Category Archives: Public View

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Confidentiality Information

A variety of discussions have taken place (and continue to take place) at the national level regarding ways to integrate the protections included in Confidentiality of Alcohol and Drug Abuse Patient Records regulations—42 CFR Part 2—with electronic health records and other health information technologies. NASADAD takes these discussions very seriously and is working through a process to provide education to our members and host forums and discussion to allow our members a chance to voice their opinions.

On February 9th, 2016, the Department of Health and Human Services published a Notice of Proposed Rulemaking on 42 CFR Part 2 in the Federal Register. The goal of the proposed changes is to facilitate information exchange within new health care models while addressing the legitimate privacy concerns of patients seeking treatment for a substance use disorder.

In 2010, NASADAD published a policy statement regarding 42 CFR Part 2 and changes in health information technology. The statement offers support for stakeholders and policymakers to have thoughtful and inclusive discussions about how the confidentiality protections in 42 CFR Part 2 can best be utilized with more advanced health information technologies. Specifically, the document says “Should the deliberative dialogue suggest a clear need to adjust current policies governing privacy and confidentiality, including 42 CFR Part 2, changes should be considered and carefully implemented. During this process, NASADAD believes any changes should:

  • Benefit from the deliberations and information generated by the stakeholders listed above,
  • Enhance communication of vital health information necessary to improve the quality of care for people with substance use disorders, and
  • Maintain the intent of 42 CFR Part 2, which protects personal privacy and confidentiality, and prevents discrimination of people with alcohol and other drug histories.”

Read NASADAD’s 2010 Statement on Confidentiality.

Read the regulations here.

Other Resources

Comments to SAMHSA regarding potential changes to 42 CFR Part 2 from:

  • The American Association for the Treatment of Opioid Dependence (AATOD) here.
  • The Legal Action Center (LAC) here. Check out LAC’s comments to SAMHSA and other resources on confidentiality.
  • The National Association of Medicaid Directors (NAMD) and the National Association of State Mental Health Program Directors (NASMHPD) here.
  • NAMD Statement on More Comprehensive Action on Substance Use Privacy Rules here.

D.C. Update – July 22, 2014

DC Update

July 22, 2014

 

Around the Agencies

  • NASADAD attends HHS 50-State meeting on prescription drug abuse
  • NASADAD participates on conference call hosted by HHS about Medicaid Innovation Accelerator Program
  • SAMHSA posts blog explaining health insurance coverage options
  • SAMHSA names Tom Coderre as new Senior Advisor
  • HHS announces $11 million to better integrate HIV services into community health centers
  • Small Business Administration to kick off Spanish language webinar series

Capitol Hill News

  • OH Representatives introduce legislation in response to heroin epidemic

Events

  • NASADAD attends briefing on the treatment of alcohol use disorders sponsored by Friends of NIAAA
  • NASADAD attends briefing on women and addiction sponsored by Senators Portman and Whitehouse
  • APHA hosts webinar on health indicators for substance abuse
  • National Behavioral Health Network for Tobacco and Cancer Control hosts webinar on nicotine addiction

Resources

  • National Safety Council releases prescription drug employer kit

 

Around the Agencies

NASADAD attends HHS 50-State meeting on prescription drug abuse

Rob Morrison, Executive Director attended the meeting, Advancing Policy and Practice: A 50-State Working Meeting to Prevent Opioid-Related Overdose, hosted by the U.S. Department of Health and Human Services (HHS) and held in Washington, DC. Many NASADAD members also participated in the meeting on behalf of their individual States. HHS Secretary Sylvia Burwell offered remarks. The meeting brought together State and local substance abuse prevention and treatment experts with HHS leaders to discuss experiences with implementing prevention strategies and to discuss potential interventions targeted toward opioid prescribers. Governors were invited to select a three-person delegation to represent the State, though some States funded additional representatives to attend. The two-day meeting involved presentations from leading experts and ample time to work directly with State partners and regions to draft action plans for States to reduce the burden of prescription drug abuse in their State. Rob participated in the closing session with representatives from the National Governors Association (NGA), Association of State and Territorial Health Officials (ASTHO), and the Safe States Alliance.

NASADAD participates on conference call hosted by HHS about Medicaid Innovation Accelerator Program

Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate participated on the conference call hosted by the U.S. Department of Health and Human Services (HHS) on July 16th. The call provided information about the recently announced Medicaid Innovation Accelerator Program and gave participants an opportunity to ask questions about the program. Cindy Mann and Patrick Conway, Deputy Administrators of the Centers for Medicare and Medicaid Services (CMS) both presented on the call. The program is primarily a technical assistance program to help States improve the patient experience for Medicaid beneficiaries. CMS has identified substance use disorders as an important focus area for the Medicaid population. The presenters gave a number of examples to use the program to improve substance use disorder treatment including developing tools to leverage new Medicaid data sources to identify high-risk/high-need populations, assess provider capacity, or build health information exchanges. During the call, Rob thanked CMS for this initiative, recognized the leadership of John O’Brien, and promoted the inclusion of State substance abuse agencies, and NASADAD during the next phase.

SAMHSA posts blog explaining health insurance coverage options

The blog, Your Health Insurance Coverage Options: The Basics, was posted on July 16th by the Substance Abuse and Mental Health Services Administration (SAMHSA). SAMHSA has a released a series of blogs and webinars aimed to educate the public about coverage options under the Affordable Care Act (ACA). The blog describes the health insurance marketplace and newly required insurance protections including providing preventive services without a co-pay, banning pre-existing condition exclusions, and covering services for mental health and substance use disorders. The blog also describes the public insurance options available: Medicaid, Medicare, and the Children’s Health Insurance Program (CHIP). 2014 open enrollment for the marketplace is over, but enrollment for 2015 plans will begin this November.

SAMHSA names Tom Coderre as new Senior Advisor

The Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator Pam Hyde sent the announcement on July 17th. Mr. Coderre was the Chief of Staff to the President of the Rhode Island Senate and is well-known in the addiction and recovery community. He previously served as the Board Chair for Rhode Island Communities for Addiction Recovery Efforts and the Field Director of Faces and Voices of Recovery. Administrator Hyde describes Mr. Coderre as “a passionate advocate and committed public servant who will be a tremendous asset as we continue our important work of crafting effective public policy to reduce the impact of substance abuse and mental illness on America’s communities” (SAMHSA email).

HHS announces $11 million to better integrate HIV services into community health centers

U.S. Department of Health and Human Services Secretary Sylvia Burwell announced the availability of the funding though the Affordable Care Act (ACA) and the Secretary’s Minority AIDS Initiative Fund. The funds can be used to support the integration of HIV services into primary care through partnerships with health centers and State health departments in Florida, Massachusetts, Maryland, and New York. The funding is part of a 3-year project called Partnerships for Care: Health Departments and Health Centers Collaborating for Improve HIV Health Outcomes. 22 health centers in those four States have been deemed eligible to apply for the funding. The funding will support health center workforce development, infrastructure development, HIV service delivery across the HIV care continuum, and the development of sustainable partnerships with State health departments.

Small Business Administration to kick off Spanish language webinar series

Small Business Administration (SBA) Administrator Maria Contreras-Sweet kicked off the series by delivering the introductory remarks at the first webinar, held on July 22nd. Representatives from the U.S. Department of Health and Human Services (HHS) and the Small Business Majority were also present for the inaugural webinar. The bimonthly webinars will run through late September 2014 and cover a wide range of topics related to the Affordable Care Act (ACA). Administrator Contreras-Sweet said “The Affordable Care Act is already helping millions of small business owners and their employees access quality, affordable health insurance. Through these webinars, small business owners will learn the important facts about the health care law so they can make the best decisions possible for their company. These interactive dialogues are a great way for small businesses to get the information they need to take advantage of and comply with key provisions of the health care law” (press release).

Capitol Hill News

OH Representatives introduce legislation in response to heroin epidemic

OH Representatives Tim Ryan and Marcia Fudge introduced the legislation, “The Breaking Addiction Act of 2014” on July 18th. The legislation would expand community treatment options by creating a pilot program to eliminate the IMD Exclusion for substance abuse providers. The Institutions for Mental Disease (IMD) Exclusion is from a 1965 Medicaid rule that 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 was included into the rule, banning Medicaid reimbursement for residential treatment centers with more than 16 beds, encompassing many residential treatment providers for substance use disorders. This makes it difficult for Medicaid beneficiaries to receive residential substance use treatment services. 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. Representative Fudge describes the effort saying, “By removing an outmoded barrier to funding for substance abuse treatment, we can go a long way toward reversing the heroin epidemic and saving lives. I am also confident that data collected from this demonstration project will show community treatment will lower the bill to taxpayers for overall health care and decrease law enforcement costs associated with opiate addiction.

