News from NASADAD

• NASADAD attends Hill briefing on medications covered in Medicare Part D
• NASADAD attends TCA Hill briefing on substance use disorder treatment for veterans
• NASADAD attends Hill briefing on prescription opioid misuse
• NASADAD releases section-by-section analysis on overdose prevention bill by Sen. Reed

Around the Agencies

• Dr. H. Westley Clark, Director of CSAT announces retirement
• SAMHSA/HRSA releases white paper on expanding MAT in safety-net settings
• CMS releases FAQ on Autism services covered in Medicaid
• CMS hosts virtual meeting on Medicaid Innovation Accelerator Program
• CMS releases informational bulletin on Medicaid Innovation Accelerator Program
• HHS releases issue brief on insurer participation in the health insurance marketplace
• HHS releases report predicting drop in hospital uncompensated care costs
• CDC releases State data on increases in heroin overdose from 2010 to 2012
• BJS releases report on prisoner recidivism

In the News

• USA Today publishes article on changing marijuana laws and road safety

 

News from NASADAD

NASADAD attends Hill briefing on medications covered in Medicare Part D

Colleen Haller, Public Policy Associate attended the briefing on September 30^th hosted by the Partnership for Part D Access. The panelists discussed the importance of maintaining access to the full range of medications under Part D. Specifically, panelists discussed Medicare’s six protected classes of medications, a policy that has protected access to a number of medications that patients may need. Panelists included Medicare beneficiaries, as well as clinicians to share their experience with medications for various conditions, particularly mental health issues, organ transplants, and epilepsy. One central theme from the presentations was the variability in medication effectiveness and side effects between individual patients. While some medications are ideal for some, other patients may require alternatives to fit their specific needs.

Moderator:

Chuck Ingoglia, National Council for Behavioral Health

Panelists:

Dr. Nicole Brandt, Senior Care Pharmacist and Professor, University of Maryland

Dr. Ray Martins, Chief Medical Officer, Whitman-Walker Health

Dr. Jeanie Tse, Associate Chief Medical Officer, ICL

Dr. Matthew Cooper, Director of Kidney and Pancreas Transplantation, MedStar Georgetown

Joanne Buzaglo, PhD, Research and Training Institute, Cancer Support Community

Trudy Lapin, Patient living with bipolar disorder

Carlton Zeigler, Patient living with epilepsy

NASADAD attends TCA Hill briefing on substance use disorder treatment for veterans

Colleen Haller, Public Policy Associate attended the briefing, “Repaying Our Debt: Expanding Access to Addiction Treatment for Veterans” hosted by the Treatment Communities of America (TCA) on September 29^th. Panelists discussed various ways that nonprofit organizations and the federal government can increase access to substance use disorder treatment for veterans, particularly veterans returning from Iraq and Afghanistan. Delays in treatment for veterans can lead to destructive behavior and involvement with the criminal justice system. The panelists provided a number of solutions and perspectives including increasing access to veteran-specific treatment programs and peer-to-peer support, expanding veterans’ treatment courts and alternatives to incarceration for veterans, and educating veterans on the services available and how to access them. Representatives Clay (D-MO) and Bass (D-CA) also provided remarks.

Panelists:

Dr. Ira Katz, Office of Mental Health, Department of Veterans Affairs

Janetta Astone-Twerell, PhD, Director of Research and Evaluation, Samaritan Village, NY

Melissa Fitzgerald, Senior Director, Justice for Vets, VA

Dan Caddy, Army National Guard and President, Battle in Distress, VT

NASADAD attends Hill briefing on prescription opioid misuse

Colleen Haller, Public Policy Associate attended the briefing, “Prescription Opioid Abuse: Fighting Back on Many Fronts” hosted by the Alliance for Health Reform on September 29^th. The briefing primarily focused on efforts to reduce the supply of prescription opioids using prescription drug monitoring programs (PDMPs) or patient review and restriction programs (PRRs). One panelist discussed how providers in rural West Virginia have implemented measures to restrict prescriptions to chronic care patients and have utilized the expertise of an addiction specialist to evaluate patients for their substance use disorder risk.

