Wednesday, October 30, 2019


Office of the Press Secretary

Via Telephone

9:43 A.M. EDT

     MR. CANTRELL:   Thank you, Operator.  Good morning everyone, and thank you for joining this morning’s briefing on the launch of

Opening statements will be on the record, and the question-and-answer portion to follow will be on background, attributable to a senior administration official.

With us today is Senior Counselor to the President, Kellyanne Conway; Health and Human Services Secretary, Alex Azar; Assistant Secretary for Mental Health and Substance Use, Elinore McCance-Katz.

If a subject matter expert is needed in the briefing, he or she will be on background, attributable to a senior administration official.

All information discussed is embargoed until the conclusion of the call.

With that, we will begin with Senior Counselor, Kellyanne Conway.

MS. CONWAY:  Thank you so much, Austin.  And thank -- I especially want to thank Dr. McCance-Katz; and, of course, our Secretary of Health and Human Services, Alex Azar; and each and every one of you for your interest in the topic.  We’re quite excited today to launch -- the latest building block in what has become a central focus for President Trump, First Lady, Mrs. Melania Trump; and the entire administration in our whole-of-government approach to treat the whole person suffering from substance misuse disorder.

Bringing the full weight of this administration to bear on three fronts of this “crisis next door,” as we call it -- number one, prevention and education; number two, law enforcement and interdiction; number three, treatment and recovery.  And that last prong really gets a big boost today by providing more of a connective tissue between those in need and those who love those in need and finding the treatment that they require and that is available to them.

Let me just review a couple of points of the progress report in our administration’s fight against the opioid and overall drug supply/drug demand crisis.  We recently received government data, showing that, for the first time in 30 years, we have a 5.1 percent decline in overdose deaths due to drugs.  That’s falling off of its peak, in some of our states, up to 24 percent -- a 24 percent reduction in overdose deaths in Ohio; 23 percent reduction in Pennsylvania; down 19 percent in Iowa; down 17 percent in Kentucky; a decline of 11 percent in the hard-hit state of New Hampshire; and the hardest-hit state, West Virginia, down 9 percent.

The battleship is turning slowly, but it’s pointed in the right direction.  Still, many continue to shy toward recovery.  The depths of addiction and misuse disorder are difficult enough without the complexities involved in trying to navigate insurance payments, privacy and confidentiality, compassion, and then of course trying to locate a treatment provider that best meets each patient’s customized needs.

No part of this administration has turned a blind eye to this crisis.  And I think, when we’re talking about recovery, I should just mention a few things:

One, the Department of Labor is aggressively engaged and has invested over $100 million in workforce training grants to 17 states and the Cherokee Nation.  In fact, just tomorrow, Secretary of Labor Gene Scalia will be in Pennsylvania announcing a new displaced worker grant.

USDA is partnering with treatment providers in rural communities to expand access to recovery housing.

Treasury has issued four, first-of-its-kind advisories to the private sector to help strengthen and secure the supply chains for fentanyl traffickers, giving the private sector more of an eye toward the money, manufacture, marketing, and movement of illicit opioids -- illicit drugs like fentanyl.

The Department of Interior has created a tribal task force specifically to combat the opioid crisis on tribal lands and to expand treatment and recovery available options there.

The recent settlements in the major opioid crisis lawsuit in Ohio proves that this is not just a supply or a demand problem, but both.

And today, we recognize that many Americans have a limited window when they themselves or someone they care about is struggling with addiction or misuse disorder, and that window closes quickly if the silence and the stigma overtake that desire and, indeed, that need to access treatment.

Too often, people will just type into a search bar: “need treatment,” “drug treatment,” “drug addiction,” “addiction services near me,” -- whatever the pedestrian language that we would all use to try to get action fast.  And I’m sorry to report that -- for years, if not decades -- there has been, I would say, an insufficient response to such a search.

So, starting today, we’re very happy to announce a newly-configured tool, through SAMHSA -- Substance Abuse and Mental Health Services Administration --  Truth in advertising.  These are real results for real people, using real language.

No more clinical language.  No more quantity over quality, so that you get this map of thousands of locations within a 500-mile radius toward you.  That actually has prevented so many people from accessing treatment because they can't customize it according to residential treatment, according to people who may want to keep their jobs and stay at home, but get some type of outpatient treatment, medically assisted treatment -- something that we have advocated for and funded in this administration.  Perhaps you want to customize your search by under-18, by one gender or the other, by LGBT sensitivity, by veterans, for example.

So we're allowing folks to customize those searches through this  This website provides information on locations, treatment options, insurance information, payment, and it takes 13,000 of the state-licensed facilities in the data set and customizes that search for folks who are accessing this type of treatment.

