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 Congressional briefing on introduction of the Mental Health Reform Act of 2015
• NASADAD attends Alliance for Health Reform briefing on the intersection of health and housing

News from the States

• Ohio encourages Medicaid sign-ups for inmates
• Ohio State University Office of Student Life pilots MAT program for students
• New Jersey Division of Mental Health and Addiction Services announces Valerie L. Mielke as new Assistant Commissioner

Around the Agencies

• CDC report examines alcohol-impaired driving among adults in 2012

In the News

• Senator Kelly Ayotte (R-NH) delivers speech on heroin problem

Upcoming Events

• Institute for Research, Education & Training in Addictions (IRETA) announces SBIRT webinar
• SAMHSA announces webinar on strategies for referral to specialty mental health and substance use disorder services
• College of Psychiatric and Neurologic Pharmacists announces webinar on increasing pharmacy access to naloxone

News from NASADAD

NASADAD attends Congressional briefing on the Mental Health Reform Act of 2015

Brian Denten, Public Policy Intern, attended the briefing held on Tuesday, August 4^th. The briefing served as the announcement of the “Mental Health Reform Act of 2015,”new legislation introduced by Senators Bill Cassidy (R-LA) and Chris Murphy (D-CT). The bill aims to increase access to treatment, improve treatment delivery, and expand treatment to underserved populations. Specifically, the legislation authorizes new grant programs for the integration of primary care and mental health, early intervention programs, designates a new Assistant Secretary for Mental Health and Substance Use within the U.S. Department of Health and Human Services (HHS), establishes a Serious Mental Illness (SMI) Coordination Committee under the Assistant Secretary, and contains provisions regarding mental health parity and the IMD exclusion. The legislation includes language regarding HIPAA as well. NASADAD will work to develop and release a “Section-by-Section” overview of the bill in the coming weeks.

Read Senator Murphy’s press release about the legislation here: http://www.murphy.senate.gov/newsroom/press-releases/cassidy-murphy-introduce-comprehensive-overhaul-of-mental-health-system

 

NASADAD attends Alliance for Health Reform briefing on the intersection of health and housing

Brian Denten, Public Policy Intern, attended the briefing held on Friday, August 7^th. The briefing included several speakers working with non-profit organizations, State agencies, and federal agencies that aim to improve healthcare outcomes by increasing access to safe housing for underserved populations. Several speakers noted the cycle between poor health and homelessness, as mental health and substance use disorders are often further aggravated by a lack of housing. Panelists advocated for increased funding for supportive housing initiatives and enhanced communication between Medicaid and agencies working with populations dealing with a lack of housing.

Panelists:

• Barbara DiPietro; National Health Care for the Homeless Council
• Jennifer Ho;S. Department of Housing and Urban Development
• Gretchen Hammer; Colorado Department of Health Care Policy & Financing
• Sister Adele O’Sullivan; Circle the City, Arizona

 

News from the States

Ohio encourages Medicaid sign-ups for inmates

Three State agencies in Ohio have started a program to enroll inmates in Medicaid following their release from the criminal justice system. 21,000 inmates are released in Ohio each year, yet many face difficulty continuing treatment for mental health or substance use disorders due to long processes at the county level. With the State’s expansion of Medicaid, inmates are able to begin signing up for Medicaid up to 90 days before leaving prison. Obtaining a Medicaid card will allow ex-offenders to continue receiving treatment as soon as they are released. Prisons Chief Gary Mohr stated to the Columbus Dispatch that the program is part of a broader mission to reduce recidivism throughout Ohio. A separate initiative in Ohio’s criminal justice system is working to double the 4,600 inmates currently enrolled in substance use disorder treatment programs in an additional effort to reduce recidivism. Officials hope to complete preliminary sign-up programs at all State prisons by the end of 2015.

Read more about this story here: http://www.dispatch.com/content/stories/local/2015/07/27/medicaid-prison-signups.html

 

Ohio State University Office of Student Life pilots MAT program for students

The Ohio State University Office of Student Life will now offer comprehensive therapeutic and Medication-Assisted Treatment (MAT) services for students in or seeking substance use disorder recovery through a pilot program beginning this fall. NASADAD spoke with Sarah Nerad, Program Manager of the Collegiate Recovery Community, about some of the University’s current and future plans to improve recovery services for OSU students.

