Author: Administrator

HHS Secretary Becerra Extends Covid-19 Public Health Emergency U.S. Health and Human Services (HHS) Secretary Xavier Becerra has extended the public health emergency (PHE) due to the Covid-19 global pandemic, effective April 21. The declaration typically lasts for 90 days, which would extend the PHE to July 20, given that Becerra renewed the PHE on April 21. Researchers to Begin Work on Opioid Vaccine with $25 Million NIH Grant Using a $25 million grant from the National Institutes of Health Helping to End Long-term initiative (HEAL), scientists from Boston Children’s Hospital’s Precision Vaccines Program and professors of psychology and medicinal chemistry at the University of Houston have partnered to develop an adjuvant opioid use disorder (OUD) vaccine. An announcement from the University of Houston noted that an adjuvant molecule boosts the immune system’s response to vaccines, which is critical for the effectiveness of anti-addiction vaccines. The vaccine targets fentanyl, a synthetic opioid. Therese Kosten, Ph.D., professor of psychology at the University of Houston, said in the announcement that the vaccine could be a “game changer” for addiction. Kosten also serves as director of the university’s Developmental, Cognitive & Behavioral Neuroscience program. “Fentanyl is different than heroin or other opioids in the way that it stimulates the nervous system,” Kosten said. “It activates the same receptors in the brain as heroin or morphine but does so by a different mechanism, which makes drugs that can reverse a heroin overdose, like Narcan, almost ineffective against it,” she added. Kosten received $1.8 million of the grant to make the combination of the adjuvant with the vaccine as powerful as possible. The NIH HEAL initiative is a trans-NIH effort to speed scientific solutions to the nation’s opioid public health crisis. The program launched in April 2018 and is focused on improving prevention and treatment strategies for opioid misuse and addiction and enhancing pain management. Bipartisan Policy Center Establishes Opioid Task Force  Former U.S. Surgeon General Jerome Adams, M.D. and former HHS Secretary Donna Shalala are among the members of the Bipartisan Policy Center’s (BPC) new Opioid Crisis Task Force that will develop evidence-based recommendations for Congress and the Biden administration. Announced this week, the new task force also includes former Gov. Steve Beshear (D-Ky.), former U.S. Rep. Mary Bono (R-Calif.), Richard Frank, Ph.D., professor of health economics at Harvard University, Patrice Harris, M.D., former president of the American Medical Association, and former Gov. Susanna Martinez (R-N.M.). The BPC’s announcement cited preliminary data from the Centers for Disease Control and Prevention (CDC) that show more than 90,000 Americans died from drug overdose deaths from October 2019 to September 2020, reflecting nearly a 30% increase from the previous year. “Congress has made substantial financial investments to tackle the opioid epidemic, yet drug overdoses and mortality rates continue to climb, driven by illicitly manufactured fentanyl, with the highest increase in mortality among Black communities,” Anand Parekh, M.D., the BPC’s chief medical advisor who leads the project, said in an announcement. “We must determine more effective ways to utilize federal investments to combat this epidemic and close the gap between those who are seeking treatment and those receiving it.” The task force will release a final report in early 2022. HHS Introduces Video Series on Disability Rights Protections that Apply to Some Individuals in Recovery from OUD  HHS this week announced it has developed a five-part video series titled “Civil Rights Protections for Individuals in Recovery from an Opioid Use Disorder.” The series is intended to inform audiences about how to apply federal disability rights laws to child welfare programs and activities; discuss protections that apply to some individuals in recovery from an OUD; provide an overview of medication-assisted treatment, or MAT; and address common misconceptions about MAT as a treatment approach. HHS’ Office of Civil Rights, the Substance Abuse and Mental Health Services Administration, and the Administration for Children and Families have partnered with the National Center on Substance Abuse and Child Welfare to develop the series. Click here to learn more and to watch the videos. NCOA to Host Older Adult Mental Health Awareness Day Symposium on May 6 The National Council on Aging (NCOA), along with the U.S. Administration for Community Living and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host the 4^th Annual Older Adult Mental Health Awareness Day Symposium as a virtual event on Thursday, May 6. Registration is free, and the all-day event for public health practitioners, professionals in the aging networks, mental health providers, healthcare professionals, and others interested in the mental health of older adults will address topics such as access to behavioral health in diverse older adults, latest interventions related to SUDs, and socialization and engagement. Learn more from the program’s agenda and click here to register. NIAA Alcohol Treatment Navigator Includes FAQs and Toolkit for Finding Quality Treatment  The National Institute on Alcohol Abuse and Alcoholism (NIAA) Alcohol Treatment Navigator is available to direct adults and families to finding evidence-based care for alcohol treatment. The resource includes sections on what to know about alcohol treatment, how to find quality treatment, and how to get support through the process, as well as frequently asked questions and a toolkit. Because the NIAA developed the Navigator, it has no commercial sponsors. Save the Date: NABH 2021 Annual Meeting NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington! Fact of the Week After a year of trauma, three in 10 healthcare workers consider leaving the profession, according to a new Washington Post-Kaiser Family Foundation poll. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Releases ‘Residential Treatment: A Vital Component of the Behavioral Healthcare Continuum’

NABH this week released Residential Treatment: A Vital Component of the Behavioral Healthcare Continuum, a white paper that emphasizes the importance and effectiveness of psychiatric residential treatment services for children and adolescents. Together the NABH team and Youth Services Committee developed the paper as a resource for policymakers, regulators, the media, and other stakeholders to help explain how and why residential treatment is a vital component in the behavioral healthcare continuum—and how children and adolescents benefit from services in this setting. NABH has posted the paper on the association’s new Youth Services page, which also includes shareable social media messages about the paper’s content for members to post on Twitter and LinkedIn. NABH urges all members to share the link to the new page and the messages with your teams. If you have questions about the paper or a comment to share with the Youth Services Committee, please contact John Snook, NABH’s director of government relations and strategic initiatives, who serves as the association’s staff liaison to the committee.

President Biden Signs Legislation to Extend Suspension of Medicare Sequestration

President Biden on Wednesday signed legislation to exempt Medicare from sequestration—a process of automatic, across-the-board, spending cuts—until Dec. 31, 2021. Late last year, the Consolidated Appropriations Act of 2021 provided a three-month extension of the Medicare sequestration moratorium, which expired on March 31. The Centers for Medicare & Medicaid Services (CMS) issued a notice in late March that said the agency would hold Medicare claims with service dates on or after April 1 “for a short period” to ensure providers would not be affected by the sequester’s 2% cut to payments.

Biden Administration Requests Investments in Mental Health and SUD Services for FY 2022

President Biden’s recent request for Fiscal Year (FY) 2022 discretionary funding asks Congress to make significant investments to expand access to mental healthcare services, help end America’s opioid crisis, and prioritize the physical and mental well-being of the nation’s students. Sometimes referred to as the president’s “skinny budget,” the White House’s discretionary funding request was sent late last week to Sen. Patrick Leahy (D-Vt.), chairman of the Senate Appropriations Committee, ahead of the president’s official budget in the coming months. As with the president’s formal budget, this funding request from the Office of Management and Budget is significant for highlighting the president’s priorities. “The opioid epidemic has shattered families, claimed lives, and ravaged communities across the nation—and the Covid-19 pandemic has only deepened this crisis,” OMB Acting Director Shalanda D. Young wrote in the request. “That is why the discretionary request includes a historic investment of $10.7 billion, an increase of $3.9 billion over the 2021 enacted level, to support research, prevention, treatment, and recovery support services, with targeted investments to support populations with unique needs, including Native Americans, older Americans, and rural populations.” The discretionary funding request also builds on the recent American Rescue Plan in providing $1.6 billion—more than double the 2021 enacted level—for the Community Mental Health Services Block Grant. It also asks for $1 billion to increase the number of counselors, nurses, and mental health professionals in schools, as well as $430 million for Full Service Community Schools, which provide comprehensive, wrap-around services to students and their families, from after-school programs to adult education opportunities, and health and nutrition services.

MACPAC’s April 2021 Public Meeting Addresses Behavioral Health

The Medicaid and CHIP Payment and Access Commission (MACPAC) included several presentations related to behavioral health at its recent public meeting. The two-day event addressed Access to Mental Health Services for Adults, Access to Behavioral Health Services for Children and Youth, Electronic Health Records as a Tool for Integration of Behavioral Health Services, and Promoting Physical and Clinical Integration Through EHRs. NABH has posted the presentations on the association’s website; click here to learn more.

Manatt Health and AMA to Host Webinars on 2020 Roadmap to End National Drug Overdose Crisis

Research firm Manatt Health and the American Medical Association (AMA) will host a series of webinars to highlight various topics addressed in the 2020 National Roadmap on State-Level Efforts to End the Nation’s Drug Overdose Epidemic, which the two organizations released in December. The first in this series, “Improving Access to Substance Use Disorder Treatment in Justice-Involved Settings,” is scheduled for Tuesday, April 20, and will feature presenters from the AMA, the American Civil Liberties Union, the Johns Hopkins School of Medicine, and North Carolina’s Health and Human Services Department. Click here to register for the free webinar.

NCOA to Host Older Adult Mental Health Awareness Day Symposium on May 6

The National Council on Aging (NCOA), along with the U.S. Administration for Community Living and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host the 4^th Annual Older Adult Mental Health Awareness Day Symposium as a virtual event on Thursday, May 6. Registration is free, and the all-day event for public health practitioners, professionals in the aging networks, mental health providers, healthcare professionals, and others interested in the mental health of older adults will address topics such as access to behavioral health in diverse older adults, latest interventions related to SUDs, and socialization and engagement. Learn more from the program’s agenda and click here to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

Female nurses die by suicide at twice the rate of the general population, according to a new study in JAMA Psychiatry. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Proposes 2.1% Payment Increase to Per-Diem Base Rate for IPFs in FY 2022

The Centers for Medicare & Medicaid Services (CMS) this week proposed a 2.1-percent, Medicare payment increase to the per-diem base rate for inpatient psychiatric facilities (IPF) for fiscal year (FY) 2022.   This adjustment would increase the per-diem base rate to $833.50 from $815.22 and the electroconvulsive therapy (ECT) rate to $358.84 from $350.97. CMS proposed several changes for inpatient psychiatric care in 2022, such as aligning an IPF policy regarding displaced residents from IPF closures and closures of IPF teaching programs with the policy changes that the agency made final in its FY 2021 IPPS rule.   In its FY 2022 proposed rule, CMS recommended the following changes to the IPF Quality Reporting Program:

• Starting in FY 2023, the agency would add a requirement to report Covid-19 Vaccination Coverage Among Healthcare Personnel in the Centers for Disease Control and Prevention’s (CDC) National Healthcare Safety Network web portal;

• For FY 2024, CMS would substitute the Follow-up After Psychiatric Hospitalization (FAPH) measure for the Follow-up After Hospitalization for Mental Illness (FUH) measure. The FAPH includes patients with substance use disorders and also expands the provider types who can provide follow-up care to include primary care providers;

• For FY 2024, the agency would remove the three following measures:
  • Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention Provided (SUB-2/2a),
  • Tobacco Use Brief Intervention Provided or Offered and Tobacco Use Brief Intervention Provided (TOB-2/2a), and
  • Timely Transmission of Transition Record -Discharges from an Inpatient Facility to Home/Self Care or Any Other Site of Care.

CMS is requesting information about how to develop a patient experience-of-care measure, as well as comments on including a patient-reported outcomes measure that assesses functional outcomes. The agency also wants feedback on measures either included in the IPFQRP now or that could be added that would be appropriate for digital data collection. The agency is also seeking comment about how to modify reporting in a way that would improve collecting information on health disparities. CMS asked specifically for feedback on stratification of quality measure results by dual eligibility, race and ethnicity, improving demographic data collection, and potential creation of a facility equity score synthesizing results across multiple social risk factors. CMS will accept public comments on the rule until June 7.

U.S. Labor Department Issues Guidance on Parity Compliance

The U.S. Labor Department (DOL) has issued guidance on new implementation requirements for the Mental Health Parity and Addiction Equity Act (MHPAEA) that the 2021 Consolidated Appropriations Act requires. Enacted on Dec. 27, 2020, the 2021 Consolidated Appropriations Act requires group health plans and health insurance issuers offering group or individual health insurance to perform and document analyses of how they comply with MHPAEA in their application of non-quantitative treatment limits (NQTLs) to mental health/substance use disorder (MH/SUD) benefits, compared with their application of NQTLs to medical/surgical benefits. As of Feb. 10, 2021, health plans and insurers must make these comparative analyses available upon request to three federal agencies that oversee MHPAEA implementation: DOL, the U.S. Department of Health and Human Services, and the U.S. Treasury Department. The required NQTL analyses by health plans and insurance issuers must include the following information:

• A description of the NQTL, plan terms, and policies at issue;

• Identification of the MH/SUD and medical/surgical benefits to which the NQTL applies;

• The factors used in applying the NQTLs to MH/SUD benefits and medical or surgical benefits;

• The evidentiary standards used for these factors;

• The comparative analyses demonstrating that the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to MH/SUD benefits, as written and in operation, are comparable to, and are applied no more stringently than, the processes, strategies, evidentiary standards, and other factors used to apply the NQTLs to medical/surgical benefits in the benefits classification; and

• The specific findings and conclusions reached by the plan or issuer, including any results of the analyses that indicate that the plan or coverage is or is not in compliance with the MHPAEA requirements.

The new law also requires the federal agencies to share findings regarding these analyses of MHPAEA compliance with the state governments where the plans or issuers are located and submit an annual report to Congress on these findings. The guidance provides additional detail regarding the following topics:

• What information plans and issuers must make available to support their comparative analyses demonstrating compliance with MHPAEA in their use of NQTLs;

• Examples illustrating when the federal agencies might determine that a comparative analysis of NQTLs is insufficiently specific and detailed;

• The types of documents that plans and issuers should be prepared to make available to the federal agencies to support their analyses and conclusions regarding their NQTL comparative analyses;

• What actions the federal agencies will take if they determine that a plan or issuer has not submitted sufficient information or is not in compliance with MHPAEA;

• Whether state agencies and plan participants and beneficiaries may request to see a plan or issuer’s comparative analysis of its use of NQTLs;

• Which specific NQTLs the federal agencies plan to focus on in the near term when requesting comparative analyses from plans and issuers for review, namely:

1. • Prior authorization requirements for in-network and out-of-network inpatient services,
   • Concurrent review for in-network and out-of-network inpatient and outpatient services,

• Standards for provider admission to participate in a network, including reimbursement rates, and

• Out-of-network reimbursement rates (plan methods for determining usual, customary, and reasonable charges).

New Federal Guidance Says Federal Grantees May Now Use Funds to Buy Fentanyl Test Strips

Guidance this week from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC) says funding may now be used to purchase rapid fentanyl test strips (FTS) as a way to help curb the sharp rise in drug overdose deaths primarily from strong synthetic opioids, including fentanyl. FTS can be used to determine if drugs have been mixed or cut with fentanyl, which will provide people who use drugs and communities with information about fentanyl in the illicit drug supply so they can work to reduce their risk of overdose. “This is a major step forward in the ongoing and critical work to prevent overdose and connect people who have substance use disorders to evidence-based treatment options,” Acting Assistant Secretary for Mental Health and Substance Use Tom Coderre, interim leader at SAMHSA, said in an announcement. “This will save lives by providing tools to identify the growing presence of fentanyl in the nation’s illicit drug supply and – partnered with referrals to treatment – complement SAMHSA’s daily work to direct help to more Americans.”

AP Reports U.S. Suicides Fell Nearly 6% in 2020, Defying Global Pandemic Expectations

Citing preliminary government data, the Associated Press on Thursday reported the number of U.S. suicides dropped by about 6% in 2020, the largest annual decline in at least 40 years. The CDC has not reported national suicide rates for 2020, nor has it provided a breakdown of suicides by state, age, or race and ethnicity. The AP story quoted Christine Moutier, M.D., chief medical officer at the American Foundation for Suicide Prevention, as saying an increase in the availability of telehealth services and other efforts to address America’s suicide problem may have contributed to the decrease in the preliminary findings.

