March 2011

This year's state legislative season promises to be among the worst in history for publicly-funded addiction prevention and treatment services.  Budget shortfalls have resulted in SAMHSA providing thirteen States with Maintenance of Effort (MOE) waivers. Federal law requires states to maintain a match in funding that is equal to the average level of expenditures over the past two years. These states have not been able to meet the required match for the Block Grants due to budget shortfalls; because of the waiver they will receive full federal funding. The waiver represents an overall decrease in funding for substance abuse treatment in those states that receive them. Those states receiving MOE waivers are: Arizona, California, Georgia, Kentucky, Maine, Ohio, Pennsylvania, Rhode Island, South Carolina, Vermont, US Virgin Islands, Washington and Wisconsin.

Other examples of the challenges confronting publicly-funded addiction treatment services include Maine Governor's LePage proposed cutting Substance Abuse Services by $6 million. This proposal would cut state contracts with 10 of 13 substance use treatment residential programs, leaving only three programs which would provide emergency detoxification services only.

Equally startling is the state of Illinois where addiction agencies are in a state of limbo after Governor Quinn stated that they were eliminating all treatment funding for non-Medicaid eligible patients in the FY 2012 budget. Currently, only 20% of patients in the Illinois publicly funded treatment system are Medicaid-eligible.. Cuts were supposed to start on February 18th, 2011; however, as of March 7, 2011, they have not materialized due to push back from the legislature.  Providers must juggle the competing demands of forcefully making their voices heard with the Legislature, while at the same time trying to figure out how to implement the staggering cuts if enacted as thousands of individuals would love access to services, and hundreds of staff members would lose jobs.

Let us not forget that the US House of Representatives has proposed a $2 million dollar reduction to SAMHSA in non-PRNS programs - meaning that these cuts would more than likely come from the block grants.  Federal action on the budget remains uncertain with the US Senate's rejection of the House Based Continuing Resolution earlier last week.

It is more important than ever that you reach out to your State and Federal legislators to let them know how important that addiction prevention and treatment funding be maintained. Developing and sustaining meaningful relationships with policymakers is critical to our community achieving our advocacy goals. With negotiations about the budget entering a new phase, there is still time to speak up for behavioral health funding in the budget! Help prevent cuts to SAMHSA and other programs by taking action and contacting your legislators today!

Resources and Reminders

Register for Upcoming National Council Webinars: Access Recordings Online
The National Council offers several webinars on issues relevant to substance abuse treatment and behavioral health. On March 23, 2011, from 2-3:30pm EST, the National Council is presenting Partnering with Health Homes and ACOs: A How to Guide. This webinar offers an in-depth look at the steps mental health and substance use providers need to take to ensure readiness to effectively partner with Health Homes and Accountable Care Organization models.

The National Council and the National Alliance on Mental Illness will be presenting the second webinar in their two-part Parity series on March 29, 2011 from 3:30-5pm EST. Parity: Navigating the Appeals Process for Providers and Consumers will provide valuable information for providers and consumers on when appeals should be filed as well as resources to help them file a successful appeal. 

Visit the National Council’s website for more information and 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.

National Council Accepting Applications for Learning Community on Trauma-Informed Care
Last week, National Council President and CEO Linda Rosenberg sent a letter emphasizing the need for behavioral health to provide trauma-informed care. She issued a call to arms, asking that we shift our focus from asking the people who seek our help what is wrong with them to asking what happened to them. The National Council is committed to helping behavioral health organizations create and sustain trauma-informed systems of care and trauma-informed best practices. We invite you to apply to participate in the 2011 “Adoption of Trauma-Informed Care Practices” Learning Community.

The deadline for applications is March 18, 2011. 15-18 organizations will be selected to join the Learning Community. Thanks to the gracious support of the Substance Abuse and Mental Health Services Administration, the National Council is able to offer this opportunity at no cost to participants.

The National Council’s Learning Community model is a proven method for bringing about practice improvements in behavioral health organizations. Organizations selected to join our Trauma-Informed Care Practices Learning Community will:

• Participate in a face-to-face kick-off meeting, featuring nationally recognized faculty, in conjunction with the 41st National Council Conference on May 5, 2011 in San Diego, CA.
• Be provided with off-site learning and information exchange opportunities including customized webinars
• Receive technical assistance and consultation to develop and implement an action plan to create and sustain trauma-informed practices.

