Provider Relief Fund Reporting Portal Now Open for Period 5

The Health Resources and Services Administration has announced that the Provider Relief Fund (PRF) Reporting Portal is now open for Reporting Period 5.
 
Recipients who received one or more General Distribution, Targeted Distribution, or ARP Rural Distribution payments exceeding $10,000, in the aggregate, from Jan. 1, 2022 to June 30, 2022 are required to report on the use of their payments during Reporting Period 5.

This latest reporting period will close at 11:59 p.m. ET on Sept. 30, 2023. Click here to learn more.

NIH Research Shows Lack of Buprenorphine for Adolescents in RTFs

Only one in four residential treatment facilities that treat adolescents in the United States for opioid use disorder offer buprenorphine, the sole U.S. Food and Drug Administration-approved medication for 16- to 18-year-olds, the National Institutes of Health (NIH) reports.

An NIH-funded research team identified 354 facilities nationwide that offered treatment for substance use in a residential treatment setting for people aged 17 and younger. Researchers called each facility to inquire about the treatments offered, and, in each case, a researcher posed as the relative of a 16-year-old with a recent, non-fatal fentanyl overdose. They found that 160 of these facilities, or 45%, provided residential treatment to patients younger than 18 years old.

Of the facilities that treated adolescents, only 39, or less than 25%, offered buprenorphine to 16- to 18-year-old patients. In contrast, almost two-thirds of adult residential facilities offer buprenorphine. The likelihood of offering buprenorphine varied by region, from 40% in the Northeast to 18% in the West, the NIH reports.

Meanwhile, the situations in which facilities offered buprenorphine also varied. Only 20 facilities—or one in eight—offered buprenorphine for ongoing treatment, and 12 offered it to patients younger than 16.

“These residential treatment centers see some of the most vulnerable adolescents in our communities,” lead researcher Caroline King, M.P.H., and an M.D./Ph.D. student in the Oregon Health & Science University School of Medicine, said in an NIH announcement about the findings. “But they don’t offer the standard of care for these kids. With rising fentanyl-related overdoses among adolescents, we really need these centers to provide the best care.”

In Case You Missed It: NABH Education & Research Foundation Workforce Resources

If you missed the 2023 Annual Meeting, be sure to access the workforce resources that the NABH Education and Research Foundation featured at the meeting and are available on the Foundation’s Resources page.

First, watch speaker John Pallasch’s presentation and listen to the question-and-answer period from NABH members. Pallasch, founder and CEO of workforce consultancy One Workforce Solutions, served previously as the Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department. Pallasch’s presentation challenged attendees to think beyond recruitment and retention and instead focus on re-designing the U.S. workforce system. He offered practical ideas for how NABH members can get involved in this process.

Also be sure to use the workforce resource guide that the Foundation co-branded with One Workforce Solutions. The guide includes links to state workforce agencies, workforce development boards, and more.

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week:

New antitransgender legislation passed in several U.S. states is raising concern among psychologists about the effect on the mental health of trans individuals—in particular children and teens—as well as members of the LGBTQ+ community, the American Psychological Association reports.

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

MedPAC Report to Congress Analyzes Behavioral Health Services and Patients

In its annual report to Congress last week, the Medicare Payment Advisory Commission (MedPAC) examined behavioral health services covered under Medicare’s inpatient and outpatient prospective payments systems and physician fee schedule.

The 76-page report’s behavioral health chapter addresses Medicare beneficiaries’ service utilization patterns, Medicare spending trends to providers and clinicians, and payment adequacy and margins. Regarding access, the report notes a drop in inpatient psychiatric facility (IPF) patient volume from 2019 through 2021 (the most recent data evaluated) due to the COVID-19 pandemic. Meanwhile, during the same period, the occupancy rates grew in government IPFs—an indicator of service shortages for patients with severe mental illness.

Concerning the 2021 acuity level of IPF patients relative to beneficiaries in other settings, IPF patients were 3.5 times more likely to be disabled and 2.4 times more likely to have low-income status (eligible for Part D low-income subsidy or dually-qualified for Medicare and Medicaid), metrics used as proxy indicators of acuity, according to the report.

For telehealth, among other findings, MedPAC cited the widely recognized increased use in telehealth services for behavioral health patients, which grew to 28% in 2021 from 1% of Part B behavioral health services in 2019.

MedPAC recommends gathering more information to assess the alignment between payments and the cost of care for ancillary and other behavioral health services, as well as additional data about patient-level outcomes. These additional data would be used to better understand variation in Medicare margins across IPF facility types, including differences due to scale and the mix of patients in different IPFs. The report also provides data on service utilization for patients affected by the Medicare’s 190-day-limit policy.

DOJ Releases Guidelines for Managing Substance Withdrawal in Jails

The U.S. Justice Department’s (DOJ) Bureau of Justice Assistance and the National Institute of Corrections this week released Guidelines for Managing Substance Withdrawal in Jails: A Tool for Local Government Officials, Jail Administrators, Correctional Officers, and Health Care Professionals.
 
In an announcement, DOJ said the document supports the department’s commitment to increasing access to evidence-based treatment for individuals with SUDs and those at risk for overdose, including individuals who are incarcerated or reentering their communities.
 
