CANDIDATE SURVEY – THE SEQUEL

In years when one, or both, houses of the state Legislature are up for election, NCAARBH conducts a survey of the candidates on issues of addiction and recovery policies. This year 58 candidates responded to the questionnaire, the highest number ever. In an earlier Blog, I analyzed the answers from the candidates who participated. This Blog reviews the responses from the 38 who were elected. Of the 38, 20 are Democrats, while 18 are Republicans. Note: Not every respondent answered every question. Further, of the 38 respondents who were elected, 35 are incumbents. Finally, of the 38, 24 were elected to the Assembly and 14 were elected to the Senate. Of the 38 winning candidates:

·        32 believe substance use disorders are preventable and treatable chronic illnesses

·        32 would support adequate funding of treatment and recovery services

·        23 would support a review of the state’s drug laws with an eye toward reform

        On Decriminalization

·        9 would support the decriminalization of all low-level drug use, possession and sales

·        7 would support the decriminalization of all low-level drug use and possession, but not sales (a                 number indicated a need for an exception for minors)

·        11 do not support the decriminalization of all low-level possession of drugs

·        11 are undecided and would like to learn more

               A sizable majority of respondents would support certain initiatives to help individuals in their recovery,                including:

·        28 endorse continued criminal record expungement reform

·        29 endorse tax credits for employers who hire people in recovery

·        26 believe in enhanced financial aid and program assistance to communities disparately impacted             by the War on Drugs

·        35 would reduce court-ordered fees and fines for persons who successfully complete a treatment or         diversion program

·        38 would support an expanded use of peer recovery services

        A significant majority of questionnaire respondents would support sufficient government funding            to expand the use of naloxone to reverse a drug overdose:

·        27 on public transportation

·        23 in public libraries

·        29 on college and university campuses

·        32 in homeless shelters

          A further majority endorse:

·        33 mandating that every pharmacy maintain a minimum supply of an opioid overdose reversal drug

·        38 authorizing EMTs to dispense naloxone

·        22 requiring a supply of naloxone in other public spaces, e.g. stadiums, arenas, theaters, etc.

 You can view the answers of any of the state legislative candidates to our Election Questionnaire here

 

SURVEY SAYS...

 

In years when one, or both, houses of the state Legislature are up for election, NCAARBH conducts a survey of the candidates on issues of addictions policies. This year, all 120 seats are up in the NJ Assembly and Senate,, and the candidates were mailed the questionnaire in mid-August. It is intended to gauge general policy inclinations rather than pinpoint support or opposition for specific legislative proposals. It also serves as an introduction for some as to the concerns of the behavioral health community.

 

NCAARBH neither endorses candidates for office nor contributes donations to political campaigns. A candidate’s response is scanned and posted on our website. The remarks are not critiqued nor given a grade or rating. The 2021 NJ Assembly and Senate Addiction Prevention, treatment and Recovery Survey is designed to assist voters in comparing candidates’ positions on drug dependence-related public policies.

 

Of the 57 candidates who responded to our survey: (Not all respondents answered every question)

 

·         48 believe substance use disorders are preventable and treatable chronic illnesses

·         53 would support adequate funding of treatment and recovery services

·         42 would support a review of the state’s drug laws with an eye toward reform

 

On Decriminalization

 

·         13 would support the decriminalization of all low-level drug use, possession and sales

·         16 would support the decriminalization of all low-level drug use and possession, but not sales

A number indicated a need for an exception for minors.

·         17 do not support the decriminalization of all low-level possession of drugs

·         15 are undecided and would like to learn more

 

A sizeable majority of respondents would support certain initiatives to help individuals in their recovery, including:

 

·         41 endorse continued criminal record expungement reform

·         47 endorse tax credits for employers who hire people in recovery

·         40 believe in enhanced financial aid and program assistance to communities disparately impacted by the War on Drugs

·         52 would reduce court-ordered fees and fines for persons who successfully complete a treatment or diversion program

·         55 support an expanded use of peer recovery services

 

A significant majority of questionnaire respondents would support sufficient government funding to expand the use of naloxone to reverse a drug overdose:

 

·         37 on public transportation

·         34 in public libraries

·         47 on college and university campuses

·         48 in homeless shelters

A further majority endorse:

·         49 mandating that every pharmacy maintain a minimum supply of an opioid overdose reversal drug

·         55 authorizing EMTs to dispense naloxone

·         33 requiring a supply of naloxone in other public spaces, e.g. stadiums, arenas, theaters, etc.

