Ohio Health Policy News

HPIO scorecard explores Ohio efforts to address addiction in the criminal justice system

The Health Policy Institute of Ohio has released the third in a series of inventories and scorecards analyzing Ohio's policy response to the addiction crisis and outlining areas where the state could be more effective.

The new report, "Ohio Addiction Policy Inventory and Scorecard: Law Enforcement and the Criminal Justice System," provides policymakers and other stakeholders with the information needed to take stock of Ohio's policy response to addiction within the law enforcement and criminal justice sectors.

Key findings include:

• Progress toward evidence-informed policies. Ohio is beginning to move in the right direction by embracing evidence-informed policies, such as Crisis Intervention Teams and specialized dockets, that address addiction in law enforcement and criminal justice settings.
• Systemic issues in the criminal justice system. National “tough on crime” policies have resulted in high rates of incarceration for addiction-related offenses. In addition, historically discriminatory criminal justice practices have disproportionately impacted communities of color. More can be done to reduce the number of people with substance use disorder in the criminal justice system, decrease spending on incarceration and improve outcomes for Ohioans struggling with addiction.
• Gaps in data and information. Policymakers do not have the information they need to comprehensively address addiction and inequities in the criminal justice system because of significant gaps in data collection, analysis and evaluation.

In 2018, HPIO released scorecard reports on prevention, treatment and recovery and overdose reversal and other forms of harm reduction. Future reports will address children's services and data and evaluation.

In recent years HPIO has created several tools for policymakers to address the addiction crisis. Addiction-related data was also included in HPIO's Health Value Dashboard.

DeWine: State, local governments close to unifying in opioid lawsuits

Ohio’s local governments are moving toward joining the state in jointly negotiating settlements of lawsuits filed against opioid manufacturers and distributors (Source: “DeWine: State, locals unifying to negotiate opioid settlements,” Columbus Dispatch, Oct. 23, 2019).

“There’s a growing consensus that if we present a united front, we can maximize the (settlement) money and put us in a much better bargaining position,” Gov. Mike DeWine told the Columbus Dispatch.

DeWine and Attorney General Dave Yost met for more than three hours Wednesday at the Governor’s Residence in Bexley with about 100 lawyers and elected officials representing cities and counties seeking damages stemming from the opioid crisis born in the proliferation of prescription painkillers. Another meeting is scheduled for next week.

Ohio bill aims to free psychiatric beds for potentially violent patients

Ohio is taking steps to change how the 1,100 beds in the six state-owned psychiatric hospitals are filled — in part to assure there is room available for those threatening gun violence (Source: “Ohio lawmakers look to free up state psychiatric beds,” Dayton Daily News, Oct. 23, 2019).

The Ohio Senate voted 30-1 in favor of Senate Bill 58, which is included in Gov. Mike DeWine’s 17-point plan to address gun violence.

Currently, a large portion of the high-security beds are occupied by people facing non-violent misdemeanor criminal charges who need to be restored to mental competency. The DeWine administration wants to give courts the ability to send non-violent defendants to step-down facilities for treatment when appropriate, leaving the secure beds for violent patients.

The bill now moves to the Ohio House for consideration.

Involuntary commitment in DeWine gun plan sparks calls for more capacity, planning

A provision of Gov. Mike DeWine’s gun safety plan that would allow 72-hour commitments of people with serious drug and alcohol problems is prompting worries about effectiveness and capacity (Source: “More capacity, planning needed for involuntary commitments in DeWine gun bill, groups say,” Columbus Dispatch, Oct. 8, 2019).

Gov. Mike DeWine’s proposed gun legislation was light on new regulations that limit how people can keep or sell guns. But it greatly expanded the number of people who can be deprived of their freedom for up to 72 hours because of serious drug or alcohol problems.

A spokesman for the Ohio Hospital Association said the facilities’ emergency departments should have the capacity for such commitments. But the group that represents Ohio’s 88 county drug and mental health agencies says those resources are already strained. And, the group’s leader said, state officials have to plan for care well beyond 72 hours if they want to make a meaningful impact on the lives of those who might be committed.

In presenting his plan, DeWine said he would only propose measures he thought would be effective in reducing gun violence and that he believed the legislature would pass. In doing so, he dropped universal background checks for all gun sales and a “red flag” provision, which would allow a judge to order the temporary seizure of a person’s weapons if the person is judged to be a danger.

Ohio AG to fund projects to combat opioid addiction

 

Ohio Attorney General Dave Yost is using $1.6 million in settlement funds from various lawsuits to underwrite a pair or projects to address Ohio’s addiction crisis, which only last year began to show signs of easing  (Source: “Attorney General Dave Yost seeks DNA markers underlying opioid addiction,” Columbus Dispatch, Oct. 3, 2019).

One study aims to find a genetic marker that could make people more prone to opioid addiction. The study will seek DNA cheek-swab samples from up to 1,500 emergency room patient volunteers at Ohio State University’s Wexner Medical Center and the University of Cincinnati Medical Center. Patients confidentially will be asked about factors associated with addiction and their use of opioids, with DNA testing to look for 180 genetic markers suspected of association with opioid addiction.

