PROVIDENCE – Sometimes what is said after the meeting of the Governor’s Task Force on Overdose Prevention and Intervention in conversations among members is just as important as what gets said during the meetings.

Take, for instance, what happened after the April 11 meeting of the Task Force, when there were a number of conversations about what to do about apparent problems in reimbursement regarding dispensing naloxone at community health centers and emergency departments.

Although there are health department regulations requiring the distribution of naloxone, there is currently no mechanism for providers to be reimbursed for the purchase of the overdose reversal medication.

As Susan Jacobsen, director of Health Equity Initiatives at Thundermist Health Center, explained it to ConvergenceRI, there is an existing recommendation that providers distribute Narcan at the point of care, at an appointment, particularly to folks who may be at a high risk of an overdose.

The problem, she continued, is that there is currently no billing mechanism that allows providers to bill for that. “We don’t have any way to be reimbursed for the naloxone we buy,” she said.

Jacobsen and others have been in conversations with Sen. Joshua Miller, also a member of the Task Force, and they are looking at potential solutions to the problem.

“We are not really sure, at this point, if the problem can be resolved by legislation, if it can be resolved through an amendment to the rules and regulations, or if it needs both of those things,” she said.

Jacobsen continued: “We are not sure if that might need to include, at least for Medicaid, for some federal rule or regulation that needs to be addressed.”

Clarity and consensus
Ian Knowles, program director at RICARES, confirmed with ConvergenceRI that there was a lack of clarity around naloxone purchases and existing billing codes. “Insurance doesn’t cover naloxone when it is distributed from an emergency department or from a health center,” Knowles explained. The providers, he continued, would have to pay for the medication up front, and then getting reimbursed for it is “iffy.”

Knowles described the apparent Catch-22 as follows: “If a health center wanted to purchase a stash of naloxone, they could, but they would have to pay for it themselves,” he said. “I’m not sure if they could ultimately be reimbursed through insurance once it is dispensed.”

Knowles confirmed that he had heard that Thundermist and others are trying to figure out a way to purchase naloxone with insurance companies covering the cost up front, and the group has been conferring with Sen. Miller about potential legislation to do that.

Reports from the front
The April 11 meeting of the Task Force was chock full of reports from the front:

• The creation of what is known as BH Link by the R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, to help fill in the gaps in the current behavioral health care system by providing a hotline and triage center to respond to those individuals experiencing a behavioral health crisis, as well as connecting people to treatment and recovery resources, with the goal of preventing unnecessary emergency services transports to emergency rooms.

• A report on the progress of the Providence Safe Stations initiative by Chief Zachariah Kenyon of the Providence Fire Department, who asked task force members to help get the word out about the program. Since its launch in January, there have been 10 cases.

• Amy Ferguson described her experience as a naloxone lay responder, injecting someone who had overdosed and saving his life.

• A report by Michelle Harter on the Burrillville Addiction Assistance Program, a new, non-clinical, peer-to-peer initiative to build a bridge between Burrillville residents and addiction treatment and recovery services.