Author: Emily Wilkins (NABH)

SAMHSA Distributes $11 million to Train First Responders & Community Groups on Overdose Prevention

The Substance Abuse and Mental Health Services Administration (SAMHSA) has distributed 13 grants totaling $11 million to reduce the number of prescription drug and overdose-related deaths and adverse events by training first responders and other essential community groups. SAMHSA’s announcement said grantees will receive up to $850,000 per year over five years for a total of $55.2 million (this distribution was for the first year). “The more SAMHSA does to equip communities across the country to prevent fatal overdoses, the more opportunities our loved ones will have to pursue treatments for substance use disorders and experience long-term recovery,” HHS Assistant Secretary for Mental Health and Substance Use Miriam E. Delphin-Rittmon, Ph.D. said in an announcement. “This is a need that preceded the Covid-19 pandemic and has only grown more urgent over the course of the past 18 months,” added Rittmon, who leads SAMHSA. Click here to see a full list of the grant recipients.

Kaiser Family Foundation Examines Pandemic’s Effects on Parents and Children 

A new report from the Kaiser Family Foundation has found that 36% of parents say their child fell behind in their social and emotional development, and about 29% said their child experienced mental health or behavioral health problems due to the Covid-19 pandemic. Kaiser’s latest Covid-19 Vaccine Monitor examines the pandemic’s effects on children’s academic and social development as a new school year approaches. Among the study’s notable conclusions is a finding that parents whose children attended school all or mostly online, or who had a mix of online and in-person schooling, were more likely than parents whose child attended school all or mostly in-person to say they had a child who had these adverse effects, even after controlling for other demographic factors and type of school setting. The study also showed that 42% of parents reported that their children experienced at least one new mental health symptom in the past 12 months that they had not experienced before the pandemic, including difficulty concentrating on schoolwork (27%), problems with nervousness or being easily scared or worried (19%), trouble sleeping (18%), poor appetite or overeating (15%), and frequent headaches or stomachaches (11%).

SAMHSA Releases Guide About Report to Congress on Preventing and Reducing Underage Drinking

SAMHSA has released a user’s guide about the agency’s report to Congress on how to prevent and reduce underage drinking. The brief resource provides an overview of the report for prevention professionals, state and local agencies, and community-based organizations.

Ohio State Seeks Providers for Study on Traumatic Brain Injury Screening in Behavioral Healthcare Organizations 

The Ohio State University College of Social Work is conducting a study to understand behavioral health providers’ attitudes and beliefs about screening for traumatic brain injury (TBI) in behavioral healthcare organizations. The university is currently seeking licensed behavioral health providers in the United States (i.e., psychologists, social workers, counselors, nurses, psychiatrists) to participate in this web-based study. Survey respondents will be asked to complete an online training on how to screen for TBI (approximately 30-45 minutes) and complete a 15-minute survey. Participants will receive a certificate of completion for one continuing education (CE) credit for completing the training, and also will be enrolled for the chance to win a $50 gift card. There will be 55 winners from the gift card drawing. The National Institute of Neurological Disorders and Stroke is funding the study (Grant #1F31NS124263-01), and Ph.D. candidate Kathryn A. Coxe is leading it. For additional information or questions, please contact Kathryn at: coxe.6@osu.edu. Click here to participate in the study.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance. Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them. Click here to learn more, including information about special healthcare system discounts.

Center for Rural Opioid Prevention, Treatment & Recovery to Host Webinar Aug. 31

The Center for Rural Opioid Prevention, Treatment & Recovery (CROP+TR) will host a webinar later this month to review the prevalence of methamphetamine use and co-use with opioids, the effect of methamphetamine on the health of people with opioid use disorder, and potentially effective interventions for methamphetamine. The webinar will be held on Tuesday, Aug. 31 at 4 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Individuals who experience early episode psychosis (EEP) were more likely to visit the emergency department for mental health related issues and to have an inpatient psychiatric hospital stay than those with late episode psychosis (LEP), according to research published in Psychiatric Services this month. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Miriam Delphin-Rittmon Sworn in As Assistant Secretary for Mental Health and Substance Use

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced that Miriam Delphin-Rittmon, Ph.D., former commissioner of the Connecticut Department of Mental Health and Addiction Services, is the new assistant secretary for mental health and substance use and agency’s administrator. In May 2014, Delphin-Rittmon completed a two-year White House appointment working as a senior adviser to the then-assistant secretary for mental health and substance use and SAMHSA administrator. “Miriam’s experience in creating and administering mental health, substance use, and prevention services and systems will serve the nation well as we work to tackle the impact of the pandemic on behavioral health,” HHS Secretary Xavier Becerra said in a statement. “On top of that, her strong leadership at federal, state and local levels offers her considerable perspective,” he added. Delphin-Rittmon earned her bachelor’s degree in social science from Hofstra University in 1989, and her master and doctoral degrees in clinical psychology from Purdue in 1992 and 2001, respectively. Click here to read her full biography.

Experts Provide Advice and Templates on Writing a Medical Necessity Letter

Authors with medical, legal, public policy, and personal experience have published advice in the Journal of Psychiatric Practice on how to provide a routine, medical necessity letter as a way to improve access to care. Mark DeBofsky, M.D., Joseph Feldman, M.B.A., NABH member Eric Plakun, M.D., and Cheryl Potts, M.B.A. authored the eight-page article, which also includes a template letter for providers.

JAMA Psychiatry Publishes Study on Contingency Management for Patients Receiving Medication for OUD

JAMA Psychiatry this week published a study of the results from an investigation of contingency management for patients who receive medication for opioid use disorder (MOUD). The purpose of the study was to examine the association of contingency management, a behavioral intervention in which patients receive material incentives contingent on objectively verified behavior change, with end-of-treatment outcomes related to stimulant use, polysubstance use, illicit opioid use, cigarette smoking, therapy attendance, and medication adherence The study’s authors noted that the results provide evidence that supports using contingency management in addressing key clinical problems among patients receiving MOUD, including the ongoing problems of comorbid psychomotor stimulant misuse. The study importantly notes that a) CM is most effective with higher earnings potential, confirming that the level of financial incentives are critical to the success of the intervention; b) cases of Medicaid fraud have never been found involving CM; and c) targeting too many drugs simultaneously decreases the effect size, although the effect remains statistically significant. “Policies facilitating integration of contingency management into community MOUD services are sorely needed,” the authors wrote.

CMS to Host Webinar on Price Transparency on Wednesday, Aug. 11 

CMS will host a Medicare National Stakeholder Webinar on Price Transparency next week to discuss how hospitals can meet the requirements of the Hospital Price Transparency Final Rule that became effective on Jan. 1, 2021. As a result of the rule, U.S. hospitals are required to 1) provide publicly accessible standard charge information online about the items and services with a comprehensive machine-readable file with all items and services, and 2) a display of 300 shoppable services in a consumer-friendly format. The agency will review the document “8 Steps to a Machine-Readable File of All Items & Services” and highlight both good and bad examples of hospital compliance. CMS will host the webinar on Wednesday, Aug. 11 from 2 p.m. to 3:30 p.m. ET. Click here to register.

SAMHSA to Host Virtual Roundtable about Creating a Diverse Behavioral Health Workforce on Aug. 18 

SAMHSA’s National Network to Eliminate Disparities in Behavioral Health will host a virtual roundtable later this month to discuss strategies that motivate racially and ethnically diverse individuals to consider behavioral healthcare as a career path. The event will address how community-based organizations are working to diversify the behavioral health workforce, such as recruiting and retaining a racially and ethnically diverse staff. SAMHSA will host the virtual roundtable on Wednesday, Aug. 18 at 1 p.m. ET. Click here to learn more and register.

Joint Commission to Start 11-part Behavioral Healthcare Accreditation Webinar Series on Aug. 28 

The Joint Commission will present an 11-part Behavioral Healthcare and Human Services Accreditation Webinar Series to help providers prepare their staffs to maintain compliance. Session topics include information management, medication management, infection prevention and control, patient safety, environment of care, and more. The Joint Commission will present the series—which will be made available Aug. 28—on demand so that organization teams can view the webinars when it’s convenient for them. Click here to learn more, including information about special healthcare system discounts.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

In 2019, 22.1% of U.S. adults with chronic pain used a prescription opioid in the past three months, according to a new report from the Centers for Disease Control and Prevention.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS to Raise IPF PPS Payment Rates by 2% in 2022

The Centers for Medicare & Medicaid Services (CMS) said it will update payment rates for IPFs by 2.0% next year in the fiscal year (FY) 2022 Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) final rule the agency released Thursday. The calculation is based on the final IPF market basket estimate of 2.7% less a 0.7 percentage point productivity adjustment. CMS said it will also update the outlier threshold to maintain outlier payments at 2% of total payments, which will result in a 0.1% overall increase to aggregate payments. CMS said it estimates total payments to IPFs to increase by 2.1%, or about $80 million, in 2022 compared with payments in 2021. The final rule also made updates to the Inpatient Psychiatric Facility Quality Reporting Program (IPF QRP), including a final proposal to adopt the Covid-19 Vaccination Coverage Among Healthcare Personnel (HCP) measure to the IPF QRP for the FY 2023 payment determination. The Centers for Disease Control and Prevention (CDC) developed the process measure to track Covid-19 vaccination coverage among HCP in IPFs. The measure will be reported using the Covid-19 Modules on the CDC’s National Healthcare Safety Network web portal. In addition, the final rule said that for the FY 2024 payment determination, CMS is finalizing its proposal to adopt the Follow-up After Psychiatric Hospitalization (FAPH) measure to the IPF QRP. This measure uses an expanded cohort based on the Follow-up After Hospitalization for Mental Illness (FUH) measure—which is currently in the IPF QRP—to include patients with substance use disorders. The final rule also said CMS is not finalizing removal of the Alcohol Use Brief Intervention Provided or Offered and Alcohol Use Brief Intervention (SUB-2/2a) measure or the Tobacco Use Treatment Provided or Offered and Tobacco Use Treatment (TOB-2/2a) measure. This was a response to public comments that indicated these measures still provide benefits that outweigh the costs of retaining them in the IPF QRP measure set. More information is available in the agency’s fact sheet, and the final rule will be published in the Federal Register on Wednesday, Aug. 4.

