T-ACT: TN Adolescent Coordination of Treatment

Evidenced-Based Practice References

2009-03-02T18:21:00.005-06:00

UNC-Greensboro has a collection of evidence-based practice information designed both for providers and families and caregivers.

Mentoring Grants from DOJ/OJJDP

2009-01-26T14:06:00.004-06:00

The DoJ's OJJDP is sponsoring mentoring programs for high-risk youth, including adolescents with substance use problems who become involved with the justice system.

National Mentoring Program Grants

Link to full page:
Summary:
The U.S. Department of Justice's Office of Juvenile Justice and Delinquency Prevention (OJJDP) will award $10 million to enable national organizations to provide mentoring services to special high-risk youth populations.
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From the solicitation:

This solicitation supports youth mentoring programs. Mentoring is a process designed to achieve specific goals, such as improved academic performance, social relationships, or job skills, and to support personal development. Mentoring uses relationships to impart changes in attitudes and behaviors. Effective mentoring programs include programs that match a mentor with one or more youth and can take place in multiple and informal settings, as well as in a school or program context. For the purpose of this solicitation, mentoring programs are defined as involving a structured relationship between an adult or trained peer, compensated or voluntary, and one or more youth, with one-on-one mentoring or group-mentoring being the preferred models. OJJDP-supported and other research and evaluation indicate that mentoring matches should be structured to support a relationship that lasts at least 12 months or through an entire school year. Research further finds that mentoring relationships that last 2 or more years increase positive outcomes for youth. Research also indicates that significant training for the mentor, oversight of the relationship, and data collection to track the relationship and its outcomes contribute to the structured support that is crucial to the mentoring relationship.
...
The goal of this program is to reduce juvenile delinquency, drug abuse, truancy, and other problem and high-risk behaviors. The objective of this program is to provide direct one-on-one or group mentoring services to underserved youth populations [emphasis added]. Successful applicants should develop programs that will recognize and address the factors that can lead to or serve as a catalyst for delinquency or other problem behaviors in underserved youth (e.g., lack of education or employment opportunities, attitudes in the community or family that condone criminal activity, lack of parental supervision). Proposals should contain a description of all services that the applicant will provide to address these issues and their expected outcomes. In addition to the required semiannual progress reports in the Grants Management System (GMS), OJJDP will require successful applicants to produce a final report, suitable for publication, at the Office’s discretion.

The application deadline is 8:00pm ET, 25 Feb 2009.

Annual Project Advisory Board Survey

2009-01-12T15:24:00.004-06:00

Dear T-ACT Project Advisory Board Member,

As most of you know, in January of each project year, the evaluation has administered a brief survey of PAB members' perceptions of the degree of coordination and strengths and challenges to coordination. Normally, this has occurred at the January PAB meeting, but this year, we will not have a meeting until March.

In order to collect this information, I'm sending you the following link to an on-line version of this survey:
Click Here to take survey.

For those who prefer to do this paper-and-pencil, you may download the questionnaire here, fill it out, and mail it or fax it to me at: 615-322-1141.

The favor of a reply is requested by January 22, 2009. Since these are intended to be anonymous and yet I want to avoid multiple mass emailings to the whole board, this will be the only email you receive about this survey. The survey should take between 5 and 10 minutes.

Thank you for your continued participation in and support of this project, and best wishes for a happy new year.

Robert Saunders

New Reports from NSDUH

2009-01-08T15:26:00.001-06:00

SAMHSA's Office of Applied Studies has some new reports out based on the National Survey of Drug Use and Health (NSDUH). This one focuses on trends in use of marijuana by adolescents between 2002 and 2007.

You can find other OAS reports at http://www.oas.samhsa.gov/topics.cfm.

Telehealth in Hawaii

2009-01-05T16:15:00.002-06:00

This item does not relate directly to adolescent substance abuse, but it does fit with our Project Advisory Board meeting in January 2008 on telehealth:

American Well, a Web service that puts patients face-to-face with doctors online, will be introduced in Hawaii on Jan 15.

...

Patients use the service by logging on to participating health plans’ Web sites. Doctors hold 10-minute appointments, which can be extended for a fee, and can file prescriptions and view patients’ medical histories through the system. American Well is working with HealthVault, Microsoft’s electronic medical records service, and ActiveHealth Management, a subsidiary of Aetna, which scans patients’ medical history for gaps in their previous care and alerts doctors during their American Well appointment.

