May 7, 2008

National Council Resources & Events
Medicaid
Medicare
Addictions
Veterans' Mental Health
Criminal/Juvenile Justice
State Watch
Grants & Funding Opportunities
Other Resources
Other Events

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NATIONAL COUNCIL RESOURCES & EVENTS

Eleanor Clift to Speak at the National Council’s Fourth Annual Hill Day, REGISTER NOW!
On June 17, Eleanor Clift, contributing editor for Newsweek magazine and regular panelist on "The McLaughlin Group,” will be among the speakers at the National Council’s Public Policy Committee meeting. Register today for Hill Day to hear her insider’s view of Washington before you head to Capitol Hill to meet with your elected officials! This year, the National Council is again opening its Public Policy Committee meeting to all interested Hill Day participants on June 17. This meeting offers attendees a detailed overview of the National Council’s Hill Day policy priorities. Eleanor Clift will be joined by Congressional staff, government officials, and other experts who will update Hill Day participants on the latest information on key issues facing mental health and addiction treatment providers. Don’t miss this exciting kick-off to Hill Day. To learn more about the National Council’s Fourth Annual Hill day, visit our website.

Discount on E-Learning Courses in Honor of May is Mental Health Month
In honor of May is Mental Health Month, the National Council’s E-Learning partner, Essential Learning, is offering a 50% discount of three online courses: Adolescent Suicide, Anxiety Disorders: Diagnosis and Treatment and Overview of Mental Health Issues in Older Adults. The discount is available May 1-31 and is applied at check-out with code: MAY08. Courses offer a variety of state specific and national continuing education credit.

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MEDICAID

CMS Issues Tool to Help States in Complying with Medicaid Integrity Program Requirements
The Centers for Medicare & Medicaid Services (CMS) issued a tool to assist States in complying with Medicaid Integrity Program requirements. A provision of the DRA increased resources to combat fraud, waste, and abuse in the Medicaid program and identified certain responsibilities required of CMS and the States in these efforts, including a requirement of States to cooperate with Medicaid Integrity Program efforts.  The State Medicaid Director (SMD) letter issued today provides a State Plan Amendment pre-print to aid States in implementing this requirement.

Kaiser Family Foundation Analysis Shows Effects of Rising Unemployment on Medicaid and SCHIP
A new Kaiser Family Foundation Commission on the Medicaid and the Uninsured report provides insight into the effects of the rising unemployment rate on state Medicaid and SCHIP programs. For every 1% rise in the national unemployment rate, 1) the number of uninsured in the country would grow by 1 million, 2) Medicaid and SCHIP enrollment would increase by 1 million, 3) the enrollment increase in Medicaid and SCHIP would lead to $3.4 billion more in spending, of which $1.4 billion would be states’ obligation, 4) State General Fund revenue would drop by 3 to 4%, leading to state budget cuts with Medicaid spending a likely target since it is a substantial segment of state budgets.

New Data on Medicaid Spending by State of Residence
New data from CMS's Office of the Actuary on total Medicaid spending estimates by state of residence for 1995 through 2004 are available for all states.

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MEDICARE

NPI Required on All Prescriptions Filled by Medicare and Medicaid Beneficiaries After May 23; May 7 is “Legacy-Free Day”
As of May 23, CMS will require that all pharmacies submit the prescriber’s National Provider Identifier (NPI) on all prescriptions for Medicare and Medicaid beneficiaries. Prescription drug claims may be rejected by the insurer if a prescriber does not have an NPI, resulting in the patient paying for their medications out-of-pocket. See CMS’s NPI webpage for further information or below for details on an upcoming CMS conference call. 

In addition, CMS has requested that clearinghouses that submit claims to fee for service Medicare to participate in a one day NPI preparation exercise. On May 7, 2008, participating clearinghouses will send Medicare claims with NPI-only in provider fields which originally contain NPI/legacy pairs from the provider.  In other words, clearinghouses will strip the legacy identifiers when they are submitted as part of an NPI/legacy pair. This exercise will help Medicare providers evaluate their NPI readiness prior to the May 23, 2008 deadline. On May 8, 2008, participating clearinghouses will revert back to sending Medicare NPI/legacy pairs, if sent to them by the provider. The outcomes of this exercise could be: 1) Claims are processed and paid by Medicare.  Under this scenario, the provider can feel confident that their cash flow will not be affected by the May 23rd implementation date. 2) Claims are rejected or suspended.  Under this scenario, the provider will know in advance that there are problems that must be resolved prior to May 23rd.  Resolution might include changes to the NPESS data or to the 855 enrollment record. Participating clearinghouses will be soon notifying provider clients about details so pay close attention to Clearinghouse communications.