NABH and Other Advocacy Groups Urge Congress to Invest in Children’s Mental Health

NABH and more than two dozen other advocacy organizations sent a letter to Senate leaders this week urging federal lawmakers to invest more funding in children’s mental health. The letter recommended that Congress strengthen Medicaid; extend and preserve telehealth flexibilities; strengthen systems of care through better coordination and integration; invest in infrastructure to promote care in the appropriate setting; and support growing the pediatric mental health workforce. The Children’s Hospital Association spearheaded the letter, and other organizations that signed on include the American Academy of Family Medicine, the American Academy of Pediatrics, the American Hospital Association, the American Association of Medical Colleges, Mental Health America, and the National Alliance on Mental Illness.

CMS to Host Webinar on Price Transparency on Wednesday, Aug. 11

CMS will host a Medicare National Stakeholder Webinar on Price Transparency to discuss how hospitals can meet the requirements of the Hospital Price Transparency Final Rule that became effective on Jan. 1, 2021. As a result of the rule, U.S. hospitals are required to 1) provide publicly accessible standard charge information online about the items and services with a comprehensive machine-readable file with all items and services, and 2) a display of 300 shoppable services in a consumer-friendly format. The agency will review the document “8 Steps to a Machine-Readable File of All Items & Services” and highlight both good and bad examples of hospital compliance. CMS will host the webinar on Wednesday, Aug. 11 from 2 p.m. to 3:30 p.m. ET. Click here to register.

SAMHSA Resource Summarizes How States Regulate Underage Drinking 

The Substance Abuse and Mental Health Resources Administration (SAMHSA) has released Learn the Law: How Does Your State Prevent Underage Drinking?, a new publication that includes 24 legal policy summaries to help people track how states regulate underage drinking as a way to help inform prevention work.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Regardless of the primary medical risk factors for severe Covid-19, patients with mental illness were more likely to die of Covid-19 than their peers, according to new research consisting of 16 observational studies from seven countries that involved more than 19,000 patients.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

CMS Accepting Grant Applications for SUPPORT Act Demonstration Project

The Centers for Medicare & Medicaid Services (CMS) on Friday released a notice of funding opportunity to solicit applications for the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment Act (SUPPORT) 36-month demonstration project. Open only to the 15 states receiving planning grants, the demonstration project is intended to increase treatment capacity of Medicaid-participating providers to provide substance use disorder (SUD) treatment and recovery services. CMS also released a technical supplement that provides information about how the agency will implement the SUPPORT Act payment provision for those states selected for the demonstration. The agency will host an informational webinar for applicants on Thursday, July 29 (and will provide information on that later) and is expected to issue awards on Sept. 10. The period of performance is between September 2021 and September 2024.

Survey Shows 84% of Americans Want to Continue Receiving Mental Health Treatment via Telehealth After Pandemic

A recent online survey of more than 1,000 Americans shows that 74% of respondents said their provider made virtual mental health services available during the Covid-19 pandemic, while 84% said they want to continue receiving mental health treatment via telehealth services after the pandemic ends. Market research company Propeller Insights conducted the survey on behalf of DrFirst, which published a survey last October that found 44% of Americans used telehealth services during the pandemic, although some admitted they multitasked and did not pay close attention during their appointments. In the May 2021 survey, 68% of respondents said the pandemic had worsened their mental health, while 17% said they sought mental health assistance for the first time.

NABH Sends Comments to ONDCP on National Drug Control Strategy

NABH this week provided a series of recommendations to the Office of National Drug Control Policy (ONDCP) on the office’s biennial National Drug Control Strategy. In a letter to Regina LaBelle, ONDCP’s acting director, NABH offered detail suggestions related to telehealth and the Covid-19 pandemic, Medicare and Medicaid, contingency management, workforce management, and medication assisted treatment (MAT). “The Centers for Medicare & Medicaid Services (CMS) should review Medicare, Medicare Advantage, and Qualified Health Plan reimbursement levels and strategies for substance use treatment services (for telehealth and non-telehealth services alike) to bring reimbursement for addiction providers to levels that are more consistent with their education, credentialing, and medical peers,” NABH President and CEO Shawn Coughlin wrote, adding later that Medicare should cover all intermediate levels of care for addiction treatment (e.g., freestanding intensive outpatient, partial hospitalization, residential) for substance use disorders and reimburse facility fees; collaborate with stakeholders to establish new conditions of participation. Other suggestions include recommending that all workforce data collection and reporting efforts at the U.S. Labor Department separate substance use from mental health providers and services, and that the U.S. Justice Department assure individuals with a substance use disorder have access to all forms of MAT while in jail and prison.

NABH Asks OSHA to Delay ETS Compliance Deadline

NABH on July 1 sent a letter to the U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) requesting that the agency delay the compliance deadline for its workplace safety rule. Last month OSHA released the rule, known as the Covid-19 Health Care Emergency Temporary Standard (ETS), to protect workers from exposure to the virus that causes Covid-19. Essential requirements of the ETS include, but are not limited to: developing and implementing a plan for each workplace; designating workplace safety coordinator(s), knowledgeable in infection control principles and practices, with the authority to implement, monitor, and ensure compliance with the plan; conducting a workplace-specific hazard assessment; and seeking the involvement of nonmanagerial employees and their representatives in the hazard assessment and plan’s development and implementation. “The new Covid-19 ETS final rule is long and complex,” NABH President and CEO Shawn Coughlin wrote in the association’s letter to James Frederick, acting assistant secretary of labor at OSHA. “It establishes many very specific requirements related to patient screenings, personal protective equipment, physical barriers, cleaning and disinfection, ventilation, vaccination, training, recordkeeping, reporting, etc. These provisions will likely require significant changes in the policies and procedures healthcare providers have already implemented to prevent Covid-19 infection.” The letter also said it’s important to consider the effects of the new requirements in the context of the challenges behavioral healthcare providers are currently facing. “Mental health and addiction treatment providers continue to experience increased need for their services as indicated by the dramatic increase in drug overdose deaths over the past year and continued elevated levels of anxiety and depression and suicidal ideation,” the letter said, adding that emergency department visits for mental health reasons were up 31% among children and adolescents earlier this year, and suspected suicide attempts were up 51% among teenage girls. NABH requested that OSHA delay the compliance deadline for the ETS—which became effective immediately when it was published in the Federal Register on June 17— for at least an additional six months.

SAMHSA to Host Third Webinar on Future of Telehealth Services in Drug Courts on July 21

The Substance Abuse and Mental Health Services Administration (SAMHSA) will host the final installment of its virtual learning community series on the future of telehealth services in drug courts on Wednesday, July 21. This last part of this three-part series will provide guidance on what to consider when delivering treatment court services in virtual formats, including both court proceedings and treatment services. The webinar will also feature a brief review of essential services elements, policies, and procedures necessary to support effective delivery, as well as strategies for ongoing quality assurance and ideas on how to track appropriate outcomes. The webinar will be held on Wednesday, July 21 at 1 p.m. ET, and a discussion segment will follow at 2 p.m. ET. Click here to register.

Reminder: NABH Denial-of-Care Portal is Open to Members

NABH’s Denial-of-Care Portal is a new resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

Register Today for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A new study in JAMA Psychiatry found that of the 14.1 million adults reported having alcohol use disorder (AUD), only 7.3% reported receiving any AUD treatment, and an even smaller percentage—1.6%–reported using medications for AUD.

NABH Introduces Denial-of-Care Portal for Members

NABH this week introduced the NABH Denial-of-Care Portal, a resource for members to provide information about their experiences with managed care organizations that impose barriers to care through insurance-claim denials. NABH’s Managed Care Committee has worked for more than a year to develop the Denial-of-Care Portal as a way to collect specific data on insurers who deny care—often without regard for parity or the effects on patients. This NABH member-only, survey-like tool allows users to add the name of a managed care organization, type of plan, level of care, type of care (mental health or substance use disorder), duration of approved treatment, duration of unapproved treatment, criteria used to deny a claim, and more. The portal allows members to submit individual examples of claim denials or upload multiple entries via Excel. It also includes sections on appeals and physician participation. In time, the tool could be a valuable resource for the NABH team’s advocacy efforts. “One of the best ways we can advocate for parity enforcement with policymakers and regulators is to provide hard data from our members that show how insurers are not complying with the landmark 2008 parity law,” said NABH President and CEO Shawn Coughlin. “We hope to gather this critical data through our new Denial-of-Care Portal.” Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions about the portal.

