House & Senate Advance Key Behavioral Healthcare Legislation to Consider in the New Year

The House and Senate advanced several behavioral healthcare-related bills this week that NABH either supports and opposes and Congress is expected to consider early in the New Year.
 
The Senate Health, Education, Labor and Pensions (HELP) Committee marked up several pieces of legislation, including reauthorization of the SUPPORT Act and S. 644, the Modernizing Opioid Treatment Access Act (MOTAA). The Committee approved its version of the SUPPORT Act reauthorization bill 19-1. This bill would reauthorize programs to improve the prevention, treatment, and recovery of substance use disorders (SUD), including supporting training for first responders and programs that support youth and mental health. The legislation also directs the U.S. Health and Human Services Department (HHS) and the Drug Enforcement Agency (DEA) to establish a special registration program permitting physicians to prescribe controlled substances through telemedicine, among other provisions.

The Modernizing Opioid Treatment Access Act, S. 644 was reported favorably as amended by a roll call vote of 16-5 with Ranking Member Sen. Bill Cassidy, M.D. (R-La.) supporting the legislation. Sens. Susan Collins (R-Maine), Rob Marshall (R-Kan.), Tommy Tuberville (R-Ala.), Markwayne Mullin (R-Okla.), and Ted Budd (R-NC) voted against the bill. NABH opposed the bill, which would expand access to methadone by permitting take-home prescribing of the drug through pharmacies.
 
On Wednesday the House passed both the Lower Costs, More Transparency Act (H.R. 5378), and the H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023.  H.R. 5378 contains provisions to promote more transparency within various sectors of the healthcare industry; delay certain disproportionate share payment cuts; and extend funding for community health centers, the National Health Service Corp, and teaching health centers that operate graduate medical education (GME) programs. The bill also increases reporting requirements for insurers, hospitals and pharmacy benefit managers, and changes Medicare payment policy so that drugs administered in a hospital outpatient department are reimbursed at the same rate as they are in a physician’s office, a policy known as site-neutral payments.
 
Meanwhile, House Energy and Commerce Subcommittee on Health Chair Brett Guthrie (R-Ky.) and Rep. Anne Kuster (D-N.H.) led H.R.4531, the Support for Patients and Communities Reauthorization (SUPPORT) Act of 2023, which the House passed in a 386-37 vote. The bill includes several important NABH priorities, including permanently lifting Medicaid’s IMD Exclusion, which restricts access to care for rehab and institutional care services; ensuring Medicaid beneficiaries have access to Medication Assisted Treatment; reauthorizing resources for residential SUD treatment for pregnant and postpartum women; and monitoring prescribing of antipsychotic medications. The House Energy and Commerce Committee passed H.R. 4531 in a 49-0 vote this past July.

These healthcare bills, in addition to the Senate Finance Committee’s previously passed Better Mental Health Care, Lower-Cost Drugs and Extenders Act, which included language from S. 3098, the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act which would make the state plan amendment option permanent, will be rolled into one healthcare package for Congress to consider in the New Year.

Other healthcare issues include addressing scheduled cuts to the Medicare Physician Fee Schedule (MPFS), reform and transparency for pharmacy benefit managers (PBM) and Medicare Advantage (MA) plans, and other bipartisan policies to address drug shortages, antimicrobial resistance, and workforce needs.

Congress has two early deadlines in 2024 to move the healthcare package across the finish line — Jan. 19 and Feb. 2, the latter of which includes the deadline for Labor-HHS-Education funding bill. NABH and allied partners will be working to stop MOTAA and include our policy priorities in this final package.

HHS Takes Step to Regulate AI in Health Data, Technology, and Interoperability Final Rule

HHS this week unveiled the department’s data-related priorities for the next two years in a rule that includes information about data sharing across the government and the private sector and using artificial intelligence (AI) to boost medical innovation and improve health outcomes.

HHS’ Office of the National Coordinator (ONC) for Health Information Technology finalized its Health Data, Technology, and Interoperability rule, which establishes the first transparency requirements for AI and other predictive algorithms that are part of certified health information technology. ONC reports that it certifies health IT that supports care delivered by more than 96% of hospitals and 78% of office-based physicians nationwide.

