Author: Administrator

U.S. House Passes First Stand-Alone IMD Exclusion Repeal Bill In a 261-155 vote, the House of Representatives this week passed the IMD CARE Act, which partially repeals the Medicaid program’s Institutions for Mental Diseases (IMD) exclusion. The move marks the first time either chamber of Congress has voted on a freestanding IMD bill. Before passing this NABH-supported bill, House members considered and adopted two amendments, which: 1) add cocaine to the list of “targeted SUDs” (substance use disorders) and apply a minimum loss ratio of 85 percent for Medicaid managed care plans, and 2) add two requirements to the report that states are required to submit. The first of those requirements asks for information about the number of individuals suffering from co-occurring disorders and the type of disorders; and the second requires information regarding access to community care for individuals suffering from a mental illness other than substance use disorder. The legislation limits eligible patients under the provision to no more than 30 days of treatment in an IMD in a year (whether or not those days are consecutive). While the provision applies to patients with opioid use disorder or cocaine disorder, the bill also includes patients with those conditions and other co-occurring mental health or SUDs. NABH has advocated to repeal the IMD exclusion for decades, and The Hill newspaper this week published a letter to the editor from NABH President and CEO Mark Covall and behavioral healthcare champion and former U.S. Rep. Patrick Kennedy (D-R.I.). Meanwhile, the Henry J. Kaiser Family Foundation released a document that highlights key questions about payment for services in IMDs. Moments after passing the IMD CARE Act, the House passed the Overdose Prevention and Patient Safety Act, which amends the Public Health Service Act to align federal privacy standards for SUD patient records more closely with standards under the Health Insurance Portability and Accountability Act (HIPAA). Specifically, this bill—which passed in a 357-57 vote—authorizes the disclosure of SUD patient records without a patient’s written consent to: 1) a covered entity for the purposes of treatment, payment and healthcare operations, as long as the disclosure is made in accordance with HIPAA; and 2) a public health authority, as long as the content of the disclosure meets HIPAA standards regarding de-identified information. The bill also repeals and replaces criminal penalties for violations involving SUD patient records with the HIPAA civil penalty structure. It also expands the existing prohibition against SUD patient records in criminal proceedings to include any use in specified federal, state, and local criminal and civil actions. Earlier this week, the White House released a Statement of Administration Policy supporting these critical behavioral healthcare reforms.   CMS Issues Bulletin on EPSDT in 21^st Century Cures Act The Center for Medicare and Medicaid Services (CMS) this week issued an information bulletin about the section of the 21st Century Cures Act (Cures) that requires Medicaid reimbursement for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services for children under age 21 in IMDs. This provision in Cures—which had been a legislative priority for NABH—corrects a long-standing oversight in the “psych under 21” benefit. Historically under EPSDT, CMS had denied coverage for medically necessary services, such as prescription drugs or practitioner services, for children in IMDs. Section 12005 of Cures ends that policy and allows children full access to EPSDT regardless of whether they are placed in an IMD. The EPSDT provision becomes effective on Jan. 1, 2019.   Federal Office of Rural Health Policy to Host Webinar on Opioid Response Funding The Federal Office of Rural Health Policy will hold a technical assistance webinar for those who want to apply for the Rural Communities Opioid Response Program on Thursday, June 28 at 1 p.m. ET. Dial-in information is available on page (ii) in the grant program guidance. To find the guidance, visit the Grants.gov, click on the Package tab, then Preview, then choose “Download Instructions.” A recording will be made available for those who cannot attend. Please contact ruralopioidresponse@hrsa.gov if you have questions. Meanwhile, the Rural Health Information Hub updated its website to highlight a guide with initiatives and funding opportunities, as well as rural-specific program examples, tools, and resources that focus on prevention, harm reduction, and treatment.   SAMHSA to Host Webinar on Preventing Suicides Among Service Members, Veterans and Their Families The Substance Abuse and Mental Health Services Administration (SAMHSA) will host a two-hour webinar to discuss “military culture-informed strategies” that can be applied to reduce access to lethal means—including poisoning and firearms—for those who are at high risk for suicide on Thursday, June 28 at 2 p.m. ET. The event is the first in a series on suicide from SAMHSA’s Service Members, Veterans and Their Families Technical Assistance Center.   World Congress Opioid Management: Treatment and Recovery Summit is Aug. 13-14 in Nashville Sarah Wattenberg, NABH’s director of quality and addiction services, will co-chair the World Congress Opioid Management: Treatment and Recovery Summit in Nashville from Aug. 13-14 in Nashville. Healthcare executives nationwide will discuss effective strategies to address the opioid epidemic across the continuum of care. Key topic areas include payer-provider partnerships, recovery support services, opioid use disorder medications, neonatal abstinence syndrome protocols, drug courts, successful organizational strategies, and more. Michael Botticelli, the former director of the White House Office of National Drug Control Policy, will also speak at conference. NABH members can register here and receive $200 off the meeting’s registration fee by using the following promotional code: SPEAKER.   Prepare Early for National Recovery Month in September SAMHSA’s toolkit to prepare for National Recovery Month in September is available here. Now in its 29^th year, National Recovery Month is meant to promote awareness and understanding about mental and substance use disorders and to celebrate individuals living in recovery. This year’s theme is Join the Voices for Recovery: Invest in Health, Home, Purpose and Community.   For questions or comments about CEO Update, please contact Jessica Zigmond

