December 2009
 

Senate Begins Debate on Healthcare Reform Bill; National Council Releases Side-by-Side Comparison of House and Senate Bills

Pamela Hyde Confirmed as Administrator of SAMHSA

Labor-HHS-Education and Other Remaining Appropriations Bills Likely to be Combined into “Minibus” for Passage this Year

Fair Sentencing Act Introduced in Senate 

Governor of West Virginia Unveils State’s Strategic Plan to Address Substance Abuse

Correctional Facility in Louisiana to Receive Funding to Provide Substance Abuse Treatment

Missouri Legislature Passes Law Requiring Providers to Offer Medication-Assisted Treatment

SAMHSA Offering $39.6 Million in Grants for Offender Reentry Programs

National Council Hosts Webinar on Applying for Federal Substance Abuse Grants; Recording Available Online

Addictions and Co-Occurring Track at National Council’s 40th Annual Conference & Expo

NIDA Unveils New Training Tools for Screening and Treatment of Substance Use Disorders

National Data Reveals that Marijuana and Alcohol are Primary Substance of Abuse for Most Treatment Admissions of Teenage Females

New SAMHSA Publication Provides Guidance on Clinical Supervision for Substance Abuse Treatment

In the last edition of Addiction News Now we highlighted both the public support for inclusion of addiction treatment within healthcare reform as well as the many ways that this public support has translated into concrete legislative proposals.  All plans offered through the newly created “Exchange” must offer services for the treatment of substance use conditions and do so in accord with the federal Domenici-Wellstone Mental Health Parity and Addiction Equity Act.  There are likewise a number of provisions related to delivery and payment reform, including Accountable Care Organizations and Medical Homes that explicitly mention the inclusion of persons with subs tance use disorders and mental illness.  Both bills also propose major expansions of Medicaid based on poverty status and not on traditional Medicaid eligibility categories.
 
We know that persons with substance use disorders are over-represented in the uninsured population – perhaps twice as likely to be uninsured.  Post-healthcare reform almost all of these previously uninsured individuals will have coverage through Medicaid or private health insurance – and it is estimated that only about 6 percent of the population will remain uninsured.

These potential changes pose many questions for addiction treatment organizations pertaining to the ability of organizations to participate in private health insurance networks, to develop adequate administrative infrastructure to submit claims to Medicaid, and to meet performance and treatment expectations of new payers.
 
This isn’t a new concept – organizations such as the National Quality Forum and the Treatment Research Institute have been promoting quality standards and performance-based reimbursement models for addiction providers; however, with the passage of national healthcare reform, the need to move in this direction will likely increase. In response to this expectation, the National Council is convening member organizations in a “Payment Reform Workgroup” to both anticipate and develop plans for the implications of these changes and we welcome additional partici pants to this effort.  To volunteer, please contact Chuck Ingoglia at the National Council.  Additionally, the upcoming Annual Conference & Expo, March 15-17 in Orlando, Florida will feature a number of sessions on healthcare reform.  We hope to see you there.

ON THE HILL

Senate Begins Debate on Healthcare Reform Bill; National Council Releases Side-by-Side Comparison of House and Senate Bills
On November 21, the Senate’s proposal for healthcare reform, the Patient Protection and Affordable Care Act, was introduced on the Senate floor in the nature of a substitute amendment to a House-passed bill: HR 3590. The Senate has now begun the process of debating its bill, which includes consideration of amendments, and will likely continue this process through most – if not all – of December.
 
The National Council has created a side-by-side comparison chart of the House and Senate bills. This chart summarizes provisions most pertinent to community behavioral health providers, including general insurance market reforms, expansion of Medicaid eligibility, and workforce and other provisions that are specifically targeted to the mental health and addiction fields.
 
Looking ahead, there are several more steps in the legislative process before a healthcare reform bill can go to the President’s desk to be signed into law: the Senate must pass HR 3590, the House and Senate must come together in conference and reconcile differences between their bills, and both the House and Senate must vote to approve the same healthcare reform bill.  
 
On Dec. 2, the National Council held a webinar on healthcare reform, which covered  many of the mental health and addictions provisions in the Senate bill and the outlook for healthcare reform going forward.  Slides from the presentation and an audio recording are available on our website.  Stay tuned to the Public Poli cy Update and the National Council’s healthcare reform update webinar series for the latest news on healthcare reform.  The next webinar in the series will be on Dec. 16 at 2:00 pm Eastern time.
 
Pamela Hyde Confirmed as Administrator of SAMHSA
On Nov. 20, the Senate voted to confirm Pamela Hyde as Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA).  Hyde will start at her new post on Dec. 7.  She has previously served as Secretary of the New Mexico Human Services Department and as Director of several other public agencies, including the Ohio Department of Mental Health, the Ohio Department of Human Services, and the Seattle Department of Housing and Human Services.  Much of Hyde’s 30 years of experience in management and consulting has been in the behavioral health arena, including her position as CEO of the non-profit behavioral healthcare organization Comcare.  The National Council has written Pamela Hyde a congratulatory letter on her confirmation as SAMHSA Administrator.
 
Labor-HHS-Education and Other Remaining Appropriations Bills Likely to be Combined into “Minibus” for Passage this Year
With healthcare reform dominating its schedule this fall, Congress has yet to approve seven of the twelve annual appropriations bills.  Four of these bills have been passed by both the House and the Senate and are awaiting a conference committee report, but three have not yet been passed out of the Senate, including the Labor-HHS-Education bill.  While congressional aides say there have been no decisions about how the appropriations process will proceed for the rest of the year, Senate Appropriations Chairman Daniel Inouye (D-HI) says he expects Congress will opt to enact a “minibus” bill made up of no more than four of the outstanding bills.  The Labor-HHS-Education bill will likely be included in the minibus package along with the other appropriations bills that have not yet been approved by the Senate.  See the Federal Budget page of our website for additional details about this year’s appropriations bills.

