News from the States

• Ohio Governor John Kasich signs executive order banning synthetic opioid U-47700

Around the Agencies

• CDC study finds 20 percent of Medicaid enrolled women of reproductive age in New York received an opioid prescription from 2008 to 2013
• HHS announces $260 million in funding to increase patient capacity and preventive health services in 45 States
• FDA announces new regulations for e-cigarettes, cigars, and other tobacco products

In the News

• ATTC seeks participants for pilot online MAT course
• House Democratic  Whip Rep. Steny Hoyer (D-MD) discusses need for Congress to act on opioids
• CHCS launches Medicaid Accountable Care Organization Resource Center

Upcoming Events

• Addiction Policy Forum announces Family Day to encourage passage of the Comprehensive Addiction and Recovery Act of 2016
• NDEWS announces webinar on national poison data system and drug-related human exposure cases

News from the States

Ohio Governor John Kasich signs executive order banning synthetic opioid U-47700
Ohio Governor John Kasich has signed an executive order making the synthetic opioid U-47700 a Schedule I controlled substance. The executive order identifies U-47700 as 7.5 times more potent than morphine, with high potential for misuse. Governor Kasich signed the order in response to a growing number of overdose deaths attributable to the substance.

Read more about the executive order here.

Around the Agencies

CDC study finds 20 percent of Medicaid-enrolled women of reproductive age in New York received an opioid prescription from 2008 to 2013
The Centers for Disease Control and Prevention (CDC) released a study last week finding that 20 percent of reproductive-aged women enrolled in Medicaid in New York received an opioid prescription at least once from 2008 to 2013.  Almost 40 percent of reproductive-aged Medicaid enrolled women in the United States received an opioid prescription during this same time, placing New York below the national average. The CDC attributes New York’s lower prescribing rates to its long history of prescription monitoring programs beginning in 1972. New York’s prescription monitoring was enhanced in 2012 via the I-STOP program, which increased the number of substances monitored by the program. Prescriptions were “lowest during the prenatal period for women who had a live birth (9.5%), intermediate for women with no indication of contraceptive use or infertility (17%), and highest for women with an indication of contraceptive use or infertility (27%).” The CDC cautions that these results only contain Medicaid enrolled women, and do not include women who obtained opioid prescriptions without Medicaid.

Read the full study here.

HHS announces $260 million in funding to increase patient capacity and preventive health services in 45 States
The Department of Health and Human Services (HHS) has announced $260 million in funding to 290 health centers in 45 States. The funding will be used to renovate and expand existing health centers in order to increase patient capacity and increase the number of comprehensive primary and preventive health services available to underserved populations. The Affordable Care Act’s Community Health Center (CHC) Fund is providing the funding following the program’s extension in the Medicare Access and CHIP Reauthorization Act of 2015. HHS previously distributed CHC funds in September 2015 to 160 health centers for the same purpose.

Read the full press release here.

View a map of FQHCs throughout the country here.

FDA announces new regulations for e-cigarettes, cigars, and other tobacco products
The Food and Drug Administration (FDA) has announced new regulations for e-cigarettes, cigars, and other tobacco products. The FDA’s previous authority only monitored cigarettes and smokeless tobacco; the new final rule extends this authority to electronic nicotine delivery systems such as e-cigarettes and vape pens, cigars, hookah tobacco, pipe tobacco, and nicotine gels. The rule further stipulates that the FDA will be able to review new tobacco products not yet on the market and evaluate the manufacturing process of tobacco process in the future. Manufacturers will now have to register and provide product listings and ingredients that are subject to premarket review and authorization by the FDA. The final rule restricts youth access to tobacco by preventing sales to individuals under the age of 18 both in-person and online and prohibiting the distribution of free samples.

Read more about the new regulation here.

In the News

ATTC seeks participants for pilot online MAT course
The Addiction Technology Transfer Center (ATTC) Network is currently seeking participants for a pilot online course on medication-assisted treatment (MAT). The course, titled “Supporting Recovery with Medication-Assisted Treatment,” is a self-paced 3 hour course intended to increase participants’ familiarity with various types of MAT. Topics will include ways to use MAT for alcohol and opioid use disorder treatment, the different types of medications available for treating alcohol and opioid use disorders, workforce and regulatory issues impeding the implementation of MAT, and methods for improving MAT awareness at the community level. Upon the pilot course’s conclusion, participants will be asked to provide feedback to improve the program before its release. The pilot course will be available between May 3^rd and May 31^st.

Register for the pilot course here.

House Democratic Whip Rep.  Steny Hoyer (D-MD) discusses need for Congress to act on opioids
The House Democratic Whip Steny Hoyer (D-MD) discussed the need for Congress to act on opioids during the American Hospital Association’s annual membership meeting last week. Rep. Hoyer enumerated several “innovative solutions” for addressing the ongoing epidemic, and asserted his hope that the necessary changes will be made in the future. Rep. Hoyer stated that, “while health care providers bear some of the responsibility of overprescribing opioids that are easily abused, I recognize a careful balance must be struck when caring for patients suffering from severe pain. This is why policymakers need to ensure that we are giving doctors and hospitals the tools needed to identify patients at the risk of abuse.”

Read the full story here from AHA News.

CHCS launches Medicaid Accountable Care Organization Resource Center
The Center for Health Care Strategies (CHCS) announced the launch of their Medicaid Accountable Care Organization Resource Center last week. The online resource center will provide a collection of resources for States interested in or already developing a Medicaid ACO program. These resources include a resource compendium with tools on ACO topics including general design, scope of services, provider management, quality measures, payment, and federal guidance, as well as an interactive map providing updates of Medicaid ACO activities by State and a news section with the latest updates on ACOs for the Medicaid, Medicare, and commercial populations.

Access the resource center here.

Upcoming Events

Addiction Policy Forum announces Family Day to encourage passage of the Comprehensive Addiction and Recovery Act of 2016
The Addiction Policy Forum has announced a Comprehensive Addiction and Recovery Act (CARA) Family Day on May 18^th-19^th. The Forum encourage families who have been impacted by addiction to meet with members of Congress and encourage them to pass legislation that will comprehensively address the opioid epidemic, including CARA (S. 524; H.R. 953).

Read more about CARA Family Day here.

NDEWS announces webinar on national poison data system and drug-related human exposure cases

The National Drug Early Warning System (NDEWS) has announced a webinar on the national poison data system and drug-related human exposure cases. The webinar will be held on May 25^th at 4PM EST and will feature a presentation from Ashlea A. Zimmerman, MPH, Director of the National Data Services, American Association of Poison Control Centers (AAPCC).

Register for the webinar here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

News from the States

• Senate Committee on Homeland Security and Governmental Affairs holds field hearing on opioid epidemic, featuring testimony from OhioMHAS Director & NASADAD member Tracy Plouck
• Jefferson County, New York begins offering Vivitrol to incarcerated individuals leaving the criminal justice system

Around the Agencies

• GAO report finds DOD’s Military Health System does not meet mental health appointment requirements
• CMS clarifies stance on Medicaid eligibility for incarcerated individuals

In the News

• House Full Judiciary Committee Considers and Approves Opioid Bill (H.R. 5046)
• House Full Energy and Commerce Committee Completes Markup of Bills on Opioids
• University of California study finds seasonal increase in college student drinking rates
• Behavioral Health IT Coalition release Integrating Behavioral Health through Technology Act of 2016 (S. 2691) fact sheet
• NGA and NCJA launch State criminal justice reform initiative
• Pew Charitable Trusts article highlights State efforts to combat synthetic drugs

News from NASADAD

• NASADAD Moderates Panel During “Stepping Up Summit” in Washington, D.C.

Upcoming Events

• CDC announces webinar on its National Viral Hepatitis Campaigns
• SAMHSA announces 2016 National Prevention Week Kick-off webcast

News from the States

Senate Committee on Homeland Security and Governmental Affairs holds field hearing on opioid epidemic, featuring testimony from OhioMHAS Director & NASADAD member Tracy Plouck
The Senate Committee on Homeland Security and Government Affairs and Senators Rob Portman (R-OH) and Sherrod Brown (D-OH) held a hearing on the opioid epidemic in Cleveland on April 22^nd. The hearing featured testimony from several substance use disorder experts, including Ohio Department of Mental Health & Addiction Services Director & NASADAD member Tracy Plouck. Ms. Plouck thanked both Senators for their work in developing a comprehensive approach to the opioid crisis, and highlighted the actions Governor John Kasich’s task force has taken in the past several years. These actions include: comprehensive prescribing guidelines for the outpatient management of acute pain released in January 2016, ongoing improvements and investments into the Ohio Automated Rx Reporting System, the Start Talking! Statewide youth drug prevention initiative, and increased mechanisms for diverting individuals in the criminal justice system into substance use disorder treatment.