U.S. House Passes Dozens of Opioid-Related Bills House members this week approved nearly three dozen pieces of legislation to address America’s opioid crisis and will likely consider several other opioid-related bills in the coming days. Next week the House is expected to focus on two NABH-supported bills. The first is the IMD CARE Act, which would partially repeal Medicaid’s Institutions for Mental Diseases (IMD) exclusion for patients with opioid use disorder or with co-occurring behavioral health conditions. And the second is the Overdose Prevention and Patient Safety Act, which would align 42 CFR (Part 2) with the Health Insurance Portability and Accountability Act of 1996. These individual bills will likely be included in a broader opioid package that the House will then send to the Senate for its consideration. Meanwhile, the influential Senate Finance Committee this week passed the Helping to End Addiction and Lessen (HEAL) Substance Use Disorders Act of 2018. Several amendments related to NABH’s key issues were not included in this bill, but NABH staff has learned those measures could be offered as amendments when the full Senate considers the legislation. The NABH team will continue to engage legislators on the association’s legislative priorities and will keep members apprised of any developments.   FDA Approves Generic Versions of Suboxone The Food and Drug Administration (FDA) this week approved the first generic versions of Suboxone (buprenorphine and naloxone) sublingual film—which is applied under the tongue—to treat opioid dependence. “The FDA is taking steps to advance the development of improved treatments for opioid use disorder, and to make sure these medicines are accessible to the patients who need them,” FDA Commissioner Scott Gottlieb, M.D., said in the public announcement. “That includes promoting the development of better drugs, and also facilitating market entry of generic versions of approved drugs to help ensure broader access.”   SAMHSA Announces $930 Million in Grant Funding to Address Opioid Crisis The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications $930 million in the agency’s State Opioid Response Grants program. According to a SAMHSA announcement, the federal funding is meant to address the crisis by expanding access to evidence-based, medication-assisted treatment; reducing unmet treatment needs; and lowering opioid-related overdose deaths. In a statement, Assistant Secretary for Mental Health and Substance Use Elinore McCance-Katz, M.D., Ph.D., said the grants were designed to meet the specific needs of communities. “The grants will expand capacity to provide much-needed, evidence-based care to people who haven’t yet been reached,” McCance-Katz said.   MACPAC Highlights Substance Use Disorder in June 2018 Report The Medicaid and CHIP Payment and Access Commission (MACPAC) included two chapters related to substance use disorder (SUD) treatment in the June 2018 Report to Congress on Medicaid and CHIP that the commission released on Friday, June 15. In the report’s chapters Substance Use Disorder Confidentiality Regulations and Care Integration in Medicaid and CHIP and Access to Substance Use Disorder Treatment in Medicaid, MACPAC commissioners examine reforming 42 CFR Part 2 (Part 2) and the IMD exclusion, both NABH priorities. Regarding Part 2, MACPAC recommended the HHS secretary issue sub-regulatory guidance to clarify key provisions and offer information about education and technical assistance for Part 2. The commission did not make any recommendations about the IMD exclusion. Commissioners acknowledged that “the IMD exclusion is not the only reason gaps in coverage exist.” They also noted that the “largest gaps in state clinical service coverage are for partial hospitalization and residential treatment” and added that “the institutions for mental diseases (IMD) exclusion is often cited as a barrier to paying for residential services.” MACPAC commissioners noted that some states—such as the commonwealth of Virginia—are reimbursing IMDs for SUD treatment through 1115 waivers. The report also said Virginia has seen a significant increase in the number of providers participating in Medicaid, as the total jumped to 77 from 4.   CMS Releases Roadmap to Address Opioid Crisis Prevention, treatment, and data are the Centers for Medicare and Medicaid Services’ three areas of focus to address the nation’s opioid crisis, according to a new roadmap the agency released this week. Presented as an infographic with key data points, analytic tools, and recommendations, the four-page roadmap also highlights best practices and a summary of CMS activities to date. For instance, the agency noted that as of this month, it has approved a dozen Medicaid 1115 demonstrations to improve access to opioid use disorder treatment, “including new flexibility to cover inpatient and residential treatment while ensuring quality of care.” Looking ahead, CMS noted in the roadmap it will focus its data efforts and provide tools for states, plans and providers to monitor success of prevention measures related to reducing overuse and misuse of prescription opioids; improve data transparency and interoperability, and expand tools such as the Medicare “heat map” of prescribing rates that help determine where to target safe prescribing efforts; analyze prescription opioid use patterns across CMS programs and in special populations; and support state Medicaid program capacity to track and report data.   Prepare Early for National Recovery Month in September SAMHSA has announced that its toolkit to prepare for National Recovery Month in September is now available. Now in its 29^th year, National Recovery Month is meant to promote awareness and understanding about mental and substance use disorders and to celebrate individuals living in recovery. This year’s theme is Join the Voices for Recovery: Invest in health, Home, Purpose and Community, and more information—including SAMHSA’s toolkit—is available here.   For questions or comments about CEO Update, please contact Jessica Zigmond.

