Mass. Nursing facilities operator settles with DOJ over substance abuse discrimination claims

Next Step Healthcare, an operator of 21 skilled nursing facilities in Massachusetts, has settled with the U.S. State’s Attorney’s Office allegations that it turned away hundreds of patients because they were taking drugs to treat their opioid use disorder.

Over a two-year period, from September 2017 to August 2019, Next Step reportedly denied admission to 548 patients who told the provider they were being treated for addiction, even though all of these patients were seeking admission to facilities for unrelated health issues. .

“It’s awful,” Dr. Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University, told GBH News. “There would have been no medical reason – no justification for denying them treatment – ​​other than stigma or misunderstandings about opioid use disorder.”

Next Step did not respond to a request for comment from GBH News.

People who use drugs to treat substance use disorders are protected under the Americans with Disabilities Act. The federal government is cracking down on institutions that discriminate against this population — the latest settlement is the 10th the Massachusetts U.S. Attorney’s Office has reached with a qualified nursing facility.

Kolodny said he thinks bias against drug treatment of the disease was likely at play in denying Next Step admission to so many people.

“This is a systemic problem rooted largely in a misunderstanding of both the disease of opioid addiction and its treatment,” Kolodny said. “With effective treatment, people can be productive members of their community. They can be good parents, good citizens.

Kolodny said many people suffer from opioid use disorder because of doctors’ prescribing practices, not because they seek opioids. But, he added, regardless of how a person develops an addiction, experts agree that the best treatment option is taking drugs to curb cravings.

“Opioid addiction is most effectively treated with medication. Without medication, people are at very high risk of overdose death,” he said. ‘abstinence is thin.’

Next Step agreed to adopt a policy of non-discrimination against people with disabilities, train its admissions staff on disability discrimination, and pay a civil penalty of nearly $100,000 to the federal government under the settlement. She will only have to pay $10,000 if the company respects the agreement.

In a statement, Massachusetts attorney Rachael Rollins said, “When people finally find the strength and courage to be open to healing, they should be met with support and understanding, not discrimination and barriers to health care. … We appreciate Next Step’s cooperation in changing its policies and practices to comply with the ADA, and we strongly encourage other qualified nursing facilities to proactively do the same.

Harry Weissman, director of advocacy for the Boston-based Disability Policy Consortium, said Next Step’s alleged discrimination devalues ​​and endangers the lives of people with disabilities. He added that people with mental health conditions often suffer from discrimination rooted in stigma, which he says was the root of Next Step’s treatment of people with opioid use disorders.

“People who deal with these things should never be turned away,” Weissman said, “whether it’s because they’re seeking treatment for this problem or something else, they’re people like the rest of us.” between us. And, you know, disabled lives are just as worth living as a non-disabled life.

The Disability Policy Consortium is continuing its efforts to pass legislation in Beacon Hill that would improve protections against discrimination for people with disabilities in health care settings. Weissman said they support a proposed bill in the state Legislature, which reached the Ways and Means Committee, but stalled there in the formal legislative session that ended over the course of the summer.

Weissman said the bill would be a big help for low-income Massachusetts residents or people of color, who are more likely to have a disability.

“To deny treatment to someone on this basis is discriminatory. … It’s racist, it’s ableist, it’s classist,” he said. “Everyone has the right to health care and should not be denied that health care for any reason.”

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