Read Ms. Plouck’s full testimony here.

Read more about the Ohio Governor’s Cabinet Opiate Action Team here.

Jefferson County, New York begins offering Vivitrol to incarcerated individuals leaving the criminal justice system
Jefferson County, New York will begin offering Vivitrol to incarcerated individuals whose release from the criminal justice system is imminent. Jefferson County Sheriff Colleen M. O’Neill states that the program will help incarcerated individuals exiting the criminal justice system maintain their sobriety during the critical 30-day period following their release, when many individuals with opioid use disorders are at greatest risk for relapse. Individuals participating in the program must still attend substance use disorder treatment programs at facilities approved by the New York State Office of Alcoholism and Substance Abuse Services (OASAS), which is led by Commissioner Arlene González-Sánchez, who is a member of NASADAD’s Board. All jail administrators, medical staff, and other relevant staff have been trained to administer the drug. Sheriff O’Neill plans for the program to be fully implemented by summer.

Read the full story here.

Around the Agencies

GAO report finds DOD’s Military Health System does not meet mental health appointment requirements
The U.S. Government Accountability Office released a report last week finding that the Department of Defense’s (DOD) Military Health System (MHS) does not meet requirements related to mental health appointment scheduling. Data on domestic and overseas direct care from April 2014 through August 2015 suggests that initial appointments for new or exacerbated conditions did not meet the 7-day access standard required by the DOD. The DOD reported that this deficiency is the result of incorrect coding that is hindering the ability of personnel to access the MHS. The GAO further found that follow-up appointments for mental health do not maintain the official DOD access standard required by federal internal controls. The report concludes that the DOD develop coding for initial appointments and access standards for follow-up appointments.

Read the full report here.

CMS clarifies stance on Medicaid eligibility for incarcerated individuals
Last week the Centers for Medicare and Medicaid Services (CMS) clarified its stance on Medicaid eligibility for incarcerated individuals in a Dear State Health Official letter. The clarification is an update of CMS’s 1997 letter that described the conditions precluding an incarcerated individual from being eligible for Medicaid. Current regulations stipulate that individuals classified as an “inmate of a public” institution are ineligible for federal financial participation for Medicaid services. Last week’s letter clarifies that “individuals on probation, parole, or community release pending trial and individuals in corrections-related supervised community residential facilities” retain Medicaid eligibility.

Read the full CMS letter here.

In the News

House Full Judiciary Committee Considers and Approves Opioid Bill (H.R. 5046)
On Wednesday, April 27, the House Judiciary Committee considered and passed the Comprehensive Opioid Abuse Reduction Act of 2016 by Rep. Sensenbrenner (R-WI) by voice-vote.  The Judiciary Committee is Chaired by Rep. Goodlatte (R-VA) and the Ranking Member is Rep. Conyers (D-MI).

The Comprehensive Opioid Abuse Reduction Act authorizes the Attorney General within DOJ to make grants to States, units of local government and non-profits “to provide services primarily relating to opioid abuse” where a number of allowable use of funds are listed.  These allowable uses include:

• providing training and resources for first responders on carrying/administering an opioid overdose reversal drug approved by the FDA ad purchasing such drug or device for first responders who have received training;
• investigations to locate or investigate illicit activities related to the unlawful distribution of opioids;
• developing, implementing or expanding a medication-assisted treatment program used or operated by a criminal justice agency, which may include training;
• developing, implementing or expanding PDMPs;
• developing, implementing or expanding programs to prevent and address opioid abuse by juveniles; and
• developing, implementing or expanding an integrated and comprehensive opioid abuse response program.

One section emphasizes coordination between State criminal justice agencies and substance abuse agencies:  The bill notes that in the case where a State is the applicant, a core focus of the grant activities would be “…facilitating or enhancing planning and collaborating between State criminal justice agencies and State criminal justice systems in order to more efficiently and effectively carry out programs described in paragraph (1) that address problems related to opioid abuse…”  The programs listed in paragraph 1 include:

• developing, implementing, or expanding treatment alternative to incarceration program, which may include pre-booking or post-booking components;
• training for criminal justice agency personnel on substance use disorders and co-occurring mental illness and substance use disorders;
• a mental health court;
• a drug court; and
• a veterans court.

Additional language on veterans services:  The bill includes additional language authorizing services to “qualified” veterans.  The bill defines a qualified veteran as a “…preliminary qualified offender who served on active duty in any branch of the Armed Forces, including National Guard or Reserves, and was discharged or released from such service under conditions other than dishonorable.”  The additional language authorizes a Veterans Court program within DOJ, along with a Veterans Assistance Program.

Medication Assisted Treatment (MAT) defined:  The bill defines “medication-assisted treatment” as “the use of medications approved by the Food and Drug Administration for the treatment of opioid abuse.”

House Initiative differs from CARA:  H.R. 5046 differs from CARA in that H.R. 5046 authorizes grants exclusively within the Department of Justice (DOJ).  Overall, CARA authorizes a number of distinct programs targeted towards different aspects of the opioid problem (prevention, treatment, recovery, media campaigns, naloxone and more) not only within DOJ but also within certain Department of Health and Human Services’ (HHS) operating divisions that include the Substance Abuse and Mental Health Services Administration (SAMHSA), Centers for Disease Control and Prevention (CDC), and others.   In the House, as previously reported, a number of bills related to opioids impacting federal health agencies are being considered in the Energy and Commerce Committee.

To view the Comprehensive Opioid Abuse Reduction Act (H.R. 5046), please visit https://judiciary.house.gov/wp-content/uploads/2016/04/HR-5046.pdf

Other bills passed by the Judiciary Committee:  In addition to H.R. 5046, the Judiciary Committee considered and approved

• H.R. 5052, the Opioid Program Evaluation Act which would require an evaluation of the grants authorized in H.R. 5046 (Rep. McCarthy, R-CA and Rep. Hoyer, D-MD)

• H.R. 5048, the Good Samaritan Assessment Act of 2016, which would require a GAO report on the extent to which ONDCP has reviewed Good Samaritan Laws and the results or findings from these reviews along with a compilation of Good Samaritan Laws in effect in the States (Rep. Guinta, R-NH)

House Full Energy and Commerce Committee Completes Markup of Bills on Opioids
The Full House Energy and Commerce Committee considered and passed on Wednesday, April 27 and Thursday, April 28 a number of bills aimed at address the opioid problem.  The Chairman of the Committee is Rep. Upton (R-MI) and the Ranking Member is Rep. Pallone (D-NJ).

On Thursday, April 28, the Committee reconvened and passed three more bills related to opioids:

• H.R. 3691, Improving Treatment for Pregnant and Postpartum Women Act would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within SAMHSA’s Center for Substance Abuse Treatment (CSAT). The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of these funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to spur innovation and fill gaps in family-centered services across the continuum of care. A section-by-section summary of the bill can be found here.  In FY 2016, the PPW grant program was funded at $15.9 million.  The bill as introduced authorized $40 million for the PPW and pilot program.

During the markup, an amendment was offered to change the authorization of funds in the bill from $40 million to $16.9 million.  Further, Rep. Ben Ray Luján (D-NM), the original sponsor of the bill, offered an amendment that would authorize the use of funds for the pilot program only if the amount for the overall PPW program exceeded FY 2016 funding levels. Both amendments passed.

• H.R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015, for the Secretary of Health and Human Services to carry out a grant program for the co-prescribing of opioid overdose reversal drugs (Rep. Sarbanes, D-MD)

• H.R. 4586, Lali’s Law, to authorize grants to States for developing standing orders and educating health care professionals regarding the dispensing of opioid overdose reversal medication without person-specific prescriptions, and for other purposes (Rep. Dold, R-IL)

The Committee considered and approved the following opioid-related bills on Wednesday, April 27:

• H.R. 4641, To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes (Rep. Brooks, R-IN and Rep. Kennedy, D-MA)

• H.R. 4978, Nurturing and Supporting Healthy Babies Act which would mandate the Government Accountability Office (GAO) to write a report neonatal abstinence syndrome (NAS) – including prevalence, coverage available under Medicaid, any federal barriers to treatment, particularly in non-hospital settings, and more.