Panelists:

Grant Baldwin, Centers for Disease Control and Prevention (CDC)

Allan Coukell, Pew Charitable Trust

Jo-Ellen Abou Nader, Express Scripts

Dr. Sarah Chouinard, Primary care physician, WV

NASADAD releases section-by-section analysis on overdose prevention bill by Sen. Reed

NASADAD released the analysis of a bill introduced by Sen. Jack Reed (D-RI) in July. The bill, the “Overdose Prevention Act” was co-sponsored by Sens. Durbin (D-IL), Leahy (D-VT), Markey (D-MA), and Whitehouse (D-RI). The legislation would create a program for organizations to enter into cooperative agreements with the Centers for Disease Control and Prevention (CDC) to reduce fatal overdose. A variety of entities would be eligible, including State governments and nonprofit organizations. Funded participants will use funds to purchase and distribute naloxone (an overdose reversal medication). Organizations may also use funds to educate health care professionals about overdose prevention, train first responders on overdose response, or educate the public about overdose prevention. The legislation also seeks to improve surveillance and data collection on overdose, both fatal and nonfatal. This includes establishing two programs to improve electronic surveillance and reporting. Finally, the legislation instructs the Secretary of the Department of Health and Human Services (HHS) to consult with a task force of stakeholders and develop a national plan to reduce the number of overdose deaths. NASADAD has not taken a position on this legislation.

Around the Agencies

Dr. H. Westley Clark, Director of CSAT announces retirement

Dr. Clark, Director of the Center for Substance Abuse Treatment (Substance Abuse and Mental Health Services Administration, SAMHSA) announced his retirement via email on September 30^th. Dr. Clark has more than 30 years of experience in substance use disorder treatment and recovery and has received a variety of awards and honors for his tremendous work throughout his career, including a 2008 President of the United States Rank of Distinguished Executive Award and the U.S. Department of Health and Human Services Secretary’s Award for Distinguished Service, among many others. Dr. Clark’s passion and dedication for improving access and services for people with substance use disorders is deeply appreciated and will be sincerely missed. His retirement will be effective October 4^th.

SAMHSA/HRSA releases white paper on expanding MAT in safety-net settings

The Center for Integrated Health Solutions, under the Substance Abuse and Mental Health Services Administration (SAMHSA) and Health Resources and Services Administration (HRSA), released the white paper, “Expanding the Use of Medications to Treat Individuals with Substance Use Disorders in Safety-Net Settings: Creating Change on the Ground, Opportunities and Lessons Learned from the Field” in September. The brief provides results from a pilot project with State substance abuse agencies and community safety-net providers to increase the adoption of medication-assisted treatment (MAT) in primary care, substance use disorder treatment, and community mental health programs. The brief offers an overview of the project, outcomes, opportunities, and lessons learned. A number of lessons were identified, including the importance of workforce development, using data, developing community partnerships, and community and State leadership.

CMS releases FAQ on Autism services covered in Medicaid

The Centers for Medicare and Medicaid Services (CMS) released a short set of frequently asked questions (FAQ) on Medicaid services for Autism Spectrum Disorder (ASD). The FAQ clarifies that specific ASD treatment modalities, such as Applied Behavioral Analysis, are not mandated under Medicaid. The FAQ also clarifies that CMS does not have a timeframe for implementing new Medicaid obligations for ASD in all States, explaining that States will first review the current policies and see which changes must be made to meet the new CMS requirements. The FAQ also discusses a plan for moving ASD service coverage away from 1915(c) waivers and towards Medicaid coverage.

CMS hosts virtual meeting on Medicaid Innovation Accelerator Program

The Centers for Medicare and Medicaid Services (CMS) will host the virtual meeting on October 9^th from 12:30-2:30 EST. The virtual meeting will allow individuals who have not been able to participate in an in-person meeting with CMS about the program to have an opportunity to learn and talk more about the program. The Medicaid Innovation Accelerator Program (IAP) will support State efforts to accelerate Medicaid innovation. This webinar will help States learn about the IAP and have an opportunity to provide feedback and suggestions on the type of technical assistance tools States will need. Participants will also be able to learn how the IAP can support State efforts related to substance use disorders.

CMS releases informational bulletin on Medicaid Innovation Accelerator Program

The Centers for Medicare and Medicaid Services (CMS) released an updated bulletin about the Medicaid Innovation Accelerator Program (IAP). The goal of IAP is to improve care and health for Medicaid beneficiaries and reduce costs for Medicaid providers. CMS aims to achieve these goals through offering new tools and resources, as well as improved analytics and evaluation of programs. Among these analytics, the bulletin shows that Medicaid currently covers more than 65 million people in the United States, 49% of whom are children, and is projected to increase by 5 million in 2015. The bulletin also shows that alcohol and substance use disorders are among the top ten diagnoses for hospital readmissions in Medicaid.

HHS releases issue brief on insurer participation in the health insurance marketplace

The Department of Health and Human Services (HHS) released the brief, “Health Insurance Issuer Participation and New Entrants in the Health Insurance Marketplace in 2015” in September. “At least 248 Qualified Health Plan issuers will participate in the federally-facilitated Health Insurance Marketplace in 2015, and at least 67 will participate in state-based Marketplaces, according to preliminary data from 44 states released yesterday by the Department of Health and Human Services. That’s 63, or 25%, more than this year. Some issuers belong to the same parent company. Fourteen issuers this year have not filed for participation in 2015” (American Hospital Association, AHA News).

