Around the Agencies

• SAMHSA releases FY 2016 grant opportunities forecast
• CDC draft opioid prescribing guideline available for public comment
• CMS releases instructional videos on ICD-10 coding
• CMS finds that more than 1 million new consumers have signed up through HealthCare.gov
• CMS updates Hospital and Physician Compare websites
• CMS releases results of FY 2016 Hospital-Acquired Condition Reduction Program
• CMS releases 2016 updates to Child and Adult Core Health Care Quality Measurement, including measure of high dosage opioid use in persons without cancer

In the News

• White House announces community forums on opioid use disorders

News from NASADAD

• NASADAD presents on law enforcement & opioid issues to the National Conference on State Legislatures
• NASADAD attends briefing on healthcare for incarcerated individuals reentering society
• NASADAD attends conference on The Excellence Act and criminal justice reform

Around the Agencies

SAMHSA releases advanced notice of FY 2016 grant opportunities forecast
The Substance Abuse and Mental Health Services Administration (SAMHSA) released an advanced notice of FY 2016 grant opportunities last week. The notice will eventually be posted to the SAMSHA website. The forecast includes many grant funding opportunities provided by the Center for Substance Abuse Treatment (CSAT), the Center for Substance Abuse Prevention (CSAP), and the Center for Mental Health Services (CMHS)

CDC draft opioid prescribing guideline available for public comment
The Centers for Disease Control and Prevention (CDC) is developing an opioid prescribing guideline to help primary care providers offer safer, more effective care for patients with chronic pain while reducing misuse, abuse, and overdose from these drugs. The guideline will provide recommendations to primary care providers about the appropriate prescribing of opioid pain medications to improve pain management and patient safety. Recommendations focus on the use of opioids in treating chronic pain. The public comment period opened December 14^th and closes January 13^th.

To review and comment, please visit: www.Regulations.gov and enter the docket number CDC-2015-0112.

CMS releases instructional videos on ICD-10 coding
The Centers for Medicare and Medicaid Services (CMS) released an instructional video on ICD-10 coding basics last week. The video features Nelly Leon-Chisen, Director of Coding and Classification at the American Hospital Association (AHA), and Sue Bowman, Senior Director of Coding Policy and Compliance at the American Health Information Management Association. Both speakers discuss several examples of how to properly utilize ICD-10 codes, including a review of valid versus invalid codes. ICD-10 code usage was made mandatory on October 1^st following the implementation of a final rule.

Access additional ICD-10 implementation resources here.

CMS finds that more than 1 million new consumers have signed up through HealthCare.gov
The Centers for Medicare  and Medicaid Services (CMS) released the most recent iteration of the open enrollment snapshot last week, finding that more than 1 million new consumers have signed up for healthcare through HealthCare.gov. The snapshot further states that 1.8 million individuals have returned to HealthCare.gov to renew healthcare coverage during the same period. CMS reports that 2.84 million individuals have made plan selections since open enrollment began on November 1^st. Open enrollment concludes on December 15^th.

CMS updates Hospital and Physician Compare websites
The Centers for Medicare and Medicaid Services (CMS) updated the Hospital and Physician Compare websites last week. The websites provide performance data on hospitals and providers for consumers. The Physician Compare website now includes performance scores for preventive care, diabetes, cardiovascular care, and patient safety for over 275 group practices, including data from Medicare’s Physician Quality Reporting System (PQRS). The Hospital Compare website now includes data from the Inpatient Quality Reporting (IQR) program on safe surgery practices.

CMS releases results of FY 2016 Hospital-Acquired Condition Reduction Program
The Centers for Medicare and Medicaid Services (CMS) released the results of the FY 2016 Hospital-Acquired Condition (HAC) Reduction Program last week. The results found that 758 out of 3,308 hospitals monitored under the HAC program were in the worst performing quartile. These poor performers will be subject to a one percent payment reduction for Medicaid charges occurring between October 1, 2015 and September 30, 2016. CMS estimates that $364 million in savings occurred as a result of the program.

CMS releases 2016 updates to Child and Adult Core Health Care Quality Measurement, including measure of high dosage opioid use in persons without cancer
The Centers for Medicare and Medicaid Services (CMS) and Center for Medicaid and Children’s Health Insurance Program (CHIP) Services (CMCS) released the 2016 updates to the Child and Adult Core Health Care Quality Measurement last week, including a new measure tracking “use of opioids from multiple providers at high dosages in persons without cancer” to the Adult Core Set. The tracking of high dosages of opioids will allow CMCS and States to better track quality of care for adults with substance use disorders.

In the News

White House announces community forums on opioid use disorders
The White House announced that the Office of National Drug Control Policy (ONDCP) Director, Michael Botticelli, will hold several community forums across the country on evidence-based policies to prevent and treat prescription and heroin use disorders this past week. The announcement followed news that opioid overdose deaths rose significantly between 2013 and 2014, with prescription opioid-related overdoses increasing 16 percent to 18,893 total deaths in 2014. The increase is partially attributed to the rise of fentanyl and other synthetic opioids. Heroin-related overdose deaths increased 28 percent to 10,574 total deaths in 2014. The first community forum hosted by ONDCP will be held on Oklahoma on December 16, and will be followed by forums in Connecticut and several other States early next year.

News from NASADAD

NASADAD presents on law enforcement & opioid issues to the National Conference on State Legislatures
On December 10^th, Rob Morrison presented at the National Conference of State Legislatures (NCSL) Capitol Forum on criminal justice and addiction policy. He presented on a panel in the NCSL Law, Criminal Justice & Public Safety Committee Track, along with Rep. Eric K. Hutchings of the Utah House of Representatives, and Mary Lou Leary of the Office of National Drug Control Policy (ONDCP). In the presentation, Mr. Morrison highlighted law enforcement & opioid issues, medication-assisted treatment (MAT), and Drug, Family, and Veterans Courts in the States. View the presentation slides here.

