Tip:
Highlight text to annotate it
X
GOOD MORNING, EVERYONE.
GOOD AFTERNOON. YES.
GOOD AFTERNOON. I HAVE BEEN DOING THAT A LOT LATELY.
I'M PAM HYDE, ADMINISTRATOR OF
THE SUBSTANCE ABUSE MENTAL HEALTH SERVICES ADMINISTRATION.
I WANT TO WELCOME YOU TO THIS FY 2015 SAMHSA BUDGET PRESENTATION EVENT.
OUR JOB HERE TODAY IS TO ROLL OUT
SAMHSA'S BUDGET AS PROPOSED IN THE PRESIDENT'S BUDGET FOR
FISCAL YEAR 2015. I THINK MOST OF YOU KNOW THAT
THE SECRETARY, SECRETARY SEBELIUS, DID AN
ANNOUNCEMENT YESTERDAY OF THE HHS BUDGET.
OF COURSE WE'RE PART OF THAT. THAT WAS RIGHT AFTER OMB
RELEASED THE ENTIRE PRESIDENT'S BUDGET.
I WANT TO START BY SAYING THE PRESIDENT'S BUDGET DOES LIVE
WITHIN AND STAYING WITHIN THE AGREEMENTS THAT WERE MADE BY
SENATOR MURRAY AND CONGRESSMAN RYAN ABOUT THE AMOUNTS,
TOTAL AMOUNTS THAT SHOULD BE AVAILABLE FOR THE BUDGET.
IT IS AN ATTEMPT TO CONTINUE THAT PROCESS AND TO STAY TRUE TO
THAT AGREEMENT. SO THE BUDGET DOES THAT.
FOR HHS, I WANT TO GIVE YOU A VERY HIGH LEVEL, IF YOU SAW THE
ROLL OUT YESTERDAY, THE HHS BUDGET IN BOTH DISCRETIONARY AND
NON-DISCRETIONARY BUDGETS IS ABOUT $800 MILLION LESS ON THE
DISCRETIONARY SIDE AND ABOUT SLOWS DOWN THE GROWTH ON THE
MANDATORY SIDE. IN BOTH CASES THE DEPARTMENT'S
BUDGET IS TRYING TO STAY WITHIN THOSE OVERALL DIRECTIONS AND YET
AT THE SAME TIME THE PRESIDENT
HAS PROPOSED SOME INITIATIVES THAT WOULD BE FUNDED OR COULD BE
FUNDED IF OTHER OPPORTUNITIES WERE PROVIDED AS HE HAS PROPOSED
IN HIS OVERALL BUDGET. HHS' BUDGET HAS SOME ISSUES ABOUT
BEHAVIORAL HEALTH, AT SOME OF THE OTHER OPERATING DIVISIONS
WHICH I'LL TELL YOU ABOUT AT THE END OF THE PRESENTATION BUT I
WANT TO TALK TO YOU ABOUT SAMHSA'S PROPOSALS FIRST.
SAMHSA'S BUDGET DOES HAVE SOME HIGH PRIORITY ISSUES AND IT IS A
RECOGNITION THAT IN THESE TOUGH TIMES WE ARE PRIORITIZING
CERTAIN THINGS AN CERTAIN PROGRAMS IN ORDER TO STAY WITHIN
THE BUDGET LIMITATIONS AND STAY WITHIN THE DIRECTIONS THAT WERE
AGREED TO BY CONGRESS AND THE PRESIDENT IS TRYING TO HONOR.
IT DOES MEAN THAT SOME THINGS WILL SHIFT WITHIN SAMHSA'S BUDGET.
WE'RE PLEASED ABOUT THE ONGOING
COMMITMENT TO THE HEALTH AND BEHAVIORAL OF THE COUNTRY AND
WE'LL TRY TO SHARE WITH YOU HOW THAT IS REFLECTED IN OUR BUDGET.
FOR THOSE WHO ARE LISTENING BY PHONE OR BY OR WATCHING BY
WEBCAST, WE WILL HAVE AN OPPORTUNITY FOR QUESTIONS A
LITTLE BIT LATER AND WHEN THAT HAPPENS THOSE OF YOU IN THE
ROOM, IF YOU HAVE A QUESTION YOU WILL NEED TO USE A MIC SO PEOPLE
ON THE PHONE AND ON THE WEBCAST CAN HEAR YOU.
WE ALSO HAVE SOME NOT THE ENTIRE CJ OR CONGRESSIONAL BY FRIDAY.
LOTS OF DEPARTMENTS, WE WILL HAVE A SHORT BUDGET SUMMARY FOR
SAMHSA THAT WILL HAVE AVAILABLE FOR THOSE OF YOU WHO ARE IN THE
ROOM AS YOU LEAVE TODAY, THAT WILL HELP YOU WITH SOME OF THE NUMBERS.
FOR THOSE WHO FOLLOWED SAMHSA'S
BUDGETS OVER THE YEARS, THEY ARE
SOMEWHAT COMPLICATED BY NUMBER OF BUDGET FUND TYPES AND HAS
GOTTEN MORE COMPLICATED BY FOUR APPROPRIATIONS RATHER THAN ONE
SO IF YOU HAVE A PROGRAM OR AREA YOU HAVE INTEREST IN YOU HAVE TO
LOOK ACROSS THE ENTIRE BUDGET BECAUSE THERE ARE SOME THINGS
THAT OCCUR IN LOTS OF DIFFERENT PLACES AND I WILL POINT OUT A
LITTLE BIT OF THAT AS WE GO FORWARD.
