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MINUTES OF THE
SOCIAL SERVICES APPROPRIATIONS SUBCOMMITTEE
Monday,
September 17, 2018
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6:00 p.m.
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Carbon County Events Center, 450 South Fairgrounds Way, Price Utah, Room 118A
Members Present:
Sen. Allen M. Christensen, Senate Chair
Rep. Paul Ray, House Chair
Rep. Raymond P. Ward, House Vice Chair
Sen. Todd Weiler
Rep. Rebecca Chavez-Houck
Rep. Rebecca P. Edwards
Rep. Sandra Hollins
Members Absent:
Sen. Luz Escamilla
Sen. Daniel Hemmert
President Wayne L. Niederhauser
| Sen. Kevin T. Van Tassell
Sen. Brian Zehnder
Rep. Timothy D. Hawkes
Rep. Michael S. Kennedy
Rep. Edward H. Redd
Rep. Travis M. Seegmiller
Rep. Norman K. Thurston
Staff Present:
Mr. Russell T. Frandsen, Fiscal Analyst
Ms. Clare Tobin Lence, Fiscal Analyst
Ms. Maddy Oritt, Fiscal Analyst
Ms. An Bradshaw, Committee Secretary
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Note: A copy of related materials and an audio recording of the
meeting can be found at www.le.utah.gov.
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| 1. Call to Order - Town Hall Meeting on the Opioid Overdose Crisis in Carbon County |
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| Chair Ray called the meeting to order at 6:30 PM. |
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| Mr. Russell Frandsen was invited to explain the agenda to the attendees. |
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| Opioid Overdose Overview for Carbon County |
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| Prescription Opioid Deaths in Utah 2000-2015 - Department of Health - September 2018 |
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| Opioid Overdoses New Funding Responses in Utah - FY 2007 - FY 2019 |
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| Prescription Drug Misuse - Policy Responses - 2007-2018 (OLRGC - 5-18-18) |
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| NATIONAL - Opioid Brief 2000-2016 |
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| STATE - Opioid Brief 2000-2016 |
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| 2. Supply Side of Opioids in Carbon County from the Provider Perspective |
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| Chair Ray invited the providers to come up and give their comments. |
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| Mr. Patrick Rezac, Executive Director, One Voice Recovery, explained the program to the committee and audience. |
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| Ms. Danielle Pendergrass, Eastern Utah Women's Health, gave a nursing perspective on the need for treating chronic conditions. |
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| Mr. Steve Barth, COO, Counted, explained the program's ability to track in real time the adherence of clients and patients to doctors' orders. He provided a handout, "Counted: Making Medication Count" to the committee and panel. |
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| Chair Ray asked Mr. Barth if his company's system could track legal marijuana prescriptions and Mr. Barth responded. |
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| Rep. Chavez-Houck asked for more information about tracking data and Mr. Barth provided the answer. |
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| Issue Brief - 2018 Interim - Suggestions for the Opioid Overdose Crisis In Carbon County |
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| Chair Ray invited the panel to introduce themselves. |
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| 2b2-DOPL Price Utah Opioid September 2018 |
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| 2b3-Health Providers Handout - September 2018 |
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| 2b4-Four Corners Community Behavioral Health - Provider Handout |
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| 2b5-Southeast Utah Health Department - Opioid September 2018 |
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| 2b9-Carbon Addiction Reduction and Elimination (CARE) Coalition - Supply |
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| 2b11-CDC - Guidelines for Prescribing Opioids for Chronic Pain - factsheet |
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| Dr. Scott F. Hill, Chief of Mental Health Services, U.S. Department of Veterans Affairs (VA), Salt Lake City Health Care System, introduced himself and the programs offered throughout the State. |
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| Ms. Karen Dolan, CEO, Four Corners Community Behavioral Health (FCCBH), introduced herself and explained the services offered by the program. |
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| Mr. Brian Besser, District Agent in Charge, U.S. Drug Enforcement Administration (DEA), State of Utah, explained the agency's focus on prevention, treatment, and recovery and its activities in the State. |
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| Mr. Jade Powell, Coordinator, Carbon Addiction Reduction and Elimination (CARE) Coalition, introduced himself and the CARE Coalition and its efforts to prevent addiction, primarily among youth. |
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| Mr. Mark B. Steinagel, Director, Division of Occupational and Professional Licensing (DOPL), Department of Commerce, described DOPL's responsibilities in licensing and overseeing professionals. |
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| Dr. Brian Shiozawa, Regional Director, Region 8, U.S. Department of Health and Human Services, introduced himself to the audience and explained the department's four primary goals: reducing opioid abuse, value-based healthcare, affordability of healthcare and insurance, and lowering the costs of prescription drugs. |
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| Ms. Anna Fondario, Program Manager, Violence and Injury Prevention Program, Department of Health (DOH), talked about the program's efforts in dealing with the opioid epidemic, particularly in Carbon and Emery Counties. |
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| Ms. Debbie Marvadakis, Health Promotion Director, Southeast Utah Health Department, talked about the department's efforts to address opioid addiction and overdose in the area. |