• H.R. 4981, Opioid Use Disorder Treatment Expansion and Modernization Act: The Opioid Use Disorder Treatment Expansion and Modernization Act (H.R. 4981), would change the number of patients to whom a practitioner can prescribe buprenorphine from 100 to 250. During the markup four amendments were offered to H.R. 4981. The first, offered by Congresswoman DeGette (D-CO), aimed to increase the cap to 500 patients, and the second by Ranking Member Pallone would increase the cap to 300. In a roll call vote, neither of the amendments to further increase the cap passed. Congresswoman Yvette Clarke (D-NY) offered an amendment to raise awareness of safe prescribing of opioids for the treatment of pain, but she later withdrew the amendment. Finally, Congressman Ben Ray Luján (D-NM) offered an amendment to authorize $1 billion for opioid use disorder prevention and treatment, primarily in the form of State targeted response cooperative agreements as proposed by the Administration. With a vote of 22-24, Congressman Luján’s amendment did not pass. (H.R. 4981 was introduced by Rep. Bucshon, R-IN and Rep. Tonko, D-NY)

• H.R. 4969, John Thomas Decker Act of 2016 to authorize a grant program within CDC to educate teens and youth injured playing sports regarding the dangers of prescription drug misuse and abuse (Rep. Meehan, R-PA)

• H.R. 4599, Reducing Unused Medications Act of 2016 to amend the Controlled Substances Act in order to allow partial fills of schedule II controlled substances (Rep Clark, D-MA)

• H.R. 4976, Opioid Review Modernization Act to require the Food and Drug Administration (FDA) to seek recommendations from an advisory committee before approval of certain new opioid-based drugs without abuse-deterrent properties (Rep. Sean Maloney, D-NY)

• H.R. 4982, Examining Opioid Treatment Infrastructure Act of 2016 would require the GAO to develop a report on the availability of substance use disorder treatment in inpatient, outpatient and detox settings (Rep.  Foster, D-IL)

• H.R. 3250, DXM Abuse Prevention Act would prohibit the sale of medicine containing dextromethorphan (DXM) to individuals under 18 without a prescription (Rep. Johnson, R-OH and Rep. Matsui, D-CA)

NASADAD will continue to track relevant legislation and provide updates to membership.

University of California study finds seasonal increase in college student drinking rates
The University of California – San Diego published a study finding seasonal increases in drinking rates among college students earlier last month. The study examined 462 college freshmen at eight different points during their first year. Researchers found that the freshmen’s drinking decreased 29 percent in the summer, increased 31 percent in the spring, and increased another 18 percent around spring break.

Read more about this study here.

Behavioral Health IT Coalition release Integrating Behavioral Health through Technology Act of 2016 (S. 2691) fact sheet
The Behavioral Health IT Coalition, of which NASADAD is a member, has released a fact sheet summarizing the Integrating Behavioral Health through Technology Act of 2016 (S. 2691). The legislation was recently introduced by Senator Sheldon Whitehouse (D-RI) and establishes a pilot program in up to five states, where incentive payments may be made to eligible professionals and behavioral health facilities for the adoption and use of certified Electronic Health Record (EHR) technology. Preference would be given to States that have a statewide health information exchange that includes mental health and substance use disorder data. Senator Whitehouse’s legislation aims to increase collaboration between mental health, substance use disorder, and primary care providers to improve overall health outcomes.

NGA and NCJA launch State criminal justice reform initiative
The National Governors Association (NGA) and the National Criminal Justice Association (NCJA) announced a joint program to support State criminal justice reform efforts last week. The program, titled the National Criminal Justice Reform Project, will support the implementation of evidence-based practices targeting recidivism, pretrial release, and mental health and substance use disorders in up to five States. The five States will be selected for the program following a meeting of twenty State teams this fall.

Read the full story here.

Pew Charitable Trusts article highlights State efforts to combat synthetic drugs
The Pew Charitable Trusts published an article last week highlighting State efforts to combat the spread of synthetic drugs in communities across the country. The most popular synthetic drugs are placed into two categories: synthetic cathinones (bath salts) and synthetic marijuana products that are commonly sold in stores. Thirty-two States have passed laws making the process to classify synthetic drugs as illegal easier since 2010. Despite these efforts, legislators continue to face significant difficulties in making synthetic drugs illegal through scheduling, as manufacturers can change just one molecule of an illegal synthetic drug to create a new legal version. This complication has spurred States to reexamine the traditional scheduling process. Florida and Washington, DC passed laws to make the scheduling of drugs include consideration of the type of drug and its reaction rather than just its chemical makeup. This adjustment makes it easier for States to keep up with the constantly shifting synthetic drug market.

Read the full article here.

News from NASADAD

NASADAD Moderates Panel During “Stepping Up Summit” in Washington, D.C.
On Tuesday, April 19, Robert Morrison, NASADAD Executive Director, served as a moderator of a panel titled “Meeting the Needs of People with Co-occurring Substance Use Disorders and Mental Illnesses” held in conjunction with the Stepping Up Summit.  The session focused on systems-level coordination and reform efforts to address co-occurring substance use and mental health disorders.  The panel was designed to explore opportunities to reduce the number of people with co-occurring disorders in jails.

Participants included:

• The Honorable Alisha Bell, Commissioner, Wayne County, Michigan (Presider)
• Mitchell Katz, MD, Director, Los Angeles County Health Agency, Los Angeles County, California
• Faye Taxman, PhD, University Professor, Criminology, Law and Society Department, and Director of the Center for Advancing Correctional Excellence, George Mason University
• Rob Morrison, NASADAD, Moderator
• Sara Wurzburg, Grantee Technical Assistance Manager, Council of State Governments (CSG), organized and supported the panel.  Sarah previously served as Research Analyst at NASADAD.

Earlier in the day, NASADAD member Tracy Plouck, Director of Ohio’s Department of Mental Health and Addiction Services, served as a featured speaker during a plenary session titled “Strategies for Financing Your Plan.”

The Stepping Up Initiative was launched by CSG, the National Association of Counties (NACo), the American Psychiatric Association Foundation in May 2015.  The goal of the initiative is to reduce the number of people with mental illness in jails.  NASADAD is a partner in the initiative.

To learn more about the Stepping Up Initiative, visit https://stepuptogether.org/

Upcoming Events

CDC announces webinar on its National Viral Hepatitis Campaigns
The Centers for Disease Control and Prevention (CDC) has announced a webinar discussing its two National Viral Hepatitis Campaigns. The webinar will provide an overview of both campaigns and the new resources associated with them.  The Know Hepatitis B campaign promotes hepatitis B testing among Asian Americans and Pacific Islanders, while the Know More Hepatitis campaign encourages hepatitis C testing in people born from 1945 to 1965. The webinar will be held on Wednesday, May 4^th at 3 PM EST.

Register for the webinar here.

Read more about the Know Hepatitis B campaign here.

Read more about the Knew More Hepatitis campaign here.

SAMHSA announces National Prevention Week 2016 Kick-off webcast
The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced the kick-off webcast for National Prevention Week 2016 in partnership with Morgan State University. The webcast will highlight communities throughout the country that have bolstered overall community health through increasing prevention-related public awareness programs surrounding mental health and substance use disorders. The webcast will be held on Monday, May 16^th from 11:00-11:45 AM EST. National Prevention Week 2016 will be observed from May 15-21, 2016.

