David Mineta, Deputy Director for Demand Reduction at the Office of National Drug Control Policy, explained to attendees of the National Conference on Addiction Disorders (NCAD) what the federal government is doing to combat the issues currently faced in the behavioral health and addiction fields. He started off his presentation by saying, “I couldn’t think of a more important time to be in this field.”
Insurance and funding
Mineta explained a study by Mathematica Policy Research that looked at Veterans Affairs (VA) funding, Medicare/Medicaid, and public benefits, as opposed to private insurance. He said the study found that if a person has public insurance, he or she is more likely to receive treatment for substance use disorders than private insurance. “That is something that everyone in this field is keenly interested in--how to get private insurance to comply.”
He then went on to talk about funding by Centers for Medicare and Medicaid Services (CMS). He said that last year, CMS announced that they were going to put out a billion dollars for healthcare innovation funds. He asked how many people in the room applied, and out of the entire audience, about two hands were raised.
Mineta went on to describe the outcomes of the CMS funding as follows:
· 8,000 people sent in a letter of intent
· 3,000 actually applied
· 107 were funded
He said there were three items for the criteria of this: better health outcomes, improved quality of care, and the applicants had to show cost effectiveness. He said that these three things are currently driving health policy and they need to be driving the field.
“Almost everyone that applied, even the ones that got awarded, had to go back and do the cost effectiveness. Because people didn’t know how to calculate that, they didn’t have the data sets available,” he explained.
He continued, “This field has to understand that because out of that 107 [that received funds], there were only four that were behavioral health. And only one was substance abuse. That is going to have to change.”
Looking at the statistics for various drugs and their usage, Mineta explained that with some drugs, there is a positive light. “There has been a drastic reduction in cocaine and methamphetamine that started in 2006 and has continued through 2011, and we’re waiting for 2012’s numbers now.”
“However, contrary to that data, starting in 2008, the reports show that we are at the highest point of illicit drug use,” he said.
He went through different plans that the federal government has in place to assist in prevention, including the “Above the Influence” campaign that is aimed at students 12-17 years old. As far as the 2012 prevention policy focus goes, he said they have been working on developing and sustaining the national drug prevention infrastructure.
Mineta said being on the prevention side of things for so many years, he’s noticed that when budgets get tight, prevention is usually an area that gets cut back financially. He said that right now, “prevention is taking a pretty decent hit across the federal government.
Other areas to work on
Another area he mentioned that is important right now is prescription drug abuse, calling it “a large, national problem.” He discussed the National Drug Take Back Day that occurred late last week and said that this was the fourth one they had held. “On the three other National Take Back Days -- a total of 12 hours on three Saturdays -- I think we took over 700 tons of unused drugs,” he said.
He also acknowledged the issues in the criminal justice system saying, “I can’t say how important the criminal justice side of this is.” He went on to discuss the goals that should be reached including “Reforming our criminal justice system to have more alternatives for incarceration” and “Moving more people towards treatment and recovery.”
Mineta ended the presentation by encouraging those in the behavioral health field to remember to focus on two specific areas. “One, is protect the entire continuum, connect from prevention, intervention and treatment to recovery support,” he said. “And two, is tell people everywhere we go how effective and how important what we’re doing is to greater health, educational achievement, economically, jobs -- there’s no area that we don’t touch and benefit.”