October 2006 NACBHDD Newsletter
The Newsletter of the National Association of County Behavioral Health and Developmental Disability Directors
In this Issue...
Save the Date: NACBHD Legislative Conference February 28 - March 1, 2007
NACBHD's annual Legislative Conference is scheduled for February 28 through March 1 at the Jurys Hotel in Washington, DC. Check the Conferences section of the NACBHD web site for upcoming registration and conference information updates.
NACBHD Board Holds Strategic Planning Session
The board's strategic planning session was facilitated by George Braunstein, Executive Director, Chesterfield Community Services Board, Chesterfield County, Virginia. The board worked from draft materials developed by the strategic planning committee, which included a mission statement, and four NACBHD goals for 2007. The mission statement, vision, and 2007 goals were adopted by the Board. Next steps include the production of a work plan for internal operations, which will be prepared by NACBHD staff. Melissa Staats commented on the very successful Board meeting, "The most positive part of the day was the active involvement of the Board. Their dedication to improving NACBHD was overwhelming. I'm grateful to George and to all the Board." Click here to view the mission statement and vision. Click here to view the 2007 goals.
NACBHD Medicaid Committee Presents at Michigan State Association Meeting
NACBHD recently met in Traverse City, Michigan at the invitation of David Lalumia, Executive Director of the Michigan state association. Leon Evans of Texas, Mike Chambers of Pennsylvania, and Mike Hammond of Kansas, delivered a presentation on Medicaid. The session was facilitated by NACBHD Medicaid Chair David Wiebe of Kansas. Each of the presenters and the facilitator focused on how Medicaid has impacted access in their states. Presenters also shared concerns about how reforms under discussion in DC (e.g. limitations on target case management and case management; redefinition of rehabilitation services) might restrict access in the future. The session was part of the Michigan Association's lunch plenary on October 17. We owe many thanks to David Lalumia and the Michigan group for providing us with the opportunity to showcase NACBHD as an important resource.
It is also significant to note that Michigan has joined the ranks of 100% states for 2007. Other 100% states include Utah, Alabama, Kansas, and California.
2007 Membership Campaign is Underway!!
In very early October, NACBHD staff disseminated 2007 Membership Campaign materials. In the package, each member (and potential member) should have received notice about NACBHD's decision to move to a population base for dues determination. As mentioned in the notice, this change is not intended to increase dues--although this did occur in some cases. The change is intended to facilitate enrollment and to move the organization in line with NACo. Members are encouraged to contact NACBHD staff if the new dues structure creates a burden to continued participation. In anticipation, the NACBHD board has established a 2 year window meaning that members can pay the same amount of dues paid in 2006 for 2007 and 2008--to allow sufficient time to obtain support (in the case of dues increases where they may have occurred).
NACBHD is most appreciative of its membership and anticipates a great year in 2007.
Medicaid Update
Policy, Spending, and DRA Information Available Online from Kaiser
The Kaiser Family Foundation published information on October 10 regarding several important Medicaid issues, including:
To access this information, see http://www.kff.org, click on "Medicaid/SCHIP."
Targeted Case Management and Rehabilitation Option
As reported, CMS is still in the process of developing new regulations for TCM and the Rehabilitation Option. DC advocates expect that both these regulations will result in restricted access by limiting reimbursement in each service category. Regulations are not expected until after the elections. Both regulations will include written comment periods. CMS can alter the regulations based on written comments, if they so choose.
Medicaid Integrity Program
The Centers for Medicare and Medicaid (CMS) recently posted description of a new program passed as part of the Deficit Reduction Act (DRA). The new program is called the Medicaid Integrity Program or MIP. Essentially, MIP was created to reduce fraud and abuse in the Medicaid program. The CMS website states:
Under the provisions of the Deficit Reduction Act (DRA) of 2005, Congress directed CMS to establish the Medicaid Integrity Program (MIP). In doing so, it dramatically increased the resources available to CMS to combat fraud, waste and abuse in the Medicaid program. The DRA provides that a five-year Comprehensive Medicaid Integrity Plan (CMIP) be written to guide MIP development and operations. (To view this document, see the link in the Downloads section below).
The plan details the two major operational requirements of the MIP:
While the DRA requires that the CMIP be revised in five-year cycles, CMS will review and update the plan annually. CMS will also report to Congress annually on the use and effectiveness of the funds appropriated for MIP.