Register for the webcast here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

In the News

• FY 2017 Commerce, Justice & Science Appropriations Bill Clears Senate Appropriations Committee
• House of Representatives Committee on Energy and Commerce holds markup on H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act
• UnitedHealth Group solidifies plans to exit health insurance marketplaces
• AP report suggests increased amount of banks and credit unions working with marijuana-related businesses
• S. House of Representatives Ways and Means Committee leaders submit letter to CMS calling for increased data transparency

Around the Agencies

• CDC FY 2015 grant funding profiles now available
• SAMHSA releases applications for FY 2016 Statewide Peer Networks for Recovery and Resiliency grant program

News from NASADAD

• NASADAD sends thank you letter to AMA for work with NGA
• NASADAD Presents to Joint NACo/League of Cities Task Force on Opioid Epidemic

Upcoming Events

• Community Catalyst announces informative call on the intersections between health and housing for vulnerable populations

In the News

FY 2017 Commerce, Justice  & Science Appropriations Bill Clears Senate Appropriations Committee
After clearing the Subcommittee on Commerce, Justice, Science and Related Agencies, on April 21^st the Senate Committee on Appropriations approved a $56.3 billion spending bill for programs related to national security, law enforcement, and scientific innovation. This is $563 million more than FY 2016 and $1.6 billion more than the President’s request. The bill was approved by the Committee with a vote of 30-0.

Some of the highlights for programs within the Department of Justice (DOJ) include:

• $2.36 billion for state and local law enforcement and crime prevention grant programs, which includes grants for State law enforcement and juvenile justice programs;
• $384 million for Byrne Justice Assistance Grants (JAG), which is a $92 million dollar cut compared to FY 2016. However, the FY 2016 appropriations included a $100 million carve out to cover extra costs of security at the two presidential nominating conventions.  The Senate Appropriations Committee’s recommendation is $500,000 higher than the President’s request for FY 2017;
• $43 million in support for Drug Courts, a $1 million increase in funding for FY 2017 compared to FY 2016;
• $6 million for Veterans Treatment Courts, which is level funding compared to FY 2016;
• $75 million for Second Chance Act grants to reduce recidivism for adults released from jail by offering substance abuse treatment, employment assistance, and other rehabilitation services. This is a $7 million increase in funding for FY 2017 compared to FY 2016, and $25 million less than the President’s request;
• $10 million for Community Oriented Policing Systems (COPS) Office Anti-Heroin Task Forces grants;
• $7 million for COPS Office Anti-Methamphetamine Task Forces grants; and
• $410 million increase in funding for FY 2017 for the Drug Enforcement Administration (DEA) compared to FY 2016.
  • Includes $12.5 million for four new heroin enforcement squads within the DEA.

A summary of proposed funding levels and a comparison to FY 2016 levels is attached here.

House of Representatives Committee on Energy and Commerce holds markup on H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act
On April 20^th the House of Representatives Subcommittee on Health within the Committee on Energy and Commerce held a markup of twelve bills related to opioid use disorders, including H.R. 3691, the Improving Treatment for Pregnant and Postpartum Women Act. The subcommittee is led by Chairman Joseph Pitts (R-PA) and Ranking Member Gene Green (D-TX).

H.R. 3691 would reauthorize the residential services for pregnant and postpartum women program (PPW) grant program within SAMHSA’s Center for Substance Abuse Treatment (CSAT). The bill would also create a pilot program for State substance abuse agencies to use up to 25 percent of funds for services to pregnant and parenting women in non-residential settings. The purpose of the pilot program is to fill gaps in family-centered services across the continuum of care. A section-by-section summary of the bill can be found here.

During the markup, Congressman Ben Ray Luján (D-NM), who introduced H.R. 3691 in October of 2015, spoke about the pervasiveness of addiction, including in his own district, and the importance of increasing access to treatment for women. Chairman Pitts also expressed support of the bill, especially the provision to provide family-based treatment services.

Other proposed legislation considered during the markup were:

• R. 4641, To provide for the establishment of an inter-agency task force to review, modify, and update best practices for pain management and prescribing pain medication, and for other purposes
• R. 3680, Co-Prescribing to Reduce Overdoses Act of 2015
• R. 1818, Veteran Emergency Medical Technician Support Act
• R. 3250, DXM Abuse Prevention Act
• R. 4969, John Thomas Decker Act of 2016
• R. 4586, Lali’s Law
• R. 4599, Reducing Unused Medications Act of 2016
• R. 4978, Nurturing and Supporting Healthy Babies Act
• R. 4976, Opioid Review Modernization Act
• Opioid Use Disorder Treatment Expansion and Modernization Act
• Examining Opioid Treatment Infrastructure Act of 2016

All of the bills are being considered by the full Committee on Energy and Commerce this week. NASADAD will continue to track relevant legislation and provide updates to membership.

UnitedHealth Group solidifies plans to exit health insurance marketplaces
UnitedHealth Group has solidified plans to exit the health insurance marketplaces created by the Affordable Care Act, announcing their intention to stop service in nearly 34 States. CEO Stephen Hemsley states that the overall market size and high risk of health insurance marketplaces prevents UnitedHealth Group from continuing to serve public exchanges. The Kaiser Family Foundation released a report asserting that, if UnitedHealth Group were to leave all 1,855 counties where it currently participates, “29% of the counties would be left with just one marketplace insurer and another 29% would be left with just two.” The report goes on to caution that areas with limited insurer availability may not realize the cost savings seen in regions with a larger number of insurers.

Read UnitedHealth Group CEO Stephen Hemsley’s statement here.

Read the Kaiser Family Foundation report here.

AP report suggests increased amount of banks and credit unions working with marijuana-related businesses
An Associated Press (AP) report released last week finds that the number of banks and credit unions working with marijuana-related businesses has increased from 51 in March 2014 to 301 in March 2016 according to federal data. Marijuana businesses have experienced barriers in response to federal regulations constricting their ability to store money in banks, leading many retailers to work with local credit unions instead of larger banking institutions. Credit card companies remain wary of accepting marijuana-related transactions in fear of federal liability. These restrictions have forced many businesses to only accept cash, in turn requiring revenue departments in Colorado, Washington, and Oregon to prepare for large cash deposits by increasing security.

Read the full article here.

U.S. House of Representatives Ways and Means Committee leaders submit letter to CMS calling for increased data transparency
Leaders from the House of Representatives Committee on Ways and Means submitted a letter to the Center for Medicare and Medicaid Services (CMS) last week calling for increased mental health data transparency. The letter specifically calls for CMS to publish more data about the mental health of Medicare beneficiaries in order for health care providers to better address the needs of seniors, while still maintaining patient privacy. Ways and Means leaders assert that increased transparency will allow Congress to make better decisions related to the mental health of Medicare beneficiaries. Leaders from both parties signed the letter, including Chairman Kevin Brady (R-TX), Ranking Member Sander Levin (D-MI), Health Subcommittee Chairman Pat Tiberi (R-OH), and Health Subcommittee Ranking Member Jim McDermott (D-WA).

Read the full letter here.

Around the Agencies

CDC FY 2015 grant funding profiles now available
The Centers for Disease Control and Prevention (CDC) released FY 2015 grant funding profiles last week. The funding profiles provide summaries of CDC cooperative agreement and grant funding programs to States, U.S. territories, and the District of Columbia after close out of the fiscal year.  Funding profiles are sortable by funding opportunity announcement, funding source, geography, and recipient type and name – and include a number of substance use disorder related grant programs.

Access the grant funding profiles here.

SAMHSA releases applications for FY 2016 Statewide Peer Networks for Recovery and Resiliency grant program
The Substance Abuse and Mental Health Services Administration (SAMHSA) released applications for the Statewide Peer Networks for Recovery and Resiliency grant program last week.  The program is administered with the help of the Center for Substance Abuse Treatment (CSAT) and the Center for Mental Health Services (CMHS). The Statewide Peer Networks for Recovery and Resiliency Grant Program provides funding for the development of increased cross-system collaboration, peer workforce expansion, and increased treatment infrastructure for substance use disorders. The grant program will award up to eight awards of approximately $100,000 for a one year period. Applications are due by Tuesday, June 21, 2016.

Access the full application here.

News from NASADAD

NASADAD sends thank you letter to AMA for work with NGA
NASADAD sent a letter to the American Medical Association (AMA) last week expressing gratitude for their statement on the opioid crisis released in collaboration with the National Governors Association (NGA).  The AMA and NGA released a statement about the opioid crisis in February 2016, calling for increased investment in prescription drug monitoring programs, increased substance use disorder training for health professionals, and expanded access to naloxone. NASADAD’s letter thanks both organizations for their work in this area and affirms NASADAD’s support for the recommendations outlined in the joint letter, especially with regard to closing the treatment gap. NASADAD’s letter is attached to this email.

Read the joint AMA/NGA statement here.

