February 2010

Obama Administration Releases Parity Guidance

FY 2011 Proposed Budget Includes Funding Increases for Addictions Prevention and Treatment Services

SAMHSA Now Accepting Nominations for its 2010 Science and Service Awards

SAMHSA, ACF Issue Notification on How TANF Funds May be Used for Short-term MH/SA Treatment

ME: State Releases Scorecard on Substance Abuse Services

National Council’s 2010 Public Policy Institute and Hill Day Registration Now Open – Register Today!

Drug-Free Communities Grants Available

$54 Million Available from SAMHSA for HIV and Addiction Prevention

Bureau of Justice Assistance to Offer Mentoring Grants

CSAT Accepting Applications for Access to Recovery Grants

SAMHSA Accepting Applications for Grants to Expand SUD Treatment in Drug Courts

Online National Resource Center Provides News & Info about Funding Opportunities; Second Chance Act RFA Issued

NADCP Launches Interactive Map of Drug Courts in the U.S.
 

Previous issues of Addiction News Now have highlighted the increased acceptance of Substance Use Disorders by policy makers and the public.  The recent release of regulations for the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act are yet another example of the progress that is being made toward equity.

This progress is also leading to increased national dialogue regarding other areas of policy that are seen as barriers to equity by some.  There is discussion occurring within the Substance Use Treatment community about the need to amend Federal privacy protections (42 USC sec.290dd-2) and regulation (42 CFR Part 2) to allow permitted disclosure of a Substance Use Disorder condition and/or services to persons or entities authorized to receive and use health information for treatment, payment or health plan operations. It is argued by some that these changes are needed to remove barriers to the exchange of important health care information and facilitate care coordination. Others express concerns about the impact such changes will have on the privacy of individuals with substance use conditions.

We’d love to hear your thoughts on this:

1. Do you have concerns about privacy and confidentiality related to 42 CFR, Part 2 and HIPAA? Do you think it is still necessary to have this protection in place? Do you think it should be reviewed, revisited, or modified? If so, in what way and for what purpose?
   
2. Do you think that 42 CFR, Part 2 interferes with SBI, and/or BH integration with primary care, especially in the context of Healthcare Reform and EHRs?
   

Please send your comments to Chuck Ingoglia, Vice President, Public Policy at the National Council.

ON THE HILL

Obama Administration Releases Parity Guidance
On Jan. 29th, the Departments of Health and Human Services, Labor, and Treasury released an interim final rule (IFR) providing guidance on how the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act must be implemented.  The IFR is available online at: http://edocket.access.gpo.gov/2010/pdf/2010-2167.pdf 

The following is a brief summary of the provisions of major interest to addiction providers:
Effective Date:  This IFR goes into effect on Apr. 5 and applies to insurance plan years starting on July 1 or later.

• Plans that Must Comply with the IFR:  The IFR applies to group insurance plans of more than 50 people.  Although the Wellstone-Domenici law also applies to Medicaid managed care plans, these plans are NOT included in the IFR.  Additional guidance on how parity will apply to Medicaid managed care will be released by the Department of Health and Human Services in the future.
• Scope of Service: The IFR divides benefits into six classifications: Inpatient, in-network; Inpatient, out-of-network; Outpatient, in-network; Outpatient, out-of-network; Emergency Care; and Prescription Drugs. Within each classification, if a plan provides substance use or mental health benefits, those benefits must be provided at parity with the medical/surgical benefits provided in that classification.
• Medical Management:  The IFR distinguishes between two types of limits on services: “quantitative limits” (for example, limits on dollar amounts or number of sessions), and “non-quantitative limits.”  The IFR expressly prohibits plans from making use of the following non-quantitative limits, unless similar restrictions exist for medical/surgical benefits: medical management, prescription formulary design, “fail-first” or step therapies, and prior authorization.
• Cumulative Financial Requirements: The IFR prohibits plans from instituting separate deductibles, copayments, and out-of-pocket limits for substance use or mental health benefits and medical/surgical benefits.  Any deductibles, copayments, and out-of-pocket limits required by the plan must be integrated and cumulative for all services.
• Exemptions: The statute allows for health insurance plans to be granted a 1-year exemption from the parity requirements if they experience total increased costs of 2% in the first year after implementation and 1% in subsequent years.  The criteria for this exemption are not included in this IFR.  They will be released in the future.
• Enforcement: The Centers for Medicare and Medicaid Services has established a helpline for reports of violations of the parity law.  The phone number is 877-267-2323, x61565.  We encourage members to inform us of suspected violations of the law as well.  Please email Chuck Ingoglia at chucki@thenationalcouncil.org.
• Comments: Public comments on the IFR will be accepted through May 3, 2010.  Instructions for how to comment are included in the official notice published in the Federal Register.  The National Council will be working with the Parity Implementation Coalition to create model comments for our members to use as a resource.  We encourage you to send us any comments that you have.  Please email Chuck Ingoglia at chucki@thenationalcouncil.org.
• Additional Information: Click here to access the National Council’s fact sheet on the Wellstone-Domenici Mental Health Parity and Addiction Equity Act. Additional information about the IFR can be found in the slides and recording from our latest healthcare reform update webinar.  Also see this IFR fact sheet by the Departments of Health and Human Services, Labor, and Treasury.