NABH and Other Organizations Offer to Work with OSHA to Ensure Safety and Quality of Care at Psychiatric Facilities

In a letter to the Occupational Safety and Health Administration (OSHA) this week, NABH and three other behavioral healthcare groups offered to work with the federal agency to develop well-informed policies that ensure the safety of patients and personnel at psychiatric facilities. NABH, the National Association of State Mental Health Program Directors, the National Alliance on Mental Illness, and the National Council for Behavioral Health sent a letter to James Frederick, the principal deputy assistant secretary of Labor for Occupational Safety and Health, that expressed concern about certain OSHA policies and implementation actions that do not align with other requirements that inpatient psychiatric facilities must follow to ensure both patient safety and quality care. For instance, one OSHA requirement calls for fully enclosing nursing stations with plexiglass—a practice that prevents patient-staff interactions that are critical for quality behavioral healthcare. “We recognize that regulatory entities face many difficulties in developing a consistent set of requirements intended to reduce hazards in the context of different treatment approaches and services offered by individual facilities, different patient populations, and various state regulatory requirements,” the letter said. “Therefore, we recommend that OSHA establish a collaborative process to gather input from leading psychiatric hospitals and units, state mental health agency officials, psychiatric providers, employee representatives, and representatives of mental healthcare consumers and their families regarding effective practices for ensuring the safety of inpatient psychiatric facilities without compromising the clinical care of patients.”   The Kennedy Forum to Start Three-Part Webinar for Employers Next Week The Kennedy Forum next week will host the first in a three-part webinar series about what employers can do to accommodate the growing demand from employees for better access to mental health and addiction care. The series will explore the effects of mental health and addiction in the workplace, the pros and cons of different internal support options, and ways to collaborate with insurers to ensure better access to treatment. Part 1 is titled “Impact—There is No Health Without Mental Health” and will be hosted on Thursday, April 15 from 2 p.m. to 3 p.m. ET. Parts 2 and 3 will be held on April 29 and May 13, respectively, at the same time. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

More than one year into the global pandemic, 76% of frontline healthcare workers say they feel “hopeful” when going to work these days, a new Kaiser Family Foundation/Washington Post survey found. For questions or comments about this CEO Update, please contact Jessica Zigmond

Biden Administration Releases Drug-Policy Priorities for Year One

The Biden administration on Thursday released a statement outlining its first-year, drug-policy priorities to address America’s overdose and addiction crises. White House Office of National Drug Control Policy (ONDCP) Acting Director Regina LaBelle noted in an announcement that these priorities will complement President Biden’s American Rescue Plan, which includes an investment of nearly $4 billion in behavioral health services. In the next year, the ONDCP will work across government to implement seven priorities:

• Expanding access to evidence-based treatment

• Advancing racial equity in our approach to drug policy

• Enhancing evidence-based harm reduction efforts

• Supporting evidence-based prevention efforts to reduce youth substance use

• Reducing the supply of illicit substances

• Advancing recovery-ready workplaces and expanding the addiction workforce

• Expanding access to recovery support services

The strategy identified several issues that NABH has discussed with the ONDCP, including, but not limited to, enforcing parity, improving reimbursement for services, permitting medications through telehealth without an in-person evaluation, and removing policy barriers to using contingency management and motivational incentives. In addition, harm reduction appears to have a more visible role in the Biden administration than with previous administrations, as do issues related to workforce, recovery-ready workplaces, and recovery-support services.

Final Rule to Implement Cures Act Interoperability Requirements Takes Effect April 5

A regulation to implement interoperability requirements outlined in the 21^st Century Cures Act and prohibit “information blocking” takes effect Monday, April 5. Information blocking is defined as a practice by a health information technology (IT) developer, health information network, health information exchange, or healthcare provider that is likely to interfere with access, exchange, or use of electronic health information. There are certain exceptions. The Office of the National Coordinator for Health Information Technology (ONC) has posted information clarifying what qualifies as information blocking, as well as a number of exceptions.

CMS Alerts Providers that Repayment of Covid-19 Accelerated and Advance Began March 30

The Centers for Medicare & Medicaid Services (CMS) this week alerted Medicare-participating providers that the federal agency began recovering Covid-19 Accelerated and Advance Payments (CAAPs). A special edition MLN (Medicare Learning Network) Matters article informed all Medicare providers and suppliers who requested and received CAAPs that the agency began recovering those payments as early as March 30, depending upon the one-year anniversary of when providers received their first payment. “Please be sure your billing staff are aware that the recovery has begun, or will begin soon, but no sooner than 1 year from the date we issued the CAAP to you,” the article said.

Bipartisan Policy Center Report Urges Congress to Integrate Primary Care and Mental Health & SUD Services

The Bipartisan Policy Center on Thursday released Tackling America’s Mental Health and Addiction Crisis Through Primary Care Integration, a 124-page report with legislative and regulatory recommendations to integrate behavioral health into primary care. “Even before the Covid-19 pandemic, the unmet need for mental health and substance use services in the United States was significant,” the report noted. “Alarmingly, less than half of adults with mental health conditions received services in 2019, and the percentage was even lower in Black and Latino communities,” it continued. “As for substance use, nearly 90% of people with a substance use disorder did not receive treatment.” The report highlights these essential recommendations: establish core, minimum standards for integration; drive integration in new and existing value-based payment models; expand, train, and diversify the workforce for integrated care teams; and promote the use of EHRs, telehealth, and other technology to support integrated care. “Broader use of EHRs is critical for improving coordination among the different levels of behavioral healthcare, including inpatient, residential, and outpatient providers of mental health and addiction treatment,” NABH President and CEO Shawn Coughlin said in a news release about the report from the Behavioral Health Information Technology Coalition, of which NABH is a member. “The lack of federal funding to help behavioral healthcare providers implement health information technology has contributed significantly to relatively lower EHR use by these providers compared with other healthcare providers.” The Bipartisan Policy also developed infographics that highlight the recommendations outlined in the report.

Next Week’s Virtual Rx Drug Abuse & Heroin Summit to Feature President Biden

President Biden will deliver a recorded message to attendees at next week’s virtual Rx Drug Abuse & Heroin Summit on Monday, April 5 at 10:15 a.m. ET. Featured during the conference’s opening plenary session, the president’s remarks will focus on the Biden administration’s efforts to reduce overdose rates and save lives. Registration is still available for the 10^th annual conference, which will present more than 75 sessions across nine educational tracks and will cover topics ranging from prevention and treatment to public safety and technology. NABH Director of Quality and Addiction Services Sarah Wattenberg will present with representatives from the Office of National Drug Control Policy, the U.S. Drug Enforcement Administration, and the Veterans Affairs Department in a session titled, “Federal and Private Sector Responses to Opioid Treatment Issues During the Covid-19 Pandemic.” For additional information, download the conference brochure, and click here to register.

NIMH Issues Notice of Special Interest in Research to Examine Covid-19’s Mental Health Effects on Children

The National Institute of Mental Health (NIMH) has issued a Notice of Special Interest (NOSI) to highlight interest in research to understand the mental health effects of Covid-19 pandemic on school-aged children, specifically those between the ages of 3 and 12. The NOSI said the NIMH is interested particularly in the potential impact of primary instruction setting disruptions, such as pre-school and elementary school, on the mental health, cognitive, social, and emotional development of children. “Empirical data would aid in balancing health risks for various public health mitigation strategies affecting children in the current pandemic as well as inform how to both be prepared and respond to future public health emergencies, including pandemics and disaster scenarios,” the noticed said. Applications are due starting June 5 and ending on Sept. 8, 2021. Click here to learn more.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

From Jan. 20, 2021–Feb. 1, 2021, more than two in five adults aged 18 or older experienced symptoms of an anxiety or a depressive disorder during the past seven 7 days. Meanwhile, one in four adults who experienced these symptoms reported that they needed but did not receive counseling or therapy for their mental health. For questions or comments about this CEO Update, please contact Jessica Zigmond

NABH Priorities for the 117^th Congress Now Available

NABH this week released its updated advocacy agenda, NABH Priorities for the 117^th Congress, in a document available on the association’s homepage.

In previous years, NABH released its Legislative and Regulatory Priorities this time of year at the Annual Meeting in time for Hill Day. This year, NABH updated the resource’s name to reflect the association’s advocacy priorities for the new Congress.

Two notable additions this year include “Increase Crisis Stabilization Services for 988 Hotline Calls” and “Maintain Coverage of Tele-Behavioral Healthcare.” The former relates to the universal, toll-free crisis hotline that holds great promise to prevent tragic outcomes and increase access to mental health and addiction treatment, while the latter advocates for expanded coverage of mental health and addiction treatment services via telehealth that have been critical during the Covid-19 global pandemic.

Each of the priorities explains an important advocacy issue for NABH and also outlines specific next steps to address it.

NABH urges its members to review the NABH Priorities for the 117^th Congress and contact any member of the NABH team with questions.

Senate Passes Bill to Extend Medicare Sequestration, Staving Off Automatic Payment Cuts

The Senate this week passed legislation that would provide a 9-month extension of the Medicare sequester moratorium that the CARES Act established and that would cut Medicare provider payments by 2%.

Late last year, the Consolidated Appropriations Act of 2021 provided a three-month extension of the Medicare sequestration moratorium, which is set to expire on March 31. The House is expected to consider the Senate-passed bill when Congress returns the week of April 12.

It is also expected that the Centers for Medicare & Medicaid Services (CMS) will hold Medicare claims until the bill is signed into law, as the agency has done in the past.

Senate Confirms Vivek Murthy as U.S. Surgeon General

The Senate on Tuesday voted 57-43 to confirm Vivek Murthy, M.D. as U.S. surgeon general, a position Murthy held from 2014 through 2017.

As surgeon general, Murthy, 43, will oversee the U.S. Public Health Service commissioned corps, a uniformed service of about 6,000 public health workers who have helped manage the coronavirus response and administer vaccines.

Sen. Bill Cassidy (R-La.), a physician, as well as Sens. Susan Collins (R-Maine) and Mitt Romney (R-Utah) were among the seven Senate Republicans who supported Murthy’s confirmation.

Late last week, the Senate confirmed former California Attorney General Xavier Becerra as secretary of the U.S. Health and Human Services (HHS) Department. Earlier, Becerra served in Congress on the powerful House Ways and Means Committee.

The Senate also has confirmed Rachel Levine, M.D., a pediatrician who served most recently as the secretary of the Pennsylvania Department of Health, as assistant secretary of health at HHS.

HHS-OIG Highlights ‘Staff Burnout and Trauma’ in Report About Covid-19’s Effect on Hospitals

HHS’ Office of Inspector General (OIG) listed “Staff Burnout and Trauma” as one of U.S. hospitals’ main challenges in a report that concluded the Covid-19 pandemic has “significantly strained” U.S. healthcare delivery.

“Hospitals reported that increased hours and responsibilities, along with other stressors caused by the Covid-19 pandemic, resulted in staff being exhausted, mentally fatigued, and sometimes experiencing possible post-traumatic stress disorder (PTSD),” the 62-page report noted. “Several hospitals reported that witnessing Covid-19-related deaths especially weighed on staffs’ mental health.”

The OIG’s office spoke with representatives from 320 hospitals that were part of a random sample of 397 hospitals. Click here to read the full report.

Psychiatry Among Specialties With ‘Sizeable Increases’ in Last Five Years

Psychiatry joins the specialties of neurology, family medicine, emergency medicine, and internal medicine that have seen sizeable increases in the number of positions offered in the last five years, the National Residency Matching Program announced March 19.

The organization celebrated “Match Day” with the thousands of applicants and programs participating in the 2021 Main Residency Match, in which medical students and graduates from the United States and around the world learned which U.S. residency programs they will train for the next three to seven years.

This year’s results were highly anticipated, given the shift to virtual recruit due to the Covid-19 pandemic. The National Resident Matching Program noted that specialties serve as indicators of workforce supply, as match results may be a predictor of future physician workforce supply—especially when examining growth in specialties over time.

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

The annual Rx Drug Abuse and Heroin Summit, known as the largest annual conference that addresses America’s opioid and addiction crises, will be held virtually this year from April 5-8.

The conference will present more than 75 sessions across nine educational tracks and will cover topics ranging from prevention and treatment to public safety and technology. NABH Director of Quality and Addiction Services Sarah Wattenberg will present with representatives from the Office of National Drug Control Policy, the U.S. Drug Enforcement Administration, and the Veterans Affairs Department in a session titled, “Federal and Private Sector Responses to Opioid Treatment Issues During the Covid-19 Pandemic.”   

For additional information, download the conference brochure, and click here to register.  

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC.

The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us!

After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

June 13-15, 2022

June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

The National Center for PTSD estimates that 28% of people who have witnessed a mass shooting will suffer from post-traumatic stress disorder, and about one-third from acute stress disorder.

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

New Milliman Study Analyzes Behavioral Healthcare Utilization During Covid-19 Pandemic An analysis of insurance claims comparing the same periods in 2019 and 2020 found that mental health and substance use disorder inpatient admissions dropped through April 2020—similar to decreases seen in physical healthcare services—but that subsequent behavioral health inpatient admissions increased through August 2020 at a much higher rate than medical services, with admission rates exceeding 2019 levels in the third quarter. That was especially true among the Medicaid population, according to the new Milliman study that the Well Being Trust released this week. The report examined 12.5 million individuals’ commercial insurance, Medicaid Managed Care, Medicare fee-for-service, and Medicare Advantage claims between January-August 2019 and January-August 2020. The analysis seeks to understand how Covid-19 affected mental healthcare in a similar, and, at times, different, way than it did medical healthcare.   “When Covid-19 forced people to press pause on receiving non-emergent care, there was a lot of conversation about the impact delayed care would have on individuals unknowingly living with cancer, cardiac, or chronic conditions,” Benjamin F. Miller, Psy.D., chief strategy officer at Well Being Trust, said in an announcement about the report. “There was noticeably less conversation about the impact this would have on the millions of Americans confronting mental health and addiction issues, for whom there were already barriers to care even before the global pandemic.”   The study also found that with the exception of Medicare beneficiaries, when remote healthcare utilization was factored into individuals’ overall behavioral healthcare utilization numbers, there were primarily year-over-year increases across all insured populations. “Mental healthcare utilization increased among the Medicaid population between 2019 and 2020, and only decreased by 1% in March and May among the commercially insured population,” the study noted. NABH Supports SERVE Act During National Eating Disorders Awareness Week  NABH supports the Supporting Eating Disorders Recovery through Vital Expansion (SERVE) Act, a bipartisan bill introduced during this National Eating Disorders Awareness Week that would ensure TRICARE, the U.S. military’s health insurance program, provides members of the military and their families with comprehensive treatment for eating disorders. “According to a recent study published by the Harvard T.H. Chan School of Public Health, at least 28.8 million Americans will suffer from an eating disorder in their lifetime,” Rep. John Katko (R-N.Y.) said in a news release about the legislation. “These disorders affect individuals from all backgrounds. But for service members and their families, some are not eligible to receive higher level eating disorders care under TRICARE due to their age,” he continued. “Our bipartisan bill extends the age limit for beneficiaries to the Medicare eligibility age for TRICARE coverage of eating disorders care, ensuring those who served our nation and their families have access to the support they deserve.”   Katko introduced the bill with Reps. Veronica Escobar (D-Texas) and Seth Moulton (D-Mass.). The legislation calls for healthcare services to treat eating disorders at both hospital-based and freestanding facilities that offer inpatient, residential, partial hospitalization, intensive outpatient, and outpatient services.   The SERVE Act would require the U.S. Defense secretary to take action to identify, treat, and rehabilitate service members affected by eating disorders, and also direct the U.S. Defense Department to establish clinical practice guidelines on eating disorder treatment.   Senators Jeanne Shaheen (D-N.H.) and Thom Tillis (R-N.C.) introduced a companion bill in the Senate earlier this month. Center for Connected Health Policy Releases Updated Telehealth Billing Guide The Center for Connected Health Policy (CCHP) this week released an updated telehealth billing guide for healthcare organizations managing the complexities of billing for telehealth and virtual services.   First released in 2020, the updated billing guide addresses whether or not there is reimbursement for telehealth both generally and/or during the Covid-19 public health emergency, as well as how to bill correctly for a telehealth service, which CCHP said is one of the most common policy questions it receives as the National Telehealth Policy Resource Center.   “Further complicating the billing process is the need to understand whether current rules are only applicable during the pandemic as well as the fact that payer policies continue to vary from payer to payer,” the CCHP said in a news release. “For example, policies that apply to a Medicare beneficiary remain different than those that apply to a state Medicaid enrollee or to patients that have private insurance.”   The 30-page guide includes infographics that highlight various patient scenarios, as well as a page of resources available in different regions of the country. SAMHSA to Host Opioid Crisis Webinar Next Week SAMHSA Chief Medical Officer Neeraj Gandotra, M.D. will lead a panel of experts in a webinar to explore how healthcare providers, government agencies, and not-for-profit organizations can work together to address the nation’s ongoing opioid crisis.   Healthcare software company WellSky will present the webinar, which is intended to help registrants learn about effective care coordination, effective strategies to produce better outcomes, and how advocates are working to align patient data sharing with the Health Insurance Portability and Accountability Act.   The webinar is scheduled for Thursday, March 25 at 1 p.m. Click here to register. Register to Attend the 2021 Rx Drug Abuse & Heroin Summit The annual Rx Drug Abuse and Heroin Summit, known as the largest annual conference that addresses America’s opioid and addiction crises, will be held virtually this year from April 5-8.   The conference will present more than 75 sessions across nine educational tracks and will cover topics ranging from prevention and treatment to public safety and technology. NABH Director of Quality and Addiction Services Sarah Wattenberg will present with representatives from the Office of National Drug Control Policy, the U.S. Drug Enforcement Administration, and the Veterans Affairs Department in a session titled, “Federal and Private Sector Responses to Opioid Treatment Issues During the Covid-19 Pandemic.”      For additional information, download the conference brochure, and click here to register.   Save the Date: NABH 2021 Annual Meeting NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings: * June 13-15, 2022 * June 12-14, 2023 We look forward to seeing you again in Washington! Fact of the Week Data pooled from 65 studies involving 97,333 healthcare workers across 21 countries identified a high prevalence of moderate depression, anxiety, and PTSD among healthcare workers during the Covid-19 pandemic. “Appropriate support is urgently needed,” the report concluded. “The response would benefit from additional research on which interventions are effective at mitigating these risks.”  For questions or comments about this CEO Update, please contact Jessica Zigmond

