News from the States

• Governor Ricketts announces Sheri Dawson as Director for Nebraska’s Division of Behavioral Health
• Illinois Consortium on Drug Policy publishes study on State’s heroin crisis

Around the Agencies

• AHRQ releases brief on newborn and maternal hospitalizations related to substance abuse
• GAO report recommends that additional State reporting may help CMS oversee prescription drug fraud
• NIH report finds that most American adults have experienced some level of pain
• NIH-funded study shows possible link between e-cigarettes and initiation of tobacco use
• CDC report finds 7 million fewer uninsured this year than in 2014
• CMS releases 2015 Health Insurance Marketplace Special Enrollment Period Report
• AHRQ releases Medical Expenditure Panel Survey Insurance Component Chartbook
• CMS report shows cost savings among Accountable Care Organizations
• CBO report finds that eliminating sequestration could result in 1.4 million more jobs

In the News

• States collected $32 billion from “sin taxes” in fiscal year 2014
• Largest insurers in the Health Insurance Marketplace raised premiums an average 75% more than smaller insurers in past year

 

News from the States

Governor Ricketts announces Sheri Dawson as Director for Nebraska’s Division of Behavioral Health
Governor Pete Ricketts announced the appointment of Sheri Dawson, R.N. as Director for the Division of Behavioral Health for the Nebraska Department of Health and Human Services (DHHS). Ms. Dawson has served as the acting director of the Division of Behavioral Health since earlier this year. Prior to serving as acting director, she held different roles within the department including Deputy Director of Community-Based Services, QI and Managed Care Administrator, Program Specialist, and Nurse Surveyor/Consultant. Additionally, Ms. Dawson served as Associate Director of Nursing for the Nebraska Department of Public Institutions.

Illinois Consortium on Drug Policy publishes study on heroin crisis
The Illinois Consortium on Drug Policy at Roosevelt University released a report on the State’s continuing heroin problem. The study found that 25 percent of State-funded treatment admissions were for heroin, significantly higher than the 16 percent of heroin admissions for the nation. The report suggests improving treatment for prescription opioid drugs, increasing access to naloxone, implementing medication-assisted treatment programs in jails and prisons, and ensuring that drug courts follow evidence-based practices.

Around the Agencies

AHRQ releases brief on newborn and maternal hospitalizations related to substance abuse
The Agency for Healthcare Research and Quality released a brief on Neonatal and Maternal Hospital Stays Related to Substance Use. From 2006 to 2012, the rate of neonatal hospitalizations related to substance use increased by 71 percent, and the rate of maternal hospitalizations related to substance use increased by 33 percent. The costs for neonatal hospitalizations rose by 135 percent, from $253 to $595 million, from 2006 to 2012. For maternal hospitalizations, costs rose by 35 percent, from $258 to $349 million. The rate of maternal hospital stays for opioid use rose by 134.7 percent. Of the newborns hospitalized because of substance use-related issues, 20 percent had low birth weight, compared with 7 percent of all other neonatal stays. There was a rise in hospital stays for neonatal abstinence syndrome, from 7,240 in 2006 to 18,968 in 2012.

GAO report recommends that additional State reporting may help CMS oversee prescription drug fraud
A new Government Accountability Office (GAO) report has recommended that the Centers for Medicare & Medicaid Services (CMS) require States to report on two controls that are not currently included in CMS’s reporting requirements: lock-in programs for abusers of non-controlled substances, and prohibitions on automatic refills.

Currently, lock-in programs address doctor shopping by restricting beneficiaries who have abused the Medicaid program to only receiving controlled substance prescriptions from a single provider and pharmacy. A lock-in program for those with non-controlled substance prescriptions could also help address potential fraud and abuse. However, CMS does not currently collect information about lock-in programs for non-controlled substances. Similarly, CMS does not collect data on automatic refill prohibitions, even though such data could reduce the potential for medication stockpiling, continued fill of discontinued medications, and waste of prescription medications. According to the report, requiring States to report on these controls could help CMS oversee prescription drug fraud, and CMS has stated that it will consider the GAO’s recommendations.

NIH report finds that most American adults have experienced some level of pain
The National Center for Complementary and Integrative Health, a branch of the National Institutes of Health, recently analyzed data from the 2012 National Health Interview Survey (NHIS) and found that most American adults have experienced some level of pain. The severity of pain varied among survey respondents, with an estimated 25.3 million adults (11.2 percent) experiencing some level of pain every day for the preceding 3 months. There were associations between pain severity and race, ethnicity, language preference, gender, and age. Those with high levels of pain were more likely to have worse health status, use healthcare services, and suffer from disability.

NIH-funded study shows possible link between e-cigarettes and initiation of tobacco use
A study on electronic cigarette use and subsequent tobacco use by adolescents, published in the Journal of the American Medical Association, found that students who have used e-cigarettes by the time they start ninth grade are more likely than others to start smoking traditional cigarettes and other combustible tobacco products within the next year.  E-cigarettes could increase tobacco initiation rates among youth who would not have otherwise smoked cigarettes; youth who try e-cigarettes and subsequently become addicted to nicotine might transition to conventional cigarettes. While the study authors cannot conclude that e-cigarette use directly leads to smoking, this study raises concerns that increases in youth e-cigarette use could increase the prevalence of smoking-related illness.