The Ohio State University currently has a Collegiate Recovery Community (CRC) that supports all students in or seeking recovery. The CRC provides specific programming in addition to a supportive network of peers to aid the recovery process. The CRC maintains a 28 bed residence hall and has two full-time employees dedicated to running the program. A separate 2,000 square foot space exists as the dedicated CRC location for weekly meetings, recreational activities, and a place to find peer-to-peer support. The program offers scholarships, individualized recovery plans, and professional and leadership development for students. Students signing up as official members of the CRC receive eligibility for scholarship funding, priority course registration, and access to special events. The program has primarily grown through word-of-mouth among students, although academic advisors and other university staff have begun referring students to the program.

Since the inception of the CRC in 2013, the Ohio State Office of Student Life has worked on implementing a Good Samaritan policy; is establishing screening, brief intervention, and referral to treatment (SBIRT) initiatives across campus; and has taken steps  to provide comprehensive therapeutic MAT services for students with substance use disorders. Starting this fall, a pilot program will offer full MAT services to eligible students. This is a partnership between three Student Life departments: Student Health Services, Counseling and Consultation Services, and the Collegiate Recovery Community. The program will include access to a variety of FDA-approved medications complemented by weekly counseling, random drug testing, and other evidence-based MAT practices. Students eligible to apply for the program will need to be on a stable dose of their medication for at least one year. The pilot program will begin with a handful of students before gradually increasing capacity over the next several years.

OSU’s CRC is a partner of the Higher Education Center for Alcohol and Drug Misuse Prevention and Recovery (HECAOD). They are hosting the 2015 National Meeting from August 4-6, 2015 in Columbus, Ohio. The conference will focus on AOD prevention, prescription drug misuse, and collegiate recovery. HECAOD is a national organization that helps colleges provide and manage prevention and recovery programs. Recently, HECAOD has focused on increasing the prevalence of SBIRT models in universities across the country.

Read more about the OSU CRC here: http://go.osu.edu/recovery

Read more about HECAOD and their upcoming conference here: http://hecaod.osu.edu/events/national-meeting/

New Jersey Division of Mental Health and Addiction Services announces Valerie L. Mielke as new Assistant Commissioner

Valerie L. Mielke, MSW, has been appointed Assistant Commissioner of the New Jersey Division of Mental Health and Addiction Services, effective August 1^st. Previously, Lynn Kovich had been Assistant Commissioner since 2011. NASADAD recognizes Ms. Kovich for her contributions to the Association in a number of areas.

Read a letter from Ms. Kovich discussing her time as Assistant Commissioner here: http://www.mhanj.org/lynn-kovichs-letter-to-stakeholders/

 

Around the Agencies

CDC report examines alcohol-impaired driving among adults in 2012

The Centers for Disease Control and Prevention (CDC) released a new report this week examining rates of alcohol-impaired driving throughout the United States in 2012. Using data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS), the report finds that “an estimated 4.2 million U.S. adults reported driving while impaired by alcohol at least once in the preceding 30 days, resulting in an estimated 121 million alcohol-impaired driving episodes annually, and a national rate of 505 episodes per 1,000 population.” The report finds substantial variation in alcohol-impaired driving rates between States – attributing this variation to differences between alcohol consumption and State prevention campaigns.

Read the full report here: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6430a2.htm?s_cid=mm6430a2_e

 

In the News

Senator Kelly Ayotte (R-NH) delivers speech on Senate floor discussing heroin epidemic

Senator Kelly Ayotte (R-NH) delivered a speech on the Senate floor discussing the heroin epidemic in New Hampshire along with her proposed legislation to increase access to naloxone and prescription drug monitoring programs this past week. Sen. Ayotte highlighted her participation in ride-alongs with the Manchester Fire Department, during which she observed first responders using naloxone to reverse heroin overdoses. Sen. Ayotte and several other Senators have introduced legislation aiming to combat the opioid epidemic through increased access to treatment and reform of current prescribing practices. The Comprehensive Addiction and Recovery Act would increase the availability of naloxone to first responders and law enforcement, in addition to enhancing treatment options for incarcerated individuals with substance use disorders. The Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act reauthorizes prescription drug monitoring programs and creates an interagency task force to determine best practices for prescribing opioid pain medication.

