Opioids Push Social Services
to the Limit
Demand for treatment
center beds, addiction
specialists and foster
families is outpacing
supply. Providers are
feeling the pinch.
By Katie Dwyer
In 2016, 11. 5 million people misused prescription opioids, 2.1 million had an opioid abuse disorder, and 42,249 died from opioid overdose, according to the National Survey on Drug Use & Health and the National Center for Health Statistics. The opioid epidemic is driving an influx of people into counseling and
addiction treatment. It’s breaking apart families and funneling more children
into foster care. Human service organizations are under immense pressure to
meet increased demand without receiving additional resources. The need for
counselors, social workers, psychiatrists, available beds and foster families is
outpacing supply, increasing safety risk and professional liability exposure.
MEDICALLY-ASSISTED TREATMENT AND PROFESSIONAL LIABILITY
The risk profile of a treatment facility depends on the services it provides. Talk-based approaches (counseling and support groups) carry less risk than residential
centers providing medically-assisted treatment. Psychiatrists and other medical
professionals who dispense medications need more robust coverage and higher
limits than social workers.
The Drug Addiction Treatment Act of 2000 permits qualified physicians
to treat opioid addiction using FDA-approved Schedule III, IV or V narcotic
medications outside traditional sites like methadone clinics. Buprenorphine is
currently the only such medication. Physicians who qualified for a waiver to
prescribe buprenorphine could only treat 30 patients at a time until recently. Now,
physicians who have had their waiver for at least one year can apply to increase
their limit to 100 patients; after another year, they can extend that to 275.
“There’s been some deregulation here to try to meet the increasing demand
of people seeking medication-assisted treatment, particularly in rural areas,” said
Brad Storey, VP of risk management, Irwin Siegel Agency Inc.
Facilities providing medically-assisted treatment should not only have professional
liability programs to protect their clinicians but should also require medical
professionals to carry their own coverage to pick up the primary layer of risk.
“Professional liability cover is usually built into insurance programs for social
service providers, but it’s typically not robust enough to cover medical services.
The cover is geared more toward social workers and counselors rather than
medical professionals. This could open the door for PL risk,” said Scott Konrad,
SVP and not-for-profit practice leader, HUB International. “Make sure your
medical providers can show proof of third party medical malpractice coverage.”
Non-medical staff may be trained in administering the overdose-reversing
drug Naloxone. Some states allow Naloxone to be dispensed without a
prescription, while others have yet to enact laws surrounding the medication.
“It’s important to be aware of the regulatory environment in your state,” Storey
said. “Running afoul of the law may nullify any coverage that would have been
available to indemnify the facility should something go wrong.”
“A traditional professional liability policy [may] contain exclusionary language
for the administration of medication without a prescription. This is a clear gap
when it comes to life-saving Naloxone,”
said Mike Liguzinski, president,
specialty human services division, Great
American Insurance Group.
“Fortunately, there is Good
Samaritan law protection in most states
protecting the insured from errors
made in administering Naloxone.
In states which have allowed the
administration without a prescription,
it is common to enact a statute that
grants civil and criminal immunity
• Widespread opioid addiction is
driving more people into treatment
and more children into foster care.
• Increased demand for services
is raising safety and professional
liability risks for providers.
• Establishing clear policies and
procedures can help mitigate
“In states which have allowed
the administration without a
prescription, it is common to
enact a statute that grants civil
and criminal immunity to the
— Mike Liguzinski, president, specialty human
services division, Great American Insurance Group
The opioid epidemic is straining social service agencies’ budgets and human resources.