Last week, CWLA submitted comments to the President’s Commission on Combating Drug Addiction and the Opioid Crisis. The comments focus on how the Commission needs to include certain actions that can help address the drug epidemic’s impact on child welfare.

On July 31, the Commission, Chaired by Governor Chris Christie (R-NJ) released an interim report of recommendations, which can be found on the CWLA Legislative index under substance use. Commissioners said, “In 2015, 27 million people reported current use of illegal drugs or abuse of prescription drugs…only 10 percent of the nearly 21 million citizens with a substance use disorder (SUD) receive any type of specialty treatment…

Overall, the report offers proposals targeted more toward treatment than law enforcement measures—is a significant political turn from the law-and-order approach to crack-cocaine in the 1980s.

The CWLA recommendations include endorsements of several of the Commission’s proposals, including granting 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; medical education training in opioid prescribing and risks of developing a substance use disorder (SUD); and enhanced access to Medication Assisted Treatment (MAT).

The CWLA comments provides numerous examples of how the epidemic is affected child welfare systems and the recommendations include, protecting Medicaid, assisting states in developing and funding plans of safe care for infants, reauthorization of regional drug treatment grant, extension of the Court Improvement Program, assistance in addressing the workforce impact on child welfare workers and enactment of the expansion of Title IV-E funding to treatment and interventions services as proposed in last year Families First Act.

The full report was due in October, but that is likely to be delayed for a month.

Key recommendations by the commission include:

  • Rapidly increase treatment capacity…by waiver eliminate barriers to treatment resulting from the federal Institutes for Mental Diseases (IMD) exclusion;
  • Mandate prescriber education initiatives;
  • Fund a federal incentive to enhance access to Medication Assisted Treatment (MAT);
  • Model legislation for states to allow naloxone dispensing via standing orders; quickly develop fentanyl detection sensors and disseminate them to federal, state, local, and tribal law enforcement agencies;
  • Enhance interstate data sharing among state-based prescription drug monitoring programs;
  • Better align, through regulation, patient privacy laws specific to addiction with the Health Insurance Portability and Accountability Act (HIPAA); and
  • Enforce the Mental Health Parity and Addiction Equity Act (MHPAEA) with a standardized parity compliance tool.

The Commission was established to develop final recommendations by October 1. Other members include Governor Charlie Baker (R-MA), Governor Ray Cooper (D-NC), former-Congressman Patrick Kennedy (R-RI), and Bertha Madras, Harvard Medical School. Members also include the Secretaries of Health and Human Services, Defense, and Attorney General.

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