BY THE WAY, ON THE STAGE HERE WITH ME IS PRINCIPLE DEPUTY
ADMINISTRATOR AND WHEN I GET DONE WITH THE PRESENTATION I
WILL SIT DOWN AT THE TABLE WITH KANA AND SHE AND I TOGETHER WILL TRY TO
ANSWER QUESTIONS. WE ALSO HAVE A FAIR NUMBER OF
THE EXECUTIVE LEADERSHIP TEAM HERE WITH US TODAY FROM SAMHSA AS WELL.
SO IF YOU HAVE QUESTIONS THAT WE
CAN'T ANSWER WE'LL LET THE EXPERTS ANSWER THE QUESTIONS.
I'M GOING TO TRY TO FLIP THESE SLIDES AS WE GO.
I DO HAVE TO TELL YOU THAT THE SLIDES IN THE ROOM ARE SO SMALL
I CAN'T TOTALLY SEE THEM EXTREMELY WELL SO HOPEFULLY I
CAN KEEP UP WITH CHANGES TO THE SLIDES THAT I NEED TO DO.
SO WE OTHER DOING SAMHSA'S 2015 BUDGET REQUEST.
IT IS AS I SAID A RECOGNITION OF THE COMMITMENT TO THE NATION'S
HEALTH AND BEHAVIORAL HEALTH. JUST AN OVERVIEW AT THE
BEGINNING, THAT THE BUDGET DOES SUPPORT THE PRESIDENT'S
COMMITMENT TO AN INVESTMENT IN THE NATION'S HEALTH THROUGH SOME
KEY BEHAVIORAL HEALTH PRIORITIES.
SOME OF WHICH WERE STARTED IN 2014, THAT WE ARE MAINTAINING OR
BUILDING ON AND SOME OF WHICH
ARE NEW FOR 2015. IT DOES MAINTAIN THE 2015 BUDGET
DOES MAINTAIN THE 2014 INCREASES IN CRITICAL BLOCK GRANT FUNDING
WHICH WE ARE VERY PLEASED ABOUT AND MAINTAINS THE 2014 FUNDING
RATIO OF 68% SUBSTANCE ABUSE DOLLARS AND 32% MENTAL HEALTH DOLLARS.
SORRY, FORGIVE ME ON THE
TECHNOLOGY HERE. THIS NEXT SLIDE IS A SLIDE THAT
SHOWS HOW SAMHSA'S BUDGET LOOKS OVER FISCAL YEAR 2009 TO THE
PRESIDENT'S BUDGET FOR FISCAL YEAR 2015.
WHAT'S IMPORTANT TO SEE HERE IS FISCAL YEAR 13 WHEN SEQUESTER
HIT AND HOW SIGNIFICANT THAT WAS REDUCING SAMHSA'S BUDGET. THEN IN 2014
MUCH OF THAT WAS RESTORED AND INCREASED IN PART BECAUSE OF THE
ANALYSIS OF TIME INITIATIVES. FOR FISCAL 15 IT WAS SOMEWHAT
LOWER THAN 2014 OVERALL BUT IN LINE WHERE BUDGETS HAVE BEEN
OVER THE LAST SEVERAL YEARS. WE HAVE PRIMARILY THREE
DIFFERENT KINDS OF FUNDING THIS BUDGET, THE GREENISH COLOR
IS PREVENTION FUNDS. THE REDDISH COLOR IS PHS EVALUATION FUNDS.
IT'S A TAP THAT HAPPENS ON ALL FUNDS AND COMES BACK TO THE
VARIOUS OPERATING DIVISIONS. THE BLUE IS WHAT WE CALL
BUDGET AUTHORITY, OR BA. YOU CAN SEE THAT PHS EVALUATION
FUNDS ARE INCREASING. THE BA HAS DECREASED A LITTLE BIT
AND THE GREEN OR PREVENTION FUNDS MAINTAINS AT ABOUT THE SAME
LEVEL AS 2014. YOU MAY ALSO KNOW THAT IF YOU
WATCHED THE ALLOCATION OF THE PREVENTION FUNDS THE FIRST
COUPLE OF YEARS THE SECRETARY MADE THOSE ALLOCATIONS.
LAST YEAR CONGRESS CHOSE WHERE THOSE DOLLARS WOULD BE PUT AND, THIS YEAR,
THE DEPARTMENT HAS PROPOSED THAT
AND WE ASSUME CONGRESS WILL MAKE SOME OF THOSE DECISIONS AS WELL.
THE OTHER THING THAT'S IN 2014 AND 15
IS A FAIRLY SMALL AMOUNT BUT WE JUST WANT TO ACKNOWLEDGE
IT IS, FOR THE FIRST TIME, SOME USER FEES, WE
PROBABLY WILL NOT COLLECT THOSE IN 2014.
BECAUSE WE HAVEN'T GONE THROUGH THE PROCESS OF SETTING HOW WE'LL
DO THAT YET. THESE ARE BOTH IN TERMS OF
EXTRAORDINARY DATA REQUESTS AND EXTRAORDINARY PUBLICATION REQUESTS.
THEY DON'T AFFECT THE REGULAR
DAY TO DAY REQUEST FOR DATA OR PUBLICATIONS THAT MUCH OF THE
STAKEHOLDER FIELD REQUESTS. MORE ABOUT THAT LATER.
THE NEXT SLIDE SHOWS YOU A COMPARISON BETWEEN 2014 AND 2015
FOR APPROPRIATIONS. WE HAVE APPROPRIATION FOR MENTAL
HEALTH SERVICE, FOR SUBSTANCE ABUSE TREATMENT, WE HAVE AN
APPROPRIATION FOR SUBSTANCE ABUSE PREVENTION.
AND WE HAVE APPROPRIATION CALLED HSPS WHICH IS PART SUBSTANCE
ABUSE AND PART MENTAL HEALTH. SO WHEN WE CALCULATE THE
68% SUBSTANCE ABUSE AND 32% MENTAL HEALTH, THE HSPS APPROPRIATION
GETS COUNTED TOWARD BOTH IN DIFFERENT WAYS.