The Hawaiian health plan’s 700,000 members pay $10 to use the service. The insurer also offers the service to uninsured patients for $45. Health plans pay American Well a license fee per member and a transaction fee of about $2 each time a patient sees a doctor.

Hawaii is particularly well suited for online medicine because the islands are remote, it takes time to travel among them and it is difficult for the state to recruit doctors to rural areas, said Mike Stollar, vice president of marketing for the Hawaii Medical Service Association.

Hospitalization for Co-occurring Mood and Substance Disorders

2009-01-02T12:57:00.005-06:00

A study in the current issue of the American Journal of Public Health has found that having a comorbid substance use disorder is an important predictor of hospitalization for mood disorders and re-hospitalization within 3-months of discharge. 15% of of individuals with a mood disorder (major depressive, bipolar, or both) had a substance use disorder, but 36% of cases admitted to inpatient and over 50% re-admitted within 3 months of discharge had a co-occurring substance use disorder.

The study used 1999-2000 adult data from the California, Florida, New Jersey, New York, and Texas Medicaid systems, but the findings may be relevant for adolescent populations to the extent that mood and substance use disorders often have onset in adolescence and are not fully addressed before adulthood.

Don't Count on the Media

2008-12-16T18:29:00.000-06:00

A report in the American Journal of Public Health evaluated the National Youth Anti-Drug Media Campaign, which spent $1 billion between 1998 and 2004. Results suggest not only was the program not effective in preventing drug use, but the program may have increased marijuana initiation.

Full citation:

Robert Hornik, Lela Jacobsohn, Robert Orwin, Andrea Piesse, and Graham Kalton. Effects of the National Youth Anti-Drug Media Campaign on Youths.2008. Am J Public Health, 98:2229-2236, 10.2105/AJPH.2007.125849.

More Things Brown Can Do for You

2008-12-16T11:10:00.000-06:00

Another online offering from Brown University/ATTC-NE, this one in CBT:

Cognitive Behavioral Therapy

Brown University Distance Learning Program is offering a credited, on-line course on cognitive behavioral therapy.

Cognitive-behavioral therapy (CBT) is a treatment approach that has gained widespread application in the treatment of a variety of mental health issues, including substance abuse. Several important features of CBT make it particularly promising as a treatment for substance abuse and dependence:
CBT is a short-term, comparatively brief approach well suited to the resource capabilities of most clinical programs.
CBT has been extensively evaluated in rigorous clinical trials and has solid empirical support as treatment for substance abuse.
CBT is structured, goal-oriented, and focused on the immediate problems faced by substance abusers entering treatment who are struggling to control their substance use.
CBT is a flexible, individualized approach that can be adapted to a wide range of patients as well as a variety of settings (inpatient, outpatient) and formats (group, individual).
CBT is compatible with a range of other treatments the patient may receive, such as pharmacotherapy and self-help groups such as Alcoholics Anonymous.
CBT's broad approach encompasses several important common tasks of successful substance abuse treatment.

This four week course will explore the central elements of CBT in the treatment of Substance Use Disorders and examine CBT treatment manuals that address alcohol and cocaine addiction.

The course instructor Justin Enggasser, Ph.D. is a Clinical Fellow at Harvard Medical School, Teaching Fellow at Boston University School of Medicine and currently works in the residential and outpatient substance abuse treatment programs at VA Boston Healthcare System. Dr. Enggasser has published several studies in the areas of cognitive vulnerability and substance use. He is currently involved in projects developing and testing new treatment models (a gender-specific cognitive-behavioral treatment protocol for women with substance use disorders) and treatment delivery methods (web-based interventions for problem drinking).

This course will begin on February 2, 2009, and will run for 4 weeks. The required time commitment is two hours per week (8 contact hours). There are no real time events associated with this course. All course material will be posted on the Internet.

The total cost of this course is $60.00 (US) the course payment is due by February 2, 2009. Refund requests will be honored until the posting of the second lesson (February 9, 2009), after which there will be no refunds. For additional information regarding this course offering, as well as a link to the Brown Distance Learning course '383 Cognitive Behavioral Therapy' registration page, please go to the following WWW site and read the Official Course Announcement.

http://www.browndlp.org/cbtann.php

To register for this course please log in/ or create your account then log into your account and click the Enroll in a New Course link at the bottom of your account page. Then select the course you wish to enroll into and click the enroll button. Having enrolled into the course you will be prompted for payment. You may make your payment online. To view payment information please see the payment policies page.

