Move could greatly increase access to opioid treatment in N.H.

  • FILE - This Feb. 19, 2013, file photo, shows OxyContin pills arranged for a photo at a pharmacy in Montpelier, Vt. Prescription painkillers should not be a first-choice for treating common ailments like back pain and arthritis, according to new federal guidelines designed to reshape how doctors prescribe drugs like OxyContin and Vicodin. Amid an epidemic of addiction and abuse tied to these powerful opioids drugs, the CDC is urging general doctors to try physical therapy, exercise and over-the-counter pain medications before turning to painkillers for chronic pain. (AP Photo/Toby Talbot, File) Toby Talbot

Monitor staff
Wednesday, February 28, 2018

New Hampshire could be getting more beds to treat opioid addiction, including 36 beds for teens at the Sununu Youth Services Center in Manchester, as it seeks to unload a restriction on Medicaid payments that has existed since the health insurance program was created a half-century ago.

The state has asked for a waiver of federal rules to allow facilities with more than 16 beds to get Medicaid reimbursement for substance abuse treatment. If approved, it would immediately help the cash-strapped Sununu Center when it opens in July, and could convince other nonprofit and for-profit entities to add beds or to open new, large facilities.

“I think it’s a big deal,” said Jeffrey Meyers, commissioner of the Department of Health and Human Services, which is requesting the waiver. “This will, I think, support additional capacity in New Hampshire ... because entities know there is a funding stream that will pay a significant percentage of the cost.”

“I’m certainly hopeful there will be providers that will look seriously at more beds” if the waiver comes through, he said.

The request comes during an all-hands effort to get federal approval of the state’s Medicaid expansion plan.

The proposed waiver application, drafted for the Centers for Medicare and Medicaid Services, is seeking to lift a barrier in federal law that Congress put in place in 1965. Meyers said Congress capped the size of institutions getting Medicaid reimbursement for substance abuse because it was worried that states would overload the new program with the cost of state hospitals, which at the time had hundreds or, in New Hampshire’s case, thousands of patients.

The request for the waiver is being submitted as New Hampshire’s opioid epidemic storms on, which has challenged behavioral facilities and spread across the public sphere.

As state officials and private administrators seek to spread their money strategically, the needs of teenagers are often overlooked, the department said. About 9 percent of New Hampshire’s 12- to 17-year-olds used narcotics in 2016 – above the national average – according to the National Survey on Drug Use and Health.

Recently, New Hampshire lawmakers have moved to address the problem, setting aside $2 million last year for the construction of a residential substance abuse treatment wing in the Sununu Youth Services Center in Manchester.

But that facility faces its own financial woes. After a round of cuts in the latest budget, Meyers has estimated that it faces a $3.6 million shortfall in Fiscal Year 2019.

The waiver application has a ways to go before being submitted. After a 30-day public comment period, it must receive the approval of the Joint Legislative Committee on Administrative Rules. A public hearing is scheduled for March 6 in Manchester. The public may also submit comments by email until March 30.

The latest effort comes in the midst of a concerted attempt by the department, the governor’s office and legislative leadership to secure approvals from the Centers for Medicare and Medicaid Services for the state’s Medicaid expansion program, unveiled earlier this month. Political leaders say they’re expecting a full response from the agency in the coming weeks.

(Ethan DeWitt can be reached at edewitt@cmonitor.com or on Twitter at @edewittNH. David Brooks can be reached at 369-3313 or dbrooks@cmonitor.com or on Twitter @GraniteGeek.)