Events

NASADAD attends briefing on the treatment of alcohol use disorders sponsored by Friends of NIAAA

Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the briefing, New Horizons in the Treatment of Alcohol Use Disorders, hosted by the Friends of the National Institutes on Alcohol Abuse and Alcoholism (NIAAA) coalition on July 21st. The briefing provided an overview on emerging research into alcohol use disorders and treatment best practices. The panelists included George Koob, PhD (Director, NIAAA), Betsy McCaul, PhD (Professor of Psychiatry, Johns Hopkins University School of Medicine), and a person in recovery. This event is one in a series of educational briefings hosted by the coalition to educate Congress about the value of alcohol use research. This particular briefing attracted a standing-room only crowd of more than 100 people.

NASADAD attends briefing on women and addiction hosted by Senators Portman and Whitehouse

Rob Morrison, Executive Director; Colleen Haller, Public Policy Associate; and Shalini Wickramatilake, Research Analyst attended the July 22nd forum hosted by Senators Sheldon Whitehouse (D-RI) and Rob Portman (R-OH) and attended by Senators Kelly Ayotte (R-NH) and Amy Klobuchar (D-MN). The forum included presentations by researchers, practitioners, policymakers, and Members of Congress. The three highlighted topics were Women and Addiction: Treatment and What Works; Women, Addiction, and Motherhood; and The Role of Trauma as a Factor Contributing to Addiction, Relapse, and Recidivism in Women. This is the second in a series of forums hosted by the two Senators to identify policy priorities for the next Congress related to prevention, treatment, and recovery for substance use disorders.

APHA hosts webinar on health indicators for substance abuse

The webinar, Who’s Leading the Leading Health Indicators: Substance Abuse, will be hosted by the American Public Health Association (APHA) on July 24th from 12-1 EST. The panelists (listed below) will address the following learning objectives: 1) describe the impact substance abuse has on the health of our nation, 2) review effective strategies to address substance abuse in multiple populations, 3) explain effective strategies to address substance abuse in youth through a collaborative effort, and 4) discuss existing resources for stakeholders to use as they address substance abuse in their communities. Work being done in a community in Wisconsin will be highlighted.

Panelists:

  • Dr. Don Wright, Director, Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services (HHS)
  • Dr. Howard Koh, Assistant Secretary for Health, HHS
  • Rear Admiral Peter Delaney, PhD, Director, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration (SAMHSA)
  • Melissa Dotter, Marathon County Health Department, Wausau, WI

National Behavioral Health Network for Tobacco and Cancer Control hosts webinar on nicotine addiction

The Centers for Disease Control and Prevention (CDC) funded National Behavioral Health Network for Tobacco and Cancer Control will host the webinar, A Journey to Recovery: What Does the Cigarette Represent, on July 29th. The panelists (listed below) will discuss how the substance abuse and mental health treatment environments can facilitate people in recovery going tobacco-free. They will also discuss some of the common myths that reinforce smoking among people working to recover from substance use disorders.

Panelists:

  • Eric Arauz, President, Arauz Inspirational Enterprises LLC
  • Chad Morris, PhD, Director, Behavioral Health and Wellness Program and Associate Professor, University of Colorado at Denver
  • Steven Schroeder, MD, Director, Smoking Cessation Leadership Center, Distinguished Professor of Health and Health Care, University of California at San Francisco

Resources

National Safety Council releases prescription drug employer kit

The kit helps educate employers about the risks of prescription drug abuse and provides tools to help them communicate those risks to their employees. The kit is divided into two sections: executive action materials to help manage prescription opioid use and misuse in the work place and educational materials for employees on prescription drug abuse. The executive action materials contain a variety of resources on the issue itself, how to update drug-free workplace programs, structuring benefit programs to address opioid misuse, and others. The educational materials include fact sheets on opioid pain relievers and the risk of addiction and overdose, medication disposal, and alternative chronic pain treatments.

 

D.C. Update – July 17, 2014

DC Update

July 17, 2014

 

News from the States

  • Pennsylvania releases physician guidelines for prescription opioids

Around the Agencies

  • CMS awards health care innovation grants
  • SAMHSA developing app to help parents and caregivers talk to their kids about underage drinking
  • HHS announces Medicaid Innovation Accelerator Program

Capitol Hill News

  • NASADAD attends briefing hosted by Coalition for Health Funding on the effects of sequestration on health
  • Sens. Booker and Paul introduce legislation to improve employment opportunities for adult non-violent offenders

Events

  • NASADAD attends town hall meeting hosted by Non-Defense Discretionary coalition on potential threats to discretionary spending
  • Alliance for Health Reform hosts briefing on health insurance marketplaces
  • National Academy for State Health Policy hosting webinar on Medicaid treatment services for children and adolescents

In the News

  • Avalere Health releases observations on essential health benefits package
  • New York Times publishes article on the IMD exclusion

Resources

  • Medicaid Directors and Mental Health Program Directors send comments to SAMHSA regarding 42 CFR Part 2
  • Commonwealth Fund study finds uninsured rate falls to 15%
  • Association of Drug Court Professionals releases brief report on the ACA
  • PDMP Center for Excellence releases report on State experiences with mandating provider participation in PDMPs
  • State Budge Officers release report on using performance data to inform State budgets

News from the States

Pennsylvania releases physician guidelines for prescription opioids

The newly released guidelines were a collective effort between the Pennsylvania Department of Drug and Alcohol Programs (led by Gary Tennis, NASADAD Board Member), the Department of Health, and Governor Tom Corbett’s Administration and were adopted by the State Medical Society. The guidelines are voluntary and encourage providers to consider a number of identified evidence-based practices for treating patients receiving opioids for chronic, non-cancer pain. Those identified practices include discussing the benefits and risks associated with opioid therapy, individualizing opioid selection and dosing, monitoring and reassessing patients periodically, and others. The Pennsylvania Chapter of the American College of Emergency Physicians (PaACEP) also adopted voluntary guidelines for treating pain in the emergency department.

Around the Agencies

CMS awards health care innovation grants

The Centers for Medicare and Medicaid Services (CMS) announced the recipients of the Health Care Innovation Awards. The $360 million in 3-year grant funds will be awarded to 39 recipients in 27 States and the District of Columbia to test innovative care models. According to U.S. Department of Health and Human Services (HHS) Secretary Sylvia Burwell, “The Health Care Innovation Awards support our ongoing work to drive down health care costs while providing high quality care to CMS beneficiaries. These awards advance innovative solutions in delivering and improving care from all across our nation” (HHS press release). Award recipients will be testing models in a number of areas of health care including improving emergency care, promoting better rural care coordination and telehealth, and promoting better care for people living with HIV/AIDS.

SAMHSA developing app to help parents and caregivers talk to their kids about underage drinking

The Substance Abuse and Mental Health Services Administration (SAMHSA) is developing the app as part of their “Talk. They Hear You.” campaign. SAMHSA previously released a successful online simulation tool that helps parents and caregivers talk to their kids about the risks of underage drinking. The newest version will include a mobile app for Android, Apple, and Windows devices to reach parents on-the-go. The tool uses virtual humans or “avatars” to educate parents and caregivers about how to effectively communicate with their child about alcohol use. Parents will be able to use the avatars to have practice conversations and get help from coaches based on the Motivational Interviewing Model.

HHS announces Medicaid Innovation Accelerator Program

The U.S. Department of Health and Human Services (HHS) announced the program which will provide more than $100 million in funding for technical support to help States improve health, improve care, and reduce costs for Medicaid beneficiaries. The letter sent to Medicaid Directors regarding the program specifically highlighted the need for additional investment in addiction and substance use disorder services. “While complementing other federal-state delivery system reform efforts such as the State Innovation Models initiative, this new initiative will help jumpstart innovation by providing federal tools and resources to support states in advancing Medicaid-specific delivery system reform. The Medicaid Innovation Accelerator Program will develop Medicaid specific resources to support state-based innovative health care reform efforts by identifying and advancing new Medicaid service delivery and financing models to improve patient care by providing data analytics, improving quality measurement and rapid cycle evaluation capabilities, and advancing effective and timely dissemination of best practices and learning among states” (HHS release).

Also check out an informational bulletin from the Center for Medicaid and CHIP Services (CMCS) on medication-assisted treatment.

Capitol Hill News

NASADAD attends briefing hosted by Coalition for Health Funding on the effects of sequestration on health

Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the Senate briefing, Faces of Austerity: How Budget Cuts Hurt America’s Health, hosted by the Coalition for Health Funding on July 15th. The Coalition for Health Funding is made up of a wide range of national organizations, including NASADAD, National Association of County and City Health Officials, American Public Health Association, National Association of Community Health Centers, and many more whose collective missions and members depend on federal funding to meet the health care and wellness needs of vulnerable populations. The panel of speakers came from varying health sectors and discussed how sequestration and other budget cuts have affected their ability to meet the health care needs of their communities. The reductions in funding have had wide ranging effects on the delivery of services, research and innovation, public health infrastructure, and individual health.

