Thursday, January 10, 2019

Help to Quit Smoking in 2019

Start the New Year Smoke Free

HEALTH– As the New Year dawns, a common resolution tops many tobacco-users’ to-do lists: making 2019 the year they finally quit for good.

Smoking is an addiction and difficult to overcome, but thousands achieve a smoke-free life each year with support and medication from their healthcare providers and the New York State Smokers’ Quitline.

One Five Boroughs resident knows this very well, as Shirley G. gained freedom from nicotine in early November.

Shirley, a 58-year old Bronx resident and executive assistant in Midtown, smoked periodically since her early teenage years. Twenty years ago, she quit “cold turkey” and maintained a smoke-free life for 10 years. However, after the passing of her parents, Shirley picked up a cigarette and got hooked again.

During a family trip to Greece this past fall, Shirley said smoking was allowed “practically everywhere” and she “smoked a ton.” 

Upon coming home, she realized she finally had enough of smoking and did an online search for support. It was then that Shirley learned about free nicotine replacement therapy and coaching support from the New York State Smokers’ Quitline.

“The Quitline was instrumental in my success,” Shirley said. “Besides the nicotine patch helping to curb my cravings, the materials I received helped me to stay on track and remind me how I’d feel better and better with each passing week. I also learned about the HelpMeQuit app from the New York City Department of Health, which tracked how many days I remained smoke-free and how much money I saved. Most important, I got a follow- up call from one of the Quitline’s Quit Coaches a few weeks after I started using the patch. That was an unexpected bonus. Someone out there cared if I was still doing well. I think positive reinforcement is such a boost for anyone during the quit-process.”

Earlier in 2018, Shirley began a weight-loss program and achieved success. In her opinion, quitting smoking is a natural second step for taking better care of her health. During this time of year, Shirley also particularly loves not having to go outside in the rain or snow for a cigarette break. Last but not least, Shirley has five young grandsons and is happy they won’t grow to know her as a smoker.

“For me, just touching a cigarette is a trigger,” she said. “So I tell myself, ‘If I don’t touch a cigarette, I can’t smoke it.’ I also remind myself there is nothing happening in my life where a cigarette will make things better. Having a cigarette won’t improve the situation. For those who struggle with quitting, a doctor once told me to at least start with one less cigarette a day and take it gradually from there. Remember that there are great resources through the Smokers’ Quitline – and they’re free.”

The New York State Smokers’ Quitline is available as a resource for all New Yorkers seeking help to quit smoking. Quit Coaches can provide personalized coaching support and check eligibility for a starter kit of nicotine replacement therapy. In addition, the New York State Smokers’ Quitline recommends smokers talk to their healthcare providers about quitting and ask for a prescription for stop-smoking medications – most of which are covered by health insurance plans.

“Smoking continues to be the leading cause of preventable death in the world, but many free resources are available in New York State to help smokers quit,” said David Davis, project manager for NYC Treats Tobacco, a program funded by the New York State Department of Health Bureau of Tobacco Control based at NYU Langone Health. “By combining coaching and medication, the odds for quitting successfully increase threefold. Healthcare providers play a major role in getting the process started, between prescribing the right medications and making referrals to the New York State Smokers’ Quitline for extra support. Health plans, especially Medicaid, often cover extra nicotine replacement therapy and local cessation classes. Quitting smoking is the best thing you can do for your health, so use all the benefits available to make it happen.”
This New Year and any year, smokers should call the New York State Smokers’ Quitline at 1-866-NY-QUITS (1-866-697-8487) anytime the journey gets tough for achieving or
maintaining a smoke-free life. Quit Coaches are available seven days a week beginning at 9 a.m., and additional resources are available online at

About the New York State Smokers’ Quitline

The New York State Smokers’ Quitline is a service of the New York State Department of Health and based at Roswell Park Comprehensive Cancer Center. It is one of the first and busiest state quitlines in the nation, and has responded to more than 2.5 million calls since its inception in 1999. The Quitline encourages tobacco users to talk with their healthcare providers and access available Medicaid or health insurance benefits for stop-smoking medications. All New York State residents can call 1-866-NY-QUITS (1-866-697-8487) for coaching and resources, free of charge, seven days a week beginning at 9 a.m.

Visit for more information.

New York to Provide Healthcare for All

DeBlasio Launches Plan to Cover All New Yorkers 

Roll Out to Start in the Bronx

NEW YORK— Mayor Bill de Blasio announced his administration will launch the largest, most comprehensive plan in the nation to guarantee health care for every New Yorker. 

