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Commission hears requests for treatment, transportation funding in opioid settlement hearing

MONTGOMERY, Ala. — The fourth and final public hearing of the Opioid Settlement Oversight Commission on Monday saw 10 rehab and health organizations give presentations on how to best combat the opioid epidemic, presentations that included suggestions as to how best allocate Alabama’s $270-plus million pool of opioid settlement money.

Among the organizations giving presentations was University of Alabama Health Systems, with Anupam Agarwal, dean and senior vice president for medicine, touting the UAB hospital system’s far reach across the state as a useful tool in reaching Alabamians for treatment, prevention and education initiatives.

Last summer, Attorney General Steve Marshall announced the securement of nearly $249 million in opioid settlement money from several drugmakers and pharmaceutical companies for their role in the opioid epidemic, which in 2020, has led to roughly 140,000 overdose deaths in the United States.

Those funds, which are expected to be paid out to Alabama over several years, will be allocated by lawmakers based, in part, on the recommendation of the Opioid Settlement Oversight Commission.

Given UAB’s status as the fourth-largest public hospital in the nation, along with its extensive network of affiliated health care facilities across the state, Agarwal proposed that an undetermined amount of opioid settlement funds be used to expand services at UAB and its affiliates.

UAB Senior Vice President for Medicine and Dean Anupam Agarwal speaks during a meeting of the Opioid Settlement Oversight Commission.

Among those proposals included expanding UAB’s Comprehensive Addiction in Pregnancy Program to include 12-months of postpartum coverage, whereas now, eligibility for the program ends at birth. Agarwal also proposed a far-reaching initiative to educate health care workers on both opioid use disorder treatments and non-opioid pain management.

“What this proposal will do is facilitate in-person learning sessions, as well as online lectures with clinical educators across the state, and it would incorporate opioid addiction education at all levels of health care,” Agarwal said.

Educating health care workers on non-opioid pain management moves away from treating pain as the “fifth vital sign,” a once dominating principle in the American health care industry where reducing pain was considered to be the number-one priority in treatment. Rising to prominence in the late 1990s, treating pain as the “fifth vital sign” has, in hindsight, been identified as playing a role in the rise of opioid addiction.

Many organizations giving presentations did not ask for any portion of the settlement money, including Find Help, a social care referral network, who instead asked that personal data collected by organizations treating patients using settlement money be properly protected, and not sold to third parties.

Some organizations did ask for funding, however, such as Maximizing Mental Health, whose founder, Kelly Cochran, asked for $150,000 to fund free mental health counseling sessions at 38 schools in Etowah County for an entire year. Others, like the Alabama Council for Behavioral Research, had larger requests: $1 million for additional detox beds, and $1.1 million to expand addiction prevention programs.

Mary Puckett, grants director for New Season, told commission members that a lack of transportation was a significant barrier to treatment for some Alabamians suffering with addiction, and proposed some of the state’s settlement money be used for her organization to partner with Uber Health.

With five treatment centers statewide, Puckett said that $895,000 would be enough to remove the transportation barrier for New Season patients.

“The top two (barriers) are transportation and staffing; one of our clinics has a bus stop, and the rest are just kind of ‘figure it out,’” Puckett said.

“For ways to increase access to care, talking about transportation, we are joining forces with Uber Health to create a partnership to allow the access for patients to be able to get transportation to come to treatment.”

Commission member Kent Davis, commissioner of the Alabama Department of Veterans Affairs, noted that he had observed past success with Uber Health partnerships.

“We actually have experience with Uber Health, the Veterans’ Health Administration uses Uber now to transport patients to VA facilities,” Davis said. “So if you’re looking for a track record, (that) might be a good model to look at.”

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