Category Archives: Public View

Last week the Senate Finance Committee held a confirmation hearing for Seema Verma, President Donald Trump’s nominee to serve as administrator of the Centers for Medicare & Medicaid Services (CMS). During the hearing, Ms. Verma, who is a health policy consultant, expressed support for helping rural and other health care providers avoid unnecessary burdens from federal regulatory requirements, including those related to the use of electronic health records. She voiced support for reauthorizing the Children’s Health Insurance Program (CHIP). Additionally, during the hearing Ms. Verma said that she would consider the idea of block granting Medicaid or enacting per-capita caps. Ms. Verma is best-known for her role in developing Healthy Indiana Plan 2.0, the Medicaid expansion plan under former Governor Mike Pence.

Watch the entire confirmation hearing here.

News from the States

Ohio Joint Study Committee on Drug Use Prevention Education releases recommendations on substance abuse education in schools

The Ohio State General Assembly has released the Ohio Joint Study Committee on Drug Use Prevention Education’s report of recommendations on options for implementing age-appropriate substance abuse education in schools across all grade levels. In August 2016, Ohio Attorney General Mike DeWine, former Senate President Keith Faber, and Speaker of the House Clifford Rosenberger formed the Ohio Joint Study Committee on Drug Use Prevention Education. The Committee examined education measures that schools and communities can take to reduce and help prevent substance use disorders. After conducting meetings and research, the Study Committee issued 15 recommendations that are outlined in the new report. The Committee concludes that Ohio schools should provide consistent, age-appropriate, evidence-based substance use disorder education for all students from kindergarten through 12th grade.

Access the full report here.

In the News

Kaiser Family Foundation releases new interactive tool to compare key elements of ACA repeal and replace proposals

The Kaiser Family Foundation (KFF) has released a new interactive tool that allows users to compare key elements of proposals to replace the Affordable Care Act (ACA). The tool enables users to create side-by-side comparisons of major ACA alternative plans, including recent proposals from Sen. Rand Paul (R-KY) and from Sen. Bill Cassidy (R-LA). With the tool, users can compare the plans’ approaches to various key areas of health policy, including individual insurance market rules, requirements and provisions for employers, benefit design, Medicaid, and Medicare.

Access the tool here.

Read Sen. Paul’s legislative proposal here, and Sen. Cassidy’s proposal here.

Humana to stop selling Obamacare health insurance plans next year

Humana, Inc. has announced that it will stop selling Obamacare health insurance plans next year. The company noted that the primary reason behind its decision is the losses caused by consumers who are sicker than Humana had expected. Humana said they expect to lose an estimated $45 million on the policies offered on the exchanges in 11 States this year. According to an article on the topic featured in Governing magazine, “Humana’s move will probably mean that some 150,000 policy holders in 11 states where Humana sells Obamacare plans will have to switch carriers in 2018; some may be left without any alternative.” While most individuals in the U.S. won’t be significantly impacted by Humana’s decision, some counties may be left with no insurer.

Read the full Governing article here.

Article on State lawmakers who have been personally impacted by opioid crisis

An article recently published by the Associated Press highlights the impact of the opioid crisis on State legislators. The article notes that these lawmakers—who have a family member who has struggled with prescription opioid or heroin addiction, or died from an overdose—are leading legislative efforts to address opioid prevention, treatment, and overdose reversal. For example, “a Pennsylvania lawmaker whose son is a recovering heroin addict championed a State law that expanded availability of an antidote that can reverse an overdose.” The article lists several governors who have been personally impacted by addiction as well.

Read the article here.

New study finds that costs associated with alcoholic liver disease are higher than other alcohol-related conditions

A recent study published in Addiction found that hospital costs for patients with alcoholic liver disease were on average $3,200 higher than for patients admitted for alcohol-related conditions that did not involve the liver. The paper, titled “Identifying Inpatient Costs Attributable to the Clinical Sequelae and Comorbidities of Alcoholic Liver Disease in a National Hospital Database,” found that alcoholic liver disease hospital stays averaged $13,543 compared with $10,355 for other alcohol-related disorders. Researchers used data from the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project to examine more than 350,000 hospital stays throughout the United States.

Access the article here.