HHS releases report predicting drop in hospital uncompensated care costs

The report, “Impact of Insurance Expansion on Hospital Uncompensated Care Costs in 2014,” was released in September by the Department of Health and Human Services (HHS). The report projects that hospitals will save $5.7 billion in 2014 in costs due to uncompensated care. The report finds that these savings are largely in result of the Affordable Care Act’s (ACA) expansion of Medicaid. Hospitals in States that have expanded Medicaid are projected to see greater savings than hospitals in States that have not expanded. In fact, $4.2 billion of the projected savings will come from expansion States (HHS press release).

CDC releases State data on increases in heroin overdose from 2010 to 2012

The Centers for Disease Control and Prevention (CDC) released the data on October 3^rd as part of their Morbidity and Mortality Weekly Report (MMWR). Using data submitted by State health departments in 28 States, CDC found that the overall death rate from heroin overdose doubled from 2010-2012. Comparing the same years, the overall death rate from prescription opioid overdose decreased by 6.6%. These rates varied widely among States. In 2012, 25-34 year olds had the highest death rate from heroin overdose and individuals aged 45-54 had the highest rate of overdose from prescription opioids. In 2012, the heroin death rate was almost four times higher for men, while the prescription opioid overdose death rate was only 1.4 times higher for men than women.

BJS releases report on prisoner recidivism

The Bureau of Justice Statistics (BJS) released a special report on prison recidivism in 30 states. The data published covers prisoner statistics from 2005 to 2010, and indicates that 67.8% of prisoners were arrested within 3 years of release, and 76.6% were arrested within 5 years of release. Among these statistics, 76.9% of drug offenders were arrested for a new crime within 5 years of release. The report includes useful tables and graphs. These illustrations highlight the demographics and common reasons behind prisoner recidivism, including age, race, location, and nature of the crime.

In the News

USA Today publishes article on changing marijuana laws and road safety

On September 25^th, USA Today reported on the effects of easing marijuana laws on traffic and road safety. Medical marijuana is now legal in 23 states, and has been decriminalized in 16 states and D.C. Road safety advocates are now looking at the impact this may have on driving accidents. While marijuana has been shown to decrease aggressive driving, its role in fatal crashes rose from 4% in 1999 to 12% in 2010. While research about the various effects marijuana has on driving abilities is at an initial level, efforts are being taken to train officers to identify drivers impaired by marijuana use.

News from NASADAD

• NASADAD welcomes new FL State Director, Ute Gazioch
• NASADAD attends Hill briefing on IMD Exclusion – Steven Baron presents
• NASADAD attends annual Harold Rogers PDMP meeting

News from the States

• Governor Cuomo launches “Combat Heroin” campaign

Around the Agencies

• SAMHSA publishes report on gambling problems
• SAMHSA announces new suicide prevention mobile app
• CMS announces report on enrollment

Resources

• PDMP researchers publish study on the impact of unsolicited reporting
• ATTC to hold clinical supervision webinar on October 14^th

 

News from NASADAD

NASADAD welcomes new FL State Director, Ute Gazioch

Ms. Gazioch previously served as the Mental Health Lead for the Department, responsible for the oversight of Statewide grants and programs as well as providing clinical and programmatic expertise on statewide adult and children’s issues. Ms. Gazioch formerly served as Project Director and then Principal Investigator for the Statewide System of Care Expansion grants, which aims to improve the state’s service delivery system for children and their families. Prior to joining the Department, Ms. Gazioch spent 16 years working with adults, children and families. Ms. Gazioch has extensive experience with direct care provision as well as program development, management and evaluation. While working at Henderson Behavioral Health, she collaborated with Broward County’s One Community Partnership, a SAMHSA funded System of Care site, and successfully implemented high fidelity Wraparound with her teams.

NASADAD attends Hill briefing on IMD Exclusion – Steven Baron presents

Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the briefing hosted by Rep. Marcia Fudge (D-OH) on September 18^th. The briefing discussed the Breaking Addiction Act, which would create a pilot program for some States to eliminate the Medicaid Institutions of Mental Disease (IMD) Exclusion that restricts Medicaid from reimbursing for services received at residential treatment programs with more than 16 beds. Steve Baron, NASADAD member and Director of the DC Department of Behavioral Health, discussed the potential effects of an IMD pilot from a State perspective. Panelists also addressed how including residential treatment centers with more than 16 beds in Medicaid coverage would increase the ability to treat the nation’s growing heroin/opiate epidemic.

