Technical Assistance Update: June 17, 2008
June 17, 2008
National Council Resources & Events
Medicare
Addictions
Veterans' Mental Health
Criminal/Juvenile Justice
State Watch
Grants & Funding Opportunities
Other Resources
Other Events
NATIONAL COUNCIL RESOURCES & EVENTS
Compliance Watch: A Behavioral Health Exclusive, Subscribe NOW!
Now you can be out in front of compliance issues with the industry's only e-newsletter devoted to keeping your organization within the letter of the law. Each quarter, Compliance Watch, published by the National Council for Community Behavioral Healthcare, brings you in-depth articles on compliance challenges and solutions unique to mental health and addictions service provider organizations and is edited by Mary Thornton, the field's foremost compliance expert. Just one bit of information gleaned from Compliance Watch could literally save your organization millions...and you your livelihood. Subscribe today to receive three issues of the Compliance Watch e-newsletter in 2008, starting in June. National Council Members: $225. Nonmembers: $500. Subscribe now!
Conference 2008: Continuing Education Credits and Handouts
The 2008 Conference took place in Boston, May 1–3. If you attended the conference, you may: Complete your evaluations to get CE credits and certificates of completion. Please take a few minutes to submit your feedback even if you are not looking for CE credits; Download session handouts, print payment receipts, and more by accessing your registration. Questions? Email the National Council.
MEDICARE
Update for Medicare Fee-for-Service Providers on Implementation of the National Provider Identifier
As included in a Centers for Medicare and Medicaid Services (CMS) email: “Medicare FFS has made excellent progress over the past week, since fully implementing the National Provider Identifier (NPI). In fact, the favorable trend in NPI compliance is better than we expected with most of the Medicare contractors reporting that over 90% of claims are NPI-compliant, with some reporting 100% compliance. Furthermore, we have experienced relatively few problems to date and we are working daily with our contractors to help resolve those issues that exist. We would like to point out that, on May 23, there were a number of rejections for claims with legacy numbers in the SECONDARY provider identifier field. As indicated, we are seeing this particular issue rapidly improve as more and more providers realize the need for NPI-only in secondary identifier fields and the relative ease in which they can appropriately complete these fields.” You can learn more on CMS’s website.
Source: CMS email
Issue Brief Highlights Record Growth in Medicare Advantage Enrollment
A new Kaiser Family Foundation issue brief prepared by Mathematica Policy Research Institute shows that Medicare Advantage plans enrolled a record 9.8 million beneficiaries, more than one in five of the nation’s 44 million people on Medicare as of April 2008. That represents an increase of more than 800,000 beneficiaries in just four months, continuing a period of unprecedented growth for private plans in Medicare since 2003.
Analysis Reveals that Nearly ¾ of Medicare Part D Beneficiaries Will Pay 16% More this Year
According to an analysis released by Avalere Health, monthly premiums for Medicare beneficiaries enrolled in the 10 largest prescription drug plans this year increased by an average of 16% to $26.39. Among the 10 prescription drug plans -- which account for about three-fourths of all Medicare beneficiaries enrolled in such plans -- six increased premiums this year, and four reduced them.
Physician Quality Reporting Initiative Final Feedback Reports Available to Practices with Professionals Who Reported Data in 2007
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce that 2007 PQRI Final Feedback Reports will be made available in mid-July on a secure website. Reports will be available to each practice, identified by Taxpayer Identification Number (TIN), under which at least one eligible professional reported 2007 PQRI quality measures data. Reports available to the practice will include information on reporting rates, clinical performance, and incentives earned by individual professionals, with summary information on reporting success and incentives earned at the practice (TIN) level. CMS recommends that practices take the time now to set up their online account so they can access their report as soon as it is available. The first step is for the professionals and appropriate staff to register for access through a new CMS security system known as the Individuals Authorized Access to CMS Computer Services – Provider Community (IACS-PC). To learn more, click here.