Source: NAPHS CEO Forecast, CMS e-mail

CMS Resource: Searchable National Database of Low-Quality Nursing Homes
The Centers for Medicare and Medicaid Services (CMS) recently added a new resource to their website: Nursing Home Compare. This searchable database allows users to find the names of nursing homes that rank in the lowest 5% to 10% in quality based on state inspection results. In addition to the database, the Web site, which CMS updates monthly, includes summarized information from state inspections and data that nursing homes must submit to regulators about their residents.

New Data on Medicare Spending by State of Residence
New data from the Centers for Medicare and Medicaid Services (CMS)'s Office of the Actuary on Medicare spending estimates by state of residence for 1995 through 2004 are now available for all states. These estimates are based on where individuals reside and include total Medicare spending, spending on hospital care, physician services, dental services, home health care, drugs, and nursing home care, total per enrollee spending, per enrollee spending by service type, and the average annual percent growth in Medicare spending from 1995 to 2004.

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ADDICTIONS

CSAT Offering Online Course on Acamprosate: CEUs Available
The Center for Substance Abuse Treatment (CSAT) Knowledge Application Program (KAP) is pleased to offer its first online e-learning course, “Acamprosate: A New Medication for Alcohol Use Disorders”. The course provides information about the use, side effects, and contraindications of Acamprosate; information to discuss with clients; and a comparison of medications used to treat alcohol use disorders. The course is self-paced so that users can log out and return later to continue where they left off. The course includes interactive exercises, case examples, and a test. Counselors who successfully complete the course receive one NAADAC-approved continuing education unit (CEU) at no cost and can print out their CEU certificate.

SAMHSA Report Reveals that 15% of Americans Admit to Driving Drunk
According to a SAMHSA report based off of data from the National Survey on Drug Use & Health (NSDUH), 15% of Americans admit to driving drunk, with the Midwest region having the highest rate of DUIs. According to Eric Gopulrud, director of Ensuring Solutions to Alcohol Problems at George Washington University, culture and demographics likely play a role in regional variations in drinking behavior.

New SAMHSA Report on Older Teens Driving Under the Influence
Impaired driving continues to be a severe and persistent threat to public safety, and the number of deaths from traffic crashes involving impaired drivers is higher than the number of deaths from all other causes among persons aged 3 to 33. This SAMHSA report, based off of the National Survey on Drug Use and Health (NSDUH), finds that 15.1 % of current drivers aged 18 or older drove under the influence of alcohol in the past 12 months and 4.7% drove under the influence of illicit drugs in the past year.

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VETERANS' MENTAL HEALTH

Closing Arguments in Class Action Lawsuit Over Veterans’ Mental Health Benefits
Arguments ended on April 30 in a class-action lawsuit against the Department of Veterans Affairs that alleges the agency is unequipped to provide medical services to treat the mental health problems of soldiers returning from the wars in Afghanistan and Iraq. The lawsuit, filed by Veterans for Common Sense and Veterans United for Truth, says that the VA is ignoring or delaying treatment of post-traumatic stress disorder for as many as 750,000 veterans of the wars. The lawsuit does not seek damages but instead wants the court to force the VA to provide improved care for veterans. The VA claims that the court does not have the authority to determine what services are covered for veterans. Meanwhile, a representative from the Department of Justice says that the VA has been providing mental health benefits and that its budget has increased from $3.2B to $3.5B last year. Additionally, the VA has set up a Veterans Suicide Hotline to provide 24-hour, 7 days a week crisis assistance.

Source: Kaiser Daily Health Policy Report

Several Senators Request Resignation of VA Mental Health Director
Senator Akaka (D-HI), Chair of the Senate Veterans’ Affairs Committee, and Senator Patty Murray (D-WA) have called for the resignation of Department of Veterans’ Affairs Mental Health Director Ira Katz, alleging that he withheld key information regarding suicide risk among veterans. In an e-mail disclosed a couple weeks ago in relation to the above-mentioned class action lawsuit against the Department of Veterans Affairs, Katz claims that 12,000 veterans annually attempt suicide while receiving treatment from the department. Katz in the e-mail wrote, "Shh!" adding, "Is this something we should (carefully) address ourselves in some sort of release before someone stumbles on it?" In related news, Senators Harkin, Murray, and Feingold have introduced legislation that would require the VA to track how many veterans commit suicide each year.