The final rule also implements the 21^st Century Cures Act’s requirement to adopt a Condition of Certification (the “Insights Condition”) for developers of certified health IT to report certain metrics as part of their participation in the Certification Program. These metrics will give more insight into how certified health IT is used in support of care delivery.

Click here to learn when ONC will host information sessions about the rule in January and February.

CMS Releases Guidance on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist, Mental Health Counselor, and Intensive Outpatient Services

The Centers for Medicare & Medicaid Services (CMS) on Thursday released Guidance to State Medicaid Agencies on Dually Eligible Beneficiaries Receiving Medicare Part B Marriage and Family Therapist Services, Mental Health Counselor Services, and Intensive Outpatient Services, an informational bulletin with changes that take effect on Jan. 1, 2024.
 
Beginning in the New Year, Medicare will become the primary payer for dually eligible beneficiaries receiving these services from Medicare-enrolled practitioners or providers.

According to CMS, typically state Medicaid agencies may not pay claims if it is likely that a third party (such as Medicare) is liable for the claim, as Medicaid is generally the payer of last resort. For dually eligible beneficiaries, Medicare is generally liable for claims for Medicare-covered services, including MFT services, MHC services, and IOP services furnished on or after Jan. 1, 2024, and therefore state Medicaid agencies are required to cost-avoid claims for such services, or seek reimbursement from the practitioner or provider.

Currently, MFTs and MHCs provide services that can be covered as an optional state plan benefit such as services of other licensed practitioners under the Medicaid state plan. IOP services are generally covered through the optional rehabilitative services benefit under the Medicaid state plan.

AMCHP and ASTHO Release Guidance on Public Health Approaches to Perinatal Substance Use

The Association of Maternal & Child Health Programs (AMCHP) and the Association of State and Territorial Health Officials (ASTHO) have released a special issue of the Maternal and Child Health Journal focused on public health approaches to perinatal substance use.

This December 2023 special issue features 21 open-access articles with the latest research, programs, and policy initiatives related to perinatal substance use that highlight approaches to preventing and mitigating the harmful effects of perinatal substance use and improving maternal and child health.

AMCHP and ASTHO will host a virtual forum about the special issue on Tuesday, Dec. 19 at 12:30 p.m. ET. Click here to learn more and register.

NABH 2024 Board Election Ballots Due Friday, Dec. 29!

NABH has e-mailed system members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2024 Board.

If you have not done so, please vote for the open Board Chair-Elect position and four available Board seats; sign the ballot (it is not valid without a signature); and return it to NABH. You can do this by scanning your completed ballot and e-mailing it nabh@nabh.org or maria@nabh.org.

NABH must receive all ballots no later than Friday, Dec. 29, 2023. New Board members and the Board Chair-elect will take office in January 2024.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

Overdoses in the United States involving methadone were 48% higher in 2020 than in 2019, according to a study of overdose deaths during the COVID-19 pandemic published in Forensic Science International.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

Senate HELP Committee to Mark Up SUPPORT Act Reauthorization Bill Next Week

The Senate Health, Education, Labor, and Pensions (HELP) Committee is slated to mark up the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment Act’s (SUPPORT Act) reauthorization bill along with other legislation – including the Modernizing Opioid Treatment Access Act (MOTAA) – on Tuesday, Dec. 12.

The SUPPORT Act expired on Sept. 30, and Congress has long been expected to reauthorize the opioid treatment and prevention programs that the 2018 law created.

NABH sent a Government Relations Network alert asking members to contact Senate HELP Committee members and urge them to apply an all-hands-on-deck approach to America’s mental health and addiction crises by reauthorizing the SUPPORT Act’s expired provisions.

The association also asked NABH members to encourage HELP Committee members to oppose the MOTAA bill, which would threaten patient safety if methadone prescriptions were allowed outside opioid treatment programs. While the MOTAA bill was not incorporated into the underlying SUPPORT Act, lawmakers will consider it as stand-alone legislation and the committee may pass it. If this happens, NABH will work with partners to oppose the bill if it moves to the full Senate for a vote and also urge House lawmakers not to consider it.

Also next week, the House is expected to pass its version of the SUPPORT Act, which includes several NABH priorities. The House Energy and Commerce Committee passed this bill with bipartisan support and did not consider the MOTAA bill in this legislation.