Moderator: Becky Vaughn, National Council for Behavioral Health

Panelists:

Wendy Doolittle, McKinley Hall

Steve Baron, DC Department of Behavioral Health

William B. Lawson, Department of Psychiatry and Behavioral Health, Howard University

NASADAD attends annual Harold Rogers PDMP meeting

Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the annual Harold Rogers Prescription Drug Monitoring Program (PDMP) National Meeting from September 22^nd-24^th. The three-day national meeting addressed a range of information regarding PDMPs and their increasing presence in combating the prescription drug epidemic. Many agencies were represented, including the Substance Abuse and Mental Health Services Administration (SAMHSA), the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and the Drug Enforcement Administration (DEA). Topics included PDMP research, data usage, law enforcement training, prescriber outreach, and PDMP updates from various states. Panelists included Denise O’Donnell, Director of U.S. Bureau of Justice Assistance; Dr. H. Westley Clark, Director of the Center for Substance Abuse Treatment at SAMHSA, and Michael Botticelli, Acting Director of the Office of National Drug Control Policy (ONDCP).

News from the States

Governor Cuomo launches “Combat Heroin” campaign

On September 22^nd, 2014 New York Governor Andrew Cuomo announced the launch of “Combat Heroin,” a campaign intended to inform New Yorkers about the risks of heroin use and opioid misuse, the signs of addiction, and resources available for those struggling with substance use disorders. The campaign launched with a dedicated website primarily targeting parents, adults, and young people. The website features videos from New Yorkers discussing the impact of heroin on their lives, statistics concerning heroin use in New York and resources about the Good Samaritan Law, information about the warning signs of substance abuse and how to access treatment providers, and educational tools for parents and health care professionals.

Around the Agencies

SAMHSA publishes report on gambling problems

The Substance Abuse and Mental Health Services Administration (SAMHSA) released the report, “Gambling Programs: An Introduction for Behavioral Health Services Providers,” to serve as an introductory resource on the topic for mental health and substance use disorder providers, discussing causes, statistics, and treatment options for those struggling with gambling problems. The report also profiles different types of gambling: pathological gambling, gambling disorder, and problem gambling. The report provides information on rates of gambling problems, demographic characteristics of people with gambling problems, and the links between gambling problems and other mental health and substance use disorders. Additionally, the report discusses tools for assessing and treating a gambling problem.

SAMHSA announces new suicide prevention mobile app

The Substance Abuse and Mental Health Services Administration (SAMHSA) is developing a mobile app to better equip providers with tools for suicide prevention. The app, titled “Suicide Safe,” is based off of SAMHSA’s Suicide Assessment Five-Step Evaluation and Triage (SAFE-T) card. Along with a virtual copy of the SAFE-T card, Suicide Safe also includes interactive sample cases, downloadable suicide prevention pamphlets, fact sheets, treatment resources, and a treatment services locator. The app is currently being developed for Apple and Android devices, and will be launching in early 2015.

CMS announces report on enrollment

On September 24^th, the Centers for Medicare & Medicaid Services (CMS) announced the July 2014 Monthly Applications, Eligibility Determinations, and Enrollment Report. This report provides state data on Medicaid and Children’s Health Insurance Program (CHIP) enrollment in the month of July. As of July, over 67 million individuals have enrolled in Medicaid and CHIP. Included in this report are tables illustrating changes in enrollment rates for both Medicaid and CHIP in all 50 states and the District of Columbia. The report covers applicant eligibility numbers, and discusses findings from July’s enrollment data.

Resources

PDMP researchers publish study on the impact of unsolicited reporting

The PDMP Center of Excellence (COE) at Brandeis University has released a newly updated report, “Briefing on PDMP Effectiveness.” The updated briefing discusses how unsolicited reporting has helped reduce the frequency of doctor shopping by 36% since the concept’s introduction. The briefing includes research studies, evaluations, and surveys from over 60 sources. The COE data also suggests that PDMPs are contributing to better health outcomes, including declines in overdose deaths, emergency department visits, and treatment for prescription opioid abuse (Center of Excellence email update).

ATTC to hold clinical supervision webinar on October 14^th

The National Frontier and Rural ATTC will be hosting a webinar on October 14^th concerning the use of telehealth technologies and expanding the role of technology in clinical supervision. The briefing will discuss the impact of technology when confronting geographical barriers to clinical supervision in isolated areas. This webinar is the latest in ATTC’s Telehealth Tuesday media series, which explores the use of technology in substance abuse treatment and recovery. The webinar will be presented by Tobie Barton, Project Manager at CASAT.