HHS Removes X-waiver, Expanding Medication-assisted Treatment for Opioid Use Disorder

January 15th, 2021

This opinion was published by the American College of Emergency Physicians (ACEP) on January 14, 2021. HVCS concurs and seconds this congratulatory statement.

 

Washington, D.C.—The American College of Emergency Physicians (ACEP) applauds the U.S. Department of Health and Human Services’ (HHS) decision to effectively remove the “X-waiver” requirement for physicians, expanding their ability to utilize medication-assisted treatment (MAT) for patients struggling with opioid use disorder (OUD).

“As emergency physicians, we see every day the devastating effects that the opioid crisis has had on the communities we serve—a crisis that has unfortunately only worsened during the COVID-19 pandemic,” said Mark Rosenberg, DO, MBA, FACEP, president of ACEP. “Buprenorphine is the most important medication in our arsenal for treating opioid use disorder, which is currently one of the most lethal diseases for Americans.”

In the decision announced on January 14, HHS issued an exemption to the X-waiver requirement for physicians registered with the Drug Enforcement Administration (DEA) who wish to prescribe buprenorphine and other MAT. While the new guidelines pertain to physicians who treat no more than 30 patients with buprenorphine for opioid use disorder at any one time, ACEP appreciates that the Department recognized the unique nature of emergency medicine and decided not to apply this limitation to hospital-based physicians, including emergency physicians.

The X-waiver presents a major obstacle to “legitimate” patient access to buprenorphine and other MAT. Before today’s announcement, physicians wishing to prescribe buprenorphine outside of opioid treatment programs had to take an eight-hour course and often waited 60 to 90 days to receive the waiver once the course is completed and the license application is submitted. The presence of this X-waiver requirement has also led to misperception about MAT and has increased negative pre-conceived notions about OUD and the treatment of this disease. As a result, some clinicians are hesitant to pursue this DEA license or even engage in treatment of patients with OUD.

Removing the X-waiver and reducing stigma to treating OUD in the emergency department has been a major priority for ACEP. In January 2020, the College hosted the Summit Addressing the Opioid Stigma in the Emergency Department—an event funded by the federal Substance Abuse and Mental Health Services Administration as part of its Opioid Response Network in which stakeholders identified strategies and behaviors to reduce practices that perpetuate stigma in the emergency department. ACEP also sent a letter to HHS to illustrate the challenges of the X-waiver and supported H.R. 2482, the “Mainstreaming Addiction Treatment Act of 2019,” which would eliminate the waiver requirement.

Added Dr. Rosenberg, “This is a great day for our patients. The X-waiver was an outdated and cumbersome barrier to treatment, and it exacerbated stigma for those struggling with opioid use disorder. Now, more than ever, we need compassion and action in treating patients with addiction.”

Merger Date With Cornerstone Set for March 1

January 12th, 2021

Late last fall, we received word from the New York State Attorney General’s office that our plan to merge with Cornerstone Family Healthcare was approved, without any comments or requested changes to the plan. We have set a merger date of March 1, 2021 for the official merger.

What This Means For Clients:

Clients of HVCS should not see or feel any difference in services once we merge. All services and programs are staying intact and operational. Clients’ case managers and contacts will all remain the same. Our website, phone numbers and email addresses will also be the same, and our physical offices will remain where they are and open the same hours.

The changes for clients are all positive: we will be able to provide clients with more services via direct and active referrals to Cornerstone’s medical, dental, OBGYN, behavioral health and mental health programs. Clients will be able to see medical staff via telemedicine appointments, either from their home or from our offices.*

We have a handy FAQ guide for clients on our website, in English and Spanish.

What This Means For Supporters:

The Hudson Valley Community Services brand will continue, like our website. Our food and toiletry closets, client emergency funds, and fundraising programs will carry on as well. (We hope to bring back some of our fundraising events, too, once the Covid-19 pandemic has eased.) Donations made to HVCS will still be applied to HVCS programs.

Cornerstone Family HealthcareWhat Is Cornerstone?

