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Public View

D.C. Update – November 14, 2014

News from NASADAD

  • NASADAD thanks NJ Governor Christie for his work to combat substance abuse
  • NASADAD attends SAMHSA listening session on State-certified behavioral health clinics
  • NASADAD attends briefing on 2015 health insurance open enrollment

News from the States

  • National Governors Association Policy Academy resources are available online

Around the Agencies

  • EDC receives $11 million to continue efforts to reduce substance abuse
  • Centers for Disease Control and Prevention reports on tobacco use among middle and high school students
  • NIAAA releases guidance on treatment options for alcohol use disorders
  • IOM Committee recommends measures for social determinants of health in meaningful use criteria for electronic health records

In the News

  • States with casino gambling expand addiction programs

Upcoming Events

  • National Council on Aging to host webinar on older adult mental health
  • Network for Public Health Law announces alcohol policy webinar

 

News from NASADAD

NASADAD thanks NJ Governor Christie for his work to combat substance abuse

NASADAD sent a letter to New Jersey Governor Chris Christie on November 3rd, 2014 acknowledging him for his work related to substance use disorders. Over the past two years, 37 States have reported increases in prescription opioid and heroin addiction. 27 States reported increases in fatal overdoses, and according to the Centers for Disease Control and Prevention (CDC), 46 Americans die from prescription drug overdose every day. In addition to improving access to treatment and recovery services, Governor Christie has been outspoken in pushing back the stigma surrounding substance abuse disorders. NASADAD also gave special mention to Ms. Lynn Kovich, Assistant Commissioner of New Jersey’s Department of Human Services who serves as the NASADAD member for the State. Ms. Kovich’s expertise and leadership are greatly appreciated, and NASADAD is eager to make progress through this partnership. NASADAD sent a similar letter to Vermont Governor Shumlin, recognizing him for his leadership after he dedicated his State of the State address to substance use disorder issues.

NASADAD attends SAMHSA listening session on State-certified behavioral health clinics

Rick Harwood, Deputy Executive Director/Director of Research and Program Applications attended the event and Colleen Haller, Public Policy Associate participated in the web conference. In March of this year, Congress passed the Protecting Access to Medicare Act that among other provisions, created a demonstration program to establish certified community behavioral health clinics that expand access to mental health and substance use disorder services and enhance Medicaid reimbursement for such services. Certification criteria must be published by September, 2015, with the Substance Abuse and Mental Health Services Administration (SAMHSA) taking the lead. SAMHSA held a listening session on November 12th to seek public and stakeholder input on the criteria. SAMHSA welcomed comments on quality and other reporting, scope of services, staffing, accessibility and availability of services, care coordination, and organizational authority. Rick Harwood provided comments from NASADAD that discussed the services that providers should be able to provide, including appropriate screening, assessment, brief interventions, provision of evidence-based outpatient substance use disorder treatment services, and the ability to prescribe and manage FDA-approved medications for medication-assisted treatment, among other recommendations. Written comments may be submitted to SAMHSA through 5 pm EST on November 26th.

NASADAD attends briefing on 2015 health insurance open enrollment

Thomas Friedlander, Public Policy Intern attended the briefing, “Health Insurance Marketplaces, Round II: Results and Expectations,” on November 14th, hosted by the Commonwealth Fund and the Alliance for Health Reform. The briefing served as a preview to the second open enrollment period for the health insurance marketplace, which begins on Saturday, November 15th. Panelists discussed the differences between this year’s open enrollment and last year’s, which included changes to the website functionality (both at the State and federal levels) and an expanded network of provider information. Panelists pointed to evidence suggesting stable and competitive marketplaces, as well as greater accessibility to tailored insurance networks to improve the efficiency of the marketplace under the Affordable Care Act (ACA). Additionally, panelists examined challenges that still face an expanding marketplace, such as specialty drug prices, rising health care costs, lack of transparency, and provider consolidation.

Moderators:

Ed Howard, Alliance for Health Reform

Sara Collins, the Commonwealth Fund

Panelists:

Meena Seshamani, Office of Health Reform at the Department of Health and Human Services

Daniel Durham, America’s Health Insurance Plans (AHIP)

Timothy Jost: Washington and Lee University School of Law

News from the States

National Governors Association Policy Academy resources are available online

The National Governor’s Association (NGA) has made available resources from a Policy Academy meeting which took place in mid-September in Lake Tahoe, NV. The meeting focused on reducing prescription drug abuse. Materials include presentations which cover critical issues concerning prescription drug abuse, such as prevention and treatment options, effective prescription drug monitoring, and strategies for health care purchasers. Additionally, several presentations discussing evidence-based best practices are included. Alongside the many presentations made available, the NGA has provided nine published resources which detail the critical discussions and lessons learned from the Policy Academy.

