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Heroin epidemic: Governor urged to declare public-heath crisis


Palm Beach County Commissioner Melissa McKinlay has asked Governor Rick Scott to follow the lead of other governors in the United States and declare a public health emergency in Florida to help local communities deal with the opioid epidemic.

“Although day after day we are battling this crisis as hard as we can with our limited resources, local government cannot solve this crisis on our own,’’ she wrote.

“By making this declaration, the state would not only help raise awareness of the epidemic, but it would provide expanded options to combat it.”

McKinlay’s letter mentioned a recent Palm Beach Post report that showed heroin-related hospital costs in Florida had reached more than $1 billion in 2015 — $4.1 million a day. And the costs are believed to be rising, right along with the number of overdoses and deaths.

She also cited Florida Department of Law Enforcement numbers showing a nearly 80 percent increase in heroin deaths and a 77 percent increase in fentanyl deaths in Florida from 2014 to 2015.

“I welcome the opportunity to discuss additional ways that the state may join forces with its local governments in fighting this deadly crisis that is robbing families of their loved ones,’’ she said.

In 2016, more than 500 people died of opioid overdoses in Palm Beach County, she wrote. That number, reported this past week by the State Attorney’s Office at a local sober-home task force meeting, could include drugs beyond heroin, fentanyl and illicit morphine, the drugs considered in a Palm Beach Post investigation that found 216 deaths in 2015

McKinlay’s letter pointed out that Virginia in 2016 and Massachusetts in 2014 declared public health emergencies after heroin deaths rose sharply in those states.

McKinlay, a Democrat, sent the letter Tuesday. She had not heard back from Scott, a Republican, as of Thursday.

“He has the authority to take limited action until the Legislature can pass legislation and his agencies can get rules and programs in place,” she said. “We have a gap where we need something in the meantime. Too many kids and too many Floridians are dying every day.”

There is a precedent in Florida for calling a drug addiction crisis a public-health emergency. Gov. Scott did just that in 2011, at the height of the OxyContin “pill mill” crisis, which was killing as many as seven Floridians a day.

He instructed the Department of Health to declare a public-health emergency, and that, in turn, gave the department wide-ranging latitude to rein in suspect clinics and pharmacies, including reactivating the inactive licenses of doctors.

Precisely what a declaration by the governor can do appears to vary widely. For instance, when Scott declared Zika a public health emergency in 2016 after nine confirmed cases — but no deaths — the declaration specifically instructed certain counties to focus on spraying in residential areas.

McKinlay, in an interview, offered examples of how a declaration by Scott can help local communities.

In Massachusetts in 2014, she said, Gov. Deval Patrick declared a public health emergency that allowed him emergency powers to expand access to naloxone, a drug that revives overdosing addicts; mandate that physicians and pharmacies monitor prescriptions; and require the state’s Interagency Council on Substance Abuse and Prevention to make recommendations on further actions within 60 days.

Patrick also issued a public health advisory to raise awareness and he immediately banned the opiate Zohydro from being prescribed until authorities were confident safeguard measures were in place.

“Finally, he announced a commitment of an additional $20 million to increase drug treatment services,” McKinlay said.

In Virginia, Gov. Terry McAuliffe’s declaration allowed all Virginians to obtain naloxone without a prescription and created increased urgency and public awareness of the epidemic.

Speaking to The Post in January, Florida Hospital Association President Bruce Rueben said, “There is no question that this is a medical — a public health — emergency.”

As for a formal declaration, he said, “It is not so important what you call it as the fact that it is recognized, that you understand the consequences so that you can take appropriate measures” — especially access to treatment.

Treatment takes money. And Gov. Rick Scott’s newly unveiled $83.5 billion budget slashes Medicaid payments to hospitals and cuts reimbursements to hospitals treating the uninsured.

Yet some of the financial burdens of the state’s perennially cash-strapped Medicaid program are a result of untreated addiction.

Take Neonatal Abstinence Syndrome. Between 2010 and 2015, NAS was a $967 million statewide problem for hospitals, The Post found, and five of every six dollars were billed to Medicaid. A single brain-damaged baby’s 440-day hospitalization cost $11.8 million. Care for a girl born in Palm Beach County totaled $4.2 million. Medicaid got the bills.

In all, $3.9 billion of $5.7 billion in heroin-related hospital bills went to Florida Medicaid in a six-year period ending in 2015.

Simply cutting reimbursements might give Medicaid some financial breathing room, but unpaid charges are typically passed on to insurers and paying customers.

McKinlay and West Palm Beach City Commissioner Shanon Materio are hosting a meeting Feb. 22 of families who have lost loved ones to the drug crisis.

The meeting, which will be held at the Palm Beach County Library on Summit Boulevard, was set in motion by McKinlay in November after the adult daughter of her then-chief aide died of an overdose following a long battle with addiction.

Tasha McCraw, daughter of former aide Johnnie Easton, died Nov. 18, just two days before The Post published Heroin: Killer of a generation, which included profiles of 216 people who died of heroin-related overdoses in Palm Beach County in 2015.



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