January 2007 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
NACBHD News
Change in NACBHD Leadership: Search Process is Underway
NACBHD President and CEO Melissa Staats resigned her position in the organization effective December 31 to become the Director of Mental Health in Westchester County, New York. (Staats continues to be a member of NACBHD.) The search for a new Executive Director is underway. In the meantime, Tom Joseph, Senior Associate, Waterman & Associates, is working to ensure that NACBHD is represented on all policy issues. Joseph says that as the Board and the Executive Committee plan the next steps, his goal is “to make sure that the transition is as seamless as possible and to give the Board the time to consider the next steps for NACBHD.”
Tom Jospeph
NACBHD will keep members updated on the search for an executive director.
NACBHD Has Moved: New Contact Information
As of January 30, NACBHD is now located at:
25 Massachusetts Avenue, N.W.
Suite 500
Washington , D.C. 20001
The telephone number, fax, e-mail addresses and Web address remain the same:
Phone: (202) 661-8816, Fax: (202) 661-8871
E-mail: mgilmore@nacbhd.org
Web site: www.nacbhd.org
The office was closed and the phones were down from January 24 - January 29 for the move. The office reopened on January 30.
NABHD Criminal Justice Committee Is At Work Again: Current Focus Is On Jail Diversion Program Materials
The NACBHD Corrections Committee is up and running again, under the leadership of Gilbert Gonzales, Director, Crisis and Jail Diversion, Center for Healthcare Services, San Antonio, Texas. NACBHD members interested in the Committee are welcome to join the committee conference calls, which take place the second Tuesday of each month at 2:00 p.m. eastern time. Currently, the group is working on collecting examples of jail diversion programs and materials to post on the NACBHD website so that NACBHD members can access useful materials that their colleagues have developed or implemented.
The next Corrections Committee conference call is scheduled for Tuesday, February 13, at 2:00 p.m. eastern time. If you would like to participate in this call or a future call, contact Maeghan Gilmore at mgilmore@nacbhd.org, or at (202) 661-8816. If you have questions about the committee, you may contact Gilbert Gonzales at ggonzales@chcs.hhscn.org.
NACBHD Legislative Conference February 28 – March 2: 2007 Priorities of SAMHSA, CMS, and the 110th Congress
NACBHD’s annual Legislative Conference is scheduled for February 28 through March 2 at the Jurys Hotel in Washington, DC. This year’s conference is an opportunity to hear first-hand from federal representatives and national advocacy partners what those in the behavioral health field may expect with the change in Congressional leadership, as well as learn about SAMHSA and CMS priorities for 2007.
To access a registration form for the conference, click here. Rooms at the Jurys Hotel can be reserved by calling 1-866-534-6835. (The room rate is $179. Use NACBHD as the group identifier.)
While all conference materials have been posted to the NACBHD web site, an agenda for the meeting also can be accessed by clicking here.
In addition to the items listed on the conference agenda, NACBHD is pleased to announce that Pete Earley, author of Crazy - Mental Health and Criminal Justice Systems will speak at the conference. And, representatives from Alicia Smith & Associates (a Washington, DC consulting firm involved in quality and cost efficiency issues in health and human services programs including Medicaid, Medicare, SCHIP, and TANF) will be present to discuss the federal budget and how it may impact the Centers for Medicaid and Medicare Services, particularly in the developmental disability arena.
Combating Autism Act Signed By President Bush: An Analysis and Forecast
The NACBHD Developmental Disability Committee has identified autism spectrum disorders as a priority issue for NACBHD. An important development in the autism policy and funding area is the Combating Autism Act, S. 843, which President Bush signed on December 19. The act, authored by Senators Santorum and Dodd, authorizes nearly $1 billion in federal money for autism-related research, early detection, and intervention, through 2011.
NACBHD recently spoke with Deidra B. Abbott, MPH, of Alicia Smith & Associates, LLC, a Washington D.C.- based consulting firm involved in advancing the quality and cost efficiency of health and human services programs, including Medicaid, Medicare, SCHIP, TANF, MR/DD programs substance abuse and mental health programs, juvenile justice programs, and child welfare programs (Title IV-E). Abbott was previously a Director for the Centers for Medicare and Medicaid Services (CMS), where she managed home and community-based waiver programs, Medicaid long-term care, and services to underserved populations. In addition, she has worked for more than 20 years on public health policy development and program implementation at the state and federal levels and in the private sector. Representatives from Alicia Smith & Associates will be at the NACBHD Legislative Conference to speak about the Combating Autism Act and about the impact of the Deficit Reduction Act.
