By Jack Carroll
As Gov. Tom Wolf introduces his 2019-20 state budget proposal, I am reminded that the spending plan is much more than a set of numbers: it is a reflection of core values and priorities.
In the coming months, lawmakers, the governor and his administration will have to make difficult decisions on how to invest limited resources among a competing array of vital services and programs that will impact 12.8 million Pennsylvanians.
It’s a tall order and I don’t envy the governor or our lawmakers. I am hopeful that they will build on their strong track record in coming together to combat the opioid epidemic that continues to wreak havoc across our state.
As we look ahead to the budget debate, I encourage lawmakers to work closely with leaders in our 67 counties to develop programs that meet local needs. There is no ‘one size fits all solution’ for this crisis or any behavioral health challenge that elected officials in each of our counties must address.
There’s no question that the state has stepped up. We now have 45 treatment facilities, called Centers for Excellence, dedicated to treating Pennsylvanians with opioid-use disorders. These centers are designed to provide ‘whole person’ care where behavioral health services – such as drug counseling – are integrated with primary and other services – which is a critical component of every county’s human services systems.
We have stronger prescription drug monitoring and better guidelines for the use of opioids. Naloxone, the lifesaving overdose antidote medication, is more readily available. There is much greater access to substance abuse treatment, including opioid-specific medication-assisted treatment. Law enforcement, our courts and local providers are working more closely than ever before.
Recent results are promising with some counties beginning to see significant reductions in overdose deaths. However, much more work needs to be done and we can build upon this foundation by focusing on local solutions. We need to recognize that Pennsylvania is a large and diverse state. Our challenges in Cumberland and Perry counties are likely very different than those that local officials are confronting in Erie, Allegheny or even York County.
This diversity is why lawmakers and Gov. Wolf must continue their support of the Behavioral HealthChoices (BHC) program, the statewide program through which every county delivers substance abuse and other behavioral health services to vulnerable Pennsylvanians enrolled in the Medical Assistance program.
The BHC program was created 21 years ago and has emerged as a critical resource in the opioid health crisis.
Under BHC, the provider network for the delivery of substance use services has increased by over 500 providers. The program helps to deliver treatment, counseling, resource coordination, shelter, food and other services for Pennsylvanians and their families.
Under BHC, each county has the opportunity to manage their own program or to work with other counties and form collaborative partnerships. Each county has the right and the responsibility to identify what specific services their constituents need. County leaders, treatment and recovery professionals, and families in need of help all work together.
In Cumberland County, for instance, county commissioners have partnered with recovery experts to develop a “warm hand off” program that is just now getting off the ground. Certified recovery specialists will be available at each of the county’s three hospitals to help overdose victims find the services they need as they are being released from the emergency room.
The county has also partnered with our courts to create an Opioid Intervention Court (OIC), which helps offenders with substance abuse disorders receive treatment at the time of their first contact with the criminal justice system.
BHC Funds have supported the expansion of treatment options and the creation of local recovery centers so that those addicted to opioids or alcohol can find support and counseling services in their communities.
Since Perry County is much more rural, it presents different challenges. BHC funding has been used to embed a certified recovery specialist with a locally-based outpatient provider, thus strengthening the connection between treatment services and community-based recovery supports. In addition, plans are underway for initiation of a medication-assisted Vivitrol program for non-violent offenders in the Perry County Prison.
The opioid crisis demands a multifaceted statewide strategy that can be tailored to local needs.
Again, lawmakers and Wolf have made tremendous strides, but local responses are best crafted by county leaders and their partners in communities across the state.
Jack Carroll is the Executive Director of the Cumberland-Perry Drug & Alcohol Commission. The Commission is responsible for planning, implementing and managing public-funded substance abuse prevention, intervention, treatment and recovery support services for its two-county service area. He writes from Carlisle, Pa.
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