NABH Comments on Rise in U.S. Suicide Rates NABH issued a news release about the need for wider access to behavioral healthcare services in the United States after the Centers for Disease Control and Prevention (CDC) reported this week that suicide rates have increased in nearly every state from 1999 to 2016. The CDC’s report was released days after designer Kate Spade, 55, died by suicide at her home in New York, and a day before it was reported that celebrity chef Anthony Bourdain, 61, died by suicide in France. “Our country has faced a difficult week filled with very sad news and grim statistics,” NABH President and CEO Mark Covall said in the news release. “We know that with suicide, hope lies in effective mental health and substance use disorder services—at inpatient psychiatric hospitals, residential treatment facilities, addiction treatment centers, and outpatient settings.” According to the CDC, suicide is a leading cause of death in the United States, and nearly 45,000 people died by suicide in 2016. Overall, suicide rates increased by 25 percent across the country and rose more than 30 percent in half of the states since 1999. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides tools and resources through its Suicide Preventionpage and National Suicide Prevention Lifeline, which is available 24 hours a day, 7 days a week. As always, NABH appreciates the hard work of its members each day to care for people with mental health and substance use disorders. Please learn more from Mark Covall in his LinkedIn article about this week’s news and NABH’s advocacy efforts to widen access to behavioral healthcare services for people who need it.   National Governors Association Supports House Opioid Legislation The nation’s governors this week sent a letter to House Speaker Paul Ryan (R-Wis.) and House Minority Leader Nancy Pelosi (D-Calif.) that supports several House bills to address the nation’s opioid crisis, including the IMD CARE Act. “We ask that any bills considered by Congress ensure that federal strategies preserve state flexibility allowing governors to meet the specific needs of their state,” said the June 7 letter from the National Governors Association. “Governors need increased financial and technical support to address this crisis and we urge Congress to avoid burdensome requirements on state programs.” On Friday, the Congressional Budget Office (CBO) estimated that enacting the IMD CARE Act would increase direct federal spending by $991 million between 2019 and 2028. The bill—which NABH supports—would expand Medicaid coverage for people experiencing opioid use disorder who are in institutions for mental diseases, or IMDs, for up to 30 days per year. The House Energy and Commerce Committee passed the bill last month. In the upper chamber, the Senate Finance Committee will consider an opioid legislative package next week.   SAMHSA Names Director of the Center for Substance Abuse Treatment In a letter to colleagues this week, Assistant Secretary for Mental Health and Substance Use Elinore McCance-Katz, MD, PhD announced that Capt. Chideha Ohuoha, MD, MPH, will join SAMHSA to lead the Center for Substance Abuse Treatment. Since 2008, Ohuoha has been stationed at Fort Belvoir in Fairfax County, Va. as an officer in the U.S. Public Health Service. He has served as director of addiction medicine there since 2015. “Capt. Ohuoha completed his psychiatric residency at St Elizabeth’s Hospital in Washington, D.C. and completed a three-year addiction psychiatry fellowship at NIMH,” McCance-Katz wrote to her staff, adding that Ohuoha earned a master’s degree in public health from Harvard. “Capt. Ohuoha’s experience in addiction psychiatry will be a great asset to SAMHSA and CSAT. His official start date here at SAMHSA will be June 11.”   Addiction Policy Forum Launches Resource Center to Address Opioid Crisis Not-for-profit organization the Addiction Policy Forum (APF) this week launched the Addiction Resource Center—which features a phone line and online portal—to support the millions of Americans battling substance use disorder as well as their families. The online portal is an interactive website intended to help individuals and families learn about substance use disorders and access help. The platform features a database of vetted local treatment providers and provides a self-assessment tool to help individuals develop a proposed action plan. Meanwhile, the hotline—1-833-301-HELP (4357)—is available Monday through Friday from 9 a.m. until 6 p.m. ET to provide confidential support and information about local treatment and recovery services.   Prepare Early for National Recovery Month in September SAMHSA announced this week that its toolkit to prepare for National Recovery Month in September is now available. Now in its 29^th year, National Recovery Month is meant to promote awareness and understanding about mental and substance use disorders and to celebrate individuals living in recovery. This year’s theme is Join the Voices for Recovery: Invest in health, Home, Purpose and Community, and more information—including SAMHSA’s toolkit—is available here.   For questions or comments about CEO Update, please contact Jessica Zigmond.