Funded at $75 million each year for 5 years, the program is being staffed up in Baltimore and across the country. NACBHD staff has a meeting scheduled with the new director of the program and will report in the November newsletter. For now, members can access information about the new program at: http://www.cms.hhs.gov/DeficitReductionAct/02_CMIP.asp
National Association of State Medicaid Directors Annual Conference Information
The National Association of State Medicaid Directors annual conference will be held in Arlington, Virginia on November 13-15. To view a draft agenda of the conference, click here. To access registration information, click here.
Medicare Update
Andrew Sperling, Director for Legislative Affairs, the National Alliance for Mental Illness, provided the following update on the 2007 Medicare Drug Benefit. This information is also published on the NAMI website at http://www.nami.org.
Getting Ready for the Medicare Drug Benefit in 2007, CMS Announces Drug Plan Offerings the New Plan Year Beginning on January 1, 2007
The Centers for Medicare and Medicaid Services (CMS) this past week announced new prescription drug plan offerings for 2007, initiating an open season process that will continue until the new plan year begins on January 1. For 2007, there will be 50 to 60 drug plan choices in most states, on average 10 to 15 more than were available in 2006. In most states, average monthly premiums will be below what they were in 2006, with the average national premium falling to $24 per month - down substantially from the standard monthly premium of $37 that was set forth by Congress in 2003.
In addition to lower than predicted prices, some plans are planning to offer enhanced benefits in 2007, including elimination of cost sharing for generic medications. Two national plans - United-AARP and Wellpoint - will be offering coverage of benzodiazepines (medications commonly prescribed for acute mania in bipolar disorder and anxiety disorders) that were excluded in 2006. This coverage is only being offered in so-called "enhanced" plans that require a supplemental premium, i.e. coverage beyond a basic drug plan.
Open Season Starts Officially on November 15
The process for selecting a Medicare prescription drug plan (PDP) mirrors the process that has existing for more than 25 years for the Federal Employees Health Benefits program - an "Open Season" in the fall during which participants select from a menu of plan options, with coverage going into effect on January 1. As noted above, CMS has already posted available plan options available in each state. By next week, CMS will be posting all available information, including each plan's formulary (list of covered drugs), cost sharing information and utilization management policies (prior authorization, step therapy and quantity limits applied to specific medications).
Beginning on November 15, and running through December 31, Medicare beneficiaries will be able to enroll in a plan for 2007. CMS is requiring every drug plan to have enrollment and coverage effective by January 1 for anyone who enrolls by December 8 - in other words, an enrollment decision by December 8 can guarantee seamless coverage available during the first week of January.
It is important to note that most beneficiaries who want to stay with the coverage they had for 2006 will not have to re-enroll for 2007 (there are some key exceptions for certain low-income dual eligible beneficiaries, see below). Others may want to change coverage as a result of changes in coverage policy, cost sharing or removal of a drug from a formulary for 2007.
How To Find the Medicare Drug Plans Available in Your State
CMS has already posted charts plans available in each state with monthly premiums, deductibles, gaps in coverage and whether or not plans are available to dual eligibles and other low-income beneficiaries. Click here to view this chart.
Drug Plan Choices for Dual Eligibles
A key population for NAMI in the drug benefit remains the 6.2 million extremely low-income Medicare beneficiaries simultaneously eligible for Medicaid in their state. In most states, as many of 40% of these dual eligibles have a serious mental illness. These dual eligible individuals will continue to participate in the Medicare drug benefit on a mandatory basis. So long as they stay with a plan that is "at or below benchmark," they will get coverage with no monthly premium, no annual deductible and no gap in coverage (the so-called "doughnut hole" gap), with their only costs being $1 for a generic and $3 for a brand name prescription.
Because of the lower than projected premiums, in many states the cost of the average "benchmark" plan has gone down for 2007. As a result, some dual eligibles are in drug plans for 2006 that will not be "at or below the benchmark" for 2007, i.e. they cannot enroll for a $0 premium for 2007. For these dual eligibles, CMS is planning to automatically re-assign them to a new drug plan with the same sponsoring organization or with an identical formulary list in an attempt to avoid disruption.
