KySAM Meeting Minutes 1-04-2012

Written by Tom Ingram, MD. Posted in Members Only

KYSAM minutes 010412 Start 7:32 End 8:52

present M. Lofwall, K. Clark, M. Jorrisch, C. Stewart, T. Ingram, R. Peavler, R. Middleton, B. Tabler, L. Hayes, J. Zinner

1. Minutes of September 27, 2011 were approved.
2. President’s report: attached
In addition K. Clark had meeting with DEA with request for physicians to report to them inappropriate prescribing practices and pharmacy utilization.
3. Vice President report: M. Lofwall is meeting with the governor’s advisory council on opiate Rx abuse. Presentations came from Project UNITE, KBML, and Pharmacy Board. Concerns were raised about new pain clinics in Kentucky as pipeline from Florida has been limited. Primary goal is to develop recommendations for use of Kasper and KYSAM has specifically been asked to make suggestions that Dr. Lofwall can present to this committee.
4. Treasurer’s Report: Current account balance is $2424.99 after recent deposit of $157.00. Outstanding deposit of $324 would increase balance to $2748.99 Account now held at Commonwealth Bank. Tax exempt status has expired and Dr. Jorrisch will be contacting ASAM to renew.
5. Membership Report: Dr. Stewart will be maintaining up to date membership list for mailings. A reminder is made of half price membership available to new members or to memberships that have lapsed. There is an ‘add a member’ program through ASAM with benefits to those bringing most new members to organization. As new members join there is to be proper notification to KYSAM.
6. Website: Dr. Ingram has developed KYSAM website which is up and running (Ky-sam.org). All members are encouraged to register. There will be a mechanism for postings (to be first reviewed by Dr. Ingram). A copy of the constitution will be available.
7. Old business: the constitution for KYSAM was presented and discussed. Consideration was made to terminology and decided that ‘addiction medicine physicians’ would be used rather than ‘addictionologists’. As well ‘addictions’ would be replaced by ‘addictions and other substance use disorders’. A vote was completed for acceptance.
An official place of business will be necessary but would be established for the time being as Dr. Kelly Clark’s (or current President) home address.
8. New business: CAPTASA and upcoming conference was discussed relative to it’s unwillingness to embrace MAT. Decision was made to maintain a relationship with CAPTASA, to look for ‘peaceful coexistence’, not to actively seek participation, but to be open to active involvement in the future.
Other business including State funding of Medicaid for addiction treatment specifically suboxone. A request from Dr. Eleanor McCance (AAAP) was made to Dr. Lofwall for contact information for persons that make decisions about Kentucky Medicaid practice because of problems with many states having arbitrary durations of treatment and dosing requirements on their stat PA’s. Together AAAP, APA, ASAM, and possibly SAMHSA will be writing letters to state Medicaid programs concering these troublesome PA’s elements. Kentucky physicians need to be approved providers of Medicaid in general. Prior authorization is necessary.
9. Next meeting: to be held again by conference call at a date to coincide with ASAM meeting in Atlanta April 19-22. All physicians are encouraged to attend this meeting. The KYSAM annual meeting will be held in September (date to be established) at a central location.

Respectfully Mark Jorrisch, MD

 

Addendum: President’s Report:

KC report jan 4 to KYSAM:

 

Development of organization:

(for starters, look at our agenda!)

-          we have a constitution to vote on

-          we have a list serve to communicate with other addictionists in KY

-          we have some recognition building via involvement with gov’n task force of prescription abuse (Michele sits on that committee and  I met with Mary Helen Davis to offer KYSAM as a resource)

-          our website development is progressing

-          we have engaged ASAM in  waving some initial dues to help us grow the KYSAM membership

-          we have a list serve to communicate with other addictionists in KY

-          we have contact information for KYSAM officers on the ASAM site

-          KYSAM has had the “freeze” on our membership dues lifted by ASAM with revenue into our coffers for the first time in years.