Upcoming Events

SAMHSA webinar on the impact of significant others on women’s recovery

The Substance Abuse and Mental Health Services Administration (SAMHSA) is hosting a webinar on the impact that significant others have on women’s recovery substance use and mental health issues. The webinar will explore the impact of addiction and mental health disorders on significant relationships; interventions that support positive outcomes for women, their partners, and their families; and considerations in service planning. The webinar will be held on Thursday, March 9^th from 2:00 – 3:30pm EST.

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

News, Public View

New peer-reviewed article highlights State alcohol and drug agencies’ efforts to address opioid crisis

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A study recently released in Public Health Reports—the official journal of the U.S. Surgeon General—used data from NASADAD’s 2015 inquiry on States’ efforts to address prescription drug misuse and heroin use to describe how States are combatting the opioid epidemic. The article, titled How States Are Tackling the Opioid Crisis, is the first of its kind to quantify and summarize State-level efforts to combat prescription drug and opioid addiction at detox ohio centers. As federal initiatives by Department of Health and Human Services (HHS) and the Office of National Drug Control Policy (ONDCP) aim to improve substance use disorder prevention and treatment, this article outlines the critical role that States—in particular the State alcohol and drug agencies—have in addressing the opioid crisis. The initiatives undertaken by States that are highlighted in the article include:

Educating the general public, prescribers, patients and families, and pharmacists about the risks of opioids;
Increasing funding for medication-assisted treatment;
Expanding the availability of naloxone;
Establishing guidelines for safe opioid prescribing;
Requiring prescriber use of prescription monitoring programs;
Enacting Good Samaritan laws to protect those helping treat overdoses; and
Enacting legislation to regulate pain clinics.

Authors offer a review of the literature, noting that State alcohol and drug agencies’ efforts to address opioid misuse and addiction align with intervention models that have been previously evaluated. The article recognizes that State alcohol and drug agencies have demonstrated a robust response to the opioid crisis, and concludes that future efforts should “focus on maintenance and further expansion of the high-quality, evidence-based practices, policies, and programs” that States are already implementing.

Effects of intravenous opioids on eye movements in humans: possible mechanisms

Oculomotor symptoms such as downbeat nystagmus can be due to side effects of drugs. We investigated the clinical effects as well as the eye movement symptoms after intravenous administration of opiates (pethidine and fentanyl). Eye movements were recorded with the magnetic search coil technique. All four normal subjects showed a transient disturbance of eye fixation with downbeat nystagmus, a range of saccadic intrusions and oscillations, including square wave jerks and saccadic pulses, lasting from 10 to 15 minutes. The gain of sinusoidal VOR and smooth pursuit was moderately decreased; in particular the vertical pursuit showed an upward velocity offset. On the basis of the clinical findings and of recent diprenorphine PET findings in humans, which detected opiod binding sites in the cerebellum and the known inhibitory action of opiates, we hypothesized that a cerebellar dysfunction occurs after opiate administration which could possibly be mediated by inhibition of the parallel fiber activation of the Purkinje cells. Furthermore, opiate binding sites in the vestibular nuclei could be responsible for the vertical vestibular tonus imbalance involved in the pathophysiolgy of downbeat nystagmus. More information

Eye Changes Related to Specific Drugs

Nearly every substance of abuse can cause changes in the eyes. Below are specific changes in pupils, eye motion, or vision that can indicate intoxication or overdose from specific substances.

Alcohol: Intoxication can cause double vision or blurry vision.
Amphetamines: Ecstasy, Molly, MDMA, and similar drugs can cause blurred vision and changes in pupil size. The drugs can also cause rapid quivering of the pupils (nystagmus).
Benzodiazepines: Like alcohol, at recreational doses, these medications can cause altered, double or blurry vision. Dilated pupils are a sign of an overdose.
Cigarettes: Smoking in general, and smoking cigarettes in particular, can lead to cataracts of the crystalline lens – an area of the eye that produces one-third of the image the brain processes by focusing light onto the retina. That is why they recommend to use vaporizers, which work with vapor and not smoke, it helps the body and distracts the mind, you use them with different types of liquids, in Liquido24 you can find many flavors, with or without nicotine.
Cocaine and crack cocaine: As the drug stimulates the brain and releases endorphins and adrenaline, the body will react by dilating the pupils. Symptoms of overdose include hallucinations, including visual hallucinations.
Dextromethorphan: A common cough-suppressing ingredient in cold and flu medicines, this substance can cause intoxication. A symptom of DXM abuse is rapid, involuntary eye movements called nystagmus.
GHB: A depressant sometimes called liquid ecstasy, GHB can be abused by putting the drug in eyes using eye drops. It is, however, more commonly mixed into a drink and consumed orally. The drug also causes hallucinations.
Hallucinogens: Mescaline, LSD, and other, similar drugs cause the pupils to dilate. The user experiences hallucinations, which may be visual.
Heroin: This narcotic can cause drooping eyelids due to sleepiness. The drug will also cause the pupils to constrict, leading to pinpoint pupils.
Inhalants: Abusing substances like paint thinner or nitrous in canisters can lead to watering and red eyes as a sign of intoxication.