"Re-Deeming" of Certain Dual Eligibles
There are some low-income Medicare beneficiaries who had dual eligible status in 2006, who will not in 2007. These are individuals that prior to 2006 qualified for Medicaid in their state as a result high medical expenses and "spend-down" eligibility. Most of these dual eligibles were automatically enrolled in a Part D plan for 2006. For 2007 however, many will not have dual eligible status because they never reached the Medicaid "spend-down" level in 2006. These individuals will need to send in a new application for the Medicare Part D "Low Income Subsidy" (LIS) in order to access affordable drug coverage for 2007 (in most cases, coverage with no monthly premium, no deductible, no gap in coverage and as little as $3 for a generic, and $5 for a brand name prescription).
Notices from CMS to these "deemed" individuals were sent by mail late last month, with an LIS application and postage paid envelope. For more information, click here:
http://www.cms.hhs.gov/partnerships/downloads/11198.pdf
http://www.cms.hhs.gov/partnerships/downloads/LISRedeterminationQA.pdf
Reaching Low-Income Individuals Eligible for "Extra Help"
Of extreme concern to NAMI since 2005 has been the large number of low-income Medicare beneficiaries who are ineligible for Medicaid, but yet are still very low-income and cannot afford drug coverage without a very deep subsidy to make coverage affordable, minimize cost sharing and avoid any gap in coverage (deductibles and the "doughnut hole"). The Low-Income Subsidy (LIS) or "Extra Help" allows many of these beneficiaries with limited incomes (about $20,000 for couples and about $15,000 for individuals) to get drug coverage with little or no premium, no gap in benefits and minimal cost sharing.
Of the projected 7.5 million Medicare beneficiaries eligible for LIS, only about 2 million have applied and been approved. In order to improve on this, CMS and a range of non-profit partners have undertaken a major outreach and enrollment effort. NAMI is supporting these efforts - including an effort by the Access to Benefit Coalition (ABC). NAMI affiliates are strongly encouraged to share these announcements and enrollment materials with their members and partner organizations to help reach low-income beneficiaries and get them all the assistance they are entitled to.
http://www.maprx.info/Extra_Help_LIS_outreach.html
http://www.cms.hhs.gov/limitedincomeandresources/
http://www.cms.hhs.gov/center/partner.asp
Lots of Web-Based Tools Available
In addition to the resources listed above, more web-based information about the Medicare prescription drug benefit is available through the following links:
The new "My Health/My Medicare" Campaign designed to promote on-line personalized information:
http://www.cms.hhs.gov/myhealthmymedicare/downloads/NationalPartnerLaunch.pdf
http://www.mentalhealthpartd.org/
An Update on Medicare Developments From Mental Health Part D
Karen Sanders, Associate Director for Publicly Funded Services at the American Psychiatric Association, this month advises members to view the updated information on the www.mentalhealthpartd.org website. The information on the site has been updated for 2007, with the left side of the home page containing access to the important 2007 transition revisions and the right side of the home page containing access to all the updates. The website is a valuable resource for the latest developments around Part D.
New Medicare Resource Available from CMS
CMS recently sent the following announcement to advocates:
Medicare & You 2007 Handbook Now Available Online
The general "Medicare& You 2007" handbook is now available at http://www.Medicare.gov/publications/pubs/pdf/10050.pdf to help people with Medicare review their coverage options and prepare to enroll in a new plan if they choose. This official government handbookcontainsimportant information aboutwhat's new, health plans, prescription drug plans, and rights for people with Medicare.You can find 48 geographic-specific versions of the handbook on the website listed below, with drug and health plan comparison charts for particular states or regions. These are the versions that will be mailed to people with Medicare in the next few weeks.
The Centers for Medicare & Medicaid Services is encouraging people with Medicareto review their current coverage this fall to see if it will meet their needs in 2007. Now is the time to help people think about the cost, coverage, and customer service that they need in a planto get the most out of their Medicare.
The state specific books are online at http://www.cms.hhs.gov/Partnerships/PFP/list.asp#TopOfPage. Beneficiaries will receive their Handbooks by the end of October.
Kaisernetwork.org Reports that CMS Stops Automatic Medicare Prescription Drug Plan Enrollment for Some Dual Eligible Beneficiaries Next Year
The following is reprinted from an October 20 Kaisernetwork.org article:
About 632,000 Medicare beneficiaries who were automatically enrolled by the government in the Medicare prescription drug benefit for 2006 will not be automatically re-enrolled in 2007 and will have to sign up for Medicare drug plans on their own, the AP/San Francisco Chronicle reports. When the drug benefit began, drug coverage for dual eligibles -- beneficiaries eligible for both Medicare and Medicaid -- was transferred from state Medicaid programs to Medicare, and the federal government automatically enrolled dual eligibles in private Medicare drug plans. Some of those beneficiaries are no longer enrolled in state Medicaid programs and therefore will not be automatically enrolled into Medicare drug plans for 2007, according to CMS. Affected beneficiaries who wish to remain enrolled in the Medicare drug benefit must shop for a plan and enroll on their own during the upcoming open enrollment period, which begins Nov. 15. Kathleen Harrington, CMS director of external affairs, said the agency will allow the affected beneficiaries to enroll in plans for an additional three months after the regular open enrollment period ends on Dec. 31. Harrington said CMS last month sent a letter to those beneficiaries instructing them that they also should apply for the low-income subsidy that allows access to plans with low or no premiums.
