News from NASADAD

• NASADAD attends Recovery Month kick-off event and luncheon
• NASADAD releases section-by-section analysis of buprenorphine legislation by Senator Markey (D-MA)

News from the States

• Arizona State Director Cory Nelson records podcast for the Payer’s Summit on Behavioral Health Management

Around the Agencies

• SAMHSA hosting two part webinar series on substance use and suicide
• SAMHSA releases brief report on 2013 data from the National Survey on Drug Use and Health
• HHS announces $60 million in grants for health insurance Navigators
• DEA releases new rules to expand prescription drug disposal options

In the News

• ASAM releases updated report on State Medicaid coverage of medication-assisted treatment

 

News from NASADAD

NASADAD attends Recovery Month kick-off event and luncheon

Rob Morrison, Executive Director and Colleen Haller, Public Policy Associate attended the events on September 4^th. The Recovery Month kick-off event was hosted by the Substance Abuse and Mental Health Services Administration (SAMHSA) and featured presentations by SAMHSA Administrator Pamela Hyde, White House Office of National Drug Control Policy (ONDCP) Acting Director Michael Botticelli, Center for Substance Abuse Treatment (CSAT) Director Dr. H. Westley Clark, Center for Mental Health Services (CMHS) Director Paolo del Vecchio, and representatives from the recovery community. Tom Coderre, SAMHSA Senior Advisor, moderated the event. Presenters offered personal stories of recovery as well as highlighting the work at the federal level to expand and promote recovery from substance use disorders and mental health disorders. Administrator Hyde also released some of the data from the 2013 National Survey on Drug Use and Health.

Following the press event, participants attended a luncheon hosted by NAADAC. SAMHSA, Young People in Recovery (YPR), and the Association of Recovery Schools partnered with NAADAC to plan the event. The luncheon opened with a song written and performed by John McAndrew, a recovery advocate. ONDCP Acting Director Botticelli and Administrator Hyde provided brief remarks and Cynthia Moreno, Executive Director of NADAAC, welcomed participants and emceed the event. A number of other speakers presented on a panel to discuss treatment and recovery issues including CSAT Director Dr. Clark,  CMHS Director Paolo del Vecchio, founding member of Young People in Recovery Mike DeAgro, and Executive Director of the Association of Recovery Schools Kristen Harper.

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

NASADAD released the analysis of a bill introduced by Sen. Edward Markey (D-MA) in August. The bill, The Recovery Enhancement for Addiction Treatment Act (TREAT Act) was co-sponsored by Senators Diane Feinstein (D-CA), John Rockefeller (D-WV), Sherrod Brown (D-OH), and Mazie Hirono (D-HI). The legislation would increase the number of patients that a waivered provider is allowed to treat to 100 in the first year and then some physicians can request to remove the limit after the first year if they are addiction specialists or if they completed additional training and practice in a qualified practice setting (named in the legislation). The legislation would also allow certain nurse practitioners and physician assistants to treat up to 100 patients per year if they are licensed in a State that allows them to prescribe controlled substances, if they complete the training, and if they are supervised by a waivered physician or are certified addiction treatment nurse practitioners who practice in a qualified practice setting. The Government Accountability Office (GAO) will also be required to produce a report on the legislation looking at chances in treatment availability and utilization, quality of treatment, primary care integration, diversion, and more. The legislation has been endorsed by a variety of organizations including the American Society for Addiction Medicine (ASAM), Trust for America’s Health (TFAH), Association of State and Territorial Health Officials (ASTHO), National Association of State and Territorial AIDS Directors (NASTAD), and others. NASADAD has not taken a position on this legislation.

News from the States

Arizona State Director Cory Nelson records podcast for the Payer’s Summit on Behavioral Health Management

Director Cory Nelson will be presenting at the summit on “Integration and Behavioral Health Management – The Arizona Experience.” 80 percent of Arizona’s frequent health care system users have a mental health or substance use condition. Mr. Nelson discusses how Arizona has been working toward the integration of physical health, mental health, and substance use disorders through its health management strategies and health care delivery system. Director Nelson also offers insight about how Arizona’s health care system will operate in the future as integration efforts grow and mature.

