Shelters that choose to become licensed under Article 28, a state health law that regulates the accreditation of public health care facilities, will be eligible for Medicaid reimbursements. | AP Photo Proposed bill would expand opioid treatment in homeless shelters

New York City homeless shelters could be the next spot for opioid users to receive medication-assisted treatment.

A new bill calls for the expansion of access to buprenorphine — often seen as the gold standard for treating opioid dependency — to city homeless shelters, among a series of other measures to to treat opioid addiction among the city's homeless population.


“Making an effective treatment for opioid addiction more accessible in the midst of an opioid addiction epidemic is a no brainer,” said Dr. Andrew Kolodny, co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management. “We should be making sure that people who are opioid addicted have access to buprenorphine wherever they are, especially homeless shelters.”

At least 311 homeless people died in city fiscal year 2017 — a 30 percent increase from 2016 — and the leading cause of death among them was drug use, with 103 deaths. Of those, 86 were from drug overdoses and the remaining 17 were from chronic drug use. More than three-quarters of the overdose deaths were opioid overdoses, according to the report by the city's Department of Health and Mental Hygiene. In 2016, only 51 homeless people died of drug overdoses.

For Bronx resident Shantae Owens, who grew up homeless in Manhattan and began using drugs around age 11, this type of bill is long overdue.

A former heroin user and current member of the grassroots group VOCAL-NY which is advocating for the expansion, Owens spent years in the shelter system. After more than two decades of the daily struggle to find money to buy heroin and then find a place to use it, he decided while living in an East Side men's shelter that he was finally ready to stop using heroin.

"When you wake up every day, in sweats, in pain, not knowing what the rest of your day is going to be like — I just got tired,” he said.

With help from a case worker, Owens, 44, decided he wanted to try Suboxone, a type of buprenorphine. But it took more than three years, he said, to work his way up the waitlist and get a prescription from a provider.

“The wait was agonizing, it was painful,” he said.

He got on methadone in the interim, which required a daily clinic trip. Instead of heading there at 5:30 a.m. every morning and waiting for it to open a little before 7 a.m., Owens can now meet with his doctor once a month and get his 30-day Suboxone prescription filled.

“Despite popular belief, there’s a lot of folks that wish to get off, don’t want to use no more. But they’re not being offered any alternative besides a wait," he said.

The bill, sponsored by Council Member Stephen Levin, could make the difference for others in similar situations. However, the Council needs to negotiate a funding model and agency responsibilities with the city.

There is currently no fiscal impact statement for the bill, which will be introduced at Wednesday’s stated meeting. Healing NYC — the citywide initiative that aims to reduce opioid dependency and its $22 million budget — could be tapped for the bill’s implementation, said Elizabeth Adams, Levin’s legislative director.

“We see this bill as a way to connect the administration’s resource investment in provider training and opening of new primary care centers with a key demographic in need of quality care,” she said.

The cost of expanding buprenorphine access will depend on the number of shelters that lack on-site clinics and trained staff.

Shelters that choose to become licensed under Article 28, a state health law that regulates the accreditation of public health care facilities, will be eligible for Medicaid reimbursements. Those rates remain low when compared to the actual cost of treatment — up to $28.04 a day for treatment in an outpatient clinic, rehab or opiate treatment program services through Medicaid, or about $800 a month.

The cost of buprenorphine treatment ranges from $430 to $640 a month, according to a National Rural Health Association policy brief.

Under the bill, the Department of Homeless Services would be responsible for implementing the expansion and assessing treatment access, Adams said. The department would also be required to list each shelter’s services on its website.

“It’s definitely something for a long time now that should have been looked at, and I’m proud and glad to stand behind [Levin] supporting this bill, because it’s such a huge need,” Owens said.

Rosa Goldensohn and Brendan Cheney contributed to this report.