Around the Agencies

EDC receives $11 million to continue efforts to reduce substance abuse

Education Development Center, Inc. (EDC) has received an additional $11 million to continue their work in substance abuse prevention. The funding comes from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Prevention (CSAP), and includes an option for four more years of funding. This extension of funding comes in the wake of EDC’s Center for the Application of Prevention Technologies (CAPT), which helped create a major network of prevention resources, both human and technical. With the increased funding, EDC will maintain and improve their technical assistance capacities in the prevention workforce and target populations who are at the greatest risk for substance abuse. Many of these activities will be directed towards the growing prescription drug abuse and underage drinking problems.

Centers for Disease Control and Prevention reports on tobacco use among middle and high school students

The Centers for Disease Control and Prevention (CDC) released a report detailing tobacco use among the nation’s adolescent youth. According to the data, published in the Morbidity and Mortality Weekly Report, 22.9% of high school and students and 6.5% of middle school students currently use tobacco products. Tobacco use is the leading preventable cause of death and disease in the US. Most tobacco use starts during adolescence, when the brain is most susceptible to the negative effects reported by the Surgeon General. The last few years have seen slight decreases in the amount of combustible tobacco use, and an increase in the use of electronic cigarettes. The long-term effects of e-cigarette use are currently unclear. However, most youth who begin using tobacco will do so with cigarettes. Given the fact that youth who use more than one tobacco product are more likely to continue into adulthood, the use of e-cigarettes combined with the initial use of combustible cigarettes poses new risks for future tobacco dependence.

NIAAA releases guidance on treatment options for alcohol use disorders

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) released the consumer tool, “Treatment for Alcohol Problems: Finding and Getting Help” on November 13th. The document includes information on the latest research on treatment options and what consumers should consider when selecting a particular treatment, including a set of questions consumers can ask themselves and advice for friends and family members. There are detailed descriptions of cognitive behavioral treatments and FDA-approved medications. It also includes information about support groups like Alcoholics Anonymous.

IOM Committee recommends measures for social determinants of health in meaningful use criteria for electronic health records

The Institute of Medicine (IOM) committee made the recommendations to the Office of the National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services (CMS). The brief report details 12 standard measures of social and behavioral determinants of health. As reported in the American Hospital Association’s AHA News, “The measures pertain to 11 social and behavioral domains: race/ethnicity; education; financial resource strain; stress; depression; physical activity; tobacco use and exposure; alcohol use; social connections and social isolation; exposure to intimate partner violence; neighborhood and community compositional characteristics.”

In the News

States with casino gambling expand addiction programs

In a recent study by the National Conference of State Legislatures (NCSL), of the 23 States that allow casino gambling, 18 have statutes that provide services for people with gambling problems. An infographic by the NCSL shows that States with legalized casino gambling tend to have addiction programs underway within 10-20 years of authorizing gambling. In recent years, some States (Maryland, Kansas, Ohio, Florida, and Pennsylvania) have authorized both gambling and problem gambling programs at the same time through their gaming laws. Furthermore, States are working to provide more free treatment and resource centers in addition to building a network of counselors.

Upcoming Events

National Council on Aging to host webinar on older adult mental health

The National Council on Aging (NCOA) is hosting a webinar on Thursday, November 20th from 1:30-3:00pm EST, concerning current mental health trends among older adults. Nancy Wilson of Baylor University’s College of Medicine will discuss these trends, which include anxiety, depression, and suicide prevention. Ms. Wilson will be joined by two representatives from two community organizations to examine successful mental health interventions among older adults.

Network for Public Health Law announces alcohol policy webinar

The Network for Public Health Law will be hosting a webinar, titled “Alcohol Law and Policy: Lessons Learned from the Field,” on Thursday, November 20th at 1:00-2:30pm EST. The webinar will address the health risks related to excessive alcohol use and explore evidence-based legal options for policymakers. By examining lessons learned in Minnesota, panelists will discuss policies related to availability, marketing, and treatment. Panelists will also discuss a new law in Washington, which abolishes State control over alcohol and its social and health impacts.

CapitolHill, Public View

D.C. Special Update: Implications of the 2014 Mid-Term Elections – November 6, 2014

Initial Review of Elections: Republicans Capture Senate, Expand Majority in House – 3 Senate Races Remain Undecided

As you know, voters took to the polls on Tuesday, November 4th and paved the way for a change in party leadership in the Senate and an expanded Republican majority in the House. Three Senate races, in Alaska, Louisiana, and Virginia are still being decided. In terms of Governors’ races, voters in a majority of States (31 vs. 17) elected Republican chief executives, with two additional races undecided.

We have drafted some supplemental materials that detail results from all of the Governor and Senate races, in addition to information about key Congressional Committees that have an impact on NASADAD priorities.

