In just more than a month as governor, Mills has named an opioid response czar and expanded Medicaid to more than 3,200 people under the first executive order of her administration. It’s unclear so far how many people are being treated for addiction under expansion.
It is backed by $1.6 million in existing state and federal funds that Gordon Smith, Mills’ opioid response director, said will be used to buy 35,000 doses of naloxone to distribute throughout the state and train 250 recovery coaches — and install coaches in 10 emergency rooms.
Mills’ executive order continues an early trend of her administration — paying for new initiatives with existing funds. In January, the new governor expanded Medicaid using surplus funds after the voter-approved expansion was delayed for most of a year by former Gov. Paul LePage.
Her order editorialized that past addiction responses have been “inadequate,” a view that most experts share and a dig at LePage, a Republican who once said naloxone “merely extends” lives. His administration’s opioid health home model had success in 2018 after a bad start.
Many of the changes that Mills wants to make will require legislation. On Wednesday, she said she is targeting the state’s two-year caps on Medicaid treatment using methadone and suboxone. She has also called for raising Medicaid reimbursement rates for treatment.
Wednesday’s order underscores financial constraints that Mills is operating under. It said Smith will be tasked with funding the order’s initiatives without state tax money. She has said her two-year budget proposal — which is due to the Legislature on Friday — won’t raise taxes while increasing funding for schools and providing long-term Medicaid expansion funding.
Mark Publicker, a Portland-based addiction treatment specialist who has been a leading critic of the state’s response, called the package “excellent” as a framework of priorities on Wednesday, though he quibbled with the focus on recovery coaches and said the first priority for funding should be reimbursement rates and medication-assisted treatment.
“Honestly, I think had these been put into place under the last governor, I don’t know how many people’s lives would have been saved, but it’s probably in the thousands,” he said.