Hospitals Permitted to Offer Detoxification Services Without OASAS Operating Certificate
March 22, 2018 - Governor Andrew M. Cuomo today announced new efforts to combat the opioid epidemic, including advancing partnerships in New York's Prescription Monitoring Program across the country, training investigators with the New York State Department of Health's Bureau of Narcotic Enforcement to carry and administer naloxone, and allowing hospitals to provide detoxification services without a separate certification from the New York State Office of Alcoholism and Substance Abuse Services.
"Tragically, opioid addiction continues to take the lives of New Yorkers every single day, but this administration will not rest until the opioid epidemic is a thing of the past," Governor Cuomo said. "By removing unnecessary roadblocks to proper care and providing more resources and training with these additional measures, New York will continue to lead the nation in implementing innovative and effective solutions to save lives, prevent overdoses, and provide the treatment those suffering from addition so desperately need."
"I have heard firsthand from countless families across the State who have felt the impact of addiction. This epidemic is claiming too many lives prematurely - the Governor and I refuse to sit on the sidelines and watch it continue," said Lieutenant Governor Kathy Hochul, Co-Chair of the Heroin and Opioid Task Force. "We're leading the nation in our efforts to provide resources and support for individuals struggling with addiction and their families. With these additional responses, New York is reinforcing our steadfast commitment to combat this crisis and help individuals on the road to recovery."
In an ongoing effort by the Department of Health to engage New York's PMP with other states, it is now interoperable with 25 states and Washington, D.C., meaning that New York's program securely shares data with and receives data from the other states' PMPs regarding patients' prescriptions. The connection to half the states in the country now provides practitioners access to nearly 150 million patients' controlled substance history records.
With this program, providers in New York will now have the ability to select participating states while searching the PMP in order to see a fuller picture of their patients' controlled substance histories. This feature is especially helpful in the Tri-State Area and other stretches across state borders. With a more visible controlled substance history, providers can more easily detect and prevent "doctor shopping", a critical tool in combatting the opioid epidemic. Since Governor Cuomo's I-STOP legislation began requiring practitioners to check the PMP before prescribing controlled substances, New York has reduced its number of "doctor shopping" incidents by over 98 percent.
The Department of Health has systematically advanced New York's PMP interoperability, first with bordering states, and ultimately expanding to the rest of the Northeast, the Eastern Seaboard and beyond. The Department annually reviews all of its agreements with other states and re-interviews their officials to ensure the continuity of applicable statutes and rules of access, data sharing and security.
In addition, investigators with the Department of Health's Bureau of Narcotic Enforcement, who are often on the frontlines of the opioid epidemic, will be trained by the Department's AIDS Institute to carry and administer naloxone, which can reverse an opioid overdose. BNE investigators across the state are responsible for enforcing the New York State Controlled Substances Act and regulations, working with law enforcement, health professionals and others to investigate suspicious drug activities in a variety of settings.
Finally, OASAS and the Department of Health now have the ability to provide hospitals with a time-limited waiver that expands the detox services they are permitted to provide. Ordinarily, a hospital may not provide detox services above the threshold of five beds, or greater than ten percent of overall patient days. This waiver will permit the admission and treatment of qualifying patients above the regulatory limits for detoxification without the need for an OASAS detox operating certificate, as long as the hospital notifies both OASAS and DOH of its intent to provide such services. This waiver will be valid until December 31, 2018, when OASAS and DOH will re-evaluate the need for a continuing waiver.
In addition to the regulatory waiver relief, hospitals are reminded that emergency room physicians may also take advantage of federal flexibility to treat addiction using medication-assisted treatment. Federal law and rules allow a physician to administer methadone or buprenorphine, once a day, for up to a 72-hour period, in the case of an emergency, while a connection to addiction treatment is made. Further, individual physicians who have obtained authorization from the federal government to administer buprenorphine to patients with an opioid use disorder may do so without obtaining an OASAS operating certificate.
Health Commissioner Dr. Howard Zucker said, "Under Governor Cuomo's leadership, we are taking bold and aggressive actions to combat the opioid epidemic and save lives. Too many New Yorkers are battling addiction in our communities, and these measures will make a difference in our continued efforts to turn the tide in their favor."
Office of Alcoholism and Substance Abuse Services Commissioner Arlene González-Sánchez said, "The opioid crisis is devastating our nation, and here in New York, we are taking bold steps to combat addiction. These initiatives will provide resources that will save the lives of many New Yorkers and give those struggling with addiction the opportunity to get connected to treatment so that they can begin a path towards recovery."
Senate Health Committee Chair Kemp Hannon said, "New York has made great strides to combat heroin and opioid abuse. I worked with the Governor to implement important legislation creating the I-STOP Program, increasing the availability of life-saving naloxone, as well as expanding access to recovery and treatment. I look forward to continuing this collaboration, as much more is needed to curb this epidemic."
Assembly Health Committee Chair Richard N. Gottfried said, "Hospitals are on the front line of the opioid epidemic. Expanding access to hospital detox services will save lives and help New Yorkers access appropriate, medication-assisted treatment."
Assembly Committee on Alcoholism and Drug Abuse Chair Linda Rosenthal said, "In New York State, there are as many different pathways to recovery as there are people struggling with substance use disorder. I applaud this effort to bolster a broad range of support services and programs, to track where and when opioids are being prescribed and to expand the universe of sites equipped to offer life-saving treatment. We cannot rest, however, until our state is blanketed with life-saving supports, which is why I am fighting so hard for my 'Naloxone Everywhere' bill, requiring facilities across the state to carry opioid antagonists and have someone on-site equipped to administer."