Medicare Announces Additional Funding for Health Insurance Counseling Programs for 2008
The Centers for Medicare & Medicaid Services (CMS) announced last week that an additional $15 million will be distributed to State Health Insurance Assistance Programs (SHIPs) to help people with Medicare get more information about their health care choices. The $15 million is the second of three installments of SHIP funding in 2008. CMS will distribute over $50 million to the nation's SHIPs in 2008; of that, $36 million was distributed on April 1 and an additional $1.5 million will be distributed in performance-based awards to SHIPs in September. This funding represents a $20 million increase in SHIP funding over fiscal year 2007. CMS expects the SHIPs to use the increased 2008 funding to conduct community-based programs targeted at reaching more beneficiaries who are unable to access other sources of information such as the CMS online tools.
ADDICTIONS
ONDCP Director Walters Wants No Strings Attached to Funding President Bush’s Mexico Anti-Drug War
The Office of National Drug Control Policy Director John Walters stated that Congress should fund President Bush's Mexican anti-drug initiative without attaching requirements for Mexico's military and police to comply with human-rights standards. Bush originally proposed giving $500 million this year to fight drug cartels, but Congress scaled the funding back. In addition, Congress is requiring Mexico to comply with rules that Walters believes would sabatoge our relationship with other countries if we asked them to comply.
Source: Join Together
Contrary to Popular Belief, Baby Boomers Continue Recreational Drug Use in Senior Years
Researchers from the National Institute on Drug Abuse (NIDA) cast doubt on the theory that these lifelong recreational drug users will "age out" of use of marijuana or other substances as they get older. For example, hospitals reported that cocaine mentions at emergency rooms rose 240% among people ages 55 and older between 1995 and 2002, while heroin mentions rose 160%, marijuana mentions rose 467%, and amphetamine mentions rose 700%. Moreover, the National Survey on Drug Use and Health found that illicit drug use among people ages 50-59 rose from 2.7% in 2002 to 4.4% in 2005. Experts say that the trends may be related to the fact that people are living longer but also holding on to the drug-use habits of their youth. The research appears in the journal Neuropsychopharmacology.
Study Finds that Co-Occurring Addictions Common Among Youth with Psychotic Disorders
For this study, researchers assessed 69 youths between the ages of 6 and 17 (mean age, 14.8 years) undergoing treatment for early onset psychosis. Subjects were assessed annually over 2 years using standardized diagnostic and symptom rating measures. Forty-five percent of subjects met criteria for substance abuse or dependence. An additional 7% did not meet criteria for a diagnosis of substance use disorder but had used illicit drugs. Of these youths, only 26% had received addictions treatment. The study was published in the Journal of Dual Diagnosis.
Source: Join Together
Computerized Alcohol Screening and Brief Intervention May Reduce Hazardous Drinking
Web-based strategies have the potential to improve delivery of alcohol screening and brief intervention. In a recent controlled study, researchers randomized 429 university students who screened positive for hazardous or harmful drinking to either a single web-based brief intervention, a web-based brief intervention with follow-up interventions at 1 and 6 months, or a control group receiving an educational pamphlet only. Interventions included alcohol assessments and personalized feedback. Participants completed web-based outcome assessments at 6 and 12 months. Compared with controls, participants in the single intervention group reported significantly lower frequency of drinking at 6 months and lower total alcohol consumption at 6 and 12 months. This article is published in the journal Archives of Internal Medicine.
Study Finds that Opioid Therapy Can Decrease Mortality Rates
Opioid-dependent patients are 13 times more likely to die than their age- and sex-matched peers in the general population. To examine predictors of long-term mortality, Australian researchers conducted a 10-year follow-up study of 405 heroin-dependent patients who had participated in a randomized trial comparing methadone and buprenorphine. The study found that each additional opioid maintenance treatment episode lasting more than 7 days decreased mortality by 28%.
Addiction Treatment Professionals: Share Your Views in a Short Online Survey
Are you an administrator or staff member in a treatment program for substance use disorders? If yes, please share your views and experiences by participating in an online survey. The National Center on Addiction and Substance Abuse (CASA) at Columbia University invites administrators and staff of public and private addiction treatment programs in the U.S. to participate in a brief online survey about the issues and barriers you face in providing quality service and about your recommendations for improvement. The survey is part of a larger study examining the state of substance abuse treatment in the U.S. and strategies to improve access, availability and quality of treatment. The online survey is only five questions and can be completed in a matter of minutes. Your responses will be anonymous and confidential; they cannot be attributed to you in any way. If you have any questions about the survey or CASA’s work, please contact Dr. Roger Vaughan, DrPh, The National Center on Addiction and Substance Abuse at Columbia University.