Around the Agencies

SAMHSA hosting two part webinar series on substance use and suicide

The Substance Abuse and Mental Health Services Administration (SAMHSA) will be hosting the series, with part one scheduled for Thursday, September 11^th at 2 pm Eastern Time. Part one of the series will focus on “Understanding the Connection between Suicide and Substance Abuse: What the Research Tell Us.” Presentations will provide information for practitioners to help them work more effectively across disciplines to address the issues around substance use disorders and suicide. This includes looking at current research and highlighting the factors that contribute to both issues and that can be addressed in a collaborative way. Part two will be centered on “Mobilizing Partnerships and Resources to Address Substance Abuse and Suicide.” This webinar will discuss how States and communities can effectively collaborate across disciplines on these issues. Presenters will highlight some of the innovate ways that practitioners have found to successfully prevent substance abuse and suicide. Participants may register online to participate.

SAMHSA releases brief report on 2013 data from the National Survey on Drug Use and Health

As part of the kick-off for Recovery Month, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a brief overview of findings from the 2013 National Survey on Drug Use and Health (NSDUH). The brief provides national estimates on the prevalence of substance use and mental illness. The report also supports the need for and barriers to receive substance use disorder treatment, mental health care, and care for individuals with co-occurring mental health and substance use disorders. An estimated 24.6 million individuals aged 12 and older were past month users of illicit drugs – 2.2 million of which are adolescents between 12 and 17 years of age.

HHS announces $60 million in grants for health insurance Navigators

The Secretary of Health and Human Services (HHS), Sylvia Burwell made the announcement on September 8^th. The grants have been awarded to 90 organizations in States with federally-facilitated and State partnership insurance marketplaces. These grants help Navigators prepare and reach out to their communities to assist with the upcoming enrollment period for the health insurance marketplaces. Navigators and other assisters helped roughly 10.6 million consumers apply for health insurance coverage in the marketplace, in Medicaid, or in the Children’s Health Insurance Program (CHIP) during the first open enrollment period. In addition to helping consumers enroll in marketplace coverage, Navigators also have an important role in helping consumers determine whether they qualify for public health coverage (Medicaid or CHIP).

DEA releases new rules to expand prescription drug disposal options

The Drug Enforcement Administration (DEA) released the final rule on September 8^th. Prior to this rule, prescription drug disposal was limited to law enforcement. The new rule allows other entities who are registered with the DEA to become authorized medication collection sites. This includes manufacturers, distributors, substance use disorder treatment programs, and pharmacies. Law enforcement continues to have autonomy over how they collect controlled substances, including holding take-back events. Anyone interested may partner with law enforcement to organize a take-back event.

In the News

ASAM releases updated report on State Medicaid coverage of medication-assisted treatment

The American Society of Addiction Medicine (ASAM) released an update of their survey of State Medicaid benefits for medications used to treat opioid use disorders. The updated report features an online, interactive map that shows how many medications are covered under each State’s Medicaid program. The State pages also provide fact sheets on the medications covered in that State, an overview of the benefits for each medication (methadone, buprenorphine, and naltrexone), as well as any limitations placed on the medications.

 

A variety of discussions have taken place (and continue to take place) at the national level regarding ways to expand access to medication-assisted treatment. One method that has been discussed is to increase the amount of patients that physicians can prescribe buprenorphine to as part of substance use disorder treatment. Under current law, physicians may apply for a waiver to prescribe buprenorphine to up to 30 patients in their first year and 100 patient in following years. 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.

NASADAD has not taken a public position on these proposed changes. However, in 2010, NASADAD released a statement in support of medication-assisted treatment. Other national organizations have begun to take public positions on this issue.

As part of NASADAD’s educational efforts, we released a section-by-section analysis of one such proposal to alter the buprenorphine patient limit.

Statements by National Organizations:

• The American Association for the Treatment of Opioid Dependence (AATOD)

DC Update

September 2, 2014

 

News from NASADAD

• NASADAD joins American Society of Addiction Medicine (ASAM) to encourage State-level collaboration
• NASADAD Public Policy Staff visits treatment program in Maryland

News from the States

• Utah receives $1 million grant to reduce opioid overdoses

From the White House

• President Obama announces Executive action on veterans’ mental health

Capitol Hill News

• Sen. Reed (D-RI) introduces legislation to reduce fatal overdose

Around the Agencies

• CMS hosts in-person conversations with States on Medicaid Innovation Accelerator Program
• CMS requests information from stakeholders on how to increase beneficiary engagement
• CMS issues guidance on training, certification, and recertification for Marketplace consumer assistance programs
• CMS releases fact sheet on SBIRT for Medicaid and Medicare programs
• SAMHSA sponsors event on how best to provide ACA-covered preventive services to pregnant women

In the News

• Washington Post features profile on ONDCP Acting Director Botticelli

News from NASADAD

NASADAD joins American Society of Addiction Medicine (ASAM) to encourage State-level collaboration