Analysis and Forecast of the Combating Autism Act
Abbott gave NACBHD the following perspective on the Combating Autism Act, including how funding issues might be interpreted and what the federal dollars may be intended for.
A critical piece of legislation
Abbott views the Combating Autism Act as an extremely important piece of legislation; it is only the second piece of legislation in many years that focuses on a specific condition. The first was the Ryan White Act. And while the funding may be relatively small in proportion to the numbers diagnosed with autism spectrum disorders, the diagnosis has been recognized as “significant enough by Congress that something needs to be done,” says Abbott.
In analyzing the Combating Autism Act, Abbott discussed the following components of the Act:
Were any funds for treatment and services specified in the legislation?
In terms of money for treatment, there was none stipulated in the legislation. In terms of services, the closest is in the area of public awareness and the priority placed on early screening of those identified at higher risk for autism spectrum disorders. Most of the funding is for data collection and research.
And, Abbott as explains, the legislation does not focus on the entire individual and the interactive and often comorbid nature of the disorder; rather it focuses on the medical treatment issues as opposed to behavioral health, developmental disability, and substance abuse issues. There are no age limits specified in the appropriation.
Funding uncertain at a time when Congressional priorities are unclear
There is no guarantee that the funding outlined in the legislation will actually be appropriated or that it will be appropriated to the extent specified in the legislation. The legislative language regarding funding, is, as Abbott describes it, “to the extent that appropriations are available.”
There is significant concern about this, Abbott explains, as the legislative priorities of this 110th session of Congress are unknown, and if the Combating Autism Act is not given priority, there is no guarantee that the funding will be appropriated. On the other hand, Abbott thinks it will be very difficult for this Congress not to make some funding available, but her guess is that Congress will not appropriate funding to the full extent authorized in the legislation.
Will the money appropriated flow down to the local level?
Abbott thinks it is possible that local entities will be considered in the grants and funding, and NACBHD members should carefully review grant announcements once they are released.
What about HCBS waivers?
Abbott says that CMS staff are working with how to implement the Deficit Reduction Act in regard to HCBS waivers. (There is provision in the Deficit Reduction Act that allows states to implement HCBS waivers.) When the guidance from CMS is released in February or March, people may be disappointed with the limitations of the state plan option; they may turn to the HCBS option as a way of providing services to a broader category, including those on the autism spectrum disorder. Abbott still sees the HCBS process as an excellent opportunity to provide services to those with autism spectrum disorders, and she thinks it will be welcomed by CMS. CMS has redesigned the waiver application, and it continues to be under the microscope of the Government Accounting Office (GAO).
What should NACBHD members do?
Abbott encourages members to “lobby, lobby, lobby,” especially in terms of CMS. She notes that it is much more effective when Congressional leaders hear from their constituents, especially since there are so many contingencies that are an area of concern within this diagnostic category and so many different interests. An effective form of lobbying, particularly in this case, is for a coalition of groups to come together to speak on a particular issue.
Comments on the Combating Autism Act from the Autism Society of America (ASA)
On December 19, 2006, the ASA issued a statement on its website regarding the Combating Autism Act. The areas of concern mentioned in this excerpt from the statement may be of interest to NACBHD members.
ASA President and CEO Lee Grossman expressed his gratitude to the President and all the members of Congress taking leadership on this effort. “This is only the beginning of ASA’s commitment to ensure federal [funding] for autism is spent wisely and, in the most effective way,” commented Grossman. “Now, we hope that Congress will get to work on a comprehensive services bill for individuals with autism, including reforming Medicaid-funding waivers, employment incentives, housing improvements, job training and so much more." ASA will work actively on the Hill in the 110th Congress to ensure further legislation for autism services, education, and environmental health. Click here for more information.
Behavioral Health Impact of War on Families Is Critical: NACBHD Involved in Effort to Develop Community Capacity
NACBHD recently spoke with James Castro, Director of Children & Adolescent Services, the Center for Health Care Services (CHCS), San Antonio, Texas, about a paper he is working on to present to Congress to gain sponsorship for behavioral health support for children, spouses, and extended families of soldiers returning from the Iraq war. (Castro works with Leon Evans, NACBHD Board member and President/CEO of CHCS.) Castro and Evans are in a good position to hear about the impact of the war on spouses, children, and extended family and caregivers; Audie L. Murphy Memorial Veterans Hospital is located in San Antonio and Brooke Army Medical Center is in nearby Fort Sam Houston.
