NMHU 3rd Annual Alcohol & Substance Abuse Treatment Conference

May 12-15, 2014

The Affordable Care Act: Four Key Strategies

Prevalence of Behavioral Conditions Among Medicaid Expansion Population: New Mexico

5

CI = Confidence IntervalSources: 2008 - 2010 National Survey on Drug Use and Health (Revised March 2012)

2010 American Community Survey

7.0% 14.9% 14.2%4.3% 11.2% 8.4%0%

2%

4%

6%

8%

10%

12%

14%

16%

18%

20%

Serious Mental Illness NM CI: 2.5% - 7.3%U.S. CI: 6.3% - 7.7%

Serious Psychological Distress

NM CI: 6.6% - 18.3%U.S. CI: 14% - 15.9%

Substance Use Disorder NM CI: 5.4% - 12.9%

U.S. CI: 13.2% - 15.2%

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Uninsured Adults Ages 18-64 with Incomes < 139% of the Federal Poverty Level (New Mexico: 170,472)

National

New Mexico

Confidence Interval

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New Mexico Medicaid Expansion Projections:

• Medicaid Expansion = 170,472

SMI (4.3%) = 7,330 SERIOUS PSYCH DISTRESS (11.2%) =

19,093 SUD (8.4%) = 14,320

TOTAL = 40,743

Prevalence of Behavioral Conditions Among Health Insurance Exchange Population: New Mexico

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CI = Confidence IntervalSources: 2008 - 2010 National Survey on Drug Use and Health (Revised March 2012)

2010 American Community Survey

6.0% 13.3% 14.6%2.8% 6.1% 17.6%0%

5%

10%

15%

20%

25%

30%

Serious Mental Illness NM CI: 1.1% - 6.9%U.S. CI: 5.5% - 6.6%

Serious Psychological Distress

NM CI: 3.6% - 10.3%U.S. CI: 12.5% - 14.2%

Substance Use Disorder

NM CI: 12.1% - 25%U.S. CI: 13.7% - 15.6%

Pre

vale

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Uninsured Adults Ages 18 - 64 with Incomes Between 133-399% of the Federal Poverty Level (New Mexico: 157,091)

National

New Mexico

Confidence Interval

I

New Mexico Marketplace Exchanges Projections:

• MARKETPLACE EXCHANGES = 157,091

SMI (2.8%) = 4,399 SERIOUS PSYCH DISTRESS (6.1%) =

9,583 SUD (17.6%) = 27,648

TOTAL = 41,630

New Mexico Data

Marketplace Plan Selection = 32,062

Medicaid/CHIP Enrollment = 60,378

Total = 92,440

30 % BH Disorders = 27,732 of 82,373

Enrollment Resources

SAMHSA Enrollment Webpage

o http://www.samhsa.gov/enrollment/

State Reform Exchange Decisions

o http://www.statereforum.org/node/10222

Enroll America Best Practices

o http://www.enrollamerica.org/best-practices-institute

Healthcare.gov

o http://www.healthcare.gov/marketplace/index.html

HHS Partners Resources

o http://www.cms.gov/Outreach-and-Education/Outreach/HIMarketplace/index.html

SAMHSA HEALTH REFORM TOOLKITS

http://tiny.cc/CommunityPrevention

http://tiny.cc/ConsumerPeerFamily

http://tiny.cc/HomelessServices

http://tiny.cc/CriminalJustice

http://tiny.cc/TreatmentProviders

http://tiny.cc/GettingReady 

(GENERAL)

 

Changing Health Care Environment

Prevention/Wellness rather than illness

SA/MH Services are Essential Health Benefit

Quality rather than Quantity – saving costs through better care rather than less care

Inclusive – Goal is to provide access to care

Public Payers’ Roles changing

Implications for the Workforce

Opportunities

ACA – new enrollment and payment opportunities

Emerging science Healthcare integration Parity – MHPAEA Final Rule AG’s call for treatment rather

than incarceration for SA ↑ understanding of BH role in

health promotion, prevention, treatment and costs

President’s/nation’s attention to MH issueso www.mentalhealth.govo www.creatingcommunitysolutions.org