CDC report finds 7 million fewer uninsured this year than in 2014
According to a report by the CDC’s National Center for Health Statistics, an estimated 29 million U.S. residents of all ages lacked health insurance in the first three months of 2015, which is 7 million fewer than in 2014. The uninsured rate for adults under age 65 fell by 7.8 percent in Medicaid expansion States, compared with 5.9 percent in non-expansion States. Among adults aged 18–64, the percentage of uninsured individuals decreased from 16.3 percent in 2014 to 13.0 percent in 2015, with a corresponding increase in private coverage, from 67.3 percent to 70.4 percent. The report analyzes insurance trends by age, poverty status, and race and ethnicity. It also presents estimates of public and private coverage, coverage through exchanges, and enrollment in high deductible health plans (HDHPs) and consumer directed health plans (CDHPs).

CMS releases 2015 Health Insurance Marketplace Special Enrollment Period Report
Although the next open enrollment period for Health Insurance Marketplace coverage doesn’t begin until November 1^st, some individuals qualify for a special early enrollment period. A consumer can qualify for a special enrollment period (SEP) if they have lost health coverage, lost Medicaid eligibility, or had a change in family status.

CMS released a snapshot of information about consumers who selected a plan from the February 23 to June 30, 2015 SEP through the HealthCare.gov platform. Nearly 950,000 new consumers selected a plan through the SEP. Of enrollments during the SEP, 50 percent of plan selections occurred because of health coverage loss, and 19 percent occurred because of Medicaid ineligibility.

AHRQ releases Medical Expenditure Panel Survey Insurance Component Chartbook
The Agency for Healthcare Research and Quality (AHRQ) released its 2014 Medical Expenditure Panel Survey Insurance Component (MEPS-IC). The MEPS-IC is an annual survey of private employers and State and local governments. The MEPS-IC produces national- and State-level estimates of employer-sponsored insurance, including offered plans, costs, employee eligibility, and number of enrollees. The Chartbook, which looks at changes in employer-sponsored insurance before and after ACA implementation, provides both single- and multi-year trend analyses using data from 2003 to 2014.

CMS report shows cost savings among Accountable Care Organizations
The Centers for Medicare & Medicaid Services Medicare released quality and financial performance results showing that Accountable Care Organizations (ACOs) are improving the quality of care that Medicare beneficiaries receive while saving money. ACOs created cost savings amounting $422 million in 2014. Compared to Medicare Shared Shavings Program (MSSP) ACOs, Pioneer ACOs are early adopters of coordinated care and tend to be more experienced. Pioneer ACOs also have an established care coordination infrastructure, and assume greater performance-based financial risk. In 2014 there were 20 Pioneer ACOs and 333 MSSP ACOs. Eleven Pioneer ACOs earned $82 million in shared savings, and 92 MSSP ACOs earned $341 million in shared savings. ACOs with three years of experience in the program were more likely to earn savings than those with only one or two years of experience.

CBO report finds that eliminating sequestration could result in 1.4 million more jobs
In response to a request from Senator Bernie Sanders (VT), the Congressional Budget Office (CBO) released a report on the macroeconomic effects of eliminating automatic reductions to discretionary spending caps. The Budget Control Act of 2011 created caps on discretionary budget authority for each year through 2021, with automatic reductions in those caps that would be triggered under certain conditions. According to the CBO, eliminating the automatic reductions for fiscal years 2016 and 2017 would allow for an increase in appropriations of $90 billion in 2016 and $91 billion in 2017. The changes in spending could increase full-time employment by 0.2 million to 0.8 million in 2016, and 0.1 million to 0.6 million in 2017; 1.4 million jobs could be created over two years without automatic reductions in budget caps.

In the News

States collected $32 billion from “sin taxes” in fiscal year 2014
According to a recent article in Governing Magazine, States collectively took in approximately $32 billion in “sin taxes”—taxes on tobacco, alcohol, and gambling—in fiscal year 2014. The most common sin tax-related practice among State legislatures is passing cigarette tax hikes. Since 2000, States enacted a total of 111 tax increases on tobacco products, and another 23 on alcohol. States rely on sin taxes to varying degrees. Delaware, New Hampshire, Nevada, Rhode Island, and West Virginia accounted for the largest share of total sin tax revenues in 2014.

Largest insurers in the Health Insurance Marketplace raised premiums an average of 75% more than smaller insurers in past year
A new study in the Harvard Journal of Technology Science looks at changes in health insurance premiums made by individual health insurance issuers in 34 federally facilitated and State partnership health insurance exchanges. The study found that the largest insurance issuers in the Health Insurance Marketplace raised premium rates by an average 23.9 percent while the other issuers raised rates by an average 13.7 percent. One suggested reason for this discrepancy is that larger and more broadly recognized issuers are more appealing to older enrollees who have a larger burden of health problems, while younger and healthier individuals may be more receptive to smaller and newer issuers.

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.

