All posts by Brian Denten

D.C. Update – May 24, 2016

News from the States

  • Ohio launches naloxone public awareness campaign for counties experiencing high rates of fentanyl overdose
  • Rhode Island Senate approves legislation addressing opioid crisis

In the News

  • House of Representatives passes package of bills addressing opioid epidemic
  • Poison control centers report increase in exposure to e-cigarettes among children
  • Mathematica Policy Research highlights success of evidence-based treatment and the cost of excessive drinking in recognition of National Prevention Week
  • Senate Judiciary Committee holds hearing on supporting youth in the foster care and juvenile justice systems

News from NASADAD

  • NASADAD attends National Viral Hepatitis Roundtable briefing on ending hepatitis C

Legislation Related to Opioids

  • House of Representatives passes package of bills addressing opioid epidemic

News from the States

Ohio launches naloxone public awareness campaign for counties experiencing high rates of fentanyl overdose
Ohio has launched a new public awareness campaign advocating for increased usage of naloxone in counties experiencing high rates of fentanyl overdoses. The campaign will focus on 15 counties that experienced 80 percent of Ohio’s fentanyl-related overdose fatalities in 2014. Family members and friends of individuals with opioid use disorders will be encouraged to obtain naloxone kits to reverse overdoses before first-responders arrive. The campaign will be supported by both the Ohio Department of Health (ODH) and the Ohio Department of Mental Health and Addiction Services (OhioMHAS), of which NASADAD member Tracy Plouck serves as Director. Fentanyl-related deaths have substantially increased in Ohio over the past several years, rising from 84 in 2013 to 503 in 2014.

Read the full press release here.

Rhode Island Senate approves legislation addressing opioid crisis
Last week the Rhode Island State Senate approved a series of bills addressing the opioid crisis. The bills were crafted in partnership with Governor Gina Raimondo’s Overdose Prevention and Intervention Taskforce. Legislators aim for the bills to deliver a more comprehensive approach to prevention and enhance the availability of substance use disorder treatment. The bills contain provisions requiring insurance companies to cover medication-assisted treatment medications, including methadone, buprenorphine, and naltrexone, as well as providing prescription coverage for opioid antagonists to family members and friends of individuals with opioid use disorders. Other provisions include the expansion of residential substance use disorder treatment and additional prescribing limits for pain medications used for acute pain. The bills now move to the Rhode Island House of Representatives.

Read more about the legislation here.

In the News

Poison control centers report increase in exposure to e-cigarettes among children
A new study conducted by the Center for Injury Research and Policy of the Research Institute and the Central Ohio Poison Center reports that poison control centers throughout the United States have observed an increase of calls related to e-cigarette exposure among children. Total number of e-cigarette exposures in children younger than 7 years old increased approximately 1,500 percent between 2012 and 2015, with ingestion of liquid nicotine being the most common form of exposure. Between 2012 and 2015, poison control centers received more than 29,000 calls related to e-cigarette and other tobacco exposure, with e-cigarettes accounting for 14 percent of the calls versus 60 percent for traditional cigarettes, and 16 percent of for other forms of tobacco. The researchers found that “young children exposed to liquid nicotine were more than five times more likely to be admitted to the hospital, and two-and-a-half times more likely to have a severe medical outcome, compared with children exposed to traditional cigarettes.”

Read the full story, and access the article here.

Mathematica Policy Research highlights success of evidence-based treatment and the cost of excessive drinking in recognition of National Prevention Week
Earlier this month Mathematica Policy Research highlighted two of its projects advancing substance use disorder awareness in recognition of National Prevention Week. The first study observed data from Mathematica’s national cross-site evaluation of Regional Partnership Grants (RPGs), which aim to strengthen families and treat substance use disorders.  Mathematica found that at time of enrollment, 35 percent of adults enrolled in RPG services had high levels of drug and alcohol use, with marijuana, amphetamines, and alcohol as the most commonly used substances. Nine percent of RPG-enrolled adults used heroin and 40 percent used other opiates.

The second study highlighted by Mathematica explores the cost of excessive drinking in the United States. High rates of drinking cost the United States almost $250 billion in 2010, with “two out of every five dollars paid for by the government, and three-quarters of the costs related specifically to binge drinking.” Mathematica goes on to discuss a November 2015 article published in the American Journal of Preventive Medicine finding that evidence-based prevention strategies may help reduce excessive drinking and its associated costs.

Read the full article here.

Senate Judiciary Committee holds hearing on supporting youth in the foster care and juvenile justice systems
The Senate Judiciary Committee held a hearing on supporting youth in the foster care and juvenile justice systems on Tuesday, May 17th. Brian Denten, Public Policy Intern, attended the hearing. The hearing featured testimony from several public officials engaged in both foster care and juvenile justice systems at the State level. Witnesses stated that a lack of communication between foster care and the juvenile justice system remains commonplace throughout many states, making it difficult for systems to identify “crossover” foster youth that have been placed within the juvenile justice system. While some States have developed working practice models to address this lack of communication, problems continue to pervade both systems. Several witnesses advocated for the reauthorization of the Juvenile Justice and Delinquency Prevention act to ensure prevention and early intervention initiatives continue to receive funding.

Witnesses:

  • Sonya Brown; New Orleans, LA
  • Lisa Nelson; Juvenile Court Officer, Third Judicial District, State of Iowa
  • Jeff Lind; Social Services Division Director, Beltrami County Health and Human Services, Bemidji, MN
  • Macon Stewart; Senior Program Manager, Center for Juvenile Justice Reform, McCourt School of Public Policy, Georgetown University

News from NASADAD

NASADAD attends National Viral Hepatitis Roundtable briefing on ending hepatitis C
On May 23rd, Brian Denten, NASADAD Public Policy Graduate Intern attended the briefing hosted by the National Viral Hepatitis Roundtable. The briefing featured several presentations from researchers working on ending hepatitis C and expanding access to hepatitis C medications to wider populations. Between 2013 and 2015, several hepatitis C medications were developed that effectively “cure” the disease for many individuals who properly adhere to the treatment regimen. Despite the success of this medication, insurance costs negatively affect adherence to treatment as many people find the mediation prohibitively expensive. Speakers highlighted the need to reform payment and financing options to ensure that individuals diagnosed with hepatitis C are able to begin treatment immediately before the more debilitating symptoms of the disease develop, stating that large cost savings may be realized from treating hepatitis C in this way. Hepatitis C has experienced an alarming rise in prevalence among young people as a result of the ongoing opioid crisis. CMS sent guidelines to State Medicaid agencies in November 2015 suggesting that agencies address the large costs of hepatitis C medications.

Speakers:

  • Jay Bhattacharya, MD, PhD; Professor of Medicine at the Center for Primary Care and Outcomes Research Stanford University
  • Ryan Clary; Executive Director, National Viral Hepatitis Roundtable
  • Anupam Jena, MD, PhD; Associate Professor of Health Care Policy, Harvard Medical School
  • Darius Lakdawalla, PhD; Quintiles Chair in Pharmaceutical Development and Regulatory Innovation, School of Pharmacy at the University of Southern California

Read the CMS guidance to State Medicaid agencies on hepatitis C medication here.

