Johns Hopkins Team Releases Major Recommendations for Strengthening Delaware’s Substance Use Disorder Treatment System

NEW CASTLE (July 24, 2018) – Following a 14-month review of Delaware’s opioid use disorder treatment system, a research team from the Johns Hopkins Bloomberg School of Public Health and the Bloomberg American Health Initiative today recommended four major strategies to achieve the state’s goal of a system of care that is accessible, evidence-based, individualized, comprehensive and accountable.

Brendan Saloner, PhD, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, presented the findings today at a meeting of the Behavioral Health Consortium at Buena Vista. The report proposes four major strategies for the state to meet its treatment vision:

  • Increase the capacity of the treatment system.
  • Engage high-risk populations in treatment.
  • Create incentives for quality care.
  • Use data to guide reform and monitor progress.

In April 2017, Department of Health and Social Services Secretary Dr. Kara Odom Walker asked a team of researchers and clinicians from the Johns Hopkins Bloomberg School of Public Health to conduct the review by meeting with state officials representing multiple agencies, behavioral health organizations, treatment providers and patient advocates, and by studying data on Delaware’s epidemic, available literature, and the experiences of other states and localities.

“Families across the state have urged me to make changes to our public addiction treatment system,” Governor John Carney said. “This Johns Hopkins report is an important step forward in building a stronger treatment system so we can help more people get the access to care they need.”

“The recommendations from the Johns Hopkins team gives us a solid foundation in data, evidence and experiences from which to strengthen the opioid use disorder treatment system in our state,” said Secretary Walker, a board-certified family physician. “With almost one Delawarean dying each day from overdoses and thousands of more individuals and their families impacted by this epidemic, we need to meet people whenever and wherever they are ready for the most effective treatment we can provide.”

In 2017, 345 Delawareans died from overdoses, according to the Division of Forensic Science (DFS). That total was up about 12 percent from 2016. In 2016, the report says, Delaware’s overdose rate tied for ninth (with Rhode Island) among all states at 30.8 deaths per 100,000. Through July 23 of this year, 145 people have died from suspected overdoses in Delaware, according to DFS.

“This report really helps to identify those priority areas we need to address to fix our broken system of treatment in Delaware,” said Lt. Governor Bethany Hall-Long. “These recommendations support the action items included in the Behavioral Health Consortium’s Three Year Action Plan. Implementing these recommendations will allow us to better serve our population and meet their needs most effectively.”

“We deeply appreciate the thoughtful recommendations from the Hopkins/Bloomberg Team to help us strengthen our response to this critical public health epidemic,” said Division of Public Health Director Dr. Karyl Rattay. “The recent passage of an Overdose System of Care bill will help us fulfill the recommendation to engage high-risk populations into treatment, through the creation of a statewide system to ensure that consistent, humane, evidence-based treatment and care is available and provided to those requiring acute management for overdose or substance use disorder.”

The Overdose System of Care will involve establishing consistent EMS and emergency department protocols to improve acute response, initiate medication-assisted treatment to manage withdrawal, and rapidly engage individuals into SUD treatment. Additionally, the bill enables the establishment of stabilization centers, which could provide medical management for individuals who have overdosed or who require acute management of SUD. The ultimate outcome of system implementation is a reduction in morbidity and mortality and improved engagement into SUD treatment.

In embracing another recommendation of the Johns Hopkins report, DHSS’ Division of Substance Abuse and Mental Health (DSAMH) will begin contracts this summer with providers to increase access to care, peer support and effective treatment for individuals living with substance use disorder. In addition to meeting individuals’ treatment needs, the new centers also will address needs for medical care, housing, vocational opportunities, education and other wraparound services.

“We need to treat each person with an opioid use disorder as a whole person,” DSAMH Director Elizabeth Romero said. “At the new centers, we will use certified recovery peers to help individuals navigate their way through both the treatment and the social services worlds. Being able to talk with someone with a similar lived experience will help individuals suffering from opioid use disorder to better coordinate their services and maintain their engagement with treatment.”

“Delaware’ leadership recognizes that the rising tide of overdoses is a public health crisis,” said Joshua Sharfstein, MD, Professor of the Practice and the Director of the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health. “We are pleased to help the state save lives by expanding access to treatment.”