Panelists:

  • Eve Anthony, Athens Community Council on Aging, Athens, GA
  • Dr. Shobna Ghosh, Virginia Commonwealth Medical Center, Richmond, VA
  • Dr. Glen Mays, University of Kentucky, Lexington, KY
  • Tim Starkey, Great Salt Plains Health Center, Cherokee, OK
  • Paulette Valentine, Southwest Utah Public Health Department, Saint George, UT

Sens. Booker and Paul introduce legislation to improve employment opportunities for ex- offenders

Senator Cory Booker (D-NJ) and Senator Rand Paul (R-KY) introduced the bill, The Record Expungement Designed to Enhance Employment Act of 2014 (REDEEM Act), in July 2014. The Act would create a pathway for nonviolent offenders, both adult and juveniles, to have their records sealed or expunged under certain circumstances. The REDEEM Act would also offer States incentives to raise the age of adult criminal activity to 18 years old, restrict room confinement of juveniles, lift the lifetime bans on some ex-offenders to receive benefits under the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF), and improve the accuracy of the FBI background check system.

Events

NASADAD attends town hall meeting hosted by Non-Defense Discretionary Coalition on threats to discretionary spending

Colleen Haller, Public Policy Associate attended the town hall, Continued Threats to Discretionary Spending (and What to Do About It) on July 8th. The Non-Defense Discretionary (NDD) Coalition is made up of groups representing a wide range of non-defense related public interests that rely on discretionary or non-mandatory funding during the federal budget process. These groups represent issues including public health, education, housing, public safety, scientific research, and others. The meeting featured presentations by the Center on Budget and Policy Priorities (CBPP) on the repercussions of a national balanced budget amendment, as well as potential opportunities and threats to discretionary funding as the appropriations process moves forward.

Alliance for Health Reform hosts briefing on health insurance marketplaces

Colleen Haller, Public Policy Associate attended the briefing, Health Insurance Marketplaces in 2014: Behind the Numbers on July 11th. The expert panel (complete list below) provided an in-depth look at enrollment numbers for the new private health insurance plans, including demographics, initial consumer experiences, and lessons learned as officials plan for the next open enrollment period. The panelists also compared enrollment across States, examined trends in access to affordable health care, and whether safeguards to prevent enrollment inaccuracies have been effective.

Panelists:

  • Arnold Epstein, Deputy Assistance Secretary, Office of Health Policy, Assistant Secretary for Planning and Evaluation (ASPE)
  • Linda Sheppard, special counsel and Director of Health Policy and Analysis at the Kansas Insurance Department
  • Richard Onizuka, Chief Executive Officer, Washington Health Benefit Exchange
  • Timothy Jost, professor, Washington and Lee University School of Law

Moderators:

  • Ed Howard, Executive Vice President, Alliance for Health Reform
  • Sara Collins, Vice President, Health Care Coverage and Access, Commonwealth Fund

National Academy for State Health Policy hosting webinar on Medicaid treatment services for children and adolescents

The webinar, Beyond the Screening: Treatment Services under the Medicaid Benefit for Children and Adolescents, will be held on Thursday, July 24th from 2-3 pm EST. The webinar will feature a presentation from the Centers for Medicare and Medicaid Services (CMS) on how States can use the Medicaid benefit for children and adolescents to meet the children’s treatment needs. Presenters from Colorado and Washington will also discuss their processes for determining Medicaid coverage for this population.

In the News

Avalere Health releases observations on essential health benefits package

The Affordable Care Act (ACA) requires health plans that participate in the new insurance marketplaces to provide a set of essential health benefits (EHB). The U.S. Department of Health and Human Services (HHS) allowed for a transitional approach to the benefits package that would be largely State-driven for plan years 2014 and 2015. HHS plans to release rules for EHBs to be applied to 2016 plans. In anticipation of HHS releasing rules, Avalere offered a series of observations and thoughts regarding the potential rulemaking process, including:

  • “Any EHB rulemaking will struggle to balance patient protections with affordability.”
  • “Rulemaking proposing significant changes to EHB for the 2016 plan year would likely need to emerge before the end of 2014.”
  • “Limited market experience makes wholesale reforms to current EHB policy unlikely.”
  • “Annual guidance for health plans offered on the federal exchange provides a vehicle to dictate policy in the majority of States.”

New York Times publishes article on the IMD Exclusion

The article, “Obscure Rule Restricts Health Law’s Expansion of Care for Addicts,” was published on July 10th and provides an overview of the IMD Exclusion and its effect on Medicaid reimbursement for residential treatment services for substance use disorders. While the Affordable Care Act (ACA) included treatment for substance use disorders in the Essential Health Benefits, a Medicaid rule from 1965 called the “Institutions for Mental Disease (IMD) Exclusion” makes it very difficult for residential treatment centers to qualify for Medicaid reimbursement. The IMD Exclusion 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 was included into the rule, banning Medicaid reimbursement for residential treatment centers with more than 16 beds, encompassing many residential treatment providers for substance use disorders. The article offers a number of State examples where the IMD Exclusion has had an impact on access to substance use disorder treatment, both from the provider and patient perspectives.

Resources

Medicaid Directors and Mental Health Program Directors send joint comments to SAMHSA regarding 42 CFR Part 2

The National Association of Medicaid Directors (NAMD) and the National Association of State Mental Health Program Directors (NASMHPD) sent the comments to Substance Abuse and Mental Health Services Administration (SAMHSA) Administrator Hyde regarding SAMHSA’s public listening session on 42 CFR Part 2 and confidentiality. The comments call for the repeal of provisions of 42 CFR Part 2 that are not aligned with the Health Insurance Portability and Accountability Act’s (HIPAA) privacy provisions, with the exception of the provision that prohibits the use of substance use disorder treatment records to initiate or substantiate criminal charges or conduct an investigation of a patient. The comments also include responses to the set of questions that SAMHSA posed regarding potential changes to 42 CFR Part 2.

Commonwealth Fund study finds uninsured rate falls to 15%

The study, Gaining Ground: Americans’ Health Insurance Coverage and Access to Care After the Affordable Care Act’s First Open Enrollment Period, looks at changes in the national uninsurance rate following the first open enrollment period under the Affordable Care Act (ACA). Significantly fewer working-age adults are uninsured than before the enrollment period began. The uninsurance rate for adults aged 19-64 fell from 20% in July-September 2013 to 15% in April-June 2014. Roughly 9.5 million fewer adults were uninsured. Younger adults aged 19-34 drove a large part of the decrease in rates. Of those with new coverage, 60% reported that they visited a doctor or hospital or filled a prescription (American Hospital Association Update).

Also check out the Commonwealth Fund’s infographic.

Association of Drug Court Professionals releases brief report on the ACA

The brief report, Engaging with the Affordable Care Act: Implications and Recommendations for Adult Drug Court Professionals, was released by the National Association of Drug Court Professionals (NADCP). The brief report provides an overview of the ACA, its provisions, and State actions to implement the law. The report also outlines potential challenges for drug courts, particularly in relation to medical necessity, residential treatment, Medicaid billing, changes in provider choice, changes in the Substance Abuse Prevention and Treatment (SAPT) block grant, parity for substance use disorder treatment, and more. NADCP offers a list of 10 actions that drug courts can undertake to best leverage the ACA’s provisions to best serve drug court participants.

PDMP Center for Excellence releases report on State experiences with mandating provider participation in PDMPs

The Brandeis University Prescription Drug Monitoring Program (PDMP) Center for Excellence released the report, Mandating PDMP Participation by Medical Providers: Current Status and Experience in Selected States, which describes the current status of States’ mandates and outcomes in Kentucky, Tennessee, and New York. “Experience in these States indicates that mandates can quickly increase registration and utilization of PDMPs, with subsequent decreases in the prescribing of some commonly abused controlled substances and in measures of doctor shopping. It also highlights policy and implementation issues for States considering mandates” (PDMP report).

State Budge Officers release report on using performance data to inform State budgets

The National Association of State Budget Officers (NASBO) released the report, Investing in Results: Using Performance Data to Inform State Budgeting, in July (NASUAD Update). The report provides information on State experiences and lessons learned from using performance data, particularly related to agency engagement and buy-in, the role of the legislature, budget purpose and design, and sustaining the initiative. The report also contains case studies on Connecticut, Iowa, Minnesota, Nevada, Oregon, Utah, Virginia, and Washington. NASBO provides a list of key terms and definitions and also provides background information on the evolution of using performance data to design State budgets.