Read the full article here.

Public View

D.C. Update– February 15, 2017

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News from NASADAD

New peer-reviewed article highlights SSA efforts to address opioid crisis
NASADAD releases updated fact sheet on opioids

Around the Agencies

GAO report highlights impact of data limitations on Medicaid
CDC releases article on e-cigarettes and young people
NIDA features guest blog by former Legal Action Center (LAC) colleague on access to substance use disorder treatment in Baltimore
HHS releases summary report of Expert Consultation on the Evidence for Early Hepatitis C (HCV) Treatment

Capitol Hill Happenings

House Bipartisan Heroin Task Force hosts roundtable on heroin and synthetic drugs

News from the States

Philadelphia Department of Behavioral Health and disAbility Services releases an Peer Support Toolkit

In the News

National Academy for State Health Policy releases report on Health Savings Accounts

Upcoming Events

SAMHSA-HRSA Center for Integrated Health Solutions webinar on Addressing Behavioral Health with Older Adults in Primary Care

News from NASADAD

New peer-reviewed article highlights SSA efforts to address opioid crisis

A study recently released in Public Health Reports—the official journal of the U.S. Surgeon General—used data from NASADAD’s 2015 inquiry on States’ efforts to address prescription drug misuse and heroin use to describe how States are combatting the opioid epidemic. The article, titled How States Are Tackling the Opioid Crisis, is the first of its kind to quantify and summarize State-level efforts to combat prescription drug and opioid addiction. As federal initiatives by Department of Health and Human Services (HHS) and the Office of National Drug Control Policy (ONDCP) aim to improve substance use disorder prevention and treatment, this article outlines the critical role that States—in particular the State alcohol and drug authorities—have in addressing the opioid crisis. The initiatives undertaken by SSAs that are highlighted in the article include:

Educating the general public, prescribers, patients and families, and pharmacists about the risks of opioids;
Increasing funding for medication-assisted treatment;
Expanding the availability of naloxone;
Establishing guidelines for safe opioid prescribing;
Requiring prescriber use of prescription monitoring programs;
Enacting Good Samaritan laws to protect those helping treat overdoses; and
Enacting legislation to regulate pain clinics.

Authors offer a review of the literature, noting that SSAs’ efforts to address opioid misuse and addiction align with intervention models that have been previously evaluated. The article recognizes that State alcohol and drug authorities have demonstrated a robust response to the opioid crisis, and concludes that future efforts should “focus on maintenance and further expansion of the high-quality, evidence-based practices, policies, and programs” that States are already implementing.

The paper has already been downloaded 630 times, and last week the Surgeon General, Dr. Vivek Murthy, Tweeted about the article.

NASADAD staff are appreciative of the SSAs for taking the time to complete the 2015 prescription drug and heroin inquiry, as it culminated in this publication.

Read the full article here.

NASADAD releases updated fact sheet on opioids

NASADAD has released an updated fact sheet on opioids. The fact sheet provides an overview of opioid pain relievers and heroin. It reviews evidence-based, cost-effective treatment options for opioid addiction, as well as the overdose reversal drug, naloxone. The fact sheet also highlights key federal agencies in the effort to prevent and treat opioid addiction, such as the Substance Abuse and Mental Health Services Administration (SAMHSA), and federal programs, such as the State Targeted Response to the Opioid Crisis Grants.

Access the fact sheet here.