Meanwhile, House and Senate conferees are negotiating a broader healthcare package for Congress to consider in early 2024. NABH will provide the latest information about these and other congressional actions next week and future editions of CEO Update.

ONDCP to Host Webinar on Medicaid 1115 Re-Entry Demonstration Opportunity on Dec. 12

The White House Office of National Drug Control Policy (ONDCP) will host a webinar on Tuesday, Dec. 12 to highlight the state of Washington’s work on the Medicaid Re-Entry Demonstration Opportunity that the Centers for Medicare and Medicaid Services (CMS) announced in April 2023.

The opportunity allows states to cover a package of pre-release services, including medications for opioid use disorder and connection to substance use disorder care, for up to 90 days before an incarcerated individual’s release date. To date, 16 states have applied for the waiver and two states have been approved.

Click here to register for the 90-minute webinar, which will begin at 2:30 p.m. ET on Tuesday.

National Academies to Host Webinar About Social Media and Adolescent Health on Dec. 13

The National Academies of Sciences, Engineering, and Medicine will host a webinar next week highlighting the conclusions and recommendations from the Academies’ ad hoc committee that drafted a report about social media’s effect on adolescents’ mental and physical health.

Click here to learn more and register for the hourlong webinar, which will start at noon ET on Wednesday, Dec. 13.

CMS Provides Guidance to States on Mandatory Medicaid and CHIP Core Set Reporting Requirements

CMS sent a letter to state health officials that offered guidance about implementing the reporting requirements outlined in the Mandatory Medicaid and Children’s Health Insurance Program (CHIP) Core Set Reporting final rule that the agency released in August.

The letter includes guidance about mandatory reporting regulations and adherence to reporting guidance; Core Set measures for which reporting is mandatory in 2024; the populations who must be included in reporting and the population exemption process; categories of stratified data that must be reported in or before 2025; measures subject to stratification in 2025; attribution rules; and the Child and Adult Core Set State Plan Amendment.

Reminder: Please Contribute Data to NABH’s Enhanced Denial-of-Care Portal

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.
With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

The first government-sanctioned overdose prevention centers (OPCs) opened in New York City in November 2021, drawing concerns that they might increase crime and disorder. A new study in JAMA that examined two OPCs and 17 syringe service programs found no significant increases in crimes recorded by the police or calls for emergency service.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

Please Urge Your Senators to Reauthorize the SUPPORT Act and Oppose MOTAA

As Congress returned this week for its year-end push, NABH continues to advocate for federal lawmakers to reauthorize the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT) and oppose the Modernizing Opioid Treatment Access Act (MOTAA).

The Senate Health, Education, Labor and Pensions (HELP) Committee has not announced a markup for these bills; however, lawmakers may act on them during the first or second week of December.

As NABH outlined in a letter to Sen. Bill Cassidy, M.D. (R-La.) on Nov. 22, the association supports efforts to reauthorize the expired provisions of the SUPPORT Act. NABH wrote in the letter that the nation’s mental health crisis requires an all-hands-on-deck approach, and that it makes no sense to limit grantees based on a facility’s tax status when many individuals who need mental health and substance use disorder services are not able to access those services.

Meanwhile, in a letter to the Senate HELP Committee this week, NABH expressed our firm opposition to the MOTAA bill, which would threaten patient safety if methadone prescription would be allowed outside Opioid Treatment Programs (OTPs). Our concern reflects the complexity of this patient population, which requires comprehensive and ongoing clinical oversight that would be difficult for busy pharmacies to provide.

To assure patient safety, NABH supports additional research and data collection prior to altering current methadone prescribing protections provided by OTPs.

Please help NABH’s advocacy efforts by contacting Senate HELP Committee members in your region and urge their support to reauthorize the SUPPORT Act and oppose MOTAA.

Thank you for your support!

Please contact NABH Director for Congressional Affairs Andy Dodson if you have questions.

HHS OIG Reports Low Misuse of Medicare Part D Buprenorphine

A new report from HHS’ Office of the Inspector General (OIG) found most Medicare Part D beneficiaries prescribed buprenorphine for opioid use disorder received recommended amounts in 2022, meaning there was likely little misuse of the drug.