The plan will serve the 600,000 New Yorkers without insurance by strengthening NYC’s public health insurance option, MetroPlus, and guaranteeing anyone ineligible for insurance – including undocumented New Yorkers – has direct access to NYC Health + Hospitals’ physicians, pharmacies and mental health and substance abuse services through a new program called NYC Care. 

All services will be affordable on a sliding scale. The programs will include customer-friendly call lines to help New Yorkers – regardless of their insurance – make appointments with general practitioners, cardiologists, pediatricians, gynecologists and a full spectrum of health care services.

“Health care is a right, not a privilege reserved for those who can afford it,” said Mayor de Blasio. “While the federal government works to gut health care for millions of Americans, New York City is leading the way by guaranteeing that every New Yorker has access to quality, comprehensive access to care, regardless of immigration status or their ability to pay.”

“With today’s announcement of NYC Care, New York City takes another leap ahead of the rest of the nation in providing mental health services,” said First Lady Chirlane McCray. “Guaranteed health care means guaranteed MENTAL health care and alcohol/drug addiction treatment. No other city or state provides these comprehensive services to ALL residents.”

“We have the tools and opportunity to guarantee health care for all New Yorkers,” said Deputy Mayor for Health and Human Services Dr. Herminia Palacio. “New Yorkers who can’t enroll in or afford health insurance will now be able to access comprehensive, patient-centered services through NYC Care. At the same time, we will amplify our efforts to increase enrollment into MetroPlus. Today we celebrate our City’s relentless commitment to accessible, high-quality health care.”

“Expanding access to care is a key step in eliminating health disparities in our city,” said Health Commissioner Dr. Oxiris Barbot. “The Affordable Care Act started us down this path, but it is time to finish the job. New York City is proud to lead the way.  I stand with Mayor de Blasio today in declaring health care is a right for all, not a privilege for only those who can afford care.”

“NYC Care will be the biggest and most comprehensive health coverage program in the country,” said Dr. Mitchell Katz, President and CEO of NYC Health + Hospitals. “Building on the great work of our doctors, nurses and staff, and working collaboratively with community partners, NYC Health + Hospitals will help give all New Yorkers the quality care they deserve.”

Thanks to the Affordable Care Act, 8 million New Yorkers now have health insurance, and the uninsured rate is about nearly half of what it was in 2013. In the last two years, New York City’s Public Engagement Unit coordinated signing up more than 130,000 New Yorkers for plans through the exchanges created by the law. However, about 600,000 New Yorkers remain without insurance, because they do not or cannot enroll. Through this new initiative, New York City will create a bigger, better, more comprehensive program for guaranteed health care. The City aims to better connect people to more effective and affordable health care in one of two ways:

· NYC Care: The city will connect hundreds of thousands of New Yorkers who are ineligible for health insurance – including undocumented New Yorkers and those who cannot afford insurance – to reliable care. 

Anyone will be able to access comprehensive care across NYC Health + Hospitals’ more than 70+ locations, once the program is fully ramped up. NYC Care is open to anyone who does not have an affordable insurance option and will be priced on a sliding scale, to ensure affordability. NYC Care will provide a primary care doctor and will provide access to specialty care, prescription drugs, mental health services, hospitalization, and more.
· NYC’s Public Option: The City will double down on efforts to boost enrollment in MetroPlus, the City’s public option. MetroPlus provides free or affordable health insurance that connects insurance-eligible New Yorkers to a network of providers that includes NYC Health + Hospitals’ 11 hospitals and 70 clinics. MetroPlus serves as an affordable, quality option for people on Medicaid, Medicare, and those purchasing insurance on the exchange. The City is committed to strengthening MetroPlus and connecting more independent workers, City vendors and City workers to that option. It also will improve the quality of the MetroPlus customer experience through improved access to clinical care, mental health services, and wellness rewards for healthy behavior.

The City is taking an unprecedented approach to health care services by tackling mental and physical issues holistically. 

Through both programs, New Yorkers will be able to access addiction services and opioid treatment, mental health counseling, and counseling services for trauma victims. New Yorkers will be able to call MetroPlus or 311 to be screened for health insurance eligibility and get connected to their best coverage option.

As part of this initiative, H+H will be significantly enhancing 24/7 customer service to seamlessly connect patients to healthcare. 

