Category Archives: CapitolHill

The “Request” category describes the Administration’s proposed funding level for FY 2016. This is only a proposal.
The “House Report” category describes the full House Appropriations Committee’s proposed funding for FY 2016. The House column is labeled in green.
The “Senate Report” category describes the full Senate Appropriations Committee’s proposed funding for FY 2016. The Senate column is labeled in red.
A final decision regarding FY 2016 funding is not expected until fall.

Substance Abuse and Mental Health Services Administration (SAMHSA)

Agency	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
SAMHSA	$3,621,706,000	$3,621,212,000	$3,665,787,000	$3,642,710,000	$21,498,000 increase	$3,460,484,000	$160,728,000 decrease

Substance Abuse Prevention and Treatment (SAPT) Block Grant

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
SAPT Block Grant	$1,819,856,000	$1,819,856,000	$1,819,856,000	$1,819,856,000	Level funding	$1,769,856,000	$50,000,000 decrease

Substance Abuse Prevention and Treatment (SAPT) Block Grant: The House report calls for $1.820 billion for FY 2016, level funding compared to FY 2015. The Senate report calls for $1.770 billion, a decrease of $50 million compared to FY 2015. The Administration also requested level funding.

House Report Language: “The Committee includes bill language directing the Administrator of SAMHSA and the Secretary to exempt the Mental Health Block Grant and the Substance Abuse Prevention and Treatment Block Grant as a source for the PHS evaluation set-aside in fiscal year 2016. The Committee does not include the requested bill language allowing the Administrator to transfer three percent or less of funds between any of the SAMHSA accounts.”

Senate Report Language: “The Committee recommendation continues bill language that instructs the Administrator of SAMHSA and the Secretary to exempt the Mental Health Block Grant (MHBG) and the Substance Abuse Prevention and Treatment (SAPT) Block Grant from being used as a source for the PHS evaluation set-aside in fiscal year 2016, as was done prior to fiscal year 2012.”

“Formula Evaluation—The Committee understands that States are having difficulty interpreting the sources of data used in the current formula for the Substance Abuse Prevention and Treatment Block Grant program. In addition, the formula has not been adjusted since 1997 and is overly confusing. States cannot defend their positions when SAMHSA does not inform them of the origin of the data used for the formula. To increase transparency, the Committee directs SAMHSA to include in their fiscal year 2017 CJ details on where SAMHSA acquires the data used for the formula and how SAMHSA utilizes this information to make funding level determinations. It is imperative that SAMHSA uses the most recent and accurate data available and should work with States to better understand the best sources for this information. SAMHSA shall also include an evaluation on whether the current formula should be updated in the future.”

**Important note about proposed amendment by Senator Patty Murray (D-WA) to restore/add substance use disorder funding – including proposed increase of $50 million for SAPT Block Grant compared to FY 2015: As this report indicates, the Senate Appropriations Committee approved a proposal to cut the SAPT Block Grant by $50 million and reduce other important programs due to stringent spending caps set by sequestration and other factors. Senator Patty Murray, the “Ranking Member” or most senior Democrat on the Committee, offered a lengthy amendment to address the spending caps and restore funding for a number of key public health programs across a number of agencies.

This large amendment included a provision that would have (1) added a total of $100 million to the SAPT Block Grant (restoring the proposed cut by the Senate Committee and adding $50 million compared to FY 2015) and (2) added $50 million for the program supporting opioid treatment where medication assisted treatment is an allowable use of funds. Ultimately, the amendment was not adopted. However, this was an important development demonstrating strong support for the SAPT Block Grant and treatment/prevention/recovery services supported by SAMHSA. Further, this action recognized the intensity of the opioid problem across the country that would benefit from dedicated federal funding. NASADAD will provide updates on this specific provision as developments move forward.

[back to top]

SAMHSA: Center for Substance Abuse Treatment – Appropriations by Program

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
CSAT TOTAL	$360,698,000	$361,463,000	$320,701,000	$377,000,000	$15,537,000 increase	$284,260,000	$77,203,000 decrease
Access to Recovery	$50,000,000	$38,223,000	$0	$38,223,000	Level funding	$0	$38,223,000 decrease
Addiction Technology Transfer Centers (ATTCs)	$9,046,000	$9,046,000	$8,081,000	$9,046,000	Level funding	$8,081,000	$965,000 decrease
Children and Families	$29,678,000	$29,605,000	$29,605,000	$29,605,000	Level funding	$28,125,000	$1,480,000 decrease
Criminal Justice Activities	$75,000,000	$78,000,000	$61,946,000	$78,000,000	Level funding	$61,946,000	$16,054,000 decrease
Crisis Systems	N/A	N/A	$5,000,000	Not funded	N/A	Not funded	N/A
Minority AIDS	$65,732,000	$65,570,000	$58,859,000	$65,570,000	Level funding	$58,859,000	$6,711,000 decrease
Opioid Treatment Programs/Regulatory Activities	$8,746,000	$8,724,000	$8,724,000	$8,724,000	Level funding	$8,724,000	Level funding
Pregnant and Postpartum Women	$15,970,000	$15,931,000	$15,931,000	$15,931,000	Level funding	$15,134,000	$797,000 decrease
Primary Care and Addiction Services Integration	N/A	N/A	$20,000,000	Not funded	N/A	Not funded	N/A
Recovery Community Services Program	$2,440,000	$2,434,000	$2,434,000	$2,434,000	Level funding	$2,312,000	$122,000 decrease
Screening, Brief Intervention, Referral, and Treatment (SBIRT)	$47,000,000	$44,889,000	$30,000,000	$46,889,000	$2,000,000 increase	$30,000,000	$14,889,000 decrease
Special Initiatives/Outreach	$1,436,000	$1,432,000	$1,432,000	$1,432,000	Level funding	$0	Program eliminated
Strengthening Treatment Access and Retention	$1,668,000	$1,000,000	$1,000,000	$1,000,000	Level funding	$0	Program eliminated
Targeted Capacity Expansion (TCE) General	$13,256,000	$23,223,000	$36,303,000	$36,303,000	$13,080,000 increase	$29,223,000	$6,000,000 increase
Medication-Assisted Treatment for Prescription Drug and Opioid Addiction	N/A	$12,000,000	$25,000,000	$25,080,000	$13,080,000 increase	$18,000,000	$6,000,000 increase
Treatment Systems for Homeless	$41,488,000	$41,386,000	$41,386,000	$41,304,000	$82,000 decrease	$39,317,000	$2,069,000 decrease

Center for Substance Abuse Treatment (CSAT): The House report calls for $377 million for FY 2016 or an increase of $15.5 million as compared to FY 2015. The Senate report calls for $284 million or a decrease of $77 million compared to FY 2015. The Administration requested a $40.8 million decrease compared to FY 2015.

Senate Report Language: “Combatting Opioid Abuse—Of the amount provided for Targeted Capacity Expansion, the Committee recommendation includes $18,000,000 for discretionary grants to States for the purpose of expanding treatment services to those with heroin or opioid dependence. The Committee directs CSAT to ensure that these grants include as an allowable use the support of medication assisted treatment and other clinically appropriate services. These grants should target States with the highest rates of admissions and that have demonstrated a dramatic increase in admissions for the treatment of opioid use disorders.”

Access to Recovery (ATR): The House report calls for $38.2 million for FY 2016 or level funding compared to FY 2015. The Senate report does not provide ATR funding for FY 2016. This is consistent with the Administration’s proposal to eliminate the ATR program in FY 2016.

Addiction Technology Transfer Centers: The House report calls for $9 million for FY 2016 or level funding compared to FY 2015. The Senate report calls for $8.1 million or a decrease of $965,000 compared to FY 2015. The Administration also requested a decrease of $965,000 compared to FY 2015.

House Report Language: “The Committee once again rejects the Administration’s request to reduce funding for the ATTCs. SAMHSA is directed to ensure that ATTCs maintain a primary focus on addiction treatment and recovery services.”

Senate Report Language: “The Committee continues to direct SAMHSA to ensure that ATTCs maintain a primary focus on addiction treatment and recovery services.”

Criminal Justice Activities: The House report calls for $78 million for FY 2016 or level funding compared to FY 2015. The Senate report calls for $61.9 million for FY 2015, or a cut of $16 million compared to FY 2015. The Administration also requested a decrease of $16 million compared to FY 2015.

House Report Language: “Drug Treatment Courts—The Committee continues to direct SAMSHA to ensure that all funding appropriated for Drug Treatment courts is allocated to serve people diagnosed with a substance use disorder as their primary condition. SAMHSA is directed to ensure that all drug treatment court grant recipients work directly with the corresponding State substance abuse agency in the planning, implementation, and evaluation of the grant. The Committee further directs SAMHSA to expand training and technical assistance to drug treatment court grant recipients to ensure evidence-based practices are fully implemented.”

Senate Report Language: “The Committee continues to direct SAMHSA to ensure that all funding appropriated for Drug Treatment Courts is allocated to serve people diagnosed with a substance use disorder as their primary condition. The Committee expects CSAT to ensure that non-State substance abuse agency applicants for any drug treatment court grant in its portfolio continue to demonstrate extensive evidence of working directly and extensively with the corresponding State substance abuse agency in the planning, implementation, and evaluation of the grant.”

Minority AIDS Initiative: The House report calls for $65.6 million for FY 2016 or level funding compared to FY 2015. The Senate report calls for $58.9 million for FY 2015, a decrease of $6.7 million compared to FY 2015. The Administration requested a decrease of $6.7 million compared to FY 2015.

Opioid Treatment Programs/Regulatory Activities: The House report calls for $8.7 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $8.7 million for FY 2016, level funding compared to FY 2015. The Administration also requested level funding.

Pregnant and Postpartum Women: The House report calls for $15.9 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $15.1 million for FY 2015, a decrease of $797,000 compared to FY 2015. The Administration requested level funding.

Recovery Community Services Program: The House report calls for $2.4 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $2.3 million for FY 2016, a decrease of $122,000 compared to FY 2015. The Administration requested level funding.

Screening, Brief Intervention, Referral, and Treatment (SBIRT): The House report calls for $46.9 million for FY 2016, or an increase of $2 million as compared to FY 2015. The Senate report calls for $30 million for FY 2016, a decrease of $14.9 million compared to FY 2016. The Administration requested a cut of $14.9 million compared to FY 2015.

Senate Report Language: “The Committee continues to direct SAMHSA to ensure that funds provided for SBIRT are used for existing evidence-based models of providing early intervention and treatment services to those at risk of developing substance abuse disorders.”

Strengthening Treatment Access and Retention: The House report calls for $1 million for FY 2016, or level funding compared to FY 2015. The Senate report does not provide funding for this program in FY 2016. The Administration requested level funding.

Targeted Capacity Expansion (TCE) General Program: The House report calls for $36.3 million for FY 2016, an increase of roughly $13 million compared to FY 2015. The Senate report calls for $29.2 million for FY 2016, an increase of $6 million compared to FY 2015. The Administration requested a $13 million increase to build on a grant program created in FY 2015 with $12 million for CSAT for grants to expand opioid treatment services – including medication-assisted treatment (MAT).

House Report Language: “Together with the $12,000,000 increase provided in the Consolidated and Further Continuing Appropriations Act of fiscal year 2015, this additional funding is provided to increase the number of States from 11 to 22 that are receiving funding to expand services that address prescription drug abuse and heroin use in high-risk communities. The Committee expects SAMSHA to provide a briefing within 45 days of enactment regarding how it intends to execute these activities and carry out the two mandates described below.