Illinois House of Representatives Passes Comprehensive Mental Health Parity Bill The Illinois House of Representatives this week passed mental health parity legislation that mental health advocacy organization the Kennedy Forum has described as the “strongest mental health parity law in the nation.” In a vote of 106-9, Illinois’ House members approved Senate Bill 1707, which, along with other provisions, addresses the opioid crisis by expanding access to addiction treatment; prohibits prior authorization and step-therapy requirements for Food and Drug Administration (FDA)-approved medications to treat substance use disorders; requires health plans to submit parity compliance analyses to the Illinois Department of Insurance and Illinois Department of Healthcare and Family Services that comply with federal parity rules; and also requires plans and managed care organizations to make parity compliance information available to those departments and to individuals through a public website. An announcement from the Kennedy Forum—founded by behavioral healthcare champion and former U.S. Representative (D-R.I.) Patrick Kennedy—noted that this bill “represents a major milestone, not just for Illinois, but for the country as a whole.”   The Joint Commission to Change How it Cites Ligature/Self-Harm Deficiencies in July The Joint Commission will start to cite ligature/self-harm deficiencies under Patient’s Rights of Condition of Participation (CoP) 482.13 on July 1. Previously, Joint Commission surveyors cited these deficiencies under Physical Environmental CoP 482.41 and under the Joint Commission’s Environment of Care (EC) standard EC.02.06.01, element of performance 1. The Joint Commission noted that it decided to make the change after consulting with Centers for Medicare & Medicaid Services. Click here for additional information about the change.   Updated Inpatient Psychiatric Facility Quality Reporting Program Resources Now Available Earlier this week, the Centers for Medicare & Medicaid Services (CMS) and the Hospital Inpatient Value, Incentives and Quality Reporting (VIQR) support contractor announced updates to two Inpatient Psychiatric Facility Quality Reporting (IPFQR) resources. The IPFQR Program Manual provides a comprehensive overview of the IPFQR program and measure specifications. It also offers detailed instructions to register on the QualityNet Secure Portal, submit data using the web-based measures application, and understand IPFQR Program Preview Report processes. Separately, the IPFQR Program Paper Tools provide an optional, informal abstraction mechanism to help IPFs collect data for the IPFQR program. These resources are located on the QualityNet website’s IPFQR Program Resources page.   CDC Reports on Outbreak of Life-threatening Coagulopathy Associated with Synthetic Cannabinoids Use The Centers for Disease Control and Prevention (CDC) has posted information for clinicians following a multi-state outbreak of coagulopathy from exposure to synthetic cannabinoid products that has resulted in more than 200 cases and five deaths. Synthetic cannabinoids (sometimes referred to as synthetic marijuana, fake weed, legal weed, K2, and Spice) are types of New Psychoactive Substances (NPS) that are misused for recreational purposes. In March, the Illinois Department of Public Health reported cases of unexplained bleeding among patients who reported using synthetic cannabinoids. Subsequent testing of drug and biological samples from case-patients detected brodifacoum, a long-acting vitamin K-depending antagonist that is used as a rodenticide, the CDC reported. The Atlanta-based agency noted that hundreds of different synthetic cannabinoid chemicals are manufactured and sold, and that new ones with unknown health risks become available every year. Based on its findings, the CDC posted recommendations for healthcare providers, starting with a suggestion to “maintain a high index of suspicion for vitamin K-dependent antagonist coagulopathy in patients with a history or suspicion of using synthetic cannabinoids” and concluding with a recommendation to contact the local poison control center (800.222.1222) for questions about diagnostic testing and managing these patients. Speciality providers of substance use and mental health services could alert patient populations to the potential adverse health risks of current batches of NPS, as patients may not be aware of the contents of the drugs they are using.   