Dan Schwartz Joins NABH as Director of Quality and Addiction Services
WASHINGTON, Dec. 10, 2024 /PRNewswire/ — The National Association for Behavioral Healthcare (NABH) is pleased to welcome Dan Schwartz as the association’s director of quality and addiction services.
Dan brings to NABH a range of experiences in federal agencies related to addiction services, including most recently in his role as a senior behavioral health policy analyst in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (HHS).
In that role, Dan engaged in federal policymaking efforts by providing subject matter expertise about the delivery, financing, and regulation of behavioral health services, with an emphasis on the substance use disorder care continuum, controlled substances, and various mental health topics.
Dan also served as the staff lead for the HHS Workgroup on Implementation Strategies for Contingency Management; co-led a workgroup that supported developing legislative proposals related to behavioral health; and was a lead analyst for developing and implementing the HHS Overdose Prevention Strategy.
“We are excited to have Dan join our team,” said NABH President and CEO Shawn Coughlin. “He brings energy, experience, and enthusiasm to a critical role in our association.”
Prior to working at ASPE, Dan worked at the White House Office of National Drug Control Policy and the Substance Abuse and Mental Health Services Administration.
Dan earned a master’s degree in public health from Johns Hopkins University, where he was a Bloomberg Fellow in Addiction & Overdose, and a bachelor’s degree in public health from George Washington University.
About NABH
The National Association for Behavioral Healthcare (NABH) represents provider systems that treat children, adolescents, adults, and older adults with mental health and substance use disorders in inpatient behavioral healthcare hospitals and units, residential treatment facilities, partial hospitalization and intensive outpatient programs, medication assisted treatment centers, specialty outpatient behavioral healthcare programs, and recovery support services in 49 states and Washington, D.C. The association was founded in 1933.
SOURCE National Association for Behavioral Healthcare
NABH Responds to The New York Times story on Opioid Treatment Programs
Washington, Dec. 7, 2024—A story published in The New York Times on Dec. 7 has prompted NABH to clarify the purpose and critical need for opioid treatment programs (OTPs) in the United States.
NABH is concerned the article’s incomplete picture of how OTP treatment works could contribute to what is already a stigmatized disease in an environment where patients should be encouraged to seek the care they need desperately. OTPs are among the most regulated facilities in the healthcare system and provide lifesaving care every day.
Millions of Americans struggle with opioid addiction, and the Centers for Disease Control and Prevention reports more than 81,000 Americans died from an opioid-related overdose in 2023.
NABH member facilities, including those that Acadia Healthcare operates, provide a lifeline to those in need. Opioid treatment programs provide medication-assisted treatment (MAT), which combines U.S. Food and Drug Administration (FDA)-approved medications, behavioral therapies, and wraparound support services. MAT is the most effective intervention to treat opioid use disorder and is proven to reduce overdose fatalities by up to 60%.[1] Meanwhile, the U.S. Surgeon General has called MAT the “gold standard” for treating opioid use disorder (OUD).[2] OTPs provide MAT while addressing patients’ unique needs, reducing barriers to care, and implementing safeguards that support long-term recovery and sustained treatment engagement.
It is important to understand that treatment at OTPs is voluntary, and staff members see patients only after patients make the decision to seek treatment. Patients benefit from the expertise of a multidisciplinary team including physicians, nurses, counselors, clinicians, peer recovery specialists, and case managers, and patients can choose to start or complete treatment based on their own decisions and unique circumstances.
In addition, OTPs are subject to strict regulations and are required by law to employ a licensed physician who oversees all medical services provided to patients based on rigorous clinical guidelines. OTPs are also accredited and regularly inspected to uphold high standards of care, and, in many cases, our members exceed the state and federal regulatory requirements needed to maintain their licenses. These providers invest heavily in staff, training and medical care, counseling, case management and wraparound support— services that often exceed what insurance will reimburse.
Our members see firsthand the growing lethality of drug use and the severe ramifications of individuals not being able to receive needed treatment right away. Yet only 1 out of 5 people living with OUD are receiving needed treatment.[3] Early intervention is critical, with scientific research showing significantly better outcomes for patients who receive comprehensive care compared with those who don’t.
