Health Committee Meeting - October 7, 2026: Examining Barriers to Substance Use Disorder Treatment

On Wednesday, October 7, 2026, the Westchester County Board of Legislators Committee on Health, chaired by Legislator Jewel Williams Johnson, met to examine barriers preventing individuals with substance use disorders from receiving timely, compassionate, and effective treatment. The meeting featured a presentation from Robert DeForde, Senior Program Manager at Shatterproof, and discussion with Trevor Payne, Director of Drug and Alcohol Services at the Department of Community Mental Health. The committee also addressed a recent measles outbreak in New York State.

Opening Remarks: Measles Outbreak Update

• Chair Johnson reported that Governor Kathy Hochul declared a state disaster emergency due to a growing measles outbreak. As of October 3, 2026, New York had 108 confirmed cases, with 101 outside New York City and 92 cases since July. The largest concentrations were in Suego, Seneca, and Steuben counties; neighboring Rockland County had four cases. No confirmed cases had been publicly announced in Westchester County as of the meeting morning.
• Chair Johnson emphasized that measles is extremely contagious, with the virus remaining airborne for up to two hours after an infected person leaves a room. Among non-immune individuals, up to 90% of close contacts can become infected. The MMR vaccine is 93% effective with one dose and 97% with two doses. She urged residents to check vaccination records and encouraged those born after 1957 without documented immunity to consult a healthcare provider about receiving another MMR dose.
• Chair Johnson referenced the May 20, 2026 Health Committee meeting for a prior update on measles and emerging infectious diseases.

Discussion Items

Shatterproof Presentation on Stigma in Healthcare

• Robert DeForde presented on the scale of substance use disorder (SUD) in the U.S.: in 2024, 48 million people aged 12 or older (nearly 17% of the population) met diagnostic criteria for SUD, yet 80% did not receive treatment. Overdose fatalities dropped to under 80,000 in 2024 from a high of 122,000, but declines were not equitable across racial and ethnic groups.
• DeForde defined stigma as a process involving labeling, stereotyping, separation, and discrimination. He distinguished between public stigma, self-stigma, and structural stigma (policies and practices that create barriers). He also noted stigma directed toward medications for opioid use disorder (MOUD).
• Shatterproof developed the Addiction Stigma Index (SASI) to measure stigma. A 2024 national survey oversampling healthcare providers found:
  • 78% of healthcare professionals agreed MOUD should be more accessible.
  • 78% believed MOUD is an effective treatment.
  • However, 43% believed MOUD substitutes one drug for another.
  • Only 47% would want an MOUD clinic in their neighborhood.
• DeForde described the Providers Pathway training program, developed with funding from the Elevance Health Foundation. The program includes asynchronous online training (free, with CEUs) and in-person team-based training. To date, nearly 8,000 healthcare providers have engaged, with 4,000 completing and receiving CEUs. Population-specific modules address the Latino community. A research study with Yale found that completers showed increased knowledge about SUD, decreased stigma, and increased confidence in treating SUD.
• DeForde advocated for making SUD education an ongoing requirement rather than a one-time mandate, citing the federal MATE Act (which requires eight hours of SUD education for prescribers but only once). He noted that New York is expected to receive $3 billion in opioid settlement dollars and encouraged local investment in stigma reduction training for providers.

Discussion on Structural Stigma and Local Efforts

• Trevor Payne (Director of Drug and Alcohol Services, DCMH) commented on the challenge of NIMBYism as a form of structural stigma, noting that some communities in Westchester are easier to place treatment services in than others. He described county efforts to reduce stigma, including panel discussions (one with nearly 100 community members), and training for professionals using opioid settlement dollars, hosted on a platform run by the Center for Practice Innovation (CPI).
• Payne reported that Westchester County has made access to addiction medications a priority for all SUD programs funded by the county. He noted that since the introduction of addiction medications in the county jail three years ago, initiations increased from 250 in the first year to over 450 by the end of 2025, and alcohol addiction medications were added last year.
• Payne highlighted the difficulty of engaging primary care physicians in training, citing time constraints and competing demands. He noted that while some individual physicians are open, getting groups to commit has been challenging.

Policy and Training Considerations

• Legislator Emiljana Ulaj (participating remotely) suggested advocating at the state level to make SUD and stigma training a recurring requirement for medical licensure, similar to other mandatory trainings. She noted that she would follow up with Assemblywoman Amy Paulin, chair of the State Assembly Health Committee.
• Robert DeForde agreed that state-level advocacy is promising, but cautioned against making it a checkbox exercise. He noted that providers are already overburdened and that federal solutions like the MATE Act are a start but not sufficient.
• Chair Johnson proposed holding a future health committee meeting where local hospital systems (New York Presbyterian, White Plains, Northwell) could bring two providers each for a mini-training session using Shatterproof’s case studies. DeForde welcomed the idea.
• DeForde also mentioned that the free asynchronous training is available on myCME.com and offers six CEUs for MDs, DOs, RNs, NPs, PAs, and social workers. He offered to share the link with the county.
• Payne added that emergency rooms are reporting more cannabis-related issues, and that better data collection from urgent care facilities is needed. He noted that the Department of Health provides some emergency room data, but it can be delayed.
• Payne also described the county’s co-occurring treatment approach: all contracted providers are required to use a co-occurring lens for assessments and treatment. The department is currently launching a six-month learning collaborative for clinicians on motivational interviewing, including a chatbot for practice and scoring.

Key Outcomes

• Chair Johnson committed to following up with Shatterproof’s Chief Policy Officer, Kristen Pendergrass, to offer assistance on state-level advocacy for mandatory training.
• Robert DeForde will provide Trevor Payne with the link to the free Providers Pathway training on myCME.com for distribution.
• Chair Johnson expressed intent to organize a future health committee meeting where hospital representatives could attend a stigma training session using Shatterproof’s case studies.
• The meeting was adjourned at 12:07 PM.