Bipolar Youth at Higher Risk of Addiction
Researchers at Massachusetts General Hospital found that adolescents with bipolar disorder are more likely to use alcohol, tobacco and other drugs. Their study compared 105 adolescents with diagnosed bipolar disorders to a control group of 98 youths with no mood disorders and found that 34% of the bipolar group smoked or were dependent upon alcohol or other drugs, compared to 4% of the control group. High rates of alcohol, tobacco and other drug use persisted even when researchers controlled for co-occurring behavioral and psychiatric conditions. The study appears in the journal Drug and Alcohol Dependence.
VETERANS' MENTAL HEALTH
Departments of Defense & HHS Announce Program to Send Mental Health Professionals to Help Soldiers with PTSD
The Departments of Defense and Health and Human Services announced that they will send over 200 psychiatrists, social workers, and other mental health professionals to military facilities to treat the increased number of soldiers who have post-traumatic stress disorder. Adm. Joxel Garcia, assistant secretary for health at HHS, said that the program will coordinate scientific research for the mental health care needs of soldiers and improve treatment and prevention efforts for PTSD. Garcia said, "We are very proud that this is an effort to essentially serve not only the veterans that are coming from war, but also their families."
Source: Kaiser Daily Health Policy Report
Military Prescribes Growing Number of Soldiers Antidepressants
The U.S. military says that 12% of combat personnel in Iraq and 17% serving in Afghanistan are taking prescription antidepressants or sleeping pills to battle the mental strain of extended tours of duty and the horrors of war. In the combat zone, soldiers say that visits to doctors are few while drug prescriptions are common. Some see the rising use of antidepressants as a result of strain on the military as a whole. "This is what happens when you try to fight a long war with an army that wasn't designed for a long war," said Lawrence Korb, the Reagan administration's military personnel chief.
Source: Join Together
CRIMINAL/JUVENILE JUSTICE
Crime Rates Decline After Two Years of Increases
FBI’s Uniform Crime Reports show that after two consecutive years of increases, the rates of violent and property crimes in the U.S. declined last year. The violent-crime rate declined 1.4 percent in 2007 while property crimes were down 2.1 percent. Violent crime had risen 1.9 percent in 2006 and 2.3 percent in 2005.
Source: Join Together
STATE WATCH
LA & MI: Study Finds Many Residents Affected by Hurricane Katrina Still Have Mental Health Problems
A study conducted by the American Medical Association of Mississippi and Louisiana residents affected by Hurricane Katrina finds that more than half of those studied still have mental health problems. Lead study author David Abramson said that although study participants reported increased access to health care, many remain insecure in their neighborhoods. In addition, he said that study participants with strong social support networks experienced the most improvement in mental health. "At the end of the day, our study shows it's not what type of housing you have, not your current economic situation, it had more to do with social factors," adding, "Helping to rebuild people's lives involves more than integrating housing, health care and education. We must figure out a way to help families fit into communities better". The study will be published in the June issue of the journal Disaster Medicine and Public Health Preparedness. An abstract is available online.
Source: Kaiser Daily Health Policy Report
MA: State Reduces Uninsured Rate by Half in the First Year of Mandatory Coverage
According to a study conducted by the Urban Institute, Massachusetts reduced its proportion of uninsured residents by nearly a half in the first year of mandatory health coverage and made improvements in the number of individuals who receive routine preventive care. The study, which was published in Health Affairs, found no evidence that residents were dropping private health coverage to take advantage of state-subsidized policies, or that employers viewed the availability of new public programs as a reason to eliminate health benefits.
Source: New York Times
CO: Governor Signs Several Bills to Lay Foundation of Future Large-Scale Health Care Expansion
Colorado Governor Bill Ritter signed 11 bills into law that which lay the foundation for the state’s efforts to expand health insurance coverage. One of the most prominent bills makes 50,000 more uninsured children eligible for federal Medicaid benefits and for the state plan, Colorado Child Health Care Plan Plus (known as CHP+). A companion piece of legislation simplifies the application process to get on Medicaid and CHP+. Another bill will will provide People with health insurance electronic cards containing all their current insurance information. The goal is to streamline the system and cut down on the huge overhead of managing insurance claims.