Sincerely,

Monte D. Bryant, BA
Technology Programming and Evaluation Administrator
Addiction Technology Transfer Center of New England
Center for Alcohol & Addiction Studies
Box G-S121 5th
Brown University
Providence, RI 02912
401-863-6606
http://www.attc-ne.org

Recommendations for the President-elect

2008-12-15T15:30:00.000-06:00

A blog entry by Mark Kleiman at UCLA summarizes his take on current issues in drug treatment, drug availability, and systems responses, including for adolescents. A couple of highlights:

9. Prevalence of diverted opioids and diverted stimulants among adolescents high and rising, with initiation at record levels. Little knowledge about how much damage this does; the pattern of peer-to-peer and internet distribution seems not to be generating problem drug markets or violence.
...
22. Data gathering and analysis is a mess.
Almost all the money is spent on two big and very expensive annual surveys: NS-DUH (household) and Monitoring the Future (school-based), which give information about prevalence but not about problems.
ADAM, which was a cheap way to monitor drug use in the criminal-justice population, was shut down early in the decade. A proposal to do the same thing even more cheaply by relying on the drug tests done routinely on probationers and parolees never happened.
The DAWN system to measure drug-related emergency room visits and deaths has broken down.
The Community Epidemiology Work Group no longer collects original data.
The DEA Stride data set on drug prices and purities is no longer available for statistical analysis.

Training Opportunity: Becoming a Supervisor

2008-12-15T13:08:00.000-06:00

This notice came over the electronic transom, announcing a training opportunity for moving line workers to supervisory positions:

Moving From Line Worker to Supervisor

Brown University Distance Learning Program is offering a credited, on-line course on moving from line worker to supervisor.

The Supervisors of tomorrow are the line workers of today. In the field of chemical dependency counseling, many of the original supervisors of programs are retiring. New qualified supervisors are needed in administrative and clinical supervisory roles. Even if you started your career as a Counselor with no intention of becoming a Supervisor, you have either been offered an opportunity to be a Supervisor or you are interested in finding about how to use your skills to move into a supervisory position, this is the course for you. Through the use of practical examples and readings, participants will learn the basics of supervision and how to incorporate clinical counseling tools into a supervisory setting and how to address the issues of moving from Peer to Supervisor. This course is designed for the new supervisor or the counselor who would aspires to become a supervisor.

The course instructor Susanne Smoller L-RCSW, CASAC, CPP, ACSW , is an independent organizational consultant specializing in substance abuse and HIV/AIDS. Susanne has worked in a variety of substance abuse settings with positions ranging from line worker to program director. Susanne also has experience as a Case Manager and Crime Victim Advocate. Susanne has also been a consultant on research grants regarding Gay, Lesbian, Bisexual teens; bridging substance abuse treatment research to practice; and New York State Expanded Syringe Access Demonstration Program (ESAP). Susanne started her own consulting practice in 2001 and became a Qualified Myers Briggs Type Indicator Practitioner. As an independent consultant, Susanne has been a strong advocate for syringe disposal and needle exchange in Long Island, NY. She has also expanded her work with HIV+ consumers, providing workshops on treatment information and risk reduction. Susanne also provides technical assistance consulting for federal grantees across the country on a variety of issues, including program sustainability and staff training needs. Susanne is currently an instructor at Molloy College's Chemical Dependency Certificate Program. Susanne was named Social Worker of the year in 1998 by the local division of the National Association of Social Workers and in 2006, Nassau County PTA Volunteer of the Year.

This course will begin on January 26, 2009, and will run for 4 weeks. The required time commitment is two hours per week (8 contact hours). There are no real time events associated with this course. All course material will be posted on the Internet.

The total cost of this course is $60.00 (US) the course payment is due by January 26, 2009. Refund requests will be honored until the posting of the second lesson (February 2, 2009), after which there will be no refunds. For additional information regarding this course offering, as well as a link to the Brown Distance Learning course 'Lineworker to Supervisor' registration page, please go to the following WWW site and read the Official Course Announcement.

http://www.browndlp.org/linetosupann.php

To register for this course please log in/ or create your account then log into your account and click the Enroll in a New Course link at the bottom of your account page. Then select the course you wish to enroll into and click the enroll button. Having enrolled into the course you will be prompted for payment. You may make your payment online. To view payment information please see the payment policies page.

