PORTLAND, Maine -- Maine's providers of substance-abuse treatment and some other behavioral-health services are seeing a major increase in reimbursement rates going into effect this month.

But advocates for mental-health support say many agencies are facing major workforce shortages and other crises that prevent them from billing at all with the new rates.

Oliver Bradeen is executive director of Milestone Recovery, a nonprofit helping people facing homelessness and addiction. It's one of the few medically monitored withdrawal centers in Maine, often known as detox centers.

"Even with the increased rates, we're still struggling with workforce, and I know that's a common theme with the added level of COVID being a challenge," Bradeen explained. "There's just such a nursing shortage that it's hard to attract new talent from the nursing field."

He said their detox is currently closed because of those staffing shortages. He added while the improved rates are a step in the right direction, it could take time for providers who've been struggling to use them.

Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, said the increase in demand during the pandemic, combined with the severe impacts on the workforce, are putting a huge strain on providers, and waitlists for services are growing daily.

She emphasized it is important the Department of Health and Human Services invest more of the federal relief funding into these services now, as well as begin the proposed regular review of MaineCare's reimbursement rates.

"It's all going to be really good for the system of care," Shaughnessy projected. "But the current reality of many agencies is the situation is pretty raw. And it needs some direct infusion of resources and support right now."

Jeff Tiner, chief program officer for clinical services at Catholic Charities Maine, said putting more funds toward substance-abuse treatment is the right thing to do to support Mainers, and saves taxpayer money on emergency services and the criminal-justice system.

Data shows nationally, more than 85% of the prison population either has a substance-use disorder or were incarcerated for something involving drugs or drug use.

"We see the overdose rates that have increased exponentially," Tiner observed. "I don't think there's anyone in my world that has not been affected pretty close to home for those losses. Investment in prevention and support and recovery is really well worth it, and is a smart as well as compassionate."

A bill before the Maine Legislature would expand the state's Good Samaritan law, which protects people seeking help for an overdose from arrest or prosecution.

Currently, the law protects the person who is experiencing the overdose and the person seeking medical assistance for them.

Courtney Allen, policy director for the Maine Recovery Advocacy Project, said it does not protect everybody at the scene, and does not protect people for things such as bail or probation violations. She explained the expanded bill would fill those gaps.

"This law is too weak to protect most of my community members, and drug-using communities are very well aware of it," Allen asserted. "We must pass a Good Samaritan Law that is clear and concise and able to be executed out to drug-using communities that they understand and that they trust."

The bill's sponsors note being arrested or convicted for drug-related offenses can have major impacts on people's ability to get housing, employment or student loans.

Sherri Talbot, a substance-abuse counselor and Narcan trainer, said it is important to call 911 when an overdose occurs, even if Narcan, a treatment for opioid overdoses, has been administered.

She said opioids can last longer than Narcan, and there may be other substances involved.

"The number of cases where people aren't calling 911 is absolutely overwhelming in the area I work," Talbot pointed out. "We hear about very few overdoses except for the ones where people don't make it. It is so vital, I cannot stress enough, it is vital that people feel safe to call, because right now they don't."

Forty-seven states plus Washington D.C. have a Good Samaritan Law, and nationwide, the Government Accountability Office found those states see lower opioid-related overdose deaths, and when people know about the law, they are more likely to call 911.

The Centers for Disease Control and Prevention has announced another staggering new death count amid the pandemic: more than 100,000 fatal drug overdoses from April 2020 to 2021.

Groups working to curb such preventable deaths in Brooklyn are also pushing for solutions statewide. The group Voices Of Community Activists and Leaders (VOCAL NY), distributes clean needles, fentanyl test strips and Narcan, which can reverse an overdose.

Darryl Roberson, senior peer in the group Voices Of Community Activists and Leaders, works on the ground with participants.

"Overdoses are common, but we've saved a lot of lives," Roberson explained. "I see down the road, that we can defeat it; we have to still have a lot of support."

VOCAL NY is among 240 organizations across the nation now calling for passage of federal legislation which could help prevent opioid deaths in every neighborhood. In a letter sent to Congress, they have called for swift passage of the federal STOP Fentanyl Act, which improves surveillance and detection of the potent drug.

New York City's Health Department reports fentanyl is the most common substance found in all overdose deaths.

Melissa Moore, director of civil systems reform for the Drug Policy Alliance, said its presence in so many illicit drug batches is a further reason for what she calls a "people-first" approach to addiction.

"We need a lot more shifting away from criminalization, and from tactics from the failed drug war that have really been ineffective," Moore asserted. "And a move to person-centered, health-centered policies."

In the meantime, New York City has taken drastic action to prevent overdoses by opening the nation's first publicly recognized safe consumption sites in Upper Manhattan.

The move has been controversial. At the Overdose Prevention Centers, people can use drugs, receive medical care and have their supply inspected for fentanyl.

Research has shown the centers to effectively prevent lethal overdoses for decades in other countries. Moore believes the need is clear in all five boroughs.

"Because we know that's going to be the thing that will actually save lives, in this moment," Moore contended.

Any New Yorker seeking help with an addiction, for themselves or a loved one, can call 877-8-HOPE-NY.

Minnesota is still grappling with the impacts of opioid use, and now, an emerging effort aims to provide CPR training in marginalized communities to prevent loss of life.

State health officials recently announced Minnesota saw an 18% increase in non-fatal overdoses during the pandemic, fueled by opioid use, while adding the spike mirrors fatal overdose data.

On the prevention side, the American Heart Association is working with partners to recruit 600 "Community CPR Champions" in high-risk communities, mainly on the east side of the Twin Cities metro.

Dale Hager, captain in the White Bear Lake Police Department and a board member of the American Heart Association of Minnesota, said it gives local residents the power to save the lives of those close to them.

"Let's get the average person who has a basic knowledge of first aid trained to train their community members in how to pull somebody back from a potential opioid overdose," Hager urged.

The American Family Indian Center in St. Paul is among those who have signed on as volunteers. In Minnesota, members of the indigenous population are seven times more likely to die of drug overdose than whites.

Beyond state data, the American Heart Association recently reported opioid overdose is the leading cause of death for Americans between ages 25 and 64.

Hager added a quicker response in an overdose situation can make a huge difference.

"As opposed to waiting for an ambulance to arrive, we want to reach people where they are," Hager explained. "We want to reach people next to where our potential victims are."

He noted they also can provide comfort or triage for a victim until first responders arrive.

Organizers said they hope to reach their recruitment goal of 600 by the end of next April. Within each community network, roughly 60 people would receive CPR training. Additional overdose-prevention tips can be found on the American Heart Association website.