The National Council released a Frequently Asked Questions document last week which provides important details and information about the proposed spending cuts that the House majority leadership has said it wants to enact. House Budget Committee Chairman Paul Ryan (R-WI) was directed in a recently passed House resolution to set a cap on non-defense discretionary spending for the remained of the 2011 fiscal year that would reduce federal spending for those months to 2008 levels – a move that is expected to result in $55-60 billion in cuts. Ryan is expected to submit his spending limits this week, at that point, the House Appropriations Committee will take that figure and apply separate spending caps for each of the 12 appropriations bills that make up the budget.

Meanwhile, the House is moving forward with a plan to extend the continuing resolution (CR) that is currently keeping the government operating at 2010 levels and will expire on March 4. On February 9, 2010, the House Appropriations Committee released a partial list of 70 cuts as part of the House GOP proposal to fund the federal government through the rest of the fiscal year. The spending bill includes a cut of $96 million from Substance Abuse and Mental Health Services.

Despite the House leadership’s widely vaunted plan to reduce the federal budget to 2008 levels, it is far from certain what the outcome of the budget debate will be, as any specific cuts are certain to run into opposition from the Senate and the President. The National Council’s new FAQ on the federal budget provides information about the proposed cuts, what to expect next in the budget debate, and what you can do to fight against cuts to the behavioral health safety net. We encourage you to write to your Members of Congress and let them know how important addictions and mental health services are to your community. We’ve provided talking points for you to use as you email your legislators – click here to take action today.

Resources and Reminders

National Council Webinars: Access Recordings Online
The National Council, in partnership with Hazelden, presented the third in a series of webinars on Treating Severe Mental Illness. Supported Employment with Individual Placement and Support covers the seven leading principles of supported employment and offers resources for further learning. Learn how you can use the evidence-based Individual Placement and Support model to achieve the best outcomes for your clients with serious mental illness and co-occurring disorders. Supported employment encourages a life in the community, social interaction, and integration for persons with mental and addiction disorders.

Attendees of the webinar received an overview of the core values and program components and learned how they can start and operate their own Housing First programs. 1 American Psychological Association and 2 NAADAC continuing educations credits are available by completing a learner assessment at the end of the webinar. There is a $10.00 administrative fee for this service.

Visit the National Council’s website to register for upcoming webinars.

Additionally, please refer to the National Council website for recordings on previous Webinars that provide useful information on healthcare reform, client outcomes and Medicaid as well as other issues.

Fight for Our Future at Hill Day, July 19-20
On July 19-20, 2011, join hundreds of your colleagues in Washington, D.C. for our field’s premiere public policy and networking event! The National Council’s Annual Public Policy Institute and Hill Day brings together addictions and mental health providers, administrators, board members, consumers, and community stakeholders from across the country. Participants come to D.C. for a full day of sessions and workshops on federal behavioral health policy – followed by visits with their elected officials on Capitol Hill to advocate for our field’s priorities.

This year, Congress is under intense pressure to slash the Federal discretionary funding that is so vital to supporting mental health and addictions services. There’s no more important time to fight for our future! Hill Day gives you the opportunity to influence policy and make your voice heard on Capitol Hill. Click here to see how last year’s attendees made a difference.

Free Registration is now open for the 7th Annual Public Policy Institute and Hill Day. Thanks to the feedback we received from last year’s attendees, the National Council is planning several enhancements and improvements to our Hill Day 2011 events – stay tuned to learn the details.

Participating in Hill Day is easy. Visit our website to learn the details and view a tentative schedule of events. Questions? Contact Rebecca Farley at RebeccaF@thenationalcouncil.org or 202-684-7457, ext 235.

National Council Paper: Partnering with Health Homes & Accountable Care Organizations
There is agreement by those involved in healthcare policy, finance, and delivery that our system is entering a period of disruptive innovation and that new payment and delivery system models are emerging. The National Council is hearing from members around the country that are involved in the conversations in their communities regarding the development of Accountable Care Organizations. Some behavioral health organizations are in conversations with primary care practices, and others with hospitals, regarding new business ventures. Still others are trying to figure out the best way to partner with emerging health homes in their community.

A new paper from the National Council, “Partnering with Health Homes and Accountable Care Organizations” helps put these developments in context and offers strategic advice to behavioral health organizations as they contemplate this brave new world. Click to download the full paper or the executive summary. We encourage members to share this paper with their boards of directors, to engage in conversations on these concepts on the National Council Member Listserve, and at the National Council Conference, May 2-4 in San Diego.

National Council Fact Sheet Examines Impact of Medicaid Expansion on People with Disabilities
The National Council has released a new fact sheet, “Medicaid Benchmark Benefits in Health Reform: Improvements and Exemptions,” which describes the differences between benchmark and standard coverage, the improvements to benchmark coverage under health reform, and the implications of these changes for individuals with disabilities. Many people with mental illness or co-occurring substance use disorders will go into traditional Medicaid beginning in 2014, but for the new Medicaid beneficiaries enrolled in benchmark plans, there are several changes in the ACA designed to cover at least a specified set of “minimum essential benefits”. These benefits much include MH/SU treatment services, rehabilitation, and “habilitative” services. The ACA also applies the 2008 Mental Health Parity and Addictions Equity Act to benchmark plans. The result of these changes is that Medicaid beneficiaries enrolled in benchmark plans in 2014 could have access to far greater MH/SU benefits than currently offered by most benchmark plans.

States will need to develop processes to identify which individuals meet the criteria of having a disabling mental disorder or functional impairment. These processes will have to incorporate both those applying for Medicaid for the first time as well as those who are currently enrolled. The National Council encourages community behavioral health organizations to work with their state Medicaid departments to ensure that the needs of individuals with mental illness and substance use disorders are addressed throughout this process.