The CEOs of the American Society of Addiction Medicine (ASAM) – Penny Mills – and the National Association of State Alcohol and Drug Abuse Directors (NASADAD) – Robert Morrison – sent the letter to their respective memberships in an effort to encourage or maintain strong relationships at the State level. The letter stems from a presentation by Penny Mills, CEO of ASAM, to the NASADAD Board of Directors last December. At this meeting, participants acknowledged how the ASAM-NASADAD partnership in Washington, D.C. helped secure tangible advancements at the federal policy level. The dialogue acknowledged the need to continue this important work.  In addition, both Associations recognized the many challenges at the State level as well. The joint letter was designed to help promote a strong relationship between the ASAM State Chapter and the State substance abuse agency. The letter includes contact information for State directors and ASAM State Chapter leaders. We appreciate feedback on this partnership and remain eager to hear your recommendations to further this work.

NASADAD Public Policy Staff visits treatment program in Maryland

Colleen Haller, Public Policy Associate visited Institutes for Behavior Resources, Inc.’s (IBR’s) REACH (Recovery Enhanced by Access to Comprehensive Healthcare) Health Services program on August 20^th. Maryland State Director, Kathleen Rebbert-Franklin arranged the visit to the program located in downtown Baltimore. REACH offers outpatient medication-assisted treatment services, primarily with methadone, to patients with opioid use disorders. In addition, REACH also offers an intensive outpatient program for clients who require additional counseling services for an opioid use disorder and other related substance use disorders. REACH Health Services has also integrated a behavioral health home, supported through Maryland Medicaid’s Chronic Health Home Initiative which was made possible under the Affordable Care Act (ACA). Health home services at REACH include health education and monitoring of chronic medical conditions, wellness promotion, and care coordination with outside primary care providers. IBR also houses a number of researchers conducting behavioral studies on a variety of topics. IBR staff provided Ms. Haller with a tour of the program, as well as a comprehensive overview of their services and program philosophy. As the health home service offerings continue to grow, REACH hopes to establish itself as a patient-centered medical home with full primary care and outpatient mental health services. In the meantime, their program offers a variety of services in addition to individualized and group counseling services. This includes educational classes, trauma-informed yoga, acupuncture, stress management, and other health and wellness services.

News from the States

Utah receives $1 million grant to reduce opioid overdoses

The three-year grant from the Centers for Disease Control and Prevention (CDC) will be used to help reduce prescription opioid misuse and abuse. Some of the funds will be used to improve the State’s prescription drug monitoring program (PDMP), perhaps enabling it to provide real-time data. In addition, the funds will be used to evaluate two recently passed laws: a 911 Good Samaritan law and naloxone access law. The naloxone law allows doctors to prescribe naloxone to third parties (e.g., friends, family members of someone at risk for an overdose) – naloxone is a medication that reverses the effects of an opioid overdose. The 911 Good Samaritan law provides limited immunity from prosecution to bystanders who report that someone is experiencing an overdose. In Utah, prescription opioid pain relievers cause more deaths than all other drugs.

From the White House

President Obama announces Executive action on veterans’ mental health

Addressing members of the American Legion, President Obama announced 19 new Executive actions to support the mental health needs of members of the armed services and veterans. One of the initiatives announced would automatically enroll departing service members who are receiving mental health treatment through the Department of Defense (DOD) into a program to transition them to mental health services through the Department of Veterans Affairs (VA). The President also highlighted progress the Administration has made toward reducing the number of homeless veterans. The Executive actions include efforts to improve access to care (reducing waitlists and increasing resources), establishing an independent review board to review potential employee misconduct, recruiting a skilled workforce, improving electronic medical records, strengthening protections for whistleblowers, and many more. In terms of substance abuse and mental health services, the new actions will pilot an expansion of mental health peer support services in primary care settings; launch new research initiatives to study PTSD, traumatic brain injuries, and suicidality; raise awareness about mental health issues and the resources available; host medication take-back days and other activities to reduce the risk of overdose; move DOD-provided health care or TRICARE toward the intent of the Mental Health Parity and Addiction Equity Act (MHPAEA does not apply to TRICARE); make substance abuse and mental health services available where active duty service members work; and many more.