LifePoint Health to Acquire Kindred Healthcare

Brentwood, Tenn.-based LifePoint Health and Louisville, Ky.-based Kindred Healthcare announced they have entered into an agreement for LifePoint to acquire Kindred in a deal expected to close in the fourth quarter of 2021. The deal will provide LifePoint with opportunities to “develop and expand critical behavioral health services across the country,” the companies said in a joint news release. LifePoint owns and operates community hospitals, regional health systems, physician practices, outpatient centers, and post-acute facilities nationwide, while Kindred is a specialty hospital company that delivers acute health services in long-term, acute-care hospitals, inpatient rehabilitation hospitals, acute rehabilitation units, and its behavioral health line business, all of which specialize in treating the most medically complex patients. Kindred Behavioral Health is an NABH member.

SAMHSA Distributes $3.3 Million in Garrett Lee Smith Campus Suicide Prevention Grants

The Substance Abuse and Mental Health Services Administration (SAMHSA) has released $3.3 million in grant awards to 33 colleges through the agency’s Garrett Lee Smith Campus Suicide Prevention grant program. The program is named after former Sen. Gordon Smith’s (R-Ore.) son Garrett Lee Smith, who died by suicide at age 21 in 2003. In 2004, President George W. Bush signed the Garrett Lee Smith Memorial Act, which authorized $82 million for suicide-prevention and awareness programs at the nation’s colleges. The Biden administration is strengthening the program through American Rescue Plan of 2021 funding, which enables SAMHSA to expand the program’s reach by eight colleges. “This grant program provides crucial support to college and university communities at a critical time,” Acting Assistant Secretary for Mental Health and Substance Use Tom Coderre said in an announcement. “Pre-pandemic, college had already been a time and environment where young adults often experienced the onset or worsening of mental health problems,” he added. “The Covid-19 pandemic has exacerbated mental health crises for adolescents and young adults. We want this grant program to provide needed supports to as many students as possible, and we are grateful for the infusion of American Rescue Plan funding to strengthen that support.”

DEA to Publish Mobile Methadone Rule on June 28

The Drug Enforcement Administration (DEA) announced it will publish the final “mobile methadone” rule on Monday, June 28. The final rule will allow narcotic treatment programs (NTPs) to operate mobile components as a coincident activity permitted under the NTP’s registration. Based on these revisions, NTP registrants who operate mobile component to dispense narcotic drugs in schedules II-V at remote location(s) for maintenance or detoxification treatment do not need a separate registration for such mobile components. This final rule waives the requirement of a separate registration at each principal place of business or professional practice where controlled substances are dispensed. Operation is permitted only in the state where the registrant is registered.

LaBelle Says Biden Administration Supports Legislation to Eliminate Federal Crack and Powder Cocaine Sentencing Disparity

Regina LaBelle, the acting director of the White House Office of National Drug Control Policy, testified in a Senate Judiciary Committee hearing this week that the Biden administration supports legislation that would eliminate the disparity in sentencing between crack and powder cocaine, which she said disproportionately affects people of color. Sens. Dick Durbin (D-Ill.) and Cory Booker (D-N.J.), both members of the Senate Judiciary Committee, introduced the Eliminating a Quantifiably Unjust Application of the Law Act (EQUAL) in late January. The bill aims to eliminate the crack and powder cocaine sentencing disparity and ensure that those who were convicted or sentenced for a federal offense involving cocaine can receive a re-sentencing under the new law. NBC News reported that LaBelle told the Senate panel that “The current disparity is not based on evidence; it has caused significant harm for decades, particularly for individuals, families and communities of color,” and is “a significant injustice in our legal system.”

OSHA Releases Fact Sheet and Guidance on Covid-19 Healthcare ETS

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) this week released a fact sheet about OSHA’s Covid-19 Healthcare Emergency Temporary Standard (ETS) that was published in the Federal Register this month. OSHA also published additional guidance and implementation information about the ETS. To learn more about the ETS, please see the June 11 edition of CEO Update.

CMS Publishes Frequently Asked Questions on Interoperability and Patient Access Rule

CMS published Frequently Asked Questions (FAQs) on various topics related to the agency’s May 2020 Interoperability and Patient Access final rule. The FAQs include additional guidance about the Admission, Discharge, and Transfer Patient Event Notification Conditions of Participation that apply to America’s psychiatric hospitals.

DEA Hires McCance-Katz as Legislative Policy Analyst

Elinore McCance-Katz, M.D., Ph.D., who served as the assistant secretary for mental health and substance use in the Trump administration, is now a senior civil servant in the Drug Enforcement Agency (DEA). DEA has hired McCance-Katz as a legislative policy analyst focused on drug diversion, or the illegal use of drugs. According to reports, officials said the role is GS-15, the highest level under the federal General Schedule, and it positions McCance-Katz to help shape the Biden administration’s strategy on drug enforcement. President Biden’s nominee to run DEA, former New Jersey Attorney General Anne Milgram, is still awaiting Senate confirmation.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Since 9/11, four times as many U.S. service members and veterans have died by suicides than have been killed in combat, according to a new report from Brown University.

CEO Update Will Publish Next on Friday, July 9

NABH will not publish CEO Update next Friday, July 2 and will publish the next issue on Friday, July 9. 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 Awards Grant to Vibrant Emotional Health to Administer 988 Crisis Hotline

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week announced Vibrant Emotional Health will be the administrators for the new 988 dialing code for the National Suicide Prevention Lifeline that will be available in July 2022. A pair of SAMHSA grants totaling $48 million—including $32 million in Coronavirus Response and Relief Supplemental Appropriations Act 2021 funding—will finance the effort to use technology to help Americans in mental health crisis and save lives. Vibrant has administered the lifeline since it was created in 2005. “These grants will work to expand the nation’s call centers’ capacity and technological readiness as the Lifeline’s shift to 988 becomes operational next summer,” Tom Coderre, acting assistant secretary for mental health and substance use and the interim head of SAMHSA, said in announcement. “Until that launch, we ask anyone who needs help or who has a loved one at risk of suicide to call or chat with Lifeline operators at 1-800-273-8255.”

Senate Finance Committee Examines Integrated Payment Models for Primary and Mental Healthcare

The Senate Finance Committee this week held a hearing to discuss mental healthcare in America and payment models that integrate mental health with primary care. In his prepared statement, Senate Finance Committee Chairman Ron Wyden (D-Ore.) said every American who needs mental healthcare should have it, “but the shameful reality is, the United States does not come close to meeting that bar today. Multiple federal laws say that mental healthcare is supposed to be on a level playing field with physical health care,” Wyden’s statement continued. “In practice, however, the system still reflects the dangerous, old stigma against recognizing and treating mental illness, and that’s why millions of people are falling through the cracks.” Members of the influential Senate panel heard from the executive director of the Wallowa Valley Center for Wellness Clinic in Oregon, one of the state’s dozen Certified Community Behavioral Health Clinics, which provides same-day treatment to patients through an integrated primary and mental healthcare model. A Modern Healthcare story reported that while the funding for the model—which comes from an enhanced Medicaid reimbursement rate based on expected costs of care—is not permanent, emergency department admissions for mental health in Wallowa County is down and the amount of veterans accessing behavioral healthcare is up 300% since the demonstration began.

NABH and Other Healthcare Groups Send Letter to United Healthcare About ED Policy

NABH was one of more than 30 healthcare and medical organizations this week that sent a letter to United Healthcare CEO Brian Thompson about the insurance company’s new policy to allow for the retroactive denial of coverage for emergency care in hospital emergency departments (EDs). The new policy will have serious medical consequences for patients, and the groups requested that United rescind the policy permanently. “Even before the Covid-19 pandemic, the need for access to mental healthcare and substance use services was reaching crisis levels,” the letter said. “In 2019, less than half of adults with mental health conditions received services, and nearly 90% of those with a substance use disorder did not receive treatment. EDs around the country often serve as the only safety net for a fragmented mental health infrastructure,” it continued. “For those in crisis for whom the ED is a lifeline for care, an added threat of a retroactive denial of coverage under this policy can be devastating.” Other groups that signed the letter include the American College of Emergency Physicians, the American College of Surgeons, the American Medical Association, the Emergency Nurses Association, the Federation of American Hospitals, The Kennedy Forum, and the Well Being Trust.

SAMHSA to Host Webinar on Behavioral Health Disorders and the Criminal Justice System on July 6

SAMHSA will host a webinar about strategies to create community-based crisis systems for people with behavioral health disorders who are at risk for involvement with the criminal justice system. The webinar will be held Tuesday, July 6 from 3:30 p.m. to 5:30 p.m. ET. Click here to register.