The findings are similar to a 2021 report’s results, which led the OIG to conclude in the new review that there continues to be little risk of buprenorphine misuse among Part D enrollees.

Click here to read the full report.

Bipartisan Policy Center to Host Medicare Reform Webinar on Dec. 11

The Bipartisan Policy Center (BPC) will explore potential solutions to improve the beneficiary experience and ensure a fiscally responsible Medicare program, which nearly 20% of Americans rely on for healthcare coverage and is estimated to become insolvent by 2031.

During the discussion, BPC will release federal policy recommendations meant to enhance Medicare benefits, increase competition, establish better program management, and improve financing.

The hourlong event starts at 11:30 a.m. ET. Click here to register.

NIDA to Host ‘Monitoring the Future’ Survey Data Release Webinar on Dec. 13

The National Institute on Drug Abuse (NIDA) at the National Institutes of Health (NIH) will host a webinar to discuss results from its annual Monitoring the Future (MTF) survey on Wednesday, Dec. 13.

The MTF survey has measured drug and alcohol use and related attitudes among adolescent students nationwide since 1975. In it, a nationally representative sample of survey participants report their drug use behaviors across three time periods: lifetime, past year, and past month. NIDA funds the survey, which is conducted by the University of Michigan.

This year, the hourlong briefing will feature Marsha Lopez, Ph.D., M.H.S., who serves as chief of the epidemiology research branch in NIDA’s Division of Epidemiology, Services and Prevention Research.

The webinar will begin at 10 a.m. ET. Click here to register.

National Academies to Host Workshop that Examines Adult ADHD Diagnosis & Treatment

The National Academies’ Forum on Drug Discovery, Development and Translation and Forum on Neuroscience and Nervous System Disorders will host a workshop to explore the diagnosis and treatment of adults with Adult Attention-Deficit/Hyperactivity (ADHD) Disorder and the challenges and opportunities for drug development on Dec. 12 and 13.

The workshop is intended to offer professionals who typically diagnose ADHD—such as physicians, psychologists, social workers, nurse practitioners, and other licensed counselors or therapists—as well as drug developers, researchers, and regulators, to discuss and support the public health goal of treating adults with ADHD safely and effectively.

Supported partly through a grant from the Food and Drug Administration’s Center for Drug Evaluation and Research, the workshop will be presented on Tuesday, Dec. 12 from 8:30 a.m. – 5 p.m. ET and on Wednesday, Dec. 13 from 8:30 a.m. – 2 p.m. ET.

Click here to register.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal.

If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Fact of the Week

Drug overdose deaths rose noticeably between January to June 2018 and July to December 2021 among 10- to 44-year-old girls and women who were pregnant or pregnant within the previous 12 months, according to a new study by NIDA researchers at the NIH.

For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA Releases 2022 National Survey on Drug Use and Health

Among U.S. adults aged 18 or older in 2022, 23.1%, or 59.3 million people, had any mental illness in the past year while 48.7 million people aged 12 or older, or 17.3%, had a substance use disorder (SUD) in the past year, according to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2022 National Survey on Drug Use and Health (NSDUH).

The annual report provides nationally representative data on the use of tobacco, alcohol, and drugs; SUDs; mental health issues; and receipt of substance use and mental health treatment among the civilian, noninstitutionalized population aged 12 or older in the United States.

In addition, the 2022 Methodological Summary and Definitions report summarizes the information users need to properly interpret NSDUH estimates related to substance use and mental health. This report accompanies the annual detailed tables and provides information on overall methodology, key definitions for measures and terms used in 2022 NSDUH reports and tables, along with some analysis of these measures and of the survey as a whole.

NIH Study Examines How to Reduce Suicide Risk Among Young People in Hospital EDs

The National Institutes of Health (NIH) has released Emergency Department Safety Assessment and Follow-Up Evaluation 2 (ED-SAFE 2), a study that shows it’s possible to significantly reduce suicidal behaviors among young people at risk for suicide in emergency departments.
ED-SAFE is a randomized clinical trial designed to improve suicide risk screening and detection in emergency department settings.

