Gov. Scott Walker issued two executive orders on Jan. 19 based on a new report from the Task Force on Opioid Abuse.

Executive Order 273 implements several agency actions based on recommendations from the Task Force’s co-chairs Lt. Governor Rebecca Kleefisch and Rep. John Nygren (R-Marinette). The order directs the Department of Health Services (DHS) explore several items, including:

• Developing training and best practices for law enforcement and first responders around opioid-related incidents.
• Applying for a federal grant to develop technology to track treatment capacity for substance abuse services.
• Reviewing whether to require prior authorization for buprenorphine treatment for Medicaid enrollees.
• Developing offender-only service units with managed care organizations and BadgerCare.

Executive Order 274 creates the Commission on Substance Abuse Treatment and Delivery that will explore the potential implementation of the “hub and spoke model” of care delivery, as recommended by Pew Charitable Trusts. The Commission will be chaired by the DHS secretary and will include the Task Force co-chairs, the administrator for the Division of Medicaid Services, and representatives from Wisconsin Hospital Association, Federally Qualified Health Centers, Wisconsin Academy of Family Physicians, and Wisconsin Society of Addiction Medicine, among others. The committee must issue a final report and recommendations to the governor by Nov. 30, 2018.

In addition to the policies enacted by the executive orders, the most recent report from the Task Force recommends:

• A dedicated fund to provide grants to state and local agencies to expand capacity in the fight against illegal drugs.
• Adding two regional drug resource prosecutors to the Department of Justice.
• Requiring continuing education on controlled substances for all prescribing professions.
• Adopting intra- and inter-state reciprocity for licensure.
• Passing the opioid recommendations in the Worker’s Compensation Advisory Council bill (SB 665).
• Clarifying that a physician assistant’s (PA) or advanced practice nurse prescriber’s (APNP) collaborating doctor does not need a federal waiver to prescribe buprenorphine, as long as the PA or APNP has one.
• A pilot program to provide medication assisted treatment to individuals in county jails in the last days before release.
• Review Wisconsin’s statutes regarding pregnant women with substance abuse disorders.
• Passing AB 829/SB 626 that would clarify standards for occupational licensing for individuals with drug convictions.

Nygren has circulated legislation (LRB 5242, LRB 5264) addressing these and other recommendations from the report.