NABH Releases 2023 Advocacy Priorities

NABH this week released its 2023 advocacy priorities, which reflect the association’s mission and outline the actions NABH will take to achieve its goals.

Categorized under the headings “Mental Health” and “The Addiction Crisis,” NABH’s 2023 advocacy priorities include securing the promise of parity; persuading lawmakers to provide incentives for behavioral healthcare providers to establish and implement a solid behavioral health information technology infrastructure; advocating Congress to repeal the Institutions for Mental Diseases (IMD) exclusion; pushing the Centers for Medicare & Medicaid Services to ensure payment rates provide adequate and appropriate reimbursement for opioid treatment program services; maintaining tele-behavioral healthcare services, and more.
 
Please review this document and share it with others. If you have questions, please contact nabh@nabh.org.

FDA Approves First Over-the-Counter Naloxone Spray

The U.S. Food and Drug Administration (FDA) on Tuesday approved Narcan, 4 mg. naloxone hydrochloride nasal spray for over-the-counter (OTC), non-prescription use, making it the first naloxone product approved to use without a prescription.

Naloxone is a medication that reverses the effects of opioid overdose rapidly and is the standard treatment for opioid overdose. The FDA’s action clears the way for this life-saving medication to be sold directly to consumers in drug stores, convenience stores, grocery stores, gas stations, and online.

The move comes at a time when the Centers for Disease Control and Prevention released provisional data earlier this month that showed 101,750 reported U.S. fatal overdoses in the 12-month period ending in October 2022, while the predicted number of fatal doses for that period is even higher at 107,669.

“As a physician, I have used Naloxone on people to reverse an opioid overdose hundreds of times and have witnessed firsthand its life-saving effects,” Rahul Gupta, M.D., director of the White House Office of National Drug Control Policy, said in a statement this week. “FDA’s announcement to make Narcan available over-the-counter is an important step to make this medicine accessible to more people at a time when the majority of overdose deaths are being driven by illicit opioids like fentanyl,” he added. “This move will also build on the progress made under the Biden-Harris administration to get more Naloxone into communities, expand access to treatment for substance use disorder, and reduce the supply of illicit drugs, which has resulted in a decline or flattening of overdose deaths for seven months in a row.”

According to the FDA, the manufacturer determines the timeline for availability and price of this OTC product. Click here to learn more.

SAMHSA Warns Providers and Grantees About Xylazine Risks

In a letter this week, the Substance Abuse and Mental Health Services Administration (SAMHSA) alerted providers to the risks of xylazine, a non-opioid agent increasingly found in combination with opioids such as fentanyl.

The letter said xylazine—which the FDA has not approved for use in humans—can cause
severe circulatory changes with devastating effects on human tissue, leading to painful open lesions, necrosis, and potentially limb loss.

“Practitioners must be aware of risks posed by xylazine and prepare to manage patients accordingly, Miriam Delphin-Rittmon, Ph.D., assistant secretary for mental health and substance use, wrote to providers. “SAMHSA’s goal with this alert is to provide information about the consequences of xylazine exposure, what practitioners can do to mitigate harm, and how SAMHSA is responding to this emerging public health challenge.”

Known as “tranq” or “tranq dope” in the illicit drug market, xylazine can cause drowsiness, lethargy, and, in rare instances, apnea and death.

SAMHSA encourages healthcare professionals and patients to report adverse events resulting from possible xylazine exposure to their local health department, poison center, or the American Association of Poison Control Centers at 1-800-222-1222. FDA’s MedWatch Adverse Event reporting may be completed online at www.fda.gov/medwatch.

SAMHSA Announces Three Recovery-Related Funding Opportunities

SAMHSA this week announced it will accept applications through May for three separate funding opportunities to implement and strengthen recovery services in communities.

The programs include the Treatment, Recovery, and Workforce Support grant to implement evidence-based programs to support individuals in substance use disorder (SUD) treatment and recovery to live independently and participate in the workforce; the Recovery Community Services Program-Statewide Network, intended to strengthen community-based recovery organizations, their statewide networks of recovery stakeholders, and specialty and general healthcare systems as key partners in delivering state and local recovery support services; and the Recovery Community Services Program, which would provide peer recovery support services to individuals with SUD or co-occurring substance use and mental disorders, including those in recovery from these disorders.

