2017 Interim LEGISLATIVE Volume 30, No. 6 September 2017 * Read online at www.lrc.ky.gov/legislation.htm RECORD Lawmakers hear sobering State account of opioid crisis prosecutors by Jim Hannah LRC Public Information warn against FRANKFORT – At one Kentucky hospi- tal, people are actually bringing in heroin and budget cuts shooting up with patients. by Rebecca Hanchett That’s one example of the “very desperate LRC Public Information situation” the opioid-abuse crisis has created, Kentucky Chamber of Commerce President FRANKFORT—Kentucky prosecutors told Dave Adkisson said while testifying before a state lawmakers during a Sept. 15 Judiciary panel of state legislators in the Capitol Annex. Committee meeting that they have little to noth- He was among more than 25 people from ing to cut from their budgets. across the country who testified on Sept. 21 Governor Matt Bevin requested that most about the best policies to attack the crisis at state agencies plan to cut around 17 percent a rare six-hour meeting of both the Interim from their current budgets in a letter recently Joint Committee on Health and Welfare and sent to state officials. The cuts are expected to Family Services, and the Medicaid Oversight save the state around $350 million, state officials and Advisory Committee. say. But prosecutors like Kenton County Com- “Today is a snapshot,” meeting co-chair Rep. Danny Bentley, R-Russell, asks a question monwealth’s Attorney Rob Sanders said the cuts Rep. Addia Wuchner, R-Florence, said of the concerning the scope of the state’s opioid would “not only eliminate (specific programs). topics on the agenda that included prevention, crisis during a joint meeting of the Interim Joint They would shut down our offices.” treatment and criminal justice issues. Committee on Health and Welfare and Family Commonwealth’s attorney and county attor- Co-chair Rep. Kimberly Poore Moser, Services and the Medicaid Oversight and ney office budgets both fall under the Executive R-Taylor Mill, said the point of combining Advisory Committee. branch, which the Governor oversees. the two committees’ meetings was to show Director Van Ingram testified that 1,404 Ken- “We’re talking one in three employees in the complexity of the opioid-abuse crisis and tuckians died of a drug overdose last year. He our office if we implement cuts October 1,” said need for a coordinated, long-term strategy to said the introduction of the synthetic opiate Sanders. By January, he said possibly 50 percent tackle it. fentanyl into the heroin supply was largely of his employees would be have to be let go, un- “We know that everything we have heard driving the death rate. In addition, fentanyl has der the plan. Warren County Commonwealth’s about the opioid use disorder problem, her- been present in 53 percent of the drug over- Attorney Chris Cohron said the same scenario oin problem, is real to many families and our doses recorded in Kentucky so far this year. would likely play out across the state, with pros- communities,” she said, “and it cuts across He said the Kentucky General Assembly ecutors in the largest judicial circuits affected all demographics. It touches everyone. We passed a number of measures in the last five or the most. know it doesn’t matter where you live. Addic- six years to address opioid abuse, but it takes “The bigger jurisdictions are going to bear tion doesn’t care how smart you are, where time for the full impact of those laws to be seen the brunt of it. Our conservative estimate is the you went to school or how much money you “People do get better,” Ingram said. “People larger offices would have to look at laying off 60 m a ke .” do recover, although for those people on the to 70 percent of our total staff. That’s just not -do Office of Drug Control Policy Executive Continued on page 2 Continued on page 2 THE KENTUCKY GENERAL ASSEMBLY 1 have a behavioral health disorder, outside of the drug issue. Opioids, “Well over half of the people,” Liu said Adkisson said the impact of the opioid crisis from page 1 on Kentucky’s health was staggering. “Less obvious, however, is the toll that is tak- front lines, it doesn’t seem that way.” en on the state’s economic growth and develop- In what he described as a “rare bright spot,” ment,” he said. “In Kentucky the opioid crisis has there were 70 million fewer dosage units of contributed to a low workforce-participation opioids prescribed last year in Kentucky than rate. in 2011. (That percentage doesn’t include bu- “At a time when job openings and investment prenorphine, a semisynthetic opioid that is used in Kentucky are reaching record highs, we must to treat opioid addiction.) There are still about provide the healthy productive workforce need- 300 million dosage units of opioids being pre- ed to grow the economy.” scribed in Kentucky. Rep. Mary Lou Marzian, D-Louisville, asked “This whole problem is the overexposure of how the state could fund the mental