 

D.C. Update – July 8, 2014

DC Update

July 8, 2014

 

News from the States

  • NASADAD attends forum on opioids held in Vermont Statehouse
  • Hayden Mathieson to serve as Florida’s Assistant Secretary for Substance Abuse and Mental Health

From the Administration

  • White House releases report on the Medicaid expansion
  • Surgeon General releases resources to promote 2014 report on smoking and health

Around the Agencies

  • SAMHSA releases two resources for clinicians on managing chronic pain in adults in recovery
  • CDC releases resources on opioid prescribing by State
  • DEA publishes final rule to reschedule tramadol to Schedule IV

Capitol Hill News

  • NH Senators introduce bills to fight prescription drug abuse

Events

  • Addiction Technology Transfer Center (ATTC) hosts webinar on telehealth

In the News

  • AATOD releases paper on increasing access to medication-assisted treatment
  • Urban Institute releases report on the Medicaid expansion

 

News from the States

NASADAD attends forum on opioids held in Vermont Statehouse

On June 16, 2014, Robert Morrison, NASADAD Executive Director, traveled to Montpelier, Vermont to attend a day-long forum designed to spur additional action related to the State’s opioid problem. Governor Shumlin provided remarks to the standing-room-only crowd. The Governor has identified addiction as a top priority for his Administration and dedicated his entire State-of-the-State address to the topic. Barbara Cimaglio, State substance abuse director of Vermont and member of the NASADAD Board of Directors, served as the emcee of the day’s activities. Other plenary speakers included:

  • Dr. Harry Chen, Commissioner, Vermont Department of Health, spoke about opioid trends in Vermont and actions taken by the Department on prevention, treatment, and recovery.
  • Dr. Mark McGovern, Dartmouth, spoke about the science of addiction and implications for the service system.
  • Mayor Christopher Louras, Mayor of Rutland, Vermont, discussed the cross-sector collaboration moving forward in his city.
  • Raina Lowell, person in recovery spoke about her challenges and current opportunities.

After the plenary speakers, representatives from different sectors discussed actions they are taking in quick five minute segments. Perspectives were shared by representatives of community coalitions, students, mentorship groups, hospitals, groups of parents that lost a child, adolescent treatment service providers, law enforcement, housing, faith community, recovery groups, businesses that noted the benefit of hiring people in recovery, and many more.

Break-out groups then offered meeting participants an opportunity to discuss specific issue areas.  NASADAD attended a session that explored the work of law enforcement. The session included a discussion from Chief Baker of the Rutland Police Department where he reviewed project VISION (Viable Initiatives and Solutions through Involvement of Neighborhoods) that promotes a collaborative approach across many sectors. “All hands on deck” is the motto of the Police Chief and Mayor.

Next, the meeting prompted participants to organize by regions. NASADAD attended a meeting of attendees from the Burlington area. A number of sectors were represented, including housing, LGBT groups, Boys and Girls Clubs, a State Senator overseeing the Committee of Jurisdiction over health issues, a State Representative overseeing law enforcement issues, a student, employer, a nurse working in a Federally Qualified Health Center (FQHC), and more.

The meeting reconvened all participants and held a short debrief session.  The regional groups planned to convene again with the goal of tangible action steps that will help reduce the impact of the opioid problem in the State.

Special thanks to Barbara Cimaglio and the rest of the staff from Vermont’s State substance abuse agency.

The article below from a Vermont newspaper described the event.

Substance abuse issues aired and solutions shared at Statehouse forum

By KATIE JICKLING / VTDigger

Posted:   06/17/2014 08:05:24 AM EDT0 Comments | Updated:   about 2 hours ago

MONTPELIER — Victor Twiggs says the addicts come for the pizza. The director of GYST – “Get Your Stuff Together” – Twiggs is building a support system for troubled young men, often with substance abuse issues, on Tuesday nights in Morrisville.

“I just see a light come on in their eyes when they see that someone’s really listening to what they have to say,” Twiggs told a full Statehouse chamber Monday.

Twiggs was one of nearly 200 participants in a community forum who came together to address problems associated with opiate addiction and trafficking on Monday.

The purpose of the forum was to build a collaborative, statewide approach to solutions in local communities. Counselors, recovering drug addicts, law enforcement officers, nonprofit representatives and elected officials from around Vermont shared ideas and resources as they sorted through the causes of the state’s escalating drug problem.

The forum – which included speakers, panels and community-based discussions – was commissioned by Gov. Peter Shumlin and organized by the Vermont Department of Health.

Rutland Mayor Chris Louras spoke about Rutland’s comprehensive approach to substance abuse treatment. In 2013, the city launched Project Vision, a coalition of community groups that are working together to solve drug-related challenges.

“The opiate epidemic is not a public health issue, it is not a law enforcement issue or a health care issue any more than it is a poverty issue or an issue of chaotic households. It is all of those. Unless you accept that, you are doomed to failure,” said Louras.

The event provided a framework for an ongoing statewide discussion about opiate abuse that was launched in January when Shumlin drew national attention to Vermont’s drug problems in his State of the State address.

At the forum, Shumlin touted that public discussion as an accomplishment. “We’ve made it possible to talk about addiction and recovery, to talk about what we’re doing well and what we’re not doing well.

The Vermont Statehouse (Wikimedia Commons)

To collectively raise our voices to talk about an issue that no one wants to talk about.”

Health Commissioner Harry Chen laid out the statistics: Opioid users become addicted after mere days of drug use, and seek treatment after an average of eight years of use, compared to nearly 25 for alcoholism. More than 50 Vermonters died of opioid poisoning in 2013. Last year was the first year that more people sought treatment for opioid use than for alcohol.

“I actually thought I’d never see that,” Chen said. “But it’s here.”

Until three years and 131 days ago, that was Raina Lowell’s reality. She talked about what it was like to be an intravenous heroin user, a crack addict and an alcoholic. She described living without heat in the winter, stealing firewood from her neighbor to keep her children warm at night, losing everything she had down to her self-respect and hope.

“The truth is, being an addict does define me,” Lowell said. “Addiction has affected every single aspect of my life. Being an addict in treatment tells you everything you need to know about me.”

Lowell tells her story “to make it a little easier to find the human being stuck deep inside the shell of an addict. Only then we can create change,” she said. She left the podium to a standing ovation.

One by one, forum participants talked about their own experiences with addiction and how they are trying to tackle the issue in their communities.

Pat Martin started a weekly support group after the 1999 death of her 19-year-old daughter Sarah to heroin overdose. “Wit’s End” in Rutland helps families cope with the devastating impacts of addiction. Burlington High School offers in-school addiction counseling and Susie Walker provides a peer recovery counseling in Brattleboro. Burlington Labs hires ex-convicts or recovering drug addicts, and others provide housing for those in recovery, or use alternative treatments methods like yoga, meditation and arts.

The Shumlin administration has committed $12 million to the crisis this year. The goal, Shumlin said, is to examine the issue from a variety of perspectives, “and turn it into the most innovative practices possible. We want to make sure that with the money we’re spending, no one who calls up asking for treatment has to wait in line.”

On Tuesday, Shumlin will sign a bill that allows for a third-party assessment with drug convictions that will allow the defendant – if deemed eligible – to seek treatment and avoid judicial processes entirely. “You’ll never have a charge filed against you and you’ll never go through the court system. And that’s just common sense,” the governor said, to applause.

Later this week, Shumlin also meets with Massachusetts Gov. Deval Patrick to address cross-border drug issues. On Thursday, Shumlin will travel to the White House for a national conference on drug policy.

The Vermont Department of Health has organized meetings for 12 Vermont cities or “community” groups that will convene again in July, and come out with actions to take, and a list of desired outcomes. St. Johnsbury participants want to increase outreach to schools and business community and the Windham County group will conduct “asset mapping,” to identify resources and services and the gaps that remain.

“We can’t solve this problem without owning it and embracing it,” Chen said. “Everyone here has a part to play the good news is Vermonters excel at community action.”

 

Hayden Mathieson to serve as Florida’s Assistant Secretary for Substance Abuse and Mental Health

Hayden Mathieson, Director of Substance Abuse and Mental Health and NASADAD member, will now serve as the Assistance Secretary for Substance Abuse and Mental Health. In addition to the promotion, Mr. Mathieson will continue to serve as the Florida State Director and NASADAD member. “Mathieson is an attorney with legislative experience, who prior to law school at Florida State, worked in behavioral healthcare with adolescents and families in inpatient and outpatient treatment settings” (Department of Children and Families press release).

From the Administration

White House releases report on the Medicaid expansion

The report, released by the White House Council of Economic Advisors, Missed Opportunities: The Consequences of State Decisions Not to Expand Medicaid, reviews the impact of the Medicaid expansion related to access to care, financial security, residents’ health and well-being, and State economies. The report also attempts to quantify these effects using economic analysis. According to the White House, an estimated 5.7 million people will be unable to access health insurance if the current number of States maintain current policies on expanding Medicaid.