SAMHSA will accept applications for all three funding opportunities until May 30.

Reminder: SAMHSA Funding Opportunity to Establish or Implement Opioid Recovery Centers

SAMHSA has announced it will grant up to $1.4 million in two awards to establish or implement comprehensive treatment and recovery centers that provide a spectrum of treatment, harm reduction, and recovery support services to address America’s opioid crisis.

Applications are due Tuesday, May 16. Click here to learn more and apply.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!
 
All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Register and Reserve Your Hotel Room Today for the 2023 NABH Annual Meeting!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Our preliminary program will be available soon. Meanwhile, please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

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. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Between 2009 and 2019, the number of pediatric mental health hospitalizations increased by 25.8%, and these hospitalizations accounted for a significantly higher proportion of pediatric hospitalizations, according to a study published in JAMA this week.

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

NABH Responds to Senate HELP Committee RFI About U.S. Healthcare Workforce Shortage

NABH thanks its many members who submitted comments detailing their workforce challenges and potential solutions, which helped form the association’s response to the Senate Health, Education, Labor & Pensions (HELP) Committee’s request for information earlier this week.

In its six-page letter, NABH noted that America’s behavioral healthcare workforce shortage has reached a crisis point, with nearly 58 million adults reporting any mental illness, about 61 million people using illicit drugs, and more than 150 million people living in federally designated mental health professional shortage areas at a time when the U.S. psychiatrist workforce will contract through 2024 to a projected low of 38,821, equal to a shortage of between 14,280 and 31,091 psychiatrists.

A diminished candidate pool, a limited employee pipeline, workplace violence, employee satisfaction in a post-pandemic environment, a highly competitive workforce, over-regulation, and an extremely limited health information technology infrastructure were the leading drivers of the segment’s workforce shortage, the association noted, based on NABH system member responses. The letter then summarized a range of solutions under the categories of reimbursement at parity, additional funding for training programs, and deregulation.

NABH will discuss how to address the behavioral healthcare workforce shortage in two sessions at the 2023 NABH Annual Meeting on Monday, June 12.

NABH Addresses Federal Lawmakers’ Stigmatizing Comments about OTPs

NABH this week sent a letter to federal lawmakers expressing deep disappointment with the congressional leaders’ recent comments that compared the nation’s opioid treatment programs (OTPs) with drug cartels and characterized this behavioral healthcare segment as an industry protecting its profits.

“These comments are highly stigmatizing to the approximately 18,000 staff who work in OTPs and have dedicated their careers to delivering life-saving services to individuals with opioid use disorders (OUD),” NABH wrote in a letter to Rep. Donald Norcross (D-N.J.) and Sen. Edward Markey (D-Mass.) “Your comments also perpetuate the ongoing stigma against medication-assisted treatment (MAT) that plagues our society,” the letter continued. “This stigma is one of the primary reasons that people with OUD do not seek, nor receive, MAT, even though it is the evidence-based, gold standard of care for patients suffering from OUD. We are confident you both agree that with our nation facing an overdose epidemic with one death every five minutes, we cannot afford to lose ground in the battle against stigmatization in addiction care.”

The letter highlights strengths and weaknesses of recent regulatory reforms and current legislation. It also provides a series of recommendations for lawmakers, such as examining the effects of recent efforts to expand access, with a specific focus on understanding the root causes behind incremental overdoses as well as the disproportionate harm that marginalized populations suffer; addressing significant barriers to treatment; and studying the potential impact of leveraging community-based pharmacies in the United States to dispense methadone widely to patients while ensuring that adequate regulatory controls can be established, given the concerning behaviors by pharmacies that recent court proceedings have documented.

NABH Files Amicus Brief on Behalf of Nine Organizations in Wit v. UBH Ruling

NABH has filed an amicus brief that supports a petition for rehearing the ongoing Wit v. United Behavioral Health (UBH) case.

