Bill could make remote addiction treatment permanent

Thousands of Miami Valley residents have gotten treatment for substance use disorder, mental health and other services virtually since the COVID-19 pandemic emerged in March.

Prior to the pandemic there were a lot of redtape that made virtual teratment difficult. However, the federal government issued temporary permits for the services to be provided by phone or video, and it’s been successful, officials said.

Now, the question is whether these changes will become permanent. Two U.S. Senators, including Rob Portman of Ohio, have introduced a bill to make telehealth permanent.

Lots of challenges, from work schedules to child care needs, can get in the way of a client making their appointment, said Helen Jones-Kelley, executive director of the Alcohol, Drug Addiction and Mental Health Services Board of Montgomery County.

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Before the pandemic, there were some options for remote appointments, but there were still restrictions that limited how much this was actually an option. New clients needed to first have an in-person appointment. Remote services had to be provided via video chat, and not everyone has the technology or internet access.

But an emergency waiver allowed for providers to be paid for these services even if given remotely on the first visit and even over the phone instead of requiring video chat.

“If this becomes permanent, this really in my mind speaks well to health equity,” Jones-Kelley said. “Not everyone has the ability to get to a provider in person. Add what we have seen with the waiver is the ability for more people to be connected to services.”

In May, the Dayton Daily News reported the number of local patients "showing up" for substance abuse treatment had jumped to nearly 90% after counselors and therapists switched to using telehealth technology because of the COVID-19 pandemic. Prior to the pandemic, the show-rate — the percentage of appointments for which clients show up — was about 40% on average.

On June 30, U.S. Senators Rob Portman (R-OH) and Sheldon Whitehouse (D-RI) introduced the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act to support the expansion of telehealth services for substance use disorder treatment.

The bill would build upon the Trump Administration’s action to waive regulatory restrictions for accessing care in the wake of the COVID-19 pandemic. While the temporary waivers let patients continue their treatments and counseling virtually, they are time limited and will expire at the conclusion of the public health emergency.

The TREATS Act would extend telehealth flexibility by making permanent waivers, including the ability to provide medication-assisted treatment and other necessary prescriptions, without needing a prior in-person visit and the ability to bill Medicare for audio-only telehealth services.

Portman said in a statement that the roll out of telehealth waivers has both helped patients maintain access to care safely at home and increased access to care for those that didn’t otherwise have access to in-person treatment.

“As we move forward and look to life beyond this pandemic, we must make sure that the advances to care and access that telehealth is currently providing is not lost and that’s exactly what this bill will do,” Portman stated, after bill was introduced. “I urge my colleagues to join me in supporting this common-sense legislation to make telehealth a permanent part of substance abuse disorder treatment.”

CORONARIVUS: Complete coverage from the Dayton Daily News

The legislation is supported by: American Society for Addiction Medicine, American College of Medical Toxicology, Kennedy Forum, National Association of Addiction Treatment Providers, National Association of Behavioral Health, National Safety Council, Shatterproof, and Well Being Trust.

In Montgomery County, there were 35 people who died from accidental overdoses in March, 19 people in April, 32 in May and 29 in June, according to preliminary data from Public Health - Dayton & Montgomery County. The year prior, 20 people in the county died from accidental overdoses in March, 24 in April, 26 in May and 19 in June.

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