FY 2011 Proposed Budget Includes Funding Increases for Addictions Prevention and Treatment Services
On Feb. 1, President Obama released his budget requests for fiscal year 2011.  Of major interest to addiction providers, the proposed budget includes a 6-month extension of the FMAP increase that was originally enacted under the American Recovery and Reinvestment Act.  Other major provisions include:

• Substance Abuse Prevention and Treatment Block Grant: $1.799 billion, level to FY 2010
• Center for Substance Abuse Treatment (CSAT), Programs of National and Regional Significance: $487 million, a 34 million increase over FY 2010. This includes approximately $37 million for the implementation of the Screening and Brief Intervention and Referral to Treatment (SBIRT) program, an increase of about $8 million from FY 2010
• Treatment Drug Courts (CSAT program): $56 million, a $12 million increase over FY 2010
• Ex-offender Reentry (CSAT program): $23 million, a $5 million increase over FY 2010
• Opioid Treatment (CSAT program): $8.9 million, level to FY 2010
• Prevention Prepared Communities (CSAP program): $22.6 million in FY 2011. This new program will assist communities in developing and implementing effective substance abuse and mental illness prevention practices, strategies, and policies that will promote the wellness of individuals aged 9-25 and the communities in which they live.

The National Council has updated our budget comparison chart to include the President’s FY 11 numbers. Now that the proposed budget has been released, Congress will begin holding hearings on the proposals and amending the budget, a process that will take many months before a final budget will be approved. Stay tuned to the Public Policy Update and Addictions News Now for future news about budgeting and the appropriations process.


IN THE NEWS

SAMHSA Now Accepting Nominations for its 2010 Science and Service Awards
The SAMHSA 2010 Science and Service Awards recognize community-based organizations and coalitions that have shown exemplary implementation of evidence-based substance abuse and mental health interventions.  Awards will be made in five categories: substance abuse prevention, treatment of substance abuse and recovery support services, mental health promotion, treatment of mental illness and recovery support services, and co-occurring disorders. To be eligible for an award, an organization must have successfully implemented a recognized evidence-based intervention. Winners will receive a commemorative award and will be further recognized on www.samhsa.gov, but do not receive any financial compensation. Complete information is available on the SAMHSA website. Applications are due by April 9, 2010.

SAMHSA, ACF Issue Notification on How TANF Funds May be Used for Short-term MH/SA Treatment
SAMHSA and the Administration on Children and Families (ACF) have issued a notification with information on how states may use Temporary Assistance for Needy Families (TANF) emergency funds to assist families needing short-term addictions or mental health treatment. According to the notification, TANF funds may be used to develop short-term assistance programs for a wide range of services, including substance use disorder services for struggling families.  Additional information is available from SAMHSA and from the Office of Family Assistance at the Welfare Peer TA network.