Legislation Related to Opioids

House of Representatives passes package of bills addressing opioid epidemic

On May 13th, the House of Representatives voted 400 to 5 in favor of a package of bills designed to address the opioid crisis. On March 10th, the Senate voted 94 to 1 in favor of the Comprehensive Addiction and Recovery Act (CARA).  A “conference committee” composed of House and Senate “conferees” shall be formed to iron out the many differences between the House opioids package and CARA. The Senate has not appointed conferees.  The House of Representatives has appointed the following conferees:

Rep. Bob Goodlatte (R-VA)
Rep. Jim Sensenbrenner (R-WI)
Rep. Lamar Smith (R-TX)
Rep. Tom Marino (R-PA)
Rep. Doug Collins (R-GA)
Rep. Dave Trott (R-MI)
Rep. Mike Bishop (R-MI)
Rep. Fred Upton (R-MI)
Rep. Joseph Pitts (R-PA)
Rep. Leonard Lance (R-NJ)
Rep. Brett Guthrie (R-KY)
Rep. Adam Kinzinger (R-IL)
Rep. Larry Bucshon (R-IN)
Rep. Susan Brooks (R-IN)
Rep. Lou Barletta (R-PA)
Rep. Buddy Cater (R-GA)
Rep. Gus Bilirakis (R-FL)
Rep. Jackie Walorski (R-IN)

Rep. Frank Pallone of (D-NJ)
Rep.  John Conyers of (D-MI)
Rep.  Robert C. “Bobby” Scott (D-VA)
Rep.  Jim McDermott (D-WA)
Rep.  Gene Green (D-TX)
Rep. Sheila Jackson Lee (D-TX)
Rep.  Joe Courtney (D-CT)
Rep.  Steve Cohen (D-TN)
Rep.  John Sarbanes (D-MD)
Rep.  Ben Ray Luján (D-NM)
Rep. Judy Chu (D-CA)
Rep. Elizabeth Esty (D-CT)
Rep. Ann Kuster (D-NH)
Rep.  Raul Ruiz (D-CA)

Although some are calling for a final bill to be sent to the White House by the end of this month, it may take more time will be needed to develop a final product.

The Senate version of CARA includes a number of distinct, authorized programs within the Department of Justice (DOJ) and the Department of Health and Human Services (HHS) designed to address the crisis.  The Senate Judiciary Committee coordinated with the Senate Health, Education, Labor and Pensions Committee (HELP) as the legislation moved forward.

To see a summary of the Senate Judiciary Committee-approved version of CARA, please click here.

The House package includes three core components with many parts:  (1) a large grant program housed within DOJ that contains a number of “allowable use of funds,” (2) a number of health related bills considered and approved by the House Energy and Commerce Committee and (3) other bills considered by other Committees of jurisdiction.

The bills considered and passed by the House of Representatives include the following:

Within the jurisdiction of the House Committee on the Judiciary:

  • The Comprehensive Opioid Abuse Reduction Act (H.R. 5046) authorizes the Attorney General within Department of Justice (DOJ) to make grants to States, units of local government and non-profits “to provide services primarily relating to opioid abuse” where a number of “allowable uses” of funds are listed.  These allowable uses include:
  • providing training and resources for first responders on carrying/administering an opioid overdose reversal drug approved by the FDA ad purchasing such drug or device for first responders who have received training;
  • investigations to locate or investigate illicit activities related to the unlawful distribution of opioids;
  • developing, implementing or expanding a medication-assisted treatment program used or operated by a criminal justice agency, which may include training;
  • developing, implementing or expanding PDMPs;
  • developing, implementing or expanding programs to prevent and address opioid abuse by juveniles;
  • developing, implementing or expanding an integrated and comprehensive opioid abuse response program, including prevention and recovery programs;
  • developing, implementing, or expanding a program (which may include demonstration projects) to utilize technology that provides a secure container for prescription drugs that would prevent individuals, particularly adolescents, from gaining access to opioid medications that are lawfully prescribed for other individuals;
  • developing, implementing, or expanding a program to prevent and address opioid abuse by veterans; and
  • developing, implementing, or expanding a prescription drug take-back program.

One section emphasizes coordination between State criminal justice agencies and substance abuse agencies:  The bill notes that in the case where a State is the applicant, a core focus of the grant activities would be “…facilitating or enhancing planning and collaborating between State criminal justice agencies and State substance abuse systems in order to more efficiently and effectively carry out programs described in paragraph (1) that address problems related to opioid abuse.”  The programs listed in paragraph 1 include:

  • developing, implementing, or expanding treatment alternative to incarceration program, which may include pre-booking or post-booking components;
  • training for criminal justice agency personnel on substance use disorders and co-occurring mental illness and substance use disorders;
  • a mental health court;
  • a drug court;
  • a veterans court;
  • a focus on parents whose incarceration could result in their children entering the child welfare system; and
  • a community-based substance use diversion program sponsored by a law enforcement agency.

Prevention provisions added to H.R. 5046. Senate-passed CARA includes an enhancement grant program for current and former Drug-Free Communities grantees to tackle prescription drug abuse and methamphetamines in their communities. While this program is not included in H.R. 5046, the House bill was amended that makes prevention an allowable use of grant funding.

Language on veterans services:  The bill includes additional language authorizing services to “qualified” veterans.  The bill defines a qualified veteran as a “…preliminary qualified offender who served on active duty in any branch of the Armed Forces, including National Guard or Reserves, and was discharged or released from such service under conditions other than dishonorable.”  The additional language authorizes a Veterans Court program within DOJ, along with a Veterans Assistance Program.

Inclusion of services for pregnant women under family-based substance abuse treatment has been added. Since the bill was introduced in April, a provision was added to amend the Omnibus Crime Control and Safe Streets Act to add pregnant women to the list of eligible recipients of family-based substance abuse treatment as an alternative to incarceration.

A provision has been added that would require the GAO to study existing programs and research gaps on substance use among adolescents and young adults. This new provision would require the Comptroller General of Government Accountability Office (GAO) to conduct a study on how the Department of Justice (DOJ) is addressing prevention, treatment, and recovery services for adolescents and young adults.

Medication Assisted Treatment (MAT) defined:  The bill defines “medication-assisted treatment” as “the use of medications approved by the Food and Drug Administration for the treatment of opioid abuse.”

  • H.R. 5048, Good Samaritan Assessment Act of 2016 requires the Government Accountability Office to submit a report about the Office of National Drug Control Policy’s (ONDCP’s) review of State and local Good Samaritan laws that exempt from criminal or civil liability any individual who administers an opioid overdose reversal drug or device or who contacts emergency services providers in response to an overdose (Rep. Guinta, R-NH).

Within the jurisdiction of the House Committee on Energy and Commerce:

  • H.R. 3691, Improving Treatment for Pregnant and Postpartum Women Act would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within SAMHSA’s Center for Substance Abuse Treatment (CSAT). The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of these funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to spur innovation and fill gaps in family-centered services across the continuum of care.

A section-by-section summary of the bill can be found here.

In FY 2016, the PPW grant program was funded at $15.9 million.  The bill as introduced authorized $40 million for the PPW and pilot program.  During the markup by the Committee on Energy and Commerce last month, an amendment was offered to change the authorization of funds in the bill from $40 million to $16.9 million.  Further, Rep. Ben Ray Luján (D-NM), the original sponsor of the bill, offered an amendment that would authorize the use of funds for the pilot program only if the amount for the overall PPW program exceeded FY 2016 funding levels. The bill passed the House as amended, with the “trigger language” and an authorization level of $16.9 million.