FDA’s Next Priority: Proactive Pharmacovigilance The FDA has invested new resources to develop the capacity to monitor emerging trends in the addiction landscape to help the agency intervene more quickly and protect the public from related risks, physician leaders at the FDA wrote in The New England Journal of Medicine this week. According to the article from the FDA’s Douglas Throckmorton, M.D., Scott Gottlieb, M.D., and Janet Woodstock, M.D., the agency has taken steps to address the opioid crisis, such as launching efforts to inform more appropriate prescribing and developing new therapeutics that can help patients in pain. Now the agency will focus on “proactive pharmacovigilance” so it can intervene more quickly when it anticipates changes in drug use and misuse. “The FDA has invested new resources in developing these capabilities,” the authors wrote, “including convening a group of professionals to evaluate epidemiologic signals that may presage new usage trends.”   Prescription Drug Monitoring Program Administrators Offer Recommendations in PEW Study A new study from the PEW Charitable Trusts highlights recommendations from Prescription Drug Monitoring Program (PDMP) administrators to enhance these programs, including the ability to sort data and better collaboration among stakeholders at the state level. PDMPs are electronic databases that allow healthcare professionals to view their patients’ controlled-substance prescription histories to better inform prescribing, dispensing and treatment decisions, the study noted. Ultimately, the programs can help reduce the misuse and diversion of prescription opioids and other controlled substances. “Although several important concerns were identified, the PDMP administrators encouraged enhancements such as the ability to sort data; maps that show distances between patients, prescribers, and pharmacies; and graphical displays of patients’ controlled-substance prescription use,” the study said. “Moving forward, states should collaborate with all stakeholders in an interdisciplinary way to determine optimal risk indicators and thresholds that are reported to prescribers.”   SAMHSA to Host Webinars on Peer Specialists, Mobile Apps and Lived Experience The Substance Abuse and Mental Health Services Administration (SAMHSA) will host three webinars on a range of behavioral healthcare topics next week. On June 5, SAMHSA will host “Peer Specialists and Police as Partners Preventing Behavioral Health Crisis” from 11:30 a.m. until 1 p.m. ET. Click here to register. Also that day, the agency will host a webinar from noon until 1 p.m. ET to review the current state of mental health apps as they related to evidence-based treatment strategies. Click here to register. Later in the week, SAMHSA will co-host “Enhancing Recovery Through Lived Experience” with the National Alliance on Mental Illness (NAMI). The June 7 webinar from 2 p.m. until 3:30 p.m. ET will explore the lived-experience approach that drives NAMI’s peer and family delivered education, support and presentation programs. Click here to register.   NABH to Host Hot Topics Call on Monday, June 4 Please join the National Association for Behavioral Healthcare (NABH) team for a members-only Hot Topics call on Monday, June 4 at 4 p.m. ET to learn about some recent developments and upcoming activities at NABH. In this hourlong call, NABH President and CEO Mark Covall and his team will provide a series of updates and also answer questions from NABH members. The call will follow this brief agenda:

• NABH Rebrand: The association rebranded to the National Association for Behavioral Healthcare from the former National Association of Psychiatric Health Systems (NAPHS) on March 19. If you were unable to attend the 2018 NABH Annual Meeting, please be sure to watch our brief video that we showed to kick off the meeting. Learn more about our rebranding, social media channels, and exciting changes ahead during this call.
• Mental Health Month Recap: The country has recognized May as Mental Health Month since 1949. Learn how NABH commemorated Mental Health Month in 2018 with its first paid social media campaign, which focused on repealing the Institutions for Mental Diseases (IMD) exclusion in Medicaid.
• Federal Policy Update: Congress continues to pay close attention to the nation’s deadly opioid crisis. Learn how the NABH team has worked with committees in both chambers of Congress to address this issue. Also learn about some important regulatory updates related to the inpatient psychiatric facility prospective payment system (IPF PPS).

