i_opioidsubstance_2017a_2017-08-01t09:36:49z4 Hearing Summary

Date: 08/01/2017

Location: RM 271

01:41 PM -- Current Options for Addiction Treatment



Mike Butler and Amy Lowe, representing Arapahoe House, presented a handout (Attachment G) and discussed the treatment options and challenges at Arapahoe House. Arapahoe House focused on outpatient, residential, and medication-assisted treatments that provide deep therapeutic and life-changing impact. They have observed a significant increase in treatment needs related to opioid admissions, as well as workforce shortages for care workers.



17Opioid0801AttachG.pdf



02:10 PM



Frank Cornelia, representing the Colorado Behavioral Health Care Council (CBHC), presented a packet of handouts (Attachment H) to the committee. He discussed the CBHC's work and the work of its member organizations, including the regional managed service organizations (MSOs) that are contracted with the Office of Behavioral Health to provide substance use disorder treatment services for patients throughout Colorado..



17Opioid0801AttachH.pdf



02:25 PM



Daniel Darting, representing Signal Behavioral Health Network, discussed addiction services provided by managed service organizations. He discussed Senate Bill 16-202 and the needs assessment required by the bill.





02:31 PM



Lorez Meinhold, representing the Keystone Policy Center, discussed the needs assessment performed pursuant to SB16-202, focusing especially on the continuum of care. In order to determine how to effectively allocate funding for substance use disorder services in Colorado, the Keystone Policy Center conducted a needs assessment. Ms. Meinhold explained that stakeholders across the state reported a need for funding that is flexible at the regional and community levels, sustainable, and focused on the development of a continuum of care.





02:40 PM



Mr. Darting and Ms. Meinhold responded to committee member questions.





02:48 PM



Brad Sjostrom, representing Colorado Association of Addiction Counselors and Colorado Providers Association, discussed access to treatment including cost, limited numbers of providers and treatment locations, stigma, and individual readiness.





03:00 PM



Angela Bonaguidi began her segment of the presentation and discussed her work with Colorado Organization for the Treatment of Opioid Dependence (COTOD) and narcotic treatment organizations and described the use of medication-assisted treatments (MAT). She highlighted the effectiveness of MAT when used for different lengths of time and described the different types of medications used. Ms. Bonaguidi described maintenance treatment for persons with opioid use disorders using MAT and stated her objection to the idea that MAT is replacing one addiction with another. She discussed the clinical aspects of MAT, including how it is prescribed by physicians and providers, dispensed by regulated facilities, and used by patients. She discussed reimbursement rates for MAT and gaps in treatment under Medicaid and Medicare. She discussed recommendations, including increased reimbursement rates, workforce support, modernization of the central registry of MAT care in the Office of Behavioral Health, and preventing patients from being detoxed from MAT treatment when moving into a higher level of care. Ms. Bonaguidi responded to questions from the committee.





03:12 PM



Dr. Laura Martin, representing the Center for Dependency, Addiction, and Rehabilitation (CeDAR) and the Colorado Society of Addiction Medicine (COSAM) began her presentation to the committee (Attachment I). She discussed opioid agonist therapy. She explained CeDAR's multidisciplinary approach to treatment, including addiction medicine, addiction psychiatry, nursing, counseling, psychology, spirituality, nutrition, fitness, recovery support, and family services. CeDAR supports medication-assisted therapies, including the use of methadone, buprenorphine, and naltrexone. She also discussed challenges to addiction treatment, including the lack of providers and clinical support, spotty insurance coverage for treatment, lack of health system support, co-occurring behavioral and medical health conditions, episodic treatment models, and lack of housing options.



17Opioid0801AttachI.pdf



03:35 PM



The panelists responded to committee questions.