WHAT YOU CAN SEE IS MENTAL HEALTH SERVICES OVERALL IS DOWN
BY ABOUT 23 MILLION, THE SUBSTANCE ABUSE PREVENTION
OVERALL IS UP BY ABOUT 10 MILLION, SUBSTANCE ABUSE
TREATMENT, WHICH IS OUR BIGGEST APPROPRIATION, IS DOWN ABOUT
64 MILLION, THE HSPS APPROPRIATION IS UP, 14 MILLION,
OVERALL THE TOTAL BUDGET IS DOWN ABOUT 63 MILLION,
BUT YET STILL MAINTAINS HIGH PRIORITY SERVICES WHICH WE'LL TALK ABOUT.
SO SAMHSA'S PRIORITY AREAS WHICH
WE WANT TO POINT OUT TO YOU, IS, FIRST, PROTECTING THE
HEALTH OF CHILDREN AND COMMUNITIES.
IN 2014, THE PRESIDENT PROPOSED, AND SAMHSA WAS PRIVILEGED TO RECEIVE
FROM CONGRESS AN APPROPRIATION -- A SET OF APPROPRIATIONS THAT
ROLLED INTO A PLAN CALLED THE NOW IS THE TIME PLAN.
THE TOTAL REQUEST WAS 130 MILLION IN 2014.
WE GOT ABOUT 115. FOR 2015 WE ARE AGAIN REQUESTING
ABOUT 130 MILLION SO INCREASE OF 15 MILLION.
THERE'S THREE AREAS WHERE WE'RE REQUESTING ADDITIONAL DOLLARS
FOR 15, ONE IS A NEW PROGRAM, NEW IDEA CALLED THE SCIENCE OF
CHANGING SOCIAL NORMS. THIS IS A RECOGNITION AS WE TRY
TO DO NATIONAL DIALOGUE, COMMUNITY CONVERSATIONS, LOTS OF
DISCUSSION ABOUT MENTAL HEALTH, AND TO THE EXTENT SUBSTANCE ABUSE
IS PART OF THOSE CONVERSATIONS, WE REALLY DON'T
HAVE THE SCIENCE TO BRING TO BEAR TO TELL US EXACTLY HOW TO
CHANGE PEOPLE'S BEHAVIOR OR THAT YOU ARE THINKING ABOUT MENTAL HEALTH
AND SUBSTANCE ABUSE. SO WE ARE STEPPING OUR TOE INTO
THAT WATER WITH THIS PROPOSAL SUGGESTING THAT WE NEED SOME
RESOURCES TO LOOK AT THAT SCIENCE AND ALSO LACK AT HOW THE
WAY WE DO OUR COMMUNICATIONS STRATEGIES AND OTHER KINDS OF
PUBLIC EDUCATION AND HOW IT WOULD BEST HELP CHANGE THE
SOCIAL NORMS AROUND BEHAVIORAL HEALTH IN OUR COUNTRY.
THE SECOND AREA THAT IS NEW FOR 2015, WE REQUESTED IN 2014 BUT
WE DID NOT GET IT FROM CONGRESS.
WE HOPE TO GET IT THIS YEAR, AND THAT IS A $10 MILLION INVESTMENT IN PEER
PROFESSIONAL WORK FORCE SO WE ARE HOPEFUL WE CAN CONVINCE
CONGRESS THAT'S A GOOD THING TO INVEST IN FOR THE FUTURE.
THE OTHER AREA IS WORK FORCE DATA WE RECOGNIZE IN THE
BEHAVIORAL HEALTH DATA WE DON'T HAVE THE BEST DATA IN THE WORLD
WHERE WORK FORCE IS AND WHAT'S NEEDED.
SO WE WANT TO BEGIN TO INVEST IN WORK FORCE DATA IN COLLABORATION WITH
HRSA AS WE GO FORWARD.
NOW IS THE TIME, JUST TO BREAK IT DOWN FOR YOU MORE,
SO YOU REMEMBER WHAT IT WAS PROPOSED AND HOW IT CAME OUT IN 2014,
THAT HAS CONTINUED INTO 15.
55 MILLION IS FOR PROJECT AWARE TO IMPROVE MENTAL HEALTH AWARENESS
AND INCREASE REFERRALS SO BEHAVIORAL HEALTH SERVICES
AND SUPPORT SYSTEMS, ABOUT 40 MILLION FOR TAKING OUR
SAFE SCHOOLS/HEALTHY STUDENTS PROGRAM TO SCALE AND THEN ABOUT 15 MILLION
TO BEGIN THE MENTAL HEALTH FIRST AID PROCESS AROUND THAT PROJECT, AS WELL.
20 MILLION OF THE 115 MILLION
THAT IS CONTINUING IN 2015 IS HEALTHY TRANSITIONS, A PROGRAM
TO SUPPORT YOUNG PEOPLE AGE 16 TO 25 WITH MENTAL HEALTH OR --
AND/OR SUBSTANCE ABUSE PROBLEMS AND THEIR FAMILIES. SO
RECOGNITION THAT THAT TRANSITION AGE, THAT EARLY FIRST EPISODE,
FIRST BEGINNING TO HAVE A DIFFICULTY AND ISSUES AND THAT
TRANSITION INTO ADULTHOOD IS A CRITICAL TIME.