 

 

 

 

News from NASADAD

• NASADAD attends House Judiciary Committee – Subcommittee on Crime, Terrorism, Homeland Security and Investigations hearing on “America’s Growing Heroin Epidemic”
• NASADAD attends World Hepatitis Day press conference
• NASADAD attends National Journal interview event with U.S. House Energy and Commerce Committee Chairman Rep. Fred Upton (R-MI)

News from the States

• Ohio releases new opioid toolkit
• States begin reforming restrictions on food stamps, welfare for individuals with drug-related felonies

Around the Agencies

• GAO report recommends DEA improve communication with pharmacies and health care entities
• NIDA releases two new online resources on substance use disorders in women and therapeutic communities research
• DEA announces reinstatement of National Prescription Drug Take-Back Days

In the News

• Senators send letter to HHS supporting broader access to naloxone
• University of Maryland Center for Substance Abuse Research finds increased rates of e-cigarette usage
• Obama administration announces plans to restore Pell Grants for prison inmates
• President Obama declares July 28 World Hepatitis Day
• AMA taskforce announces plans to encourage physicians to register for State-based PDMP programs
• House Energy and Commerce Committee approves PDMP reauthorization bill with language to help promote collaboration with State substance abuse agencies
• House Energy and Commerce Committee Considers and Approves H.R. 1462, the Protecting Our Infants Act

News from NASADAD

NASADAD attends House Judiciary Committee – Subcommittee on Crime, Terrorism, Homeland Security and Investigations hearing on “America’s Growing Heroin Epidemic”
Rob Morrison, Executive Director, and Shalini Wickramatilake-Templeman, Public Policy Associate attended the hearing. The hearing featured a discussion between subcommittee members and health officials on the scope of the heroin problem, the role of law enforcement in reducing heroin abuse, and promising law enforcement practices. The panel was made up of representatives from federal agencies with oversight of substance use disorder issues, as well as a Commonwealth Attorney from Virginia and District Attorney from New Mexico. The panelists provided an overview of the shift from prescription drug abuse to heroin abuse and emphasized the importance of medication-assisted treatment and naloxone. Additionally, the panelists discussed the role of law enforcement in inhibiting the supply of heroin, as well as how law enforcement can connect individuals with heroin use disorders with the treatment services they need as an alternative to criminal prosecution.

Panelists:

• Michael Botticelli; Director, Office of National Drug Control Policy
• Jack Riley, Acting Deputy Administrator, Drug Enforcement Administration, Department of Justice
• Nancy G. Parr, Commonwealth Attorney, City of Chesapeake, VA
• Angela R. Pacheco, First Judicial District Attorney, Santa Fe, NM

 

NASADAD attends World Hepatitis Day press conference
Brian Denten, Public Policy Intern, attended the press conference held by U.S. Representatives Mike Honda (D-CA), Hank Johnson (D-GA), and Judy Chu (D-CA) on Tuesday, July 28^th. Each Representative spoke on their personal experiences with viral hepatitis, noting that the viral hepatitis mortality rate exceeds the HIV mortality rate in many areas. Other speakers highlighted the racial disparity in viral hepatitis diagnosis and mortality rates, and encouraged enhanced public awareness campaigns about the importance of early and frequent testing for both at-risk and general populations. The press conference noted that the rise in hepatitis C cases among young people under 30, as observed in Scott County, Indiana, is largely driven by increases in injection drug use. Speakers called for additional syringe services programs, medication-assisted therapy, and further interventions to help this population. Following the press conference, speakers and activists spent the day advocating for additional funding for viral hepatitis treatment and prevention on Capitol Hill.

NASADAD attends National Journal interview event with U.S. House Energy and Commerce Committee Chairman Rep. Fred Upton (R-MI)
Brian Denten, Public Policy Intern, attended the event held by the National Journal on Tuesday, July 28^th. The event, titled “Conversation with the Chair,” was the latest in a series of interviews between the National Journal and U.S. House Energy and Commerce Committee Chairman Rep. Fred Upton (R-MI). Rep. Upton spoke about the committee’s priorities for the upcoming session of Congress, noting that in a major energy and infrastructure bill, and mental health reform will remain a priority.

News from the States

Ohio releases new opioid toolkit
Ohio released a new Opioid Toolkit this past week as an additional resource for communities fighting opioid use disorders. The toolkit was created and published by the Ohio Governor’s Cabinet Opiate Action Team (GCOAT), created by Governor John Kasich in 2011. Ohio has worked to increase access to medication-assisted treatment through Medicaid, establishing new prescriber guidelines, increasing access to naloxone, and establishing several notable prevention initiatives. The new toolkit focuses on further opiate prevention initiatives, the promotion of responsible prescribing of opiate painkillers, expanding overall treatment capacity, and expanding access to treatment for individuals within the criminal justice system. Tracy Plouck serves as the NASADAD member in Ohio and has been leading a number of these efforts.

States begin reforming restrictions on food stamps, welfare for individuals with drug-related felonies
Many States across the country have been reforming restrictions on food stamps and welfare for individuals with drug-related felonies, as Pew Trusts reports this week. During the height of the War on Drugs, many States banned people with drug related felonies from receiving welfare and food stamp assistance, leading to inmates facing large difficulties when re-entering society following their sentence. Many States have begun lifting the bans and allowing people with certain types of drug felonies to receive assistance. Pew Trusts reports that, “since 1996, 18 States have lifted restrictions on food stamps, known as the Supplemental Nutrition Assistance Program, and 26 allow people with certain types of drug felonies to get those benefits – leaving six States where a felony drug record disqualifies a person from receiving them.” Despite this, many States are still restrictive in providing welfare benefits through Temporary Assistance to Needy Families – with 14 States lifting the restriction, 24 States with some restriction remaining, and 12 States maintaining full restrictions for felons with drug convictions.