NABH strongly supports the potential of recent federal efforts to expand access to care through telehealth services, expanded methadone take-home privileges, and other flexibilities offered through regulatory revisions. However, we continue to express serious concerns regarding the Modernizing Opioid Treatment Access Act (MOTAA) due to the potential unintended consequences and harms that may result from legislation proposing such abrupt and expansive regulatory changes.
And we are not alone. Other stakeholders have also expressed significant concerns, including six of the nation’s largest law enforcement organizations. For more information about this issue, please see NABH’s letter to House and Senate leaders on Dec. 4, 2024.
OTP facilities play a vital role in addressing the nation’s opioid and addiction crises, and it is imperative that we continue to support providers who do this important work so people in need can immediately access the personalized care, treatment options, and ongoing support services they need to achieve long-term recovery.
About NABH
The National Association for Behavioral Healthcare (NABH) represents provider systems that treat children, adolescents, adults, and older adults with mental health and substance use disorders in inpatient behavioral healthcare hospitals and units, residential treatment facilities, partial hospitalization and intensive outpatient programs, medication assisted treatment centers, specialty outpatient behavioral healthcare programs, and recovery support services in 49 states and Washington, D.C. The association was founded in 1933.
SAMHSA Updates OTP Regulations
SAMHSA Updates OTP Regulations
Updated Feb. 2, 2024 The Substance Abuse and Mental Health Services Administration published Medications for the Treatment of Opioid Use Disorder late yesterday for public inspection. The final rule was published earlier today and becomes effective on April 2, 2024, with compliance by October 2, 2024. [Please note that this is a correction of the compliance date of October 2, 2026 that was published yesterday in the public notice.] NABH provided comments on the Notice of Proposed Rule Making that was issued in December 2022 calling for greater regulatory flexibility for opioid treatment programs (OTPs). The final regulations align closely to NABH recommendations and herald greater deference to clinical decision-making in the nation’s (OTPs). Among the provisions, the regulations:- Make permanent the Covid-era take-home schedule;
- Permit methadone for new patients via audio-visual telemedicine with the dispensing of medication at the OTP (not audio-only).
- Permit audio-only telemedicine when the patient is in the presence of a practitioner who is registered to prescribe SII, including dispensing.
- Clarify (in response to NABH off-line discussion and official comments) that the prescription of methadone to community pharmacies is NOT permitted;
- Change the requirement for a one-year history of OUD for eligibility so that now either the patient must a) meet diagnostic criteria for moderate-severe OUD, or b) be in OUD remission, or c) at high risk for overdose;
- Remove the requirement for two treatment failures for people under 18 to be eligible for services;
- Remove requirement for a one-year history of OUD for people recently released from a correctional facility, pregnant patients, or previously enrolled individuals;
- Allow medication units to provide all OTP services;
- Decouple medication and attendance at counseling services;
- Permit interim treatment for 180 days, including at for-profit OTPs;
- Permit mid-levels (“…those appropriate licensed by the state”) to prescribe without exemption;
- Clarified accreditation standards to reduce potential for a burdensome increase in less-than 3-year accreditations;
- Permit buprenorphine prescribing in an OTP via audio-only and audio-visual without an in-person evaluation; and
- Update terminology to reflect contemporary, non-stigmatizing language.
Andrew Dodson Joins NABH as Director of Congressional Affairs
WASHINGTON, Aug. 17, 2023 /PRNewswire/ — The National Association for Behavioral Healthcare (NABH) is pleased to welcome Andrew (Andy) Dodson as the association’s director of congressional affairs, effective Aug. 16.
Andy brings to NABH more than 20 years of legislative and regulatory advocacy experience in senior government affairs positions with several national trade associations and a multi-client government affairs consulting firm.
He has advocated for companies and associations in the insurance, technology and telecommunications, real estate, and business aviation industries, and he is eager to represent behavioral healthcare providers.
“We are very excited that Andy has joined our team because he brings with him a keen understanding of Capitol Hill, extensive lobbying experience, and a strong background in regulatory affairs,” said NABH President and CEO Shawn Coughlin. “He is what NABH needs, and we know he will enhance and strengthen our advocacy efforts.”
Most recently Andy led the American Wood Council’s federal, state, and local advocacy efforts, where he developed and implemented successful political campaigns and government relations initiatives.
