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Gov. Tony Evers signed into law four bills on Tuesday that target substance use disorder and opioid use in Wisconsin.
Evers said more needs to be done to expand access to healthcare across the state and bolster treatment and recovery services.
“Folks have seen firsthand how substance use disorder—especially opioid use—has torn apart families and communities across our state, and we need to get serious about tackling this issue in Wisconsin," Evers said in a statement. "I am proud to sign these bipartisan bills into law today that are a step in the right direction, but we know that there is more work we have yet to do."
The bills are part of Marinette Republican Rep. John Nygren's Heroin, Opioid Prevention and Education Agenda. The four bills bring the total number of HOPE Agenda laws to 34.
“While there is always more work to be done, more lives to save, and more avenues to recovery that need opening, today’s actions are another arrow in the state’s quiver to combat substance abuse," Nygren said in a statement.
Nygren also called on the Senate to act on two more bills that passed the state Assembly.
One bill would repeal a sunset for a law that provides some legal immunity for aiders who help a person experiencing an overdose as well as overdose victims.
The other would create a Medicaid benefit for acupuncture and increase rates for chiropractors and physical therapists.
The bills signed by Evers will:
Create a Medicaid benefit for peer recovery coach services and mandate that DHS establish a program to coordinate and continue care following an overdose.
Evers also signed into law additional healthcare-related bills that will:
Attorney General Josh Kaul said Wednesday that an agreement with a generic drugmaker will help provide more resources to fight the opioid epidemic.
Ireland-based Mallinckrodt, currently the largest generic opioid manufacturer in the United States, announced Tuesday that it's tentatively agreed to pay $1.6 billion to settle thousands of lawsuits related to the epidemic.
Under the deal, the company's future generics opioid business would be subject to strict rules that prevent marketing. The company would also have to ensure systems are in place to prevent diversion.
“Getting accountability from pharmaceutical companies is an important part of our strategy for fighting the opioid epidemic,” Attorney General Josh Kaul said in a statement. “With this agreement, more resources will be available to help combat this crisis.”
Mallinckrodt is the subject of a multi-state investigation that Wisconsin is participating in, said DOJ spokeswoman Rebecca Ballweg.
Negotiation of how the funds will be distributed is ongoing, she added. The agency is focused on ensuring that the money goes to addressing the opioid epidemic.
The agreement, subject to court approval and other conditions, is backed by a group of 47 state and U.S. territory attorneys general.
The majority of payments would go to a trust that would establish an abatement fund to cover the cost of opioid-addiction treatment and provide support to communities impacted by the crisis.
The settlement would become effective after the company’s subsidiaries focused on specialty generics go through a court-supervised bankruptcy process.
Mallinckrodt CEO Mark Trudeau said that reaching the agreement and associated debt refinancing activities will help resolve uncertainties in their business related to the litigation and provide a “clear path forward to achieving our long-term strategy.”
Last May, Kaul announced Wisconsin filed lawsuits against two Purdue Pharma entities and Richard Sackler, alleging deceptive and false marketing practices in the sale of opioids.
Wisconsin is part of multi-state investigations of opioid distributors Amerisource Bergen, Cardinal Health and McKesson.
The Assembly signed off on raising the tobacco purchase age to 21 during a floor session on Thursday.
The federal government raised the age last year, but state and local law enforcement don't have the authority to enforce federal law.
States have to comply with the federal law or else risk losing funding on a block grant for mental health services that relies on compliance with the policy.
Lawmakers approved an amendment to the original bill striking the mention of the age 21 and instead referencing the age set by federal law.
Bill author Rep. John Spiros, R-Marshfield, said that would ensure that lawmakers won't have to modify state law if federal law changes again.
"By passing this bill, not only are we ensuring that Wisconsin does not lose federal funding, but we are also helping to stop the public health crisis in its tracks," Spiros said.
Rep. Jill Billings, D-La Crosse, offered an amendment voted down by Republicans that would provide $2 million for smoking cessation and education.
For some young adults who smoke, raising the age could cut off access to tobacco purchase, she said.
"We'll have a ton of people who are addicted, who have been smoking legally for years, who will need smoking cessation help," she said.
A coalition of health groups and educational groups applauded the chamber for taking action.
"Youth use of e-cigarettes is an epidemic,"” Brad Gast, member of the American Heart Association’s Advocacy Committee, said in a statement. “Once fully implemented, this legislation will help us curb youth usage of e-cigarettes and keep e-cigarettes and vaping out of our schools.”
Lawmakers also approved legislation that would:
The bills head to the Senate for consideration.
The Assembly also passed a bill that the Senate approved allowing law enforcement and firefighters diagnosed with post-traumatic stress disorder to submit workers’ compensation claims. They amended the plan to make additional changes to workers’ compensation law.
The Assembly also passed bills that the Senate has already green lit. Those bills now head to Gov. Tony Evers for his consideration. They would:
Ned Daniels Jr., chairman of the Forest County Potawatomi Community, called for more action on the opioid epidemic during the annual State of the Tribes address Tuesday.
“We must maintain a sharp focus on improving the lives of those we represent in the new decade as we grapple with the responsibility of addressing complex changes before us,” he told lawmakers. “And there is no challenge more complex than that of the opioid epidemic.”
The crisis has hit native communities across the state especially hard, Daniels said.
“Opioids are tearing apart our communities,” he said. “One by one, they are killing our people. They are leaving our families devastated, and our young ones without parents.”