Department of Defense Announces New Policy on Disclosure of Mental Health Treatment for Military Personnel
DOD Secretary Robert Gates announced a new policy that seeks to reduce the stigma for military personnel who seek mental health treatment. Under the policy, military personnel will no longer have to disclose any service-related treatment that they have received when they apply for security clearance. Many military personnel do not seek mental health treatment because of concerns about the loss of their security clearance, the effect on their careers and embarrassment, according to a recent report that prompted the policy change.

Source: Kaiser Daily Health Policy Report

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Criminal/Juvenile Justice

U.S. Holds 25% of Global Prisoner Population
The United States imprisons people for drug use and other crimes that rarely result in prison sentences in other nations, helping to explain why a country with 5% of the world's population accounts for 25% of the global prison population. Research from the International Center for Prison Studies in London, England, also found that offenders in the U.S. are typically sentenced to longer terms in prison than those in other nations. Experts say that harsh sentencing laws, the War on Drugs, and even democracy play a role in America’s high incarceration rate. Elected judges, experts note, are more susceptible to public pressure to lock up offenders.

Source: Join Together

Thousands of Crack Offenders Have Sentences Reduced
The U.S. Sentencing Commission announced that since the new federal sentencing guidelines went into effect on March 3, 3,647 crack-cocaine offenders have applied for sentence reductions, and federal judges had granted their request in 3,075 cases. About 1,600 of the offenders were eligible for early release as a result. 30% of inmates whose sentences were reduced were minor or first-time offenders, while violent or repeat offenders constituted 9% of cases where sentenced were shortened.

Source: Join Together

Supreme Court Rules that Drugs Seized in Improper Arrest Can Still Lead to Conviction
According to a unanimous U.S. Supreme Court ruling, criminal charges arising out of a police search during an arrest can stand even if the arrest was later shown to be improper. In the case before the court, Virginia police arrested a man for driving with a suspended license. During a search, they found crack cocaine and charged the man with drug possession. The man was later sentenced to 3-1/2 years in prison. The Virginia Supreme Court dismissed the drug indictment but the U.S. Supreme Court overrode the state court's decision saying that police have the right to arrest and search citizens when they believe a crime has been committed, in order to safeguard evidence and ensure their own safety.

Source: Join Together

Resource: Alcohol and Drug Treatment in the Criminal Justice System
SAMHSA’s resource, “Alcohol and Drug Treatment: How it Works and How it Can Help You” is designed to inform people involved in the criminal justice system and their families about substance abuse treatment resources in prison and the community. It describes what can be gained through substance abuse treatment while a person is incarcerated, on probation, or on parole; encourages people to seek help for substance use disorders; and stresses the importance of family support when seeking this assistance.

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STATE WATCH

CT: Two Out of Three Prison Inmates Have Serious Addiction Problems
According to a report sponsored by the Drug Policy Alliance and A Better Way Foundation, two out of three inmates of Connecticut prisons have serious addiction problems. The study found that serious alcohol and other drug problems are rampant among the 20,000 inmates in the state and called for abolishing mandatory minimum drug sentencing and investing more money in drug and alcohol treatment programs. The report and some lawmakers also urge Governor Jodi Rell to ease parole restrictions and fund new halfway houses for released prisoners.

Source: Join Together

CA: Dental Problems Prevent Female Inmates from Enrolling in Addiction Treatment Programs
Oral health problems are preventing female inmates in California from accessing drug and alcohol treatment and vocational programs which require inmates to be free of pre-existing health problems. Female inmates interested in these programs face a several month wait to see a dentist, or having their teeth removed. This dental clearance policy has also meant that relatively few women have qualified for program that allows incarcerated mothers to be reunited with their children while serving their sentence. Legislation has been introduced to reduce the wait time for dental appointments.

Source: Join Together

KY: Poll Finds that More than One in Five Residents Uninsured in Early 2008
According to the Kentucky Health Issues Poll, 23% of adult residents aged 18-64 were uninsured during the beginning of this year. Additionally, 31% of adults have been uninsured at some point during the previous 12 months. For the poll, funded by the Health Foundation of Greater Cincinnati and the Foundation for a Healthy Kentucky, researchers surveyed 1,632 adults in Kentucky in January and February. The poll found that about 4.3% of adults were covered by Medicaid statewide.

Source: Kaiser Daily Health Policy Report

CA: Governor Announces Plan to Attempt Second Health Care Reform Proposal
California Governor Arnold Schwarzenegger has said that he would try again to pass state health care reform and would not try to reduce the scale of his plan to get it passed, despite his failed effort of 2007. In an interview with the Associated Press, the Governor said he feels obligated to try to make health care available for the over 5 million uninsured in his state. This interview came after a recent Field Poll that found that nearly ¾ of state voters are in favor of the basic premise of the Governor’s plan.