There is growing evidence, which Castro has been compiling data on, that the families of soldiers returning from Iraq, especially those families of soldiers suffering from PTSD, are suffering secondary behavioral health issues, such as anxiety, depression, and substance abuse.
For example, he says pediatricians from Brooke Army Medical Center are seeing more children of Iraq veterans who are experiencing secondary trauma. In addition, spouses of soldiers returning from Iraq who are responsible for caring for the children are also suffering from the secondary stressors.
The impact on families
A recent VA report says that as many as one-third of the soldiers returning home from Iraq may have PTSD. The symptoms of PTSD pose significant stressors for families and have a behavioral health impact on the soldiers’ spouses and children. Castro hopes to correlate the numbers of children and spouses likely impacted in his research. In addition, Castro says it is important to remember that symptoms of PTSD do not always exhibit immediately, and may in fact, take years to exhibit. There needs to be research on the number of children, spouses, and extended family/caregivers at risk, and that from that data, a capacity for care can be built.
Improved medical care has allowed more soldiers to survive, but there may be more soldiers with traumatic injuries with long-term consequences. There are 22,565 wounded at this point, and over 3,000 dead. This means the burdens on secondary caregivers will be enormous, and consequently the impact on communities can be expected to be significant. Castro refers to it as a potential “mini-crisis.”
From a Center for American Progress article, Castro says the estimated costs for caring for a 24 year old male soldier married with one child who returns home with a disabling mental illness is $1.3 million over the span of a lifetime. And, this number was arrived at without addressing such potential related problems as divorce and child delinquency. On the other hand, Castro says, there are no figures available on the cost of prevention and treatment.
Castro says the families at risk would be considered as part of the priority population, with a service member coming home with PTSD determined to have a trigger effect on a family member or caregiver. He would like to see marital conflict considered as a trigger. In 2004, 3,300 army marriages ended in divorce; this was up 78% from 2003.
Castro is compiling the data on children, spouses, and extended family and caregivers impacted mostly from Internet research. In addition, there was a December 2006 Military/Behavioral Health Community Navigation Discussion meeting attended by Castro, former NACBHD President and CEO Melissa Staats, NACBHD’s Leon Evans, and the Jeannie Campbell of the National Council for Community Behavioral Healthcare, among others, to discuss the problem and possible solutions. Castro also went to a spring conference on the issue, and there are many veterans’ organizations with related data. He has culled useful information from the Department of Defense, the Institute of Policy Studies, the Government Accounting Office, and the Veterans of America.
Access to and Availability of Treatment
The Mental Health Task Force, created by the Department of Defense, started work in 2006, and has a report due in 2007. It is made up of half active and half non-active service members. The 2007 report will have recommendations, and Castro’s group sent a letter to the task force to see if they discuss the issue with them.
A possible collaborative solution
Community mental health centers are located all over the country and may be a good point for providing the services these families need. The Department of Defense allocated $800 million in the VA system to mental health services, but there is $46 million left out of the $800 million allocated. Part of the dollars the government dedicated to the VA was for Centers for Excellence, and it seems natural to have these dollars dedicated to training with community mental health, to finding a way to share that makes training and treatment available. One approach may be to consider these VA Centers of Excellence as regional training sites.
Next steps
Castro has sent the paper, “The Growing Behavioral Health Needs for Active, Reserve, and National Guard and for their Children, Spouses, and Extended Families” to an editor for review. Once it is finalized (hopefully by the end of February), he hopes to “get an audience” with senators or congressmen, and then to present to a subcommittee or committee of Congress or the Mental Health Task Force, so that an argument can be made to assist and complement the Department of Defense in behavioral health efforts for families. Then, the effort would be piloted in two to three sites around the country. Castro’s site (CHCS) would be a good pilot site because of their location near Audie L. Murphy Memorial Veterans Hospital and Brooke Army Medical Center. (CHCS has award-winning mental health care on the adult side.)