The United States has seen a 500 percent increase in admissions to treatment for prescription drug abuse since 2000. Moreover, according to a recent study, 28 states saw an increase in admissions to treatment for heroin dependence during the past two years. The fiscal year 2015 Consolidated and Further Continuing Appropriations Act provided funding for Targeted Capacity Expansion specifically for prescription drug and heroin treatment. The Center for Substance Abuse Treatment is directed to include as an allowable use medication-assisted treatment and other clinically appropriate services to achieve and maintain abstinence from all opioids and heroin and prioritize treatment regimens that are less susceptible to diversion for illicit purposes.

Since the passage of the Drug Addiction Treatment Act of 2000, SAMHSA has led the nation in educating physicians, patients, and treatment systems on the use of medication-assisted treatment. To keep pace with advancements in science and research, SAMHSA is directed to update all of its public-facing information and treatment locators such that all evidence-based innovations in counseling, recovery support, and abstinence-based relapse prevention medication-assisted treatment are fully incorporated.”

Senate Report Language: “Combating Opioid Abuse.-Of the amount provided for Targeted Capacity Expansion, the Committee recommendation includes $18,000,000 for discretionary grants to States for the purpose of expanding treatment services to those with heroin or opioid dependence. The Committee directs CSAT to ensure that these grants include as an allowable use the support of medication assisted treatment and other clinically appropriate services. These grants should target States with the highest rates of admissions and that have demonstrated a dramatic increase in admissions for the treatment of opioid use disorders.”

Treatment Systems for the Homeless: The House report calls for $41.3 million for FY 2016, a slight decrease in funding compared to FY 2015. The Senate report calls for $39.3 million for FY 2016, a $2.1 million decrease compared to FY 2015. The Administration requested level funding.

[back to top]

SAMHSA: Center for Substance Abuse Prevention – Appropriations by Program

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
CSAP TOTAL	$175,129,000	$175,148,000	$210,918,000	$190,219,000	$15,071,000 increase	$182,731,000	$7,583,000 increase
Center for the Application of Prevention Technologies (CAPT)	$7,511,000	$7,493,000	$7,493,000	$7,493,000	Level funding	$7,119,000	$374,000 decrease
Fetal Alcohol Spectrum Disorder Center for Excellence	$1,000,000	$1,000,000	$1,000,000	$1,000,000	Level funding	$0	Program eliminated
Grants to Prevent Prescription Drug/Opioid Overdose Related Deaths	N/A	N/A	$12,000,000	Not funded	N/A	$6,000,000	New program
Federal Drug-Free Workplace Program (formerly Mandatory Drug Testing)	$4,906,000	$4,894,000	$4,894,000	$4,894,000	Level funding	$4,894,000	Level funding
Minority AIDS	$41,307,000	$41,205,000	$41,205,000	$41,205,000	Level funding	$39,145,000	$2,060,000 decrease
Science and Service Program Coordination	$4,082,000	$4,072,000	$4,072,000	$4,072,000	Level funding	$3,868,000	$204,000 decrease
Sober Truth on Preventing Underage Drinking (STOP Act)	$7,000,000	$7,000,000	$7,000,000	$7,000,000	Level funding	$6,650,000	$350,000 decrease
Strategic Prevention Framework/Partnerships for Success	$109,754,000	$109,484,000	$118,254,000	$109,484,000	Level funding	$114,984,000	$5,500,000 increase
Strategic Prevention Framework Rx	N/A	N/A	$10,000,000	Not funded	N/A	$5,500,000	New program
Tribal Behavioral Health Grants	N/A	N/A	$15,000,000	$15,000,000	New program	Not funded	N/A

Center for Substance Abuse Prevention (CSAP): The House report calls for $190.2 million in FY 2016, a $15.1 million increase from FY 2015. The Senate report calls for $182.7 million for FY 2016, an increase of $7.6 million compared to FY 2015. The Administration requested a $35.8 million increase over FY 2015.

Senate Report Language: “Combatting Opioid Abuse—The Committee provides $6,000,000 for grants to prevention opioid overdose related deaths. As part of the new initiative to Combat Opioid Abuse, this new program will help States equip and train first responders with the use of devises that rapidly reverse the effects of opioids. The Committee directs SAMHSA to ensure applicants outline how proposed activities in the grant would work with treatment and recovery communities in addition to first responders. Furthermore, the Committee provides $5,500,000 for the Strategic Prevention Framework Rx program to increase awareness of opioid abuse and misuse in communities.”

Center for the Application of Prevention Technologies: The House report calls for $7.5 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $7.1 million for FY 2016, a decrease of $374,000 compared to FY 2015. The Administration requested level funding.

Federal Drug-Free Workplace Program (formerly Mandatory Drug Testing): The House report calls for $4.9 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $4.9 million for FY 2016, level funding compared to FY 2015. The Administration also requested level funding.

Fetal Alcohol Spectrum Disorder (FASD) Center of Excellence: The House report calls for $1 million for FY 2016, level funding compared to FY 2015. The Senate report does not provide funding for the FASD Center of Excellence. The Administration requested level funding. The FASD portfolio absorbed a significant cut of $8.8 million in FY 2014 when the program went from $9.8 million in FY 2013 to $1 million in FY 2014.

Minority AIDS Initiative: The House report calls for $41.2 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $39.1 million for FY 2016, a decrease of $2.1 million compared to FY 2015. The Administration requested level funding.

Science and Service Program Coordination: The House report calls for $4.1 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $3.9 million for FY 2016, a decrease of $204,000 compared to FY 2015. The Administration requested level funding.

Sober Truth on Prevention Underage Drinking (STOP) Act: The House report calls for $7 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $6.7 million for FY 2016, a decrease of $350,000 compared to FY 2015. The Administration requested level funding.

Senate Report Language: “The Committee directs that all funds appropriated for STOP Act community-based coalition enhancement grants, shall be used for making grants to eligible communities, and not for other purposes or activities.”

Strategic Prevention Framework/Partnerships for Success: The House report calls for $109.5 million for FY 2016, level funding as compared to FY 2015. The Senate report calls for $115 million for FY 2016, an increase of $5.5 million compared to FY 2015. The Administration requested $118.3 million for FY 2016, an $8.8 million increase in funding from FY 2015.

Senate Report Language: “The Committee intends that these two programs continue to focus exclusively on: addressing State- and community-level indicators of alcohol, tobacco, and drug use; targeting and implementing appropriate universal prevention strategies; building infrastructure and capacity; and prevention substance use and abuse.”

Tribal Behavioral Health Grants: The House report calls for $15 million for this new program in FY 2016. The Senate report does not provide funding for Tribal Behavioral Health Grants. The Administration requested $15 million.

[back to top]

SAMHSA: Center for Mental Health Services – Appropriations by Program

Program	FY 14	FY 15 Enacted	FY 16 Request	HY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
CMHS TOTAL	$377,315,000	$370,538,000	$377,289,000	$383,597,000	$13,059,000 increase	$378,597,000	$8,059,000 increase
Children and Family Programs	$6,474,000	$6,458,000	$6,458,000	$6,458,000	Level funding	$6,458,000	Level funding
Children’s Mental Health	$117,315,000	$117,026,000	$117,026,000	$117,026,000	Level funding	$117,026,000	Level funding
Community Mental Health Services (CMHS) Block Grant	$483,744,000	$482,571,000	$482,571,000	$482,571,000	Level funding	$482,571,000	Level funding
Consumer/Consumer Support TA Centers	$1,923,000	$1,918,000	$1,918,000	$1,918,000	Level funding	$1,918,000	Level funding
Consumer and Family Network Grants	$4,966,000	$4,954,000	$4,954,000	$4,954,000	Level funding	$4,954,000	Level funding
Criminal and Juvenile Justice Programs	$4,280,000	$4,269,000	$4,269,000	$4,269,000	Level funding	$4,269,000	Level funding
Crisis Systems	N/A	N/A	$5,000,000	Not funded	N/A	Not funded	N/A
Disaster Response	$1,958,000	$1,953,000	$1,953,000	$1,953,000	Level funding	$1,953,000	Level funding
Grants for Adult Treatment, Screening, and Brief Response	N/A	N/A	$2,896,000	Not funded	N/A	Not funded	N/A
Grants to States for the Homeless/Prj. for Assist. in Transition from Homelessness	$64,794,000	$64,635,000	$64,635,000	$54,635,000	$10,000,000 decrease	$40,000,000	$24,635,000 decrease
Healthy Transitions	$20,000,000	$19,951,000	$19,951,000	$19,951,000	Level funding	$19,951,000	Level funding
HIV/AIDS Education	$773,000	$771,000	$771,000	$771,000	Level funding	$771,000	Level funding
Homelessness	$2,302,000	$2,296,000	$2,296,000	$2,296,000	Level funding	$2,296,000	Level funding
Homelessness Prevention Programs	$30,772,000	$30,696,000	$30,696,000	$28,696,000	$2,000,000 decrease	$30,696,000	Level funding
Mental Health First Aid for Veterans’ Families	N/A	N/A	$4,000,000	Not funded	N/A	Not funded	N/A
MH System Transformation and Health Reform	$10,582,000	$3,779,000	$3,779,000	$3,779,000	Level funding	$3,779,000	Level funding
Minority AIDS	$9,247,000	$9,224,000	$15,935,000	$8,224,000	$1,000,000 decrease	$9,224,000	Level funding
National Traumatic Stress Network	$46,000,000	$45,887,000	$45,887,000	$45,887,000	Level funding	$45,887,000	Level funding
Primary and Behavioral Health Care Integration	$50,000,000	$49,877,000	$26,004,000	$43,000,000	$6,877,000 decrease	$49,877,000	Level funding
Primary/Behavioral Health Integration TA	$1,996,000	$1,991,000	$1,996,000	$1,991,000	Level funding	$1,991,000	Level funding
Project AWARE	$54,865,000	$54,865,000	$54,865,000	$54,865,000	Level funding	$54,865,000	Level funding
*Mental Health First Aid*	$15,000,000	$14,963,000	$14,963,000	$14,963,000	Level funding	$14,963,000	Level funding
*Project Aware State Grants*	$40,000,000	$39,902,000	$39,902,000	$39,902,000	Level funding	$39,902,000	Level funding
Project LAUNCH	$34,640,000	$34,555,000	$34,555,000	$34,555,000	Level funding	$34,555,000	Level funding
Protection and Advocacy	$36,238,000	$36,146,000	$36,146,000	$36,146,000	Level funding	$36,146,000	Level funding
Seclusion & Restraint	$1,150,000	$1,147,000	$1,147,000	$1,147,000	Level funding	$1,147,000	Level funding
Suicide Prevention	$60,032,000	$60,032,000	$62,032,000	$72,725,000	$12,693,000 increase	$60,032,000	Level funding
Al/AN Suicide Prevention Initiative	$2,938,000	$2,931,000	$2,931,000	$2,931,000	Level funding	$2,931,000	Level funding
GLS – Suicide Prevention Resource Center	$6,000,000	$5,988,000	$5,988,000	$6,681,000	$693,000 increase	$5,988,000	Level funding
GLS – Youth Suicide Prevention – Campus	$6,500,000	$6,488,000	$6,488,000	$6,488,000	Level funding	$6,488,000	Level funding
GLS – Youth Suicide Prevention – States	$35,500,000	$35,427,000	$35,427,000	$47,427,000	$12,000,000 increase	$35,427,000	Level funding
National Strategy for Suicide Prevention	$2,000,000	$2,000,000	$4,000,000	$2,000,000	Level funding	$2,000,000	Level funding
Suicide Lifeline	$7,212,000	$7,198,000	$7,198,000	$7,198,000	Level funding	$7,198,000	Level funding
Tribal Behavioral Health Grants	$5,000,000	$4,988,000	$15,000,000	$15,000,000	$10,012,000 increase	$4,988,000	Level funding
Youth Violence Prevention	$23,156,000	$23,099,000	$23,099,000	$23,099,000	Level funding	$23,099,000	Level funding

Senate Report Language: “Access to Mental Health Services for Veterans—The Committee is aware of the success achieved in localities that use locally customized web portals to assist veterans struggling with mental and substance use issues. These portals provide veterans with a directory of local mental health providers and services in addition to all military and VA funded programs. They also provide quick access to local crisis intervention and emergency care programs; comprehensive job search and support; a peer social networking platform, and personal health records. The Committee encourages SAMHSA to expand and maintain the capacity of locally customized internet-based Web portals nationwide.”