40 MILLION DOLLARS OF THAT NOW IS THE TIME PLAN GOES TO BEHAVIORAL HEALTH
WORK FORCE ACTIVITIES JOINTLY ADMINISTERED WITH HRSA, IN PART,
SO 35 MILLION OF THAT IS A
JOINTLY ADMINISTERED PROGRAM WITH HRSA TO EXPAND MENTAL AND
BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANT PROGRAM IN HRSA
TO DO ADDITIONAL MENTAL HEALTH AND SUBSTANCE ABUSE
PRACTITIONERS, THEN $5 MILLION FOR EXPANSION OF MINORITY
FELLOWSHIP PROGRAM SPECIFICALLY FOCUSING ON PRACTITIONERS
INTERESTED IN SERVING YOUTH. THAT IS A SMALL AMOUNT OF MONEY
BUT IT DOUBLES OUR MINORITY FELLOWSHIP PROGRAM, WE'RE
PLEASED ABOUT THAT. VERY IMPORTANT EFFORT TO GET
ADDITIONAL NEEDED PRACTITIONERS THAT HAVE DIVERSE BACKGROUNDS
INTO OUR FIELD.
THE NEXT AREA IS PRIORITY IS EVIDENCE BASED PRACTICES THROUGH OUR BLOCK GRANTS.
WE ARE PLEASED, I SAID EARLIER, WE'RE PLEASED THAT THE SUBSTANCE
ABUSE PREVENTION AND TREATMENT BLOCK GRANT WE CALL SABG IS AT
1.8 BILLION, THIS IS CONSISTENT WITH THE 2014 LEVEL AND
MAINTAINS $110 MILLION INCREASE OVER 2013.
THE COMMUNITY MENTAL HEALTH BLOCK GRANT IS 484 MILLION, THIS
IS ALMOST A 10% INCREASE OVER FISCAL YEAR 2014.
ABOUT 47 MILLION MORE THAN 2013. AND 2015 PROPOSAL DOES CONTINUE
THE CONGRESSIONALLY DEVELOPED -- 5% SET ASIDE
THAT STARTED IN 2014 FOR EVIDENCE BASED MENTAL HEALTH
PREVENTION AND TREATMENT PRACTICES TO ADDRESS THE NEEDS
OF INDIVIDUALS WITH EARLY SERIOUS MENTAL ILLNESS INCLUDING
PSYCHOTIC DISORDERS. REGARDLESS OF THE AGE AT ONSET.
SO THIS IS NOT JUST YOUNG PEOPLE, BUT CERTAINLY COULD BE AND IS
ALSO NOT JUST PSYCHOTIC DISORDERS BUT CLEARLY THAT IS A
FOCUS, IT IS FOCUSED ON EVIDENCE BASED PRACTICES
AROUND EARLY SERIOUS MENTAL ILLNESS.
WE'RE WORKING WITH NIMH TO PROVIDE GUIDANCE TO THE STATES ON
THAT 5% SET ASIDE IN 2014. WE PROPOSE IT CONTINUES TO 2015.
THE NEXT AREA OF PRIORITY IS BUILDING THE WORK FORCE.
THIS IS ACTUALLY A REPETITION OF WHAT I HAVE TOLD YOU, THERE'S
ABOUT 56 MILLION IN THE NOW IS THE TIME PLAN THAT IS 11 MILLION NEW
THAT 11 MILLION NEW IS TWO AREAS
THE PEER WORK FORCE THAT WE ARE PROPOSING AGAIN AND THE
1 MILLION FOR DATA SERVICES. OR WORK FOES DATA PROGRAM OR SPENDING.
THAT, AGAIN, AS WE SAID, MAINTAINS
THE EFFORT IN INVESTMENT IN 2014 AND BROADENS IT.
STRENGTHENING AND INTEGRATING CARE IS AREA WHERE SAMHSA HAS HAD ACTIVITY
FOR SOME TIME BUT IT'S BEEN FOCUSED PRIMARILY IN THE
PRIMARY CARE AND MENTAL HEALTH
INTEGRATION AREA. IN SOMETHING WE CALL PBHCI OR PRIMARY BEHAVIORAL
HEALTH CARE INTEGRATION GRANT PROGRAM.
WE ARE PROPOSING A NEW PROGRAM ON THE SUBSTANCE ABUSE SIDE
CALLED PRIMARY CARE AND ADDICTION SERVICES INTEGRATION
OR THE NEW ACRONYM IS PCASI. WE ARE THE FEDERAL GOVERNMENT SO
WHEN WE HAVE NEW PROGRAMS, WE HAVE NEW ACRONYMS.
THIS ONE IS A $20 MILLION PROGRAM THAT WOULD ALLOW ADDICTION TREATMENT
PROVIDERS TO OFFER AN ARRAY OF PHYSICAL HEALTH ADDICTION
TREATMENT SERVICES. AND IS MODELED, SOMEWHAT, AFTER
THE PRIMARY BEHAVIORAL HEALTHCARE INTEGRATION PROGRAM
WE HAVE SO MUCH WORK GOING ON WITH OUR COLLEAGUES AT AHRQ, HRSA,
AND INNOVATION CENTER WITHIN CMS, ABOUT A VARIETY OF MODELS, WE
WANT TO BRING SOME OF THOSE LEARNINGS AND MODELS TO THE
ADDICTION WORLD AND MAKE SURE THAT PEOPLE WHO ARE GETTING TREATMENT
AND SERVICES FOR ADDICTION ALSO GET THEIR HEALTHCARE SERVICES
INTEGRATED AND COLLABORATIVELY DONE.
WE ALSO HAVE A PROGRAM PROPOSED IN 2015 USING EXISTING RESOURCES
BUT IT'S AN *** AIDS CONTINUUM OF CARE. IT'S $24 MILLION OF EXISTING
RESOURCES THAT LINKS THE MINORITY AIDS INITIATIVE, THE
PRIMARY BEHAVIORAL HEALTHCARE INTEGRATION PROGRAM AND NEW PCASI PROGRAM TOGETHER.