Capitol Hill News

Sen. Reed (D-RI) introduces legislation to reduce fatal overdose

Senator Jack Reed (D-RI) introduced the Overdose Prevention Act at the end of July. The legislation would expand access to naloxone, a medication that reverses the effects of an opioid overdose, and overdose prevention programs. The bill would empower the Centers for Disease Control and Prevention (CDC) to enter into cooperative agreements with overdose prevention organizations, including those that distribute naloxone. The bill would also help define and disseminate best practices regarding overdose prevention, improve monitoring and surveillance efforts, and help establish a federal plan of action to address overdose. The bill is cosponsored by Sens. Patrick Leahy (D-VT), Richard Durbin (D-IL), Sheldon Whitehouse (D-RI), and Edward Markey (D-MA). A similar bill was introduced in the House of Representatives by Rep. Donna Edwards (D-MD).

Around the Agencies

CMS hosts in-person conversations with States on Medicaid Innovation Accelerator Program

The Centers for Medicare & Medicaid Services (CMS) launched the Medicaid Innovation Accelerator Program in July. 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. CMS is hosting a series of free, in-person meetings to educate attendees about the program’s priority areas and to receive feedback from stakeholders on the initiative. The meetings will be hosted in Denver, Colorado; Baltimore, Maryland; and Chicago, Illinois (dates and times listed below)

• Denver: September 10, 9-5 pm MST
  • Register by September 3
• Baltimore: September 15, 9-5 pm EST
  • Register by September 8
• Chicago: September 25, 9-5 pm CST
  • Register by September 18

CMS requests information from stakeholders on how to increase beneficiary engagement

The Centers for Medicare and Medicaid Services (CMS) released a Request for Information (RFI) on August 15. The RFI seeks comments from stakeholders regarding the possibility that the Innovation Center will be testing innovative models to increase the engagement of beneficiaries with their health and health care in Medicare, Medicaid, and/or the Children’s Health Insurance Program (CHIP). Comments are due by midnight on September 15^th.

CMS issues guidance on training, certification, and recertification for Marketplace consumer assistance programs

The Centers for Medicare and Medicaid Services (CMS) issued guidance related to Federally-facilitated and State Partnership Marketplace consumer assistance programs. The guidance defines the training, certification, and recertification requirements applicable to Navigators, non-Navigator assistance personnel, and certified application counselors. CMS issues the guidance in preparation for the next open enrollment period that begins on November 15^th.

CMS releases fact sheet on SBIRT for Medicaid and Medicare programs

The Centers for Medicare & Medicaid Services (CMS) released the fact sheet on Screening, Briefing, Intervention, and Referral to Treatment (SBIRT) services on August 27. SBIRT is an evidence-based tool used to identify problem drinking and substance abuse and refer those clients to a brief intervention and/or treatment services.  The fact sheet offers health care professionals an overview of Medicare and Medicaid coverage for SBIRT services, including who can perform services, what documentation is required, guidance on billing and coding, information on payment, and other resources (CMS press release). The educational fact sheet provides very specific information on which providers can perform SBIRT, as well as links to all of the relevant federal regulations and guidance.

SAMHSA sponsors event on how best to provide ACA-covered preventive services to pregnant women

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host the event on September 23^rd from 9-10:30 am EST at Ohio State University. The event will also be available as a webcast for participants who will not be able to attend in person. The presentation will provide information on how preventive services covered under the Affordable Care Act (ACA) for tobacco or alcohol use, depression, intimate partner violence, obesity, breastfeeding, and others can employ trauma-informed principles. The educational event is intended for health care providers; system leaders; integrated care teams; behavioral health centers; community-based and social service organizations; case managers; and Women, Infants and Children program providers. Participants can register online.

In the News

Washington Post features profile on ONDCP Acting Director Botticelli

The front-page profile appeared in the Post on August 27^th. The profile features an in-depth interview with Acting Director of the Office of National Drug Control Policy (ONDCP) Michael Botticelli where he discusses his personal and professional history and his public health-anchored philosophy on U.S. drug policy. Mr. Botticelli was named Acting Director when the previous Director, Mr. Gil Kerlikowske, was confirmed by the Senate as the Commissioner of U.S. Customs and Border Protection within the Department of Homeland Security (DHS). Mr. Botticelli first began his tenure at ONDCP in November 2012 as Deputy Director. Immediately before ONDCP, he served as the State substance abuse agency Director in Massachusetts and was very involved as a member of NASADAD. NASADAD sent a letter to the White House on June 20 of this year urging President Obama to nominate Mr. Botticelli as the permanent Director. President Obama announced Mr. Botticelli’s nomination to serve as Director on August 28^th. The nomination will be referred to the Senate Judiciary Committee, led by Senator Patrick Leahy (D-VT), Chairman and Senator Chuck Grassley (R-IA), Ranking Member.