Historic $1.9 Trillion Covid Relief Bill Includes Billions for Behavioral Healthcare

President Biden on Thursday signed the American Rescue Plan, a $1.9 trillion stimulus package to help Americans and the U.S. economy rebuild amid the Covid-19 global pandemic that brought the world to a halt a year ago this week. The landmark legislation provides some $8.5 billion in new funding for the Provider Relief Fund, focused primarily on the nation’s rural providers. It also includes $125.8 billion for the Elementary and Secondary School Emergency Relief Fund, some of which may be used for mental health supports, such as implementing evidence-based services in schools. In a White House announcement on Inauguration Day, the Biden administration said “Districts must ensure that funds are used to not only reopen schools, but also to meet students’ academic, mental health and social, and emotional needs in response to Covid-19 (e.g. through extended learning time, tutoring, and counselors), wherever they are learning.” Meanwhile, the new law includes $3 billion for the Substance Abuse and Mental Health Services Administration (SAMHSA) community mental health and substance abuse prevention and treatment grants, and $420 million for Certified Community Behavioral Health Clinics. It also provides $80 million in pediatric mental healthcare access funding, and $50 million in grants—for which behavioral health organizations are eligible—to address local behavioral health needs, including addressing surge capacity for behavioral health, telehealth, and crisis intervention services. The law also provides $30 million for substance use disorder (SUD) harm-reduction programs and $20 million for youth suicide-prevention programs. Here are other essential behavioral healthcare provisions in the American Rescue Plan:

• Provides for mandatory coverage of COVID-19 vaccines, administration, and treatment under Medicaid

• Allows states to extend Medicaid eligibility to women for 12 months postpartum for five years

• Offers a Medicaid enhanced match (95%) for states that newly expand Medicaid as authorized under the Affordable Care Act

• Includes a 7-percent increase in Medicaid match for home and community-based services including mental health services

• Provides a Medicaid enhanced federal match (85% for three years) for mobile crisis services

• $100 million for Behavioral Health Workforce Education and Training grants to graduate and professional training programs

• $40 million for behavioral healthcare providers to support mental health among their workforce

• $20 million to CDC for an education and awareness campaign directed to health care professionals and first responders

• $80 million for behavioral healthcare for first responders

NABH Joins Other Healthcare Organizations to Support Medicare Sequester Extension

NABH is one of nearly 50 healthcare organizations that has requested House and Senate leaders extend the Medicare sequester moratorium and prevent the projected 4-percent Medicare spending cut scheduled to begin next year. Signed into law in late December, The Consolidated Appropriations Act of 2021 provided a three-month extension—until March 31—of the Medicare sequester moratorium that the CARES Act enacted. Meanwhile, unless Congress acts, a sequestration order will be issued to reduce spending in fiscal year 2022 by $381 billion, including a reduction in Medicare spending by four percentage points, which is an estimated $36 billion for that year. “Such extreme cuts would have a long-lasting and devastating impact on health care providers and patients alike,” the groups wrote in a letter Friday to House Speaker Nancy Pelosi (D-Calif.), House Minority Leader Kevin McCarthy (R-Calif.), Senate Majority Leader Chuck Schumer (D-N.Y.) and Senate Minority Leader Mitch McConnell (R-Ky.).

Fauci Says He is “Very Much” Concerned About a Mental Health Pandemic in Covid-19 Aftermath

Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases, told Norah O’Donnell of the CBS Evening News this week he is “very much” concerned about a mental health pandemic in the wake of the Covid-19 public health emergency. “That’s the reason why I want to get the virological aspect of this pandemic behind us,” Fauci said, “because the long-term ravages of this pandemic are so multifaceted.” Fauci also expressed his concerns about the prolonged symptomatology for those who have had the Covid-19 virus, the pandemic’s long-lasting economic effects, and the amount of routine medical examinations that Americans were forced to forego during the pandemic’s shutdown.

SAMHSA Accepting Applications for MAT-Prescription Drug-Opioid Addiction Grants

SAMHSA is accepting applications for fiscal year 2021 Medication-Assisted Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) grants to expand and enhance access to MAT services for individuals with opioid use disorder who are seeking or receiving MAT.   SAMHSA’s announcement said the agency plans to issue about 89-135 awards of up to $1 million per year for states and up to $525,000 per year for other domestic, public or not-for-profit organizations for up to five years. The deadline to apply is Tuesday, April 27. Click here to learn more and apply.

IPFQR Webinar Scheduled for Next Week

The Quality Reporting Center has scheduled a webinar for participants in the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program about navigating public reporting websites on Wednesday, March 17 at 2 p.m. ET. According to an announcement, the presentation will describe how the IPF community can access publicly reported IPFQR program data on the Medicare Care Compare and Provider Data Catalog websites. Click here to learn more and to register.

Upcoming Opioid Crisis Webinar to Feature SAMHSA Chief Medical Officer Neeraj Gandotra, M.D.

SAMHSA Chief Medical Officer Neeraj Gandotra, M.D. will lead a panel of experts in a webinar to explore how healthcare providers, government agencies, and not-for-profit organizations can work together to address the nation’s ongoing opioid crisis. Healthcare software company WellSky will present the webinar, which is intended to help registrants learn about effective care coordination, effective strategies to produce better outcomes, and how advocates are working to align patient data sharing with the Health Insurance Portability and Accountability Act. The webinar is scheduled for Thursday, March 25 at 1 p.m. Click here to register.

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

The annual Rx Drug Abuse and Heroin Summit, known as the largest annual conference that addresses America’s opioid and addiction crises, will be held virtually this year from April 5-8. The conference will present more than 75 sessions across nine educational tracks and will cover topics ranging from prevention and treatment to public safety and technology. NABH Director of Quality and Addiction Services Sarah Wattenberg will present with representatives from the Office of National Drug Control Policy, the U.S. Drug Enforcement Administration, and the Veterans Affairs Department in a session titled, “Federal and Private Sector Responses to Opioid Treatment Issues During the Covid-19 Pandemic.” For additional information, download the conference brochure, and click here to register.

Save the Date: NABH 2021 Annual Meeting 

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

A recent Kaiser Family Foundation health tracking poll found that during the Covid-19 pandemic, adults in households with job loss or lower incomes reported higher rates of symptoms of mental illness than those without job or income loss: 53% versus 32%. For questions or comments about this CEO Update, please contact Jessica Zigmond

Murthy Vows to Focus on Pandemic’s Mental Health Effects if Confirmed as Surgeon General

U.S. surgeon general nominee Vivek Murthy, M.D. said this week he will focus on the mental health effects of the Covid-19 global pandemic if he is confirmed to the post. Murthy told CBS This Morning on Tuesday that the nation is facing a “deeply concerning” increase in mental illness during the pandemic, including among children. “We know a lot of what we need to do, we just aren’t doing it,” Murthy said in the interview. “We have, for example, programs that we could be investing in schools to help provide mental health counseling to kids to detect symptoms of mental illness,” he continued. “We can train more mental health providers.” Ultimately, Murthy said, the country needs to have a “very different conversation” about mental health. “If you are struggling with your mental health, that does not mean that you are broken,” Murthy said. “What it means is that you are a human being having a human experience—one that many of us have been going through during this pandemic and many will experience long after the pandemic is over.” Murthy served as America’s 19th surgeon general from December 2014 until April 2017.

Joint Commission Journal Publishes Report on Staff Emotional Support During Pandemic

The Joint Commission Journal on Quality and Patient Safety this week published a study that examined different interventions that Montefiore Medical Center (MMC) applied to treat psychological distress among staff during the pandemic. According to the November 2020 study, the health system’s Moses campus admitted two patients diagnosed with Covid-19 a year ago on March 11, 2020. At the time of the study’s writing, more than 6,000 patients were admitted to MMC (including 91% from the Bronx), and more than 2,200 patients and 21 staff died from the virus. “On March 15, 2020, psychiatry leadership collaborated with leadership from various sectors of MMC to establish the Staff Emotional Support (SES) Team,” the study noted. “Over 10 weeks during the initial phase of the pandemic, the SES Team created a variety of mental health services to meet the needs of as many staff as possible, understanding that individuals respond to traumatic experiences and to support services in diverse ways.” The study said MMC applied a host of interventions, including psychoeducational resources, a phone support line, staff support centers (SSCs), a clinical treatment program, team support sessions, and more. “We believe that SSCs were the most frequently used,” the report said, “because they were easily accessible places for respite, refreshment, and recharging and offered a basic forum of human connection not necessarily associated with the potential stigma of seeking formal support.”

IPFQR Webinar Scheduled for Wednesday, March 17

The Quality Reporting Center has scheduled a webinar for participants in the Inpatient Psychiatric Facility Quality Reporting (IPFQR) Program about navigating public reporting websites on Wednesday, March 17 at 2 p.m. ET. According to an announcement, the presentation will describe how the IPF community can access publicly reported IPFQR program data on the Medicare Care Compare and Provider Data Catalog websites. Click here to learn more and to register.

SAMHSA Accepting Applications for MAT-Prescription Drug-Opioid Addiction Grants

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for fiscal year 2021 Medication-Assisted Treatment-Prescription Drug and Opioid Addiction (MAT-PDOA) grants to expand and enhance access to MAT services for individuals with opioid use disorder who are seeking or receiving MAT. SAMHSA’s announcement said the agency plans to issue about 89-135 awards of up to $1 million per year for states and up to $525,000 per year for other domestic, public or not-for-profit organizations for up to five years. The deadline to apply is Tuesday, April 27. Click here to learn more and apply.

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

The annual Rx Drug Abuse and Heroin Summit, known as the largest annual conference that addresses America’s opioid and addiction crises, will be held virtually this year from April 5-8. The conference will present more than 75 sessions across nine educational tracks and will cover topics ranging from prevention and treatment to public safety and technology. NABH Director of Quality and Addiction Services Sarah Wattenberg will present with representatives from the Office of National Drug Control Policy, the U.S. Drug Enforcement Agency, and the Veterans Affairs Department in a session titled, “Federal and Private Sector Responses to Opioid Treatment Issues During the COVID-19 Pandemic.” For additional information, download the conference brochure, and click here to register.

Register to Attend the 6^th Annual Population Health Payer Innovations for Medicare, Medicaid & Duals

The 6^th Annual Population Health Payer Innovations for Medicare, Medicaid, & Duals will host its conference virtually this year from May 18-19. Free for hospitals, the conference will address topics such as combatting the opioid crisis, using community paramedics, and partnering clinical and analytic teams to explore value-based insurance design (VBID) models of care. Health plans that focus on Medicaid, Medicare, and dual-eligible beneficiaries, along with providers, will share best practices and how to build and manage population health programs to ensure compliance, improve outcomes, and control costs. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week 

A new study found that health literacy (HL) “strongly correlated” with two-week and total readmissions among adult patients with bipolar disorder and supported the feasibility of assessing HL further in this patient population. The findings could also be useful for patient education, discharge planning, and policymaking. For questions or comments about this CEO Update, please contact Jessica Zigmond

CDC Reports U.S. Suicide Rate Fell Before Covid-19 Global Pandemic

The Centers for Disease Control and Prevention (CDC) this week reported that after increasing for 13 years, the U.S. suicide rate dropped overall by 2% between 2018 and 2019, but it cautioned those figures do not account for the Covid-19 pandemic’s impact. A total of 47,511 deaths were attributed to suicide in 2019, with half involving guns, although that rate also fell, the Atlanta-based agency said. Suicide rates declined by 3.2% for women and 1.8% for men. Meanwhile, the decrease varied by state and race, falling overall in Idaho, Indiana, Massachusetts, North Carolina, and Virginia—and only among white people. People aged 85 and older had the highest suicide rate of any age group, and levels appeared lowest in large, central metropolitan areas. “As the United States continues to respond to the coronavirus disease 2019 (Covid-19) pandemic and its long-term impacts on isolation, stress, economic insecurity, and worsening mental health and wellness, prevention is more important than ever,” the CDC’s Morbidity and Mortality Weekly Report noted. “Past research indicates that suicide rates remain stable or decline during infrastructure disruption (e.g., natural disasters), only to rise afterwards as the longer-term sequalae unfold in persons, families, and communities.”

‘Unified Vision’ to Address Mental Health and SUD Gains Support from 35 More Organizations

Thirty-five additional organizations have offered their support to the Unified Vision, a seven-pillar roadmap to address the future of mental health and substance use disorders (SUD) in America that a coalition of mental health and SUD organizations announced in December. NABH is part of that coalition, which developed the Unified Vision to provide action items meant to encourage and establish policy, programs, and standards that prioritize mental health and substance use care. The Unified Vision also addresses the social and economic conditions that disproportionately affect people of color and people whose income levels are below the federal poverty level. Organizations that joined recently include the American Academy of Child and Adolescent Psychiatry, Anxiety and Depression Association of America, National Association of School Nurses, and Trust for America’s Health. “An early priority is to break down the silos that currently exist in the mental health and substance use care space, which are all too often barriers to systemic change,” Daniel H. Gillison, Jr. of the National Alliance on Mental Illness, said in an announcement this week about the new signatories. “Our leadership team and recent signatories collectively represent close to 40 independent organizations, willing to work together on one of the direst issues of our time.” NABH, National Council and NASMHPD Urge CDC to Include Persons with SMI and SUD in Phase 1c Vaccination Groups NABH, the National Council, and the National Association of State Mental Health Program Directors (NASMHPD) have urged the CDC to include individuals with serious mental illness (SMI) and SUD in the agency’s Phase 1c vaccination groups for Covid-19 due to the high mortality rates among these patients from the coronavirus. In a letter to CDC Acting Director Rochelle Walensky, M.D., the three organizations assert that by excluding individuals with serious behavioral health conditions from Phase 1c prioritizations, these persons face increased risk of severe illness from Covid-19. CDC should also take immediate steps to distribute available vaccines directly to outpatient and inpatient behavioral health providers, the letter noted. The three groups outlined some action steps, such as urging the CDC to partner with the Substance Abuse and Mental Health Services Administration (SAMHSA) to allocate directly a limited supply of Covid-19 vaccine to select community mental health centers and community behavioral health organizations and inpatient psychiatric hospitals, as well as outpatient and residential treatment providers.