Surgeon General releases resources to promote 2014 report on smoking and health

The new resources include a video interview with Rear Admiral Boris Lushniak, Acting Surgeon General on why Surgeon General reports matter. The Acting Surgeon General also gives an overview of the key findings of the previous 31 reports, providing valuable information on tobacco control, disparities, and the health effects of smoking. The Office of the Surgeon General will also be co-hosting a Twitter chat on July 16th at 2 pm EST with the Centers for Disease Control and Prevention (CDC) on reproductive health and smoking. Finally, the Office is inviting people to sign up for their Tips from Former Smokers Thunderclap. A “Thuderclap” is an application that sends out identical messages via social media (Twitter, Facebook, Tumblr) form multiple accounts.

Use #SGR50chat to join the Twitter discussion on July 16th at 2 pm EST

Around the Agencies

SAMHSA releases two resources for clinicians on managing chronic pain in adults in recovery

The Substance Abuse and Mental Health Services Administration (SAMHSA) released two KAP Keys based on Treatment Improvement Protocol (TIP) 54: Managing Chronic Pain in Adults with or in Recovery from Substance Use Disorders and a quick guide for clinicians. The resources provide concise information on “chronic non-cancer pain, pain management, treatment, and recovery for adults with substance use disorders” (SAMHSA press release). This includes information on comprehensive patient assessments, a summary of non-opioid pain relievers, and recommendations for clinicians when opioid therapy is indicated.

CDC releases report on opioid prescribing by State

The resources from the Centers for Disease Control and Prevention (CDC) provide State-specific information on opioid prescribing patterns, as well as information on prescription opioid overdoses. Variation across States varies widely with providers in the highest-prescribing State writing almost 3 times as many prescriptions for opioid pain relievers per person than the lowest-prescribing State. The resources, including two studies, a Vital Signs issue, and a fact sheet, also make recommendations for States to encourage more responsible prescribing practices. Firstly, CDC recommends that States increase use of prescription drug monitoring programs (PDMPs) and consider policies to better regulate pain clinics to ensure patient safety. One of the resources is a review of overdose death rates in Florida following State policy changes related to opioid prescribing patterns.

DEA publishes final rule to reschedule tramadol to Schedule IV

The U.S. Drug Enforcement Administration (DEA) published the final rule in the Federal Register rescheduling tramadol to Schedule IV, effective on August 18th. Tramadol, an opioid pain reliever, was originally approved by the Food and Drug Administration (FDA) in 1995. In 2010, the U.S. Department of Health and Human Services (HHS) conducted a review and analysis of tramadol for the DEA. Given the drug’s abuse potential, the analysis recommended that the DEA schedule tramadol as a Schedule IV substance. Some States, including Arkansas, Mississippi, and New York have already listed tramadol as a controlled substance (National Association of State Controlled Substances Authorities (NASCSA) press release).

Capitol Hill News

NH Senators introduce bills to fight prescription drug abuse

New Hampshire Senators Kelly Ayotte and Jeanne Shaheen introduced their legislation in June and July of 2014, respectively. Sen. Ayotte’s bill, the “Heroin and Prescription Opioid Abuse Prevention, Education, and Enforcement Act of 2014,” creates an inter-agency task force with representatives from the U.S. Department of Health and Human Services (HHS), National Institutes of Health (NIH), Institute of Medicine (IOM), Department of Veterans Affairs (VA), Department of Defense (DOD), the Drug Enforcement Administration (DEA), and other professional addiction and physician experts to develop a set of best prescribing practices for pain management. The bill also authorizes appropriations for the Harold Rogers Prescription Drug Monitoring Program, reauthorizes the Byrne Justice Assistance Grant Program, directs the Office of National Drug Control Policy (ONDCP) to update the Prescription Drug Abuse Prevention Plan to account for the increase in heroin use, and directs the creation of a drug-free media campaign on prescription drug and heroin abuse.

Sen. Shaheen’s bill, the “National All Schedules Prescription Electronic Reporting Reauthorization Act of 2014,” reauthorizes the National All Schedules Prescription Electronic Reporting (NASPER) grant program for prescription drug monitoring programs (PDMPs) that is housed within HHS. The bill amends the 2005 NASPER reauthorization to emphasize data-sharing between States and integration between the PDMP and electronic health records, health information exchanges, and e-prescribing systems. The bill also provides that de-identified information from the PDMP may be released to other State agencies for the purposes of research. No later than 3 years from the date that funds are appropriated, the Secretary of HHS will complete a report that includes an analysis of the extent to which PDMPs have strengthened initiatives to link patients to substance use disorder services.

Events

Addiction Technology Transfer Center (ATTC) hosts webinar on telehealth

The webinar, Telehealth: Improving Access to Services, was hosted by the South Southwest Addiction Technology Transfer Center (ATTC) on July 9th. As efforts to expand access to treatment continue to grow, some communities have a difficult time with access to care. This can result from a shortage in the health care workforce, as well as long-distances between treatment centers and those seeking help. Telehealth technology is one innovative way to increase access to treatment for those struggling, often rural, communities. The webinar featured presenations by Doug Denton, Executive Director of Homeward Bound, Inc. and Mary S. Cook, Research Associate at UT Austin Center for Social Work Research.

In the News

AATOD releases paper on increasing access to medication-assisted treatment

The American Association for the Treatment of Opioid Dependence (AATOD) released a paper, “Increasing Access to Medication to Treat Opioid Addiction versus Increasing Access for the Treatment of Opioid Addiction with Medications” on July 2nd. The paper outlines the history surrounding access to and regulation of medication-assisted treatment (MAT). The paper touches on the full spectrum of FDA-approved medications to treat opioid addiction: methadone, buprenorphine, and naltrexone. AATOD calls on policymakers to fully investigate these issues and offers a series of questions to help facilitate the discussion. In particular, AATOD discusses the original intent of the patient limit for buprenorphine prescribers and offers some items to consider in efforts to raise or eliminate the limit. The paper provides a comprehensive overview of MAT for opioid addiction, as well as some important takeaways for policymakers.

Urban Institute releases report on Medicaid expansion

The Urban Institute report from the Health Reform Monitoring Survey, Increase in Medicaid under the ACA Reduces Uninsurance, According to Early Estimates, shows that States that expanded Medicaid had a 4% drop in the rate of uninsurance, compared to 1.4% in States that did not expand. This analysis shows that individuals gaining insurance through Medicaid under the Affordable Care Act (ACA) were previously uninsured, rather than switching from private insurance to Medicaid. According to the report, “Strong gains in any Medicaid/State coverage accompanied falling uninsurance rates among low-income adults, younger and older adults, white non-Hispanic adults, and women” (Urban Institute report).

 

D.C. Update – June 27, 2014

DC Update

June 27, 2014

News from NASADAD

  • NASADAD All States Policy Call scheduled for July 18th from 4-5 pm EST
  • Update on 42 CFR Part 2
  • NASADAD sends letters to President and Vice President in support of ONDCP Acting Director Botticelli to serve as permanent Director

Around the Agencies

  • SAMHSA releases two publications to help clinicians address viral hepatitis
  • CDC releases resources on fetal alcohol spectrum disorders (FASD)
  • CDC continues Tips from Former Smokers campaign with additional educational resources
  • CMS announces $60 million in funding available to support Navigators in insurance marketplaces
  • HHS announces auto-enrollment plans for current Marketplace consumers for 2015
  • Government Accountability Office (GAO) releases report on tobacco product regulation

Capitol Hill News

  • Mental Health Liaison Group and PhRMA sponsor Hill briefing on access to mental health treatment

Events

  • White House hosts Men’s Health and My Brother’s Keeper briefing
  • Faces and Voices of Recovery host America Honors Recovery reception

In the News

  • The Washington Post publishes op-ed The Myths of Smoking Pot

 

News from NASADAD

NASADAD All States Policy Call scheduled for July 18th from 4-5 pm EST

The next NASADAD All States Policy Call will be held on Friday, July 18th from 4-5 pm EST (dial-in information below) and will feature a presentation by Mark Parrino, President of the American Association for the Treatment of Opioid Dependence (AATOD). Mr. Parrino will be discussing 42 CFR Part 2 among other issues. The All States Policy Calls will take place on the third Friday of each month from 4-5 pm EST, with the exception of the month of August. We wish everyone safe summer travels and will resume our regular call schedule in September.

