NEW CASTLE (Oct. 2, 2018) – The Department of Health and Social Services’ Division of Substance Abuse and Mental Health (DSAMH) last week launched its online referral network – Delaware Treatment and Referral Network (DTRN) – allowing Delaware health care providers seeking substance use disorder treatment or mental health services for their patients to make a digital referral with one of 24 organizations participating in the first phase.

DSAMH is partnering with OpenBeds, a leading provider of a health care technology solutions, whose platform identifies, unifies, and tracks behavioral health resources to create single, common networks; facilitates rapid digital referrals; and fosters collaboration among mental health, substance use and medical providers.

Within hours of last week’s launch of the Delaware Treatment and Referral Network, 13 behavioral health centers, hospitals, referral organizations, and other state agencies and support resources were using the online platform to connect patients to the appropriate and needed level of care. At launch, there were 24 treatment organizations statewide listing 66 mental health and substance use disorder (SUD) services. The collection of these network members represents the first phase of the project, which the Department of Health and Social Services (DHSS) intends to grow to include all mental health services statewide.

“Real-time online treatment referrals and acceptances are an important step forward in making our behavioral health system more responsive for the people we serve,” said DHSS Secretary Dr. Kara Odom Walker, a board-certified family physician. “Because of the Delaware Treatment and Referral Network, health care providers, in consultation with individuals and their families, won’t have to spend hours on the phone trying to find out if a treatment slot of bed is available. Faxed paperwork won’t get misplaced. And a bed won’t be given away to someone else while an individual seeking treatment tried to get to a treatment location.”

In 2017, 345 died in Delaware from overdoses, according to the Division of Forensic Science (DFS). Through Oct. 1 of this year, 218 people have died from suspected overdoses in the state, including a record monthly total of 39 lives lost in August, according to DFS.

DSAMH Director Elizabeth Romero said having real-time information about treatment availability is critical in helping health care providers make the best decisions about care for their patients. “The Delaware Treatment and Referral Network will expedite referrals for patients and ensure that treatment begins as quickly as possible,” Romero said. “Because treatment organizations will update their bed, slot or appointment capacity at least twice a day, referring health care providers will have a strong picture of what services are available for their patients.”

In its first week, Romero said the network facilitated 95 online patient referrals, with 72 requests accepted for treatment, six declined and 17 remaining open.

The Delaware Treatment and Referral Network also supports the identification of peer recovery support services and pre-authorizations by the Eligibility and Enrollment Unit at DSAMH for certain substance use disorder referrals. In the coming months, DSAMH will continue to add providers to the network and introduce additional functionality and support services. Ultimately, DHSS hopes to gain insights from the network that will help identify gaps in care, share best practices and better manage treatment resources.

“OpenBeds provides an amazing opportunity for providers across Delaware to remain informed throughout the referral process so that those we serve are able to be provided with care in a more transparent and efficient manner,” said Erin Booker, Corporate Director for Behavioral Health at Christiana Care Health System.

DTRN, in partnership with OpenBeds, coordinates multiple independent services and pool capacity, and captures real-time utilization data and referral patterns to:

• Identify service gaps;
• Effectively target funding;
• Identify and scale successful services;
• Produce program evaluations;
• Cross-reference data with other databases.

“We are pleased to have the opportunity to make a positive impact on those in need of behavioral health treatment in Delaware,” said Nishi Rawat, M.D. and Founder of OpenBeds. As a critical care physician, Dr. Rawat experienced first-hand the frustrations of using inefficient manual processes to locate the proper care for her patients whose conditions she couldn’t treat in the facilities she was serving. “We thank the state of Delaware for this innovative and forward-thinking initiative to take immediate action in this increasingly challenging time of substance abuse and mental health crisis across the U.S. – one that is adversely affecting our communities, families, friends, and neighbors today.”

The OpenBeds platform already has been successfully deployed statewide in Indiana.

-30-

The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

Legislation Includes Creating the Nation’s first Overdose System of Care

NEW CASTLE, Del. – On Monday, Governor Carney joined Lt. Governor Hall-Long, members of the Behavioral Health Consortium, first responders, and advocates to sign three bills into law aimed at fighting the addiction epidemic and saving lives in Delaware. All three bills, HS #1 for House Bill 440,Senate Bill 206 and Senate Bill 225, are first year priorities of the Behavioral Health Consortium‘sThree Year Action Plan.

