Author: Administrator

September is National Recovery Month & National Suicide Prevention Month

This past week began National Recovery Month and National Suicide Prevention Month, which are intended to educate Americans about services, treatment, and resources available to those with mental health and substance use disorders and to promote suicide prevention. Elinore McCance-Katz, M.D., Ph.D, assistant secretary for mental health and substance use at the Substance Abuse and Mental Health Services Administration (SAMHSA), helped kick off the month-long observances in a video message celebrating those in recovery and the recovery community’s work in the fight against addiction in the United States. SAMHSA will host a webinar series throughout Recovery Month that will feature a different topic every Thursday. Upcoming topics include supported employment, communities supporting recovery, and the importance of integrating recovery support services. Meanwhile, the National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention. Please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. In addition, the group will host National AI/AN Hope for Life Day on Sept. 10. That event falls during Suicide Prevention Week from Sept. 6-12. Please see the Hope for Life Day toolkit and visit the Action Alliance’s #BeThere webpage for more information.   And please remember to follow NABH on Twitter and LinkedIn to learn what NABH members, federal agencies, and other organizations are doing to honor National Recovery Month and National Suicide Prevention Month.

AHRQ Seeks Comment on Strategies for Opioid Use and Misuse in Older Adults in Primary Care

The Agency for Healthcare Research and Quality (AHRQ) is working on a project to assess and describe the current prevalence, awareness, and management of opioid use, misuse, and abuse in older adults and identify gaps and areas of needed research. The new project will support primary care practices in both developing and testing innovative strategies, approaches, and/or tools for opioid management within learning collaboratives and will culminate in a “Compendium of Strategies” for opioid management in older adults in primary care settings. AHRQ mapped out its data collection method in the agency’s project description and is seeking public comments about that process. The notice was posted on Aug. 26, and AHRQ will accept comments for 30 days after that publication date. Anthem-Affiliated Health Plans More than Doubled the Number of Consumers Receiving Whole-Person Treatment for OUD After committing four years ago that it would ensure more consumers would receive both drug therapy and counseling treatment, health insurer Anthem announced this week that it increased the combined percentage of consumers in employer-based, individual, and Medicaid plans with opioid use disorder (OUD) to 36% from 18% in 26 plans nationwide. The Indianapolis-based insurer released the announcement at the start of National Recovery Month and added that Medicaid plans alone increased to 55% from 24%. Greg Williams, a national recovery advocate who helped launch the Surgeon General’s report Facing Addiction in America and who co-founded The Alliance for Addiction Payment reform, applauded Anthem for its efforts and said it’s more important than ever for health insurers to take on this leadership role. “Medication for certain substance use disorders has the potential to save lives, but medication alone is not a panacea for long-term outcomes,” Williams said in a news release from Anthem. “The best way to promote sustained recovery is to combine the use of medication in treatment with evidence-based behavioral therapies and recovery support services.” Click here to read Anthem’s Sept. 2 announcement.

JAMA Article Examines OUD Therapies in Residential Treatment Programs

A new article in JAMA explores the findings of research that investigated the OUD treatment that the nation’s residential treatment programs offer. Published Aug. 25, the research letter notes that residential treatment programs are “a common, costly setting for treating opioid use disorder and are frequently promoted in policy proposals to improve access to care.” But concerns have arisen about the quality of care and a low use of evidence-based opioid agonist treatment in these settings. Because data on these programs are based primarily on self-reported surveys, the researchers simulated patients calls to audit the treatments that these programs offer. Click here to read the research letter.

Georgetown Offers New Master’s Program in Addiction Policy and Practice

Georgetown University is offering a new master’s program in addiction policy and practice that is intended to build a national policy workforce that will respond to the chronic health condition of addiction. The program will draw from the faculty and resources of the university’s schools, including the Graduate School of Arts and Science, the O’Neill Institute for National and Global Health Law at Georgetown University Law Center, Georgetown University Medical Center, the McCourt School of Public Policy, and the basic and social science departments of Georgetown College. Applications for the one-year program will open this fall and the first class is scheduled to begin in July 2021. Click here to learn more.

Fact of the Week A prevalence of depression symptoms in the United States was more than three-fold higher during Covid-19 compared with before the pandemic.

2020 NABH Annual Survey Opens Today!

Data collection for the 2020 NABH Annual Survey starts today, Friday, Aug. 28. Your participation in this survey will help NABH continue to provide an accurate, up-to-the-minute picture of the U.S. behavioral healthcare industry. This year NABH has added a few new questions related to substance use to help us better measure our membership’s activities. NABH’s contractor, Dobson DaVanzo & Associates, will conduct the NABH Annual Survey again this year. Dobson DaVanzo & Associates brings extensive data-analysis experience and data-security expertise to this project. The firm has analyzed data for the last several NABH Annual Surveys. Dobson DaVanzo will send personalized links to the survey instrument via e-mail directly to the CEOs of all NABH-member organizations. If you receive a request to participate in the survey, please respond as soon as possible. The 2020 online entry form will provide a personalized, secure e-mail link for each facility. You will be able to enter, save, and review data— and review that data internally with others in your organization who have completed the survey—until you click “Done” on the survey’s last page. After you click “done,” you may not make changes. The survey data are used in dozens of ways to help protect mental health and addiction treatment benefits; ensure fair and adequate payments; improve patient care; and communicate trends to the media, payers, benefit consultants, and the public. Within your organization, you can also use the NABH aggregate data you will receive to measure how your facility compares with national trends. Because the survey collects the most current information about the field, it can provide a valuable perspective for administrative and clinical operations. The NABH Annual Survey Report is an invaluable strategic planning tool as well as a reference document every behavioral healthcare organization should have. If you have any questions or suggestions about this survey, please contact Shawn Coughlin or Kirsten Beronio. Thank you for your time. We appreciate your help in making us stronger advocates for you and your teams!

HHS Extends Provider Relief Fund Phase 2 General Distribution Deadline to Sept. 13

The Department of Health and Human Services (HHS) has extended the deadline to apply for Phase 2 General Distribution Funding for Medicaid, Medicaid managed care, Children’s Health Insurance Program, dental providers, and certain Medicare providers until Sunday, Sept. 13. This funding is through the Provider Relief Fund, which the federal government established in this year’s Coronavirus Aid, Relief, and Economic Security Act (CARES) and Paycheck Protection Program and Health Care Enhancement Act. These payments do not need to be repaid to the government if providers comply with terms and conditions. HHS has extended this Phase 2 General Distribution Funding deadline before, with the latest deadline scheduled for Friday, Aug. 28. Providers now have a few extra weeks to apply. Click here to read HHS’ six steps to applying for the Phase 2 General Distribution.

CMS Makes Covid-19 Data Collection a Requirement in Conditions of Participation

The Centers for Medicare & Medicaid Services (CMS) is requiring Covid-19 data collection and reporting as a condition of participation (CoP) for hospitals participating in the Medicare and Medicaid programs, including psychiatric facilities. CMS added the requirement with other provisions in an interim final rule and said it will accept comments for 60 days. The rule noted the requirement will become effective when it is published in the Federal Register, although it did not list a specific date. Under the new requirement, hospitals will need to report daily data, including—but not limited to—the number of confirmed or suspected Covid-19 positive patients, intensive care unit beds occupied, and the availability of supplies and equipment, such as ventilators and personal protective equipment. CMS warned in the rule that if a hospital fails to comply with this new CoP, it could face possible termination from the federal healthcare programs.

NABH Supports ‘Eliminating the Provider Relief Fund Tax Penalties Act’

NABH is one of 29 healthcare advocacy organizations this week to support the Eliminating the Provider Relief Fund Tax Penalties Act, a bill that would offer some financial relief to healthcare providers during the Covid-19 pandemic. Congress’ allocation of $175 billion in financial support to healthcare professionals through this year’s Public Health and Social Services Emergency Fund (PHSSEF) has done much to help the healthcare community provide critical services to patients. At the same time, PHSSEF assistance is taxable, which results in a reduction of 21% or more to the benefit for taxpaying healthcare professionals, compared with non-taxpaying healthcare professionals. “This negative impact penalizes those who care for our nation’s most vulnerable,” the organizations wrote in a letter to House and Senate lawmakers. “The passage of H.R. 7819/S. 4525 would remove the negative tax implications for PHSSEF recipients by ensuring that all Provider Relief Fund assistance is not taxable, while maintaining that expenses tied to this assistance are tax-deductible.”

Urban Institute Study Examines Naloxone Products and Pricing in Medicaid, 2010-2018 

Medicaid enrollees’ naloxone options will remain limited—and could potentially worsen the nation’s overdose crisis—without new federal policies that regulate prices and/or promote robust price competition, according to new research from the Urban Institute. For the study, researchers tracked changes in Medicaid spending from 2010-2018 on naloxone, its price per unit, and Medicaid-covered naloxone prescriptions for generic naloxone products, the brand-name Narcan nasal spray, and the Evzio autoinjector. “We find dramatic increases in Medicaid prescriptions for and spending on naloxone between 2010 and 2018,” Senior Research Associate Lisa Clemans-Cope and her team concluded in the study. “This may partially owe to the new naloxone formulations that offer advantages in administration,” the study’s authors wrote, adding that needle-free naloxone nasal spray is highly effective and easy to use, while the quick-acting autoinjector naloxone works for people with nasal abnormalities, which make up a substantial share of those with opioid use disorder. “Ideally, prescribers could write naloxone prescriptions suited to each Medicaid patient’s circumstances,” the researchers wrote. “However, we find that the autoinjector formulation was not offered in any state Medicaid program in 2018, likely because of their very high and variable prices per prescription in years prior and lack generic equivalents.”

SAMHSA Accepting Applications for Disaster Response State Grant Program

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for its Disaster Response State Grant Program, which is meant to provide mental and substance use disorder treatment, crisis counseling, and other related supports for adults and or school-aged children affected by hurricanes, typhoons, wildfires, and earthquakes during 2018. The agency said it plans to issue about 17 grants of up to $7 million per year for one year and will accept applications through Wednesday, Sept. 2. Click here to learn more.

SAMHSA Helpline Offers 24/7 Crisis Counseling Services

As Americans withstand the effects of Hurricane Laura and California’s wildfires, NABH reminds all members that SAMHSA’s Disaster Distress Helpline provides crisis counseling services 24 hours a day, seven days a week, 365 days a year. NABH thanks its members for providing essential behavioral healthcare services in the nation’s disaster areas during an already difficult time.

