A Call for Your Advocacy

Last month, Centerstone’s Legislative Advocacy team shared the anticipated timeline of a Senate vote on their version of an opioid package, noting it could come anywhere between July and December, 2018. They are now hearing that the Senate could vote on their version of an opioid package starting sometime next week.

The team wants to offer the full picture of the opioid crisis and Centerstone’s legislative efforts:

The House of Representatives, at the height of its activity, was drafting and vetting over 70 distinct pieces of legislation drawn up from scratch aimed at increasing access to high quality SUD treatment, curbing the excessive use of opioids, and offering new enforcement authority across many branches of government to limit improper importation and dissemination of illegal opioids.

Centerstone has played an active role in helping certain members of Congress develop ideas for legislation as well as edit accompanying bill language.

The Senate, on the other hand, has mostly utilized existing House bills to underpin their larger proposal and has, thus far, reached for the least controversial ones. The Senate aims to craft an opioid package that ensures a smooth approval process. Within this context, Centerstone has aimed to selectively interject with subject-matter expertise to recommend action on bills that would have the greatest impacts on improving care quality in the behavioral health industry.

The Senate opioid package is currently composed of various bills that have been reported favorably out of the Senate HELP Committee, the Senate Finance Committee, the Senate Judiciary Committee and the Senate Committee on Commerce, Science & Transportation – the full text is available.

Over the past several months, the team has drafted a letter of support for the HELP Committee’s proposal, formal suggestions to Senate leadership as to how to improve their opioid package proposal as well as informal requests urging Senators to consider adding some of the more controversial bills – notably the Part 2 bill passed by the House of Representatives – to their opioid package proposal.

The provisions most relevant to Centerstone currently included in the Senate opioid proposal released just days ago are the below.

• A reauthorization of 21st Century Cures funding for the State Response to the Opioid Abuse Crisis grants through 2021;
• An authorization for HHS to disburse grants to eligible entities to establish Comprehensive Opioid Recovery Centers (CORCs) that will serve as models for comprehensive treatment and recovery;
• An authorization for HHS to disburse up to five-year grants to entities to establish evidence-based programs to help individuals in recovery from a substance use disorder transition from treatment to independent living and the workforce (CAREER Act);
• An authorization for HHS to award grants to eligible entities to use recovery coaches to help individuals having experienced a non-fatal overdose connect to treatment and recovery programs, peer support networks, recovery community organizations, appropriate health care providers, educational facilities, employers, housing services and child welfare agencies;
• An authorization for CMS Center for Medicare and Medicaid Innovation to test payment and delivery models that include financial incentives for behavioral health providers to adopt and use certified electronic health records to improve quality and coordination of care through information exchange (BHIT bill);
• A call on the Attorney General to promulgate final regulations regarding when special registration with the DEA for health care providers to prescribe controlled substances via telemedicine without an initial in-person contact may be issued;
• An authorization to award grants to eligible entities to facilitate strategic partnerships with treatment providers, employers, education providers, etc. within their communities to offer coordinated wraparound services to people with substance use disorders who aim to maintain recovery and employment;
• An authorization for HHS to enter into loan repayment contracts with health care professionals providing substance use disorder treatment services in facilities located within mental health professional shortage areas or, subject to the Secretary’s discretion, in areas where drug overdose deaths are higher than the national average;
• An authorization to waive originating site and geographic restrictions for the delivery of telehealth to Medicare beneficiaries with a substance use disorder diagnosis.

*Please note that, for most of these Senate proposals, Centerstone has suggested improvements.

However, the Senate’s current proposal lacks one important piece, which would help behavioral health providers offer safer, more integrated, coordinated and more efficient care. That is:

• The Opioid Prevention and Patient Safety Act (OPPS Act) (S.1850 / H.R.6082). This bill would align Part 2 with HIPAA’s consent requirements for the limited purposes of treatment, payment, and health care operations (TPO) – a change that would allow for the appropriate sharing of SUD records, among covered entities, to ensure persons with OUD and other SUDs receive the integrated care they need. More information here.

Now is the time for your advocacy!

We request that you call your Senators starting now to ask them to vote on legislation that would help promote integrated, safe and fully informed care. Specifically, we are requesting that you urge your Senator to support Part 2 reform in the upcoming opioid package.

For some talking points on how to discuss Part 2, please see this reference put together by the Partnership to Amend Part 2, and this reference, which details examples/stories generated by Centerstone.

If you are interested in sharing this infomation on social media, the Legislative Advocacy team has assembled some suggestions.

TWITTER:

• Aligning #42CFR Part 2 with the Health Insurance Portability and Accountability Act (#HIPAA) will allow appropriate access to patient information that is essential for providing whole-person care. Learn more here: http://www.helpendopioidcrisis.org.
• Substance use disorders can have complicated ripple effects on a patient’s health that must be carefully identified and coordinated. That is why we are committed to aligning #42CFR Part 2 with #HIPAA. Learn more: http://www.helpendopioidcrisis.org
• #42CFR Part 2 provisions aren’t compatible with the way #healthcare is currently delivered. Outdated regulations run counter to new, innovative models where patient data is used to treat the health of a population. http://www.helpendopioidcrisis.org

FACEBOOK:

• We are committed to aligning 42CFR Part 2 with Health Insurance Portability and Accountability Act (#HIPAA) to allow appropriate access to patient information that is essential for providing whole-person care. Failure to integrate services and supports leads to risks and dangers to individual patients, such as contraindicated prescription medicines and problems related to medication adherence. Learn more here: http://www.helpendopioidcrisis.org.
• Access to a patient’s entire medical record, including addiction records, is essential to provide safe, effective, high quality care. We are committed to aligning #42CFR Part 2 with Health Insurance Portability and Accountability Act (#HIPAA) to allow appropriate access to patient information that is essential for providing whole-person care. http://www.helpendopioidcrisis.org

The opioid proposal that the Senate is anticipated to vote on in the coming weeks does not match the one passed by the House in June (H.R.6 + H.R.6082 + H.R.5797). Therefore, members of the House and Senate will still have to come together in “conference” after the upcoming Senate floor vote to reconcile the differences between their versions. We understand that a more meaningful opportunity to request specific changes will occur during this conference period, and Centerstone is prepared to chime in during that time.

Further down the line, should a consensus be reached, one single comprehensive bill will need to go back to the House and Senate floors for another vote before the President has the opportunity to sign it into law.

We know this has been a long process, and it is still not over, but the ship is moving. Slowly, but surely …