White House budget request decimates substance use prevention

The White House budget request for fiscal year 2021 for the Substance Abuse and Mental Health Services Administration (SAMHSA) proposes to zero out a major prevention program — the Strategic Prevention Framework State Incentive Grant — Partnerships for Success program. This is a cut of $109 million. It recommends using the prevention set‐aside (20%) from the Substance Abuse Prevention and Treatment (SAPT) block grant instead. But it doesn't give any more money to the block grant.     

President's proposed budget would slash treatment and prevention funding

We had a feeling of déjà vu when the White House sent its proposed budget to Congress last week. Similar to past years, the Office of National Drug Control Policy (ONDCP) would be decimated, moving the $100 million Drug‐Free Communities program to the Center for Substance Abuse Prevention (CSAP) at the Substance Abuse and Mental Health Services Administration (SAMHSA). There's no additional money in the Substance Abuse Prevention and Treatment (SAPT) block grant and cuts to the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, CSAP and SAMHSA's Center for Substance Abuse Treatment.     

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Analysis of Client Deaths in California Recommends Tougher Counselor Standards New Study Claims Parents Can Judge Teen Substance Use Reality of Relapse Requires Changing to a Chronic Care Approach Center for Substance Abuse Prevention (CSAP) Stands to Lose More Than $40 Million if White House Vetos Spending Bill Parental Behavior Influences Teen Drug Use Briefly Noted State Watch Resources Call for Presentations Coming up     

As HIPAA changes loom,patients demand continued confidentiality for SUD records

In last week's issue, we wrote about the plans by the federal Department of Health and Human Services (HHS) to weaken the Health Insurance Portability and Accountability Act (HIPAA), citing regulatory burdens and the need for information‐sharing (see ADAW, Jan. 21). The plans, detailed in a request for information (RFI) issued Dec. 12, throw a wrench into the plans by the “make 42 CFR Part 2 like HIPAA” movement, which would erase the federal confidentiality regulation protecting substance use disorder (SUD) treatment records by watering it down to HIPAA standards. Now, with even HIPAA seeming too burdensome, the need is even greater to protect the consent provision of 42 CFR Part 2 — which is basically all that's left after the Substance Abuse and Mental Health Services Administration (SAMHSA) allowed information‐sharing for the vague “health care operations” without consent last year (see ADAW, Jan. 8, 2018). Last week, H. Westley Clark, M.D., J.D., dean's executive professor at Santa Clara University and former director of the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration, made this abundantly clear in his comments to ADAW.     

NASADAD pushes block‐grant increase for stimulus 4 bill

The National Association of State Alcohol and Drug Abuse Directors (NASADAD) last week wrote to Sen. Patty Murray (D‐ Washington) and Sen. Roy Blunt (R‐Missouri), the Senate co‐chairs of the Labor, Health and Human Services (HHS), Education, and Related Agencies Appropriations Subcommittee, asking specifically for the $1.5 billion in supplemental funding as provided by the House in the HEROES Act for the Substance Abuse Prevention and Treatment (SAPT) block grant (see “Proposed bill for HEROES Act would give $1.5 billion to SAPT block grant,” ADAW, May 18, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32722 ).     

Senators call for $2 billion in supplemental SAMHSA funding

As the fourth stimulus bill, the HEROES Act, awaits action by the Senate, 19 senators sent a letter last week to Senate and House leadership calling for increased investments in substance use disorder programs during the COVID‐19 pandemic. The letter, from Senators Tammy Baldwin (D‐Wisconsin) and Jeanne Shaheen (D‐New Hampshire), along with 17 other senators (all Democrats), calls for “$2 billion in funding for the Substance Abuse and Mental Health Services Administration (SAMHSA) to administer supplemental grant allocations under the Substance Abuse Prevention and Treatment (SAPT) Block Grant program and the State Opioid Response (SOR) grant program.”     

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University Collaboration Seeks to Improve SA Treatment in Managed Care House, Senate Committees Approve Versions of TANF Reauthorization Brandeis/Harvard Collaboration Includes Four Initiatives Biden Bill Would Train Health Professionals to Recognize Substance Use Ramstad Introduces Substance Abuse Parity Legislation Literature Review Yields Findings on Treatment Cost‐Effectiveness SAMHSA Releases Group Therapy Guide for SA Treatment Briefly Noted Coming Up     

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Army Homicide Investigations Highlight Role of Unaddressed Substance Use House Appropriations Committee Clears Field‐Related Spending Bill Treatment Providers Don't Fare Too Badly in Conn. Budget Florida Drug Strategy Sets Goals for Treatment and Prevention Michael Jackson's Death Raises Questions About Abuse Potential of Propofol Briefly Noted State News Resources Call for Comments Coming up     

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House Parity Bill Gives Fairer Treatment to Addiction Treatment What Makes for a Good Methadone Program? Report on College Substance Abuse Attacks Culture of Acceptance Teen Use of Inhalants Rising: SAMHSA Treatment Team Three Meetings at SAMHSA Briefly Noted Call for Applications Resources Coming up     

Briefly Noted

By the time this issue of ADAW is published, the final figures will be out. At press time, some $400 million in a $2 trillion stimulus package designed to combat economic problems from the coronavirus pandemic is going to the Substance Abuse and Mental Health Services Administration, according to Andrew Kessler, principal with Slingshot Solutions. Both the Senate and House versions allocated $400 million. The Senate bill proposed $425 million, while the House proposed $435 million. In both bills, $15 million goes to the Indian Health Service and $50 million to suicide prevention. In the Senate bill, $250 million is allocated to certified community behavioral health clinics (CCBHCs), while that number is $200 million in the House version. These clinics currently exist in only eight states, Kessler pointed out. The CCBHC money will allow states to apply for grants and put forth their own behavioral health priorities, said Kessler. Watch next week's issue for details.     