A RECOGNITION THAT PEOPLE WITH ***/ AIDS HAVE A VARIETY OF ISSUES
ACROSS THOSE DIFFERENT PROGRAMS THAT NEED TO BE BROUGHT TO BEAR TOGETHER.
IT BUILDS ON A FISCAL YEAR 2014
PILOT THAT WE ARE DOING AND WOULD MOVE THAT PROGRAM ALONG TO 2015.
REACHING AMERICANS IN COMMON
HEALTHCARE SETTINGS IS ANOTHER PRIORITY AND ONE WAY WE'RE
TRYING TO DO THIS IS THROUGH A PROGRAM WE PROPOSED FOR A YEAR OR TWO
CALLED THE GRANTS FOR ADULT TRAUMA SCREENING AND BRIEF INTERVENTION
OR GASTBE. WE THINK THIS IS AN APPROPRIATE TERM.
IT IS A $2.9 MILLION PROGRAM,
A FAIRLY SMALL BUT NEVERTHELESS A CRITICAL ONE IN TRYING TO
ADVANCE THE KNOWLEDGE BASE TO ADDRESS TRAUMA FOR WOMEN AND
PRIMARY CARE, OBGYN, AND EMERGENCY DEPARTMENTS, HOSPITALS, AND URGENT CARE SETTINGS.
THIS IS DEVELOPED AS A PILOT
RESEARCH PROGRAM LOOKING TO BE DEVELOPED BY US IN CONSULTATION
WITH OUR SISTER AGENCIES OF ACF, CDC,
NIAAA NIDA, NIMH AND THE VETERANS ADMINISTRATION.
I HOPE ALL OF YOU LISTENING ARE WELL TOOLED IN FEDERAL ACRONYMS
ENOUGH YOU KNOW WHAT THE SISTER AGENCIES ARE.
ANOTHER PRIORITY AREA FOR SAMHSA, REFLECTED IN THIS BUDGET, IS FIGHTING
PRESCRIPTION DRUG ABUSE. THIS IS SOMETHING WE HAVE BEEN WORKING ON, AGAIN, WITH
OUR SISTER AGENCIES HERE IN HHS AND ALSO OTHER AGENCIES WITHIN THE
FEDERAL GOVERNMENT. OTHER DEPARTMENTS.
WE ARE PROPOSING A NEW PROGRAM OF STATE GRANTS, THAT WOULD PROVIDE STATE GRANTS
WITHIN THE STRATEGIC PREVENTION FRAMEWORK PROGRAM
SPECIFICALLY FOCUSED ON PRESCRIPTION DRUG ABUSE AND
OPIOID OVERDOSE. WE CALL IT SPF RX.
WE ARE LOVING OUR ACRONYMS THIS YEAR.
THIS IS A $10 MILLION PROGRAM AND IT'S COORDINATED WITH A
$16 MILLION DOLLAR PROGRAM BEING PROPOSED IN THE CDC BUDGET.
SO YOU MAY WANT TO LOOK AT THEIR BUDGET AS WELL.
THE IDEA WOULD BE THAT WE WOULD EACH PROVIDE RESOURCES TO
CERTAIN STATES AND WOULD COORDINATE THAT -- THOSE GRANTS
IN ORDER TO ADDRESS NOT ONLY CLINICAL PRESCRIBING PRACTICES
BUT ALSO A PREVENTION APPROACH AND SEE IF WE CAN DO -- HELP THOSE
STATES REALLY MAKE A DENT. OUR PROGRAM WOULD ALSO PROVIDE
PLANNING GRANTS TO SEVERAL STATES TO BEGIN TO LOOK AT THE
PRESCRIPTION DRUG ABUSE ISSUE. THIS ACTUALLY GOES WITH A
CHALLENGE THE PRESIDENT MADE TO THE PUBLIC HEALTH AUTHORITIES.
TO ADDRESS PRESCRIPTION DRUG ABUSE.
THEY ARE VERY INTERESTED IN THIS AND ACTIVELY WORKING WITH US AND
THE NATIONAL GOVERNOR'S ASSOCIATION
PRESCRIPTION DRUG POLICY ACADEMIES THIS YEAR.
SO THESE PROGRAMS IN SAMHSA AND CDC WILL BUILD ON THE EFFORT AND WILL BE COORDINATED.
WE'LL COLLABORATE ON RISKS OF OVERPRESCRIBING AND USE OF
PRESCRIPTION DRUG MONITORING PROGRAMS, OR PDMPs, BETWEEN STATES,
PUBLIC HEALTH AND BEHAVIORAL HEALTH AUTHORITIES, AND PHARMACEUTICAL
AND MEDICAL COMMUNITIES. SO THIS REALLY EXCITING NEW PROGRAM
THAT WE'RE PLEASED ABOUT AND HOPEFULLY WE CAN GET THE
RESOURCES TO BEGIN THIS.
PREVENTING SUICIDE HAS BEEN A PRIORITY FOR SOME TIME. WE ARE TAKING THE
NEXT STEP IN SUICIDE PREVENTION IN A COUPLE OF WAYS.
ONE IS AS YOU KNOW THE NATIONAL STRATEGY FOR SUICIDE PREVENTION
SURGEON GENERAL'S NSSP, WAS PASSED OR ROLLED OUT IN 2012.
WE ARE IN THE PROCESS NOW WITH A PUBLIC - PRIVATE PARTNERSHIP WITH
BEGINNING IMPLEMENTATION OF THAT STRATEGY.
THIS IS A 2 MILLION-DOLLAR NEW PROGRAM THAT WILL GO WITH SOME
OTHER RESOURCES TO ASSIST STATES ESTABLISHING AND EXPANDING
SUICIDE PREVENTION EFFORTS ESPECIALLY MOVING INTO THE ADDRESSING
THE MIDDLE AGE POPULATION. MOST OF YOU KNOW THAT THE MIDDLE-AGE,
WORKING-AGE MEN IS THE PLACE WHERE MOST SUICIDE DEATHS THE
HIGHEST NUMBER OF SUICIDE DEATHS OCCUR IN THAT POPULATION.