health, opioids to our country and state,” Ingram said. treatment and prevention programs needed after “We are reducing that overexposure.” the governor recently proposed cuts of 17 per- He said the passage of House Bill 333 earlier cent for most state agencies in the current fiscal this year would further drive down the number year to make up for an expected budget shortfall. of opioids prescribed. It prevents doctors from Department for Behavioral Health, Develop- prescribing more than a three-day supply of opi- mental and Intellectual Disabilities Medical Di- oid painkillers, with some exceptions allowed. It rector Dr. Allen J. Brenzel said grant money is Rep. Joni Jenkins, D-Shively, comments on the also increased penalties for trafficking in opioids helping to pay for programs to tackle the opioid state’s opioid crisis during a joint meeting of the and authorized the state Office of the Inspector Interim Joint Committee on Health and Welfare crisis. and Family Services and the Medicaid Oversight General to investigate trends in drug usage and “The good news ... is that resources are com- and Advisory Committee. trafficking. ing,” he said. “That is something I don’t often say. Department for Medicaid Services Medical We have received funding from the legislature, said. Director Dr. Gil Liu testified on the impact of the governor’s budget and we have received a sig- Wuchner said the grant money couldn’t come opioid abuse disorder on Kentucky’s Medicaid nificant number of grants.” fast enough. program. Kentucky was recently awarded a $10.5 mil- “Opioid addiction is a ravenous beast be- At the beginning of 2014 Kentucky spent lion federal grant to help on programs for opioid cause its increasing tolerance requires individu- about $56 million in Medicaid money on behav- overdose victims, pregnant and parenting wom- als to take higher doses to stave off withdrawal ioral health and substance abuse treatment, he en, individuals re-entering society upon release and addiction spiral can happen quickly,” she said. By the end of 2016, Kentucky was spending from criminal justice settings and adolescents said. “It fractures families, lives, communities about $117 million in Medicaid money on those and young adults at risk of addiction. and futures. It fills our headlines daily. It fills treatments. “Now, what is very critical, is that we use our courtrooms, our jails, our hospital ERs, our Rep. Danny Bentley, R-Russell, asked what those dollars, and guide those dollars to the most NICUs (neonatal intensive care unit). It fills our percent of people with substance abuse disorder effective evidence-based intervention,” Brenzel court dockets, and it fills our morgues.” Budget, from page 1 “There are human costs to this,” he said. the panel. able,” he told the committee. Henderson County Attorney Steven Gold, Rep. Jason Petrie, R-Elkton, asked how much Cohron said staff cuts would negatively im- who is also the president of the Kentucky County of a cut the prosecutorial system could with- pact the state’s heroin “Rocket Docket”—an effi- Attorneys Association, said the state’s 120 county stand. None, Sanders said. ciency program in place in over 30 of the state’s attorney offices collect child support, serve as a “How much of a cut we can sustain when 57 judicial circuits that puts treatment ahead of financial watchdog, and advise and assist coun- we’re talking about budget reduction? Zero. Be- incarceration for certain drug offenses. Local ty governments. They are also a key player in all cause…we’re already going to be short on funds. jails statewide are on track to save around $50 criminal cases in the Commonwealth, he said, We’re already going to be laying people off,” he million by the end of fiscal year 2018 due to the “plus mental health, guardianship, child depen- said. success of the Rocket Docket program, he said. dency/neglect/abuse, truancy and runaway” cas- Rep. Robert Benvenuti, R-Lexington, said Staff cuts could also restrict funding for ad- es and more. While Gold said county attorneys government’s top priority is public protection. He vocacy of elderly, children and domestic violence “embrace” their work, they need the funding to encouraged prosecutors to make that clear when victims, Cohron said, since criminal prosecution meet their obligations. Budget reductions would working with lawmakers in coming months. comes first. All non-court personnel, including work counter to that, he said. “Don’t be shy about saying ‘why is the state victim advocates, would “have to be looked at “If we are to believe that out of the crucible spending money on this when we don’t have being reduced immediately,” he said, adding that that is court comes justice, we must have good enough law enforcement officers on the street? court appearances and timely disposition of cas- people—well-funded, well-trained people—on When we don’t have enough prosecutors?” Ben- es would also be impacted by reductions.