Opioids: A Regional Perspective on a National Epidemic Ed Heidig Regional Director HHS Region IX @HHSRegion9 1
Region IX The U.S. Department of Health & Human Services 2
Region IX The U.S. Department of Health & Human Services Divisions Administration for Children and Families Administration for Community Living Assistant Secretary for Preparedness and Response Agency for Toxic Substances Disease Registry Centers for Disease Control and Prevention Centers for Medicare and Medicaid Services Food and Drug Administration Health Resources Services Administration Indian Health Service Office of the Assistant Secretary for Health Office of Civil Rights Office of the Inspector General Substance Abuse and Mental Health Services Administration 3
HHS Top Priorities Enhance and Protect the Health and Well-Being of All Americans • Goal 1 : Prevent & Treat Opioid Abuse • Goal 2 : Reduce Prescription Drug Prices • Goal 3 : Increase Accessibility & Affordability of Health Insurance • Goal 4: Pay for Value & Outcomes in Healthcare Delivery • Goal 5: Reduce New HIV/AIDS Infections by 90% by 2030 4
HHS Top Priorities Enhance and Protect the Health and Well-Being of All Americans • Goal 1 : Prevent & Treat Opioid Abuse • Goal 2 : Reduce Prescription Drug Prices • Goal 3 : Increase Accessibility & Affordability of Health Insurance • Goal 4: Pay for Value & Outcomes in Healthcare Delivery • Goal 5: Reduce New HIV/AIDS Infections by 90% by 2030 5
Presentation Overview • Scope of the Opioid Epidemic • Our National Strategy at HHS • From Policy to Practice • The Region IX Approach to Collaboration • Where Do We Go From Here? 6
Scope of the Opioid Epidemic
The Opioid Epidemic in Context Scope of the Problem Source: HHS: HHS.gov/opioids/about-the-epidemic/index.html Source: SAMHSA: SAMHSA.gov/sites/default/files/aatod_2018_final.pdf
The Opioid Epidemic in Context Source: CDC/NCHS 2006 2016 9 Estimated Age-Adjusted Death Rates for Drug Poisoning by County
The Opioid Epidemic in Context Drug Overdose Deaths, 1970 - 2015 10 Source: CDC/NCHS
Risk Factors for Heroin Misuse 3 out of 4 people who used heroin in the past year misused opioids first 7 out of 10 people who used heroin in the past year also misused opioids in the past year Nonmedical use of Rx Opioids: A significant risk factor for heroin use 11 Source: Chris Jones/SAMHSA
Epidemic Is Driving Increased Healthcare Utilization Source: AHRQ-HCUP
The National Response
A Comprehensive Strategy 14
Improving Access to Prevention, Treatment & Recovery Services Prevent the health, social, and economic consequences associated with opioid addiction and enable individuals to achieve long-term recovery Supporting Targeting Providing Strengthening Services Populations Education Collaborations 15
Targeting the Distribution & Availability of Overdose-Reversing Drugs Ensure the broad provision of overdose-reversal drugs to people likely to experience or respond to an overdose, with a particular focus on targeting high-risk populations Building Providing Capacity Education 16
Advancing the Practice of Pain Management Enable access to high-quality, evidence-based pain care that reduces the burden of pain for individuals, families, and society while also reducing the inappropriate use of opioids and opioid-related harms Developing Providing Policies Education Former CMO Dr. Vanila Singh , Chair of the Inter-Agency Pain 17 Management Task Force
Strengthening Timely Public Health Data & Reporting Improve the timeliness and specificity of data to inform a real- time public health response as the epidemic evolves Enhanced Data Surveillance Sharing 18
Supporting Cutting-Edge Research Advance our understanding of pain and addiction, support the development of new treatments, and identify effective public health interventions to reduce opioid-related harms Understanding Addiction & Epidemiology & Pain Overdose Policy 19
From Policy to Practice
The 2018 Omnibus Substance Abuse & Mental Health Services Administration • State Opioid Response Grants : Authorized $1 billion in new funding for grants to States to address the opioid crisis – In addition to the $500M provided in the 21st Century Cures Act – $50M for grants to Indian tribes and tribal organizations • Medication-Assisted Treatment for Prescription Drug and Opioid Addiction: $84M authorized for MAT expansion – $5M set-aside for Indian tribes, tribal organizations, or consortia 21