SO OUR SUICIDE EFFORTS, TO DATE, HAVE BEEN LARGELY IN YOUNG PEOPLE BECAUSE OF NATURE
OF OUR PROGRAMS AND THE NATURE OF OUR AUTHORIZATION. SO THIS PROGRAM WOULD
ALLOW US TO WORK WITH STATES TO MOVE IN TO THAT MIDDLE-AGE POPULATION.
AND IMPROVE SOME FOLLOW-UP AFTER SUICIDE ATTEMPTS.
OUR GOAL AT SAMHSA IS NOT ONLY
TO REDUCE DEATH BY SUICIDE, WE CLEARLY WANT TO DO THAT. BUT WE ALSO WANT TO
REDUCE THE NUMBER OF ATTEMPTS. WE KNOW THE NUMBER OF PEOPLE WHO
ACTIVELY CONSIDER SUICIDE IS IN THE MILLIONS, IF YOU ADD BOTH
YOUNG PEOPLE AND ADULTS, PROBABLY SOMEWHERE IN THE
NEIGHBORHOOD OF 11 MILLION PEOPLE EVERY YEAR SERIOUSLY
THINK ABOUT SUICIDE. IF WE CAN PREVENT PEOPLE FROM
ACTUALLY ATTEMPTING SUICIDE WE CAN ADDRESS THE PSYCHOLOGICAL DISTRESS,
AND OBVIOUSLY GET TO OUR GOAL OF REDUCING THE NUMBER OF DEATHS.
WE ALSO HAVE A NEW PROGRAM THAT'S BEEN
PROPOSED IN 14 THAT WE'LL CONTINUE INTO 15. WE'RE
PROPOSING IN 15 TO CONTINUE, THE TRIBAL BEHAVIORAL HEALTH GRANTS.
THIS WAS A PROGRAM THAT WE PROPOSED FOR A COUPLE OF YEARS,
ONE YEAR AT $50 MILLION, ANOTHER YEAR AT $40 MILLION.
NEITHER ONE OF THOSE WERE FUNDED, BUT IN 14 WE DID GET A
DOWN PAYMENT ON THAT PROGRAM OF $5 MILLION WHICH WOULD BE GRANTS
TO TRIBES WITH THE HIGHEST RATES OF SUICIDE ESPECIALLY AMONG
YOUNG PEOPLE, FOCUSING ON SUBSTANCE ABUSE PREVENTION,
SUICIDE PREVENTION, AND PROMOTION OF MENTAL HEALTH.
THOSE ARE THE WORDS USED IN THE CONGRESSIONAL LANGUAGE.
I THINK THE RECOGNITION IS THAT THOSE THINGS GO TOGETHER AND HAVE
IMPACT COLLECTIVELY ON THE RATES OF SUICIDE AMONG TRIBAL YOUTH.
I WILL TALK MORE IN A BIT ABOUT WHERE SOME OF THOSE DOLLARS, HOW SOME OF THOSE DOLLARS SHIFTED,
BUT THIS IS THE RECOGNITION THAT WE'RE TRYING TO MOVE INTO AREAS THAT WE HAVEN'T BEEN ABLE
TO WORK IN LIKE SUICIDE PREVENTION IMPLEMENTATION, GOING FORWARD.
NEXT SERIES OF OUR PRIORITIES IS BUILDING PARTNERSHIPS AND
EXPANDING PRACTICES THAT WORK. SOMETHING WE'VE DUBBED THE BBHC
ACRONYM YOU WANT TO GET USED TO. BUILDING BEHAVIORAL HEALTH COALITIONS.
THIS HAS TAKEN $3 MILLION OF
EXISTING RESOURCES, PARTLY FROM THE CENTER FOR MENTAL HEALTH SERVICES
AND CENTER FOR SUBSTANCE ABUSE PREVENTION,
IT'LL BE JOINTLY ADMINISTERED BY THOSE TWO CENTERS.
IT'S WORKING THE ADDRESS SHARED RISK AND PROTECTIVE FACTORS FOR
SUBSTANCE ABUSE AND MENTAL ILLNESS AND BUILDING RESILIENCE
AND EMOTIONAL HEALTH TO ADDRESS BOTH OF THESE ISSUES AND, ESPECIALLY, BRINGING THE
CONCEPT OF COMMUNITY COALITIONS INTO THE MENTAL HEALTH WORLD.
WE KNOW A LOT OF THE COALITIONS OUT THERE ARE DOING WORK LIKE THIS, BUT WE HAVE NOT
BEEN ABLE TO WORK WITH THEM ON IT. EACH SETS OF DOLLARS WILL
CONTINUE TO FOCUS ON SUBSTANCE ABUSE AND CONTINUE TO FOCUS ON MENTAL ILLNESS BUT TRY
TO BRING TOGETHER THE COALITION EFFORTS IN A PARTICULAR COMMUNITY.
OTHER NOTABLE INCREASES.
A COUPLE I WANT TO MENTION TO YOU - YOU SEE THE BUDGET.
ONE IS OUR TARGETED CAPACITY EXPANSION PROGRAM, IN OUR SUBSTANCE ABUSE
TREATMENT CENTER. IS INCREASED BY $2 MILLION DOLLARS.
IT IS OVER 14. IT'S STILL A LITTLE BIT LESS THAN WHAT WAS IN 2013
BUT MORE THAN 14. WE ARE -- WITH THESE DOLLARS
WE'RE TRYING TO CREATE A BEHAVIORAL HEALTH PRIVACY CENTER OF EXCELLENCE.