Andy began his political career working in the Texas legislature and on several statewide political campaigns before he moved to Washington, D.C., where he worked for House Majority Leader Richard Gephardt (D-Mo.) and several Texas lawmakers. He also worked as a regional fundraising director for the Democratic Congressional Campaign Committee and the Clinton/Gore Re-Election Committee.
Andy is a graduate of the University of Texas at Austin. He lives Bethesda, Md. with his wife and two sons.
About NABH
The National Association for Behavioral Healthcare (NABH) represents provider systems that treat children, adolescents, adults, and older adults with mental health and substance use disorders in inpatient behavioral healthcare hospitals and units, residential treatment facilities, partial hospitalization and intensive outpatient programs, medication assisted treatment centers, specialty outpatient behavioral healthcare programs, and recovery support services in 49 states and Washington, D.C. The association was founded in 1933.
SOURCE National Association for Behavioral Healthcare
CMS Final Rule Estimates Overall IPF Payments to Increase by 2.3% in 2024
The Centers for Medicare & Medicaid Services (CMS) on Thursday released its Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) final rule for Fiscal Year (FY) 2024, which is estimated to increase overall payments to IPFs by 2.3%, or $70 million, relative to FY 2023.
While the agency’s final FY 2023 payment update is larger than its earlier proposed 1.9% increase, NABH will continue to push policymakers to recognize fully the high costs that our association’s members face.
The FY 2024 update includes increases in the federal per-diem base rate to $895.63 from $865.63, and in the outlier threshold to $33,470 from $24,630, which will reduce the number of cases that qualify for an outlier payment.
CMS released a fact sheet with the final rule. The NABH team is currently reviewing the rule and will share a more detailed summary in tomorrow’s CEO Update.
HHS, DOL and Treasury Release Proposed Rules to Strengthen MHPAEA
The U.S. Health and Human Services (HHS), Labor (DOL), and Treasury Departments on Tuesday released proposed rules to bolster the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and remove obstacles to behavioral healthcare access.
The rules propose several amendments to the 2013 MHPAEA final regulations, as well as provisions that would establish the content requirements of the Non-Qualitative Treatment Limitations, or NQTL, comparative analyses required under amendments to MHPAEA included in the Consolidated Appropriations Act, 2021 (CAA, 2021).
“Today’s rules show the Biden administration’s continued effort to implement the landmark parity law,” said NABH President and CEO Shawn Coughlin. “We’re hopeful these changes will do much to eliminate the illegal restrictions and barriers to behavioral healthcare that exist today, nearly 15 years after the law passed.”
The three departments also released a Technical Release on NQTLs that outlines principles and seeks public comment to inform future technical guidance about the application of proposed data collection and evaluation requirements to NQTLs related to network composition that the rule proposes.
Along with the proposed rules, the departments released the 2023 MHPAEA Comparative Analysis Report to Congress that the CAA, 2021 requires. The report includes information about the agencies’ enforcement efforts and identifies plans and issuers that received final determinations of non-compliance with MHPAEA.
The White House released a fact sheet about the rule and DOL’s Employee Benefits Security Administration posted all the related documents here.
NABH will seek feedback from members and submit comments about the proposed rules and Technical Release.
CMS Coverage for PHP Telehealth Services Set to End After May 11
As the COVID-19 Public Health Emergency (PHE) draws to a close at the end of Thursday, May 11, the Centers for Medicare & Medicaid Services (CMS) has shared with NABH and other stakeholders the agency’s plans to end telehealth coverage for partial hospitalization program (PHP) services implemented during the PHE.
In addition, CMS has explained that telehealth coverage will continue through December 2024 for Intensive Outpatient Program (IOP) services that qualify under the outpatient prospective payment system as “remote mental health services.”
NABH continues to communicate with key Members of Congress to clarify the legislative intent behind the telehealth coverage extensions that were authorized in the Consolidated Appropriations Act, 2023 last December. The NABH team understands that some Members of Congress intended for the telehealth coverage extension to include PHP services.
Given the persistent confusion on these matters, NABH has urged CMS to issue clarification in writing. NABH will keep members apprised of our efforts to extend telehealth coverage for PHP services.