  • H.R. 4978, Nurturing and Supporting Healthy Babies Act which would mandate the Government Accountability Office (GAO) to write a report neonatal abstinence syndrome (NAS) – including prevalence, coverage available under Medicaid, any federal barriers to treatment, particularly in non-hospital settings, and more.
  • H.R. 4641, To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes (Rep. Brooks, R-IN and Rep. Kennedy, D-MA).
  • H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, for the Secretary of Health and Human Services to carry out a grant program for the co-prescribing of opioid overdose reversal drugs for patients at high risk of overdose (Rep. Sarbanes, D-MD). The Energy and Commerce Committee included an offset to pay for the bill when it considered the legislation earlier this month.
  • H.R. 1818, Veteran Emergency Medical Technician Support Act of 2016 amends the Public Health Service Act to direct the Department of Health and Human Services to establish a demonstration program for States with a shortage of emergency medical technicians (EMTs) to streamline State requirements and procedures to assist veterans who completed military EMT training to meet state EMT certification, licensure, and other requirements (Rep. Kinzinger, R-IL and Rep. Capps, D-CA).
  • H.R. 4969, John Thomas Decker Act of 2016 to authorize a grant program within CDC to educate teens and youth injured playing sports regarding the dangers of prescription drug misuse and abuse (Rep. Meehan, R-PA).
  • H.R. 4586, Lali’s Law, to authorize grants to States for developing standing orders and educating health care professionals regarding the dispensing of opioid overdose reversal medication without person-specific prescriptions, and for other purposes (Rep. Dold, R-IL).
  • H.R. 4599, Reducing Unused Medications Act of 2016 to amend the Controlled Substances Act in order to allow partial fills of schedule II controlled substances (Rep Clark, D-MA).
  • H.R. 4976, Opioid Review Modernization Act to require the Food and Drug Administration (FDA) to seek recommendations from an advisory committee before approval of certain new opioid-based drugs without abuse-deterrent properties (Rep. Sean Maloney, D-NY).
  • H.R. 4982, Examining Opioid Treatment Infrastructure Act of 2016 would require the GAO to develop a report on the availability of substance use disorder treatment in inpatient, outpatient and detox settings (Rep.  Foster, D-IL).

Within shared jurisdiction of the House Energy and Commerce Committee and House Committee on the Judiciary:

  • S. 32, Transnational Drug Trafficking Act of 2015 amends the Controlled Substances Import and Export Act to prohibit the manufacture or distribution of a controlled substance in schedule I or II, or a listed chemical by individuals having reasonable cause to believe that such substance or chemical will be unlawfully imported into the United States (Rep. Marino, R-PA and Rep. Pierluisi, D-PR; Sen. Dianne Feinstein, D-CA and Sen. Udall D-NM).
  • H.R. 5052, OPEN Act to direct the Attorney General and the Secretary of Health and Human Services to evaluate the effectiveness of grant programs that provide grants for the primary purpose of providing assistance in addressing problems pertaining to opioid abuse (Rep. McCarthy, R-CA and Rep. Hoyer, D-MD).
  • R. 4981, Opioid Use Disorder Treatment Expansion and Modernization Act: As passed by the House Committee on Energy and Commerce, the Opioid Use Disorder Treatment Expansion and Modernization Act (H.R. 4981) would have changed the number of patients to whom a practitioner can prescribe buprenorphine from 100 to 250. However, the bill was modified from the version approved by the Energy and Commerce Committee due to cost concerns.  The bill approved by the House last week includes only a “Sense of Congress” (language which doesn’t have the force of law) that HHS should increase the caps on buprenorphine prescribing by physicians to 250 patients. Additionally, the bill only temporarily permits nurse practitioners and physician assistants to prescribe buprenorphine for 3 years, whereas the bill as approved by the Committee would have permanently allowed them to prescribe. On the floor, bill sponsor Rep. Tonko (D-NY) called on Congress to replace the Sense of Congress with a statutory increase and permanently permit mid-level prescribing during the House/Senate negotiation process (Rep. Bucshon, R-IN and Rep. Tonko D-NY).

Within the jurisdiction of the House Committee on Education and the Workforce:

  • H.R. 4843, Infant Plan of Safe Care Improvement Act to amend the Child Abuse Prevention and Treatment Act (CAPTA) by requiring the Department of Health and Human Services (HHS) to provide information about best treatment practices for infants born affected by illicit drug exposure, withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder. States will be required to submit data reports that “include the total number of such infants for whom a plan of safe care was developed, and for whom referrals are made for appropriate services, including services for the affected family or caregiver” (Rep. Barletta, R-PA and Rep. Walberg, R-MI).

Within the jurisdiction of the House Committee on Veterans’ Affairs:

  • H.R. 4063, Promoting Responsible Opioid Management and Incorporating Scientific Expertise Act or the Jason Simcakoski PROMISE Act to improve the use of opioids by the Secretary of Veterans Affairs in treating veterans (Rep. Bilirakis, R-FL and Rep. Kind, D-WI).

Within the jurisdiction of the House Committee on House Foreign Affairs and Committee on the Judiciary:

  • H.R. 4985, Kingpin Designation Improvement Act of 2016 amends the Foreign Narcotics Kingpin Designation Act to allow classified information to be submitted to a reviewing court ex parte or in camera in a judicial review of a determination by the President that a foreign person is subject to sanctions as a significant foreign narcotics trafficker. (Rep. Katko, R-NY and Rep. Rice, D-NY).

 

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

D.C. Update – May 16, 2016

In the News

  • House of Representatives approves Improving Treatment for Pregnant/Postpartum Women Act (H.R. 3691)
  • House of Representatives passes Improving Safe Care for the Prevention of Infant Abuse and Neglect Act (H.R. 4843)
  • White House issues statement calling for additional funding for opioid legislation
  • House Energy and Commerce Committee Chairman Fred Upton (R-MI) writes blog about committee’s determination to fight opioid epidemic
  • Altarum Institute releases addiction recovery timeline, highlighting milestones in the history of recovery services

News from the States

  • Vermont details plans for Next Generation Accountable Care Organization program
  • Delaware proposes stricter prescribing guidelines for prescription pain medications

Around the Agencies

  • HHS issues final rule on Section 1557 of the Affordable Care Act, clarifying nondiscrimination requirements

In the News

House of Representatives approves Improving Treatment for Pregnant/Postpartum Women Act (H.R. 3691)
The full House of Representatives considered and passed H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act last week. The bill was authored by Rep. Luján (D-NM), with original co-sponsors including Reps. Tonko (D-NY), Matsui (D-CA), and Cardenas (D-CA). The bill contains the following provisions:

Reauthorization of the “PPW” Program: The Improving Treatment for Pregnant and Postpartum Women Act would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Treatment (CSAT).  This important program supports family-centered substance use disorder for women and young children in residential settings.

Creation of Pilot Program for State Substance Abuse Agencies: The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of these funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to spur innovation and fill gaps in family-centered services across the continuum of care.  The legislation would require SAMHSA to lead a process where State substance abuse agencies, experts in addiction services and others would meet to discuss the development of the new application for the pilot program.

Funding: In FY 2016, the PPW received $15.9 million. The bill as introduced authorized $40 million for the PPW and pilot program.  During the markup held in the full House Energy and Commerce Committee, an amendment was offered to change the authorization of funds in the bill from $40 million to $16.9 million.

“Trigger Language” Added During Mark-Up:  Further, Rep. Ben Ray Luján (D-NM), the original sponsor of the bill, offered an amendment that would authorize the use of funds for the pilot program only if the amount for the overall PPW program exceeded FY 2016 funding levels.

Next Steps: The bill was inserted into a larger House package on the opioid crisis that was approved on May 13th.

Read NASADAD’s section-by-section summary of the bill here.

House of Representatives passes Improving Safe Care for the Prevention of Infant Abuse and Neglect Act (H.R. 4843)
The House of Representatives unanimously passed the Improving Safe Care for the Prevention of Infant Abuse and Neglect Act (H.R. 4843) with a vote of 421-0 last week. The legislation, originally introduced by Rep. Barletta, Lou (R-PA), amends the Child Abuse Prevention and Treatment Act (CAPTA) by requiring the Department of Health and Human Services (HHS) to provide information about best treatment practices for infants born affected by illicit drug exposure, withdrawal symptoms, or a Fetal Alcohol Spectrum Disorder. States will be required to submit data reports that “include the total number of such infants for whom a plan of safe care was developed, and for whom referrals are made for appropriate services, including services for the affected family or caregiver.” H.R. 4843 was inserted into a larger House package on the opioid crisis that was approved on May 13th.

Read more about this bill here.