“These guidelines are a critical and much-needed resource to support local government officials, jail administrators, correctional officers and healthcare professionals faced with the difficult task of managing substance withdrawal in jail settings,” Associate Attorney General Vanita Gupta said in a statement. “Providing this new, evidence-based tool and treatment guidance, developed by a committee of clinical and correctional experts, will better safeguard the health and well-being of individuals at risk for or experiencing substance withdrawal in jails.”

DEA Now Requires One-Time Training for Buprenorphine Prescribing

Starting this week, the Drug Enforcement Agency (DEA) requires clinicians who register to prescribe controlled medications to complete a new, one-time, eight-hour training.

In January, the Substance Abuse and Mental Health Services Administration (SAMHSA) announced clinicians no longer need a federal waiver to prescribe buprenorphine to treat opioid use disorder. Instead, the DEA now requires all clinicians prescribing any controlled substance to complete a one-time training.

Exceptions for the training requirement include practitioners who are board-certified in addiction medicine or addiction psychiatry, and those who graduated from a medical, dental, physician assistant, or advanced practice nursing school in the United States within five years of June 23, 2023.

In addition, Rural Health Clinics (RHCs) will have the opportunity to apply for a $3,000 payment on behalf of each provider who received buprenorphine waiver training between Jan. 1, 2019 and Jan. 25, 2023 (when Congress eliminated the waiver requirement). According to the Health Resources and Services Administration, about $900,000 in program funding remains available for RHCs and will be paid on a first-come, first-served basis.

The International Certification and Reciprocity Adopts SAMHSA’s National Model Standards for Peers

The International Certification and Reciprocity Consortium (IC&RC) has announced it has adopted SAMHSA’s National Model Standards for Peer Support Certification in the form of a new credential.

In an announcement, the IC&RC said this national entry-level peer credential is intended to be the first rung of a career ladder that will lead to stronger substance use disorder (SUD) workforce development that is needed greatly nationwide. The IC&RC is the first—and currently only—nationally recognized, peer-certification organization to adopt the standards.

FDA Publishes First Draft Guidance on Psychedelic Drug Trials

The U.S. Food and Drug Administration (FDA) has published its first draft guidance on clinical trials for psychedelic drugs as research on using psychedelic drugs to treat conditions such as depression and post-traumatic stress disorder increases.

In an announcement, FDA noted that developing psychedelic drugs poses several challenges, including minimizing the risk of the drugs being misused and addressing the role that psychotherapy plays in psychedelic drug administration.

“By publishing this draft guidance, the FDA hopes to outline the challenges inherent in designing psychedelic drug development programs and provide information on how to address these challenges,” Tiffany Farchione, director of the division of psychiatry in FDA’s drug center, said in a news release. “The goal is to help researchers design studies that will yield interpretable results that will be capable of supporting future drug applications.”

GAO Examines Behavioral Healthcare Services in Critical Access Hospitals

A new Government Accountability Office (GAO) study of 10 critical access hospitals (CAHs) found that these providers offered behavioral healthcare services in a variety of ways in various settings, including emergency departments, inpatient services, and outpatient services.

Unlike other hospitals, under Medicare fee-for-service, CAHs are paid based on the cost of providing services in most, but not all, care settings. GAO researchers received mixed views on how Medicare fee-for-service payment policies affect CAHs’ ability to provide behavioral healthcare services in various settings that are not paid solely based on cost.

GAO said officials from multiple CAHs and stakeholders said factors outside Medicare were “substantial challenges” to their ability to provide behavioral healthcare services and patients’ access to these services.

“Hiring and recruitment of behavioral health professionals, such as psychiatrists and licensed clinical social workers, was cited as one of their biggest challenges due to nationwide workforce shortages,” the study said. “In addition, they said shortages of inpatient psychiatric beds made it difficult to find inpatient treatment for their patients,” the study continued, adding that patients were sometimes stuck in an emergency department for several days waiting to be transferred to an open psychiatric bed elsewhere in their community or state.

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week:

The two most common mental disorders among adults aged 18 to 65 were major depressive disorder (15.5%, or about 31.4 million adults) and generalized anxiety disorder (10%, or about 20.2 million adults), according to the SAMHSA-funded Mental and Substance Use Disorders Prevalence Study from RTI International.

The NABH team wishes all its members, their teams, and their families a safe and happy Independence Weekend!

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

2023 NABH Annual Meeting Presentations Now Available

Earlier this week NABH posted all 2023 Annual Meeting presentations for which the association has received permission to share publicly.

Please remember to save the date for next year’s Annual Meeting: May 13-15, 2024 at the Salamander Washington, DC. We look forward to seeing you then!

We Want Your Opinion: Please Submit Your 2023 Annual Meeting Evaluation!

NABH welcomes your feedback on the 2023 Annual Meeting held in Washington, D.C. last week.

If you attended this year’s Annual Meeting, please take a moment to complete NABH’s 10-question evaluation form if you have not done so already.

Your comments help to inform future NABH Annual Meetings. Thank you for your time!

SAMHSA Releases Resource on Findings from Drug-Related ED Visits in 2022

Alcohol was reported in the highest percentage of drug-related emergency department (ED) visits (45.0%) in 2022, followed by opioids (12.7%) and cannabis (11.9%), according to data from the Drug Abuse Warning Network (DAWN): Findings from Drug-Related Emergency Department Visits, 2022 that the Substance Abuse and Mental Health Services Administration (SAMHSA) released this week.