DEA Extends COVID-19 Telehealth Flexibilities for Prescription of Controlled Medications for Now
The U.S. Drug Enforcement Administration (DEA) on Wednesday said it will extend its COVID-19 telemedicine flexibilities for prescription of controlled medications as the agency works to determine how to move forward in a way that gives Americans access to needed medicine with the appropriate safeguards.
An announcement from DEA noted the agency received a record number of comments on its proposed telemedicine rules, which prompted DEA and HHS to submit a draft temporary rule to the Office of Management and Budget requesting an extension. NABH submitted comments on this matter (see CEO Update, April 28, 2023).
“Further details about the rule will become public after its full publication in the Federal Register,” the announcement said.
NABH Education & Research Foundation Webpage Now Features Grants & Funding Opportunities
The NABH Research and Education Foundation has updated its webpage with a section devoted to potential funding resources and opportunities for behavioral healthcare organizations and their employees.
To access the Foundation’s webpage, visit NABH’s homepage and locate the “NABH Foundation” tab in the navigation menu. From there, hover over the tab to find a drop-down menu with the following sections: About, Grants & Funding Opportunities, Resources, and Contribute.
We urge you to visit the page and search for potential funding opportunities, which NABH also includes in CEO Update, the association’s weekly e-newsletter.
Please contact foundation@nabh.org if you have a grant or other funding opportunity to share. Thank you!
CBO Report: Budgetary Effects of Modifying or Eliminating the IMD Exclusion
CBO Report: Budgetary Effects of Modifying or Eliminating the IMD Exclusion
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FDA Approves First Over-the-Counter Naloxone Spray
The U.S. Food and Drug Administration (FDA) today approved Narcan, 4 mg. naloxone hydrochloride nasal spray for over-the-counter (OTC), non-prescription use, making it the first naloxone product approved to use without a prescription.
Naloxone is a medication that reverses the effects of opioid overdose rapidly and is the standard treatment for opioid overdose. The FDA’s action today clears the way for this life-saving medication to be sold directly to consumers in drug stores, convenience stores, grocery stores, gas stations, and online.
The move comes at a time when the Centers for Disease Control and Prevention released provisional data this month that showed 101,751 reported U.S. fatal overdoses in the 12-month period ending in October 2022, while the predicted number of fatal doses for that period is even higher at 107,689.
“Today’s approval of OTC naloxone nasal spray will help improve access to naloxone, increase the number of locations where it’s available, and help reduce opioid overdose deaths throughout the country,” FDA Commissioner Robert M. Califf, M.D said in today’s announcement. “We encourage the manufacturer to make accessibility to the product a priority by making it available as soon as possible and at an affordable price.”
According to the FDA, the manufacturer determines the timeline for availability and price of this OTC product. Click here to learn more.
President Biden to Outline Approach for Addressing Nation’s Mental Health & Opioid Crises in State of the Union
In tonight’s State of the Union address, President Biden is expected to mention specific ways his administration will address America’s mental health crisis, beat its opioid overdose epidemic, and ensure parity.
In a fact sheet about the speech, “mental health” is mentioned 32 times, and “fentanyl” 23 times, signaling the Biden’s administration commitment to tackling two of the nation’s toughest domestic problems. The White House will also discuss these issues in a briefing on Wednesday, Feb. 8 at 2:30 p.m. ET. Click here to register for the webinar.
In a boost for parity, President Biden is expected to say that this administration will propose new rules this spring to ensure that insurance plans do not impose inequitable barriers to care and that mental healthcare providers are being paid by health plans on par with other healthcare professionals.
President Biden is also expected to provide details on how his administration will help expand access to mental healthcare services for all who need it, such as expanding peer support specialists for veterans; creating healthy environments for children, adolescents, and teens; and supporting the nation’s mental healthcare workforce.
The Biden administration also intends to improve the capacity of the 988 lifeline by investing in expanding the nation’s crisis care workforce; scaling mobile intervention services; and developing additional guidance on best practices in crisis response. To enhance telehealth services, HHS will triple resources dedicated to promoting interstate license reciprocity to deliver mental health services across state lines, according to the White House.
