On opioid declaration, some say declaration should come with cash

The declaration of a national emergency for the opioid epidemic could fuel a classic Washington fight: the battle over money.

Some lawmakers and advocates say an emergency declaration on opioids will do little without significant federal funding to combat the staggering overdose death rates from prescription painkillers and heroin.

When asked how much money is needed, one advocate pointed to the fact that tens of thousands of people are dying every year.  

“So the math is almost incalculable,” said Andrew Kessler, founder of Slingshot Solutions, a consulting firm specializing in behavioral health policy.

{mosads}“If you’re going to say it’s an emergency, and you’re going to say we need funding, then it’s got to be comparable to other emergencies,” Kessler said. He pointed to a $5.4 billion emergency supplemental Congress passed to help address Ebola, a disease that killed two people in the United States.

It’s not clear that the emergency declaration would unlock any extra funds, and in any event, getting additional money through Congress doesn’t happen quickly.

“While this declaration would be an important step, cooperation with Congress to provide the necessary funding to properly support such an emergency declaration is critical,” four leaders of the House’s Bipartisan Heroin Task Force, two Democrats and two Republicans, wrote in a letter to Trump Friday.

“We urge you to work with Congress in a bipartisan fashion to advance emergency supplemental funding as well as legislative proposals.”

President Trump said on Aug. 10 that his administration was drafting paperwork to declare the opioid epidemic a national emergency, but a declaration has yet to be made.

“We are going to be doing that next week,” Trump declared at a press conference this week. “By the way, you know that’s a big step,” Trump added, saying that it’s been “time-consuming work.”

But there’s skepticism on how the process of hammering out the declaration is moving along. According to a source who has spoken with multiple employees in the executive branch, the people who would normally be briefed haven’t been briefed.

Various agencies — such as Health and Human Services (HHS), the Office of National Drug Control Policy and the Department of Justice — have been working to declare the epidemic an emergency and come up with long-term solutions to the crisis, an HHS official said.

There hasn’t been any indication from the administration on what form an emergency declaration would take, and whether it would come with money. Some say the declaration is an important step, and one that should be taken, even if Congress doesn’t dole out more funds.

“‘The bigger things that could happen are on the regulatory side,” said Jessica Nickel, the president and CEO of Addiction Policy Forum. She said potential changes could help overturn a statutory hurdle that bars Medicaid from paying for some residential treatment facilities, help increase access to medication-assisted treatment and more.

The move would be unprecedented, as a national emergency has never been declared for drug abuse, as they’re usually reserved for natural disasters and disease outbreaks.

The White House didn’t respond to questions about funding a national emergency declaration.

Traditionally, there’s two ways to declare a national emergency, and they normally happen quickly.  

The Department of Health and Human Services could declare an emergency under the Public Health Service Act, which is usually reserved for infectious diseases like Zika. Or, the president could make this declaration under the Stafford Act, typically used for natural disasters or terror attacks. The administration could also do both.

The amount of money left in the public health emergency fund is paltry — just $57,000.

The Disaster Relief Fund — reserved for Stafford Act emergencies — has roughly $4.3 billion left, according to FEMA, though a package is moving through Congress to up that fund after three hurricanes slammed the United States and its territories earlier this year.

Typically, the total amount of funding for this kind of emergency can’t exceed $5 million, though a declaration of a “major disaster” frees up more funding.

Last year Congress passed the Comprehensive Addiction and Recovery Act, which authorized grants to states to address the opioid crisis. Another bill, 21st Century Cures, appropriated a total of $1 billion for this effort over two years.

Sen. Maggie Hassan (D-N.H.) hails from one of the states the opioid epidemic has hit the hardest and is concerned with what she views as Trump’s “lack of urgency and his continued inaction.”

“I look forward to seeing more details about what kind of national emergency the president plans to declare and what new power and resources it would bring to our efforts to combat this epidemic, because an emergency declaration without additional resources will do little to help address this crisis,” Hassan said in a statement to The Hill.