DAWN is a nationwide public health surveillance system that captures data on ED visits related to recent substance use directly from the electronic health records of participating hospitals. In 2022, DAWN identified 143,596 (unweighted) drug-related ED visits from 53 participating hospitals.

These data were analyzed to generate 1) nationally representative weighted estimates for all drug-related ED visits, 2) the top drugs involved in drug-related ED visits, 3) for different opioid types involved in ED visits, 4) to describe polysubstance in ED visits, and 5) to identify newly mentioned drugs in 2022.

The analysis for 2022 also showed heroin (5.6%) and prescription or other opioid (5.0%) were reported more often than fentanyl (2.7%) in drug-related ED visits.

CDC: Nearly One in Five U.S. Adults Report Having Ever Been Diagnosed with Depression

Data from the Centers for Disease Control and Prevention (CDC) show nearly one in five U.S. adults reported having ever been diagnosed with depression, although the rate – averaging at 18.4% in 2020 –varies significantly by state and county.

State-level, age-standardized estimates ranged from 12.7% in Hawaii to 27.5% in West Virginia. Meanwhile, model-based, age-standardized, county-level prevalence estimates ranged from 10.7% to 31.9%, and there was considerable state-level and county-level variability.

The CDC notes decisionmakers can use these estimates to guide resource allocation to areas where the need is greatest, possibly by implementing recommendations from The Guide to Community Preventive Services Task Force and SAMHSA.

NIH Study Deepens Understanding of Possible Mechanism Through Which Xylazine Affects Overdose Risk

A new study in rats suggests that xylazine, the active ingredient in a non-opioid veterinary tranquilizer not approved for human use, can worsen the life-threatening effects of opioids.

Published in Psychopharmacology, the study’s findings imply that when used in combination with opioid drugs such as fentanyl and heroin, xylazine may damage the ability of the brain to get enough oxygen, one of the most dangerous effects of opioid drugs that can lead to death.

Research has shown xylazine is often added to illicit opioids, including fentanyl, and that xylazine has been increasingly detected in the illicit opioid supply.

“Drug mixtures containing both xylazine and opioids such as fentanyl demonstrate how rapidly the drug supply can change, and how dangerous products can proliferate despite rampant overdose deaths,” Nora Volkow, M.D, director of the National Institute on Drug Abuse – which led the study – said in a statement about the study. “Understanding the mechanisms behind how xylazine contributes to drug overdoses is essential to enable us to develop interventions that can reverse overdoses and save lives,” she continued. “In the meantime, naloxone, an opioid overdose reversal medication, should always be administered in the event of an overdose because xylazine is most often combined with opioids such as fentanyl.”

Fact of the Week:

Men had a two-to-three times greater rate of overdose mortality from opioids – such as fentanyl and heroin – and psychostimulants –such as methamphetamine and cocaine – than women, according to a new study published in Neuropsychopharmacology.

For questions about CEO Update, please contact Jessica Zigmond.

2023 NABH Annual Meeting Starts Monday!

We’re pleased to devote this week’s edition of CEO Update to details about the 2023 Annual Meeting that starts on Monday, June 12 in Washington, D.C.

This year’s Annual Meeting celebrates two important milestones for NABH: the association’s 90^th anniversary and the 15^th anniversary of the Mental Health Parity and Addiction Equity Act (MHPAEA). We’re eager to remind our members of the many ways the behavioral healthcare community has helped change the U.S. healthcare system, and, in turn, helped improve and save lives in the last nine decades.

Mostly, though, we’re looking ahead. This year’s Annual Meeting theme – Securing the Promise of Parity – is a call to action for the work that remains to ensure MHPAEA is implemented fully and fairly.

NABH is pleased to welcome HHS Secretary Xavier Becerra, J.D. on Monday, and you also won’t want to miss our parity panel with NABH President and CEO Shawn Coughlin, U.S. Labor Department Assistant Secretary for Employee Benefits Security Lisa Gomez, and former U.S. Rep. Patrick Kennedy (D-R.I.), founder of The Kennedy Forum, on Tuesday. We’ll conclude our meeting on Wednesday with Sen. Chris Murphy (D-Conn.), who will address attendees at this year’s policy breakfast. Details about these and other sessions and events follow below.

To prepare for the meeting, view our preliminary program, learn more about this year’s speakers, and see our list of exhibitors and sponsors.

Be Sure to Access the 2023 NABH Annual Meeting Mobile App

Again this year, attendees will have access to all Annual Meeting programming and materials through NABH’s online mobile app.

On Monday, June 12, NABH will send all attendees an Annual Meeting alert with a link to the app that will display important details about sessions, events, exhibitors and sponsors, our 2023 advocacy priorities, restaurant recommendations in the Washington area, and more.

Attendees can also access the link through a QR code near the Registration Desk at the meeting.

HHS Secretary Becerra to Kick Off Annual Meeting

HHS Secretary Xavier Becerra, the 25^th secretary of the U.S. Health and Human Services Department and the first Latino to hold that office, will open this year’s Annual Meeting on Monday, June 12 at 2:15 p.m. in the Salamander hotel’s Grand Ballroom.

Secretary Becerra will offer brief remarks and then engage in a question-and-answer session with 2023 NABH Board Chair Harsh Trivedi, M.D., M.B.A., president and CEO of Sheppard Pratt.
Previously Secretary Becerra was California’s attorney general and before that served for 12 terms in the U.S. House of Representatives, where he was the first Latino to serve as a member of the powerful House Ways and Means Committee. He also served as chairman of his party’s caucus and as the ranking member of both the Ways and Means Subcommittee on Health and Ways and Means Subcommittee on Social Security.

