 50 states.

– Mandate prescriber education initiatives with the assistance of medical and dental schools across the country to enhance prevention efforts. Mandate medical education training in opioid prescribing and risks of developing an SUD by amending the Controlled Substance Act to require all Drug Enforcement Administration (DEA) registrants to take a course in proper treatment of pain. HHS should work with partners to ensure additional training opportunities, including continuing education courses for professionals.

– Provide model legislation for states to allow naloxone dispensing via standing orders, as well as requiring the prescribing of naloxone with high-risk opioid prescriptions; we must equip all law enforcement in the United States with naloxone to save lives.

– Prioritize funding and manpower to the Department of Homeland Security’s (DHS)Customs and Border Protection, the DOJ Federal Bureau of Investigation (FBI), and the DEA to quickly develop fentanyl detection sensors and disseminate them to federal, state,local, and tribal law enforcement agencies. Support federal legislation to staunch the flow of deadly synthetic opioids through the U.S. Postal Service (USPS).

– Provide federal funding and technical support to states to enhance interstate data sharing among state-based prescription drug monitoring programs (PDMPs) to better track patient-specific prescription data and support regional law enforcement in cases of controlled substance diversion. Ensure federal health care systems, including Veteran’s Hospitals, participate in state-based data sharing.

– Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA) to ensure that information about SUDs be made available to medical professionals treating and prescribing medication to a patient. This could be done through the bipartisan Overdose Prevention and Patient Safety Act/Jessie’s Law.

– Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool to ensure health plans cannot impose less favorable benefits for mental health and substance use diagnoses verses physical health diagnoses.

For more information:

President’s Commission on Combating Drug Addiction and the Opioid Crisis Preliminary Report

Trump Holds off on Declaring Opioid Crisis a National Emergency (The Washington Post)

Trump Didn’t Declare the Opioid Crisis a National Emergency. What If He Had? (Route Fifty)

Trump’s Opioid Commission Had Some Stunningly Good Recommendations. He Ignored Them for 80s Drug War Nostalgia (The Intercept)

Hogan Lauds St. Mary’s Police Efforts and Murder Charges for Drug Dealers

At a press conference held Wednesday morning in Leonardtown, Governor Larry Hogan joined St. Mary’s County’s Sheriff Tim Cameron, Attorney Richard Fritz, and Sheriff Captain Eric Sweeney, as well as Maryland State Police Colonel William Palozzi to praise their efforts through a long-term investigation to bring charges against suspected drug dealers whose actions have led to overdose deaths.

McClatchy DC Bureau reports on Hogan’s remarks on what the success in St. Mary’s could mean for other counties running investigations across the state and for turning the tide on the crisis:

Hogan, speaking a news conference in Leonardtown, said he hopes the long-term investigation would serve as a model to prosecutors statewide for fighting a deadly epidemic that resulted in more than 2,000 overdose deaths last year in Maryland.

“Everyone is entitled to due process, and everyone is innocent until proven guilty, but I believe that this is the level of tough prosecution that we need in order to turn the tide in this deadly fight,” Hogan said. “Investing in prevention and treatment can only work if we eliminate the threat posed by drug traffickers all across the state of Maryland.”

The Bay Net provides more information on the charges that were filed against the eight individuals:

Fritz announced the indictments of eight individuals on second-degree murder charges related to drug sales and the deaths of drug users.

Each of the suspected drug dealers is now facing charges of second degree murder, involuntary manslaughter, reckless endangerment and additional distribution and possession charges.

For more information:

Fritz to announce murder charges related to overdose deaths (The Bay Net)

Maryland governor applauds murder charges in overdose cases (McClatchy DC Bureau)

 

City Pilots Doula Program to Reduce Infant Mortality

The Baltimore City Health Department is piloting a program to incorporate doulas, non-medical persons who provide physical assistance and emotional support to a mother before, during, and after birth, into their B’More Healthy Babies program.

The B’More Healthy Babies program, which was launched in 2010, has successfully reduced the city’s infant mortality rate by 38% and the sleep-related infant death rate by more than 50%. By incorporating doulas into the program, the city hopes to reduce the health disparity between low-income and minority women, and other women who have better resources and access to prenatal care.

As reported in The Baltimore Sun:

The city health department has started a pilot program to train Nelson and four other city residents to become doulas — non-medical companions who provide emotional support and comfort to women during delivery.

Doulas can also play a guiding role during pregnancy. They help moms develop birth plans, and can work in conjunction with physicians to make sure expectant mothers have the medical information they need to lead a healthy lifestyle during pregnancy.