Senate

  • Appropriations, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies
  • Health, Education, Labor and Pension (HELP) Committee
  • Judiciary Committee

House of Representatives

  • Appropriations, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies
  • Appropriations, Subcommittee on Commerce, Justice, Science, and Related Agencies
  • Energy and Commerce, Subcommittee on Health

 

The Committees listed above have a direct role in the appropriations process and have jurisdiction over key issue areas of concern to the Association.

Over the next few days, NASADAD Public Policy staff will continue to review other Committee changes, including changes in Chairmanships and other leadership positions. In addition, we plan to review this information and provide additional updates during the next All States Public Policy call on Friday, November 14th at 4 pm EST.

Current Breakdown of House and Senate Membership

Currently the Senate has 52 Republicans, 43 Democrats, 2 Independents (both caucus with the Democrats), and 3 undecided races in Alaska, Louisiana, and Virginia. Alaska incumbent Mark Begich (D-AK) is currently trailing challenger Dan Sullivan (R) as the remaining ballots are counted. Neither Louisiana Democrat Mary Landrieu nor challenger Bill Cassidy (R) received the required 50% of the vote – a runoff election will be held in January. Finally, in Virginia, Incumbent Mark Warner (D-VA) has a narrow lead over challenger Ed Gillespie (R-VA). Given the close result, Mr. Gillespie has not ruled out a recount.

In the House, there are 243 Republicans and 179 Democrats, with 13 races still undecided.

Key Changes: Committee Leadership vs. “Rank and File” Members

Generally speaking, there were relatively few changes in the “rank and file” make-up of the key Committees of interest to NASADAD. However, there will be significant changes in the leadership of some of the Committees.

There is no precise method of predicting how Chairmanships will be assigned. On the Senate side, Chairmanships are often, though not exclusively, determined by seniority. In contrast, the process in the House is somewhat less clear. Seniority is certainly a factor, though there is also some degree of jockeying between Chairmanships. House Republican leaders also self-imposed a 6 year term limit on their Chairmanships. This means that in addition to election results, Chairmen/Chairwomen whose term has expired may switch Chairmanships, taking leadership positions in completely different Committees. House Republicans will take an anonymous vote to elect the new leadership for Committee vacancies.

The following updates include potential candidates for leadership positions; however, we cannot confirm any of the positions until they are made public. We will continue to update the members as more information becomes available.

One constant for the full House Appropriations Committee is the Chairmanship of Rep. Hal Rogers (R-KY). Rogers is expected to maintain his role as Chairman of the Committee and continue his work to support work on issues related to addiction in general and the opioid problem in particular.

The House Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies will see a change in Chairmanship. Chairman Jack Kingston (R-GA) unsuccessfully ran for Georgia’s Senate seat, giving up his seat in the House of Representatives. House leadership has not announced who the new Chairperson will be, although Vice Chairman Steve Womack (R-A) may be a potential candidate. Rank and file membership will likely not change, with the possible exception of Rep. Mike Honda (D-CA), whose race is still too close to call.

This Appropriations Subcommittee has jurisdiction over the budgets for the Departments of Labor, Education, and Health and Human Services (HHS). This includes funding for the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), and National Institutes of Health (NIH). In March, NASADAD presented testimony to this Subcommittee to provide recommendations on FY 2015 funding for SAMHSA, including the Substance Abuse Prevention and Treatment (SAPT) Block Grant; the National Institute on Drug Abuse (NIDA); and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

The House Appropriations Subcommittee on Commerce, Justice, Science, and Related Agencies will also see a change in Chairmanship. Chairman Frank Wolf (R-VA) lost his reelection bid to Barbara Comstock (R). House leadership has not indicated who the new Chairperson will be, although Vice Chairman Robert Aderholt (R-AL) may be considered. Rank and file membership will likely not change, with the possible exception of Rep. Mike Honda (D-CA), whose race is still too close to call.

This Appropriations Subcommittee has jurisdiction over the budgets of the Department of Commerce and Department of Justice (DOJ), in addition to federal science policy. This includes funding for DOJ programs like the Hal Rogers Prescription Drug Monitoring Program (PDMP), drug courts, and others. Chairman Wolf demonstrated intense interest in addiction issues, calling a series of hearings to explore substance use disorder programming within the Department of Justice (DOJ).

The House Energy and Commerce Subcommittee on Health will see a number of changes in the rank and file membership. On the Republican side, Rep. Mike Rogers (R-MI) retired from Congress, Rep. Phil Gingrey (R-GA) did not seek reelection to unsuccessfully pursue Georgia’s Senate seat, and Rep. Bill Cassidy (R-LA) did not run for reelection and will be competing for Louisiana’s Senate seat in a runoff election to be held in January. Four Democrats from this Committee will not be returning to the chamber: Rep. John Dingell (D-MI) announced his retirement after serving for more than 58 years, Rep. Jim Matheson (D-UT) did not seek reelection, Rep. John Barrow (D-GA) lost his reelection bid to Rick Allen (R), and Rep. Henry Waxman (D-CA) did not seek reelection. Chairman Joe Pitts (R-PA) was reelected to Congress and there have been no announced changes to his leadership position.

