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Interim Report to the 86Th Texas Legislature

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Interim Report to the 86Th Texas Legislature Interim Report to the 86th Texas Legislature HOUSE SELECT COMMITTEE ON OPIOIDS AND SUBSTANCE ABUSE November 2018 HOUSE SELECT COMMITTEE ON OPIOIDS AND SUBSTANCE ABUSE TEXAS HOUSE OF REPRESENTATIVES INTERIM REPORT 2018 A REPORT TO THE HOUSE OF REPRESENTATIVES 86TH TEXAS LEGISLATURE FOUR PRICE CHAIRMAN COMMITTEE CLERK SANDRA TALTON ASSISTANT COMMITTEE CLERKS ELIZABETH FARLEY AUDREY RHYNERSON Select Committee On Opioids and Substance Abuse November 12, 2018 Four Price P.O. Box 2910 Chairman Austin, Texas 78768-2910 The Honorable Joe Straus Speaker, Texas House of Representatives Members of the Texas House of Representatives Texas State Capitol, Rm. 2W.13 Austin, Texas 78701 Dear Mr. Speaker and Fellow Members: The Select Committee on Opioids and Substance Abuse of the Eighty-fifth Legislature hereby submits its interim report including recommendations for consideration by the Eighty-sixth Legislature. Respectfully submitted, __________________________ Four Price, Chairman __________________________ __________________________ Joe Moody, Vice Chairman Representative Carol Alvarado __________________________ __________________________ Representative Garnet Coleman Representative Jay Dean __________________________ __________________________ Representative Ina Minjarez Representative Andrew Murr __________________________ __________________________ Representative Poncho Nevárez Representative Kevin Roberts ________________________ ________________________ Representative Toni Rose Representative J.D. Sheffield __________________________ __________________________ Representative Gary VanDeaver Representative James White ACKNOWLEDGEMENTS The Chairman, the Vice-Chairman, and the Members of the House Select Committee on Opioids and Substance Abuse would like to acknowledge and thank Ms. Sandra Talton, Committee Director, for her dedication throughout the entire committee process and for preparation of this report. The Chairman, the Vice-Chairman, and the Members of the House Select Committee on Opioids and Substance Abuse also express gratitude to Ms. Elizabeth Farley and Ms. Audrey Rhynerson, Assistant Committee Clerks, for their assistance during the committee process and throughout the writing of the report and to each Member's respective office staff for their efforts on the success of the House Select Committee on Opioids and Substance Abuse. TABLE OF CONTENTS SELECT COMMITTEE ON OPIOIDS AND SUBSTANCE ABUSE ......................................... 1 EXECUTIVE SUMMARY ............................................................................................................ 1 INTRODUCTION .......................................................................................................................... 3 INTERIM STUDY CHARGES ...................................................................................................... 6 PUBLIC HEARING 1: CHARGE 1 - OPIOIDS AND SUBSTANCE ABUSE............................ 8 Brief History ........................................................................................................................... 8 Statistics .................................................................................................................................. 9 Overview of Substances ........................................................................................................ 11 The State of the Crisis ........................................................................................................... 12 Recent Legislative Actions and Funding Measures .............................................................. 14 National and State Overviews ............................................................................................... 17 Substance Abuse and Mental Health Services Administration (SAMHSA) and Association of Substance Abuse Programs (ASAP) ..................................................................................... 17 PhRMA ................................................................................................................................. 19 Programs and Services in Texas ........................................................................................... 20 Department of State Health Services (DSHS) ...................................................................... 20 Health and Human Services Commission (HHSC) .............................................................. 21 Department of Family and Protective Services (DFPS) ....................................................... 23 Texas Department of Criminal Justice (TDCJ) .................................................................... 24 Office of the Governor - Criminal Justice Division (CJD) ................................................... 26 Advocates .............................................................................................................................. 26 Texas Council of Community Centers .................................................................................. 26 Texas Hospital Association (THA) ....................................................................................... 27 Meadows Mental Health Policy Institute (MMHPI) ............................................................ 27 Texas Association of Health Plans (TAHP) ......................................................................... 29 Challenges ............................................................................................................................. 30 Recommendations ................................................................................................................. 30 PUBLIC HEARING 2: CHARGE 6 - REVIEW OF OPIOIDS AND SUBSTANCE ABUSE IMPACT ON THE CHILD PROTECTIVE SERVICES SYSTEM, CHARGE 1 - OPIOIDS AND SUBSTANCE ABUSE (OVERVIEW CONTINUED), CHARGE 2 - REVIEW OF PREVALENCE OF SUBSTANCE ABUSE AND SUBSTANCE USE DISORDERS IN SPECIFIED POPULATIONS, AND CHARGE 3 - REVIEW OF POLICIES/GUIDELINES OF STATE AGENCIES TO MONITOR FOR AND PREVENT ABUSE OF PRESCRIPTION DRUGS IN STATE-FUNDED/ADMINISTERED PROGRAMS ............................................... 33 Charge 6: Review of Opioids and Substance Abuse Impact on the Child Protective Services System ................................................................................................................................... 34 Charge 1: Opioids and Substance Abuse (Overview Continued) ......................................... 34 Statistics ................................................................................................................................ 34 Providers of Substance Abuse Services ................................................................................ 35 Charlie's Place Recovery Center (Charlie's Place) ............................................................... 35 Memorial Hermann Prevention and Recovery Center (PaRC) ............................................. 36 Charge 2: Review of Prevalence of Substance Abuse and Substance Use Disorders in Specified Populations............................................................................................................ 37 Pregnant Women ................................................................................................................... 37 Background ........................................................................................................................... 37 Programs and Providers of Services ..................................................................................... 38 Health and Human Services Commission (HHSC) - Neonatal Abstinence Syndrome ........ 38 Department of State Health Services (DSHS) - Maternal Mortality and Morbidity ............ 39 Homeless Individuals ............................................................................................................ 40 Programs and Providers of Services ..................................................................................... 41 Health and Human Services Commission (HHSC) Referenced Programs ........................... 41 Texas Department of Housing and Community Affairs (TDHCA) Programs ..................... 42 A Best Practice Community Based Services Provider - Haven for Hope ............................ 42 Veterans ................................................................................................................................ 43 Programs and Providers of Services ..................................................................................... 44 Texas Veterans Commission (TVC) and Health and Human Services Commission (HHSC) ............................................................................................................................................... 44 Metrocare Services................................................................................................................ 45 Aliviane ................................................................................................................................. 46 Challenges Related to Charge 2 ............................................................................................ 46 Charge 3: Review of Policies/Guidelines of State Agencies to Monitor For and Prevent Abuse Of Prescription Drugs in State-Funded/Administered Programs.......................................... 47 Texas Medicaid Program (administered by Health and Human Services Commission) ...... 47 Texas Department of Insurance Division of Workers' Compensation (DWC)..................... 48
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