The 2018 Omnibus Health Resources & Services Administration • National Health Service Corps: $105M ↑ to expand/improve access to quality opioid & substance use disorder treatment in rural & underserved areas nationwide • Rural Communities Opioids Response: $100M initiative to support treatment for & prevention of substance use disorder – 8 counties in Nevada covered by grantees • Telehealth Centers of Excellence: $4M for technical assistance 22
The 2018 Omnibus Centers for Disease Control & Prevention • Opioid Prescription Drug Overdose (PDO) Prevention Activity : $475,579,000 to advance the understanding of the opioid overdose epidemic and scale up prevention activities – CDC shall use $10M of the funds provided to conduct an opioid nationwide awareness and education campaign • Promote the use PDMPs, including making them more interconnected, real-time, and usable for public health surveillance and clinical decision making at State and local level 23
The 2018 SUPPORT Act • Treatment and Recovery • Prevention • Protecting Communities • Fighting Fentanyl 24
The SUPPORT Act Medicaid Provisions to Address the Opioid Crisis • Section 1001 : Prohibits termination of Medicaid eligibility for juveniles who are inmates of public institutions • Section 1005: Requires HHS Secretary to issue guidance within 1 year of enactment to improve care for infants with neonatal abstinence syndrome and their families • Section 1006: Temporarily requires coverage of MAT under Medicaid 25
The SUPPORT Act Medicare Provisions to Address the Opioid Crisis • Section 2001 : Exempts SUD telehealth services from specified requirements, such as geographic restrictions, under Medicare • Section 2002: The initial exam of new enrollees and annual wellness visits under Medicare must include SUD screening and a review of any current opioid prescriptions • Section 2004: Medicare prescription drug sponsors must establish drug-management programs for at-risk beneficiaries 26
The SUPPORT Act FDA and Controlled Substance Provisions • Section 3014 : The FDA must coordinate with the DHS and USPS to improve screening & identification of unlawful controlled substances at international drug import facilities • Section 3201: Increases the maximum number of patients that health care practitioners may initially treat with MAT (i.e., under a buprenorphine waiver) – This provision codifies the ability for qualified physicians to prescribe MAT for up to 275 patients 27
The SUPPORT Act Other Medicaid Provisions • Section 5052 : Allows states to apply to receive federal Medicaid payment for specified services provided in IMDs for enrollees (aged 21 to 64) with substance-use disorders, through FY2023. – Medicaid programs may receive federal reimbursement for up to 30 total days of care in an IMD during a 12-month period for eligible individuals 28
The SUPPORT Act Other Medicare Provisions • Section 6001 : CMS Innovation Center may test models to provide incentive payments to behavioral health providers for adopting electronic health records technology and for using said technology to improve the quality and coordination of care • Section 6065 : CMS must identify outlier prescribers of opioids under Medicare Part D and Medicare Advantage plans, based on specialty and geographic area, and annually notify such prescribers of their status 29
The Region IX Approach
How Region IX Approaches the Opioid Epidemic • Federalism : Support state and local innovation to meet the needs of their communities • Collaboration : breaking down bureaucracy both internally and externally brings the best information and resources to the epidemic the fastest • Active Listening : States have been bold in their strategies, and asking the right questions allows all parties to learn and inform 31
We Are Turning The Tide Centers for Medicare & Medicaid Services
We Are Turning The Tide Centers for Medicare & Medicaid Services
We Are Turning The Tide Health Resources & Services Administration During last week’s National Health Center Week, HRSA awarded: – ~ $70M for Opioid Workforce Expansion Programs for Professionals & Paraprofessionals – ~ $17M for Graduate Psychology Education Program – ~ $200M in Integrated Behavioral Health Services grants to health centers • $668K to 4 centers in Nevada – ~ $111M for the Rural Communities Opioid Response Program initiative • $1M to Community Chest in Virginia City, NV Learn more: http://www.hrsa.gov/opioids
Recommend
More recommend