NYC Care will launch in summer 2019 and will roll out geographically, starting in the Bronx. It will be fully available to all New Yorkers across the five boroughs in 2021. The program will cost at least $100 million annually at full scale. Additionally, MetroPlus will announce a series of enhancements throughout the year.

“Health care is a human right. Every New Yorker, no matter their race, gender, sexual orientation, or socio-economic status should have accessible and reliable health care. I believe the Mayor’s plan is a powerful step in this fight for affordable and reliable health care. This is also why I continue to fight for single-payer healthcare as a New York State Senator,” said Senator Jessica Ramos.

“Providing healthcare to all NYC residents -- including addiction, rehabilitation and mental health services -- is a monumental step toward in the delivery of necessary medical treatment for all. I look forward to working with the administration to implement real affordable medical treatment for each and every NYC resident,” said Assembly Member Michael G. Dendekker.

It is so important to connect all New Yorkers with affordable and reliable health care, and I’m thrilled that the City has taken steps to provide this basic right to our 600,000 uninsured neighbors across NYC. Expanding enrollment in MetroPlus and providing affordable care through NYC Care regardless of insurance means that more New Yorkers will get the comprehensive services that they need,” said Assemblymember Jo Anne Simon.

“Health care should be a right, and while the ACA has helped, too many of us are still uninsured and struggle to get the care we need,” said Manhattan Borough President Gale A Brewer. “With this far-reaching plan to guarantee care for everyone, the de Blasio administration is showing the rest of the country that New Yorkers look out for each other. I’m thrilled that 600,000 uninsured people in our city will have new peace of mind knowing they’ll be able to access comprehensive care through MetroPlus and NYC Health+Hospitals, including vital services for addiction and mental health.”

“As the representative of East Harlem and the South Bronx — both of which are neighborhoods with significant uninsured populations, I am ecstatic about the implementation of NYC Care, as it will provide thousands of New Yorkers with access to comprehensive health care services. I thank Mayor de Blasio, Deputy Mayor Palacio, and Dr. Katz for their efforts to make this plan possible,” said Council Member Diana Ayala, Chair of the City Council’s Committee on Mental Health, Disabilities, and Addiction.

"Let's say it loud and clear today - healthcare is a basic human right. No New Yorker should ever have to choose between paying for their health or putting food on the table. I want to thank Mayor de Blasio for working to ensure that everyone, including the hundreds of thousands of New Yorkers who are undocumented, has access to a healthcare option they can afford. This plan will not only strengthen the health of everyday New Yorkers, but also the health of our public hospital system. I look forward to working with the Mayor to implement this ground-breaking plan," said City Councilwoman Carlina Rivera, Chair of the Council's Committee on Hospitals.

“Today the city is taking a big step in ensuring access to health services for all New Yorkers regardless of immigration status. Immigrants in particular are faced with huge barriers to healthcare and we have yet to see significant action at the state and federal level to ensure access to coverage for all of the uninsured. We look forward to working with Mayor de Blasio to implement NYC Cares and ensure access to H+H options and insurance, if eligible," said Rebecca Telzak, Director of Health Programs at Make the Road New York.

“For too long, too many, particularly women low-wage workers, have not had access to health care. This is an inspiring and extremely practical model for every city in the nation," said Ai-jen Poo, Executive Director, National Domestic Workers Alliance.

"Affordable, high-quality healthcare for immigrant workers is essential to our city's thriving, and no one knows that better NICE members who work in some of the most dangerous, unregulated sectors of our economy, like construction and domestic work," said Manuel Castro, Executive Director of New Immigrant Community Empowerment (NICE). "Our members historically have struggled to access appropriate care that they can afford in the languages they speak, so we applaud the city for taking another step in providing necessary healthcare for all New Yorkers, particularly in a time when immigrants are under attack." 

“All people, regardless of their income or immigration status, deserve access to high-quality health care. Period. We applaud Mayor Bill de Blasio for launching NYC Care to ensure that all New Yorkers can access health care, including preventive care, gynecological care, mental health care and other services. As the White House continues to spew anti-immigrant rhetoric and attempt to block immigrants from accessing basic resources they need, NYC must do everything we can support our immigrant communities. NYC is a place for everyone—a place where all people can live and thrive without fear to be who we are—and the new NYC Care program affirms that,” said Laura McQuade, President and CEO, Planned Parenthood of New York City.