Source: Kaiser Daily Health Policy Report

LA: Residents Still Face Many Mental Health Problems Two Years After Hurricanes; Many Will Not Admit to Needing Help
According to the Baton Rouge Advocate, many Louisiana residents are still facing negative health consequences over two years after Hurricanes Katrina and Rita, including mental health problems. The report, co-sponsored by the Tulane University School of Public Health and Tropical Medicine and Pfizer, found that 41% of respondents said the storms had a significant impact on their mental health but did not believe they needed counseling. In addition, 70% of respondents said that residents generally feel ashamed and embarrassed about mental health problems.

Source: Kaiser Daily Health Policy Report

WI: Enrollment in BadgerCare Plus Far Exceeds Expectations, Could Raise Costs
Enrollment in Wisconsin’s BadgerCare Plus has far exceeded official estimates, with more than 71,000 residents enrolling in the first 6 weeks of the program. The program consolidates and streamlines the state's existing Medicaid, Healthy Start and Badger Care programs. The program is expected to cost $50 million over the next year-and-a-half, and the federal government will pay more than 60% of the costs. Officials had expected that an additional 26,000 to 27,000 eligible residents would enroll in the program during the first 12 to 18 months. The high enrollment "will add to the program's cost at a time when the economy is slowing" and "could undercut the state's projection that the cost would be offset by streamlining state health programs, expanding the use" of HMOs and the premiums and copayments from beneficiaries. Enrollment could continue to increase, but officials expect that some residents will lose coverage because of failure to contribute monthly premiums.

Source: Kaiser Family Foundation

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GRANTS & FUNDING OPPORTUNITIES

Tufts Health Plan Foundation Grants for Massachusetts Nonprofits
The Tufts Health Plan Foundation will award grants to nonprofits that work to improve health and welfare in Massachusetts communities by promoting healthy lifestyles and delivering high-quality healthcare services. Program priorities include addressing disparities in healthcare delivery, nursing faculty education, and health-consumer education, including instruction on navigating the healthcare system and adopting healthy lifestyles. The application deadline is July 7.

OJJDP Tribal Youth Program’s Juvenile Accountability Discretionary Grants
The Office of Juvenile Justice and Delinquency Prevention is currently seeking applications for its FY08 Tribal Youth Program’s Juvenile Accountability Discretionary Grants. These grants are aimed at developing and implementing programs that hold tribal youth accountable for their delinquent behavior and strengthen tribal juvenile justice systems. OJJDP encourages federally-recognized tribes and tribal partnerships to apply. The application deadline is June 13.

McKnight Foundation Awards for Minnesota Human Services Workers
The McKnight Foundation will award $10,000 for up to 6 human services workers in Minnesota. The McKnight Awards in Human Service will go to individuals "who have demonstrated an exceptional personal commitment to helping others in their communities but who have received little or no public recognition." Program staff or volunteers may be nominated. The foundation is especially interested in nominees who work to make communities more responsive to the needs of poor or disadvantaged residents. Nominations are due by July 7.

Mattel Children’s Foundation to Award Grants to Nonprofits Serving Youth
The Mattel Children’s Foundation will award grants ranging from $5,000 to $25,000 to non-profit organizations that "directly and effectively impact children with demonstrated needs (physical, financial, emotional, and health-related)." Foundation priorities include learning and literacy, health (with an emphasis on promoting healthy, active lifestyles), and empowerment of girls up to age 12. Applications are due July 15.

NIH Funding for Medication Development for Cannabis-Related Disorders
The National Institutes of Health will award $3 million in grants to up to six recipients for research into medications that can be used to treat marijuana-related disorders. The grants will "support research studies that focus on the identification, and preclinical and clinical evaluation of medications that can be safe and effective for the treatment of cannabis-use and -induced disorders, as well as their medical and psychiatric consequences." Nonprofits, for-profit companies, schools, government agencies, and others may apply. The application deadline is September 10.

Bank of America Offers Two Grant Opportunities to Non-Profits
The Bank of America Charitable Foundation is now accepting applications for two grants programs under its Neighborhood Excellence Initiative: the Neighborhood Builders program and the Local Heroes program. Under the Neighborhood Builders program, the foundation will award $200,000 grants to two nonprofits that work to promote vibrant neighborhoods. Efforts should closely track local priorities in health and human services, education, community development, etc. Local Heroes honorees will be individuals who make a significant impact on individuals, families, or the community at large, inspire others to community service, or act as catalysts for change. Up to five individuals will receive $5,000 awards that can be passed on to the charity of their choice. The application deadline for both opportunities is June 27.

