Last August we helped spread the word on Florida’s CORE Network. At the time, we were a little puzzled to see it covered only 12 of the state’s 67 counties, and that even then the help would be coming in two separate stages. We were also puzzled to see Palm Beach County wasn’t on the list, especially considering the program was based upon one started by Palm Beach County State Attorney (and tireless Opioid Warrior) David Aronow a full two years beforehand.
Since then we learned that Palm Beach County wasn’t on the initial list because it apparently didn’t need to be. Makes sense, considering the CORE Program was already up-and-running in PBC. Makes even more sense considering the county’s Director of Behavioral Health, Dr. Courtney Phillips, had been appointed Statewide Director of Opioid Recovery. Dr. Phillips oversaw the pilot program in Palm Beach, so it’s only natural she’d oversee its statewide expansion.
Back then we also learned that Brevard, Clay, Duval, Escambia, Gulf, Marion, Pasco, and Volusia counties belonged to the first phase. And that the second included the counties of Citrus, Duval, Flagler, Manatee, and Pinellas. Phase Two reportedly went into effect in November of 2022.
The Follow-Up
Well, on February 17th the Florida Governor returned to discuss the matter, this time to deliver a breakdown on how the CORE Network will be funded. The Governor (and his wife) also announced the addition of five more (unnamed) counties.
While 17 (or 12) counties isn’t nothing; it’s still 50 (or 55) short of the 67 total that comprise the state. More importantly perhaps, the list doesn’t include four of the five most populous Florida counties, and only includes the fifth because that’s where CORE originates.
Allies will insist that’s because Miami-Dade, Broward, Hillsborough and Orange counties already have some substance abuse and recovery options, while CORE’s initial stage addresses those that have few or none. Critics will conclude that the Governor didn’t include those counties because a majority of Miami, Fort Lauderdale, Tampa and Orlando didn’t vote for him. And though West Palm Beach also mostly voted otherwise, again, their county got a pass because that’s where it all began.
Hmmm…
CORE Network Funding
Here’s how Florida’s Governor broke down the CORE Network funding:
- Establishing the Office of Opioid Recovery – $10.2 Million
- Improving access to treatment and recovery services – $92.5 Million
- Developing educational prevention materials – $39.4 Million
- Expanding the CORE Network – $26.8 Million
- Expanding recovery and peer support services – $25.3 Million
- Pioneering an integrated statewide database – $11.3 Million
Sounds great, no? It may even be great. But since there were no details, we don’t really know. We did learn one detail though – and it’s a doozy.
The “more than $39 million going towards education will be used to create hard-hitting campaigns for middle and high school students,” reports Katie Dente at WJHG.
“It’s like Just Say No, but it’s really Just Say No, and here’s why,” said Florida’s First Lady. “We have to tell our children that when they think they’re taking something like a Xanax, we don’t recommend but if they are doing that, and it’s laced with fentanyl, that’s it. That’s the end of their life. There are no do-overs.”
That’s right. The second largest statewide opioid-fighting expenditure is going to regurgitate a campaign that didn’t even work for Nancy Reagan in the ’80s! Whether that’s tied in with Mrs. Governor’s The Facts, Your Future vanity project that was launched in 2019 is anyone’s guess. The words from the Shoreline Church podium don’t leave us much hope though.
Retention vs Attrition
The Governor claims that over the course of its first six months, the CORE Program has “serviced and evaluated 2,682 individuals for opioid use disorder,” with “a retention rate of 70% and an “average relapse rate of 2%.”
“So, that’s pretty good,” said the Governor.
Pretty good? That’s astounding! Especially considering that the National Institute on Health found the exact opposite to be true! Indeed, in their addiction treatment assessment of 1822 unique individuals, the NIH found the attrition rate to be 75-80%. And that was over a decade ago, before fentanyl took hold.
What’s the Secret?
How on Earth did Florida’s CORE Network flip the prevailing script a full 180 degrees? And how on Earth did they do so while things got so much worse? Surely it’s not because rural county addicts are somehow more susceptible to recovery than their more urban counterparts.