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| Ms. Virginia Keys, Special Agent, U.S. Food and Drug Administration (FDA), Office of Criminal Investigations, explained her role in working with the DEA, Homeland Security, and the other panelists' organizations to address the opioid crisis and educate the public about risks of the dark web. |
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| Rep. Chavez-Houck asked about the Legislature's designated funds for the 360 program. She also asked how law enforcement deals with its dual roles of providing outreach and education along with being investigative and enforcement bodies. |
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| Mr. Besser responded to both questions and discussed the efforts of the Utah Opioid Task Force to address the crisis. |
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| Ms. Keys responded and explained the FDA's work in integrating with other community services and educating medical and veterinary providers. |
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| 3. Supply Side of Opioids in Carbon County from the Provider Perspective |
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| Chair Ray asked questions that were submitted to the providers. The first question was, "Could you paint a picture of what providers face in dealing with the opioid crisis?" |
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| Dr. Hill asked Dr. Amber Martinson, Co-Director, Primary Care Pain and Opioid Program, VA, to address the question. |
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| Rep. Ward asked about opioids and chronic pain. Dr. Martinson responded. |
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| Chair Ray continued with the submitted questions, asking, "What laws could we change that affect prescribing opioids to help with the crisis?" |
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| Ms. Dolan responded that more providers need to be educated about addiction and possible treatments. |
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| Ms. Marvadakis responded that the public needs to be educated about which drugs are opioids and how addictive they are. |
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| Dr. Shiozawa responded that the emphasis should be on those who push opioids and not the users. |
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| Mr. Steinagel answered that recently passed laws are being implemented and should be successful in addressing some of the issues. |
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| Mr. Besser responded that big pharmacy and insurance companies focus too much on profits and changes need to be made on a macro level. |
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| Sen. Christensen suggested warning labels for opioids that clearly state the product is an opioid and can be or is addictive. |
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| Dr. Hill made a comment that addiction treatment is a specialty and suggested incentivizing training for treating addictions. |
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| Ms. Keys gave information about the FDA's efforts regarding labeling opioids and suggested allowing the FDA to access the drug database for its criminal investigations. |
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| Rep. Ward asked about the roles of the FDA and DEA in overseeing medication prescriptions. Ms. Keys responded. |
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| Mr. Steinagel gave information about recently passed legislation. |
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| Ms. Fondario clarified that recently-passed H.B. 399 deals with labeling of opioids. |
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| Chair Ray gave the final submitted question, "Where is the drug supply of opioids coming from in Carbon County?" |
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| Mr. Besser responded that the problem is ubiquitous and the supply is coming from all over, including locally. |
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| Ms. Keys responded that a lot of fentanyl is coming from China but another supply source is prescriptions taken from parents and distributed to friends. It is also widely manufactured in the State. |
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| Opioids - Potential Demand Side Solutions |
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| Ms. Carolyn Phippen, Majority Chief of Communications, Utah House of Representatives, gave a presentation of potential supply side solutions. |
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| 4. Demand/User Side of Opioids in Carbon County from the Community Perspective |
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| 3a-Opioid Utah Research Report FINAL - 9-17-2018 |
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| Opioid Epidemic Resources - Carbon-Emery County |
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| Opiate Overdose Outreach Pilot Program Leg Factsheet 18 (4) - September 2018 |
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| 3b1-Veterans Affairs - Price Questions - September 2018 |
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| 3b3-Health - General Public Handout - 9-2018 |
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| 3b4-Four Corners Community Behavioral Health - Demand Handout |
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| 3b6-Region VIII Opioid Presentation |
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| 3b8-NSS-2-BRIDGE One Page Insurance Summary |
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| 3b9-Carbon Addiction Reduction and Elimination (CARE) Coalition - Demand |
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| Mr. Layne Miller, Price City Council, spoke about the experiences he and his wife have had as foster parents to teenage boys. He asked, "What do we do now?" |
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| Ms. Sharon Miller, Aunt Sharon's Early Care and Education Program, spoke about some of the children she treats who were born addicted to opioids and the need for funding of high quality child care. |