Looking Ahead: September is Suicide Prevention Month

The National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention during Suicide Prevention Month in September. To help in the effort, please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. In addition, the group has scheduled a #BeThere Twitter chat on Tuesday, Sept. 1 at 2 p.m. ET and will host National AI/AN Hope for Life Day on Sept. 10. That event falls during Suicide Prevention Week, which is Sept. 6-12. Click here for the Hope for Life Day toolkit and visit the Action Alliance’s #BeThere webpage for more information. Fact of the Week In April, 64% of the U.S. population reported feeling “nervous on several or more days.” That increased by five percentage points to 69% by July, according to a Census Bureau survey. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Sets New OUD Target in ‘Healthy People 2030’ Public Health Plan The Health and Human Services Department (HHS) this week released Healthy People 2030, the federal government’s 10-year plan to address the nation’s most critical public health priorities and problems. In it, HHS features 355 core, or “measurable,” objectives with 10-year targets, including one to reduce the proportion of persons with opioid use disorder (OUD) in the past year. Specifically, the plan notes a baseline of 0.7% of persons aged 12 years and older who reported an OUD (heroin or prescription pain reliever) in the 12 months of 2018. Healthy People 2030 sets a new target of 0.5%. A federal advisory committee of 13 external leaders and a workgroup of subject matter experts from more than 20 federal agencies contributed to Health People 2030, which also incorporated public comments during the development process. EEOC Releases Guidance for Healthcare Providers to Help Opioid Patients Stay Employed The U.S. Equal Employment Opportunity Commission (EEOC) has released a fact sheet to help explain the healthcare provider’s role under the American with Disabilities Act of 1990 when a patient who uses opioids needs a reasonable accommodation or when questions surface about a patient’s ability to perform a job safely. As the EEOC noted in its announcement, this information is not new; instead, it applies to principles established in the 30-year-old law and previously issued guidance. The new publication is meant to provide clarity under all existing requirements. In the publication, the EEOC recommends medical documentation be written using plain language that explains the provider’s professional qualifications and details regarding the nature and length of the relationship with the employee; the nature of the employee’s medical condition; the extent to which the employee’s opioid use would limit a “major life activity” (such as walking, lifting, sleeping, or concentrating) without treatment; the need for reasonable accommodation; and suggested accommodations “without overstating the need for any one particular accommodation in case an alternative is necessary.” Click here to learn more. NABH Participates in CMS Stakeholder Listening Session NABH members and staff participated in a call about OUD during the public health emergency with leaders of the Centers for Medicare & Medicaid Services (CMS) this week. Kimberly Brandt, principal deputy administrator for policy and operations at CMS, hosted the call and NABH President and CEO Shawn Coughlin represented the association. Joe Pritchard, CEO of Pinnacle Treatment Centers, and Greg Marotta, CEO of CleanSlate, also participated. During the call, CMS reviewed previous Trump administration activities and asked stakeholders to comment on outstanding issues related to expanding access to treatment for individuals with opioid use disorders. The topics discussed included streamlining provider credentialing, collaborating with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Drug Enforcement Administration (DEA) on telemedicine rules, making all Covid telehealth flexibilities permanent; permitting methadone induction through telehealth, supporting state licensure reciprocity, covering services for incarcerated individuals prior to reentering the community, covering contingency management as an evidence-based practice for individuals with stimulant disorders, and targeting specific funds to behavioral healthcare providers. For more information, please contact Sarah Wattenberg, NABH’s director of quality and addiction treatment services. Atrium Health’s Behavioral Health to Host Webinar on Virtual Care Model Next Week NABH member Atrium Health’s Behavioral Health will host the first webinar in its series “Delivering Behavioral Health Services in a Pandemic Environment” next Wednesday, Aug. 26 at 1 p.m. ET. The webinar, Transitioning Outpatient Services to a Virtual Care Model, is open to all. Click here to join the meeting. Looking Ahead: September is Suicide Prevention Month The National Action Alliance (Action Alliance) for Suicide Prevention has developed several resources to help build awareness about suicide prevention during Suicide Prevention Month in September. To help in the effort, please see the Action Alliance’s #BeThere activities and use the hashtag #BeThere to educate your organization’s social media followers. In addition, the group has scheduled a #BeThere Twitter chat on Tuesday, Sept. 1 at 2 p.m. ET and will host National AI/AN Hope for Life Day on Sept. 10. That event falls during Suicide Prevention Week, which is Sept. 6-12. Click here for the Hope for Life Day toolkit and visit the Action Alliance’s #BeThere webpage for more information. #BeThere activities and created a Hope for Life Day toolkit.   Fact of the Week Among U.S. adults aged 18 and older, 5.1% engaged in heavy drinking, or the consumption of an average of more than 14 alcoholic drinks per week for men or more than 7 drinks per week for women. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Releases Provider Relief Fund Step-by-Step Guide and Stakeholder Toolkit

The U.S. Health and Human Services Department (HHS) this week hosted a webinar to clarify issues related to the Coronavirus Aid, Relief, and Economic Security Act’s (CARES) Provider Relief Fund and released materials for providers navigating the system to receive federal funding during the Covid-19 pandemic. On Thursday, HHS’ Health Resources and Services Administration (HRSA) hosted the webinar about the Provider Relief Fund’s Phase 2 General Distribution, in which providers may receive up to 2% of their reported revenue from patient care. The agency later released the presentation slides, as well as a step-by-step guide about the fund and a stakeholder toolkit. These and other pandemic-related materials are posted to NABH’s Covid-19 resources page.

Milliman Study Shows Individuals with Behavioral and Physical Health Conditions Drive High Total Healthcare Costs

Individuals with behavioral health conditions in addition to physical health conditions drive high total healthcare costs even though spending for behavioral healthcare treatment among these patients is a small portion of that total spending. That is the conclusion of a new study from actuarial and consulting firm Milliman, Inc. this week that analyzed claims data for 21 million commercially insured individuals. The Path Forward for mental health and substance use, a private-sector initiative to spur market-based improvements in behavioral health treatment, commissioned the study. The initiative receives funding from the Mental Health Treatment and Research Institute LLC, a tax-exempt subsidiary of The Bowman Family Foundation. According to the report, 5.7% of the entire study population—high-cost patients with both behavioral and physical health conditions—accounted for 44% of all healthcare spending. Meanwhile 50% of patients with behavioral health conditions had less than $68 of total annual spending for behavioral treatment. “This is a tragedy,” Henry Harbin, M.D., a psychiatrist and advisor to The Path Forward, said in news release about the study’s findings. “And now we know this population accounts for more than half of our total healthcare spending,” he continued. “Tremendous savings and improved outcomes are achievable if these individuals who deserve care are identified early and provided with prompt evidence-based behavioral treatment.” The report is intended to provide a baseline for estimating the effects of Covid-19 on behavioral healthcare.

CDC Report Shows 93,000 Americans Died from Excessive Alcohol Use from 2011-2015

An average of 255 Americans die from excessive drinking every day, shortening their lives by an average of 29 years, according to the Centers for Disease Control and Prevention (CDC). A recent Mortality and Morbidity Weekly Report, or MMWR, from the federal public health agency showed excessive alcohol use was responsible for about 93,000 deaths and 2.7 million “YPLL,” or years of potential lives lost, during 2011-2015. The majority of these alcohol-attributable deaths involved males, and about four in five deaths among adults aged 65 or older was nearly double that among adults aged 20-34 years, the findings showed. The report noted some recommendations from the Community Preventive Services Task Force that could reduce both alcohol-attributable deaths and YPLL, such as increasing alcohol taxes and regulating the number and concentration of alcohol outlets.

GAO Examines Medicaid Coverage for SUD Peer Support Services and Eating Disorders in the Military

A recent study from the Government Accountability Office (GAO) found that 37 states covered peer support services for adults with substance use disorders (SUDs) in their Medicaid programs in 2018. GAO researchers analyzed Medicaid and Children’s Health Insurance Program (CHIP) Payment and Access Commission data for the report. The findings noted that officials from the three states GAO reviewed—Colorado, Missouri, and Oregon—reported that their Medicaid programs offered peer support services as a complement, rather than an alternative, to clinical treatment for SUD. Separately, GAO also released a report on eating disorders in the U.S. military, which reviewed how the U.S. Defense Department (DOD) screens and provides treatment for eating disorders. That report showed that with DOD health coverage, service members and their dependents can receive specialized care for eating disorders through civilian providers working in 166 eating disorder facilities across 32 states. Of those facilities, more than three-quarters provide treatment to both adult and child and adolescent populations.

Manatt Health Releases Tracking Tool for Telehealth Coverage After Public Health Emergency

Manatt Health this week released a federal and 50-state tracking tool that highlights policy, regulatory, and legal changes related to telehealth during the Covid-19 pandemic. The research firm released this resource a week after the Centers for Medicare & Medicaid Services (CMS) announced in its physician fee schedule proposed rule that certain Medicare telehealth flexibilities during the pandemic would be made permanent, while others would be temporary. Manatt’s tracking tool includes a complete list of services that the proposed rule addresses.

RTI International Tracks Addiction Treatment Quality Across Time and States

A recent RTI International study found improvements in quality on most measures for addiction treatment between 2007 and 2017 but concluded that “performance on several measures remained low.” The North Carolina-based research and technical services firm said the study’s objective was to track trends in the signs of higher-quality addiction treatment based on definitions from the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Addiction, and the Substance Abuse and Mental Health Services Administration. According to the report, a greater percentage of U.S. addiction treatment facilities had attributes indicating higher quality in 2017 than in 2007, with most of the improvement occurring between 2011 and 2017. “Nonetheless, in 2017 fewer than 50 percent of facilities offered medications for opioid use disorder; testing for hepatitis C, HIV, and STDs; self-help groups; employment assistance; and transportation assistance,” the study said.

JAMA Article Explores Outpatient Mental Health Services for Youth After Psychiatric Hospitalization

A new JAMA study found that mental health follow-up received within seven days of discharge was associated with a reduced risk of suicide among children and adolescents during the eight to 189 days after hospital discharge. Researchers examined a cohort study of 139,694 child and adolescent inpatients in the Medicaid program and concluded that “shorter hospital stay, lack of prior mental healthcare, managed care, Black race, older age, and medical comorbidities were associated with delayed follow-up care.”

National Association of Mental Health Program Directors to Host Webinar Next Week

The National Association of Mental Health Program Directors will hold a two-part webinar series titled “Establishing and Building Bed Registry Systems” next week. Part One will focus on understanding the essential elements of an effective statewide registry, while Part Two will highlight three different models for success in establishing and building statewide crisis service and bed registries. Click here to register for Part One on Wednesday, Aug. 19 from 1:30 p.m. to 3 p.m. ET, and here  to register for Part Two on Thursday, Aug. 20, also from 1:30 p.m. to 3 p.m. ET.

Fact of the Week

 About 25% of young adults between the ages of 18 and 24 reported they have seriously considered suicide during the Covid-19 pandemic. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Announces 2.2% Increase in Base Payment Rate for IPFs and Scope-of-Practice Changes for 2021

The Centers for Medicare & Medicaid Services (CMS) will update the Medicare base payment rate for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) by 2.2% in Fiscal Year (FY) 2021, the agency announced in a final rule. In its April proposed rule, CMS had estimated a 2.4% payment rate update for IPFs next year. The agency included its updated estimates and calculations in a fact sheet accompanying the final rule. The agency said in the final rule that it estimates the 2021 update will increase total IPF payments to providers by 2.3%, or about $95 million. The agency included its calculations in a fact sheet accompanying the final rule. CMS said in the final rule that it will allow advanced practice providers, including physician assistants, nurse practitioners, psychologists, and clinical nurse specialists, to operate within the scope of practice allowed by state law by documenting progress notes in the medical record of patients for whom they are responsible, receiving services in psychiatric hospitals. NABH has advocated for this policy change and is pleased the agency made this update. CMS also finalized its proposal to adopt revised Office of Management and Budget statistical area delineations resulting in wage index values that the agency said are “more representative of the actual costs of labor in a given area.” CMS is finalizing its proposed policy that any decline in a provider’s wage index value from its FY 2020 wage index, regardless of the circumstance causing the decline, will be capped at a 5 percent decrease for FY 2021.

CMS Proposes Expanding Medicare Telehealth Benefits and Scope of Practice Beyond Pandemic

CMS is proposing to maintain—either permanently or temporarily— many of the Medicare telehealth benefits and workforce flexibilities authorized during the Covid-19 pandemic, according to the fiscal year 2021 Medicare physician fee schedule proposed rule the agency released Monday. In issuing these proposed changes, CMS referred to President Trump’s Aug. 3 Executive Order on improving rural health and telehealth access that directs the Health and Human Services (HHS) secretary to propose regulations to extend flexibilities provided during the Covid-19 public health emergency (PHE) as appropriate. Please click here to read the full NABH Analysis about this rule. Also this week, NABH was one of 20 organizations that sent a letter to federal lawmakers supporting the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. Please click here to read the full letter.

HHS Extends Deadline for Provider Relief Fund Until Aug. 28

HHS has extended the deadline to Friday, Aug. 28 from Monday, Aug. 3 for healthcare providers who participate in Medicaid and CHIP to apply to the Provider Relief Fund established in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. HHS had previously extended this deadline to Aug. 3 from July 20. HHS said it plans to issue a simplified application form soon. In addition, HHS said it is re-opening the portal for Medicare-participating providers to apply for funding set aside from the Provider Relief Fund. The previous deadline to apply for this distribution was June 3. Providers will now have until Aug. 28 to apply for the balance of funding up to 2% of their annual patient revenue. HHS is re-opening this application process after learning that many providers, including many Medicaid and CHIP providers, did not apply to the prior Medicare-based distribution because they had relatively low Medicare revenues. HHS also announced it is working on another funding distribution from the Provider Relief Fund focused on providers who have not received any of this funding including those who only bill commercially or do not directly bill for the services they provide to Medicare and Medicaid beneficiaries. Information about how to apply for the various Provider Relief Fund distributions is on the HHS website.

CMS and SAMHSA Add Kentucky and Michigan to CCBHC Demonstration

CMS and SAMHSA have chosen Kentucky and Michigan as additional participants in the Certified Community Behavioral Health Clinic (CCBHC) demonstration that the CARES Act requires, CMS announced this week. The demonstration is part of a broader effort to integrate behavioral healthcare with physical healthcare, increase evidence-based practices on a consistent basis, and improve access to high quality care for people with mental health and substance use disorders. Although the Protecting Access to Medicare of 2014 created this demonstration for a two-year period, the program has been extended several times. Kentucky and Michigan join the original participants selected in 2016.