     We incorporated 300 pieces of feedback, including -- in addition to 60 long-form informational interviews from recovery professionals, health-line operators, local advocates, parents seeking help, and, indeed, Americans in active recovery.  The input is just as important as the output. was built to help all Americans struggling with substance abuse disorder, and we are thrilled to launch this website today.

     I would now like to turn it over to Secretary of Health and Human Services, Alex Azar.

     SECRETARY AZAR:  Thanks, Kellyanne, for kicking off the call and thanks for your dedication to combatting this crisis.

     Today, the Trump administration is announcing a way to make it much easier and more convenient to find the treatment that you or a loved one might need for substance abuse.

     We know that finding access to the right provider at the right time can be essential to helping someone start on the road to recovery.  In fact, it can be lifesaving.

     Today's action is just part of our broader commitment to expanding access to treatment for substance abuse -- especially opioid addiction -- which includes not just connecting people to treatment, but also increasing the quality of that treatment and expanding the supply of treatment providers.

     One of the first public appearances that I made in my time as Secretary was speaking to the National Governors Association about the opioid crisis.  I emphasized that there is a lot we still need to learn about how to beat this crisis, but we do know one thing very well: Treatment and, in particular, medication-assisted treatment works.  We're not going to beat this crisis without connecting more Americans to evidence-based treatment.  In the case of opioid addiction, that is medication-assisted treatment -- or “MAT” -- with appropriate, psycho-social services and recovery support.

     We unequivocally and strongly support MAT because we see addiction as a medical issue, not a moral failing.  Addiction demands treatment, not judgment.  President Trump agrees.  When he launched the Opioid Strategy last year in New Hampshire, he said we need to, quote, "make medically assisted treatment more available and affordable."
     Our estimates suggest that before the President took office in 2016, 921,000 Americans were receiving medication-assisted treatment.  Now, in 2019, our estimates suggest we have 1.27 million Americans receiving this treatment -- a 38 percent increase.

     In the $1.5 billion State Opioid Response grant that SAMHSA has dispersed over the last two years, we've put a special focus on medication-assisted treatment by requiring that all treatment providers receiving grants make all forms of MAT available.

     We're also expanding access to treatment through our insurance programs.  When the President asked HHS to declare a public health emergency regarding the opioid crisis back in 2017, he promised more approvals of Medicaid waivers for states to help, quote, "unlock treatment for people in need."  They’d come, quote, "very, very fast," end quote, he said.  And since he took office, we've approved waivers for 22 states, compared with 4 under the previous administration.

     These results are just part of broader work we're doing to prevent addiction and save lives, including a 378 percent increase in Naloxone prescribing, and a 31 percent decrease in the total amount of opioids prescribed.

     We're achieving these results in cooperation with communities on the ground, because expanding access to treatment for Americans struggling with addiction is a priority all across HHS.  That ranges from CMS, where we're opening up new ways to pay for treatment; to IHS, the Indian Health Service, where we're expanding access to MAT providers; to NIH and FDA, where we're helping support work toward new MAT formulations; to CDC, where we're helping communities using overdose data to connect people to treatment as effectively as possible.

     And, of course, at SAMHSA, we're focused on supporting evidence-based treatment and relying on the best science possible.

     So, now I want to hand things over to Assistant Secretary McCance-Katz, who can explain more about the context of how SAMHSA helps Americans access treatment and how she's advanced those efforts.

     ASSISTANT SECRETARY MCCANCE-KATZ:  Thank you, Secretary Azar.  This launch represents an exciting action for the Substance Abuse and Mental Health Services Administration for the field and for millions of Americans struggling with substance use disorder across the United States.

     SAMHSA is the primary federal agency charged with addressing mental and substance use disorders for the nation.  One of SAMHSA's primary roles is to increase access to evidence-based prevention treatment and recovery support services for individuals across the country with mental or substance use disorders.

     As the Assistant Secretary for Mental Health and Substance Use, I take this responsibility quite seriously and see the launch of an updated, easier-to-use treatment locator as a key step in how we will increase access to substance use disorder treatment.

     We know that, unfortunately, the opioid crisis has taken the lives of far too many Americans.  We need to work together to do all we can to ensure that locating treatment is not the barrier to actually receiving treatment.

     As an addiction psychiatrist, I've spent the majority of my career treating substance use disorders, including opioid use.  And I know firsthand that when a person makes a decision to seek treatment, if treatment options are not readily accessible and available, the opportunity may be lost.
     The nature of addiction is not one in which we can ask people to wait while treatment becomes more easily accessible.  With substance use disorders, we must act immediately and have systems in place that do the same.