Source: Stateline
HI: State Ranks High in Teen Suicides in National Survey
According to a national survey conducted by the U.S. Centers for Disease Control and Prevention (CDC), Hawaii public high school students again rank high in a national public health survey about whether they seriously considered suicide or came up with a suicide plan (18.5%). Hawaii students also registered high rankings in whether they attempted suicide or had a suicide attempt treated by a doctor.
Source: Stateline
NV: Panel Approves State Health Insurance Coverage for Same Sex Partners
A panel that oversees the state employee health insurance program voted Thursday to extend coverage to the domestic partners of plan participants despite budget problems that could make the $2.7 million cost unaffordable. If funding does not materialize in the 2009 legislative session to pay for the expansion of benefits to domestic partners starting July 1, 2009, including those of the same sex, and their children, the regulation will not take effect and the benefit will not be available. The vote means the cost of the expansion will be included in the board's submission to Gov. Jim Gibbons for the 2009-11 budget. If Gibbons does not include the cost in his budget, the Legislature would be asked to find the money to pay for the expansion.
Source: Stateline
SC: Legislature Overrides Governor’s Veto of SCHIP Expansion Bill
South Carolina lawmakers on Wednesday voted to override Gov. Mark Sanford's vetoes of several bills, including a measure to expand SCHIP. The bill provides an additional $21 million to expand the income eligibility limits for Partners for Healthy Children, the state's version of SCHIP. Supporters of the bill said the measure will allow 88,000 additional children to enroll in the program.
Source: Kaiser Daily Health Policy Report
MN: State to Offer Financial Incentives to Doctors for Treating Depression
By this time next year, it is expected that Minnesota will offer financial incentives to doctors for successfully treating depression in their patient population. Successful treatment will be defined as achieving significant improvement in patients with depression within six months, with full recovery occurring within a year. The Buyers Health Care Action Group, a health improvement-oriented coalition of 40 of the state’s largest employers, is funding this program which is the first depression pilot program for Bridges to Excellence, a national effort to recognize and reward health care providers for offering effective, patient-centered treatment.
Source: Mental Health Weekly
FL: Governor Approves FY 2009 Budget Which Includes Cuts to Health Care
Florida Gov. Charlie Crist (R) on Wednesday signed into a law a "bare-bones" $66 billion state budget for fiscal year 2009 that includes funding cuts for state hospitals, nursing homes and other social programs. The budget is $6 billion less than the current budget. Crist said the budget includes adequate funding to enroll 38,000 additional children into KidCare, the state's version of SCHIP. However, state House Minority Leader Dan Gelber (D) said the budget would cut funding to "the state's health care system that will harm our most sick and most vulnerable," and other state and educational organizations.
Source: Kaiser Daily Health Policy Report
GRANTS & FUNDING OPPORTUNITIES
OJJDP Invites Applications for the Latino Youth Mentoring Program
The Office of Juvenile Justice and Delinquency Prevention (OJJDP) invites interested parties to apply for funding through the Latino Youth Mentoring Program. The program focuses on developing and supporting a peer mentoring program that proactively reaches youth before they are recruited by gangs to develop and strengthen protective factors against gang involvement and other problem behaviors. Successful applicants will include local school districts with a demonstrable Latino gang problem committed to or already working with nonprofits, faith-based organizations, and other community partners to provide mentoring services to at-risk youth. Targeted programs will feature schools with large populations of non-native, Hispanic youth. The application deadline is June 20, 2008.
SAMHSA Applications for National Suicide Prevention Lifeline Crisis Center Follow-Up Grants
The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services, is accepting applications for FY 2008 National Suicide Prevention Lifeline Crisis Center Follow-Up grants. The purpose of this program is to promote systematic follow-up of suicidal persons who call the National Suicide Prevention Lifeline. It is expected that $350,000 will be available to fund up to five grants of $70,000 per year for up to three years. Eligible applicants are members of the National Suicide Prevention Lifeline Crisis Center network who provide 24-hour-a-day coverage and meet the additional eligibility requirements described in the full announcement.
