Wisconsin Health News

Officials from the Department of Health Services expressed broad support for the latest package of bills from Rep. John Nygren’s Heroin, Opioid Prevention and Education Agenda but called for some modifications, during a Senate Committee on Health and Human Services hearing on Wednesday.

Earlier in the hearing, Nygren said he was open to changes.

“We’ve been working with DHS,” said the Marinette Republican. “These issues are some of the remaining pieces that we have been working on with our friends from the Pew Charitable Trusts to address the gaps in our system.”

Paul Krupski, director of opioid initiatives for DHS, said that a measure requiring the department to reimburse peer recovery coaches as a Medicaid benefit would, as written, have to be paid for with all state dollars. That’s because the federal government won’t provide matching funds for peer-provided services unless that individual is supervised by a licensed mental health professional, Krupski said. The bill proposes that they are supervised by another peer with certain training.

“With some changes, there may be opportunity to draw down federal matching funds and better preserve the existing workforce by either building upon our existing certified peer specialists infrastructure, or by providing DHS with additional oversight of the training and other requirements so that the department can align it with the existing infrastructure,” he said.

Nygren said that adding the supervision is “something we are willing to look at to make sure we maximize our federal dollars.” He said the state has seen a spike in peer recovery coaches because they are an effective tool in navigating the complicated system of addiction. 

Krupski also pushed back against legislation that would require the department to establish and maintain a registry of approved recovery residencies. Under the bill, DHS may not include a recovery residence in the registry if it excludes any resident solely on the basis that the resident participates in medication-assisted treatment. 

Krupski said that while DHS recognizes medication-assisted treatment as a “valid, evidence-based therapy,” many of the residencies do not accept individuals receiving the treatment.

“We must carefully consider the impact of creating a statewide registry of residencies which, as a prerequisite to receiving state or federal pass through funding, must not exclude a resident solely on the basis that they are participating in MAT,” Krupski said. “The Legislature will need to weigh the potential unintended consequences of eliminating state funding for current sober housing options that do not allow their residents to use MAT.”

Nygren said he would be open to an amendment phasing in the requirements.

“[DHS] has a concern about putting existing houses that may discriminate currently with someone on medication-assisted treatment out of business,” Nygren said. “That is not the goal of myself or anyone who supports this bill.”

Meanwhile, Krupski praised legislation that would allow for the Medicaid reimbursement of acupuncturists and increase the Joint Finance Committee’s supplemental appropriation by $1 million to boost payments for chiropractors and physical therapists. Gov. Tony Evers vetoed a similar measure in the budget that did not include reimbursement for acupuncture. 

“The Department supports efforts to reimburse providers for non-opioid and non-pharmacological pain management techniques,” Krupski said.

Other bills in the package would:

• Require DHS to study the availability of medication-assisted treatment for opioid use disorder in prisons and jails.
• Extend a sunset to 2025 for a law requiring prescribers to check a patient’s records in the state’s prescription drug monitoring program before issuing a prescription order.
• Repeal a sunset for a law that grants immunity from prosecution for certain controlled substance crimes and from having probation, parole or extended supervision revoked for possessing a controlled substance for those calling for help for another person suffering an overdose and overdose victims who complete a drug treatment program.
• Require the Medical Examining Board to issue guidelines on the best practices for treating neonatal abstinence syndrome.