Wit v. UnitedHealthcare Hearing Delayed to Wednesday, Sept. 2

The remedies hearing in the Wit v. UnitedHealthcare case that had been scheduled for this week has been delayed to Wednesday, Sept. 2. NABH has learned that U.S. Chief Magistrate Judge Joseph Spero has re-scheduled the hearing due to meetings related to Covid-19. Members of the public and press are welcome to join the webinar, and NABH will send an updated Zoom link when it becomes available.

Fact of the Week

A new study shows 55% of patients who have survived Covid-19 were diagnosed with at least one psychiatric disorder. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Extends Coronavirus Public Health Emergency On Thursday, July 23, HHS Secretary Alex Azar extended the public health emergency determination regarding Covid-19. Public health emergencies last for 90 days.  As a result, emergency authorities are extended to late October. HHS Extends Medicaid/CHIP Provider Relief Deadline and Announces Additional Hotspot Funding HHS extended to Monday, August 3, the deadline for providers that participate in Medicaid and CHIP to apply for $15 billion from the Provider Relief Fund authorized in the Coronavirus Aid, Relief, and Economic Security (CARES) Act to support healthcare providers affected by Covid-19.To be eligible, providers must not have received a payment from the earlier Medicare-based distributions from the Fund. For details see updated HHS fact sheet on eligibility and how to apply for the Medicaid and CHIP Provider Distribution. HHS is also holding a webinar on Monday, July 27, 3-4 p.m. EST to go over the application process for the Medicaid and CHIP provider funding. Click on this link to register. Not as many providers as expected have applied for the Medicaid and CHIP provider funding, and HHS held focus groups this week to gather feedback on the process, as highlighted in an NABH Alert. HHS has posted a set of FAQs regarding the Medicaid and CHIP provider funding and has established a provider support line for application inquiries at (866) 569-3522. HHS also announced last Friday, July 17, that it would distribute an additional $10 billion to hospitals in areas heavily impacted by Covid-19. HHS is basing these distributions on data submitted by hospitals on Covid-19 positive inpatient admissions for the period January 1 to June 10, 2020. In May, HHS distributed $12 billion from the Provider Relief Fund in the first round of funding for hotspot areas. HHS Changes Reporting Requirement for Provider Relief Fund Recipients Healthcare providers that received more than $10,000 from the Provider Relief Fund will have to report how they spent these funds by February 15, 2021, according to an HHS notice. Providers with unexpended funds as of December 31, 2020, will be required to submit a second and final report by July 31, 2021. HHS had previously announced that providers would not have to submit quarterly reports. HHS stated it would release detailed reporting instructions by August 17, 2020, and that the reporting system would become available on October 1, 2020. Court Upholds Medicare Site Neutral Hospital Payments A three-judge panel of the D.C. Court of Appeals unanimously ruled that HHS has the legal authority to reduce Medicare payments to hospital clinics for services typically provided at lower reimbursement rates by independent physician offices. This site-neutral payment policy took effect in January 2019, but was blocked by a district court last summer. The American Hospital Association that led the suit, has not indicated whether it will appeal the ruling. NABH Requests Data from Members to Help Advocate for Expanded Telehealth Coverage NABH issued an alert circulating a short survey, this week, asking members to share data on the impact of expanded coverage of telehealth during the Covid-19 pandemic. This information will help make the case for continued expanded coverage of services provided via telehealth after the public health emergency ends. Please provide requested information at this survey site  as soon as possible and by next Friday, July 31, at the latest. CMS Shortens Approval Cycle of Joint Commission The Centers for Medicare and Medicaid Services (CMS) approved the Joint Commission’s program for accrediting hospitals for only two years, until mid-July 2022. CMS may approve accrediting organizations that survey healthcare facilities for participation in Medicare and Medicaid for up to six years. CMS stated that the approval was limited to two years because of concerns related to Joint Commission surveyor performance and comparability of the Joint Commission’s survey process with the agency’s process. CMS indicated they expect to carry out more frequent reviews of the Joint Commission’s activities to avoid continued inconsistencies and to ensure requested revisions are implemented. CMS required the Joint Commission to make several changes including requiring additional training for its surveyors related to off-site location standards, reviews of medical records, and the level of detail provided to facilities during briefings. In addition, CMS required changes to the Joint Commission’s process related to leading and probing questions during interviews and more restrictions on interviewing frontline caregivers in the presence of supervisors. HHS Establishes New Covid-19 Data Dashboard and Database HHS restored public access to coronavirus data on Monday with a new system that brings together numerous datasets and a HHS Coronavirus Data Hub that includes, for example, a dashboard on hospital capacity that shows percent of inpatient beds occupied, percent occupied by COVID-19 patients, and percent of ICU beds occupied in each state. AMA Issues Report on Opioid Overdose Epidemic The American Medical Association Opioid Task Force issued a 2020 Progress Report that calls on policymakers to act to remove barriers to evidence-based care for those with pain and those with a substance use disorder. The report highlights health insurance company, pharmacy chain, and pharmacy benefit manager practices as well as state laws that delay and deny access to non-opioid pain care and evidence-based treatment for opioid use disorder. MedPAC Issues 2020 Databook The Medicare Payment Advisory Commission issued its July 2020 Data Book: Health Care Spending and the Medicare Program. The Data Book provides information on national health care and Medicare spending as well as Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare program, and Medicare beneficiary and other payer liability. It also examines provider settings—such as hospitals and post-acute care—and presents data on Medicare spending, beneficiaries’ access to care in the setting, and the sector’s Medicare profit margins, if applicable. In addition, it covers the Medicare Advantage program and prescription drug coverage for Medicare beneficiaries, including Part D.

Fact of the Week

According to Kaiser Health News, a recent analysis from Well Being Trust, a national public health foundation, predicted as many as 75,000 people might die from suicide, overdose or alcohol abuse, triggered by the uncertainty and unemployment caused by the pandemic. For questions or comments about this CEO Update, please contact Kirsten Beronio.

FCC Designates 988 as Three-Digit Number for National Suicide Prevention Hotline

The Federal Communications Commission (FCC) this week adopted rules to establish 988 as the new, nationwide, three-digit phone number for Americans in crisis to connect with suicide prevention and mental health crisis counselors. All phone service providers are required to direct all 988 calls to the existing National Suicide Prevention Lifeline by July 16, 2022. During the transition period, Americans who need help should continue to contact the National Suicide Prevention Lifeline by calling 1-800-273-8255 (1-800-273-TALK) or through online chats. Veterans and U.S. service members may reach the Veterans Crisis Line by pressing 1 after dialing, chatting online at www.veteranscrisisline.net, or texting 838255.

U.S. Drug Overdose Deaths Hit Record High of 71,000 in 2019

Nearly 71,000 Americans died of drug overdoses in 2019, according to preliminary data from the Centers for Disease Control and Prevention this week. The record high number of overdose deaths predates the Covid-19 pandemic, which experts predict will increase the number of overdose deaths even higher. Reports show that fentanyl and similar synthetic opioids—which accounted for about 36,500 overdose deaths—are driving the trend, while deaths involving cocaine and methamphetamine are also rising.

HHS Announces Changes to Covid-19 Daily Data Reporting Process Effective July 15 

HHS announced that as of Wednesday, July 15, the CDC’s National Healthcare Safety Network (NHSN) Covid-19 module is no longer an option for hospitals to fulfill the agency’s request for daily data reporting on bed capacity, utilization, personal protective equipment (PPE), and in-house laboratory testing data. Instead, HHS has asked hospitals to use one of these four options to report that information:

• If your state has assumed reporting responsibility, submit all data to your state each day and your state will submit on your behalf. Your state can provide you with a certification if they are authorized to submit on your behalf.
• Submit data to TeleTracking™. All instructions about the data submission are on that site and the new and updated fields will be ready as of July 15.
• Authorize your health information technology (IT) vendor or other third party to share information directly with HHS.
• Publish to the hospital or facility’s website in a standardized format, such as schema.org.

For additional details about these options, please see page 9 in HHS’s updated guidance. This information is also posted to NABH’s Covid-19 resources page.

SAMHSA Updates Confidentiality of Patient Records in Final Rule

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week issued a final rule to update the Confidentiality of Substance Use Disorder Patient Records known as 42 CFR part 2 (or “part 2”) regulations, further aligning the regulations with other healthcare delivery rules. Key changes include:

• Part 2 programs may share information verbally with a non-part 2 provider without subjecting the non-part 2 record to the requirements of part 2, as long as the non-part 2 provider segregates specific substance use disorder (SUD) records.
• Patients may consent to disclosures without naming a specific individual to receive this information; the update provides instructions for disclosures to exchanges and research institutions and provides guidance on disclosures related to care coordination and case management.
• Non-part 2 providers are not required to redact information in their medical records and may redisclose information if the patient has signed a written consent, or if the disclosure is otherwise permitted under the regulations.
• Written consents expressly allow sharing information with 18 types of payment and healthcare operations, including for care coordination and case management.
• Non-opioid treatment providers have access to central registries if they have a treatment relationship to the patient.
• Opioid treatment programs have new permissions to disclose information to prescription drug monitoring programs.
• During medical emergencies, information may be shared among part 2 programs or other SUD treatment providers during state or federally declared natural and major disasters.
• Disclosures for conducting scientific research may be made to non-Health Insurance Portability and Accountability (HIPAA) covered entities and those who are not subject to the Common Rule.
• Permits federal, state, and local agencies to conduct audits and evaluations.
• Extends to 12 months the period of placement of undercover agents or informants, which may be further authorized by a new court order.

These changes do not include provisions that recently became law in the Coronavirus Aid, Relief and Economic Security Act (CARES Act). CARES Act provisions are effective March 27, 2021. The rule was published in the Federal Register on July 15. For questions about this rule, please contact Sarah Wattenberg, NABH’s director of quality and addiction services, at sarah@nabh.org.

NABH Sends Telehealth Letter to Capitol Hill as Congress Considers Latest Covid-19 Relief Bill

NABH this week sent a letter to congressional health policy staff that highlights the ways telehealth is essential in providing access to critical behavioral health services. “Shortly after the pandemic arose, our members rapidly adjusted their programs and services to implement telehealth technologies so they could continue providing critically needed mental health and addiction treatment services during these incredibly stressful times,” NABH President and CEO Shawn Coughlin said in the letter, which included preliminary data from some NABH members that show how crucial the increased coverage of services through telehealth has been during the Covid-19 pandemic. Separately this week, Manatt released a comprehensive 50-state tracker for policy, regulatory, and legal changes related to telehealth during the Covid-19 pandemic.   

JAMA Examines Behavioral Health Parity Efforts Nationwide

Citing SAMHSA data, a new article in JAMA showed that less than two-thirds of patients with schizophrenia, bipolar disorder, or other more serious mental health conditions received care for their illness in 2018, while the same study showed only in five people with an opioid use disorder obtained treatment. The findings attributed the reasons for these statistics to stigma, barriers to care due to cost and clinical resources, and the overall scarcity of clinicians treating patients with mental health and substance use orders. “These factors compound the difficulty of finding a clinician willing to accept patients associated with only “in-network” payments for their services,” the article noted. “A 2014 study using data from the National Ambulatory Medical Care Survey found that in 2009-2010, nearly half of psychiatrists surveyed did not accept network commercial insurance payment or Medicare, and more than half did not accept Medicaid,” it continued, adding that psychiatrists have one of the lowest Medicaid participation rates among medical specialists.

Fact of the Week

According to ProPublica Illinois, more than 1,180 Cook County residents have died or are suspected to have died from opioid-related overdoses this year. Half of the confirmed opioid-related deaths have been among Black people, even though Black residents make up less than a quarter of the county’s population. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Plans to Extend Covid-19 Public Health Emergency

HHS has signaled it will extend the Covid-19 public health emergency before it expires on July 25. The news was reported via Twitter on June 29 from HHS spokesman Michael Caputo, who noted that the department has renewed the public health emergency once before. After it is extended, the public health emergency will remain effective for an additional 90 days. This extension will help providers continue to use waivers and flexibilities that have been issued to help them address the global pandemic.