Drug Fee Communities Support Program Funding
The Office of National Drug Control Policy (ONDCP) and the Substance Abuse and Mental Health Services Administration (SAMHSA) announced the availability of funding for the Drug Free Communities Support Program. Approximately $9.35 million is expected to be awarded for 75 competing grants to support the efforts of community coalitions working to prevent and reduce substance use among youth. ONDCP has scheduled three live application workshops: Feb 1-San Diego, Feb 3-New Orleans, and Feb 11—CADCA’s National Leadership Forum in National Harbor, MD. To learn more about these workshops, visit www.WhiteHouseDrugPolicy.gov/dfc. ONDCP will also post an online workshop and slide presentation on www.WhiteHouseDrugPolicy.gov/dfc by the end of the month.  This opportunity is open to community-based coalitions focused on addressing youth substance use and who meet all of the Drug Free Communities statutory eligibility requirements.  Applications must be submitted by Friday, March 18, 2011.

Video Program: Preventing Prescription Abuse
The Multijurisdictional Counterdrug Task Force Training Program is producing a free hour-long video program called “Preventing Prescription Abuse”. Viewers will hear from prevention and law enforcement leaders about what we can do to help prevent prescription drug abuse. The program will also look at take-back programs, which can help keep drugs from getting into the wrong hands. The satellite feed was scheduled for January 27; however, a webcast will be available for viewing anytime after January 27 and will remain on-line for on-demand viewing.  
 

On the Hill

Congressional Addiction, Treatment and Recovery Caucus Co-Chairs Announced
Reps. John Sullivan (R-OK) and Tim Ryan (D-OH) announced that they will serve as co-chairs of the bipartisan Congressional Addiction, Treatment and Recovery Caucus in the 112th Congress. Reps. Mary Bono Mack (R-CA) and Paul Tonko (D-NY) have signed on to serve as vice co-chairs. The Addiction, Treatment and Recovery Caucus, founded in 2004, is dedicated to educating and raising awareness among lawmakers about addictions issues in hopes of increasing legislative support for expanding access to treatment.

House Appropriations Committee and Subcommittee Assignments Announced
As Congress resumes its work on the Fiscal Year 2011 spending bills and prepares to consider President Obama’s upcoming 2012 budget proposals, no congressional committees have more influence over the process than the powerful Appropriations Committees in each chamber. Decisions made my these committees largely shape the final contents of the annual appropriations bills and can have a significant impact on the levels of discretionary funding included in the budge for important programs.

The National Council encourages you to find out whether your Members of Congress sit on the Appropriations Committee in the House. Senate committee assignments have not yet been released.

Click to view the Republican and Democratic members of the committee. If your Representative sits on this committee, your voice can have an extra impact when you contact your legislators in support of funding for addictions and mental health services. Visit our Policy Action Center online and stay tuned to the National Council’s Action Alerts to learn about opportunities to speak up for behavioral health funding.
 

In The News

Doctors-To-Be Require More Training in Substance Use Issues
Educators at the Yale School of Medicine and other U.S. medical schools indicate that doctors in medical programs need more training to address substance abuse than they currently receive. According to the article, substance use disorders are at the root of many medical, behavioral and social problems. The authors made several recommendations to address the training deficit: raise the priority of substance abuse education, integrate core competencies into resident training, make substance abuse screening and management routine in primary care and more. For more information please check out "Integrating Addiction Medicine Into Graduate Medical Education in Primary Care: The Time Has Come" published in the January 4th issue of Annals of Internal Medicine.

Addiction & Schizophrenia among Top Predictive Factors for Hospital Readmissions
A recent report, “Hospital Readmissions among Medicaid Beneficiaries with Disabilities: Identifying Targets of Opportunity” found that addiction and schizophrenia were among the top predictive factors for hospital readmissions within 30 days among fee-for-service Medicaid beneficiaries hospitalized between 2003-2005. People with addiction disorders were six percentage points more likely to be readmitted compared to a base readmission rate of 16.3%. People with schizophrenia were 5.9 percentage points more likely to be readmitted within a 30-day period. In consumers with co-occurring schizophrenia and substance use, the probability of readmission increased by 11.9 percentage points.  The researchers also listed other conditions that were predictive of readmission: people who did not see a physician after discharge, prescribing expensive mixes of medications,  and conditions such as skin infections, cancer and diabetes.  The report was published in December 2010 by the Center for Health Care Strategies, Inc. An abstract summary of the report and a copy of the full report may be obtained on-line from the CHCS website.

Emergency Room Visits Increase Due to Prescription Drug Abuse
The Substance Abuse and Mental Health Services Administration’s (SAMHSA) Drug Abuse Warning Network (DAWN) provides estimates on emergency room visits linked to drug abuse and use. The data from 2009 indicate that 4.6 million visits to emergency rooms were drug-related and that 45.1% were linked to the abuse and misuse of drugs, legal and illegal. Of the 4.6 million visits estimated, 1.2 million (27.1%) were due to prescription drug abuse, an increase of 98.4% from 2004 (627,291). Highlights of the DAWN report are available. A full copy of the DAWN report can be found here.

In a press release, The Office of National Drug Control Policy (ONDCP), indicated that as a result of this increase, the Obama Administration will be mounting a government-wide effort to combat prescription drug abuse. Efforts will include increasing prescription drug return, take-back and disposal programs across the nation, expanding state-based prescription drug monitoring programs, educating prescribers and assisting states in stopping the practice of “doctor shopping”.