NABH Signs MHLG Coalition Letter to Support the TREAT Act

As a member of the Mental Health Liaison Group, NABH this week signed a letter to the Senate Health, Education, Labor, and Pensions and House Energy & Commerce Committees supporting the recently introduced Temporary Reciprocity to Ensure Access to Treatment Act (TREAT). The legislation from Senators Chris Murphy (D-Conn.) and Roy Blunt (R-Mo.) and Reps. Bob Latta (R-Ohio) and Debbie Dingell (D-Mich.) would increase access to healthcare services during the Covid-19 public health emergency by allowing practitioners with licenses to provide services—including telehealth services—in all states for the duration of the public health emergency. “The TREAT Act aims to increase access to crucial health services during this time by temporarily permitting health professionals to practice across state lines,” the letter noted. “The bill stipulates that a provider who holds a valid license in any state (and is not barred in another state) can practice in accordance with applicable state law in every state during the national public health emergency and during a 180-day transition period after the declaration is lifted,” it added.

Children’s Healthcare Groups Launch Youth Mental Health Awareness Campaign

The Children’s Hospital Association and the American Academy of Pediatrics (AAP) this week urged Congress and the Biden administration to prioritize children’s mental, emotional, and behavioral health in proposals that address the effects of the Covid-19 pandemic. In a joint announcement, the two organizations emphasized that the pandemic has exacerbated a disturbing trend, as hospital admissions and emergency room visits for suicide attempts doubled at children’s hospitals between 2008 and 2015. Hospitalizations at U.S. children’s hospitals increased last summer amid the pandemic, which included a 20% increase in suicide attempts and more than 40% in disruptive behavior disorders. “Almost a year into the pandemic, what began as a public health emergency is turning in a mental health crisis among our nation’s children and adolescents,” Dr. Lee Beers, president of the AAP, said in a news release. “The duration of the pandemic, isolation from friends and family, effects of parental stress and economic hardship, and loss of loved ones are all taking their toll on children’s mental health,” he added. “Now is the time for us to step up and invest in a broad-scale, comprehensive approach to prevention, early intervention, and treatment.”

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

The annual Rx Drug Abuse and Heroin Summit, known as the largest annual conference that addresses America’s opioid and addiction crises, will be held virtually this year from April 5-8. The conference will present more than 75 sessions across nine educational tracks and will cover topics ranging from prevention and treatment to public safety and technology. For additional information, download the conference brochure, and click here to register.

Register to Attend the 6^th Annual Population Health Payer Innovations for Medicaid, Medicare & Duals

The 6^th Annual Population Health Payer Innovations for Medicaid, Medicare & Duals will host its conference virtually this year from May 18-19. Free for hospitals, the conference will address topics such as combatting the opioid crisis, using community paramedics, and partnering clinical and analytic teams to explore value-based insurance design (VBID) models of care. Health plans that focus on Medicaid, Medicare, and dual-eligible beneficiaries, along with providers, will share best practices and how to build and manage population health programs to ensure compliance, improve outcomes, and control costs. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

Non-prescribed fentanyl and methamphetamine increased 78% and 29%, respectively, according to a new study from Millennium Health.   For questions or comments about this CEO Update, please contact Jessica Zigmond

House Reconciliation Package Includes Strong Support for Behavioral Healthcare

U.S. House committees this week began marking up the Covid-19 reconciliation package that largely reflects the Biden administration’s priorities and includes strong support for behavioral healthcare and a number of NABH priorities. House members expect quick passage on a party-line basis for the legislation, which includes significant funding for state and local governments. NABH will apprise members of the final bill’s provisions when they are available. As of this week, the reconciliation package:

• Includes Substance Abuse and Mental Health Services Administration (SAMHSA) block grants funded at $3.5 billion, split equally between the Block Grants for Community Mental Health Services and the Block Grants for Prevention and Treatment of Substance Abuse. Taken in conjunction with the $4.25 billion in funding that SAMHSA received in December as part of the stimulus package, this represents the largest onetime federal investment in behavioral health in our nation’s history.

• Addresses the so-called Medicaid Inmate Exclusion Policy (MIEP) by allowing for medical assistance under Medicaid for inmates during the 30-day period preceding their release. This provision would expire after five years.

• Provides enhanced Medicaid support for bundled mobile crisis intervention. States would be permitted to provide bundled payments for mobile crisis services at an 85% FMAP rate. This provision would expire after five years.

• Provides for mandatory coverage of Covid-19 vaccines, administration, and treatment under Medicaid.

• Allows states to extend Medicaid eligibility to women for 12 months postpartum for five years.

• Provides $100 million for Behavioral Health Workforce Education and Training (BHWET) grants through the Public Health Service.

• Provides $80 million for behavioral healthcare training for health care professionals, paraprofessionals, and public safety officers in the form of grants through the U.S. Health Resources and Services Administration (HRSA).

• Provides $30 million for community-based substance use disorder programs for harm-reduction services and the prevention and control of the spread of infectious diseases through SAMHSA.

• Provides $20 million for youth suicide prevention activities.

After the House passes this latest Covid-19 relief package, the Senate is expected to consider it after the upper chamber completes former President Trump’s impeachment trial.

Foley & Lardner Survey Examines Telehealth Commercial Insurance Laws Across States

Forty-three states and Washington, D.C. maintain some sort of telehealth commercial payer statute, although the quality and efficacy of these laws varies considerably from state to state, a new telehealth survey from law firm Foley & Lardner shows. The 190-page report notes that the legal landscape has “significantly improved” since the firm’s 2019 report, which is intended as a guide to telehealth insurance laws and regulations for healthcare providers, lawmakers, entrepreneurs, telemedicine companies, and other industry stakeholders. According to the report, although telehealth coverage has expanded widely, the same cannot be said for reimbursement/payment parity. “Currently, 22 states maintain laws expressly addressing reimbursement of telehealth services (an increase from 16 states in 2019), and 14 of those offer true “payment parity” (an increase from 10 in 2019), meaning that providers outside those 14 states may find they receive lower payment for telehealth-based services compared to in-person services (i.e., same service code, but different reimbursement rates),” the report said. “States with payment parity laws are Arkansas, California, Delaware, Georgia, Hawaii, Kentucky, Minnesota, Missouri, New Mexico, Texas, Utah, Vermont, Virginia, and Washington.”

Kaiser Family Foundation Analysis Shows Covid-19 Pandemic’s Effects on Mental Health and SUD

A new issue brief from the Kaiser Family Foundation reports that about four in 10 U.S. adults have reported symptoms of anxiety or depressive disorder during the Covid-19 global pandemic, up from one in 10 adults who reported these symptoms from January to June 2019. Meanwhile, a Kaiser Family Foundation tracking poll from July 2020 found that many adults are reporting specific negative effects on their mental health and well-being, such as difficulty sleeping (36%) or eating (32%), increases in alcohol and consumption or substance use (12%), and worsening chronic conditions (12%) due to worry and stress about the coronavirus. The study also examines the effects of adults losing their jobs, communities of color, young adults, and essential workers.

Pandemic-Related Alcohol Abuse Leads to Hospitalizations for Liver Disease

Hospitals nationwide have reported dramatic increases in alcohol-related admissions for critical diseases such as alcoholic hepatitis and liver failure, according to a story published this week in the Los Angeles Times. The story reported that alcoholism-related liver disease was a growing problem even before the Covid-19 pandemic, with about 15 million people diagnosed with the condition nationwide and with hospitalizations doubling during the last decade. “But the pandemic has dramatically added to the toll,” the story noted. “Although national figures are not available, admissions for alcoholic liver disease at Keck Hospital of the University of Southern California were up 30% in 2020 compared with 2019, said Dr. Brian Lee, a transplant hepatologist who treats the condition in alcoholics.” Meanwhile, specialists affiliated with the University of Michigan, Northwestern University, Harvard University, and Mount Sinai Health System in New York City reported rates of admissions for alcoholic liver disease have risen by up to 50% since last March. Click here to read the full story.

CMS’ Medicaid Initiatives Can Help States Fund the New Crisis Stabilization Services for Callers to the 988 Hotline

In a recent interview with Crisis Talk, Kirsten Beronio, NABH’s director of policy and regulatory affairs, explains how the Centers for Medicare & Medicaid Services’ (CMS) Medicaid initiatives can help states fund crisis stabilization services for callers to 988, the new three-digit national hotline for behavioral health emergencies. “988 has the potential to be a game-changer,” said Beronio, a former senior policy advisor at CMS, “And if we talk about it as a behavioral health crisis line, then states and commercial payers are more likely to see it as offering concrete opportunities to make improvements on a broader set of behavioral health issues that they’ve been struggling to address.” Click here to read Kirsten’s interview.

Register Today for National Drug and Alcohol Facts Week: March 22-28, 2021

The National Institute on Drug Abuse (NIDA) urges providers to register and sponsor an event for National Drug and Alcohol Facts Week, which will be held from March 22-28 this year. The week-long observance highlights science-based facts on how drugs and alcohol affect the brain and body, and NIDA has created five steps for providers to host an event. Click here to register and learn more.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

A new study from researchers at the Yale School of Medicine’s Department of Psychiatry found that people with serious mental illness are significantly overrepresented in deaths by suicide, even compared with individuals with other psychiatric diagnoses. Despite making up around 4% of the population of the United States, people with serious mental illness accounted for more than twice (8.7%) of those deaths by suicide, according to the results published in Schizophrenia Research.   For questions or comments about this CEO Update, please contact Jessica Zigmond

CMS Announces Special Enrollment Period in Marketplaces During Covid-19 Pandemic

The Centers for Medicare & Medicaid Services (CMS) has announced a special enrollment period (SEP) for consumers—including both individuals and families—in the 36 states that operate health insurance marketplaces through HealthCare.gov, citing the “unprecedented challenges” that the Covid-19 public health emergency has created. “Millions of Americans are facing uncertainty and millions of Americans are experiencing new health problems during the pandemic,” said the announcement, which aligns with an Executive Order from President Biden. “Due to the exceptional circumstances and rapidly changing Public Health Emergency impacting millions of people throughout the U.S. every day, many Americans remain uninsured or underinsured and still need affordable health coverage.” Beginning Feb. 15 and continuing through May 15, marketplaces using the HealthCare.gov platform will make an SEP available to all marketplace-eligible consumers who are submitting a new application or updating an existing one. Eligible consumers who enroll under this SEP will be able to select a plan with coverage that starts prospectively the first month after plan selection. Consumers will then have 30 days from the time they applied to choose a plan.

ONDCP Announces 100-Day Priorities

The White House Office of National Drug Control Policy (ONDCP) this week outlined its priorities for the first 100 days of the new Biden administration, including a focus to lift burdensome restrictions on medications for opioid use disorder. The announcement from Acting Director Regina LaBelle perhaps signals that the Biden administration might further consider regulations related to buprenorphine prescribing for physicians who treat fewer than 30 patients. On Jan. 21, the new administration pulled back a guidance changing the requirements for these physicians as part of the regulatory freeze on Trump administration policies issued in the previous 60-days. In addition, ONDCP’s strategic aims include enhancing evidence-based, harm-reduction efforts, a departure from the previous administration.

Joint Commission Releases Sentinel Event Alert: Pandemic Special Edition, Part 1

The Joint Commission this week released a Sentinel Event Alert that addresses concerns from healthcare workers and offers examples for providers to manage the current Covid-19 pandemic and respond to future challenges. “Covid-19 is highlighting the absolute indispensability of a dedicated and fearless healthcare workforce,” the article noted. “The need to better ensure the safety and health of workers has become the topic of a national conversation,” it continued. “As of Jan. 15, 2021, 3,176 healthcare workers have died from Covid-19, according to independent tracking from The Guardian and Kaiser Health News.” The seven-page article examines how to foster transparent communication, remove barriers to workers seeking mental health services, ensure patient safety, develop and evaluate a flexible workforce, and more. According to the Joint Commission, this is the first in a series of special edition Sentinel Event Alerts about the Covid-19 pandemic.

JAMA Psychiatry Examines Trends in ED Visits for Mental Health, Overdose, and Violence

A study of nearly 190 million emergency department (ED) visits found that ED visit rates for mental health conditions, suicide attempts, all drug and opioid overdoses, intimate partner violence, and child abuse and neglect were higher in mid-March 2020 through October 2020, compared with the same period in 2019. The findings published this week in JAMA Psychiatry suggest that seeking care in an ED shifts during a pandemic and underscores the need to integrate mental health, substance use, and violence screening and prevention services into response activities during public health crises.

University of Michigan’s Behavioral Health Workforce Research Center Releases Telehealth Study Findings

All healthcare providers who participated in a study of Michigan behavioral healthcare providers last summer indicated they would like to see telebehavioral health services continue after the Covid-19 pandemic ends. Between late July and mid-August 2020, a team at the University of Michigan’s Behavioral Health Workforce Research Center, a contractor for the Substance Abuse and Mental Health Services Administration, conducted a study that included in-depth interviews with 31 Michigan behavioral healthcare providers statewide who provide telebehavioral health services. The center released a report that summarizes the study’s findings and suggests future policy considerations. Two accompanying briefs from the University of Michigan’s Institute for Healthcare Policy & Innovation—which funded the project— highlight the report’s essential findings and policy considerations, including one focused on state policy implications and the other on federal policy implications. “In order to continue treating clients and keep them safe, and as a result of state and federal policy changes, providers rapidly expanded their use of telehealth,” the summary noted. “Policy changes at the state and federal level expanded telehealth authorization and reimbursement across insurers, allowed for services to be delivered via video or audio-only methods, and removed requirements for written consent for treatment, allowing verbal consent, among other changes,” the summary added. Sarah Wattenberg, NABH’s director of quality and addiction services, is a member of the University of Michigan’s Behavioral Health Workforce Research Center’s Advisory Group, which guides the center’s research work. Please contact Sarah if you have ideas for future research projects.

DOJ Accepting Applications for Substance Use-Related Programs

The U.S. Justice Department (DOJ) is accepting applications for two substance use-related programs: the Second Chance Act Pay for Success Initiative and the Residential Substance Abuse Treatment (RSAT) for State Prisoners Program. In the Second Chance Act Pay for Success Initiative, the DOJ is seeking applications for funding for state, local, and tribal governments to enhance or implement performance-based and outcomes-based contracts with reentry, permanent supportive housing, or recovery housing providers to reduce recidivism and address the substance use disorders impacting formerly incarcerated people. The DOJ is also seeking funding applications for the RSAT program, which helps state, local, and tribal efforts to break the cycle of drug addiction and violence by reducing the demand for, use, and trafficking of illegal drugs. Applications for both programs are due in March; click here to learn more about the Second Chance Act Pay for Success Initiative and here to learn about the RSAT for State Prisoners Program.