     SAMHSA's treatment locator has been in operation for nearly 20 years, beginning in 2000, with a simple searchable interface to find treatment.  The last major overhaul of the system was done in 2002, and a large map interface was added at that time.  Since 2002, adjustments have been made to the locator, adding more facilities and ensuring greater ease in searching.

This launch reflects the commitment, on the part of President Trump and Secretary Azar, to truly bring the locator into the 21st century with better technology, a modernized search capability, and a more efficient way to search for treatment.  The new and improved locator reflects months of improvements based on feedback from members of the public.

I know that, since January 1st of this year, the SAMHSA locator has already had over 2 million visitors and I'm confident that the newly improved locator will yield even more interest.  I'm very hopeful that this step will serve as an integral tool in helping Americans and their families find treatment they so urgently need.

By increasing access to treatment, I know we can stem the tide of the opioid crisis across the country and save lives and communities across our nation.

MR. CANTRELL:  Thank you, all.  Operator, we will now take some questions. 

Q    Hi, this is Trevor Shirley.  I'm a reporter with Nexstar, here in D.C.  I think anybody can answer this or jump in on it, but -- when you go into the search engine and you type in your ZIP Code and the options come up, what's being done to ensure that you're getting quality over quantity?  In essence, I mean, are there -- I mean, are these all certified places, licensed places, so that we know that people aren’t preying on other people in their time of need?

SENIOR ADMINISTRATION OFFICIAL:  Yes.  Yes.  Thanks for that question.  That’s a really important question.  These programs are all programs that we at SAMHSA get information about through our National Survey on Substance Abuse Treatment Services -- or “N-SSATS.”  These are all state-registered programs and are regulated within the states, and those are the only kinds of programs for treatment that we placed on the site.
     Q    Hi, this is Brianna Ehley with Politico.  I'm just following up on that question.  So, you said the way that you guys are ensuring that the programs listed on this treatment locator are safe is just basically trusting that the state has already vetted them?  Or will you do additional vetting just to make sure that they're good quality treatments?

     SENIOR ADMINISTRATION OFFICIAL:  We trust the states to monitor the programs in their jurisdictions -- that they certify those programs and we accept their word.

     SENIOR ADMINISTRATION OFFICIAL:  It’s [senior administration official].  If I may just interject, also, that is -- there are over 13,000 state-licensed facilities already in the system.  So there is -- they are reflected.  This is why we believe, since we know that the crisis is indiscriminate, affecting everyone, we want the treatment to be indiscriminate, so that it’s accessible.

     Look, some people may not want a treatment location close to them.  They may want to go farther out.  And that’s something that we're sensitive to, as well, which is why you can now customize your search according to any number of factors that are important to you or immutable to you.

     Secondly, I just want to give praise to Google, who has been a wonderful private-sector partner to all of us in our efforts, through everything from their website, “Recover Together”; to Take Back Day.  They're up to 8,300 locations that they will map for you for Take Back Day.  Secretary Azar and Acting Administrator Dhillon and I were over at Google in April for Take Back Day.  They had about 5,600 locations (inaudible) for this most recent Take Back Day.

Why do I mention that?  For two reasons.  One: It’s a good model for how when you populate a popular website -- accessible website, to begin with -- with additional resources, people will come and access those resources.  So, here, we're dealing with 13,000 state-licensed facilities.

Number two: Google, early on in our administration, at our urging, helped to shut down a lot of these ads for crackpot, quote, "treatment facilities" that are not licensed, would not be recognized by Assistant Secretary McCance-Katz and the state facilities that she is describing.

     Q    Hi, it's Lenny Bernstein at the Washington Post.  Quick question about the data cited at the top of the call -- those encouraging statistics.  Are you -- are those still provisional numbers, or are you offering -- are you saying those are final from 2018 right now?

     SENIOR ADMINISTRATION OFFICIAL:  Hi, this is [senior administration official].  Those are still provisional numbers.  But remember, those provisional numbers have 99.85 percent of data already included in them.  So although they are provisional and may be subject to a decimal point move in some direction, they're going to be pretty close to approximating the final numbers when those are released.

     Q    Yes.  Hello, this is Alicia Ault with Medscape Medical News.  And I'm just wondering how you plan on getting word of this site out to the public, but also to referring physicians.

     SENIOR ADMINISTRATION OFFICIAL:  Well, I think one vehicle is this call, hoping that you all will be able to get the word out and report on it.  I know that I'm doing -- I'm doing a bunch of media today on that, and Kellyanne will also be.  I think the Administrator is getting out there.  And so those are just the usual tools to try to communicate this, and have it out there, and echo it out.

We'd encourage you to please do everything you can to do that.  And the White House will be promoting across all of its digital and social media channels.