Texas and Alabama are the most recent States to lift bans on individuals with drug-related felonies receiving food stamps. Texas’s food stamp program is now available to anyone convicted of using or selling drugs. However, if someone violates their probation they are ineligible to receive benefits for two years; and if someone is convicted of any other felony they are banned for life. Alabama opted to fully lift the ban without any further restrictions. Some States such as Pennsylvania have continued to impose additional bans; a pending Pennsylvania bill would restrict access to welfare benefits for anyone serving more than 10 years for a drug-related offense.

Around the Agencies

GAO report recommends DEA improve communication with pharmacies and health care entities around Controlled Substance Act compliance
A new Government Accountability Office (GAO) report has recommended that the Drug Enforcement Administration (DEA) improve communication with pharmacies and health care entities (otherwise known as “registrants”) on issues surrounding Controlled Substance Act (CSA) compliance. The report finds that many registrants are unaware of the DEA’s full array of resources for complying with the CSA and preventing the diversion of prescription drugs. While a large percentage of registrants surveyed reported generally high satisfaction with DEA field office staff, other registrants commented that improved communication with the DEA would be helpful in establishing best practices for eliminating the risk of diversion. The report was the result of a series of GAO interviews conducted with various State government agencies and National Associations. The GAO concludes the report with a recommendation that the DEA improve communication with registrants and clarify responsibilities required of them by the CSA.

NIDA releases two new online resources on substance use disorders in women and therapeutic communities research
The National Institutes on Drug Abuse (NIDA) released two new online resources this past week: one focusing on substance use disorders in women, and the other focusing on new research on therapeutic communities. The resource discussing substance use disorders in women outlines data summarizing the most commonly used drugs among women, along with the newest research on substance use during pregnancy and breast feeding. The therapeutic communities resource discusses the commonly used model of “long-term residential treatment for substance use disorders,” and discusses their recovery rather than abstinence orientation. Acknowledging the chronic nature of substance use disorders and prevalence of relapses, the therapeutic community model aims to have patients learn from their relapses as they continue on in recovery.

DEA announces reinstatement of National Prescription Drug Take-Back Days
The Drug Enforcement Administration (DEA) announced the reinstatement of National Prescription Drug Take-Back Days this past week. Acting Administrator Chuck Rosenberg announced that the 10^th National Prescription Drug Take-Back will occur on September 26, 2015 from 10am to 2pm local time in all 50 States with the exception of Pennsylvania and Delaware, where the event will be held on September 12^th. The program will allow residents of communities across the country to return unwanted, unneeded, or expired prescription drugs at DEA sponsored sites. Diversion of prescription drugs has become a significant public health issue, as rates of prescription drug abuse and poisonings continue to rise. The DEA’s reinstatement aims to educate Americans on the proper methods for safe disposal. Previous take-back events held from 2010-2014 collected over 4 million pounds of prescription drugs.

Some time ago, Senators Kelly Ayotte (R-NH), Edward Markey (D-MA), Charles Schumer (D-NY), Sherrod Brown (D-OH), Shelley Moore Capito (R-WV), Dianne Feinstein (D-CA), Charles Grassley (R-IA), Orrin Hatch (R-UT), and Joe Manchin (D-WV) sent a letter to the DEA asking for reinstatement of the program.  The letter called on the DEA to reinstate the program in response to the growing heroin and prescription drug epidemic seen throughout the country. Following the DEA’s announcement, Senator Kelly Ayotte stated that, “National Prescription Drug Take-Back Days allow for a safe, convenient way to dispose of unused, unneeded, or expired medications, and I am pleased the DEA is taking steps to reinstate this successful program.

In the News

Senators send letter to HHS supporting broader access to naloxone
Senator Edward Markey (D-MA) and several members of Massachusetts Congressional delegation drafted a letter to the Department of Health and Human Services (HHS) expressing support for increased access to naloxone this past week. The letter specifically requests HHS examine policies for co-prescribing naloxone with opioid painkillers, as well as reducing barriers to payment for naloxone coverage and reimbursement. Naloxone has proven successful in preventing opioid overdose fatalities when used by medical professionals, first responders, and trained community and family members. More than 1,000 opioid overdoses were recorded in Massachusetts in 2014. Senator Elizabeth Warren (D-MA), and Reps. Michael Capuano (D-MA), Katherine Clark (D-MA), Jim McGovern (D-MA), Seth Moulton (D-MA), William Keating (D-MA), Joe Kennedy (D-MA), and Richard Neal (D-MA) joined Senator Markey in submitting the letter.

University of Maryland Center for Substance Abuse Research finds increased rates of e-cigarette usage
The University of Maryland Center for Substance Abuse Research published a new study this past week finding increased rates of e-cigarette usage among U.S. teenagers. The study used information from the most recent Monitoring the Future survey, discovering that “more than twice the percentage of 8^th and 10^th graders reported past month use of e-cigarettes compared to use of tobacco cigarettes (9% vs. 4% and 16% vs. 7%, respectively).” This difference was smaller among 12^th graders, with 17% reporting past month e-cigarette use compared to 14% reporting past month tobacco cigarette use. The study notes that while tobacco cigarette use continues to decline, e-cigarette use remains popular even among individuals who have never tried tobacco cigarettes. The study reports that “between 4% and 7% of 8^th, 10^th, and 12^th graders who reported past 30-day e-cigarette use had never smoked a tobacco cigarette.