Justice Clearinghouse to Host Webinar on Successful Mental Health Diversion Programs: Feb. 9

The Justice Clearinghouse, an organization of more than 80,000 justice and public safety professionals, will host a webinar next week that will explore what successful mental health diversion should look like. John Snook, NABH’s new director of government relations and strategic initiatives, will serve as a presenter during the webinar, which is scheduled for Tuesday, Feb. 9 from 3 p.m. to 4:15 p.m. ET. Click here to learn about the other presenters and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

The New York Times reports that 69% of U.S. mothers say they have experienced adverse health effects due to worry and stress during the pandemic, compared with 51% of U.S. fathers.   For questions or comments about this CEO Update, please contact Jessica Zigmond

CMS Issues Memo to Clarify Expectations of Hospital Surveys During Pandemic

The Centers for Medicare & Medicaid Services (CMS) Center for Clinical Standards and Quality has issued a memo that clarifies expectations regarding hospital surveys during the ongoing Covid-19 global pandemic. According to the memo, surveys will be limited to “Immediate Danger” complaint allegations for the 30 days following the memo’s release on Jan. 20. The memo also said hospital recertification surveys would be suspended for the most part. Meanwhile, hospital enforcement actions for deficiencies that do not represent “Immediate Jeopardy” will have their termination date extended for at least 30 days. The memo is also posted on NABH’s Covid-19 resources webpage.

HHS Releases Call to Action to Implement the National Strategy for Suicide Prevention

HHS has released The Surgeon General’s Call to Action to Implement the National Suicide Prevention Strategy (National Strategy), a 92-page guide from Jerome Adams, M.D., M.P.H., the nation’s most recent U.S. surgeon general. First released in 2001, the National Strategy was updated in collaboration with the Action Alliance in 2012. It identifies 13 goals and 60 objectives that address every aspect of suicide prevention—from fostering healthy and empowered individuals, families, and communities to providing effective prevention programs and clinical care. The guide is categorized into the following six action areas: activating a broad-based public health response to suicide, addressing upstream factors that impact suicide, ensuring lethal means safety, supporting adoption of evidence-based care for suicide risk, enhancing crisis care and care transitions, and improving the quality, timeliness, and use of suicide-related data. Adams served as U.S. surgeon general from September 2017 until Jan. 20, 2021. This week President Biden appointed Rear Admiral Susan Orsega, M.S.N. as acting U.S. surgeon general pending Senate confirmation of Vivek Murthy, M.D., M.B.A, who served as U.S. surgeon general from 2014 through 2017 in the Obama administration. Orsega has served in the surgeon general’s office since March 2019. In a letter this week to the Biden administration, the Kennedy Forum, Mental Health America, and the National Alliance on Mental Illness urged policymakers to integrate the nation’s mental health and addiction response in the fight against Covid-19 and listed suicide prevention as one of the priorities.

Coalition Endorses Principles to Guide State and Local Spending of Opioid Litigation Settlement Funds 

The faculty at the Johns Hopkins Bloomberg School of Public Health has coordinated a coalition of 31 professional and advocacy organizations that has released Principles for the Use of Funds from the Opioid Litigation, which provides five principles to help guide state and local spending of the forthcoming opioid litigation settlement funds. NABH was one of the organizations to endorse the principles. An announcement noted the guidelines are meant to avoid mistakes made in the 1988 tobacco litigation settlement and support efforts based on evidence to save lives. “As states, counties, and municipalities begin receiving funds from entities that exacerbated America’s opioid overdose crisis, it will be critical for decision makers to use that money wisely,” Paul Earley, M.D., president of the American Society of Addiction Medicine, said in the announcement. “To make the most of this opportunity, state and local leaders should invest in evidence-based approaches to prevent and treat addiction, promote racial equity, and save lives.” The five principles include spending money to save lives, using evidence to guide spending, investing in youth prevention, focusing on racial equity, and developing a fair and transparent process for deciding where to spend the funding.

Research Shows Schizophrenia Second to Age as Greatest Risk Factor for Covid-19 Death

A new study shows people with schizophrenia, a mental disorder that affects mood and perception of reality, are nearly three times as likely to die from the coronavirus than those without the psychiatric illness. Researchers at the New York University Grossman School of Medicine led the study, which found that schizophrenia is by far the biggest factor (2.7 times increased odds of dying) after age (being 75 and older increased the odds of dying 35.7 times). “Our findings illustrate that people with schizophrenia are extremely vulnerable to the effects of Covid-19, lead author Katlyn Nemani, M.D., said in a news release about the study. “With this newfound understanding, healthcare providers can better prioritize vaccine distribution, testing, and medical care for this group.” The study was published this week in JAMA Psychiatry.

Center for Connected Health Policy to Host Telehealth Policy Webinar Next Week

The Center for Connected Health Policy will host Telehealth & Medicaid: What’s Next? A Roadmap for Telehealth Beyond the Pandemic next Friday, Feb. 5, 2021 at 2 p.m. ET. The webinar will feature experts in a panel discussion about what the future looks like for telehealth policy in Medicaid. Attendees will hear from high-level administrators and policy staff from the Medicaid and CHIP Payment Advisory Commission (MACPAC), the Arizona Health Care Cost Containment System, the Colorado Department of Health Care Policy and Financing, and the Oregon Health Authority. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

A new study reports 46% of health care workers say their mental health has worsened during the pandemic, while 38% say there’s been no change.   For questions or comments about this CEO Update, please contact Jessica Zigmond

Coderre & LaBelle Named as Acting Heads of SAMHSA and ONDCP

Tom Coderre, former Region 1 administrator at the Substance Abuse and Mental Health Services Administration (SAMHSA), has been named SAMHSA’s acting assistant secretary for mental health and substance use, and Regina LaBelle, former chief of staff at the White House Office of National Drug Policy (ONDCP), has been named ONDCP’s acting director in the new Biden administration. Coderre served in the Rhode Island Senate from 1995 until 2003 and later as senior advisor to Rhode Island Gov. Gina Raimando. In his previous role as chief of staff at SAMHSA, he led the team that produced Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Coderre is the first person in recovery to lead SAMHSA, and his bio notes that he acknowledges the essential role of peer recovery support services to help people with mental health and substance use disorder (SUD) rebuild their lives. LaBelle is a distinguished scholar and program director of the addiction and public policy initiative at the O’Neill Institute for National and Global Health Law at Georgetown University and is on a leave of absence from that position. LaBelle worked as the chief of staff and senior policy advisor at ONDCP during the Obama administration and oversaw the agency’s efforts to address the nation’s opioid crisis.

White House Issues Regulatory Freeze Pending Review 

The White House on Thursday notified the leaders of federal executive departments and agencies that the Biden administration is freezing the federal regulatory process pending review. A memorandum from Ron Klain, assistant to the president and chief of staff, outlined the steps that department and agency leaders are expected to take immediately. It begins with the instruction that—subject to exceptions from the Office of Management and Budget in emergency situations—they propose or issue no rule in any manner, including sending a rule to the Office of the Federal Register, until a department or agency head appointed or designated by President Biden reviews and approves the rule. The memo also includes details about rules that have been published in the Federal Register, and those that have been issued in any manner but have not yet taken effect.

Joint Commission Proposes New Standards for Preventing Workplace Violence 

The Joint Commission (TJC) on Wednesday proposed new, revised standards for workplace violence prevention. The standards provide a framework for developing strong workplace violence prevention systems, defining workplace violence, and developing a leadership structure, policies, and procedures, reporting systems, post-incident strategies, training, and education to decrease workplace violence. TJC will accept comments on the proposed new standards until Tuesday, Feb. 16. Click here to read the standards and to submit comments.

CMS Releases T-MSIS-based Medicaid SUD Data Book

The Centers for Medicare & Medicaid Services (CMS) this week released its second publication of the Transformed Medicaid Statistical Information System (T-MSIS)-based Medicaid Substance Use Disorder (SUD) Data Book to help policymakers, researchers, and other stakeholders better understand where to focus drug prevention and treatment efforts. The data book includes 2018 data on Medicaid beneficiaries treated for SUD and the services they received by type, setting, delivery system, and progression of care. According to the data book’s findings, of the 55.9 Medicaid beneficiaries ages 12 and older with full or comprehensive benefits, 4.6 million, or 8%, were treated for a SUD in 2018. Meanwhile, nearly half of beneficiaries, or 46%, treated for SUD received emergency services, and 26% received at least one service in an outpatient or home- or community-based setting within 30 days of discharge.

NABH Welcomes New Committee Chairs

NABH is pleased to announce new leaders for some of the association’s standing committees and thanks its outgoing leaders for their service. Tom Kenny of Sequel Youth & Family Services succeeds Pat Connell of Boys Town Behavioral Health Division as the new chairman of NABH’s Youth Services Committee, and Joe Pritchard of Pinnacle Treatment Centers succeeds Jeff Hillis of AdCare Hospital as the new chairman of the association’s Addiction Treatment Commitment. NABH is also pleased to welcome Kim Sanderson of Acadia Healthcare as the chairwoman for the SUD Medication Treatment Subcommittee.

NABH Releases Issue Brief on Changes to Medicare Coverage for SUD

NABH this week sent members an NABH Issue Brief to provide more details about recent changes to Medicare coverage for SUD that were included in the 2021 Physician Fee Schedule (PFS) rule. The Issue Brief includes information about how the rule expanded the PFS bundled payments to include all SUDs, as well as details about nasal naloxone.

Center for Connected Health Policy to Host Telehealth Policy Webinar on Feb. 5

The Center for Connected Health Policy will host Telehealth & Medicaid: What’s Next? A Roadmap for Telehealth Beyond the Pandemic on Friday, Feb. 5, 2021 at 2 p.m. ET. The webinar will feature experts in a panel discussion about what the future looks like for telehealth policy in Medicaid. Attendees will hear from high-level administrators and policy staff from the Medicaid and CHIP Payment Advisory Commission (MACPAC), the Arizona Health Care Cost Containment System, the Colorado Department of Health Care Policy and Financing, and the Oregon Health Authority. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

Compared with 2019, the proportion of mental health-related visits for children aged 5 to 11 years old and 12 to 17 years old increased about 24% and 31%, respectively. For questions or comments about this CEO Update, please contact Jessica Zigmond

HHS to Expand Access to MAT by Eliminating ‘X-Waiver’ for DEA-Registered Physicians

The U.S. Health and Human Services Department (HHS) on Thursday said it will publish new guidelines that will exempt office-based physicians from having to receive a DATA 2000 waiver, known as the X-waiver, in order to prescribe buprenorphine for opioid use disorder treatment for up to 30 patients. The guidance is effective immediately. Specifically, the new guidance permits physicians to prescribe buprenorphine for up to 30 patients without completing eight hours of training prior to prescribing buprenorphine. The training requirement has been cited as a barrier to more physicians prescribing the drug. The new guidance does not change the existing regulations for physician assistants, nurse practitioners, or other mid-level practitioners. This move is intended to address the surge in opioid deaths in the past year. After declining between 2017 and 2018 by 4.1%, the number of overdose deaths increased 18.2% from June 2019 to May 2020. During this period, overdose deaths increased more than 20% in 25 states and the District of Columbia, 10% to 19% in 11 states and New York City, and up to 9% in 10 states. The new guidance has been issued under regulatory flexibility that permits the administration to make exemptions from the regulatory requirements, as deemed necessary, in consultation with the Drug Enforcement Administration, the National Institute on Drug Abuse, and the U.S. Food and Drug Administration. A new issue brief from the HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE) found that increasing buprenorphine prescribing capacity of one patient per 100 residents increases prescribing by 3.8% and decreases the use of other opioid prescribing by 2.3%. The relationship holds true only for metropolitan areas.

Meena Vythilingam, M.D. Named Acting Assistant Secretary for Mental Health and Substance Use

Capt. Meena Vythilingam, M.D. of the United States Public Health Service is serving as the acting assistant secretary for mental health and substance use, succeeding Elinore McCance-Katz, M.D., Ph.D., who resigned last week. Vythilingam, a board-certified psychiatrist, is also the first director of the HHS Center for Health Innovation, and the senior advisor for mental health and opioids in HHS’ office of the assistant secretary for health. Before she completed her psychiatry residency and post-doctoral fellowship at the Yale University School of Medicine, Vythilingam completed a residency in psychological medicine at the National Institute of Mental Health and Neurosciences in Bangalore, India. The Substance Abuse and Mental Health Services Administration (SAMHSA) announcement did not indicate how long Vythilingam will serve in the position.

NABH Highlights Priorities in Letter to the Biden-Harris Transition Team 

NABH this week sent a letter to the Biden-Harris transition team that outlines the biggest challenges for behavioral healthcare and recommendations on how to address those problems. The 12-page letter describes the heightened need for mental health and substance use disorder services in the United States, which the Covid-19 pandemic has exacerbated. “Elevated levels of mental health and substance use disorders are expected to linger long after the Covid-19 pandemic ends,” NABH President and CEO Shawn Coughlin wrote. “Large-scale disasters such as the current pandemic are known to have widespread and long-lasting detrimental effects on mental health and substance use. Moreover, studies of past disasters have shown the mental health distress and suicidality often do not peak until years after the disaster has ended.” The letter includes recommendations related to vaccines for behavioral healthcare providers, continued telehealth coverage for mental health and addiction treatment, flexibilities regarding Special Conditions of Participation, increased availability of behavioral healthcare for children and youth, and the 988 hotline.

NABH Issue Brief Provides Details on Expanded Telehealth Coverage 

NABH this week sent an Issue Brief to members that highlights details of the extended Medicare coverage that the Centers for Medicare & Medicaid Services (CMS) authorized in its final 2021 Medicare Physician Fee Schedule rule that was published in the Federal Register last month. Click here to learn more.

RAND Corp. Releases Report on Transforming U.S. Mental Health System

RAND Corp. has released a report with analysis and recommendations in 15 areas where there is potential to help improve the lives of more than 60 million Americans living with mental illness. How to Transform the U.S. Mental Health System addresses the following three questions: 1) How can policy changes at all levels of government effect transformational change to improve the lives of Americans with mental illness? 2) What are the best practices and recent innovations in the mental health sector? and 3) What opportunities for change in the mental healthcare system are supported by the research literature? The report is divided into five chapters, and it focuses on topics areas such as integrating behavioral health expertise in general health settings, strengthening mental health parity regulation and enforcement, establishing evidence-based behavioral health treatments at their true cost, linking homeless individuals with mental illness to supportive housing, and more. NABH Director of Policy and Regulatory Affairs Kirsten Beronio served on the advisory panel for this report.

NIH-Supported Study Finds Team-Based Approach May Improve Buprenorphine Care 

A recent pilot study concluded that a collaborative approach to treating opioid use disorder that relies heavily on community pharmacists “is feasible and may increase adherence and participant satisfaction,” according to research published in the journal Addiction.   The study—which the National Institute on Drug Abuse, part of the National Institutes of Health, supported—studied the transfer of care of 71 participants using buprenorphine maintenance therapy for opioid use disorder from waivered physicians to trained community pharmacists. According to the study, about 90% of people in the United States live within five miles of a community pharmacy. Researchers from Duke University and their collaborators found that nearly 89% of participants remained in the study and 95.3% adhered to the daily medication regimen. “Participants, physicians, and pharmacists alike reported high rates of satisfaction with the program,” the journal article noted. The study’s authors concluded that the pilot shows “strong support” for advancing physician-pharmacist team-based approaches to leveraging community resources when it comes to expanding access to opioid use disorder treatment with buprenorphine.

SAMHSA Accepting Applications for Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths

SAMHSA’s Center for Substance Abuse Treatment is accepting applications for fiscal year 2021 grants to prevent prescription drug and opioid overdose-related deaths through Monday, March 1. The program is meant to reduce the number of prescription drug and opioid overdose-related deaths and adverse events among individuals aged 18 and older by training first responders and community members on preventing these deaths and on how to implement secondary prevention strategies, such as buying and distributing naloxone. SAMHSA said it has a total amount of about $11.4 million for this project and expects to grant 13 awards of up to $850,000 per year for up to five years. Click here to learn more.