Register Today for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

In a new study of nearly 43,000 adults who responded to a national survey on drug and alcohol use in 2019, researchers found that roughly 6% had alcohol use disorder, fewer than 10% of whom reported receiving any treatment for their condition. The authors suggest the findings highlight the need for more even access to medication for alcohol use disorder. For questions or comments about this CEO Update, please contact Jessica Zigmond.

OSHA Releases Covid-19 Workplace Safety Rule for Healthcare Workers

The U.S. Labor Department’s Occupational Safety and Health Administration (OSHA) on Thursday released a workplace safety rule intended to protect workers from exposure to SARS-Cov-2, the virus that causes Covid-19. Called an Emergency Temporary Standard (ETS), the rule applies only to workers in healthcare settings, a disappointment for unions and other workplace safety advocates. Essential requirements of the ETS include, but are not limited to: developing and implementing a plan for each workplace; designating workplace safety coordinator(s), knowledgeable in infection control principles and practices, with the authority to implement, monitor, and ensure compliance with the plan; conducting a workplace-specific hazard assessment; and seeking the involvement of nonmanagerial employees and their representatives in the hazard assessment and plan’s development and implementation. The ETS also includes requirements about personal protective equipment, physical distancing, cleaning and disinfection, training, vaccination, ventilation, and more. Click here for more information in OSHA’s summary of the rule.

Senators Murphy and Cassidy Introduce The Parity Implementation Assistance Act

Senators Chris Murphy (D-Conn.) and Bill Cassidy, M.D. (R-La.) this week introduced The Parity Implementation Assistance Act to offer incentives to states to comply with mental health parity requirements. The bill would authorize $25 million in grants for states to support their oversight efforts of health insurance plans’ compliance with parity. The new legislation builds on the Murphy-Cassidy Mental Health Parity Compliance Act of 2019, which became law last year and provided federal and state health insurance regulators with additional resources to monitor and assure compliance with mental health parity laws. U.S. Reps. Tony Cárdenas (D-Calif.) and Brian Fitzpatrick (R-Pa.) are introducing a companion bill in the House. “We applaud Senators Murphy and Cassidy and Representatives Cárdenas and Fitzpatrick for their continued leadership and steadfast commitment to improving compliance with MHPAEA,” NABH President and CEO Shawn Coughlin said in the senators’ joint news release about the bill this week. “The Parity Implementation Assistance Act would provide critically needed resources to state regulators so they can improve parity enforcement using the new documentation requirements,” he added.

Americans Identify Affordability and Provider Availability as Biggest Barriers to Accessing Care

A new Bipartisan Policy Center-Morning Consult national poll found that 51% of Americans surveyed cited affordability and 41% cited availability of providers taking new patients as the two biggest barriers to accessing the care they need. Meanwhile, a majority of Americans (58%) said the cost of a provider and whether the provider is in their insurance network (58%) are their top priorities when seeking treatment. “This survey shows that we must tackle the high cost and the enormous shortage of mental health professionals in our country by advancing the integration of primary care and mental health and substance use services,” Marilyn Serafini, the Bipartisan Policy Center’s health project director, said in an announcement about the poll. “We know integrated care works. It enhances treatment, improves outcomes, and is cost effective.”

MHA Names Schroeder Stribling as New President and CEO 

Mental Health America this week named Schroeder Stribling as the community-based, not-for-profit’s new president and CEO, effective June 28. Stribling will start her new role after 18 years at N Street Village, a not-for-profit that provides housing support services for women and families in Washington, D.C.  Most recently Stribling served as N Street Village’s CEO and helped the organization expand to eight locations from one. She also helped diversify revenue streams, create partnerships with government entities, and lead city-wide initiatives on homelessness. Before her time at N Street Village, Stribling was a senior social worker at Johns Hopkins Bayview Hospital, where she was responsible for implementing new mental health programs in the inner-city Head Start school system. Stribling earned a bachelor’s degree in political science from Wellesley College, a master’s degree in social work from Smith College, and a certificate in nonprofit management from Georgetown University.

Forbes Reports Venture Funding for Mental Health Hits Record High

Venture investors poured a record $1.5 billion into mental health startups in 2020, as 42% of U.S. adults reported symptoms of anxiety or depression, compared with about 11% who reported those symptoms in 2019, according to a recent article in Forbes. The article notes there are now seven mental health unicorns in the United States, up from only two a year ago. In venture capital, a unicorn is a privately held company valued at more than $1 billion. Forbes identifies the U.S.-based mental health unicorns as Genoa ($2.5 billion), Lyra Health ($2.3 billion), Calm ($2 billion), BetterUp ($1.7 billion), Talkspace ($1.4 billion), Modern Health ($1.4 billion), and Ginger ($1.1 billion). “I hope that the interest in mental health is now persistent,” Lisa Suennen, a healthcare investor who leads the venture fund at law firm and consultancy Manatt, Phelps & Phillips, said in the article. Suennen added that both the funding surge and ballooning valuations concern her. “Some of these valuations are beyond appropriate given the underlying fundamentals,” Suennen said. “And that’s not unique to mental health, that’s digital health across the board right now.”

AMA and Advocacy Resource Center Highlight National and State Research on America’s Overdose Crisis

The American Medical Association and Advocacy Resource Center have released a nearly 30-page issue brief that aggregates data on the nation’s drug overdose crisis from national, state, and local public health agencies, law enforcement, emergency medical services, hospitals, treatment centers, journals, and the media. Every state has reported an increase in overdose deaths during the Covid-19 pandemic, according to the issue brief.

HRSA Announces New Education Loan Repayment Program 

The U.S. Health Department’s Health Resources and Services Administration (HRSA) announced a new loan repayment program that broadens the types of providers and facilities that are eligible to participate and provides a higher rate of repayment.   The STAR-LRP will provide repayment of education loans for individuals working in a full-time substance-use disorder (SUD) treatment job that involves direct patient care at a STAR LRP-approved facility located in either a Health Professional Shortage Area (HPSA) designated for Mental Health, or a county/municipality where the average drug overdose death rate exceeds the national average. Participants will receive up to $250,000 in exchange for six years of full-time SUD employment (including fellowship) that involves direct treatment or recovery support of patients with or in recovery from a substance use disorder. The program expands access to SUD treatment through the inclusion of disciplines and treatment facilities that are not eligible for existing loan repayment programs. The STAR-LRP is open to master’s level social workers, psychologists, counselors, marriage and family therapists, psychiatric mental health practitioners, occupational therapists, psychology doctoral interns, and behavioral health paraprofessionals and physicians, physician assistants, and nurses, who are involved full-time in SUD treatment employment (including fellowships). Among the eligible facilities are for-profit programs, including but not limited to inpatient psychiatric facilities, inpatient rehabilitation, non-opioid SUD Treatment facilities, opioid treatment programs, office-based opioid treatment, outpatient rehabilitation. HRSA anticipates making $28 million available to fund approximately 112 loan repayment awards in FY 2021. Applications are due by July 22, 2021, 7:30 p.m. ET.

DOJ Accepting Applications for Opioid, Stimulant, and Substance Abuse Program Training and Technical Assistance Program

The U.S. Justice Department’s Office of Justice Programs and Bureau of Justice Assistance will accept grant applications for its Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) Training and Technical Assistance Program through Monday, June 21. The program’s purpose is to identify one provider to support a collaborative team and coordinate training and technical assistance for state, tribal, and local criminal justice and substance abuse treatment agencies and their partner agencies for more than 400 COSSAP site-based programs. Click here to learn more and to apply.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

Nearly one in four older U.S. adults between the ages of 50 and 80 reported they had three or more alcoholic drinks in one sitting, according to a new poll from the University of Michigan’s National Poll on Healthy Aging.

President Biden’s $6 Trillion Budget Proposal Includes Funding Increases for SAMHSA

President Biden’s $6 trillion budget proposal for 2022 includes significant funding increases for several Substance Abuse and Mental Health Services Administration (SAMHSA) programs, including a $1.65 billion increase—including 10% set aside for recovery services—for the agency’s Substance Abuse Prevention, Treatment, and Recovery Block Grant for a total of about $3.51 billion in that program. The president’s budget—notable for mapping out the president’s priorities—also includes:

• An $825-million funding increase for SAMHSA’s Community Mental Health Services Block Grant for a total of $1.58 billion, with $75 million set aside for crisis-stabilization services,

• $750-million increase in State Opioid Response grants for a total of $2.25 billion,

• An additional $125 million for Certified Community Behavioral Health Clinics,

• A $78-million increase for the National Suicide Prevention Lifeline for a total of $102 million to prepare for the nation’s “988” behavioral health crisis hotline, and

• $4.4-million increase for opioid treatment programs for a total of $13.1 million.

The budget also includes a $27-million increase for the U.S. Labor Department’s Employee Benefits and Security Administration to enforce the Mental Health Parity and Addiction Equity Act.

