HOUSE OF REPRESENTATIVES

H.C.R. NO.

24

TWENTY-NINTH LEGISLATURE, 2018

H.D. 1

STATE OF HAWAII

 

 

 

 

 

HOUSE CONCURRENT

RESOLUTION

 

 

REQUESTING THE DEPARTMENT OF HEALTH AND THE HAWAII OPIOID INITIATIVE TO ASSESS THE SOCIAL AND FINANCIAL EFFECTS OF LIMITED ACCESS TO PREVENTION AND TREATMENT SERVICES FOR OPIOID AND OTHER SUBSTANCE ABUSE DISORDERS.

 

 

 


     WHEREAS, opioids are a class of drugs that include the illegal drug heroin, synthetic opioids such as fentanyl, and prescription pain relievers such as oxycodone, hydrocodone, codeine, and morphine; and

 

     WHEREAS, while opioids are generally safe when taken for a short period of time as prescribed by a physician, regular use of opioid pain killers, even as prescribed by a physician, can lead to dependence; and

 

     WHEREAS, because opioid pain relievers produce euphoria in addition to pain relief, they are prone to misuse and can easily lead to overdoses and deaths; and

 

     WHEREAS, the Centers for Disease Control and Prevention formally declared an opioid epidemic in 2011; and

 

     WHEREAS, according to the American Society of Addiction Medicine, more than 2,500,000 Americans have an opioid use disorder; and

 

     WHEREAS, the opioid epidemic is the deadliest drug crisis in United States history, claiming more than 200,000 lives, or more than three times the number of United States military deaths in the Vietnam War; and

 

     WHEREAS, in 2016 alone, drug overdoses claimed more lives than motor vehicle accidents or gun violence, and every three weeks the opioid epidemic causes about the same number of deaths as occurred in the September 11, 2001, terrorism attacks; and

 

     WHEREAS, Hawaii is also experiencing the effects of the opioid epidemic, with two hundred seventy-five individuals dying from opioid overdoses between 2012 and 2016 and about two thousand more suffering from nonfatal overdoses; and

 

     WHEREAS, all substance use disorders including opioid use disorders are understood to be chronic illnesses that require a broad spectrum of treatment interventions; and

 

     WHEREAS, the American Society of Addiction Medicine provides a framework for determining levels of care for substance use disorders across six dimensions of functioning and that this framework is an industry standard; and

 

     WHEREAS, the Department of Health has initiated a comprehensive opioid and substance abuse action plan that follows a policy framework and includes stakeholders from a broad array of the community, and that the framework has six workgroups that review and assess the status of the substance abuse prevention and treatment care system and how to improve access and effectiveness; and

 

     WHEREAS, section 321-193, Hawaii Revised Statutes, requires in part that the Department of Health shall:

 

     (1)  Coordinate all substance abuse programs including rehabilitation, treatment, education, research and prevention activities;

 

     (2)  Prepare, administer, and supervise the implementation of a state plan for substance abuse which may consist of a plan for alcohol abuse prevention and a plan for drug abuse prevention;

 

     (3)  Identify all funds, programs, and resources available in the State, public and private, and from the federal government which are being used or may be used to support substance abuse prevention, rehabilitation, treatment, education, and research activities; and

 

     (4)  Encourage and coordinate the involvement of private and public agencies in the assessment of substance abuse problems, needs, and resources; and

 

     WHEREAS, the Legislature seeks to evaluate the current substance abuse system of care in relationship to:

 

     (1)  Specific opioid and other substance abuse prevention and treatment services or providers that could be covered under current healthcare plans;

 

     (2)  The extent of the coverage currently available;

 

     (3)  Target groups that would benefit from expanded or targeted coverage under healthcare plans;

 

     (4)  Limits on utilization, if any; and

 

     (5)  Standards of care; and

 

     WHEREAS, the Legislature believes that sufficient health insurance coverage specifically for persons suffering from substance abuse disorders will prevent the loss of precious lives, ensure that those persons receive needed treatment, and help to eradicate the current epidemic of opioid overdoses in Hawaii; and

 

     WHEREAS, the Department of Health in partnership with other stakeholders involved in the opioid plan is best positioned to continue efforts to examine and report to the Legislature:

 

     (1)  The extent to which opioid and other substance use disorder treatment or services are generally utilized by a significant portion of the population;

 

     (2)  The extent to which insurance coverage for these services are already generally available;

 

     (3)  If coverage is not generally available, the extent to which the lack of coverage results in persons being unable to obtain necessary health care treatment; and

 

     (4)  If the coverage is not generally available, the extent to which the lack of coverage results in unreasonable financial hardship on those persons needing treatment, and on other components of the social and medical care system such as emergency departments; and

 

     WHEREAS, anecdotal evidence suggests that patients currently face a variety of gaps and barriers when seeking insurance coverage for opioid and other substance dependence treatment; and

 

     WHEREAS, the Legislature is concerned that these gaps and barriers may prevent patients from receiving necessary opioid and other substance abuse treatment, resulting in those patients relapsing and suffering fatal or near fatal overdoses; and

 

     WHEREAS, the Hawaii Opioid Initiative found that, in addition to a growing opioid crisis, the State continues to struggle with the negative impacts of other substance abuse problems, including methamphetamine, alcohol, cannabis and tobacco, resulting in high cost to the emergency medical care system; and

 

     WHEREAS, the high medical costs from opioid related overdoses and from the disabling effects of other substance use disorders could be avoided if patients are able to receive sufficient drug treatment in a timely manner; now, therefore,

 

     BE IT RESOLVED by the House of Representatives of the

Twenty-ninth Legislature of the State of Hawaii, Regular Session

of 2018, the Senate concurring, that the Department of Health, through utilization of the current framework of the Hawaii Opioid Initiative’s working groups, is requested to conduct an assessment and provide a report on:

 

     (1)  The extent to which substance use disorder treatment or services are generally utilized by a significant portion of the population;

 

     (2)  The extent to which insurance coverage for these services are already generally available;

 

     (3)  If coverage is not generally available, the extent to which the lack of coverage results in persons being unable to obtain necessary health care treatment; and

 

     (4)  If the coverage is not generally available, the extent to which the lack of coverage results in unreasonable financial hardship on those persons needing treatment; and

 

     BE IT FURTHER RESOLVED that the Department of Health is requested to submit findings and recommendations to the Legislature, including any necessary legislation, twenty days prior to the convening of the Regular Session of 2019; and

 

     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of Human Services, Director of Public Safety, and the Insurance Commissioner, who in turn is requested to transmit copies to each insurer in the State that issues health insurance policies.

 

 

 

Report Title: 

Mandated Coverage; Addiction Treatment; Opioid Dependence; Auditor Study