Read more about Sen. Ayotte’s speech, and watch a video here: https://www.ayotte.senate.gov/?p=press_release&id=2119

Read a NASADAD overview of the Comprehensive Addiction and Recovery Act here: http://nasadad.org/2015/03/comprehensive-addiction-and-recovery-act-of-2015-s-524h-r-953-a-section-by-section-analysis/

 

Upcoming Events

Institute for Research, Education & Training in Addictions (IRETA) announces SBIRT webinar

The Institute for Research, Education & Training in Addictions has announced a new webinar discussing screening, brief intervention, and referral to treatment (SBIRT) best practices. The webinar will evaluate the efficacy of various SBIRT programs and examine the evidence behind utilizing SBIRT as a mechanism for treatment. The webinar will be hosted by Richard Brown, MD, MPH, a professor in the Department of Family Medicine, School of Medicine, and Public Health at the University of Wisconsin. In addition to conducting NIH-funded research, Dr. Brown currently serves as the Director for the Wisconsin Initiative to Promote Health Lifestyles and worked as the President of the Association for Medical Education and Research in Substance Abuse (AMERSA) from 1997 to 1999. The webinar will be held on Wednesday, August 26, 2015 from 1-2:30 PM EST.

Read more, and register for the webinar here: http://ireta.org/improve-practice/addiction-professionals/webinars/?utm_source=iContact&utm_medium=email&utm_campaign=IRETA&utm_content=

 

SAMHSA announces webinar on strategies for referral to specialty mental health and substance use disorder services

The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced a new webinar on best practices for referring patients to specialty mental health and substance use disorder services. This webinar will discuss best practices for referring patients from primary care to specialty mental health and substance use disorder services, particularly as they relate to Patient-Centered Medical Homes and providers adopting screening, brief intervention, and referral to treatment (SBIRT).  The webinar will be held on Wednesday, August 19, 2015 at 2:30 PM EST.

Read more, and register for the webinar here: https://goto.webcasts.com/starthere.jsp?ei=1072566

 

College of Psychiatric and Neurologic Pharmacists announces webinar on increasing pharmacy access to naloxone

The College of Psychiatric and Neurologic Pharmacists (CPNP) announced an upcoming webinar discussing increasing pharmacy access to naloxone. As prescription opioid and heroin overdoses continue to rise across the country, many communities have demonstrated success in using naloxone to reverse overdoses and save lives. Because naloxone remains a prescription medication, pharmacists play an essential role in increasing access to naloxone across the country. This webinar will discuss the usage of Communities with Overdose Education and Naloxone Distribution (OEND) programs to improve opioid overdose prevention and treatment. Several speakers will comment on their personal experiences with implementing OEND programs in their respective areas. The webinar will be held Thursday, August 13, 2015 from 8-9 PM EST.

Read more, and register for the webinar here: https://cpnp.org/ed/university/course/putting-naloxone-action

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.

News from the States

• Mark Stringer (NASADAD Immediate Past President, MO) appointed new Director for the Missouri Department of Mental Health

Around the Agencies

• SAMHSA report finds gaps in mental health and substance use disorder treatment among minorities and people without health insurance
• SAMHSA report finds consistent decline in underage drinking from 2002 to 2013
• VA and DoD develop continuing education course for health care professionals working with veterans

In the News

• White House releases new fact sheet on enhancing the fairness and effectiveness of the criminal justice system
• New National Academies of Sciences, Engineering, and Medicine report suggests new psychosocial interventions for people with mental health and substance use disorders
• ONDCP Director Michael Botticelli publishes blog post about Conner Adams, a young woman in recovery
• Center for Substance Abuse Research publishes study finding national treatment admissions for heroin at highest recorded level

