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.     

NASADAD requests $250 million for Phase 4 stimulus

If there will be a Phase 4, as Rep. Nancy Pelosi (D‐California) has promised, of stimulus money to help America cope with the fallout from COVID‐19, the substance use disorder (SUD) treatment field hopes to get some of it this time. Publicly funded SUD treatment and prevention got nothing — nothing — from the $2 trillion CARES Act passed at the end of March (see “In case you haven't heard,” ADAW, April 3, https://onlinelibrary.wiley.com/doi/10.1002/adaw.32684 ).     

The social costs of child abuse in Japan

The present study calculates the social costs of child abuse in Japan. The items calculated included the direct costs of dealing with abuse and the indirect costs related to long-term damage from abuse during the fiscal year 2012 (April 1, 2012, to March 31, 2013). Based on previous studies on the social costs of child abuse and peripheral matters conducted in other countries, the present study created items for the estimable direct costs and indirect costs of child abuse, and calculated the cost of each item. Among indirect costs, future losses owing to child abuse were calculated using extra costs with a discount rate of 3%. The social cost of child abuse in Japan in the fiscal year 2012 was at least ¥1.6 trillion ($16 billion). The direct costs totaled ¥99 billion ($1 billion), and the indirect costs totaled ¥1.5 trillion ($15 billion). This sum of ¥1.6 trillion for only the year 2012 is almost equal to the total amount of damages of ¥1.9 trillion caused by the 2011 Tohoku Earthquake and Tsunami in Fukushima Prefecture. Moreover, abuse is a serious problem that occurs every year and has recurring costs, unlike a natural calamity. However, Japan has no system for calculating the long-term effects of abuse. Therefore, owing to the scarcity of data, the calculations in the present study may underestimate the true costs.     

What does $8 billion for coronavirus say about opioid funding?

Last week, Congress gave $8 billion to the fight against coronavirus, seemingly overnight. Certainly, compared to the extra $2 billion a year for addressing the opioid epidemic, the money came much faster. It took years for the State Targeted Response to the Opioid Crisis (STR) grant to be included, as it was in the Cures Act passed by Congress in 2016 and signed into law by President Obama in December of that year. The State Opioid Response (SOR) grants continue. How did the coronavirus $8 billion — $6 billion more than the White House had asked for — materialize so quickly? We asked two Capitol Hill experts.     

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.”     

Sign‐on letter for SAPT increase due March 20

Representatives Paul Tonko (D‐New York) and Brian Fitzpatrick (R‐Pennsylvania) need signatures for their letter to the House Appropriations Committee urging a $500 million increase for the Substance Abuse Prevention and Treatment (SAPT) block grant in fiscal year 2020. “This funding stream serves as the cornerstone of States' substance abuse treatment, prevention, and recovery systems,” states the letter. “SAPT Block Grant funds, which are distributed by formula to all States and Territories, provide lifesaving treatment services to approximately 1.5 million individuals per year. In some States, the SAPT investment accounts for 100 percent of substance use prevention dollars. Unfortunately, SAPT Block Grant funding has not kept up with inflation, resulting in a 24 percent—or $444 million—decrease in actual funding since 2009.” The block grant has been just over $2 billion for decades. The letter requests that legislators fund just over $2.358 million for the SAPT block grant, which is equal to what the House of Representatives approved in the FY2019 Labor‐Health and Human Services Appropriations legislation and a $500 million increase over current funding levels. To sign on to the letter, contact Jeff Morgan in Rep. Tonko's office at jeff.morgan@mail.house.gov or Joseph Knowles in Rep. Fitzpatrick's office at joseph.knowles@mail.house.gov .     

警惕中国经济泡沫化——中国经济增长模式面临的严重挑战

改革开放以来,中国经济35年增长主要是外向型经济拉动的。但2008年国际金融危机时间,中国出台的"4万亿"投资刺激计划,改变了中国原有的经济增长模式,投资在经济增长中的作用越来越重要。同时,带来了两个结构性矛盾:一是投资中政府融资平台的崛起,深刻地改变了中国的投资结构,投资效率开始下降;二是投资拉动的经济增长模式必然依靠货币信贷释放来支撑,容易带来经济泡沫化。评论中国经济是否有泡沫化现象,可以从经济货币化指数、固定资产投资占GDP的比重、PPI和CPI的长期背离三个方面进行分析。     

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 ).     