Obama administration announces plans to restore Pell Grants for prison inmates
President Obama’s administration has announced plans to restore Pell Grant funding for prison inmates seeking to pursue education. The restoration plans to offer thousands of U.S. inmates access to up to $5,775 a year in tuition, fees, books, and other expenses. The Wall Street Journal reports that the U.S.’s prison population doubled between the mid-1990s and 2013, with recidivism as a leading cause of the overall growth. A 2013 Rand Corporation study suggested that increasing access to education within prisons would significantly lower recidivism rates. The program is expected to last 3-5 years as officials gauge the effect of restoring Pell Grants. More information is expected following the announcement Friday by Education Secretary Arne Duncan and Attorney General Loretta Lynch.

President Obama declares July 28 World Hepatitis Day
President Obama declared July 28 World Hepatitis Day in an announcement released earlier this week. Noting that more than 1 million people die annually from viral hepatitis infections, the press release expresses the importance of regular testing to detect the disease early. The proclamation cites recent gains in terms of access to testing and treatment. The proclamation also notes more work is needed to reduce the disparities observed between minorities in treatment and mortality rates.

AMA taskforce announces plans to encourage physicians to register for State-based PDMP programs
An American Medical Association (AMA) task force has announced plans to encourage physicians to register for and use State-based prescription drug monitoring programs (PDMPs) in an effort to reduce rates of opioid use disorders across the country. The AMA Task Force to Reduce Opioid Abuse is made up of 27 physician organizations, including the AMA, American Osteopathic Association, the American Dental Association, and a number of other specialty and State-based medical societies. The task force will initially focus on educating physicians and other medical professionals on the benefits of using PDMP programs when considering treatment plans for patients. The AMA has also created a webpage dedicated to providing physicians with resources aimed at increasing knowledge and awareness about PDMP programs.

House Energy and Commerce Committee approves PDMP reauthorization bill with language to help promote collaboration with State substance abuse agencies
On Wednesday, July 29, the Full House Energy and Commerce Committee considered and approved H.R. 1725, the National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization Act of 2015.  The author of the bill is Representative Ed Whitfield (R-KY) and co-sponsors include Representatives Kennedy (D-MA), Buscon (R-IN), and Pallone (D-N.J.).  The Chairman of the Full House Energy and Commerce Committee is Rep. Upton (R-MI) and the Ranking Member is Rep. Frank Pallone (D-NJ).  The Energy and Commerce Subcommittee on Health approved the bill last week.

The bill seeks to continue the momentum gained by States on issues related to data interoperability by requiring applicants for NASPER funds to include certain information in their application.  For example, H.R. 1725 requires applicants to report the extent to which the PDMP program is able to share information with other health IT systems such as e-prescribing systems, health information exchanges and electronic health records systems.

Coordination with NASADAD members:  The NASPER Reauthorization Act of 2015, under Section (h), the “Education and Access to the Monitoring Section,” requires States receiving NASPER funding to “…facilitate linkage to the State substance abuse agency and substance use disorder services.”  Additional language regarding State substance abuse agencies is included in a section requiring the release of a federal report not later than three years after federal funds are first appropriated under NASPER.  This report, among other issues, must include an analysis of the “…extent to which the operation of controlled substance monitoring programs have reduced inappropriate use, abuse, or diversion of controlled substances, established or strengthened initiatives to ensure linkages to substance use disorder services” and other matters.

Federal appropriations for NASPER would still need to be approved: In order for grants to move forward under NASPER, Congress would have to consider and pass federal funding for the bill.  The bill authorizes $10 million for this purpose.  Successful applicants would receive funds based on a formula.  No FY 2016 funds were proposed to be directed to NASPER by the Administration, Senate or House Appropriations Committees.

Representative Whitfield promoting collaboration between NASPER and Hal Rogers Program: Last week, during the Subcommittee consideration, Rep. Whitfield, noted how work to reauthorize NASPER has been moving forward for a number of years.  He also noted other programs that help support PDMPs are housed in the Department of Justice (DOJ) and Centers for Disease Control and Prevention (CDC). He expressed his hope that work could be done to develop and adopt an amendment to NASPER to help coordinate these efforts.  No amendment was announced during the Full Committee mark-up although amendments may be considered on the House floor should a rule be adopted to allow for this to move forward.

House Energy and Commerce Committee Considers and Approves H.R. 1462, the Protecting Our Infants Act
On Wednesday, July 29, the Full House Energy and Commerce Committee considered and approved H.R. 1426, the Protecting Our Infants Act authored by Representatives Katherine Clark (D-MA) and Steve Stivers (R-OH).  The author in the Senate is Majority Leader Mitch McConnell (R-KY).  The bill would authorize the Secretary of HHS, through the Agency for Healthcare Research and Quality (AHRQ) to conduct a study and develop recommendations for preventing and treating prenatal opioid abuse and NAS.  The bill would also authorize the Secretary of HHS to lead a review of planning and coordination efforts across HHS.  Finally, the legislation would require the Centers for Disease Control and Prevention (CDC) to offer technical assistance to States to improve the availability and quality of data related to NAS.

View a NASADAD two pager on the Protecting Our Infants Act here.

View a NASADAD two pager on NAS here.

View a NASADAD statement on the Use of Medications for substance use disorders here.

Next Steps for Both Bills
The two bills will now move forward to the House for further consideration.  We are not aware of a specific date for this next step.

