CEO Update 215
Senate Committees Hold Hearings for HHS Secretary Nominee
The Senate Finance Committee and Senate Health, Education, Labor, and Pensions Committee held hearings on Wednesday and Thursday, respectively, to consider the nomination of Robert F. Kennedy Jr. for Secretary of Health and Human Services.
On issues related to behavioral health, Kennedy indicated a willingness to work with Congress on repealing Medicaid’s Institution for Mental Diseases exclusion, proposed to incorporate more training on substance use disorder treatment into graduate medical education for primary care providers, said that medications for substance use disorders should be available but are not the gold standard of treatment, and suggested that additional studies be conducted on the safety of antidepressants.
Prior to the hearings, Patrick Kennedy – former congressman and founder of The Kennedy Forum – expressed support for his cousin’s nomination with respect to substance use disorder treatment, saying that Robert F. Kennedy Jr. is open to multiple pathways to recovery, including medication.
The Senate Finance Committee is expected to vote on Kennedy’s nomination next week.
States’ Access to Medicaid Portals is Restored, but Uncertainty Remains with Federal Funding Pause
On Monday, the White House issued a memo directing federal agencies to temporarily pause spending on a broad swath of programs while their compliance with recent executive orders is reviewed. This coincided with an outage of portals for states to access Medicaid payments, prompting concern that the pause applied to federal Medicaid funding. The White House subsequently issued guidance clarifying that the pause did not apply to Medicaid, and access to portals was restored.
Nonetheless, uncertainty remains about the status of the funding pause; a judge temporarily blocked its implementation, after which the White House rescinded the memo that directed the pause but then later stated that the pause is still in effect.
NABH continues to monitor this situation as it evolves.
President Trump Issues Executive Order on Transgender Youth Services
President Trump issued an executive order on Tuesday aimed at limiting the use of gender-affirming care (i.e., hormones, hormone blockers, surgery) for youth under age 19 who are transgender or experience gender dysphoria.
This order directs federal agencies to ensure that medical institutions receiving research or education grants do not provide such services to youth, as well as consider other actions to prevent the availability of these services, which may involve conditions of participation for Medicare and Medicaid, essential health benefits requirements, and other policies. Among other things, the order also directs TRICARE and federal employees’ health plans to exclude coverage of these services for youth and requires the publication of best practices for youth experiencing gender dysphoria.
NABH is Preparing a Response to the Proposed Rule on Telehealth for Controlled Substances
The Drug Enforcement Administration (DEA) recently proposed a rule regarding the prescribing of controlled substances via telehealth without an in-person evaluation (a final rule specific to prescribing buprenorphine for opioid use disorder via telehealth was also released). The proposed rule includes a variety of concerning items, such as substantial limitations on prescribing schedule II medications, an expansive prescription drug monitoring program review requirement, and the need to obtain multiple registrations. For a summary of the proposed rule, please check out NABH’s issue brief.
NABH plans to submit a comment letter outlining concerns with the proposed rule. To inform its development, we would like to meet with interested members to discuss major concerns. If you would like to be involved, please reach out to Dan Schwartz.
The Joint Commission Updates Requirements for Behavioral Healthcare Providers
The Joint Commission made updates to emergency management and infection control requirements in the behavioral healthcare and human services accreditation program, which will take effect on July 1, 2025. For infection control, a fully revised chapter will replace the current requirements, in alignment with updates for other hospitals; see this reference guide on changes to standards. For emergency management, the updates seek to provide more clarity on hazard vulnerability analyses, leadership involvement, and staff education and training.
While the NABH Quality Committee will review these updates, all members are encouraged to email any questions or concerns to Rochelle Archuleta.
House Schedules Hearing on Illicit Drug Threats
The House Energy and Commerce Committee’s Health Subcommittee scheduled a hearing on existing and emerging illicit drug threats for February 6. The announcement highlights xylazine and nitazenes as concerning issues and mentions that the hearing will help advance the subcommittee’s previous work to “crack down on drug traffickers; provide support to those suffering from substance use disorder; and restore hope to families, law enforcement, and emergency medical personnel.”
Up to now, the federal government has formally designated two emerging drug threats: (1) methamphetamine, and (2) fentanyl adulterated or associated with xylazine.
FDA Approves New Non-Opioid Pain Medication
On Thursday, the Food and Drug Administration (FDA) approved Journavx (suzetrigine), a first-in-class non-opioid oral pain medication indicated for adults with moderate to severe pain. Journavax works by inhibiting the transmission of pain signals in the peripheral nervous system before reaching the brain, which could be associated with a lower risk of dependence relative to opioids.
Researchers Find a Decline in Availability of Some Crisis Services Since 988 Launch
In July 2022, the 988 Suicide and Crisis Lifeline was created to make it easier for people experiencing behavioral health crises to access support than the previous ten-digit dialing code. However, a study found that after 988 launched, several crisis services had less availability nationally: emergency psychiatric walk-in services, mobile crisis response, and suicide prevention services. The greatest decrease was for emergency psychiatric services, a trend that began prior to 988’s launch. Meanwhile, there was an increase in the availability of peer support services.
Across states, there were significant differences in changes to crisis service availability, which may be attributable to different funding levels or varying degrees of preparedness for 988. There were also a variety of facility-level factors associated with greater crisis service availability, such as accepting Medicaid or private insurance.
Ultimately, the authors indicated that “the lack of meaningful growth in most crisis services may limit the long-term success of 988, in particular if callers feel that reaching out to 988 fails to result in access to appropriate sources of care.”
Study Shows Promising Results from Emergency Department Methadone Bridge Clinic
Findings from a new study indicate that emergency departments have the potential to facilitate uptake of methadone for patients with opioid use disorder. Among a small sample of patients initiating methadone at an emergency department-based bridge clinic, 56% completed linkage to a partner Opioid Treatment Program, and 100% of linked patients were retained in treatment at 30 days.
This clinic leveraged a federal rule that allows non-Opioid Treatment Program clinicians to initiate patients with opioid use disorder on methadone by dispensing up to a three-day supply of medication.
Save the Date: Join Us in May for the 2025 NABH Annual Meeting!
Please plan to join your peers and the NABH team at the Salamander Washington, DC from May 12-14 for the 2025 NABH Annual Meeting.
NABH will provide more details soon in future editions of CEO Update and in NABH Annual Meeting Alerts. We look forward to seeing you in Washington!
Fact of the Week
A new JAMA study suggests that mindfulness groups may be useful during opioid use disorder treatment, especially for patients with residual opioid craving while they are prescribed buprenorphine.
For questions or comments about this CEO Update, please contact Jessica Zigmond.