 

Read The Baltimore Sun to learn more.

Related coverage from Conduit Street:

City Health Commissioner Charts Path Through Uncertainty

Infant Deaths Reach Record Low in City

Prince George’s Announces 2018 Domestic Violence Grant Program

The Prince George’s County Council has announced an FY 2018 appropriation of $500,000 to support the Council’s Domestic Violence Grant Program.

According to a press release,

The grant program is a funding resource for programs that serve the housing, counseling, and advocacy needs of County residents who are victims of domestic violence. The program also supports prevention activities through a coordinated and collaborative community response to domestic violence in Prince George’s County.

The FY 18 Prince George’s County Council Domestic Violence Grant Program funds are available to nonprofit organizations through a review and evaluation process for all applicants.

“This County Council initiative is the start of a continuing offensive against the tragedy of domestic violence. We reaffirm our commitment to joining the efforts of our entire community to comprehensively address the scourge of domestic violence…TOGETHER.” – Council Chairman Derrick Leon Davis

Read the full Prince George’s County press release for more information.

Harford County Receives $570K State Grant to Assist Families in Need

The state of Maryland has awarded a total of $570,994 to Harford County’s Local Management Board to fund child and family focused programs in fiscal year 2018.

According to a press release,

The Local Management Board (LMB) is a grant-funded organization within the county’s Office of Children, Youth and Families, under the administration of County Executive Barry Glassman. This year’s total includes a competitive grant award of $88,000, which the LMB will use for new programs to reduce childhood hunger, empower families to escape poverty and diminish the impact of parental incarceration on children in Harford County. The funding was announced on May 31, 2017 by the Maryland’s Children’s Cabinet, through the Governor’s Office for Children as part of $18 million in statewide grant awards to Maryland’s Local Management Boards.

Specifically, this year’s total grant funding will allow the LMB to offer the following new programs in Harford County:

“Getting Ahead in a Just Getting By World” is an educational program for low income families that addresses the causes of poverty.

“Parenting Inside Out (PIO)” is an evidence-based parenting skills training program for families affected by parental incarceration.

“Project S.E.E.K. (Services to Empower and Enable Kids)” is a program aimed at reducing intergenerational incarceration. The program addresses the risk and protective factors associated with delinquency and criminal behavior at both the individual and family levels.

“Reducing Childhood Hunger” helps families become more self-sufficient, food-secure, and economically stable. Rather than offering pre-packaged/pre-weighed food, the program creates a food pantry where clients can shop for their own groceries using a point system.

Formed in 1994, Harford County’s Local Management Board brings together local child-serving agencies; local child providers; clients of services; families, and other community representatives to address the critical needs of and recommends priorities for the County.

Read the full Harford County press release for more information.

To Boost Veterans’ Health Services President Touts Technology

The Trump Administration has announced new technology based initiatives to improve access to and delivery of veterans’ health services. The initiatives are expected to expand access to services in rural areas, and access to mental health and suicide prevention services across the board.

The AP reports:

Initiatives include using video technology and diagnostic tools to conduct medical exams. Veterans also will be able to use mobile devices to make and manage appointments with Veterans Administration doctors.

“We call it ‘anywhere to anywhere’ VA health care,” VA Secretary David Shulkin said. Shulkin said the goal is better health care for veterans wherever they are. He said existing “telehealth” programs provided care to more than 700,000 veterans last year.

The article notes that the initiatives await regulations in order to be launched.

Read the AP article to learn more.

Learn about how counties are working to provide innovative services and support to veterans at the 2017 MACo Summer Conference session “Serving Those Who Served Our Country” on Friday, August 18, from 2:15 pm – 3:15 pm.

The MACo summer conference is August 16-19, 2017 at the Roland Powell Convention Center in Ocean City Maryland. This year’s theme is “You’re Hired!”.

Learn more about MACo’s Summer Conference:

Anne Arundel Conducts In-Service Dementia Awareness Training

The Anne Arundel County Department of Aging and Disabilities and the Anne Arundel County Police Department announced the successful conclusion of the 2017 in-service dementia awareness training of 691 members of the force. This collaboration was recognized at an event at the Department of Aging and Disabilities. During the event, training staff members were presented police citations in recognition of their hard work and dedication.

According to a press release,

Every 66 seconds, someone in the United States develops the disease. There are currently more than 5 million Americans living with the disease. By 2050, this could increase to more than 16 million.