WE KNOW THIS WAS A HUGE ISSUE IN
BOTH SUBSTANCE ABUSE AND MENTAL HEALTH BUT ESPECIALLY THE
SUBSTANCE ABUSE FIELD IN PART BECAUSE OF FEDERAL LAWS.
AS WE LOOK AT HEALTH INFORMATION TECHNOLOGY EFFORTS AND
ELECTRONIC HEALTH RECORDS, THIS IS AN AREA WE HAVE TO HELP STATES
AND PROVIDERS AND OTHERS DEAL WITH THE ISSUE.
DISASTER RESPONSE IS ALSO SOMETHING WE HAVE BEEN DOING A LOT
IN THE LAST COUPLE OF YEARS IN A PILOT MODE AND WE'RE PLEASED
TO SAY IN FISCAL YEAR 2014 WE GOT DOLLARS TO -- ALMOST
$1 MILLION DOLLARS -- TO CONTINUE DISASTER RESPONSE HELP LINE WHICH HAS
BECOME REALLY IMPORTANT IN A NUMBER OF TRAGEDIES AND DISASTERS,
WHETHER IT'S MAN MADE, WEATHER MADE OR FRANKLY THE MASS
TRAGEDY SITUATIONS WE HAVE SEEN BECAUSE OF DOMESTIC VIOLENCE OR
SHOOTINGS OR WHATEVER. SO THAT DISASTER DISTRESS WORK
WILL BE ABLE TO CONTINUE FROM 14 INTO 15.
THERE ARE SOME REDUCTIONS THAT I WANT TO ACKNOWLEDGE IN FISCAL YEAR 2014,
SAY A WORD ABOUT, ONE AREA THAT IS REDUCED IS PRIMARY BEHAVIORAL
HEALTHCARE INTEGRATION SERVICES -- PBHCI.
IT'S STILL AT $26 MILLION. THIS PARTICULAR PROGRAM HAS GONE
UP AND DOWN OVER THE LAST SEVERAL YEARS DEPENDING ON WHAT
FUND SOURCE IT'S FUNDED FROM BUT WE WILL BE ABLE TO CONTINUE THIS
THIS PROGRAM AND CONTINUE TO ADD NEW GRANTS AND WE WANT TO BE ABLE TO ASSURE
WE CONTINUE TO LEARN FROM THE EVALUATION OF THIS PROGRAM.
SBIRT IS ALSO DOWN, IT'S STILL AT $30 MILLION, BUT IT'S DOWN $17 MILLION
FROM 2014. THE IDEA HERE IS THAT WE HAVE
LEARNED A LOT ABOUT SBIRT AND WE WANT TO CONTINUE TO HAVE IT
INCORPORATED INTO PRIMARY CARE AND TO EMERGENCY ROOMS AND LOTS
OF DIFFERENT SETTINGS. BUT THE IDEA OF A SEPARATELY
FUNDED PROGRAM IS NOT SOMETHING WE'LL SUPPORT AT THE SAME TIME
LEVEL BECAUSE THERE'S OTHER
FUNDING STREAMS LIKE MEDICAID AND OTHERS BEGINNING TO COVER
INSURANCE, ET CETERA, THEY'RE BEGINNING TO COVER THIS SERVICE.
OUR ACCESS TO RECOVERY - ATR - PROGRAM IS ALSO DOWN.
THE PROGRAM IS ELIMINATED IN 2014. IT WENT DOWN SIGNIFICANTLY
FROM 13 TO 14. AND THEN HAS BEEN OVER 2 OR 3
YEARS REDUCING TO BEING ELIMINATED THIS YEAR, WE'RE
LOOKING AT PROVIDING INFORMATION FOR STATES REGARDING POSSIBLE
USE OF VOUCHERS THROUGH THE SABG FUNDING STREAM IF STATES WANT TO
DO THAT. A LOT OF SERVICES THAT ARE
AVAILABLE THROUGH THAT PROGRAM ARE AVAILABLE NOW THROUGH OTHER
FUNDING MECHANISMS AND, TO THE EXTENT THEY'RE NOT AVAILABLE,
THE DOLLARS ARE MOVING AROUND SUCH THAT WITH ADDITIONAL
COVERAGE FOR SUBSTANCE ABUSE PEOPLE WITH THOSE DISORDERS, THE ATR
PROGRAM IS LESS IMPORTANT TO CONTINUE IN THE CURRENT FORMAT.
CRIMINAL JUSTICE SERVICES, OUR PROGRAM IS DOWN A LITTLE BIT,
ABOUT $11 MILLION, IT'S RETURNED TO THE $64 MILLION LEVEL
THAT WAS SLIGHTLY MORE THAN IT WAS IN 2013.
CONGRESS PROPOSED TO INCREASE BY ABOUT $11 MILLION IN 2014 AND WE
WILL PUT THOSE DOLLARS TO GOOD USE.
AND THEN RETURN IT TO THE $64 MILLION LEVEL FOR FISCAL YEAR 2013.
THE GARRET LEE SMITH YOUTH
SUICIDE PROGRAM IS DOWN A LITTLE BIT, YOU CAN SEE THAT WE HAVE
ADDED QUITE A NUMBER OF OTHER SUICIDE PREVENTION
IMPLEMENTATION SERVICES. PART OF THE ISSUE HERE IS THE GARRET LEE
SMITH PROGRAM IS TO FOCUSED ON A
VERY SPECIFIC SET OF AGE GROUPS AND IN ORDER TO EXPAND THE AGE
GROUPS AND DO OTHER THINGS AND TRIBES AND OTHER THINGS WE
HAVEN'T BEEN ABLE TO DO AT DIFFERENT AGE LEVELS WE ARE
SHIFTING THOSE DOLLARS A LITTLE BIT.