Additional details are available in the Application Kit. Applications are due March 18, 2011.

National Council Announces February Advocacy Challenge Winner: John Sczomak, NSO
The National Council is pleased to announce that John Sczomak of Neighborhood Service Organization in Detroit, Michigan is the winner of our February Advocacy Challenge. Congratulations to John for his dedication and commitment to advocacy on behalf of addictions and mental health treatment! The National Council encourages all of our members to help build support in Congress for a strong behavioral health safety net by participating in the monthly advocacy challenge. From now until Hill Day, be the person who is most active each month in contacting your legislators through our Action Alert system.  Each month, we’ll honor the individuals who took action on the most alerts with special recognition in our email newsletters and on our website. Click for more information.

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.

New Opportunity for Compliance Officers and Members: Learn from Your Peers and Experts in the Field
In light of healthcare reform, many agencies are asking for information as to how they should implement new requirements for compliance programming. The health reform law mandates that all providers implement corporate compliance programs as a condition of enrollment in Medicare, Medicaid, and CHIP. In answer to these questions and concerns, the National Council is pleased to announce a new opportunity for Compliance Officers and others who are interested in compliance issues.  The Compliance Networking Group will provide a peer-to-peer resource for participants to share information about their practices or agencies and discuss implementation of compliance programs. Participants will have the opportunity to learn and share information through webinars and conference calls that will cover issues in the development and maintenance of compliance programs.

If you are interested in being part of the Compliance Networking Group, please click here to submit your  contact information to the National Council in order to stay informed about upcoming networking group events and announcements.

Training in Evidence-Based Practices for Juvenile Drug Courts
The National Drug Court Institute (NDCI) along with the Office of Juvenile Justice and Delinquency Prevention and the Center for Substance Abuse Treatment is offering free training and certifications for juvenile drug courts. Training will help local courts “implement Brief Intervention and Referral to Treatment (BIRT) combined with Motivational Enhancement Therapy and Cognitive Behavioral Therapy (MET-CBT-5)”. This workshop is designed for clinicians who work with juvenile drug clients and want to become certified in MET/CBT-5 treatment. Following training, courts could provide evidence-based treatment to teens over the course of five sessions. This would include two one-on-one motivational enhancement therapy sessions and three weekly group cognitive behavioral sessions.  In order to receive the training, agencies must agree to the certification process. For additional information, please refer to the NDCI website.

Education on Evidence-Based Substance Abuse Tools Available On-Line
NIDAMED, an outreach effort started in 2007, by the National Institute on Drug Abuse (NIDA) was initiated to bridge the gap between care of patients with substance abuse disorders and physician education. Several medical schools were appointed to serve as “Centers for Excellence for Physician Information (COEs)”. COEs were charged with developing innovative and evidence-based substance abuse training resources in easy to access formats. The overall goal of NIDAMED is to provide students and educators with evidence-based tools to improve screening and treatment. Training materials, PowerPoint presentations and training videos as well as training tools are all available for download on the NIDA COE website. 

Handbook Resource on Underage Drinking
Mothers Against Drunk Driving along with the American College of Emergency Physicians have released a free handbook as part of MADD’s “Power of Parents. It’s Your Influence” campaign. MADD reports that 30% of eighth graders drink alcohol and 20% binge drink. Recent federal statistics cite an average of 546 emergency department visits per day for underage drinkers in 2009. This handbook is a resource for parents to educate them on ways to talk to their teens about alcohol. The handbook is available to those who sign up through the MADD website.

On the Hill

Congress Continues 2011 Budget Negotiations
In the ongoing congressional debate over the FY 2011 budget, the Senate Democratic leadership has outlined a new spending proposal in response to the steep cuts approved last month by the House. The new Senate proposal would make cuts of $6.5 billion below FY 2010 spending levels. This figure is $51 billion below President’ Obama’s FY 2011 spending proposals, which were never enacted.  In contrast, the House-passed measure (HR 1) makes cuts of $61 billion below 2010 levels (over $100 billion less than the President’s 2011 proposals) and includes a reduction of over $200 million to the budget for the Substance Abuse and Mental Health Services Administration, along with significant cuts to other important programs for individuals with additions and mental health disorders.