 

My next blog will be after Election Day (Nov. 2, 2021) in which I’ll analyze the questionnaire answers given by the winning candidates.

To view the answers of any of the state legislative candidates to:

2021 Candidate Surveys

The level of candidate participation in the Survey, along with the deeper understanding of the complexities of the addiction problem is encouraging. The acknowledgement among a sizable majority of legislative candidates, that a sickness is better treated than punished, and that this approach requires a commitment of resources, gives advocates a foundation from which to work.

WHEELS WITHIN WHEELS

 

Any good lobbyist will tell you your proposal is doomed to fail, regardless of what your issue is. It’s simple math. Approximately 10,000 bills are introduced in to a typical two-year term of the NJ Legislature, with a few hundred making it through the legislative process and signed by the governor. King Minos in ancient Crete ordered the building of a labyrinth to keep the Minotaur (or anyone else who entered) from ever exiting unscathed at the other end. One sees the regal hand of Minos in the design of the legislative abattoir/maze that must be traveled in order to experience the realization of a recommended public policy.

This is what impresses when reviewing the many measures that have, either moved a considerable way through the legislative process, or been enacted, just in the past few months dealing with behavioral health and recovery. Prior to the Legislature’s summer recess, a number of these bills either got closer to the finish line, or actually made it across. These included:  

·         S.2953/A.4785 – Provides reentry services for prisoners being released from county jails, and removes the eligibility ban on General Assistance benefits for individuals with drug distribution convictions – On the Governor’s desk

·         S.3801/A.5597 – Authorizes school districts to conduct student health surveys – Enacted

·         A.5703/S.3800 – Mandates health insurance coverage for naloxone without prior authorization requirements – Enacted

·         A.5457/S.3491 – Permits anyone to administer or distribute naloxone – Enacted

·         S.3802/A.5595 – Naloxone placed on the Division of Consumer Affair’s retail price list – Enacted

·         S.3867/A.5868 – Dedicates pharmaceutical litigation settlement monies toward drug prevention and treatment programs – On the Governor’s desk

·         A.970/S.2259 – Establishes a Mental Health Screening in Schools Grant Program – Enacted

·         S.2559/A.4200/A.4179 – Mandates insurance reimbursement rates for telemedicine be on a par with those for in-person visits – On the Governor’s desk

·         A.4221 – Requires the Office of Information Technology to establish a centralized, one-stop website resource guide to assist persons in navigating the state’s mental health and substance use disorder service systems – In Appropriations Committee

·         A.5507/S.3319 - Eliminates certain monetary penalties for juveniles in the criminal justice system, including: the Drug Enforcement on Demand (DEDR) fee, and the costs of an approved remedial education or counseling program to which the juvenile is diverted – Passed the Senate, in Assembly Appropriations Committee

·         S.52/A.798 – Establishes Drug Fatality Review Boards in each county – Passed the Assembly, on the Senate Floor, then back to the Assembly Floor for concurrence

·         A.1919/S.250 – Prohibits landlords from discriminating against tenant applicants with a criminal history – Enacted

·         A.5641/S.3658 – Eliminates mandatory minimum sentence for a non-violent offense – Conditionally vetoed

·         A.2649/S.892 – Mandates training in behavioral health issues for nursing home staff – On Assembly Floor, in Senate Health Committee

·         A.5754 – Requires the Department of Corrections to issue an annual report to the Legislature on a number of items, including the number of prisoners with behavioral health disorders – Passed the Assembly, in Senate Law and Public Safety Committee

·         S.3493/A.5458 – Legalizes possession and distribution of syringes – Passed the Senate, in Assembly Judiciary Committee

·         S.3400/A.5052 – Authorizes EMTs to dispense naloxone – On Assembly Floor, in Senate Health Committee

·         A.275/S.1112 – Reduces court-ordered fines for anyone successfully completing a drug treatment or diversion program – Passed the Assembly, in Senate Judiciary Committee

·         S.3009/A.4847 – Expands the number of needle exchange programs in the state – In Senate Budget Committee, in Assembly Health Committee

·         A.4901/S.3065 – Permits syringes to be mailed – In Assembly Health Committee, on Senate Floor

·         A.5565 – Establishes a Behavioral Health Crisis Mobile Response project – In Appropriations Committee

A Life Sentence: Rory’s True Story

 I walked up to the window at the county jail and asked if my son could use his knee brace in the jail. The guard answered with absolutely no emotion, “WE TAKE EVERYTHING!” I walked away thinking, no truer words have ever been spoken. My son turned himself in and all the way home all I could think of was the guard’s words and the nightmare of a journey we had been on.

