In an extraordinary move, Gov. Tom Wolf declared Pennsylvania's opioid epidemic a statewide disaster emergency, foreshadowing a flurry of changes to rules and regulations and leading state, county and municipal officials to speculate on what the declaration means for the state's fight against opioids.

In remarks Wednesday afternoon, Wolf said the 90-day disaster declaration includes 13 “key initiatives,” which include speeding up and expanding access to treatment, changes to rules for EMTs responding to reported overdoses, and expanded roles for nurse practitioners who deal with addicts seeking recovery services.

State Rep. Brian Ellis, R-11th, said the governor's declaration was “overdue,” but praised Wolf and Pennsylvania Attorney General Josh Shapiro — whose office is leading a nationwide investigation into the practices of some pharmaceutical manufacturers — for getting involved.

“This has been taking tolls on families in Butler County, Pa., and across our country for far too long,” Ellis said. “Hopefully the governor is serious about reallocating resources to help combat this issue.”

Disaster emergencies are most often declared in response to destructive but natural occurrences, like severe storms or flooding. The governor's actions Wednesday can redirect funding to help response and cleanup efforts, and change the way agencies work together in such circumstances.

But in this case — widely thought to be the first time Pennsylvania has used an emergency declaration to respond to a public health crisis — the implications are much broader.

The declaration of emergency will mean changes for hospital systems and treatment centers working to help addicts kick their opioid habit. It means more responsibility and power for some health care professionals — like nurse practitioners — who work with addicts before they enter treatment. It also expands the ability of pharmacists to partner with organizations to increase access to naloxone, an overdose antidote.

Jason Beckwith, a recovering addict who works as a counselor at the Ellen O'Brien Gaiser Center — a drug and alcohol treatment facility — called Wolf's announcement a positive step.

“I will say that I believe it's long overdue,” Beckwith said. “But I also believe that Gov. Wolf has been very helpful in everything I've tried to do here locally. I think it's a good thing. Maybe it'll free up some funds that go to places that can actually help this epidemic.”

Linda Franiewski, the center's director, agreed, calling the declaration “a very positive move.”

“We have to give every available resource to people we can, to keep them alive, is my takeaway from this,” Franiewski said.

She said Wolf's decision to relax some fees and rules to make it easier for addicts seeking treatment to get services was a positive step.

“It's a really big job to maneuver through the system yourself,” Franiewski said.

Declaring an emergency will allow state officials to suspend rules and regulations they believe are hampering Pennsylvania's fight against the opioid epidemic.

Wolf said the declaration would waive licensing requirements for some treatment centers and hospitals, in an effort to speed up access to treatment for addiction. The move also will ease restrictions and requirements for medication-assisted treatment at satellite facilities.

Ruthane Durso, supervisor of behavioral health programs for Butler Health System, said she hopes Wolf's declaration will result in more flexibility and less “bureaucratic red tape” for health care professionals and treatment providers.

The declaration also has implications for the state's 45 Centers of Excellence — hospitals and health care systems that have been selected by the state to act as “central, efficient hub(s) around which treatment revolves.”

Butler Memorial Hospital was designated a Center of Excellence in January 2017, and Durso said changes that allow the health system to focus more time and resources on training and treatment would be positive steps. She also stressed the declaration shouldn't be viewed as a panacea. “No matter what they do, there's going to be addiction,” Durso said. “But people are dying at a record rate. When you're looking at those kinds of numbers, that's a huge issue. So anything the state is doing to address this is a good thing.”

Pennsylvania reported 4,642 deaths from drug overdoses in 2016, according to the Centers for Disease Control and Prevention. Nearly 85 percent involved opioids.

On Wednesday, Wolf said early numbers indicate that 5,260 Pennsylvanians died of drug overdoses in 2017.

The crisis hit Butler County particularly hard in 2017. By mid-November the county had matched its overdose death total — 74 — from all of 2016.

As of Wednesday, the Butler County Coroner's Office had confirmed 89 drug overdose deaths for the year, with four toxicology reports still outstanding.

The deaths were spread throughout the county, according to records filed by the coroner's office, though 35 occurred within the city limits.

Law enforcement officials and Butler County Coroner William Young III have said that most of the deaths can be attributed to fentanyl, a potent cousin of morphine.

Commissioner Leslie Osche echoed Ellis when asked about Wolf's announcement, saying the declaration, in and of itself, wasn't earth-shaking.

“It's been an emergency, and we've been saying that for a year and a half,” Osche said. “It's one thing to declare an emergency. What's coming with that?”

Osche said she's concerned that the measures outlined by Wolf fail to address some critical issues county officials have identified. Among those is a lack of financial relief for ambulance services, many of which are struggling to cope with the costs of overdose response calls since companies aren't reimbursed if a victim refuses medical transport.

Osche said there also is a need for more collaboration from the state police which has often failed to participate in conferences addressing the opioid crisis.

“There are still some really critical issues, and we're not sure that we're going to see anything different here at the local level,” Osche said.

Butler County Sheriff Mike Slupe, whose office heads up the county's naloxone distribution program, called the declaration a positive step.

“I'm glad the governor is taking this step to assist in this crisis that has taken so many lives,” Slupe said.

Wolf's announcement included a call for the wide distribution of the anti-overdose medication. In addition to giving pharmacists more leeway to distribute the antidote, the emergency declaration will allow EMTs to leave naloxone behind for overdose victims who refuse to enter treatment after being revived.

In 2017, the county sheriff's department distributed 120 doses of naloxone to law enforcement agencies. Late last year the program was expanded to include all first responders, a move that brought volunteer fire companies, homeless shelters, public defenders, libraries and others into the mix.

Mark Pfeffer, Slupe's chief deputy and a consistent voice for compassion and a treatment-based approach to the crisis, said, “I would just hope that it would continue to heighten the awareness — especially to the treating physicians (and) the suppliers of the opioid-based medications that are out there. We have to view these folks as people that are still salvageable, and do whatever we can to bring them back.”

Wolf's announcement made Pennsylvania the eighth state to declare an emergency in the opioid epidemic, in addition to Arizona, Florida, Maryland, Massachusetts, South Carolina and Virginia.