Castro believes it is important to recognize that services that work well in one area may not work well in another, and one of his key recommendations will be to examine who is doing what around the country and what the best practices are, and what works best where. In terms of training for professionals to work with those impacted by trauma, Castro says that there are systems out there in place that could be tapped into to respond to the need. For example, a lot of good training came out of 9/11, and the Red Cross has an excellent system of training.
Feedback from soldiers and families, other areas already involved in care for families
Recently Castro attended a veteran’s breakfast with state congressman Rodriguez, and veterans and spouses attending talked with Castro with enthusiasm about the effort. Castro notes that there are some efforts already underway around the country to address the effect of trauma on soldiers and families. In North Carolina, the psychological association has put together a pro bono clinic. Mental Health America (formerly the National Mental Health Association) has started Operation Healthy Reunions, an anti-stigma and educational campaign that distributes materials on such topics as reuniting with families, adjusting after war, depression, and post-traumatic stress disorder (PTSD). See http://www.nmha.org/reunions, for more information and for useful statistics and facts on the behavioral health impact of the war.
For questions or for more information, contact James Castro at: JCastro@chcs.hhscn.org.
SAMHSA Has New Administrator
SAMHSA has a new Administrator, nominated by the President and confirmed by Congress at the end of 2006. See the information reprinted below from the SAMHSA web site http://www.samhsa.gov/About/bio_cline.aspx for details. Look for an interview with Dr. Cline in an upcoming newsletter.
Terry Cline, Ph.D., was nominated by President George W. Bush on November 13, 2006 and confirmed by the U.S. Senate on December 9, 2006 as Administrator for SAMHSA. As SAMHSA Administrator, Dr. Cline reports to Health and Human Services Secretary Michael O. Leavitt and leads the $3.3 billion agency responsible for improving the accountability, capacity and effectiveness of the nation’s substance abuse prevention, addictions treatment, and mental health service delivery systems. Throughout his career Dr. Cline has worked to ensure individual and family needs are the driving force for the prevention, treatment and recovery support services delivered. He has championed the principle that mental health and freedom from substance abuse are fundamental to overall health and well-being and that mental and substance use disorders should be treated with the same urgency as any other health condition.
Prior to his appointment as SAMHSA Administrator, Dr. Cline put these core values to work as Oklahoma’s Secretary of Health, a position he was appointed to by Governor Brad Henry in 2004. At the same time, he served as Oklahoma’s Commissioner of the Department of Mental Health and Substance Abuse Services, a position he held since January 2001. He actively participated in and supported the creation of grassroots coalitions to improve the health status of local communities. During his tenure in Oklahoma, Dr. Cline built strong collaborative relationships among the multiple constituency groups and government agencies that touch the lives of people with substance abuse and mental health problems. As a result of these partnerships significant advances were made in transforming the State’s service delivery systems, including the creation of Oklahoma’s Integrated Services Initiative which creates a holistic approach to treatment needs, a wide expansion of drug courts throughout the State and the introduction of mental health courts into Oklahoma along with a Statewide focus on recovery and recovery support services. Dr. Cline has extensive experience in overseeing health and human services at the State level. He has also served as a provider through an earlier post as the Clinical Director of the Cambridge Youth Guidance Center in Cambridge, Massachusetts and as a Staff Psychologist at McLean Hospital in Belmont, Massachusetts. His professional history also includes a six-year appointment as a Clinical Instructor in the Department of Psychiatry at Harvard Medical School and Chairman of the governing board for a Harvard teaching hospital in Cambridge, Massachusetts. A native of Ardmore, Oklahoma, Dr. Cline attended the University of Oklahoma where he earned a bachelor’s degree in psychology in 1980. He then received both a master’s degree and a doctorate in clinical psychology from Oklahoma State University. Dr. Cline has involved himself in community service, including membership on a number of local, State and national committees and boards with a focus on improving the overall health of the community and the Nation.
Update on the Campaign for Mental Health Reform
Bill Emmet, Director of the Campaign for Mental Health Reform (of which NACBHD is a partner), provided an update on the most recent and upcoming Campaign activities.
The Campaign is working on the presumed centerpiece of Campaign activity for 2007, the Omnibus Bill: "The Mental Health is Integral to Health Act of 2007." Campaign partners are providing input, and then the proposal will be taken to some key members of Congress in hopes of attracting sponsorship. Emmet will share more detail on this proposed legislation in February.