“Today, Delaware became the first state in the nation to enact an Overdose System of Care to improve our state’s care and treatment for Delawareans and families affected by the opioid crisis,” said Governor Carney. “We strengthened our Prescription Monitoring Program and we encouraged prescribers and patients to consider using non-opioid methods when treating back pain. These steps will help build on our system of support for those families and individuals dealing with the opioid crisis personally or professionally. Thank you to the members of the General Assembly, advocates and law enforcement for their tireless work on this epidemic affecting far too many Delaware families.”

The package of legislation addresses critical gaps identified by Delaware’s Behavioral Health Consortium which will tackle a range of issues including the creation of the nation’s first Overdose System of Care model to better transition individuals after an overdose or crisis from an emergency room setting to more comprehensive treatment for their addiction. Additional legislation also creates better access and education to alternative therapies to opioids and improved data sharing of health information between agencies to better assess and analyze prescribing patterns.

All three bills are year one priorities of the Behavioral Health Consortium, chaired by Lt. Governor Hall-Long.

“The addiction crisis ignores income, race, and geography,” said Lt. Governor Hall-Long.Delawareans deserve a treatment system that works for them when they need it most. With today’s bill signing, Delaware is another step closer to creating a more comprehensive, integrated, and timely treatment system from initial contact with first responders through the entire continuum of care.”

The legislative package received widespread support from many in Delaware’s General Assembly, most of whom see the devastating impacts of addiction in their communities.

“In Delaware, we are blessed to have a small, tight-knit community that can respond quickly to challenges as daunting as the current opioid epidemic,” said Sen. Bryan Townsend. “The bills that we have signed today are the result of that spirit of partnership and cooperation. They are a positive sign for the future of addiction and chronic pain treatment in our state. Our constituents deserve this kind of responsive government and I am as proud to be a part of today’s signing ceremony as I will be to keep the ball rolling next year.”

SB 225 encourages prescribers and patients to consider the use of proven alternative therapies instead of opioids and requires continuing education to prescribers about the risks of opioids and benefits of alternative treatments.

“Few Delawareans have made it through the last few years without being affected by the opioid crisis in some way,” said Sen. Stephanie Hansen. As elected officials, we are duty-bound to respond with every ounce of energy, creativity, and dedication we have to find solutions and make much-needed changes to our system of care, treatment methods, and prescription practices. As we continue to spend long hours poring through the data, news articles, and legislative documents trying to come up with new solutions, I am encouraged to see these bills passed today. They represent the combined efforts of an incredible team of people from all corners of this state and it has been a privilege to do my part in the Senate to get these bills drafted and passed. With the governor’s signature now affixed to these new laws, I am looking forward to carrying the momentum into the 150th General Assembly.”

“Combatting the addiction epidemic takes a collaborative approach, with many stakeholders coming to the table. The legislation we are signing into law today helps to establish wrap-around systems of care for overdose patients, better identify prescribing patterns and support alternative treatments to opioids,” said Rep. Helene Keeley, D-Wilmington South. “I was proud to be the prime sponsor of SB 225, and raise awareness about alternative pain care such as physical therapy and chiropractic care. Delawareans who struggle with back pain deserve all options at their disposal. I hope we can build on this legislation and continue the push for access for alternative pain treatments.”

Last year, nearly 2,000 individuals in Delaware suffered a non-fatal overdose, yet many continued to be prescribed opioids or did not receive treatment for substance use disorder. This prompted the need for SB 206, to better coordinate data sharing between state agencies and the Delaware Prescription Monitoring Program to study overdose data and create recommendations around safer prescribing and best practices.

“It seems like every day we hear about another overdose, another tragic death or another family struggling to beat addiction. Addiction doesn’t discriminate, and our policies should address the wide-ranging impacts of the disease,” said Rep. David Bentz, D-Christiana. “It has been an honor to work with the Behavioral Health Consortium and Lt. Governor Hall Long to address this systematic issue. The bills signed into law today by Governor Carney help continue to move Delaware forward and help the many families that struggle with addiction.”

Dr. Sandy Gibney, an emergency department physician at St. Francis Hospital was a leading advocate for legislation forming the nation’s first Overdose System of Care.

