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Pennsylvania agencies fighting opioid crisis fall short in key ways, audit finds

| Thursday, July 13, 2017, 6:45 p.m.
Steph Chambers | Tribune-Review
An empty heroin stamp bag.

If you want to evaluate a drug treatment center before you or a loved one checks in, the Pennsylvania Department of Drug and Alcohol Programs doesn't make it easy to find inspection data, much less interpret it.

The lone metric the state Department of Corrections uses to gauge if its alcohol rehabilitation program is working is whether or not the inmate reoffends.

And the state Department of Human Services isn't sure some of its opioid addition treatment data is accurate.

Those are among the key findings in a 94-page report Pennsylvania Auditor General Eugene DePasquale released Thursday that outlines improvements the three departments could make.

“From 2013 to 2015, Pennsylvania rose from ninth to sixth nationally in the number of opioid overdose deaths,” DePasquale said in a news release. “We have more than an opioid crisis in Pennsylvania; we have a disease epidemic that is ripping apart the lives, finances and families of people in every community. This epidemic will not go away overnight, so we must plan, (and) direct and coordinate our efforts to maximize the state's resources to help people.”

The report recognizes the difficulty in monitoring effectiveness of programs over time among a population of people with varying attitudes toward being monitored. The report also acknowledges the difficulty of evaluating how well any treatment among the range of available treatments best suits any particular person.

The Department of Drug and Alcohol Programs inspects drug treatment centers to make sure they are complying with regulations, but does not measure how effective its treatment initiatives are over time, the report states.

After inspections, the department lists deficiencies on its website but does not make it easy for people to find information on treatment center quality, according to the report. Unlike in the Department of Health's nursing home reports, the deficiencies are not sorted by severity, the report states, leaving website users to sift through regulatory jargon.

The department hasn't been fully funded since its creation in 2010, according to the report. It is understaffed, with just 11 staffers to inspect more than 700 licensed drug and alcohol treatment centers in the state – a number that is growing as need increases.

Were the department better funded, it might do more to monitor whether doctors are diverting buprenorphine, an opioid treatment, to illegal markets, according to the report. The report calls buprenorphine prescribing “under regulated” in Pennsylvania.

In a response to the audit, the department's acting secretary, Jennifer Smith, said the department is implementing a new data system that should help track treatment effectiveness. Smith said the department would work to expand on information on its website, including considering adding severity designations.

Gov. Tom Wolf's 2017-2018 budget includes more money for the department, Smith said.

The report notes that 64 percent of people entering the Pennsylvania correctional system have substance use disorders. The department operates drug treatment programs, yet only one of seven of the programs for alcohol and other drugs are monitored for effectiveness, according to the report. And that monitoring is limited to whether or not a person commits another crime.

Department of Corrections Secretary John Wetzel agreed the department doesn't formally monitor the programs on a “scheduled, reoccurring or regular” basis, but said the department has undergone independent evaluations of the seven programs.

Wetzel says in the response the department will take steps to improve.

The report recognizes the Department of Human Services for creating a network of Centers of Excellence meant to treat opioid addiction by addressing its roots in each person, but notes the department has no “apparent plans” to make sure the data it uses to monitor the centers is accurate.

In a response letter, DHS Secretary Ted Dallas agreed with the finding, saying the department would do more to ensure accuracy.

Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676, or via Twitter @wesventeicher.

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