Concerns
Some advocates are concerned that many of the 632,000 beneficiaries will "fall through the cracks" and not realize that their drug coverage has lapsed until they try to fill prescriptions in January, the AP/Chronicle reports. James Firman, president and CEO of the National Council on Aging, said, "We believe many, if not most of the people, simply won't respond to a letter. Many won't read the letter, they won't understand the letter, they won't know how to fill out the application form." Firman said that NCOA has found that about 20% of low-income seniors generally respond to letters, adding, "We're talking about a population that's sick, may have low literacy. There are a lot of challenges. What they need is one-on-one assistance from trusted intermediaries." According to the AP/Chronicle, some of the beneficiaries "who lost their Medicaid coverage may have lost eligibility because they're making more money and no longer qualify for the extra help." However, Firman said it is "more likely that some states tightened eligibility requirements, or the individual did not complete all the paperwork needed to be recertified for Medicaid." Harrington said CMS has informed insurers who market Medicare drug plans of which former dual eligibles will need to enroll on their own, adding, "It's very much in the interest of the plans to keep them in coverage" (Freking, AP/San Francisco Chronicle, 10/19).
Update on the Campaign for Mental Health Reform:
The Campaign for Mental Health Reform actively continues to work with national advocacy partners, including NACBHD, on critical issues. Bill Emmet, Interim Director for the Campaign, and Melissa Staats provided an update on the Campaign's recent activities.
A two-part policy and communications retreat has been planned for some time, with the fall part taking place on October 12 and part two planned for December 5, after the election, to determine the next course of action.
Melissa Staats attended the October 12 retreat and felt that, "This was the most productive meeting of the campaign so far. The members focused on what makes this group different from the other advocacy groups. I think they decided that they could make a difference by putting their work in the context of "discrimination--rephrased from stigma"--this would be the message of the campaign. No decisions have been made, but the group laid the groundwork for part two of the retreat." Staats emphasized that she feels the discrimination message is especially important, as discrimination prevents formulation of public policy, and consequently, funding advances. There was some discussion of utilizing a high-profile figure to promote the message. Emmet added that "The Campaign is in the midst of its planning for the coming year, but none of the details will be clear until we know what Congress will look like after the elections. We will be meeting to finalize our 2007 agenda in early December."
North Carolina Council's New Executive Director Ushers in Reform
Yvonne Copeland, the new Executive Director of North Carolina's Council of Community Programs for Mental Health, Developmental Disability, and Substance Abuse, recently spoke with NACBHD about her background, experience, and the critical changes that have now been implemented in the North Carolina behavioral health and developmental disability systems as a result of recent legislative reforms.
Copeland is relatively new to North Carolina (since 2000). Her background is in human services. Prior to moving to North Carolina, she was Director of Continuing Education for the National Association of Social Workers' New Jersey chapter. In this position, she was utilized as a human services advisor for Governors Whitman and Florio. In addition, she worked for the Educational Testing Service in the research department. Since 2004, she has been at the North Carolina Council (the Council) as Director of Public Policy Implementation. (Before working for the Council, she home-schooled her children in North Carolina.) While Copeland feels her strength is in mental health, she has focused on social services as a whole.
Reform provides much-needed clarity for the system, including the role of LME's
Copeland came in at the "hump" of reform in North Carolina - a time she considers very advantageous in developing policy in North Carolina. The state's recently enacted House Bill 2077 defines the responsibility for local management entities (LMEs)--separating out provider and oversight functions--in the state, and Copeland describes it a providing "much needed clarity for the system." The existing statute was broad, and the LMEs were in jeopardy during the reform process. The new legislation solidified the LMEs' roles and responsibilities. LMEs are Council members, and how they should interface with service providers is now defined. And, they are now management entities with defined management roles. With these changes, Copeland says this is a year for LMEs and providers to reach out to one another and address their mutual dependency and issues related to service delivery.