For a full list of the proposed spending levels in HR 1 and the Senate alternative, click here. Please note that the spending reductions displayed in this chart are in comparison to the President’s 2011 budget proposals – not to the actual 2010 levels of spending that are currently in place under the continuing resolution that is funding the government through March 18. Without another extension or agreement by March 18th on the budget for the rest of the current fiscal year (which ends on September 30), government operations will be forced to shut down.

With negotiations about the budget entering a new phase, there is still time to speak up for behavioral health funding in the budget! Help prevent cuts to SAMHSA and other programs by taking action and contacting your legislators today!

In The News

Substance Abuse Screenings in Primary Care
The Centers for Medicare and Medicaid Services (CMS) issued a call for comments on how often screening and brief interventions should be performed in primary care and who is qualified to provide it. Medicare does not pay for screenings unless there is specific statutory authority; however, under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), CMS can add preventive services if the United States Preventive Services Task Force (USPSTF) gives the service a Grade A or B rating. USPSTF recommended a Grade B for Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse. If Medicare decides to pay for screening and brief intervention services it would be an incentive for more physicians to perform them. Additionally, under the Affordable Care Act, copayments are not allowed for preventative services which would benefit Medicare beneficiaries. Please visit the CMS website to read the call for comments, view comments from others and submit your own

Research Report Series: Marijuana Abuse
The National Institute on Drug Abuse recently released a report in their Research Report Series which discusses marijuana abuse. According to the 2008 National Survey on Drug Use and Health, marijuana is the most commonly used illicit drug with 15.2 individuals reporting usage in the past month. Data from the Survey suggests that an estimated 2.2 million Americans used marijuana for the first time; more than half were under the age of 18. The NIDA research report provides information as to how marijuana affects the brain and body, produces its effects, and how it can affect work and school. Different treatment modalities are also briefly touched upon. This report is available for download from the NIDA website.

Substance Abuse and Criminal Justice System Referrals
A nationwide study sponsored by the Substance Abuse and Mental Health Services Administration, shows that alcohol and marijuana were the most commonly abused substances reported among those referred to substance abuse treatment from parole or probation. 42% of admissions to substance abuse treatment that were referred by the criminal justice system, were attributed to probation or parole referrals, making the probation and parole system the largest source of criminal justice referrals to treatment. Some other notable findings include: 76% of admissions were male, 81% were between the ages of 18-44 and 52% were non-Hispanic White. The majority of individuals (57.5%) had been in treatment prior and 18% reported three or more treatment episodes.  The full report is available on line at: http://www.oas.samhsa.gov/2k11/231/231ProbParol.cfm

“Above the Influence” Campaign Reduces Teen Marijuana Use
A study of more than 3,000 students in 20 communities nationwide found that by the end of 8th grade, 12% of those surveyed who had not seen the campaign were using marijuana. In comparison, only 8% of those youth surveyed who had seen the campaign were using the drug. Each youth was surveyed four times over the course of 18 months and as many as 79% of the students reported that they had seen the “Above the Influence” campaign. Researchers indicate some limitations to the study include a lack of random sampling and findings based on self-reports, but said results were encouraging as previous research on a similar campaign “My Anti-Drug” had found no effects. The complete study “Assessing Media Campaigns Linking Marijuana Non-Use with Autonomy and Aspirations: ‘Be Under Your Own Influence’ and ONDCP’s ‘Above the Influence’” was published in Prevention Science and is available online.

Underage Alcohol Use Findings 
Data from the National Survey on Drug Use and Health conducted annually from 2006 through 2009, estimated that 709,000 adolescents ages 12 to 14 have consumed alcohol. Many adolescents (44.8%) reported that they got the alcohol for free from their family or at home. In a news release from SAMHSA, SAMHSA Administrator Pam S. Hyde said that “people who begin drinking before the age of 15 are sic times more likely than those who start at age 21 and older to develop alcohol problems. Parents and other adults need to be aware that providing alcohol to children can expose them to an increased risk for alcohol abuse and set them on a path with increase potential for addiction.” A copy of the one page report is accessible at: http://oas.samhsa.gov/spotlight/Spotlight022YouthAlcohol.pdf