Sincerely,

Monte D. Bryant, BA
Technology Programming and Evaluation Administrator
Addiction Technology Transfer Center of New England
Center for Alcohol & Addiction Studies
Box G-S121 5th
Brown University
Providence, RI 02912
401-863-6606
http://www.attc-ne.org

Prescription Pain Killers and Overdoses in WV

2008-12-11T15:35:00.001-06:00

A study of unintentional pharmaceutical overdoses in WV found that prescription opioids were present in 93% of cases, according to a CDC study reported in JAMA. From the abstract:

Pharmaceutical diversion [of prescriptions to those not prescribed] was associated with 186 (63.1%) deaths, while 63 (21.4%) were accompanied by evidence of doctor shopping. Prevalence of diversion was greatest among decedents aged 18 through 24 years and decreased across each successive age group...Substance abuse indicators were identified in 279 decedents (94.6%).

An accompanying editorial by Tom McLellan and Barbara Turner of Treatment Research Institute (TRI) calls for better monitoring of prescriptions. Below is a press release from TRI.

December 11, 2008

CDC Study of West Virginia Overdoses Suggests Need for Better Compliance Monitoring

More Vigilance, Better Electronic Records are Needed, Not Less Use of Opioids to Control Pain, Contend A. Thomas McLellan, Ph.D. and Barbara J. Turner, M.D., MSED in Special JAMA Editorial

Physicians who prescribe opioids should be more vigilant and step up monitoring, but not avoid prescribing these drugs when needed for pain management, according to A. Thomas McLellan, Ph.D. and Barbara J. Turner, M.D., MSED in an editorial appearing in the December 10, 2008 Journal of the American Medical Association (JAMA).

Their editorial accompanied a study in the same JAMA issue by Aron Hall, M.D. and other CDC researchers finding that prescription opioids were involved in 275 of the 295 overdose deaths in West Virginia in 2006, and that less than half of those who died had actually been prescribed the drugs. The findings, which McLellan and Turner called "disturbing," suggest that diversion of expensive and potent pain medications (sold or stolen) can lead to lethal outcomes.

"These findings provide further evidence of how significant abuse and misuse of prescription medications has become to America's drug problem," McLellan said. "We know that legitimate, doctor prescribed and managed opioid use is on the rise because of the high prevalence of chronic pain-causing diseases like arthritis. Very disturbing, however, is the rapid increase in accidental drug overdoses, most from opioid use," he said.

"The real message - from this and other studies - is that physicians should increase monitoring, particularly for patients who admit to a history of substance use/abuse when formally queried," he said, "and they should be queried."

In addition to asking patients about past drug, alcohol, and possibly tobacco use, McLellan and Turner recommended executing agreements where patients assent to: receiving opioid drugs from one physician and one pharmacy; limits on timing of refills; taking the medications as prescribed; and adhering to doctor visits for urine screens and other safety checks. Another necessary monitoring tool, they said, is through statewide or even multi-state prescription monitoring databases that physicians can easily access from their offices. "For 20% of the West Virginia deaths, patients appeared to be 'doctor shopping' (obtaining prescriptions from multiple physicians, sometimes based on fraudulent claims of pain or other symptoms). This makes a compelling case for prescription monitoring programs that span multiple states - but such databases are not widely available," they said.

Copies of the editorial and the CDC study can be obtained from the JAMA website.
The Treatment Research Institute is a non-profit research and development organization specializing in science-driven reform of policy and practice in substance use and abuse. For more information contact Bonnie Catone, TRI Director of Communications, at bcatone@tresearch.org.

ED Visits for Underage Drinkers

2008-12-09T14:13:00.000-06:00

SAMHSA's Drug Abuse Warning Network (DAWN) reports this month on ED use by underage drinkers.

SAMHSA Releases New Data on Drug-related Hospital Emergency Department Visits (12/5/08)

The latest Drug Abuse Warning Network (DAWN) report - drawn from a sample of hospital emergency departments across the Nation - indicates that more than 1.7 million visits for treatment were associated with some form of substance misuse or abuse. The 2006 DAWN report, developed by the Substance Abuse and Mental Health Services Administration (SAMHSA), provides the latest estimates on how substance use affects this critical part of the Nation's healthcare system.