SAMHSA reauthorization is projected for fairly early in this Congressional session. In 2004, the Campaign compiled a number of possible elements for the reauthorization, and Campaign partners are now hoping, as Emmet says, “to winnow them down to a few priorities, perhaps adding some pieces from our Omnibus bill, if appropriate.”
In addition, the Campaign is awaiting the Centers for Medicare and Medicaid Services regulations on Targeted Case Management and the rehab option. And, the Campaign will be working with the Council of State Governments, the National Association of Counties, and others to seek more funding for the Mentally Ill Offender program.
Medicaid Update
On January 18, Tom Joseph sent the following information to members regarding a proposed major Medicaid rule affecting counties:
The Centers for Medicare and Medicaid Services today published a proposed regulation which would have a major negative impact on county governments' ability to finance government-operated health facilities and programs supported by Medicaid and the State Children's Health Insurance Programs. The proposed rule would cut Medicaid funding by $3.9 billion over the next five years. Proposed initially in the administration's FY 2007 budget released last February, this and other proposed administrative changes have generated bi-partisan opposition in both the House and Senate.
There is a 60 day comment period ending March 19, 2007. As this process unfolds over the next two months, we will provide you with additional analysis we receive and will update you on any congressional efforts to stop the proposed rule.
The release dates of other regulations are still unknown, including limiting targeted case management and the rehabilitation services option.
Today's proposed rule would include the following changes (this section is taken from a health news service):
Clarify that only government entities are permitted to finance the nonfederal share of Medicaid payments and define such entities. The newly proposed definition includes only state or local government entities that have taxing authority or health care providers that are state-, city-, or tribe-operated. The rule would also restrict which health care providers are considered "special purpose districts" with the status to make intergovernmental transfers (IGTs) or certified public expenditure (CPEs). For instance, health care providers that are independent entities not an integral part of the unit of government, such as many not-for-profit hospitals, would not be permitted to finance Medicaid payments, whether by IGT or by CPE, under the proposed rule.
Establish new minimum standards for the documentation required to support a CPE. The rule proposes to require that CPEs be supported by auditable documentation in a form that would be issued by the secretary of Health and Human Services. The new form would be required for certain types of CPEs where CMS has found improper claims, such as school-based services, according to the rule. States would need to identify the category of expenditure, explain whether the contributing unit of government is considered a provider-related tax or donation, demonstrate the actual expenditures of the funds (not simply stating that funds are available or estimates of funds spent), and be subject to periodic state audit and review. "Costs that are certified by units of government for purposes of CPE cannot include the costs of providing services to the non-Medicaid population or costs of services that are not covered by Medicaid," the proposal states, except for costs that are the basis for a disproportionate share hospital payment.
Limit the reimbursements for government health care providers to the cost of providing covered services to eligible Medicaid beneficiaries. Many states now pay government-operated providers in excess of their costs and use the fund to subsidize other health care operations or return a portion of the funds to the states, according to CMS. The proposed rule would limit reimbursement to the providers' actual cost and would direct the HHS secretary to determine a reasonable method for identifying allowable Medicaid costs, incorporating Medicare cost principles. "For hospital and nursing facility services, we find that Medicaid costs are best documented when based upon a standard, auditable, nationally recognized cost report," the rule states.
Establish a new regulatory provision explicitly requiring providers to receive and retain the full amount of their Medicaid payments, to remove any potential for abuse of intergovernmental transfers. "Since the summer of 2003, we have examined Medicaid State financing arrangements across the country, and we have identified numerous instances in which health care providers did not retain the full amount of their Medicaid payments but were required to refund or return a portion of the payments received, either directly or indirectly," CMS wrote in the proposed rule. "Failure of the provider to retain the full amount of reimbursement is inappropriate and inconsistent with statutory construction that the Federal government pays only its proportional cost for the delivery of Medicaid services."
SAMHSA Announcements
From a January 5 SAMHSA press release:
New Report Provides Snapshot of Substance Use Within 15 Largest U.S Metropolitan Areas
The two U.S. metropolitan areas with the highest rates of past month illicit drug use are San Francisco (12.7 percent) and Detroit (9.5 percent) while the national average was 8.1 percent, says a new report by SAMHSA. Chicago (25.7 percent) and Houston (25.6 percent) had higher rates of binge drinking than the national average (22.7 percent), and Detroit was the only metropolitan statistical area with a past month cigarette use rate that was higher than the national average (25.3 percent).