This is the first year that the changes resulting from reform will be in place, and that the Council will be able to examine the system. Their focus is on:
Changes in services
Service definitions were implemented in March 2006, and the Council is going forward with a whole new service array for the first year. This new array of services is bundled into an enhanced package of community support for all three consumer groups (mental health, substance abuse, and developmental disability), which includes case management, skill building, outpatient therapy, and peer mentoring. These comprehensive services provide a broad umbrella and more flexibility, and all services and LMEs must be accredited by national accrediting bodies, such as the Council on Accreditation, the Utilization Review Accreditation Commission, the Council on Quality Leadership, and the Joint Commission on Accreditation of Healthcare Organizations.
Copeland says reform has not come easily in North Carolina. While it has not been viewed as a bad thing, it has simply been difficult to get there. North Carolina is unique in that most states do not reform the management of services.
Other areas of focus
The Council is concerned about the challenge of determining consumers served in their catchment area because consumers are not attached directly to the LME; they goto providers who bill Medicaid directly. One of the tasks facing the Council is to work out mechanisms to make sure they know the number served, and to strive for a uniform portal or "no wrong door." In addition, high on theCouncil's priorities is service capacity, especially in rural areas. Other areas of focus are care coordination for high risk groups and the integration of behavioral health care and primary care, which Copeland describes as making both "clinical and fiscal sense."
Peer Support Specialists: New Position Key in the Recovery Process
Background
NACBHD recently spoke with Molly Clouse, who has worked on a consulting basis with the Kentucky Department of Mental Health and Mental Retardation to bring peer support specialists to Kentucky. Clouse was involved in the Kentucky Medication Algorithm Project (KYMAP), which had a consumer piece that was never implemented. In addition, she presented at a recent national conference on evidence based practices and implementation of medication management approaches in psychiatry. Clouse was involved in KYMAP from the beginning as a consumer. She was diagnosed with bipolar disorder before the concept of recovery was common; maintenance was viewed as the best practice and there was little consideration of the quality of life. In addition, her twenty-four years of experience as an educator with an MA in Education contributed not only to her interest in the educational aspects of the program, but to her ability to contribute solid educational and training expertise.
The program
The program is a six-week course of medication education. Consumers participating in the program liked the peer-to-peer element so much that they did not want to leave, and took the course over and over again. Clouse says that with a peer-to-peer model, peers are responding directly to one another without input from the provider community. This program represented the first time in their system that consumers had this experience. There was no other type of peer group to participate in, and Clouse kept urging the community mental health center to form another peer-to-peer group. She looked for other situations in which she could develop peer-to-peer relationships, which in turn led her to the certified peer specialist program. The program started with Ike Powell and Larry Fricks in Georgia who created and initiated it and who have taken it to other states, including South Carolina, which has an especially strong consumer web site. Clouse received her training in South Carolina, and adopted South Carolina's certification program to Kentucky.
There have been two trainings so far in Kentucky, one of which was statewide and one in Louisville, with funding from SAMHSA block grant money. While Clouse would like to have two weeks for training, the training is 9:00 a.m. to 5:00 p.m. for five days, and individuals have to pass an oral or written exam with a 70% or higher to be certified. They must have a high school diploma or a GED. "The growth that occurred in these folks was just phenomenal," says Clouse, noting many individuals in this situation may not have taken a test in a long time.
Peer specialists are now full-time employees with benefits
The Seven Counties Mental Health Center in Louisville, Kentucky has just created six peer support specialists positions; the positions are full time with benefits in the $20,337 to $30,555 salary range. The next area of Kentucky to embark on the program will be the western part of the state; the community mental health centers in that part of the state may examine hiring part-time peer specialists with no benefits.
Clouse says the certified peer specialists in Seven Counties will be members of the treatment team and can be involved in any of the following areas:
Funding
Clouse says the system is always confronted with the issue of no money, but that they found the money in the grant to support the training program The money was there in the grant, but the grant was written in such a way that it was hard to know that the funding was there for consumer education. And, in terms of supporting the actual peer support services, Clouse notes that there is some movement to make peer support a billable service under Medicaid, with the possibility that a notice may go to state Medicaid directors soon.