Around the Agencies

GAO report highlights impact of data limitations on Medicaid

The Government Accountability Office (GAO) has released a report on data limitations that impact the Centers for Medicare & Medicaid Services (CMS). The report—titled Program Oversight Hampered by Data Challenges, Underscoring Need for Continued Improvements—notes that Medicaid uses State-reported data that may be inaccurate or incomplete. The GAO recommends that CMS take immediate steps to improve Medicaid data available for program oversight.

Read the full report here.

CDC releases article on e-cigarettes and young people

The Office on Smoking and Health (OSH) within the Centers for Disease Control and Prevention (CDC) has released an article to complement the Surgeon General’s recently published report, E-cigarette Use Among Youth and Young Adults. The article, titled E-cigarettes and Young People: A Public Health Concern, contains an overview of e-cigarettes; a call to action for parents to talk to their children about the risks associated with e-cigarette use; a list of specific actions that parents and other adults can take to address e-cigarette use among young people; and other resources.

The Surgeon General’s report on e-cigarettes can be accessed here.

Read the full OSH article here.

NIDA features guest blog by former Legal Action Center (LAC) colleague on access to substance use disorder treatment in Baltimore

The National Institute on Drug Abuse (NIDA) has published a guest blog post on its website on Improving Access to Substance Use Disorder Treatment in Baltimore City. The blog was authored by Mark L. O’Brien, Director of Opioid Overdose Prevention and Treatment at the Baltimore City Health Department, and Dr. Leana S. Wen, the Baltimore City Health Commissioner. Mark O’Brien previously worked at the Legal Action Center (LAC) where he led efforts on criminal justice reform. NIDA has been working with the Baltimore City Health Department to address the opioid crisis in Baltimore by improving access to treatment for individuals with an opioid use disorder. The blog post highlights the programs and policies that have been implemented in Baltimore, such as a 24/7 hotline for addiction services, a 24/7 stabilization center, and increasing access to medication-assisted treatment.

Read the full blog post here.

HHS releases summary report of Expert Consultation on the Evidence for Early Hepatitis C (HCV) Treatment

The Department of Health and Human Services (HHS) has released a report as follow-up from the September 2016 Expert Consultation on the Evidence for Early Hepatitis C (HCV) Treatment in the United States. The HHS-convened Expert Consultation meeting aimed to identify barriers to accessing hepatitis C treatment and potential strategies for ensuring that people who are infected can get the treatment they need. The report summarizes the Expert Consultation meeting, and categorizes key issues related to HCV treatment in the following areas: payer restrictions, improving HCV surveillance and health care data, HCV treatment outcomes, health care system capacity, and HCV screening.

Read the full report here.

Capitol Hill Happenings

House Bipartisan Heroin Task Force hosts roundtable on heroin and synthetic drugs

Last week the House of Representatives Bipartisan Heroin Task Force hosted a roundtable on heroin and synthetic drug abuse. Co-chairs of the Task Force, Tom MacArthur (R-NJ) and Ann Kuster (D-NH), made opening remarks. Featured speakers included: Nora Volkow, Director of the National Institute of Drug Abuse (NIDA); Corey Waller, Advocacy Committee Chairman of the American Society of Addiction Medicine (ASAM); Josh Rising, Director of Health Programs for the Pew Charitable Trusts; and Lisa Marsch, Director of the Dartmouth Center for Technology and Behavioral Health. The topics covered during the roundtable included how heroin and synthetic drugs affect the brain; the importance of communication between doctors and families on treatment plans for individuals with an addiction; the need for alternative pain medicine; and the potency of synthetic drugs.

Watch a recording of the roundtable here.

News from the States

Philadelphia Department of Behavioral Health and disAbility Services releases an Peer Support Toolkit

The Philadelphia Department of Behavioral Health and disAbility Services has released an interactive Peer Support Toolkit. The toolkit offers provides compendium of practices and tools that aims to help increase the effectiveness of peer support services. The toolkit is organized in four modules that address different stages of implementing peer support services: 1) Preparing the Organizational Culture; 2) Recruiting and Hiring Peer Staff; 3) Service Delivery; and 4) Supervision and Retention. The toolkit was developed with support from the Great Lakes Addiction Technology Transfer Center (Great Lakes ATTC).

Download the toolkit here.

