The Legislature will debate multiple proposals to create a specific position, and Gov. Janet Mills has said she plans to appoint an opioid czar as well.
BY ERIC RUSSELL – STAFF WRITER
Maine lawmakers will debate at least three bills to establish Cabinet-level positions in state government to respond to the prolonged opioid crisis that has claimed more than 1,000 lives in the last three years.
Newly elected Gov. Janet Mills, a Democrat, also has pledged to create a new position – director of opiate response – to coordinate services across state agencies.
Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services of Maine, which represents treatment providers, said she already has seen a shift in Augusta toward prioritizing response to the crisis that her members hope continues. During the last Legislature, Republican Gov. Paul LePage vetoed a bill that would have created a separate office in the Department of Health and Human Services to address opioids.
“I think communication has opened up in a way that providers feel like they have a partner,” Shaughnessy said.
When the 129th Legislature convenes this month, it’s expected to take up a host of bills that would tackle the problem. One of those bills, L.D. 80, sponsored by Rep. Anne Perry, D-Calais, seeks to establish the Department of Substance Use Disorder as a new agency outside the DHHS. It would be led by a commissioner appointed by the governor, and would oversee all services related to treatment and prevention.
Perry, who is a nurse practitioner, said she’s been thinking about this idea for some time.
“We have not made a big dent in tackling the opioid crisis in Maine,” she said Monday. “I think having these services within DHHS limits what we can do.”
‘MORE THAN ONE SOLUTION’
Also, Reps. Michael Brennan of Portland and Steve Stanley of Medway, both Democrats, have submitted bills that would create Cabinet-level offices dedicated to the crisis, which claimed more than 1,000 lives from 2015-2017 and shows few signs of slowing down.
It’s not yet clear whether any of the three bills conflict with Mills’ plan to create a director of opiate response, which will be announced soon. Her spokesman, Scott Ogden, said in a statement Monday that Mills “appreciates the work of the many lawmakers, including Representative Perry, who are committed to fighting this epidemic.”
“The governor also looks forward to engaging with the Legislature to advance important reforms that will enhance prevention and treatment options and improve access to recovery care,” he said.
Perry said she has not spoken with Mills’ office about her bill, but said she’d support any efforts to increase staffing around the issue.
“There is more than one solution to the problem,” she said.
‘NOT CONNECTING ACROSS AGENCIES’
Rep. Beth O’Conner of Berwick, the ranking Republican on the Health and Human Services Committee, did not return a call for comment about creating a Cabinet-level position on opioids.
Perry said beyond the symbolism of having a separate agency devoted to the drug crisis, there would be opportunities for a new department to better work with other areas of government – education and law enforcement, for instance.
Many treatment advocates for years have bemoaned the lack of collaboration across agencies, which has created duplicative or even conflicting initiatives.
“I think one of the biggest problems we often have is: People are doing good work but they are in silos and not connecting across agencies,” Shaughnessy said. “They’re not leveraging the resources out there to more effectively meet the needs of people.”
In the past several years, there have been multiple task forces created to outline solutions. Some of that has turned into legislation and law but many recommendations have been ignored.
THE IMPACT OF MEDICAID EXPANSION
This isn’t the first time lawmakers have tried to elevate the state’s response to a crisis that has ravaged communities and torn apart families all over the state.
During the last Legislature, Rep. Patricia Hymanson, D-York, proposed legislation that would have created within DHHS a separate office to address the opioid crisis. The bill passed but did not survive a veto from LePage. Before that, former assistant House Minority Leader Ellie Espling, a Republican from New Gloucester, proposed creating a separate legislative committee that could deal with bills specific to the opioid crisis. That proposal never gained traction.
Meanwhile, other states that have been hit hard by the opioid crisis – including New Hampshire, Vermont, West Virginia and Ohio – have taken steps to elevate their response by creating boards or an executive-level position to take on the problem.
Mills already has taken steps to increase access to substance use disorder treatment – namely, finally expanding Medicaid to tens of thousands of low-income Mainers.
Perry said that change could have the biggest impact. She remembers when LePage’s administration eliminated Medicaid coverage for a group of people classified as able-bodied adults without children. Two of her clients who were enrolled in medication-assisted treatment programs were in that group and lost coverage
“One of them was far enough along in treatment and ended up being OK,” she said. “I don’t know what happened to the other.”