Upcoming Events

• SAMHSA’s Center for Integrated Health Solutions announces webinar on trauma-informed care
• Congressional Addiction Forum focusing on veterans’ treatment announced for July 29^th
• The National SBIRT ATTC announces new webinar on the relationship between LGBTQ populations and substance use

News from the States

Mark Stringer (NASADAD Immediate Past President, MO) appointed new Director for the Missouri Department of Mental Health
Former NASADAD president Mark Stringer began his new job as Director of the Missouri Department of Mental Health this past week. Stringer previously worked for eight years as the Director of the Division of Behavioral Health, in addition to more than 28 years of experience in the mental health field. Speaking in an interview with the Mid-Missouri public radio station KBIA, Mr. Stringer states that his priorities as Director include building a new State hospital, developing a proper treatment model for people with developmental disabilities and serious mental illness, and securing additional funding for mental health and substance use disorder treatment programs to ensure all Missouri residents have access to treatment. Mr. Stringer is excited to begin his work as Director by visiting State hospitals, rehabilitation centers, and contracted agencies to better understand the full scope of his post.

Around the Agencies

SAMHSA report finds gaps in mental health and substance use disorder treatment among minorities and people without health insurance
A new Substance Abuse and Mental Health Services Administration (SAMHSA) report has found mental health and substance use disorder treatment gaps among minority populations and individuals without health insurance. The “Behavioral Health Equity Barometers” tracks the mental health and substance use disorder treatment of youth and adults by demographics and insurance status on an annual basis. This year’s report found that “approximately 41.6 percent of White adolescents received treatment for depression in the past year, while only 36.9 percent of Hispanic or Latino adolescents and 28.6 percent of Black adolescents received similar treatment.” The report further states that adults without health insurance were more likely to have a dependence on alcohol than those adults with insurance (9.7 percent versus 6.0 percent). Adults without insurance were also significantly less likely to receive proper mental health treatment.

SAMHSA report finds consistent decline in underage drinking from 2002 to 2013
The Substance Abuse and Mental Health Services Administration (SAMHSA) released a new report this past week finding a steady decline in underage drinking from 2002 to 2013. Although alcohol remains the most commonly used substance among adolescents aged 12 to 20, underage drinking among this population decreased from 28.8 percent in 2002 to 22.7 percent in 2013. Youth binge drinking rates similarly declined throughout this period, declining from 19.3 percent in 2002 to 14.2 percent in 2013. The report credits increased parental involvement and national prevention efforts for the observed decreases in underage drinking, yet notes that much work remains to be done.

VA and DoD develop continuing education course for health care professionals working with veterans
The United States Department of Veteran Affairs (VA) and Department of Defense (DoD) developed a new online continuing education course titled “Military Culture: Core Competencies for Health Care Professionals.” The free course aims to help health care professionals better understand the military experiences of veteran patients in order to provide more effective treatment. The course is part of the larger Veterans Choice Program’s effort to increase the quality of health care for veterans across the country.

In the News

White House releases new fact sheet on enhancing the fairness and effectiveness of the criminal justice system
The White House released a new fact sheet on enhancing the fairness and effectiveness of the criminal justice system this past week. The fact sheet compiles a list of policy proposals President Obama recently announced – including sentencing reforms, the re-integration of prisoners post-incarceration into society, community trust in local law enforcement, and juvenile justice. The White House states that “unwarranted disparities and unduly harsh sentences undermine trust in the rule of law and offend the basic principles of fairness and justice.” The Obama Administration hopes that Congress will act on the proposals outlined in this fact sheet to create broad, structural criminal justice reform.

New National Academies of Sciences, Engineering, and Medicine report suggests new psychosocial interventions for people with mental health and substance use disorders
A new report from the National Academies of Sciences, Engineering, and Medicine suggests a new framework for psychosocial interventions in clinical practices for individuals with mental health or substance use disorders. The report suggests that the Department of Health and Human Services (HHS) adopt the outlined framework in order to ensure a consistently high level of care for patients. The framework notes that while many providers are aware of best intervention practices, these practices are rarely utilized in treatment. The National Academies of Sciences, Engineering, and Medicine hopes the framework outlined in the report will help bridge this treatment gap.