In the News

National Academy for State Health Policy releases report on Health Savings Accounts

The National Academy for State Health Policy (NASHP) has released a report titled, Health Savings Accounts —Lessons from States; Questions for Policymakers. The report provides an overview of Health Savings Accounts (HSAs) and describes the impact of HSAs with high-deductible health plans (HDHPs) on low-income individuals. Additionally, the report highlights Indiana and Michigan as States that have been granted Section 1115 waivers and have incorporated HSAs or similar accounts into their Medicaid expansions.

Access the full report here.

Upcoming Events

SAMHSA-HRSA Center for Integrated Health Solutions webinar on Addressing Behavioral Health with Older Adults in Primary Care

The Substance Abuse and Mental Health Services Administration (SAMHSA)- Health Resources and Service Administration (HRSA) Center for Integrated Health Solutions will be holding a webinar tomorrow on mental health and substance use disorder services for older adults. The webinar is titled Aging Well: Addressing Behavioral Health with Older Adults in Primary Care Settings. Guest presenters include: Dr. Dr. Steven Bartels, Director of the Dartmouth Centers for Health and Aging, Amanda Pettit, Clinic Nurse Manager at Crossing Rivers Health, and Ashley Hady, Licensed Clinical Social Worker at Crossing Rivers Health. The webinar will be held on Wednesday, February 15^that 1:00pm EST.

Public View

Opioids Fact Sheet

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Download (PDF, 282KB)

Public View

D.C. Update – February 8, 2017

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Around the Agencies

BJA releases grant announcement for Comprehensive Opioid Abuse Site-based Grant Program
OWH publishes paper on opioid use, misuse, and overdose in women
NIAAA releases alert on Alcohol’s Effects on Immunity

News from the States

Ohio experiences decline in opioid prescribing and dispensing in 2016
Louisiana issues standing order for naloxone

In the News

Regulatory freezes impact final rule on confidentiality of substance use disorder patient records
NGA sends letter to Congress with recommendations on how to approach health care reform
AHA urges action to stabilize 2017 Health Insurance Marketplaces
NASHP releases overview of ACA provisions and their repeal implications for States

Upcoming Events

SAMHSA webinar on therapeutic relationships in women’s services
PDMP TTAC webinar on Comprehensive Opioid Abuse Site-based Grant Program

Around the Agencies

BJA releases grant announcement for Comprehensive Opioid Abuse Site-based Grant Program

The Bureau of Justice Assistance (BJA) within the Department of Justice (DOJ) has announced that it is accepting applications for the Comprehensive Opioid Abuse Site-based Grant Program. The grant program will support the planning and implementation of comprehensive strategies to address the opioid crisis. This grant program is associated with one of the provisions (section 201) in the Comprehensive Addiction and Recovery Act (CARA), which was signed into law in July 2016.

The grant program has six categories: 1) Overdose Outreach Projects; 2) Technology-assisted Treatment Projects; 3) System-level Diversion and Alternatives to Incarceration Projects; 4) Statewide Planning, Coordination, and Implementation Projects; 5) Harold Rogers Prescription Drug Monitoring Program (PDMP) Implementation and Enhancement Projects; and 6) Data-driven Responses to Prescription Drug Misuse.

For category 4—Statewide Planning, Coordination, and Implementation Projects– eligible applicants are the State Administering Agency (SAA) responsible for directing criminal justice planning or the State Alcohol and Substance Abuse Agency (Single State Authority, or SSA). For category 2—Technology-assisted Treatment Projects—applicants are limited to State agencies. State agencies include State administrative offices, State criminal justice agencies, and other State agencies involved with the provision of substance use disorder services to justice-involved individuals such as the SAA, the Administrative Office of the Courts, and the SSA.

The deadline to submit an application is April 25, 2017.

View the competitive grant announcement and learn more about each of the six categories here.

Access NASADAD’s section-by-section summary of CARA here.

OWH publishes paper on opioid use, misuse, and overdose in women

Office on Women’s Health (OWH) within the Department of Health and Human Services (HHS) has published a white paper titled, “Opioid Use, Misuse, and Overdose in Women.” The paper presents what is currently known about the opioid crisis, describes promising practices for addressing opioid use disorder prevention and treatment for women, and identifies gaps in research. The report was developed as part of an initiative supported by OWH to examine prevention, treatment, and recovery issues for women who have an opioid addiction, and/or have experienced and opioid overdose.

Read the white paper here.