Kaiser Family Foundation Releases Analysis on Mental Health and SUD

A new analysis from the Kaiser Family Foundation (KFF) on Friday found that 36.5% of adults in the United States report symptoms of anxiety or depressive disorder, up from 11% in 2019. Meanwhile, Louisiana (42.9%), Florida (41.5%), and Oregon (41.3%) have the highest shares reporting these symptoms, while Wisconsin (27.2%), Minnesota (30.5%), and Nebraska (30.6%) have the lowest, the analysis showed. KFF reported the statistics in a series of state facts sheets, which also showed New Mexico, Montana, Wyoming, Alaska, and Idaho are the states with the highest rates of suicide.

Commonwealth Fund Report Says Covid-19 Highlights Gaps in Medicare Mental Health Coverage

A report from the Commonwealth Fund released this week shows gaps that remain in Medicare beneficiaries’ access to mental health services, including the federal healthcare program’s 190-day lifetime limit for inpatient psychiatric stays and limited coverage for telemental health services. The article’s purpose was to offer an overview of Medicare beneficiaries’ needs and benefits, as well as the initiatives to improve both financing and mental health services delivery in Medicare. According to the study, more than 112 million Americans live in areas of the country where healthcare providers are in short supply, and experts predict increasing shortages in psychiatrists, clinical and counseling psychologists, mental health social workers, mental health counselors, and other specialty mental health professionals through 2025. “Policies to expand coverage of telemental health should be rigorously studied and potentially made permanent as a strategy to increase access to mental health services,” researchers noted in the report. Separately, JAMA on July 1 published a new analysis that examines the trends in the prevalence of U.S. adults who screened positive for depression and the proportion who received treatment from 2007 to 2016, with consideration of health insurance coverage.

Today is the Deadline to Register for DOL Discussion on Parity Compliance

The U.S. Labor Department (DOL) will host a 90-minute virtual discussion titled “Parity Compliance: Progress and Challenges” next Thursday, July 16 at 1:30 p.m. ET. As part of DOL’s Fiscal Year 2020 MH/SUD Enforcement Evaluation Program—published in the 2020 DOL MHPAEA Report to Congress— DOL’s Employee Benefits Security Administration (EBSA) announced it would host a listening session to gain feedback on the agency’s interpretive guidance and enforcement program. EBSA also noted that attendees could use the opportunity to comment on the MHPAEA self-compliance tool that EBSA proposed on June 19. The last day to register for the event is today, July 10.

NAMI To Host First Virtual NAMICon Next Week

The National Alliance on Mental Illness (NAMI) has transitioned its in-person NAMICon to a virtual event on July 13 and 14. The event’s plenary session will feature National Institute of Mental Health Director Joshua Gordon, M.D., Ph.D., who will discuss the challenges and opportunities of mental health research. The program will also explore the importance of diversity, inclusion, and cultural competence, and how to address issues such as identity, language, and demographics. Click here to register for the event and here for the program’s two-day schedule.

NNED, SAMHSA to Host Roundtable Next Week on Addressing Covid-19 and Behavioral Health Needs in Communities of Color

The National Network to Eliminate Disparities in Behavioral Health (NNED) and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host a host a virtual roundtable next week to address how the Covid-19 pandemic, the current economic crisis, and civil unrest from incidents of police brutality have worsened disparities in mental health. The event—part of National Minority Mental Health Awareness Month this July—will highlight how faith-based NNED partner organizations are supporting mental health concerns of racial and ethnic minorities and providing opportunities to receive support and connection through faith-based practices and partnerships. Click here to register for the event on Thursday, July 16 at 3 p.m. ET. And please remember to follow NABH on Twitter and LinkedIn for information and events related to National Mental Health Awareness Month.

BPC to Host Webinar on Covid-19’s Effect on Mental Health Access for People of Color

The Bipartisan Policy Center (BPC) will host a webinar titled “Covid-19’s Adverse Impact on Mental Health Access for People of Color” on Tuesday, July 21. The BPC notes that as the Covid-19 pandemic has increased mental health and substance use problems, the situation is even worse for Black, Indigenous, and people of color populations, which have long experienced disparities in access to care. This 90-minute webinar will discuss this trend and how integrating behavioral health services with primary care can benefit these patient populations. Click here to register for the event, which starts at 11:30 a.m. ET.

Fact of the Week

During the initial phase of the Covid-19 crisis in April 2020, the prevalence of serious psychological distress among adults age 55 and older was nearly double pre-COVID levels; among Hispanic and low-income adults, rates were more than triple. For questions or comments about this CEO Update, please contact Jessica Zigmond.

FCC To Vote Next Month on Designating 988 as National Suicide Hotline Number

Federal Communications Commission (FCC) Chairman Ajit Pai this week presented his team with draft rules to establish 988 as the new, nationwide, three-digit phone number for Americans to connect with suicide prevention and mental health crisis counselors. The Commission is scheduled to adopt the rules at its open meeting on July 16. If adopted, the rules would require all phone service providers to start directing all 988 calls to the existing National Suicide Prevention Lifeline by July 16, 2022. During the transition period, Americans who need help should continue to contact the lifeline by calling 800-273-8255 (TALK). “988 will save lives. Helping Americans in crisis connect to counselors trained in suicide prevention is one of the most important things we can do at the FCC,” Chairman Pai said in a statement this week. “We believe that 988—which has an echo of the 911 number we all know as an emergency number—will help people access mental health services,” he continued. “Establishing this special purpose number will also highlight the urgency of addressing rising suicide rates in America and reduce the stigma too often associated with seeking assistance from suicide prevention and mental health services.”

HHS Announces MENTAL Health Innovation Challenge to Combat Social Isolation and Loneliness

HHS this week said the Administration for Community Living and the Office of the Assistant Secretary for Health launched the MENTAL Health Challenge to fight social isolation and loneliness among older adults, people with disabilities, and veterans. The White House Office of Science and Technology Policy is coordinating the Mobilizing and Empowering the Nation and Technology to Address Loneliness & social isolation (MENTAL) Health Innovation Challenge, and other federal partners include the FCC and the Veterans Affairs Department. A total of $750,000 in prizes will be awarded for developing an easy-to-use online system that offers recommendations for programs, activities, and resources that can help users connect to others and engage in the community, based on their needs, interests, and abilities. HHS’ announcement said the winning system will be announced—and demonstrated—in January 2021 at CES, the Consumer Technology Association’s annual trade show. That winning system will then become the centerpiece of a national public awareness campaign. “We need a multipronged public health approach to change the way we address social isolation, especially among our most at-risk populations,” U.S. Surgeon General VADM Jerome M. Adams, M.D., M.P.H. said in the announcement. “This approach must include the development of innovative solutions to combat the harmful physical and mental health effects of social isolation and the role technology has in promoting better connections for all.” Nearly a quarter of Americans who are 65 or older have few social relationships or infrequent social contact with others, and more than 40% of people 60 and older report feeling lonely, according to HHS. The department also noted that the number of older adults is projected to nearly double by the year 2060, while the population of people with disabilities is growing and 22 veterans die by suicide every day. 

CMS Creates Office to Coordinate Administrative Burden Reduction Efforts 

The Centers for Medicare & Medicaid Services (CMS) this week announced it created the Office of Burden Reduction and Health Informatics to consolidate the agency’s efforts to reduce regulatory and administrative burden. This new office is part of CMS’ Patients over Paperwork (PoP) initiative to eliminate duplicative, unnecessary, and costly federal requirements and regulations. In addition to efforts that reduce administrative burden, the new office will focus on health informatics, which uses and applies health data and clinical information to provide better healthcare to patients. “Fostering innovation through interoperability will be an important priority, and the office will leverage technology and automation to create new tools that allow patients to own and carry their personal health data with them seamlessly, privately, and securely throughout the health care system,” the agency’s announcement said.

Taskforce on Telehealth Policy Seeks Public Comment Through July 9

The Taskforce on Telehealth Policy is seeking public comments as it develops recommendations for policymakers on how to maximize telehealth services benefits while maintaining high quality and program standards. The Alliance for Connected Care, National Committee for Quality Assurance, and the American Telemedicine Association convened the taskforce, which represents a broad range of providers, consumer advocates, payers, and health quality experts from the public, private, and not-for-profit sectors. Click here to learn more about the taskforce and here to access the portal for submitting comments.

GAO Recommends Steps for U.S. Labor Department to Address SUD

The U.S. Labor Department (DOL) should clarify expectations of state workforce agencies and how funding from the 2014 Workforce Innovation and Opportunity Act (WIOA) can be used to address the needs of people with substance use disorders (SUD) and potential employers, the Government Accountability Office (GAO) recommended in a recent report. DOL has awarded grants to states to address the nation’s opioid crisis after HHS declared the crisis a public health emergency in October 2017. The GAO was asked to investigate how WIOA-funded programs are addressing the employment and training needs of those affected by SUD. For this report, the GAO interviewed officials in four of the 10 states that received DOL grants as of March 2019—Maryland, New Hampshire, Ohio, and Washington—and two that did not—Alabama and Arizona—as well as DOL officials and researchers. “DOL officials said they support SUD-affected communities mainly by providing information to states that apply for and receive targeted grants,” the GAO report noted. “However, officials in two selected states expressed uncertainty about DOL’s expectations of states in serving the needs of SUD-affected job seekers and potential employers.” The GAO noted that DOL agreed with GAO’s recommendations.

House Energy & Commerce Health Subcommittee to Examine Mental Health Bills Next Week

The House Energy and Commerce Health Subcommittee will hold a remote hearing next week to examine several bills intended to improve mental healthcare in the United States. “As we confront a global pandemic, severe economic downturn, and systemic racism, we are faced with increased anxiety and stress,” House Energy and Commerce Chairman Frank Pallone, Jr. (D-N.J.) and Health Subcommittee Chairwoman Anna Eshoo (D-Calif.) said in a joint statement. “Mental health is an essential part of our nation’s health and and it is uniquely important during this time of unprecedented crisis—particularly for those with existing mental health conditions.” The remote hearing will begin at 11 a.m. ET on Tuesday, June 30 and will examine more than 20 mental health-related bills.

Manatt Compares Presidential Campaign Healthcare Policy Positions in New Infographic 

Research firm Manatt this week has released an infographic that maps out the healthcare policy positions of President Donald Trump and Democratic presidential candidate and former Vice President Joe Biden during this 2020 election cycle. The category “Increase Access to Treatment” shows President Trump would remove the Institutions for Mental Diseases (IMD) exclusion to allow residential treatment facilities with more than 16 beds to receive Medicaid reimbursements, and it shows former Vice President Biden would expand health insurance coverage, expand funding for mental health services and providers, and enforce mental health parity laws.

Fact of the Week

In 2018, national surveys from the Henry J. Kaiser Family Foundation, AARP, and Cigna examined the prevalence of loneliness, which they estimated to be 22%, 35%, and 47%, respectively. Using the same methodology as for its 2018 survey, in 2020 Cigna reported loneliness among Americans increased to 61% in 2019.

CEO Update Will Publish Next on Friday, July 10

NABH will not publish CEO Update next Friday, July 3 and will publish the next issue on Friday, July 10. The NABH team wishes you and your families a happy and safe Independence Day weekend! For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA Offers Guidance and Forms for Medicaid/CHIP Provider Relief Fund Payments

HHS’ Substance Abuse and Mental Health Services Administration (SAMHSA) is providing guidance, instructions, and application forms after HHS announced this week it will distribute $15 billion to eligible Medicaid and Children’s Health Insurance Program (CHIP) providers during the Covid-19 pandemic. HHS said the payment to each provider will be at least 2% of reported gross revenue from patient care. The department also said the final amount each provider receives will be determined after the data is submitted, including information about the number of Medicaid patients providers serve. According to SAMHSA, before applying to the enhanced provider relief portal, applicants should read the Medicaid provider distribution instructions and download the Medicaid provider distribution application form.

Independent Task Force Recommends Screening All Adults for Unhealthy Drug Use

The U.S. Preventive Services Task Force (USPSTF) this week recommended that all adults 18 and older be screened regularly for unhealthy drug use, which is defined as using illegal drugs or taking medications not specified for a medical reason. Previously the agency did not issue a recommendation on the subject, saying there was insufficient evidence to suggest regular screening. This new guidance follows a review of studies that evaluated the sensitivity of screening tools—most of which were moderately or highly accurate in identifying unhealthy drug use. Established in 1984, USPSTF is an independent, volunteer panel of national experts in prevention and evidence-based medicine. The group works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screening, counseling services, and preventive medications. The task force’s views are not meant to be construed as those of HHS or HHS’ Agency for Healthcare Research and Quality (AHRQ).