CMCS Releases Bulletin on American Rescue Plan’s Medicaid, CHIP, and BHP Provisions

The Center for Medicaid and CHIP Services (CMCS) this week released a bulletin that provides information to states on the Medicaid, CHIP, and Basic Health Program (BHP) provisions in the American Rescue Plan. Part of the guidance includes section 9813, the “State Option to Provide Qualifying Community-Based Mobile Crisis Intervention Services,” which adds a new section to the Social Security Act and provides states the option to provide for certain “qualifying community-based mobile crisis intervention services” to be covered under the Medicaid state plan or a waiver of such plan during a five-year period beginning on April 1, 2022. In addition, the bulletin said states will be eligible for a federal matching rate of 85% for qualifying community-based mobile crisis intervention services during each of the first 12 fiscal quarters between April 1, 2022 through March 31, 2027, in which a state meets the requirements in the statute. This provision also provides funding for the HHS secretary to issue planning grants to states to develop state plan amendments or waiver requests to provide such qualifying community-based mobile crisis intervention services. CMCS said it plans to issue additional guidance in the coming months on certain provisions and is available to provide states with technical assistance as they begin to implement these changes.

EEOC Releases Updated Guidance Regarding Covid-19 Vaccinations, Incentives

The U.S. Equal Employment Opportunity Commission (EEOC) recently released its first updated guidance about Covid-19 vaccinations since December 2020. The new guidance addresses mandatory vaccination policies, employer-provided vaccine incentives, confidentiality, and accommodating workers who may be unwilling or unable to obtain a vaccination. Click here to read a summary of the provisions.

National Guard Officers to Provide Temporary Staffing at Oregon State Hospital

The Oregon State Hospital will begin training 30 members of the National Guard on Monday to fill an unprecedented staffing shortage at the Salem-based psychiatric hospital, according to a news report in The Oregonian. National Guard members will spend about two weeks learning how to work directly with patients, including training on de-escalation and behavioral emergencies. The story noted that the National Guard will help serve patient meals, escort patients to and from treatment, and with other activities on the unit. The state hospital has faced a staffing shortage since last year when employees began taking Covid-19-related leave.

Kennedy Forum to Host June 7 Webinar on Future of Mental Healthcare

The Kennedy Forum will feature Mental Health America CEO Paul Gionfriddo and National Alliance on Mental Illness CEO Daniel Gillison, Jr. in a webinar about the future of mental healthcare on Monday, June 7. Other panelists will include Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.); Peter O’Brien, chairman of The Kennedy Forum Illinois; and Cheryl Potts, executive director at The Kennedy Forum Illinois. The webinar will begin at 2 p.m. ET. Click here to register.

DOJ Accepting Applications for Opioid, Stimulant, and Substance Abuse Program Training and Technical Assistance Program

The U.S. Justice Department’s Office of Justice Programs and Bureau of Justice Assistance will accept grant applications for its Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) Training and Technical Assistance Program through Monday, June 21. The program’s purpose is to identify one provider to support a collaborative team and coordinate training and technical assistance for state, tribal, and local criminal justice and substance abuse treatment agencies and their partner agencies for more than 400 COSSAP site-based programs. Click here to learn more and to apply.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

New research from Athenahealth shows women were twice as likely as men to receive a diagnosis of anxiety from their primary care provider (6.5% versus 3.3%), and were also diagnosed with depression at twice the rate (4.2% versus 2.1%). For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH Submits Comments on IPF-PPS FY 2022 Proposed Rule NABH on Friday submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the agency’s inpatient psychiatric facility (IPF) prospective payment system (PPS) proposed rule for fiscal year 2022. The eight-page letter provided an overview of how the Covid-19 pandemic has led to an increasing need for quality mental health and addiction treatment in America, and how previous pandemics have had an effect on behavioral health for years to come. NABH offered comments on labor market delineations, the wage index, and several issues related to the Inpatient Psychiatric Facility Quality Reporting Program. CMS will accept public comments until Monday, June 7. U.S. Senate Confirms Chiquita Brooks-LaSure as CMS Administrator In a 55-44 vote, the U.S. Senate this week confirmed Chiquita Brooks-LaSure to lead CMS as the agency’s administrator. Most recently Brooks-LaSure served as the managing director of the health division at Manatt, Phelps & Phillips. Previously she served as the director of coverage policy at the U.S. Health and Human Services Department (HHS) during the Obama administration, where she led implementation of the Affordable Care Act’s coverage and insurance reform policy provisions. Earlier, the Senate Finance Committee had split evenly on whether to advance Brooks-LaSure’s nomination, with all Republicans on the panel not supporting her. Senate Majority Leader Chuck Schumer (D-N.Y.) was able to bring her nomination vote to the Senate floor through a procedural vote.

HHS Commits $4.8 Billion to Reimburse Providers for Covid-19 Testing for the Uninsured

HHS this week announced it will dedicate $4.8 billion from the American Rescue Plan to support the Health Resources and Services Administration’s (HRSA) Covid-19 Uninsured Program. Specifically, the funding will allow the program to reimburse healthcare providers for testing uninsured individuals for Covid-19. “As we vaccinate the country, let’s continue taking the preventive measures necessary to keep the virus under control and prevent it from spreading,” HHS Secretary Xavier Becerra said in an announcement. “Testing remains critical and now it’s available at no cost to those who need it,” he added. “This funding will help ensure everyone has access to testing regardless of whether they have health insurance.” Click here to learn more about HRSA’s Covid-19 Uninsured Program.

NABH and Other National Organizations Urge Biden Administration to Name ONDCP Director

This week NABH coordinated an effort among several leading addiction treatment groups and other national organizations to send a letter urging President Biden to name a director to the White House Office of National Drug Control Policy (ONDCP). Regina LaBelle, on a leave of absence from her position as program director of the Addiction and Public Policy Initiative at Georgetown’s O’Neill Institute for National and Global Health Law, currently serves as the office’s acting director. NABH and the other organizations—including the American College of Emergency Physicians, the American Society of Addiction Medicine, the National Association of Addiction Treatment Providers, and the National Safety Council—expressed concern that a nominee to the post has not yet been named, especially when the Covid-19 global pandemic has accelerated the nation’s drug overdose deaths through a combination of treatment disruptions, social isolation, and other challenges. “The Biden-Harris Administration’s Statement of Drug Policy Priorities for Year One was a concise and focused document that clearly identified issues that need addressing,” the letter said. “An ONDCP director is now needed to implement, and build upon, those priorities for a nation that continues to be devastated by the preventable and treatable disease of addiction and drug overdoses.” Politico wrote a story about the letter on May 27, calling it “the first notable sign of public pressure on Biden to fill the drug czar role, which he’s long supported.”

NABH and Other Mental Health and Addiction Groups Urge Congress to Fund 988 Hotline Infrastructure

NABH was one of more than two dozen mental health and addiction organizations that sent a letter to congressional leaders, requesting that Congress provide funding to build the needed infrastructure to support the nation’s 988 crisis hotline. In its letter to the majority and minority leaders in the House and Senate, the organizations recommend that Congress, at a minimum, invest $10 billion in a 988 crisis hotline infrastructure package. “While there is a clear vision for what a successful 988 crisis response system requires, there are very few examples of systems that meet these standards,” the letter said. “Existing suicide prevention call centers rely on a patchwork of inadequate funding, leaving insufficient capacity to meet current needs, let alone the increased demand spurred by the adoption of 988,” it continued. “There is growing availability of mobile crisis teams, but demand still far outstrips supply, particularly for children and adolescents. And there is a nationwide dearth of crisis stabilization programs. Finally, there are widespread shortages of behavioral health professionals to staff crisis response systems.” The groups noted that the funding could provide for technology, training, and operations at crisis call centers; expand capital projects to include crisis receiving and stabilization and peer respite programs; broaden federal loan repayment criteria to include crisis call centers, mobile crisis teams, crisis receiving and stabilization programs; and develop behavioral health workforce training programs.

Napolitano, Kaptur, Lee Urge HHS to Expand Mental Health Workforce

NABH recently supported a letter from three House Democrats who are urging HHS to include mental health and substance use treatment providers within the $7.6 billion public health workforce expansion included in the American Rescue Plan.   In their May 21 letter to HHS, Reps. Grace Napolitano (D-Calif.), Marcy Kaptur (D-Ohio), and Barbara Lee (D-Calif.) wrote that a section of the new law can support about 100,000 new positions. The congresswomen—with support from other Democrats—recommend that one-third of those positions be devoted to behavioral health. “This number would permit each small county to add five behavioral health providers, each mid-sized county to add 10 providers, and each large county to add 20 providers,” they wrote. “County public health workers should also receive basic training for the screening of common mental health and substance use disorders, which would allow them to identify struggling Americans and refer them to services,” they added. Click here to read the full letter.

New DOE Guidance on American Rescue Plan Funding for Schools Includes Mental Health

The U.S. Education Department (ED) recently released a set of frequently asked questions (FAQ) about how funding under the Elementary and Secondary School Emergency Relief (ESSER) Fund, including the American Rescue Plan’s ESSER program, and the Governor’s Emergency Education Relief Fund, may be used to address the pandemic’s effects on students in pre-K-12 education. The FAQ mentions mental health services throughout the document and includes providing “positive behavioral interventions and supports and mental health services for children with disabilities” and “meeting rising mental health and behavioral needs (for example, contracting with community mental health providers to support students virtually and/or on-site at school).” Members of the NABH team have had recent discussions with the ED staff and discussed several items outlined in the guidance.

