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D.C. Update – November 21, 2014

News from NASADAD

  • NASADAD releases section-by-section analysis of overdose legislation by Senator Markey (D-MA)
  • NASADAD releases section-by-section analysis of IMD legislation by Representative Fudge (D-OH)
  • NASADAD attends Capitol Hill briefing on opioid use during pregnancy
  • NASADAD signs on to a letter recognizing the importance of federal research funding

News from the States

  • OhioMHAS releases November e-update

Around the Agencies

  • Medicaid.gov expands and improves

Upcoming Events

  • November 24th:  Webinar on HIV and enrollment in the health insurance marketplace
  • December 9th: Webinar on screening and assessment for family engagement and retention

 

News from NASADAD

NASADAD releases section-by-section analysis of overdose legislation by Senator Markey (D-MA)

The legislation, the Opioid Overdose Reduction Act of 2014, S. 2092, was introduced by Sen. Edward Markey (D-MA) and co-sponsored by Sens. Kelly Ayotte (R-NH), Jay Rockefeller (D-WV), and Tim Kaine (D-VA). The legislation would extend civil liability protections to health care professionals who provide or prescribe naloxone, to individuals who distribute naloxone from an overdose prevention program, and to individuals who administer naloxone. State laws that are inconsistent with the above mentioned civil liability protections would be preempted, though State laws that provide additional protections would not. The legislation also provides a mechanism for States to opt out of its provisions.

NASADAD releases section-by-section analysis of IMD legislation by Representative Fudge (D-OH)

The legislation, the Breaking Addiction Act of 2014, H.R. 5136, was introduced by Rep. Marcia Fudge (D-OH) and originally co-sponsored by Reps. Tim Ryan (D-OH), Elijah Cummings (D-MD), Barbara Lee (D-CA), Eleanor Holmes Norton (D-DC), Cedric Richmond (D-LA), Alcee Hastings (D-FL), and Yvette Clarke (D-NY). The legislation would expand community treatment options by creating a 5-year demonstration project waiving the Institutions for Mental Diseases (IMD) Exclusion for those suffering from substance abuse. The IMD Exclusion originated in the 1965 Medicaid statute and was originally created so that patients receiving long-term, residential mental health services at a State psychiatric hospital would not be eligible to receive Medicaid coverage for that treatment. Substance use disorder treatment has been included in subsequent enacting legislation, thereby banning Medicaid reimbursement for residential treatment centers with more than 16 beds, which constitute a significant proportion of all residential treatment providers for substance use disorders. This makes it difficult for Medicaid beneficiaries to receive the residential substance use treatment services they need. When the pilot is completed, the bill directs the Secretary of the U.S. Department of Health and Human Services (HHS) to prepare a report to evaluate the impact of the program on a range of health care issues including costs, access to care, re-admissions, and emergency care.

NASADAD attends Capitol Hill briefing on opioid use during pregnancy

Shalini Wickramatilake-Templeman, Research Analyst attended the briefing, “Drug Exposure in Mothers and Newborns: Addressing Neonatal Abstinence Syndrome,” hosted by the March of Dimes Birth Defects Foundation (MDBDF) on November 19th. The briefing featured remarks by Rep. Steve Stivers (R-OH) and Rep. Katherine Clark (D-MA) who co-sponsored the Coordinated Recovery Initiative for Babies (CRIB) Act which was introduced in June and seeks to increase research at the federal level on neonatal abstinence syndrome (NAS), including identification, treatment, and surveillance. Jennifer Conklin from Sen. Mitch McConnell’s (R-KY) office also provided remarks about a similar piece of legislation the Senator introduced called the Protecting Our Infants Act. Jessica Young of the American Congress of Obstetricians and Gynecologists (ACOG) gave an overview of NAS and the negative effects of punitive measures against pregnant women who use opioids, both medically and non-medically. Dr. Cecilia Spitznas of the Office of National Drug Control Policy (ONDCP) presented on ONDCP efforts related to NAS and Dr. Mark Hudak of the American Academy of Pediatrics provided an overview of the current body of research on NAS, including variability in symptoms and treatment options.

NASADAD signs on to a letter recognizing the importance of federal research funding

NASADAD was one of over 300 groups that signed on to a letter urging Congress to prioritize fiscal year 2015 budget appropriation legislation. The letter, published on November 12th, 2014, was put together by the Ad Hoc Group for Medical Research and expressed the importance of bipartisan action to pass final, omnibus spending legislation by the end of the year. The omnibus, the group writes, should include appropriations that restore funding for the National Institutes of Health (NIH) to pre-sequestration levels. The group mentioned the importance of the research conducted and funded by NIH, and wrote that only through restored funding could NIH continue their record of excellence. NASADAD priority programs with NIH include the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

News from the States

OhioMHAS releases November e-update

The Ohio Department of Mental Health and Addiction Services (OhioMHAS) has released their November 2014 e-Update. The update includes a series of stories detailing Ohio’s progress in addiction and mental health services, beginning with a $10 million increase in funding for addiction recovery housing. Additionally, the update discusses the recent grant awarded to the University of Cincinnati to continue combating Hepatitis C among needle users. Finally, the update provides links to research publications, recent studies, and national news.

Around the Agencies

Medicaid.gov expands and improves

In time for the 2015 open enrollment period, Medicaid.gov has announced several improvements to the Medicaid website. The improved website is more streamlined, modern, and accessible. This means that consumer resources are more easily available through a Consumer Action page. Additionally, the Medicaid Moving Forward section has been remodeled to provide information about both Medicaid and the Children’s Health Insurance Program (CHIP). This section is coupled with expanded Medicaid and CHIP profiles for each state.

Upcoming Events

November 24th:  Webinar on HIV and enrollment in the health insurance marketplace

The US Department of Health and Human Services (HHS) will host a webinar on Monday, November 24th, 2014 from 2:00-2:45pm EST. The webinar, titled “Toward an AIDS-free Generation: Healthcare Outreach and Enrollment for People Living with HIV,” will discuss the critical relationship between the 2015 open enrollment period and the needs of the HIV community. This webinar, designed for service providers and community-based organizations, will also focus on the role of the Affordable Care Act in implementing the National HIV/AIDS Strategy and Viral Hepatitis Action Plan.

December 9th: Webinar on screening and assessment for family engagement and retention

The New England Addiction Technology Transfer Center (ATTC) Network will host a webinar on Tuesday, December 9th, 2014 from 1:00-2:30pm EST. The webinar will focus on effective strategies and practices for working with families with substance use disorders. This is the second webinar that will focus on screening and assessment targeted towards family engagement and retention. It will also explore effective methods of substance abuse treatment for parents at both a practice and systems level. Panelists will discuss the importance of expanding collaboration between States and stakeholders.

 

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.