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Advocates pan Trump effort on opioid crisis

The following article by Rachel Roubein and Nathaniel Weixel was posted on the Hill website October 26, 2017:

Credit: Mandel Ngan/AFP/Getty Images

Advocates for greater opioid treatment panned the president’s long-awaited declaration of a public health emergency, saying they need dollars to fight the epidemic killing tens of thousands of Americans every year.

President Trump’s declaration, promised in August, doesn’t include millions in new federal funding. Nor did it ask Congress to appropriate any new money, and Democrats are calling for tens of billions in more funds.

A robust effort to combat the crisis of deaths from prescription painkillers and heroin requires the requisite resources to fund treatment, prevention and education, advocates and Democratic lawmakers said.

“There is no solution without funding,” said Rebecca Farley David, vice president of policy and advocacy at the National Council for Behavioral Health. “We heard many bold words, now it’s the time to back that up with bold action and funding. Otherwise, those words become empty promises.”

The public health emergency declaration followed more than two months of review by administration officials over what kind of emergency to declare and whether it would come with additional public funding.

Fourteen Senate Democrats and an independent introduced a billWednesday to invest $45 billion to address the opioid crisis.

By contrast, there’s not much left in the public health emergency fund — just $57,000.

After more than two months of delay, with fanfare to a room packed with advocates and lawmakers, Trump said “it is time to liberate our communities from this scourge of drug addiction.”

“We can be the generation that ends the opioid epidemic. We can do it,” he said to long, thunderous applause. His wife, Melania, made opening remarks about people she’s met with an addiction.

In an interim report, Trump’s commission to tackle the opioid crisis called declaring a national emergency its “first and most urgent” recommendation. This could be done, the commission wrote, by using the Public Health Service Act or the Stafford Act.

A member of Trump’s opioid commission — former Rep. Patrick Kennedy (D-R.I.) — had sought the Stafford Act designation, telling The Hill in an interview earlier this month that “as I’ve always said, we need a FEMA-like response for the opioid crisis.”

Funds under the Stafford Act — typically used for natural disasters and terrorist attacks — can’t exceed $5 million, though declaring a “major disaster” frees up more money.

Acting Health and Human Services Secretary Eric Hargan officially signed the public health emergency declaration Thursday.

According to the White House, the action will help agencies “overcome bureaucratic delays and inefficiencies” in the hiring process, expand access to telemedicine, and allow for the shifting of resources within HIV/AIDS programs to help people eligible for those programs receive substance use disorder treatments.

The declaration will also allow the agency to shift around existing sources of funding to help combat the epidemic, but it won’t add any new money.

“In the past, when there have been public health emergencies it was traditional for the White House to say, ‘I am requesting this much money to give Congress a starting point,’ and we don’t have that starting point,” said Andrew Kessler, founder of Slingshot Solutions, a consulting firm specializing in behavioral health policy.

The administration didn’t detail a congressional funding request Thursday, and congressional Republicans did not appear eager to add more money.

“There’s a lot of money in the Cures Act, so I’m not sure money right now is the issue,” Sen. Bill Cassidy (R-La.) told The Hill, referring to the biomedical innovation law that provided $1 billion over two years to address the opioid epidemic.

“Money will become an issue, I’m not sure how much of that Cures Act money is left … maybe authority right now is more important than extra money.”

When it comes to funding, New Jersey Gov. Chris Christie (R) said “that’s Congress’s job.”

“For members of Congress who say where’s the money? I read the Constitution. The money starts with them,” said Christie, who helms the president’s opioid commission. “So they’re going to have to show a commitment to this now.”

Administration officials told reporters there have been ongoing discussions with Congress about securing more money as part of the year-end spending bill, but would not discuss specific dollar amounts.

Sen. John Cornyn (Texas), a member of Republican leadership, said he has not personally heard from anyone in the administration about funding the emergency declaration, and would like to see more details.

“I would hope we would come up with a plan before we start talking about money,” Cornyn told The Hill. “I don’t know what the White House plan is. It is an emergency, I grant them that, but I think we need some more meat on the bone.”

Another advocate said that while he agreed with the vision Trump laid out, it was time for concrete plans with firm due dates.

“Until I see that and until I see that happening and the dates being hit — as a father who lost a child and as a father of four other children and leading an organization, leading the fight to protect Americans all across this country — I’m not satisfied. And no American should be,” said Gary Mendell, the founder and CEO of Shatterproof, a nonprofit dedicated to combating addiction.

House and Senate Democrats said those actions will mean nothing if there’s no additional money to back them up.

“The President’s announcement today does not unleash the financial resources necessary to end this epidemic,” House Energy and Commerce Committee ranking member Frank Pallone Jr. (D-N.J.) and Judiciary Committee ranking member John Conyers Jr. (D-Mich.) said in a joint statement. “This is not the way to fight an epidemic of this magnitude.”

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