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| Mr. Jonathan Farber, treatment provider, FCCBH, was asked by Ms. Wendy Marrelli to give her story about overcoming addiction. She recommends more treatment opportunities in jail and better options after release. He also spoke about other treatment needs and overcoming his own addiction to opioids. He encouraged the participants to remember the human component of the opioid addiction crisis. |
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| Ms. Heather Barker, citizen, talked about overcoming her opioid addiction with the help of jail ministries and being saved by Narcan. She expressed the need for transitional help for people being released from incarceration. |
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| Rep. Hollins asked for advice about dealing with homelessness and addiction. Ms. Barker responded. |
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| Mr. Colton World, citizen, talked about his recovery and the need for transportation, employment, and having somewhere to go after being released from jail. |
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| Mr. Scott Reed, Utah Attorney General's Office, offered information about the Utah Solutions Summit being held on October 12, 2018. |
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| Mr. Randy Parker, State Director, USDA Rural Development, provided information and handouts regarding federal funding assistance, including opioid-related help the federal government is providing. |
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| Ms. Gina Gagon, Community Economic Council, talked about occupational patterns in opioid overdoses. She also addressed the community's needs from the Legislature. |
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| Ms. Jeanette Lloyd, citizen, asked the DEA about big drug companies. Mr. Besser provided the information. |
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| Mr. David Jelin, citizen, asked the committee about the correlation between opiate addiction and medical conditions and also asked how many opioid users are abusers and how many are careful users for pain management. |
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| Ms. Olivia Dudding, Director, Boys and Girls Club of Price, expressed concern that some of the problems of vulnerable youth are not being addressed by the committee. |
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| Ms. Rebecca Gray, citizen, spoke about her experience caring for a man with paranoid schizophrenia who was an alcoholic, who later died in her home. She expressed sorrow that she did not have the financial resources to give him the help he needed. |
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| Ms. Deanne Fulcher, Eating to Heal, spoke about her experiences as a nurse in the opioid treatment program for FCCBH and her former use of prescription medications and resulting efforts to help others avoid excessive prescription use. |
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| Ms. Erin Darger, Women's Jail Ministry, spoke about the ministry's programs and the need for a transition center. |
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| Ms. Pam (no last name given), citizen, said she's been an addict since she was seventeen years old and asked what will actually be done to help addicts. |
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| Chair Ray expressed the committee's desire to help and told of some of its efforts to find solutions. |
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| Ms. Eileen Green, prevention specialist, FCCBH, talked about the importance of preventing addiction and addressing risk factors in children. |
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| Ms. Amanda Grill, citizen, said she is a recovering heroin addict and told of her experience trying to get help to overcome her addiction. |
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| Ms. Debbie Peet, FCCBH Board of Trustees, talked about the need for funding. |
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| Rep. Hollins reminded the crowd of the need to remember the elderly population and the effect drug use has on others preying on or abusing them. |
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| Chair Ray detailed efforts made by the Legislature to fund and address the opioid crisis in Carbon County. |
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| Dr. Shiozawa explained the efforts of the federal government to help communities with the effects of the opioid crises and addressed the needs for prevention, treatment, and recovery. He also told of Colorado's program that has reduced prescribed opioids in emergency rooms by 36 percent. |
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| Mr. Steinagel explained federal and state funds being used to combat the opioid problem. |
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| Ms. Fondario gave details about grants from the Centers for Disease Control and Prevention and the programs they fund. |
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| Rep. Christine F. Watkins thanked the panel, committee, and community members for coming. |
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| Opioids - Potential Demand Side Solutions |
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| Ms. Phippen continued with her presentation. She discussed options for addressing the demand side of the opioid epidemic, including family residential treatment programs. She also recommended an outside audit of all treatment programs receiving state funds. |
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| MOTION: Rep. Hollins moved to adjourn.
The motion passed with a vote of 7-0-10.
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| Yeas - 7 | Nays-0 | Abs-10 | |
Rep. R. Chavez-Houck
Sen. A. Christensen
Rep. R. Edwards
Rep. S. Hollins
Rep. P. Ray
Rep. R. Ward
Sen. T. Weiler
| | Sen. L. Escamilla
Rep. T. Hawkes
Sen. D. Hemmert
Rep. M. Kennedy
Sen. W. Niederhauser
Rep. E. Redd
Rep. T. Seegmiller
Rep. N. Thurston
Sen. K. Van Tassell
Sen. B. Zehnder
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| Chair Ray adjourned the meeting at 9:25 PM. |
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