Center for Connected Health Policy to Host Telehealth Policy Webinar on Feb. 5

The Center for Connected Health Policy will host Telehealth & Medicaid: What’s Next? A Roadmap for Telehealth Beyond the Pandemic on Friday, Feb. 5, 2021 at 2 p.m. ET.   The webinar will feature experts in a panel discussion about what the future looks like for telehealth policy in Medicaid. Attendees will hear from high-level administrators and policy staff from the Medicaid and CHIP Payment Advisory Commission (MACPAC), the Arizona Health Care Cost Containment System, the Colorado Department of Health Care Policy and Financing, and the Oregon Health Authority. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you in Washington!

Fact of the Week

A Mental Health America survey between June-September 2020 found that 76% of healthcare workers reported exhaustion and burnout. For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA’s Elinore McCance-Katz Resigns Following Violence at U.S. Capitol

Elinore McCance-Katz, M.D., Ph.D. announced Thursday she is resigning as the nation’s assistant secretary for mental health and substance use, citing the riotous takeover of the U.S. Capitol on Jan. 6. According to her statement, McCance-Katz had intended to stay in her role at the Substance Abuse and Mental Health Services Administration (SAMHSA) until the change in administration later this month. Those plans changed after she returned from a visit to a residential treatment program in New York and saw events unfold Wednesday. “I believe that we are given certain life situations where we must make the difficult decisions and we get one chance to do it the right way,” McCance-Katz said in her statement. “Because I believe that the mental health of our people has suffered so greatly under the stresses of Covid-19, the social justice issues that have been so painful for so many, and now with the rending of our nation over questions raised about the presidential election, I cannot support language that results in incitement of violence and risks our very existence.” McCance-Katz adds her name to a list of other high-ranking officials who have distanced themselves from the Trump administration through their resignations this week, including Transportation Secretary Elaine Chao, Education Secretary Betsy DeVos, Deputy National Security Adviser Matthew Pottinger, and others.

CMS Issues Guidance on Medicaid Coverage for Opioid Use Disorder Treatment

The Centers for Medicare & Medicaid Services (CMS) released guidance in late December about new Medicaid coverage requirements to treat opioid use disorders (OUD). The guidance provides information to state Medicaid programs about a new mandatory Medicaid benefit added under the 2018 SUPPORT Act that requires these programs to cover all drugs and biologicals that the U.S. Food and Drug Administration has approved or licensed to treat OUD, including methadone. It also includes information about the medications and treatment services included in this new medication-assisted treatment (MAT) benefit and the locations where MAT can be provided. In addition, the guidance includes details about other Medicaid authorities to help states expand their opioid use disorder service continuum.

SAMHSA Report Addresses How to Manage Increased Need for Services During Pandemic

SAMHSA has released a 25-page report and plan on how to address the heightened need for mental and behavioral healthcare services resulting from the effects of the Covid-19 global pandemic. Saving Lives Through Increased Support for Mental and Behavioral Health Needs is a result of President Trump’s Executive Order of the same name on Oct. 5, 2020. The effort is meant to address preventing suicide, ending the nation’s opioid crisis, and improving mental and behavioral health in the United States. The Executive Order’s goal is to reduce the number of immediate life-threatening situations related to mental illness and substance use disorders, and it also outlines ways to alleviate these ongoing problems. Most of the report highlights “building on existing strengths,” such as prevention, crisis services, the work of current programs, and more, while the remainder of the report offers recommendations.

NABH Welcomes Jameson Norton as 2021 Board Chair and New Board Members

NABH is pleased to welcome Jameson K. Norton, M.B.A., F.A.C.H.E., who has served on the NABH Board of Trustees, as the association’s 2021 Board Chair, effective Jan. 1. Based in Nashville, Norton serves as the chief operating officer of Newport Healthcare, which treats individuals ages 12–27 who struggle with depression, anxiety, and/or trauma-related issues, along with co-occurring eating disorders and substance abuse. Formerly he served as president of Vanderbilt Psychiatric Hospital and Outpatient Services. Norton has served in the U.S. Marine Corps and earned a B.A. at the University of Virginia and M.B.A. at Vanderbilt University’s Owen Graduate School of Management. In addition, NABH welcomes board members Pat Connell, M.B.A., F.A.C.H.E., C.B.H.E., C.H.C., vice president of behavioral health, compliance and government relations at Boys Town Behavioral Health Division in Boys Town, Neb.; Dwight A. Lacy, M.B.A., group president of western operations at Franklin, Tenn.-based Acadia Healthcare, Inc.; and Susan L. Wright, M.B.A., director of behavioral health operations at BayCare Behavioral Health in Clearwater, Fla. The association also welcomes Teena Ahuja, vice president of behavioral health at Prime Healthcare in Ontario, Calif.; Joe Pritchard, CEO of Pinnacle Treatment Centers, Inc. in Mount Laurel, N.J.; and Patricia Rehmer, M.S.N., A.C.H.E., president, behavioral health network and senior vice president of Hartford HealthCare, who have joined as automatic board seat members.

John Snook to Join NABH as Director of Government Relations and Strategic Initiatives

John Snook will join the National Association for Behavioral Healthcare (NABH) as director of government relations and strategic initiatives on Jan. 18. John comes to NABH from the Treatment Advocacy Center, where he served as the mental health advocacy organization’s executive director since 2015. He also brings with him more than 15 years of advocacy and policy experience at the state and federal levels. The Treatment Advocacy Center’s influence has been far-reaching: more than half of the states have reformed their mental health laws due in large part to the Center’s advocacy efforts, and the group’s original research on issues such as criminalization of mental illness has rewritten the national narrative on severe mental illness treatment. During his tenure as executive director of the Treatment Advocacy Center, John secured more than $70 million in federal funding for assisted outpatient treatment programs across the country, guided advocacy efforts that led to bipartisan mental health reforms in the 21st Century Cures Act; directed the publication of 15 major research reports; and oversaw the passage of 44 new laws designed to improve access to treatment for people with severe mental illness. “John is well-respected in Washington for his strong commitment to improving behavioral healthcare access and services in the United States,” said NABH President and CEO Shawn Coughlin. “We are excited and fortunate to welcome him to NABH,” he added. “Our national membership and Washington-based team will benefit greatly from his knowledge, experience, and ideas.” John’s interest in mental health began when he was in law school and saw a loved one struggle with mental illness. He championed mental illness reform, working first with the West Virginia Supreme Court on mental health issues, and then as an advocate at the Treatment Advocacy Center. John earned a B.A. from Washington & Jefferson College and a J.D. from the George Mason School of Law. 

Center for Connected Health Policy to Host Telehealth Policy Webinar on Feb. 5 

The Center for Connected Health Policy will host Telehealth & Medicaid: What’s Next? A Roadmap for Telehealth Beyond the Pandemic on Friday, Feb. 5, 2021 at 2 p.m. ET.   The webinar will feature experts in a panel discussion about what the future looks like for telehealth policy in Medicaid. Attendees will hear from high-level administrators and policy staff from the Medicaid and CHIP Payment Advisory Commission (MACPAC), the Arizona Health Care Cost Containment System, the Colorado Department of Health Care Policy and Financing, and the Oregon Health Authority. Click here to learn more and to register.

Save the Date: NABH 2021 Annual Meeting

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you in Washington!

Fact of the Week

In a typical year, Native American youth die by suicide at nearly twice the rate of their white peers in the United States, according to a story in Kaiser Health News that cited the Centers for Disease Control and Prevention. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Congress Works to Complete Covid-19 Relief Bill as Federal Funding Deadline Nears

Federal lawmakers on Friday continued to work on a $900 billion Covid-19 funding relief bill to avert a government shutdown before federal funding expires at midnight. Congress has already agreed on a $1.4 trillion omnibus bill, the legislative vehicle for the $900 billion economic relief package that lawmakers still need to complete. NABH has learned the Covid-19 relief bill is likely to include about $700 million for the U.S. Health and Humans Services Department (HHS) to use for additional research and procurement and medical supply needs, such as personal protective equipment, and about $35 billion for the Provider Relief Fund. The bill is also likely to provide about $3.15 billion to the Substance Abuse and Mental Health Services Administration (SAMHSA) for the Substance Abuse Prevention and Treatment Block Grant, the Community Mental Health Services Block Grant, tribal programs, emergency relief, and peer recovery programs and suicide prevention efforts at the Centers for Disease Control and Prevention (CDC); about $1.3 billion to State Opioid Response Grants, and about $150 million to the Certified Community Behavioral Health Centers Program. Meanwhile, the bill’s addiction and mental health provisions would also expand access to medication-assisted treatment (MAT) through a limited extension of Centers for Medicare & Medicaid Services (CMS) and Drug Enforcement Administration (DEA) telehealth waivers. It would also eliminate the requirement that practitioners apply for a waiver through the DEA in order to prescribe buprenorphine for substance use disorder treatment to the end of the public health emergency or to Dec. 31, 2021, under the conditions of appropriate state oversight and a follow-up study on buprenorphine diversion. NABH staff is tracking congressional developments and will keep members apprised of the legislation’s effects on behavioral healthcare providers.

HHS Starts Distributing $24.5 Billion in Phase 3 Covid-19 Provider Relief Funding

HHS announced Dec. 16 that it has increased and started to distribute $24.5 billion in the Provider Relief Fund’s (PRF) third phase. The announcement from HHS said the department completed its review of Phase 3 applications from the PRF and will distribute the funding to more than 70,000 providers. HHS also said the sum is greater than the $20 billion that was planned originally, with $4.5 billion being used “to satisfy close to 90% of each applicant’s reported lost revenues and net change in expenses” that the coronavirus pandemic caused during the first half of 2020. Click here to view HHS’ first set of Phase 3 payments by state.

Mental Health and Addiction Organizations Urge HHS to Include Behavioral Healthcare Providers Among Covid-19 Vaccine Priority Groups 

NABH is one of nearly 50 mental health and addiction treatment advocacy groups that sent a letter Friday to HHS Secretary Alex Azar urging him to direct the CDC to issue guidance advising states to include mental health and addiction treatment providers among the prioritized groups for receiving the Covid-19 vaccines. The letter notes this group includes the behavioral healthcare practitioners and staff that the U.S. Homeland Security Department deems as critical essential workers; recovery support providers; and patients in inpatient psychiatric and residential treatment and community-based treatment settings. “The Covid-19 pandemic is having a significant impact on the behavioral health of children and adolescents,” the letter said. “According to another recent CDC report, the proportion of children’s visits to emergency departments for mental health reasons increased dramatically starting in April 2020 and continuing through October of 2020.”

CEOs from 14 Mental Health Groups Release ‘Unified Vision’ to Address U.S. Mental Health Crisis

The chief executives of the country’s 14 leading mental health advocacy organizations and professional associations this week announced they have formed a unified coalition to engage federal and state officials nationwide to introduce a plan for accelerating effective mental health and substance use care as America manages the global Covid-19 pandemic. NABH President and CEO Shawn Coughlin represents the association in the coalition, which also includes the American Psychiatric Association, American Psychological Association, Massachusetts Association for Mental Health, Meadows Mental Health Policy Institute, Mental Health America, National Alliance for Mental Illness, National Council for Behavioral Health, One Mind, Peg’s Foundation, Steinberg Institute, Kennedy Forum, Treatment Advocacy Center, and Well Being Trust. “The lesson of the Covid pandemic is not simply about lack of preparedness,” Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.) and Thomas Insel, M.D. wrote in a joint op-ed about the coalition in The Newark Star-Ledger. “It is also about our resourcefulness as a society to mobilize public-private partnerships that could develop treatments and vaccines at unprecedented speed and scale.” The coalition’s vision statement provides “pathways for success” across seven critical policy areas: early identification and prevention, especially for families and young people; rapid deployment of emergency crisis response and suicide prevention; leveling inequities in access to care; establishing integrated health and mental health care to ensure “whole-person” well-being; achieving parity in payment by health plans for mental health and substance-use coverage; assuring evidence-based standards of treatments and care; and, engaging a diverse mental health care workforce, peer support and community-based programs. Visit the Unified Vision homepage to learn more.

HHS-OIG Requests Recommendations for New or Updated Safe Harbor Provisions

HHS’ Office of Inspector General (OIG) this week requested proposals and recommendations to develop new, or to modify existing, safe harbor provisions under the Social Security Act’s federal anti-kickback statute. The statute applies criminal penalties for whoever knowingly—and willingly—offers, pays, solicits, or receives money to induce or reward the referral for, or purchase of, items and services that are reimbursed under any federal healthcare program. Because of the statute’s broad reach, there was concern that the statute included relatively harmless business arrangements. This has had an especially negative effect on implementing “contingency management/motivational incentive treatment” practices in which individuals receive small rewards for improving treatment outcomes. Contingency management is an evidence-based practice that the National Institute on Drug Abuse and the SAMHSA developed as a joint initiative in 2001. This treatment intervention is especially critical for individuals with stimulant use disorders, for which there are no effective treatment medications. According to the CDC, drug overdoses involving psychostimulants increased 33.3% between April 2019 and April 2020, the highest percentage increase of all categories of drugs involved in overdoses for that time period. Healthcare providers and others could comply with safe harbor conditions so that they are not subject to the federal anti-kickback statute. The OIG will accept comments on the proposed rule until Tuesday, Feb. 16, 2021. Click here to learn how to submit recommendations.

SAMHSA Announces Mental Health and SUD Grant Funding Opportunities 

SAMHSA this week announced it is accepting applications for more than a dozen grant funding opportunities in behavioral healthcare. The programs cover topics related to mental health, recovery, suicide, traumatic stress for children, and more. Click here to read about the program opportunities and application deadlines. Center for Connected Health Policy to Host Telehealth Policy Webinar on Feb. 5 The Center for Connected Health Policy will host Telehealth & Medicaid: What’s Next? A Roadmap for Telehealth Beyond the Pandemic on Friday, Feb. 5, 2021 at 2 p.m. ET.   The webinar will feature experts in a panel discussion about what the future looks like for telehealth policy in Medicaid. Attendees will hear from high-level administrators and policy staff from the Medicaid and CHIP Payment Advisory Commission (MACPAC), the Arizona Health Care Cost Containment System, the Colorado Department of Health Care Policy and Financing, and the Oregon Health Authority. Click here to learn more and to register.

Reminder: NABH 2021 Board Election Ballots Due Thursday, Dec. 31 

NABH has e-mailed members NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2021 Board. If you have not done so, please vote for the open Board Chair-Elect position and three available Board seats; sign the ballot (it is not valid without a signature); and return it to NABH. You can do this by scanning your completed ballot and e-mailing it nabh@nabh.org, or faxing it to 202-783-6041. NABH must receive all ballots no later than Thursday, Dec. 31, 2020. New Board members and the Board Chair-elect will take office in January 2021.

Save the Date: NABH 2021 Annual Meeting 

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you in Washington next year! Fact of the Week  A recent JAMA Psychiatry study examining the pandemic’s effects on mental health found that among Black residents, suicide deaths appeared to double the recent historical average from March 5, the date Maryland declared a state of emergency and shut down, until May 7, when the first public spaces reopened. While the researchers highlighted the study’s limitations, they concluded that “…policy interventions and targeted resource allocation may be warranted to mitigate disparities impacting Black individuals.”

Happy Holidays from NABH!

NABH will not publish CEO Update for the next two weeks and will resume on Friday, Jan. 8, 2021. The entire NABH team wishes you, your teams, and your families a very happy, healthy, and safe holiday season! For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Updates Covid-19 Reporting Guidance for Hospitals, Labs, and Acute-Care Facilities

In guidance released this week, the U.S. Health and Human Services Department (HHS) said hospitals, hospital laboratories, and acute-care facilities will be required to include incidences of patients with influenza in their Covid-19 data reporting data as of Dec. 18. The new influenza fields were added as optional elements to the Covid-19 data reporting set in October and will be mandatory starting next week. In addition, the new reporting requirements include weekly reporting on inventory and use of Covid-19 therapeutic medications. Please note the relevant new provisions highlighted in this week’s guidance, which is also available on NABH’s Covid-19 resources webpage.

