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Spotlight hits Huntington’s recovery needs


The Herald-Dispatch

HUNTINGTON, W.Va.  — A week ago, as first lady Melania Trump sat down within earshot of about a dozen infants suffering addiction withdrawal and asked what the White House could do for Lily’s Place, there was one glaring tangle of red tape on Rebecca Crowder’s mind.

Rebecca Crowder, executive director of Lily’s Place
(Herald-Dispatch photo by Ryan Fischer)

The world’s first center established for the sole purpose of treating babies born with neonatal abstinence syndrome along 7th Avenue in Huntington had hit a legal wall in that it can only accept infants from one-third of the Tri-State: West Virginia. Even those born within walking distance at Cabell Huntington Hospital, and within sight of the state of Ohio, must remain in the hospital’s often overwhelmed neonatal therapeutic unit.

As it stands, Lily’s Place cannot be licensed through Medicaid to accept infants from other states because a federal licensing category for NAS centers has not been defined, Lily’s Place being the first of its kind with no equivalent facility yet open in Ohio or Kentucky.

“It’s heartbreaking when a mother gives birth at Cabell Huntington Hospital, calls me and tells me she wants to come here, and I have to say no because of money. It’s just not right,” said Crowder, executive director of Lily’s Place since 2015.

“They might be beyond full, and we’ll be sitting half empty and not be able to take a baby because we can’t take an Ohio baby. That’s not fair to the family, and it’s not fair to the hospital.”

Nationwide licensing sought

What it would take for that to change, and what Crowder asked of the first lady, was for NAS centers to receive nationwide licensing through Medicaid to serve babies from any state. Such recognition would not only allow Lily’s Place to operate at its fullest capacity and shore up its funding, but also would pave the way for future NAS centers.

“What’s going to sustain the program is to be able to serve more individuals and bill more; that’s what I specifically asked for help with,” Crowder said.

Lily’s Place relies on grants and public donations for around 40 percent of its annual funding. Nationwide licensing, which would allow the center to be reimbursed more through Medicaid along with serving a new market of out-of-state residents, would drop the required fundraising to around 15 percent to 20 percent of its budget, Crowder said.

The majority of billing has fallen on West Virginia’s state government at this point, Crowder said, though adding the state has been exceptionally supportive of Lily’s Place as a pilot program to treat NAS, now touted as a nationwide example as the opioid epidemic gains more national exposure. Other states, however, may be leery of footing the bill for their own NAS centers if more of the burden is not passed to the federal government through Medicaid.

“For it to be successful elsewhere, it’s going to have to shift to where (NAS centers) are recognized federally in order to serve more people and get more reimbursements,” Crowder said.

Individual states have the ability to pass their own amendments requesting for its residents to be recognized through Medicaid in other states, though an overarching federal recognition would negate the need for such action.

The first lady left without any promises, but Crowder said it genuinely seemed like her visit was to educate herself in developing a plan. Crowder has been in contact with the White House for more than two weeks since first meeting the first lady during a White House discussion on addiction in Washington, D.C., last month.

“It wasn’t like a situation where they said thanks and walked out the door,” Crowder said. “They were like ‘OK, email me this. Tell me this.’ So I really feel like they’re going to follow up.”

Attention, for better and worse

West Virginia was approved for the Medicaid 1115 Waiver last Tuesday, which expands Medicaid coverage to several addiction-related treatments including methadone, naloxone, withdrawal management and recovery services. NAS treatment, however, was not included in the waiver.

But the waiver is certainly still a positive, said Bob Hansen, director of addiction services at the Marshall University Joan C. Edwards School of Medicine and Marshall Health. He credited Gov. Jim Justice and the state government for its work in soliciting more help from the federal levels.

“It’s a big step forward for all of us,” Hansen said of the waiver. “It’ll certainly help getting moms in treatment programs expanded locally in the state.”

Additional aid may be carved by the two-edged sword of global attention to the region’s opioid epidemic. While national media may have ignobly dubbed Huntington the “overdose capital of America,” Hansen said the city is now also receiving recognition for its innovative solutions to the problem as well.

Lily’s Place, the first of its kind, and the first lady’s visit Oct. 10, are examples of that.

Along with the first lady’s visit, Hansen said he has been encouraged that the Trump administration understands the opioid epidemic as a national problem that needs to be addressed.

Trump has said he will officially declare the opioid crisis a “national emergency” but so far has not done so. However, he said Monday he will make the designation next week, the Associated Press reported.

“That is a very, very big statement. It’s a very important step,” Trump said.

With healthcare reform and the mantra “repeal and replace” ringing out in Washington, Hansen said it remains too early to tell what any Medicaid reform, or cuts, would mean for addressing the region’s epidemic.

But if the title “epidemic” is to used to describe the problem, he added, it needs to be treated with the full focus of the federal government as it would with any other disease.

“We talk about the situation as the ‘opioid epidemic,’ and when you think about what an epidemic is and how to address it, I think it needs to be addressed by everyone with a sense of urgency,” Hansen said.

“It’s going to take a lot of time and effort, but if we’re going to call it an epidemic, there should be a sense of urgency.”

Follow reporter Bishop Nash on Twitter at @BishopNash.

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