Selecting peer specialists
Using her background as an educator and as a consumer, Clouse developed a training and trained a group of 10 to 12 consumers who had signed a contract to participate in peer to peer support for a year. Nine of those individuals are still participating now, in year two. One of the twelve passed away, and two became symptomatic and needed to take a break. Clouse says once consumers become involved as peer specialists, they are very dedicated and faithful to the program. Some individuals realize from the beginning that it is a commitment that they cannot handle. Clouse was very selective in the process of choosing the individuals involved in the program; she looks for people who tell a "wellness story" and not an illness story. In other words, she says consumers who are ready to be involved in the effort are talking about recovery and how they got there vs. the past trauma of the illness.
Clouse says that in the medical model there was a paternal instinct to protect consumers against failure rather looking at such opportunities as a chance for "someone to blossom." Clouse says, "It was just amazing. There was just as much benefit for the facilitator as the people who were working with them."
Some reflections on peer support specialists and on the program
While Clouse emphasizes the professional nature of the certified peer specialists' job and says they are not there to serve a social function, she does on the other hand, emphasize that peer specialists are very involved in "creating a support system for people who may have isolated or alienated themselves from those who care about them." She notes that there is very often not much support for individuals recovering from mental illness when they go back into the community. Clouse describes the peer specialist as someone who can say, "I know it's scary. I'll come pick you up. I'll walk you around the block." And, she adds, "The peer can take the pressure off the professionals and let them do the jobs they were trained to do and that we need them to do."
Clouse is enthusiastic about the program and feels that those who believe in recovery have embraced it, while those still functioning under the auspices of the medical model are having a harder time with it, perhaps viewing it as a threat to their positions or as a waste of money. Clouse believes that eventually systems will become used to it, and she sees that as a gradual process. Part of the curriculum, she says, is to help understand where various reactions "are coming from." In addition, there is substantial training on the concept of recovery and the transition to recovery.
There is currently no organization that certifies peer support specialists, but a member organization, the National Alliance of Peer Specialists, is now being formed. Larry Fricks is instrumental in setting up this organization. To read more about this organization, click here.
"It's life-changing for the people being trained. It's extremely empowering to and very affirming to say 'Look you've got experience the system can utilize.' It lets consumers take that life of hard knocks and turn it into something positive."
To access more information
Clouse has provided extensive information on peer support specialists and the program. To read detailed information about certified peer support specialists and peer support services, a sample job description, information on the peer support specialist training and the core curriculum, click here. To access a fact sheet about peer support specialists, including information on the recovery orientation of the program and its benefits to the system, to peers, and to providers, click here. For a detailed white paper on these issues, click here.
To contact Molly Clouse
Clouse is available for speaking, workshops, and trainings around the country. She can be contacted at mmmc@iglou.com.
Faces and Voices of Recovery: News and Some Reflection on Recovery Month
Pat Taylor, Campaign Coordinator, Faces and Voices of Recovery, spoke with NACBHD about the organization's activities and about Recovery Month; various recovery-oriented activities took place in September, which is annual Recovery Month.
September 28 Capital Hill Briefing and Rally for Recovery Both a Big Success
Taylor describes the rally and Capitol Hill briefing which were part of Recovery Month as very successful. Faces and Voices, along with the Congressional Addiction, Treatment, and Recovery Caucus hosted a Capitol Hill briefing on innovative programs that support people in recovery from substance abuse addiction. Representatives Kennedy and Ramstad spoke at the September 28 briefing on addiction recovery. And, one federal program received special note, the Recovery Community Services Program (RCSP) - in the Department of Health and Human Services' Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT). Recipients are pioneering ways that communities can support people in recovery and their families. For more information on the briefing, click here.
There was significant participation and press coverage around Rally for Recovery, which was held for the first time. Forty to fifty thousand people around the country participated, and local press coverage was notable. For example, the Bangor Daily News, ran daily information and profiles for the entire month of September. Next year's Rally for Recovery is planned for September 16. For detailed information on the rally and recovery walks, see http://www.facesandvoicesofrecovery.org/recovery_walks/index.php.
Trainings
Training is an ongoing Faces and Voices activity. Last Spring, there was a training on the science of addiction recovery, and there will be more of these trainings to understand the science behind recovery from addiction. In addition, there is ongoing media and messaging training.
Other ongoing efforts
Taylor lists several efforts related to voting, including a voter registration activity which will issues of recovery in the context of civil life, activities related to restoring the voting rights of those incarcerated for drug violations, and a recovery community civic engagement campaign.
Faces and Voices also will launch a membership campaign.