Meanwhile, Congress and the nation can expect to hear about this administration’s aggressive plans to combat the nation’s ongoing opioid crisis. News reports Tuesday quoted Office of National Drug Control Policy (ONDCP) Director Rahul Gupta, M.D. as saying President Biden will apply a “forceful approach” for going after fentanyl and expanding public health efforts to reduce overdose deaths. Such measures will include disrupting the trafficking, distribution, and sale of fentanyl. Tonight the president is expected to announce that his administration will add 123 new, large-scale scanners at land points of entry along the nation’s Southwest border by 2026, and also lead a sustained, diplomatic push to address fentanyl and its supply chain abroad.
The president is also supposed to announce a commitment to expanding access to evidence-based prevention, harm reduction, treatment, and recovery. In the last year, the Biden administration has permitted using $50 million for local public health departments to purchase naloxone; released guidance making it easier for programs to obtain and distribute naloxone to at-risk populations; and prioritized reviewing over-the-counter naloxone applications.
President Biden will deliver his State of the Union address at 9 p.m. ET.
NABH Education and Research Foundation Partners with Manatt to Produce Issue Brief on Telehealth Services in PHP and IOP
NABH is pleased to announce that the NABH Education and Research Foundation today released an issue brief that shows how telehealth services effectively augment traditional partial hospitalization programs (PHP) and intensive outpatient programs (IOP).
The telehealth issue brief is the first resource from the NABH Education and Research Foundation, which worked with NABH members and Manatt to compile and evaluate data to measure the impact that telehealth services have had on access and outcomes.
Results from the study show that using telehealth services improved access to care and optimized the reach of existing personnel. The initial findings from several NABH members also indicated that, relative to in-person services, telehealth delivery-of-care produced similar or better outcomes for PHP and IOP patients.
The telehealth issue brief’s key findings also include:
- During the COVID-19 crisis, regulatory flexibilities enabled traditional in-person PHPs and IOP programs to implement telehealth services rapidly.
- Using telehealth to deliver PHP and IOP services has improved access to care for remote patients and those facing other access obstacles.
- Emerging research is showing that, relative to in-person care, the use of telehealth in PHPs and IOPs generally is improving the quality of clinical care, patient satisfaction and the overall efficiency of the healthcare system.
SAMHSA Proposed Rule Permits Methadone Prescribing for New Patients via Telemedicine
The Substance Abuse and Mental Health Services Administration (SAMHSA) on Tuesday proposed updating federal regulations to permit using audio-visual telehealth services for any new patient treated with methadone in an Opioid Treatment Program (OTP) under specific conditions.
In a proposed rule, SAMHSA said federal regulations should be updated to allow using audio-visual telehealth services for patients treated with methadone in OTPs only if a program physician, or an authorized healthcare professional under the supervision of a program physician, determines that an adequate evaluation of the patient can be accomplished via an audio-visual telehealth platform.
This change is not extended to using audio-only telehealth platforms and applies only to ordering methadone that an OTP dispenses under existing OTP procedures.
In addition, SAMHSA’s proposed changes would update 42 CFR Part 8 by removing stigmatizing or outdated language; supporting a more patient-centered approach to treatment; and reducing barriers to receiving care.
SAMHSA’s proposed changes also would revise standards to reflect an OTP accreditation and treatment environment that has evolved since Part 8 became effective in 2001. Consequently, SAMHSA said its proposed revisions reflect evidence-based practice, language that aligns with current medical terminology, effective patient engagement approaches, and the workforce providing services in OTPs, including:
- expanding the definition of an OTP treatment practitioner to include any provider who is appropriately licensed to dispense and/or prescribe approved medications. The current Part 8 rule defines a practitioner as being: “a physician who is appropriately licensed by the State to dispense covered medications and who possesses a waiver under 21 U.S.C.823(g)(2).” During the Covid-19 public health emergency, this has been formally expanded to align with broader definitions of a practitioner (nurse practitioners, physician assistants, etc.), and OTPs reported that this change was essential in supporting workflow and access;
- adding evidence-based delivery models of care, such as split dosing, telehealth, and harm-reduction activities;
- removing such outdated terms as “detoxification”;
- updating criteria for provision of take-home doses of methadone;
- strengthening the patient-practitioner relationship through promoting shared and evidence-based decision-making;
- allowing for early access to take-home doses of methadone for all patients, to promote flexibility in creating plans of care that facilitate such every-day needs as employment, while also affording people with unstable access to reliable transportation the opportunity to also receive treatment; likewise, promoting mobile medication units to expand an OTPs geographic reach; and
- reviewing OTP accreditation standards.
