Cantwell Introduces Bill to Take WA-Developed, Low-Barrier Fentanyl Treatment Pilot Program Nationwide

In UW study, access to Health Engagement Hubs shown to reduce fatal overdoses by a staggering 68%; Hubs would offer access to safe & free addiction treatment without an appointment; Bill intro falls day before 1-year anniversary of Cantwell’s first of 10 community roundtables on the fentanyl crisis

WASHINGTON, D.C. – Today, U.S. Senator Maria Cantwell (D-WA) and U.S. Senator Bill Cassidy (R-LA) introduced the Fatal Overdose Reduction Act, a bipartisan bill that would expand a Washington-state-developed, low-barrier fentanyl treatment pilot program across the United States.

“This bipartisan bill will create free, low-barrier, and evidence-based addiction treatment centers across the country. A University of Washington-led pilot program found that this Health Engagement Hub model achieved an astounding 68% reduction in fatal overdoses, which could make a real difference given last year we saw over a thousand deaths in King County alone. Access to treatment must be easier than access to fentanyl,” Sen. Cantwell said.

The Health Engagement Hub model was developed by Dr. Caleb Banta-Green at the University of Washington. The innovative hub model provides a one-stop shop where substance use disorder patients can receive near-immediate FDA-approved treatment (buprenorphine) and access primary care, harm reduction, and other social services without an appointment.

Research data from UW shows that, among 825 participants, this community-based, medication-first approach decreased overdose mortality rates by 68%.

In 2023, the Washington State Legislature funded a $4 million state pilot program to establish health engagement hubs because the model demonstrates great potential in addressing the opioid epidemic.

Today, Dr. Banta-Green addressed Sen. Cantwell and colleagues about the effectiveness of the Health Engagement Hub model during a hearing of the Senate Finance Committee titled “Front Lines of the Fentanyl Crisis: Supporting Communities and Combating Addiction through Prevention and Treatment.”

“We really need to allow people to access care rapidly and stay engaged. The process of recovery […] for opioids and stimulants, it's about three years. And during that process of recovery, people are often returning to use,” Dr. Banta-Green said. “We need a place that people can start today and come back tomorrow, no matter what.”

Watch today’s full hearing HERE; a transcript of Sen. Cantwell and Dr. Banta-Green’s remarks is HERE.

The Fatal Overdose Reduction Act would allow existing and qualifying entities to receive a Health Engagement Hub certification, similar to the process for mental health treatment centers to be designated as Certified Community Behavioral Health Centers. Under this bipartisan bill, certified Health Engagement Hubs would receive enhanced Medicaid payments for providing services including substance use disorder treatment, primary care, and case management. Certified hubs would also operate under a “no wrong doors” approach and offer services in a drop-in manner without prior appointment or proof of payment.

To qualify as a Health Engagement Hub, an organization would need to offer:

  • Substance use disorder treatment using FDA-approved medications;
  • Harm reduction services such as overdose education, naloxone distribution, and emotional counseling;
  • Patient-centered physical and behavioral health care services such as primary care, disease vaccination, psychiatric care, and secure medication storage;
  • Case management, care navigation, and care coordination services including housing, identification, employment, recovery support, family reunification, and criminal-legal services; and
  • Community health outreach and navigation services.

In addition, a Health Engagement Hub must meet certain minimum staffing requirements:

  • One part-time or full-time health care provider who is licensed to practice in the state and is licensed and registered to prescribe controlled substances;
  • One part-time or full-time registered professional nurse or licensed practical nurse who can provide medication management, medical case management, care coordination, wound care, vaccine administration, and community-based outreach;
  • One part-time or full-time licensed behavioral health staff who is qualified to assess and provide counseling and treatment recommendations for substance use and mental health diagnoses; and
  • A full-time team of outreach, engagement, and care navigation staff. This could include peer counselors, community health workers, and recovery coaches. At least 50% of such staff must be individuals with a personal history of addiction treatment and recovery.

Read the bill text HERE.

Sen. Cantwell introduced the Fatal Overdose Reduction Act after holding 10 roundtables across the State of Washington over the last year with people on the front lines of the fentanyl crisis, including first responders, law enforcement, health care providers, and people with firsthand experience of fentanyl addiction.

She convened the first roundtable – in Tacoma – exactly one year ago tomorrow. A full timeline of Sen. Cantwell’s actions to combat the fentanyl crisis, including footage and information from her fentanyl roundtables in Tacoma, Everett, Tri-Cities, Seattle, Spokane, Vancouver, Port Angeles, Walla Walla, Yakima, and Longview, is available HERE.