Additional Resources
View the Committee’s Majority Staff backfround memo on the bills here.

View the opening statement by Rep. Pitts from last week here.

View the opening statement for today’s mark up by Rep. Pallone here.

View the opening statement by Rep. Upton here.

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

News from NASADAD

• NASADAD delivers President’s Award to Bob Glover, Executive Director of National Association of State Mental Health Program Directors (NASMHPD)
• NASADAD attends Capitol Hill briefing on benefits of prevention
• NASADAD attends Capitol Hill briefing on hepatitis prevention and treatment
• NASADAD attends Capitol Hill briefing on criminal justice reform

Around the Agencies

• New GAO study finds 17 percent of low-income, uninsured adults have mental health or substance use disorders
• Carlos Blanco appointed to lead NIDA’s Division of Epidemiology, Services, and Prevention Research

In the News

• NAMSDL releases new reports on medicinal and legal marijuana legislation
• Washington, D.C. plans new campaign to fight underage drinking
• Faces & Voices of Recovery announce the addition of H. Westley Clark, Jan Brown, Stacia Murphy, and Sis Wenger to Board of Directors
• House Energy and Commerce Committee approves PDMP authorization bill with language to help promote collaboration with State substance abuse agencies
• House Energy and Commerce Subcommittee Committee considers and approves H.R. 1462, the Protecting Our Infants Act

News from NASADAD

NASADAD delivers President’s Award to Bob Glover, Executive Director of National Association of State Mental Health Program Directors (NASMHPD)
On Friday, July 17, NASADAD Executive Director Robert Morrison (pictured on the right) presented Bob Glover (left) with an award for his decades of service to State Mental Health Authorities in particular, and the public mental health service system in general, as Executive Director of NASMHPD. Dr. Glover has served NASMHPD as Executive Director since 1993. In addition, Dr. Glover led State mental health service delivery systems in States such as Maine, Colorado, Ohio, and Pennsylvania. Mark Stringer, State Director of Missouri and past-President of NASADAD, chose to honor Glover before stepping aside as Board Chair in June 2015. The award was announced during NASADAD’s Annual Meeting held in Charleston, South Carolina. After presenting the award, Robert Morrison then met with Dr. Glover and Brian Hepburn, MD, the new Executive Director of NASMHPD, to share priorities and talk about continued collaboration of the two Associations.

NASADAD attends Capitol Hill briefing on benefits of prevention
On Thursday, July 16, Robert Morrison, Executive Director attended a Capitol Hill briefing sponsored by the National Coalition on Health Care (NCHC) titled “Bending the Health Care Cost Curve: The Role of Investments in Prevention.” The speakers included David Dobbins, Chief Operating Officer, the Legacy Institute; Rich Hamburg, Deputy Director, Trust for America’s Health (TFAH); and Chris Hansen, President, American Cancer Society’s Cancer Action Network. The speakers outlined issues from their organizations’ particular perspectives with an emphasis on prevention and cancer in particular. Rich Hamburg of TFAH discussed recent actions taken by his organization, including an initiative that examines obesity in the United States. As many NASADAD members recall, TFAH has dedicated many resources to addressing the opioid issue as well. For example, in 2013, TFAH issued Prescription Drug Abuse: Strategies to Stop the Epidemic that included a number of NASADAD-supported recommendations – including the benefits of investing in substance use disorder treatment, prevention, and recovery services.

To learn more about the Legacy Institute, click here.

To learn more about the Cancer Action Network, click here.

To learn more about the Trust for America’s Health (TFAH), click here.

To learn more about the National Coalition on Health Care (NCHC), click here.

NASADAD attends Capitol Hill briefing on hepatitis prevention and treatment
On Tuesday, July 21, Brian Denten, Public Policy Intern, attended a Congressional briefing on hepatitis prevention and treatment hosted by the Hepatitis Foundation International. The briefing focused on the prevalence of hepatitis throughout the United States and the disparities in diagnosis and treatment within minority populations. Hepatitis currently affects more than 5.3 million Americans, yet 3 in 4 with viral hepatitis do not know they are infected. Viral hepatitis and its variations disproportionately affect African-American, Latino, and Asian-American communities compared to the general population; with 3 percent of African-Americans and 2.6 percent of Latinos having hepatitis C compared to the national average of 1.5 percent, and Asian-Americans accounting for more than half of the country’s chronic hepatitis B population despite making up less than 5 percent of the total U.S. population.

The briefing heard from several advocates representing each minority group, reinforcing the need for a comprehensive strategy for reducing the spread of hepatitis among minority populations. From 2010-2013, diagnoses of acute hepatitis C rose over 150% as a result of injection drug use among white and adolescent populations. The Centers for Disease Control and Prevention (CDC) is currently developing two projects to address the rise of hepatitis C among this group. Pending legislation such as The Viral Hepatitis Testing Act would authorize more than $80 million over three years to “create the first comprehensive national system to combat viral hepatitis, in addition to enhancing and strengthening surveillance, education, testing, and linkage to care for at-risk Americans.”

Speakers:

• Representative Brett Guthrie (R-KY)
• Ivonne Fuller Cameron; CEO, Hepatitis Foundation International
• John Ward; Director of Hepatitis, CDC
• J. Nadine Garcia; Director of Minority Health, HHS
• Nicole Smith; Associate Director, Division of Viral Hepatitis, CDC
• Rui Grabowski; HFI North Carolina Patient Ambassador
• Mollie B. Jackson-Woodson; HFI Maryland Patient Ambassador

To learn more about activities moving forward on Hep C by our sister Association, the National Alliance of State and Territorial AIDS Directors, visit here.