This Subcommittee has jurisdiction over health related issues, including portions of Medicaid, Medicare, programs authorized under the Public Health Service Act, and more – this includes SAMHSA. Rep. Tim Murphy’s (R-PA) widely discussed bill, the Helping Families in Mental Health Crisis Act (H.R. 3717), was referred to this Subcommittee for consideration. The legislation touches a variety of issues including patient privacy, court-ordered community treatment, reauthorization of mental health courts, and a significant reorganization of the Substance Abuse and Mental Health Services Administration (SAMHSA). There has been some discussion about breaking Rep. Murphy’s bill into multiple bills so that less controversial provisions could be voted on individually, though Rep. Murphy remains committed to passing the comprehensive bill.

The Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies will see significant leadership changes. Chairman Tom Harkin (D-IA) retired from the Senate, leaving his position open in addition to the change in majority leadership. Ranking Member Jerry Moran (R-KS) is a likely choice to become Chairman, with Sen. Patty Murray (D-WA) likely to become Ranking Member. Sen. Mark Pryor (D-AR), a member of the Subcommittee, lost reelection to Tom Cotton (R). While the Republican membership will likely grow, Democratic membership on all of the Senate committees will likely be reduced, so Sen. Pryor will likely not be replaced on the Subcommittee.

This Subcommittee is the Senate companion to the House Subcommittee of the same name. It has jurisdiction over the budgets for the Departments of Labor, Education, and Health and Human Services (HHS), which includes SAMHSA.

The Senate Health, Education, Labor, and Pension (HELP) Committee will also see significant leadership changes. Sen. Tom Harking (D-IA) was also Chairman of the HELP Committee. Ranking Member Lamar Alexander (R-TN) is a likely candidate for the Chairmanship. Sen. Barbara Mikulski (D-MD) or Sen. Patty Murray (D-WA) will likely become Ranking Member. The only rank and file change will be Sen. Kay Hagan (D-NC), who lost her reelection bid to Thom Tillis (R). Similar to above, Sen. Hagan will likely not be replaced on the Committee.

The HELP Committee, like its name, has jurisdiction over issues related to health, education, and labor. Statues related to SAMHSA, including reauthorization, and other HHS programs fall under this Committee’s jurisdiction. Committee also looks at other issues including public health, biomedical research and development, individuals with disabilities, and much more. The Committee has held a number of listening sessions regarding potential action related to the opioid problem. This includes considerations of a number of bills, including legislation to reauthorize the National All Schedules Prescription Electronic Reporting (NASPER) Act, Senator Markey’s (D-MA) bill to change prescriber limits for buprenorphine, and many others.

The Senate Judiciary Committee did not have any changes in membership due to the election. However, Chairman Patrick Leahy (D-VT) will likely become Ranking Member and Ranking Member Chuck Grassley (R-IA) will likely assume the Chairmanship. There will likely be reductions in the nine Democratic members of this Committee.

This Committee has jurisdiction over statues related to criminal justice issues, oversees the Office of National Drug Control Policy (ONDCP), and conducts hearings on federal judges and other presidential nominees before they are considered by the entire Senate. The Committee also reviews legislation for the Department of Justice (DOJ) programs, including the Second Chance Act. The Committee still may consider (this year) the nomination of Michael Botticelli to serve as the Director of ONDCP. Further, there is a chance that the Judiciary Committee will take action on the Comprehensive Addiction and Recovery Act of 2014 (S. 2839), introduced by Sens. Whitehouse (D-RI) and Portman (R-OH). This action could take the form of a hearing or a formal mark-up of the bill.

Looking Forward: Wrapping Up the 113th Congress and Clearing the Way for the 114th

A good deal of work remains for the 113th Congress, both in terms of budget appropriations and leadership selections.

First, the 113th Congress must finish its business when they return from the elections. This includes FY 2015 appropriations work. The current continuing resolution that was passed this fall to postpone budget discussions until after the elections expires on December 11th. Congress must either pass a budget resolution, outlining the scope of the federal FY 2015 budget or pass another continuing resolution to further postpone negotiations until after the new Congress has been sworn in.

Second, party leadership will also adjust as a result of the elections. Sen. Harry Reid (D-NV), current Majority Leader in the Senate, is expected to run for Minority Leader. He does not appear to have any significant opposition at this point. Sen. Mitch McConnell (R-KY) will likely be elected Majority Leader, although some members of his caucus have expressed doubts about his leadership. We do not expect major changes in House leadership. Committee Chairmanships will likely shift, as we have outlined above.

NASADAD will continue to monitor new developments and provide updates to the membership as they occur.