AHRQ Requests Information on Older Adult Opioid Use and Misuse in Primary Care Settings

AHRQ this week issued a notice requesting public comments on identifying and testing strategies for management of opioid use and misuse in older adults in primary care practices. According to the notice, this project is meant to assess and describe the current prevalence, awareness, and management of opioid use, misuse, and abuse in older adults, and identify the gaps and areas of needed research. “Additionally, this project will support primary care practices in developing and testing innovative strategies, approaches, and/or tools for opioid management within the context of facilitated learning collaboratives, culminating in a compendium of strategies for opioid management in older adults in primary care settings,” the notice said. Click here to learn more about the project and how to submit comments within 60 days of the June 8 notice.

ONDCP to Launch Rural Community Toolbox Website on June 24

The White House Office of National Drug Control Policy and senior Trump Administration officials will virtually launch the Rural Community Toolbox website, a resource for rural communities affected by addiction, on Wednesday, June 24. The Rural Community Toolbox is intended to serve as a clearinghouse for funding and resources in more than a dozen different federal agencies to help rural leaders build healthy, drug-free communities. Click here for more information when it becomes available and to register for the virtual launch, which will begin at 3 p.m. ET.

NABH President and CEO Shawn Coughlin Participates in Project Wake Up Panel Discussion

NABH President and CEO Shawn Coughlin was one of seven panelists to participate in an in-depth panel discussion about mental health stigma and suicide in America. Project Wake Up led the June 11 panel as a follow-up to the world premiere last week of Wake Up, a documentary about suicide, ending mental health stigma, and making sure people who need treatment receive it. Former U.S. Rep. Patrick Kennedy (D-R.I.), Craig Bryan, Psy.D. of the Ohio State University’s psychology department, Morissa Henn of InterMountain Healthcare, and Michael Zibilich, whose son died by suicide in 2012, were among the other panelists.

Fact of the Week

Buprenorphine treatment rates by primary care providers increased from 12.9 people per 10,000 population in 2010 to 27.4 in 2018. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Psych Hub Releases Race, Racism & Mental Health Resources During Week of Protests

Mental health educational platform Psych Hub released Race, Racism, & Mental Health Resources for individuals and communities amid a week of national and global protests against racism and police brutality following the death of George Floyd. Psych Hub compiled the list of resources on antiracism and Black mental health that includes links to organizations, online resources, books, and social media. “Experiencing and witnessing racism in any of its forms has traumatic effects that can build up with time and repetition,” the resources page noted. Also this week, NABH President and CEO Shawn Coughlin made a statement on Twitter and LinkedIn that included a link to the Substance Abuse and Mental Health Services Administration’s (SAMHSA) behavioral health equity page. “Racism and all acts of discrimination cause suffering, fear, anxiety, and depression,” Coughlin said. “We must advocate for behavioral health equity: the right to access quality healthcare for all populations, regardless of a person’s race, ethnicity, gender, socioeconomic status, sexual orientation, or geographical location.” NABH joined Psych Hub as a partner this year.

NABH Sends CMS Recommendations on Additional CoP

NABH this week sent a letter to the Centers for Medicare & Medicaid Services (CMS) outlining the association’s concerns with additional conditions of participation (CoP) for behavioral healthcare providers and recommendations to provide some regulatory relief. The letter also urged continued expanded coverage of behavioral healthcare services via telehealth. “The additional Conditions of Participations (CoP) for psychiatric hospitals and accompanying sub-regulatory guidance in the State Operations Manual (known as the B-tags) impose more than $625 million in additional costs annually, according to a recent study,” NABH President and CEO Shawn Coughlin wrote in the letter to CMS Administrator Seema Verma. “The Covid-19 pandemic has added to the strain on these facilities with additional financial losses and unexpected costs, including those related to greatly increased personal protective equipment, screening everyone coming into the facility, additional staffing needs for screening, and other infection control measures, including isolation rooms and units, software and hardware purchases to facilitate telework for administrative staff and telehealth for patients, and lost revenue due to decreased patient volume because of infection concerns and reduced referrals,” he added. NABH’s Covid-19 task force contributed to and reviewed the final letter, which is available on the association’s homepage and Covid-19 resources page.

HRSA Awards $20.3 Million to Expand Addiction Workforce in Underserved Communities

HHS’ Health Resources and Services Administration (HRSA) this week announced it awarded $20.3 million to 44 recipients to increase the number of fellows at accredited addiction medicine and addiction psychiatry fellowship programs. HRSA’s Addiction Medicine Fellowship program is part of the agency’s effort to fight the nation’s ongoing opioid crisis. The awardees will train addiction specialists at facilities in high-need communities that integrate behavioral and primary care services. “The need for physicians with the expertise and skills to provide substance use prevention, treatment, and recovery services is essential,” HRSA Administrator Tom Engels said in a news release. “Addiction specialists can respond to patients’ specific behavioral health needs and help communities that are hit hardest by the opioid epidemic.” Click here to view the list of award recipients.

Health Affairs Study Explores OUD Treatment of Commercially Insured Adults

A research article published in the journal Health Affairs this week explored treatment provided to people with opioid use disorder (OUD), rather than efforts to reduce prescriptions and misuse. Analyzing claims data representing 12 million to 15 million nonelderly adults covered through commercial group insurance during the period 2008-2017, researchers examined rates of OUD diagnoses, treatment patterns, and spending, and they identified three essential patterns. “The rate of diagnosed OUD nearly doubled during 2008-19, and the distribution has shifted toward older age groups; the likelihood that diagnosed patients will receive any treatment has declined, particularly among those ages 45 and older, because of a reduction in the use of medication-assisted treatment (MAT), and despite clinical evidence demonstrating its efficacy; and treatment spending is lower for patients who chose MAT,” the article noted. The researchers noted these patterns suggest that policies supporting MAT use are “critical to addressing the undertreatment of OUD among the commercially insured” and that additional research is needed.

JAMA Commentary Examines Treating Patients with OUD in Their Homes

A late May commentary in JAMA examined an emerging treatment model for OUD in recent years that uses telehealth to provide medication treatment to patients in their homes. The article notes that about 50,000 deaths from OUD overdose occur each year in the United States, and the prevalence of heroin use is increasing. And while more than 2 million people with an OUD need treatment and a rising number of individuals are receiving treatment, still less than 20% receive effective medications such as buprenorphine. According to researchers, some telehealth companies have advertised the convenience of their model in leveraging telehealth services for OUD treatment. Meanwhile, the article suggests another potential benefit. “By minimizing the need to travel and increasing privacy for patients who may not want to be seen seeking care,” the article noted, “these programs also could address the access challenges that are especially problematic for underserved patients.”

NABH System Members: Please Submit Your Annual Dues!

NABH thanks its members for the excellent work they do each day to advance NABH’s mission, most especially during this unprecedented, difficult time in our nation’s history. Our mission has never been more important than it is today. This is a reminder to all NABH system members to please submit their annual dues payments if they have not done so already. NABH members’ active involvement and prompt payment are critical in helping our association achieve its vision and ensure that NABH remains the leading advocate for our nation’s behavioral healthcare providers. As we continue to navigate the Covid-19 pandemic together, we want to be sure you receive information about the work we do and the resources we provide. Please visit our website at www.nabh.org and follow us on Twitter (@NABHbehavioral), LinkedIn, and YouTube. Also, please be sure to visit our Covid-19 webpage for important guidance, external links, and other resources. Please contact NABH Director of Operations Maria Merlie if you have questions about your organization’s dues payment.

Fact of the Week

More than 88,000 additional people have developed anxiety or depression due to the Covid-19 pandemic, according to new data from Mental Health America’s online screening program. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Extends Compliance Deadline for Providers to Receive Covid-19 Relief Funds

HHS late last week announced a 45-day, compliance deadline extension for healthcare providers who receive payments from the Provider Relief Fund to accept the department’s required terms and conditions. The extension means HHS has granted providers a total of 90 days from the time they receive payments—made available through the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act— until the time they accept the department’s terms and conditions. If providers do not meet the terms and conditions, they must return the funds. Visit HHS’ Provider Relief Fund webpage for more information.

The Joint Commission to Resume Surveys Next Month

The Joint Commission said this week it will resume regular surveys and reviews in June and will contact organizations due for a survey to assess the effects the coronavirus has had on their operations. The Oakbrook Terrace, Ill.-based accrediting organization said it is reviewing a variety of factors and criteria to determine which organizations will be surveyed—including identifying and prioritizing low-risk areas. In its announcement, The Joint Commission said the survey process will include changes to protect safety. For instance, the surveys will limit the number of individuals in group sessions and minimize the number of people who accompany the surveyor on tracer activities. In addition, using masks will be a routine practice, and The Joint Commission said it expects “the organization to provide masks and/or other personal protective equipment to surveyors and reviewers while on-site.” “Our survey will focus on a thorough assessment but will not retroactively review compliance,” the announcement said. “The implementation of an organization’s emergency operations plan will not be the focus of return survey activity considering the Centers for Medicare and Medicaid Services (CMS) waivers and other extensions,” it continued. “Rather, we will work to understand how you have adapted to the pandemic and review your current practices to assure you are providing safe care and working in a safe environment.” Click here to view The Joint Commission’s resources for healthcare staff fighting the Covid-19 pandemic.

Recording of HHS’ Webinar on Ensuring Safety During Covid-19 Available Next Week

HHS’ Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) will host a webinar on Tuesday, June 2 featuring how healthcare providers in the field have planned and implemented operational changes during Covid-19. Registration for the 90-minute webinar is full, so HHS announced that a recording will be available 24 hours after the event. The webinar will include officials from HHS’ Health Resources and Services Administration (HRSA) and Agency for Healthcare Research and Quality (AHRQ), as well as leaders from health systems in Louisiana, Massachusetts, New York, and Washington, D.C. ONDCP Director to Lead Stakeholder Call Next Week on Supporting SUD Care in Rural America James Carroll, director of the White House Office of National Drug Control Policy (ONDCP), and other senior agency officials will host a rural stakeholder call on Tuesday, June 2 at 3 p.m. ET to discuss the changes that have been made to increase access to substance use disorder (SUD) care in rural America during the global pandemic. Leaders from the Centers for Medicare & Medicaid Services, the Substance Abuse and Mental Health Services Administration, the Centers for Disease Control and Prevention, the Department of Agriculture, and other organizations will serve as speakers during the hourlong call. Click here to learn more and to register, as space is limited.

AHRQ to Host Webinar on the Role of Telehealth in Increasing Access to Care on June 9

HHS’ AHRQ will host a 90-minute webinar on Tuesday, June 9 to highlight how telehealth can increase access to care and improve healthcare quality. Presenters—including a clinical professor of psychiatry and behavioral sciences at the University of California at Davis—will discuss their work on the effectiveness of telepsychiatry, the effect of telemedicine on chronic disease management, and the facilitators and barriers to adopting urban telemedicine. Click here to learn more and to register.

Fact of the Week

A joint Census Bureau-National Center for Health Statistics survey during Covid-19 global pandemic found that 24% of Americans are showing clinically significant symptoms of major depressive disorder and 30% are showing symptoms of generalized anxiety disorder. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Healthcare Providers Must Act by June 3 to Receive Additional Relief Fund Payment

Eligible healthcare providers have until Wednesday, June 3 to submit their revenue information and accept all terms and conditions to receive an additional payment from the Provider Relief Fund’s $50 billion general distribution, HHS said this week. HHS’ notice said all providers who automatically received an additional general distribution payment before Friday, April 24 must provide HHS with “an accounting of their annual revenues by submitting tax forms or financial statements.” Providers must also agree to program terms and conditions if they want to keep the funds. The CARES Act and the Paycheck Protection Program and Health Care Enhancement Act provide $175 billion in relief funds to hospitals and other healthcare providers during the Covid-19 global pandemic. Previously HHS said $50 billion of the Provider Relief Fund was allocated for general distribution to facilities and providers who bill Medicare and were affected by Covid-19, based on providers’ net revenue. Of that funding, $30 billion was distributed immediately, proportionate to providers’ share of Medicare fee-for-services reimbursements in 2019. Then HHS began distributing an additional $20 billion on April 24.   According to HHS, every healthcare provider who has provided treatment for uninsured Covid-19 patients on or after Feb. 4 can request claims reimbursement through HHS’ Health Resources and Services Administration portal and will be reimbursed at Medicare rates, subject to available funding. The required steps include enrolling as a provider participant, checking patient eligibility and benefits, submitting patient information, submitting claims, and receiving payment via direct deposit. Click here for more information.