For detailed information on the civic engagement campaign, see: http://www.facesandvoicesofrecovery.org/campaigns/civic_engagement_campaign.php.
For information on the trainings, membership campaign, and e-newsletter, see the Faces and Voices website at: http://www.facesandvoicesofrecovery.org.
New Online Mental Health Resource for Older Adolescents
Dana Crudo, Program Associate, the Child & Adolescent Action Center of the National Alliance on Mental Illness, recently sent the following information to advocates regarding an online mental health resource for older adolescents. A similar site is under consideration for American teenagers. Please note that she would appreciate feedback on the site; her contact information is below.
An interactive website that provides valuable information for teenagers to help improve their mental health and wellbeing during the transition-age years is now available at www.reachout.com.au. Developed for Australian youth, the materials are useful to any teenager. The site includes coping tips, forums, fact sheets, personal stories as well as resources regarding mental illness, school, employment, stress and relationships. The website was created after the developers conducted research with youth focus groups and determined what appeals to teenagers most when learning about mental health issues. Reachout plans to develop a similar website in America and will be conducting research here to determine what is best for American teenagers. Therefore, please feel free to send any feedback regarding the website to Dana Crudo, Child & Adolescent Center Program Associate, NAMI, at danac@nami.org.
Free National Institute of Drug Abuse (NIDA) Resources Available Online
NIDA, which is part of the National Institutes of Health, recently forwarded information to advocates regarding new, free resources.
The NIDA Community Drug Alert Bulletin covers the latest scientific research on the non-medical use of prescription drugs related to abuse and addiction, and summarizes the emerging problem and trend of non-medical use of prescription drugs. It is geared for parents, teachers, counselors, school nurses and health professional concerned about those at risk of prescription drug abuse for non-medical purposes.
In addition, the "Research Report Series on Prescription Drugs Abuse and Addiction," describes the consequences of prescription drug abuse and reviews recent research, and the companion laminated "Commonly Abused Drugs" chart provides information about most major drugs of abuse, their commercial street names, their short-and long-term effects, their modes of administration, and their DEA controlled substances schedules.
Visit http://www.drugabuse.gov or call (800) 729-6686 to order these free publications and resources. To order bulk publications, please e-mail Kellyn Hickey, Health Communications Specialist, IQ Solutions at khickey@iqsolutions.com.
SAMHSA Announcements
From an October 6 press release:
SAMHSA Awards $49 Million in Grants To Treat People Who Are Homeless
SAMHSA) today announced a series of grants to provide treatment to persons who are homeless, suffering from substance use or mental disorders or both. The first grant program (Development of Comprehensive Drug/Alcohol and Mental Health Treatment Systems for Persons Who are Homeless, also known as The Treatment for Homeless program), includes 23 grants totaling $45 million for five years to expand and strengthen treatment services. These grant programs define a person who is homeless as someone who lacks a fixed, regular, adequate nighttime residence. Those who have a disabling condition and have either been continuously homeless for a year or more or have had at least four episodes of homelessness in the past three years are considered chronically homeless. In addition, 21 supplemental grants totaling $4 million for one year were awarded to help current grantees enhance their services component to ensure that individuals experiencing chronic homelessness obtain mental health and substance abuse treatment, linkage to housing and housing support services, case management, and other recovery-oriented services. "It is estimated that up to 600,000 persons are homeless on any given night. Many have serious mental health and substance abuse problems that can be treated," said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA's Acting Deputy Administrator. "These grants will help provide the treatment and recovery support services needed to help these people overcome their illnesses and obtain a safe, decent place to live." The 23 grant awards are funded up to $400,000 each in total costs per year for five years. Continuation of these awards is subject to both availability of funds and progress achieved by awardees. The total funding for 2006 is approximately $9 million. The grants are administered by SAMHSA's Center for Substance Abuse Treatment (CSAT).
For a complete list of grantees, see http://www.samhsa.gov/news/newsreleases/061006_homeless.aspx.