Community Mental Health Services (CMHS) Block Grant: The House report calls for $482.6 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $482.6 million for FY 2016, level funding compared to FY 2015. The Administration also requested level funding.

House Report Language: “The Committee continues the five percent set-aside within the Mental Health Block Grant for evidence-based programs that address the needs of individuals with serious mental illness, including psychotic disorders. The Committee expects SAMHSA to continue its collaboration with the National Institute of Mental Health to encourage States to use this block grant funding to support programs that demonstrate strong evidence of effectiveness.”

Senate Report Language: “The Committee recommendation continues bill language requiring at least 5 percent of the funds for the MHBG program be set-aside for evidence-based programs that address the needs of individuals with early serious mental illness, including psychotic disorders. The Committee commends SAMHSA for its collaboration with NIMH on the implementation of this set-aside. The Committee notes that it usually takes 17 years to translate research findings into practice, and hopes that this joint effort between NIMH and SAMHSA may be a model for how to reduce this timeframe. The Committee directs SAMHSA to continue its collaboration with NIMH to ensure that funds from this set-aside are only used for programs showing strong evidence of effectiveness and targets the first episode of psychosis. SAMHSA shall not expand the use of the set-aside to programs outside of the first episode psychosis. The Committee directs SAMHSA to include in the fiscal year 2017 CJ a detailed table showing at a minimum each State’s allotment, name of the program being implemented, and a short description of the program.”

Criminal and Juvenile Justice Programs: The House report calls for $4.3 million or level funding compared to FY 2015. The Senate report calls for $4.3 million or level funding compared to FY 2015. The Administration also requested level funding.

Grants to States for the Homeless: The House report calls for $54.6 million for FY 2016 or a decrease of $10 million compared to FY 2016. The Senate report calls for $40 million or a decrease of $24.6 million compared to FY 2016. The Administration requested level funding.

Primary and Behavioral Health Care Integration (PBHCI): The House report calls for $43 million for FY 2016 or a decrease of $6.9 million compared to FY 2015. The Senate report calls for $49.9 million or level funding compared to FY 2015. The Administration requested $26 million for FY 2016, a $23.9 million decrease in funding compared to FY 2015.

Suicide Prevention: National Strategy for Suicide Prevention: The House report calls for $2 million for FY 2016 or level funding compared to FY 2015. The Senate report calls for $2 million for FY 2016 or level funding compared to FY 2015. The Administration requested a $2 million increase over FY 2015.

Tribal Behavioral Health Grants: The House report calls for $15 million for FY 2016, or a $10 million increase in funding from FY 2015. The Senate report calls for $5 million or level funding compared to FY 2015. The Administration requested an increase of $10 million.

[back to top]

SAMSHA: Health Surveillance and Program Support – Appropriations by Program

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
Behavioral Health Workforce	$45,695,000	$46,669,000	$77,669,000	$45,669,000	$1,000,000 decrease	$45,669,000	$1,000,000 decrease
Behavioral Health Workforce Data	N/A	$1,000,000	$1,000,000	$1,000,000	Level funding	$1,000,000	Level funding
Health Surveillance	$47,428,000	$47,258,000	$49,428,000	$47,258,000	Level funding	$44,895,000	$2,363,000 decrease
Performance and Quality Information Systems	$12,996,000	$12,918,000	$12,918,000	$12,918,000	Level funding	$10,000,000	$2,918,000 decrease
Program Support	$72,729,000	$72,002,000	$79,559,000	$72,002,000	Level funding	$68,402,000	$3,600,000 decrease
Public Awareness and Support	$13,571,000	$13,482,000	$15,571,000	$13,482,000	Level funding	$10,000,000	$3,482,000 decrease

Behavioral Health Workforce: The House report calls for $45.7 million for FY 2016 (this amount includes $10,669,000 for the Minority Fellowship Programs), a $1 million decrease compared to FY 2015. The Senate report calls for the same as the House report. The Administration requested a $31 million increase from FY 2015.

House Report Language: “Mental and Behavioral Health Education and Training Program—Within the amount available for Health Surveillance Support, the Committee recommends $35,000,000 for the joint SAMHSA HRSA Mental and Behavioral Health Education and Training Grant Program. Eligible entities for this program shall include accredited programs that train Master’s level social workers, psychologists, counselors, marriage and family therapists, psychology doctoral interns, as well as behavioral health paraprofessionals. The Committee directs SAMHSA to share information concerning pending grant opportunity announcements with State licensing organizations and all the relevant professional associations.”

Senate Report Language: “The Committee is concerned about the uneven distribution of funds among specialties resulting from the initial grant competition in 2014. Therefore, the Committee directs SAMHSA and HRSA to ensure that funding is distributed relatively equally among the participating health professions, including paraprofessionals, master’s level social workers, counselors, marriage and family therapists, and doctoral psychology interns. The Committee directs SAMHSA and HRSA to consider other strategies to achieve this relative distribution such as issuing separate funding opportunity announcements for each participating health profession. In addition, the Committee directs SAMHSA and HRSA to include doctoral psychology schools in the funding opportunities to support doctoral level students completing their practicums which are necessary to move on to internships. SAMHSA and HRSA shall award meritorious applications for doctoral psychology interns first, before doctoral psychology schools applying to support practicums.”

Health Surveillance: The House report calls for $47.3 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $44.9 million for FY 2016, a decrease of $2.4 million compared to FY 2015. The Administration requested a $2.2 million increase from FY 2015.

Public Awareness and Support: The House report calls for $13.5 million for FY 2016, level funding compared to FY 2015. The Senate report calls for $10 million for FY 2016, a decrease of $3.5 million compared to FY 2015. The Administration requested a $2.1 million increase from FY 2015.

[back to top]

Centers for Disease Control and Prevention (CDC) – Appropriations for Selected Programs

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
HIV/AIDS, Viral Hepatitis, STD, and TB Prevention	$1,120,566,000	$1,117,609,000	$1,161,747,000	$1,117,609,000	Level funding	$1,090,609,000	$27,000,000 decrease
HIV Prevention by Health Departments	$398,238,000	$397,161,000	$397,161,000	$397,161,000	Level funding	$397,161,000	Level funding
School Health	$31,161,000	$31,081,000	$37,377,000	$31,081,000	Level funding	$31,081,000	Level funding
Viral Hepatitis	$31,410,000	$31,331,000	$62,820,000	$31,331,000	Level funding	$36,331,000	$5,000,000 increase
Sexually Transmitted Infections	$157,719,000	$157,310,000	$157,310,000	$157,310,000	Level funding	$125,310,000	$32,000,000 decrease
Chronic Disease Prevention and Health Promotion	$1,187,962,000	$1,198,220,000	$1,058,058,000	$1,097,482,000	$100,738,000 decrease	$1,052,922,000	$145,298,000 decrease
Tobacco	$210,767,000	$215,492,000	$215,492,000	$105,492,000	$110,000,000 decrease	$216,492,000	$1,000,000 decrease
Excessive Alcohol Use	Not broken out	$3,000,000	Not broken out	$3,000,000	Level funding	$3,000,000	Level funding
Prevention Research Centers	$25,530,000	$25,461,000	$25,000,000	$24,000,000	$1,461,000 decrease	$25,461,000	Level funding
Community Grants	$131,005,000	$130,950,000	$60,000,000	$0	Program eliminated	$0	Program eliminated
Birth Defects and Developmental Disabilities	$122,435,000	$131,781,000	$131,781,000	$133,510,000	$1,729,000 increase	$132,781,000	$1,000,000 increase
Fetal Alcohol Syndrome	$10,532,000	$10,505,000	$10,505,000	$11,000,000	$495,000 increase	$10,505,000	Level funding
Injury Prevention and Control	$150,839,000	$170,447,000	$256,977,000	$211,300,000	$40,853,000 increase	$187,947,000	$17,500,000 increase
Unintentional Injury	$8,619,000	$8,598,000	$8,598,000	$8,750,000	$152,000 decrease	$8,598,000	Level funding
Injury Prevention Activities	$29,023,000	$48,950,000	$107,602,000	$98,950,000	$50,000,000 increase	$66,450,000	$17,500,000 increase
Prescription Drug Overdose	N/A	$20,000,000	$68,000,000	$70,000,000	$50,000,000 increase	$31,921,000	$11,921,000 increase
Illicit Opioid Use Risk Factors	N/A	N/A	$5,579,000	Not funded	N/A	$5,579,000	New program
Preventive Health and Health Services Block Grant	$160,000,000	$160,000,000	$0	$170,000,000	$10,000,000 increase	$160,000,000	Level funding

Tobacco: The House report calls for $105.5 million for FY 2016, a $110 million decrease from FY 2015. The Senate report calls for $216.5 million for FY 2016, a decrease of $1 million from FY 2015. The Administration requested level funding.

House Report Language: “The Committee notes CDC supports tobacco use and prevention activities throughout numerous programs like the Prevention Research Centers and Chronic Disease Prevention activities. The Committee provides funding in the tobacco line to primarily focus on underage smoking. Further, CDC is directed to consolidate and reduce duplication with other tobacco prevention programs and activities. The Committee does not provide support for CDC’s tobacco research activity. The NIH has an existing tobacco research portfolio that in fiscal year 2015 is estimated at $322,000,000. The CDC shall coordinate with NIH to identify meritorious tobacco research opportunities for NIH to consider through its peer-reviewed process and its existing portfolio funding level. The Committee requests an analysis in the fiscal year 2017 budget request identifying all the CDC programs that provide any funding for tobacco control or prevention activities with the name of the program and annual tobacco related funding level.”

Fetal Alcohol Syndrome: The House report calls for $11 million for FY 2016, an increase of $495,000 over FY 2015. The Senate report calls for $10.5 million for FY 2016 or level funding compared to FY 2015. The Administration requested level funding.

House Report Language: “The Committee includes increased resources to support an information clearinghouse, expansion of existing national community-based FAS networks, dissemination of evidence-based intervention strategies, and an Alaska Native/Native American-focused collaborative for FAS.”

Senate Report Language: “Neonatal Abstinence Syndrome Data—The Committee directs CDC to provide technical assistance to States to improve the availability and quality of data collection and surveillance activities regarding neonatal abstinence syndrome, including: (a) the incidence and prevalence of neonatal abstinence syndrome; (b) the identification of causes for neonatal abstinence syndrome, including new and emerging trends; and (c) the demographics and other relevant information associated with neonatal abstinence syndrome. CDC shall also collect any available surveillance data described in the previous sentence from States and make it publicly available on an appropriate website. Furthermore, the Committee directs CDC to increase utilization of effective public health measure to reduce neonatal abstinence syndrome.”

