Senate Democratic panel takes up improving Pa. treatment centers amid rising overdose deaths
‘Some treatment centers and recovery homes are wonderful while others are predatory,’ Heather Arata testified before the Senate Democratic Policy Committee during a public hearing on improving drug treatment centers in Pennsylvania
Larry and Heather Arata testify during a Senate Democratic Policy Committee hearing on improving drug treatment centers in Pennsylvania on Monday, Dec. 7, 2021. (Screenshot)
Larry and Heather Arata mourn the death of their 23-year-old son every day. But their grief comes with a mission motivated by hope for a time where there is no longer an opioid epidemic.
Brendan Arata was sober for 96 days before a fatal relapse in December 2017. Months after their son’s death, the Aratas founded the Opioid Crisis Action Network, a nonprofit that educates the public about solutions to addiction and treatment options for a crisis that has only worsened during the COVID-19 pandemic.
Their son went through detoxification and rehabilitation twice, partial hospitalization and intensive outpatient programs, and hundreds of Narcotics Anonymous meetings. But when it came to treating their son’s addiction, the Aratas relied on word-of-mouth referrals for treatment.
Nearly four years after their son overdosed in their Havertown family home, the couple testified before the Senate Democratic Policy Committee during a Monday public hearing on improving drug treatment centers in Pennsylvania. They called upon elected officials to provide “commonsense regulation and transparency” to the industry.
“Some treatment centers and recovery homes are wonderful while others are predatory,” Heather Arata said of the group homes for those combating substance abuse problems. “And due to the largely deregulated state of the industry, it’s often impossible to discern the difference. It’s almost impossible to get any information on outcomes or safety.”
Doug Nemeth also testified, recounting the build-up to the September 2021 fatal overdose of his 31-year-old son Zachary Nemeth, and detailed the confusion surrounding treatment facilities, halfway houses, and inpatient and outpatient care.
“Some of them were these little, dumpy places, looked like they were unregulated,” Doug Nemeth, of Berks County, said of sober houses his son went to after going through inpatient and outpatient treatment programs.
Doug Nemeth said each place his son received treatment for almost a decade offered his son “new hope,” but his addiction became “almost impossible to command.” Some of the “happiest moments” during his addiction came when Zachary Nemeth was in jail, his father said, because “he had no temptation to take drugs.”
“I think every day of what I could have done, how I could change things, what I would have done differently,” Doug Nemeth said.
Gov. Tom Wolf, a Democrat, declared the opioid and heroin overdose epidemic a public health emergency in January 2018 when Pennsylvania reported a record for opioid deaths. The declaration expired in August after the Republican-controlled Legislature, with expanded emergency powers, declined a request from Wolf to extend it.
Though the Wolf administration and Republican-controlled Legislature have supported bills to make treatment more accessible and regulate the distribution and disposal of medications, overdose deaths have continued to increase, with a three-year high in 2020.
“We can’t go back in time and change what’s already happened, but what we can do now is look at how we can make sure history doesn’t repeat itself,” Sen. Judy Schwank, R-Berks, said, adding that she doesn’t want to punish providers or the Department of Drug and Alcohol Programs. “I think we’ve taken our eye off the ball on this issue, even before quite frankly the pandemic hit and things got worse.”
Schwank has proposed prohibiting treatment centers from refusing admittance to anyone reporting to a facility requesting services addressing substance use disorder — even if the person is under the influence at the time — and publishing responses to an annual survey completed by every Pennsylvania treatment center and recovery home.
Robert Dellavella, chief executive officer of Self Help Movement, a treatment center in Philadelphia, testified that, of those with a substance use disorder, one in 10 will engage in treatment. He noted that recovery is not a “one-size-fits-all.”
Dellavella also noted the reimbursement disparities between treatment centers whose clients have private insurance and ones with Medicaid.
“The insurance companies probably pay anywhere from two to seven times the daily rate for private insurance than a Medicaid-funded program,” he said, adding that while Medicaid-funded programs can offer longer stays, they have to “jump through a lot of hoops for that.”
Asked what’s getting in the way of care providers doing their jobs and what the Legislature should do differently, Dellavella said there is a need for “better knowledge of treatment facilities.”
“I sometimes just think of myself as someone who’s not familiar with the system,” he said. “In trying to access what’s out there is next to impossible. You’ll get nothing but ads and programs that are really paid solicitations, and that’s not the way it should be.”
According to the Department of Drug and Alcohol Programs, Pennsylvania has about 800 substance use treatment centers, but the public has expressed concern about recovery house conditions and regulation enforcement. Earlier this year, the department removed a “comparison tool,” which claimed to help guide people in treatment center quality, from its website after a report by The Morning Call of Allentown revealed that the resource showed incorrect numbers for treatment and violations.
Pennsylvania Secretary of Drug and Alcohol Programs Jennifer Smith said Monday the state did not remove information about treatment center quality. Instead, she testified that users can’t pull up two or more centers for comparison.
Smith said the state is working with the addiction-focused nonprofit Shatterproof to develop an online resource to locate treatment facilities. The online resource will show if treatment facilities meet principles of care established by Shatterproof, service details, accepted insurances, and hours of operation, Smith said.
Smith testified Monday that the tool should be live in spring 2022, and discussions to include information about recovery houses are ongoing. The state is also preparing to publish a new licensure program for recovery houses.
“While it is really important for the public to understand how to access treatment resources, we do have to keep in mind that selecting the appropriate types of services is a clinical decision,” she said, stressing the importance of a clinical assessment. “And so while it’s important for the public to know how to find these places and how to know whether they offer good quality services or not, there are some facilities that only offer certain types of services.”
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