CMS Hospital Price Transparency Final Rule Presentation Now Available

The Centers for Medicare & Medicaid Services (CMS) has provided slides from the agency’s Dec. 8 webinar about the hospital price transparency final rule. Beginning Jan. 1, all U.S. hospitals will be required to provide transparent and accessible pricing information online about the items and services they provide. According to CMS, hospitals will be required to do this in two ways: first as a comprehensive, machine-readable file that notes all items and services, and second as a display of shoppable services in a consumer-friendly format. The webinar identified who must comply with the rule, defined hospital “standard charges,” and outlined what items and services must be included.

Biden Chooses Becerra, Murthy, and Walensky for Top Federal Healthcare Posts

President-elect Joseph Biden has selected California Attorney General Xavier Becerra as his nominee to lead HHS and internist Vivek Murthy, M.D. to reprise his earlier role as U.S. surgeon general. Becerra, who represented California in the U.S. House of Representatives from 1993 to 2017, was chairman of the House Democratic Caucus from 2013 to 2017 and served on the powerful House Ways and Means Committee. He earned both his bachelor and law degrees from Stanford. If confirmed, Becerra would be the first Latino to lead HHS. A fierce champion of the Patient Protection and Affordable Care Act, Becerra is leading 20 states and Washington, D.C.  to protect the seminal 2010 healthcare law from being dismantled. Becerra would oversee the department at a critical time during the Covid-19 pandemic, as caseloads surge and a massive vaccination effort is set to launch soon. Murthy served as the nation’s 19th U.S. surgeon general during the Obama administration from December 2014 until January 2017. Murthy completed his internal medicine residency at Brigham and Women’s Hospital and Harvard Medical School, and also led and managed medical teams as a faculty member. Biden also named Rochelle Walensky, M.D., M.P.H., chief of infectious diseases at Massachusetts General Hospital, to lead the Centers for Disease Control and Prevention in Atlanta. Walensky also serves as professor of medicine at Harvard Medical School and is an expert on AIDS and HIV.

Well Being Trust and IHI Publish Resources to Help Providers and Communities Address Mental Health During Pandemic

Well Being Trust and the Institute for Healthcare Improvement (IHI) have released two resources to help healthcare providers, payors, and community partners implement strategies to help save lives from overdose and suicide, and care for front-line health workers during the Covid-19 pandemic. A Guide for Health Systems to Save Lives from “Deaths of Despair” and Improve Community Well-Being is a 37-page resource that explores the role of healthcare systems in improving health and well-being and proposes an approach that identifies who the population is, how to implement methods, and what interventions to use in communities. The shorter of the two resources, A Guide to Promoting Health Care Workforce Well Being During and After the Covid-19 Pandemic defines key concepts, such as “moral injury,” “psychological first-aid,” and “grief leadership,” and then offers applicable steps that healthcare organizations can take to build on existing support systems.

SAMHSA Releases Treatment Guide on Youth Suicide

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released Treatment for Suicidal Ideation, Self-harm, and Suicide Attempts Among Youth, a 57- page guide that provides interventions to treat suicidal ideation, self-harm, and suicide attempts among youth. Elinore McCance-Katz, M.D., Ph.D., assistant secretary for mental health and substance use, noted in a foreword that the guide is part of SAMHSA’s response to the 21^st Century Cures Act’s requirement to disseminate information on evidence-based practices and service delivery models. McCance-Katz also wrote that suicide is the second leading cause of death for youth in the United States. The suicide rate for youth aged 10 to 24 increased 56% to 10.6 per 100,000 people in 2017 from 6.8 per 100,000 people in 2007.

Reminder: NABH 2021 Board Election Ballots Due Thursday, Dec. 31

NABH this week e-mailed system members the NABH Board of Trustees candidate profiles and a ballot to elect new members to the 2021 Board. If you have not done so, please vote for the open Board Chair-Elect position and three available Board seats; sign the ballot (it is not valid without a signature); and return it to NABH. You can do this by scanning your completed ballot and e-mailing it nabh@nabh.org, or faxing it to 202-783-6041. NABH must receive all ballots no later than Thursday, Dec. 31, 2020. New Board members and the Board Chair-elect will take office in January 2021.

Save the Date: NABH 2021 Annual Meeting 

NABH will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you in Washington next year!

Fact of the Week

A new Morning Consult poll found that 36% of Americans reported their mental health has suffered during the Covid-19 global pandemic, while 19% said their physical health has worsened. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CDC Director Approves ACIP’s Covid-19 Vaccine Plan for Healthcare Workers, LTCFs

Centers for Disease Control and Prevention (CDC) Director Robert Redfield, M.D. on Thursday approved a CDC committee’s recommendation that healthcare personnel and long-term care facility (LTCF) residents be offered the Covid-19 vaccine in the vaccination program’s initial phase. The agency’s Advisory Committee on Immunization Practices (ACIP) Covid-19 Vaccines Work Group earlier this week outlined a phased allocation for the vaccines that highlighted the committee’s scientific and ethical considerations. The ethical principles include maximizing benefits, minimizing harm, promoting justice, and mitigating health inequities. ACIP members defined LTCF residents as “adults who reside in facilities that provide a variety of services, including medical and personal care, to persons who are unable to live independently,” and a footnote on slide 12 of the presentation includes psychiatric facilities in the LTCF definition. As part of this effort, NABH sent a letter to the National Governors Association that asked governors to prioritize behavioral healthcare providers in the first round of the Covid-19 vaccine distribution. In the letter, NABH President and CEO Shawn Coughlin emphasized that demand for mental health and addiction services has increased during the global pandemic, while challenges such as personal protective equipment shortages and reduced staff availability have placed additional burdens on behavioral healthcare providers. “It is critical that we preserve and even increase access to behavioral healthcare as a key component of the response to Covid-19,” Coughlin wrote. “Since the onset of the pandemic, our members have been intensely focused on implementing many new practices and protocols to address the increased demand for behavioral healthcare while preventing the spread of the coronavirus,” he added. “They have developed and implemented new screening and infection- control measures. Unfortunately, some of these measures, such as quarantine rooms, reduce their capacity to provide care.”

CMS Maintains Some Telehealth Provisions in 2021 Medicare Physician Fee Schedule 

In the Calendar Year (CY) 2021 Medicare Physician Fee Schedule rule released this week, the Centers for Medicare & Medicaid Services (CMS) said it will maintain some of the telehealth service coverage it authorized during the Covid-19 pandemic, including telehealth coverage for group psychotherapy and psychological and neurological testing. CMS said it will decline to continue covering evaluation and management services via audio-only technology, and instead will provide coverage on an interim basis during CY 2021 for an extended, audio-only assessment service to determine whether an in-person visit is needed. This rule also finalized regulations to allow Medicare coverage of telehealth services provided to existing patients while at home, regardless of where they live for treatment of substance use disorders and co-occurring mental health conditions. The Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) authorized this exception to the Medicare rules that do not generally cover telehealth services that originate from the patient’s home and limit coverage of telehealth to certain geographic areas.

CMS Includes PHP Payment Rates in 2021 OPPS Rule

CMS this week included payment rates for partial hospitalization programs (PHPs) in the CY 2021 Outpatient Prospective Payment System (OPPS) final rule the agency released on Dec. 3. In the rule, CMS made final its August proposal to use its existing methodology for calculating the CY 2021 geometric mean per diem cost using the most recent updated claims and cost data. Based on available data at that point, the proposed per diem rates were $243.94 for hospital-based PHPs and $121.62 for community mental health centers (CMHCs). Using the most recent updated claims and cost data as proposed, the final CY 2021 hospital-based PHP geometric mean per diem cost is $253.76 and the final CMHC geometric mean per diem cost is $136.14. CMS also finalized the proposed payment rate for Level 2 Health and Behavior Services (Ambulatory Payment Classification 5822) at $78.54, based on existing claims data.

CMS Announces RFA for the Value in OUD Treatment Initiative

CMS has announced a request for application (RFA) for a new initiative intended to increase access to opioid use disorder (OUD) treatment services to eligible Medicare fee-for-service beneficiaries and those dually eligible for Medicare and Medicaid. Funded through the SUPPORT Act, the Value in Opioid Use Disorder Treatment is a four-year demonstration that creates two new payments to participating providers: 1) a per-beneficiary, per-month, care-management fee, and 2) a performance-based incentive payment. The SUPPORT Act makes available $10 million each of the fiscal years 2021-2024 for demonstration payments. According to CMS, these payments will be made in addition to the OUD treatment services Medicare covers already. The demonstration is open to a range of participants, including opioid treatment programs, certified community behavioral health clinics, and community mental health centers. CMS will accept applications through Jan. 3, 2021, and selected participants are expected to implement the demonstration by April 1, 2021, at which time payments will begin. Click here to learn more and apply.

CMS to Host Hospital Price Transparency Webcast on Dec. 8

CMS will host a Hospital Price Transparency Webcast on Tuesday, Dec. 8 to provide a more detailed overview of the resources the agency outlined in an Open Door Forum late last month. Before Thanksgiving, CMS hosted a Rural Health Open Door Forum to highlight hospital price transparency resources to help providers prepare for complying with the agency’s Hospital Price Transparency Rule that takes effect on Jan. 1, 2021. Next week’s webcast will also provide a question-and-answer session after the presentation. Click here to register for the hourlong webcast, which will begin at 2 p.m. ET on Dec. 8.

The Commonwealth Fund Examines Covid-19’s Long-term Effects on Mental Health

U.S. policymakers should consider increasing the mental health provider workforce and investing in telehealth as the global pandemic’s mental health repercussions are likely to grow, according to a new report from The Commonwealth Fund. The report cites modeling estimates from the Well Being Trust that show the Covid-19 pandemic could lead to more than 75,000 additional deaths from alcohol and drug misuse and suicide. Meanwhile, the report notes that the pandemic’s effect on social determinants of health—such as employment, income levels, housing and food security—have “threatened basic survival,” and that nearly one-quarter of adults surveyed in early November reported they had not received needed care in the past four weeks. In addition to their mental health workforce and telehealth recommendations, researchers also suggested that states examine their respective insurance laws to ensure that mental health parity or equal treatment of mental health and substance use disorders is enforced, and enact plans to help children access the mental health resources they received previously in schools.

Learn about Prime Healthcare in Our NABH Member Profile!

In our latest Member Profile, NABH member Prime Healthcare shared some of the effective programs and resources the award-winning health system has developed and implemented during the pandemic.   Click here to read Prime’s profile, and please contact Emily Wilkins at NABH if you would like to submit a profile about your organization.

Save the Date: NABH 2021 Annual Meeting

NABH is pleased to announce it will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022

• June 12-14, 2023

Thank you for all you do to advance NABH’s mission and vision. We look forward to seeing you in Washington next year!

Fact of the Week

A study from the Centers for Disease Control and Prevention this summer found 15% of non-Hispanic Black adults had seriously considered suicide in the past 30 days, and 18.6% had started or increased their use of substances to cope with pandemic-related stress. For questions or comments about this CEO Update, please contact Jessica Zigmond

Former U.S. Rep. Jim Ramstad (R-Minn.), Addiction Recovery Champion, Dies at 74

Former U.S. Rep. Jim Ramstad (R-Minn.), a champion for addiction recovery, died Thursday at the age of 74. Ramstad, who had been ailing from Parkinson’s Disease, channeled his personal battle with addiction to become a strong advocate for recovery. He represented Minnesota’s third district in the U.S. House of Representatives for nine terms before he retired in 2009. The Minnesota Republican was the chief sponsor for the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, the bill that opened access to treatment for millions of Americans suffering from mental illness or chemical addiction. News outlets reporting Ramstad’s death described how the former congressman’s personal battle with alcoholism spurred him to help others battling addiction. The stories also mentioned Ramstad’s arrest for disorderly conduct while he served in the Minnesota state legislature, the event that caused him to give up drinking. “If I had not wound up in that jail cell, I would not have sought treatment,” Ramstad told The New York Times in 2006. Ramstad celebrated his 39^th year of sobriety at his death, according to news reports.

Federal Court Orders Class-Wide Remedies in Wit v. United Behavioral Health

NABH legal consultant and psychotherapist Meiram Bendat, Ph.D., J.D., sent the following summary to NABH this week regarding the remedies in the Wit v. United Behavioral Health case: In its 99-page ruling, the court explained the need for: (1) a 10-year injunction requiring UBH to exclusively apply medical necessity criteria developed by non-profit clinical specialty associations; (2) appointment of a special master; (3) training of UBH in the proper use of court-ordered medical necessity criteria; and (4) reprocessing of nearly 67,000 mental health and substance use disorder benefit claims denied during the class period. Today’s ruling stems from two consolidated class actions, Wit et al. v. United Behavioral Health. and Alexander et al. v. United Behavioral Health, brought by Psych-Appeal, Inc. and Zuckerman Spaeder LLP under the Employee Retirement Income Security Act of 1974 (“ERISA”) in 2014, certified in 2016, and tried in October 2017. While nearly 50,000 ERISA insureds will be eligible for class-wide relief in this case, non-ERISA insureds (such as governmental employees) adversely impacted by UBH’s defective guidelines must rely on state and federal regulators to intervene on their behalf. I trust that you recognize the significance of today’s ruling as much as we do.  -Meiram Bendat, Ph.D., J.D., Founder and President, Psych Appeal

DEA Publishes Regulations to Implement the Controlled Substances Act and the Preventing Drug Diversion Act

The Drug Enforcement Administration (DEA) this week published regulations to implement amendments that the 2018 SUPPORT Act made to the Controlled Substances Act. The regulations became effective on Friday, Oct. 30 and appeared in the Federal Register on Nov. 2. The updated regulations:

• Allow a practitioner to treat up to 100 patients if a practitioner meets additional credentialing requirements, or if the practitioner provides covered medications (MAT) in a qualified practice setting, and up to 275 patients if the practitioner meet specific additional requirements (42 CFR 8.610-8.655);
• Permanently include nurse practitioner or physician assistant in the definition of ”qualifying other practitioner,” and temporarily expand the definition (until Oct. 1, 2023) to include a clinical nurse specialist, certified registered nurse anesthetist, or a certified nurse midwife who meets certain qualifications;
• Provide an additional option for a physician to be considered a ”qualifying physician” if the physician graduates in good standing from an accredited school of allopathic medicine or osteopathic medicine in the United States five years prior to notifying HHS of his or her intention to dispense narcotic drugs for maintenance or detoxification treatment. This does not eliminate the SUPPORT Act’s eight-hour opioid training requirement; rather, it permits the training to be completed in medical school or residency, not just through post-residency continuing medical education; and
• Permit pharmacies to deliver a controlled substance to a prescribing practitioner’s location for the purpose of administering the medication (through implantation or injection) to the patient or research subject, as previously permitted under a DEA exception. This permits administration directly in the provider’s office without requiring a trip to the pharmacy.

In separate rulemaking, the DEA proposed its intention to amend the Preventing Drug Diversion Act of 2018 related to the identifying and reporting of suspicious orders by DEA registrants. The proposal offers a two-option framework for reporting suspicious orders, establishes a centralized database for reporting, defines four terms: “due diligence,” “order,” “order received under suspicious circumstances,” and “suspicious order,” and requires registrants to design and operate privacy-law-compliant systems. The provisions are intended to clarify procedures for registrants and address a lack of uniformity in reporting suspicious orders. Comments are due by Monday, Jan. 4, 2021.