Prescription Drug Overdose Prevention: The House report calls for $70 million for FY 2016, an increase of $50 million over FY 2015. The Senate report calls for $31.9 million for FY 2016, an increase of $11.9 million compared to FY 2015. The Administration requested an increase of $48 million.

House Report Language: “The Committee commends CDC for its leadership to expand the efforts on prescription drug overdose. The Committee directs the CDC Director to implement these activities based on population-adjusted burden of disease criteria when distributing funds for the state Prescription Drug Overdose Prevention activities and to adhere to all terms and conditions identified in the fiscal year statement of managers accompanying the 2015 Appropriations Act and accompanying statement for this program.”

Senate Report Language: “The Committee includes $37,500,000, an increase of $17,500,000 above fiscal year 2015, for efforts to respond to and reverse the opioid epidemic in the United States. This includes $31,921,000 to fund the Prescription Drug Overdose (PDO) Prevention for States program, a competitive cooperative agreement that targets those States with the greatest burden of opioid overdoses and demonstrated readiness to implement prevention strategies, and $5,579,000 to specifically strengthen surveillance efforts for heroin-related deaths. The Committee notes the strong connection between prescription opioids and other types of opioids like heroin. Activities targeting one area will have a significant impact on the other. Therefore, funding will support activities such as implementing guidelines to improve prescribing behaviors and collecting real-time and more accurate data for heroin-related opioid deaths. The Committee urges CDC to require applicants applying for the PDO Prevention for States Program to collaborate with the State substance abuse agency or other agencies or those agencies managing the State’s PDMP to ensure linkages to clinically appropriate substance use disorder services. In addition, the Committee directs CDC to use the funds provided to expand the surveillance of heroin-related deaths beyond CDC’s current activities in HHS’ Region One by targeting States that have the greatest burden of heroin abuse.”

“Opioid Prescribing Guidelines—The Committee directs CDC to complete its work in developing safe opioid prescribing guidelines for chronic, non-cancer pain in outpatient settings for release no later than July 31, 2016, and a technical package to guide States in the implementation of safe opioid prescribing through coordinated care. The guidelines and technical package should include information for providers on the use of opioids for pregnant women and women that might become pregnant, as well as the potential risks of birth defects and neonatal abstinence syndrome from exposure to such medications. The Committee directs CDC to broadly disseminate the guidelines and technical package and to immediately evaluate the effects of the new guidance. Furthermore, the Committee urges CDC to work with the VA and DOD on implementing these guidelines in the appropriate facilities and directs CDC to share data and best practices on safe opioid prescribing with these agencies.”

[back to top]

Health Resources and Services Administration (HRSA) – Appropriations for Selected Programs

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
Community Health Centers	$1,495,236,000	$1,491,422,000	$1,491,422,000	$1,491,522,000	$100,000 increase	$1,419,522,000	$100,000 increase
Interdisciplinary Community-Based Linkages	$71,563,000	$73,403,000	$53,153,000	$74,403,000	$1,000,000 increase	$74,992,000	$1,589,000 increase
Mental and Behavioral Health	$7,916,000	$8,916,000	$8,916,000	$9,916,000	$1,000,000 increase	$8,916,000	Level funding
Maternal and Child Health Block Grant	$634,000,000	$637,000,000	$637,000,000	$638,200,000	$1,200,000 increase	$615,276,000	$21,724,000 decrease
Rural Health	$142,335,000	$147,471,000	$127,562,000	$147,471,000	Level funding	$150,571,000	$3,100,000 decrease
Rural and Community Access to Emergency Devices	$3,364,000	$4,500,000	$0	$4,500,000	Level funding	$0	Program eliminated
Telehealth	$13,900,000	$14,900,000	$14,900,000	$14,900,000	Level funding	$18,000,000	$3,100,000 increase
Ryan White HIV/AIDS Program	$2,318,781,000	$2,318,781,000	$2,322,781,000	$2,318,781,000	Level funding	$2,293,781,000	$25,000,000 decrease

Mental and Behavioral Health: The House report calls for $9.9 million for FY 2016, an increase of $1 million over FY 2015. The Senate report calls for $8.9 million for FY 2016, level funding compared to FY 2015. The Administration requested level funding.

House Report Language: “The Committee recommendation includes $9,916,000 for the interprofessional Graduate Psychology Education Program to increase the number of health service psychologists (including doctoral-level clinical, counseling and school psychologists) trained to provide integrated services to high-need underserved populations in rural and urban communities. The Committee encourages HRSA to build on recent efforts to expand training to increase mental and behavioral health services for returning service members, veterans and their families, with a strong emphasis on veterans reintegrating into rural civilian communities. Recognizing the growing need for highly trained mental and behavioral health professionals to deliver evidence-based services to the rapidly aging population, the Committee encourages HRSA to invest in geropsychology training programs and to help integrate health service psychology trainees at Federally Qualified Health Centers.”

Maternal and Child Health Block Grant: The House report calls for $638.2 million for FY 2016, an increase of $1.2 million over FY 2015. The Senate report calls for $615.3 million for FY 2016, a decrease of $21.7 million compared to FY 2015. The Administration requested level funding.

House Report Language: “Fetal Alcohol Syndrome—The Committee recommends that the fetal alcohol syndrome initiative within HRSA address high-risk Alaska Native and American Indian populations through a Native American-focused collaborative.”

Rural and Community Access to Emergency Devices: The House report calls for $4.5 million in FY 2016 or level funding compared to FY 2015. The Senate report does not provide funding for this program. The Administration proposed that this program be eliminated in FY 2016. In FY 2015, Congress appropriated a $1.1 million increase over 2014 to be used for opioid overdose reversal emergency devices.

Ryan White HIV/AIDS Program: The House report calls for $2.3 billion for FY 2016 or level funding as compared to FY 2015. The Senate report calls for $2.293 billion for FY 2016, a $25 million decrease compared to FY 2015. The Administration requested a $4 million increase in funding for FY 2016.

[back to top]

National Institute on Alcohol Abuse and Alcoholism (NIAAA) – Appropriations

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
NIAAA	$446,025,000	$447,408,000	$459,833,000	$456,012,000	$8,604,000 increase	$469,355,000	$21,947,000 increase

National Institute on Alcohol Abuse and Alcoholism (NIAAA): The House report calls for $456 million for FY 2016, an increase of $8.6 million compared to FY 2015. The Senate report calls for $469 million for FY 2016, an increase of $21.9 million compared to FY 2015. The Administration requested a $12.4 million increase from FY 2015.

House Report Language: “Fetal Alcohol Syndrome (FAS) Research—The Committee was pleased that NIAAA’s budget request proposed increases in research on how alcohol interferes with human development and the various underlying aspects of alcohol-induced fetal damage. The Committee encourages NIH to consider the benefits and methods to support a clearinghouse and improved coordination with federal and private sector partners to best facilitate the translation of science into public health promotion strategies and interventions benefiting individuals living with FAS.”

Senate Report Language: “Genomic Research and Alcohol Dependence—The Committee commends the NIAAA for its research efforts to increase understanding of the genetic and neurobiological mechanisms underlying alcohol use disorder (AUD). Research shows that genes contribute 40-60 percent of the risk for developing AUD. Factors such as stress may make individuals who carry genomic variations associated with increased risk for AUD more vulnerable to developing the disorder. NIAAA-supported studies have identified several genes that contribute to susceptibility to AUD and many others that show some evidence of involvement; and these research findings are paving the way for new opportunities in prevention and treatment. The Committee encourages the NIAAA to capitalize on advances in genomic science and “big data,” and explore collaborative opportunities to gain additional insight into the genetics of AUD, including its relationship to related problems such as post-traumatic stress disorder in military personnel and veterans.”

National Institute on Drug Abuse (NIDA) – Appropriations

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
NIDA	$1,025,435,000	$1,028,614,000	$1,047,397,000	$1,050,875,000	$22,261,000 increase	$1,069,086,000	$40,472,000 increase

National Institute on Drug Abuse (NIDA): The House report calls for $1.1 billion for FY 2016, an increase of $22.3 million over FY 2015. The Senate report calls for $1.1 billion for FY 2016, and increase of $40 million compared to FY 2015. The Administration requested an $18.8 million increase from FY 2015.

House Report Language: “Adolescent Behavioral and Cognitive Development (ABCD)—The Committee applauds the Collaborative Research on Addictions at NIH initiative and the launch of the ABCD study. Unique in its scope and duration, the study will recruit 10,000 youth before they begin using alcohol, marijuana, nicotine, and other drugs, and follow them over 10 years into early adulthood to assess how substance use affects the trajectory of the developing brain. The Committee commends the study design which will used advanced brain imaging as well as psychological and behavioral research tools to evaluate brain structure and function and track substance use, academic achievement, IQ, cognitive skills, and mental health over time.

Medications Development—The Committee understands NIDA is considering new technologies for the development of next-general pharmaceuticals. For example, NIDA is exploring approaches to develop viable immunotherapeutic or biologic (e.g., bioengineered enzymes) approaches for treating addiction. The Committee looks forward to hearing more about work in this area in the fiscal year 2017 budget request.

NIDAMED—The Committee encourages its support for NIDAMED, an initiative designed to reach out to physicians, physicians in training, and other health care professionals to increase especially those treating our youth to better recognize the signs that lead to drug abuse and addiction.

Opioid Drug Abuse—The Committee remains concerned about prescription drug abuse, specifically the misuse of orally administered opioid drugs. According to some reports, more than 35 million Americans have abused prescription opioids at some point in their lifetimes. The June 2011 Institute of Medicine report on relieving pain indicates that such abuse and misuse resulted in an annual estimated cost to the Nation of $72.5 billion. The Committee expects NIDA to continue to support meritorious scientific activities related to research on medications to alleviate pain with reduced abuse liability and, as appropriate, to work with private partners on innovative research into such medications. In addition, NIDA should continue to fund research to better prevent and treat prescription drug abuse and to coordinate with CDC to help identify scientific research gaps. The Committee requests an update in the fiscal year 2017 budget request on the activities related to addressing the opioid drug abuse problem.”

[back to top]

Department of Justice – Appropriations for Selected Programs

Program	FY 14	FY 15 Enacted	FY 16 Request	FY 16 House Report	FY 15-House FY 16 Change	FY 16 Senate Report	FY 15-Senate FY 16 Change
Drug Enforcement Administration	$2,018,000,000	$2,033,320,000	$2,091,609,000	$2,073,945,000	$40,625,000 increase	$2,033,320,000	Level funding
Office of Justice Programs	$1,503,300,000	$1,537,300,000	$1,649,900,000	$1,015,400,000	$521,900,000 decrease	$1,467,800,000	$69,500,000 decrease
Research, Evaluation and Statistics	$120,000,000	$111,000,000	$151,900,000	$0	Not explicitly funded	$117,000,000	$6,000,000 decrease
State and Local Law Enforcement Assistance	$1,171,500,000	$1,241,000,000	$1,142,300,000	$1,015,400,000	$225,600,000 decrease	$1,102,000,000	$139,000,000 decrease
Byrne Memorial Justice Assistance Grants	$376,000,000	$376,000,000	$388,000,000	$509,000,000	$133,000,000 increase	$382,000,000	$6,000,000 increase
Drug Courts	$40,500,000	$41,000,000	$36,000,000	$46,000,000	$5,000,000 increase	$41,000,000	Level funding
Mentally Ill Offender Act	$8,250,000	$8,500,000	$14,000,000	$13,000,000	$4,500,000 increase	$10,000,000	$1,500,000 increase
Residential Substance Abuse Treatment (RSAT)	$10,000,000	$10,000,000	$14,000,000	$0	Program eliminated	$12,000,000	$2,000,000 increase
Second Chance Act/Offender Reentry	$67,750,000	$68,000,000	$120,000,000	$68,000,000	Level funding	$68,000,000	Level funding
Veterans Treatment Courts	$4,000,000	$5,000,000	$4,000,000	$15,500,000	$10,500,000 increase	$5,000,000	Level funding
Prescription Drug Monitoring	$7,000,000	$11,000,000	$9,000,000	$16,000,000	$5,000,000 increase	$7,000,000	$4,000,000 decrease
Juvenile Justice Programs	$254,500,000	$251,500,000	$339,400,000	$183,500,000	$68,000,000 decrease	$253,500,000	$2,000,000 increase
Community Oriented Policing Systems (COPS)	$214,000,000	$208,000,000	$303,500,000	$235,000,000	$27,000,000 increase	$212,000,000	$4,000,000 increase
Anti-Methamphetamine Task Forces	$7,500,000	$7,000,000	$0	$0	Program eliminated	$7,000,000	Level funding
Anti-Heroin Task Forces	New line item	$7,000,000	$0	$0	Program eliminated	$7,000,000	Level funding

Drug Enforcement Administration: The House report calls for $2.1 billion for FY 2016, a $40.6 million increase from FY 2015. The Senate report calls for $2 billion or level funding as compared to FY 2015. The Administration requested an increase of $58.3 million.