White House issues statement calling for additional funding for opioid legislation
Last week the White House issued a statement calling for additional funding for opioid legislation. The statement acknowledges that while pieces of legislation such as H.R. 4641 (To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication) and H.R. 5046 (the Comprehensive Opioid Abuse Reduction Act of 2016) move treatment and recovery services in the right direction, they will require appropriate financial resources to be effective. The Obama Administration previously submitted a budget proposal in February 2016 to provide for $1.1 billion in new funding to address the opioid epidemic and expand access to treatment.

Read the full statement here.

House Energy and Commerce Committee Chairman Fred Upton (R-MI) writes blog about committee’s determination to fight opioid epidemic
Last week the House of Representatives’ Energy and Commerce Committee Chairman Fred Upton (R-MI) released a blog detailing the committee’s determination to fight the opioid crisis. The blog describes the impact opioid use has had in Rep. Upton’s district in Kalamazoo, MI, as opioid overdoses increased from 9 in the first quarter of 2012 to 13 in the first quarter of 2013. Rep. Upton emphasizes the need for policies that contain both public health and criminal justice approaches, stating that “we cannot simply arrest our way out of this epidemic.” The blog concludes by highlighting the passage of the Protecting Our Infants Act of 2015 (S. 799) and the Improving Regulatory Transparency for New Medical Therapies Act (H.R. 639) at the end of 2015 as indications of the Energy and Commerce Committee continued commitment to combating the opioid epidemic.

Read the full blog here.

Altarum Institute releases addiction recovery timeline, highlighting milestones in the history of recovery services
The Altarum Institute released its addition recovery timeline last week, highlighting a variety of milestones in the history of recovery support services. The timeline traces the history of recovery support services from the formation of Native American recovery circles beginning in 1750 to the UNITE to Face Addiction Rally held in Washington, DC in October 2015. The timeline was compiled with the support of William L. White and other recovery movement historians, and will be updated as new events occur.

Access the timeline here.

News from the States

Vermont details plans for Next Generation Accountable Care Organization program
Vermont‘s forthcoming Next Generation Accountable Care Organization (Vermont Next Gen ACO) program was detailed in a Center for Health Care Strategies, Inc. article last week. Vermont released a request for proposals for its Next Gen ACO program in April, stating that the program will enable Vermont’s Medicaid Shared Savings Program (VMSSP) to save money and deliver high-quality health care services to Medicaid enrollees throughout the State. The Vermont Next Gen ACO is similar to CMS’s Medicare Next Gen Model, yet differs in several ways – most notably by “requiring participating ACOs to accept full risk for their Medicaid patients in exchange for a capitated payment.”

The Vermont Next Gen ACO also contains differences from Vermont’s existing Medicaid ACO program by shifting to prospective payment and by reducing the number of quality metrics from 28 to 6, with each metric in the Next Gen ACO model related to payment. The Vermont Next Gen ACO is expected to launch sometime in 2017.

Read the full article here.

Delaware proposes stricter prescribing guidelines for prescription pain medications
Delaware has announced plans to more strictly regulate prescription pain medications, as the Wilmington News Journal reports. The new regulations limit the amount of pain medication doctors are able to prescribe by restricting initial maximums to a seven-day supply. The regulations further require that patients’ histories be examined in Delaware’s Prescription Drug Monitoring Program (PDMP) and that doctors provide information about addiction risks when providing medication to patients. Chronic pain patients would be required to sign a treatment agreement and take urine-based drug tests twice each year. Medications falling under the new regulations include morphine, codeine, fentanyl, meperidine, and methadone. While Delaware officials do not believe the regulations will interfere with treatment, pain management specialists are concerned that limiting initial supplies to seven days will hinder the ability of doctors to help patients.

Read the Wilmington News Journal article here.

Read more about Delaware’s efforts to combat the opioid epidemic here.

Around the Agencies

HHS issues final rule on Section 1557 of the Affordable Care Act, clarifying nondiscrimination requirements
The Department of Health and Human Services (HHS) issued its final rule on Section 1557 of the Affordable Care Act (ACA) last week. The rule clarifies and codifies nondiscrimination requirements and describes plans to implement Section 1557. Section 1557 prohibits discrimination on the basis of sex in any health program or activity that receives HHS funding, insurers in the marketplace that receive HHS funding, and any other program that HHS administers. The final rule prohibits discrimination on the basis of gender identity and sex stereotyping, and requires that individuals be provided access to facilities consistent with their gender identity. The rule also contains provisions providing guidance on requirements for language assistance services, including oral interpreters and written translations. The rule will be made effective on July 18, 2016.

Read the full final rule here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

D.C. Update – May 9, 2016

News from the States

  • Ohio Governor John Kasich signs executive order banning synthetic opioid U-47700

Around the Agencies

  • CDC study finds 20 percent of Medicaid enrolled women of reproductive age in New York received an opioid prescription from 2008 to 2013
  • HHS announces $260 million in funding to increase patient capacity and preventive health services in 45 States
  • FDA announces new regulations for e-cigarettes, cigars, and other tobacco products

In the News

  • ATTC seeks participants for pilot online MAT course
  • House Democratic  Whip Rep. Steny Hoyer (D-MD) discusses need for Congress to act on opioids
  • CHCS launches Medicaid Accountable Care Organization Resource Center

Upcoming Events

  • Addiction Policy Forum announces Family Day to encourage passage of the Comprehensive Addiction and Recovery Act of 2016
  • NDEWS announces webinar on national poison data system and drug-related human exposure cases

News from the States

Ohio Governor John Kasich signs executive order banning synthetic opioid U-47700
Ohio Governor John Kasich has signed an executive order making the synthetic opioid U-47700 a Schedule I controlled substance. The executive order identifies U-47700 as 7.5 times more potent than morphine, with high potential for misuse. Governor Kasich signed the order in response to a growing number of overdose deaths attributable to the substance.

Read more about the executive order here.

Around the Agencies

CDC study finds 20 percent of Medicaid-enrolled women of reproductive age in New York received an opioid prescription from 2008 to 2013
The Centers for Disease Control and Prevention (CDC) released a study last week finding that 20 percent of reproductive-aged women enrolled in Medicaid in New York received an opioid prescription at least once from 2008 to 2013.  Almost 40 percent of reproductive-aged Medicaid enrolled women in the United States received an opioid prescription during this same time, placing New York below the national average. The CDC attributes New York’s lower prescribing rates to its long history of prescription monitoring programs beginning in 1972. New York’s prescription monitoring was enhanced in 2012 via the I-STOP program, which increased the number of substances monitored by the program. Prescriptions were “lowest during the prenatal period for women who had a live birth (9.5%), intermediate for women with no indication of contraceptive use or infertility (17%), and highest for women with an indication of contraceptive use or infertility (27%).” The CDC cautions that these results only contain Medicaid enrolled women, and do not include women who obtained opioid prescriptions without Medicaid.

Read the full study here.

HHS announces $260 million in funding to increase patient capacity and preventive health services in 45 States
The Department of Health and Human Services (HHS) has announced $260 million in funding to 290 health centers in 45 States. The funding will be used to renovate and expand existing health centers in order to increase patient capacity and increase the number of comprehensive primary and preventive health services available to underserved populations. The Affordable Care Act’s Community Health Center (CHC) Fund is providing the funding following the program’s extension in the Medicare Access and CHIP Reauthorization Act of 2015. HHS previously distributed CHC funds in September 2015 to 160 health centers for the same purpose.

Read the full press release here.

View a map of FQHCs throughout the country here.