Biden Administration Launches Opioid Overdose Dashboard
The Biden Administration on Thursday unveiled a new website featuring the Office of National Drug Control Policy’s (ONDCP) new Opioid Overdose Tracker to track non-fatal, opioid overdoses in the pre-hospital setting in an effort to prevent overdose deaths.
Non-fatal overdoses are a good predictor of fatal overdoses, Biden administration officials said during a news briefing Wednesday according to Politico. People who experience at least one non-fatal overdose are about two to three times more likely to eventually die from one, they said.
Using data submitted to the National Emergency Medical Services Information System (NEMSIS), the new dashboard contains one interactive page with a geo-surveillance view, and its data set includes all de-duplicated Emergency Medical Services (EMS) patient care reports for a rolling time period that meet specific inclusion criteria.
In 2022, all 50 states, three territories (the Virgin Islands, Guam, and the Northern Mariana Islands), and Washington, D.C. had submitted data to the national database, according to NEMSIS. The NEMSIS Technical Assistance Center collects data from about 95% of all EMS agencies in the United States that respond to 911 requests for emergency care and transport patients to acute care facilities.
Earlier this year, the Centers for Disease Control and Prevention estimated that 80,816 Americans died from opioid overdoses in 2021, increasing from an estimated 70,029 in 2020.
According to a National Public Radio story, ONDCP Director Rahul Gupta, M.D. told reporters during a call that “We could see tens of thousands of additional lives saved” with the new tool, which Gupta said he hopes first responders, clinicians, and policymakers will use to connect people to care and also minimize response times and ensure that resources are available.
Rochelle Archuleta Joins NABH as Executive Vice President for Government Relations and Public Policy
Rochelle Archuleta has joined the National Association for Behavioral Healthcare (NABH) as executive vice president for government relations and public policy, effective Sept. 6.
Rochelle brings to NABH 30 years of experience in the health policy, healthcare delivery system, and legislative arenas. During her 20-year tenure as a policy director for the American Hospital Association (AHA), Rochelle led AHA’s post-acute care policy team. In this role, Rochelle partnered with providers, policymakers, and leading trade associations on issues pertaining to the home health, skilled nursing facility/nursing home, inpatient rehabilitation facility, and long-term care hospital sectors.
These advocacy efforts expanded to include issues of common concern to all post-acute care providers and their hospital partners, including issues pertaining to Medicare Advantage and commercial insurers, as well as the Medicare program’s effort to create a new, unified payment system to reimburse the aforementioned, post-acute care settings.
“We are pleased to welcome Rochelle to our team,” said Shawn Coughlin, president and CEO at NABH. “Rochelle’s extensive work in healthcare policy, as well as her strong relationships with partner associations, will enhance NABH’s advocacy efforts—both with legislators and regulators.”
Rochelle is a research fellow in the Georgetown University McCourt School of Public Policy and is a former David Winston Health Policy Fellow. She earned a master of science in health administration and a master of business administration from the University of Alabama at Birmingham School of Health Professions and a bachelor of arts in political science from the University of Colorado at Boulder.
NABH’s Enhanced Denial-of-Care Portal is Now Available!
The National Association for Behavioral Healthcare is pleased to announce enhancements to its Denial-of-Care Portal that are intended to make the portal easier for members to use.
A year ago, NABH developed the Denial-of-Care Portal to collect specific data on insurers who deny care—often without regard to parity or the effects on patients. Now the association has updated this resource to make it more user-friendly for members and also more aligned with what regulators need to identify parity violations.
The updated portal includes fewer questions, which will require less time for members to complete. In addition, all questions are now optional. NABH hopes this will make it more likely for members to share the data they have. Lastly, NABH has added a checklist of “red flags” that were included in the 2022 MHPAEA Report to Congress from the U.S. Health and Human Services, Labor, and Treasury Departments in January.
“We know the best way to advocate for parity enforcement with 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 these new changes will make it easier—and faster—for our members to use so that we can gather that critical data.”
Please e-mail Emily Wilkins, NABH’s administrative coordinator, if you have questions.
As always, thank you for all you do each day to support and advance NABH’s mission and vision!