CADCA Now Accepting Applications for ‘Got Outcomes’ Awards
Community Anti-Drug Coalitions of America (CADCA) is now accepting applications for its Got Outcomes! Coalition of Excellence Awards, which recognize groups that use data-driven strategies to achieve demonstrable declines in alcohol and other drug abuse. Award winners will receive free registration to CADCA's February 2009 National Leadership Forum and be honored at the event. Semifinalists for the awards also will receive up to $1,000 to offset the cost of attending a regional training program on outcomes. Three awards will be made: Coalition of the Year (multiple strategies toward multiple aims), the Milestone Award (community-level changes in intermediate outcomes), and the Coalition in Focus Award (multiple strategies toward reducing use of one substance). The awards have a two-phase application process and a deadline of June 27. For more details, contact Shannon Weatherly, technical assistance manager at CADCA's National Coalition Institute, at 1-800-54-CADCA (1-800-542-2322), ext. 240, or via email.
Nonprofits Invited to Apply to the American Legion Child Welfare Foundation
Nonprofits that contribute to the physical, mental, emotional, and spiritual welfare of children through the dissemination of knowledge about established and/or new and innovative organizations designed to benefit youth may apply for funding from the American Legion Child Welfare Foundation. Grants are awarded to programs that have the potential to help children in a large geographic area. e.g. more than one state. The application deadline is July 15.
Robert Wood Johnson Foundation to Give $300M in Healthcare Improvement Grants
The Robert Wood Johnson Foundation (RWJF) has announced that it will award $300 million through its Aligning Forces for Quality initiative to improve the quality of healthcare in the U.S. The money will support community-based teams that will disseminate information on how individuals can partner with their healthcare provider to ensure that they receive quality healthcare, help doctors improve patient care, improve hospital care, and reduce healthcare inequities. Resources will be focused on the following communities and states: Cincinnati; Cleveland; Detroit; Humboldt County, California; Kansas City, Missouri; Maine; Memphis; Minnesota; Seattle; south-central Pennsylvania; western Michigan; western New York State; the Willamette Valley in Oregon; and Wisconsin.
NIDA & NIAAA Awarding Grants for Research into the Economics of Alcohol & Other Drug Treatment Prevention & Treatment
The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA) will award grants for research into the economics of alcohol and other drug treatment and prevention services. The scope of the research grants includes financing and purchasing of drug and alcohol treatment and prevention services. Nonprofits, for-profit entities, schools, government agencies, and others may apply. Grants will be made under the R01, R03, and R21 research-grants mechanisms.
Training Available from the National Highway Traffic Safety Administration's (NHTSA) Office of Safety Programs for Developing DWI Courts
Communities interested in creating special courts to deal with drunk-driving offenders may apply to participate in training offered by the National Highway Traffic Safety Administration's (NHTSA) Office of Safety Programs. Applications are now being accepted for the 2009 DWI Court Training initiative, conducted by NHTSA in cooperation with the National Center for DWI Courts, a program of the National Association of Drug Court Professionals. Communities accepted into the program will take part in a planning process commencing in March 2009 and ending in October 2009. For more information, contact Brian Chodrow at NHTSA at 202-366-9765 or brian.chodrow@dot.gov.
AHRQ to Provide Small Grants to Non-Profits Offering Conferences Focused on Best Practices
The federal Agency for Healthcare Research and Quality (AHRQ) will award grants to nonprofit organizations and others who want to run conferences that disseminate research-based information on healthcare best practices. The Small Grant Program for Conference Support offers grants of up to $50,000 to nonprofits, tribal, state, and other governments, schools, public-housing agencies. The application deadline is October 20, 2008.