-          We have responded to halt the use of our name to advertise activities which we have not endorsed ( CAPTASA)

 

Announcements:

  1. ASAM BOD is an open meeting to members and is held the two days immediately preceding the Med-Sci annual meeting (BOD is 4/17 and 18; Med-Sci is April 19-22).  All ASAM members are welcome.
  2. The prior week in Orlando, April 10-12 is the National Prescription Drug Abuse Summit, sponsored by the Appalachian Regional Commission and Project UNITE
  3. I met with Humana’s Head of State Relationships; discussed the business case to become involved in problem of prescription abuse in KY.
  4. The DEA agent for the Louisville office and points west is Jason Smith.  He would like ot know about abnormal prescribing practices we may encounter, be the outliers office-based physicians, or from urgent care/ERs, dentists, or pharmacies.  His telephone number is 502-475-6379 and email Jason.r.smith@us.doj.gov.  As a reminder, the ASAM website has information on how to approach a visit from the DEA regarding buprenorphine prescribing. Agents are visiting all doctors prescribing bupe using an X number ( docs prescribing for pain without an X number are practicing without this oversight).

Time Limits on Suboxone Therapy

Written by Tom Ingram, MD. Posted in Kentucky Issues

I am very concerned about the movement developing in a few areas of the country to put a time limit on buprenorphine therapy for treating addiction.  The medical, community health, and economic arguments are all strongly aligned in favor of ensuring the availability to all affected patients of evidence based treatments, such as buprenorphine office based therapy.  Unfortunately, short-sighted dollar savings in pharmacy benefits during a time of a weak economy appears to be invoked to justify the stigmatization of people with addictive disease.  The economic argument in favor of evidence based medical care as well as the social costs of this epidemic seems to be getting lost in some areas of the country.

The overwhelming evidence, including the recent Health Affairs article, the data on ER usage, unnecessary MRI/CT usage and unnecessary physician appointments to obtain controlled drugs, the morbidity and mortality associated with the abuse of pure opioid agonists, as well as the societal costs of this epidemic must be the basis of rational coverage decisions for therapies.  These decisions must not be made on the random whim of a pharmaceutical carve-out company, which concerned neither with the other more expensive costs of care of our patients, nor the quality of the lives of our patients, their children, and their communities.
We do not want the people of Kentucky to be unable to access evidence-based treatments and best-practices of medicine.  We know that the taxpayers and employers of Kentucky, as well as all the stakeholder citizens affected by prescription opioid abuse in Kentucky, want the most valuable and cost-effective care for Kentuckians.
If arbitrary limits are being proposed on coverage of this care, KYSAM has an obligation to respond in our role of the state’s experts in the medical treatment of the addictions.  In the member’s section, KYSAM members have the opportunity to discuss this issue among ourselves. This website also allows KYSAM to receive information from others interested in this issue.
 I urge everyone concerned with ensuring access of Kentuckians to medically rational, evidenced based care for addictions to closely monitor and be involved in this issue.

KY Governors Task Force on KASPER

Written by Tom Ingram, MD. Posted in Kentucky Issues

Below are files from the most recent meeting of the Ky Governors Task Force on KASPER.

Law Enforcement use of KASPER

KASPER Task Force 12.2.11

KASPER Advisory Council Overview 12-2011

KASPER Advisory Council Minutes 12-02-2011

 

Submitted by:

Michelle Lofwall, M.D.
University of Kentucky College of Medicine
Departments of Psychiatry and Behavioral Science
Center on Drug and Alcohol Research
Lexington, KY 40502
Office: (859) 323-6774

KYSAM Officers

Written by Tom Ingram, MD. Posted in About KYSAM, Officers

2012  Officers
President: Kelly Clark, M.D.
Vice President: Michelle Lofwall, M.D.
Secretary/Treasurer: Mark Jorrisch, M.D.
Director-at-Large: Rich Soper, M.D.

 

In other leadership positions we also have:
Chair of Membership Committee: Chris Stewart, M.D
Developer of KYSAM Website: Tom Ingram, M.D.