From an October 10 press release:
SAMHSA News Highlights Efforts to Blend Research with Practice
Successful efforts to incorporate research findings into clinical practice are described in the September/October 2006 issue of SAMHSA News, the newsletter of the Substance Abuse and Mental Health Services Administration. The issue describes a joint effort by SAMHSA and the National Institute on Drug Abuse (NIDA) to decrease the 17-year gap that typically occurs between the publication of research results in scholarly journals and their application in clinical practice. The "Blending Initiative," as the effort is called, takes findings on substance abuse treatment typically gleaned from NIDA's Clinical Trials Network and packages them into readily understandable curricula and tools for service providers. Topics covered so far include the treatment of opioid addiction with the medication buprenorphine and the use of the Addiction Severity Index, a tool for addiction counselors to collect information about all aspects of a client's life to use in building a treatment plan. Other newsletter articles include a project called "Digital Access to Medication," which is developing a centralized database of information on patients in treatment for opioid dependence. The purpose of "D-ATM" is to enable service providers throughout the nation to prescribe dosage-specific medication during or following emergencies such as hurricanes or terrorist attacks that cause power failures or population dispersal. The issue also announces new SAMHSA grant awards, survey findings showing a continuing decline in youth drug use, and newly available publications. The September/October 2006 issue is available online at http://www.samhsa.gov/samhsa_news/. SAMHSA News is published bimonthly in both hardcopy and electronic format. To receive a free subscription, telephone 1 (888) 577-8977 (toll-free) or (240) 221-4001 in the Washington, DC, metropolitan area.
From an October 11 press release:
$54.6 Million for Cooperative Agreements for Screening, Brief Intervention, Referral and Treatment (SBIRT)
SAMHSA and the Office of National Drug Control Policy (ONDCP) today jointly announced the award of four cooperative agreements totaling $54.6 million over five years for its Screening, Brief Intervention, Referral and Treatment (SBIRT) program for persons with substance use disorders. This brings the total of SBIRT awards to states and tribal organizations to 11. An additional 12 brief intervention grants have been made to colleges and universities to integrate screening and brief intervention into their student health programs. Under the most recent SBIRT awards, states will work to expand their continuum of care for persons at risk for or diagnosed with a substance abuse disorder to include screening, brief intervention, and referral to treatment. These services are performed in general medical and other community settings, such as community health centers, nursing homes, schools, student assistance programs, occupational health clinics, hospitals and emergency departments. "Screening and intervention for alcohol and drug use problems for people in general health settings can be and should be as routine as screening for heart disease and diabetes," said Assistant Surgeon General Eric Broderick, DDS, MPH, Acting Deputy Administrator of SAMHSA. "The SBIRT program helps reduce the risk for drug and alcohol abuse through brief interventions and acts as a doorway to specialized care for those who need it. Early detection and referral can help promote positive behavior change early on before the problem gets worse." John Walters, Director of National Drug Control Policy, said, "The SBIRT program can help us dramatically improve the quality of public health and our healthcare system. Engaging the entire medical community in the early detection of and intervention against drug abuse supports our efforts to reduce the disease of addiction and can help change the face of this problem for generations to come." The four awards are for up to $2.8 million per year in total costs for up to 5 years of funding. Continuation of these awards is subject to both availability of funds and progress achieved by awardees.
For a list of this year's grantees, see http://www.samhsa.gov/news/newsreleases/061011_SBirt.aspx.
From an October 13 press release:
Science-Based Substance Abuse Prevention Planning System Now Available to States
SAMHSA today announced the availability of Communities That Care (CTC) -- a science-based substance abuse prevention planning system for use by States and communities to help prevent drug and alcohol abuse before it starts. CTC models a community-wide approach to prevention that also enables communities to select the right substance use prevention program for their needs in preventing substance abuse problems. CTC helps communities monitor and improve overall program quality, and ultimately prevention practice. "The Communities That Care system has a long and distinguished history across our country and by incorporating the CTC tools and processes, States and communities across the U.S. seeking to use CSAP's Strategic Prevention Framework will now have the technology they need to succeed," said Assistant Surgeon General Eric Broderick, D.D.S., M.P.H., SAMHSA's Acting Deputy Administrator.
Broderick further explained: "With the acquisition of the CTC operating system, we now have the opportunity for communities to engage in locally operated, data-driven, evidence-based prevention using the latest advances in prevention science."
SAMHSA Communities That Care materials are available on their website, http://preventionplatform.samhsa.gov. for downloading and reproduction. The Regional Centers for Applied Prevention Technology (CAPT) will provide upon request a Training of Trainers of the CTC tool to States. The States then will be able to assist communities in implementing CTC in their areas. The CTC products were acquired from the Channing Bete Company in September of 2005. The system enhances the SPF program and provides useful tools and materials, including a student survey to guide communities in developing comprehensive plans to solve substance abuse and other related problems in communities.