DAILY DISASTER OF UNPREVENTED AND UNTREATED M/SUDs

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Region 6 Profile

State Capital Population1 Pop. Density2 Joint

SUD Prevalence3

SMI Prevalence4

Suicide Rate5

Arkansas Little Rock 2,915,918 56 Yes 6.94 5.41 15.5

Louisiana Baton Rouge 4,533,372 104.9 Yes 7.66 3.78 12.3

New Mexico Santa Fe 2,059,179 17 Yes 9.15 4.51 20.1

Oklahoma Oklahoma City 3,751,351 54.7 Yes 9.15 5.06 16.5

Texas Austin 25,145,561 96.3 Yes 8.13 3.33 11.7

United StatesWashington,

DC308,745,538 87.4 N/A 8.5 3.9 12.1

1U.S. Census 2010 resident population, all ages2U.S. Census 20103SAMHSA, NSDUH 2010-2011, Table 19. Dependence on or Abuse of Illicit Drugs or Alcohol in Past Year among Persons Aged 18 or Older (Substance Use Disorder). 4SAMHSA, NSDUH 2010-2011, Table 22. Serious Mental Illness in Past Year among Persons Aged 18 or Older (revised October 2013). 5CDC, National Vital Statistics System-Mortality (NVSS-M) 2010, per 100,000

MENTAL HEALTH & ADDICTION EQUITY ACT (MHAEPA)

• The Mental Health Parity and Addiction Equity Act requires insurance groups that offer coverage for mental health or substance use disorders to provide the same level of benefits that they do for general medical treatment. Visit "Parity" to learn more.

Mental Health Parity and Addiction Equity Act (MHPAEA)

A group health plan and a health insurance issuer offering health insurance coverage in the group or individual market

must ensure that

Financial requirements (such as copays and deductibles)

applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than

and Treatment limitations (such as visit limits)

the predominant requirements or limitations applied to substantially all medical/surgical benefits.

MHPAEA/ACA: Projected Reach

*These estimates include individuals and families who are currently enrolledin grandfathered coverage

2015 BUDGET/WORKFORCE

SAMHSA 2015 PROPOSED BUDGET

PROTECTING THE HEALTH OF CHILDREN AND COMMUNITIES

Now Is the Time – $130 M (+ $15.0 M)

$115 M continued from FY 2014

Science of Changing Social Norms (+ $4 M)

Peer Professionals (+ $10 M)

Workforce Data (+ $1.0 M)

STRENGTHENING & INTEGRATING CARE

Primary Care and Addiction Services Integration (PCASI) – + $20 M

• Allow addiction treatment providers to offer an array of physical health and addiction treatment services

• Modeled after Primary/Behavioral Health Care Integration (PBHCI) program

LEADING CHANGE 2011 – 2014 8 STRATEGIC INITIATIVES

LEADING CHANGE 2.0: 2015 – 2018•Out for public comment this month•Will contain 6 initiatives•Will guide the next 4 years•Final early fall

SAMHSA’s StrategicInitiatives 2011 – 2014

1. Prevention

2. Trauma and Justice

3. Military Families

4. Recovery Support

5. Health Reform

6. Health Information Technology

7. Data, Outcomes & Quality

8. Public Awareness & Support

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SAMHSA’s Strategic Initiatives 2015 – 2018

1.Prevention2.Health Care and Health Systems Integration3.Trauma and Justice4.Recovery Support5.Health Information Technology6.Workforce

SAMHSA OF THE FUTURE – FY 2014 AND BEYOND

SAMHSA’s Strategic Initiatives

SAMHSA’S THEORY OF CHANGE

“NOT YOUR GRANDMOTHER’S SAMHSA”

• Leadership & Voice – Influencing Public Policy

• Data & Surveillance

• Practice Improvement

• Grant Making w/ a Designated Purpose

• Regulation/Guidelines

• Public Awareness/Education

Thank you!

Michael DuffySAMHSA Regional Administrator-HHS Region VI

(AR, LA, NM, OK, TX)US Dept. of Health and Human Services1301 Young StreetSuite 1030Dallas, Texas 75202michael.duffy@samhsa.hhs.govOffice: 214-767-0522