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

Congress Sends Veterans Bill to President Trump The Senate passed sweeping legislation this week to overhaul medical care options for the nation’s veterans. In a 92-5 vote, senators approved the VA Mission Act, a package totaling more than $50 billion that is intended to give veterans more access to private physicians and hospitals. “The Senate passage of the VA MISSION Act is a major victory for our nation’s veterans who will benefit from more choice and fewer barriers to care,” Sen. Johnny Isakson (R-Ga.), chairman of the Senate Committee on Veterans’ Affairs, said in a news release after the bill passed. According to a summary, the bill consolidates seven Veterans Affairs (VA) community care programs into on streamlined program; removes barriers for VA healthcare professionals to practice telemedicine; strengthens the process for VA and partnering healthcare providers who prescribe opioids to veterans; and requires VA to implement an information technology system to better support, assess and monitor the program. Senators Bob Corker (R-Tenn.), Jeff Merkley (D-Ore.), Mike Rounds (R-S.D.), Bernie Sanders (I-Vt.) and Brian Schatz (D-Hawaii) voted against the legislation, which President Trump is expected to sign in the coming days.   Senate Judiciary Approves Five Opioid Bills The Senate Judiciary Committee on Thursday passed five pieces of legislation to address the nation’s opioid crisis. Among the bills is the Substance Abuse Prevention Act, which would raise public awareness about opioid and heroin addiction (which the existing Comprehensive Addiction and Recovery Act (CARA) authorizes); provide resources for families to stay together when a family member is fighting addiction; and require the Attorney General and HHS to complete a plan for educating and training healthcare providers in best practices for controlled substances. Another bill — the Opioid Quota Reform Act—would allow the Drug Enforcement Administration (DEA) to consider additional factors when setting annual quotas for opioid drug production in the United States. Currently, DEA can consider only past sales and estimated demand. This legislation would allow the agency to consider diversion, abuse, overdose deaths and public health impacts when setting quotas, a summary noted.   House Majority Leader Pens Op-ed on Opioid Crisis House Majority Leader Kevin McCarthy (R-Calif.) this week summarized Congress’ efforts to fight America’s opioid crisis in an op-edpublished in USA Today. McCarthy highlighted Republican efforts to address the crisis and noted that although Congress’ legislative agenda is important, “healing the wounds of drug abuse” will take more than government action. “It will take a commitment by every citizen to fulfill our duties to one another,” McCarthy wrote. “That means supporting people near us who are struggling with drug addiction—and supporting their families and loved ones as well.”   FDA Approves First Non-Opioid Medication to Treat Opioid Withdrawal Symptoms The Food and Drug Administration (FDA) has approved the first non-opioid medication to treat opioid withdrawal symptoms after an advisory panel recommended its approval earlier this year. Lucemyra—the generic name is lofexidine—has been shown to result in less severe withdrawal symptoms and also to facilitate completion of a withdrawal protocol in two placebo-controlled studies, according to a story in Addiction Professional. The drug suppresses the neurochemical surge that produces withdrawal symptoms that include muscle spasms, stomach cramps and heart pounding. It is expected to be available on the U.S. market in August.   GAO Reports Need for Improvement in SAMHSA’s State Protection and Advocacy Programs In a new report, the Government Accountability Office (GAO) found that the Substance Abuse and Mental Health Services Administration (SAMHSA) should improve its procedures to oversee its state Protection and Advocacy for Individuals with Mental Illness (PAIMI). Established by Congress in 1986, the PAIMI grant awards totaled about $36 million in 2016. SAMHSA administers the grants to support state programs that protect and advocate for the rights of individuals with significant mental illness by investigating reports of incidents of abuse and neglect in facilities such as hospitals and also in the community. “GAO recommends that SAMHSA take steps to ensure that changes to performance benchmarks are examined over time, and to ensure onsite reviews are completed—and findings are provided to state programs— in a timely manner,” the report noted.   Separate NIH Studies Examine Depression Risk and Opioid Therapy for Chronic Pain A study published in the May 2018 issue of Preventive Medicine shows that African Americans and Latinos are “significantly more likely to experience serious depression” than Whites, although chronic stress does not appear to explain the differences. The study from the National Institute on Minority Health and Health Disparities (part of the National Institutes of Health) also found that African Americans and Latinos were more likely to have higher levels of chronic stress and more unhealthy behaviors. Researchers examined data on 12,272 participants between the ages of 40 and 70 from 2005 until 2012. Separately, a study from scientists at NIH and McGill University in Montreal found that pain-induced changes in the rat brain’s opioid receptor system may help explain the limited effectiveness of opioid therapy in chronic pain—and may play a role in the depression that often goes with it. “It’s well known that there’s a link between chronic pain and depression,” said M. Catherine Bushnell, Ph.D., scientific director of the National Center for Complementary and Integrative Health’s (NCCIH) Division of Intramural Research and one of the study’s authors. “The results of this study indicate that pain-induced changes in the brain’s opioid system may play a role in this association,” she added. “Animals with the greatest decrease in opioid receptor availability showed the greatest increase in depression-like symptoms after experiencing chronic pain.   Save the Date: NABH to Host 2019 Annual Meeting from March 18-20 in Washington, D.C. Please mark your calendars for March 18-20, 2019 and plan to attend the 2019 NABH Annual Meeting at the Mandarin Oriental Washington, D.C.! Also, please take a moment to view a brief photo gallery from the 2018 NABH Annual Meeting. For questions or comments about CEO Update, please contact Jessica Zigmond.