NASADAD Presents to Joint NACo/League of Cities Task Force on Opioid Epidemic
On April 7^th, Robert Morrison, NASADAD’s Executive Director, presented to the National City-County Task Force on the Opioid Epidemic – a panel made up of representatives from the National Association of Counties (NACo) and National League of Cities (NLC).  The event was the first gathering for the panel.  The 24 member Task Force is led by co-chairs Judge Gary Moore of Boone County, Kentucky and Mayor Mark Stodola of Little Rock, Arkansas.  The panel hopes to encourage further collaboration at the local level and generate recommendations for federal policy makers to consider to help local governments address the opioid crisis.  Robert Morrison educated the Task Force regarding the publicly funded prevention, treatment and recovery system; the benefits of collaborating with State alcohol/drug authority directors; and the need to ensure that any plan and initiative includes a commitment to primary prevention.  The Task Force includes Greg Puckett, Commissioner in Mercer County, West Virginia, who described his work as a lead of a community anti-drug coalition.  Finally, Morrison encouraged the Task Force to not only engage in actions focused on opioids, but to consider actions that would address addiction in general.

Learn more about the Task Force here.

Upcoming Events

Community Catalyst announces informative call on the intersections between health and housing for vulnerable populations
Community Catalyst has announced a new informative call discussing the intersections between health and housing for vulnerable populations. The call will examine current policies and research involving housing and feature presentations from several stakeholders. Community Catalyst recognizes an opportunity to collaborate with stakeholders and other organizations in the social justice movement so support the work of healthcare advocates working to expand access to housing. The call will be held on Wednesday, May 11^th from 1-2:30 PM EST.

RSVP for the call here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

News from the States

• Ohio announces new strategies for addressing the opioid epidemic
• Minnesota health home successes highlighted in new Governing article
• Tennessee becomes first State with CMS-approved HCBS Statewide transition plan

Around the Agencies

• Sixty Senators caution CMS to delay the release of hospital quality star ratings
• CDC releases updated child abuse and neglect prevention resources

In the News

• New Hilton Foundation, Washington Post articles highlight recent developments in youth alcohol prevention
• National Academy of Sciences, Engineering, and Medicine releases report on hepatitis B and C
• New study finds alarming rates of alcohol use disorders and mental health conditions within the U.S. legal profession
• MacArthur Foundation announces $25 million in criminal justice reform grant programs
• Legal Action Center releases report on usage of medication-assisted treatment in drug courts

News from NASADAD

• NASADAD attends APA briefing on collaborative care models for mental health and substance use disorders

Upcoming Events

• ASTHO announces webinar on aligning SIM program implementation with population health needs
• Shriver Center announces webinar on housing rights for individuals with criminal records

News from the States

Ohio announces new strategies for addressing the opioid epidemic
Ohio announced new plans to address the opioid epidemic at a press conference last week featuring Lt. Governor Mary Taylor and NASADAD member Tracy Plouck, who is the Director of the Ohio Department of Mental Health and Addiction Services (OhioMHAS). The new plans include licensing pharmacy technicians with the State, increasing the number of methadone clinics, and limiting the length of pain medication prescriptions. The opening of new methadone clinics will be facilitated via a waiver to the current statutory requirement stipulating that a provider be certified in Ohio for two years before becoming a methadone clinic. The recommendations also include plans to expand access to naloxone by allowing facilities that regularly interact with high-risk individuals to carry naloxone on site.

Read the full list of recommendations here.

Minnesota health home successes highlighted in new Governing article
Minnesota’s numerous health home successes were highlighted in a new Governing article published last week. The article follows the announcement of the Comprehensive Primary Care Plus program to shift treatment options to incentivize States to adopt health home models that improve health outcomes and save money. Health home models consolidate primary and specialist care, pharmacy assistance, and mental health and substance use disorder specialists into one site, easing collaboration and information sharing between different types of healthcare providers.

Minnesota began investing in health home models in 2008 under Governor Tim Pawlenty in an effort to cut healthcare costs. The initiative has been a success, with 54 percent of Minnesota’s primary care clinics now certified as health homes, versus 15 percent nationally. The University of Minnesota believes that these health homes have saved the State more than $1 billion dollars over the past five years according to a study published earlier this year. Aside from cost savings, the program has found improved health outcomes, such as 39 percent of asthmatic children treated in health homes experiencing fewer hospitalizations compared to 19 percent in traditional primary care clinics.

Read the article here.

Tennessee becomes first State with CMS-approved HCBS Statewide transition plan
Tennessee’s home and community-based services (HCBS) statewide transition plan was approved by the Centers for Medicare & Medicaid Services (CMS) last week. Tennessee’s plan was the first to be approved by CMS following Tennessee’s completion of systemic assessments and site specific assessments on how the State plans to bring existing HCBS systems into compliance with the final regulations detailed in January 2014. CMS will require Tennessee to provide quarterly written and phone updates to track the State’s progress. CMS further stipulates that Tennessee must work with CMS to identify areas requiring additional scrutiny.

View Tennessee’s approved plan here.

View the HCBS final regulations here.

Around the Agencies

Sixty Senators caution CMS to delay the release of hospital quality star ratings
Sixty Senators representing members of both parties have released a statement urging the Centers for Medicare & Medicaid Services (CMS) to delay the April 21^st release of the overall hospital quality star ratings. The Senators assert that while publicly available provider quality data is important, the current star ratings system “may not accurately take into account hospitals that treat patients with low socioeconomic status or multiple chronic conditions.” The Senators also requested more transparency surrounding the methodology used to determine hospitals’ star ratings. A similar letter is currently being circulated in the House of Representatives.

Read the full letter here.

CDC releases updated child abuse and neglect prevention resources
The Centers for Disease Control and Prevention (CDC) released updated versions of their child abuse and neglect prevention services last week. The updates were released in recognition of April as National Child Abuse Prevention Month. The updated resources include new infographics, updated information on adverse childhood experiences (ACEs) data collection, maps of State-level ACE data, ACE prevention strategies, and a directory of journal articles related to child abuse and neglect.

Access the resources here.

In the News

New Hilton Foundation, Washington Post articles highlight recent developments in youth alcohol prevention
The Conrad N. Hilton Foundation’s Alexa Eggleston published an article last week highlighting recent developments in alcohol use prevention among youth. The article notes that despite the mounting costs and deaths associated with drinking in the United States, 2015 marked the lowest levels of alcohol use among high school youth. Recent data from the Centers for Disease Control and Prevention (CDC) states that 35 percent of current high school students indicated drinking alcohol at least one day in the past month – a 15 percent decrease from the 50 percent of students indicating past month alcohol use in the mid-1990s.

Much work remains however, as youth alcohol use is strongly associated with alcohol use disorders later in life. Research suggests that individuals who begin drinking before age 15 are “six times more likely to develop an alcohol use disorder than those who begin drinking at or after age 21.” The article recommends increased prevention efforts, including the suggestions made by the Community Preventive Services Task Force such as electronic alcohol screening and brief intervention (eSBI). The Hilton Foundation currently lists substance use prevention as an organizational strategic initiative, and is working to increase awareness and access to treatment.

The Washington Post published an article written by the Vice President of the International Association of Chiefs of Police, Steven Casstevens last week in recognition of April as Alcohol Responsibility Month. In the article Mr Casstevens calls for greater parental involvement to reduce rates of underage drinking. The article describes several recent news stories involving parents illegally providing alcohol to minors resulting in arrests or deaths. The 2014 National Survey on Drug Use and Health found that “53 percent of current underage drinkers reported family and friends as their source for the alcohol they consumed.”

Read the Hilton Foundation article here.

Read the Washington Post article here.

National Academy of Sciences, Engineering, and Medicine releases report on hepatitis B and C
The National Academy of Sciences, Engineering, and Medicine released a report on hepatitis B and C last week. The report was created in partnership with the Centers for Disease Control and Prevention (CDC) Division of Viral Hepatitis (DVH) and the Department of Health and Human Services (HHS) Office of Minority Health (OMH). The report contains several recommendations on how to best address the spread of hepatitis B and C in the United States. The Consensus Committee notes that while hepatitis B and C may be able to be eliminated eventually, disease control is a more achievable short-term goal. The report identifies several current barriers to eliminating hepatitis B and C, including sporadic and underfunded surveillance, inconsistent diagnosis, difficulty reaching marginalized populations, and the spread and stigma of hepatitis B and C among individuals who inject drugs.