    

My son’s involvement with criminal justice began a week after his 18th birthday. He was charged with 3rd degree possession that led to years of probation violations for positive drug tests and more non-violent possession charges for his personal use. He was trapped in a punitive system that did far more damage than good. Years of the same mandatory treatment for substance use never addressed the underlying issues that ultimately lead him to self-medicating.

In the beginning, like many families, I had hoped that accountability and forced treatment would result in recovery. What happened was the opposite. He became an outcast in our community and most of the family was angry because his struggle to find recovery affected how they were judged in the community. Every failure to get well was criminalized which made him cope the only way he knew how, more substances.

He was diagnosed with ADHD and bi-polar disorder in his teens, but the only treatment focus was on his substance use. No one discussed medications with him or re-evaluated him while on medications in his 11 years in the system. Addressing trauma from jail and prison and the 40 friends and acquaintances he lost was never part of any treatment plan. No one talked about his multiple overdoses and asked him if he ever wished he would die to escape the pain.

At 29 years old, he was not permitted to leave the state since he became an adult. No vacations, no job opportunities in other areas, missing grandparents’ funerals, etc. 

He wanted to be a commercial fisherman since he was 6 years old, but it is a field that can be high risk for individuals with substance use disorder, so it was not allowed. Instead of treating the underlying issues and using his passion as a motivator to stay well he was denied the only thing he ever cared about, leading to debilitating depression and punishment for being unable to function and meet court requirements. Non-compliance was a violation, punished by MORE treatment or prison.

Mental health symptoms got worse over the years, despite going to approximately 20 treatment programs. His hopelessness and overwhelming grief for the life he dreamed of since he was a young boy fills me with sadness.  The system imprisoned him for the last 11 years!  

And now it has taken him from me.  My dynamic and hysterically funny son, with a generous heart, recently lost his battle with mental health and substance use disorders.  When Rory sought help for his disease, he instead received punishment.  Rather than criminalizing his illness, a more refined and caring treatment response might have helped our family avoid this unspeakably tragic loss.

Tonia Ahern

Mother and Advocate

A Woman’s Recovery

 

One of our Advocacy Leaders, Melissa O’Mara, recently described her on-going recovery efforts in a C4 Recovery Solutions podcast.  She discussed the assistance she received from NCAAR’s Substance Abuse Initiative (SAI) program and how she has dedicated her career toward helping others seeking to attain and maintain long-term recovery from addiction.

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I’m twenty-eight years old. I grew up in Hackettstown, New Jersey, which is in Warren County. I currently live in Burlington County, New Jersey. And I’m an assistant prosecutor and have been since September of 2018. I’m a person in long-term recovery from drugs and alcohol since August 30^th of 2011. I basically got involved with C4 before I even knew that I was involved with C4 based on their participation in building a program in the state of New Jersey, which got me on the path to recovery.

 

In 2011, I was living in homeless shelters, living on the street, bouncing in and out of treatment for my drug use, and I was visiting the local welfare office in Warren County, New Jersey, where I grew up, trying to get services. And at that time, they said they had a program that was for women who had substance use disorders who were seeking treatment. And I, at first, was hesitant. But they linked me up with the individual who was to be my guide through this program that they had implemented in the welfare offices. And when I was ready, he helped me get into treatment. And I think, during that time, I was in a really acute phase of my addiction. I was using heroin and cocaine, IV drug use on a daily basis. I was not employed. I was unemployable. I was going to college at the time, but because of my use, the college was on the verge of kicking me out. And my family had completely disowned me. So, the only people that were on my side at this time was the individual who I met within the welfare office.

 

When I showed up unannounced on their doorstep on August 28^th of 2011 and told them that I wanted to go to treatment for the umpteenth time and that I didn’t want to live—because the night before, I tried to kill myself—instead of just shooing me away like many others at that point were, because I was an individual who bounced in and out of treatment, they – they really didn’t look at me like a burden on society and they said, “We know what you’re facing. We know what you’re going through. And we have a treatment for that issue if you’re willing to take it at this time.”