GAO Recommends CMS Include Detailed Information About SUD Coverage in “Medicare & You”

A new Government Accountability Office (GAO) report recommends the Centers for Medicare & Medicaid Services (CMS) include “explicit information” on the services Medicare covers for beneficiaries with substance use disorders (SUDs) in the agency’s Medicare & You publication. The GAO’s analysis of Medicare claims data in 2018 shows that almost 5 million beneficiaries used services for behavioral health services, which represented about 14% of the more than 36 million fee-for-services Medicare beneficiaries. About 96% of all behavioral health services accessed in 2018 (the year for which the latest data are available) were for a primary diagnosis in one of the following five behavioral health disorder categories: mood disorders (42%), anxiety and stress-related disorders (22%), schizophrenia and other non-mood, psychotic disorders (15%), disorders due to known physiological conditions (10%), and SUDs (7%). For this study, researchers also examined how CMS provides information to Medicare beneficiaries about coverage for behavioral health services. In doing so, they learned CMS mails Medicare & You—the most widely disseminated source of information on Medicare benefits—to all Medicare beneficiaries every year. “GAO reviewed the fall 2019 and January 2020 editions of Medicare & You,” the study noted. “While the January 2020 edition describes a new coverage benefit for beneficiaries with opioid use disorders, neither edition includes an explicit and broader description of the covered services available for substance use disorders,” it continued. “Both HHS and CMS have stated that addressing substance use disorders is a top priority. Given that coverage for substance use disorders is not explicitly outlined in Medicare’s most widely disseminated communication, Medicare beneficiaries may be unaware of this coverage and may not seek needed treatment as a result.” This finding led the GAO to recommend that CMS include “explicit information” on SUD coverage. “HHS reviewed a draft of this report,” the GAO study said, “and concurred with the recommendation.” Mental Health Survey Analysis Shows How People Worldwide Respond to Depression Treatment A new JAMA study shows that of more than 80,000 respondents surveyed in 16 countries, 68.2% of adults with a lifetime history of major depressive disorder obtained treatment they considered helpful. The findings showed that other patients stopped seeking treatment after early unhelpful treatment. Meanwhile, the findings showed that most patients (93.9%) were helped if they persisted through 10 treatment professionals, but only 21.5% of patients were that persistent. This led researchers to conclude “many more patients with major depressive disorder might obtain helpful treatment if they persist after early unhelpful treatment.”

SAMHSA Covid-19 Emergency Response for Suicide Prevention Grant Applications Due Today

The deadline to apply for the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Covid-19 Emergency Response for Suicide Prevention (Covid-19 ERSP) grants is today, Friday, May 22. The agency said it plans to issue 50 Covid-19 ERSP grants of up to $800,000 per year for 16 months for the program that is meant to support states and communities to prevent suicide and suicide attempts among adults 25 and older during the pandemic. SAMHSA’s announcement noted there are currently 57.8 million Americans living with mental and/or substance use disorders and suicide is the tenth leading cause of death in the United States. “The current national Covid-19 crisis will certainly contribute to the growth in the number of Americans needing urgent care to address mental health needs, including suicidality,” the announcement said. “Americans across the country will struggle with increases in depression, anxiety, trauma, grief, isolation, loss of employment, financial instability and other challenges, which can lead to suicide and suicide attempts.” Click here to for the application materials.

Join the Conversation!

If you have not done so yet, please register today to access our Covid-19 Forum, an interactive comments page for all NABH members on NABH’s Covid-19 resources webpage. The Covid-19 Forum now requires an NABH login to view and post any content. Previously, a login was required only to post new content. So although members of the general public would not be able to post comments, they would be able to view them. This added feature makes it more exclusive to members. To participate you must first create an account and log-in. Your current NABH username and password will not work for this new feature. To help us connect your account to the correct NABH member organization, please use your work e-mail when registering. After you create a new username and password, you will use that information as your new login for all member-only resources at www.nabh.org, including CEO Update. After you have created an account, please visit the section, post information, and comment often. This forum is for you to post questions about issues you and your teams are managing during the coronavirus pandemic and to help provide answers and potential solutions to other NABH members. Please note that in creating this account, you are agreeing to view and post information that all NABH members can access. Our members will generate and share the content in this forum for other NABH members to use. NABH has not created this content; however, NABH staff will review postings regularly and may delete or reproduce posts if necessary. In addition, NABH is not liable to visitors of this site for any posted content. Our members agree to post questions or content that they believe is relevant to other member organizations. NABH may not be held liable for loss or damages that occur by the posting of or action taken on content posted. All content is for educational and informational purposes and is not intended as medical, legal, or other advice. If you have any questions, please contact nabh@nabh.org for assistance.

Follow NABH on Twitter and LinkedIn During Mental Health Month 

This Mental Health Month, please remember to follow NABH on Twitter @NABHBehavioral and on LinkedIn at the National Association for Behavioral Healthcare to learn what NABH members and other organizations are doing during the annual national observance.

Fact of the Week

Among all adult discharges from opioid addiction treatment in the period 2015–17, 10.4% used both self-help groups and medications. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Health Affairs Blog Examines Strategies for Helping Individuals with OUD During Covid-19

A Health Affairs blog post this week outlines specific strategies that the federal government, states, and other stakeholders can apply to help individuals with opioid use disorder (OUD) mitigate the effects of Covid-19. Co-writers Jocelyn Guyer, managing director at Manatt Health, and Karen Scott, president of the Foundation for Opioid Response Efforts, note in the blog post that states and providers should update their approach to OUD treatment and “not only change their policies on paper but also issue clear and authoritative guidance to explain the new options available to help people with OUD through the pandemic.”   The article highlights the various federal agencies involved in regulating medications used for OUD and recommends what should come next. “In the longer term, as the Covid-19 crisis eases, it also will be important to evaluate whether any of the temporary policy changes should be adopted on an ongoing basis,” the authors wrote. “These could include, for example, eliminating prior authorization requirements for medications used for OUD; allowing access to medications used for OUD even if someone is not participating in counseling; and using telehealth to ease access to medications used for OUD, peer supports, and individual counseling.”

AHRQ Releases Consent Form for Telehealth Services

HHS’ Agency for Healthcare Research and Quality (AHRQ) has released a consent form for providers to document they had a discussion with a patient about telehealth services and that the patient understood the information discussed. AHRQ said providers should mail or provide an electronic portal to the form so patients have it before the discussion, and they should arrange for a qualified interpreter if the patient does not speak English well. The agency said the form is intended as a checklist to make sure providers cover all important information with patients in easy-to-understand language. Click here to access the form and for tips to follow during the consent discussion. Brookings Releases Report on Removing Barriers to Telehealth Services Research organization The Brookings Institution this week released Removing Regulatory Barriers to Telehealth Before and After Covid-19, a report that concludes state and federal barriers have prevented telehealth services from launching its full capabilities. The report provides a brief overview of the U.S. healthcare system; defines telemedicine, telehealth, and digital health; and examines federal versus state telehealth use implementation. Researchers noted that Covid-19 has shown the world the value of telemedicine, and asserted that telehealth regulations, especially those at the state level, should be written with a “broad eye toward the future,” being as flexible as possible. “While progress was being made before the coronavirus outbreak to adopt telehealth in states,” the study’s researchers wrote, “the pandemic not only demonstrated its worth but also proved it necessary to avert larger meltdowns in hospital systems and among medical professionals—even those whose work was stopped due to social distancing.”

Next Week is National Prevention Week

The Substance Abuse and Mental Health Services Administration’s next National Prevention Week is May 10 through 16. This Mental Health Month, click here to download a toolkit from Mental Health America and here for resources from the National Alliance on Mental Illness.

NABH Joins Psych Hub

NABH recently became a partner with Psych Hub, an online learning platform about mental health, substance use, and suicide prevention. Psych Hub’s free micro-video library hosts more than 100 consumer-facing, animated videos focused on improving mental health literacy and reducing stigma about seeking care. Click here to see all of Psych Hub’s partner organizations.

Fact of the Week

A recent Kaiser Family Foundation tracking poll found that older adults were less likely than adults ages 18 to 64 to report that worry or stress related to the coronavirus has had a negative effect on their mental health: 31% versus 49%, respectively. For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Announces Additional Medicare Coverage Flexibility for Behavioral Healthcare Services

The Centers for Medicare & Medicaid Services (CMS) on Thursday announced additional flexibility in Medicare coverage for several behavioral healthcare services during the Covid-19 pandemic, including partial hospitalization. CMS said it will allow payment for certain partial hospitalization services—namely, individual psychotherapy, patient education, and group psychotherapy—that are delivered in temporary expansion locations, including patients’ homes. In addition, hospitals may bill for services provided remotely by hospital-based practitioners to Medicare patients registered as hospital outpatients, including when the patient is at home when the home is serving as a temporary provider-based department of the hospital. Examples of this include counseling and educational service as well as therapy services. This change expands the types of healthcare providers that can provide using telehealth technology. CMS said hospitals may also bill as the originating site for telehealth services that hospital-based practitioners provide to Medicare patients registered as hospital outpatients, including when the patient is located at home. And while CMS announced previously that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians, the agency on Thursday broadened that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This would increase payments for these services to about $46-$110 from a range of about $14-$41. The payments are retroactive to March 1, 2020. The changes will also allow Opioid Treatment Programs (OTPs) to perform periodic assessments through two-way audio-visual technology and through audio-only telephone calls. This change builds on CMS’ March 31^st guidance, in which the agency said audio-only telephone calls were permitted for therapy, counseling, and counseling add-on codes. In addition, CMS said pharmacists may perform medication management in accordance with state scopes of practice and laws. This modification does not, however, apply to the dispensing of methadone. Thursday’s rule reaffirmed the continuation of methadone dispensing by certified and accredited OTPs, under the supervision of clinicians who have received appropriate training and as required by the Controlled Substances Act. Until now, CMS only added new services to the list of Medicare services that may be provided via telehealth using its rulemaking process. CMS is changing its process during the Covid-19 pandemic and will add new telehealth services on a sub-regulatory basis as it considers practitioner requests.  CMS also announced that teaching hospitals, including inpatient psychiatric facilities, can increase temporary beds and admit more patients to alleviate pressure on acute-care hospital bed capacity without facing reduced teaching status payments and reduced payments for indirect medical education.

May is Mental Health Month

May 1 kicks off Mental Health Month, and Mental Health America (MHA) has created a 2020 Mental Health Month Toolkit to commemorate the national observance. MHA and its affiliates nationwide have led this monthly observance since 1949, and this year will promote a “Tools 2 Thrive” theme to provide practical tools to improve mental health. According to MHA, which reports that one in five people will experience a mental illness during their lifetime, some of the tools may need to be adapted due to social-distancing restrictions during the global pandemic.

HRSA Seeks Public Comment on Bureau of Health Workforce Substance Use Evaluation

HHS’ Health Resources and Services Administration (HRSA) announced it is seeking public comment for the next 30 days on its Bureau of Health Workforce Substance Use Evaluation. In September 2017, HRSA’s Bureau of Health Workforce launched a multi-pronged effort to increase the U.S. healthcare system’s workforce capacity to prevent and treat the nation’s deadly opioid crisis. HRSA developed or expanded activities under five programs as part of this effort—including programs such as the National Health Service Corps Loan Repayment Program and the Behavioral Health Workforce Education and Training Program—and is now seeking feedback to assess these program changes. Click here to learn more about the comment submission process.

AHA to Host Webinar Next Week on Outpatient Services Featuring Sheppard Pratt Leaders

The American Hospital Association (AHA) will host a webinar about outpatient behavioral health services during the Covid-19 pandemic featuring leaders from NABH member Sheppard Pratt Health System on Monday, May 4. Harsh Trivedi, M.D., M.B.A., an NABH board member and AHA trustee, along with Sheppard Pratt’s chief medical officer, chief operating officer, and medical director for outpatient services, will discuss the system’s efforts to redesign and adapt innovative treatment programs across the full continuum of outpatient services. This event follows a webinar that AHA hosted last month on Sheppard Pratt’s processes and protocols in the system’s inpatient psychiatric settings during the pandemic. The hourlong webinar will begin on Monday at 3 p.m. ET. Click here to register.