“For one hundred years, the progressive movement has fought for an America where everyone has the medical care they need. I hope to live to see the establishment of Medicare For All, finally achieving that dream. In the meantime, I am so grateful to Mayor de Blasio for putting the full strength of his administration behind this important cause. I am eager to see it succeed, transforming the lives of so many New Yorkers and proving to the country that universal health care is possible,” said Ady Barkan, Center for Popular Democracy.

"This is exactly how New York should lead in the era of Trump. Mayor de Blasio's initiative recognizes that when the federal government fails to guarantee a basic right like health care, cities and states have the power to step up. This will make New York a stronger, healthier city, and elected officials around the country should take note," said Dahlia McManus, Deputy Director of the New York Working Families Party.

“We applaud Mayor de Blasio for taking this important step to address the health needs of hundreds of thousands of undocumented immigrants in our city who are under attack by the Trump Administration,” said David R. Jones, Esq., President and CEO of the Community Service Society. “And we encourage the State, which has been a leader in expanding health care coverage to needy populations in New York, to continue its trailblazing efforts to make our health insurance system more accessible. For just $532 million annually—a mere rounding error in the State’s health care budget—the State could build on its health care accomplishments and offer comprehensive health coverage to all immigrant New Yorkers left behind under the Affordable Care Act.” 

“No one should have to decide between putting a roof over their head or seeing a doctor, yet this is too often the reality. All New Yorkers deserve access to the health care they need and we applaud Mayor de Blasio and his administration for making this their top priority,” said Andrea Miller, President of the National Institute for Reproductive Health. “New York City has long been a leader in ensuring access to reproductive healthcare, beginning with abortion training for residents in H+H hospitals, access to contraception at comprehensive school based health centers, and today with the expansion of insurance coverage for all New Yorkers.”

“CCC applauds Mayor de Blasio for this bold plan to guarantee all New Yorkers have access to affordable health care,” said Jennifer March, Executive Director of Citizens’ Committee for Children of New York. “Children are more likely to be insured when their parents are insured, and expanding coverage options will lead to healthier families and healthier communities. In the face of constant federal threats to healthcare, New York can be a leader in protecting and expanding access to essential health and behavioral health services for all New Yorkers, including undocumented New Yorkers.”

“Mayor de Blasio’s announcement today that New York City will provide health care to every City resident affirms the belief, strongly held by New York’s entire hospital community, that health care is a fundamental human right,” said Greater New York Hospital Association president Kenneth E. Raske. “By enrolling as many City residents as possible in NYC H + H’s MetroPlus program and launching NYC Care for those who cannot access insurance programs, New York City is demonstrating its deep commitment to achieving universal coverage. I applaud the Mayor and NYC H + H for launching this extremely important initiative."

"Most of New York City’s professional drivers already rely on Health and Hospitals clinics and hospitals for primary care and emergency services.  This initiative can fill voids that still exist in access to care and will be a lifeline for New Yorkers who, like many of our members, don’t qualify for Medicaid but still can’t afford premiums. And it will finally allow our undocumented neighbors access to much-needed healthcare services. The initiative could transform NYC into a global city leading our country in common sense and compassion with universal healthcare coverage," said Bhairavi Desai, Executive Director of 21,000-membet New York Taxi Workers Alliance which represents yellow, green, App, livery and black car drivers.

“We applaud the Mayor's effort to expand access to critical services for all New Yorkers. Healthcare is a right and should be accessible to all regardless of income or immigration status,” said John Park Executive Director of the MinKwon Center for Community Action.

"We welcome this great initiative, NYC Care, and we look forward with working the City and Mayor de Blasio to ensure that all eligible New Yorkers are covered," said Elsie Saint-Louis, Executive Director of Haitian-Americans United for Progress.

“Our rights to health care have been infringed and under attack from the federal government.  It is important to ensure that all have opportunity to get covered.  We support the city and mayor in their efforts to create a program for the uninsured. The benefits of expanding coverage outweigh the costs for added services,” said Anthony Feliciano, Director of the Commission on the Public’s Health System. 

“New York Lawyers for the Public Interest applauds this ambitious effort to save lives. The City’s continuing commitment to care for New Yorkers who are ineligible or can’t afford insurance means NYC Health + Hospitals can better address the impact of the nation’s healthcare crisis on the people of New York City. As attacks on the Affordable Care Act and healthcare for New Yorkers who are immigrants drive people away from the basic care they need, New York City leads in providing vital help," said Laura F. Redman, Health Justice Director, New York Lawyers for the Public Interest.