The trial differs from similar studies because routine clinical staff—rather than researchers—deliver the suicide risk intervention, according to the NIH. This approach increases the likelihood that the suicide prevention strategies can be reliably implemented and sustained in the real world.

ED-SAFE is also the largest practical clinical trial of suicide-related best practices in emergency departments.

National Academies Examines How to Support and Sustain the Current and Future Workforce to Care for People with Serious Illness

The National Academies Roundtable on Quality Care for People with Serious Illness has released a resource from its April 2023 public workshop that explored strategies and approaches to address major workforce challenges for those who care for people with serious illness.

The workshop built on a 2019 Roundtable workshop, Building the Workforce We Need to Care for People with Serious Illness.

Click here to access the free resource.

SAMHSA to Host Webinar on Certified Peer Specialist Career Outcomes Study

SAMHSA’s Office of Recovery will host a webinar later this month to discuss the results from the Certified Peer Specialist (CPS) Career Outcomes Study.

Laysha Ostrow, Ph.D. will present some of the findings from the three-year study, including information about wages and financial wellbeing, workplace burnout, and CPS in rural areas.

The webinar will start Monday, Nov. 27 at 1 p.m. ET. Click here to register.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

More Americans used illicit drugs in 2022 than in 2021, with illicit marijuana being the most common. Nearly 62 million people used illicit marijuana last year, up from 52.5 million in 2021, according to the 2022 National Survey on Drug Use and Health.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Happy Thanksgiving!

The NABH staff wishes its members and their families a very happy, healthy, and safe Thanksgiving! NABH will not publish CEO Update next week and will resume on Friday, Dec. 1, 2023.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

Senate Finance Committee Advances ‘Better Mental Health Care, Lower-Cost Drugs and Extenders Act’

The Senate Finance Committee on Wednesday advanced the bipartisan Better Mental Health Care, Lower-Cost Drugs and Extenders Act in a unanimous vote.

The healthcare package partially mitigates Medicare payment cuts for physicians, extends certain expiring Medicare and Medicaid provisions, targets pharmacy benefit manager practices, and extends several substance use disorder (SUD) measures that expired on Oct. 1 as lawmakers missed the deadline to reauthorize the SUPPORT Act.

Included in the legislation is language from S. 3098, the Securing Advances and a Variety of Evidence-Based (SAVE) Institutions for Mental Diseases (IMD) Options Act that Sens. John Thune (R-S.D.), Maggie Hassan (D-N.H.), and Marsha Blackburn (R-Tenn.) introduced to make the state plan amendment option permanent, a provision also included in the House Energy & Commerce Committee-passed SUPPORT Act Reauthorization bill. Some states, including South Dakota and Tennessee, opted into a state plan amendment option authorized under the SUPPORT Act that allows states to avoid the IMD Exclusion. Without renewal, states avoiding the payment exclusion will be forced to terminate payments to IMD facilities or cover such costs through state funds.

Other provisions in the legislation include prohibiting states from terminating Medicaid coverage for incarcerated individuals and expanding access to mental health and SUD services for Medicaid-eligible individuals 30 days prior to their release from incarceration. The legislation also requires the Centers for Medicare & Medicaid Services (CMS) to collect and publish data from Medicare Advantage plans on the number of prior authorization requests, denials, and appeals for mental health and SUD services at the plan level, including the timelines of prior authorization decisions and justifications for denials.

Senate Finance Committee leaders said the goal is to include the Better Mental Health Care, Lower-Cost Drugs and Extenders Act legislation into a broader healthcare package, a second Continuing Resolution (CR), or end-of-year omnibus funding package.

CMS Extends MA Coverage to Additional Behavioral Healthcare Practitioners

In a proposed rule released this week, CMS proposed several changes to increase access to behavioral healthcare services for Medicare Advantage (MA) enrollees.

As required by law, CMS proposed to expand network adequacy standards for MA plans by adding a new category of specialists, “outpatient behavioral health” providers, as a required element of each network. Practitioners in this new category would include marriage and family therapists, mental health counselors, opioid treatment program providers, community mental health centers, addiction-medicine physicians, and other providers already providing traditional Medicare-covered addiction medicine and behavioral health counseling or therapy services.