ONDCP Director Michael Botticelli publishes blog post about Conner Adams, a young woman in recovery
The Office of National Drug Control Policy (ONDCP) Director Michael Botticelli published a blog post on the White House this week regarding a correspondence between Conner Adams, a young woman in recovery, and President Barack Obama. Botticelli published the post in the wake of President Obama’s commuting of 46 sentences of prisoners convicted of non-violent crimes. The blog post features the letter Conner Adams wrote to President Obama about her own path towards recovery. Adams writes of the importance of second chances and access to treatment, noting the importance that proper treatment had in helping her establish a successful life. President Obama praises Ms. Adams’ progress in his response, stating that her experience is an example of the effect treatment programs can have. The Obama Administration remains committed to advocating for evidence-based solutions that recognize substance use disorders as a medical condition rather than a moral failing.

Center for Substance Abuse Research publishes study finding national treatment admissions for heroin at highest recorded level
The Center for Substance Abuse Research published a new study this past week finding national treatment admissions for heroin at their highest recorded level. The report states that “the percentage of admissions to State-funded substance use disorder treatment facilities citing heroin as a primary substance of abuse has reached the highest level since data collection began in 1992, according to the national Treatment Episode Data Set (TEDS).” Heroin admissions increased to 16% in 2012 from 14% in 2010, while admissions for other opiates remained at 9.7% in 2012 compared to 10.1% in 2011.

Upcoming Events

SAMHSA’s Center for Integrated Health Solutions announces webinar on trauma-informed care
The Substance Abuse and Mental Health Services Administration (SAMHSA)’s Center for Integrated Health Solutions (CIHS) announced a new webinar on trauma-informed care to be held on Wednesday July 29^th from 2-3:30 PM EST. The webinar will focus on methods for integrating trauma-informed approaches into primary care clinic practices. SAMHSA notes that trauma-informed care has the potential to improve patient engagement with health care providers to create better health outcomes. Simple steps that all clinics can take to become trauma-informed will be discussed throughout the webinar.

 

Congressional Addiction Forum focusing on veterans’ treatment announced for July 29^th
The next installment of the Congressional Addiction Forum – Advancing Treatment and Recovery for Veterans and Servicemembers – has been announced for Wednesday July 29^th from 2-4 PM EST. The forum will be hosted by the Addiction Policy Forum, and will feature discussion from stakeholders and policy makers involved in the veteran substance use disorder treatment process. Honorary co-hosts include Senator Sheldon Whitehouse (D-RI), Senator Rob Portman (R-OH), Senator Amy Klobuchar (D-MN), Senator Kelly Ayotte (R-NH), Senator Tammy Baldwin (D-WI), Senator Shelley Moore Capito (R-WV), Congressman Tim Ryan (D-OH), Congressman Steve Chabot (R-OH), Congressman Hal Rogers (R-KY), Congresswoman Tammy Duckworth (D-IL), Congressman Doug Collins (R-GA), and Congresswoman Anne Kuster (D-NH). The forum will be livestreamed over the internet.

The National SBIRT ATTC announces new webinar on the relationship between LGBTQ populations and substance use
The National SBRIT ATTC has announced a new webinar to be held on Wednesday, July 22 from 3-4 PM EST discussing the relationship between lesbian, gay, bisexual, and transgender (LGBTQ) populations and substance use. The webinar will examine the social geography of substance use among LGBTQ individuals, and address the ways substance use may relate to larger health disparities. SAMHSA studies suggest that LGBTQ populations use substances at higher rates than the general population yet enter treatment less frequently.