“The importance and impact this legislation cannot be understated, said Dr. Sandy Gibney, St Francis Hospital. “Utilizing the ‘system of care’ approach for substance use disorder and overdose care will ensure that an effective and collaborative statewide treatment and intervention plan will be put in place. The Systems of Care that are already established in Delaware for trauma, pediatric emergencies, and stroke have paved the way for an Overdose System of Care. All have demonstrated to be a highly effective and collaborative method for statewide patient care and treatment.”

Delaware’s first responders are often on the front lines of the addiction epidemic.

“Emergency medical services providers, such as emergency medical technicians and paramedics, are a vital component of the community health care system, said Larry Tan, Chief of Emergency Medical Services Division. “Our experience has demonstrated that leveraging their capabilities in defined ‘systems of care’ can have a significantly positive impact on survival and the quality of life in our communities.”

###

Senate Bill 230 addresses first recommendation of Behavioral Health Consortium’s Action Plan

WILMINGTON, Del. – Governor John Carney on Wednesday signed Senate Bill 230 beside members of the General Assembly, Lieutenant Governor Bethany Hall-Long and the Behavioral Health Consortium, and other mental health and addiction advocates.

“I am proud to sign this bill into law, a concrete step to assist Delawareans dealing every day with mental illness and drug and alcohol dependency,” said Governor John Carney. “This legislation recognizes that mental health and drug or alcohol dependency benefits should be treated the same as medical benefits. Thank you to Lieutenant Governor Bethany Hall-Long for her leadership on this issue with the Behavioral Health Consortium, and to all of the advocates who helped with this legislation.”

Senate Bill 230, also known as Mental Health Parity, is a critical step to eliminating coverage discrimination in Delaware and mandating certain reporting requirements that will allow the state to determine if health insurance carriers and Medicaid managed care organizations are applying treatment limitations which may prevent someone from accessing care for their addiction or mental illness. The legislation will help ensure compliance with the Mental Health Parity and Addiction Equity Act, passed by United States Congress in 2008, in order to ensure fair access to behavioral health treatment and making sure that those who need help can receive it.

“For far too long, people struggling with addiction and mental illness have not been treated fairly when it comes to getting the quality health care they need and deserve,” said Lt. Governor Hall-Long. “That ends now. This legislation is an important step to knocking down the barriers to treatment and eliminating stigma. I am thrilled we are enacting the first recommendation of the Behavioral Health Consortium’s Three Year Action Plan today.”

Lt. Governor Hall-Long, and members of the consortium, worked closely with former U.S. Representative Patrick Kennedy on this legislation.

“I applaud Governor Carney for signing Senate Bill 230, which represents a major step forward in ending coverage discrimination against those with mental health and addiction challenges in Delaware,” said Patrick Kennedy, Founder of the Kennedy Forum. “Make no mistake: This new law will save lives. By forcing health plans to submit proof of their compliance with parity laws, Senate Bill 230 shifts the burden back to insurance companies and away from families in crisis. I would particularly like to thank Lieutenant Governor Hall-Long, whom I worked closely with on this bill, for her outstanding leadership, as well as Representative Bentz, Senator Townsend, and Senator Henry for helping to expand access to treatment.”

Senate Bill 230 requires health insurance issuers to complete an initial analysis, and submit a report to the Department of Insurance and the Delaware Health Information Network.

“Mental health and substance abuse disorders are among the greatest public health challenges that our country and our state face,” said Senator Bryan Townsend, prime sponsor of Senate Bill 230. “It’s important for our entire health care system, from public policy to commercial insurance, to respond to that challenge by demonstrating that we value mental health just as much as physical health and that parity is a standard we take seriously in Delaware. I’m thankful to the Lt. Governor for her advocacy on this issue and to Gov. Carney for signing this bill into law.”

“The Behavioral Health Consortium gives us the opportunity to take a deep dive into Delaware’s challenges as they relate to behavioral and mental health. I thank Lt. Gov Hall-Long for her leadership on these issues,” said Representative David Bentz. “Senate Bill 230 was a collaborative effort that increases reporting of insurance coverage for mental and behavioral health in an effort to help us get a clear picture of the care in our state. Addiction is a disease – like cancer or heart disease – and we should be doing what we can to combat it and help those who struggle.”

