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‘Baby step’ bill to oversee the NH addiction care system fails

State lawmakers want to wait another year before passing legislation that would provide more oversight of New Hampshire’s substance use disorder treatment programs, disappointing advocates and treatment providers.

The bill, first proposed in December, was introduced in direct response to the NHPR’s investigation into sexual misconduct in recovery communities, as seen on the podcast “The 13th Step.”

Although the proposal was introduced with bipartisan support and was significantly watered down in recent months, some lawmakers were concerned that there were still too many unanswered questions about how the proposal would work. The bill was introduced during a conference committee meeting on Thursday.

“I think throughout this process there has been universal recognition of the need to better strengthen our substance abuse treatment system and better serve individuals across the system,” said Jake Berry, vice president of Policy for New Futures, the advocacy group that helped write and lobby for the bill.

However, Berry added, “I think some lawmakers felt that this bill did not answer or clarify their questions about the best way to achieve our shared goals.”

The original proposal included two ideas: First, the bill created a system that requires any substance abuse treatment provider to be certified by the New Hampshire Department of Health and Human Services. Addiction treatment facilities without this certification would not be allowed to operate in the state. The bill never specified what that process would look like, leaving regulations up to the discretion of the Department of Health, if passed.

But that component was eventually reduced to only outpatient providers, in response to concerns from some DHHS staff, so as not to overlap with existing state licensing for residential providers. In its final form, the bill was, as DHHS’s Jenny O’Higgins put it, “the baby step” the agency needed to start putting in place the rules and staff needed for additional oversight.

According to DHHS, the state is currently aware of 65 outpatient treatment organizations registered with Medicaid, yet the state of New Hampshire only contracts with nine of them. That means there are 56 facilities that provide substance abuse treatment without state oversight — and those are just the facilities that DHHS is aware of.

The second part of the proposed bill would have added a position in the Department of Health’s ombudsman office specifically charged with handling and investigating complaints about mental health or substance abuse facilities. Advocates have long worried about a “culture of silence” within the addiction care industry, in which people seeking recovery are afraid to come forward about misconduct out of shame, fear of not being believed, or because the perpetrator of the abuse intimidation or the abuse is in the corner. a position of power or authority. Their goal was to create a clearer path for clients with complaints about harm or the quality of treatment to express these concerns.

The bill passed the Senate, but the House of Representatives voted to refer the bill to interim examination. Advocates tried to revive the proposal by linking it to another bill moving through the state legislature. But that last-ditch effort came to an end on Thursday.

Throughout the process, lawmakers have raised questions about costs and staffing requirements. It was also clear that some lawmakers were unclear about what they were protecting people with substance use disorders from, or what problem this legislation could solve.

At a conference committee meeting Thursday, Republican Rep. Matthew Simon of Grafton asked Berry if there were any statistics Berry could provide that “indicate the urgency” of misconduct in New Hampshire treatment facilities.

“There’s no way to know, and that’s one of the reasons we’re here,” Berry said. “There is no monitoring mechanism. There is no way for the state to track these things, to handle these types of complaints right now. That is what we are trying to achieve here.”

The bill will now move to an interim study, meaning a group of House members will discuss the legislation sometime this summer and fall, with the hope of introducing new legislation based on it next year.

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