Cornerstone Family Healthcare (CFH) is a non-profit Federally Qualified Health Center with a mission to provide high quality, comprehensive, primary and preventative health care services in an environment of caring, dignity and respect to all people regardless of their ability to pay. For more than fifty years, Cornerstone has been responsive to meeting the needs of the communities they serve with a continued emphasis on the under-served and those without access to health care–regardless of race, economic status, age, sex, sexual orientation or disability.

Since Cornerstone is also a non-profit, you can choose, in the future, to donate to the entire organization and help even more people access the healthcare they need. Cornerstone serves more than 40,000 people each year!

 

*All visits are by appointment only, until further notice.

Syringe Exchange Expands Into Westchester

January 11th, 2021

Project Reach Out vanSince the 1980’s, HVCS has provided services throughout Westchester County to people who use drugs, including HIV, STD and Hepatitis C prevention and education, HIV and STD testing, linkage to substance use disorder treatment services, and, when possible, emergency food and supplies. Many of these specific services were provided by our Project Reach Out program (PRO), which travels to Westchester’s urban areas—places hit hardest by the double HIV and opioid epidemics.

We were just approved to offer what is called “second tier syringe exchange” services via our PRO staff. They will be able to provide access to syringes, recoupment of used syringes, Narcan trainings, referrals to treatment, and information about prevention services to people who use drugs (PWUD). This is a form of “peer-delivered” services, where staff are permitted to carry out exchanges wherever they are, without being fixed to a particular location like our other syringe exchange programs in Rockland and in the Mid-Hudson.

This is a significant enhancement to the PRO program and a boon to Westchester’s PWUD population. By being embedded in the community and gaining clients’ trust, we aim to refer even more people to substance use treatment facilities and other services than ever before.

What’s Toya Cooking? A Free Recipe

January 5th, 2021
Our first-ever souvenir cookbook is here! Order your copies online–they are shipping now, right to your door! This full-color compilation cookbook is a hardcover over 85 pages long and will sell for $22.00 (plus a $4 shipping fee). That includes a $10 donation to HVCS. Our staff and board members submitted their favorite recipes–from the healthiest gluten-free vegan recipes to full-on frosted cakes. We’ve also got several all-time-favorite potluck recipes.
Here’s a recipe submitted by our Director of Human Resources, Toya, which was inadvertently left out of the book. But, you now get it for free!

Toya’s Oxtail

Ingredient Checklist:

  • 2 ½ pounds of oxtail
  • 1 tablespoon Worcestershire sauce
  • 1 tablespoon soy sauce
  • 1 tablespoon salt
  • 1 tablespoon white sugar
  • 1 teaspoon browning sauce
  • ½ teaspoon ground paprika
  • ¼ teaspoon ground cayenne pepper
  • ¼ teaspoon grown black pepper
  • 2 tablespoon vegetable oil
  • 1 small can of butter beans, rinsed and drained
  • 2 carrots, sliced or cubed
  • 2 stalks celery, sliced or cubed
  • 1 large onion chopped
  • 4 garlic cloves minced
  • 3 cups of low-sodium beef broth
  • 1 bunch of fresh thyme
  • 1 sprig of fresh rosemary
  • 1 bay leaf
  • 2 tablespoons unsalted butter

 

Directions:

  1. In a bowl put oxtail and combine Worcestershire sauce, soy sauce, salt, sugar, garlic and herb seasoning, browning sauce, paprika, cayenne pepper, and black pepper together in a small bowl. Rub both sides of oxtail with marinade; pour out excess.
  2. Heat vegetable oil in a large, deep skillet over medium-high heat. Sear oxtail in hot oil until golden brown, about 3 minutes per side. Remove to a plate and set a side.
  3. Saute carrots, celery, onion, and garlic in the same skillet until softened, about 5 minutes. Add butter beans, beef broth, thyme, rosemary, and bay leaf; bring to a boil. Add oxtail, with its juices, and butter. Reduce heat to low, cover, and simmer until oxtail is fork tender, about 3 hours. (You can also use a crock pot.)
  4. Uncover skillet and increase heat to high. Cook, stirring occasionally, until sauce reduces and thickens, about 5 minutes.

Our apologies to Toya–if you could only see what she brings to our staff potluck lunches!