Click on the link for more information about the DAWN report

Key findings:

According to the Drug Abuse Warning
Network (DAWN):
During 2004, an estimated 142,701 alcohol-related emergency department (ED) visits were made by patients aged 12 to 20.
Nearly half (42%) of drug-related ED visits among patients aged 12 to 20 involved alcohol.
Patients aged 18 to 20 were approximately 3 times as likely as patients aged 12 to 17 to have an alcohol-related ED visit.
Visits involving alcohol with other drugs were almost 2 times as likely as visits involving only alcohol to result in admission to the hospital for inpatient care (19% vs. 10%).

Reno 411

2008-12-09T14:09:00.000-06:00

The College on Problems of Drug Dependence meets 20-25 June 2009 in Reno, NV. SAMHSA's Randy Muck sent this email regarding travel scholarships for practitioners that wish to attend (award deadline: 10 Jan 2009):

Dear Grantee,

The College on Problems of Drug Dependence (CPDD) is holding is 71st Annual Scientific Meeting, June 20-25, 2009 in Reno/Sparks, Nevada and CSAT will once again be sponsoring up to 30 Travel Awards for clinical supervisors or directors who are in positions to implement evidenced-based practices in substance abuse treatment and recovery settings. The CPDD conference is the premier scientific conference in the field and this is an exceptional opportunity for those clinical supervisors and program directors to learn first-hand about the most recent findings in treatment and recovery that they can use in their programs. In addition, it is a wonderful opportunity for providers and clinical supervisors to dialogue with researchers in an environment conducive to promoting the adoption of evidenced-based practices.

Below is specific information about the application process, including the deadline for the applications and the person to whom the applications should be sent.

CSAT Travel Awards
The Center for Substance Abuse Treatment (CSAT) will sponsor up to 30 Travel Awards for substance abuse treatment practitioners to attend the 2009 CPDD meeting. To be eligible, candidates must hold full-time employment as a director or clinical supervisor in a substance abuse treatment program and not be an employee of the federal government. Only one award will be given to any specific program. Previous CSAT travel award recipients are not eligible to apply. All expenses will be covered: i.e., conference registration, airfare, travel to and from the airport, and hotel accommodation. Applicants will be sent emails by the end of March indicating award status.

To apply, send five collated copies of the following:

1. An up-to-date resume or vitae including contact information, previous travel fellowships, if applicable, work experience and academic experience. Please include your current e-mail address.

2. A one page letter on institutional letterhead indicating interest in receiving an award and including a statement as to how this conference will benefit your work in your current position. Please include a valid telephone number and e-mail address.

3. A letter of support on institutional letterhead from your direct supervisor stating should you be selected that you will be allowed to attend.

Complete, collated applications must be received on or before January 10, 2009. Late or incomplete applications will not be considered. Applicants are required to arrive prior to 4:30 PM on June 19, attend a networking session sponsored by CSAT in the evening on June 19, the CSAT-sponsored satellite session June 20, a breakfast sponsored by CPDD for the awardees on June 21, and remain for the entire CPDD meeting. Materials should be mailed to:

Dr. Alison Oliveto, Chair, CPDD Travel Awards Committee, University of Arkansas for Medical Sciences, 4301 W. Markham Street, Mail Slot 843, Little Rock, AR 72205. For inquiries call: 501.686.8969.”

Randolph D. Muck, M.Ed.
Chief, Targeted Populations Branch
Division of Services Improvement
Center for Substance Abuse Treatment
1 Choke Cherry Road
Room 5-1097
Rockville, MD 20857

Phone: 240-276-1576

Gender Drinking Gap

2008-12-09T14:08:00.001-06:00

An article in the popular press discusses increases in female alcohol consumption.

Alcohol Taxes Saving Lives in Alaska

2008-11-24T07:41:00.000-06:00

A recent study of mortality and tax data in Alaska reports increases in state taxes on alcohol purchases led to declines in death due to alcohol-related causes. See abstract below:

Effects of Alcohol Tax Increases on Alcohol-Related Disease Mortality in Alaska: Time-Series Analyses from 1976 to 2004

Alexander C. Wagenaar, Mildred M. Maldonado-Molina, Bradley H. Wagenaar

Objective. We evaluated the effects of tax increases on alcoholic beverages in 1983 and 2002 on alcohol-related disease mortality in Alaska.