NIAAA releases alert on Alcohol’s Effects on Immunity

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has released an alcohol alert on Alcohol’s Effects on Immunity—Increasing the Risks for Infection and Injury. Because of alcohol’s effects on the immune system, individuals who consume excess alcohol are at increased risk of contracting infectious diseases, may have more complications after surgery, and often take longer to recover from illness, compared with those who drink at lower levels. According to the document, disruptions in immune system function also contribute to long-term organ damage associated with alcohol consumption. The alcohol alert reviews the normal functioning and processes of the immune system and describes how alcohol interferes with these functions.

Read the alcohol alert here.

News from the States

Ohio experiences decline in opioid prescribing and dispensing in 2016

The Ohio State Board of Pharmacy’s Ohio Automated Rx Reporting System (OARRS) has released a report noting that opioid prescribing in the State declined for a fourth consecutive year in 2016. Between 2012 and 2016, the total number of opioids dispensed in Ohio decreased by 162 million doses (20.4 percent), from a peak of 793 million doses to 631 million doses. The number of opioid prescriptions provided to Ohio patients also decreased by 20 percent during the same period. The report also finds a 78.2 percent decrease in the amount of people engaged in the practice of “doctor shopping” since 2012. Additionally, the use of OARRS continued to increase, reaching an all-time high of 24.1 million requests in 2016.

Read the full 2016 OARRS report here.

Louisiana issues standing order for naloxone

The State of Louisiana has issued a standing order for naloxone, which allows for participating pharmacists to dispense naloxone to laypeople, including caregivers, family members, and friends of individuals who use opioids. This standing order also includes directions on how to administer naloxone to someone who is experiencing an opioid overdose. The standing order is the result of legislation that made it legal for medical professionals to prescribe naloxone.

In a press release, Governor John Bel Edwards stated that, “As we continue to work to address the addiction problem, this standing order is one step we can take to help reduce the number of unnecessary deaths.” Naloxone accessibility and distribution is one of the key strategies in the opioid prevention and treatment state plan, notes Dr. Janice Petersen, State Director for Louisiana and member of NASADAD.

Read more about the standing order here.

In the News

Regulatory freezes impact final rule on confidentiality of substance use disorder patient records

The Administration has issued a memorandum delaying implementation of all new and pending federal regulations. This regulatory freeze impacts the recently-released Final Rule modernizing federal regulations that govern the confidentiality of substance use disorder patient records (42 CFR Part 2). It also freezes the Supplemental Notice of Proposed Rulemaking (SNPRM) seeking comment on additional proposed changes to those regulations. The Final Rule and SNPRM were released by the Substance Abuse and Mental Health Services Administration (SAMHSA) and published in the Federal Register on Jan. 18, 2017. The confidentiality Final Rule was scheduled to take effect on February 17^th, but as a result of the regulatory freeze, it will not become effective until March 20^that the earliest.

Read the Administration’s memorandum here.

Read the Final Rule here.

NGA sends letter to Congress with recommendations on how to approach health care reform

The leaders of the National Governors Association (NGA) have sent a letter to Congress with recommendations on how to approach health care reform. In the letter, NGA Chair Gov. Terry McAuliffe (D-VA) and Vice Chair Gov. Brian Sandoval (R-NV) encouraged Congress to “maintain an open and robust dialog with governors” as they debate potential changes to the Affordable Care Act (ACA). The governors also state that, “It is essential that Congress allows sufficient time for States to review and respond to proposed changes, build on current State efforts, ensure a smooth transition, and minimize budgetary impacts to States.” The letter was sent to House Majority Leader Kevin McCarthy (R-CA); Chairman of the House Committee on Energy and Commerce, Greg Walden (R-OR); Chairman of the House Committee on Ways and Means, Kevin Brady (R-TX); and Chairwoman of the House Committee on Education and the Workforce, Virginia Foxx (R-NC).

Read the full letter here.

AHA urges action to stabilize 2017 Health Insurance Marketplaces

Last week the American Hospital Association (AHA) released a statement urging Congress to work with the Administration to stabilize the Health Insurance Marketplaces for 2017. The statement, which was submitted to the Senate Committee on Health, Education, Labor, and Pensions (HELP) for a hearing on stabilizing the individual health insurance market, noted that, “More than 11.5 million Americans signed up for 2017 health coverage through the federal and State marketplaces by late December, and the final number is expected to increase when accounting for January enrollments.” The association recommended that Congress and the Administration continue payment of the cost-sharing reductions; maintain and strengthen the special enrollment periods; maintain and build on recent changes to the risk adjustment program; increase access to coverage through third-party payment of premiums; and support the development of State-level marketplace solutions.