Public View

DC Update – October 31, 2014

News from NASADAD

  • 45 national organizations express support for Michael Botticelli to become ONDCP Director
  • NGA works with NASADAD and Virginia member to facilitate site visit for 7 Governors’ D.C.-based offices
  • NASADAD attends briefing on adolescent brain development sponsored by Friends of NIDA and Friends of NIAAA
  • NASADAD attends overdose prevention conference
  • NASADAD participates in meeting for tangible action on opioid issues

News from the States

  • Michigan launches prescription drug misuse website

Around the Agencies

  • CMS/SAMHSA to host webinar on health insurance marketplace
  • DOJ launches the Law Enforcement Naloxone Toolkit – promotes connection to NASADAD members
  • ONDCP announces webinar on controlled substance disposal
  • SAMHSA announces listening session on criteria for community clinics
  • ATTC releases issue brief on substance abuse and health care integration

In the News

  • CSH announces webinar on subsidized housing and social services
  • NAMD releases prescription drug abuse prevention report

 

News from NASADAD

45 national organizations representing health, social service, and other sectors express support for Michael Botticelli to serve as permanent Director of ONDCP

On October 23rd, a diverse group of 45 national health, social service, and other organizations joined together to send a letter to Senate Judiciary Chairman Patrick Leahy (D-VT) and Ranking Member Chuck Grassley (R-IA) expressing support for the nomination of Michael Botticelli to serve as the permanent Director of the Office of National Drug Control Policy (ONDCP). Mr. Botticelli currently serves as Acting Director. The letter recognizes that “…addiction intersects with a myriad of other public health issues, such as health disease, HIV/AIDS, Hepatitis C, liver damage and prenatal conditions.” The correspondence also notes, “we know substance use disorders are connected with societal problems such as child abuse/neglect, domestic violence, homelessness and others.”  The opioid epidemic was cited as a problem requiring cross-agency coordination “…as the nation witnessed over 16,600 deaths caused by opioid pain relievers in 2010 and another 3,000 deaths caused by heroin during the same year (CDC, 2011).”  The letter cites Mr. Botticelli’s successful experience working “…collaboratively not only with the health community, but also with other sectors representing criminal justice, education, interdiction, prevention, and others.”  Organizations sending the letter included the American Psychiatric Association, National Association of Social Workers, National Association of County and City Health Officials, National Child Abuse Coalition, National Association of State Alcohol and Drug Abuse Directors, and a number of others.

National Governors Association (NGA) works with NASADAD and Virginia member to facilitate substance use disorder services site visit for 7 Governors’ D.C.-based offices

On Friday, October 24th, Robert Morrison, NASADAD Executive Director participated in a site visit at an Alexandria, Virginia treatment center as part of an effort by NGA to educate Governors’ offices about addiction services. NGA has dedicated time and energy to discussing issues regarding prescription drug abuse – convening policy academies, discussing the topic at its summer meeting, and developing materials. As these initiatives have evolved, more time has been dedicated to discussing aspects of the issue related to prevention, treatment, and recovery services. The site visit included a presentation by Mellie Randall, State substance abuse agency director from Virginia, where she provided background on addiction, the service system in Virginia, and some demographics related to the opioid problem. The site visit took participants to the Alexandria Community Services Board’s substance abuse services location which includes medication-assisted treatment. Susan Tatum, Clinical and Emergency Services/Assistant Director and Judi Booker, Team Leader for Substance Abuse Outpatient Treatment followed Ms. Randall to talk more about the specific services offered at the facility. A person in recovery from opioid addiction spoke about her experience and her pathway to recovery. Attendees were particularly interested in the positive impact services had on her children. A rich dialogue took place throughout the informative briefing.  We wish to recognize the many people who contributed to this event. We specifically thank Mellie Randall, NASADAD member; Melinda Becker, Legislative Director, Health and Human Services Committee; the Governors’ staff in attendance representing Illinois, Alaska, North Carolina, New Jersey, Virginia, Nevada, and Wisconsin; and the people at the Alexandria Department of Community and Human Resources!

Read about VA Governor McAuliffe’s Executive Order establishing the Governor’s Task Force on Prescription Drug and Heroin Abuse.

Learn more about NGA’s work on prescription drug abuse at the Center for Best Practices.

Learn more about NGA’s Health and Human Services Committee.

Check out NASADAD’s report on State substance abuse agencies’ work on prescription drug abuse and heroin.

