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CEO Update 109

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.