NASADAD attends briefing on healthcare for incarcerated individuals reentering society
Brian Denten, Public Policy Intern, attended the briefing hosted by the Alliance for Health Reform on Friday, December 11^th. The briefing included panelists involved in researching the healthcare needs of incarcerated individuals reentering society after the conclusion of their sentence. Healthcare costs within the criminal justice system have substantially increased over the past ten years, growing from 10% of criminal justice expenditures in 2001 to 20% in 2011. Speakers highlighted ongoing efforts at the State level to enroll incarcerated individuals into Medicaid and other healthcare plans, focusing on the successes of Ohio’s pre-release enrollment program. Strong stakeholder partnerships and cultural competency were stressed as key factors in successful program implementation.

Panelists:

• Matt McKillop; The Pew Charitable Trusts
• Kara Miller; Ohio Department of Medicaid
• Saroya Friedman-Gonzalez; The National Urban League

NASADAD attends conference on The Excellence Act and criminal justice reform
Brian Denten, Public Policy Intern, attended the conference hosted by the Community Oriented Correctional Health Services (COCHS) and the National Council for Behavioral Health on Tuesday, December 8^th. The conference featured several panels discussing the intersections between the criminal justice system, mental health, and substance use disorders. Speakers stressed the wide health disparities experienced by minorities both inside and outside the criminal justice system, and suggested increased investment in certified community behavioral health clinics (CCBHCs) as a possible response. Justice-involved individuals experience higher rates of illnesses including hypertension, hepatitis, and mental and substance use disorders compared to the general population.

CCBHCs are clinics designed for individuals experiencing serious mental health and substance use disorders, providing evidence-based treatment, peer support services, and 24/7 crisis response to those in need. CCBHCs were created through the provisions in the Protecting Access to Medicare Act (H.R. 4302) referred to as the Excellence in Mental Health Act (The Excellence Act). The Excellence Act initially designed a CCBHC demonstration grant program for a total of eight States. The demonstration grants provide two years of funding for the eight demonstration programs.

Panelists:

• Steven Rosenberg; President, Community Oriented Correctional Health Services
• Linda Rosenberg; MSW, President and Chief Executive Officer, National Council for Behavioral Health
• Senator Debbie Stabenow (D-MI); Co-Sponsor of the Excellence Act (S. 264)
• Jeff Richardson; Chief Executive Officer, Mosaic Group; Second Vice Chair, Board of Directors, National Council for Behavioral Health
• Lisa Puglisi; MD, MAS, Assistant Professor, Yale School of Medicine
• Gary Puckrein; PhD, Chief Executive Officer, National Minority Quality Forum
• Malvise A. Scott; Senior Vice President for Partnership and Resource Development, National Association of Community Health Centers
• Judith Solomon; JD, Vice President for Health Policy, The Center on Budget and Policy Priorities
• Kana Enomoto; Acting Administrator Substance Abuse and Mental Health Services Administration
• Dan Mistak; JD, MS, MA, General Counsel, Community Oriented Correctional Health Services
• Robert Davison; MA, LPC, Executive Director, Mental Health Association of Essex County, New Jersey
• Jean Peters Baker; JD, Prosecutor, Jackson County, Missouri
• Captain Mark Neuman; Administrative Commander at Kent County Correctional Facility, Kent County, Michigan Sheriff’s Department
• Carson Fox; JD, Chief Executive Officer, National Association of Drug Court Professionals
• Dina Passman; MPH, Public Health Advisor at U.S. Department of Health and Human Services
• Karen Chrisman; JD, MA, CHP, CSCS, Staff Attorney, Governor’s Office of Electronic Health Information for the State of Kentucky
• Kamala Mallik-Kane; MPH, Research Associate at the Justice Policy Enter, The Urban Institute

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

• Missouri health organizations endorse new opioid prescribing recommendations
• Ohio announces $2.5 million in grant funding for recovery housing

Around the Agencies

• SAMHSA names Peggie Rice as new Legislative Director
• AHRQ reports 17 percent decline in hospital acquired conditions since 2010
• NIDA announces 2016 National Drug and Alcohol Facts Week
• CMS reports 5.3% growth in healthcare spending during 2014

In the News

• NGA announces Scott Pattison as new Executive Director and Chief Executive Officer
• White House releases updated federal HIV/AIDS strategy
• National Center on Addiction and Substance Abuse releases new guide on best policies for reducing substance use disorders at the State and federal level

Upcoming Events

• SAMHSA announces new quarterly Health IT Webinar series
• SAMHSA announces webinar on increasing health insurance marketplace open enrollment

News from the States

Missouri health organizations endorse new opioid prescribing recommendations
A group of Missouri health providers announced a a new policy recommendation on opioid use. The strategy for reduced misuse and abuse of opioids includes a comprehensive pain assessment prior to prescribing opioids, among nine other suggestions. The sponsoring organizations include the Missouri Hospital Association, the Missouri Academy of Family Physicians, the Missouri Association of Osteopathic Physicians and Surgeons, the Missouri College of Emergency Physicians, the Missouri Dental Association, and the Missouri State Medical Association.

Ohio announces $2.5 million in grant funding for recovery housing
Last week the Ohio Department of Mental Health and Addiction (OhioMHAS) announced $2.5 million in grants for the improvement and expansion of recovery housing for Ohio residents with substance use disorders. The grants will support 25 projects in 18 counties in an effort to add 200 new beds to Ohio’s recovery housing system. Tracy Plouck, OhioMHAS Director and NASADAD member, outlined the importance of recovery housing stating, “Recovery housing provides a safe, supportive environment where a person in recovery can adjust to sobriety, rebuild shattered relationships, obtain employment and seek permanent housing.” Ms. Plouck noted that funding was prioritized for high-need communities that have previously not received State funding for recovery housing.

Around the Agencies

SAMHSA names Peggie Rice as new Legislative Director
The Substance Abuse and Mental Health Services Administration (SAMHSA) selected Peggie Rice as its new Legislative Director late last month. The Legislative Director position serves as SAMHSA’s primary Congressional liaison and works with constituency organizations to improve the country’s health care systems. Ms. Rice joins SAMHSA following years of experience working with Congress. She previously worked as Legislative Analyst with the Office of the Assistant Secretary for Legislation at the Department of Health and Human Services (HHS), and most recently served as a health policy analyst at the Centers for Disease Control and Prevention’s (CDC) Washington, D.C. office. SAMHSA also announced the hiring of Brian Payne as a new Legislative Analyst.

AHRQ reports 17 percent decline in hospital acquired conditions since 2010
A new Agency for Healthcare Research and Quality (AHRQ) report indicates that a 17 percent decline in hospital-acquired conditions (HACs) occurred between 2010 and 2014. A total of 2.1 million fewer HACs were experienced by patients, saving approximately 87,000 patient lives and $19.8 billion in health care costs. The cause of the decline in HACs remains unclear, yet AHRQ asserts that increases in hospital safety as a result of Medicare payment incentives may be partially responsible.

NIDA announces 2016 National Drug and Alcohol Facts Week
The National Institute on Drug Abuse (NIDA) announced the dates for the 2016 National Drug and Alcohol Facts Week this past week. The week-long observance will be held from January 25-31, 2016. NIDA encourages organizations to plan and promote educational events or activities for teens during the week. NIDA will offer support for registered events, including free science-based materials and activity ideas.

CMS reports 5.3% growth in healthcare spending during 2014
The Centers for Medicare & Medicaid Services (CMS) reports that healthcare spending in the United States grew 5.3% during 2014. CMS attributes the growth to major coverage expansions generated by the Affordable Care Act, especially for Medicaid and private insurance populations. New Hepatitis C drugs drove a 12.2% increase in prescription drug spending. Medicaid spending increased 11% in 2014, yet Medicaid spending per enrollee decreased 2%. The report also notes that overall hospital care spending increased 4.1% in 2014, yet hospital prices increased at a slower rate. Federal government healthcare spending grew more quickly in 2014 than other healthcare spending sources, “creating a 2 percentage-point increase in total healthcare spending between 2013 and 2014.”

In the News

NGA announces Scott Pattison as new Executive Director and Chief Executive Officer
The National Governors Association (NGA) announced Scott Pattison as the new NGA Executive Director and Chief Executive Officer last month. Mr. Pattison previously worked as the Executive Director of the National Association of State Budget Officers (NASBO) since 2001, and has also served within the Virginia Department of Planning and Budget and in the office of the Virginia Attorney General. Mr. Pattison began his new position at the NGA on December 1^st.

White House releases updated federal HIV/AIDS strategy
The White House released an updated federal plan for addressing HIV/AIDS last week. The plan includes four main goals: 1) reducing new HIV infections through increased prevention efforts and evidence-based approaches, 2) increasing access to care and improving health outcomes for people living with HIV, 3) reducing HIV-related disparities and health inequities, and 4) achieving a more coordinated national response to the HIV epidemic. The plan sets new short- and long-term goals for federal agencies to meet within the next three to five years.

National Center on Addiction and Substance Abuse releases new guide on best policies for reducing substance use disorders at the State and federal levels
The National Center on Addiction and Substance Abuse released a new guide last week. The Guide for Policymakers: Prevention, Early Intervention and Treatment of Risky Substance Use and Addiction outlines best policies and practices for dealing with substance use disorders at the State and federal levels. The guide is the result of more than 20 years of work at the National Center on Addiction and Substance Use, and contains resources and references for individuals working within the substance use disorder field in both the public and private sectors. Contemporary topics such as marijuana legalization, e-cigarettes, and medication-assisted treatment are discussed in depth.

Upcoming Events

SAMHSA announces new quarterly Health IT Webinar series
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced a new series of webinars, the first of which will be held on Tuesday, December 8^th from 2-3PM EST. The series will partner with the Office of the National Coordinator for Health Information Technology (ONC) to discuss new developments in health information technology. The first installment will concentrate on the integration of substance use disorders and mental health into health information exchanges (HIE), and will feature several speakers from SAMHSA, ONC, the Colorado Regional Health Information Organization (CORHIO) and the Quality Health Network (QHN) of Colorado.

SAMHSA announces webinar on increasing health insurance marketplace open enrollment
The Substance Abuse and Mental Health Services Administration (SAMHA) announced a new webinar focusing on increasing health insurance marketplace enrollment for States targeting substance use disorder prevention, treatment, and recovery. SAMHSA has partnered with the Office of National Drug Control Policy (ONDCP) to present the webinar, and will discuss strategies for increasing health insurance enrollment for individuals with substance use disorders. Kana Enomoto, Acting Administrator of SAMHSA; Michael Botticelli, Director of ONDCP; and Tom Hill, Acting Director of CSAT will speak during the webinar. The webinar will be held on Tuesday, December 8^th from 2-3:30PM EST.

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 releases analysis finding increasing similarities between male and female alcohol consumption
• SAMHSA appoints Amy Haseltine as Acting Principal Deputy Administrator
• SAMHSA announces FY 2016 grant program focusing on treatment for adolescent and transition aged youth
• CSAP announces e-learning course on prevention set-aside of SAPT Block Grant
• NREPP accepting submissions of substance use and mental health interventions

In the News

• White House seeks nominations for Champions of Change program highlighting substance use disorder advocates
• NAIC approves model State-level legislation for ensuring health insurance provider network adequacy
• Kaiser Family Foundation survey looks at effects of prescription painkiller abuse

Around the Agencies

NIAAA releases analysis finding increasing similarities between male and female alcohol consumption
The National Institute on Alcohol Abuse and Alcoholism (NIAAA) released a study examining similarities between male and female alcohol consumption last week. The study examined data from national surveys conducted between 2002 and 2013, finding that differences between male and female alcohol consumption have decreased over the past decade. NIAAA found that alcohol consumption in the past 30 days increased from 44.9 percent to 48.3 percent among females and decreased from 57.4 percent to 56.1 percent among males. The average number of drinking days in the past month experienced a similar pattern, with female drinking days increasing from 6.8 to 7.3 days and male drinking days decreasing from 9.9 to 9.5 days. NIAAA recommends additional studies to determine the causes behind the changing patterns.

SAMHSA appoints Amy Haseltine as Acting Principal Deputy Administrator
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced the appointment of Amy Haseltine as Acting Principal Administrator, effective December 13, 2015. Ms. Haseltine will oversee the management of SAMHSA’s budget and grant management in her new position. Ms. Haseltine previously worked for the Department of Health and Human Services (HHS) in the Office of the Assistant Secretary for Financial Resources (ASFR), and currently serves as the Deputy Assistant Secretary for HHS’s Office of Grants and Acquisition Policy and Accountability (OGAPA) where she oversees policies and procedures related to grant programs.

SAMHSA announces FY 2016 grant program focusing on treatment for adolescent and transitional aged youth
The Substance Abuse and Mental Health Services Administration (SAMHSA) announced the opening of applications for the FY 2016 Cooperative Agreements for Adolescent and Transitional Aged Youth Treatment Implementation this past week. The grant program will offer two awards of up to $800,000 a year for up to three years to eligible State governments and tribal organizations. Grant funds should be used to improve the treatment of substance use and co-occurring mental health disorders for adolescent and transitional aged youth through the implementation of evidence-based treatment models and recovery support services. Applications are due by Tuesday, January 26, 2016.

CSAP announces e-learning course on prevention set-aside of SAPT Block Grant
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Center for Substance Abuse Prevention (CSAP) has created an e-learning course for State agencies on the primary prevention component of the Substance Abuse Prevention and Treatment (SAPT) Block Grant. The goal of the course is to provide participants with the basic knowledge they will need to successfully apply for and plan for the use of the primary prevention set-aside of the SAPT Block Grant.

The course includes nine modules that are broken down into three sections. The modules include examples from the field and opportunities for viewers to test their knowledge of grant requirements. The first three modules provide an overview of the statutory and regulatory requirements of the SAPT Block Grant and, in particular, the primary prevention set-aside. The second three modules provide further detail about the primary prevention programmatic requirements. Finally, the last three modules review primary prevention performance and expenditure reporting.

NREPP accepting submissions of substance use and mental health interventions
The National Registry of Evidence-Based Programs and Practices (NREPP), developed by the Substance Abuse and Mental Health Services Administration (SAMHSA), is accepting submissions of substance use and mental health interventions until January 26^th, 2016. NREPP is a searchable online database of more than 350 mental health and substance use interventions. The minimum requirements for submission are listed on the SAMHSA website.

In the News

White House seeks nominations for Champions of Change program highlighting substance use disorder advocates
The White House continues to seek nominations for its Champions of Change program highlighting substance use disorder advocates. The Champions of Change Program aims to recognize friends, family, colleagues, and advocates of individuals with substance use disorders working to improve access to treatment and recovery. The selected Champions of Change will be honored during a Spring 2016 event. The Obama Administration requires that all nominations be submitted by midnight on Sunday, December 19^th.

NAIC approves model State-level legislation for ensuring health insurance provider network adequacy
The National Association of Insurance Commissioners (NAIC) approved a model State-level legislation for ensuring health insurance provider network adequacy last week. The approval follows an 18-month examination of and engagement with health plans, providers, and consumer advocates working within healthcare. The model law aims to increase State regulation and oversight of provider networks in an effort to increase health insurance plan transparency. One portion of the model legislation creates a “structured mediation process” for reconciling large costs unexpectedly incurred by patients using out-of-network physician and specialists. New definitions for tiered networks and new requirements for provider directories are also included in the draft.

Kaiser Family Foundation survey looks at effects of prescription painkiller abuse
A recent Kaiser Family Foundation survey found that nearly four in 10 people know someone who has been addicted to prescription painkillers, including 25 percent who say it was a close friend or family member and 2 percent who acknowledge their own substance use disorder. According to the survey, 6 percent said they had taken a prescription painkiller that was not prescribed to them, 16 percent reported knowing a person who died from an overdose of pain medication, and 9 percent said they had lost a relative or good friend to an overdose. Large majorities say a number of efforts would be effective in reducing painkiller abuse, including treatment programs, monitoring doctors’ prescribing habits, public education programs, training doctors, and encouraging people to appropriately dispose of leftover medication.

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

• GAO issues report on group home and institution care for foster children
• FDA approves nasal spray formulation of naloxone
• CMS announces more than 1.08 million people have selected health plans through federal exchanges since the beginning of open enrollment this month

In the News

• New State PDMP profile reports posted on TTAC website
• 2016 Health Insurance Marketplace opens enrollment period
• National Academy of Science study finds increasing mortality of middle-aged white men and women associated with drug and alcohol poisonings
• Congresswoman Suzan DelBene organizes bipartisan letter in support of NIH funding
• UnitedHealthcare warns of possible exit from ACA exchanges within next two years

Upcoming Events

• SAMHSA announces webinar discussing behavioral health outreach to American Indian and Alaska Native veterans

Around the Agencies

GAO issues report on group home and institution care for foster children
The Government Accountability Office (GAO) recently released a report on the usage of group home or institutional care for foster children. The report examined the prevalence of group home or institutional foster care, commonly referred to as congregate care, throughout the country. Many States have worked towards placing foster children in family-based settings instead of congregate care over the past decade. The GAO report examined eight States’ foster care systems, finding that usage of congregate care declined 47 percent from FY 2004 to FY 2013 using data available from the Department of Health and Human Services (HHS). The report notes that the States examined still retained many children within the congregate care system, ranging from 5 percent to 34 percent of foster children within each respective State in FY 2013. The GAO recommends that HHS continue to support State efforts to reduce congregate care.

FDA approves nasal spray formulation of naloxone
The U.S. Food and Drug Administration (FDA) announced its approval of intranasal naloxone last week. Intranasal naloxone is a new formulation of naloxone that administers the medication via a nasal spray. First responders and primary caregivers have long suggested that intranasal naloxone presents a preferable alternative to the usage of syringes or auto-injectors, as nasal sprays are easier to deliver to overdose patients and carry a lower risk of contamination. The FDA’s approval follows a public-private partnership organized by the National Institute on Drug Abuse (NIDA) to speed development of and conduct clinical trials for intranasal naloxone. Clinical trials found the nasal spray as or more effective as traditional naloxone, with the FDA eventually fast-tracking its review for the nasal spray.

CMS announces more than 1.08 million people have selected health plans through federal exchanges since the beginning of open enrollment this month
The Centers for Medicare and Medicaid Services (CMS) announced that more than 1.08 million people have signed up for healthcare coverage through the federal exchanges since the beginning of open enrollment earlier this month. CMS made the announcement as part of a weekly “Open Enrollment Snapshot” released at the end of each week during open enrollment. These snapshots provide real-time estimates of plan selections, call center activity, and traffic to HealthCare.gov. CMS notes that two-thirds of plan selections were made by individuals renewing coverage or selecting a new plan, with one-third of selections made by individuals without current marketplace coverage.

In the News

New State PDMP profile reports posted on TTAC website
New State prescription drug monitoring program (PDMP) reports were recently posted on the PDMP Training and Technical Assistance Center (TTAC) website. The new reports were compiled using data from TTAC surveys and contact with PDMP administrators, and contain updated contact information, technological capabilities, policies and procedures, available reports, and authorized requestors for each respective PDMP. TTAC also created several new maps and tables designed to illustrate PDMP processes throughout the country.

2016 Health Insurance Marketplace opens enrollment period
The 2016 enrollment period for health insurance began on November 1^st. Individuals seeking insurance may now visit Healthcare.gov to apply for a 2016 plan, renew their current plan, or pick a new plan through the Health Insurance Marketplace.

National Academy of Science study finds increasing mortality of middle-aged white men and women associated with drug and alcohol poisonings
The National Academy of Science published a study finding that the increasing mortality of middle-aged white men and women is associated with drug and alcohol use. The study suggests that increased prescribing of opioid painkillers beginning in the late 1990s led to significant misuse and mortality from 1999 to 200, finding that “for every prescription painkiller death in 2008, there were 10 treatment admissions for abuse, 32 emergency department visits for misuse or abuse, 130 people who were abusers or dependent, and 825 nonmedical users,” according to Centers for Disease Control and Prevention (CDC) data. The National Academy of Science notes that more stringent regulation of prescription painkillers may have pushed individuals with substance use disorders to use heroin, further increasing to mortality.

Congresswoman Suzan DelBene organizes bipartisan letter in support of NIH funding
Congresswoman Suzan DelBene (D-WA) organized and submitted a bipartisan letter in support of increased funding for the National Institutes of Health (NIH) last week. The letter asks the House Appropriations Committee to provide at least $32 billion in funding for the NIH in any forthcoming appropriations bills, and outlines the importance of the NIH in researching diseases such as Alzheimer’s and cancer. Supporters of increased NIH funding assert that federal appropriations for NIH research has stagnated over the past decade, with the agency’s purchasing power decreasing more than 20 percent since 2013. The current House bill (H.R. 3020) allocates $31.2 billion for the NIH in FY 2016, compared to $32 billion in the Senate appropriations bill. One hundred and forty-five members of the House signed on to the letter in support.

UnitedHealthcare warns of possible exit from ACA exchanges within next two years
UnitedHealthcare warned of its possible exit from healthcare exchanges established by the Affordable Care Act (ACA) during a shareholder meeting last week. Stephen Hemsley, UnitedHealthcare’s CEO, stated that the recent closures of healthcare co-ops may increase risks and costs for the company. UnitedHealthcare’s projects its fourth-quarter revenue will be $425 million less than expected, and plans to eliminate 2016 marketing plans in response. The company will continue to monitor the insurance exchange marketplace throughout 2016 to determine its participation in 2017 and beyond.

Upcoming Events

SAMHSA announces webinar discussing outreach to American Indian and Alaska Native veterans
The Substance Abuse and Mental Health Services Administration (SAMHSA) recently announced a new webinar discussing outreach to American Indian and Alaska Native veterans. The webinar will focus on the need for increased cultural competency among mental health and substance use disorder providers when dealing with these communities, including better knowledge of tribal health practices and increased federal and State coordination with tribal community health programs. Best practices for enhancing outreach and increasing access to treatment will also be examined. The webinar will be held on Friday, December 11^th from 3-4 PM EST.

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

• SAMHSA announces several leadership changes, including Tom Hill as the new Acting Director of CSAT
• SAMHSA releases new pocket guide on medications for alcohol use disorders
• CMS sends letter to hepatitis C medication manufacturers seeking input on cost reductions for State Medicaid programs

In the News

• White House announces new actions promoting rehabilitation and reintegration of formerly-incarcerated individuals
• White House seeks nominations for Champions of Change program highlighting substance use disorder advocates
• Mental Health Liaison Group writes letter advocating for sequestration relief for Labor-HHS appropriations bill

News from the States

• President Obama visits New Jersey rehabilitation facility, speaks on importance of criminal justice reform
• Hawaii announces Edward Mersereau as the new Division Chief of Hawaii’s Alcohol and Drug Abuse Division

News from NASADAD

• NASADAD attends briefing on high-need, high-cost behavioral health patients
• NASADAD attends briefing on patient review and restriction programs

Around the Agencies

SAMHSA announces several leadership changes, including Tom Hill as the new Acting Director of CSAT
Last week the Substance Abuse and Mental Health Services Administration (SAMHSA) announced several leadership changes, including Tom Hill’s appointment as the new Acting Director for the Center for Substance Abuse Treatment (CSAT). Mr. Hill previously worked within the recovery community as an advocate for individuals, families, and communities struggling with substance use disorders. Mr. Hill has worked with SAMHSA on many programs, and has been in long-term recovery for over twenty years. Daryl Kade, CSAT’s previous Director, has been appointed as Acting Director of the Center for Behavioral Health Statistics and Quality (CBHSQ). Rear Admiral Peter Delany, CBHSQ’s previous Director, will move on to serve as Special Advisor to the Director of the Office of National Drug Control Policy, effective November 16^th.

SAMHSA releases new pocket guide on medications for alcohol use disorders
The Substance Abuse and Mental Health Services Administration (SAMHSA) released a new pocket guide on medications for treating alcohol use disorders last week. The pocket guide provides a checklist for prescribing medications, a list of approved medications for treating alcohol use disorders, and guidance regarding standard drink sizes limits.

CMS sends letter to hepatitis C medication manufacturers seeking input on cost reductions for State Medicaid programs
The Centers for Medicare & Medicaid Services (CMS) sent a letter to hepatitis C (HCV) medication manufacturers seeking input on cost reductions for State Medicaid programs this past week. The letter asks manufacturers to detail their arrangements with commercial health insurance plans for providing HCV medication.  CMS requests that manufacturers describe whether similar arrangements are offered to State Medicaid programs, and any potential barriers to implementing programs expanding access to HCV medication in the future. CMS notes that manufacturers have an important role to play in ensuring the affordability of HCV medication for Medicaid patients.

In the News

White House announces new actions promoting rehabilitation and reintegration of formerly-incarcerated individuals
The White House announced several measures promoting the rehabilitation and reintegration of formerly-incarcerated individuals last week. The efforts include a new grant program within the Department of Education awarding up to $8 million to 9 communities. The grant program will support rehabilitation and reintegration, clarify “one-strike” policies, promote efforts to “ban the box” on job applications inquiring about candidates’ criminal histories, and expand job training for individuals with criminal records. Other measures include an Office of Juvenile Justice and Delinquency Prevention and Department of Housing and Urban Development grant program aiding public housing residents under the age of 25 in expunging or sealing criminal records in accordance with State laws. President Obama also called on Congress to pass criminal justice reform legislation such as the pending bipartisan Sentencing Reform and Corrections Act of 2015.

White House seeks nominations for Champions of Change program highlighting substance use disorder advocates
The White House announced the beginning of the nomination process for its Champions of Change program highlighting substance use disorder advocates last week. The Champions of Change program aims to highlight friends, family, colleagues, and advocates of individuals with substance use disorders working to improve access to treatment and recovery. The selected Champions of Change will be honored during a Spring 2016 event. The Obama Administration requests that all nominations be submitted by midnight on Sunday, December 19^th.

NASADAD signs on to Mental Health Liaison Group letter on sequestration relief for Labor-HHS appropriations bill
The Mental Health Liaison Group (MHLG), a coalition of non-profit organizations working to represent mental and behavioral healthcare, submitted a letter to the Senate and House Labor, Health and Human Services, and Education Subcommittee on Appropriations, regarding sequestration relief. The Bipartisan Budget Act of 2015 lifted spending caps imposed on budgets as part of sequestration. Original FY 2016 budget allocations determined prior to the Bipartisan Budget Act’s passage cut Labor-HHS programs by nearly $4 billion. These proposed cuts include a $50 million cut to the Substance Abuse Prevention and Treatment (SAPT) Block Grant and a $77 million cut to the Center for Substance Abuse Treatment (CSAT). The MHLG requests that these funding decisions be reconsidered in order to adequately fund mental health and substance use disorder treatment priorities.

News from the States

President Obama visits New Jersey rehabilitation facility, speaks on importance of criminal justice reform
President Obama visited a residential drug rehabilitation facility in Newark, New Jersey last week to speak about the importance of criminal justice reform and reentry programs. The President toured Integrity House, a State-funded residential treatment center, and praised their work in aiding individuals with substance use disorders. President Obama stressed the importance of reentry programs in helping individuals with substance use disorders and criminal backgrounds find employment, and announced that the federal Office of Personnel Management (OPM) would now wait until later in the hiring process to ask candidates about potential criminal histories.

Hawaii announces Edward Mersereau as the new Division Chief of Hawaii’s Alcohol and Drug Abuse Division
Hawaii announced Edward Mersereau as the new Division Chief of Hawaii’s Alcohol and Drug Abuse Division this past week. Mr. Mersereau is a Licensed Clinical Social Worker (LCSW) and Hawaii State Certified Substance Abuse Counselor (CSAC), and attained his Masters of Social Work degree from the University of Hawaii. Mr. Mersereau has worked as an adjunct instructor for the University of Hawaii School of Social Work for the past several years, in addition to over 25 years of behavioral health clinical experience. Mr. Mersereau is a committed advocate for integrated healthcare solutions, and looks forward to serving in his new position.

News from NASADAD

NASADAD attends briefing on high-need, high-cost behavioral health patients
Brian Denten, Public Policy Intern, attended the briefing hosted by the Alliance for Health Reform on Friday, October 30^th. The briefing included several panelists working within the mental health community on ways to address patients with high needs and costs. Speakers noted that the sickest 10 percent of Americans accounted for 65 percent of healthcare expenditures in 2011, and that savings can be achieved by more efficiently integrating primary and mental healthcare. High-cost and high-need patients are diagnosed with mental health disorders at higher rates than the average patient, making primary and behavioral healthcare integration essential in managing costs. Panelists stressed that behavioral health is a critical component of comprehensive primary care, and that stigma surrounding mental health disorders may decrease with full primary care integration.

Panelists:

• Jose Figueroa; Harvard University T.H. Chan School of Public Health
• Howard Goldman; University of Maryland School of Medicine
• Jeff Richardson; Mosaic Community Services
• Benjamin Miller; Eugene S. Farley, Jr. Health Policy Center, Department of Family Medicine, University of Colorado School of Medicine

NASADAD attends briefing on patient review and restriction programs
Brian Denten, Public Policy Intern, attended the briefing hosted by The Pew Charitable Trusts on Tuesday, November 3^rd. The briefing focused on the expansion of patient review and restriction (PRR) programs to Medicare Part D beneficiaries in an effort to curb the growing prevalence of prescription drug abuse disorders. PRR programs are used by State Medicaid programs to restrict a patient’s access to prescription drugs if they are suspected of misuse without eliminating the patient’s Medicaid benefits altogether. PRR-type programs are currently used in 46 States and Washington, DC, but are not used within Medicare Part D. 9 million Medicare Part D beneficiaries received prescription opioids for chronic pain in 2011, with 225,000 of these patients taking unsafe doses for over 90 consecutive days. Of these patients, “over 28 percent obtained prescriptions from four or more prescribers, and almost 18 percent used four or more pharmacies to obtain prescription opioid drugs.” The expansion of the Center for Medicare & Medicaid Services’ Overutilization Monitoring System (OMS) Medicare Part D beneficiaries would provide prescribers with additional resources for identifying at-risk patients. Panelists stressed the importance of prescription drug monitoring programs (PDMPs) similar to PRRs in improving prescriber practices and reducing rates of prescription drug misuse.

Panelists:

• Michael Botticelli; Director, National Drug Control Policy, Executive Office of the President
• Dr. Tom Frieden; Director, Centers for Disease Control and Prevention
• Senator Rob Portman (R-OH)

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

• NASADAD releases section-by-section analyses of Helping Families in Mental Health Crisis Act and Mental Health Reform Act
• Steve Brazill announced as new NTN in Kansas
• Sarah Mariana announced as new Washington State NPN;  Michael Langer remains as NTN
• NASADAD attends Congressional briefing on the decriminalization of individuals with mental illness
• NASADAD attends Friends of NIAAA briefing on College AIM

News from the States

• New report finds more Alaska teenagers using e-cigarettes than regular cigarettes
• S. District Court ruling highlights State and federal disagreement over medical marijuana
• Ohio announces investment of up to $1.5 million a year into Ohio Automated Rx Reporting System

In the News

• NAATP releases statement on MAT for substance use disorders
• NCADD announces launch of new website

Upcoming Events

• CSH and National Council announce webinar discussing long-term substance use disorder recovery and integrated housing and service solutions

News from NASADAD

NASADAD releases section-by-section analyses of Helping Families in Mental Health Crisis Act and Mental Health Reform Act
Today NASADAD released section-by-section analyses of Rep. Tim Murphy’s (R-PA) Helping Families in Mental Health Crisis Act (H.R. 2646), and Sens. Cassidy (R-LA) and Murphy’s (D-CT) Mental Health Reform Act (S. 1945). The bills both propose a restructuring of the Substance Abuse and Mental Health Services Administration (SAMHSA) by creating a new Assistant Secretary for Mental Health and Substance Use Disorders. Rep. Murphy’s proposed H.R. 2646 will be marked up on November 3^rd and 4^th by the Subcommittee on Health in the House Energy and Commerce Committee.

Steve Brazill announced as new NTN in Kansas
Last week, Steve Brazill was announced as the new NTN representative in Kansas, as previous NTN, Charles Bartlett, announced that he is moving on to a new position. In his new role, Mr. Bartlett’s new duties will include oversight of Consumer Affairs, where he will remain committed to the development of peer support services. Mr. Bartlett will additionally work as the coordinator for forensic services and diversion from the criminal justice system, and as the liaison to the Governor’s Behavioral Health Service Planning Council for coordination and logistics. NASADAD thanks Mr. Bartlett for his contributions to the NTN, and welcomes Mr. Brazill.

Sarah Mariana announced as new Washington State NPN; Michael Langer remains as NTN
Earlier this week, Sarah Mariana was announced as Washington State’s new NPN delegate, effective December 1^st. Ms. Mariana previously led Washington’s Research Conference Program Committee, and has participated in many NPN-related meetings over the past several years. Washington’s previous NPN, Michael Langer, will maintain his role as Washington’s NTN delegate and will work with Ms. Mariana on relevant NPN issues.

NASADAD attends Congressional briefing on the decriminalization of individuals with mental illness

Brian Denten, Public Policy Intern, attended the briefing on Thursday, October 29^th. The briefing heard from a range of mental health and criminal justice professionals on the need for moving mental health treatment out of the criminal justice system and into communities. Once incarcerated, individuals with mental illness spend longer in the criminal justice system than those without mental illness due to safety and health concerns, further exacerbating already existing mental health and substance use disorders. Speakers highlighted the large financial and human costs associated with mental illness in the criminal justice system, as many jails spend up to three times on individuals with mental illness compared to the average prisoner. The briefing concluded with an affirmation of the need for a full continuum of mental healthcare to improve on disjointed mental healthcare delivery and produce better health and societal outcomes.

Speakers:

• Renee Binder, M.D.; Professor and Director of Psychiatry and Law Program, Associate Dean for Academic Affairs at UCSF School of Medicine; President, American Psychiatric Association
• Paton Blough; Mental Health Advocate, NAMI South Carolina State Board Member
• Commissioner Mary Ann Borgeson; Chair, National Association of Counties (NACo) Health Steering Committee
• Sheriff Rich Stanek; Hennepin County Sheriff’s Office
• Robert L. Trestman, M.D. PhD; Professor of Medicine, Psychiatry, and Nursing UConn Health; Executive Director, Correctional Managed Health Care, Interim Director, Center for Public Health and Health Policy

NASADAD attends Friends of NIAAA briefing on College AIM

Robert Morrison and Shalini Wickramatilake attended a Congressional briefing hosted by Friends of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) on the College Alcohol Intervention Matrix, or College AIM. The matrix is a comprehensive and easy-to-use tool to help college staff make informed decisions about evidence-based alcohol interventions. With College AIM, college officials can learn how their current strategies compare to other evidence-based alternatives; find new strategies to consider; and select a combination of approaches that best meets the particular needs of their students and campus.  College officials are in a unique position to improve the health and safety of their students – and they must choose alcohol interventions wisely.

Speakers:

• George F. Koob, Ph.D., Director, National Institute on Alcohol Abuse and Alcoholism, NIH
• Mary Larimer, Ph.D., Director, Center for the Study of Health and Risk Behaviors, University of Washington
• Jonathan Gibralter, Ph.D., President, Wells College, Aurora, NY

News from the States

New report finds more Alaskan teenagers using e-cigarettes than regular cigarettes
A new report released by the Alaska Department of Health and Social Services has found that Alaskan teenagers are using e-cigarettes at higher rates than regular cigarettes. The report was released by Valerie Davidson, commissioner of the Alaska Department of Health and Social Services, at the annual Alaska School Health and Wellness Institute earlier this week.  A Spring 2015 survey conducted as part of the report found that 11 percent of Alaskan high school students reported smoking cigarettes once in the past 30 days compared to 18 percent reporting e-cigarette use in the same time period. Ms. Davidson warned that the variety of e-cigarette flavors appeals to teenagers despite growing evidence that e-cigarettes are as or more harmful than traditional tobacco use. Following the report’s release, a number of advocacy groups – including the AARP, American Lung Association, and the American Heart Association – issued a press release in support of a statewide smoke-free workplace law.

U.S. District Court ruling highlights State and federal disagreement over medical marijuana
A U.S. District Court ruling, issued by Judge Charles R. Breyer in San Francisco, removed a federal injunction against the Marin Alliance for Medical Marijuana this week. Judge Breyer stated that the Justice Department was “defying the will of Congress and improperly intruding on California’s medical marijuana laws” in his decision. The ruling follows four years of legal battles after federal officials closed down the Marin Alliance for Medical Marijuana in 2011. Judge Breyer’s decision is seen as a test of a federal appropriations bill amendment signed by President Obama in 2014 that banned “any expenditure of Justice Department funds to prevent States from implementing laws ‘that authorize the use, distribution and possession of medical marijuana.’”

Ohio announces investment of up to $1.5 million per year into Ohio Automated Rx Reporting System
Ohio’s Governor John Kasich announced an investment of up to $1.5 million per year into Ohio’s prescription drug monitoring program (PDMP) database this past week. The  investment aims to integrate the Ohio Automated Rx Reporting System (OARRS) with electronic medical records and pharmacy information systems throughout the State in an effort to reduce the prevalence of prescription drug diversion and misuse. The investment marks Ohio as the first State to integrate its prescription drug monitoring database Statewide.

In the News

NAATP releases statement on MAT for substance use disorders
The National Association of Addiction Treatment Providers (NAATP) released a statement regarding the use of medication-assisted treatment (MAT) for substance use disorders this week. The statement highlights NAATP’s belief in the importance of evidence-based treatment methods such as MAT in developing a robust continuum of care for individuals with substance use disorders. The NAATP supports “bio-psycho-social-care, including 12-step care and peer driven support” in conjunction with MAT to provide a full spectrum of treatment options.

NCADD announces launch of new website
The National Council on Alcoholism and Drug Dependence (NCADD) announced the launch of its new website this week. The new website compiles a broad array of information about alcoholism and its associated disorders, and connects individuals seeking help with healthcare providers in their local communities. The website further provides a number of recovery stories that highlight successful treatment of alcohol use disorders.

Upcoming Events

CSH and National Council announce webinar discussing long-term substance use disorder recovery and integrated housing and service solutions
CSH: The Source for Housing Solutions and the National Council for Behavioral Health have announced a new webinar discussing long-term substance use disorder recovery and integrated housing and service solutions, to be held on Friday, November 6^th from 1:30 to 2:45 PM EST. The webinar will include presentations from several field experts about innovative ways communities are integrating housing with treatment and recovery support to aid in the long term recovery of individuals with substance use disorders. CSH and the National Council recently released a summary report of their 2014 convening on housing and substance use disorders. The report highlights potential opportunities and challenges surrounding the integration of housing and substance use disorder treatment, and underlines the evidence supporting better access to housing in treating substance use disorders.

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.