Senate Report Language: “Drug Diversion at Veterans Health Administration Facilities – The Committee is alarmed by the rates of prescription drug opioid abuse and related overdoses among veterans, as well as allegations of diversion of prescription opioids from Veterans Health Administration (VHA) facilities into the illicit drug market. The notion that VHA facilities are a source for the unauthorized distribution and use of opioids is extremely concerning. The Committee urges the DEA to maintain open communication with the VHA and treat investigations of drug diversion in VHA facilities as a priority.

Prescription Drug Abuse – The Committee believes that prescription drug abuse continues to remain an urgent public health crisis. Of particular concern is the link between prescription opioid abuse and its connection to heroin use. The Committee urges the DEA to continue to combat prescription drug abuse and heroin use by fully utilizing all available resources, including the Diversion Control Program, and by facilitating inter-agency and inter-department cooperation.”

Byrne Memorial Justice Assistance Grants: The House report calls for $509 million for FY 2016, an increase of $133 million over FY 2015 levels. The Senate report calls for $382 million for FY 2016, a $6 million increase over FY 2015.The Administration requested a $12 million increase.

Senate Report Language: “The Department should expect State, local, and tribal governments to target funding to programs and activities that conform with evidence-based strategic plans developed through broad stakeholder involvement. The Committee directs the Department to make technical assistance available to State, local, and tribal governments for the development or update of such plans.”

Drug Courts: The House report calls for $46 million for FY 2016, an increase of $5 million as compared to FY 2015. The Senate report calls for level funding for FY 2016, or $41 million. The Administration requested a $5 million decrease compared to FY 2015.

House Report Language: “The recommendation includes $41,000,000 for drug courts, which is $5,000,000 above the request. Drug courts help reduce recidivism and substance abuse among non-violent offenders and increase the likelihood of an offender’s successful rehabilitation through intense, judicially supervised treatment, mandatory periodic drug testing, community supervision, and appropriate sanctions according to this addiction treatment in different rehab centers online. The Committee expects these funds to be used to provide grants and technical assistance to State, local, and tribal governments to support the development, expansion, and enhancement of drug courts, based upon their efficacy as a systematic response to substance abuse and crime.”

Prescription Drug Monitoring: The House report calls for $16 million for FY 2016, an increase of $5 million compared to FY 2015. The Senate report calls for $7 million or a $4 million decrease compared to FY 2015.The Administration requested a $2 million decrease for FY 2016.

House Report Language: “The recommendation includes $11,000,000 for the Prescription Drug Monitoring Program (PDMP). The diversion and abuse of prescription medications has become our Nation’s fastest growing drug problem, with overdose deaths now surpassing motor vehicle accidents as the number one cause of accidental deaths nationwide. The Committee maintains its support for the provision of technical assistance for PDMPs, PDMP data users and other key stakeholders through this program. Further, the Committee directs the Bureau of Justice Assistance (BJA) to continue partnerships with other professional organizations that foster interstate interoperability and connectivity among State-run PDMPs, and encourages BJA to continue its support for efforts to establish a national network of interconnected PDMPs. The Committee also supports efforts to increase use of PDMPs among authorized users. The Committee directs BJA to assess the impact of establishing threshold enrollment and utilization rates and, where enrollment and utilization rates are not 100 percent, assess the feasibility of requiring benchmarks for improvements in enrollment and utilization as grant eligibility criteria. The Committee directs the Department to report, not later than 180 days after enactment of this Act, on this assessment, including the potential of prioritizing funding based on the goal of optimizing prescriber and dispenser enrollment and utilization rates for PDMPs by prescriber and dispensers. In the meantime, the Committee directs BJA to prioritize grant funding for States which are engaged in initiatives to integrate PDMP data with electronic health systems, such as electronic health records and electronic prescribing systems.”

Senate Report Language: “The Committee directs the Bureau of Justice Assistance to assess the impact of establishing threshold enrollment and utilization rates for the Prescription Drug Monitoring Program and, where enrollment and utilization rates are below 100 percent, assess the feasibility of requiring benchmarks for improvements in enrollment and utilization as grant eligibility criteria. The Committee directs the Department to report, not later than 180 days after enactment of this act, on this assessment, including the potential of prioritizing funding based on the goal of optimizing prescriber and dispenser enrollment and utilization rates for Prescription Drug Monitoring Programs by prescribers and dispensers as a ratio compared to the potential universe of prescribers and dispensers and controlled substance prescribing rates, respectively.”

Mentally Ill Offender Act: The House report calls for $13 million for FY 2016, an increase of $4.5 million compared to FY 2015. The Senate report calls for $10 million in funding for Mentally Ill Offender Courts (likely referring to Mentally Ill Offender Act), a $1.5 million increase over FY 2015. The Administration requested a $5.5 million increase.

Residential Substance Abuse Treatment (RSAT): The House report does not provide funding for the RSAT program. The Senate report calls for $12 million for FY 2016, or an increase of $2 million over FY 2015.The Administration requested $14 million for FY 2016, a $4 million increase in funding compared to FY 2015.

Second Chance Act/Offender Reentry: The House report calls for $68 million for FY 2016, level funding compared to FY 2015. The Senate report also calls for level funding or $68 million for FY 2016.The Administration requested a $52 million increase.

House Report Language: “The Committee remains concerned that despite a dramatic increase in corrections spending over the past two decades, recidivism and re-incarceration rates are largely unchanged. The Committee is aware that case studies of innovative, evidence-based practices provide a strong indication that this pattern can be reversed. The Committee expects that Second Chance Act grants will foster the implementation of strategies that have been proven to reduce recidivism and ensure safe and successful reentry back to their communities of adults released from prisons and jails. The Committee expects DOJ to designate funds for proven, evidence-based programs that will further the goal of maximizing public safety.”

Senate Report Language: “The SCA supports activities such as employment assistance, substance abuse treatment, housing, mentoring, family programming, and victim support. SCA grants will also support demonstration projects designed to test the impact of new strategies and frameworks…The Department is directed to submit as part of its spending plan for State and Local Law Enforcement Assistance a strategy for the use of all funds appropriated for Second Chance Act programs, including new initiatives requested by the Department that are funded in this recommendation.”

Veterans Treatment Courts: The House report calls for $15.5 million for FY 2016, an increase of $10.5 million compared to FY 2015. The Senate report also calls for level funding or $5 million for FY 2016. The Administration requested a $1 million decrease compared to FY 2016.

House Report Language: “The recommendation includes $5,000,000 to support veterans treatment courts. The Committee expects the Department to work in conjunction with the Department of Veterans Affairs, as appropriate, to provide grant support for collaborative, rehabilitative approaches for continuing judicial supervision over offenders who are veterans. These funds are to be used for court startup and training costs.”

Senate Report Language: “The Committee urges the Department to work in conjunction with the Department of Veterans Affairs to provide grant support for collaborative, rehabilitative approaches for continuing judicial supervision of offenders who are veterans. The Committee recommends not less than $5,000,000 for Veterans Treatment Courts and urges the Department to strengthen funding for existing Veterans Treatment Courts with successful track records to promote best practices.”

[back to top]

CapitolHill, Public View

D.C. Update – June 26th, 2015

June 30, 2015 aaa

Around the Agencies

CMS releases April 2015 report on State Medicaid and CHIP eligibility and enrollment data
CDC releases report on prevalence of diagnosed and undiagnosed HIV infection
CDC release report on 2011 State tobacco control program spending

In the News

Parity Implementation Coalition and Kennedy Forum release new guide on mental health and substance use disorder parity
AMA passes model State law for medication-assisted treatment
Legal Action Center releases new web tool providing information on available health coverage options in each State
Network for Public Health Law warns of nicotine poisoning among children and youth

Upcoming Events

SAMHSA announces webinar discussing peer-run organization and recovery community organization sustainability

Around the Agencies

CMS releases April 2015 report on State Medicaid and CHIP eligibility and enrollment data
The Centers for Medicare and Medicaid Services (CMS) released the April 2015 report on Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollment data this week. The report highlights the substantial increases in Medicaid and CHIP enrollment since the open enrollment period began on October 13. As of April 2015, over 71.1 million people are enrolled in Medicaid and CHIP programs. Enrollment has steadily increased over time, as 76,645 additional people were enrolled in April 2015 compared to March 2015. States that have carried out Medicaid expansion programs have seen enrollment rise by approximately 28.2 percent compared to the July-September 2013 baseline period. States that did not implement Medicaid expansion programs have only seen enrollment increases of approximately 8.8 percent.

CDC releases report on prevalence of diagnosed and undiagnosed HIV infection
The Centers for Disease Control and Prevention (CDC) released a new report this week discussing the prevalence of diagnosed and undiagnosed HIV infections. Persons with undiagnosed HIV contribute to nearly one third of transmission in the United States. To combat this, and other sources of transmission, the CDC recommends that all adults be tested at least once and that persons with increased risk for HIV infections be tested annually. The report suggests that States make an effort to expand access to HIV testing to ensure higher rates of diagnosis. Because HIV rates vary significantly between regions (110 per 1000,000 persons in Iowa with HIV versus 3,936 per 100,000 persons in Washington, DC) the CDC proposes that each State create testing procedures that are best suited for their State. Decreases in undiagnosed HIV in recent years have been attributed to expanded access to testing, underlining the efficacy and importance of broadened access to testing.

CDC release report on 2011 State tobacco control program spending
The Centers for Disease Control and Prevention (CDC) released a new report this week examining tobacco control program spending throughout the United States in 2011. The report finds that States with larger investments in tobacco prevention programs saw faster decreases in cigarette sales and smoking than States without similar programs. Despite this progress, tobacco prevention programs remain underfunded throughout the country. The report states that in 2011 States “spent approximately $658 million on tobacco control and prevention, which accounts for less than 3% of the States’ revenues from the sale of tobacco products and only 17.8% of the level recommended by the CDC.” The CDC’s Best Practices for Comprehensive Tobacco Control Programs recommended in 2007 that States spend approximately $3.7 billion annually on tobacco prevention initiatives in order to see substantial decreases in cigarette use.

