DATE:    February 25, 2020
TO:         Human Services Committee
FROM:  Ben Shaiken, Manager of Advocacy & Public Policy, The Alliance

RE:         H.B. 5232 An Act Concerning a Minimum Base Rate for Methadone Maintenance Treatment and S.B. 193 An Act Concerning Methadone Maintenance

Good evening Senator Moore, Representative Abercrombie, Senator Logan, Representative Case and members of the Human Services Committee.

My name is Ben Shaiken, Manager of Advocacy & Public Policy at the CT Community Nonprofit Alliance (The Alliance). The Alliance is the statewide association of community nonprofits.  Community nonprofits provide essential services in every city and town in Connecticut, serving half a million people in need and employing 117,000 people across the State. They are an important part of what makes Connecticut a great place to live and work and an important piece of our economy.

Thank you for the opportunity to provide testimony today on two bills:

1. In support of H.B. 5232 An Act Concerning a Minimum Base Rate for Methadone Maintenance
2. With concerns regarding S.B. 193 An Act Concerning Methadone Maintenance.

H.B. 5232 An Act Concerning a Minimum Base Rate for Methadone Maintenance

Last year, the budget implementer included language directing DSS to create performance measures for Methadone providers. This language – which was never vetted though a public hearing process –set unrealistic deadlines for performance measures to be developed and go into effect. Ultimately, this language, currently in law, would penalize providers with rate cuts if the measures were not met. In July, Methadone providers immediately working with DSS with great concern, and after months of work, DSS has still not been able to meet any of these deadlines.

If the legislature does not pass H.B. 5232, lifesaving Methadone treatment would be the only service in the entire Medicaid program in which providers’ rates would be cut for not meeting performance metrics with no benefits for improving patient outcomes.

This is not only important to providers, but the people they serve who are struggling in the midst of an opioid crisis. Methadone is an FDA-approved medication used to treat Opioid Use Disorder. Connecticut’s Methadone clinics are contracted with the State and serve thousands of patients recovering from heroin and other opioid addiction. Of the FDA-approved medications to assist in treating opioid addiction, Methadone is the oldest and has been available since 1964. In study after study, Methadone is shown to reduce illicit opioid use and improve retention in opioid treatment. Simply put: Methadone and other FDA-approved Medication Assisted Treatments save lives every single day.

In the United States, methadone is heavily regulated by the federal and state government. It is offered only through specialized methadone treatment programs that provide psychosocial support as well as close patient monitoring. Most methadone recipients receive their medication daily at the methadone treatment facility. Some people also become eligible for take-home doses.

Please support H.B. 5232, which would repeal the problematic language in its entirety. Repealing the language, which is not being implemented, is the cleanest solution to the problem it has created.

S.B. 193 An Act Concerning Methadone Maintenance.

We appreciate the proposal in S.B. 193, which would establish a value-based payment system that includes financial incentives as well as “downside risk” for providers, and pushes deadlines out to the future. However, we still believe this language is too restrictive and worry that the deadlines it sets may not be correct as the work begins on a value-based reimbursement system.

DSS could work with providers to establish a value-based reimbursement system without the legislative authorization proposed in S.B. 193. Since the July, we have expressed our willingness to participate in designing such a system, so long as it is fair to providers and allows them to better serve people recovering from opioid addiction.

Given our willingness to work together, we ask you to support H.B. 5232 repealing the language. Thank you for your consideration.