The NSDUH Report: Substance Use in the 15 Largest Metropolitan Statistical Areas: 2002-2005 compares estimates for illicit drug use, binge alcohol use, and cigarette use for the nation as a whole with the same behaviors in the 15 largest metropolitan statistical areas (MSAs).
An MSA is a core area containing a large population nucleus together with adjacent communities having a high degree of economic and social integration with that core. Approximately one third of the U.S. population lived in the 15 largest MSAs in 2005.
“Previous research has shown that rates of substance use vary across states and within areas within states,” said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA Acting Deputy Administrator. “This new report, with bar graphs showing rates of use for each substance, provides a very clear snapshot of which of the 15 major metropolitan areas have serious problems and which have rates comparable to or less than the national averages.”
All estimates of substance use in the report are annual averages based on combined data from the 2002 to 2005 National Survey on Drug Use and Health (NSDUH). Illicit drugs refer to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically. Binge alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least one day in the past 30 days.
MSAs with rates of illicit drug use that were lower than the national average include Houston (6.2 percent), Dallas (6.5 percent), and Washington, DC (6.5 percent). Rates of binge drinking were lower than the national average in the Los Angeles (18.6 percent) Riverside/San Bernardino (19 percent), Washington, DC (19 percent), and New York (21.3 percent) MSAs. The Los Angeles (17.9 percent), San Francisco (17.9 percent), Riverside/San Bernardino (19.2 percent), Washington, DC (19.8 percent), Boston (20.8 percent), Seattle (21.4 percent), Miami (22 percent), and New York (22.5 percent) MSAs all had lower rates of past month cigarette use than the nation as a whole.
The complete report is available online at http://oas.samhsa.gov. The NSDUH Report is published periodically by the Office of Applied Studies. The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by SAMHSA. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
From a January 23 SAMHSA press release:
New Study Shows American Indians and Alaska Natives Continue to Have Higher Rates of Alcohol Use and Illicit Drug Use Disorders Than Other Racial
American Indians and Alaska Natives ages 12 or older were less likely to have used alcohol in the past year than were members of other racial groups, but they were more likely than members of other racial groups to have a past-year alcohol use disorder and to have a past-year illicit drug use disorder, according to new report from SAMHS.
Substance Use and Substance Disorders among American Indians and Alaska Natives shows that 60.8 percent of American Indians and Alaska Natives and 65.8 percent of other racial groups used alcohol in the past year, that 10.7 percent of American Indians and Alaska Natives reported having a past-year alcohol use disorder compared with 7.6 percent of other racial groups and that 5.0 percent of American Indians and Alaska Natives had a past-year illicit drug use disorder compared with 2.9 percent of other racial groups. American Indians and Alaska Natives also had higher rates than members of other racial groups for past-year marijuana use (13.5 percent vs. 10.6 percent), cocaine use (3.5 percent vs. 2.4 percent), and disorders involving hallucinogen use (2.7 percent vs. 1.7 percent). However, rates of past-year heroin use and past-year nonmedical use of pain relievers, tranquilizers, and sedatives were similar for American Indians and Alaska Natives and members of other racial groups. All findings are annual averages based on combined 2002, 2003, 2004 and 2005 National Survey on Drug Use and Health (NSDUH) data.
“Tragically, American Indians and Alaska Natives continue to have higher rates of substance use disorders than other racial groups within the United States,” says Terry L. Cline, Ph.D., SAMHSA Administrator. “While improvements in some areas of substance use have been realized, such as decreased alcohol use in the past year, we intend to keep working to ensure that culturally appropriate substance abuse treatment and native healing approaches can bring help where it is so badly needed.”
For this report, American Indians and Alaska Natives include all respondents who reported this race, including those who reported it in addition to another race or ethnicity. This categorization varies from SAMHSA’s National Survey on Drug Use and Health in which persons who identify themselves as Hispanic and American Indian or Alaska Native are categorized as Hispanic, and persons who identify themselves as American Indian or Alaska Native and another race (e.g., White, Black or African American, Asian, Native Hawaiian or Other Pacific Islander, or other) are categorized as “two or more races.”
Illicit drugs refer to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically. The National Survey on Drug Use and Health (NSDUH), on which this report is based, defines illicit drug or alcohol dependence or abuse using criteria specified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Substance dependence or abuse includes such symptoms as withdrawal, tolerance, use in dangerous situations, trouble with the law, and interference in major obligations at work, school, or home during the past year.
