October 2009
 

Healthcare Reform Update: Senate Finance Committee Releases Legislative Language Which Includes Several Key Improvements

NY Times Features Story on Innovative Community Program to Treat Addiction

National Data Indicates that CJ System is Largest Source of Referrals to Substance Abuse Treatment

New York to Expand Residential Treatment & Outpatient Capacity Using ARRA Funds

California Dept. of Corrections and Rehabilitation Finds that Substance Abuse Treatment Programs Cut Recidivism by Nearly Half

SAMHSA Resources on Medication Assisted Treatment for Consumers, Families, and Providers

TAP #31: Implementing Change in Substance Abuse Treatment Programs

A recent national poll from the Open Society Institute and Lake Research Partners shows that 77% of Americans support including addiction treatment in healthcare reform with 69% of supporters stating that they would be willing to pay higher insurance premiums to make addiction treatment more accessible and affordable. Such support is seen across the political spectrum: a majority of Democrats, Independents, and Republicans expressed support for inclusion.

With this information and parity for mental health and addiction services and other provisions to support community treatment included in current Congressional proposals for healthcare reform, the advocacy community has much to be proud of. As Linda Rosenberg, the National Council’s President & CEO, points out in her latest Letter from Linda, “Healthcare reform is signaling that behavioral health has come of age, indeed viewed as fundamental to good general health. We have made great strides since the time that mental illnesses and addictions were seen primarily as moral failings and recovery as unexpected.”

While we’ve made great strides thus far, more work needs to be done. Negotiations continue in both chambers of Congress to meld varying reform proposals together and our vocal support will be necessary to ensure that addiction and mental health services remain in the final bill. As we remain engaged in this process, we must also consider what a post-healthcare reform world looks like, and begin to prepare ourselves for this reality. The National Council encourages you to get involved by responding to our Action Alerts and reaching out to your elected officials to express your support for reform and inclusion of community addiction and mental health services.

ON THE HILL

Healthcare Reform Update: Senate Finance Committee Releases Legislative Language Which Includes Several Key Improvements
As negotiations to merge the various healthcare reform proposals continue in both chambers of Congress, the Senate Finance Committee released legislative language for the conceptual bill it had approved several weeks ago. Included in this language are two important improvements:

• The conceptual language created a Medicaid State Option to provide health homes for beneficiaries with chronic conditions. The legislative language now explicitly lists “substance abuse” and “mental health condition” as conditions that qualify for inclusion.
• The conceptual language extended Medicaid eligibility to childless adults, up to 133% of FPL, and detailed that mental health services could be provided up to 75% of actuarial value. The legislative language requires that, beginning in 2014, any benchmark or equivalent plan for childless adults would be required to offer substance use disorder and mental health services at parity with physical health services.
   

IN THE NEWS

NY Times Features Story on Innovative Community Program to Treat Addiction
A recent New York Times article highlights a network of Philadelphia community programs which provide a variety of addiction recovery services, including assistance with housing, employment, and education. While longitudinal studies have not been completed yet, early evidence indicates that additional costs of this comprehensive approach are repaid by lower relapse rates. Due to a federal grant program, this model is being replicated throughout the country.

National Data Indicates that CJ System is Largest Source of Referrals to Substance Abuse Treatment
SAMHSA’s latest Treatment Episode Data Set (TEDS) report indicates that 37% of admissions to substance abuse treatment programs originate from the criminal justice system, representing the largest source of referrals. The fastest growth in criminal justice system referrals has been among admissions younger than 18 and admissions for primary marijuana and primary methamphetamine abuse. Additionally, the report emphasizes the importance of policymakers recognizing this referral trend and ensure adequate resources to meet the needs of these referrals from the criminal justice system.

New York to Expand Residential Treatment & Outpatient Capacity Using ARRA Funds
In response to an increase in demand for services due to the state’s Rockefeller Drug Laws, state officials recently announced $50M in new investments to expand residential treatment, outpatient and assessment services. As outlined by a framework of revisions to the Rockefeller laws, many non-violent drug offenders will remain justice-supervised but will receive treatment rather than incarceration. In the first phase of the expansions, the state sought proposals from agencies that could quickly expand their residential capacity. As part of the outpatient service expansion, the state expects to release funds to local governments to address increased demand. Agencies that receive funding are expected to regular report data to the state.
Source: Alcoholism & Drug Abuse Weekly

California Dept. of Corrections and Rehabilitation Finds that Substance Abuse Treatment Programs Cut Recidivism by Nearly Half
According to the State of California Department of Correction and Rehabilitation’s annual report, criminal offenders who completed an in-prison substance abuse program followed by community-based treatment were far less likely to return to prison than those who did not receive services. More specifically, 21.9% of program graduates returned to prison after one year and 35.3% returned after two years, compared to 39.9% after one year and 39.9% after two years for all offenders.  Treatment was found to be especially effective for female prisoners, whose rate of recidivism was only 8.8%, compared to 30.1% for all female offenders.

RESOURCES & REMINDERS

SAMHSA Resources on Medication Assisted Treatment for Consumers, Families, and Providers
The Center for Substance Abuse Treatment (CSAT) has released several new resources for consumers and families on the basics of Medication-Assisted Treatment (MAT) and how medication options fit into a broader recovery process. Medication-Assisted Treatment for Opioid Addiction: Facts for Family and Friends provides useful information for friends and family on addiction and what to expect when someone undergoes MAT. The Facts about Naltrexone and The Facts about Buprenorphine are written for clients entering MAT. SAMHSA also recently released an advisory for physicians highlighting emerging issues in the use of methadone.

TAP #31: Implementing Change in Substance Abuse Treatment Programs
This SAMHSA resource provides guidance on how to integrate evidence-based practices (EBPs) for substance abuse treatment into clinical practice. This step-by-step guide highlights important considerations during pre-planning, planning, implementation, evaluation, and sustainability of EBPs. The appendix section contains listings of various useful implementation and evaluation online resources.