FDA announces new regulations for e-cigarettes, cigars, and other tobacco products
The Food and Drug Administration (FDA) has announced new regulations for e-cigarettes, cigars, and other tobacco products. The FDA’s previous authority only monitored cigarettes and smokeless tobacco; the new final rule extends this authority to electronic nicotine delivery systems such as e-cigarettes and vape pens, cigars, hookah tobacco, pipe tobacco, and nicotine gels. The rule further stipulates that the FDA will be able to review new tobacco products not yet on the market and evaluate the manufacturing process of tobacco process in the future. Manufacturers will now have to register and provide product listings and ingredients that are subject to premarket review and authorization by the FDA. The final rule restricts youth access to tobacco by preventing sales to individuals under the age of 18 both in-person and online and prohibiting the distribution of free samples.

Read more about the new regulation here.

In the News

ATTC seeks participants for pilot online MAT course
The Addiction Technology Transfer Center (ATTC) Network is currently seeking participants for a pilot online course on medication-assisted treatment (MAT). The course, titled “Supporting Recovery with Medication-Assisted Treatment,” is a self-paced 3 hour course intended to increase participants’ familiarity with various types of MAT. Topics will include ways to use MAT for alcohol and opioid use disorder treatment, the different types of medications available for treating alcohol and opioid use disorders, workforce and regulatory issues impeding the implementation of MAT, and methods for improving MAT awareness at the community level. Upon the pilot course’s conclusion, participants will be asked to provide feedback to improve the program before its release. The pilot course will be available between May 3rd and May 31st.

Register for the pilot course here.

House Democratic Whip Rep.  Steny Hoyer (D-MD) discusses need for Congress to act on opioids
The House Democratic Whip Steny Hoyer (D-MD) discussed the need for Congress to act on opioids during the American Hospital Association’s annual membership meeting last week. Rep. Hoyer enumerated several “innovative solutions” for addressing the ongoing epidemic, and asserted his hope that the necessary changes will be made in the future. Rep. Hoyer stated that, “while health care providers bear some of the responsibility of overprescribing opioids that are easily abused, I recognize a careful balance must be struck when caring for patients suffering from severe pain. This is why policymakers need to ensure that we are giving doctors and hospitals the tools needed to identify patients at the risk of abuse.”

Read the full story here from AHA News.

CHCS launches Medicaid Accountable Care Organization Resource Center
The Center for Health Care Strategies (CHCS) announced the launch of their Medicaid Accountable Care Organization Resource Center last week. The online resource center will provide a collection of resources for States interested in or already developing a Medicaid ACO program. These resources include a resource compendium with tools on ACO topics including general design, scope of services, provider management, quality measures, payment, and federal guidance, as well as an interactive map providing updates of Medicaid ACO activities by State and a news section with the latest updates on ACOs for the Medicaid, Medicare, and commercial populations.

Access the resource center here.

Upcoming Events

Addiction Policy Forum announces Family Day to encourage passage of the Comprehensive Addiction and Recovery Act of 2016
The Addiction Policy Forum has announced a Comprehensive Addiction and Recovery Act (CARA) Family Day on May 18th-19th. The Forum encourage families who have been impacted by addiction to meet with members of Congress and encourage them to pass legislation that will comprehensively address the opioid epidemic, including CARA (S. 524; H.R. 953).

Read more about CARA Family Day here.

NDEWS announces webinar on national poison data system and drug-related human exposure cases

The National Drug Early Warning System (NDEWS) has announced a webinar on the national poison data system and drug-related human exposure cases. The webinar will be held on May 25th at 4PM EST and will feature a presentation from Ashlea A. Zimmerman, MPH, Director of the National Data Services, American Association of Poison Control Centers (AAPCC).

Register for the webinar here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

D.C. Update – May 4, 2016

News from the States

  • Senate Committee on Homeland Security and Governmental Affairs holds field hearing on opioid epidemic, featuring testimony from OhioMHAS Director & NASADAD member Tracy Plouck
  • Jefferson County, New York begins offering Vivitrol to incarcerated individuals leaving the criminal justice system

Around the Agencies

  • GAO report finds DOD’s Military Health System does not meet mental health appointment requirements
  • CMS clarifies stance on Medicaid eligibility for incarcerated individuals

In the News

  • House Full Judiciary Committee Considers and Approves Opioid Bill (H.R. 5046)
  • House Full Energy and Commerce Committee Completes Markup of Bills on Opioids
  • University of California study finds seasonal increase in college student drinking rates
  • Behavioral Health IT Coalition release Integrating Behavioral Health through Technology Act of 2016 (S. 2691) fact sheet
  • NGA and NCJA launch State criminal justice reform initiative
  • Pew Charitable Trusts article highlights State efforts to combat synthetic drugs

News from NASADAD

  • NASADAD Moderates Panel During “Stepping Up Summit” in Washington, D.C.

Upcoming Events

  • CDC announces webinar on its National Viral Hepatitis Campaigns
  • SAMHSA announces 2016 National Prevention Week Kick-off webcast

News from the States

Senate Committee on Homeland Security and Governmental Affairs holds field hearing on opioid epidemic, featuring testimony from OhioMHAS Director & NASADAD member Tracy Plouck
The Senate Committee on Homeland Security and Government Affairs and Senators Rob Portman (R-OH) and Sherrod Brown (D-OH) held a hearing on the opioid epidemic in Cleveland on April 22nd. The hearing featured testimony from several substance use disorder experts, including Ohio Department of Mental Health & Addiction Services Director & NASADAD member Tracy Plouck. Ms. Plouck thanked both Senators for their work in developing a comprehensive approach to the opioid crisis, and highlighted the actions Governor John Kasich’s task force has taken in the past several years. These actions include: comprehensive prescribing guidelines for the outpatient management of acute pain released in January 2016, ongoing improvements and investments into the Ohio Automated Rx Reporting System, the Start Talking! Statewide youth drug prevention initiative, and increased mechanisms for diverting individuals in the criminal justice system into substance use disorder treatment.

Read Ms. Plouck’s full testimony here.

Read more about the Ohio Governor’s Cabinet Opiate Action Team here.

Jefferson County, New York begins offering Vivitrol to incarcerated individuals leaving the criminal justice system
Jefferson County, New York will begin offering Vivitrol to incarcerated individuals whose release from the criminal justice system is imminent. Jefferson County Sheriff Colleen M. O’Neill states that the program will help incarcerated individuals exiting the criminal justice system maintain their sobriety during the critical 30-day period following their release, when many individuals with opioid use disorders are at greatest risk for relapse. Individuals participating in the program must still attend substance use disorder treatment programs at facilities approved by the New York State Office of Alcoholism and Substance Abuse Services (OASAS), which is led by Commissioner Arlene González-Sánchez, who is a member of NASADAD’s Board. All jail administrators, medical staff, and other relevant staff have been trained to administer the drug. Sheriff O’Neill plans for the program to be fully implemented by summer.

Read the full story here.

Around the Agencies

GAO report finds DOD’s Military Health System does not meet mental health appointment requirements
The U.S. Government Accountability Office released a report last week finding that the Department of Defense’s (DOD) Military Health System (MHS) does not meet requirements related to mental health appointment scheduling. Data on domestic and overseas direct care from April 2014 through August 2015 suggests that initial appointments for new or exacerbated conditions did not meet the 7-day access standard required by the DOD. The DOD reported that this deficiency is the result of incorrect coding that is hindering the ability of personnel to access the MHS. The GAO further found that follow-up appointments for mental health do not maintain the official DOD access standard required by federal internal controls. The report concludes that the DOD develop coding for initial appointments and access standards for follow-up appointments.

Read the full report here.

CMS clarifies stance on Medicaid eligibility for incarcerated individuals
Last week the Centers for Medicare and Medicaid Services (CMS) clarified its stance on Medicaid eligibility for incarcerated individuals in a Dear State Health Official letter. The clarification is an update of CMS’s 1997 letter that described the conditions precluding an incarcerated individual from being eligible for Medicaid. Current regulations stipulate that individuals classified as an “inmate of a public” institution are ineligible for federal financial participation for Medicaid services. Last week’s letter clarifies that “individuals on probation, parole, or community release pending trial and individuals in corrections-related supervised community residential facilities” retain Medicaid eligibility.

