January 2010

House and Senate Begin Final Negotiations on Healthcare Reform

President Obama Signs Omnibus Appropriations Bill; Includes Funding for Key SUDs Programs

Senate Judiciary Committee Approves Juvenile Justice and Delinquency Prevention Act

CMS Releases Criteria on “Meaningful Use” of Electronic Health Records

House Passes Jobs for Main Street Act; Includes FMAP Increase Extension

Save the Date for the National Council’s 6th Annual Hill Day: June 29-30, 2010

National Council President & CEO Discusses “Hope for People with Mental Illnesses and Substance Use Disorders” in Online Column

National Council Submits Comments on CCHIT Behavioral Health EHR Criteria

Pennsylvania Commission on Sentencing Calls on State to Reform Mandatory Sentencing Laws

New Mexico Dept. of Health Issues Report: Economic Costs of Alcohol Abuse Amounted to $2.6 Billion in 2006

Deadline Extended for Peer-to-Peer Recovery Support Services Grants

Deadline Extended for Offender Reentry Grants

NIDA to Offer Grants for Addressing HIV in the Criminal Justice System

Conference Calls to Provide Information on Substance Abuse and Jobs for Veterans

Data from National Survey on Drug Use and Health Now Available for Analysis

With both the House and Senate having acted on their respective healthcare reform bills, the two chambers must now agree on a final product that can incorporate the differences while still attracting enough support to be passed again before going to the President for his signature.

As a result of the insurance coverage expansions in the bills, 93 percent of all Americans will have some type of health insurance coverage.  Health reform will also introduce additional payment and delivery system reform demonstrations, including healthcare homes, accountable care organizations, and community care teams.  These reforms incorporate elements of bundled payment for total healthcare costs and the use of quality measures to monitor performance of healthcare practitioners and systems.

Because the most costly individuals to the system are those with untreated behavioral health conditions, the National Council believes that these initiatives will increase the importance of behavioral healthcare interventions and organizations.  These healthcare homes, accountable care organizations and community care teams will need to have relationships with high performing specialty providers to manage these conditions in a cost-effective way.

The Substance use treatment field has been preparing for this movement for some time.  In 2007 the National Quality Forum (NQF) released National Voluntary Consensus Standards for the Treatment of Substance Use Conditions: Evidence-Based Treatment Practices.   The standards enumerate 11 evidence-based practices along four domains – identification, initiation and engagement in treatment, therapeutic interventions, and continuing care management. 

The National Council is interested in hearing about your experiences in implementing the NQF Evidence-Based Treatment Practices – both your successes and challenges.  We also want to know how prepared you feel for the future and how we might help support your organization in this transition to a world of near universal insurance coverage and increased expectations for performance and accountability.
 

ON THE HILL

House and Senate Begin Final Negotiations on Healthcare Reform
Democratic leaders in the House and Senate have begun their last round of negotiations on healthcare reform, with the intent of sending a final bill to President Obama before his State of the Union address in late Jan. or early Feb.  To expedite passage of the legislation, Congressional leaders have agreed to bypass a formal conference committee process.  Instead, the House will take up the Senate’s version of the bill, amend it with an agreed-upon package of changes, and send the bill back to the Senate for final approval.  No details are currently available on how the negotiations are progressing, but many differences between the bills must be resolved, including the level of subsidies available to low- and moderate-income families to purchase health insurance and the question of how the bill will be paid for. 

To see the National Council’s health care reform chart, which compares the bills passed by the House and Senate, click here. For further updates, join us for the next in our Healthcare Reform Update webinar series on Jan. 13 at 2pm EST.  Registration is available on our website.

