A few weeks ago, Capital Tonight discussed why advocates are pushing Gov. Kathy Hochul to declare an addiction public health state of emergency. Since then, calls for her to do so have only grown louder as hundreds of providers, families and members of the Legislature from across the state rallied at the Empire State Plaza on Monday. 

Capital Tonight asked the Hochul administration about her position on calling for such a state of emergency. While spokesman Avi Small didn’t directly answer the question, he did point out that the governor is personally familiar with the tragedies behind the epidemic. 

“As one of the millions of Americans who lost a loved one to overdose, Gov. Hochul is committed to aggressively tackling the Opioid crisis and has invested a historic $2.8 billion in addiction services since taking office. Governor Hochul will continue making smart, responsible investments to address the extraordinary scale of this crisis and deliver support to those who need it," Small said.

In a separate emailed statement, Evan Frost, a spokesman for the state Office of Addiction Services and Supports (OASAS), wrote that the agency recognizes that “we are in the middle of the worst overdose epidemic in history, and are continuing to work with our providers and stakeholders on a series of initiatives to support individuals, families, and communities impacted by this crisis.”

According to Robert Kent, president of Kent Strategic Advisors, former general counsel for the Biden administration’s White House of National Drug Control Policy and former general counsel for OASAS, New York has the resources to tackle the opioid epidemic, but is being held back.

“New York has the most robust treatment system in the United States of America,” Kent told Capital Tonight. “But that network of providers is struggling.”

According to Kent, providers are unable to hire or retain staff, which means they cannot safely serve the number of people they are approved to serve. 

Kent also questioned why the state is only purchasing one brand of naloxone when, he said, there are now multiple versions of the drug on the market, all approved by the FDA. 

But the OASAS argued that currently, Narcan is the only FDA-approved naloxone nasal spray for over-the-counter distribution.

OASAS spokesman Evan Frost continued:

“New York does make multiple formulations available through our partnership with NEXT Distro, including intramuscular naloxone. Earlier this year, OASAS launched a new ordering system for New Yorkers to obtain free naloxone. To date, approximately 70,000 naloxone kits have been ordered through this system, along with 3.2 million fentanyl test strips and 2.9 million xylazine test strips.”

The most important change that Kent is looking for has to do with the state’s 30 or so recovery centers which are urging OASAS and Hochul to “certify” them so that centers may bill for peer services.

Outpatient treatment facilities like Hope House are required to have peers on site, and they can bill Medicaid, Medicare and other insurance for work that those peers do.

Recovery community centers cannot. 

“We have nine peers on staff,” according to Kellie Roe, of Second Chance Opportunities, a not-for-profit organization in Albany that offers people in recovery a range of wraparound services. “Every single person who walks through our doors is assigned a recovery coach. Everyone in housing has a recovery coach. Everyone on our employment contracts has one. They’re a professional cheerleader.”

Certification by OASAS would create another revenue stream for organizations like Second Chance Opportunities. 

“When we moved addiction treatment services into Medicaid Managed Care, it opened up the opportunity to license entities, such as recovery community centers, which would then allow them to bill for services provided by their Certified Peer Recovery Advocates,” said Kent, who works with Second Chance Opportunities.

In the same emailed response to Capital Tonight, OASAS stated that there are avenues by which certified recovery centers can be paid for peer counseling, though certification is not currently available under existing regulation.

“There is no existing regulation to certify recovery centers. However, recovery centers are able to be designated now to bill for Community Oriented Recovery and Empowerment (CORE) services, which include peer services for people who are covered under a Health and Recovery Plan (HARP),” wrote OASAS spokesman Evan Frost.

But Kent argues that HARP is a very limited program that only offers services to the most needy who are already engaged in treatment.

“OASAS could choose to create a regulation to certify recovery centers which would open the door to serving more people and saving more lives,” he told Capital Tonight via email.

Another recommendation Kent says will prevent overdoses is an investment in Overdose Prevention Centers (OPCs), also called Safe Injection Sites. 

The Opioid Settlement Board pushed to have some of the settlement cash fund OPCs, but OASAS denied that recommendation since the centers are illegal under federal law.  

Kent responded by saying, “They ignored federal law for marijuana!  States, like Rhode Island, are moving forward with OPCs and they are using opioid settlement funds to support the work.  If they are challenged with the legal argument that it violates federal law, they will argue that they exercised their police power which is protected by the US Constitution as a power preserved to the states and will likely win any such challenge.”

The legislative session begins in two weeks.