A three-judge panel in the 9^th U.S. Circuit Court of Appeals on Jan. 26 replaced its March 2022 ruling in the Wit v. UBH case with a new opinion that was a major disappointment to both mental health patients and providers.

NABH asserts the latest opinion will materially reduce the benefit of insurance because it does not protect medically necessary treatment based on generally accepted standards of care.

NIH Study Reveals Shared Genetic Markers Underlying SUD

Scientists have identified genes commonly inherited across addiction disorders, regardless of the substance used, according to a study published in Nature Mental Health.

With support from the National Institute on Drug Abuse, the National Institute on Alcohol and Alcoholism, the National Institute of Mental Health, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute on Aging, researchers at Washington University in St. Louis, along with more than 150 coauthors worldwide, analyzed genomic data from more than 1 million people.

Their findings also reinforce the role of the dopamine system in addiction, by showing that the combination of genes underlying addiction disorders was also associated with regulation of dopamine signaling. Click here to learn more.

SAMHSA Announces Funding Opportunity to Establish or Implement Opioid Recovery Centers

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced it will grant up to $1.4 million in two awards to establish or implement comprehensive treatment and recovery centers that provide a spectrum of treatment, harm reduction, and recovery support services to address America’s opioid crisis.

Applications are due Tuesday, May 16. Click here to learn more and apply.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide!

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!

All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Register and Reserve Your Hotel Room Today for the 2023 NABH Annual Meeting!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

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. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

The National Alliance on Mental Illness (NAMI) reports that research shows the effects of solitary confinement on mental health are often fatal, both during and after incarceration. A recent showed individuals were overall 24% more likely to die in the first year after release, including from suicide (78% more likely) and homicide (54% more likely). They were also 127% more likely to die of an opioid overdose in the first two weeks after release.

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

NABH Remembers Former Board Member Frank Fortunati, Jr., J.D., M.D.

NABH remembers with grateful appreciation Frank Fortunati, Jr., J.D., M.D., 58, who died March 5 after a protracted, courageous battle against prostate cancer.

A psychiatrist, attorney, and pharmacist, Fortunati had served as assistant professor of psychiatry and deputy chair for Yale-New Haven Health System. Since 2016, he was the vice chief and medical director of psychiatry and behavioral health for Yale-New Haven Hospital, where he was also active in the department’s COVID Healthcare Worker Support Task Force and Anti-racism Task Force.

Referred to as a true Renaissance Man, Fortunati was an accomplished musician who played saxophone, guitar, piano, and flute. His obituary noted that one of his great joys was performing with his friends and fellow psychiatrists in their band “Schedule II.” In the car, he enjoyed listening to jazz or classic Rock. He was also an avid gardener, spending hours growing and harvesting tomatoes, peppers, eggplants, grapes, and figs.
 
Fortunati served as a member of the NABH Board of Trustees from 2018-2020 and was also an engaged member of NABH’s Quality Committee, Workplace Violence Prevention Workgroup, and COVID-19 Task Force. His fellow board members and the Washington-based NABH team will remember how he always listened well and offered thoughtful, practical solutions to any topic—and proposed solutions that made life better for patients and the healthcare teams who cared for them.

“Fortunati led by example, often serving in multiple roles (vice chief, section head, inpatient medical director),” the Yale School of Medicine wrote in an announcement about his death. “He earned the respect of everyone who worked with him. His credibility enabled him to drive change and improve quality. He put others ahead of his personal needs, repeatedly declining to complete the paperwork necessary for his own promotion in the service of looking out for others.”

Fortunati is survived by his wife, Karen; children Jenna and Frankie; other family members; and the Fortunati family’s three cherished dogs. Funeral services were held at Saint Mary Church (Precious Blood Parish) in Milford, Conn. on March 11.

NABH Raises Information System Limitations and Prior Authorization Concerns with CMS

NABH this week submitted comments to the Centers for Medicare & Medicaid Services (CMS) about the agency’s electronic prior authorization proposed rule as it pertains to behavioral healthcare patients and providers.