House Energy and Commerce Committee Approves 25 Opioid Bills The House Energy and Commerce Committee this week approved 25 bills that address the nation’s deadly opioid crisis. All of the legislation received bipartisan support, and the committee is scheduled to examine another set of opioid-related measures next week. The Comprehensive Opioid Recovery Centers Act of 2018 is among the bills the committee passed this week. Co-sponsored by Reps. Brett Guthrie (R-Ky.) and Gene Green (D-Texas), the legislation would award grants on a competitive basis to entities that would establish or operate comprehensive opioid recovery centers. The centers would need to provide a range of services, including periodic patient assessments, detoxification, counseling, residential rehabilitation and more. Earlier this spring, Congress appropriated about $4 billion to fight the country’s drug abuse crisis as part of a large spending bill. It’s not certain if federal lawmakers will appropriate more money to address the problem.   SAMHSA Highlights Communities, Partnerships & Resource Sharing for National Prevention Week National Prevention Week starts on Sunday, May 13 to increase public awareness and action around substance abuse and mental health issues. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), National Prevention Week has three primary goals: to involve communities in raising awareness about behavioral health issues and implementing strategies; foster partnerships with federal agencies and national organizations dedicated to behavioral and public health; and promote and disseminate quality behavioral health resources and publications. National Prevention Week takes place each year during the third week of May—in the middle of Mental Health Month—close to the start of summer, which SAMHSA notes is a critical time for schools, communities and professionals to focus on prevention. Click here for more information. Also, please remember to follow NABH on Twitter @NABHbehavioral and on LinkedIn, where our theme throughout Mental Health Month emphasizes repealing the Institutions for Mental Diseases (IMD) exclusion.   New England Journal of Medicine Examines Link Between Suicide and Opioid Overdoses Solutions to address America’s opioid crisis require that “we tailor interventions to preventing opioid-overdose deaths due to suicidal intent,” according to a recent article in the New England Journal of Medicine. As the physician authors report, interventions to prevent opioid deaths in suicidal people will differ from interventions targeted toward accidental overdose. But most strategies for reducing opioid-overdose deaths do not include screening for suicide risk, nor do they address the need to adjust interventions for suicidal persons. Meanwhile, the authors continued, two populations that are more likely than others to receive opioid prescriptions—patients with chronic pain and those with mood disorders—are also at greater risk for suicide. Separately, the April 26^th issue also includes an article that explores improving electronic health record (EHR adoption in psychiatric care. In it, the authors note the implications for patients and providers due to a lag in EHR use in psychiatric care.   U.S. Preventive Services Task Force Seeks Comment on Draft Plan to Reduce Drug Use in Children and Adolescents The U.S. Preventive Services Task Force is seeking comment on its draft plan on interventions to reduce illicit drug and nonmedical prescription drug use in children and adolescents.Released this week, the plan is available for review through Wednesday, June 6. The task force notes that anyone can comment on the plan, although the task force writes these types of documents for researchers, primary care physicians and other healthcare providers. Click here to review the research plan and submit a comment.   DOJ’s Bureau of Justice Assistance to Highlight COAP Grant Program in Webinar on May 15 Leaders from the U.S. Justice Department’s Bureau of Justice Assistance will host a webinar on Tuesday, May 15 from 1 p.m. to 2:30 p.m. ET to review the fiscal year 2018 Comprehensive Opioid Abuse Program (COAP) solicitation. The bureau created COAP as a response to the Comprehensive Addiction and Recovery Act, or CARA, which Congress passed in July 2016. COAP’s purpose is to provide financial and technical assistance to states, local governments, and Indian tribal governments to plan, develop, and implement efforts to identify and treat those affected by the opioid crisis. The program includes the following six grant categories: first responder partnerships; technology-assistant treatment projects; system-level diversion projects; statewide planning, coordination and implementation projects; the Harold Rogers Prescription Drug Monitoring Program implementation and enhancement projects; and public safety, behavioral health, and public health information sharing partnerships. Click here to register for the webinar.   