Dr Bazron thank you for your call yesterday,
Our OUD patients in 2020 are on pace to die with a 50% increase overall and most dramatically in the homeless and 60-69 age group. So one might ask, why are our Black OUD patients in DC dying at the fastest rate in the country? In the Middle of the Worse Health Crisis in a Century …. Let me count the ways:
1- Mass disruption thru abrupt Medicaid MCO reassignment in 3 months (Oct 1- Dec 31, 2020) some of the most mentally challenged + OUD + unstably housed clients.
2- Feb 2020 callous removal of the homeless (MI +!OUD) from the 3rd Street Undepass and Franklyn Park.
3- Nov, 2019 DCHCF buprenorphine fiasco as reported in the City Paper.
4- Switch to inferior buprenorphine (yellow generics) in mid 2019.
5- Continued nonsensical Prior authorization for buprenorphine doses > 24 mgs. In the midst of a 95% fentanyl epidemic (African American patient nationwide receive only 2.7 % of buprenorphine prescriptions due to insurance discrimination).
6- Incarceration as treatment for OUD with Inconsistent MAT treatment and uninterrupted community reintegration.
7- Inconsistent notification of Medicaid MCOs and follow up when patients are incarcerated or hospitalized for drug related issues.
8- NO Medicaid MCO support for ”social determinants of health” (housing, transportation, food, etc) to community private providers of buprenorphine.
9- Non payment for same day Psychiatric and/or Primary Care and/or Social Worker (such policies completely undermine the concept of patient-centered, value-based care for complex individuals)
In spite of being “Blackballed” x 5 years by the DC Government, my opinion is obviously respected by the National Medical Association, HHS Office of Minority Health, National Academies of Science Engineering and Medicine, Georgetown Law School O’Neill Institute, Brookings Institution, Qlarant Quality Improvement, and American Society of Addiction Medicine.
I am NOT a RACIST but I can’t stomach foolishness when OUR PEOPLE ARE DYING in the STREETS due to these consistently INCOMPETENT PUBLIC HEALTH POLICIES!
Edwin C. Chapman, MD, DABIM, FASAM