AHRQ Seeking Information on Evaluation of Mental Health Applications

HHS’ Agency for Health Research and Quality (AHRQ) is seeking scientific information to help inform the agency’s review on Evaluation of Mental Health Applications, which AHRQ’s Evidence-based Practice Centers Program is conducting. The federal notice said access to both published and unpublished pertinent, scientific information will improve the quality of the review. Submissions are due 30 days from the May 21 notice. Click here to learn more.

NABH President and CEO Highlights IMD Repeal in LinkedIn Pulse Article

As Mental Health Month draws to a close, NABH President and CEO Shawn Coughlin this week reflected on improving America’s approach to mental healthcare in part by repealing Medicaid’s outdated Institutions for Mental Diseases (IMD) exclusion. In a LinkedIn Pulse article, Coughlin provided an overview of the IMD exclusion and highlighted congressional leaders who are working to solve this issue: Reps. Tom Emmer (R-Minn.) and Grace Napolitano (D-Calif.). Emmer has re-introduced Expanding Access to Inpatient Mental Health Act, which would eliminate the IMD exclusion’s arbitrary cap on mental health services. Specifically, it would eliminate the 15-day cap for Managed Care Organizations (MCOs) and Prepaid Inpatient Health Plan (PIHP) beneficiaries receiving care in an IMD. Meanwhile, Napolitano’s Increasing Behavioral Health Treatment Act would repeal the IMD exclusion and  require states to submit a plan to: increase access to outpatient and community-based behavioral health care; increase availability of crisis stabilization services; and improve data sharing and coordination between physical health, mental health, and addiction treatment providers and first responders. “Efforts such as these,” Coughlin wrote, “could ensure Medicaid beneficiaries finally receive the professionally guided care they deserve, and we can ensure that clinicians, not artificial restrictions, govern mental healthcare for all Americans.”

Kennedy Forum to Host June 7 Webinar on Future of Mental Healthcare

The Kennedy Forum will feature Mental Health America CEO Paul Gionfriddo and National Alliance on Mental Illness CEO Daniel Gillison, Jr. in a webinar about the future of mental healthcare on Monday, June 7. Other panelists will include Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.); Peter O’Brien, chairman of The Kennedy Forum Illinois; and Cheryl Potts, executive director at The Kennedy Forum Illinois. The webinar will begin at 2 p.m. ET. Click here to register.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A recent study of more than 2,800 U.S. coal miners showed that nearly 40% of these workers reported symptoms consistent with major depressive disorder and anxiety, while more than one in 10 reported actively thinking about suicide.   For questions or comments about this CEO Update, please contact Jessica Zigmond.

SAMHSA to Distribute $3 Billion in Block Grants; Becerra Forms Behavioral Health Council

The U.S. Health and Human Services Department (HHS) this week announced the Substance Abuse and Mental Health Services Administration (SAMHSA) will distribute $3 billion in American Rescue Plan funding, the largest aggregate funding amount to date for the agency’s mental health and substance use block grant programs. According to HHS’ announcement, the Community Mental Health Services Block Grant Program and Substance Abuse Prevention and Treatment Block Grant Program will disperse $1.5 billion each to states and territories. This funding amount follows a March announcement of supplemental funding of almost $2.5 billion for these programs. SAMHSA has expedited federal funding to grantees to help the nation’s communities manage their mental health and substance use needs during the Covid-19 pandemic. Meanwhile, HHS Secretary Xavier Becerra has formed a Behavioral Health Coordinating Council to collaborate what the department has described as “innovative, transparent, equitable, and action-oriented approaches” to addressing HHS’ behavioral health agenda. Assistant Secretary for Health Rachel Levine, M.D. and HHS’ assistant secretary for mental health and substance use will serve as co-chairs of the new coordinating council, which is composed of senior leaders across the department. Tom Coderre currently serves as the acting assistant secretary for mental health and substance use. “Behavioral health is a priority for the Department of Health and Human Services,” Becerra said in an announcement. “The Covid-19 pandemic has made clear the need to invest resources in our nation’s mental health and address the inequities that still exist around behavioral healthcare. That’s why we are making this historic investment in mental health and substance use services,” he added. “In addition, this national problem calls for department-wide coordination to address the issue. That’s why I am convening the Behavioral Health Coordinating Council to work across HHS to facilitate collaboration and strategic planning as we implement our behavioral health agenda.” Also this week, HHS announced the Health Resources and Services Administration (HRSA) will disperse $14.2 million from the American Rescue Plan to expand pediatric mental healthcare access by integrating telehealth services into pediatric primary care. The funding will go toward Pediatric Mental Health Care Access (PMHCA) projects in new states and geographic areas nationwide and will provide teleconsultations, training, technical assistance, and care coordination for pediatric primary care providers to diagnose, treat and refer children and youth with mental health conditions and substance use disorders.

CMS Data Show Vulnerable Americans Forgoing Mental Healthcare During Pandemic

The Centers for Medicare & Medicaid Services (CMS) late last week released new findings that show Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries have forgone millions of primary, preventive, and mental healthcare visits from March 2020 through October 2020 compared with the same period in 2019. The agency also reported that while some treatments have rebounded to pre-pandemic levels, mental health services have been the slowest to pick up. According to the data, there has been a 34-percent decline in the number of mental health services used by children under age 19, compared with the same time period in 2019, and a 22-percent decline in the number of mental health services used by adults aged 19 to 64, compared with the same time period in 2019. This translates to about 14 million fewer mental health services for children and approximately 12 million fewer mental health services for adults, for a total of nearly 26 million fewer mental health services used across both groups. Meanwhile, although preliminary reports show increased drug-related mortality due to the pandemic, substance use disorder services utilization fell by 3.6 million services (a 13-percent decline) when compared with the same time period in 2019. “More than 100 million Americans, including 43 million children, relied on us to deliver access to mental health and other services they needed through Medicaid and CHIP in 2020,” CMS Acting Administrator Liz Richter said in an announcement, adding that the new data provide a glimpse into how the pandemic has affected America’s most vulnerable people. “While we’re encouraged that people are accessing some healthcare services at pre-pandemic levels, there is work to do to connect people to mental healthcare services and to ensure we fill the gap in other types of services that was caused by the pandemic,” Richter said.

DOJ Accepting Applications for Opioid, Stimulant, and Substance Abuse Site-based Program Grants

The U.S. Justice Department (DOJ) has announced that applications for its Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) are due June 21. Developed in the Comprehensive Addiction and Recovery Act (CARA), COSSAP is intended to reduce the effect of opioids, stimulants, and other substances on individuals and communities, including a reduction in the number of overdose fatalities. The program is also meant to mitigate the effects of crime victims by supporting collaborative initiatives. Click here for more information about how to apply.

SAMHSA to Host Meth and OUD Webinar Next Week

SAMHSA will host a webinar next week to discuss recent trends in co-occurring methamphetamine use and opioid use disorder (OUD), including overdose fatalities. The webinar, Meth 2.0 and Opioid Use Disorder—A Collision of Epidemics, will also address treatment approaches. Click here to register.

CMS to Host Quality Measurement Webinars Next Month

CMS will host CMS Quality Measurement: Where It’s Headed and How We’ll Get There, a webinar that will highlight the agency’s efforts to improve quality measures and provide information on available quality-measurement resources. The webinar, which will be presented twice in June, will address CMS’ goals for advancing quality measurement in the next five to 10 years, and agency staff will provide an overview of the agency’s new Digital Quality Measurement Blueprint. Click here to register for the June 15 webinar and here to register for the webinar on June 17.

Kennedy Forum to Host Parity Webinar Featuring U.S. Labor Secy. Martin Walsh on May 27

U.S. Labor Department (DOL) Secy. Martin Walsh will serve as a panelist during the Kennedy Forum’s webinar, “Mental Health Parity: Ending Discrimination in Health Insurance Coverage,” on Thursday, May 27. The hourlong webinar will address a range of issues, including DOL’s role in enforcing the 2008 Mental Health Parity and Addiction Equity Act; common parity violations and how they inhibit access to care; new statutory requirements requiring plans to conduct detailed parity analyses; and more. Free for attendees, the webinar will also feature Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.) and Ann Marie Sullivan, M.D., commissioner for New York’s Office of Mental Health. Click here to register.

Registration Now Open for the NABH 2021 Annual Meeting

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

The Trevor Project’s 2021 National Survey on LGBTQ Mental Health reports that 42% of LGBTQ youth seriously considered attempting suicide in the past year, including more than half of transgender and nonbinary youth. For questions or comments about this CEO Update, please contact Jessica Zigmond.