HHS Extends Compliance Deadline for Information Blocking and Health IT Certification

The U.S. Health and Human Services Department (HHS) recently released an interim final rule that gives healthcare providers and vendors an additional five months to comply with healthcare information blocking and interoperability regulations by April 5, 2021. In March, HHS’ Office of the National Coordinator for Health IT (ONC) released a 21^st Century Cures Act final rule that established exceptions to the Cures Act’s information blocking provision and adopted new health information technology (health IT) certification requirements to improve patients’ smartphone access to their health information at no cost through application programming interfaces. The new interim final rule extends dates in the information blocking provisions—including a November compliance deadline for providers—as well as dates for the Conditions and Maintenance of Certification provisions that require electronic health records platforms to be interoperable. This is the second time HHS has extended the compliance deadline due to the Covid-19 pandemic. “We are hearing that while there is strong support for advancing patient access and clinician coordination through the provisions in the final rule, stakeholders also must manage the needs being experienced during the current pandemic,” Don Rucker, M.D., national coordinator for health IT, said in an announcement. “To be clear, ONC is not removing the requirements advancing patient access to their health information that are outlined in the Cures Act final rule,” he continued. “Rather, we are providing additional time to allow everyone in the health care ecosystem to focus on Covid-19 response.” The rules require that various types of clinical notes be shared with patients, although the rules do not apply to “psychotherapy notes recorded in any medium by a healthcare provider who is a mental health professional documenting or analyzing the contents of a conversation during a private counseling session or a group, joint, or family counseling session and that are separate from the rest of the individual’s medical record,” according to a summary.

Reminder: DOL’s Rural Healthcare Workforce Training Grant Applications Due Nov. 13

The U.S. Labor Department’s Employment and Training Administration (ETA) will accept applications for its H-1B Rural Healthcare Grant Program until next Friday, Nov. 13. Earlier this fall, ETA announced $40 million in available grant funding for employment and training programs in healthcare occupations—including behavioral and mental healthcare—that serve rural populations. According to the announcement, employment and training programs through this funding can propose a wide range of models, including Registered Apprenticeship Programs and Industry-Recognized Apprenticeship Programs. Pre-apprenticeships are permitted only “as on-ramps” to apprenticeship programs proposed as a response to the funding notice and must lead to apprenticeships during the life of the grant. Click here to learn more about the training programs and here to learn how to apply for the funding.

Bipartisan Policy Center to Host Telehealth Webinar Next Week

Sen. Angus King (I-Maine), Maine healthcare providers, and Bipartisan Policy Center experts will lead a webinar about the future of telehealth next Friday, Nov. 13 at noon ET. The webinar will address the investments and changes that both policymakers and healthcare providers need to make to sustain access to quality healthcare through telehealth. Click here to learn more and to register.

NABH to Host Next Annual Meeting in October 2021

NABH is pleased to announce it will host its 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. The association re-scheduled for this later date in 2021 due to the ongoing Covid-19 pandemic. We hope you can join us! After 2021, NABH will host its subsequent Annual Meetings in June. Please save the date for these future NABH Annual Meetings:

• June 13-15, 2022
• June 12-14, 2023

Thank you for all you do to advance NABH’s mission and vision. We look forward to seeing you in Washington next year! Fact of the Week Individuals with a serious mental illness have an average life expectancy 10 to 25 years lower than the rest of the population. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Presidential Executive Order Establishes Coronavirus Mental Health Working Group

The White House last week issued an executive order to create a Coronavirus Mental Health Working Group that is expected to develop a plan that addresses Covid-19’s mental health effects on Americans and calls for agencies to maximize support for behavioral healthcare treatment. President Trump’s Saving Lives Through Increased Support for Mental—and Behavioral-Health Needs executive order notes that the working group’s efforts will consider the mental and behavioral health conditions of the vulnerable populations that the pandemic has affected, including minorities, seniors, veterans, small business owners, children, individuals potentially affected by domestic violence or physical abuse, persons living with disabilities, and individuals with substance use disorder (SUD). “We know that the Covid-19 pandemic has created or exacerbated serious behavioral health challenges for many Americans, both adding new stresses and disrupting access to treatment,” U.S. Health and Human Services (HHS) Secretary Alex Azar said in a statement.  “The president’s executive order is a welcome opportunity to increase efforts to address the mental health effects of the pandemic, which have already included hundreds of millions of dollars in grants and historic flexibilities to ensure Americans can continue to receive treatment for mental illness and substance use disorders.” Azar will co-chair the new working group with Brooke Rollins, acting director of the U.S. Domestic Policy Council.

U.S. Congress Joint Economic Committee Examines Covid-19’s Toll on Americans’ Mental Health

The United States Congress Joint Economic Committee has released a report that examines how Covid-19’s health and economic repercussions have led to “an unprecedented mental health crisis” in America. The 13-page report summarizes earlier surveys and studies that have found two-thirds of Americans fear that they or their loved ones will be exposed to the virus; more than 12 million Americans are unemployed, and, since February, more than 5 million have given up looking for work; and that nearly one-third of adult Americans are having trouble paying for typical household expenses. “There is yet no clear end in sight for the coronavirus pandemic, which will continue to have devastating effects on public health and on the economy,” the report said. “The Institute of Health Metrics and Evaluation projects more than 360,000 deaths by the end of 2020 under current circumstances, and upward of 430,000 if mandates continue to be eased,” it continued. “The Federal Reserve expects the unemployment rate to remain above pre-pandemic levels until at least the end of 2021. These intense stresses likely will have a growing and lasting impact on Americans’ mental health.

CMS Corrects Announcement to Say Providers Cannot Use PRF When Repaying Medicare Loans

The Centers for Medicare & Medicaid Services (CMS) corrected a misstatement in its Oct. 8 news release to say the nation’s healthcare providers and suppliers cannot use Provider Relief Funds (PRF) to repay Medicare loans the agency has made during the Covid-19  public health emergency. The correction first appeared in an FAQ on Oct. 9. CMS subsequently corrected its original release.

AAAP Releases Buprenorphine Provider Survey Report to Inform Policymakers

The American Academy of Addiction Psychiatry (AAAP) this week released the findings from a new survey that found 80% of X-waivered physicians, physician assistants, and nurse practitioners who treat patients with opioid use disorder (OUD) want telehealth options to continue after the Covid-19 public health emergency. The X-waiver permits office-based clinicians to prescribe Suboxone (buprenorphine/naloxone) for OUD patients. The AAAP led the project with help from other organizations, including the American Psychiatric Association, the American Society of Addiction Medicine, Boston Medical Center, Boston University, and the Yale Program in Addiction Medicine. According to the survey, 78% of respondents said the Covid pandemic has caused them to put on hold or reduce in-person visits. Meanwhile, 75% of physicians and other healthcare professionals said they have used virtual visits to help maintain medication to treat OUD, and 48% reported they used telehealth to initiate medication to help treat OUD. “During the pandemic, physicians and other health care professionals have adapted to quickly provide high-quality, evidence-based care, but this was only possible due to new flexibilities in telehealth rules,” the survey said.

National Addiction Treatment Week Begins Monday, Oct. 19

Monday kicks off National Addiction Treatment Week to build awareness that addiction is a disease, evidence-based treatment is available, and recovery is possible. The week is also meant to encourage people to enter the field of addiction treatment. The American Society of Addiction Medicine (ASAM) launched National Addiction Treatment Week three years ago with partner organizations. Partners include the National Institute on Drug Abuse, the American Medical Association, and the National Association of Addiction Treatment Providers. Click here for ASAM’s schedule of the week and toolkit. Separately, ASAM released an updated cannabis policy statement on Oct. 10.

Please Complete the 2020 NABH Annual Survey!

The 2020 NABH Annual Survey will close on Saturday, Oct. 31. NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. Thank you for your time!

Fact of the Week

The rate of domestic violence that women with serious mental illness experience throughout their adulthood was more than double than that of the general population: 69% versus 33%. Men with serious mental illness showed a similar trend when compared with the general population: 49% versus 17%, respectively. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Gives Medicare Part A & B Providers One More Year to Repay AAP Loans

The Centers for Medicare & Medicaid Services (CMS) said Thursday it will give Medicare Part A and B providers and suppliers an additional year to repay loans the agency made to them during the Covid-19 public health emergency (PHE). CMS had advanced payments to Medicare Part A and B providers and suppliers through the Accelerated and Advance Payment (AAP) program to help cover costs as the PHE disrupted healthcare services this year. Initially CMS had required providers to start making repayments in August 2020. “CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors,” CMS Administrator Seema Verma said in an announcement. “While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal,” she added. According to the agency’s new terms, after that first year, CMS will automatically recoup 25% of Medicare payments otherwise owed to the provider or supplier for 11 months. After that period, CMS will increase the recoupment amount to 50% for another six months. CMS said it will send letters to providers who have any outstanding balances after the entire period—a total of 29 months— informing them that repayment will be subject to a 4% interest rate. Those letters will also include guidance on how to request an Extended Repayment Schedule (ERS) due to financial hardship. The agency’s announcement urged providers and suppliers to contact their Medicare Administrative Contractor for information about how to request an ERS. An ERS will allow a provider or supplier to repay these debts over the course of three to five years. CMS also said providers and suppliers may use Provider Relief Funds to repay these Medicare loans. CMS said it will communicate with each provider and supplier about the amount they owe and all applicable terms in the coming weeks.

New CMS Guidance Requires Psychiatric Hospitals to Report Covid-19 Data Weekly

CMS has released guidance that requires Medicare- and Medicaid-participating psychiatric hospitals to report Covid-19 data to the agency on a weekly basis. CMS published an interim final rule in early September that said hospitals would be required to submit Covid-19 data during the public health emergency in a frequent, standardized way that the U.S. Health and Human Services Department (HHS) secretary specified. This week’s awaited guidance makes it clear that the nation’s psychiatric hospitals—along with rehabilitation hospitals—need to report their data weekly, and not on a daily basis as other hospital types are required to do. NABH advocated for CMS to lessen the reporting frequency for psychiatric hospitals and is pleased with the change. The agency listed the required data in new guidance and also developed an infographic that highlights when the agency plans to alert hospitals about gaps in reporting and compliance. These materials are also available on NABH’s Covid-19 resources webpage.

HRSA Releases Provider Relief Fund Phase 3 Distribution Guide and Fact Sheet

HHS’ Health Resources and Services Administration (HRSA) has released a 12-page provider guide and separate fact sheet to help the nation’s healthcare providers navigate the third phase of the Provider Relief Fund (PRF) distribution during the Covid-19 pandemic. The guide includes specific details on eligibility requirements, application requirements, and reporting guidelines, while the fact sheet condenses the guide’s information and also provides links. HHS announced an additional $20 billion in additional funding last week and encouraged behavioral healthcare providers to apply. The department also developed a list of providers eligible for the funding, including addiction counseling centers, mental health counselors and psychiatrists. The Phase 3 Distribution application process opened this past Monday, Oct. 5, and the application deadline is Friday, Nov. 6. HRSA has scheduled an informational webinar to learn more about the Phase 3 Distribution process next Thursday, Oct. 15 at 3 p.m. ET. Click here to register. HHS has scheduled a webinar about the Phase 3 Distribution process specifically for behavioral healthcare providers and the associations that represent them for Friday, Oct. 16 at 3 p.m. ET. Click here to register.

NABH Submits Comments to CMS on 2021 Physician Fee Schedule Proposed Rule

NABH on Oct. 2 provided feedback to CMS on the telehealth services and substance use disorder (SUD) provisions in the agency’s 2021 physician fee schedule (PFS) proposed rule. In a letter to CMS Administrator Seema Verma, NABH said it supports the proposed rule’s provisions that would continue some of the expanded Medicare coverage of services provided via telehealth, including provisions to extend permanently Medicare coverage for group psychotherapy and psychological testing. The association also said it supports those provisions clarifying that clinical social workers and clinical psychologists and therapists can furnish online assessment and management services, virtual check-ins, and remote evaluations. “We urge you to continue covering evaluation and management services and behavioral health counseling as well as opioid/addiction treatment program counseling and periodic assessment services provided via audio-only technology, i.e., telephone,” the letter said. “Furthermore, we recommend continuing to pay for these services at the same or comparable rates as in-person care—as well as paying for administrative fees to help cover the costs of this technology.” NABH also provided comments on the Opioid Treatment Program (OTP) bundled payment regulations, emphasizing more equitable reimbursement for naloxone and community education for naloxone, as well as reduced limitations on the frequency of reimbursement to align with medical necessity determinations. In addition, NABH’s letter said the association supports continued coverage of periodic telehealth assessments beyond the PHE (including audio-only), and to be reimbursed every 60-90 days, consistent with many state requirements to perform such assessments. The association encouraged CMS to continue the simple, one-bundle structure that has been used successfully to date and reiterated NABH’s recommendation from last year that CMS provide a 17% adjustment to encourage the development of rural OTPs. And NABH underscored the importance of continuing to permit greater flexibility in take-home medications, as well identifying the need to permit reimbursement for OTPs who are under a Substance Abuse and Mental Health Services-provisional certification. Finally, NABH supported the agency’s proposal to expand the PFS bundled payments for Opioid Use Disorder to all SUDs.

U.S. Labor Department to Provide $40 Million in Rural Healthcare Workforce Training Grants 

The U.S. Labor Department’s Employment and Training Administration has announced about $40 million in available grant funding for employment and training programs in healthcare occupations—including behavioral and mental healthcare—that serve rural populations. According to the announcement, employment and training programs through this funding can propose a wide range of models, including Registered Apprenticeship Programs and Industry-Recognized Apprenticeship Programs. Pre-apprenticeships are permitted only “as on-ramps” to apprenticeship programs proposed as a response to the funding notice and must lead to apprenticeships during the life of the grant. The deadline to apply is Friday, Nov. 13. Click here for additional information and how to apply.

U.S. Justice Department to Develop Guidelines to Manage Substance Withdrawal in Jail-based Settings

The U.S. Justice Department’s Bureau of Justice Assistance (BJA) and the National Institute of Corrections is seeking feedback to develop evidence-based, clinical guidelines and protocols that will help jail administrators, correctional officers, and jail-based clinicians identify and safely manage substance withdrawal in jail-based settings. According to an announcement, the guidelines will address a host of issues, including, but not limited to, rapid withdrawal from opioids, benzodiazepines, alcohol, methamphetamine, and cocaine individually or in combination, including specification of persons who exhibit withdrawal symptoms or report histories or information from other sources that indicate the necessity of immediate referral to medical facilities outside of the jail; screening for risk of suicide, specifically opioid withdrawal-potentiated suicides; and medication maintenance for entering detainees with prescriptions for opioid or antipsychotic medications. The BJA will select one applicant for a 10-month award to create a document that outlines the guidelines and protocols. Applications are due by Wednesday, Oct. 28. Click here for more information.

Joint Commission to Host Virtual Behavioral Health Care and Human Services Conference

The Joint Commission will host its Behavioral Health Care and Human Services conference in a virtual format on Friday, Oct. 28. This year, attendees will have the option to choose from two tracks: Track A, designed for organizations accredited under the Behavioral Health Care Accreditation Manual, and Track B, intended for those accredited under the Hospital Accreditation Manual and supplemented with the Behavioral Health Care Manual. Click here for more information and to register.

Today is the Deadline to Submit Recommendations for the 2021 NABH Board of Trustees

The deadline is today, Friday, Oct. 9, to submit nominees for NABH’s Board Chair-Elect and three NABH Board of Trustees seats that will become available in 2021. NABH’s Selection Committee is particularly interested in identifying senior managers who represent broad diversity within the NABH membership, including various levels of care, organizational structures, and size. If you have not done so yet, please download a nomination form to share your recommendations of individuals you would like to see included in the single-slate ballot for 2021. Please be sure to attached a curriculum vitae (CV) for each individual you recommend, which will help the Selection Committee in its deliberations. You are welcome to recommend yourself. Please send your completed form and all candidate CVs to NABH Director of Operations Maria Merlie. Thank you for your time!

Please Complete the 2020 NABH Annual Survey! 

The 2020 NABH Annual Survey opened in late August and NABH members should have received personalized links to the survey from consulting firm Dobson DaVanzo. If you have not received a link, please click here and follow the instructions to submit your survey today. Your feedback will help inform and improve NABH’s advocacy efforts. The survey closes on Saturday, Oct. 31. Thank you for your time!

Fact of the Week

In the first half of 2019, just more than one in 10 adults (11%) reported symptoms consistent with a diagnosable anxiety or depressive disorder. By July 2020, during the Covid-19 pandemic, that number had increased to 40%. For questions or comments about this CEO Update, please contact Jessica Zigmond.