Read the report here.

New study finds alarming rates of alcohol use disorders and mental health conditions within the U.S. legal profession
The Hazelden Betty Ford Foundation and the American Bar Association Commission on Lawyer Assistance Programs published a study revealing alarming rates of alcohol use disorders and mental health conditions within the U.S. legal profession last week. The report finds that “21 percent of licensed, employed attorneys qualify as problem drinkers, 28 percent struggle with some level of depression, and 19 percent demonstrate symptoms of anxiety.” Young attorneys were found to exhibit the highest rates of these disorders, reversing previous studies that suggested alcohol use disorder rates increased as individuals progressed in their careers.

Read the full study here.

MacArthur Foundation announces $25 million in criminal justice reform grant programs
The John D. and Catherine T. MacArthur Foundation announced $25 million in new criminal justice reform grant programs last week. The program will award 11 jurisdictions between $1.5 million and $3.5 million to reduce jail populations and address racial disparities within their criminal justice systems. Nine additional jurisdictions will be provided $150,000 in grant funding to continue criminal justice reform and enhance collaboration between cities, counties, and States. The newly announced $25 million is part of a larger MacArthur Foundation initiative named the Safety and Justice Challenge which seeks to facilitate criminal justice reforms at the local level.

Read more about this program here.

Legal Action Center releases report on usage of medication-assisted treatment in drug courts
The Legal Action Center released a new report on the usage of medication-assisted treatment (MAT) within drug courts last week. The report contains three profiles of drug courts with effective MAT programs, providing lessons and best practices on how to successfully incorporate MAT within urban, rural, and suburban drug court programs. The Legal Action Center provides nine recommendations at the end of the study, including: the importance of counseling and other services, the development of strong relationships with treatment programs and regular communication regarding patient progress, screening and assessment considering all forms of treatment, and monitoring for the illicit use of MAT medication.

Read the full report here.

News from NASADAD

NASADAD attends APA briefing on collaborative care models for mental health and substance use disorders
On April 14^th, 2016, Brian Denten, NASADAD Public Policy Graduate Intern attended the briefing hosted by the American Psychiatric Association. The briefing heard from two industry & academic professionals working to increase usage of collaborative care models for mental health and substance use disorders. Both speakers discussed the myriad benefits associated with collaborative care models, including up to $26 to 48 billion dollars in annual healthcare savings. Collaborative care models involve the integration of care management performed by a social worker or psychologist to primary care practices. These coordinators work to review primary care patient records to ensure the delivery of proper mental health and substance use disorder treatment services. Despite collaborative care model’s demonstrated success at improving mental health and substance use disorder treatment outcomes, care management and psychiatric consultation services are not currently reimbursable by Medicare and Medicaid. The APA is working with the Centers for Medicare & Medicaid Services (CMS) and other stakeholder groups to design reimbursement codes for collaborative care services.

Speakers:

• Jürgen Unützer, MD, MPH, MA; Professor & Chair, University of Washington’s Department of Psychiatry and Behavioral Health Services; Director of the Advancing Integrated Mental Health Solutions (AIMS) Center
• David Roll, MD; Internist & Pediatrician, Cambridge Health Alliance’s Revere Family Health Center; Regional Medical Director for the Revere and Everett Health Centers; Instructor In Medicine, Harvard Medical School

Upcoming Events

ASTHO announces webinar on aligning SIM program implementation with population health needs
The Association of State and Territorial Health Officers (ASTHO) has announced a new webinar focusing on the alignment of State innovation models (SIM) with population health needs. Round two SIM applications required States to “develop a population health plan in order to assess the overall health of the State, and identify measurable goals, objectives and interventions to improve healthcare quality and reduce healthcare costs.” This webinar will feature speakers from Iowa and Washington’s Departments of Public Health that have worked to implement SIM programs in their respective States. Both speakers will provide insight on how their States have adjusted SIM implementation to better suit population health needs. The webinar will also discuss collaboration opportunities between State public health departments and other stakeholder groups. The webinar will be held on Thursday, May 5 from 3:30-5:00 PM EST.

Register for the webinar here.

Shriver Center announces webinar on housing rights for individual with criminal records
The Shriver Center announced a new webinar on housing rights for individuals with criminal records last week. The webinar will feature remarks from Housing and Urban Development (HUD) Secretary Julian Castro in addition to several other speakers. Earlier this month, HUD issued new guidance suggesting that admission denials and evictions based on criminal records may violate racial discrimination provisions of the Fair Housing Act. The webinar will discuss this new guidance and cover examples of best housing practices throughout the country. The Shriver Center will host the webinar on Thursday, April 28 from 2:00-3:00 PM EST.

Register for the webinar here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

Around the Agencies

• NIAAA study recommends primary care physicians implement single-question alcohol screening for adolescents
• Latest NIAAA Spectrum newsletter now available online

In the News

• National Alliance for Model State Drug Laws updates report on medical marijuana legislation
• Alcohol Awareness Month begins in April with theme of parental involvement
• NAMD releases report on the Medicaid link between service delivery and payment

News from NASADAD

• NASADAD attends Senate Drug Caucus hearing titled “Is the Department of Justice Adequately Protecting the Public from the Impact of State Recreational Marijuana Legalization?”
• NPN announces call for 2016 National Exemplary Awards applications

News from the States

• Public Policy Institute of California releases report analyzing Washington and Colorado’s regulatory approaches to marijuana legalization

Upcoming Events

• ONDCP announces webinar on community benefit
• SAMHSA and CMS announce webinar on mental health and substance use disorder parity for Medicaid and CHIP
• The Sentencing Project announces webinar on sentencing reform at the State level

Around the Agencies

NIAAA study recommends primary care physicians implement single-question alcohol screening for adolescents
A study funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends physicians implement single-question alcohol screenings for adolescents. Researchers examined rates of alcohol use disorder (AUD) among adolescents in rural Pennsylvania, finding that “10 percent of rural youth over age 14 met diagnostic criteria for AUDs in the past year.” Forty-four percent of adolescents who reported drinking on three or more days in the past year were found to have AUDs. While many primary care physicians do not currently screen adolescents for AUDs as a result of time constraints, the report recommends that physicians implement single-question screening related to frequency of alcohol consumption. The study’s authors assert that single-question screening detects AUDs among adolescents with 91 percent sensitivity and that it is effective at identifying problematic usage of alcohol in adolescents.

Read the full study here.

Latest NIAAA Spectrum newsletter now available online
The most recent version of the National Institute on Alcohol Abuse and Alcoholism’s (NIAAA) Spectrum newsletter is now available online. The newsletter was previously published in February 2016. This edition of the newsletter contains stories regarding the differences between male and female alcohol consumption, alcohol use disorder prevalence among Native American and Mexican young adults, pediatrician substance use disorder and mental health intervention, and discussion of a new study examining how substance use affects adolescent brain development.

Read the full newsletter here.

In the News

National Alliance for Model State Drug Laws updates report on medical marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) has updated its report on State medical marijuana legislation. The report summarizes ongoing and future efforts to regulate medical marijuana at the State level. The updated medical marijuana report follows last week’s updates on follow-up, decriminalization, and personal non-medical use marijuana legislation.

Read the medical marijuana legislation report here.

Read the “follow-up” legislation report here.

Read the decriminalization report here.

Read the personal non-medical use report here.

Alcohol Awareness Month begins in April with theme of parental involvement
This year’s Alcohol Awareness Month began at the start of April with the theme “Talk Early, Talk Often: Parents Can Make a Difference in Teen Alcohol Use.” The National Council on Alcoholism and Drug Dependence (NCADD) sponsors the event and helped to develop the theme. The National Association for Children of Alcoholics (NACoA) has prepared several resources to help parents discuss alcohol use with their children. Other NACoA materials include informational videos, teen web portals with information on alcohol, and recommendations from recovery author Claudia Black.

Access NACoA’s resources here.

View NCADD’s 2016 Alcohol Awareness Month organizing guide here.