ME: State Releases Scorecard on Substance Abuse Services
The Maine Substance Abuse Services Commission has released a scorecard that evaluates the states’ substance use disorder treatment services.  The scorecard ranked Maine’s services across four categories: Leadership/Structure and Sustainability; Resources; Legislative Initiatives; and Measurement and Accountability.  The state received a C in the first three categories and a B in Measurement and Accountability. The full report is available online.


RESOURCES & REMINDERS

National Council’s 2010 Public Policy Institute and Hill Day Registration Now Open – Register Today!
The National Council's 6th Annual Public Policy Institute and Hill Day will be held on June 29-30, 2010 at the Hyatt Regency hotel in Washington, D.C. The Public Policy Institute is a unique opportunity for you to directly engage with key congressional staff, officials from the Obama Administration, and leaders in the behavioral health industry.

You’ll also have a chance to participate in discussions about the issues and network with hundreds of your colleagues from around the country.  The next day, head over to Capitol Hill to meet with your elected officials to discuss the policy issues of importance to your communities.  Registration for Hill Day is free and now open.  Check out our new Hill Day 2010 website for helpful resources on what to expect from Hill Day, how to plan visits with your elected officials, how to successfully communicate your priorities to your Members of Congress, and much more!  If you have questions about Hill Day, please contact Rebecca Farley at rebeccaf@thenationalcouncil.org or 202-684-7457 ext. 235.

Drug-Free Communities Grants Available
The Substance Abuse and Mental Health Services Administration announced it is accepting applications for $18.75 million in new grants under the Drug-Free Communities program.  Up to 150 grants will be awarded for proposals from community anti-drug coalitions that seek to prevent and reduce substance use disorders among youth.  The application deadline is Mar. 19, 2010.
 
$54 Million Available from SAMHSA for HIV and Addiction Prevention
SAMHSA has released a call for applications for $54 million in grants to programs that provide integrated HIV prevention and addictions disorder treatment.  Eligible applicants are previously funded grantees of the Substance Abuse, HIV, and Hepatitis Prevention for Minority Populations and Minority Reentry Populations in Communities of Color program.  The application deadline is Feb. 23, 2010.
 
Bureau of Justice Assistance to Offer Mentoring Grants
Under the Second Chance Act Mentoring Grants to Nonprofit Organizations, grants of up to $300,000 will be awarded to nonprofits that mentor individuals transitioning back into the community after incarceration. The application deadline is Mar. 18, 2010.

CSAT Accepting Applications for Access to Recovery Grants
The Center for Substance Abuse Treatment (CSAT) at SAMHSA is now accepting applications for up to $382 million in Access to Recovery grants.  Up to 30 grants of $2-4 million each will be awarded to support treatment voucher programs that expand access to treatment and recovery services. The application deadline is Mar. 10, 2010.

SAMHSA Accepting Applications for Grants to Expand SUD Treatment in Drug Courts
The Substance Abuse and Mental Health Services Administration is now accepting applications for programs to expand the capability of drug courts to offer substance use treatment. Awardees may receive up to $325,000 per year for three years.  Eligible applicants are existing adult treatment drug courts that have demonstrated relationships with community-based treatment providers and other nonprofit entities.  The application deadline is Mar. 16, 2010.

Online National Resource Center Provides News & Info about Funding Opportunities; Second Chance Act RFA Issued
The National Reentry Resource Center, which was established as part of the Second Chance Act, provides education, technical assistance, information about funding opportunities, and many more tools and resources to nonprofits and public entities assisting prisoners with reentry to their communities. Among the upcoming events  sponsored by the Resource Center is a series of webinars to assist groups that will be applying for Second Chance Act grants. In related news, the Department of Justice has issued a request for applications for the Second Chance Act Adult and Juvenile Offender Reentry Demonstration Projects.  Awards of up to $750,000 for one year will be made for projects that provide a comprehensive range of services to offenders, sustained case management, treatment interventions that target criminal thinking, or assessment instruments for reentry planning. Eligible applicants are state, county, and local government agencies and Indian tribes.  The application deadline is Mar. 4, 2010.

NADCP Launches Interactive Map of Drug Courts in the U.S.
The National Association of Drug Court Professionals has launched an online map showing the location and type of drug courts across the country. The map displays information on a state-by-state basis and also shows the individual location and contact information for each drug court.