Libertarian gubernatorial nominee Jilletta Jarvis supports job training as part of any initiative to combat the opioid epidemic in New Hampshire, but she's opposed to Medicaid expansion, which several state leaders say has been a critical tool in response to the health crisis. Morning Edition host Rick Ganley interviewed Jarvis to further discuss health care issues.
Morning Edition is interviewing gubernatorial candidates all week to discuss health policy.
First, let's start with the opioid crisis. You've said you'd like to focus on improving post-care for people who are leaving treatment and re-entering the workforce. How so?
We need to provide them support which includes things like job training, getting into a new job, one that wasn't exactly what they were doing before, so they are not going right back to the same situation helping them find a new place to live. So they're not putting themselves back into the environment that they were in prior to becoming clean.
And these are these are part of new addiction treatment models that are being used nationally and some of that has been talked about recently in New Hampshire. But what specifically is not being done that you want to see done that would help with that post care?
Well, I think also that legalizing cannabis would assist because those places that have legalized have seen a drop in their opioid addiction rates. And we also need to provide the support to people in our homeless community.
There has been some tension between grassroots organizations versus the states plan to establish addiction hubs across New Hampshire, which is something that's in the works right now. How do you feel about that hub and spoke model that's now being proposed that's federal monies come to the Granite State?
Well my fear when it comes to federal monies that come in is that it all goes into a general fund and the general fund has a tendency to kind of have that money just get lost. So that concerns me all in itself. If we are going to have money set aside for certain projects, such as addiction treatment, I think they need to be in a separate fund, a fund that's dedicated just to us we always know how much money is in there how much money is available and how much money is going out when things get into the general fund.
There are specific rules about this money being spent and how it has to be spent?
Kind of. There are rules, unfortunately not always are they completely adhered to.
Are you opposed to federal funding at all for addiction treatment?
I fear federal funds because they typically come with strings attached. We'll give you this money as long as you do this with it, money that doesn't come with strings attached. This is our taxpayer money that we have spent. We have sent over to the federal government in the form of income taxes. Getting some of that back. I don't have a problem with as long as they don't tell us how we have to spend it. I would rather have that if it's earmarked for treatment it has to go to treatment and not no strings on how how we treat it. It can't be earmarks saying this is for treatment but it must be used for ... 90 percent of it must go to incarceration of addicts ...
"I fear federal funds because they typically come with strings attached."
Well, we have to be clear that's not one of the standards right now for this particular money coming in for that. What about the workforce issue we have surrounding health care in general and mental health specifically. What about high turnover rates we have in the state. You know it's difficult for people to get access to the already existing services that we have here in New Hampshire because there's just not enough professionals in the Granite State to treat people well?
One of our problems is that if you are a licensed provider in say Massachusetts, and you want to come and you want to work in New Hampshire, you have to make sure that you have a New Hampshire license to work, but there's no difference between how you're going to treat people in Massachusetts and how you're going to treat people in New Hampshire. I think we would welcome more people into the state by eliminating that need as long as they are licensed in this country. There's already standards on how they treat patients here in this country. So as long as they're licensed here we should eliminate that relicensing need. That would allow more people to freely come here without having to pay to do their job in another state. So it would open a door.
Would you support continuing Medicaid expansion in the state?
That's a difficult one for me. I would like to change the way our welfare program is working currently. I think that we when we're giving welfare to people we are ... we punish them when they start working again. We punish them when they are finally starting to become self-sufficient instead of ramping down the payments, we just cut them off. So if you for example when I was working as an adjunct professor at the community college, there was a student there who was on Medicaid and her son was on Medicaid, and she had finally gotten a promotion at her part-time work at a retail place to be a manager. That gave her consistent hours across the board so that she could more easily get care for her son. And she got a 25 cent per hour raise, which made her lose her Medicaid options.
So you want to look at a graduated system?
I would think a graduating system would be better. And then we promote people to get them back to work so that they can be self-sustaining because that should be the goal of a program like that if we're going to offer a program that helps you while you are unable to help yourself. The goal is to get you to the point where you can help yourself again.
So you're not opposed to Medicaid expansion on principle but you would like to alter the system itself?
I'd like to alter the system itself.
Would you support a paid family and medical leave initiative?
The Paid Family and Medical Leave initiative that was introduced, I do not support. I think that it would hurt smaller businesses. From the ones that I spoke to they said that they would end up laying off employees and just doing more work themselves instead of providing additional support.
Could you be in favor of a paid painful medically bill that was altered in some fashion that did not affect smaller businesses?
Most large businesses already offer it. So the people who would be focused at are those who already offer it. And in the five states that have already tried to initiate this program none of them, even Washington state which was the first one to initiate it, and they have a mandatory -- you must be part of it, you must pay into the system -- they still haven't been able to financially make it work. It's not self-sustaining. Until a program that can be offered can prove that it can sustain itself, dtuI don't think I could support it.