NASADAD All States Policy Call Dial-In Information:

Toll Free: 1-855-747-8824

Passcode: 1287903424

[Alternative dial-in: 1-719-325-2630]

Update on 42 CFR Part 2 – NASADAD did not send letter to SAMHSA

NASADAD will continue its discussions on 42 CFR Part 2. At this point, the Association has not sent any letters, but will continue to share updates and information with Members. The Substance Abuse and Mental Health Services Administration (SAMHSA) held a public listening session on June 11th to solicit information on 42 CFR Part 2. SAMHSA also accepted written comments through June 25th. NASADAD discussed confidentiality issues during their Board Meeting at the NASADAD Annual Meeting in June and held an informational call on June 9th with the Legal Action Center. NASADAD Members noted the need for additional dialogue in the coming months. We will share any new information or documents from other organizations to help keep Members informed on any 42 CFR Part 2 developments.

NASADAD sends letters to President and Vice President in support of ONDCP Acting Director Botticelli to serve as permanent Director

On June 20th, NASADAD sent a letter to President Obama and Vice President Biden in support of nominating Michael Botticelli, Acting Director of the Office of National Drug Control Policy (ONDCP), to serve as the permanent Director. Acting Director Botticelli has been an exceptional ally on addiction issues, and NASADAD looks forward to his continued leadership.

Around the Agencies

SAMHSA releases two publications to help clinicians address viral hepatitis

The Substance Abuse and Mental Health Services Administration (SAMHSA) released two publications on viral hepatitis Addressing Viral Hepatitis in People with Substance Use Disorders, one for clinicians and one for clinicians and administrators. The documents provide an overview of the disease, as well as “information on screening, evaluation, treatment, side effects management, and potential interactions among medications used to treat chronic hepatitis” (SAMHSA press release). The resources also provide information about interactions with medications used to treat mental health and substance use disorders.

CDC releases resources on fetal alcohol spectrum disorders (FASD)

The Centers for Disease Control and Prevention (CDC) released a series of free materials that promote “alcohol-free pregnancies to women in your communities” (CDC web page). These materials cover a broad array of topics related to alcohol use during pregnancy, including information on risk factors, health consequences, and frequently asked questions. The research-based materials include a brochure, posters, print ads, health e-cards, and social media tools. These items are downloaded free-of-charge, with the option to order print copies from the CDC.

CDC continues Tips from Former Smokers campaign with additional educational resources

The Centers for Disease Control and Prevention (CDC) launched the Tips from Former Smokers campaign in 2012. The campaign shares the stories of real individuals who are living with serious health problems due to smoking. The newest advertisements (radio, print, TV, posters, social media, etc.) will feature stories about cancer, stroke, pregnancy complications, and others. The ads remind viewers that there is a hotline available for people who want help to quit smoking. There are also a variety of other educational resources made available on the CDC website, including faith-based resources (Legacy Foundation update).

CMS announces $60 million in funding available to support Navigators in insurance marketplaces

The Centers for Medicare and Medicaid Services (CMS) announced that it is accepting letters of intent through June 30th to apply for funding to support Navigators in insurance marketplaces (both State- and federally-facilitated). “The funding opportunity announcement is open to eligible individuals, as well as private and public entities, Indian tribes, tribal organizations, and urban Indian organizations applying to serve as Navigators in States with a federally-facilitated or State partnership marketplace. It is open to new and returning Navigator applicants” (CMS press release). The Navigator application closes on July 10th. CMS is also hosting a pre-application webinar on July 1st from 1:30-3:00 pm EST.

HHS announces auto-enrollment plans for current Marketplace consumers for 2015

The U.S. Department of Health and Human Services (HHS) plans to provide assistance to insurance marketplace consumers and offer them a simple way to auto-enroll in their existing plan each year, rather going through the enrollment process in 2015. This option would be available to those that would like to keep their existing plan, while those who want to make changes will be free to do so. Under the plan, consumers will receive a notice on how to update their income information for tax credit purposes and will receive information from their insurer about premiums and any other relevant payment information.

Government Accountability Office (GAO) releases report on tobacco product regulation

The report, Tobacco Product Regulation: Most FDA Spending Funded Public Education, Regulatory Science, and Compliance and Enforcement Activities, was released on June 20th. Required by the Tobacco Control Act, the report “examines (1) how FDA spent tobacco user fees for key activities using its authorities granted in the act, and (2) any challenges FDA encountered in using its authorities” (GAO highlights). Of the $1.88 billion in tobacco user fees the FDA has collected since 2009, $1.48 have been spent on various activities. Activities include public education ($508 million), regulatory science ($478 million), and compliance and enforcement ($181 million).

Capitol Hill News

Mental Health Liaison Group and PhRMA sponsor Hill briefing on access to mental health and substance use disorder treatment

Colleen Haller, NASADAD Public Policy Associate attended the briefing, titled Mental Health: Partnering for Access and Treatments for Patients and co-hosted by Representatives Leonard Lance (NJ) and Doris Matsui (CA). The information session included information on the needs of patients living with mental illness and substance use disorders and developments made in research and emerging treatments, particularly pharmacological advances. The panelists offered a broad range of perspectives from pharmaceutical research to community substance abuse and mental health providers to a patient’s perspective (please see the complete list below). The panelists cited a need to expand public and private research partnerships, as well as remove barriers to accessing comprehensive treatment.

Panelists:

  • Moderator – Dr. Bill Chin, Executive Vice President, Scientific and Regulatory Affairs, PhRMA
  • Chuck Ingoglia, Senior Vice President, Public Policy and Practice Improvement, National Council for Behavioral Health and Co-Chair of the Mental Health Liaison Group
  • Stevin Zorn, PhD, Executive Vice President and U.S. Site Head, Neuroscience Research and Development, Lundbeck Research USA
  • Dr. Dario Mirski, Vice President, Medical Affairs, Otsuka America Pharmaceutical, Inc.


Events

White House hosts Men’s Health and My Brother’s Keeper briefing

Rob Morrison, NASADAD Executive Director attended the briefing which was co-hosted by the White House and the U.S. Department of Health and Human Services (HHS) and included information on a range of topics related to men’s health. The briefing included four sessions: Mental Health and Substance Abuse; Disease Prevention: Heart and Stroke, Diabetes, and Cancer; Engaging Young Men of Color in their Health; and My Brother’s Keeper: The Road Ahead. Dr. H. Westley Clark, Director of the Center for Substance Abuse Treatment, served as a speaker and moderated the breakout session on substance abuse and mental illness. A complete list of speakers is included below.

Speakers:

  • Marlon Marshall, Special Assistant to the President, Principal Deputy Director of Public Engagement
  • Dr. Samuel Acre, Chairman of the National Hispanic Medical Association
  • Gautam Raghavan, Public Engagement Advisor, Office of Public Engagement
  • Marco Davis, Deputy Director of the White House Initiative on Education Excellence for Hispanics
  • Dr. H. Westley Clark, Director of the Center for Substance Abuse Treatment, U.S. Department of Health and Human Services
  • Dr. George Askew, Chief Medical Officer for the Administration for Children and Families (ACF), U.S. Department of Health and Human Services
  • Dr. Ananad Parekh, Deputy Assistant Secretary for Health, U.S. Department of Health and Human Services
  • Jesse Moore, Speechwriter, Office of Public Engagement
  • Heather Foster, Public Engagement Advisor, Office of Public Engagement


Faces and Voices of Recovery host America Honors Recovery reception

Rob Morrison, NASADAD Executive Director attended the reception which honors the recovery community and exceptional organizations that advocate for recovery. The reception, hosted by Faces and Voices of Recovery (FAVOR), was held in Washington, D.C. on June 25th, and awards were presented to 5 individuals and one recovery organization for “their significant contributions toward putting a face on recovery, fighting discrimination facing people with addiction, and advocating for recovery” (FAVOR press release).

In the News

The Washington Post publishes op-ed The Myths of Smoking Pot

Washington Post columnist Ruth Marcus wrote the op-ed, featuring an interview with Dr. Nora Volkow, Director of the National Institute on Drug Abuse (NIDA). Dr. Volkow provided an overview of the research on marijuana use and important considerations and cautions related to efforts to legalize the drug for personal use. Dr. Volkow also discusses her particular concerns with adolescents and the effects of marijuana use during adolescent development. In addition to the health effects, Dr. Volkow also expressed concern about the impact of legalization on social norms and perceptions of risk, both of which have significant effects on youth and adolescent behavior.