Furthermore, how are these lucky folks even becoming aware of treatment? The CORE Network page on the Florida Health site includes no information about who to see or where to go. In fact, the page hasn’t even been updated since September of ‘22. Thankfully, there is a link to follow on the Florida Gov site, but you’ve got to read to the very last word of the Governor’s press release before you can find it. Heck, even the good folks at My Florida Families only link to an old pdf handout. Makes no sense, especially considering the good folks at the Department of Children and Families (DCF) are one of CORE Network’s partners. Well, they’re one of FL-OD2A’s partners anyway.
So are:
- Centers for Disease Control and Prevention (CDC)
- Agency for Health Care Administration (AHCA)
- Florida Perinatal Quality Collaborative (FPQC)
- Florida Hospital Association
- Florida Medical Association
In case you’re wondering, OD2A means Overdose Data to Action, and FL-OD2A is simply the Sunshine State’s designation.
In reality:
The Florida Overdose Data to Action (FL-OD2A) program is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $60.6 million with 100 percent funded by CDC/HHS.
In other words, it’s the Feds’ program, baby, from funding to finish.
As are its activities, including:
Monitoring & Surveillance
- OD2A includes Florida’s Drug Overdose Surveillance and Epidemiology (FL-DOSE)
- FLHealthCHARTS: Substance Use Dashboard
- Neonatal Abstinence Syndrome (NAS) as a reportable event, tracked by the FL Birth Defects Registry
- Florida’s Prehospital Emergency Medical Services (EMS) Tracking and Reporting System (EMSTARS)
- Syndromic Surveillance System
- Florida Vital Statistics
- State Opioid Surveillance Plan
Reducing & Managing Access
- Prescription Drug Monitoring Program (PDMP)
- Multi-board Fact-Finding Workgroup
- ASTHO OMNI Learning Collaborative
- Collaboration with the Council of Florida Medical School Deans’ Pain Management Workgroup
- County Health Departments support county Syringe Exchange Programs
In Praise of the CORE Network
Listen, at its, er, core, the CORE Network is phenomenal. Well, the way Palm Beach County put it together seems to be phenomenal anyway. And Meredith Moran’s ace report for the National Association of Counties says so too.
The pilot program was initially just for patients at HCA Florida-JFK Hospital in West Palm Beach who had been taken to the emergency room due to an opioid overdose. As the program grew, the hospital created a formal outpatient clinic and Addiction Stabilization Unit (ASU).
“The way that we’ve molded the program now is anybody can walk in, and we tried to do that where, at least with our [ASU] we have a triage program, if somebody comes in off the street, our staff then tries to determine, ‘Do you need inpatient? Do you need heavy outpatient? Can we come and treat you in your home?’” Commissioner Melissa McKinlay said. “Like, ‘[what is] the best option?’ And then the other thing that we tried to establish was if you’re the parent or the loved one of somebody going through addiction, you can pick up and call and ask for guidance in trying to find help.”
Still, as good as Palm Beach County is at fighting SUD, even they don’t report stats anywhere near those reported by the Governor. What PBC officials do say is that at any given time, 400-500 individuals are receiving some form of treatment. Beyond that though, they’re very cautious.
Continues Moran:
The recovery program has been successful in Palm Beach, with drastically lower relapse rates among those participating in the program versus those who are not. Brief addiction monitoring assessments, which are self-reporting questionnaires that pertain to mental and physical health in relation to sobriety, have also shown that patients’ average protective factors go up and risk factors go down.
That makes much more sense.
Honesty, Please
It also sounds much more honest. And as everyone who’s ever been in recovery knows, honesty is fundamental. So you’ll forgive us if we’re skeptical of some unverified boasts coming from some church in Destin and instead believe our neighbors from the Palm Beach Health District.
That’s not to say Healing Properties doesn’t want the CORE Network to work, mind you. It’s to say we want to see it work, and for it to work across all of Florida to boot. Until then, it’s simply lip service. And the opioid crisis is killing far too many Floridians for any more lip service.