CMS Announces $49.1M to Fund State High Risk Pool Operations
The Centers for Medicare & Medicaid Services (CMS) announced the availability of $49.1 million to fund High Risk Pool operations through a State Health Official Letter sent on May 1, 2008. States that have established a qualified high risk pool and who have also incurred operational losses and meets certain programmatic and operational standards may apply for the funding. States that are eligible for the grant due to operational losses may also apply for a bonus grant for supplemental consumer benefits. Grant applications are due July 9th. Please see a National Council issue brief on High Risk Pools.

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OTHER RESOURCES

Trauma-Informed Care Online Informational Network Now Available
The Center for Mental Health Services National Center on Trauma-Informed Care (NCTIC) has recently launched their own page on the interactive networking website, Ning.com. Participants can "listen in" to discussions or chime in on trauma and trauma-informed care through postings, blogs, and forums where they can upload images as well as documents.  Here, in this virtual pubic forum for trauma-informed care, survivors can meet and converse with consumers while caregivers can swap information about best practices, and all visitors can stroll by a virtual kiosk where updates on upcoming events will be posted.

Opportunity Agenda and Families USA Report on Equity in State Health Care Reform Efforts
The Opportunity Agenda and Families USA have released a report, “Identifying and Evaluating Equity Provisions in State Health Care Reform”. The report seeks to: 1) Identify state-level policies that promote equitable health care access and quality for all populations (equity benchmarks), 2) Evaluate existing laws, regulations, or reform proposals in five states - MA, CA, IL, PA, and WA - to determine whether they address health care disparities relative to these equity benchmarks.

Report Finds that Employer-Sponsored Health Insurance Premiums for Family Coverage Rose Faster than Income
According to a report released by the Robert Wood Johnson Foundation, employer-sponsored health insurance premiums for family coverage rose 10% faster than U.S. employees’ median income from 2001-2005. Data from the U.S. Census Bureau and the Medical Expenditure Panel Survey were analyzed for the study. According to the report, what workers paid toward premiums for family coverage increased 34.6% from $1,921 in 2001 to $2,585 in 2005, while median family income rose 3.1% from $40,818 to $42,068 during the same period.

Reports Find that Enrollment in Health Savings Accounts has Increased, Especially Among Higher Income Individuals
According to a Government Accountability Office report, the adjusted gross income of people enrolled in high-deductible plans with health savings accounts (HSAs) in 2005 was $139,000, compared to $57,000 for other taxpayers. Another report from America’s Health Insurance Plans finds that enrollment in HSAs increased by 35% since early 2007 to 6.1 million people. This report also found that nearly a quarter of new enrollees in these high-deductible plans with HSAs were uninsured in the previous year.  

Updated Data on Mental Health Mandated Insurance Benefits in the States
Updated information from Thomson West’s Health Policy Tracking Service (HPTS) on state mandates for specific services, such as mental health services, are now available for 2008 for all states and the nation.

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OTHER EVENTS

National Center on Trauma-Informed Care Conference “Dare to Transform”, July 11-12, Washington, DC
The Center for Mental Health Services National Center on Trauma-Informed Care (NCTIC) will host a national conference, “Dare to Transform” on July 11-12 in Washington, DC. This conference is designed to create a revolutionary learning exchange devoted to trauma-informed innovation and systems transformation and will bring together noteworthy experts on trauma-informed care and transformation across multiple sectors and areas of need. Registration is free.

OJJDP National Youth Gang Symposium, June 24-26, Atlanta, GA
The Office of Juvenile Justice and Delinquency Prevention (OJJDP) will be hosting a National Youth Gang Symposium on June 24-26 in Atlanta, GA. Under the theme "Partnering to Prevent Gang Violence: From Faith-Based and Community Organizations to Law Enforcement," the symposium will feature workshops designed to enhance efforts by law enforcement, school personnel, faith-based and community organizations, policymakers, youth serving agencies, and others who are working together to combat youth gang problems. Featured speakers include Attorney General Michael Mukasey and OJJDP Administrator J. Robert Flores.

CMS to Host NPI Roundtable, May 14, 2-3:30 PM EST
CMS will host a national NPI Roundtable to address additional questions from the Medicare provider community regarding Medicare's NPI implementation.  The Roundtable will be on May 14th from 2-3:30PM EDT. Providers will be able to submit questions through the online registration system at the time of sign up for the call.