New Podcast Episode Video: PTSD & Sexual Assault

December 10th, 2020

 

HVCS’ Andy Reid, Shakira Williams and Pat Ocasio talk with Prof. Sarah Espinosa, who teaches psychology at NYU, about the links between PTSD and sexual assault. This is part of our podcast series on sexual health. Learn more about our Women’s Services Program and our free STI (sexually transmitted infection) testing program.

New Podcast Episodes! “Let’s Talk About Porn”

December 1st, 2020

Peer Health Alliance PodcastOur Peer Health Alliance’s podcast returns for a second season with a three-part episode all about pornography. Some of our prevention specialists talk with Dr. Rev. Katie Cuminski, a professor at the College of Staten Island, about the effects of pornography on our sexuality, dating, and expectations. Settle in for this meaty discussion on this important and impactful topic. (And yes, these episodes are meant for adult ears only.)

Link to the episodes here:

https://anchor.fm/hvcspha/episodes/Lets-Talk-About-Porn-Part-1-en7jft

https://anchor.fm/hvcspha/episodes/Lets-Talk-About-Porn-Part-2-en7jpv

https://anchor.fm/hvcspha/episodes/Lets-Talk-About-Porn-Part-3-en7jr7

 

Or subscribe to ALL our episodes here: https://podcasts.apple.com/us/podcast/hvcs-peer-health-alliance/id1497018707

Most Important Meal Online Auction

November 13th, 2020

MIM AuctionInstead of our usual cereal buffet in-person event, this year’s Most Important Meal takes the form of an online auction. It will run for one week starting on Sunday, November 15th:

https://charitygrow.org/Browse/C821127/Hudson_Valley_Community_Services

Gift cards and most physical items were donated by generous supporters. The TV/movie memorabilia is on consignment from CharityGrow and will ship right to the winning bidder. Winners may need to pick up other items from whichever HVCS office is closest to them.

Once someone registers and places a bid, the website will contact them if they are outbid. Since expenses for this event were so low, we already have about $6,000 in profits thanks to our sponsors.

HVCS’ ESAP Explainer Video (Expanded Syringe Access Program)

November 2nd, 2020

HVCS created this video for the New York State “End the Epidemic” campaign.

Advocate With Gov Cuomo for Harm Reduction Services

October 22nd, 2020

Overdose, Hepatitis C, and HIV rates are climbing in New York State.
Do you have one minute to advocate for harm reduction services for people who use drugs?

Call the Governor and advocate!

Governor Cuomo’s Office: 518-474-8390

Use this handy phone script:

“Hello,
My name is _____________ and I’m calling from (part of the state you’re calling from) to talk to Gov. Cuomo about the overdose crisis and COVID-19. The current pandemic has worsened the overdose crisis, putting people who use drugs at risk across our state. The programs that provide services to them are losing. People are being arrested for carrying syringes and lifesaving medication like buprenorphine. New York law that criminalizes syringe possession and buprenorphine goes against public health, and can cause sharing or reusing of syringes. This will lead to increases in HIV and Hepatitis C infection.

Due to the Department of Health’s syringe shortage and fiscal issues, we are in a more urgent situation than ever before. Syringe service programs across the state do not have needed supplies, meaning people are carrying equipment longer, putting them at risk of arrest. Not only will decriminalizing syringes reduce unnecessary arrests, it will also reduce the amount of syringes that get unsafely discarded in our communities. Lifting Expanded Syringe Access Program (ESAP) limits at pharmacies will ensure people have access to what they need.

Governor Cuomo can and must act now. We need him to decriminalize syringes and buprenorphine, lift ESAP limits at pharmacies, and stop withholding harm reduction funds. *Optional: add in related personal experience*
Thank you for your time.”

Food & Toiletry Closets To Reopen Soon

October 22nd, 2020

As part of our gradual reopening plan, effective November 2nd, we will reopen all HVCS food closets for non-Thrives/non-Emily’s Pantry clients . (Those two programs were giving out food already.) HVCS staff have been working hard to restock and have all the pantries ready for distribution by November 2nd. We’re sure you are looking forward to returning to our offices and some sense of normalcy to your life.