The Johns Hopkins report, available on DHSS’ website, includes details on each of the four strategies:

  • Increasing treatment capacity: Recommendations include DHSS’ Division of Substance Abuse and Mental Health (DSAMH) implementing a Centers of Excellence-type program to provide rapid intake and assessment, treatment, peer services and access to chronic disease management; DSAMH creating an online inventory of all credentialed treatment providers; DHSS leading a campaign to increase the number of providers who prescribe buprenorphine; and DHSS developing a plan to support housing and employment for individuals in recovery.
  • Engaging high-risk populations in treatment: Recommendations include the Department of Correction offering opioid use disorder treatment that includes all FDA-approved medications to all individuals in detention facilities; the state upgrading the three existing withdrawal management centers; and DHSS setting standards for hospital provision of SUD treatment for medication-assisted treatment and the use of peers.
  • Creating incentive for quality care: Recommendations include DSAMH reviewing its current rates to ensure there is adequate and consistent reimbursement for high-quality care; DHSS’ Division of Medicaid and Medical Assistance (DMMA) ensuring that current value-based payment initiatives applied through Managed Care Organizations (MCOs) are extended to opioid use disorder treatment; and DHSS, in partnership with other state agencies, developing a compliance strategy.
  • Using data to guide reform and monitor progress: Recommendations include DHSS developing a dashboard that collects and publicizes statewide data on treatment capacity, utilization and quality indicators; DHSS overseeing a linkage project that brings together multi-agency data for understanding system effectiveness and identifies opportunities for improvement; and DHSS evaluating program and policy changes and rapidly disseminating findings to facilitate continuous improvement.


Hall-Long Selected to Help Lead Nation’s Lieutenant Governor’s Association

 

“I am honored to have been nominated by my peers to help lead the National Lieutenant Governors,” said Lt. Governor Bethany Hall-Long. “The NLGA serves as a terrific platform and voice for our state’s leaders to collaborate and provide bi-partisan solutions to the issues all of our state’s face.”

 

Lt. Governor Hall-Long was sworn in as Delaware’s 26th Lieutenant Governor in January of 2017. As Chair of the Behavioral Health Consortium, she has been leading the state’s efforts to address mental health and addiction in Delaware including expanding access to treatment and coordinating and integrating services.

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Lt. Governor Hall-Long’s Statement on Senate’s Passage of Overdose System of Care

Dover, DE–Lt. Governor Hall-Long issued the following statement on the Senate’s passage of HS 1 for HB 440:

“Delawareans deserve a treatment system that works for them when they need it most. With today’s passage of HS 1 for HB 440, Delaware is one step closer to establishing an overdose system of care that will provide our citizens with a more comprehensive, integrated, and timely treatment system from initial contact with first responders through the entire continuum of care. This was a key recommendation of the Behavioral Health Consortium, and I thank to Rep. David Bentz for his leadership on this issue, and I look forward to joining Governor Carney for the signing of this important legislation.”


Governor Carney Hosts Ramadan Iftar Dinner at Woodburn

DOVER, Del. – Governor John Carney hosted 30 guests on Wednesday night at a Ramadan Iftar dinner at Woodburn, including members of Delaware’s Muslim community and statewide elected officials.

The Iftar is the evening meal after sunset that concludes the daily fasting during the month of Ramadan, which ends the evening of June 14 this year. For observers, the Iftar dinner and Ramadan are a time to reflect on humanity and to reaffirm commitments to helping the less fortunate.

Iftar at Woodburn

“Ramadan heightens our compassion and commitment to care for the most vulnerable among us, in addition to the spiritual practice of fasting that underlies the holy month,” said Governor Carney. “I will always stand as a friend of Delaware’s strong and vibrant Muslim community, which has given so much to our state and strengthened it in many ways.”

Wednesday’s event was the second Iftar dinner hosted by Governor Carney, and the fourth Iftar dinner hosted by a governor of Delaware. In attendance were representatives from six Delaware mosques, as well as First Lady Tracey Quillen Carney, Lieutenant Governor Bethany Hall Long, and Dover Mayor Robin Christiansen.

“We welcome Governor Carney’s celebration of friendship by hosting his second Iftar dinner and welcoming us to Woodburn,” said Muhammed A. Niaz, chairman of the Islamic Academy of Delaware. “This historic home to Delaware’s governors is a fitting setting for reflection, conversation, and recommitting ourselves to helping others.”