     SENIOR ADMINISTRATION OFFICIAL:  And, at SAMHSA, we will -- our Office of Communications will be doing email blasts.  We have about 80,000 people that -- of practitioners that we'll reach that way.  And we'll post it on our website.  We'll take our steps in communicating with stakeholders and practitioners in the field.

     Q    Hi, it’s Abby Goodnough at the New York Times.  I’m wondering if there’s any attempt at the federal level to track outcomes of medication-assisted treatments in programs that are receiving the Opioid Response grant money -- like relapse rates, how long people are staying on the medication, that sort of thing?

     SENIOR ADMINISTRATION OFFICIAL:  Yes, thank you for that question.  In fact, at SAMHSA we do collect data on outcomes for every person who receives services through our grants.  We have a data collection system.  It’s required by federal law.  And we look at it regularly to follow the numbers of people who are getting treatment, the types of treatment they’re getting, and the outcomes.

     Q    Hi, this is (inaudible) News Medical Unit.  So what would you say -- just two quick questions -- the major kind of differences between this specific -- like the improvements and the older version?  So is it the locator or would you say it’s the customizable kind of search engine that provides the better filter?

     SENIOR ADMINISTRATION OFFICIAL:  It’s [senior administration official].  And I should have mentioned here or someone should have, prior to this call, that perhaps we should tell you how it was redesigned -- no government contracting, very few resources used.  It actually was redesigned through a combination of GSA; Office of Digital Strategy, here at the White House; obviously, HHS; and SAMHSA.

So we -- we will list a little bit later -- we’d like show you the before and after, because I think to grasp it visually is quite remarkable.     

     SENIOR ADMINISTRATION OFFICIAL:  Yeah, this is [senior administration official].  It’s actually -- it’s really quite an incredible tool.  You go in and you can just -- I was doing it this morning -- you put your ZIP Code in, and you can customize the search based on: Are you looking for inpatient?  Are you looking for temporary?  Are you looking for outpatient?  Are you looking for MAT?  You can even customize based on the type of MAT that you’re looking for, based on the drug used in the program.

You can -- something I find really important -- you can customize the search by payment accepted.  So are they a Medicaid provider?  Do they take private insurance?  Obviously, it’s a geographic search.

As my colleague mentioned, these even have options -- you have a LGBT option to search with.  You have an 18-and-under or 19-and-over option.  So just, really, a fantastic search engineer there.

SENIOR ADMINISTRATION OFFICIAL:  We did away with the clinical language and we even -- there was a language expert involved from the health (inaudible).

SENIOR ADMINISTRATION OFFICIAL:  I think another major change was the old tool also had purely mental health -- I believe there was some mental health in there.  Is that right, [senior administration official]?

SENIOR ADMINISTRATION OFFICIAL:  That’s right.  It does have the mental health treatment programs, nationally, as well.  Yeah.

SENIOR ADMINISTRATION OFFICIAL:  And then we’re going to turn over the call, also, for a little bit more expertise to [senior administration official] and [senior administration official] from the Office of Digital Strategy.

SENIOR ADMINISTRATION OFFICIAL:  So with this website redesign, you really started with the users and started with doing those individual interviews.  So it was a user-centered design.  We kind of call it an “American-centered design” -- starting with what the American people need.

And from those interviews, we realized the things that they really needed and the questions that they were asking were centered around the type of -- the services the facilities offered.  Services, that is: How do I pay for my treatment?  What are different types of treatment options?

So, as we were going through the process, we prioritized the things that the American people really needed and that they were asking the questions about.  So instead of finding the location that was closest to them, this website is designed to find the location that best meets the needs of that individual person to get the treatments that they so desperately need.

SENIOR ADMINISTRATION OFFICIAL:  And another great benefit of the site are the ways in which it shows people the information they need to understand more about treatment.  So further down, below the search box on the site, there is some really great resources provided by SAMHSA that shows people the kind of information we heard, directly from them, was critical as they explored their treatment options.

Q    Hi, it’s Alicia Ault with Medscape again.  I’m just wondering if this site is dynamic in anyway.  Obviously, over the last few years, a lot of providers have jumped into this market and you also have providers that are being disqualified for various reasons -- some of them being found to be fraudulent.  So do you remove providers or add providers on a dynamic basis?

SENIOR ADMINISTRATION OFFICIAL:  Yes, we do.  The survey that I mentioned a few minutes ago -- the National Survey on Substance Abuse Treatment Services -- is collected yearly, and our staff do update the website based on that.

MR. CANTRELL:  Great.  Thank you, everyone.  This will conclude our call.  Again, opening remarks were on the record.  The question-and-answer section is on background, attributable to a senior administration official.  Again, any subject matter experts that may have added to the briefing are on background as well.

As always, direct all further questions to the White House Press Office.  Thank you every one for joining this morning. 

                        END                10:09 A.M. EDT  

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