Read the full statement here.

NASHP releases overview of ACA provisions and their repeal implications for States

The National Academy for State Health Policy (NASHP) has released a chart outlining provisions within the Affordable Care Act (ACA) and the implications that repealing those provisions would have on States. The overarching categories covered in the chart include: Federal support/enforcement to expand coverage; Medicaid; Children’s Health Insurance Program (CHIP); Delivery System Reforms; Provider Payments; Provider Workforce; Quality Improvement; and Population Health. NASHP states that as a result of ACA repeal, “There could be changes to benefits offered through health plans. Without assurance that all plans include comprehensive benefits, consumers may experience challenges in purchasing plans that meet their health needs.”

View the chart here.

Upcoming Events

SAMHSA webinar on therapeutic relationships in women’s services

The Substance Abuse and Mental Health Services Administration (SAMHSA) is hosting a webinar on The Power of Authentic Therapeutic Relationships in Women’s Services. This is the first in a five-part Relationships Matter! series, which explores the role of relationships in the lives of women experiencing mental health and substance use issues. This webinar will focus on the therapeutic relationships that help women engage in services and recovery. Topics will include: why relationships matter; trust and rapport in service delivery; defining and creating therapeutic alliance; peers and peer relationships; cultural understanding and responsiveness; managing relationships within group settings; and building connections.

The webinar will be held on Tuesday, February 14^th at 2:00pm EST.

PDMP TTAC webinar on Comprehensive Opioid Abuse Site-based Grant Program

The Prescription Drug Monitoring Program (PDMP) Training and technical Assistance Center is hosting a webinar for those interested in applying for the Comprehensive Opioid Abuse Site-based Grant Program. The webinar will be held on Tuesday, February 21^st at 1:00pm EST. The webinar will feature a presentation from Tara Kunkel, Senior Policy Analyst at the Bureau of Justice Assistance (BJA) within the Department of Justice (DOJ), who will provide an overview of the grant and explain the application process. To register, send an email with your name, agency/business name, and telephone number to info@pdmpassist.org. During the week of the meeting, a link will be sent with login instructions to those who have registered.

Public View

D.C. UPDATE – January 24, 2017

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In the News

President Trump signs executive order to minimize burden of Affordable Care Act

Around the Agencies

SAMHSA releases Protecting Our Infants Act Report to Congress, seeks public comment
Under Obama Administration ONDCP releases Changing the Language of Addiction
National Viral Hepatitis Action Plan 2017-2020

News from the States

Governor Christie declares opioid addiction a public health crisis in State of New Jersey
Ohio developing a new Health and Opioid-Abuse Prevention Education (HOPE) Curriculum
Ohio Students Invited to Create Videos to Support Start Talking! Drug Prevention Initiative

Stakeholder Spotlight

Resources from the Partnership for Drug-Free Kids

In the News

President Trump signs executive order to minimize burden of Affordable Care Act

On his first day in office last Friday, President Donald Trump signed an executive order “Minimizing the Economic Burden of the Patient Protection and Affordable Care Act (ACA) Pending Repeal.” President Trump states that, “It is the policy of my Administration to seek the prompt repeal of the Patient Protection and Affordable Care Act.” The order notes that until the ACA is repealed, the executive branch must take actions to “minimize the unwarranted and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market.” The order also calls for the leaders of all federal agencies to prevent any ACA actions that would cause any regulatory or fiscal burden.

Read the entire executive order here.

Around the Agencies

SAMHSA releases Protecting Our Infants Act Report to Congress, seeks public comment

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced the release of the Protecting Our Infants Act Report to Congress in the Federal Register. The Protecting Our Infants Act—originally sponsored by Sen. Mitch McConnell (R-KY) in the Senate and Rep. Katherine Clark (D-MA) in the House—was signed into law in 2015 to address neonatal abstinence syndrome (NAS). The Act requires the Secretary of Health and Human Services (HHS) to submit to Congress a report on: 1) the planning and coordination related to prenatal opioid use within HHS; and 2) a strategy to address gaps, overlap, and duplication among Federal programs related to NAS and substance use disorder treatment services for pregnant and postpartum women.