“The Governor’s support for Delaware’s Muslim community during Ramadan is greatly appreciated,” said Usman Sandhu, president of the Islamic Society of Central Delaware. “We are pleased by our elected officials’ devotion to equality and diversity in our great state.”

Click here for photos from the dinner.

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Lieutenant Governor, Behavioral Health Consortium Present Governor with “Three-Year Action Plan”

 

Advisory body developed roadmap to address prevention, treatment and recovery

 

WILMINGTON, Del. – On Tuesday, Lieutenant Governor Bethany Hall-Long, along with members of the Behavioral Health Consortium, presented Governor Carney with their initial report, a “Three-Year Action Plan,” to confront addiction and mental illness across Delaware.

“I am proud to release this initial report to Governor Carney,” said Lieutenant Governor Bethany Hall-Long. “The members of the Behavioral Health Consortium have been meeting for over six months listening to members of the community tell their personal stories and experiences of how the addiction epidemic has affected them and gathering their feedback on how we can improve our behavioral health care system and better serve Delawareans. This report is an initial roadmap for the Governor and members of the General Assembly to address the challenges we face and start saving lives.”

Creation of the Behavioral Health Consortium was a recommendation of Governor Carney’s Action Plan for Delaware. Last August, the Governor signed Senate Bill 111, creating the advisory body of advocates, health officials, law enforcement, state leaders, and members of the community to develop an integrated plan addressing prevention, treatment and recovery for mental health, substance use, and co-occurring disorders. It has been meeting since October to develop both short and long term solutions to address behavioral health and the addiction epidemic in Delaware.

“Too many Delaware families are dealing with the effects of addiction and mental illness,” said Governor Carney. “This action plan gives us a path to follow, to directly confront many of the challenges facing Delaware families, to expand access to prevention and treatment services, and to reduce the stigma around mental illness and substance abuse. I asked Lieutenant Governor Hall-Long to lead this effort because she has the experience and leadership necessary to help us make real change. I look forward to reviewing this plan in more detail, and to talking to members of the General Assembly about a path forward. Thank you to the Lieutenant Governor, and all the advocates across our state for their leadership on this very important issue.”

Based on the data gathered by the Consortium, and from the voices of more than 600 Delawareans that participated in a community forum process, the report is divided into six main areas of action:

  • Access and Treatment
  • Changing Perceptions and Stigma
  • Corrections and Law Enforcement
  • Data and Policy
  • Education and Prevention
  • Family and Community Readiness

Each contains both immediate and longer term recommendations for action to improve the behavioral health care system in Delaware.

“Although the consortium already had a great deal of expertise among its members, the group still solicited a lot of public input that helped inform this first report,” said Representative David Bentz. “It’s also encouraging that this report includes a detailed action plan, which is something we can begin to enact almost immediately. This won’t be a report that sits on a shelf and collects dust – it’s going to get put good use right away, making a difference for residents facing mental health and substance abuse issues.”

“Thousands of families, advocates, medical professionals, and policymakers across the state have stood up and said that we need to meet the addiction crisis head-on,” said Senator Stephanie Hansen. “That’s an incredible resource, and the Behavioral Health Consortium’s focus has been keeping this train moving in the right direction. The Consortium’s final report is the product of months of work that provides a valuable North Star for Delaware as we combat this harrowing epidemic.

For more information on prevention, addiction, treatment and recovery, please visit HelpIsHereDE.com. Individuals who are suffering from addiction can also call DHSS’ 24/7 Crisis Hotline to be connected to treatment options. In New Castle County, call 800-652-2929, or Kent and Sussex Counties, call 800-345-6785.

Click here to view the Behavioral Health Consortium’s Three-Year Action Plan.

Click here to view the livestream from today’s event.

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Related news:
Delaware Opioid Prescription Rates Falling Seven Months After New Regulations Enacted
In Response to Addiction Epidemic, DHSS Seeks Proposals to Implement Centers of Excellence Model to Improve State’s Substance Use System of Care
Delaware Steps Up Fight Against Addiction; Begins Work to Expand Mental Health Services
Governor Carney Signs Legislation Forming a Behavioral Health Consortium and Addiction Action Committee in Delaware
Governor Carney Signs Package of Legislation to Combat Addiction Crisis