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DC Update – October 31, 2014

News from NASADAD

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

News from the States

  • Michigan launches prescription drug misuse website

Around the Agencies

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

In the News

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

 

News from NASADAD

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

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

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

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

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

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

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

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

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

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

Panelists

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

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

Sandra A. Brown, University of California, San Diego

NASADAD attends overdose prevention conference

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

NASADAD participates in meeting for tangible action on opioid issues 

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

News from the States

Michigan launches prescription drug misuse website

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

Around the Agencies

CMS/SAMHSA to host webinar on health insurance marketplace

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

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

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

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

ONDCP announces webinar on controlled substance disposal

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

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

SAMHSA announces listening session on criteria for community clinics

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

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

ATTC releases issue brief on substance abuse and health care integration

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

In the News

CSH announces webinar on subsidized housing and social services

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

NAMD releases prescription drug abuse prevention report

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

D.C. Update – October 20, 2014

News from NASADAD

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

Around the Agencies

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

Capitol Hill News

  • Senator Markey releases report on prescription drug and heroin epidemic

In the News

  • National Safety Council releases white paper on pain medication efficacy

 

News from NASADAD

NASADAD attends briefing on health care incentives

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

Moderators:

Ed Howard, Alliance for Health Reform

Anne-Marie Audet, the Commonwealth Fund

Panelists:

Ashish Jha, Harvard School of Public Health

Ateev Mehrotra, Harvard Medical School

Patrick Herson, Fairview Medical Group

NASADAD attends briefing on trauma-informed care

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

Moderator:

Jane Stevens, Aces too High News

Panelists:

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

Cheryl Sharp, National Council for Behavioral Health (NCBH)

Bonnie Stone, Women in Need (WIN)

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

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

Moderator:

John Walsh, Senior Associate, Washington Office on Latin America

Panelists:

Wells Bennett, Fellow, Governance Studies, The Brookings Institution

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

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

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

Around the Agencies

CMS announces new model for ACOs in Medicare

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

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

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

Capitol Hill News

Senator Markey releases report on prescription drug and heroin epidemic

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

In the News

National Safety Council releases white paper on pain medication efficacy

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