The Department of Aging and Disabilities provided the training Communicating Through Behaviors with the Virtual Dementia Tour to the Anne Arundel County Police Department. This is a scientifically proven method of building a greater understanding of dementia through the use of patented sensory tools and instruction. This is an up-close, hands-on experience that provides critical insight to those caring for dementia. This tour is an eye-opening experience that proves how difficult the disease can be for the patients and caregivers alike.

“This is yet another example of how our county agencies are collaborating toimprove service to the public while enhancing public safety,” said County Executive Steve Schuh.

Director of the Anne Arundel County Department of Aging and Disabilities, Pamela Jordan, stated, “It is so important that we support our first responders to give them the tools they need to understand this disease. The likelihood that first responders will encounter this in field is very high.”

For information call the Anne Arundel County Department of Aging and Disabilities at 410-222-4257 or go online to http://www.aacounty.org/aging. TTY users, please call via Maryland Relay 7-1-1. All materials are available in an alternative format upon request.

Learn how counties are collaborating with stakeholders to provide citizens with resources to assess, treat, and manage cognitive impairment at the 2017 MACo Summer Conference session “Smoothing the Rough Road: Addressing Dementia Challenges” on Friday, August 18, from 1:00 pm – 2:00 pm.

The MACo summer conference is August 16-19, 2017 at the Roland Powell Convention Center in Ocean City Maryland. This year’s theme is “You’re Hired!”.

Learn more about MACo’s Summer Conference:

Balance Food & Home Safety With Business Growth at #MACoCon

Learn how environmental health officials protect the public by ensuring safe food and homes, their role in driving economic development by providing certainty and safety, and the balancing act they sometimes must perform to allow for new and innovative business models.

Walking the Tightrope: Protecting the Public, Energizing the Economy

Description

Environmental health officials work to protect the health and safety of county residents. They also play an important role by increasing confidence in our growing and changing economy. From familiar needs like restaurant cleanliness to the challenges and opportunities presented by the up-and-coming food truck industry, these dedicated officials always have health and safety – and the economy – in mind. For example, by ensuring the safety of our food, environmental health officials increase consumer confidence to eat at restaurants. By ensuring proper sanitation in our homes, they increase lender confidence when providing mortgages or developer loans. Speakers will discuss the roles environmental health officials play in both protecting the public and energizing the economy, and highlight how those roles work with respect to home lending and the emergent food truck industry.

Speakers

  • Donald Wilson, Environmental Health Director, Caroline County
  • Willy Dely, Founder, Au Jus Solutions
  • William Castelli, Senior Vice President, Government Affairs, Maryland Realtors Association

Moderator: The Honorable Sharon Green Middleton, Baltimore City Council Member

Date & Time: Friday, August 18, 2:15 PM – 3:15 PM

Learn more about MACo’s Summer Conference:

Smoothing the Rough Road: Addressing Dementia Challenges at #MACoCon

Dementia is more than just “forgetfulness,” as many people often believe. Memory problems are certainly one element of dementia, but communication, emotional, and behavioral issues are often also present. Caregivers are often surprised when their loved one suddenly experiences problems in one of these areas, especially if the only early symptoms were limited to problems with memory. At this year’s annual MACo Summer Conference, learn how counties are collaborating with stakeholders to provide citizens with resources to assess, treat, and manage cognitive impairment.

Smoothing the Rough Road: Addressing Dementia Challenges

Description: Local governments play a key role in ensuring communities are vibrant, inclusive, and supportive of all citizens. As we begin to see a rise in the number of dementia cases due to our aging population, it is crucial for local governments to work in collaboration with stakeholders to mitigate pressure on services and develop new and innovative service systems. In this session, panelists will discuss the impacts of dementia, the challenges facing family caregivers and those with a dementia diagnosis, and the practical actions government, individuals, businesses, and community stakeholders can take to improve the day-to-day well-being of residents.

Speakers:

  • Jay Kenney, Chief, Aging and Disability Services, Montgomery County
  • Gloria Lawlah, Former Maryland Secretary of Aging and Dementia Friendly Lead, Prince Georges County
  • Celene Steckel, Bureau Chief of Aging and Disabilities, Carroll County
  • Michael Buckley, Vice President, Public Affairs, BrightFocus Foundation
  • Nora Super, Chief of Programs and Services, National Association of Area Agencies on Aging

Moderator: Rushern L. Baker, County Executive, Prince George’s County

Date/Time: Friday, August 18, 2017; 1:00 pm – 2:00 pm

The MACo summer conference is August 16-19, 2017 at the Roland Powell Convention Center in Ocean City Maryland. This year’s theme is “You’re Hired!”

Learn more about MACo’s Summer Conference: