Addictions News Now - February 2012

Dear Readers,

On December 16, 2011, the Department of Health and Human Services (HHS) released an informational bulletin presenting its intended regulatory approach on the essential health benefits (EHB) that plans must cover under the Affordable Care Act (ACA). When finalized, this policy will have a significant impact on the services available through both public and private health insurance plans because it establishes the minimum benefits that health plans must cover beginning in 2014.

Rather than define one package at the federal level, the HHS bulletin proposes to leave considerable discretion to the states in crafting their own EHB packages. The four options are: (1) any of the three largest small-group plans in the state; (2) any of the three largest state employee health plans; (3) any of the three largest federal employee health benefits program (FEHBP) options; or (4) the largest insured commercial non-Medicaid HMO plan operating in the state. Last week, the National Council submitted its comments on the HHS proposed approach. These comments express our concern that the December bulletin does not include sufficient protections to ensure adequate access to substance use disorder treatment services. The National Council offered recommendations to HHS on strengthening its EHB guidance by:

• Developing and enforce safeguards to ensure that affording state flexibility for development of EHB plans does not undermine access to care
• Assuring a transparent and inclusive determination process
• Establishing stronger oversight for Parity implementation and adherence
• Requiring chronic disease management to be person-centered and involve interdisciplinary care coordination
• Defining rehabilitation and habilitation benefits so as to explicitly include services to maintain, as well as improve, daily functioning

HHS has said it intends to engage in formal rulemaking to further clarify its guidance on EHBs but has not announced a timeframe when advocates can expect to see a regulation issued. For additional information on the December bulletin and its impact on substance use disorder treatment services, check out the HHS guidance from December 16th. 

The National Council and Hazelden also signed onto the Coalition for Whole Health’s final comments in order to provide additional feedback on the essential health benefits Bulletin to help ensure comprehensive care for Substance Use and Mental Health Disorders. 

As always, we welcome your thoughts and feedback and remind you to check out the National Council’s website, blog, and Hazelden’s website for all the latest news!

Sincerely,

Mohini Venkatesh
Senior Director, Public Policy

Dean Peterson
Director of the Center for Public Advocacy at Hazelden
 

RESOURCES & REMINDERS

National Council’s 42nd Annual Mental Health and Addictions Conference
Are you planning on joining the best and the brightest in healthcare in Chicago this April for the National Council’s annual conference? The 42nd Annual National Council Mental Health and Addictions Conference will be taking place April 15–17, 2012 at the Chicago Hilton and is guaranteed to afford participants opportunities to participate in conference sessions as well as engage with experts on a number of issues related to addictions and co-occurring disorders. You can learn all about our conference by visiting our website and by checking out our preliminary program, but here is a list of sessions that you don’t want to miss:

• Breaking the Intergenerational Cycle of Substance Abuse
• Broken: My Story of Addiction and Redemption
• Integrated Treatment of Co-Occurring mental and Substance Use Disorders
• Supporting Recovery: Medication-Assisted Treatment
• Best Practices in Treating Prescription Addiction
• Long Day’s Journey Into Night: The Addiction Performance Project
• Managing Recovery for Persons with Addictive Disorder

In addition to these conference sessions, there will be a number of other offerings in the areas of healthcare reform, board governance, organizational excellence, Health Information Technology and more to provide compliance officers and staff with important information as we approach 2014 and as implementation of the Affordable Care Act begins.

2012 National Council Compliance Watch E-Newsletter – Subscribe Now to Save!

The Patient Protection and Affordable Care Act broadens the definition of fraud, increases financial penalties, and establishes new government audit programs in behavioral health. For the first time, compliance programs are mandatory conditions of enrollment in Medicare, Medicaid, and CHIP. Under the new law, many people with substance use disorders, who are currently ineligible for Medicaid, will become eligible as of 2014. This expansion creates a new reimbursement opportunity for substance use providers so it’s more important than ever to get involved and prepare for what’s ahead. How do you keep up with new and emerging mandates and prepare for an increasing number of investigations and audits? The National Council offers all the resources you need.

Start by subscribing to our Compliance Watch web newsletter to stay on top of current regulatory changes and best practices in corporate compliance. The only publication of its kind in behavioral health, Compliance Watch is brought to you by the National Council and edited by Feldesman Tucker Leifer Fidell LLP. The newsletter features articles by experts sharing their successes in reducing audit and investigatory risk while maintaining high clinical standards. Subscribers receive regular email updates listing the latest articles available online, as well as alerts on breaking news.

To start or renew your Compliance Watch subscription for 2012, visit our web store and remember to subscribe by February 21st to receive $50 off!

Online Course Provides Training in Treatment of Co-Occurring Disorders
A newly launched online course for behavioral health professionals offers comprehensive training on integrated treatment for co-occurring disorders. Available through Hazelden with credentialing offered by IC&RC, Focus on Integrated Treatment (FIT) provides training in practitioner skills, clinical approaches and administrative practices in implementing integrated treatment.

Only 2% of the 5.6 million adults with co-occurring substance use and mental health disorders in the U.S. receive integrated care, due in part to the lack of professional training on this approach. Integrated treatment -- the delivery of mental health and addiction treatment services by one team at one time in one setting -- is the evidence-based approach for treatment of co-occurring disorders.

“Focus on Integrated Treatment is specifically designed to improve practitioners’ understanding of the integrated treatment of co-occurring disorders,” says Mary Jo Mather, executive director of IC&RC. To support the training of behavioral health professionals, Mather says IC&RC “made the unprecedented step of partnering with Hazelden.”

The FIT online modules provide training on evidence-based practices such as cognitive-behavioral therapy, motivational interviewing and IDDT’s stage-wise treatment. Professionals may choose to complete the entire 35-module FIT program, register for the clinician or the administrator track, or take courses in specific topic areas like Screening & Assessment, Stagewise Treatment and Motivational Interviewing. Clinicians completing all of the available modules can earn up to 52.5 continuing education hours.

Additional information about FIT can be found at www.hazelden.org/FIT. The Dartmouth Psychiatric Research Center (PRC) and the Center for Practice Innovations at Columbia Psychiatry developed the original online program, with support from the New York State Office of Mental Health and New York State Office for Alcoholism and Substance Abuse Services. The award-winning program has been adapted for national release by Hazelden, Dartmouth PRC’s publisher of record. Hazelden is also a partner organization in the recently launched Focus on Integrated Recovery.

New Youth Initiative from the United Nations Office on Drugs and Crime
The United Nations Office on Drugs and Crime has recently launched a new youth initiative aimed towards empowering and connecting youth from around the globe to become active in their schools, communities and youth groups for the prevention of substance abuse. Their website will help provide young people with great resources and opportunities to help them make the best decisions for themselves and their communities.

New Resource Available to Help Families Navigate Addiction Treatment Options
A new resource developed by the National Institute on Drug Abuse (NIDA), Seeking Drug Abuse Treatment: Know What to Ask, offers guidance to help individuals and families struggling with addiction to make sure they ask the right questions before choosing a treatment plan. “This booklet highlights the treatment components that research has shown are critical for success, to help people make an informed choice during a very stressful time,” said NIDA Director Dr. Nora D. Volkow. This free resource recommends five helpful questions people should ask and explains what the research has found to be most effective noting that finding the right treatment for an individual’s specific needs is critical for recovery.

IN THE NEWS

New Mobile App Used to Assess Intoxication Levels
A new self-assessment mobile application was recently released and is intended help you realize how impaired you may become when consuming alcohol based on users’ reaction times and responses to memory challenges. Although the impairment score is based on reaction times and accuracy, not actual blood alcohol levels, a positive result can also indicate fatigue or other issues where it would be unsafe to drive. Law enforcement helped test the application, created by Innocorp, during DUI training and were given alcohol and then asked to launch the application. The results were tested against blood alcohol levels and Innocorp estimated that the results were 95% accurate. Learn more. 

SAMHSA Survey Finds Higher Rates of Substance Use Disorders among Those with a Mental Illness
As many as 1 in 5 adults in the U.S. experienced a mental illness last year, and this group was three times more likely to meet the criteria for substance abuse or dependence than were adults who reported no mental health symptoms in 2010. About 20% of adults with mental health disorders had co-occurring substance use disorders, and only 39% of those reporting mental health symptoms received services.

These findings and others from the Substance Abuse and Mental Health Services Administration (SAMHSA) can be found in its National Survey on Drug Use and Health.

The rate of co-occurring mental health and substance use disorders escalated with the presence of serious mental illness. Just over 25% of the population with serious mental illness also experienced substance abuse or dependence. According to the survey, 5% of the adult population, or 11.4 million adults, had a serious mental illness last year. Serious, or severe, mental illness is defined as mental health disorders that substantially interfere or limit one or more major life activities.

The pattern of co-occurring disorders also held for adolescents. Youth ages 12 to 17 who reported having an episode of major depression were more than twice as likely to experiment with illegal drugs. Just over 37% reported using illicit drugs, versus 17% of all adolescents, and nearly 20% had a substance use disorder, versus 6.1% of all youth.

The 2010 annual National Survey of Drug Use and Health includes data from a survey of approximately 67,500 people throughout the country.

CDC Report Finds Binge Drinking Huge Problem
Binge drinking is a bigger problem than previously thought. So says a recent analysis by the Centers for Disease Control and Prevention, which looked at 2010 data and found that binge drinking accounts for more than half of the estimated 80,000 deaths in this country attributable to excessive alcohol consumption.

The report found that one in six U.S. adults binge drink. That translates into an estimated 38 million U.S. adults who binge drink, consuming an average of 8 alcoholic beverages per occasion.

The prevalence was highest among adults under age 35 (28%) while the frequency was highest among adults age 65 and older (5.5 episodes per month). Excessive drinking is the 3rd leading cause of preventable death in the U.S. and contributes to more than 54 types of injuries and diseases. The CDC also found that college-age adults average 9 alcoholic beverages when they binge drink.

Smoking Cessation Text Message Program Increases Smoking Abstinence Rates
The text message-based smoking cessation program, text2stop, has proven to help individuals who want to quit smoking. Six months after completing the 31 week trial study, 10% of participants remained abstinent, compared to 5% of participants in a control group. Participants received five text messages a day for five weeks and three text messages a week for the remaining 26 weeks.

Text2stop is a five week program that sends personalized motivational text messages to participants, based on their demographic and baseline information, to encourage them to quit smoking. While not only helping to keep participants smoke free after the program ended, the text2stop program also helped to increase the number of individuals who quit smoking while still participating in the program.

Data Spotlight

The following provides summaries of recently-released data and research findings:

• A new report shows that treatment admissions for the abuse of prescription pain relievers rose 430% from 1999-2009 -- at the same time that admission rates for the treatment of alcohol, heroin, and cocaine abuse decreased. 
• An estimated 200 million people around the world use illegal drugs. This according to an estimate based on data from the U.N. Office on Drugs and Crime (UNODC) and from national surveys and peer-reviewed studies that appeared in the journal The Lancet.
• According to data from the National Survey on Substance Abuse Treatment Services (N-SSATS), an average of 89% of beds were filled at non-hospital residential facilities providing addiction treatment services in the United States compared to 96% at facilities that were owned/operated by the federal government. 
• In 2007, about 15% of veterans had mental illness and addiction disorders and accounted for 33% of the nearly$36 billion the Veterans Administration spent on health care that year. Read more. 
   

GOVERNMENT AFFAIRS UPDATE

Lawmakers Urge Support for Key Law Enforcement Provisions of MIOTCRA
Four members of Congress this month began circulating a Dear Colleague letter urging their congressional colleagues’ support for sustaining key law enforcement provisions in the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA). Representatives Bobby Scott (D-VA), Richard Nugent (R-FL), Michael Grimm (R-NY), and Raul Grijalva (D-AZ) expressed their concern in the letter about a proposal by the Obama Administration in its 2012 budget to consolidate MIOTCRA into a single problem-solving courts initiative which could exclude many of the key elements of MIOTCRA. Congress did not adopt the Obama proposal.

The letter states, “Large numbers of people with serious mental illnesses and co-occurring substance use disorders get caught up in the criminal justice system, often with tragic results for these individuals, their families, and the communities in which they live… MIOTCRA program dollars improve public safety by providing cross-training of criminal justice and mental health personnel, training of local law enforcement officers, diversion and alternative prosecution programs, corrections and transitional services as well as a wide range of responses to juveniles.”

The National Council’s Addiction News Now is published monthly and is produced in partnership with Hazelden.