 

D.C. Update – June 20, 2014

D.C. Update

June 20, 2014

 

Around the Agencies

  • ONDCP hosts summit on heroin and prescription drug abuse
  • CMS launches “From Coverage to Care” to assist consumers with new health coverage
  • The National Institutes of Health release resource to help older adults stop smoking

Capitol Hill News

  • Sen. Hatch (UT) and Sen. Levin (MI) host Senate forum on buprenorphine
  • Friends of NIDA host Congressional briefing, “Marijuana: Health Effects, Changing Patterns of Use and Societal Impact”

Events

  • Upcoming webinar “Building a State Health Workforce Center: Lessons Learned in the Carolinas”
  • The National Health Policy Forum host meeting on “Controlling Opioid Drug Excess: Health Plan Interventions”

Resources

  • Applications to BHbusiness Plus open through August 15th

 

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Around the Agencies

ONDCP hosts summit on heroin and prescription drug abuse

Robert Morrison, Executive Director presented at the Office of National Drug Control Policy’s (ONDCP) summit on heroin and prescription drug abuse on June 19th. Mr. Morrison reviewed NASADAD’s report that was released just weeks ago detailing the actions that State substance abuse agencies have taken to address heroin and prescription drug abuse. The report found that 42 States categorize prescription drug abuse as “most” or “very” important, and that 37 States have seen increases in admissions to treatment for heroin abuse during the past two years. Mr. Morrison’s presentation was followed by two panels: “Prevention, Intervention, and Treatment” and “Overdose and Infectious Disease Prevention.” Other presenters included ONDCP Acting Director Michael Botticelli, U.S. Attorney General Eric Holder, Governor Peter Shumlin (VT), and representatives from the National Institute on Drug Abuse (NIDA), the Center for Substance Abuse Treatment (CSAT). Presenters discussed national opioid abuse trends and sought to “identify innovative practices and models, and discuss how practitioners at every level can help reduce overdose deaths and public health consequences” (Federal Register notice).

View the webcast at: https://www.youtube.com/ONDCP. There are multiple video clips uploaded to the site, NASADAD’s presentation is labeled: “Rx Drug and Heroin Epidemic in the States.”

Also check out NASADAD’s inquiry report on State responses to prescription drug and heroin abuse.

CMS launches “From Coverage to Care” to assist consumers with new health coverage

The Centers for Medicare and Medicaid Services (CMS) released their web-based resource, From Coverage to Care (C2C), “which is designed to help answer questions that people may have about their new health coverage, to help them make the most of their new benefits, including taking full advantage of primary care and preventive services. It also seeks to give health care providers the tools they need to promote patient engagement” (CMS press release). The website contains a variety of educational videos and other resources such as the Roadmap to Better Care and a Healthier You, which helps consumers and providers understand the terms and benefits of their new coverage, including how to use those benefits to seek primary care and preventive services. These and other resources are available on the C2C website.

The National Institutes of Health release resource to help older adults stop smoking

The web-based resource, “Quitting Smoking for Older Adults” features videos, worksheets, health information, quitting strategies, and other resources for older adults who want to quit smoking. The latest Surgeon General’s report, The Health Consequences of Smoking – 50 Years of Progress “provides new data that links smoking to bone disease, cataract, diabetes, macular degeneration, and erectile dysfunction. Research shows that people who quit smoking, regardless of their age, are less likely than those who continue to smoke to die from smoking-related illness. Although the rates of smoking have declined in recent years for all age groups, nearly 10 percent of adults over 65 – almost 4 million older Americans – continue to smoke” (NIH Press Release).

Capitol Hill News

Sen. Hatch (UT) and Sen. Levin (MI) host Senate forum on buprenorphine

Robert Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the forum convened by Senators Hatch and Levin on June 18th and titled “Buprenorphine in the Treatment of Opioid Addiction: Successes and the Impediments of Expanded Access.” Panelists (complete list of panelists below) were asked to discuss the benefits of medication-assisted treatment, particularly buprenorphine, and the challenges associated with expanding access to buprenorphine. Senator Levin expressed an interest in identifying clear action steps that could be taken at the federal level to expand access to buprenorphine. Of particular concern were identifying ways to reduce physician barriers to becoming buprenorphine prescribers, discussing the 100 patient limit and potential modifications, and strategies to improve coverage for buprenorphine treatment for patients with private insurance, Medicaid, and Medicare. A variety of strategies were discussed and participants agreed that the ultimate goal should be to expand quality access to buprenorphine for the treatment of opioid use disorders.

Panelists:

  • Michael Botticelli, Acting Director, White House Office of National Drug Control Policy (ONDCP)
  • June Sivilli, Chief, Treatment Branch, Office of Demand Reduction, ONDCP
  • Jayme Delano, Policy Analyst, ONDCP
  • Dr. Nora Volkow, Director, National Institute on Drug Abuse (NIDA)
  • Dr. Jack Stein, Director, Office of Science Policy and Communications, NIDA
  • Dr. Westley Clark, Director, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA)
  • Dr. Elinore McCance-Katz, Chief Medical Officer, SAMHSA
  • Dr. Andrew Kolodny, Medical Director, Phoenix House Foundation; President, Physicians for Responsible Opioid Prescribing
  • Dr. John Kitzmiller, Certified Buprenorphine Prescriber, Lake Orion, Michigan
  • Dr. Corey Waller, American Society for Addiction Medicine (ASAM)
  • Colleen LaBelle, Program Director, State Technical Assistance Treatment Expansion Office Based Opioid Treatment with Buprenorphine
  • Two buprenorphine patients in recovery

Also check out NASADAD’s consensus statement on medication-assisted treatment.

Friends of NIDA host Congressional briefing, “Marijuana: Health Effects, Changing Patterns of Use and Societal Impact”

Colleen Haller, Public Policy Associate attended the briefing hosted by Friends of the National Institute on Drug Abuse (NIDA) in conjunction with the Addiction, Treatment, and Recovery Caucus on Thursday 19th. Members of the Congressional Caucus were also in attendance including Rep. John Fleming (LA), Rep. Paul Tonko (NY), and Rep. Andy Harris (MD). Topics covered include youth perceptions of marijuana use risk, marijuana’s changing legal status, and the long-term effects of increased marijuana use on individuals’ health and society. Presentations were made by:

  • Wilson Compton, MD, Deputy Director of the National Institute on Drug Abuse, will provide an overview of NIDA’s current and planned portfolio on marijuana research as well as scientific information on what we know about the health effects of marijuana use.
  • Robert Booth, PhD, Professor of Psychiatry, University of Colorado School of Medicine, will discuss results from his NIDA-funded research on changing patterns of marijuana use and its consequences.
  • Former Congressman Patrick J. Kennedy, Co-Founder Project SAM (Smart Approaches to Marijuana).

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Events

Upcoming webinar “Building a State Health Workforce Center: Lessons Learned in the Carolinas”

The webinar will be held on June 25th at 2 pm EST and will feature a presentation by Linda M. Lacey, Director of the Office for Healthcare Workforce Analysis and Planning in South Carolina. Ms. Lacey has been part of the development process of two health workforce centers, one for the North Carolina nursing workforce and one working with all health worker groups in South Carolina. She will share her experience in working on these two projects and any important lessons learned. This webinar will be hosted by the Health Workforce Technical Assistance Center (HWTAC) and does not require prior registration.

The National Health Policy Forum held a meeting on “Controlling Opioid Drug Excess: Health Plan Interventions”

Colleen Haller, Public Policy Associate attended the National Health Policy Forum’s discussion called “Controlling Opioid Drug Excess: Health Plan Interventions” on June 20th. The event was moderated by Judith Miller Jones, Director of the National Health Policy Forum and features presentations from four health plans: Blue Cross Blue Shield of Massachusetts, Florida Blue, Humana Pharmacy Solutions, and the Association for Community Affiliated Plans (complete list of the presenters below). The presentations focused primarily on supply-side solutions to the opioid pain reliever epidemic that health plans have undertaken, including prescriber and patient education, prescription drug utilization monitoring, and collaborating with pharmacies. Each of the panelists discussed these efforts in relation to commercial insurance plans, Medicare Part D, Medicaid, and dual-eligible populations.

Panelists:

  • Thomas Kowalski, RPh; Clinical Pharmacy Director, Health and Medical Management; Blue Cross Blue Shield of Massachusetts
  • Cynthia Griffin, PharmD; Senior Director, Pharmacy Government Programs; Florida Blue
  • Kim Caldwell, RPh; Director of Pharmacy Professional Affairs; Humana Pharmacy Solutions
  • Deborah Kilstein, JD, MBA; Vice President, Quality Management and Operational Support; Association for Community Affiliated Plans

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Resources

Applications to BHbusiness Plus open through August 15th

BHbusiness is accepting applications now through August 15th for round one learning networks to be held in October 2014 (rounds two and three will be held in winter and spring 2015, respectively). Applicants can join a learning network in two ways: as an individual provider who will be placed into a network or as a convener or group of providers to form a network. Single State Agencies (SSAs), State Mental Health Agencies, and ATTCs are all potential conveners. These learning networks offer more customized technical assistance with shorter time periods. Covered topics include “billing, third-party contract negotiations, new business planning, mergers and acquisitions, enrollment and eligibility, and much more” (BHbusiness press release).