“NYC Cares is a giant leap in the right direction toward guaranteeing the right to healthcare for all. We applaud New York City and Mayor de Blasio for this critical program. While providing access to coverage for the uninsured is a necessity for a high functioning health system, the Campaign for NY Health remains committed to working with all stakeholders to address the high costs and financial barriers for the millions of New Yorkers with private health insurance coverage who struggle to afford the care they need,” said Katie Robbins, Director, Campaign for NY Health.

"In a time when expanded access to health care is threatened under our current Federal Administration, The Center applauds the City and Mayor de Blasio for stepping up to ensure that all New Yorkers have the access they deserve to coverage through NYC Care," said Glennda Testone, Executive Director of NYC's LGBT Community Center. "LGBTQ New Yorkers, including undocumented community members, face serious health care disparities and this program will provide a lifeline for those who need it most."

“By guaranteeing health care access to many of New York City’s most vulnerable, underserved populations, Mayor Bill de Blasio is helping us reach our collective goal to end the AIDS epidemic in New York City and New York State,” said Kelsey Louie, CEO of Gay Men’s Health Crisis (GMHC). “More access to health care means more access to not just HIV prevention, testing, and treatment, but more access to treating the drivers of the epidemic like mental health and substance use issues. This is a huge step forward in our fight to end AIDS.”

"At a time when access to health care is under attack, it is crucial to expand access to affordable, comprehensive coverage in New York and continue the gains made through the Affordable Care Act,"  said Melanie Kruvelis, Northeast Policy Analyst at Young Invincibles. "We commend City Hall’s effort to expand coverage to every remaining uninsured New Yorker, especially young adults and immigrants who often get left out of the system."
“We are most privileged to live in a City where all people matter and will be able to provide health care for all. Religious tradition teaches that we have a moral responsibility to preserve human health. Thank you Mayor for making it possible for us to fulfill a tradition that belongs to all of as believers of different faiths but also as members of one human family," said Rabbi Joseph Potasnik, Executive Vice President, New York Board of Rabbis.

“Is anything better than a healthy city?  From strong health comes strong people. Thank you mayor de Blasio.”Rev. Dr. Donna Schaper, Senior Minister, Judson Memorial Church.

“This announcement is a major breakthrough for all New Yorkers. As I think of all those who have been turned away because they dont have coverage, who have suffered, and who have even died because of lack of coverage, I am so elated to see us take an extraordinary leap to healthcare for all.  It is a big step in the right direction," said Rev. Que English, Bronx Christian Fellowship Church & Mayor's Clergy Advisory Council.

Thursday, January 3, 2019

Bronx Weed Grow House Shut Down

BX News: Bronx Weed Grow House Shut Down: Apartment Altered to Grow Weed By David Greene BRONX – A call for a report of live wires down led firefighters to discover two apar...

Mom Shot by Cop Files $10 Million Lawsuit

BX News: Mom Shot by Cop Files $10 Million Lawsuit: Attorney Sanford Rubenstein sits with his client Irene Urena Perez, 46, who was shot by a police officer along Loring Place North on De...

Back Alley Plastic Surgery Blamed for Death

Botched Butt Lift with Silicone Implants

By Dan Gesslein

HEALTH- A woman who performed fake butt lifts out of her Castle Hill home was arrested after one of her patients died. The felonious plastic surgeon has been convicted twice before for dangerous cosmetic procedures.

Published reports say 44-year-old Whalesca Castillo is being held at the 43rd Precinct and is expected to be charged with manslaughter in the death of her former patient Leslie Ayala.

Cops say in June, Castillo performed a butt lift on Ayala in the phony doctor’s Seward Avenue home. During the course of her buttocks being injected with silicone implants, Ayala suffered cardiac arrest. The Medical Examiner’s Office ruled Ayala’s death a homicide. Castillo is expected to be charged soon.

Castillo is no stranger to running afoul of the law over questionable cosmetic procedures. Investigators said she had been convicted twice of performing illegal cosmetic procedures.

In addition to using questionable substances such as silicone, Castillo had been known to use Krazy Glue as a sealant on patient’s buttocks after injecting silicone.  

Injections of substances like silicone and collagen in the buttocks have not been approved by the FDA. The agency rejects silicone because it has been linked to permanent disfigurement, and death.