Please join us in welcoming him and be sure to stay for additional remarks from NABH Board Chair Trivedi, who will introduce a brief video commemorating our 90 years as an advocacy association.

Monday’s General Sessions to Examine Workforce Challenges and Potential Solutions

Following Monday’s opening session, NABH will present back-to-back sessions that will examine current behavioral healthcare workforce challenges and how to address them.

At 3 p.m., NABH will welcome John Pallasch, former Senate-confirmed assistant secretary for employment and training at the U.S. Labor Department (DOL) and the founder and CEO of One Workforce Solutions, a workforce consultancy in Aiken, S.C. He served previously as executive director of Kentucky’s Office of Employment and Training, and—in his first stint at DOL—as deputy assistant secretary in the department’s Mine Safety and Health Administration.

Pallasch has spent more than 20 years influencing organizational personnel, efficiency, and productivity in the public and private sectors. He will draw from those experiences to help NABH members think more critically about their workforce challenges and more creatively about how to solve them.

Following Pallasch’s presentation, the NABH Education and Research Foundation will lead a panel discussion about workforce challenges and potential solutions at 4 p.m. ET.

New Season/Colonial Management Group CEO Jim Shaheen, the foundation’s vice president, will moderate the hourlong panel that will feature Hackensack Meridian Health Carrier Clinic President Donald Parker, the foundation’s president; Vanderbilt Psychiatric Hospital and Clinics President Mary Pawlikowski, the foundation’s secretary; and Susan Wright, director of BayCare Behavioral Health’s Behavioral Health Operations and this year’s Annual Meeting program chair.

Panelists will discuss best practices on a variety of topics and answer questions from Shaheen and audience members. Earlier presenter John Pallasch will also participate in the panel’s question-and answer period.

Please join us for both sessions in the Salamander’s Grand Ballroom.

Tuesday’s Parity Panel to Feature DOL Official Lisa Gomez and Former U.S. Rep. Patrick Kennedy on Tuesday, June 13

NABH President and CEO Shawn Coughlin will moderate a parity panel discussion with Lisa Gomez, assistant secretary for employee benefits security at the U.S. Labor Department, and former U.S. Rep. Patrick Kennedy (D-R.I.). on Tuesday, June 13 at 9:30 a.m., the Annual Meeting’s second day.

Before she was sworn in last October, Gomez was a partner with the law firm Cohen, Weiss and Simon LLP and chair of the firm’s management committee. She has deep technical and practical experience in the field of employee benefits law and spent almost three decades representing various Taft-Hartley and multiemployer pension and welfare plans, single employer plans, jointly administered training program trust funds, a federal employees health benefit plan, and other plans covering employees in a range of industries. Gomez earned her bachelor’s degree at Hofstra University and her law degree at Fordham.

Former Rep. Kennedy is the CEO of The Kennedy Forum, a not-for-profit he founded in 2013 to unite advocates, business leaders, and government agencies to advance evidence-based practices, policies, and programming mental health and addiction. During his time in Congress, Kennedy was the lead author of MHPAEA. Kennedy is also the founder of Don’tDenyMe.org, an educational campaign that empowers consumers and providers to understand parity rights and connects them to essential appeals guidance and resources; and co-founder of One Mind, an organization that pushes for greater global investment in brain research.

The panel will take place in the Grand Ballroom and will discuss the landmark 2008 parity law and the work that remains to secure the law’s promise.

Center for Medicaid & CHIP Services CMO Aditi Mallick, M.D. to Address Attendees on Tuesday

Aditi Mallick, M.D., chief medical officer at the Center for Medicaid and CHIP (Children’s Health Insurance Program) Services (CMCS), will discuss her department’s mental health and substance use disorder initiatives at the 2023 Annual Meeting on Tuesday, June 13 at 11 a.m.

Dr. Mallick leads the Center’s clinical strategy and cross-center work on health equity, social determinants of health, and innovation in whole-person care among other areas. Before joining CMCS, Dr. Mallick led the COVID-19 Response Command Center for the North Carolina Department of Health and Human  Services (NCDHHS), where she oversaw strategic and operational efforts around vaccination, testing, case investigation, and contact tracing statewide. A core focus of her COVID-19 work was ensuring equitable access and improving outcomes for historically marginalized populations.

Before her work at NCDHHS, Dr. Mallick worked closely with a range of healthcare stakeholders across the public and private sectors – including state Medicaid agencies, provider organizations, managed care organizations, and other payors – focusing on strategy, innovation, and data-driven change implementation.

Dr. Mallick continues to care for patients and brings that experience to her work at CMS. She earned her bachelor’s degree with honors from Harvard College, her medical degree from Stanford University School of Medicine, and completed internal medicine residency at Massachusetts General Hospital and Harvard Medical School.

NABH President and CEO Shawn Coughlin to Address Attendees at Annual Meeting Luncheon

Please join us for this year’s Annual Meeting Luncheon on Tuesday, June 13 at noon to hear from NABH President and CEO Shawn Coughlin.

Coughlin will provide updates on NABH’s work and initiatives and will help prepare any attendees who will head to Capitol Hill for congressional visits following the luncheon.

