In response to the state’s heroin epidemic, Governor Cuomo recently launched a new comprehensive website with accompany public service announcements (PSAs). The message on the home-page of the well-designed site is clear; ‘addiction can happen to anyone, any family, at any time’. Smithtown mother Linda Ventura is that any family and she can be found on that website: www.combatheroin.com.
Like so many other Long Island moms, Ventura sat on the side-lines in the cold at her son’s sporting events; she went to back to school night to meet his teachers, took him to church, helped him with his home-work and science projects and told him she loved him over and over throughout his life. She even talked to him about the perils of drugs and alcohol. The Ventura family is the ‘any family’ on the state’s website.
On both the site and in the PSA’s Ventura tells the harrowing story of her son’s battle with heroin addiction. She talks about the loss of her beautiful twenty-one year old son who was a popular athlete in Kings Park. Thomas was also a great son, brother, uncle and friend. He loved to spend time by the water at the Kings Park Bluff – he was a great kid who made a bad choice as an adolescent as so many kids do. The PSA’s with Ventura appear on dozens of television channels throughout the state. Her Thomas died two and half years ago and at that time Ventura decided to use her pain to advocate for change and to help other parents.
And advocate she has done. She was part of a team of advocates on Long Island and Buffalo who headed to Albany several times this past year to lobby for a series of bills. “Senator Phil Boyle and Senator Kemp Hannon are champions; they brought Opioid Addiction to the forefront this year,” she said. Ventura attended the Long Island Senate hearings held by the Suffolk Senators which she credits for bringing about greater awareness and the passage of an historic package of bills.
“Senators and Assemblymen needed personal stories to fully comprehend the horrific fallout of Opioid and heroin abuse,” she explained. Like so many on the front line, Ventura says that Long Island was the epicenter of what is now a statewide and nationwide epidemic.
“The main focus of my advocacy was the Access to Care bill,” she added. Ventura, like so many other parents was told her son was not high enough for treatment. “That’s a statement I still struggle to understand; in addition, Thomas needed to FAIL at outpatient before receiving inpatient treatment,” she lamented. Ventura says the disease of Addiction is a fatal, progressive disease and needs to be treated as one. She and many of fellow advocates called the thousands of insurance denials around the state discriminatory practices.
“In May 2014, I brought my son’s ashes with me to Albany so that the lawmakers could fully comprehend what failure at outpatient looks like. I respectfully asked the politicians to remember what that failure looks like and how my family is forever changed,” she shared. In June 2014 she boldly sat at an Assembly roundtable in June and put her son’s ashes on the table for the President of the NYS Insurance Plans to recognize that profits over treatment are unacceptable.
Ventura said in April 2015, Access to Treatment becomes effective and insurance companies will not be allowed to discriminate treatment for Opiate and Heroin Abuse. She said they are making strides and the new laws, website and PSAs are all excellent tools. “However, there is more work to be done education and prevention programs must be put back in the schools otherwise we are going to be right where we are today in five years,” she demanded.
Ventura says it is very difficult to think clearly when a loved one is struggling with this disease. “I would say to parents, this disease has nothing to do with good parenting and it discriminates against no one,” she added. She says parents should never think it’s OK that their child is “only” smoking pot and drinking alcohol. She implores parents to get educated and seek help if they suspect their child is having a problem.
“I don’t want any more parents to be a member of my Club, I celebrate the victories we have had in Albany but I paid the ultimate price,” she said sadly. The NYS website also provides prevention resources, a list of warning signs and places to get help or get involved.
**NYS law requires that treatment programs funded by OASAS provide treatment services for people who cannot pay for the services.**
Right to Coverage for Addition Treatment Services
Under New York and Federal law, if you have insurance you have the right to receive the following addiction treatment services when medically necessary:
- Unlimited detoxification services in a hospital;
- Unlimited inpatient care in a hospital, inpatient rehabilitation or residential treatment facility;
- Unlimited outpatient care in both outpatient facilities or in your provider’s office;
- Outpatient methadone treatment (an insurer may require that methadone administration be accompanied by other substance use treatment); and
- Suboxone and subutex, if your health insurance coverage includes a prescription drug benefit.
Knowing the details of your health insurance plan, the law and your rights can be critical when you seeking treatment for yourself or a loved one. For more information visit the New York State Office of Financial Services website
Denial of Coverage
If your health insurer denies coverage for any addiction treatment services for the reason that it is not medically necessary, you have a right to appeal the decision with your health insurer. If your health insurer upholds the denial you have the right to an external appeal with an independent reviewer.
For more information on your rights to appeal the denial of insurance coverage visit New York State Office of Financial Services website
If you, a family member or friend is abusing or misusing heroin, prescription drugs or other Opioid call the New York State HOPEline at 1-877-8-HOPENY (1-877-846-7369) for help. Calls to the HOPEline are toll free and you will speak with a trained professional who will answer your questions and help you find treatment 24 hours a day, seven days a week. All calls are anonymous and confidential and call services are provided in over 125 languages.