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President Trump’s Opioid Emergency Declaration to Expand Telemedicine Access

October 26, 2017
by Mark Hagland
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The president’s scheduled declaration of a public health emergency around the opioid crisis will expand access to telemedicine

As The Washington Post reported on Thursday morning, “President Trump plans to declare Thursday afternoon that the opioid crisis — which is killing more than 100 people each day — is a public health emergency. By doing so, the federal government will waive some regulations, give states more flexibility in how they use federal funds and expand the use of telemedicine treatment, according to senior administration officials who briefed reporters on Thursday morning.” What’s more, the president’s declaration will allow for expanded access to telemedicine services for those Americans in need of care for opioid addiction and issues.

The article, by Jenna Johnson, went on to say that “[T]he president will stop short of declaring a more sweeping national state of emergency that would have given states access to funding from the federal Disaster Relief Fund, just as they would be following a tornado or hurricane. Officials who briefed reporters said that declaring that sort of emergency is not a good fit for a longtime crisis and did not offer authorities that the government doesn't already have.”

Johnson wrote that “Trump plans to sign a presidential memorandum that will order Acting Secretary of Health and Human Services Eric Hargan to declare a nationwide public health emergency and direct all federal agencies to use any emergency authorities that they have to reduce the number of opioid overdose deaths. The last time that a national public health emergency of this scope was called was in 2009 in response to the H1N1 influenza virus. The emergency will last 90 days but can be repeatedly renewed.”

According to a fact sheet released by the White House to reporters Thursday morning, the following are the parameters of the public health emergency declaration:

> The action allows for expanded access to telemedicine services, including services involving remote prescribing of medicine commonly used for substance abuse or mental health treatment.

> The action helps overcome bureaucratic delays and inefficiencies in the hiring process, by allowing the Department of Health and Human Services to more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation’s ongoing public health emergency.

> The actions allow the Department of Labor to issue dislocated worker grants to help workers who have been displaced from the workforce because of the opioid crisis, subject to available funding.

> The action allows for shifting of resources within HIV/AIDS programs to help people eligible for those programs receive substance abuse treatment, which is important.


POLITICO report finds a “catch” in the President’s announcement

On Friday, Oct. 27, one day after President Trump declared a public health emergency around the opioid crisis, POLITICO published a report in its morning eHealth edition online, questioning the practical significance of the telemedicine element in the president’s announcement. Darius Tahir wrote, “Trump's order sets his administration on a course to expand telemedicine use—including allowing for remote prescription of substance abuse and mental health therapies - assuming he can get the bureaucracy to do what he wants. Currently, prescription of these treatments via telemedicine is barred by a 2008 law. The logjam there,” Tahir wrote, “is in the Drug Enforcement Agency, which has been working for years without much apparent progress. We contacted the agency's spokesman about the order, who said the relevant regulation was still under development.”

Tahir quoted Larry Cote, a former associate chief counsel at the DEA who now works at the law firm Quarles & Brady, who said that the DEA has "been telling people for years they're working on a regulation now, the fact that they said it today means nothing to me.” As Tahir wrote, “While the White House wants to make this telemedicine change, the DEA is reluctant—as they have for years—because of fears over being too lax with controlled substances, which include opioids and anti-addiction medications.” And he further quoted Libby Baney, a Washington attorney who works on the issue, as saying that "It sounds like they're not terribly close.” As other federal agencies like Veterans Affairs and Medicare move to further the use of telemedicine, "the DEA is not there yet," she told POLITICO.

Healthcare Informatics will continue to update readers on this developing story.

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