Read the full CMS letter here.

In the News

House Full Judiciary Committee Considers and Approves Opioid Bill (H.R. 5046)
On Wednesday, April 27, the House Judiciary Committee considered and passed the Comprehensive Opioid Abuse Reduction Act of 2016 by Rep. Sensenbrenner (R-WI) by voice-vote.  The Judiciary Committee is Chaired by Rep. Goodlatte (R-VA) and the Ranking Member is Rep. Conyers (D-MI).

The Comprehensive Opioid Abuse Reduction Act authorizes the Attorney General within DOJ to make grants to States, units of local government and non-profits “to provide services primarily relating to opioid abuse” where a number of allowable use of funds are listed.  These allowable uses include:

  • providing training and resources for first responders on carrying/administering an opioid overdose reversal drug approved by the FDA ad purchasing such drug or device for first responders who have received training;
  • investigations to locate or investigate illicit activities related to the unlawful distribution of opioids;
  • developing, implementing or expanding a medication-assisted treatment program used or operated by a criminal justice agency, which may include training;
  • developing, implementing or expanding PDMPs;
  • developing, implementing or expanding programs to prevent and address opioid abuse by juveniles; and
  • developing, implementing or expanding an integrated and comprehensive opioid abuse response program.

One section emphasizes coordination between State criminal justice agencies and substance abuse agencies:  The bill notes that in the case where a State is the applicant, a core focus of the grant activities would be “…facilitating or enhancing planning and collaborating between State criminal justice agencies and State criminal justice systems in order to more efficiently and effectively carry out programs described in paragraph (1) that address problems related to opioid abuse…”  The programs listed in paragraph 1 include:

  • developing, implementing, or expanding treatment alternative to incarceration program, which may include pre-booking or post-booking components;
  • training for criminal justice agency personnel on substance use disorders and co-occurring mental illness and substance use disorders;
  • a mental health court;
  • a drug court; and
  • a veterans court.

Additional language on veterans services:  The bill includes additional language authorizing services to “qualified” veterans.  The bill defines a qualified veteran as a “…preliminary qualified offender who served on active duty in any branch of the Armed Forces, including National Guard or Reserves, and was discharged or released from such service under conditions other than dishonorable.”  The additional language authorizes a Veterans Court program within DOJ, along with a Veterans Assistance Program.

Medication Assisted Treatment (MAT) defined:  The bill defines “medication-assisted treatment” as “the use of medications approved by the Food and Drug Administration for the treatment of opioid abuse.”

House Initiative differs from CARA:  H.R. 5046 differs from CARA in that H.R. 5046 authorizes grants exclusively within the Department of Justice (DOJ).  Overall, CARA authorizes a number of distinct programs targeted towards different aspects of the opioid problem (prevention, treatment, recovery, media campaigns, naloxone and more) not only within DOJ but also within certain Department of Health and Human Services’ (HHS) operating divisions that include the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), and others.   In the House, as previously reported, a number of bills related to opioids impacting federal health agencies are being considered in the Energy and Commerce Committee.

To view the Comprehensive Opioid Abuse Reduction Act (H.R. 5046), please visit https://judiciary.house.gov/wp-content/uploads/2016/04/HR-5046.pdf

Other bills passed by the Judiciary Committee:  In addition to H.R. 5046, the Judiciary Committee considered and approved

  • H.R. 5052, the Opioid Program Evaluation Act which would require an evaluation of the grants authorized in H.R. 5046 (Rep. McCarthy, R-CA and Rep. Hoyer, D-MD)
  • H.R. 5048, the Good Samaritan Assessment Act of 2016, which would require a GAO report on the extent to which ONDCP has reviewed Good Samaritan Laws and the results or findings from these reviews along with a compilation of Good Samaritan Laws in effect in the States (Rep. Guinta, R-NH)

House Full Energy and Commerce Committee Completes Markup of Bills on Opioids
The Full House Energy and Commerce Committee considered and passed on Wednesday, April 27 and Thursday, April 28 a number of bills aimed at address the opioid problem.  The Chairman of the Committee is Rep. Upton (R-MI) and the Ranking Member is Rep. Pallone (D-NJ).

On Thursday, April 28, the Committee reconvened and passed three more bills related to opioids:

  • H.R. 3691, Improving Treatment for Pregnant and Postpartum Women Act would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within SAMHSA’s Center for Substance Abuse Treatment (CSAT). The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of these funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to spur innovation and fill gaps in family-centered services across the continuum of care. A section-by-section summary of the bill can be found here.  In FY 2016, the PPW grant program was funded at $15.9 million.  The bill as introduced authorized $40 million for the PPW and pilot program.

During the markup, an amendment was offered to change the authorization of funds in the bill from $40 million to $16.9 million.  Further, Rep. Ben Ray Luján (D-NM), the original sponsor of the bill, offered an amendment that would authorize the use of funds for the pilot program only if the amount for the overall PPW program exceeded FY 2016 funding levels. Both amendments passed.

  • H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, for the Secretary of Health and Human Services to carry out a grant program for the co-prescribing of opioid overdose reversal drugs (Rep. Sarbanes, D-MD)
  • H.R. 4586, Lali’s Law, to authorize grants to States for developing standing orders and educating health care professionals regarding the dispensing of opioid overdose reversal medication without person-specific prescriptions, and for other purposes (Rep. Dold, R-IL)

The Committee considered and approved the following opioid-related bills on Wednesday, April 27:

  • H.R. 4641, To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes (Rep. Brooks, R-IN and Rep. Kennedy, D-MA)
  • H.R. 4978, Nurturing and Supporting Healthy Babies Act which would mandate the Government Accountability Office (GAO) to write a report neonatal abstinence syndrome (NAS) – including prevalence, coverage available under Medicaid, any federal barriers to treatment, particularly in non-hospital settings, and more.
  • H.R. 4981, Opioid Use Disorder Treatment Expansion and Modernization Act: The Opioid Use Disorder Treatment Expansion and Modernization Act (H.R. 4981), would change the number of patients to whom a practitioner can prescribe buprenorphine from 100 to 250. During the markup four amendments were offered to H.R. 4981. The first, offered by Congresswoman DeGette (D-CO), aimed to increase the cap to 500 patients, and the second by Ranking Member Pallone would increase the cap to 300. In a roll call vote, neither of the amendments to further increase the cap passed. Congresswoman Yvette Clarke (D-NY) offered an amendment to raise awareness of safe prescribing of opioids for the treatment of pain, but she later withdrew the amendment. Finally, Congressman Ben Ray Luján (D-NM) offered an amendment to authorize $1 billion for opioid use disorder prevention and treatment, primarily in the form of State targeted response cooperative agreements as proposed by the Administration. With a vote of 22-24, Congressman Luján’s amendment did not pass. (H.R. 4981 was introduced by Rep. Bucshon, R-IN and Rep. Tonko, D-NY)
  • H.R. 4969, John Thomas Decker Act of 2016 to authorize a grant program within CDC to educate teens and youth injured playing sports regarding the dangers of prescription drug misuse and abuse (Rep. Meehan, R-PA)
  • H.R. 4599, Reducing Unused Medications Act of 2016 to amend the Controlled Substances Act in order to allow partial fills of schedule II controlled substances (Rep Clark, D-MA)
  • H.R. 4976, Opioid Review Modernization Act to require the Food and Drug Administration (FDA) to seek recommendations from an advisory committee before approval of certain new opioid-based drugs without abuse-deterrent properties (Rep. Sean Maloney, D-NY)
  • H.R. 4982, Examining Opioid Treatment Infrastructure Act of 2016 would require the GAO to develop a report on the availability of substance use disorder treatment in inpatient, outpatient and detox settings (Rep.  Foster, D-IL)
  • H.R. 3250, DXM Abuse Prevention Act would prohibit the sale of medicine containing dextromethorphan (DXM) to individuals under 18 without a prescription (Rep. Johnson, R-OH and Rep. Matsui, D-CA)

NASADAD will continue to track relevant legislation and provide updates to membership.