In the News

Parity Implementation Coalition and Kennedy Forum release new guide on mental health and substance use disorder parity
The Parity Implementation Coalition (PIC) and Kennedy Forum have released a new guide discussing the mental health and substance use disorder parity law. The guide was primarily created to educate individuals seeking mental health or substance use disorder services on their rights and benefits under current parity law. The PIC and Kennedy Forum believe the guide will promote increased communication with insurance plans, in addition to helping resolve disputes with health plans over coverage and reimbursement for mental health and substance use disorder services. The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) was passed in 2008, with final regulations published in 2013.

AMA passes model State law for medication-assisted treatment
The American Medical Association (AMA) has passed a model State law calling for increased access to medication-assisted treatment (MAT) for individuals with opioid or other substance use disorders. The law requires the Governor to appoint a task force to develop recommendations surrounding MAT best practices. The law further outlines the regulatory framework of MAT programs, stating that MAT services will not be subject to “any annual or lifetime dollar limitations, limitations to a pre-designated facility, specific number of visits, or days of coverage.” The health benefits and MAT services described in the legislation would apply to all health insurance plans if the model law is passed in a State.

Legal Action Center releases new web tool providing information on available health coverage options in each State
The Legal Action Center (LAC) released a new online tool containing health coverage profiles for each State this past week. The tool is the result of significant research efforts to determine the essential information on health system agencies and points of contact for every State. The LAC has partnered with the U.S. Department of Justice’s Bureau of Justice Assistance, and the Advocates for Human Potential to provide further technical assistance to health professionals, in addition to spreading information about potential methods for expanding access to health care for those currently incarcerated within the criminal justice system.

Network for Public Health Law warns of nicotine poisoning among children and youth
The Network for Public Health Law published an article this week warning of increased rates of nicotine poisoning among children and youth. The article suggests these increased rates are a result of the popularity of electronic cigarettes and the liquid nicotine, or e-liquid, used within them. States across the country have seen nicotine poisoning rates rise, with the Minnesota Poison Control System reporting a 35 percent increase from 2013 to 2014. New York reported the first known infant death from e-liquid in December 2014. While the U.S. Food and Drug Administration (FDA) has announced plans to regulate electronic cigarettes and other non-cigarette tobacco products, no specific regulations have taken effect. States are drafting regulations in place of the FDA, with Minnesota, New York, and Vermont passing legislation requiring that e-liquid be sold in child-proof packaging. Other States have considered relabeling e-liquid containers to make their dangers more clear.

Upcoming Events

SAMHSA announces webinar discussing peer-run organization and recovery community organization sustainability
The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced a new webinar discussing peer-run organization (PRO) and recovery community organization (RCO) sustainability. PROs and RCOs play essential roles in providing mental health and substance use disorder services, yet sometimes face challenges when developing infrastructure or diversifying funding. This webinar will discuss potential strategies for PROs and RCOs to increase capacity, strengthen procedures, and construct policies that will lead to increased sustainability in the future. The webinar will be held on Wednesday, July 22^nd from 1-2:30pm Eastern Time.

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.

CapitolHill, News, Public View

NASADAD Releases Appropriations Update for SAMHSA, NIDA, NIAAA, CDC, HRSA, and DOJ

Image June 26, 2015 aaa

The update provides an overview of the status of the FY 2016 appropriations process in both the House and Senate. Individual program allocations are included in the detailed charts – with information about the FY 2015 budget allotment, President’s request, House version, and Senate version.

Continue reading →

CapitolHill, Public View

D.C. Update – June 22, 2015

June 23, 2015 aaa

News from NASADAD

NASADAD attends Alliance for Health Reform briefing on small businesses and health reform

Around the Agencies

CDC releases report on the provision of naloxone kits to laypersons, finding substantial increase in naloxone use over the past five years

In the News

Medicaid and CHIP Payment and Access Commission releases new report focusing on mental health and substance use disorders
PDMP Training and Technical Assistance Center releases guide discussing potential PDMP data errors
Colorado releases data on adult marijuana use
Trust for America’s Health releases new report on injury deaths, finding drug overdoses as leading cause
House Energy and Commerce Subcommittee on Health holds hearing on mental health reform legislation

Upcoming Events

FDA hosts series of meetings on issues surrounding naloxone
Child Welfare League announces 2016 annual conference focusing on the effect of substance use disorders on families

News from NASADAD

NASADAD attends Alliance for Health Reform briefing on small businesses and health reform
Brian Denten, Public Policy Intern, attended the briefing on small businesses and health reform hosted by the Alliance for Health Reform. The briefing featured several panelists speaking on the forthcoming Affordable Care Act (ACA) small business health care expansion. The pending expansion would take effect in 2016, and would redefine small businesses as employers with up to 100 employees. The current ACA small business provision only applies to companies with 1-50 employees. The expansion would apply the ACA small business regulation to companies with 51-100 employees. Some panelists warned that this expansion would make it difficult for mid-sized firms to provide health care to employees, and suggested that mid-sized firms may leave the insurance marketplace rather than paying potentially higher rates. These panelists advised that the expansion in its current state would raise small group market premiums by 7 percent in 2016, and proposed either delaying the expansion entirely or permanently allowing States to determine the size of the small group market. Other speakers disagreed with this interpretation, believing that the small group expansion will help diversify the risk of the marketplace and eventually result in lower premiums.

Panelists:

Sabrina Corlette, Senior Research Fellow and Project Director, Georgetown University’s Center on Health Insurance Reforms
Terry Gardiner, Vice President, Small Business Majority
Katie Mahoney, Executive Director, Health Policy, U.S. Chamber of Commerce
Alissa Fox, Senior Vice President of the Office of Policy and Representation, Blue Cross Blue Shield Association

Around the Agencies

CDC releases report on the provision of naloxone kits to laypersons, finding substantial increase in naloxone use over the past five years
The Centers for Disease Control and Prevention (CDC) released a new report on the provision of naloxone kits to laypersons this past week. The CDC states that organizations providing naloxone kits to laypersons increased substantially over the past five years, with responding organizations increasing by 183 percent, local sites providing naloxone increasing by 243 percent, the number of laypersons provided naloxone kits increasing 187 percent, the number of reversals reported increasing by 160 percent, and a 94 percent increase in States with at least one organization providing naloxone. Despite these large increases, 20 States still do not have any organizations facilitating the provision of naloxone to laypersons. The report finds that the majority of laypersons receiving naloxone kits were people with substance use disorders, and that individuals with substance use disorders performed the majority of reported overdose reversals.

In the News

Medicaid and CHIP Payment and Access Commission releases new report focusing on mental health and substance use disorders
The Medicaid and CHIP Payment and Access Commission (MACPAC) released a new report focusing on mental health and substance use disorders this past week. The report is part of an annual series of MACPAC reports issued to Congress each year. The report discusses the prevalence of mental health and substance use disorders throughout the country, with sections focusing on comorbidity and the use of Medicaid to treat mental health and substance use disorder-related conditions. MACPAC finds that “adult Medicaid enrollees with any mental illness or substance use disorder are more likely to report having worse overall health status than those with private coverage or who are insured.” MACPAC attributes this disparity to differences in the socioeconomic status of Medicaid enrollees versus the rest of the country. The report further finds that 24.2 percent of expenditures for mental health disorders for adults age 18-64 were paid for by Medicaid; and that 24 percent of adults aged 18-64 with Medicaid coverage reported receiving “some mental health treatment during the past year, compared to 14 percent of privately insured and 10 percent of uninsured adults.” This data reflects the importance of Medicaid in increasing access to mental health and substance use disorder services to high-need populations.

PDMP Training and Technical Assistance Center releases guide discussing potential PDMP data errors
The Prescription Drug Monitoring Program (PDMP) Training and Technical Assistance Center (TTAC) released a new guide discussing errors involved with PDMP data collection this past week. The guide was compiled following an October 2014 work group meeting that examined issues surrounding prescription data. TTAC’s new guide explores current PDMP data collection practices, and identifies potential areas in the data collection process where errors may occur. The guide concludes with a discussion about possible corrective measures for errors and best practices for prescribers, dispensers, and other relevant stakeholders to consider in the future.

Colorado releases data on adult marijuana use
Colorado released a new infographic featuring data on adult marijuana use in 2014 collected from the Colorado Behavioral Risk Factor Surveillance System. The infographic states that 13.6 percent of Colorado adults reported using marijuana during the past month, and of those who currently use, 33.2 percent use marijuana daily. 18.8 percent of marijuana users reported driving after using marijuana. Colorado further found that marijuana use is highest among adults with lower household incomes, and that marijuana use dramatically decreased with age.

Trust for America’s Health releases new report on injury deaths, finding drug overdoses as leading cause
Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) have released a new report on injury deaths in the United States. The report finds that injury deaths are responsible for nearly 193,000 deaths per year, making injuries the leading cause of death for Americans age 1 to 44. TFAH and the RWJF find that drug overdoses are the leading cause of injury death, with nearly 44,000 people overdosing from substances each year. Drug overdose related deaths have more than doubled in the past 14 years. The report states that half of this increase comes from prescription drug overdoses (22,000 deaths per year). Overdose rates have significantly increased in 26 states and Washington, D.C. over the past four years.

House Energy and Commerce Subcommittee on Health holds hearing on mental health reform legislation
The House Energy and Commerce Subcommittee on Health held a hearing on mental health reform legislation this past week. The hearing heard testimony from several current and former elected officials and a variety of other stakeholders. Representative Tim Murphy (R-PA) proposed the Helping Families in Mental Health Crisis Act (H.R. 2646). Representatives asked the panelists about their insight on the proposed law and other issues related to mental health services.

Witnesses:

Creigh Deeds, Senator, Senate of Virginia
Patrick J. Kennedy, Former U.S. Representative (RI), Founder, Kennedy Forum
Jeffrey A. Lieberman, M.D., Chairman, Department of Psychiatry, Columbia University College of Physicians and Surgeons
Paul Gionfriddo, President and CEO, Mental Health America
Steve Coe, Chief Executive Officer, Community Access
Mary Jean Billingsley, Parent, National Disability Rights Network
Harvey Rosenthal, Executive Director, New York Association of Psychiatric Rehabilitation Services

Upcoming Events

FDA hosts series of meetings on issues surrounding naloxone
The Food and Drug Administration (FDA) will host a series of meetings on issues surrounding uptake of naloxone in certain medical settings on July 1^st and 2^nd. The meetings aim to open a public discussion about uptake of naloxone on ambulances and in association with prescriptions for opioid use disorders; in addition to introducing naloxone to new settings to help reduce opioid overdose fatalities. Legal, regulatory, logistical, and clinical aspects related to naloxone availability will also be discussed. The meetings will feature several panels of academic, policy, and industry experts throughout the two days. Rob Morrison, Executive Director, and Colleen Haller, Public Policy Associate, will attend the meetings.

Child Welfare League announces 2016 annual conference focusing on the effect of substance use disorders on families
The Child Welfare League of America (CWLA) in partnership with Children and Family Futures (CFF) will host the CWLA 2016 National Conference on August 1-3, 2016 in Orange County, California. This year’s conference will focus on the effect of substance use disorders on children, youth, and families. CWLA intends for the conference to create increased national awareness of issues surrounding substance use, in addition to promoting multidisciplinary collaboration among stakeholders to advance best practices and policies for families dealing with substance use disorders. The CWLA is currently accepting proposals for presentations at the conference.