NAMD releases report on the Medicaid link between service delivery and payment
The National Association of Medicaid Directors (NAMD) has released results of a study on the efforts State Medicaid agencies are taking to rework the connection between healthcare service delivery and reimbursement. The report asserts that nearly two-thirds of the 34 States participating in the study have or will implement State-designed programs reforming payment at the provider level. Medicaid directors interviewed as part of the project stressed the significant resources involved with implementing new service delivery and payment models, underscoring the need for high-quality data and stakeholder involvement throughout the full span of the process. The report recommends that new rate setting procedures may be required to support alternative payment models, and cautions that efforts to establish multi-payer reform must coordinate between Medicare and Medicaid to ensure that all payers work in the same direction.

Read NAMD’s press release here.

Read the full report here.

News from NASADAD

NASADAD Attends Senate Drug Caucus Hearing titled “Is the Department of Justice Adequately Protecting the Public from the Impact of State Recreational Marijuana Legalization?”
On April 5th, 2016, Brian Denten, NASADAD Public Policy Graduate Intern, attended the hearing convened by the Senate Caucus on International Narcotics Control. The Chairman of the Caucus is Senator Grassley (R-IA) and the Ranking Member is Senator Feinstein (D-CA).  Other members of the Caucus include Senators Sessions (R-AL), Schumer (D-NY), Risch (R-ID), Cornyn (R-TX), and Whitehouse (D-RI).

The hearing focused on the release of a report by the Government Accountability Office (GAO) titled “State Marijuana Legalization: DOJ should Document its Approach to Monitoring the Effects of Legalization.”  The report examines DOJ’s enforcement of the Controlled Substances Act (CSA) with regard to marijuana and actions taken on marijuana in Colorado and Washington State.  The CSA established that it is a federal crime for anyone to knowingly or intentionally manufacture, distribute, dispense, or possess marijuana.  However, over time States have passed laws allowing for the purchase and use of limited quantities of marijuana for certain medical conditions and more recently States passed laws allowing for the retail purchase of marijuana.

In response, DOJ issued on August 29^th, 2013 a memorandum designed to serve as guidance to all U.S. Attorneys. This memo, known as the “Cole Memo” because it was written by then-Deputy Attorney General James Cole, listed eight federal priorities that the federal government would focus on in terms of enforcement.  A few of these eight priorities included:

• preventing the distribution of marijuana to minors;
• preventing revenue from the sale of marijuana being directed towards criminal organizations;
• preventing diversion if legal marijuana to States where it remains illegal; and
• preventing drugged driving and other adverse public health consequences.

DOJ noted that it would consider stepping up its enforcement if certain areas were found to be problematic.

Senators Grassley and Feinstein asked GAO to investigate the mechanisms used by DOJ to monitor actions in States that have allowed retail purchase of marijuana for personal use (Washington State and Colorado) and lessons learned by DOJ on enforcement efforts of States with medical marijuana laws.

The report found that DOJ has not documented its monitoring process and a number of questions were raised about the data currently being collected.

During the hearing, Senators expressed concern over what they considered insufficient oversight, highlighting data from Colorado suggesting that emergency room visits related to marijuana and adolescent marijuana use have both increased since legalization.

The DOJ witness indicated that the Department plans to create a public web portal with information tracking State legalization efforts.

Witnesses:

• Benjamin B. Wagner; U.S. Attorney of the Eastern District of California
• Jennifer Grover; Director, Homeland Security and Justice, U.S. Government Accountability Office
• Doug Petersen; Attorney General for the State of Nebraska
• Kathryn Wells; Medical Director, Denver Health Clinic at the Family Crisis Center

View a video of the hearing here.

Read the GAO report on marijuana legalization here.

Read the DOJ’s Cole Memo on marijuana enforcement here.

News from the States

Public Policy Institute of California releases report analyzing Washington and Colorado’s regulatory approaches to marijuana legalization
The Public Policy Institute of California (PPIC) has released a report analyzing Washington and Colorado’s regulatory approaches to marijuana legalization. The report was compiled with the intention of providing information for California’s potential legalization of marijuana. The report makes three main recommendations based on Washington’s and Colorado’s experiences: (1) marijuana regulation must be flexible to deal with rapid changes in the time following legalization, (2) collecting data on the marijuana market and its impact on society must be gathered by robust mechanisms, and (3) California should develop a single restrictive regulatory model for both the recreational and medical marijuana markets in light of marijuana’s illegal status under federal law.

Read the full report here.

Upcoming Events

ONDCP announces webinar on community benefit
The Office of National Drug Control Policy (ONDCP) has announced a webinar discussing community coalition partnerships in collaboration with the Community Anti-Drug Coalitions of America (CADCA). The webinar, titled “Community Health Needs Assessment and Substance Use Disorders: How Partnerships with Community Coalitions can Benefit Local Substance Use Prevention Efforts,” will feature several speakers from ONDCP, CADCA, and the National Institute on Drug Abuse (NIDA). The webinar will be held on Thursday, April 14^th from 2:30-4 PM EST.

Learn more and register for the webinar here.

SAMHSA and CMS announce webinar on mental health and substance use disorder parity for Medicaid and CHIP
The Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Medicare & Medicaid Services (CMS) have announced a webinar on mental health and substance use disorder parity for Medicaid and CHIP. The webinar will discuss the implementation of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) for “individuals enrolled in Medicaid managed care organizations (MCOs), Medicaid alternative benefit plans (ABPs), and CHIP.” Changes from the Notice of Proposed Rulemaking will also be discussed by several speakers from both SAMHSA and CMS. The webinar will be held on Thursday, April 14^th from 1-2 PM EST.

Register for the webinar here.

The Sentencing Project announces webinar on sentencing reform at the State level
The Sentencing Project has announced a webinar on sentencing reform at the State level. The webinar will examine State sentencing policies that have driven the increase in incarceration rates throughout the United States. Current sentencing reform efforts and potential consequences associated with them will be discussed by a number of speakers representing jurisdictions across the country, including Delaware, Georgia, and Michigan. The webinar will be held on Tuesday, April 19^th on 3 PM EST.

Register for the webinar here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

News from NASADAD

• NPN announces call for 2016 National Exemplary Awards applications

News from the States

• CDC issues report examining fentanyl-related drug overdose deaths in Ohio
• Kansas passes juvenile justice reforms, shifting focus from detention centers to community-based programs

Around the Agencies

• CMS finalizes rule on mental health and substance use disorder parity for Medicaid and CHIP
• SAMHSA announces Daryl Kade as CBHSQ Director, Monica Feit as OPPI Director
• HHS releases new guidance on federal funding for syringe service programs

In the News

• NAATP announces new study tracking treatment outcomes data
• National Alliance for Model State Drug Laws updates reports on marijuana legislation
• President Obama announces additional actions to address the opioid crisis

News from NASADAD

NPN announces call for 2016 National Exemplary Awards applications
The National Prevention Network (NPN) has announced their call for applications for the 2016 National Exemplary Awards for Innovative Substance Abuse Prevention Programs, Practices, and Policies. The Exemplary Awards program identifies and honors outstanding achievements in substance abuse prevention throughout the country. The 2016 Awards will recognize exceptional substance abuse efforts and serve to focus national attention on the field of substance abuse prevention. They are intended to showcase “grassroots,” evidence-based substance abuse prevention programs and strategies that have been evaluated and may be replicated by others.  Applications are due Friday, May 6^th, 2016.

Access the 2016 Exemplary Awards application here.

News from the States

CDC issues report examining fentanyl-related drug overdose deaths in Ohio
The Centers for Disease Control and Prevention (CDC) has released a report analyzing fentanyl-related drug overdose deaths in Ohio. Ohio’s Department of Health had previously requested assistance from the CDC after data suggested fentanyl-related overdose deaths increased from 84 in 2013 to 502 in 2014. The CDC’s investigation examined death certificates, medical examiner reports, emergency department visit data, and prescription history data from the Ohio Automated Rx Reporting System, the State’s prescription drug monitoring program (PDMP). Results from the study indicate that individuals experiencing fentanyl-related overdose deaths are 69 percent male, 89 percent white, and 94 percent with some college or less education. The average age of those experiencing fentanyl overdoses was 37.9 years old. The study recommends that counties continue to monitor fentanyl-related deaths and perform targeted interventions as necessary. The CDC suggests improving access to naloxone for first responders.

Read the full report here.