Fair Sentencing Act Introduced in Senate
 Ten senators have introduced a bill to eliminate the sentencing disparity between crack and powder cocaine.  The Fair Sentencing Act (S. 1789) would equalize the criminal penalties for the possession of crack cocaine and powder cocaine; currently, the quantity of powder cocaine that triggers a mandatory prison sentence is 100 times greater than the amount of crack cocaine that triggers the same sentence.  The bill would also provide for harsher penalties for large-scale drug traffickers and violent crimes.  A similar bill, the Fairness in Cocaine Sentencing Act (H.R. 3245), has been approved by the House Judiciary Committee with bipartisan support and is awaiting a hearing by the House Energy and Commerce Committee.

IN THE NEWS
 
Governor of West Virginia Unveils State’s Strategic Plan to Address Substance Abuse
Last month, Governor Joe Manchin (D) unveiled the state’s strategic plan to address substance abuse, which calls for $23.5 million per year to fund the effort. The plan focuses on evaluating, researching, and monitoring drug use trends throughout the state; providing training and workforce development; providing community technical assistance; and maintaining open communication between communities and state leadership. The Governor is considering the possibility of requesting funding from the state legislature during its next session.
 
Correctional Facility in Louisiana to Receive Funding to Provide Substance Abuse Treatment
A correctional facility for youth in Monroe, Louisiana will receive $6.2 million for a new program to provide substance abuse treatment behavior modification, Governor Bobby Jindal has announced.  The funds will cover the renovation of two former dormitories at the Swanson Correctional Center for Youth that will separately accommodate 12 boys and 12 girls.  As part of the program, the youth will also receive counseling through the Louisiana State University Health Sciences Center and will take classes through the local school systems.
 
Missouri Legislature Passes Law Requiring Providers to Offer Medication-Assisted Treatment
Missouri has passed a new law requiring providers to offer medication-assisted treatment (MAT) as part of their array of services.  Prior to 2008, providers were prohibited from using MAT, but the state legislature added $1.2 million to this year’s budget specifically for the purpose of promoting MAT.  The state anticipates that the switch will result in savings to the state as improved treatment outcomes reduce spending in the health care system.

RESOURCES & REMINDERS
 
SAMHSA Offering $39.6 Million in Grants for Offender Reentry Programs
SAMHSA is now accepting grant applications for reentry programs that help people transition from the criminal justice system to the community.  Grants of up to $400,000 each will be awarded for programs to expand or enhance substance abuse treatment and recovery services to juvenile and adult offenders reentering the community.  The application deadline has been extended to Feb. 2, 2010.

National Council Hosts Webinar on Applying for Federal Substance Abuse Grants; Recording Available Online
At the end of November, the National Council hosted a National Council Live webinar, “Applying for Federal Substance Abuse Grants”, featuring Linda Kaplan, Project Officer at SAMHSA and Jeannie Campbell, Executive Vice President at the National Council. SAMHSA is currently accepting applications for fiscal year 2010 grants to expand substance abuse treatment capacity in targeted areas of need. The purpose of this program is to expand the community’s ability to provide integrated and comprehensive community-based responses to a targeted, well-documented substance abuse treatment capacity program and/or improve the quality and intensity of services. During this webinar, Ms. Kaplan reviewed grant application requirements and answered questions from attendees. The recording and presentation from this webinar are now available on the National Council’s website and you can download the application for this grant program online. Applications are due by January 14, 2009.
 
Addictions and Co-Occurring Track at National Council’s 40th Annual Conference & Expo
The National Council’s 40th National Mental Health and Addictions Conference & Expo features over 100 sessions, including sessions specifically geared towards providers of addiction services. Sessions include: Building Partnerships Across Systems to Improve Substance Abuse Treatment for Offenders, Prescription Drug Abuse: The Silent Epidemic, Delivering Medication-Assisted Therapy, and Treating Addiction as a Chronic Care Paradigm. Register before December 16th to receive the deepest discounts. Learn more and download the conference brochure online.
 
NIDA Unveils New Training Tools for Screening and Treatment of Substance Use Disorders
The National Institute on Drug Abuse (NIDA) has released several new teaching tools to improve physicians’ ability to diagnose and treat drug abuse and addiction.  These tools have been incorporated into the curriculum for the NIDA Centers of Excellence for Physician Information Program and will help train physicians to incorporate screening for drug use into their daily practices, help patients that are abusing to stop; and refer more serious cases to specialized treatment.
 
National Data Reveals that Marijuana and Alcohol are Primary Substance of Abuse for Most Treatment Admissions of Teenage Females
According to 2007 data from the Treatment Episode Data Set (TEDS), marijuana and alcohol accounted for 80 percent of all primary substances of abuse reported by adolescent (aged 12-17) female substance abuse treatment admissions. Reports of cocaine/crack, heroin, or methamphetamine as the primary substance of abuse were relatively rare among all adolescent female admissions, but were slightly higher among those aged 15 to 17 than among those admissions aged 12 to 14. Among adolescent female substance abuse treatment admissions, criminal justice system referrals to treatment increased with age while school referrals decreased.
 
New SAMHSA Publication Provides Guidance on Clinical Supervision for Substance Abuse Treatment
SAMHSA has released a new publication with information and guidance on clinical supervision in substance abuse treatment settings.  Parts 1 and 2 of the publication, titled “Treatment Improvement Protocol (TIP) 52: Clinical Supervision and Professional Development of the Substance Abuse Counselor” present information for clinical supervisors and program administrators, including a “how-to” guide.  Part 3 of the publication is available online and contains an analysis of the literature and a bibliography.