CapitolHill, Public View

D.C. Update – June 11, 2015

June 12, 2015 aaa

News from NASADAD

NASADAD attends Capitol Hill briefing on opioid use among college students
NASADAD releases section-by-section analysis of the Treatment and Recovery Investment Act

Around the Agencies

SAMHSA releases report examining impact of Medicaid in providing and increasing access to mental health and substance use disorder services
CDC releases new treatment guidelines for those with or at-risk for sexually transmitted diseases
GAO issues report on electronic cigarette import volume and tariff revenue
CDC issues report on adverse health effects associated with synthetic cannabinoid use

In the News

New study examines methadone treatment for incarcerated individuals
American Society of Addiction Medicine releases new guidelines for treatment of opioid use disorders
Parity Implementation Coalition and Kennedy Forum release new guide on mental health and substance use disorder parity
Collaborative for Effective Prescription Opioid Policies publishes USA Today column discussing opioid epidemic
Alliance for Health Reform releases recap of King v. Burwell briefing
ONDCP Director Michael Botticelli appears on Diane Rehm Show

News from NASADAD

NASADAD attends Capitol Hill briefing on opioid use among college students
Rob Morrison, Executive Director, and Colleen Haller, Public Policy Associate, attended the briefing, “Prevention Opioid Deaths among Young People,” hosted by the Hazelden Betty Ford Foundation Institute for Recovery Advocacy on June 10^th. The briefing was well attended and included appearances by several members of Congress: Majority Leader Kevin McCarthy (R-CA), Sen. Sheldon Whitehouse (D-RI), Sen. Klobuchar (D-MN), and Co-Chair of the Prescription Drug Abuse Caucus, Rep. Stephen Lynch (D-MA). The panelists discussed results from a recent survey of college students on their attitudes to drug use, and particularly the misuse of prescription pain relievers. Panelists also shared their personal stories of recovery, as well as their efforts to establish collegiate recovery programs. Greg Williams, Director of the Anonymous People, also highlighted an upcoming national recovery event on the National Mall: UNITE to Face Addiction scheduled for October 4, 2015.

Panelists:

William Moyers, Vice President of Public Affairs and Community Relations, Hazelden Betty Ford Foundation
Amelia Arria, Director, Center on Young Adult Health and Development at Univ. of MD School of Public Health
Sarah Nerad, Director of Recovery, Ohio State University
Joseph Lee, Medical Director, Hazelden Betty Ford Foundation’s Youth Continuum
Greg Williams, Director of the Anonymous People and Campaign Director for UNITE to Face Addiction
Ivana Grahovac, Executive Director, Transforming Youth Recovery

NASADAD releases section-by-section analysis of the Treatment and Recovery Investment Act
NASADAD released a section-by-section analysis of the Treatment and Recovery Investment Act this past week. The bill, sponsored by Senator Ed Markey (D-MA), would amend the Public Health Service Act to authorize the Director of the Center for Substance Abuse Treatment (CSAT) to award grants to State substance abuse agencies, units of local government, and Indian tribes or tribal organizations to create or expand substance use disorder services. The legislation would also create separate grant programs for opioid use disorder treatment, treatment for pregnant and parenting women with opioid use disorders, and treatment plans for adolescents with substance use disorders. An additional grant program aimed at expanding and enhancing recovery support services, including education and peer-mentoring networks, is also authorized in the bill. The legislation contains language that would increase the budget authorization for the Substance Abuse Prevention and Treatment Block Grant.

Around the Agencies

SAMHSA releases report examining impact of Medicaid in providing and increasing access to mental health and substance use disorder services
The Substance Abuse and Mental Health Services Administration (SAMHSA) released a new report examining the impact of Medicaid in providing and increasing access to mental health and substance use disorder services. The report was compiled by SAMHSA’s Center for Financing Reform and Innovation, and discusses information on Medicaid fee-for-service spending on prescription drugs. The report further compares spending for dually-eligible Medicare-Medicaid enrollees versus spending for enrollees without dual eligibility. SAMHSA aims to help inform policy makers, program staff, and providers with better knowledge on the spending and utilization of mental health and substance use disorder services.

CDC releases updated treatment guidelines for those with or at-risk for sexually transmitted diseases
The Centers for Disease Control and Prevention (CDC) released new treatment guidelines for those with or at-risk for sexually transmitted diseases (STDs). The guidelines were compiled following a Spring 2013 conference in Atlanta. The new guidelines discuss alternative treatment options for gonorrhea, alternative treatment options for genital warts, best practices for HPV vaccine recommendations and counseling, transgender treatment, and annual testing for hepatitis C for at-risk individuals, among several other topics.

GAO issues report on electronic cigarette import volume and tariff revenue
The United States Government Accountability Office (GAO) has issued a new report on import volume and tariff revenue for electronic cigarettes. The report notes that electronic cigarette import volume and tariff revenue is currently unknown due to the Harmonized Tariff Schedule of the United States (HTS) not tracking data specific to electronic cigarettes or any associated accessories. The GAO does not make any recommendations in its report.

CDC issues report on adverse health effects associated with synthetic cannabinoid use
The Centers for Disease Control and Prevention (CDC) issued a report on the adverse health effects associated with synthetic cannabinoid use this past week. United States poison centers have reported a substantial increase in calls related to synthetic cannabinoid usage in the past year. Calls increased 330% from 349 in January 2015 to 1,501 in April 2015. The most frequently reported adverse health effects include agitation (35.3%), tachycardia or faster than normal heart beat (29.0%), drowsiness (26.3%) and vomiting (16.4%). Most users reported consuming synthetic cannabinoids by inhalation (80.3%) or ingestion (19.5%). The CDC suggests that increasing rates of synthetic cannabinoid usage pose an emerging public health threat.

In the News

New study examines methadone treatment for incarcerated individuals
A new Brown University study has found that individuals taken off of methadone treatment while in custody are “two times less likely than those staying on the medication to return to methadone treatment in the community within a month after release.” The study, led by Josiah Rich, MD, MPH, was performed from 2011-2013 within the Rhode Island Department of Corrections. Researchers randomly assigned inmates to either continue methadone treatment or begin a tapered withdrawal in accordance with existing correctional guidelines. Nearly all of the inmates who continued treatment while incarcerated returned to community clinics within a month after release, while only 20 percent of inmates forced to undergo withdrawal returned to methadone treatment after release. Rhode Island has responded to the findings by adjusting methadone tapering protocols, extending the tapering period from one to six weeks.

American Society of Addiction Medicine releases new guidelines for treatment of opioid use disorders
The American Society of Addiction Medicine (ASAM) released new guidelines for the usage of medication when treating opioid use disorders this past week. The guide aims to educate clinicians and providers about the benefits of using treatment medications for patients in recovery. Despite the medications’ benefits, less than 30% of treatment programs currently offer any medication options in their treatment regimens. ASAM President Jeffrey Goldsmith notes that these guidelines are the first to address all the available FDA-approved medications used to treat opioid use disorders.

Collaborative for Effective Prescription Opioid Policies publishes USA Today column discussing opioid epidemic
The Collaborative for Effective Prescription Opioid Policies (CEPOP) published a USA Today column discussing ongoing efforts to address the opioid epidemic this past week. CEPOP identifies the complexity of the crisis in the column, stating the challenges associated with ensuring access to adequate pain management while balancing the serious risks of addiction associated with these medications. The Centers for Disease Control and Prevention notes that the number of prescribed opioid painkillers has increased substantially in the past several decades, representing a need for robust patient and provider education. CEPOP concludes the column with a call for stakeholders to work together to develop a comprehensive plan to address the epidemic through effective government and private sector solutions.

Alliance for Health Reform releases recap of King v. Burwell briefing
The Alliance for Health Reform has released a recap of last week’s briefing on potential implications of the King v. Burwell ruling. A Supreme Court ruling for the King petitioners would likely eliminate the ability for individuals to receive subsidies to purchase health insurance through federal marketplaces. As of February 2015, 87% of people selecting a marketplace plan receive premium subsidies. According to the briefing, a ruling for the King petitioners would make these subsidies no longer available in States with federally-run marketplaces, and would essentially render any affected health insurance exchanges inoperable. Several speakers noted that affected States may be able to create new State-based exchanges by using other States’ infrastructure or by leasing federal IT services. Republicans are expected to prepare a legislative response to the ruling in the event the King petitioners are successful.

ONDCP Director Michael Botticelli appears on Diane Rehm Show
Michael Botticelli, Director of the White House Office of National Drug Control Policy (ONDCP), appeared on the radio show on June 11^th. Director Botticelli shared his personal recovery story, as well as information on ONDCP’s work to expand prevention, treatment, and recovery. Director Botticelli highlighted the supports that assisted his journey to sustained recovery and commented on how the federal government can expand access to those supports. Director Botticelli also discussed the science of addiction, the role of criminal justice reform, and the ways that federal drug policy can make positive changes in the lives of individuals with substance use disorders and their families.

CapitolHill, News, Public View, WSN

NASADAD releases fact sheet on neonatal abstinence syndrome

Image June 8, 2015 aaa

The fact sheet provides information about neonatal abstinence syndrome (NAS) including prevalence, appropriate treatment options for mothers and newborns, and key federal programs for pregnant and parenting women with substance use disorders.

Continue reading →

CapitolHill, Public View

D.C. Update – May 27, 2015

May 28, 2015 aaa

News from NASADAD

NASADAD Board Chair, Mark Stringer (MO) testifies before Congressional hearing on opioid issues – Members ask about SAPT Block Grant
Colorado selects Dr. Nancy VanDeMark as new Director of the Office of Behavioral Health
NASADAD attends Altarum recovery forum
NASADAD attends briefing on mental health and substance use disorder parity on Capitol Hill
NASADAD attends Congressional briefing on the Veteran Wellness Act

Around the Agencies

SAMHSA report shows significant decrease in underage cigarette smoking
SAMHSA releases consumer booklet in recognition of Hepatitis Awareness Month
SAMHSA now accepting applications for FY 2015 Joint Adult Drug Court Solicitation to Enhance Services, Coordination, and Treatment Grants
SAMHSA now accepting applications for FY 2015 PPHF-2015 Cooperative Agreements for State-Sponsored Youth Suicide Prevention and Early Intervention grants
SAMHSA now accepting applications for FY 2015 Minority Serving Institutions Partnerships with Community-Based Organizations grants
SAMHSA now accepting applications for FY 2015 planning grants for Certified Community Behavioral Health Clinics
CMS and SAMHSA mental health and substance use disorder parity webinar now available on YouTube
CDC report examines decline in Staten Island opioid analgesic-involved overdose death rate

In the News

Senators Richard Durbin (D-IL) and Lindsey Graham (R-SC) announce Senate National Institutes of Health caucus
Government Accountability Office releases report examining highest cost Medicaid-only enrollees
Garrett Lee Smith Memorial Act Reauthorization of 2015 introduced in the Senate
CDEWS study finds synthetic cannabinoid usage among criminal justice populations in Washington, DC; Denver; and Tampa

News from NASADAD

NASADAD Board Chair, Mark Stringer (MO) testifies before Congressional hearing on opioid issues – Members ask about SAPT Block Grant
Rob Morrison, Executive Director, Colleen Haller, Public Policy Associate, and Brian Denten, Public Policy Intern attended the hearing called by the House Energy and Commerce Subcommittee on Oversight and Investigations. The Subcommittee is chaired by Rep. Tim Murphy (R-PA), and Rep. Diana DeGette (D-CO) is the Ranking Member. The hearing featured testimony from State health commissioners, as well as NASADAD Board President Mark Stringer (MO), on the need for increased access to care and expanded prescription drug monitoring programs (PDMPs). Panelists stressed that improving access to care remains a top priority in helping individuals with substance use disorders. Several Representatives inquired about the practice of “doctor shopping,” and of potential methods to decrease its prevalence. All panelists affirmed the need for interstate interoperability or the ability of PDMPs to communicate information across State lines. The panelists further advocated for increased education to train prescribers on best opioid prescribing practices and on substance use disorders.