University of California study finds seasonal increase in college student drinking rates
The University of California – San Diego published a study finding seasonal increases in drinking rates among college students earlier last month. The study examined 462 college freshmen at eight different points during their first year. Researchers found that the freshmen’s drinking decreased 29 percent in the summer, increased 31 percent in the spring, and increased another 18 percent around spring break.

Read more about this study here.

Behavioral Health IT Coalition release Integrating Behavioral Health through Technology Act of 2016 (S. 2691) fact sheet
The Behavioral Health IT Coalition, of which NASADAD is a member, has released a fact sheet summarizing the Integrating Behavioral Health through Technology Act of 2016 (S. 2691). The legislation was recently introduced by Senator Sheldon Whitehouse (D-RI) and establishes a pilot program in up to five states, where incentive payments may be made to eligible professionals and behavioral health facilities for the adoption and use of certified Electronic Health Record (EHR) technology. Preference would be given to States that have a statewide health information exchange that includes mental health and substance use disorder data. Senator Whitehouse’s legislation aims to increase collaboration between mental health, substance use disorder, and primary care providers to improve overall health outcomes.

NGA and NCJA launch State criminal justice reform initiative
The National Governors Association (NGA) and the National Criminal Justice Association (NCJA) announced a joint program to support State criminal justice reform efforts last week. The program, titled the National Criminal Justice Reform Project, will support the implementation of evidence-based practices targeting recidivism, pretrial release, and mental health and substance use disorders in up to five States. The five States will be selected for the program following a meeting of twenty State teams this fall.

Read the full story here.

Pew Charitable Trusts article highlights State efforts to combat synthetic drugs
The Pew Charitable Trusts published an article last week highlighting State efforts to combat the spread of synthetic drugs in communities across the country. The most popular synthetic drugs are placed into two categories: synthetic cathinones (bath salts) and synthetic marijuana products that are commonly sold in stores. Thirty-two States have passed laws making the process to classify synthetic drugs as illegal easier since 2010. Despite these efforts, legislators continue to face significant difficulties in making synthetic drugs illegal through scheduling, as manufacturers can change just one molecule of an illegal synthetic drug to create a new legal version. This complication has spurred States to reexamine the traditional scheduling process. Florida and Washington, DC passed laws to make the scheduling of drugs include consideration of the type of drug and its reaction rather than just its chemical makeup. This adjustment makes it easier for States to keep up with the constantly shifting synthetic drug market.

Read the full article here.

News from NASADAD

NASADAD Moderates Panel During “Stepping Up Summit” in Washington, D.C.
On Tuesday, April 19, Robert Morrison, NASADAD Executive Director, served as a moderator of a panel titled “Meeting the Needs of People with Co-occurring Substance Use Disorders and Mental Illnesses” held in conjunction with the Stepping Up Summit.  The session focused on systems-level coordination and reform efforts to address co-occurring substance use and mental health disorders.  The panel was designed to explore opportunities to reduce the number of people with co-occurring disorders in jails.

Participants included:

  • The Honorable Alisha Bell, Commissioner, Wayne County, Michigan (Presider)
  • Mitchell Katz, MD, Director, Los Angeles County Health Agency, Los Angeles County, California
  • Faye Taxman, PhD, University Professor, Criminology, Law and Society Department, and Director of the Center for Advancing Correctional Excellence, George Mason University
  • Rob Morrison, NASADAD, Moderator
  • Sara Wurzburg, Grantee Technical Assistance Manager, Council of State Governments (CSG), organized and supported the panel.  Sarah previously served as Research Analyst at NASADAD.

Earlier in the day, NASADAD member Tracy Plouck, Director of Ohio’s Department of Mental Health and Addiction Services, served as a featured speaker during a plenary session titled “Strategies for Financing Your Plan.”

The Stepping Up Initiative was launched by CSG, the National Association of Counties (NACo), the American Psychiatric Association Foundation in May 2015.  The goal of the initiative is to reduce the number of people with mental illness in jails.  NASADAD is a partner in the initiative.

To learn more about the Stepping Up Initiative, visit https://stepuptogether.org/

Upcoming Events

CDC announces webinar on its National Viral Hepatitis Campaigns
The Centers for Disease Control and Prevention (CDC) has announced a webinar discussing its two National Viral Hepatitis Campaigns. The webinar will provide an overview of both campaigns and the new resources associated with them.  The Know Hepatitis B campaign promotes hepatitis B testing among Asian Americans and Pacific Islanders, while the Know More Hepatitis campaign encourages hepatitis C testing in people born from 1945 to 1965. The webinar will be held on Wednesday, May 4th at 3 PM EST.

Register for the webinar here.

Read more about the Know Hepatitis B campaign here.

Read more about the Knew More Hepatitis campaign here.

SAMHSA announces National Prevention Week 2016 Kick-off webcast
The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced the kick-off webcast for National Prevention Week 2016 in partnership with Morgan State University. The webcast will highlight communities throughout the country that have bolstered overall community health through increasing prevention-related public awareness programs surrounding mental health and substance use disorders. The webcast will be held on Monday, May 16th from 11:00-11:45 AM EST. National Prevention Week 2016 will be observed from May 15-21, 2016.

Register for the webcast here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

D.C. Update – April 26, 2016

In the News

  • FY 2017 Commerce, Justice & Science Appropriations Bill Clears Senate Appropriations Committee
  • House of Representatives Committee on Energy and Commerce holds markup on H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act
  • UnitedHealth Group solidifies plans to exit health insurance marketplaces
  • AP report suggests increased amount of banks and credit unions working with marijuana-related businesses
  • S. House of Representatives Ways and Means Committee leaders submit letter to CMS calling for increased data transparency

Around the Agencies

  • CDC FY 2015 grant funding profiles now available
  • SAMHSA releases applications for FY 2016 Statewide Peer Networks for Recovery and Resiliency grant program

News from NASADAD

  • NASADAD sends thank you letter to AMA for work with NGA
  • NASADAD Presents to Joint NACo/League of Cities Task Force on Opioid Epidemic

Upcoming Events

  • Community Catalyst announces informative call on the intersections between health and housing for vulnerable populations

In the News

FY 2017 Commerce, Justice  & Science Appropriations Bill Clears Senate Appropriations Committee
After clearing the Subcommittee on Commerce, Justice, Science and Related Agencies, on April 21st the Senate Committee on Appropriations approved a $56.3 billion spending bill for programs related to national security, law enforcement, and scientific innovation. This is $563 million more than FY 2016 and $1.6 billion more than the President’s request. The bill was approved by the Committee with a vote of 30-0.

Some of the highlights for programs within the Department of Justice (DOJ) include:

  • $2.36 billion for state and local law enforcement and crime prevention grant programs, which includes grants for State law enforcement and juvenile justice programs;
  • $384 million for Byrne Justice Assistance Grants (JAG), which is a $92 million dollar cut compared to FY 2016. However, the FY 2016 appropriations included a $100 million carve out to cover extra costs of security at the two presidential nominating conventions.  The Senate Appropriations Committee’s recommendation is $500,000 higher than the President’s request for FY 2017;
  • $43 million in support for Drug Courts, a $1 million increase in funding for FY 2017 compared to FY 2016;
  • $6 million for Veterans Treatment Courts, which is level funding compared to FY 2016;
  • $75 million for Second Chance Act grants to reduce recidivism for adults released from jail by offering substance abuse treatment, employment assistance, and other rehabilitation services. This is a $7 million increase in funding for FY 2017 compared to FY 2016, and $25 million less than the President’s request;
  • $10 million for Community Oriented Policing Systems (COPS) Office Anti-Heroin Task Forces grants;
  • $7 million for COPS Office Anti-Methamphetamine Task Forces grants; and
  • $410 million increase in funding for FY 2017 for the Drug Enforcement Administration (DEA) compared to FY 2016.
    • Includes $12.5 million for four new heroin enforcement squads within the DEA.