Methods. We used a quasi-experimental design with quarterly measures of mortality from 1976 though 2004, and we included other states for comparison. Our statistical approach combined an auto regressive integrated moving average model with structural parameters in interrupted time-series models.

Results. We observed statistically significant reductions in the numbers and rates of deaths caused by alcohol-related disease beginning immediately after the 1983 and 2002 alcohol tax increases in Alaska. In terms of effect size, the reductions were –29% (Cohen’s d=–0.57) and –11% (Cohen’s d=–0.52) for the 2 tax increases. Statistical tests of temporary-effect models versus long-term effect models showed little dissipation of the effect over time.

Conclusions. Increases in alcohol excise tax rates were associated with immediate and sustained reductions in alcohol-related disease mortality in Alaska. Reductions in mortality occurred after 2 tax increases almost 20 years apart. Taxing alcoholic beverages is an effective public health strategy for reducing the burden of alcohol-related disease.

2008-11-17T17:04:00.000-06:00

Nancy Reed passed along the following information related to adolescent substance abuse treatment.

Bulletin Analyzes Co-occurrence of Substance-Related Behaviors
The Office of Juvenile Justice and Delinquency Prevention (OJJDP) has published "Co-occurrence of Substance Use Behaviors in Youth."

The bulletin draws on data from the National Longitudinal Study of Youth to analyze the prevalence and overlap of substance-related behaviors among youth. The central finding of this analysis is that given one substance-related behavior, other substance-related behaviors become more likely.

Click here for a copy of the bulletin. Below is the abstract:
Examines the prevalence and overlap of substance-related behaviors among youth, making comparisons based on age group, gender, and race/ethnicity. Findings reported in this Bulletin are drawn from the first two stages of the 1997 National Longitudinal Survey of Youth, which gathered self-reports from a nationally representative sample of youth ages 12–17 in 1997 and 1998. The data are derived from questions survey participants answered regarding their alcohol and drug use during the previous 30 days, including the frequency of their consumption, the types of drugs used, and whether they had sold drugs. The central finding was that, given one substance-related behavior, other substance-related behaviors became much more likely.

Here's a training opportunity reminder:

On behalf of the National Child Traumatic Stress Network (NCTSN), a new training opportunity has been added to the Adolescence and Substance Abuse section of the NCTSN website.

A presentation by Dr. Robert Pynoos titled, "Youth with Trauma Histories, PTSD, and Co-Occurring Substance Abuse" has been added. The presentation explores the relationship between youth with trauma histories and co-occurring substance abuse disorders as well as assessment and treatment strategies. View the presentation by clicking on this website.

Trauma, PTSD and Substance Use

2008-11-04T16:26:00.000-06:00

This note crossed our transom:

Grantees:
On behalf of the National Child Traumatic Stress Network I would like to pass along to all of you a new training opportunity. Please see the announcement below.

I would like to announce a new addition to the Adolescence and Substance Abuse section of the NCTSN website. A presentation by Dr. Robert Pynoos has been added titled, “Youth with Trauma Histories, PTSD, and Co-Occurring Substance Abuse”. The presentation explores the relationship between youth with trauma histories and co-occurring substance abuse disorders as well as assessment and treatment strategies. I hope everyone will enjoy this new resource.

http://nctsn.org/nccts/nav.do?pid=ctr_top_adol

Thanks,

Carly B. Dierkhising, MA
Program Coordinator, Service Systems
National Center for Child Traumatic Stress, UCLA
cdierkhising@mednet.ucla.edu
p: 310-235-2633

The site listed above contains a ton of information for MH and SA providers, as well as families and youth, not just the particular presentation referenced.

Next PAB Meeting

2008-10-31T12:28:00.000-05:00

The next PAB meeting is scheduled for Wednesday 19 November 2008 at the TennCare building in MetroCenter, site of several of our most recent meetings.

On the agenda for this meeting are updates by Mary Rolando on the GOCCC's Substance Abuse Collaborative and Carol Nixon and STARS on the True North brief intervention pilot.

Note: due to the state's budget cuts, lunch will NOT be provided this time. We will work something out so that people don't die of starvation during the meeting.