Several Members of the subcommittee raised questions about the need to increase funding for the Substance Abuse Prevention and Treatment (SAPT) Block Grant. Mr. Stringer explained how critical the SAPT Block Grant is to States’ substance use disorder prevention, treatment, and recovery systems and the serious consequences that reductions in funding have on individuals’ access to vital services. In particular, Mr. Stringer pointed to NASADAD’s newly released fact sheet on the SAPT Block Grant, highlighting that the purchasing power of the grant has decreased by 25% over the last 10 years. The fact sheet also reveals that Congress would need to appropriate an addition $450 million to the SAPT Block Grant program to restore the funding to 2006 levels.

Panelists:

Jerome Adams, M.D., M.P.H.; Health Commissioner, Indiana State Department of Health
Monica Bharel, M.D., M.P.H.; Commissioner, Massachusetts Department of Public Health
Mark Stringer, M.A., L.P.C., N.C.C.; Director, Division of Behavioral Health, Missouri Department of Mental Health
Larry Wolk, M.D., MSPH; Executive Director and Chief Medical Officer, Colorado Department of Public Health and Environment

Colorado selects Dr. Nancy VanDeMark as new Director of the Office of Behavioral Health
Colorado has selected Dr. Nancy VanDeMark as the new Director of the Office of Behavioral Health. Dr. VanDeMark has been a partner with the Innovela Consulting Group for the past seven years, working with providers, State advocacy groups, and federal contractors in program planning, organizational analysis, proposal writing, program evaluation, and performance monitoring. Prior to her time at Innovela Consulting Group, Dr. VanDeMark worked at the Arapahoe House Inc. substance use disorder treatment program in multiple executive-level positions. Dr. VanDemark holds a Master’s Degree in Social Work with a concentration in administration and planning from the University of Denver and a Ph.D. in Public Affairs from the University of Colorado. Dr. VanDeMark will start her new role as Director of the Office of Behavioral Health on Monday, June 15^th.

NASADAD attends Altarum recovery forum
Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the forum, “Addiction and Recovery in the United States: Reinforcing Community-Based Solutions,” on Thursday, May 14^th. The purpose of the forum was to discuss important advances taking place in the recovery movement, as well as raise awareness of the Comprehensive Addiction and Recovery Act of 2015 (CARA) which includes important recovery-specific provisions. Speakers included staff from Sen. Rob Portman’s (R-OH) staff (co-sponsor of CARA), Michael Botticelli (Director, White House Office of National Drug Control Policy), Tom Coderre (Senior Advisor to the Administrator, Substance Abuse and Mental Health Services Administration), Carol McDaid (Principal and Founder, Capitol Decisions), Holly Cekala (Executive Director, RICares), Kristin Harper (Executive Director, Association of Recovery Schools), Joe Powell (Executive Director, Association of Persons Affected by Addiction), and Justin Luke Riley (Executive Director, Young People in Recovery). View a video of the event here.

NASADAD attends briefing on mental health and substance use disorder parity on Capitol Hill
Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the briefing, “Parity 101: Understanding the Mental Health Parity and Addiction Equity Act,” on Thursday, May 14^th. Panelists provided an overview of federal parity protections and highlighted the challenges that still exist in fully implementing parity. Panelists included family members, national experts on substance use disorder and mental health parity, and a representative from the Kennedy Forum. Representatives Paul Tonko (D-NY) and Grace Napolitano (D-CA) attended the briefing and provided introductory remarks.

NASADAD attends Congressional briefing on the Veteran Wellness Act
The briefing was attended by Brian Denten, Public Policy Intern. The briefing discussed Reps. Tim Ryan (D-OH) and Glenn Thompson’s (R-PA) new legislation, the Veteran Wellness Act. The Veteran Wellness Act aims to increase the ability of Veteran Service Organizations (VSOs) to promote good health among the country’s veterans. The proposed legislation would create a grant program through the Department of Veterans Affairs targeted at helping VSOs expand wellness activities and modernize existing facilities. Several panelists spoke at the briefing, noting that improving mental health for veterans is an essential part of smoothing the transition from deployment to civilian life. Many veterans do not receive health care through the Veterans Affairs system, underlining the importance of increasing the quality of care provided by community organizations. Panelists stressed the need for full federal mental health and substance use disorder parity in achieving better outcomes for veterans.

Panelists:

LTC Chris Ivory; Chief of Behavioral Health at the Office of the Surgeon General
Harold Kudler, M.D.; Chief Consultant for Mental Health, US Department of Veterans Affairs
Chad Moos; Deputy National Service Director, Disabled American Veterans
Brandon Gehrke; Senior Legislative Associate, Veterans of Foreign Wars
Steve Gonzalez; Assistant Director of Employment and Education, The American Legion

Around the Agencies

SAMHSA report shows significant decrease in underage cigarette smoking
A new Substance Abuse and Mental Health Services (SAMHSA) report shows a significant decrease in underage cigarette smoking from 2003 to 2013 among those aged 12 to 17. The overall national level of underage cigarette smoking declined from 12.6 percent in 2003 to 6.1 percent in 2013. The study notes that significant differences between States remain, with a range of 4.3 percent in California to 9.5 percent in Kentucky. SAMHSA suggests that an increase in the underage perception of risk from smoking one or more packs of cigarettes a day partially accounts for the decrease in rates of underage cigarette smoking. Despite the decrease in underage cigarette smoking, underage use of other tobacco products like e-cigarettes and hookah continues to rise.

SAMHSA releases consumer booklet in recognition of Hepatitis Awareness Month
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released a new consumer booklet in recognition of May as Hepatitis Awareness Month. Take Action Against Hepatitis C: For People in Recovery from Mental Illness or Addiction educates people in recovery from mental illnesses or substance use disorders about the dangers of Hepatitis C and the importance of preventative screening.

SAMHSA now accepting applications for FY 2015 Joint Adult Drug Court Solicitation to Enhance Services, Coordination, and Treatment Grants
The Substance Abuse and Mental Health Services Administration (SAMHSA) is now accepting applications for FY 2015 Joint Adult Drug Court Solicitation to Enhance Services, Coordination, and Treatment Grants. Applicants will apply for two awards (one grant from SAMHSA and one grant from the Bureau of Justice Assistance) on the same application. Funding should be used to enhance drug court services and substance use disorder treatment options. SAMHSA estimates 10 grantees will be awarded up to $325,000 per year for up to three years. Applications are due by June 1, 2015.

SAMHSA now accepting applications for FY 2015 PPHF-2015 Cooperative Agreements for State-Sponsored Youth Suicide Prevention and Early Intervention grants
The Substance Abuse and Mental Health Services Administration (SAMHSA) is now accepting applications for FY 2015 PPHF-2015 Cooperative Agreements for State-Sponsored Youth Suicide Prevention and Early Intervention grants. Funding should be used to support State and tribal efforts to develop youth suicide prevention and early intervention strategies. SAMHSA estimates that 12 grantees will be awarded up to $736,000 per year for up to five years. Applications are due by June 2, 2015.

SAMHSA now accepting applications for FY 2015 planning grants for Certified Community Behavioral Health Clinics
The Substance Abuse and Mental Health Services Administration (SAMHSA) is now accepting applications for FY 2015 planning grants for Certified Community Behavioral Health Clinics (CCBHCs). Funding should be used to support States in implementing certification for CCBHCs. The grant program will also “establish prospective payment systems for Medicaid reimbursable services at the clinics.” SAMHSA estimates that up to 25 grantees will be awarded up to $2 million in funding for up to one year. Applications are due by August 5, 2015.

CMS and SAMHSA mental health and substance use disorder parity webinar now available on YouTube
A recent Centers for Medicare & Medicaid Services (CMS) and Substance Abuse and Mental Health Services Administration (SAMHSA) webinar discussing mental health and substance use disorder parity is now available SAMHSA’s YouTube channel. The webinar, “Overview of NPRM Application of MHPAEA to Medicaid and CHIP,” provides an overview of the newly proposed parity rule and the procedure for comment submission. Comments on the rule are due by June 9, 2015.

CDC report examines decline in Staten Island opioid analgesic-involved overdose death rate
A new Centers for Disease Control and Prevention (CDC) report has found a significant decline in the opioid analgesic-involved overdose death rate in Staten Island. Staten Island’s opioid analgesic-involved overdose death rate declined 29 percent from 2011 to 2013, while the rate remained unchanged for the other four New York City boroughs. The decline is attributed to targeted and general public health initiatives implemented by Staten Island officials – including townhall meetings and promotional campaigns focusing on opioid prescribing guidelines. Both the meetings and campaigns were tailored specifically to Staten Island populations. The report recommends a similarly targeted approach for other jurisdictions with high rates of opioid analgesic-involved mortality.

In the News

Senators Richard Durbin (D-IL) and Lindsey Graham (R-SC) announce Senate National Institutes of Health caucus
Senators Richard Durbin (D-IL) and Lindsey Graham (R-SC) announced the formation of the Senate National Institutes of Health (NIH) caucus this past week. The caucus will create a bipartisan group for Senators to educate each other about the importance of the NIH and the need for increased funding for biomedical research. All Senators are invited to join the new NIH caucus. Advocacy organizations are encouraged to help increase caucus membership by contacting their respective Senators to suggest joining the caucus.

Government Accountability Office releases report examining highest cost Medicaid-only enrollees
The Government Accountability Office (GAO) released a new report examining highest cost Medicaid-only enrollees this past week. The report found that the most expensive 5 percent of Medicaid-only enrollees accounted for nearly half of annual Medicaid expenditures for Medicaid-only enrollees in fiscal years 2009 through 2011. Disabled Medicaid-only enrollees made up the majority of the high-cost population. 53 percent of high-cost Medicaid-only enrollees had mental health conditions and 20 percent had a substance use disorder. The Senate Finance Committee requested the report.

Garrett Lee Smith Memorial Act Reauthorization of 2015 introduced in the Senate
The Garrett Lee Smith Memorial Act Reauthorization of 2015 was introduced in the Senate on May 12, 2015. The legislation was introduced by Senators Jack Reed (D-RI) and Lisa Murkowski (R-AK), and would renew federal funding for three key youth and college suicide prevention grant programs. The State and Tribal program helps create public-private partnerships to address youth suicide prevention and early-intervention needs. The Campus Suicide Prevention program increases access to services, outreach, and education for students with mental health or substance use disorders, and the Suicide Prevention Resource Center program informs and trains States and Tribes on suicide prevention strategies for high-risk groups. NASADAD signed on to a letter supporting the passage of the bill along with other mental health and substance use disorder nonprofits.

CDEWS study finds synthetic cannabinoid usage among criminal justice populations in Washington, DC; Denver; and Tampa
A new Community Drug Early Warning System (CDEWS) study has found synthetic cannabinoid usage among criminal justice populations in Washington, DC; Denver; and Tampa. The study examined urine samples previously collected by criminal justice agencies, finding varying types of synthetic cannabinoid usage among the surveyed populations. DC juveniles were found to be using different synthetic cannabinoid formulations than DC adults. The types of synthetic cannabinoids detected in this study differed significantly compared to the first study performed one year ago. Synthetic cannabinoids were often found in urine specimens that otherwise tested negative for drugs in standard criminal justice drug screenings. The study recommends expanding urine analysis to include screening for a broad array of synthetic cannabinoids.