For Week of April 8, 2001
After revision of the COMPA’s by-laws and a vote to
elect a new Board of Directors, the following individuals have been selected to
serve terms of between 1 and 3 years: Herbert Barish, First Vice President of
Lower Eastside Service Center, New York; Willard Campbell, Clinic Administrator
from Suffolk County Division of Alcohol and Substance Abuse Services; Peter
Coleman, Senior Director of Substance Abuse at the NYC Health and Hospitals
Corporation; Eugenia Curet, Administrator at NY Presbyterian Cornell Medical
Center MTP in Manhattan; Robert Krauss, Director of the Long Beach Hospital
MMTP; Ira Marion, Executive Director of the Division of Substance Abuse at
AECOM-Montefiore in the Bronx; Johanne Morne, Program Director at the Whitney
Young MMTP in Albany; Robert Sage, Senior Vice President of A.R.T.C. in Brooklyn; Sheila Tierney, Manager of
Chemical Dependency at Crouse Hospital in Syracuse; Ira Wolfe, Director of the
Unity Center at St. Like’s Hospital, Newburgh; and Richard Woytek, Director of
the Long Island Jewish MMTP. At the
first meeting of the Board in January, Peter Coleman was selected to serve as
President, Ira Marion was selected to serve as Vice President, Johanne Morne
was selected as Secretary, and Richard Woytek was selected to continue as
Treasurer.
The effective date of the Final Rule, which will
replace the current FDA inspection-focused methadone regulations with a
certification project administered by Center for Substance Abuse Treatment
(CSAT), has been moved to May 18, 2001.
CSAT will shortly begin distributing to clinics prepared materials which
provide a copy of the Final Rule, a Press Release which announces the issuance
of the Final Rule, a Fact Sheet which provides a background and summarizes the
intent of the Final Rule, an Info Sheet announcing CSAT sponsored Technical
Assistance Workshops, and an Application for Certification to Use Opioid Drugs
in a Treatment Program. Important dates
to keep in mind include May 18th when the rules become effective,
the week of May 21 when CSAT will provide a day-long Technical Assistance Workshop
in New York City, and August 17th, which is the deadline for
submitting an Application for Certification.
All programs in operation on May 18, 2001 will be
considered by CSAT to be in transitional status. Failure to submit an Application for Certification by August 17,
2001 will technically result in program being out of business. After submitting the application, programs
will then have two years to become accredited.
Programs will also be able to request a one year extension. All exemptions currently in place will carry
over.
CSAT states that a contract will be awarded to
provide Technical Assistance to the programs during the transition period. CSAT further stated that no money has been
targeted specifically to assist methadone treatment programs with meeting
accreditation standards, although there has been an increase in the state block
grant funds, and providers could that some of this increase be allocated to
methadone programs.
Uncertainty continues regarding the availability of
Methadone Hydochloride after Ganes experienced problems with the manufacturing
of the base product and was forced to shut down their manufacturing
process. UDL and Ganes officials state
that they plan on reentering the market during May 2001, which currently leaves
only Mallincrodt as the only stable source as
Roxanne is partially dependent on Ganes for its base product.
Mallincrodt has pledged to maintain adequate supplies for clinics and
inpatient units, but programs are advised to consider increasing their supplies
on hand at least for the immediate future.
When all of this ends, price increases are also likely.
This year’s AMTA Conference will be held at the
Regal Riverfront Hotel in St. Louis from October 7 – 10. The deadline for Early Registration ends on
April 15, after which standard registration fees apply. In addition to the usual conference
activities, both NIDA and CSAT are sponsoring numerous Pre-Conference Sessions
which will begin on Saturday, October 6.
For Conference information contact Christine Rossiter or Michelle
Thompson at Tally Management (856-423-7222 ex. 350)
OASAS, the Department of Parole, and the Department
of Probation are sponsoring a symposium on Wednesday, April 25, 2001, from 9:00
am to 3:30 pm at Albert Einstein College of Medicine. The symposium will present a broad range of issues that impact
upon methadone patients who may also be involved in the criminal justice
system. The Conference will also
address concerns around methadone as a viable option for the courts, and
attempt to bridge the gap in understanding that exists between the two
systems. Space is limited and
reservations must be received by April 18th. For more information or to register please
contact Larry Samuels at 646-728-4580.
In an ironic twist, as the Federal Government moves
ahead with providing regulatory relief from the burden of cumbersome rules
which dictated medical treatment and limited access to methadone treatment,
along comes the NYC Human Resources Administration to fill the void. New York City programs recently received a
letter from HRA asking them to sign a Letter of Agreement if they wish to
remain on HRA’s approved provider list.