State and local retirement plans: innovation and renovation

This Special Report/Issue Brief examines the universe of state and local retirement plans. It describes how these plans have developed and continue to evolve in a number of areas, including plan features, regulatory framework, governance, and asset management. While these retirement programs differ in many respects from private-sector plans, the disparity in some areas has narrowed. This report also includes a discussion of trends and the underlying forces for change. Public-sector retirement programs provide an important source of pension coverage in the United States, and are a significant part of the total retirement market: Combined public-sector retirement assets (state, local, and federal governments) comprised 29 percent of the $11.2 trillion U.S. retirement market in 1998. State and local plans are dominant in the public-sector retirement market, holding $2.7 trillion in assets, compared with $696 billion held by federal plans (both military and civilian). More than 16 million individuals are employed by state and local jurisdictions in the United States. State and local retirement plans share certain common features because of the environment in which they operate. Legal statutes, governance, and tradition all play a role in defining what is sometimes referred to as a "public-sector culture." Despite common features, there is considerable diversity among public-sector retirement plans. To attract and retain a skilled work force, public-sector employers have increased their use of defined contribution (DC) plans to supplement defined benefit (DB) plans (or, to a lesser extent, replace or serve as an alternative to them) and improve cost-of-living adjustments. At the same time, a combined federal-state regulatory framework has encouraged certain plan design features, unavailable in the private sector, which include multiple tiers for successive generations of employees in a single plan and different strategies to increase portability. State and local retirement plans reflect an increasing role by the federal government in pension system design and operation, which has led to greater complexity in such areas as Social Security participation and deferred compensation arrangements. Complexity can be expected to increase with the recent passage of P.L. 107-16, the Economic Growth and Tax Relief Reconciliation Act of 2001. The latest full-year data included in this report are for 1999 and in some cases 2000. After this report went to press, the Federal Reserve issued significantly revised quarterly data for state, local, and federal retirement plan assets, which were not incorporated in this Issue Brief.     

Gavel-to-Gavel Congressional Television Coverage as Political Advertising: The Impact of C-Span on Legislative Sessions

This article examines the effect of television on the length of legislative sessions at the federal level in the United States. Data from the U.S. Congress during the period 1972–96 are employed, during part of which time each house of Congress received significant television coverage by C-SPAN and C-SPAN2. Evidence from a Parks regression suggests that the presence of C-SPAN has increased House sessions by 88–250 hours and the presence of C-SPAN2 has increased Senate sessions by a striking 252–431 hours, other things constant. Additional estimates suggest that House sessions are about two minutes longer per bill introduced under the eye of C-SPAN, and Senate sessions are about four minutes longer per bill introduced in the presence of C-SPAN2. Longer sessions, which represent low-cost forms of advertising for incumbents, are not without costs to taxpayers. We estimate that these costs lie somewhere between $16 million and $392 million in real terms per session of Congress.     

Stimulus package includes 42 CFR Part 2 provisions

The language in the stimulus package, as of March 26, revises 42 CFR Part 2 (confidentiality of substance use disorder patient records requiring patient consent before release), eliminating the consent provisions – allowing patients to give consent only once: “it shall be permissible for a patient's prior written consent to be given once for all such future uses or disclosures for purposes of treatment, payment, and health care operations, until such time as the patient revokes such consent in writing.”While not full alignment with the Health Insurance Portability and Accountability Act (HIPAA), it is bad news for confidentiality. Many programs probably require consent before admitting patients to treatment. The vague “health care operations” is included as a party that can get information redisclosed. If the House and the President signs off, the new law goes into effect immediately. 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 said the pending NPRM on 42 CFR Part 2 from SAMHSA should be suspended, that 42 CFR Part 2 should be formally moved from SAMHSA to the Office of Civil Rights (OCR) of the Department of Health and Human Services since OCR has the function to collect data, monitor breaches, and impose penalties.” In addition, stakeholders should “ask what the new 42 CFR part 2 look like with the proposed changes which include the consent provisions, the breach notification provisions, the penalty provisions and all the other bells and whistles.” The bill was passed unanimously by the Senate March 25, and was scheduled to go to the House of Representatives for a vote March 27, after which President Trump was expected to sign it.     

Table of Contents

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     

Book Review

AIDS AND THE NEW ORPHANS COPING WITH DEATH. Barbara O. Dane & Carol Levine (Eds.). Westport, Connecticut: Auburn House, 1994, 158 pp.; $49.95 (hardback) or $17.95 (paperback).     