This year’s Annual Meeting Luncheon will take place in the hotel’s Gallery Room.

Hill Day Returns!  

For the first time since 2019, NABH is eager to welcome its members and guests back to Hill Day on Tuesday, June 13 from 1:30 to 5 p.m. ET.

This year NABH is working with the firm Advocacy Associates to help schedule congressional meetings and briefings on Capitol Hill for interested Annual Meeting attendees during Hill Day.
NABH will help prepare interested attendees by providing materials through a mobile app. For those attending Hill Day this year: please look for additional correspondence on Friday, June 9.

Also, Hill Day participants—and all Annual Meeting attendees—can review the association’s 2023 Advocacy Priorities and Contingency Management fact sheet before or during the Annual Meeting.

U.S. Sen. Chris Murphy to Address Attendees at Annual Meeting Policy Breakfast

U.S. Sen. Chris Murphy (D-Conn.) will address attendees at the 2023 Annual Meeting policy breakfast on Wednesday, June 14 at 9:30 a.m. ET.

Sen. Murphy serves on the Senate Foreign Relations Committee, the Health, Education, Labor and Pensions (HELP) Committee, and the Appropriations Committee. Before he was elected to the Senate, Sen. Murphy represented Connecticut’s fifth congressional district for three terms in the U.S. House of Representatives. Murphy is known in Congress as a leading voice for stronger anti-gun violence measures, a smarter foreign policy, and reform of our nation’s mental health system.

Before he was elected to Congress, Murphy served for eight years in the Connecticut state legislature. Murphy graduated with honors from Williams College in Massachusetts and received his law degree from the University of Connecticut School of Law. Please help us welcome Sen. Murphy on Wednesday.

The NABH team wishes everyone a safe trip to Washington, and we look forward to seeing you soon!

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

U.S. Sen. Chris Murphy to Address Attendees at Annual Meeting Policy Breakfast

NABH is pleased to announce U.S. Sen. Chris Murphy (D-Conn.) will address attendees at the 2023 Annual Meeting policy breakfast on Wednesday, June 14 at 9:30 a.m. ET.

Sen. Murphy serves on the Senate Foreign Relations Committee, the Health, Education, Labor and Pensions (HELP) Committee, and the Appropriations Committee. Before he was elected to the Senate, Sen. Murphy represented Connecticut’s fifth congressional district for three terms in the U.S. House of Representatives. Murphy is known in Congress as a leading voice for stronger anti-gun violence measures, a smarter foreign policy, and reform of our nation’s mental health system.

Before he was elected to Congress, Murphy served for eight years in the Connecticut state legislature. Murphy graduated with honors from Williams College in Massachusetts and received his law degree from the University of Connecticut School of Law.

Please help us welcome Sen. Murphy on June 14. And if you haven’t done so yet, please be sure to register for the Annual Meeting.

NABH Education and Research Foundation to Present Workforce Panel at Annual Meeting

The NABH Education and Research Foundation is pleased to lead a panel discussion about workforce challenges and potential solutions during the Annual Meeting on Monday, June 12 at 4 p.m. ET.

New Season/Colonial Management Group CEO Jim Shaheen, the foundation’s vice president, will moderate the hourlong panel that will feature Hackensack Meridian Health Carrier Clinic President Donald Parker, the foundation’s president; Vanderbilt Psychiatric Hospital and Clinics President Mary Pawlikowski, the foundation’s secretary; and Susan Wright, director of BayCare Behavioral Health’s Behavioral Health Operations and this year’s Annual Meeting program chair.

Panelists will discuss best practices on a variety of topics and answer questions from Shaheen and audience members. The panel will follow a 3 p.m. workforce presentation from John Pallasch, founder and CEO of One Workforce Solutions and former assistant secretary for employment and training at the U.S. Labor Department. Pallasch will participate later in the panel’s question-and answer period.

Please join us for both sessions in the Salamander’s Grand Ballroom on the Annual Meeting’s first day. We look forward to seeing you there!

Reminder: Hill Day is Back!  

NABH is excited to welcome its members and guests back to Hill Day during the 2023 Annual Meeting!

This year NABH is working with the firm Advocacy Associates to help schedule congressional meetings and briefings on Capitol Hill for interested Annual Meeting attendees during Hill Day on Tuesday, June 13 from 1:30 to 5 p.m. ET.

NABH will help prepare interested attendees by providing materials through a mobile app. There is still time to take advantage of this free opportunity. Please indicate that you want to participate in Hill Day when you register for the 2023 Annual Meeting or contact Emily Wilkins at NABH.

SAMHSA Awards Grants to Bolster Mobile Response Teams for 988 Lifeline

The Substance Abuse and Mental Health Services Administration (SAMHSA) has awarded 13 grants to communities to create new or enhance existing mobile crisis response teams to support the national 988 Suicide and Crisis Lifeline.

In an announcement, HHS noted the Biden administration has invested about $3.8 billion through the American Rescue Plan and more than $800 million through the Bipartisan Safer Communities Act through SAMHSA programs as part of President Biden’s effort to improve access to mental healthcare, prevent overdoses, and save lives.

“The expansion of mobile crisis response across the country is a big part of our efforts to achieve comprehensive, responsive crisis care services,” HHS Assistant Secretary for Mental Health and Substance Use and SAMHSA leader Miriam Delphin-Rittmon, Ph.D., said in an announcement. “Responding effectively to behavioral health crises in our communities will involve strong partnerships among first responders, community-based support services, and 988 Lifeline call centers.”