Brookings to Host May 6 Webinar on Telehealth Before and After Covid-19

Research organization Brookings will host an hourlong webinar about telehealth services before and after Covid-19 next Wednesday, May 6 at 2 p.m. ET. In its announcement, Brookings noted that before the global pandemic, federal and state regulations around reimbursement and licensure requirements limited telehealth use, while private insurance programs and Medicaid have historically excluded telehealth services from coverage. “Whether through remote clinical health management or real-time patient monitoring, telehealth will increasingly become a necessity in health care, especially in assessing treatment options prior to any hospital visits,” the webinar announcement said. The Center for Technology at Brookings and the John Locke Foundation will host the webinar to discuss the findings of a forthcoming paper on this issue, as well as the status of regulations and how to support telehealth services in the future. Click here to register.

SAMHSA to Host May 7 Webinar on Combatting Social Isolation for Seniors During Covid-19

The Substance Abuse and Mental Health Services Administration (SAMHSA), the Administration for Community Living, the Veterans Health Administration, and the National Coalition on Mental Health and Aging will host a webinar about combatting social isolation for seniors during the pandemic to commemorate National Older Adult Mental Health Awareness Day on Thursday, May 7. The discussion will include practical ideas to promote connection and recovery for older adults with serious mental illness and substance use disorders during the global pandemic. Click here for more information about the 90-minute webinar, which will begin at 1 p.m. ET.

Fact of the Week

According to the Kaiser Family Foundation, 56% of U.S. adults report that worry or stress related to the coronavirus outbreak has caused them to experience at least one negative effect on their mental health and wellbeing, such as problems with sleeping or eating, increased alcohol use, or worsening chronic conditions. For questions or comments about this CEO Update, please contact Jessica Zigmond.

HHS Announces $30 Billion in Immediate Covid-19 Relief Funding for Providers

HHS announced on Friday it is distributing $30 billion immediately to healthcare providers fighting the deadly Covid-19 pandemic. The funding is the first portion of the $100 billion allotted to hospitals and other providers as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act that President Trump signed on March 27. The funding will arrive via direct deposit to eligible providers starting on Friday, April 10. HHS’ announcement said the money is in the form of payments, not loans, so the money will not need to be repaid. Eligible healthcare providers include all facilities and providers that received Medicare fee-for-service reimbursements in 2019. According to HHS, payments to practices that are part of larger medical groups will be sent to the group’s central billing office. Click here to learn how HHS will determine the payments and what eligible providers need to do. To receive funding, providers must agree not to seek to collect out-of-pocket payments from a Covid-19 patient that are greater than what the patient would have otherwise been required to pay if an in-network provider had provided care, HHS said. HHS has created a public website that shows all Covid-19 grant and cooperative agreement awards, which features a U.S. map detailing the amounts awarded by states, graphics highlighting the numbers of awards, amounts awarded by agency, and more.

NABH Sends Latest Covid-19 Recommendations to Vice President Pence and Hill Leaders

NABH on Thursday sent Vice President Mike Pence and top Senate and House leaders a six-page letter outlining critical behavioral healthcare recommendations as lawmakers prepare for the next round of legislation to provide relief during the Covid-19 pandemic. The letter highlights behavioral healthcare provider needs related to payment issues, health information technology, telehealth, parity compliance, medication treatment for opioid use disorder, youth services, and additional emergency funding needs. Please visit NABH’s enhanced Covid-19 resources page for all pandemic-related correspondence, guidance, and external webpage links.

NABH and Other Behavioral Health Organizations Request Emergency Covid-19 Relief

Earlier this week, NABH joined more than 35 other associations on a request for $38.5 billion in emergency funding for behavioral health organizations during Covid-19. The appropriations request calls for the $38.5 billion in emergency supplemental funding for direct payments to behavioral health organizations to ensure they can remain open and operating during the pandemic. A significant portion of the funding would be set aside for behavioral healthcare organizations enrolled in Medicaid. Also this week, NABH also supported a Mental Health Liaison Group letter to HHS Secretary Alex Azar and Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma that requested CMS immediately expand Medicare coverage of telehealth to allow audio-only communications and waive Medicare’s current requirement for audio-video connecting during the pandemic.

The Joint Commission Releases FAQs on Healthcare Provider Face Masks Brought from Home

The Joint Commission (TJC) this week released frequently asked questions (FAQs) regarding TJC’s position statement on using face masks brought from home. TJC’s Office of Quality and Patient Safety has received many complaints from healthcare workers about inadequate personal protective equipment (PPE), such as a lack of N95 masks for performing aerosolizing procedures or working without routinely wearing a mask when exposed to a large number of patients who could have Covid-19. “If a hospital cannot provide N95 masks for staff performing these procedures or working in the immediate vicinity, staff should be allowed to bring in their own masks,” TJC noted. Click here to read the FAQ document, which is also posted on NABH’s Covid-19 resources page.

CDC Reports National Suicide Rate Increased 35% Between 1999 and 2018

The Centers for Disease Control and Prevention (CDC) this week reported the U.S. suicide rate increased 35% between 1999 and 2018. During that period, suicide rates among females were highest for those between the ages of 45 and 64, while the rates were highest among males for those aged 75 and older. Meanwhile, in 2018, the suicide rate for males was 3.7 times the rate for females. According to the CDC, suicide is the 10^th leading cause of death for all ages in the United States.

Fact of the Week

The U.S. suicide rate increased on average about 1% per year from 1999 to 2006 and then by 2% per year from 2006 through 2018. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Covid-19 Resources Page Highlights Summaries, FAQs, and Links

Please visit NABH’s Covid-19 resources page for the latest behavioral healthcare guidance, recommendations, and best practices related to the Covid-19 pandemic. New resources this week include NABH’s priority issue areas and recommendations for the Centers for Medicare & Medicaid Services (CMS), an NABH summary of CMS’ policy changes, and a blog post from the law firm Holland & Knight about Covid-19 funding for healthcare providers. Also be sure to follow NABH on Twitter @NABHBehavioral and on LinkedIn at the National Association for Behavioral Healthcare to learn about the innovative practices NABH members are implementing during the national emergency.

Joint APA-NABH Covid-19 Webinar Recording Now Available

NABH thanks NABH Board members Frank Ghinassi, Ph.D., A.B.P.P., CEO at Rutgers University Behavioral Health Care, and Harsh Trivedi, M.D., M.B.A., president and CEO of Sheppard Pratt Health System, for serving as presenters during a joint webinar with the American Psychiatric Association about Covid-19 on Wednesday, April 1. A recording of the webinar, How to Address Covid-19 Across Inpatient, Residential, and Other Non-ambulatory Care Settings, is free with registration if you missed it. Click here to register.

SAMHSA Announces Covid-19 Emergency Grant Opportunities

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for Emergency Grants to Address Mental and Substance Use Disorders During Covid-19. According to the National Survey on Drug Use and Health, 2018, there are 57.8 million Americans living with mental and/or substance use disorders (SUDs). SAMHSA noted in its grant announcement this week that the Covid-19 pandemic will contribute to an increase in this figure. The agency said it plans to issue 60 grants of up to $2 million per state or up to $500,000 for territories and tribes for 16 months. The program is meant to provide crisis intervention services, mental and substance use disorder treatment, crisis counseling, and other related supports for children and adults affected by the COVID-19 pandemic. Click here for more information and to apply. Applications are due April 10.

SAMHSA Announces Treatment, Recovery, and Workforce Support Grants

SAMHSA this week also said it is accepting applications for its Treatment, Recovery, and Workforce Support grants, which implement evidence-based programs to support individuals in SUD treatment and recovery to live independently and participate in the U.S. workforce. The agency said it expects to issue eight grants of up to $500,000 per year for up to five years. Click here for more information and to register. Applications are due June 1. NABH 2020 Exhibitor & Sponsor Guide Available Online NABH mailed all association members a printed copy of the NABH 2020 Exhibitor & Sponsor Guide on March 16. The Guide is also available online to download on the NABH Resources page. NABH thanks its exhibitors and sponsors and looks forward to working with them on the NABH 2021 Annual Meeting!

Fact of the Week

Since fiscal year 2015, the Government Accountability Office has made more than 80 recommendations to multiple agencies responsible for addressing the drug crisis. More than 60 of these recommendations have yet to be implemented. For questions or comments about this CEO Update, please contact Jessica Zigmond.

A Message President and CEO Shawn Coughlin

It’s hard to believe it has been only 10 days since we decided to cancel the 2020 NABH Annual Meeting. It feels more like 10 years. On behalf of our NABH team here in Washington, thank you for all you have done to provide excellent behavioral healthcare services during one of the most difficult and stressful times in our nation’s history. Through you, our members, we have learned and shared much in one week’s time. Ultimately, we hope to use the lessons we learn during the Covid-19 pandemic to help our members—and improve behavioral healthcare in the United States. As we all navigate the pandemic, I want to highlight some actions NABH has taken to apprise our members of federal guidance, to inform relevant federal agencies and lawmakers about our recommendations, and to share best practices with each other. First, please visit our Covid-19 webpage, which includes our weekly recommendations to the Centers for Medicare & Medicaid Services (CMS), guidance from relevant federal agencies, and other external resources that we think you and your teams will find useful. We will update that page regularly. We will also continue to send NABH Alerts when we have crucial and/or urgent information to share. This week’s CEO Update includes the NABH Alerts we sent earlier this week, in case you missed those. In addition, please remember to follow us on Twitter @NABHBehavioral and on LinkedIn, where we will post important information and share what our members are doing. Finally, please keep us informed about the challenges you’re managing and processes that are working well. You can reach us at nabh@nabh.org. Again, our thanks and very best wishes to each of you, your teams, and your families to stay healthy and safe. Shawn Coughlin President and CEO

NABH Sends Covid-19 Priority Recommendations to Vice President Pence, Hill Leaders

NABH on Friday sent a letter to top federal leaders outlining the association’s priority recommendations during the Covid-19 pandemic. Congress is considering a legislative package to address Covid-19 issues, and NABH alerted Vice President Mike Pence and congressional leaders about the major challenges that NABH members are managing during the pandemic. Click here for the full letter.   CMS Outlines Actions for Healthcare Providers During Covid-19 National Emergency CMS this week released a fact sheet for healthcare providers and states following President Trump’s declaration of a national emergency due to Covid-19. You can learn more from the agency’s news release about these actions.

Federal Agencies Offer Flexibility on Telehealth and HIPAA During Covid-19 Pandemic

Agencies within the U.S. Health and Human Services Department (HHS) as well as the U.S. Drug Enforcement Administration (DEA) on Tuesday released essential guidance allowing for expanded telehealth use during the Covid-19 pandemic. Also Tuesday, HHS’ Centers for Medicare & Medicaid Services (CMS) issued important information about waivers or modifications under section 1135 of the Social Security Act during the national public emergency. Please see below for information and related links. Meanwhile, CMS released a virtual toolkit for its partners, which includes links to the websites of other federal agencies, as well as guidance for schools, workplaces, Medicare beneficiaries, clinicians, caregivers, and others. The agency’s announcement on increased flexibility in telehealth for Medicare beneficiaries allows Medicare payment for professional services for patients in any healthcare facility and in patients’ homes – no longer limited to rural settings and certain types of facilities. See also the FAQs on this announcement.

• CMS so also released guidance about telehealth services in the Medicaid program.

• HHS’ OIG released a policy statement and a fact sheet about telehealth cost-sharing during the Covid-19 pandemic.

• HHS Office for Civil Rights announced guidance on a limited waiver of HIPAA sanctions and penalties related to telehealth during the Covid-19 national emergency.

• DEA issued information related to telemedicine and medication assisted treatment.

In addition, CMS has approved first Section 1135 waiver in Florida allowing, among other flexibilities:

• • Reimbursement of otherwise payable claims from providers not enrolled in Florida’s Medicaid program or Medicare if certain conditions are met;
  • Waiver to allow facilities, including nursing facilities, intermediate care facilities for individuals with intellectual and developmental disabilities (ICF/IDDs), psychiatric residential treatment facilities (PRTFs) and hospitals’ NFs to be fully reimbursed for services rendered during an emergency evacuation to an unlicensed facility (where an evacuating facility continues to render services);
  • Waiver for Pre-Admission Screening and Annual Resident Review (PASRR) Level I Level II Assessments for 30 days. All new admissions can be treated like exempted hospital discharges;
  • See CMS guidance, for more information on section 1135 authority that allows waiver of certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements.