OTHER RESOURCES
Study Finds that Fastest Growing Group of People Using the EDs are Those with Insurance
According to a study published in the Annals of Emergency Medicine, the fastest growing group of people using emergency departments is middle-income patients with health insurance, rather than uninsured patients. The study, which is based on the national Community Tracking Study Household Surveys, looks at the overall trend in ED use for various income groups and found that uninsured patients accounted for 15.5% of ED visits in 1996-1997 and 14.5% of visits in 2003-2004. During the same time periods, the percentage of ED visits by higher-income patients increased from 21.9% to 29%, and the percentage of ED visits by those who obtain care in physician offices in most cases increased from 52.4% to 59%. As a result, experts maintain that the "underlying assumption" in the national health care debate that an expansion of health insurance to more U.S. residents would result in decreased use of EDs "turns out to be ... false”.
Source: Kaiser Daily Health Policy Report
Number of Underinsured Increased by 60% Between 2003 and 2007
The number of underinsured U.S. adults increased by 60% from 2003 to 2007, according to a study published in the journal Health Affairs. The study defined as underinsured adults who had health insurance all year but had out-of-pocket medical costs equal to at least 10% of their annual incomes or greater than 5% for those with low incomes, as well as those who faced deductibles greater than 5% of income. The study found that 25 million U.S. adults -- about one in every five younger than age 65 -- were underinsured in 2007, compared with 16 million in 2003.
KFF Resource: Perspectives on State Health Reform
In the fourth installment of the new Kaiser Family Foundation series, “Pulling It Together…from Drew Altman,” the Foundation's President and CEO draws on his personal experience in state and federal government and Foundation research to write this essay. It discusses the critical factors that influence state health reform efforts.
Life Expectancy Reaching a New High
Life expectancy for U.S. residents reached a record high of 78.1 years in 2006, compared with a previous record high of 77.8 years in 2005, according to a preliminary report released by the National Center for Health Statistics at CDC. According to the report, life expectancy was 80.7 years for women and 75.4 years for men. Experts said that the disparity in life expectancy between women and men has decreased since 1979 as more women have become smokers. The report found that white women had the longest life expectancy, at 81 years, followed by black women at 76.9 years, white men at 76 years and black men at 70 years. The report also found that the overall mortality rate decreased to 776 deaths per 100,000 individuals in 2006 from 799 per 100,000 in 2005.
Survey on State Regulatory Oversight of Individual Health Insurance Market
The individual market is increasingly important as employer-sponsored health insurance declines and some elected officials promote its deregulated expansion. Yet what this report highlights is that the individual private market does not well protect consumers. This recently released report from Families USA, is based on a 50-state survey of insurance commissioners and shows that more needs to be done to protect consumers from certain insurance company practices.
OTHER EVENTS
CMS’s Provider Communications Group to host a PQRI Conference Call, June 18, 3:30-5:00 PM EST
The Centers for Medicare & Medicaid Services' (CMS) Provider Communications Group will host the third in a series of national provider conference calls on the 2008 Physician Quality Reporting Initiative (PQRI). This call will provide an overview of the alternative reporting periods and alternative criteria for satisfactorily reporting quality measures for the 2008 PQRI as authorized by the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) (P.L. 110-173) which was enacted on December 29, 2007. In 2008, eligible professionals may earn an incentive payment of 1.5% of their total allowed charges for Physician Fee Service covered professional services furnished during the respective alternative reporting periods based on data submitted via these mechanisms. In order to receive call-in information, you must register for the call. The powerpoint presentation will be available just prior to the call.
CSAT and Partners to Host 3rd National Conference on Women, Addiction and Recovery, September 15-17
The Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment, in partnership with New Century Institute and the Florida Alcohol and Drug Abuse Association, is pleased to host the 3rd National Conference on Women, Addiction and Recovery: Inspiring Leadership, Changing Lives, September 15-17, 2008, at the Tampa Marriott Waterside Hotel and Marina in Tampa, Florida. The audience will find a broad mix of topics addressed, including best practices as well as innovative and emergent approaches to treating women, issues pertaining to recovery support, health and wellness, as well as program administration and management.
Webinar: Creating Trauma-Informed Services and Settings for People who are Homeless, June 24, 1-2 PM EST
This webinar is part two of a two part series sponsored by the Homelessness Resource Center. During this session, HRC will discuss “trauma-informed care,” including definitions and principles; compare this approach to the more “traditional” approaches to service provision; and begin a discussion about what it means to provide trauma-informed care.