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 attends AAAS briefing on substance use disorders and incarceration

Around the Agencies

• Veterans Health Administration releases videos on the safe administration of naloxone
• CMS releases new infographic outlining five key steps for health care providers transitioning to ICD-10
• CDC releases new date showing increased heroin usage rates over the past 10 years
• New AHRQ report states that nearly one in three hospital stays in 2012 involved at least one mental or substance use disorder diagnosis
• Proposed CMS regulations for Medicare managed care seeks to alter the IMD exclusion

In the News

• Former Ohio Department of Alcohol and Drug Addiction Services Director Luceille Fleming passes away at age 91
• Alliance for Health releases new toolkit on telemedicine
• President Obama nominates Andy Slavitt for CMS administrator

Upcoming Events

• SAMHSA announces webinar discussing 42 CFR Part 2, the federal regulation governing drug and alcohol use treatment and prevention record confidentiality

News from NASADAD

NASADAD attends AAAS briefing on substance use disorders and incarceration
Brian Denten, Public Policy Intern, attended the briefing hosted by the American Association for the Advancement of Science (AAAS). Two prominent researchers concentrating on the science of substance use disorders spoke at the briefing, noting the high success rates of medication-assisted treatment (MAT) in treating individuals with substance use disorders. Both speakers spoke at length on the effect that substance use disorders have on the brain, suggesting that a combination of MAT and cognitive therapy is the best combination for successful treatment. Methadone, buprenorphine, and Vivitrol were all discussed as potential medication options for individuals struggling with opioid use disorders. The speakers recommended that the criminal justice system increase its effort to create substance use disorder treatment programs for individuals while they are incarcerated to prevent relapse among individuals exiting prison.

Speakers:

• Charles O’Brien, PhD; Vice-Chair of Pyschiatry at University of Pennsylvania and Director of the Prestigious Center for Studies in Addiction
• Joshua Lee, PhD; Assistant Professor in Medicine and Psychiatry at New York University Langone Medical Center
• Remarks: Representative Chaka Fattah (D-PA)

Around the Agencies

Veterans Health Administration releases videos on the safe administration of naloxone
The Department of Veterans Affairs, (VA) Veterans Health Administration released a new series of videos on the safe administration of naloxone. The series is available on YouTube, and describes the signs and symptoms of an opioid overdose and the proper method for administrating intranasal and intramuscular naloxone. A separate video displays how naloxone auto-injectors can also be used to reverse opioid-overdoses.

CMS releases new infographic outlining five key steps for health care providers transitioning to ICD-10
The Centers for Medicare & Medicaid Services (CMS) released a new infographic describing the procedure for health care providers transitioning to the ICD-10 diagnosis codes taking effect on October 1^st. The infographic describes five key steps to facilitate a smooth transition process that include staff training, the updating of processes, and the testing of systems. All health care providers covered by the Health Insurance Portability Accountability Act (HIPAA) are required to transition to ICD-10.

CDC releases new data showing increased heroin usage rates over the past ten years
The Centers for Disease Control and Prevention (CDC) released a new edition of the monthly Vital Signs publication this week. This month’s edition concentrates on changing trends and risk factors surrounding heroin use in the United States, finding that in the past ten years “heroin use has more than doubled among people who abused or were dependent on prescription opioid painkillers.” The issue further describes how groups with historically low rates of heroin use – including women, privately insured individuals, and high-income populations – have seen increased rates of heroin use in recent years. The groups at highest risk for heroin use disorders include “non-Hispanic whites, men, 18-to-25 year olds, persons with annual household incomes less than $20,000, people living in urban areas, Medicaid recipients, and the uninsured.” Heroin-related overdose deaths have almost quadrupled in the United States from 2002 to 2013, underlining the importance of determining a comprehensive approach to the heroin epidemic.

New AHRQ report states that nearly one in three hospital stays in 2012 involved at least one mental or substance use disorder diagnosis
A new Agency for Healthcare Research and Quality (AHRQ) report has found that nearly one in three hospital stays in 2012 involved at least one mental health or substance use disorder diagnosis – accounting for 8.6 million patients and 32.3 percent of inpatient stays. About 1.8 million inpatient stays were primarily for mental health or substance use disorders, with mood disorders being the most common mental health diagnosis and alcohol-related disorders being the most common substance use disorder diagnosis. Mental health and substance use disorder inpatient stays were on average longer (6.6 days for mental health and substance use disorders versus 4.8 days for other conditions), yet had lower average costs ($6,300  for mental health and substance use disorders versus $12,600 for other conditions).