More on the Parity Legislation

2008-10-31T12:24:00.000-05:00

Via Nancy (by way of JoinTogether.org):

JT Direct News Alert
Join Together
Friday, Oct. 3, 2008 - 3:55 p.m. ET
---
Congress, Bush Approve Addiction and Mental Health Parity Legislation

The long-held dream of parity in behavioral healthcare is now a
reality: The U.S. House of Representatives voted 263-171 to
approve the Wall Street bailout bill, which includes a provision
that mandates parity coverage for addiction and mental-health
care, and President George Bush swiftly signed the measure into
law.

READ MORE:

http://members.jointogether.org/ct/-dsEC5n1WYuY/parity

http://www.jointogether.org/news/features/2008/congress-approves-addiction.html

Nutritional Treatment for Drug Addiction?

2008-10-21T15:42:00.000-05:00

A report in the Economist summarizes some current research in Britain and the U.S. on nutrition's effects in aiding recovery from drug addiction. The essence is: eating particular foods makes available more of the raw materials necessary to restore imbalances in neurotransmitters associated with addiction or other mental disorder. By removing the drugs and providing the nutrients, the brain's neurochemistry returns to "normal" and helps to fight chemically driven urges for substance use.

Mental Health and Addiction Parity Act Passes

2008-10-03T14:28:00.000-05:00

Embedded in this week's economic bailout/rescue package that was passed today by the House of Representatives--and which will become law upon the president's signature--was the Paul Wellstone and Pete Domenici Mental Health and Addiction Equity Act of 2008.

The bill calls for parity in coverage of mental health and substance abuse services (from the linked article):

The legislation applies to group health plans of 51 or more employees. The bill takes the following steps:
If a plan offers out-of-network benefits for medical or surgical care, it must also offer out-of-network coverage for mental health and addiction treatment and provide services at parity.
Strong state parity and consumer protection laws are preserved while extending parity protection to 82 million more people who are not protected by state laws and 31 million in plans that are subject to state regulation.

State parity laws vary widely from state to state (for a map of state laws, visit www.mentalhealthamerica.net/go/parity/states).
...
For fact sheets on the legislation and more information, go to www.mentalhealthamerica.net.

What Might P4P in Addiction Treatment Look Like?

2008-09-21T01:24:00.002-05:00

The October issue of Fast Company reports on a hospital network that offers fixed price coronary artery bypass (CABG) surgery at a fixed price with a 90-day "any complications and your surgery is free."

One aspect of their model: a standardized checklist of 40 steps from pre-surgery through recovery that medical personnel must sign off on. (Doctors can elect to skip a step, but they must document that they're skipping the step.)

Another aspect of the model: the price charged includes a fraction of the expected costs of follow-up care usually associated with complications. If a surgery usually costs $50,000 and follow-up procedures might cost $10,000, a fraction of that $10,000 is built into the new list price for the surgery for all patients (say, $50,800).

Some questions to think about:

What might such a model look like for adolescent substance abuse treatment?
How is substance abuse treatment different from surgery?
Are those differences barriers to such a strategy?
Could some differences enhance the utility of this model for substance abuse services?
How is the checklist different from procedures and standards set by accrediting organizations?

Sustaining Community Programs

2008-09-12T15:33:00.000-05:00

SAMHSA has published: Sustaining Grassroots Community-Based Prorgrams: A Toolkit for Community- and Faith-Based Service Providers. The report highlights strategies for:

organizational assessment and readiness
effective marketing
financial management
sustainability (fund development and fund raising)
results-oriented evaluation.

Reminder: CANS Conference 9/28-9/30

2008-09-12T15:25:00.001-05:00

The 5th Annual National Child and Adolescent Needs and Strengths (CANS) Conference will be September 28th through September 30th, 2008 at the Hilton Downtown Nashville.

Follow these links for more info: Registration, Agenda.

Topics include:

Total Clinical Outcomes Management: A framework for managing services for Programs, Agencies, and Systems
Training and Implementation Issues, including a hands on demonstration of web-based training and certification approaches
Decision Support Applications for intensity of services and level of care
Measuring and Managing Outcomes: The role of structured assessment in performance contracting
Quality improvement applications
System Management Strategies including geo mapping approaches to support service matching
Strategies for incorporating youth and families in the planning process
Using the CANS to Support Trauma-Informed Care
Adult Needs and Strengths (ANSA).

Treatment for Women

2008-08-26T12:12:00.001-05:00

SAMHSA has a new web site devoted to funding and treatment for women and children with substance use disorders. Some of this materials is relevant for adolescent treatment (e.g., when youth have mothers with substance use disorders).