Daniels thanked Rep. John Nygren, R-Marinette, and other lawmakers for their work on the Heroin, Opioid Prevention and Education Agenda.
He said it’s important that the approaches aren’t “one size fits all" and allow native communities to provide treatment according to their cultural beliefs.
He noted there are few places that provide such treatment, leading Wisconsin tribes to work on developing a youth wellness and treatment center.
They plan to locate the facility centrally between the tribal nations where it'll be a hub for children needing treatment. Lawmakers have supported the project.
“This facility has the potential to do great things, and we hope that you will continue to work with us on this endeavor,” he said.
One of the Northwestern Mutual Data Science Institute's first projects will be on the opioid crisis, according to a recent statement.
The institute, a partnership between Northwestern Mutual, Marquette University and the University of Wisconsin-Milwaukee, announced its first projects last week.
The opioid-focused project will involve using public data from local sources and "geospatial analysis" to study opioid overdoses in the city. That project will launch Feb. 21, and investigators hope it could provide insights to help other communities around the country.
JAMA - American Medical Association Sarah E. Wakeman, MD1,2; Marc R. Larochelle, MD, MPH3,4; Omid Ameli, MD, MPH5; et al
The increasing burden of opioid use disorder (OUD) has resulted in increased opioid-related morbidity and mortality, with 47 600 overdose deaths in 2017 alone.1-3 From 2002 to 2012, hospitalization costs attributable to opioid-related overdose increased by more than $700 million annually.4 Associated health complications, such as hepatitis C infection, HIV infection, and serious injection-related infections, are also increasing.5-7 In addition, as rates of opioid-related death have increased despite decreases in prescription opioid supply, there is an increasing recognition that greater attention must be paid to improving access to effective OUD treatment.8,9
Medication for opioid use disorder (MOUD) is effective and improves mortality, treatment retention, and remission, but most people with OUD remain untreated.10-15 Many parts of the United States lack access to buprenorphine prescribers, and only a few addiction treatment programs offer all forms of MOUD. 16-18 This lack of access has resulted in a treatment gap of an estimated 1 million people with OUD untreated with MOUD annually.19
Nationally representative, comparative effectiveness studies of MOUD compared with nonpharmacologic treatment are limited. One prior study 12 compared MOUD with psychosocial treatments but was limited to a Massachusetts Medicaid population. Studies 20-23 examining OUD treatment among nationally representative populations have examined trends in MOUD initiation, patterns of OUD treatment, and effectiveness of different types of MOUD at reducing overdose using Medicaid and commercial claims data. However, none of those studies 20-23 compared the effectiveness of MOUD with nonpharmacologic treatments in a national sample. Despite better access to medical care, only a few commercially insured patients are treated with MOUD, and psychosocial-only treatments continue to be common, suggesting that greater understanding of the comparative effectiveness of these different treatments is needed.21
In this study, we used a large, nationally representative database of commercially insured and Medicare Advantage (MA) individuals to evaluate the effectiveness of MOUD compared with nonpharmacologic treatment. This retrospective comparative effectiveness study was designed to inform treatment decisions made by policy makers, insurers, practitioners, and patients.
Read more.
The American Journal of Psychiatry / Nora D. Volkow, M.D.
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Rogers Behavioral Health has gained approval to break ground this spring on a new location in Sheboygan, according to a statement released last week.
The $4 million facility is expected to open late this year or early 2021. Its support comes from an anonymous donor.
The location will include a 10,000-square-foot outpatient clinic to treat OCD, anxiety, depression, other mood disorders and co-occurring substance use disorder in adults and adolescents.
It'll be able to serve up to 12 teenagers and 28 adults at a time.
Wisconsin Medical Society - Medigram
More than 260 people have taken the new online Bucket Approach training for clinicians to learn how to help patients with serious or significant mental illness quit smoking. The course, developed by UW-CTRI Researcher Dr. Bruce Christiansen, offers 8.25 free continuing education credits.
The project is funded by the State of Wisconsin Department of Health Services Division of Care and Treatment Services. Donna Reimer, the grant administrator, serves with Christiansen on a steering committee focusing on helping patients with behavioral health issues to quit smoking (WiNTiP).
Read More.
The Department of Health Services is planning to re-work a benefit for residential treatment for substance use disorder that was set to start Feb. 1. The agency delayed implementation last Friday.
Curtis Cunningham, assistant administrator for long-term care benefits and programs at the Division of Medicaid Services, said during a Wednesday webinar they consider the review a “fresh restart” on the policy.
“This is the start of a conversation, not an end,” Cunningham said.
There’s no new timeline on implementing the benefit, but they’re hoping to start a work group in the next 30 days to weigh in, he said.
Pam Appleby, director of the Bureau of Benefits Management at the Division of Medicaid Services, said they heard concerns about the benefit, including requests that the agency ensure rates cover costs, provide reimbursement timely and have a fast, streamlined authorization process.
“We understand that delays can cause a member to walk away and never come back,” Appleby said.
Other concerns were about housing for members, discharge requirements for patients who don't have homes and how the benefit would work with those in the corrections system.
The agency also heard that some providers who offer specialized services that go beyond the basic benefit requirements need a reimbursement system that would cover their cost.
They’ve also heard feedback from counties support the benefit and its impact. And they’ve also had conversations about funding for room and board and how to keep local governments involved in the treatment, Appleby said.
Wisconsin Society of Addiction Medicine563 Carter Court, Suite B,Kimberly, WI 54136