SAMHSA Releases 42 CFR Part 2 Guidance During Covid-19

The Substance Abuse and Mental Health Services Administration (SAMHSA) on Thursday released 42 CFR part 2 guidance clarifying patient consent requirements during the Covid-19 pandemic. SAMHSA’s announcement acknowledges that patients may not be able to sign written consents due to social distancing and increased telehealth services during the pandemic. To ensure that substance use treatment is not interrupted, the agency’s guidance reminds providers they may determine that a “bona fide medical emergency exists” under the existing “medical emergency exception.” Please contact Sarah Wattenberg, NABH’s director of quality and addiction services, if you have questions.

Fact of the Week

SAMHSA this week released tips on taking care of your behavioral health during the Covid-19 pandemic.   For questions or comments about this CEO Update, please contact Jessica Zigmond

CMS Announces Actions to Address Spread of Coronavirus

The Centers for Medicare & Medicaid Services (CMS) this week announced a series of actions intended to limit the spread of Coronavirus 2019 (COVID-19), starting with directing healthcare providers nationwide to ensure they are implementing their infection-control procedures, which providers are required to maintain at all times. CMS also announced that until further notice, state survey agencies and accrediting organizations will focus their facility inspections exclusively on issues related to infection control and other serious health and safety threats, such as abuse allegations, starting with nursing homes and hospitals. Vice President Pence—who is leading the government’s response to COVID-19—said this shift in approach will allow inspectors to focus their energies on addressing the spread of COVID-19. The agency also provided information on suspension of survey activities, guidance for infection control and prevention concerning COVID-19 and related FAQs, and guidance for infection control and prevention of COVID-19 in nursing homes. As of noon ET on Friday, the Centers for Disease Control and Prevention reported a total of 164 COVID-19 cases and 11 deaths in the United States, with 19 states reporting cases. The Atlanta-based agency has also provided guidance for healthcare facilities and information about clinician outreach and activity. Click here for an overview and additional information. NABH alerted 2020 NABH Annual Meeting participants on March 3 that the association is watching federal updates closely and will continue its plans for the Annual Meeting in Washington, D.C. from March 16-18.

Senators Manchin, Moore Capito Reintroduce Protecting Jessica Grubb’s Legacy Act

Senators Joe Manchin (D-W.Va.) and Shelley Moore Capito (R-W.Va.) this week reintroduced the Protecting Jessica Grubb’s Legacy Act, which would allow patients to opt in and share their addiction medical records. The legislation would also make it easier to share addiction records for the purposes of treatment, payment, and healthcare operations, while allowing patients to remain in control. The bill would also provide new protections under 42 CFR Part 2, which was passed in the 1970s before the Health Insurance Portability and Accountability Act of 1996 and electronic medical records. NABH has long supported reforming 42 CFR Part 2. Click here to read a summary of the bill from Sens. Manchin and Moore Capito.

NABH Supports Medicare Mental Health Inpatient Equity Act

NABH was one of 40 organizations in the Mental Health Liaison Group this week to support the Medicare Mental Health Inpatient Equity Act, which would eliminate Medicare’s 190-day lifetime limit for Medicare beneficiaries who require inpatient psychiatric hospital care. “This lifetime limit does not apply to psychiatric units in general hospitals and there is no such lifetime limit for any other Medicare specialty inpatient hospital service,” the MHLG wrote in a letter to Sens. Susan Collins (R-Maine) and Tina Smith (D-Minn.) “Through passage of landmark legislation, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, Congress put coverage for mental health and substance use disorders on par with other medical disorders,” the letter continued. “Also, that year, Congress passed important legislation to phase-in equalization of the Medicare outpatient coinsurance for mental and physical health. We must now finish the parity job and finally give Medicare beneficiaries the full parity that other individuals now have.” The MHLG also sent a letter to Reps. Paul Tonko (D-N.Y.), an NABH Behavioral Healthcare Champion, and Bill Huizenga (R-Mich.) regarding a companion bill in the House.

CMS Issues Guidance on Access to Mental Health and SUD Services for Children and Pregnant Women

CMS this week sent a letter to state health officials that describes a provision in the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act related to coverage of mental health services for children and pregnant women. “While the SUPPORT Act builds on MHPAEA, it is different in two important ways,” Calder Lynch, deputy administrator and director for the Center of Medicaid and CHIP Services, wrote in the letter. “Unlike MHPAEA, the SUPPORT Act explicitly requires coverage of behavioral health services.”

ONDCP to Host Webinar on Building the Addiction Physician Expert Workforce

Office of National Drug Control Policy (ONDCP) Director James Carroll and HHS Assistant Secretary for Health Admiral Brett Giroir, M.D. will host the webinar Building the Addiction Physician Expert Workforce to promote understanding of the addiction physician’s role in meeting the needs for substance use disorder (SUD) prevention and treatment. The hourlong session on Tuesday, March 10 at 2 p.m. ET will also provide information and resources for efforts to expand the addiction physician workforce. Click here to register.

NABH Welcomes Domestic Policy Council Director Joe Grogan as Annual Meeting Speaker

NABH is pleased to welcome Joe Grogan, assistant to President Trump and director of the Domestic Policy Council, as a speaker to kick off the Annual Meeting policy breakfast on Wednesday, March 18 at 8 a.m. Grogan, who leads the Trump administration’s domestic policy agenda, served previously as associate director for health programs at the Office of Management and Budget, where he managed the allocation and budgeting of more than $1 trillion in federal spending. In the private sector, Grogan has worked in management at leading biotechnology firms Gilead Sciences, Inc., and Amgen, Inc. During President George W. Bush’s administration, he served as both a civil servant and in policy-making roles for more than seven years. Grogan has also served as executive director of the Presidential Advisory Council on HIV and AIDS (PACHA), senior advisor to the FDA commissioner, and special assistant in the Administration for Children and Families. Learn more about our Annual Meeting speakers and preliminary program. We look forward to seeing you in Washington!

Fact of the Week

In 2018, estimated 27.2 million Americans age 18 and older reported they experienced an alcohol or other drug use problem in their lifetime and approximately 20.2 million Americans over 18 described themselves as being in recovery from a drug or alcohol problem or having recovered from one. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Insurers Sign Settlement with Massachusetts Attorney General Over Mental Health Parity Five large Massachusetts health insurers and two behavioral healthcare companies on Thursday signed a settlement with Massachusetts Attorney General Maura Healey regarding allegations that the organizations violated the state’s mental health parity laws. A statement from Healey’s office said a number of the state’s healthcare companies have under-reimbursed mental healthcare services; imposed unlawful barriers, including prior authorization requirements for behavioral health services that were not required for comparable physical health services and could not be justified under the Parity Act; and had inaccuracies in their provider directories. The companies will pay a combined $1 million for a fund to promote initiatives to broaden access to mental health. The settlement involves Harvard Pilgrim Healthcare and its behavioral health management company United Behavioral Health, which does business as Optum, Fallon Health and its behavioral health management company Beacon Health Strategies, Always Health Partners, Blue Cross Blue Shield of Massachusetts, and Tufts Health Plan. “Treatment for substance use disorder and access to therapy are vital to public health, but too many people are facing unlawful barriers to the care they need,” Healey said in the statement. “These companies are making substantial and unprecedented changes to help ensure patients don’t have to struggle to find behavioral health services in Massachusetts.” DEA Eases Regulations for Mobile Methadone The Drug Enforcement Administration (DEA) this week proposed a regulation that revises the Controlled Substances Act (CSA) to permit narcotic treatment programs (NTPs)—opioid treatment programs, detoxification services that use methadone, and compounders— to operate mobile components, or mNTPs, without separate registrations. The rule also proposes requirements related to security, recordkeeping, reporting, and inventory. The purpose of the rulemaking is to address the opioid epidemic by expanding access to methadone treatment, especially for residents of rural and underserved communities. Learn more here from the NABH Issue Brief about the proposed rule. CDC Requests Information on Workplace Supported Recovery The Centers for Disease Control and Prevention’s (CDC) National Institute for Occupational Safety and Health (NIOSH) is seeking feedback on a NIOSH plan to develop resources and conduct research on Workplace Supported Recovery. Workplace Supported Recovery programs help workers and employers facing the nation’s opioid crisis and other substance use disorders. Click here to learn more about the request for information. CMS Requests Public Comments on Rural Maternal and Infant Healthcare The Centers for Medicare & Medicaid Services (CMS) has released a request for information regarding rural maternal and infant healthcare to improve access, quality, and outcomes for women in rural communities before, during, and after pregnancy. Click here to read the agency’s Issue Brief on maternal healthcare in rural communities, and here to learn more about CMS’ request for information. NABH Endorses NSC’s National Plan to Address Opioid Misuse NABH this week joined more than 50 other organizations to endorse the National Safety Council’s National Plan to Address Opioid Misuse, which is intended for any presidential candidate to adopt as a roadmap to tackle America’s opioid crisis. The plan offers solutions for the entire lifecycle of addiction, from prevention to recovery. It also offers recommendations that address the role prescribers play and that improve training and education of the non-addiction specialist medical workforce, including primary care, emergency department, Acura Care, and nw ark health professionals. Kirsten Beronio Joins NABH as New Director of Policy and Regulatory Affairs NABH is pleased to welcome Kirsten Beronio as the association’s new director of policy and regulatory affairs, effective Feb. 24. Kirsten comes to NABH with more than 20 years of experience developing mental health and substance use disorder policy in leadership positions she has held in the legislative and executive branches of the federal government and at Mental Health America. “Kirsten’s background in developing, implementing, and advocating for policies that help people struggling with mental health and substance use disorder positions her well for this role, and we are thrilled to have her join our team,” NABH President and CEO Shawn Coughlin said in a Feb. 24 news release. Most recently Kirsten served as the senior policy advisor for behavioral health in the Center for Medicaid and Children’s Health Insurance Program (CHIP) at the Centers for Medicare & Medicaid Services from 2016 to 2020. Before that, Kirsten worked as the first division director for behavioral health and intellectual disabilities policy in HHS’ Office of the Assistant Secretary for Planning and Evaluation. In addition to developing this new division from its inception, Kirsten served as a subject matter expert focused on federal parity legislation and regulations, implementation of key provisions of the Affordable Care Act, and various healthcare financing policies in Medicaid, Medicare, and CHIP. Kirsten earned a B.A. from Princeton University and a J.D. from Georgetown University. At NABH, Kirsten will oversee quality and regulatory issues and will serve as the staff liaison for the Youth Services and Quality Committees. 2020 NABH Online Membership Directory Now Available NABH this week released its 2020 online Membership Directory to help clinicians, hospital admissions staff, employee assistance directors, school counselors, policymakers, journalists, patient advocates, and families identify systems and facilities that provide essential behavioral healthcare services. This is the second year NABH has made the Membership Directory available online, and the first year it is available only in a digital format. 2020 also marks the first time NABH has made the directory available to the general public. “We are eager to share this useful resource with the public at a time when the need for quality behavioral healthcare services has never been greater,” NABH President and CEO Shawn Coughlin said in a Feb. 26 news release. “We hope people will find it helpful and share it with others who are looking for mental health or substance use treatment in their area.” Directory information includes each NABH system member’s name, leadership, address, phone number, and website, as well as the behavioral healthcare facilities that each system operates. Please call NABH at 202-393-6700 or e-mail nabh@nabh.org if you have questions. NIMH, CDC Leaders to Address Attendees at NABH 2020 Annual Meeting NABH is pleased to welcome federal healthcare officials from the National Institute of Mental Health (NIMH) and the CDC at the Annual Meeting in Washington next month. Please join us on Tuesday, March 17 at 8:30 a.m. to hear from Joshua Gordon, M.D., Ph.D., director of the NIMH, whose work has had direct relevance to schizophrenia, anxiety disorders, and depression. And on Wednesday, March 18 at 9 a.m., NABH will welcome Debra Houry, M.D., M.P.H., director of the CDC’s National Center for Injury Prevention and Control. Dr. Houry, who completed her residency training in emergency medicine, will discuss adverse childhood experiences, overdose, and suicide. Learn more about Drs. Gordon and Houry and our other Annual Meeting speakers on our Annual Meeting Speakers page. We look forward to seeing you next month in Washington! Fact of the Week Despite the number of people in recovery, nearly 89% of the estimated 20.2 million Americans who met the criteria for a substance use disorder (SUD) in 2018 did not receive specialized treatment for their condition. For questions or comments about this CEO Update, please contact Jessica Zigmond