Stakeholders, such as the Ability Network of Delaware and NAMI Delaware, were also heavily involved in the passage of this legislation.

“Ultimately, real parity breaks down the final barrier to stigma,” said Carolyn Petrak, Associate Executive Director of the Ability Network of Delaware.  “When insurers cover mental health and substance use disorders in an unbiased measure and those seeking treatment need not weigh the cost maybe then, the barriers that stigma creates start to crumble.”

“Already there is significant stigma about mental health conditions. Only about half of the 1 in 5 Americans affected by mental illness seek treatment each year,” said Anne Slease, Director of Advocacy & Education for the National Alliance on Mental Illness (NAMI) in Delaware. “Overcoming the stigma is a big obstacle. Paying the bill shouldn’t have to be.”

Click HERE for photos from the bill signing.

###

NEW CASTLE (Aug. 14, 2018) – Eight people have died from suspected overdoses in a four-day span across the state causing Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker to alert the community to the wave of deaths and urging people in active use to seek treatment immediately and to carry the overdose-reversing medication naloxone.

“The eight deaths beginning last Friday have doubled the total number of deaths from suspected overdoses this month,” said Secretary Walker, a board-certified family physician. “These deaths have happened in all three counties, to men and women, and to people in their 20s to those in their 50s. This horrific toll shows that no one in active use is immune from the risk of death in our state.”

As of Aug. 13, the Division of Forensic Science (DFS) has reported 16 deaths from suspected overdoses in Delaware this month. Since the start of the year, the total number of deaths from suspected overdoses reported by DFS is 167.

Elizabeth Romero, director of DHSS’ Division of Substance Abuse and Mental Health, encouraged individuals in active substance use in Delaware to see a medical provider immediately, ask police or other first responders for help, or to call DHSS’ 24/7 Crisis Services Hotline to be connected to trained crisis professionals who can discuss treatment options.

“If you are in active use, we urge you to seek treatment immediately,” Romero said. “If you continue to use substances, have the overdose-reversing medication naloxone with you because the risk for death is increased. Our first priority is to reduce harm and save lives. From there, we can connect people to the treatment options that will work best for them.”

In New Castle County, the 24/7 Crisis Services Hotline number is 1-800-652-2929. In Kent and Sussex counties, the number is 1-800-345-6785. Individuals and families also can visit DHSS’ website, www.HelpIsHereDE.com, to find addiction treatment and recovery services in Delaware or nearby states.

Naloxone is available at many Delaware pharmacies without a prescription, or by attending community trainings through Brandywine Counseling and Community Services. The next community training is at 6 p.m. Aug. 27 at Abundant Life Christian Church, 28714 Seaford Road, Laurel. As part of International Overdose Awareness Day on Aug. 29, atTAcK addiction will provide community naloxone training at 6:30 p.m. at Recovery Centers of America at Delaware, 2383 Limestone Road, Wilmington.

If individuals see someone overdosing, they should call 911. Under Delaware’s 911/Good Samaritan Law, people who call 911 to report an overdose and the person in medical distress cannot be arrested for low-level drug crimes.

If a user has ingested fentanyl or a drug laced with fentanyl, time is critical because the powerful opioid quickly affects the central nervous system and the brain. Users often have trouble breathing or can stop breathing as the drug sedates them. If someone is too drowsy to answer questions, is having difficulty breathing, or appears to be so asleep they cannot be awakened, call 911 immediately.

In 2017, about 61 percent of the overdose deaths in Delaware involved fentanyl and 40 percent involved heroin. In many overdose deaths, multiple substances are found in a person’s system during toxicology screens.

Naloxone, the overdose-reversing medication carried in Delaware by community members, paramedics, some police officers and other first responders, can be administered in overdoses involving opioids – fentanyl, heroin or opioid painkillers. Because fentanyl is more potent than heroin or opioid painkillers, multiple doses of naloxone may be needed to reverse an overdose. In 2017, Delaware paramedics and police officers administered naloxone 2,714 times in suspected overdose situations to a total of 1,906 patients.

Overdose deaths continue to increase in Delaware. In 2017, 345 people died from overdoses, up 12 percent from the 308 people who died in 2016, according to the Division of Forensic Science.

-30-

The Department of Health and Social Services is committed to improving the quality of life of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.

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.