Click here to view the list of grant awardees.

Reminder: HRSA’s Substance Use Disorder Treatment and Recovery Loan Repayment Program Now Open

The Health Resources and Services Administration’s (HRSA) Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) application is open now through mid-July.

Anyone who is a behavioral health clinician or support worker, clinical support staff, or trained in substance use disorders may apply to the STAR LRP and receive up to $250,000 in loan repayment. In exchange, loan recipients must work full time for six years in a STAR LRP-approved facility.

The application process ends on Thursday, July 13 at 7:30 p.m. ET. Click here to learn more.

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

More than half of Americans who suffer from schizophrenia or another mental illness didn’t get the care they needed in 2021, the National Alliance on Mental Illness reports. A recent analysis in Kaiser Health News shows that coverage often depends on where you live—and how coverage of early psychosis treatment can be lifesaving.

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

NABH 2023 Annual Meeting is Approaching: Be Sure You’re Registered!

NABH’s 2023 Annual Meeting—Securing the Promise of Parity—is a little more than two weeks away!

Please review our online preliminary program, learn about this year’s speakers, view the list of exhibitors and sponsors, register for the meeting, and reserve your hotel room, if you haven’t done so yet.

We look forward to seeing you in Washington!

U.S. Surgeon General Releases Advisory on Social Media and Youth Mental Health

U.S. Surgeon General Vivek Murthy, M.D. this week released Social Media and Youth Mental Health, a new advisory that shows while social media may offer some benefits, there are “ample indicators” that social media can pose a risk of harm to the mental health and well-being of children and adolescents.

The advisory notes that social-media use by young people is nearly universal, with up to 95% of young people ages 13-17 reporting using a social media platform and more than a third saying they use social media “almost constantly.”

“The most common question parents ask me is, ‘Is social media safe for my kids?’” Murthy said in a news release about the advisory. “The answer is that we don’t have enough evidence to say it’s safe, and in fact, there is growing evidence that social media use is associated with harm to young people’s mental health,” he continued. “Children are exposed to harmful content on social media, ranging from violent and sexual content, to bullying and harassment. And for too many children, social media use is compromising their sleep and valuable in-person time with family and friends,” he added. “We are in the middle of a national youth mental health crisis, and I am concerned that social media is an important driver of that crisis – one that we must urgently address.”

Murthy’s office reported that adolescents spending more than three hours per day on social media face double the risk of experiencing poor mental health outcomes, such as symptoms of depression and anxiety; yet one 2021 survey of teenagers found that, on average, they spend 3.5 hours a day on social media.

NIMH Finds Youth Suicide Rates Increased During the COVID-19 Pandemic

The National Institute of Mental Health this week released research that shows 5,568 youth died by suicide during the first 10 months of the COVID-19 pandemic, which was higher than the expected number of deaths had the pandemic not occurred.

Higher-than-expected suicide rates were found a few months into the pandemic, starting in July 2020. According to the research, the increase in suicide deaths varied significantly by sex, age, race and ethnicity, and suicide method.

For this period, researchers also found higher-than-expected suicide deaths among males, preteens aged 5–12 years, young adults aged 18–24 years, non-Hispanic American Indian or Alaskan Native youth, and non-Hispanic Black youth as compared with before the pandemic. Suicide deaths involving firearms were also higher than expected, the study showed.

CMS Reports to Congress on SUD Planning Grant Implementation

The Centers for Medicare & Medicaid Services (CMS) has released the Initial Report to Congress that the SUPPORT Act requires.

The 2018 law directs CMS to release three reports to Congress, and the one released this week provides details on states awarded planning grants under the SUPPORT Act, the criteria used to select these states, and initial activities proposed or carried out under the planning grants.

Findings in the report are from the first 13 months of the planning period of the demonstration: Sept. 30, 2019-Oct. 31, 2020.

Now Open: HRSA’s Substance Use Disorder Treatment and Recovery Loan Repayment Program

The Health Resources and Services Administration (HRSA) announced this week that the agency’s Substance Use Disorder Treatment and Recovery Loan Repayment Program (STAR LRP) application is open now through mid-July.

Anyone who is a behavioral health clinician or support worker, clinical support staff, or trained in substance use disorders may apply to the STAR LRP and receive up to $250,000 in loan repayment. In exchange, loan recipients must work full time for six years in a STAR LRP-approved facility.

The application process ends on Thursday, July 13 at 7:30 p.m. ET. Click here to learn more.

Also this week, HRSA announced a grant program for professionals focused on behavioral health workforce education and training for children, adolescents, and transitional-aged youth. The grant’s purpose is to address the behavioral health needs of children, adolescents, and transitional-aged youth by increasing the supply and distribution of behavioral health providers in rural and underserved communities. Click here to view the grant opportunity.

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

A new study published in Health Affairs found that although almost all insurance plans covered immediate-release buprenorphine in 2021 (with a general trend of decreasing prior authorization requirements and quantity limits since 2017), only two payers had relatively low coverage of extended-release buprenorphine, with only 46% of commercial plans and only 19% of Medicare Advantage plans covering this formulation. The study authors recommended that policymakers and researchers “concerned with buprenorphine insurance barriers should shift their attention to extended-release buprenorphine.”