So, I ended up entering a detox facility. Actually, funny timing. During the time that I actually went into treatment through SAI, it was during Hurricane Irene in New Jersey, and the treatment center I was going to was underwater. But I still was connected to detox, still got there, and then went right into a thirty-day program, continued into a halfway house, and eventually made my way into sober living. So, I sailed right through. And as I had discussed earlier, I had never done that before. I was that person who was in the revolving door of detox, IOP, just never being able to get a continuum of care or get the services that I required.

 

What made me go back when I finally did want help was that they were kind to me. They were understanding. Something that was different this time, because I had been to many treatment programs, both long-term adolescent treatment, other outpatient services before, this time, instead of going just to detox and being released or going just to inpatient and being released, I was met with a continuum of care. So, I went from the SAI office to a detox, to an inpatient program, to a halfway house, to a sober living house, which really stepped me down and reintegrated me into the community and really helped me rebuild the skills that I didn’t have, because I never had them, because I was a teenager and never developed them. And then, really put me on a path where, once I was in remission from my substance use disorder, I was able to get back successfully into college, resume my classes, figure out who I was as a person, and figure out what I wanted to do and who I wanted to be, which, eventually, I realized I wanted to go into law enforcement. I wanted to work with people who were in my position, specifically with women who might not have the financial resources available to them when facing addiction.

 

In 2011, there was nothing available, really, besides for this program. County funding was scarce. I really was trying to navigate a system that I didn’t understand. So, even if there were services out there, I wasn’t getting connected to them. And that’s why I think having the service in the welfare office was so powerful, because that’s where I ended up. I wasn’t being offered any services when I encountered law enforcement. I wasn’t being given any services by anybody else within the community at that time. So, this really had a direct impact and kind of got me at a point where they could intervene face-to-face.

For me, having NCADD [now NCAAR-BH] there and the staff within the welfare offices really had an impact on me being able to move forward with my life, because of their compassion and their understanding of addiction, so much that not only did I want to contact them as I went through the process early and treatment, but to this day I have the business card of that counselor who put me in to that treatment back in 2011. And so, after five years, I called him and thanked him for being there in that welfare office and giving me the ability and the opportunity to recover. And then, you know, almost ten years later, I didn’t want to throw it away, because it meant so much to me for someone who understood and cared to be there.

 

The general public as well as, you know, the community really had a misunderstanding of substance use disorders. And, really, my view of how I was treated was that it was my moral failing. And I think, over time, as well as getting into recovery, I really was able to see a shift in the beliefs of my community and even the state of New Jersey and the organizations within it, because we’ve really moved to this addiction-as-a-disease model and that people who have the disease of addiction are not just people who are choosing to use, but really have these underlying conditions that are preventable and treatable. And so, that kind of growth has been really helpful.

 

The biggest impediment that I see to those women out there with children is really services for women and women with children, they’re hard to access. These barriers pop up. And without somebody being able to assist in overcoming those barriers, women are deterred from getting recovery. So, having a program like this is something that will help women across the board, no matter where you stand in your life.

 

I think my experience going through addiction and being in recovery has made me a better law enforcement officer, has made me a better prosecutor. SAI changed my life and put me in a place where I had the ability and opportunity to recover. I’d been given many chances to recover before, but I wasn’t presented the opportunity with the actual backup of the services to actually successfully do that.

 

Melissa O’Mara

Advocate Leader

A CRISIS WITHIN A CRISIS

 

On March 18, 2021 NCAAR-BH Policy Analyst, Ed Martone, submitted remarks on the proposed Fiscal Year 2022 State Budget to the Senate and Assembly Budget Committees, as follows:

 

Thank you for the opportunity to address our comments on the proposed FY 2022 State Budget.

 

The National Center for Advocacy and Recovery for Behavioral Health (NCAAR-BH) (formerly the National Council on Alcoholism and Drug Dependence - New Jersey (NCADD-NJ) is a New Jersey-based incorporated, private non-profit organization. NCAAR-BH enjoys an expertise in public policy and education, care coordination, and recovery leadership. Its goal is to advance the implementation and maintenance of a recovery-oriented system of care for individuals struggling with addictions.

 

The coronavirus has made a ruin of our health and economy. Prior to the COVID-19 pandemic, the Garden State was gripped by an epidemic of opioid use resulting in a troubling rise in overdoses caused in part by the introduction, and acceleration, of fentanyl to the state's illegal drug supply.

