Governor Gavin Newsom vetoed a bill introduced by Senator Scott Wiener (D-San Francisco) that would have paid people to stay sober.
Wiener introduced the bill to address the worsening methamphetamine addiction crisis facing the State of California.
The Recovery Incentives Act legalizes the substance use disorder treatment known as “contingency management,” and authorizes Medi-Cal to cover it. He said the contingency management has proven to be the most effective method of treatment for methamphetamine addiction, and is frequently used as a treatment program by the Veterans Affairs Administration. This intervention program gives those struggling with substance use disorder financial rewards if they enter substance use treatment programs, stay in the program, and get and remain sober. This positive reinforcement helps people reduce and even fully stop substance use.
There is currently no form of Medication-Assisted Treatment (MAT) for meth, unlike with opioids where treatment options such as methadone are available. Contingency management is thus a critical tool in addressing the meth addiction crisis.
According to the San Francisco Department of Public Health (SFDPH), since 2008, meth overdose deaths in San Francisco have increased by 500%. Additionally, 50% of psychiatric emergency room admissions at San Francisco General Hospital are now meth-related. These disturbing statistics demonstrate the urgency with which San Francisco and other communities must address this epidemic.
With drug overdose deaths on the rise across the country, the state, and in San Francisco — San Francisco had a record number of overdose deaths in 2020 — effective substance use intervention programs are more important than ever. In San Francisco, according to data collected in 2019, roughly 60% of all overdose deaths were meth-related.
Meth use has spiked all over California and in San Francisco, and worsened through the COVID-19 pandemic. With social isolation, mental health issues like depression, and economic suffering all worse for many than in prior years, meth use has also increased significantly. Since COVID-19 was declared a national emergency on March 12th, The Hill reports that patients across the country “tested positive for methamphetamines at a roughly 20 percent higher rate between March and May than previous samples.”
The bill would also require the California Department of Health Care Services (DHCS) to issue guidance on the use of contingency management programs for Medi-Cal patients.
Senator Scott Wiener Issued the Following Statement after the veto:
Sacramento – Today, Governor Gavin Newsom vetoed Senator Scott Wiener’s (D-San Francisco) legislation, Senate Bill 110.
The Recovery Incentives Act, SB 110, would have legalized the effective substance use disorder treatment known as “contingency management” — financial incentives to get and stay sober — and authorized Medi-Cal to cover it.
“I’m deeply disappointed that the Governor has chosen to veto SB 110,” said Senator Wiener. “So many people across California are dying from meth overdoses. And they’re dying right now. Time is of the essence. We know from more than a decade of data and experience that contingency management is highly effective in helping people stop using meth. Contingency management is a proven tool, and we don’t need pilot programs to tell us that. SB 110 would have made clear that contingency management is legal and would have allowed its implementation across the state. This veto is a setback in our effort to confront this epidemic.”
Here is the veto message from Governor Gavin Newsom:
I am returning Senate Bill 110 without my signature.
This bill would require Medi-Cal substance use disorder services to include contingency management services as an optional benefit under the Drug Medi-Cal organized delivery system, subject to utilization controls.
Given the promise of contingency management as a treatment for stimulant use disorders, the 2021-22 Budget includes funding to support a pilot contingency management Medi-Cal benefit from January 2022 through March 2024. The Department of Health Care Services has sought federal approval for
this pilot project and will work expeditiously to implement it once it is authorized.
The outcomes and lessons learned from the pilot project should be evaluated before permanently extending the Medi-Cal benefit. As such, this bill is premature, and I am returning it without my signature.