Yost also announced the creation of a task force of medical, pharmacy and other health experts to identify and develop new addiction prevention techniques.

Ohio to spend $4.1 million to combat youth e-cigarette use, feds mull banning all vaping products

The Trump administration and the Ohio Department of Health both shared new plans to reduce youth vaping, amid an urgent public health investigation into 450 cases of lung illness across the U.S. associated with e-cigarettes (Source: “Ohio to spend $4.1M on initiatives aimed to fight youth vaping,” Dayton Daily News, Sept. 11, 2019).

Dr. Amy Acton, director of the Ohio Department of Health, announced $4.1 million in new initiatives to prevent youth vaping. President Trump said Wednesday that his administration is working on a plan to ban all non-tobacco-flavors from vaping products.

State and local public health officials in Ohio have confirmed that 10 reports of severe pulmonary illness are likely due to vaping and are investigating an additional 14 reports of illness. In 33 states, the CDC says that it’s aware of more than 450 possible cases of severe pulmonary illness after vaping and six deaths.

The DeWine administration has already worked on several initiatives to curb teen vaping. This includes raising the purchase age to 21 starting Oct. 17 and placing an excise tax on e-cigarettes, which in the past were not subject to an excise tax. Raising the price of tobacco through an excise tax is an evidence-based way to reduce consumption.

Medical Board rejects medical marijuana for autism, anxiety

The State Medical Board of Ohio this week opted against allowing Ohio medical marijuana for people who suffer from anxiety and autism spectrum disorder  (Source: “Board rejects Ohio medical marijuana for autism and anxiety, sides with traditional medicine,” Associated Press via Cleveland Plain Dealer, Sept. 11, 2019).

The public will get another shot at trying to add ailments to the list of qualifying conditions when the next window for petitions opens, Nov. 1 through Dec. 31, said Dr. Michael Schottenstein, president of the medical board.

However, Schottenstein has also said that once a condition is added to the list, it cannot be removed. That’s the medical board’s reading of the state’s medical marijuana law.

The board hasn’t asked the legislature to change or clarify the law to give it the power to remove a condition once cannabis is proven ineffective or harmful for it.

ODI appeal process recovers millions on health insurance claims

More than $21 million in previously denied health care benefits and services to Ohioans has been recovered through an appeals process started by the Ohio Department of Insurance nearly two decades ago (Source: “Patients denied benefits, services by health insurers are using appeal process to recover millions,” Columbus Dispatch, Aug. 26, 2019).

Patients can initiate an appeal by contacting the health insurance company. If the company doesn’t agree to overturn the decision, the patient can start the external review process.

If the provider’s decision doesn’t involve a medical judgment, the request is sent to ODI. If the decision involves a medical judgment, the request goes to an independent review organization for consideration by a medical professional.

In Ohio in 2017, 514 cases involving over $6.3 million in health care benefits and services were submitted for independent review. The insurance companies’ original decisions were reversed in 36% of the cases, saving consumers $1.17 million, according to ODI.

ODI has created a document titled How to Appeal a Decision by Your Health Plan Issuer to explain the process.

Medicaid OKs Ohio plan to reduce lead in homes

Medicaid approved a plan this week that will remove hurdles and expand the ways Ohio can use federal healthcare money to keep children in families with low incomes safe from lead (Source: “Medicaid-approved changes remove barriers for Ohio’s lead clean-up program,” Cleveland Plain Dealer, Aug. 20, 2019).

The state first pursued new funding for lead abatement in 2017 through its Children’s Health Insurance Program. In its biennial budget that year, the state committed to spending about $300,000 to leverage $10 million in Medicaid funding for lead abatement work in high-risk homes across the state.

But the program was not as successful as hoped, with just $1.2 million of the available $10 million spent in the two-year period. Instead of expanding the program in his first budget, Gov. Mike DeWine opted to create a new version of the plan, approved by the Centers for Medicaid Services, that eliminates some of the bureaucratic impediments that kept property owners and tenants from being able to use the money to remove lead hazards.

Ohio prescription drug tracking system most-utilized in U.S.

Use of the Ohio system tracking prescriptions for controlled substances has reached record levels, Gov. Mike DeWine and State of Ohio Board of Pharmacy Executive Director Steven Schierholt announced last week (Source: “Use of Ohio’s prescription tracking program hits record high,” Portsmouth Daily Times, Aug. 5, 2019).

The Ohio Automated Rx Reporting System (OARRS,) operated by the State of Ohio Board of Pharmacy, allows doctors and pharmacists to access patients’ controlled substance prescription history to help detect prescription drug abuse and intervene with high-risk patients.

Use of OARRS recently surpassed 1 million daily queries on two separate occasions, a milestone which, according to data from the American Medical Association, ranks OARRS as the most utilized prescription drug monitoring program in the country.

According to the state board of pharmacy, the number of individuals engaged in doctor shopping decreased by 89 percent between 2011 to 2018 and the total number of opioid prescriptions decreased by 4.6 million between 2012 and 2018.