President Obama Signs Omnibus Appropriations Bill; Includes Funding for Key SUDs Programs
On December 16, President Obama signed an omnibus appropriations bill (HR 3288) that includes funding for Labor-HHS-Education and Commerce-Justice-Science into law. The bill includes several important spending increases for addictions services, including:

• $1.8 billion for the Substance Abuse Prevention and Treatment Block Grant, a $20 million increase vs. FY 2009 levels
• $65 million in grants to states for homelessness, a $5 million increase vs. FY 2009
• $12 million for the Mentally Ill Offender Treatment Crime Reduction Act, a $2 million increase vs. FY 2009
• $100 million for Second Chance Act Recovery programming, four times the FY 2009 allocation of $25 million
• $29.1 million for Screening and Brief Intervention and Referral to Treatment (SBIRT), level funding from FY2009.
• $43.9 million for drug treatment courts, a $20 million increase vs. 2009
• $1.0598 billion for the National Institute on Drug Abuse, an increase of about $27 million vs. FY 2009
• $462 million for the National Institute on Alcohol Abuse and Alcoholism, an increase of about $12 million vs. FY 2009.

The National Council has updated our Fiscal Year 2010 Budget Chart with the newest funding levels from the omnibus bill. We are grateful to all of the National Council members who have supported these budget increases at Hill Day and in other interactions with their members of Congress.

Senate Judiciary Committee Approves Juvenile Justice and Delinquency Prevention Act
On Dec. 17, the Senate Judiciary Committee voted 12-7 to approve the bipartisan Juvenile Justice and Delinquency Prevention Act (S. 678).  This legislation, introduced by Sen. Patrick Leahy and seven cosponsors in March 2009, increases federal funding of prevention, intervention, and treatment programs designed to reduce the incidence of juvenile crime.  The bill requires states to implement alternatives to detention for juveniles who are status or first time offenders, including community-based services to address the needs of at-risk youth.  S. 678 also creates incentive grants to state and local governments for the prevention and reduction of juvenile delinquency prevention programs, including evidence-based programs such as mental health/substance abuse screening and treatment and mentoring programs.

CMS Releases Criteria on “Meaningful Use” of Electronic Health Records
The Centers for Medicare and Medicaid Services (CMS) has released its proposed criteria for establishing “meaningful use” of electronic health records, as required in order to receive incentive payments under the American Recovery and Reinvestment Act of 2009.  The criteria will be published in the Federal Register on Jan. 13, 2010, and CMS will be accepting public comments for 60 days after the date of publication.  However, the criteria will actually go into effect 30 days after publication.  The National Council will be analyzing and submitting comments on the proposed criteria.  Stay tuned to future issues of the Public Policy Update for more information.

House Passes Jobs for Main Street Act; Includes FMAP Increase Extension
On December 16, the House of Representatives passed the Jobs for Main Street Act of 2010.  The bill contains $75 billion in investments in infrastructure, public service jobs, and emergency relief.  Several provisions in the bill are of particular interest to behavioral health providers:

• $23.5 billion to extend the Federal Medical Assistance Percentage (FMAP) increase enacted under the American Recovery and Reinvestment Act
• $1 billion to the National Housing Trust Fund to provide communities with funds to build, preserve, and rehabilitate rental homes that are affordable for extremely and very low-income households
• $65 million for project-based vouchers to support units built by the National Housing Trust Fund
• $305 million to freeze Department of Health and Human Services (HHS) poverty guidelines at 2009 levels in order to prevent a reduction in eligibility for public programs, including Medicaid.

A summary of all the spending provisions in the bill is available online.  The National Council has signed on to a letter in support of the FMAP extension and would like to thank members who responded to Action Alerts in support of increased funding for the National Housing Trust Fund.

Save the Date for the National Council’s 6th Annual Hill Day: June 29-30, 2010
Make your voice heard on Capitol Hill!  Join us for the National Council's 6th Annual Hill Day on June 29-30th, 2010 at the Hyatt Regency.  The Hyatt is located right on Capitol Hill in Washington, D.C. You can book your hotel room at a rate of $239/night by calling the hotel: 202-737-1234 and mentioning the National Council room block.  Registration for Hill Day will begin later this month.  Stay tuned to the Public Policy Update and the Hill Day 2010 page of our website for further updates, including a link to the registration tool when it becomes available, a schedule of events, speakers, and much more!


