News from NASADAD

• Heather Dougherty joins NASADAD’s Research and Program Applications Department

News from the States

• Interview with Vermont Governor Peter Shumlin highlights substance use disorder treatment success

Around the Agencies

• SAMHSA study finds variations in first-time substance use among college students

In the News

• President Obama proclaims September 2015 as National Alcohol and Drug Addiction Recovery Month

Upcoming Events

• SAMHSA announces webinar on campus-based prevention data collection
• ONDCP announces online event in celebration of National Alcohol and Drug Addiction Recovery Month
• Medicaid Innovation Accelerator Program announces webinar on incorporating substance use disorder services into Medicaid managed care contracts

News from NASADAD

Heather Dougherty joins NASADAD’s Research and Program Applications Department
NASADAD is pleased to announce that Heather Dougherty has been hired to join the Research and Program Applications Department.  Heather will serve as liaison to the Women’s Services Network (WSN) and Youth Coordinators Committee, among other duties.  Heather previously served as a contractor for the United States Army where she worked as a Drug and Alcohol Prevention Specialist.  In this capacity, she worked closely with military and civilian populations located at Fort Dietrich and Walter Reed Naval Hospital.  Heather also worked with homeless populations in Connecticut as a member of AmeriCorps.  Heather earned her B.S. degree from James Madison University where she majored in Health Science with a Public Health Concentration.  Heather earned her Master’s in Public Health at the University of Massachusetts.

Heather can be reached via email at heather@nasadad.org or by phone at (202) 293-0090 x4874.

News from the States

Interview with Vermont Governor Peter Shumlin highlights substance use disorder treatment success
A new interview in Governing Magazine with Vermont’s Governor Peter Shumlin highlights the State’s success in fighting substance use disorders by increasing access to medication-assisted treatment. Governor Shumlin invested $6.7 million for a “’hub and spoke” treatment system of central facilities with small treatment outposts, medication-assisted treatment accessibility, tougher sentences for drug traffickers, and new regulations for prescribing and monitoring prescription drugs. Individuals arrested for possession of illicit drugs in Vermont now have the option of avoiding jail time and a criminal record by choosing to enter treatment. Vermont has rapidly built new treatment facilities to facilitate this policy, and now leads the country in number of providers per 1,000 adults with substance use disorders. The program has seen measurable success, with Vermont reporting in January 2015 that “medically assisted drug treatment increased by 40 percent, and of those who completed treatment plans 75 percent showed improved functioning.”

Around the Agencies

SAMHSA study finds variations in first-time substance use among college students
A new Substance Abuse and Mental Health Services Administration (SAMHSA) study has found first-time substance use among college-students varies substantially depending on the type of drug being used. Using information from SAMHSA’s National Survey on Drug Use and Health from 2002 to 2013, the study found that first-time marijuana use among college students peaks in June with an average of 1,500 new users a day – compared to a 1,000 new users per day year-long average. A similar pattern is observed among first time users of alcohol, with an average of 1,883 college students trying alcohol for the first time in June compared to a 1,200 a day year-long average. Conversely, non-medical use of prescription medication including pain relievers and stimulants peaks during the winter with 850 initiates a day in December, compared to a 700 per day year-long average. SAMHSA notes that the increase in prescription medication during December may be related to the belief that prescription stimulants aid exam performance.  The study concludes with a call for parents and college staff to discuss the risks of substance abuse with college students.

In the News

President Obama proclaims September 2015 as National Alcohol and Drug Addiction Recovery Month
President Obama announced September 2015 as National Alcohol and Drug Addiction Recovery Month. This year’s theme is  “Join the Voices for Recovery: Visible, Vocal, Valuable!” This year’s Recovery Month aims to eliminate the negative stigma associated with substance use disorders, and encourage communities to increase prevention and treatment efforts. The proclamation further affirms the Obama Administration’s pursuit of evidence-based strategies to treat substance use disorders as part of a broader drug control strategy.

NASADAD encourages members to submit a copy of their State’s recovery month proclamation to Shalini Wickramatilake-Templeman, Public Policy Associate, at swickramatilake@nasadad.org.

Upcoming Events

SAMHSA announces webinar on campus-based prevention data collection
The Substance Abuse and Mental Health Services Agency (SAMHSA) has announced a webinar on campus-based prevention data collection. The webinar will be held on October 1, 2015 from 3:00-4:00PM EST, and will discuss ongoing efforts with college campuses to improve the collection of primary and secondary prevention data for college student populations. Best practices for approaching college administrators and other stakeholders will be discussed.

ONDCP announces online event in celebration of National Alcohol and Drug Addiction Recovery Month
The Office of National Drug Control Policy (ONDCP) has announced an online event to be held at the White House in celebration of National Alcohol and Drug Addiction Recovery Month (Recovery Month). The event will be held on September 17, 2015 from 7:00-8:00PM EST and will target youth currently in recovery from substance use disorders. A panel of leaders working within youth recovery will speak at the event to educate and inform viewers on the benefits of seeking recovery. The panel will take questions from Twitter during the event using the hashtag #Recovery atWH prior to or during the event. The event will be broadcasted on the White House’s website here.

Please contact Nataki MacMurray at recovery@ondcp.eop.gov or (202) 395-5510 with any questions.

Medicaid Innovation Accelerator Program announces webinar on incorporating substance use disorder services into Medicaid managed care contracts
The Medicaid Innovation Accelerator Program (IAP) has announced a webinar on the incorporation of substance use disorder services into Medicaid managed care contracts. The webinar will be held on Monday, September 14 from 3:30-5:00PM ES as part of IAP’s new Targeted Learning Opportunities (TLOs) initiative. The webinar will highlight several State models for the incorporation of substance use disorder services including carve-ins and carve-outs, in addition to discussing the key factors for merging substance use disorder services into managed care. Representatives from Arizona will speak on their new “integrated physical and behavioral health managed care program,” and Beacon Health Options will provide the health plan perspective of working with States transitioning to managed care models for substance use disorder services.

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

News from the States

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

Around the Agencies

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

In the News

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

News from the States

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

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

Around the Agencies

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

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

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

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

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

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

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

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

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

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

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

In the News

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

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

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