Senator Collins also urged the health experts to address neonatal abstinence syndrome, shortage of substance use counselors in rural areas
Washington, D.C. – Today, U.S. Senator Susan Collins (R-ME), a member of the Senate Health Committee, participated in a hearing titled, “Strengthening Federal Mental Health and Substance Use Disorder Programs: Opportunities, Challenges, and Emerging Issues.”
In light of the 9,500 drug overdoses that occurred in 2021 in Maine, Senator Collins emphasized to the administration officials that more data is necessary to track nonfatal overdoses. This data is critical for law enforcement and health care providers to appropriately gauge the scope of the crisis in their local communities and target resources where they are needed. Senator Collins also urged the administration officials to take steps to address neonatal abstinence syndrome—which disproportionately impacts Maine—as well as take steps to help increase the number of substance use disorder professionals in rural areas.
Witnesses testifying today included Miriam Delphin-Rittmon, PhD, Assistant Secretary for Mental Health and Substance Use, Substance Abuse and Mental Health Services Administration (SAMSA), and Carole Johnson, Administrator, Health Resources and Services Administration (HRSA).
Senator Collins began by asking Dr. Delphin-Rittmon about the troubling number of nonfatal drug overdoses in Maine and how to better support individuals struggling with addiction.
Sen. Collins said: “In Maine last year, we had 636 deaths, a 23 percent increase, primarily as a result of fentanyl. This is the highest level we've ever experienced, but what is equally troubling is if you look at total overdoses in 2021, the number exceeds 9,500. And what I'm hearing from law enforcement and public health officials is that they need data on nonfatal overdoses in order to identify and investigate the sources of opioids and fentanyl and other drugs in their communities, and to be able to direct people to drug treatment programs. I'm working on a bill based on recent GAO recommendations, which would require the Administration to improve the timeliness, accuracy, and accessibility of both fatal and nonfatal overdose data. During our meeting prior to your confirmation, you described yourself as a data person, would you support legislation to provide better information on nonfatal overdoses? Because if we're just looking at the tragic deaths, we are missing the picture.”
Dr. Delphin-Rittmon responded, “It's so important that we have a good sense of both overdose data as well as non[fatal] overdose data. We'll be definitely interested in talking with you further about that. I think to the extent that we can understand some of the non[fatal] overdose trends as well, it could help to inform programs, and services, and interventions, so happy to have further conversations about that. I do believe that will be an important area of work.”
Senator Collins turned next to the topic of neonatal abstinence syndrome and questioned Dr. Delphin-Rittmon on how the Women, Infants, and Children (WIC) program can better serve mothers and children struggling with this heartbreaking condition.
Sen. Collins said: “Maine has the terrible distinction of having the second highest rate of neonatal abstinence syndrome in our country…in 2020, 901 babies were born drug affected. As a member of the Appropriations Committee, I've encouraged the Administration to enhance efforts to screen, treat, and support infants through the WIC program. USDA designates neonatal abstinence syndrome as a nutrition risk. WIC programs do not currently have uniform, evidence-based nutrition educational materials. Does SAMHSA coordinate with USDA on this issue?
Dr. Delphin-Rittmon responded: “So the WIC program is… a USDA program, although we do have coordination and collaborations with USDA, and can certainly develop additional work in this area. We currently have collaborations related to rural technical assistance related to opioid use, but can certainly expand our working collaboration in terms of the WIC program as well which they administer.”
Senator Collins concluded by asking Ms. Johnson about how HRSA’s STAR Loan Repayment Program can better address the nationwide shortage of medical providers.
Sen. Collins said: “[The STAR Loan Repayment Program] offers loan repayment to eligible substance use disorder professionals who agree to work in areas that are located in the country with overdose rates that are greater than the national average or have mental health professional shortages. Unfortunately, what we're finding in Maine is that some clinicians have been denied loan repayment because HRSA does not consider telehealth patient care, unless both the originating site where the provider is located and the distant site where the patient is meet the geographic criteria, and that's in conflict with the flexibilities that Congress enacted to enable access to telehealth during the COVID public health emergency. I've written to HRSA on this, and I'm told that you need a legislative fix. Would you support making such a change to ensure that qualified substance use disorder professionals are not disadvantaged because the care delivery for vulnerable patients has shifted to telehealth during this pandemic, particularly for rural areas and underserved communities?”
Ms. Johnson responded: “As you know, HRSA is the home of the Federal Office of Rural Health Policy. We are very dedicated to making sure that we are doing everything we can to get services and supports to rural communities. And increasingly, as you know, our loan repayment programs are reaching into rural communities, and we are doing everything we can to ensure those programs continue to grow in rural areas. We also have used a number of COVID flexibilities, as many as we can, throughout the pandemic for our loan repayment program. So I’m very interested in having a follow-up conversation with your staff about the opportunities here because we want to support rural communities as much as possible.”
As a member of the Health Committee and Appropriations Committee, Senator Collins is dedicated to providing Mainers and local communities with the treatment and resources they need to tackle the opioid epidemic. In January, Senators Collins, Ben Ray Luján (D-NM), and Bob Casey (D-PA) introduced a bipartisan bill to expand access to mental health resources during public health emergencies. This bill was included in the PREVENT Pandemics Act, which was favorably reported from Committee on March 15.
Senator Collins has also been an advocate for combatting the rural health care workforce shortage. In January, Senators Collins, Tina Smith (D-MN), Cory Booker (D-NJ), and Lisa Murkowski (R-AK) introduced bipartisan legislation to reinforce and expand our public health workforce amidst significant shortages. In November 2021, Senator Collins joined Senator Maggie Hassan (D-NH) in introducing bipartisan legislation to support hospitals in hiring and training doctors in addiction medicine, addiction psychiatry, and pain management.