 

D.C. Update – June 13, 2014

NASADAD D.C. Update

June 13, 2014

 

Around the Agences

  • HHS Leaders Call for Expanded Use of Medications to Combat Opioid Overdose Epidemic
  • CMS Releases “EPSDT – A Guide for States: Coverage in the Medicaid Benefit for Children and Adolescents” and Includes Section on Substance Abuse Services

News from the States

  • Marijuana Tax Collections Booming in Colorado
  • Massachusetts Department of Public Health Releases Report on Recommendations Responding to the Opioid Epidemic

Resources

  • CDC Releases 2013 Youth Risk Behavior Survey (YRBS)
  • Recording Available Online of April 2014 Town Hall Meetings to Prevent Underage Drinking

 

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Around the Agencies

HHS Leaders Call for Expanded Use of Medications to Combat Opioid Overdose Epidemic

The New England Journal of Medicine published commentary authored by the National Institute on Drug Abuse (NIDA), Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health Services Administration (SAMHSA), and Centers for Medicare and Medicaid Services (CMS) on the underutilization of addiction medications and efforts by the U.S. Department of Health and Human Services (HHS) to encourage their use. “The commentary calls upon health care providers to expand their use of medications to treat opioid addiction and reduce overdose deaths, and describes a number of misperceptions that have limited access to these potentially life-saving medications. The commentary also discusses how medications can be used in combination with behavior therapies to help drug users recover and remain drug-free, and use of data-driven tracking to monitor program progress.”

HHS released a full press release.

See also NASADAD’s one-page consensus statement on the use of medications.

CMS Releases “EPSDT – A Guide for States: Coverage in the Medicaid Benefit for Children and Adolescents” and Includes Section on Substance Abuse Services

The report provides an overview of the Early and Periodic Screening, Diagnostic and Treatment services (EPSDT) and provides information on screenings, diagnostic services, the scope of treatment services, limitations on covered services, other available federal services, and access to services. The report also describes that EPSDT covers mental health and substance abuse treatment services regardless of whether the services are provided under the State’s plan. EPSDT covers a variety of substance abuse services, and numerous examples are provided.

Medicare Announces New Hep C Screening Policy from National Association of Medicaid Directors (NAMD) Update on June 10th

Medicare announced last week that it will now cover the cost of screening for Hepatitis C. Adults at high risk for infection, including those who inject illegal drugs or had a blood transfusion before 1992, are eligible, as is anyone in Medicare ages 49 to 69. Medicare didn’t previously cover screening. Coverage for the new Hepatitis C product, Sovaldi will fall under the Medicare Part D Prescription Drug Program. Part D plans are scheduled to submit their premium bids for 2015 later this month, and this could reveal more about the impact on costs to Medicare.

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News from the States

Marijuana Tax Collections Booming in Colorado

News reports claim that tax collections show that Colorado sold roughly $22 million worth of marijuana for personal use in April, an increase of about 17% from March and 58% from January (when retail sales began). The Colorado Department of Revenue estimates that the State collected more than $5 million from marijuana taxes and fees in April. Medical marijuana sales outpaced personal use sales by about 44% during the same month.

Massachusetts Department of Public Health Releases Report on Recommendations Responding to the Opioid Epidemic

The MA Dept. of Public Health released the Opioid Task Force’s report, Findings of the Opioid Task Force and Department of Public Health Recommendations on Priorities for Investments in Prevention, Intervention, Treatment and Recovery on June 10th. The report was drafted in response to Governor Patrick’s declaration that opioid use had become a public health emergency in the State. The recommendations include expanding treatment capacity, the creation of a service locator to help consumers find treatment services, facilitating additional opioid prevention coalitions, identifying additional safeguards for commonly misused opioids, and the expansion of injectable naltrexone for persons exiting correctional facilities.

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Resources

CDC Releases 2013 Youth Risk Behavior Survey (YRBS)

Data from the 2013 Youth Risk Behavior Survey, released on June 12th, finds that cigarette smoking rates among U.S. high school students have dropped to a 22-year low. This trend achieves the Healthy People 2020 goal of reducing teen smoking to 16% or less. Reducing the use of other tobacco products (hookah and e-cigarettes) remains a challenge. The report includes data on a variety of other health behaviors, including fighting, sexual behaviors, use of technology while driving, sedentary behavior, and much more. This survey is the “only surveillance system designed to monitor a wide range of priority health risk behaviors among representative samples of high school students at the national, State, and local levels.”

Recording Available Online of April 2014 Town Hall Meetings to Prevent Underage Drinking

Robert Morrison, NASADAD Executive Director attended the national launch of the 2014 Town Hall Meetings to prevent underage drinking held by the Substance Abuse and Mental Health Services Administration (SAMHSA) in April at the University of Maryland, School of Public Health. Featured presentations included:

Acting Surgeon General Boris D. Lushniak, M.D., M.P.H;
SAMHSA Administrator Pamela S. Hyde, J.D.;
Amelia Arria, Ph.D., the Maryland Collaborative to Reduce College Drinking and Related Problems and the University of Maryland School of Public Health; and
Brittany Sandidge, Prevention Council of Roanoke County, Virginia.

A recording of this event is now available on the web portal of the Interagency Coordinating Committee on the Prevention of Underage Drinking, for on-demand viewing.

 

Treatment & Recovery Resources

Below is information about organizations that maintain a strong focus on alcohol and other drug (AOD) abuse treatment and recovery. This list is not exhaustive and does not necessarily indicate an endorsement by NASADAD.

  • Addiction Technology Transfer Center (ATTC) Network: The ATTC Network continuously strives to improve the quality of addictions treatment and recovery services by facilitating alliances among front line counselors, treatment and recovery services agency administrators, faith-based organizations, policy makers, the health and mental health communities, consumers and other stakeholders. By connecting them to the latest research and information through activities such as skills training, academic education, online and distance education, conferences, workshops, and publications, the ATTC Network responds to the emerging needs of the field.
  • Center for Substance Abuse Treatment (CSAT): The mission of the Center for Substance Abuse Treatment is to promote community-based substance abuse treatment and recovery services for individuals and families in every community. CSAT provides national leadership to improve access, reduce barriers, and promote high quality, effective treatment and recovery services.
  • Child and Family Futures (CCF): The mission of Children and Family Futures is to improve safety, permanency, well-being and recovery outcomes for children, parents and families affected by trauma, substance use and mental health disorders.
  • Connecticut Community for Addiction Recovery (CCAR): CCAR works closely with Connecticut’s Department of Mental Health and Addiction Services to emphasize the fiscal and social benefits of recovery and advocate for pro-recovery policy at the State level.
  • Faces and Voices of Recovery (FAVOR): Faces & Voices of Recovery is dedicated to organizing and mobilizing the over 23 million Americans in recovery from addiction to alcohol and other drugs, our families, friends and allies into recovery community organizations and networks, to promote the right and resources to recover through advocacy, education and demonstrating the power and proof of long-term recovery.
  • International Certification and Reciprocity Consortium (IC &RC): IC&RC will offer two levels of Peer Recovery Support credential for alcohol and other drugs, mental health, and co-occurring disorders.
  • The NIAAA Alcohol Treatment Navigator helps individuals and their loved ones negotiate the complicated process of choosing treatment for alcohol misuse. The site offers what they need to know, and what they need to do, to recognize and choose quality care. As NIAAA shares your organization’s goal to help people address alcohol problems, I thought this might be a beneficial tool for your constituents.

    Visit https://alcoholtreatment.niaaa.nih.gov to learn more.

    Additionally, the Navigator offers multiple graphics, videos, tweets, Facebook posts, and Instagram content ready to share with your social media followers at the following link: https://alcoholtreatment.niaaa.nih.gov/spread-the-word.

  • SAMHSA Behavioral Health Treatment and Services for Substance Use Disorders (SUDs): A compilation of information related to behavioral health treatment and substance use disorders.
  • SAMHSA National Recovery MonthRecovery Month promotes the societal benefits of prevention, treatment, and recovery for mental and/or substance use disorders.
  • SAMHSA Treatment Locator: The Behavioral Health Treatment Services Locator is an online source of information for persons seeking treatment facilities in the United States or U.S. Territories for substance abuse/addiction and/or mental health problems.
  • State of Connecticut Department of Mental Health and Addiction Services.(2002). Recovery initiative: The Recovery Resource Guide page describes Connecticut’s efforts related to ROSC. It provides policy statements on recovery, education and training, reports, presentations, resources and links related to ROSC.
  • White, W (2008). Recovery management and recovery-oriented systems of care: scientific rationale and promising practices: Authored by William White, this is the first and most comprehensive attempt to lay out the empirical support for moving to recovery-oriented systems of care.