Under the direction of the NABH Managed Care Committee, the association raised concerns that the current limitations of the behavioral healthcare sector’s information system infrastructure are such that, without federal investment in compliant information technology to enable behavioral healthcare connectivity, most behavioral healthcare providers will remain shut out of 1) the interoperable exchange of patient health information, and 2) the electronic prior authorization processes that the rule proposes.

NABH’s letter also strongly supports modifying existing regulation to treat prior authorization approvals as a promise of payment that cannot be retracted, in addition to a determination of whether an item or service is medically necessary.

NABH Opposes Proposed FTC Ban on Non-Compete Clauses

In comments submitted today, NABH asked the Federal Trade Commission (FTC) to withdraw its proposed rule that would ban non-compete clauses.

NABH’s opposition to this proposal was based on three distinct concerns: the rule proposes an overly simplified, one-size-fits-all approach for all employees across all industries; given the workforce disruptions related to the COVID-19 pandemic, now is not the time to upend the healthcare labor markets; and, finally, the FTC lacks the statutory authority to promulgate this wide-reaching regulation.

Members of Congress Request Telehealth Parity Guidance from DOL

A bipartisan group of Members of Congress have sent a letter to the U.S. Labor Department (DOL) urging the department to provide guidance regarding parity enforcement for mental health and substance use disorder (SUD) services delivered via telehealth.

In the letter, House members expressed concern that health plans may be less motivated to cover behavioral healthcare telehealth services after the COVID-19 public health emergency is scheduled to end on May 11.

“Since the onset of the pandemic, telehealth use has risen dramatically, with 41% of MH/SUD care delivered via telehealth by October 2020,” the letter noted. “Mental health conditions continue to be the top claims diagnosis in the commercial market rising from 30% in January 2020 to roughly 65% in November 2022,” it continued. “Given the immense need for MH/SUD services combined with acute behavioral health workforce shortages, we want to ensure insurance plans and issuers understand their responsibility under federal parity law as it relates to behavioral health services delivered via telehealth.”

Click here to read the full letter.

SAMHSA Announces National Strategy for Suicide Prevention Funding Opportunity

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced it will grant five awards totaling $2 million to implement suicide prevention and intervention programs for adults that help implement the 2021 Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention.
 
With an emphasis on older adults, adults in rural areas, and American Indian and Alaskan native adults, the program is meant to address the Call to Action’s broad-based public health approach to suicide prevention through enhancing collaboration among stakeholders such as county health departments, workplace settings, criminal justice setting, senior-serving organizations, and community firearm stakeholders.

Applications are due Monday, May 15. Click here for more information.

Advertise in the 2023 NABH Exhibitor and Sponsor Guide! 

NABH will distribute the 2023 NABH Exhibitor and Sponsor Guide to all registrants at the 2023 NABH Annual Meeting from June 12-14, 2023 at the Salamander Washington, DC. Be sure your organization is included in it!

All ads are due by April 21, 2023. Please click here for details about advertising options, requirements, payment, and more.

The association also will send the guide to all NABH members after the meeting and post it on the NABH Annual Meeting webpage.

Registration is Open for the 2023 NABH Annual Meeting: Securing the Promise of Parity!

Please join us in Washington, DC from June 12-14, 2023 for this year’s NABH Annual Meeting at the Salamander Washington, DC (formerly the Mandarin Oriental hotel).

NABH’s theme this year is Securing the Promise of Parity, which recognizes the Mental Health Parity and Addiction Equity Act’s (MPAEA) 15^th anniversary and that we have more work to do to ensure the landmark law is implemented fully.

Please visit our Annual Meeting homepage to register, reserve your hotel room, and view our Annual Meeting At-a-Glance.

We look forward to seeing you in Washington!

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. Your data will help NABH highlight problems in the field related to health plan denials and timeliness.

Several policymaking entities are interested in these data, which could support advocacy for expanded access to care. For new participants, please e-mail Emily Wilkins, NABH’s administrative coordinator, for support.

Fact of the Week

Black and Hispanic adults with co-occurring disorders were less likely to receive mental health or substance use treatment (47% and 43%, respectively) than White adults (64%), according to research from The Pew Charitable Trusts. 

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