Among other things, this Letter of Agreement commits programs to adhering
to the HRA Clinical Practice Guidelines, requires on-going detailed reporting,
requires programs to obtain consent and then notify HRA when public assistance
recipients apply for treatment, requires participation in the STARS Reporting
System, and coordinate services and care with programs under HRA auspices.
General issues that have been identified by COMPA
providers include:
(1)
Confidentiality –
concern that the fear of having to disclose to HRA will discourage people in
need who are receiving public assistance from seeking treatment; informed
consent requires patient knowledge of the benefits and risks of disclosure to
HRA, a document that has been requested but not provided; and questions arise
about the ultimate need and purpose of HRA for such detailed information
(2)
Appropriate computer
hardware, software, cabling and internet access is lacking in many programs. In
addition, hospitals often have firewall and security issues that must be
resolved in order to utilize STARS efficiently;
(3)
HRA reporting
requirements have significantly increased, from approximately one hour per
month per program in 1998 to anywhere from 1 – 4 hours per client per month
now. OASAS has taken issue with the resultant decrease in counselor time
available to provide direct services to patients.
(4)
Questions regarding
HRA’s statutory authority to issue practice guidelines, as well as the concept
of “mandating” guidelines and enforcing adherence which may restrict the
program’s right to determine appropriate clinical treatment and measure
progress towards individualized goals established by treatment plans.
(5)
Toxicology - most
methadone treatment programs do not perform toxicology testing for all 7
substances as required by HRA nor test weekly beyond 90 days if the patient is
stable, and to do so will incur additional costs; Concern has been expressed that review of toxicology and
attendance data outside of context of treatment may not reflect the actual
progress a client has made.
COMPA supports the mandates of the Welfare Reform Law
which requires work in exchange for public assistance, and is appreciative of
the task facing HRA in have individuals receiving public assistance move to
self-sufficiency, participate in WEP activities, and move where possible from
welfare to work. COMPA recognizes as
well that research has shown a positive relationship between work and recovery.
COMPA remains concerned, however, about HRA’s approach in dealing with the
treatment system as well as the lack of acknowledgement that for some
individuals addiction is a life long disease which is severely
debilitating.
COMPA recommends that programs desiring to continue
serving public assistance recipients known to HRA need to respond, either by
signing this agreement or formally requesting an extension in order to have
sufficient time to consider the various issues. COMPA also recommends that programs not sign this agreement
without considering the various issues involved, completing an assessment of
program needs and impacts, and undertaking a legal review of the terms of the
Letter of Agreement. Towards this end,
we understand that some of our members, after review by their attorneys, are
planning to sign an amended Letter of Agreement, which addresses the language
problems in the existing document.
Martin Livenstein, COMPA’s Executive Director for 13 years, retired on March 2 and a
retirement reception was held in his honor at the Griffis Faculty Club at New
York – Presbyterian Hospital. His
humor, dedication and hard work over the years has been much appreciated by all
and he will be sorely missed. We wish
him well.
While the new Executive Director is being recruited,
the Board has engaged Michael McAllister on a per diem basis to fill in and
help out. Please bear with us during
this interim period. Please be patient. We will continue to fulfill requests and
return calls as quickly as possible.
COMPA’s Board of Directors has decided to move ahead
with a replacement for Marty and is currently soliciting expressions of
interest from those who wish to be considered for this position. Those interested should submit an expression
on interest, along with salary history and requirements, and a resume to Herb
Barish at the Lower Eastside Service Center; 157 Chambers Street – 8th
Floor; New York, NY 10007. Applications
must be received no later than May 15th and interviews will be held
in New York and Albany during the last two weeks of May. Please note that interested candidates must
be willing and able to spend time in both New York City and Albany.
COMPA will soon begin publishing a new Quarterly
Newsletter which will
be distributed to all organizational and individual members of COMPA. Each edition of the newsletter will focus on
a specific topic of interest to the field and will also include items such as
quarterly meeting calendars and notices; conference announcements; training
opportunities; committee reports;
resource listings; and letters from the Executive Director and the
Board. Articles are currently being
solicited regarding Office Based Treatment and should be directed to Bob Krauss
at the Long Beach Hospital MTP, 455 East Bay Drive, Long Beach, NY 11561. The first edition is expected
before the Summer.
The COMPA Bulletin is written and distributed by:
The Committee of Methadone Program Administrators of
NYS Inc.
250 Fifth Avenue, Suite 210
New York, N.Y. 10001
212-447-6682
www.compa-ny.org