May 15, 2018

Udall, Heinrich, Luján Call for NM Counties to be Prioritized in Federal Funding to Fight the Opioid Epidemic

WASHINGTON - Today, U.S. Senators Tom Udall and Martin Heinrich and U.S. Representative Ben Ray Luján urged the Health Resources and Services Administration (HRSA) to include New Mexico counties in the list of rural counties that will be prioritized for federal funding to fight the opioid epidemic.

HRSA will soon award grants as part of a new Rural Communities Opioids Response Planning Initiative focused on counties considered "at risk" based on the Centers for Disease Control and Prevention's (CDC) recommendations. However, the CDC’s list of 220 counties prioritized counties based on confirmed HIV and acute hepatitis C virus (HVC) infection rates rather than opioid overdose rates, and does not include any counties in New Mexico – including Rio Arriba County, which ranks in the top five in the nation for rates of overdose deaths involving opioids. The lawmakers are concerned that the list of counties was not based on a comprehensive assessment of what rural counties are experiencing related to the opioid epidemic and that the $100,000,000 that Congress appropriated for this initiative will not be spent as Congress intended.

In a letter to HRSA Administrator Dr. George Sigounas the lawmakers wrote, “As you know, in establishing this new initiative, Congress required HRSA to support treatment for and prevention of substance use disorder on those 220 counties and other rural communities ‘at the highest risk for substance use disorder.’ However, based on the recent release of the intended 220 counties and explanation of its methodology, we are very concerned that HRSA will fail to accurately direct support to the rural communities at the highest risk for substance use disorder.”

“We are deeply concerned that the current list leaves out counties in New Mexico that have had some of the highest rates of drug overdose in the nation for the last two decades. New Mexico has also experienced rapid outbreaks of HCV due to intravenous drug use, and in response it has developed one of the best HCV intervention strategies in the country. However, challenges still remain and access to treatment is still out of reach for many families in our state,” the lawmakers wrote. “In 2016 Rio Arriba county in northern New Mexico had 90 drug overdose deaths per 100,000 people. The CDC reported that New Mexico, a largely rural state, had 497 deaths in 2016 as a result of drug overdose. Federal resources are desperately needed to help combat this epidemic in our state…. We urge you to act quickly to more effectively prioritize rural comminutes that this program was intended to reach. We are eager to see this initiative succeed and to reach the rural communities that are desperately in need of it.”

Lauren Reichelt, Director of Health and Human Services Director for Rio Arriba County, said, “Rio Arriba County finds a great deal wrong with this ranking. They are promoting this list as counties vulnerable to opioids, when in fact, it is a list of counties vulnerable to HIV transmission through injection. While HIV spread is important, this list is being used by HRSA and CDC to prioritize counties for funding for opioid treatment, an entirely different problem.”

Full text of the letter is available HERE and below:

Dear Administrator Sigounas,

We write to express our concern regarding the Health Resources and Services Administration’s (HRSA) recent announcement about the new Rural Communities Opioid Response (Planning) (RCORP) initiative in FY 2018. RCORP intends to focus resources on 220 counties identified by a Center’s for Disease Control (CDC) county-level vulnerability assessment for rapid dissemination of HIV or HCV infections among persons who inject drugs. As you know, in establishing this new initiative, Congress required HRSA to support treatment for and prevention of substance use disorder on those 220 counties and other rural communities “at the highest risk for substance use disorder.” However, based on the recent release of the intended 220 counties and explanation of its methodology, we are very concerned that HRSA will fail to accurately direct support to the rural communities at the highest risk for substance use disorder.

The 2016 CDC vulnerability assessment sited in HRSA’s grant announcement is an important study that was created to identify counties vulnerable to the rapid spread of HIV hepatitis C virus (HCV) infections in the wake of the HIV/HVC outbreak in Scott County Indiana. The assessment identified 220 counties that could potentially be at high risk of HIV or HVC infection among persons who inject drugs. While this is important information to implement harm reduction programs, like implementing infectious disease prevention strategies, including syringe services programs, it is not a comprehensive assessment of what rural counties are experiencing related to the opioid epidemic. Therefore we believe to target rural communities with the highest risk of substance use disorder, HRSA must expand the counties prioritized for this program. HRSA should identify those additional counties by using a formula that that identifies the actual risk of substance use disorder in a rural community.

We are deeply concerned that the current list leaves out counties in New Mexico that have had some of the highest rates of drug overdose in the nation for the last two decades. New Mexico has also experienced rapid outbreaks of HCV due to intravenous drug use, and in response it has developed one of the best HCV intervention strategies in the country. However, challenges still remain and access to treatment is still out of reach for many families in our state. In 2016 Rio Arriba county in northern New Mexico had 90 drug overdose deaths per 100,000 people. The CDC reported that New Mexico, a largely rural state, had 497 deaths in 2016 as a result of drug overdose. Federal resources are desperately needed to help combat this epidemic in our state.

We were pleased the FY 2018 spending bill included $100,000,000 for this initiative and want to ensure that HRSA appropriately directs these resources. We understand that HRSA announced that it plans to issue a Notice of Funding Opportunity soon to award 75 grantees up to $200,000 as part of the RCORP initiative. We ask that you adhere to the Congressional intent of this initiative and give equal consideration to other rural communities at the highest risk for substance use disorder as laid out in the 2018 Omnibus, not just those outlined in the CDC vulnerability assessment. We urge you to act quickly to more effectively prioritize rural comminutes that this program was intended to reach.

We are eager to see this initiative succeed and to reach the rural communities that are desperately in need of it. Thank you for your consideration and should you have any questions please contact our offices.