Transitioning SOR to the SAPT BG: Why not?

It's time to think about transitioning the State Opioid Response (SOR) grants to the Substance Abuse Prevention and Treatment (SAPT) block grant, Robert Morrison, executive director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD), told the House Energy and Commerce Committee at its March 3 hearing on opioid legislation. The STR and SOR grants went directly to single state authorities (SSAs) in charge of the SAPT block grants — NASADAD members — so this makes perfect sense. These are the officials who best know how funding should be spent in their states — on what substances, including alcohol. Instead of having a designated amount set up for opioids — although that was expanded to include stimulants as well (see “FY 2020 Appropriations: Stimulants added to SOR's $1.5 billion,” ADAW, Dec. 23, 2019, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32573 ) — each SSA should just have this funding added permanently to the block grant.     

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NASADAD Inquiry Underscores Need for Collaboration Between SSA, Criminal Justice Okla. Considers Adding Substance Abuse Screening to Protective Custody Screening In Colorado, Closing Two Budget Gaps Hinges on the Stimulus House Passes FY 2009 Spending Bill with SA Funding Increases Briefly Noted OptumHealth Gets New Mexico Contract State News Call for Applications Coming up     

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CSAT Rescinds 2008 Directive on Take‐Homes, Citing Field Confusion Provider Agencies Overcome Uncertainty in Instituting Walk‐in Assessments Iowa Governor Preserves Funding for Substance Abuse Treatment NIATx Calls for Proposals for Its New Health Reform Initiative Indian Health Care Now Included in House Version Live Grenade in Chicago Treatment Program Briefly Noted State News Call for Applications Coming up     

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Delaware Uses Penalties and Rewards to Increase Utilization and Retention ONDCP Strategy Document Addresses Rx Monitoring, ATR, Screening Delaware: Not NOMs Sex‐Drug Fusion Complicates Methamphetamine Recovery House Passes Parity Bill No Medication‐Substance Abuse Link Found in ADHD Study Clarifications Briefly Noted State Watch Business Names in the News Coming up     

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SAMHSA Report: States Will Bear More of Substance Abuse Treatment Cost Burden Maryland Counties Seek Efficiencies to Assist in Closing Treatment Gap Untreated Sex Addiction Can Lead to Relapse to Alcohol/Drug Use House Committee Report Charges ONDCP was Used for Political Purposes $1‐Billion National Youth Anti‐Drug Media Campaign Found Ineffective Briefly Noted State Watch Coming up     

SAMHSA to write new application for new SOR with stimulants included

The addition of stimulants as an allowable use for State Opioid Response (SOR) grants will require a new application, which the Substance Abuse and Mental Health Services Administration (SAMHSA) is working on, ADAW has learned. The change was in the FY 2020 appropriations bill passed last month by Congress (see ADAW, Dec. 23, 2019; “FY 2020 Appropriations: Stimulants added to SOR's $1.5 billion,” https://onlinelibrary.wiley.com/doi/10.1002/adaw.32573 ), along with funding for other SAMHSA programs, including the Substance Abuse Prevention and Treatment block grant (SAPT BG). After the bill passed before Christmas, Washington went away for the holidays.     

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Field Struggles to Hold on to BG‐Funded Residential Treatment in Face of ACA Murder at New York Treatment Center Shines Spotlight on Facility Safety GOP Control of House May Mean Changes, or At Least Delays, for ACA Mass. Voters Opt to Repeal Alcohol Tax, Killing Dedicated Fund Alcohol and the Workplace: The Elephant in the Room Caron Offers Free Substance Abuse Training for Pediatric Residents Briefly Noted State News Business Coming up     

Nuggets from AATOD: New CSAT director comments

Here are more reports from last month's American Association for the Treatment of Opioid Dependence (AATOD) conference in Orlando — in particular, insights from Louis Trevisan, M.D., the new director of the Center for Substance Abuse Treatment (CSAT) of the Substance Abuse and Mental Health Services Administration (SAMHSA).     

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No Money for Safe and Drug‐Free Schools Again, New ATR Vouchers House Subcommittee Considers Beefing up Treatment Language in Second Chance Act New ATR Voucher Program Substance Abuse Services and the Budget ‘Disproportionate Impact’ on African Americans FY 2006 Budget, Good and Bad Private Treatment Program for Methadone Detox Focuses on Buprenorphine SAMHSA Survey Looks at Role of Schools in Providing Services Applications Now Being Accepted for Director of Research and Program Applications Briefly Noted Resources Coming Up     

SAMHSA grantees can't use funds for medical cannabis

Some states are adjusting their contracts to the recent edict from the Substance Abuse and Mental Health Services Administration (SAMHSA) banning grantees, including Substance Abuse Prevention and Treatment (SAPT) and State Opioid Response (SOR) grantees, from.