IN THE NEWS

National Council President & CEO Discusses “Hope for People with Mental Illnesses and Substance Use Disorders” in Online Column
In a column recently posted on HealthNewsDigest.com, the National Council’s President & CEO, Linda Rosenberg, discusses the potential for healthcare reform to expand coverage and increase access to healthcare for individuals with mental illnesses and substance use disorders. This couldn’t come at a better time, with “demand for mental health and substance use treatment up just as state budgets for these types of services are being severely reduced.” Linda continues her comments by stating, “While healthcare reform is not a panacea for people with mental illnesses and substance use disorders, it takes groundbreaking steps in the right direction and may help stem the escalating death rates of people with serious mental illnesses.”

National Council Submits Comments on CCHIT Behavioral Health EHR Criteria
The National Council has submitted its comments on the Certification Commission for Health Information Technology (CCHIT) proposed certification criteria for behavioral health electronic health records (EHRs).  The CCHIT proposals can be viewed online; one set of criteria applies to the needs of behavioral health as an add-on to a physician’s office, and another set applies to behavioral EHRs as a stand-alone certification.

Pennsylvania Commission on Sentencing Calls on State to Reform Mandatory Sentencing Laws
The Pennsylvania Commission on Sentencing has issued a report calling on the state legislature to allow judges more discretion in sentencing for drug offenses and to reduce the mandatory minimum penalties for possession of cocaine.  The commission found that the state’s mandatory minimum sentencing laws had no impact on recidivism.  The full report is available online.

New Mexico Dept. of Health Issues Report: Economic Costs of Alcohol Abuse Amounted to $2.6 Billion in 2006
The New Mexico Department of Health has issued a report on the economic and human costs of alcohol abuse in the state in 2006, finding that it cost the state over $2.5 billion in health costs, lost earnings, and other social costs.  The revenue collected from alcohol-related tax revenue amounted to less than 4% of these total costs.  The report also found that alcohol abuse resulted in nearly 1,000 lives lost, which chronic liver disease being the leading cause of alcohol-related death in the state.


RESOURCES & REMINDERS

Deadline Extended for Peer-to-Peer Recovery Support Services Grants
The deadline for SAMHSA’s peer-to-peer recovery support services grants has been extended to Feb. 16, 2010. Grants of up to $350,000 will be awarded for peer-to-peer recovery support services that help prevent relapse and promote sustained recovery from alcohol and drug use disorders. Projects must include a performance assessment of the services.

Deadline Extended for Offender Reentry Grants
The deadline for SAMHSA’s Offender Reentry Grants has been extended from Jan. 19 to Feb. 2, 2010. 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.

NIDA to Offer Grants for Addressing HIV in the Criminal Justice System
The National Institute on Drug Abuse, National Institute of Mental Health, and the National Institute of Allergy and Infectious Diseases have announced the availability of grants for addressing HIV in the criminal justice system.  A total of $10.6 million will be awarded for programs to test the “seek, test, and treat” model of expanding access to HIV testing and treatment, with particular focus on continuity of treatment during and after community re-entry following incarceration.  Eligible grantees include community organizations working with criminal justice systems and populations.  The application deadline is April 1, 2010.

Conference Calls to Provide Information on Substance Abuse and Jobs for Veterans
The Homeless Veterans’ Reintegration Program (HVRP) National Technical Assistance Center will host a series of conference calls on issues related to substance abuse and employment of veterans.  Upcoming calls include: “Substance Abuse and Employment of Homeless Veterans” and “Green Jobs.” For more information and to register, visit the HVRP website.

Data from National Survey on Drug Use and Health Now Available for Analysis
The 2008 National Survey on Drug Use and Health (NSDUH) data is now available for download and analysis on the Substance Abuse and Mental Health Data Archive (SAMHDA) website.  While SAMHSA had previously released their annual report of NSDUH data, SAMHDA also offers several online tools that allow users to create their own analytic tables, slides, and documents.  All SAMHDA data and tools are free.