NASADAD attends Capitol Hill briefing on criminal justice reform

The briefing, held on Thursday, July 23, was attended by Brian Denten, Public Policy Intern. The briefing was hosted by the American Conservative Foundation, the American Coalition for Criminal Justice Reform, and Families Against Mandatory Minimums. Several speakers and formerly incarcerated individuals spoke about the need for broad structural reform of mandatory minimum sentencing laws and the creation of programs within prisons to reduce recidivism. Representative Jim Sensenbrenner (R-WI) opened the briefing with a discussion of how the federal prison population has risen substantially in recent decades despite an overall decrease in crime rates. Rep. Sensenbrenner stated that the current criminal justice system lacks the ability to rehabilitate non-violent offenders, leading to high rates of recidivism throughout the country.

Speakers:

• Representative F. James Sensenbrenner, Jr.
• David Keene; Opinion Editor, Washington Times
• Pat Nolan; Director, Center for Criminal Justice Reform, American Conservative Union Foundation
• Bernard Kerik; Director and Founder, American Coalition for Criminal Justice Reform
• Kevin Ring; Director of Strategic Initiatives, Families Against Mandatory Minimums
• Moderator: Molly Gill; Government Affairs Counsel, Families Against Mandatory Minimums

Around the Agencies

New GAO study finds 17 percent of low-income, uninsured adults have mental health or substance use disorders
The U.S. Government Accountability Office (GAO) released a new report this week examining the prevalence of mental health and substance use disorders among low-income and uninsured adults. Using data from 2008-2013, the study found that “approximately 17 percent of low-income, uninsured adults (3 million) had a behavioral health condition, defined as a serious mental illness, a substance use condition, or both.” The GAO notes that the frequency of each respective condition varies substantially at the State level – with Indiana, Wisconsin, Idaho, Ohio, and North Dakota having the highest rates of serious mental illness, and Rhode Island, Alaska, Ohio, Indiana, and North Dakota having the highest rates of substance use disorders among the low-income, uninsured adult population.

Carlos Blanco appointed to lead NIDA’s Division of Epidemiology, Services, and Prevention Research
Carlos Blanco, M.D., Ph.D., has been appointed to lead the National Institute on Drug Abuse’s (NIDA) Division of Epidemiology, Services, and Prevention Research. This division concentrates on improving public health through the support of research investigating the patterns and effects of substance use disorders, in addition to advocating for evidence-based treatment practices. Dr. Blanco currently works as a professor of psychiatry at Columbia University Medical Center, and is nationally recognized as an expert in treating co-occurring substance use and mental health disorders. His past notable research accomplishments include an extensive examination of the different stages of substance use disorders, the development of research methods to improve clinical trials, and the testing of various evidence-based treatment theories. Dr. Blanco’s research recently found that individuals in recovery from a substance use disorder are not at increased risk of developing a new substance use disorder for a different drug.

In the News

NAMSDL releases new reports on medicinal and legal marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) released a series of new reports on medicinal, legal, and illegal marijuana legislation. The reports summarize ongoing and future efforts to regulate both the medical marijuana and legal marijuana industries at the State level. Four reports are available, summarizing legislation dealing with: medicinal use of marijuana (including low-THC / high cannabinoid products), “follow-up” legislation in States that have legalized the personal usage of marijuana (Alaska, Colorado, D.C., Oregon, and Washington), the usage of marijuana in States with ongoing legalization efforts, and legislative efforts to decriminalize or lower penalties for illicit, personal non-medical use.

Washington, D.C. plans new campaign to fight underage drinking
Washington D.C. Mayor Muriel Bowser announced a new campaign to fight underage drinking this past week. The campaign, titled “There’s a Reason,” will be coordinated by the D.C. Department of Behavioral Health using federally provided funding. A 2012 D.C. Department of Health study examining underage drinking found that nearly a quarter of D.C. youth consume alcohol before age 13, and that 6 percent of boys 11 or younger have tried alcohol. The survey also found that alcohol is more commonly used within D.C.’s middle schools than marijuana and other illicit substances; with approximately 31 percent of adolescents entering high school stating they drank an alcoholic beverage in the past month.  The campaign plans to target parents through educational pamphlets and additional outreach activities, and will primarily focus on people under the age of 18 rather than D.C.’s large college student population.

Faces & Voices of Recovery announce the addition of H. Westley Clark, Jan Brown, Stacia Murphy, and Sis Wenger to Board of Directors

Faces & Voices of Recovery (FAVOR) has announced the addition of four new members to the foundation’s Board of Directors: H. Westley Clark, Jan Brown, Stacia Murphy, and Sis Wenger.