Wednesday, January 2, 2019

City Island Heroin Death Conviction

BX News: City Island Heroin Death Conviction: Prosecutors say He Supplied Heroin to the Bronx Island Nabe  Paid Junkies to Deal in Heroin BRONX – The heroin kingpin of City ...

$15 Minimum Wage Takes Effect

BX News: $15 Minimum Wage Takes Effect: Cuomo Hails New Minimum Wage for New York  ALBANY - Governor Andrew M. Cuomo announced the minimum wage increase in New York State...

NYC Combats Opioid Addiction

Expanded Treatment at Clinics

NYC Health + Hospitals Increases Access to the Opioid Addiction Treatment Buprenorphine in All Five Boroughs

BRONX– NYC Health + Hospitals announced expanded access to buprenorphine, a prescription drug to manage opioid addiction, through adult medicine clinics in 18 community and hospital-based ambulatory care centers. 

Located in all five boroughs, the 18 clinics will integrate the clinical management of buprenorphine into primary care, making availability easier and treatment more holistic.

The new access to buprenorphine—a life-saving office-based opioid treatment—adds to existing availability through the public health system’s emergency departments, inpatient care, and specialty outpatient clinics and reflects its ongoing transformational efforts to expand community-based care.

Opioid treatment at each clinic is led by a clinician who has undergone special training and licensing to authorize the prescription of buprenorphine. While other medication-assisted treatments are also available, buprenorphine is an important option for patients because it eliminates the need for a daily clinic visit, which is required of most patients receiving methadone. Additional benefits of buprenorphine are its low potential for abuse and negligible risk for overdose.

“A key component in the success of treatment for opioid use disorder is the patient’s willingness and commitment to treatment, which can be triggered by a range of different factors, and it is critical for us in the health care field to engage, connect, and treat patients wherever they are on their road to recovery,” said Daniel Schatz, MD, director of program and policy in the Office of Behavioral Health at NYC Health + Hospitals. “Increased access to buprenorphine—including now through primary care—is yet another tool that will help save more lives.”

“NYC Health + Hospitals sees approximately 20,000 unique patients with opioid use disorder every year, many of whom aren’t ready to enter into a substance treatment program,” said Mitchell Katz, MD, president and chief executive officer of NYC Health + Hospitals. “Empowering primary care providers to play a greater role in connecting patients to care for opioid addiction is a useful strategy since these are the clinicians most likely to have ongoing relationships with these patients. Personally, I completed the x-waiver training so I can best help my patients.”

“There is treatment available for anyone who suffers from addiction in NYC, and treatment that can be life-saving. Buprenorphine, an evidence-based treatment option, is now available at 18 community clinics and ambulatory care centers,” said First Lady Chirlane McCray. “More locations where people can be treated with buprenorphine means more second chances for New Yorkers in their own communities.”
“This critical expansion ensures that buprenorphine is more readily available for our communities most impacted by the opioid epidemic,” said Deputy Mayor for Health and Human Services Dr. Herminia Palacio. “I am proud our public health care system is integrating its community-based, ambulatory care network with effective, evidence-based treatment for opioid addiction.”

“Buprenorphine access is a critical step toward recovery for New Yorkers struggling with addiction,” said Assembly Health Committee Chair Richard N. Gottfried. “This clinic service expansion will connect buprenorphine treatment to primary care, ensuring better integration of services and care management for New Yorkers seeking treatment.”
“Medication Assisted Treatment (MAT) is the gold standard of harm reduction treatment, and for us to finally turn the tide on the opioid epidemic, we must continue to expand access to MAT and other treatment options. I applaud NYC Health + Hospitals for helping to lead the way in this effort by bringing buprenorphine to clinics across the five boroughs,” said Assemblymember Linda B. Rosenthal, Chair of the Assembly Committee on Alcoholism and Drug Abuse.

“Increasing access to buprenorphine throughout our healthcare system, including at primary care facilities, is essential in our fight against the opioid epidemic. We need to engage individuals battling addiction as often as possible and this step will increase their options to receive appropriate and extended help in a setting that has the potential to be more conducive to treatment,” said State Senator Gustavo Rivera. “I applaud the efforts of NYC Health + Hospitals for its continuous commitment to adequately combat the serious crisis we are facing.”
“If New York City is going to make a serious commitment to combatting the opioid epidemic, we have to increase access to tools that can provide safe treatment options and help end addiction. I want to thank NYC Health + Hospitals for doing just that with their expansion of buprenorphine treatment to all Five Boroughs. Bringing buprenorphine directly to community clinics will help de-stigmatize this crisis and show those struggling that there is help available,” said Councilwoman Carlina Rivera, Chair of the Council’s Committee on Hospitals.
“Experts agree that buprenorphine saves lives but, too often, people struggling with addiction don’t have access to this life-saving treatment. These disparities in access disproportionately impact low-income families and people of color,” said Council Member Stephen Levin. “I applaud NYC Health and Hospitals for expanding access to buprenorphine prescriptions to 18 adult medical facilities making treatment all the more available to the people who most need it. Make no mistake about it, this expansion will save lives.”

