More on State of the State Proposals – Opioid Epidemic

January 5, 2022

Unlike other areas of the State of the State Briefing Book in which there are fund amounts discussed in relation to specific proposals, the section of the Briefing Book dealing with the Governor’s proposals related to ending the Overdose Epidemic and expanding access to care for New Yorkers with SUD does not include specific funding amounts.  This could be for a variety of reasons having to do with the as yet unspent Opioid Settlement funds and the work (yet to be performed) by the Settlement Fund Advisory Council.

Part I-G: Support More New Yorkers with Stronger Addiction, Suicide, Mental Health, and Domestic Violence Services

The pandemic has occupied the bulk of public attention these past two years, but that has not meant that other critical public health crises have gone away. On the contrary, the economic stress and severe constraints of the pandemic have worsened some of these challenges. Substance use rose in response to the pandemic as a coping mechanism, and New York State drug overdose deaths increased by 33 percent24 during the first year of COVID-19. Roughly 1,700 New Yorkers die by suicide every year, and across the country, depression symptoms were three times as prevalent during the pandemic than before it.25 Additionally, during the first 11 months of the pandemic, calls to the State’s Domestic and Sexual Violence Hotline rose 34 percent over the year before. All the while, the opioid epidemic has continued to plague our state, with thousands of New Yorkers dying annually from overdoses in recent years.

Governor Hochul will initiate a far-reaching set of actions and evidence-based programs to help all New Yorkers struggling with addiction, suicide, mental health challenges, and domestic violence, focused on access and equity for those in underserved communities across the state.

Fight the Opioid Epidemic in New York State Using a Public Health Approach 

To make a push toward ending the opioid epidemic, the State will expand and enhance a public health-style program coordinated by DOH and the Office of Addiction Services and Supports (OASAS) that includes harm-reduction services, health monitoring, and evidence-based community interventions. Programs will include established initiatives such as expanded access to sterile syringes, naloxone, buprenorphine, and other medications used to treat opioid use. 

The State will create a Division of Harm Reduction within OASAS to develop and incorporate harm reduction principles and strategies across the OASAS system of care. This new division, in collaboration with the DOH’s Office of Drug User Health, will implement harm-reduction initiatives that could include:

  1. Expanding naloxone and buprenorphine access by mandating pharmacies to maintain a stock of these medications, 
  2. Invest in fentanyl test strips, opioid overdose prevention kits, safety kits, and resources to prevent individuals from overdosing while alone. and 
  3. Develop a public awareness campaign to prevent overdose deaths in public settings. 

The state will also:

  • create and implement a medication-assisted treatment program for uninsured individuals.
  • expand access to sterile syringes by allowing emergency departments and health departments to provide syringes to individuals who present with signs and symptoms of injection drug use, and

  • Expand Mobile Treatment Services for Opioid Addiction

Governor Hochul will build on this progress and revise the opioid treatment program rules to allow for opioid treatment providers to implement a robust mobile methadone program as a way to reach unserved and underserved communities, further expanding access to life saving medications. Under this proposal, OASAS will strengthen and modernize outpatient addiction programs, including opioid treatment programs (OTP), by taking the following actions:

  • Remove the regulatory requirement that OTP locations must be in contiguous counties
  • Develop guidelines for providing mobile methadone
  • Retrofit existing outpatient mobile treatment units
  • Purchase additional units to provide mobile services
  • Invest in additional telehealth equipment for mobile service providers to expand service capability and access across the State
  • Provide Individuals with Supportive Recovery Housing:  Discussion:  For individuals recovering from substance use disorder, a lack of safe housing or drug-free environments can derail the recovery process, no matter how determined they are to end substance use or reduce harm from addiction. This proposal will direct OASAS to create a voluntary certification process for recovery-supportive housing that provides substance-free environments and mutual support for individuals engaged in the recovery process. Certification would involve inspection, record-keeping, and operational standards for recovery homes. 

Enhance Suicide Prevention in Schools, Homes, and Communities:  To address the mental health crisis among youths and in communities, Governor Hochul will: 

  • Provide Home-Based Crisis Intervention (HBCI) to More Families: 
  • Establish a Mental Wellness Community Workforce: New York State will build on prevention priorities identified for pandemic recovery by establishing a frontline workforce of credible messengers to engage communities on the ground, called the Mental Wellness Community Workforce. This workforce, a community corps of lay personnel trained in mental health, will be certified to provide quality care to New Yorkers who currently have little or no access to mental health care. Using a state-of-the-art Mental Wellness Everywhere Digital Platform, this new workforce will engage with community healthcare providers as well as places of worship, senior centers, and social service agencies to offer personalized treatment options for New Yorkers experiencing depression, anxiety, substance use, and suicide risk. An initial pilot will expand over time to provide timely access to mental health services for far more New Yorkers.