Proposed CMS regulations for Medicare managed care seeks to alter the IMD exclusion
The Centers for Medicare and Medicaid Services (CMS) have proposed new rules that would alter the institutions of mental disease (IMD) exclusion. The proposed rules would update the managed care regulations for Medicaid and the Children’s Health Insurance Program (CHIP) to alter the prohibition on using federal Medicaid funding for adult mental health and substance use disorder treatment in institutions of mental disease (residential treatment facilities with more than 16 beds). Under the proposed rules, Medicaid managed care plans would be able to provide funding for adult IMD treatment for up to 15 days. In addition to providing funding for some IMD treatment, the proposed rules would require States to create quality ratings for all Medicaid and Children’s Health Insurance Program (CHIP) managed care plans to ensure plans meet federal standards. NASADAD is working with the Coalition for Whole Health to develop a sign-on letter in support of the proposed rules, along with the suggestion to remove the language limiting IMD stays to only 15 days. Comments are due on July 27, 2015, after which CMS will review the comments received, make changes, and respond with final regulations.

In the News

Former Ohio Department of Alcohol and Drug Addiction Services Director Luceille Fleming passes away at age 91
The former Director of Ohio’s Department of Alcohol and Drug Addiction Services, Luceille Fleming, recently passed away at age 91 following decades of service. Luceille led both Pennsylvania’s and Ohio’s substance use disorder agencies, working under six Governors in two separate States over the course of her career. Her forthright, charismatic leadership helped provide second chances for thousands of men and women. Ohio greatly expanded substance use disorder programs for women and juveniles and established new support groups in prisons – in addition to securing millions of dollars in federal grants for Ohio’s substance use disorder systems during her time as Director. Luceille retired from the Ohio Department of Alcohol and Addiction Services in 2003, receiving numerous State and national awards for her work including the esteemed National Governor’s Distinguished Service Award and induction into the Ohio Women’s Hall of Fame. Ms. Fleming was very active in NASADAD, serving on the NASADAD Board of Directors, including as Board Chair, and participating on the Public Policy Committee, Child Welfare Committee, and much more. Her family suggests donations in her memory be made to the Fleming House in Lisbon, Ohio, or the House of Hope and First Village in Columbus.

Alliance for Health releases new toolkit on telemedicine
Alliance for Health released a new toolkit focusing on the background and future of telemedicine this past week. The toolkit provides an overview of the policy implications and uses of telemedicine, as well as a variety of news articles examining telemedicine in greater detail. Alliance for Health notes that the field of telemedicine has greatly expanded in recent years as more rural and areas take advantage of telemedicine’s lower costs and easier accessibility. The toolkit was produced with support from the Robert Wood Johnson Foundation.

President Obama nominates Andy Slavitt for CMS administrator
President Obama nominated Andy Slavitt for the position of Centers for Medicare and Medicaid Services (CMS) administrator. Slavitt has worked as acting administrator of CMS since March 2015, previously working as an executive at Optum from 2012 to 2014. The former CMS administrator Marilyn Tavenner stepped down from the agency in February following nine years of service. Slavitt will continue to guide CMS through the implementation of the Affordable Care Act, including the issuance of rules on how insurers, pharmaceutical companies, and hospitals should operate under the legislation.

Upcoming Events

SAMHSA announces webinar discussing 42 CFR Part 2, the federal regulation governing drug and alcohol use treatment and prevention record confidentiality
The Substance Abuse and Mental Health Services Administration has announced a new webinar discussing 42 CFR Part 2 to be held on Tuesday, July 21 from 1-2 PM EST. The webinar aims to address and debunk common myths surrounding 42 CFR Part 2 – the federal regulation governing drug and alcohol use treatment and prevention record confidentiality. Several experts will speak on the application of 42 CFR Part 2 and the how adopting electronic health records and health information exchanges affects compliance.

Featured presenters include:

• Kate Tripping, JD; Public Health Advisor, SAMHSA
• Deborah Reid, JD; Senior Health Policy Attorney, Legal Action Center
• Katie O’Neill, JD; Consultant, Legal Action Center

 

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.