NASADAD attends briefing on adolescent brain development sponsored by Friends of NIDA and Friends of NIAAA

Colleen Haller, Public Policy Associate and Shalini Wickramatilake-Templeman, Research Analyst attended the briefing, “Adolescent Brain Development: Understanding the Impact of Substance Use,” on October 20th, hosted by the Friends of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the Friends of the National Institute on Drug Abuse (NIDA). The briefing discussed how a young person’s brain continues to develop well into their twenties, and the role that alcohol and drug use plays in this development. Panelists presented developmental research on drug and alcohol abuse, as well as treatment outcomes for adolescent substance abuse patients. Additionally, the briefing discussed the proposed Adolescent Brain Cognitive Development Study, which will study the effects of substance use on 10,000 adolescents. Robert Morrison, Executive Director serves on the Executive Committees of both Friends of NIDA and Friends of NIAAA.

Panelists

George F. Koob, National Institute on Alcohol Abuse and Alcoholism (NIH)

Nora D. Volkow, National Institute on Alcohol Abuse and Alcoholism (NIH)

Sandra A. Brown, University of California, San Diego

NASADAD attends overdose prevention conference

Colleen Haller, Public Policy Associate attended the “National Harm Reduction Pre-Conference on Overdose Prevention” on October 22nd, 2014, hosted by the North Carolina Harm Reduction Coalition (NCHRC) and the national Harm Reduction Coalition (HRC). The conference focused on improving harm reduction capacities in areas of the country where resources and training are limited. Specifically, the speakers discussed increasing access to naloxone in more isolated areas. The conference featured workshops that covered many pressing issues, such as prescription monitoring, law enforcement, and treatment.

NASADAD participates in meeting for tangible action on opioid issues 

On October 20th and 21st, NASADAD Executive Director Robert Morrison participated in a meeting held in Tampa, Florida convened by the Trust for America’s Health, Community Anti-Drug Coalitions of America (CADCA), and Former Member of Congress Mary Bono with Faegre Consulting to talk about developing a core set of recommendations related to the opioid problem that would be ripe for action. The working group members first heard from Pam Bondi, Florida’s Attorney General, who discussed Florida’s work on this topic. The meeting facilitator then reviewed some categories that participants were asked to comment on: (1) prevention, (2) education, (3) treatment and recovery, (4) technology and manufacturing, and (5) monitoring and deterrence.  Meeting participants spent time in working groups in an effort to identify actions that could be taken to address the opioid issue. Special attention was placed on balancing access to medication for pain and remaining vigilant regarding issues dealing with addiction. In addition to the co-coveners, Meeting participants represented a cross-section of organizations, including the National Governors Association, National Institute on Drug Abuse (NIDA), Office of National Drug Control Policy (ONDCP), National Hospice and Palliative Care Organization, Hazelden, Mallinckrodt Pharmaceuticals, CareFirst, and others. NASADAD will keep the members informed as developments take place.

News from the States

Michigan launches prescription drug misuse website

The Michigan Department of Community Health (MDCH) developed a website to increase awareness concerning the potential harm of prescription and over-the-counter drug misuse and abuse. The website, titled “Do your Part: Be the Solution,” provides everyday steps that people can take to prevent drug misuse and abuse. The website also provides fact sheets, prevention tips, professional reports, and resources for recovery and drug disposal programs. Additionally, the website features public service announcements (PSAs) on the dangers of underage drinking.

Around the Agencies

CMS/SAMHSA to host webinar on health insurance marketplace

The webinar, “Health Insurance Marketplace 101,” will be held on Tuesday, November 4th at 3pm EST and is hosted by the Centers for Medicare and Medicaid Services (CMS) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The webinar will cover basic information about the new marketplaces, including information on tax credits, cost-sharing, eligibility, renewal instructions, and enrollment periods. The webinar will also provide information on how to help others enroll in coverage by becoming a Certified Application Counselor. No prior registration is required for the webinar. To join, visit: https://www.mymeetings.com/emeet/join/index.jsp?customHeader=mymeetings&netId=PW9314435&netPass=OC114&netType=conference&acceptTerms=on

And use the Dial-in number: 1-888-390-0973, Conference I.D. number: PW9314435, and Audience passcode: OC114

DOJ launches the Law Enforcement Naloxone Toolkit – promotes connection with NASADAD members

The Department of Justice (DOJ) has released a toolkit with a wide range of resources pertaining to naloxone treatment and law enforcement. These resources, organized and presented as the Law Enforcement Naloxone Toolkit, aim to enable and improve responses to opioid overdoses. Drug overdoses cause 110 deaths per day in the United States, and law enforcement officers need every tool they can get to reduce this number. The toolkit provides information on naloxone, a pure opioid antagonist with no potential for abuse. The toolkit also provides information on how law enforcement can collaborate with State substance abuse agencies, including a link to the NASADAD State Directors contact list. With 80 resources from 30 contributing law enforcement and public health agencies, the toolkit has the potential to be instrumental in developing naloxone intervention programs.