Kansas passes juvenile justice reforms, shifting focus from detention centers to community-based programs
The Kansas House of Representatives has passed a bill reforming the State’s juvenile justice system. The bill places larger emphasis on therapeutic treatment options for non-violent juvenile offenders by shifting support from detention centers to community-based programs. Kansas expects the bill to save the State about $72 million in funding over the next five years, as research suggests community-based programs decrease recidivism and increase high school graduation rates. The Kansas State Senate passed a similar measure earlier in the session that phases out Kansas’s use of youth residential facilities by 2018. This phasing out contradicts the House version of the bill that keeps 50 beds available in youth facilities. This disagreement will be negotiated by both chambers before being submitted to Governor Brownback.

Read more about Kansas’s juvenile justice reforms here.

Around the Agencies

CMS finalizes rule on mental health and substance use disorder parity for Medicaid and CHIP
The Centers for Medicare & Medicaid Services (CMS) announced the finalization of a rule related to mental health and substance use disorder parity for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries last week. The rule was released in conjunction with President Obama’s visit to the National Rx Drug Abuse and Heroin Summit in Atlanta. The rule intends to expand access to evidence-based treatment by providing States flexibility in managed care delivery mechanisms while requiring that Medicaid beneficiaries are able to access mental health and substance use disorder benefits in a similar way to other medical benefits. Plans are required to provide information on mental health and substance use disorder benefits, including determination of medical necessity criteria, under the new rule. States must now disclose the rationale behind any denial of reimbursement for mental health and substance use disorder benefit claims.

View the final rule here.

SAMHSA announces Daryl Kade as CBHSQ Director, Monica Feit as OPPI Director
The Substance Abuse and Mental Health Services Administration (SAMHSA) has announced Daryl Kade as the new Director of the Center for Behavioral Health Statistics and Quality (CBHSQ) and Monica Feit, Ph.D. as Director of the Office of Policy, Planning, and Innovation (OPPI). Ms. Kade and Dr. Feit were both already serving as Acting Directors of both CBHSQ and OPPI, respectively.

As CBHSQ Director, Ms. Kade will provide national leadership in substance use disorder treatment, substance abuse prevention, and mental health statistics. Ms. Kade previously served as Acting Director of the Center for Substance Abuse Treatment (CSAT) and as Director of SAMHSA’s Office of Financial Resources. Ms. Kade has also worked within the Office of National Drug Control Policy (ONDCP) as a budget and legislative analyst.

As OPPI Director, Dr. Feit will assist SAMHSA in policy formulation and implementation in conjunction with external stakeholders. Dr. Feit previously joined the Department of Health and Human Services (HHS) as Director of the Division of Public Health Services in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in 2013. Before joining HHS, Dr. Feit worked as a Senior Program Officer at the Institute of Medicine (IOM).

HHS releases new guidance on federal funding for syringe service programs
Last week the U.S. Department of Health and Human Services (HHS) released new guidance for State, local, and tribal health departments seeking to fund syringe service programs (SSPs) through federal grant money. The guidance states that health departments are now able to use federal funding to create or enhance SSPs to help prevent the spread of HIV and viral hepatitis. It is important to note that while federal funds can be used for a large array of services, they cannot be used to purchase sterile needles or syringes.

HHS will require that health departments consult with the Centers for Disease Control and Prevention (CDC) to determine whether there is a need for SSPs in their jurisdiction. Once consulted, CDC will decide whether health departments are eligible to apply for SSP funding from their respective federal agencies.

Read the full guidance document here.

In the News

NAATP announces new study tracking treatment outcomes data
The National Association of Addiction Treatment Providers (NAATP) has announced a new study tracking patient outcomes from residential and outpatient treatment programs. The NAATP will collaborate with the OMNI Institute to collect data from over one-thousand patients following their first year after treatment. The study will examine a number of outcomes, including: detoxification, patient engagement, medication, counseling, peer and family support, and twelve-step activity.

Read the full press release here.

National Alliance for Model State Drug Laws updates reports on marijuana legislation
The National Alliance for Model State Drug Laws (NAMSDL) has updated its series of reports on medicinal, legal, and illegal marijuana legislation for 2016. The reports summarize ongoing and future efforts to regulate both the medical marijuana and legal marijuana industries at the State level. Three reports are now available: a report examining “follow-up” legislation in States that have legalized the personal use of marijuana, a report examining legislation to decriminalize the personal use of marijuana, and a report examining general marijuana legalization efforts.

Read the “follow-up” legislation report here.

Read the decriminalization report here.

Read the personal non-medical use report here.

President Obama announces additional actions to address the opioid crisis
On March 29^th President Obama announced the following policies during a speech at the National Rx Drug Abuse and Heroin Summit:

• HHS will issue a proposed rule increasing the buprenorphine treatment cap from 100 to 200 patients for qualified physicians treating opioid use disorders.
• HHS will release $94 million in new funding to 271 Community Health Centers – expected to help treat approximately 124,000 new patients with substance use disorders.
• SAMHSA will release $11 million in funding opportunities to expand medication-assisted treatment in up to 11 States.
• President Obama will sign a memorandum authorizing the creation of a Mental Health and Substance Use Disorder Parity Task Force to be chaired by the Domestic Policy Council. The Task Force will be held to an October 31 deadline to ensure that important parity protections are implemented.
• HHS will finalize a rule bolstering mental health and substance use disorder parity in Medicaid and CHIP.

For more information, click here.

Should you have any questions, or require additional information, please do not hesitate to contact Robert Morrison, Executive Director, (202) 293-0090 or Shalini Wickramatilake-Templeman, Public Policy Associate, at (202) 293-0090.

President Obama speaks at the 2016 National Rx Drug Abuse and Heroin Summit
President Obama plans to deliver a speech at the 2016 National Rx Drug Abuse & Heroin Summit on 3/29 at 2:15 PM EST. The President’s remarks will discuss the actions currently being taken to prevent the spread of opioid use disorders and will examine future potential policies for expanding access to treatment.

Read more about President Obama’s speech here.

View the speech here.

President Obama Announces Additional Actions to Address the Prescription Opioid Abuse and Heroin Epidemic
President Obama will announce the following policies during today’s speech at the National Rx Drug Abuse and Heroin Summit:

• HHS will issue a proposed rule increasing the buprenorphine treatment cap from 100 to 200 patients for qualified physicians treating opioid use disorders.
• HHS will release $94 million in new funding to 271 Community Health Centers – expected to help treat approximately 124,000 new patients with substance use disorders.
• SAMHSA will release $11 million in funding opportunities to expand medication-assisted treatment in up to 11 States.
• President Obama will sign a memorandum authorizing the creation of a Mental Health and Substance Use Disorder Parity Task Force to be chaired by the Domestic Policy Council. The Task Force will be held to an October 31 deadline to ensure that important parity protections are implemented.
• HHS will finalize a rule bolstering mental health and substance use disorder parity in Medicaid and CHIP.

Other actions are detailed here.

Guidance for Syringe Service Programs (SSPs)
Congress reversed a longstanding ban on the usage of federal funds for SSPs in late 2015. The U.S. Department of Health and Human Services (HHS) recently released new guidance for State, local, and tribal health departments seeking to fund SSPs through federal grant money. The guidance states that health departments are now able to use federal funding to create or enhance SSPs to help prevent the spread of HIV and viral hepatitis. It is important to note that while federal funds can be used for a large array of services, they cannot be used to purchase sterile needles or syringes.

HHS will require that health departments consult with the Centers for Disease Control and Prevention (CDC) to determine whether there is a need for SSPs in their jurisdiction. Once consulted, CDC will decide whether health departments are eligible to apply for SSP funding from their respective federal agencies.

Read the full guidance document here.

CMS finalizes rule dealing with mental health and substance use disorder parity for Medicaid and CHIP
The Centers for Medicare & Medicaid Services (CMS) have announced the finalization of a rule strengthening mental health and substance use disorder parity for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries. The rule was released in conjunction with President Obama’s visit to the National Rx Drug Abuse and Heroin Summit in Atlanta. The rule intends to expand access to evidence based treatment by providing States flexibility in managed care delivery mechanisms while requiring Medicaid beneficiaries are able to access mental health and substance use disorder benefits in a similar way to other medical benefits. Plans are required to provide information on mental health and substance use disorder benefits, including determination of medical necessity criteria, under the new rule. States must now disclose the rationale behind any denial of reimbursement for mental health and substance use disorder benefit claims. The final rule will be published in the Federal Register on March 30, 2016.

View the final rule here.