• Westley Clark, M.D., J.D., M.P.H., CAS, FASAM: Dr. Clark currently serves as the Dean’s Executive Professor of Public Health at Santa Clara University in Santa Clara, California. Dr. Clark formerly served as the Director of the Center for Substance Abuse Treatment (CSAT) at the Substance Abuse and Mental Health Services Administration (SAMHSA) where he focused on expanding access to treatment for Americans with substance use disorders. Dr. Clark has also served as the former chief of the Associated Substance Abuse Programs at the U.S. Department of Veterans Affairs Medical Center in San Francisco, California; as senior program consultant to the Robert Wood Johnson Foundation Substance Abuse Policy Program; and as co-investigator on several National Institute on Drug Abuse (NIDA) research grants.
• Jan Brown: Jan Brown currently works as the Founding/Executive Director of Spiritworks Foundation Center for Recovery of the Soul located in Williamsburg, Virginia. Ms. Brown is in long-term recovery from her own substance use disorder, and is certified as a Recovery Support Specialist in addition to being one of four people in the country certified as a Master Recovery Life Coach. Ms. Brown was recently appointed to the Governor of Virginia’s Task Force on Prescription Drug and Heroin Abuse.
• Stacia Murphy: Stacia Murphy previously served as the appointed President of the National Council on Alcoholism and Drug Dependence (NCADD) from September 1999 to January 2006. Prior to working with NCADD, Ms. Murphy gained considerable experience working as a community organizer with young adults and adolescents in East and West Harlem and Brooklyn, New York. Additionally, Ms. Murphy worked as a member of the National Institute on Alcoholism and Alcohol Abuse from 2000 to 2006 and as a member of the steering community work group at SAMSHA.
• Sis Wenger: Sis Wenger has worked as the President and CEO of the National Association for Children of Alcoholics (NACoA) for the last 21 years. At NACoA, Ms. Wenger has worked as an advocate and researcher for policy issues related to alcohol use disorders. Ms. Wenger previously served as the lead developer of SAMHSA’s Children’s Program Kit – a tool created for school prevention and treatment programs for children with parents struggling with substance use disorders.

House Energy and Commerce Committee approves PDMP authorization bill with language to help promote collaboration with State substance abuse agencies
On Thursday July 23, the House Energy and Commerce Committee considered and approved H.R. 1725, the National All Schedules Prescription Electronic Reporting (NASPER) Reauthorization Act of 2015. The author of the bill is Representative Ed Whitfield (R-KY) and co-sponsors include Representatives Kennedy (D-MA), Buscon (R-IN), and Pallone (D-N.J.). The Chairman of the House Energy and Commerce Subcommittee on Health is Joe Pitts (R-PA) and the Ranking Member of the Subcommittee is Gene Green (D-TX). The bill seeks to continue the momentum gained by States on issues related to data interoperability by requiring applicants for NASPER funds to include certain information in their application. For example, H.R. 1725 requires applicants to report the extent to which the PDMP program is able to share information with other health IT systems such as e-prescribing systems, health information exchanges, and electronic health records systems.

Coordination with NASADAD members: The NASPER Reauthorization Act of 2015, under Section (h), the “Education and Access to the Monitoring Section,” requires States receiving NASPER funding to “…facilitate linkage to the State substance abuse agency and substance use disorder services.” Additional language regarding State substance abuse agencies is included in a section requiring the release of a federal report not later than three years after federal funds are first appropriated under NASPER. This report, among other issues, must include an analysis of the “…extent to which the operation of controlled substance monitoring programs have reduced inappropriate use, abuse, or diversion of controlled substances, established or strengthened initiatives to ensure linkages to substance use disorder services,” and other matters.

Opening statements note importance of addressing opioid issue: In opening statements, a number of Subcommittee members commented on the impact of the opioid issue in their districts. Rep. Whitfield, for example, noted how work to reauthorize NASPER has been moving forward for a number of years.  He also noted that other programs that help support PDMPs are housed in the Department of Justice (DOJ) and Centers for Disease Control and Prevention (CDC). He expressed his hope that work could be done to help coordinate these efforts. Representatives Upton, Pallone, and Pitts echoed their own concerns with the opioid issue and the need for action. Rep. Kennedy dedicated his time to telling a story that seems representative of thousands of others across the country where the use of opioid pain relievers leads to addiction, overdose, and ultimately death.

House Energy and Commerce Subcommittee Committee considers and approves H.R. 1462, the Protecting Our Infants Act
On Thursday, July 23, the House Energy and Commerce Subcommittee on Health considered and approved H.R. 1426, the Protecting Our Infants Act authored by Representatives Katherine Clark (D-MA) and Steve Stivers (R-OH). The author in the Senate is Majority Leader Mitch McConnell (R-KY). The bill would authorize the Secretary of the Department of Health and Human Services (HHS), through the Agency for Healthcare Research and Quality (AHRQ) to conduct a study and develop recommendations for preventing and treating prenatal opioid abuse and NAS. The bill would also authorize the Secretary of HHS to lead a review of planning and coordination efforts across HHS. Finally, the legislation would require the Centers for Disease Control and Prevention (CDC) to offer technical assistance to States to improve the availability and quality of data related to NAS.

View a NASADAD two pager on the Protecting Our Infants act here.

View a NASADAD two pager on NAS here.

View NASADAD’s statement on the Use of Medications for substance use disorders here.

Next Steps for Both Bills
The full Energy and Commerce Committee is expected to consider both bills. This could take place as early as next week. The Chairman of the Full Energy and Commerce Committee is Fred Upton (R-MI) and the Ranking Member is Frank Pallone (D-N.J.).

Additional Resources

To see the Committee’s background memo on the bills, please visit here.

To see the opening statement by Rep. Pitts, please visit here.

To see the opening statement by Rep. Upton, please visit here.

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