Also, CMS would extend the existing 10% compensation boost to this new category of practitioners for any MA network that has at least one provider group providing telehealth services.

Comments on this rule are due to CMS by Jan. 25, 2024.

White House, ONDCP, Domestic Policy Council, and 12 Federal Agencies Release Recovery-Ready Workplace Toolkit

The White House, the Office of National Drug Control Policy, the Domestic Policy Council, and a dozen federal departments and independent agencies released their Recovery-Ready Workplace Toolkit: Guidance and Resources for Private and Public Sector Employers this week.

The 140-page resource supports the fourth pillar of President Biden’s Unity Agenda for the Nation: beating the opioid and overdose epidemic. Specifically, the toolkit is designed to help businesses and other employers prevent and respond more effectively to substance misuse among employees, build their workforces through hiring of people in recovery, and develop a recovery-supportive workplace culture.

It is also intended to serve as a resource to states, local governments, labor organizations, business groups, and non-profits considering launching multi-employer recovery-ready workforce initiatives at the local or state levels.

HHS Releases ‘Action for Adolescents: A Call to Action for Adolescent Health and Well-Being’

HHS recently released Action for Adolescents: A Call to Action for Adolescent Health and Well-Being, a new effort to promote collaboration and prompt action to improve the health and well-being of U.S. adolescents nationwide.

Take Action for Adolescents is a research-based resource that outlines a vision, key principles, and eight goals, including: 1) Eliminate disparities to advance health equity, 2) Increase youth agency and youth engagement, 3) Ensure access to safe and supportive environments, 4) Increase coordination and collaboration within and across systems, 5) Expand access to health care and human services, 6) Strengthen training and support for caring adults, 7) Improve health information and health literacy, and 8) Support, translate, and disseminate research. The resource also includes a Take Action toolkit.

In other HHS news related to the nation’s youth, HHS Secretary Xavier Becerra was recently named Chair of the U.S. Interagency Council on Homelessness and announced $6.1 million in new measures on affordable housing and support for runaway youth. Some of that funding will be used to enhance a variety of supportive services, including mental health services, on-site child care, financial literacy and coaching, GED preparation classes, transportation assistance, and early childhood and youth programs.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Fact of the Week

For young people between the ages of 15 to 24, time spent in person with friends has reduced by nearly 70% during the last two decades to 40 minutes per day in 2020 from roughly 150 minutes per day in 2003 to 40 minutes per day in 2020, according to The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community.

Save the Date for the NABH 2024 Annual Meeting!

Please mark your calendars and plan to join us at the Salamander Washington, DC from May 13-15, 2024 for next year’s NABH Annual Meeting!

Many Thanks to All Veterans!

This Veterans Day Weekend, NABH thanks its members and their families who have served or are serving in the U.S. military. We appreciate your sacrifice and service.
 
For questions or comments about this CEO Update, please contact Jessica Zigmond.

White House Asks Congress for $1.55 Billion to Address Nation’s Fentanyl Crisis

The Biden administration this week requested $1.55 billion from Congress for HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) State Opioid Response grants to provide treatment, harm reduction, and recovery support services in all states and territories to combat the nation’s ongoing fentanyl crisis.
 
“Thanks to historic funding and bipartisan efforts, the rate of overdose deaths is slowing after a period of exponential increase, access to treatment is expanding, and historic amounts of fentanyl are being seized at our borders,” the White House said in a fact sheet about the Biden administration’s domestic spending requests to Congress. “But our work to beat the overdose epidemic is far from over and additional resources are needed to continue the Administration’s aggressive action to save lives.”

CDC: Healthcare Workers Report a Decrease in Odds of Burnout if They Trust Management

Healthcare workers continued to face a mental health crisis in 2022, although positive working conditions were associated with less burnout and better mental health, the Centers for Disease Control and Prevention (CDC) concluded in a Vital Signs report released this week.

From 2018 to 2022, healthcare workers reported an increase of 1.2 days of poor mental health during the previous 30 days (to 4.5 days from 3.3 days), while the percentage who reported feeling burnout very often increased to 19% from 11.6%, the findings showed. However, the report found healthcare workers experienced a decrease in odds of burnout if they trusted management, had supervisor help, had enough time to complete work, and felt their workplace supported productivity.