While primary care clinicians at these 18 clinics who are authorized to prescribe buprenorphine now number 40—health system-wide, there are now 169 authorized prescribers—those numbers will continue to grow.

Preparing Clinicians to Prescribe Buprenorphine

The training required of clinicians to prescribe buprenorphine is ongoing. Provided by the New York City Department of Health and Mental Hygiene, upcoming sessions are scheduled at NYC Health + Hospitals/Harlem in October and at NYC Health + Hospitals/Jacobi in November, with dozens of clinicians registered at each. (The training is often called “x-waiver training” because upon completion, clinicians have an “x” added to their unique Drug Enforcement Agency identification number that indicates they are qualified to prescribe buprenorphine.) Dozens more clinicians have completed the training and are awaiting final federal approval to proceed. Training is also available to clinicians from OneCity Health’s community-based partners, which will help increase access to buprenorphine throughout New York City.

All doctors who want to prescribe buprenorphine must undergo four hours of on-line work and four hours of in-person training, followed by the licensing process, which typically takes four to six weeks. Training is also available for nurse practitioners and physician assistants.
At NYC Health + Hospitals, primary care providers who want to prescribe buprenorphine undergo additional training, learning more about integrating behavioral health into primary care practice. They benefit from 16 weeks of enhanced training that features the international Project ECHO model. Through, a video-conferencing learning collaborative, Project ECHO (Extension for Community Healthcare Outcomes) extends specialty education and support to primary care providers on targeted diseases or health conditions, expanding the scope of services available to patients in primary care and reducing barriers to care and treatment. Training on the prescription of buprenorphine is just the first application of Project ECHO at NYC Health + Hospitals, with its Office of Population Health planning other applications as the health system transforms primary care.

What Patients Can Expect
When patients come to one of the primary care clinics, they can ask their primary care provider, a nurse, or a social worker about treatment options for opioid use. Screening for opioid use is also being introduced so a provider may also start the discussion. As in typical primary care, the provider takes a patient history and performs a physical exam. If, following the assessment, the patient is diagnosed with opioid use disorder, a discussion ensues to arrive at the most appropriate treatment plan for that patient. For patients who need a higher level of care, the patient may be referred to a specialty clinic, where more intensive care, often involving methadone, is available. For others, buprenorphine may be an option. The process is explained, one to three doses are prescribed, and the patient receives instruction on how to proceed. A follow-up appointment is scheduled.

Buprenorphine is prescribed in a low maintenance dose. Each dose is dissolved under the tongue. Initially, patients need weekly doctor’s visits, and over time, based on their treatment progression, might only need to visit a clinic monthly or every few months.

The initial goal is to increase the number of patients system-wide every year by 125.

Other Pathways to Opioid Addiction Treatment

The new widespread availability of buprenorphine through primary care in adult medicine clinics is just the latest addition in the public health system’s armament of ways to connect patients with substance use disorder and life-saving treatment—through emergency department, inpatient, and outpatient specialty care.
“The key to making a difference has two parts, and both are important,” said Noah Isaacs, MPA, director of health care planning and analysis in the Office of Behavioral Health for NYC Health + Hospitals. “We need to make an initial connection, and we need to solidify that connection to a long-term plan of care. Both parts need to work for the patient.”

Locations of the Adult Medicine Clinics in the Bronx
NYC Health + Hospitals/Gotham Health, Belvis
545 East 142nd Street
Bronx, New York 10454
NYC Health + Hospitals/Gotham Health, Morrisania
1225 Gerard Avenue
Bronx, New York 10452
NYC Health + Hospitals/Jacobi
1400 Pelham Pkwy. South
Bronx, NY 10461
NYC Health + Hospitals/Lincoln
234 East 149th Street
Bronx, NY 10451
NYC Health + Hospitals/North Central Bronx
3424 Kossuth Avenue
Bronx, NY 10467