The complete report is available online at http://oas.samhsa.gov. The NSDUH Report is published periodically by the Office of Applied Studies. The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by SAMHSA. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
From a January 4 SAMHSA press release:
Funding Available for 65 Targeted Capacity Expansion Grants for Substance Abuse Treatment and HIV/AIDS
SAMHSA is soliciting applications to enhance and expand substance abuse treatment and /or outreach and pretreatment services in conjunction with HIV/AIDS services in African American, Hispanic, and other racial ethnic communities severely affected by substance abuse and HIV/AIDS. All awards will be subject to the availability of funds.
Annual awards amounts are expected to be about $500,000 per year in total costs for treatment services and $400,000 for outreach and pretreatment services for up to five years. The actual amounts may vary, depending on the availability of these funds. The grants will be awarded by SAMHSA’s Center for Substance Abuse Treatment.
WHO CAN APPLY: Eligible applicants are domestic public and private nonprofit entities such as state and local governments; federally recognized American Indian/Alaska Native tribes and tribal organizations, urban Indian organizations, public or private universities and colleges and community and faith-based organizations may apply. The statutory authority for this program prohibits grants to for-profit agencies. TCE/HIV grantees in the FY2003 and FY2006 cohorts are ineligible for this program.
HOW TO APPLY: Applicants for No. TI-07-004 are available by calling SAMHSA’s Clearinghouse at 1-800-729-6686, or by downloading from www.grants.gov, or www.samhsa.gov. Applicants are encouraged to apply on line using www.grants.gov.
APPLICATION DUE DATE: Applications must be received by February 28, 2007.
ADDITIONAL INFORMATION: Applicants with questions on program issues should contact David Thompson at 240-276-1623 or e-mail david.thompson@samhsa.hhs.gov. For questions on grants management issues, contact Kimberly Pendleton at 240-276-1421 or Kimberly.pendleton@samhsa.hhs.gov.
This program is being announced prior to the FY 2007 appropriation for SAMHSA’s programs, with funding estimates based on the President’s budget request for FY 2007. Applications are invited based on the assumption that sufficient funds will be appropriated for FY 2007 to permit funding of a reasonable number of applications solicited. All applicants are reminded, however, that we cannot guarantee that sufficient funds will be appropriated to permit SAMHSA to fund any applications.
From a December 20 SAMHSA press release:
New Resources on Primary Care, Criminal Justice, and Self-Direction Related to Mental Health
SAMHSA has released two new publications from the Center for Mental Health Services (CMHS) Building Bridges Series and three new fact sheets on the issue of mental health and self- direction. The Building Bridges Series are reports of CMHS dialogue meetings that examine approaches which impact personal and mental health system transformation. Dialogue participants discuss their experiences, identify factors that promote and hinder recovery of people and mental health care systems, and offer recommendations to overcome obstacles to improve opportunities for individuals to recover.
The Building Bridges: Mental Health Consumers and Primary Health Car Representatives in Dialogue publication discusses the findings of a two-day dialogue meeting between mental health consumers and primary care representatives, including providers, researchers and policymakers. Topics discussed included the availability, affordability, and quality of, medical and mental health services; interaction of general health and mental health; cross-training in primary care and mental health care and others. The report is available online at http://mentalhealth.samhsa.gov/publications/allpubs/sma06-4040/.
The Building Bridges: Consumers and Representatives of the Mental Health and Criminal Justice Systems in Dialogue publication provides consumers, providers, advocates, policy makers and representatives from both criminal justice and mental health systems with an understanding of issues that mental health consumers experience in the criminal justice system. Issues discussed include diversion from incarceration, prevention prior to people with mental illnesses entering into jails and prisons, and community reentry efforts. In addition, factors were discussed at both consumer level and systems level that promote or hinder recovery from mental illnesses. The report is available online at http://mentalhealth.samhsa.gov/publications/allpubs/SMA05-4067/.
The Mental Health and Self-Direction Fact Sheets provide an overview of the principles that focus on promoting consumer choice and control of services and supports that foster recovery as critical elements in the process of transforming Americas mental health care system as well as approaches to implementing these principals.
Free additional copies of these publications and fact sheets are available by calling SAMHSAs National Mental Health Information Center at 1-800-789-2647 or 1-866-889-2647 (TDD).