ONDCP announces webinar on controlled substance disposal

The Office of National Drug Control Policy (ONDCP) will host a webinar titled, “The DEA Disposal of Controlled Substances Final Rule for Community Agencies,” on Thursday, November 6th between 10:00 and 11:00am EST. The webinar will feature ONDCP Acting Director Michael Botticelli, Imelda Paredes of the Drug Enforcement Agency (DEA), and Alameda County government officials who will be discussing expansions to drug disposal programs. Under these expansions, there are more convenient, environmentally-friendly options for disposing unwanted, unused, and expired prescription drugs. Approved hospitals, pharmacies, and treatment clinics can accept these drugs. This webinar also invites those interested in establishing take-back programs.

Please note that the registration deadline is Friday, October 31st, at 5:00pm EST

SAMHSA announces listening session on criteria for community clinics

The Substance Abuse and Mental Health Services (SAMHSA) announced an upcoming listening session to discuss the development of criteria for community clinics to become “certified community behavioral health clinics” under the Protecting Access to Medicare Act of 2014. The Act was passed in March of 2014 and created a demonstration project to authorize the establishment of community mental health and substance use disorder clinics similar to the federally qualified health center (FQHC) model. The all-day listening session will take place on Wednesday, November 12th from 9:00am-5:00pm EST and may be attended in-person or as a live webcast. NASADAD staff will attend the session.

Registration is open until Wednesday, November 5th, or until maximum capacity is reached.

ATTC releases issue brief on substance abuse and health care integration

The Addiction Technology Transfer Center (ATTC) Network released an issue brief detailing the impact of integrating substance use disorder into general healthcare. The brief describes how health reform laws, such as the Mental Health Parity and Addiction Equity Act (MHPAEA) and Patient Protection under the Affordable Care Act (ACA) have allowed more individuals to access substance use disorder treatment to the same degree one would access physical health care. This coordination in substance use disorder treatment is what the Substance Abuse and Mental Health Services Administration (SAMHSA) describes as “integrated care.” The brief provides examples of how integrated care is changing the face of substance use disorder treatment. Additionally, the brief discussed critical factors to integrated care, such as treatment environment, clinical supervision, and education for substance use disorder treatment workers. These topics will be discussed during a meeting sponsored by the ATTC Network on November 4th and 5th in Baltimore, MD. NASADAD member, Barbara Cimaglio (VT) will present and NASADAD staff will attend.

In the News

CSH announces webinar on subsidized housing and social services

The Corporation for Supportive Housing (CSH), in partnership with the Center for the Study of Social Policy (CSSP) has an upcoming webinar concerning a link between subsidized housing and social services. The webinar, titled “Partnering to Improve Outcomes for Families and Children,” will take place on Wednesday, November 12th at 4:00pm EST, and will focus on the observed improved outcomes of keeping families together through supportive housing and services. This information is based on the first year of a research project in five sites across the country. The webinar will discuss the findings, as well as successes and challenges to the project.

NAMD releases prescription drug abuse prevention report

The National Association of Medicaid Directors released a report titled, “State Medicaid Interventions for Preventing Prescription Drug Abuse and Overdose,” earlier this month. The report discusses the rising prescription drug epidemic, which now accounts for more overdose deaths than from heroin and cocaine combined, and focuses on the implications for Medicaid patients. Medicaid patients are six times more likely to have a prescription drug overdose, and make up 45% of all drug overdose patients. The report provides descriptions of a number of initiatives that States are taking to prevent prescription drug abuse among Medicaid patients, as well as challenges and recommendations based on these initiatives.

CapitolHill, Public View

D.C. Update – October 20, 2014

News from NASADAD

  • NASADAD attends briefing on health care incentives
  • NASADAD attends briefing on trauma-informed care
  • NASADAD attends briefing on the international impacts of changing marijuana policies in the US

Around the Agencies

  • CMS announces new model for ACOs in Medicare
  • CMS announces effort to help enrollees in the new Marketplace stay covered

Capitol Hill News

  • Senator Markey releases report on prescription drug and heroin epidemic

In the News

  • National Safety Council releases white paper on pain medication efficacy

 

News from NASADAD

NASADAD attends briefing on health care incentives

Thomas Friedlander, Public Policy Intern attended the briefing, “Incentives 2.0: Is Paying for Performance Enough?” on October 14th, hosted by the Commonwealth Fund and the Alliance for Health Reform. The briefing discussed how to make the “pay-for-performance” (P4P) system of incentives work among diverse health care systems. Panelists discussed the “Incentives 2.0” approach, which takes into account behavioral economics such as risk aversion, uncertainty, and organizational culture. “Incentives 2.0” also features a rewards system that encourages more consistent improvement over single-payment programs, which panelists argued did not promote health care responses.

