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Illinois CTA (Collaboration + Transformation = Awareness) Plan

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Tekisha King
September 7, 2019

 

Opioids are highly used drugs that do not discriminate against age, race or sex. These drugs are contributing to mortality rates nationwide. The Illinois Department of Public Health (ILDPH) reports that in 2017, there were 2,202 opioid overdose deaths in the state of Illinois, a substantial increase over 1,203 in 2014; 1,382 in 2015; and 1,946 in 2016.

Opioid users are individuals who consume and abuse prescription and non-prescription (street-drugs) for medical, mental and substance abuse reasons. According to 2019 data from ILDPH, the five types of opioids are:

  • Heroin-involved.
  • Synthetic-involved (fentanyl, carfentanil).
  • Natural/or semi-synthetic involved (natural opioid: morphine, codeine & semi-synthetic: oxycodone, hydrocodone).
  • Methadone-involved (prescribed or obtained illegally to treat pain).

Are we combating the opioid epidemic or wasting billions of tax-payer dollars with medical-assistant treatment (MAT) and substance-abuse rehabilitation programs? The National Association of County and City Health Officials (NACCHO) discovered in their biannual 2018 Forces of Change Study that about two-thirds of LHDs were actively addressing the opioid crisis in 2017. Therefore, the problem is the lack of interoperability leveraging technology, accountability for grant funding and a need to develop a public nation-wide neighborhood watch program.

Today, the opioid epidemic has elevated in rural and urban communities, correctional facilities, and education and medical institutions. It is demoralizing efforts from community-based organizations. In addition, we as healthcare leaders are not leveraging technology effectively to collaborate and report public incidents efficiently with local, state and government authorities.

Why do substance-abuse prevention programs differ by state to target opioid users? According to the 2019 edition of Health Affairs, the Affordable Care Act Nondiscrimination Provision and the Mental Health Parity and Addiction Equity Act of 2008 (the Parity Act) requires some health plans in most states to provide comprehensive coverage for substance-use disorder (SUD) with health plan benefits. Why does the Parity Act benefit some states as opposed to all states?

According to the Centers for Medicare & Medicaid Services, The Affordable Care Act requires non-grandfathered health plans in the individual and small group markets to cover essential health benefits (EHB), which include items and services in the following ten benefit categories:

  1. Ambulatory patient services.
  2. Emergency services.
  3. Hospitalization
  4. Maternity and newborn care.
  5. Mental health and substance use disorder services including behavioral health treatment.
  6. Prescription drugs.
  7. Rehabilitative and habilitative services and devices.
  8. Laboratory services.
  9. Preventive and wellness services and chronic disease management.
  10. Pediatric services, including oral and vision care.

Many of the required EHBs services can be utilized via telemedicine services for mental and behavioral health treatment. As stated in the 2018 edition of The Indian Journal of Psychiatry, evidence with the use of digital technology, including mobile applications in the treatment and prevention of substance use disorders, could help overcome the barriers and improve access to substance abuse care. Is your state SUD program(s) compliant with the Meaningful Use Act required to combat the opioid epidemic with local, state and federal public health agencies in your state?

The valued-based healthcare model (VBH) utilizes evidence-based medicine with digital technology under the Meaningful Use Act (MUA) as a cost-effective advantage that is vital for all substance-use disorder (SUD) treatment programs. In addition, the federal government offers on-going grant programs to the public for innovative proposals targeted at the opioid epidemic. For instance, the National Institute of Drug Abuse (NIDA) has formed a Justice Community Opioid Innovation Network (JCOIN) with 12 awarded grantees to conduct research on quality research treatment for Opioid Disorder (OUD) in criminal justice settings nationwide—jails, drug courts, problem-solving courts, policing and diversion, re-entry and probation and parole.

Lastly, some states are allocating more healthcare funding for opioid rehabilitation programs, cost of medical-assisted treatment (MAT) programs, pain medications and healthcare workforce-training development than the average yearly healthcare costs accumulated for a health plan beneficiary. Although the efforts are positive, the outcomes are forcing hospital systems to go bankrupt, medical facilities to have abrupt closures and retail pharmacy businesses to become scarce in rural communities. Furthermore, the efforts utilized thus far has had a minimal impact with opioid mortalities as opposed to controlling prescribed opioids and accounts to billions of tax-payer monies wasted in healthcare.

My recommendation is to build a hybrid public awareness program with IL state residents in a public forum to develop a nation-wide community watch program with state representatives to report opioid incidents. For instance, many opioid users pose as homeless, disabled, expectant mothers or human-trafficking individuals residing on the streets with evident symptoms of poor hygiene, shabby clothing, lacerated scars or wounds on  the body, loitering, and panhandling resident’s for money to use for drugs and alcohol. The incidence of (neonatal abstinence syndrome or neonatal opioid withdrawal syndrome (NAS/NOWS) between 2004 and 2014 accounts for 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births, which equates to one baby born with NAS/NOWS every 15 minutes in the United States. This is with hospital costs from $91 million to $563 million, after adjusting for inflation, according to 2019 data from NIDA. As a society, together we can stand united for the future leaders of tomorrow by reporting suspicious public substance, behavioral or mental-health incidents using mobile devices to combat the opioid epidemic.


Author: Tekisha is committed to the expansion of accountable government healthcare programs providing accessible high-quality and cost-efficient innovative healthcare solutions for a consumer-centric vision. She is focused on integral solutions with digital methodologies leveraged using technology on behalf of health plan, provider’s, shareholder’s, state, and federal authorities. Tekisha is a devoted doctorate student exploring challenging employment opportunities for government health programs.

Contact Information:

Tekisha King
Innovative Doctorate Healthcare Leader
[email protected]

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