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.

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.

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.