NABH and Other Healthcare Groups Urge HHS to Extend Provider Relief Fund Deadline

NABH and eight other healthcare associations this week urged the U.S. Health and Human Services Department (HHS) to extend the June 30 deadline by which providers must use their Covid-19 Provider Relief Fund (PRF) payments. Instead, the groups wrote in a letter to HHS Secretary Xavier Becerra, HHS should use the length of the public health emergency as a guideline for providers to finish using the funds. The letter also requested that HHS expedite distributing the remaining PRF resources. “Congress has allocated $178 billion to date to aid all types of health care providers through the PRF and designated in the most recent Covid-19 relief package an additional $8.5 billion through the Rural Relief Fund,” the letter noted. “However, not all of the funds have been distributed, and those that have may not yet have been fully utilized by the recipients,” it continued. “We previously noted the ongoing financial burden our members are facing; add to this the uncertainty regarding when the pandemic will ease more considerably to allow for a full return to “business as usual,” such as regular wellness visits and the resumption of scheduled surgeries,” the letter said, adding that the nation’s hospitals will continue to face challenges beyond the June 30 deadline. Separately this week, Secy. Becerra signaled his department is considering it. “Some folks have asked for an extension,” Becerra was reported as saying during a House Energy and Commerce Health Subcommittee hearing. “We’re looking at that very, very closely.”

Biden Administration Plans to Open Applications for Billions in Provider Grants 

News outlets this week reported the Biden administration plans to open applications for billions of dollars in grants for hospitals and other healthcare providers before the end of May. Hospitals have asked administration officials to release more of the funds that Congress approved in December 2020. To date, providers have been reimbursed for only a portion of their losses through June 2020 due to the Covid-19 pandemic. According to the stories—which sourced people familiar with the plans—the next tranche of money will deplete most of the money in the $178 billion fund to help providers.

CMS Issues Guidance on Requirements Added to Medicare’s Conditions of Participation 

The Centers for Medicare & Medicaid Services on May 7 released interpretive guidance on the new hospital admission, discharge, and transfer notification requirements that were added to the Medicare program’s Conditions of Participation. The new rules became effective on May 1, 2021, after having been delayed because of the pandemic.

Overdose Prevention Network to Host Youth Engagement Discussion on May 26

The Overdose Prevention Network will host a 30-minute online discussion about how youth engagement and providing stability can play a meaningful role in supporting overdose prevention and providing connections to treatment. Part of the organization’s “Meet the Partner” series, the “Saving Lives with Youth Engagement” session will feature Graciela Razo, harm reduction coordinator for Safe Horizon’s Streetwork Project in New York City. Click here to learn more and register.

Kennedy Forum to Host Parity Webinar Featuring U.S. Labor Secy. Martin Walsh on May 27

U.S. Labor Department (DOL) Secy. Martin Walsh will serve as a panelist during the Kennedy Forum’s webinar, “Mental Health Parity: Ending Discrimination in Health Insurance Coverage,” on Thursday, May 27. The hourlong webinar will address a range of issues, including DOL’s role in enforcing the 2008 Mental Health Parity and Addiction Equity Act; common parity violations and how they inhibit access to care; new statutory requirements requiring plans to conduct detailed parity analyses; and more. Free for attendees, the webinar will also feature Kennedy Forum founder and former U.S. Rep. Patrick Kennedy (D-R.I.) and Ann Marie Sullivan, M.D., commissioner for New York’s Office of Mental Health. Click here to register.

Registration Now Open for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

Fact of the Week

A new study in JAMA found fatal drug overdoses in San Francisco increased by 50% during after the Covid-19 pandemic lockdown. For questions or comments about this CEO Update, please contact Jessica Zigmond.

May 7 is National Children’s Mental Health Awareness Day

To honor National Children’s Mental Health Awareness Day today, NABH President and CEO Shawn Coughlin published a LinkedIn Pulse article about the critical role that residential treatment plays in youth behavioral healthcare. The article highlights Residential Treatment: A Vital Component of the Behavioral Healthcare Continuum, the white paper that NABH released in April. Please click here to visit our Youth Services webpage to download the paper and access shareable social media messages, especially during Mental Health Month throughout May. Also for Mental Health Month, the National Association of Medicaid Directors (NAMD) this week released fact sheets to promote the role that Medicaid programs play in ensuring access to mental health and addiction treatment. The first fact sheet shows how Medicaid supports crisis support systems, and the second resource highlights opportunities for Medicaid programs to provide addiction treatment.

Registration Now Open for the NABH 2021 Annual Meeting!

Registration is open for the NABH 2021 Annual Meeting from Wednesday, Oct. 6 – Friday, Oct. 8, 2021 at the Mandarin Oriental Washington, DC. We hope you join us as we recognize our meeting theme, Expanding Access: Right Care. Right Setting. Right Time. Please visit our Annual Meeting webpage to register for the meeting and to reserve your hotel room. We look forward to seeing you in Washington!

NABH Submits Comments to HHS on HIPAA Privacy Rules

NABH this week sent comments to the U.S. Health and Human Services Department’s (HHS) Office of Civil Rights (OCR) about the office’s proposed rule, “Proposed Modifications to the HIPAA Privacy Rule to Support, and Remove Barriers to, Coordinated Care and Individual Engagement.” HHS released the proposed rule in January, and the Biden administration’s freeze on certain regulations issued during the prior administration did not apply to this one. The letter includes sections about overlap among Health Insurance Portability and Accountability Act (HIPAA), interoperability, and 42 CFR Part 2 regulations; modifications to the right to inspect and obtain copies of protected health information; information disclosure to third parties; care coordination and case management; standards for disclosing information when in an individual’s interest or to prevent harm; and notices of privacy practices. “As Covid-19 continues to have a significant impact on behavioral health, mental health and addiction treatment providers must remain focused on improving access to care,” NABH President and CEO Shawn Coughlin wrote in the letter. “They continue to struggle with the new demands imposed by social distancing and precautions they must take to prevent Covid-19 infection. Healthcare staff and providers were already greatly strained by the ongoing stress and demands created by this pandemic,” he continued. “Moreover, behavioral healthcare providers and HIT vendors are still working to implement the new interoperability standards as they continue to face staffing shortages,” he wrote, adding that NABH urges OCR to delay the deadline of this and any additional regulatory changes such as those in the proposed rule.

Patients with Mental Health Conditions in EDs During Pandemic More Likely to Require Admission

New research from JAMA shows that patients with mental health (MH) conditions presenting for emergency department (ED) visits since the onset of the pandemic have been more likely to require admission and have had longer admissions. “The COVID-19 pandemic continues to place novel stressors on the provision of pediatric MH care,” the article noted. “Our findings may reflect challenges in disposition to definitive MH care and may suggest a scarcity of MH treatment resources.” The researchers went on to write that their limitations in the study include an inability to account for the complexity of presenting MH conditions and the limited generalizability to non-children’s hospitals. Still, they continued, the findings of the cross-sectional study underscore the need for increased pediatric MH services.”

HRSA to Host Provider Webcast on Covid-19 Coverage Assistance Fund on May 12

HHS’ Health Resources and Services Administration (HRSA) has announced a new program that covers the costs of administering Covid-19 vaccines to patients enrolled in health plans that either do not cover vaccination fees or cover them with patient cost-sharing. HRSA will host an informational webcast for providers to present an overview of its Coverage Assistance Fund on Wednesday, May 12 at 2 p.m. ET. Click here to learn more and register.

Fact of the Week

Nearly one in five adults between the ages of 50 and 80 said their overall mental health has gotten worse since the pandemic began in March 2020, and an equal percentage said their sleep suffered in that time too, according to a new aging study from the University of Michigan. For questions or comments about this CEO Update, please contact Jessica Zigmond.

Mental Health Awareness Month Begins Saturday, May 1

Mental Health Awareness Month, also referred to as Mental Health Month, kicks off Saturday, May 1 to recognize the millions of Americans living with a mental illness. Please be sure to follow NABH on Twitter and LinkedIn to help promote Mental Health Month, and visit the websites for the National Alliance on Mental Illness (NAMI) and Mental Health America for more information and toolkits.

HHS Provides Exemptions for Buprenorphine Prescribers for Fewer Than 30 Patients

The U.S. Department of Health and Human Services (HHS) announced this week that practitioners prescribing buprenorphine, a controlled substance, for opioid use disorder to fewer than 30 patients are exempt from certain regulatory requirements codified under 21 U.S.C. 823(g)(2)(B)(i)-(ii). Under the new guidance, physicians, physician assistants, nurse practitioners, clinical nurse specialists, certified registered nurse anesthetists, and certified nurse midwives are exempt from having to make certain training related certifications and certifying their capacity to provide counseling and other ancillary services. The guideline does not remove the DATA 2000 Waiver, otherwise known as the ‘X-Waiver.’ Providers are still required to file a Notice of Intent with the Substance Abuse and Mental Health Services Administration. The exemption applies to practitioners who are state-licensed and DEA-registered. It also generally limits prescribing to patients who are located in states where the practitioner is licensed. Practicing under this exemption does not count toward the time requirements for prescribing to a higher patient limit under 21 U.S.C. 823(g)(2)(B)(iii). This exemption also applies to other Schedule III, IV, and V drugs. Tuesday’s guidance encourages practitioners to provide access to psychosocial services to improve treatment retention and outcomes. In addition, medical education institutions are strongly encouraged to implement comprehensive training in substance use disorder diagnosis and management. In late January, the Biden administration placed a freeze on Trump administration guidelines that intended to exempt physicians from the X-Waiver. That notice cited clinical concerns and stated the Executive Branch did not have the legal authority to make the change.