The report highlighted the CDC’s National Institute for Occupational Safety and Health (NIOSH), which has implemented efforts to promote the mental health and well-being of healthcare workers, including a national social marketing campaign, Impact Wellbeing, which emphasizes primary prevention strategies such as worker participation in decision-making, supportive supervision, and increasing psychological safety for help-seeking.

“NIOSH has also developed burnout training for supervisors of public health workers and through its efforts has emphasized improving the work environment, rather than asking workers to be more resilient or fix problems themselves,” the report said.

SAMHSA Summary Report Shows Climate Change is a Social Determinant of Mental Health

A recent SAMHSA report concluded climate change is a social determinant of mental health; behavioral health systems should become “climate-informed;” and intergenerational trauma will be one of the layered effects of climate-related environmental change.

The report summarized the findings from SAMHSA’s August 2022 request for information that sought feedback about potential agency actions regarding mental health and substance use wellbeing in the context of climate change and health equity.

Respondents suggested SAMHSA should develop an agency-wide climate action plan to serve as a roadmap for change and integration of climate-informed behavioral health in SAMHSA research, programs, contracts, technical assistance, and reports.

They also said SAMHSA should support increased resources and allowable costs that shift behavioral health systems toward public behavioral health strategies for mental health promotion, substance use prevention, community-level response, and community-based mental health resilience.

“Respondents emphasized that a protective factor for healthcare workers is adequate training and preparation,” the report said. “Therefore, building out a climate-informed behavioral health system that provides resources to an increasingly diverse behavioral health workforce is protective to both the behavioral health workforce and the communities they serve,” it continued. “Timely and tailored interventions need to be designed in such a way that they can be altered over time to meet current and evolving needs.”

CMS Seeking Feedback to Improve Provider Resources

The Centers for Medicare and Medicaid Services (CMS) is conducting a study to help the agency improve user experience with Medicare program and billing resources.

Responses are confidential, and the survey should take about 10 minutes to complete. Click here to take the survey, which is due Thursday, Nov. 9.

SAMHSA Releases 988 Lifeline Videos

SAMHSA has produced two new videos that promote the 988 Lifeline. Called “Impact of the 988 Lifeline” and “You Matter PSA,” the videos are included in SAMHSA’s 988 Partner Toolkit.

In its announcement, SAMHSA noted that its 988 fact sheet, available in both English and Spanish, has been helpful in communicating about the 988 Lifeline’s services and successes.

Reminder: NABH’s Enhanced Denial-of-Care Portal is Now Available!

NABH thanks all members who have submitted data to the association’s Denial-of-Care Portal. You have provided critical information that expands the portal and helps NABH strengthen its advocacy efforts related to erroneous prior-authorization denials.

With guidance from our members, NABH has improved the portal by adding two elements:

1. Time-based data on the number of days between a request for coverage and a plan’s denial, which improves our ability to assess and compare health plan responsiveness.

1. The gap between days of provided care versus days of covered care to quantify and compare uncompensated days per health plan.

We strongly encourage all NABH members to submit their denial-of-care data in the portal. If you need help starting, or if you have other questions, please e-mail NABH Associate Manager for Congressional Affairs Emily Wilkins.

Reminder: The O’Neill Institute to Host Webinar on Recovery Housing Next Month

The O’Neill Institute’s Addiction and Public Policy Initiative will host a webinar next month about the current state of recovery housing and the opportunities for improving recovery housing in the United States.

As the O’Neil Institute explains, social determinants, such as housing, and expanded access to medications for substance use disorder are part of effective, long-term solutions. National standards for recovery housing, along with protecting the rights of individuals under the law, are central to facilitating a needed societal shift and maximizing opportunities for people with substance use disorder.

Recognizing the critical role that housing plays in improving outcomes for people with substance use disorder (SUD), SAMHSA recently issued Best Practices for Recovery Housing, and the U.S. Justice Department protects the rights of individuals with SUD afforded under the Fair Housing Act and the Americans with Disabilities Act.

Fact of the Week:

More than 1 million hospital emergency department visits are attributed annually to children and adolescents with a mental health disorder diagnosis, according to a new CDC study.

For questions or comments about this CEO Update, please contact Jessica Zigmond.