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

Please Meet with NABH’s Exhibitors and Sponsors at the 2023 Annual Meeting Next Month!

NABH appreciates the generous support of our exhibitors and sponsors, whose valuable products and services help NABH members deliver quality behavioral healthcare every day to those who need it!

Please make time to visit our exhibitors and sponsors at the Annual Meeting from June 12-14 at the Salamander Washington, DC. Before then, you can view a complete list of our exhibitors and sponsors on our Annual Meeting homepage.

Also, please be sure to register for the Annual Meeting and reserve your hotel room today if you haven’t done so yet. We look forward to seeing you in Washington!

U.S. Labor Department Projects Five Mental Health Jobs Will Grow ‘Much Faster’ than Average from 2021-2031

The U.S. Labor Department’s (DOL) Bureau of Labor Statistics projects these five mental health-related careers will grow “much faster” than average between 2021-2031: mental health and substance abuse social workers; substance abuse, behavioral disorder, and mental health counselors; community health workers; healthcare social workers; and marriage and family therapists.

“Together, they employed about 761,000 workers in 2021 —and they are expected to have more than 91,000 openings on average each year through 2031,” DOL reported in its blog. “The education typically required to enter these occupations ranges from a high school diploma to a master’s degree, and they all pay around or more than the $46,310 median for all occupations in 2022.”

Click here to learn more about growth projection for each position.

CMS Releases Guide for Medicaid School-based Services

The Centers for Medicare & Medicaid Services (CMS) this week released a guide for Medicaid school-based services to make it easier for schools to deliver and receive payment for healthcare services to millions of eligible students.

CMS worked with the U.S. Department of Education to produce the Comprehensive Guide to Medicaid Services and Administrative Claiming, which is a result of the Bipartisan Safer Communities Act.

“With this guide, we are helping states and schools bring health care to kids where they are, rather than the other way around,” CMS Administrator Chiquita Brooks-LaSure said in a statement. “Children spend most of their waking hours in school. We also know that children have suffered serious declines in access to mental and behavioral healthcare services during the COVID-19 pandemic. We’re making it easier for states and schools to maximize Medicaid coverage to grow connections to care.”

Medicaid and CHIP cover more than half of all U.S. children, or more than 41 million children, according to CMS. The guide is intended to help states and schools leverage Medicaid and CHIP, and it maps out how they can build a bridge between education and healthcare, including mental healthcare, to support children enrolled in these programs and help them thrive.

House and Senate Committees Press Insurers for Information on Claims

Two congressional oversight committees this week pressed the nation’s insurers for information regarding denial of claims in one instance and denial of care in Medicare Advantage in the second.

Republicans from the House Energy and Commerce Committee sent a letter to Cigna President and CEO David Cordani asking for clarification after online news source ProPublica released an investigative report that suggested the insurance company’s physicians reject claims without reading them.

Meanwhile, the Senate Homeland Security & Governmental Affairs Committee Permanent Subcommittee on Investigations hosted a hearing about delays and denials of care in Medicare Advantage. That hearing follows an April 2022 report from the HHS Office of Inspector General that found Medicare Advantage insurers have denied some coverage or payment for services that would have been covered under traditional Medicare.

Federally Supported Study Finds More than Half of Physicians Ranked Stigma as Highest Barrier to Treating Patients for OUD

A University of Vermont study of more than 450 clinicians and counselors in rural New England found that more than half (55%) ranked stigma as the highest barrier to treating patients for opioid use disorder (OUD) among other factors that included time and staffing, medication diversion, and organizational/clinic barriers.

Meanwhile, 60% of physicians and 51% of counselors surveyed disagreed that medications for OUD “replace addiction to one kind of drug with another.” However, among clinicians with the ability to prescribe, there was considerable difference in this belief, depending on whether they were currently treating with medications for OUD, or MOUD.

“More than 80% of those currently treating with MOUD believed it is not an addiction replacement; among those not currently treating with OUD, fewer than half felt that way,” the Federal Office of Rural Health Policy (FORHP) announced. FORHP is part of HHS’ Health Resources and Services Administration and supports the Center on Rural Addiction at the University of Vermont, which conducted the study.

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness. If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that more Black Americans died from fentanyl overdoses than from any other drug in 2021 and at far higher rates than whites or Hispanics.

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

NABH to Host Parity Panel with DOL Official Lisa Gomez and Former U.S. Rep. Patrick Kennedy on Tuesday, June 13

NABH President and CEO Shawn Coughlin will moderate a parity panel discussion with Lisa Gomez, assistant secretary for employee benefits security at the U.S. Labor Department, and former U.S. Rep. Patrick Kennedy (D-R.I.). on Tuesday, June 13, the second day of the 2023 Annual Meeting.

Before she was sworn in last October, Gomez was a partner with the law firm Cohen, Weiss and Simon LLP and chair of the firm’s management committee. She has deep technical and practical experience in the field of employee benefits law and spent almost three decades representing various Taft-Hartley and multiemployer pension and welfare plans, single employer plans, jointly administered training program trust funds, a federal employees health benefit plan, and other plans covering employees in a range of industries. Gomez earned her bachelor’s degree at Hofstra University and her law degree at Fordham.

