Arizona Opioid Treatment Coalition (AOTC) Monthly Meeting 
Wed, May 14, 2025

Summary:

The Arizona Opioid Treatment Coalition convened to address various logistical and operational challenges related to opioid treatment in the state. Technical difficulties with meeting invites were discussed, with participants expressing concerns about joining the wrong session. Suggestions were made to create a new invite to streamline future communications. The use of an AI tool for minute-taking was also noted, indicating an effort to improve documentation during meetings.

Significant updates on state-level opioid treatment issues were shared, including the veto of a bill affecting the zoning of opioid prevention centers and ongoing budget negotiations amid leadership changes at the Arizona Department of Health Services. Catherine highlighted the political challenges faced by the Arizona Family Support Alliance, emphasizing the need for adaptability in decision-making processes due to the absence of an official director. The current political climate remains uncertain, impacting stakeholders' ability to navigate these changes effectively.

The discussion also focused on recent changes to opioid treatment program reimbursement rates, with concerns raised about some providers not receiving the updated rates in their reimbursements. Vicky reported issues with claims being denied by major healthcare plans, prompting a conversation about the necessity for agencies to verify their billing practices. Additionally, updates on Medicaid changes revealed potential financial burdens for patients, particularly regarding new co-pays and work requirements, which could affect access to treatment.

Further insights included updates on telehealth regulations for buprenorphine prescriptions and the ongoing development of the Opioid Treatment Services Locator, which aims to enhance user experience. Concerns about naloxone accessibility and funding were raised, particularly in light of recent cuts and the uncertainty surrounding opioid settlement funds. The meeting concluded with discussions on the implications of rising substance use trends and the evolving funding landscape, underscoring the need for continued advocacy and adaptation in response to these challenges.


Chapters & Topics:

Meeting Logistics and Introductions
Nick Stavros opened the meeting by addressing issues with multiple invites, ensuring that participants could hear him clearly. Liana S Soto confirmed her attendance since September and clarified her association with Hope Center. The group discussed the confusion surrounding the meeting links, with several participants mentioning their attempts to join the correct session.

State-Level Updates on Opioid Treatment Initiatives
Nick Stavros shared updates regarding Arizona's opioid treatment initiatives, highlighting the veto of a bill that would have restricted zoning for opioid prevention centers. He also noted that budget negotiations are still ongoing and that there is uncertainty due to the interim leadership at ADHS and ACCESS. Catherine Dobler added that AFSA is navigating political gridlock and leadership reorganization, with Kristin Shalifoam and Mark jointly leading decision-making.

OTP Code and Rate Discussion
Nick Stavros raised concerns about the implementation of the new OTP reimbursement rates, noting that some agencies were not seeing the increased rates reflected in their reimbursements. Vicky confirmed that claims for the H033 code were being denied by multiple plans, including United Healthcare Community Plan. Catherine Dobler clarified that the rate increase was effective for services starting April 1, and emphasized the importance of billing at the new rate to receive proper reimbursement.

Medicaid Updates and Patient Concerns
Nick Stavros addressed the current state of Medicaid proposals, noting that while some harmful provisions have been removed, new challenges such as work requirements and co-pays are emerging. He emphasized the importance of supporting patients in navigating these changes, particularly with the potential for a six-month renewal process for Medicaid. Stavros encouraged open communication among staff and patients to alleviate fears and promote advocacy efforts.

Rx Summit Updates and Funding Concerns
At the Rx Summit, Nick Stavros noted RFK Jr.'s endorsement of methadone and buprenorphine in addressing the opioid crisis. He also mentioned the ARPA funding cuts resulting from an executive order, which are currently being litigated, and advised members to stop billing for these funds. Additionally, he discussed the draft of the SUPPORT Act, which includes significant cuts to federal agencies but indicated that CSAT and the Division of Pharmacological Therapy are expected to remain unaffected.

Updates on Telehealth and Buprenorphine Prescriptions
Nick Stavros discussed the current telehealth regulations for buprenorphine, confirming that telemed inductions can occur without in-person visits until the end of the year. Mark Grant raised a question about the potential for longer prescription refills, but responses from Elizabeth Moran and Catherine Dobler suggested that most are still issuing monthly prescriptions. Liana Soto mentioned that her practice has been able to provide three-month prescriptions without denials.

System Partner Updates and Opioid Treatment Locator Enhancements
Catherine Dobler discussed the current status of the Opioid Treatment Services Locator, noting that both the DHS and ACCESS are without permanent directors. She outlined enhancements to the locator, such as a chatbot feature and compliance indicators for treatment programs. Catherine also mentioned the importance of accurate provider profiles and the need for contracted programs to submit annual reports to maintain compliance.
* Discussion on the Opioid Treatment Services Locator and its verification process.

Naloxone Access and Funding Challenges in Arizona
Nick Stavros highlighted the challenges surrounding naloxone access, particularly for harm reduction groups in Arizona. Catherine Dobler clarified that although ARPA funding has been reduced, naloxone remains available through state opioid response dollars and various distribution channels. However, she warned that funding availability may change significantly after September 30th due to anticipated Medicaid retractions.

Trends in Substance Use and Testing
Nick Stavros pointed out the detection of carfentanil in Pima County and discussed the rising positivity rates for buprenorphine among patients entering treatment. Elizabeth Moran observed a return of heroin use, which had previously diminished, while Mark Grant noted anecdotal cases of withdrawal symptoms in patients starting buprenorphine. The group expressed concern about the implications of these trends on treatment efficacy and safety.
* Trends in substance use, particularly regarding buprenorphine and heroin usage.

Medicaid and Substance Use Block Grant Allocation Discussion
Mark Grant raised a question regarding the SUBG allocation for July 1, 2025, and its potential changes. Catherine Dobler explained that the funding landscape is uncertain, particularly due to the end of the FGBD block grant contract year and the impact of Medicaid decisions on substance use disorder treatment funding. She emphasized that planning is currently based on the existing federal formula for the SUBG block grant.
* Updates on state-level and national Medicaid proposals.

Funding Challenges and Future Outlook
Arbita Ferozepurwalla expressed concerns about the lack of SUBG funding in Maricopa, which is affecting the ability to support members on methadone. Catherine Dobler noted that while Medicaid is at risk due to budget cuts, the future of SUBG funding remains uncertain. Nick Stavros mentioned that he sent out a new meeting invite for next month, indicating a transition to a new Teams link.
* Confusion regarding meeting invites and links.


Action Items:

* Nick Stavros will email everyone a new meeting link to ensure all participants can join the correct meeting.
* Vicky will start a new invite for the next meeting to avoid confusion with the current invites.
* Nick Stavros will reach out to Allison Huff to obtain the meeting minutes generated by the AI tool.
* Nick Stavros will follow up on the potential changes regarding the frequency of buprenorphine prescriptions to clarify the current regulations.
* Catherine will communicate with providers to ensure their programs are listed correctly on the Opioid Treatment Services Locator.


Key Questions:

* What are the implications of the recent Medicaid proposals on patient access to services?
* What updates are there regarding the opioid treatment services locator?
* How will the changes in funding affect the availability of naloxone in Arizona after September?


Notepad:

* No notes