Moderators:

Ed Howard, Alliance for Health Reform

Anne-Marie Audet, the Commonwealth Fund

Panelists:

Ashish Jha, Harvard School of Public Health

Ateev Mehrotra, Harvard Medical School

Patrick Herson, Fairview Medical Group

NASADAD attends briefing on trauma-informed care

Colleen Haller, Public Policy Associate and Shalini Wickramatilake-Templeman, Research Analyst attended the briefing, “Trauma-Informed Care: Change the Culture to Change the Outcome,” on October 14th hosted by the American Institutes for Research. The briefing discussed the impact of traumatic stress events, and how failing to properly address these events can lead to long-term damaging health effects. In light of this, providers have been working on a model for “trauma-informed care,” which can help improve outcomes for traumatic stress survivors. Distinct from trauma-specific clinical services that treat survivors’ symptoms, trauma-informed care is an organizational structure that understands, recognizes, and responds to all the effects of trauma. Panelists discussed the specifics of trauma-informed care, as well as the impact of successfully implemented trauma-informed approaches. Panelists also addressed the projected needs for implementation and the cultural and organizational changes one may expect from trauma-informed care.

Moderator:

Jane Stevens, Aces too High News

Panelists:

Larke N. Huang, Substance Abuse and Mental Health Services Administration (SAMHSA)

Cheryl Sharp, National Council for Behavioral Health (NCBH)

Bonnie Stone, Women in Need (WIN)

NASADAD attends briefing on the international impacts of changing marijuana policies in the US

Colleen Haller, Public Policy Associate attended the event, “International Impacts of the U.S. Trend towards Legal Marijuana,” hosted by The Brookings Institution on October 17th. The panelists discussed the international implications of changes to marijuana policies in some US States. The panelists particularly discussed the impacts of US drug policies in various Latin American countries and how changes in the US marijuana policy landscape have prompted similar discussions in parts of Central and South America. The panelists also raised questions about how changes in US policy related to marijuana and other illicit drugs affect international drug control treaties, of which the US is a signatory.

Moderator:

John Walsh, Senior Associate, Washington Office on Latin America

Panelists:

Wells Bennett, Fellow, Governance Studies, The Brookings Institution

Sandeep Chawla, Former Deputy Executive Director and Director of Research and Policy, UN Office on Drugs and Crime

Martin Jelsma, Director, Drugs and Democracy Program, Transnational Institute

Lisa Sanchez, Program Manager, Mexico Unido Contra la Delincuencia and Transform Drug Policy Foundation

Around the Agencies

CMS announces new model for ACOs in Medicare

The Centers for Medicare & Medicaid Services (CMS) announced the availability of a new investment model for accountable care organizations (ACOs) in the Medicare Shared Savings Program on October 15th. The new model will give ACOs in Medicare more flexibility in setting goals for quality and financial goals. Under the new model, the CMS Innovation Center will invest $114 million in up to 75 ACOs across the country. CMS will recover this investment through an offset of an ACO’s earned shared savings. ACOs that joined the Shared Savings Program in 2012, 2013, 2014, and 2016 will be eligible to apply for funds (AHA News Now).

CMS announces effort to help enrollees in the new Marketplace stay covered

The Centers for Medicare & Medicaid Services (CMS) announced the beginning of a communications effort to ensure that consumers enrolled in coverage in the new Marketplace know how to renew their coverage for 2015. Consumers will begin receiving notices that explain the renewal process and how they can return to the Marketplace from November 15th to December 15th (open enrollment) to update their application and review policies to make sure they choose the best plan. In addition to mailed notices, CMS will also use email, digital marketing efforts, and telephone calls. CMS also developed the 5 Steps to Staying Covered: Review, Update, Compare, Choose, and Enroll and released a two-page consumer fact sheet.

Capitol Hill News

Senator Markey releases report on prescription drug and heroin epidemic

Senator Edward Markey (D-MA) released a comprehensive report outlining a federal strategy to combat the growing drug epidemic in the US. The report, titled, “Overdosed: A Comprehensive Federal Strategy for Addressing America’s Prescription Drug and Heroin Epidemic,” focuses primarily on opioid painkillers, which have shown the most dramatic increase in abuse and overdose over the last several years. The report is organized into three categories: Prevention, Treatment, and Enforcement. In this report, Senator Markey recommends many policies which have shown positive results, such as take-back programs and expanding Medicaid coverage.

In the News

National Safety Council releases white paper on pain medication efficacy

The National Safety Council (NSC) released a white paper titled, “Evidence for the Efficacy of Pain Medications,” which discusses alternatives to highly addictive opioid medications in treating acute pain. The paper states that over-the-counter pain medications, such as ibuprofen and acetaminophen, are more effective under some circumstances than prescription painkillers. This paper coincides with the recent Drug Enforcement Administration’s (DEA) reclassification of hydrocodone products from Schedule III to Schedule II, making them harder to prescribe and to obtain. While opioid painkillers have been shown to be effective in certain treatment processes, the paper argues that the risk of addiction and the increasing number of opioid-based overdoses strengthens the logic behind alternative medications. You can also access a short version of the paper.