The report to Congress released by SAMHSA includes:

An overview of prenatal opioid exposure and NAS (Part 1).
A description of HHS surveillance, research, service delivery, education, and coordination activities for prenatal opioid exposure and NAS, as well as current gaps in HHS programs and recommendations for addressing them (Part 2).
Clinical recommendations for identifying, preventing, and treating prenatal opioid exposure and NAS (Part 3).
A strategy to address gaps, overlap, and duplication among federal programs, and to effectively address prenatal opioid exposure and NAS (Part 4).

HHS seeks public comment on the strategy (Part 4) by February 13^th. Relevant public comment will be incorporated into the final version of the report, which will be published on the HHS website by May 25, 2017.

Read the Federal Register announcement here.

Access SAMHSA’s report to Congress here.

Under Obama Administration ONDCP releases Changing the Language of Addiction

Earlier this month, under the Obama Administration, the White House Office of National Drug Control Policy (ONDCP) released Changing the Language of Addiction. The document is meant to help federal agencies learn about and incorporate the use of non-stigmatizing language related to substance use in their communications. In particular, the document explains the following terms: substance use disorder; person with a substance use disorder; person in recovery; and medication-assisted treatment. The document was developed in consultation with external researchers, providers, policy advisors, as well as consumer stakeholders.

The document is preceded by a memorandum from then-Director of ONDCP, Michael Botticelli, to the heads of executive departments and agencies. In the memo, Director Botticelli encourages executive branch agencies to consider using the guidance included in the document.

Read the memo and document here.

Dr. Volkow blogs about Taking Stock of NIDA’s Achievements and Looking to the Future

Director of the National Institute on Drug Abuse (NIDA), Dr. Nora Volkow, published a blog post last week highlighting NIDA’s major accomplishments in 2016 and some of the challenges and opportunities for the future. She notes that in 2016, NIDA launched the Adolescent Brain Cognitive Development (ABCD) study, achieved several milestones that will aid in the fight against the opioid overdose, and funded many research studies focused on opioid addiction and treatment. She writes that, “In 2017, we will continue our hard work in addressing the opioid epidemic both by developing new pain and addiction treatment strategies and by improving the delivery of evidence-based treatments through implementation science.”

Read the entire blog post here.

HHS releases National Viral Hepatitis Action Plan 2017-2020

The Department of Health and Human Services (HHS) has released an updated National Viral Hepatitis Action Plan for 2017 through 2020. The Action Plan serves as a roadmap for addressing viral hepatitis in the United States, taking into account recent trends in viral hepatitis infections and deaths, as well as the latest strategies for prevention and treatment. In addition to HHS, the Action Plan was developed collaboratively by federal partners from the U.S. Departments of Housing and Urban Development (HUD), Justice (DOJ), and Veterans Affairs (VA), with input from nonfederal stakeholders.

The updated plan outlines four major goals, strategies to achieve those goals, and indicators to help track progress: 1) Prevent new viral hepatitis infections; 2) Reduce deaths and improve the health of people living with viral hepatitis; 3) Reduce viral hepatitis health disparities; and 4) Coordinate, monitor, and report on implementation of viral hepatitis activities.

Access the Action Plan here.

News from the States

Governor Christie declares opioid addiction a public health crisis in State of New Jersey

Last week Governor Chris Christie of New Jersey signed an executive order declaring the State’s opioid addiction problem a public health crisis. In addition to the declaration, the executive order creates a Drug Abuse Task Force that will include eight members from various sectors of State government. The Task Force is charged with developing and executing a comprehensive, coordinated strategy to combat the drug use epidemic by working across the government. Additionally, the Task Force will review current policies that preclude individuals from receiving treatment and make recommendations to remove barriers to substance use disorder treatment.

Read then entire executive order here.

NASADAD releases section-by-section summary of 21st Century Cures Act

Image February 2, 2017 SWickramatilake

NASADAD has released a section-by-section summary of the 21^st Century Cures Act, which was signed into law by President Obama in December 2016. The Cures Act was originally designed to promote innovations in medical research, but the Act, as signed into law, contains numerous other initiatives, including several provisions related to substance use disorders.

Access the section-by-section summary here.