Former Rep. Kennedy is the CEO of The Kennedy Forum, a not-for-profit he founded in 2013 to unite advocates, business leaders, and government agencies to advance evidence-based practices, policies, and programming mental health and addiction. During his time in Congress, Kennedy was the lead author of the Mental Health Parity and Addiction Equity Act. Kennedy is also the founder of Don’tDenyMe.org, an educational campaign that empowers consumers and providers to understand parity rights and connects them to essential appeals guidance and resources, and co-founder of One Mind, an organization that pushes for greater global investment in brain research.

The panel will begin at 9:30 a.m. ET in the Salamander’s Grand Ballroom and will discuss the landmark 2008 parity law and the work that remains to secure the law’s promise.

Please be sure to register for the Annual Meeting and reserve your hotel room today, if you haven’t done so yet. We look forward to seeing you in Washington!

CMS Coverage for PHP Telehealth Services Ends With COVID-19 PHE’s Conclusion

The Centers for Medicare & Medicaid Services (CMS) has shared with NABH and other stakeholders the agency’s plans to end telehealth coverage for partial hospitalization program (PHP) services implemented during the COVID-19 Public Health Emergency (PHE) when the PHE concluded at the end of Thursday, May 11.

In addition, CMS has explained that telehealth coverage will continue through December 2024 for Intensive Outpatient Program (IOP) services that qualify under the outpatient prospective payment system as “remote mental health services.”

NABH continues to communicate with key Members of Congress to clarify the legislative intent behind the telehealth coverage extensions that were authorized in the Consolidated Appropriations Act, 2023 last December. The NABH team understands that some Members of Congress intended for the telehealth coverage extension to include PHP services.

Given the persistent confusion on these matters, NABH has urged CMS to issue clarification in writing. NABH will keep members apprised of our efforts to extend telehealth coverage for PHP services.  

DEA Rule to Extend Telemedicine Flexibilities for Prescription of Controlled Substances Effective May 11

The U.S. Drug Enforcement Administration’s (DEA) temporary extension of COVID-19 telemedicine flexibilities for prescription of controlled medications took effect Thursday, May 11.

Under the DEA’s rule, the agency has extended the full set of telemedicine flexibilities adopted during the PHE for six months through Nov. 11, 2023. For any practitioner-patient telemedicine relationships that have been or will be established up to Nov. 11, 2023, the full set of telemedicine flexibilities regarding prescription of controlled medications established during the PHE will extend for one year through Nov. 11, 2024.

In a letter to DEA on March 31, NABH advocated to remove requirements for in-person medical examinations for Schedule II stimulant medications for ADHD and Schedule III-V mental health medications.

Please contact Sarah Wattenberg, NABH’s director of quality and addiction services, with questions or comments.

SAMHSA and FDA Officials Release Letter to Practitioners to Promote Medication First Model

Officials from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the U.S. Food and Drug Administration (FDA) this week sent a letter to healthcare practitioners noting that although counseling and other services are important parts of treatment plans, they should not be prerequisites for receiving medication.

“An often-cited barrier to prescribing buprenorphine for the treatment of OUD is the perception that patients must engage in counseling and other services in order to start or continue receiving the medication,” wrote Miriam Delphin-Rittmon, Ph.D. and Patrizia Cavazzoni, M.D. “This letter serves to clarify the importance of counseling and other services as part of a comprehensive treatment plan, but to also reiterate that the provision of medication should not be made contingent upon participation in such services,” they added.

Delphin-Rittmon serves as the assistant secretary for mental health and substance use at SAMHSA and Cavazzoni is the director of the FDA’s Center for Drug Evaluation and Research.

SAMHSA Announces Funding Opportunity for Cooperative Agreements for 988 Suicide and Crisis Lifeline Crisis Center Follow-Up Programs

SAMHSA has announced it anticipates funding a total of $5 million in 10 awards to expand efforts among 988 lifeline centers to support individuals in follow-up programs.

Specifically, the money would support individuals post-contact to provide continued support and linkages to decrease suicide risk by 1) ensuring the systematic follow-up of suicidal persons who contact the 988 suicide and crisis lifeline; 2) providing enhanced crisis stabilization coordination, crisis respite, mobile crisis outreach response services, and other services on the crisis continuum of care; 3) reducing unnecessary police engagement; and 4) improving connections for high-risk populations.

Click here to learn more.

SAMHSA Distributes Additional Grant Funding for Programs to Combat Overdose and SUD

Also this week, SAMHSA announced awards in four grant programs totaling nearly $11.3 million in additional funding to support the Biden administration’s ongoing efforts nationwide in prevention, treatment, recovery support, and harm reduction.

The four grant programs are Screening, Brief Intervention to Referral Treatment (SBIRT) (nearly $6.9 million); Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths ($2.6 million); Target Capacity to Expansion-Special Projects ($1.1 million); and Provider’s Clinical Support System to universities (more than $725,000).

Click here to learn more about the programs

Reminder: Please Submit Data to Enhance NABH’s Managed-Care Advocacy Efforts

Thank you to all members who have submitted data to NABH’s denial-of-care portal!

We are still seeking data from additional members to support advocacy on health plan denials and prior-authorization timeliness.

If you are a new participant, please e-mail NABH Administrative Coordinator Emily Wilkins for support.

Fact of the Week

The Centers for Disease Control and Prevention reports that overdose deaths increased by 279% for drug overdoses involving fentanyl during the five-year study period to 21.6 per 100,000 standard population in 2021 from 5.7 per 100,000 standard population in 2016.

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