A summary of proposed funding levels and a comparison to FY 2016 levels is attached here.

House of Representatives Committee on Energy and Commerce holds markup on H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act
On April 20th the House of Representatives Subcommittee on Health within the Committee on Energy and Commerce held a markup of twelve bills related to opioid use disorders, including H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act. The subcommittee is led by Chairman Joseph Pitts (R-PA) and Ranking Member Gene Green (D-TX).

H.R. 3691 would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within SAMHSA’s Center for Substance Abuse Treatment (CSAT). The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to fill gaps in family-centered services across the continuum of care. A section-by-section summary of the bill can be found here.

During the markup, Congressman Ben Ray Luján (D-NM), who introduced H.R. 3691 in October of 2015, spoke about the pervasiveness of addiction, including in his own district, and the importance of increasing access to treatment for women. Chairman Pitts also expressed support of the bill, especially the provision to provide family-based treatment services.

Other proposed legislation considered during the markup were:

  • R. 4641, To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes
  • R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015
  • R. 1818, Veteran Emergency Medical Technician Support Act
  • R. 3250, DXM Abuse Prevention Act
  • R. 4969, John Thomas Decker Act of 2016
  • R. 4586, Lali’s Law
  • R. 4599, Reducing Unused Medications Act of 2016
  • R. 4978, Nurturing and Supporting Healthy Babies Act
  • R. 4976, Opioid Review Modernization Act
  • Opioid Use Disorder Treatment Expansion and Modernization Act
  • Examining Opioid Treatment Infrastructure Act of 2016

All of the bills are being considered by the full Committee on Energy and Commerce this week. NASADAD will continue to track relevant legislation and provide updates to membership.

UnitedHealth Group solidifies plans to exit health insurance marketplaces
UnitedHealth Group has solidified plans to exit the health insurance marketplaces created by the Affordable Care Act, announcing their intention to stop service in nearly 34 States. CEO Stephen Hemsley states that the overall market size and high risk of health insurance marketplaces prevents UnitedHealth Group from continuing to serve public exchanges. The Kaiser Family Foundation released a report asserting that, if UnitedHealth Group were to leave all 1,855 counties where it currently participates, “29% of the counties would be left with just one marketplace insurer and another 29% would be left with just two.” The report goes on to caution that areas with limited insurer availability may not realize the cost savings seen in regions with a larger number of insurers.

Read UnitedHealth Group CEO Stephen Hemsley’s statement here.

Read the Kaiser Family Foundation report here.

AP report suggests increased amount of banks and credit unions working with marijuana-related businesses
An Associated Press (AP) report released last week finds that the number of banks and credit unions working with marijuana-related businesses has increased from 51 in March 2014 to 301 in March 2016 according to federal data. Marijuana businesses have experienced barriers in response to federal regulations constricting their ability to store money in banks, leading many retailers to work with local credit unions instead of larger banking institutions. Credit card companies remain wary of accepting marijuana-related transactions in fear of federal liability. These restrictions have forced many businesses to only accept cash, in turn requiring revenue departments in Colorado, Washington, and Oregon to prepare for large cash deposits by increasing security.

Read the full article here.

U.S. House of Representatives Ways and Means Committee leaders submit letter to CMS calling for increased data transparency
Leaders from the House of Representatives Committee on Ways and Means submitted a letter to the Center for Medicare and Medicaid Services (CMS) last week calling for increased mental health data transparency. The letter specifically calls for CMS to publish more data about the mental health of Medicare beneficiaries in order for health care providers to better address the needs of seniors, while still maintaining patient privacy. Ways and Means leaders assert that increased transparency will allow Congress to make better decisions related to the mental health of Medicare beneficiaries. Leaders from both parties signed the letter, including Chairman Kevin Brady (R-TX), Ranking Member Sander Levin (D-MI), Health Subcommittee Chairman Pat Tiberi (R-OH), and Health Subcommittee Ranking Member Jim McDermott (D-WA).

Read the full letter here.

Around the Agencies

CDC FY 2015 grant funding profiles now available
The Centers for Disease Control and Prevention (CDC) released FY 2015 grant funding profiles last week. The funding profiles provide summaries of CDC cooperative agreement and grant funding programs to States, U.S. territories, and the District of Columbia after close out of the fiscal year.  Funding profiles are sortable by funding opportunity announcement, funding source, geography, and recipient type and name – and include a number of substance use disorder related grant programs.

Access the grant funding profiles here.

SAMHSA releases applications for FY 2016 Statewide Peer Networks for Recovery and Resiliency grant program
The Substance Abuse and Mental Health Services Administration (SAMHSA) released applications for the Statewide Peer Networks for Recovery and Resiliency grant program last week.  The program is administered with the help of the Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS). The Statewide Peer Networks for Recovery and Resiliency Grant Program provides funding for the development of increased cross-system collaboration, peer workforce expansion, and increased treatment infrastructure for substance use disorders. The grant program will award up to eight awards of approximately $100,000 for a one year period. Applications are due by Tuesday, June 21, 2016.

Access the full application here.

News from NASADAD

NASADAD sends thank you letter to AMA for work with NGA
NASADAD sent a letter to the American Medical Association (AMA) last week expressing gratitude for their statement on the opioid crisis released in collaboration with the National Governors Association (NGA).  The AMA and NGA released a statement about the opioid crisis in February 2016, calling for increased investment in prescription drug monitoring programs, increased substance use disorder training for health professionals, and expanded access to naloxone. NASADAD’s letter thanks both organizations for their work in this area and affirms NASADAD’s support for the recommendations outlined in the joint letter, especially with regard to closing the treatment gap. NASADAD’s letter is attached to this email.

Read the joint AMA/NGA statement here.

NASADAD Presents to Joint NACo/League of Cities Task Force on Opioid Epidemic
On April 7th, Robert Morrison, NASADAD’s Executive Director, presented to the National City-County Task Force on the Opioid Epidemic – a panel made up of representatives from the National Association of Counties (NACo) and National League of Cities (NLC).  The event was the first gathering for the panel.  The 24 member Task Force is led by co-chairs Judge Gary Moore of Boone County, Kentucky and Mayor Mark Stodola of Little Rock, Arkansas.  The panel hopes to encourage further collaboration at the local level and generate recommendations for federal policy makers to consider to help local governments address the opioid crisis.  Robert Morrison educated the Task Force regarding the publicly funded prevention, treatment and recovery system; the benefits of collaborating with State alcohol/drug authority directors; and the need to ensure that any plan and initiative includes a commitment to primary prevention.  The Task Force includes Greg Puckett, Commissioner in Mercer County, West Virginia, who described his work as a lead of a community anti-drug coalition.  Finally, Morrison encouraged the Task Force to not only engage in actions focused on opioids, but to consider actions that would address addiction in general.

Learn more about the Task Force here.

Upcoming Events

Community Catalyst announces informative call on the intersections between health and housing for vulnerable populations
Community Catalyst has announced a new informative call discussing the intersections between health and housing for vulnerable populations. The call will examine current policies and research involving housing and feature presentations from several stakeholders. Community Catalyst recognizes an opportunity to collaborate with stakeholders and other organizations in the social justice movement so support the work of healthcare advocates working to expand access to housing. The call will be held on Wednesday, May 11th from 1-2:30 PM EST.

RSVP for the call here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.