The new economics of labour migration and the role of remittances in the migration process

This analysis considers international migration remittances and their impact on development in migrant-sending areas. The new economics of labor migration (NELM) posit that remittances lessen production and market constraints faced by households in poor developing countries. The article states that remittances may be a positive factor in economic development, which should be nurtured by economic policies. The impact of remittances and migration on development varies across locales and is influenced by migrants' remittance behavior and by economic contexts. Criteria for measuring development gains may include assessments of income growth, inequity, and poverty alleviation. It is hard to gauge the level of remittances, especially when remittances may not flow through formal banking systems. The International Monetary Fund distinguishes between worker remittances sent home for over 1 year; employee compensation including the value of in-kind benefits for under 1 year; and the net worth of migrants who move between countries. This sum amounted to under $2 billion in 1970 and $70 billion in 1995. The cumulative sum of remittances, employee compensation, and transfers was almost $1 trillion, of which almost 66% was worker remittances, 25% was employee compensation, and almost 10% was transfers during 1980-95. Total world remittances surpass overseas development assistance. Remittances are unequally distributed across and between countries. Migration research does not adequately reveal the range and complexity of impacts. Push factors can limit options for use of remittances to stimulate development.     

Text of opioid bill released by House Ways and Means Committee: 42 CFR Part 2 is spared

Last week, the long‐awaited opioid package was released by the House of Representatives Ways and Means Committee. Notably, 42 CFR Part 2, which the House version had slated for elimination but the Senate had not addressed, is spared. The confidentiality regulation, which requires substance use treatment providers to obtain consent from patients before releasing their information, would have been replaced with the Health Insurance Portability and Accountability Act (HIPAA), which would have included their information in their record.     

Table of Contents

New Treatment Money for West Virginia Providers under Justice Reinvestment Act OTPs Confront Price Challenges as They Diversify Drug Options Documentary Trailer Outrages W.Va. Town SUDs Mentioned at White House Meeting on Mental Health $26.9 Million Increase for SA Services in Texas Budget NIAAA Study Shows Varenicline Reduces Alcohol Consumption BFC and Hazelden Pursue Alliance State News Names in the News Resources Coming up     

Table of Contents

Local Communities Bristle Over High Concentrations of Centers Block Grant up for $35 Million Increase, Depending on Senate and White House Schools Need Help with Prevention Education, Says Report Recommendations by Join Together Researchers Federal Auditors to Scrutinize ATR in 2008 Briefly Noted Names in the News Coming up     

Questions and answers on employee benefit issues

This Issue Brief addresses 19 topics in the areas of pensions, health insurance, and other benefits. In addition to the topics listed below, the report includes data on the prevalence of benefits, tax incentives associated with benefits, lump-sum distributions, number of private pension plans, pension coverage rates, 401(k) plans, employer spending on group health insurance, self-insured health plans, employer initiatives to reduce health care costs, and employers' response to the retiree health benefits accounting rule, and flexible benefits plans. In 1992, U.S. employers (public and private) spent $629 billion for noncash benefits, representing nearly 18 percent of total compensation, excluding paid time off. In 1992, 71 percent of the 50.1 million individuals aged 55 and over received retirement benefits, including distributions from private and public pensions, annuities, individual retirement accounts, Keoghs, 401(k)s, and Social Security. Among the 76 percent of all private pension plan participants who participated in a single plan, 30 percent named a defined benefit plan as their pension plan type, 58 percent named a defined contribution plan as their pension plan type, and 12 percent did not know their plan type. Private and public pension funds held more than $4.6 trillion in assets at the end of 1993. The 1993 year-end assets are more than triple the asset level of 1983 (nominal terms). According to the Congressional Budget Office, U.S. expenditures on health care were expected to have reached $898 billion in 1993, up from $751.8 billion in 1991, an increase of 19.4 percent in nominal terms.     

Sex researchers and sex myths: A challenge to activism

THE SEX PROFESSION: WHAT SEX THERAPY CAN DO. Patricia Schiller. Washington, D.C.: Chilmark House, 1981; 233 pages; $11.00.

SEX‐RELATED ISSUES IN CORRECTIONAL FACILITIES: A CLASSIFIED BIBLIOGRAPHY. David A. Shore (Ed.). Chicago: The Playboy Foundation, 1981; 39 pages; $5.00.

THE HITE REPORT ON MALE SEXUALITY. Shere Hite. New York: Alfred Knopf, 1981; 1162 pages; $19.95.

FREUD, BIOLOGIST OF THE MIND: BEYOND THE PSYCHOANALYTIC LEGEND. Frank J. Sulloway. New York: Basic Books, Inc., 1979; 612 pages; $20.00.

THERAPIE SEXUELLER STÖRUNGEN. (2nd ed.). Volkmar Sigusch (Ed.). Stuttgart/New York: Georg Thieme Verlag, 1980; 420 pages; DM 28.80.     

Table of Contents

Co‐Occurring Disorders Can Be Treated Within SAPT Block Grant Advocates Optimistic as Second Chance Act Clears House Committee Doctor's Sentence Highlights Challenges of Methadone Treatment Recovery Month Slated for Elimination by President's Proposed Budget SAMHSA Announces $96 Million in Access to Recovery Grants Briefly Noted Names in the News Coming up