GAO Releases Behavioral Health Study on Access, Claims Payments, and Covid-19 Effects 

In a report released Friday, the Government Accountability Office (GAO) said evidence collected during the Covid-19 pandemic suggests the prevalence of behavioral health conditions has increased, while access to in-person behavioral health services has decreased. The report noted that Centers for Disease Control and Prevention (CDC) surveys found about 38% of respondents reported symptoms of anxiety or depression from April 2020 through February 2021, reflecting an increase of 11% since 2019. Meanwhile, U.S. emergency department visits for overdoses and suicide attempts from mid-March to mid-October 2020 were up 36% and 26%, respectively, since 2019. The study also highlighted issues related to payment for services. “Officials GAO interviewed from provider organizations offered anecdotal examples of problems with payments for behavioral health services, including examples suggesting that denials and delays were more common for these services than they were for medical/surgical services,” the report said. “However, most officials were not aware of published data that could confirm their concerns, and data from reports from two states on claims denials either did not support their concerns or were inconclusive,” it continued. “In addition, a report in one state that examined mental health parity—requirements that behavioral health benefits are not more restrictive than medical/surgical benefits—found that the rate of complaints associated with behavioral health services was notably lower than those for medical/surgical services.”

CMS Launches Behavioral Health Follow-up Care Learning Collaborative

The Centers for Medicare & Medicaid Services (CMS) has launched the “Improving Behavioral Health Follow-up Care Learning Collaborative” to support state Medicaid and Children’s Health Insurance Program (CHIP) agencies’ efforts to improve access, coordination, and follow-up care for beneficiaries who visit an emergency department or who are hospitalized for a mental health or substance use condition. In an announcement, CMS said state behavioral health agencies, managed care plans, and providers will learn about evidence-based interventions to improve access to timely follow-up behavioral healthcare during the global pandemic recovery period and beyond. The new learning collaborative includes a four-part webinar series beginning next month and an “affinity group” starting in July. According to CMS, states interested in acting on the concepts and strategies introduced in the webinar series will have an opportunity to participate in an action-oriented affinity group that will facilitate state-to-state learning and support state teams in designing, implementing, and scaling up quality-improvement projects in their state. Click here for more details about the webinar series and affinity group and here to register for the webinars.

NABH Welcomes Comments on Federal Privacy Regulations

Earlier this year, HHS issued a notice of proposed rulemaking (NPRM) that outlined significant changes to federal privacy regulations. The Biden administration’s freeze on certain regulations issued during the prior administration does not apply to this proposed rule, and the current administration has extended the deadline for comments on this NPRM to May 6, 2021. Notably, the NPRM includes a section entitled “Encouraging Disclosures of PHI [Personal Health Information] when Needed to Help Individuals Experiencing Substance Use Disorder (Including Opioid Use Disorder), Serious Mental Illness, and in Emergency Circumstances.” This link to that section discusses the following proposed changes to federal privacy regulations:

• Revising the standard for determining when a disclosure or use of PHI is in the best interests of the individual to be based on a “good faith belief” instead of “exercise professional judgment”; and

• Changing the standard for use or disclosure of PHI to prevent or lessen a “serious or imminent threat” to the health or safety of a person or the public to instead be allowable based on a “serious and reasonably foreseeable threat” to a person or the public.

This section of the proposed rule also includes scenarios illustrating how the proposed changes to the privacy rules would help improve care for patients. NABH welcomes comments about these changes and requests that members send any comments to Kirsten Beronio, NABH’s director of policy and regulatory affairs, by next Tuesday, May 4.

NIDA Director Says Addiction Should be Treated, Not Penalized in Health Affairs Blog

People with substance use disorders need treatment, not punishment, and drug use disorders should be approached with a demand for high-quality care and compassion for those affected. Those are the words of Nora Volkow, M.D., director of the National Institute on Drug Abuse, or NIDA, in a Health Affairs blog post this week. Volkow also noted that the Covid-19 pandemic has highlighted the large racial health disparities in America, and that Black Americans have experienced worse outcomes during the pandemic, continue to die at a greater rate than White Americans, and also suffer disproportionately from a wide range of other acute and chronic illnesses. “We have known for decades that addiction is a medical condition—a treatable brain disorder—not a character flaw or a form of social deviance,” Volkow wrote. “Yet, despite the overwhelming evidence supporting that position, drug addiction continues to be criminalized,” she continued. “The U.S. must take a public health approach to drug addiction now, in the interest of both population well-being and health equity. Separately this week, an opinion piece in Stat from former Office of National Drug Control Policy (ONDCP) Deputy Director Tom McLellan, Ph.D. and Jacob Crothers, M.D., an addiction medicine physician, proposed that the United States should engage in a rapid response similar to “Operation Warp Speed” (for the Covid-19 vaccine development and rollout) to address the nation’s ongoing opioid crisis. In their observations, McLellan and Crothers wrote the U.S. Drug Enforcement Administration surveillance of providers sends a confusing message about encouraging the use of U.S. Food and Drug Administration-approved addiction medications. They also warned against discharging patients for positive drug tests and prohibitive prior authorization policies, and they suggested extending the Medicare opioid treatment bundle to Medicaid.

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

Nearly a quarter of all child and adolescent admissions to psychiatric hospitals are involuntary, according to a new study in The Lancet. The report also showed children admitted against their will more often had a diagnosis of psychosis, substance misuse, or intellectual disability. For questions or comments about this CEO Update, please contact Jessica Zigmond.

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

• June 13-15, 2022

• June 12-14, 2023

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

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

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

President Biden Signs Legislation to Extend Suspension of Medicare Sequestration

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

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

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

MACPAC’s April 2021 Public Meeting Addresses Behavioral Health

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

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

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

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

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

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

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

U.S. Labor Department Issues Guidance on Parity Compliance

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

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

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

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

• The evidentiary standards used for these factors;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

Biden Administration Releases Drug-Policy Priorities for Year One

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

• Expanding access to evidence-based treatment

• Advancing racial equity in our approach to drug policy

• Enhancing evidence-based harm reduction efforts

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

• Reducing the supply of illicit substances

• Advancing recovery-ready workplaces and expanding the addiction workforce

• Expanding access to recovery support services

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

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

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

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

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

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

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

NABH Priorities for the 117^th Congress Now Available

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

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

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

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

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

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

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

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

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

Senate Confirms Vivek Murthy as U.S. Surgeon General

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

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

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

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

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

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

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

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

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

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

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

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

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

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

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

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

June 13-15, 2022

June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

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

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

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

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

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

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

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

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

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

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

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

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

• $80 million for behavioral healthcare for first responders

NABH Joins Other Healthcare Organizations to Support Medicare Sequester Extension

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

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

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

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

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

IPFQR Webinar Scheduled for Next Week

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

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

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

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

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

Save the Date: NABH 2021 Annual Meeting 

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

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

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

Joint Commission Journal Publishes Report on Staff Emotional Support During Pandemic

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

IPFQR Webinar Scheduled for Wednesday, March 17

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

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

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

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week 

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

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

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

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

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

NABH Signs MHLG Coalition Letter to Support the TREAT Act

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

Children’s Healthcare Groups Launch Youth Mental Health Awareness Campaign

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

Register to Attend the 2021 Rx Drug Abuse & Heroin Summit

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

House Reconciliation Package Includes Strong Support for Behavioral Healthcare

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

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

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

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

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

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

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

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

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

• Provides $20 million for youth suicide prevention activities.

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

Foley & Lardner Survey Examines Telehealth Commercial Insurance Laws Across States

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

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

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

Pandemic-Related Alcohol Abuse Leads to Hospitalizations for Liver Disease

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

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

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

ONDCP Announces 100-Day Priorities

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

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

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

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

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

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

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

DOJ Accepting Applications for Substance Use-Related Programs

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

CMS Issues Memo to Clarify Expectations of Hospital Surveys During Pandemic

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

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

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

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

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

Coderre & LaBelle Named as Acting Heads of SAMHSA and ONDCP

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

White House Issues Regulatory Freeze Pending Review 

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

Joint Commission Proposes New Standards for Preventing Workplace Violence 

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

CMS Releases T-MSIS-based Medicaid SUD Data Book

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

NABH Welcomes New Committee Chairs

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

NABH Releases Issue Brief on Changes to Medicare Coverage for SUD

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you again in Washington!

Fact of the Week

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

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

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

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

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

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

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

NABH Issue Brief Provides Details on Expanded Telehealth Coverage 

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

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

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

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

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you in Washington!

Fact of the Week

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

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

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

CMS Issues Guidance on Medicaid Coverage for Opioid Use Disorder Treatment

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

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

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

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

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

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

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

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

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

Save the Date: NABH 2021 Annual Meeting

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

• June 13-15, 2022

• June 12-14, 2023

We look forward to seeing you in Washington!

Fact of the Week

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

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

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

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

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

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

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

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

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

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

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

SAMHSA Announces Mental Health and SUD Grant Funding Opportunities 

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

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

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

Save the Date: NABH 2021 Annual Meeting 

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

• June 13-15, 2022

• June 12-14, 2023

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

Happy Holidays from NABH!

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