 

Stresses related to the COVID-19 crisis, such as economic strains, as well as pandemic-related isolation and other factors hindering treatment and support for individuals with substance use issues, have contributed to the current rise in drug and alcohol misuse, relapses, and overdoses.

It has been reported that a little over 3,000 lives were lost in 2020 due to drug overdoses. In this January and February, another 540 people succumbed to drug overdoses.

 

The NJ Legislature has for years understood that addictions are health matters and ought to be dealt with as such. Governor Phil Murphy's proposed Budget builds upon the refinement in policy that has been the foundation for the Legislature's, and his, approach to this crisis. The lens through which every proposal should be seen is: How will this assist folks in attaining, and maintaining, long-term recovery?

 

It is our view, that a number of proposals put forth in Governor Murphy's State Budget are deserving of your support.

*        Enhancement of the availability of the overdose reversal drug, naloxone

*        An additional $1m for harm reduction projects

*        $6.8m to end the General Assistance benefits ban for certain drug offenders

*        An additional $9m in the N.J. Dept. of Labor for its Pathways to Recovery Initiative to provide support and training to participants who have become separated from employment due to the opioid crisis

*        $1m to expand County Drug Overdose Fatality Review Teams statewide

*        $1.3m to implement a single license for integrated primary and substance use disorder treatment Thank you for your consideration.

 

Respectfully submitted,

 

Edward Martone

Policy Analyst

 

COVID – 19 RELIEF PACKAGE

 

COVID – 19  RELIEF  PACKAGE

(based on information from the Natl. Assoc. for Addiction Professionals)

 Last month, with the 116^th Congress drawing to a close, lawmakers passed comprehensive government spending legislation that provided $900b in coronavirus stimulus funds. After a prolonged, insensible delay, President Trump signed the bill into law. The spending package extends funding for federal agencies through Sept. 30, 2021, allocates spending increases for programs at the Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA), and provides $4.25b in emergency monies for substance use disorder and mental health programs.

The package allotted investments in both addiction infrastructure and programs, including:

* Substance use treatment: $3.8b, an increase of $17m, including continued funding for opioid prevention and treatment, including:

_ $1.7b for Substance Abuse Prevention and Treatment Block Grant; and

_ $1.5b for State Opioid Response Grants.

* Substance use prevention: $208m, an increase of $2m.

 Health Workforce: $1.2b, an increase of $30m, for HRSA’s Bureau of Health Professions programs, including:

_ $112m for the Behavioral Health Workforce Education and Training (BHWET) program, a $10m increase that also includes an allocation of $13m for community based experiential training for students preparing to become peer support specialists and other types of behavioral health-related paraprofessionals;

_ $29.7m for the Mental and Substance Use Disorder Workforce Training Demonstration program, with the $3m increase being allotted for new grants to expand the number of nurse practitioners, physician assistants, health service psychologists, and social workers trained to provide mental and substance use disorder services in underserved community-based settings.

_ $16m for the Loan Repayment program for Substance Use Disorder Treatment Workforce, a $4m increase; and

_ $16.1m for Minority Fellowship Programs, a $2m increase.

 

The bipartisan COVID-19 relief portions of the spending package also includes an additional $4.25b in emergency funding for substance use and mental health programs above and beyond regular Fiscal Year 2021 spending, including the following:

_ $1.65b for the Substance Abuse Prevention and Treatment Block Grant.

_ $1.65b for the Community Mental Health Services Block Grant, with no less than half of the monies directed to behavioral health providers.

_ $600m for Certified Community Behavioral Health Clinic (CCBHC) Expansion Grants to be allocated by SAMHSA.

_ $240m in emergency grants to states.

The relief package also includes the following provisions:

* Provider Relief Funds: Allots an additional $3b for hospitals and health care providers. It also directs HHS to allocate not less than 85 percent of unobliged funds in the Provider Relief Fund through an application-based portal to reimburse providers for financial losses incurred in 2020.

* Community Mental Health Services Demonstration: The bill extends a series of programs funded by the Centers for Medicare and Medicaid Services (CMS), including the Certified Community Behavioral health Clinics (CCBHC’s) Medicaid demonstration, until Sept. 30, 2023. CCBHCs are designed to provide a comprehensive range of mental health and substance use disorder services to vulnerable individuals.

* Telehealth: Expands access to telemedicine services in Medicare to allow beneficiaries to receive mental health services via telehealth. It also appropriates monies for telemedicine and broadband grant programs.