DeSantis Panel Delves Into Substance-Abuse Funding

Jan 3, 2019

Incoming Gov. Ron DeSantis bemoaned Medicaid costs while in Congress and while on the campaign trail, but he is being asked by some members of his health-care advisory committee to consider expanding Medicaid eligibility to people with substance-use disorders.

Members of DeSantis’ Advisory Committee on Health and Wellness said Wednesday the state should examine ways to tap into more Medicaid funds to help offset the costs of providing treatment and care for people who don’t currently qualify for Medicaid.

But not all members of the committee were on board with the idea.

Former state Rep. Jason Brodeur said the DeSantis administration should understand the existing substance-abuse programs and which ones are successful before making any moves.

“I have a much more tactical suggestion in the substance-abuse portion, and that is that we start doing baseline and random drug testing to authenticate our treatment plans,” said Brodeur, a former chairman of the House’s health-care budget committee.

Brodeur said it would be “politically hot” but insisted that the state needs to measure the effectiveness of programs that it funds and needs to take a hard look at success rates as it tries to abate the opioid crisis.

“It’s not a be-all, end-all, but it would be part of a broader solution to fighting the opioid crisis if we knew how we were doing,” he said. “When we do economic development at the state level, we want to know how many jobs are created. When we pave roads, we base it on milestone payments because we want to make sure we are hitting our endpoints. … And yet we don’t know what we are doing in the opioid crisis in terms of efficacy of treatment and authenticating the plan.”

DeSantis, who will take office Tuesday, set up the Transition Advisory Committee on Health and Wellness in December and named Lt. Gov.-elect Jeanette Nunez to help lead the panel.

Wednesday’s meeting was the third and final session for the group. Staff members will compile a report based on the panel’s discussions before next week’s inauguration.

When addressing health care, DeSantis and Nunez on the campaign trail spoke mostly about their opposition to the Affordable Care Act and a potential Medicaid expansion. It’s not clear how the idea to expand the state’s $26 billion Medicaid program to provide more coverage for substance-use disorders will sit with the incoming administration.

But there is a blueprint for the state to follow if it chooses, said Medicaid director Beth Kidder, who updated members of the advisory committee about the state’s Medicaid managed-care program and new five-year contracts with HMOs and other managed-care plans.

The Agency for Health Care Administration and the Department of Children and Families compiled a report that showed the agencies provided care to 680,041 people with serious mental illness or substance-abuse issues in 2016. About 132,940 of them were treated for substance-use disorders but didn’t qualify for the Medicaid program.

The report was a blueprint for how the state could increase funding for the program, including possibly amending one of two Medicaid “waivers” to extend Medicaid eligibility for people who suffer from substance-use disorders and tap Medicaid funds to offset the costs of care.

Meanwhile, other advisory committee members on Wednesday stressed the increased use of telemedicine and the role it could play in delivering mental-health and substance-abuses services to people.

While telemedicine, or telehealth as it is also known, is heralded by providers and insurance companies as a tool that should be used, there has been a longstanding dispute over “parity,” or requiring telehealth services to be reimbursed similarly to services that are provided face to face.

It’s a hot-button issue that usually pits insurance companies against health providers and one that the Legislature has been loath to tackle.

Nunez, though, predicted that the telehealth issue will surface in the next two years.