HRSA to Host Webinar about Treating Pregnant Women with Opioid Use Disorder on May 16 The Health Resources and Services Administration (HRSA) will host an hourlong webinar on Wednesday, May 16 at 1 p.m. ET to provide guidance on treating pregnant and parenting women with opioid use disorder. The webinar will discuss the Substance Use Warmline, a resource that provides free and confidential clinician-to-clinician consultation for substance use evaluation and management. Click here to register.   SAMHSA to Address Behavioral Health Needs of Older Veterans in Webinar on May 22 To recognize both Mental Health Month and Older Americans Month in May, SAMHSA will host an hourlong webinar on May 22 to help community service providers understand the behavioral health needs of older veterans; identify Veterans Health Administration resources; and discuss the importance of collaborating across mental health, aging and veterans services. Click here to register.   IPF PEPPER Review Webinar Recording Now Available The recording and transcription from the PEPPER Review webinar on May 2 is now available here on the PEPPER Training and Resources page. The early May webinar reviewed the release of the Q4FY17 PEPPER that was released in April.   For questions or comments about the CEO Update, please contact Jessica Zigmond.

NABH Focuses on IMD Repeal Exclusion During May’s Mental Health Month NABH on Friday kicked off a monthlong social media campaign centered on urging lawmakers to repeal the Institutions for Mental Diseases (IMD) exclusion. Mental Health Month in May provides an opportunity for NABH to promote its message that the IMD exclusion blocks access to mental healthcare within a heightened national conversation about mental health. Please follow NABH on Twitter @NAHBbehavioral and on LinkedIn at the National Association for Behavioral Healthcare. And please engage in the conversation by retweeting our messages using the hashtags #MentalHealthMonth and #MHM2018 on Twitter and sharing our messages with your connections on LinkedIn.   House Energy and Commerce Committee to Consider Opioid Legislation Next Week House Energy and Commerce Committee Chairman Greg Walden (R-Ore.) announced his full committee will begin to markup legislation to fight the nation’s opioid crisis next week. Walden’s full panel will review the opioid-related bills in its first markup on Wednesday, May 9, and the bills will be posted here on Monday, May 7. The committee announced the second markup is scheduled for Thursday, May 17. In late April, the House Energy and Commerce Health Subcommittee advanced 57 bills to address the opioid crisis and passed 48 of those bills by voice vote.   HSAG Invites Comments on Proposed Screening for Pregnancy Quality Measure On behalf of the Centers for Medicare & Medicaid Services (CMS), the Health Services Advisory Group (HSAG) is inviting healthcare professionals, stakeholder organizations, and individuals to provide comments on the Screening for Pregnancy measure. HSAG’s announcement noted that after the measure is made final, CMS could propose that it be adopted in the Inpatient Psychiatric Facility (IPF) Quality Reporting program. The IPF Outcome and Process Measure Development and Maintenance Project is developing the measure, which assesses the percentage of female patients of childbearing age (15-44 years) admitted to an IPF who have had a pregnancy status in their medical record. The public comment period begins Friday, May 4 and extends through Thursday, May 31 at noon ET. Click here for more information, and click here to submit comments. Please contact Marie Hall at mhall@hsag.com if you have trouble submitting comments.   NIH Launches ‘All of Us’ Research Program The National Institutes of Health (NIH) has announced its All of Us research program, which is meant to engage 1 million or more volunteers in the United States to contribute their health data to improve health outcomes and stimulate development of new treatments for diseases. The program is a piece of the Precision Medicine Initiative, or PMI, a research effort to transform how we improve health and treat disease. According to the NIH, PMI is intended to leverage advances in genomics; emerging methods for managing and analyzing large data sets while also protecting privacy; and health information technology to hasten biomedical discoveries.   Study Shows Improved Performance in Hospitals Reporting Inpatient Psychiatric Services Measures to The Joint Commission The Joint Commission announced this week that a study in the July 2018 issue of Psychiatric Services shows hospitals reporting inpatient psychiatric services measures to The Joint Commission demonstrated improved performance on measures related to admission screening, multiple antipsychotic medication justification, discharge planning, and restraint and seclusion use.   For questions or comments about the CEO Update, please contact Jessica Zigmond.