Representing prevention, treatment and recovery, staff members at Goodwin Community Health met with Governor Maggie Hassan Monday for a substance abuse roundtable.

Hassan, a Democrat, outlined the state’s efforts to address the substance abuse epidemic and mentioned several times the importance of reauthorizing the New Hampshire Health Protection Program (HPP), also known as Medicaid expansion.

Hassan said the good news is many more people are now covered and community health centers like Goodwin may be able to do even more community care and outreach as a result.

Hassan said HPP has been very successful, in particular by reducing cost shifting from the uninsured to businesses and those with insurance.

“We have more than 40,000 Granite Staters now covered,” Hassan said. “We have seen a decrease in uncompensated care and a decrease in visits by the uninsured to the emergency room.”

Janelle Levein, an RN and director of quality improvement, agreed. “It opens doors and saves lives, we had about 40 percent uninsured rate and now it is down to 29 percent.”

Hassan said she has also been focused on the HPP because of its close connection to substance abuse.

“It is truly our most pressing public health and safety problem in the state right now,” Hassan said. “I could go into any room in the state with more than two people and ask ‘do you know anybody affected by substance abuse’ and hands will go up.”

Hassan said the state needs a multi-pronged approach with more treatment beds.

“What I hear from treatment providers right now is that before they will make the capital investment to expand their capacity they want to know that the program is going to continue,” Hassan said. “For more treatment beds, the most important thing we can do is reauthorize expansion.”

Hassan said reauthorization means tens of millions of federal dollars coming into the state that would signal to providers that we are in it for the long haul.

Some of the most important voices supporting reauthorization, Hassan said, come from the law enforcement community.

“Our law enforcement agencies have been clear, we cannot arrest our way out of this problem,” Hassan said. “Without treatment they see the same people over and over again.”

Hassan’s senior director for substance misuse and behavioral health, whose position is funded by the New Hampshire Charitable Foundation, John Wozmak has come forward with his first set of recommendations.

Hassan said Wozmak’s primary focus is on reauthorization of HPP, making access to Narcan easier, expanding access to treatment, strengthening the provider network, taking the drug court models statewide.

Melissa Silvey, director of public health prevention at Goodwin Community Health, said Strafford County’s Opioid Task Force is probably the longest-running program aside from the state’s own drug task force.

“We were the first to successfully get Narcan through pharmacies and to set up Narcan training for caregivers. We have three very active support groups in the area,” Silvey said. “Goodwin is trying to help caregivers get the Narcan overdose kits.”

Silvey said despite the changes to state law it is still very difficult to get Narcan into the hands of the people who need it. She urged the governor to help iron out the challenges created at the state level.

Dr. Joann Buonomano added that the hospitals do not have an effective way to treat overdose patients, equating it to a suicide or other near death experience.

“In the emergency room they are sent home the same day, there is no bed available and the next day they are at our offices'” Buonomano said. “But we do not have the staff and resources to handle them.”

Dr. Kevin Zent pointed out that although there is a registry now to curb the misuse of prescription drugs, the states do not yet share information and the border is just down the street. Hassan said changes were made to state law this year that will allow data to be shared but it will not happen overnight.

Hassan urged the group to contact their state legislators to let them know how the substance abuse impacts communities.

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