SO OUR PROGRAMS THAT WE'VE PROPOSE INCREASES IN SUICIDE PREVENTION,
ALLOWING EXPANSION OF AGES AND INCREASING FOCUS WITH TRIBES
WITH HIGHEST RATES OF SUICIDE.
THIS NEXT SLIDE REALLY IS THERE FOR YOUR INFORMATION.
THE PREVENTION FUND OVER THE LAST THREE YEARS, 13, 14 AND
THEN PROPOSED FOR 15. IT SHOWS YOU THE DIFFERENCE BETWEEN FISCAL
YEAR 2014 AND 15, THE ATR PROGRAM WAS ACTUALLY SHIFTED FROM BA TO
PREVENTION FUND FOR 14 AND THAT IS NOW GOING AWAY. AND THE PRIMARY
HEALTHCARE INTEGRATION IS ACTUALLY GOING BACK TO PREVENTION FUND OR
A SIGNIFICANT PORTION OF IT IS, SO THAT ONE ALSO HAS GONE BACK AND FORTH
FROM DIFFERENT FUNDS STREAM. HEALTH SURVEILLANCE IS UP IN THE
PREVENTION FUND, SUICIDE PREVENTION WORK WAS SOMEWHAT IN
THE PREVENTION FUND LAST YEAR AND STAYS THAT WAY IN 15.
THEN NATIONAL STRATEGY OF SUICIDE PREVENTION IS LESS IN THE
PREVENTION FUND AND MORE BACK IN THE BA.
SO OVERALL THE PROPOSAL IS THAT WE WOULD HAVE JUST $4 MILLION LESS
IN PREVENTION FUNDS IN 2015 THAN WE HAVE IN 14.
I WANT TO SAY A COUPLE MORE WORDS ABOUT WHERE SAMHSA IS GOING.
FISCAL YEAR 15 REPRESENTS THE BEGINNING OF A 4-YEAR
PROCESS OR 4-YEAR TIME PERIOD IN WHICH SAMHSA HAS A STRATEGIC PLAN
WHICH IS UNDER DEVELOPMENT. AS YOU RECALL HAVE A STRATEGIC PLAN
IN PLACE NOW CALLED LEADING CHANGE.
LEADING CHANGE HAS EIGHT STRATEGIC INITIATIVES. I'M SURE
YOU'RE ALL VERY FAMILIAR WITH THEM. THEY -- WE ARE IN THE LAST YEAR OR
LAST HALF OF THE LAST YEAR OF THAT FOUR-YEAR PROCESS.
AS WE HAVE BEEN DOING LOTS OF WORK WITH STAKEHOLDERS AND
OURSELVES AND WITH OTHERS WE HAVE PROPOSED OR WE'RE ABOUT TO
PROPOSE LEADING CHANGE 2.0. WHICH WILL COVER 2015 TO 2018.
SO, WE HAD TO PROPOSE THE INITIATIVES IN THIS BUDGET PROCESS.
THIS ACTUAL PLAN WILL BE OUT FOR
PUBLIC COMMENT, WE HOPE, NEXT MONTH.
AT THIS POINT WE'RE PROPOSING THAT IT CONTAINS SIX INITIATIVES
AND WILL GUIDE US OVER THE NEXT FOUR YEARS.
SO LET ME SHOW YOU A LITTLE BIT ABOUT HOW THIS WORKS.
AND IF YOU HAVE ANY QUESTIONS ABOUT THIS, KANA ENOMOTO WILL DEFINITELY BE THE
PERSON TO ANSWER SOME OF THESE QUESTIONS.
THIS IS AN ATTEMPT, ALL IN ONE SLIDE, TO SHOW YOU ON THE
LEFT-HAND SIDE THE 8 STRATEGIC INITIATIVES THAT WE HAD GOING
THE LAST FOUR YEARS. AND TO SHOW YOU ON THE RIGHT
HAND SIDE THE 6 STRATEGIC INITIATIVES FOR THE NEXT FOUR YEARS.
WE WANT -- I WANT TO JUST POINT
OUT A COUPLE OF THINGS. PREVENTION REMAINS OUR NUMBER-ONE INITIATIVE.
WE CONTINUE TO TRY TO DO
PREVENTION NOT JUST IN NEW PROGRAMS, ALTHOUGH YOU SEE A COUPLE
OF NEW PROGRAMS WE'RE TRYING TO DO ABOUT THAT.
BUT ALSO BY INFUSING PREVENTION PRINCIPLES IN JUST ABOUT EVERYTHING
WE'RE DOING. SO, WHETHER IT'S TRAUMA WORK
OR WHETHER IT IS CRIMINAL OUR JUSTICE WORK, TRYING TO GET FURTHER UPSTREAM TO
PREVENT PEOPLE FROM GETTING INTO THE CRIMINAL JUSTICE SYSTEM
OR TRYING TO BRING PREVENTION EFFORTS INTO THE MENTAL HEALTH
WORLD OR TRYING TO BRING MENTAL HEALTH UNDERSTANDINGS INTO THE
SUBSTANCE ABUSE PREVENTION WORLD.
WE CONTINUE TO HAVE THAT. PREVENTION OF PRESCRIPTION DRUG ABUSE,
PREVENTION OF SUICIDE AND EVEN STARTING TO LOOK AT THIS
ISSUE OF PREVENTING FIRST EPISODES OF MENTAL HEALTH ISSUES
OR FRANKLY SUBSTANCE ABUSE ISSUE THAT EARLIER PREVENTION EFFORT
CONTINUES TO BE A HIGH PRIORITY.
THE SECOND INITIATIVE, THAT WE HAD BEEN CALLING IN THE PAST "HEALTH FINANCING," THIS WAS
REALLY AROUND THE ACA, AND MHPAEA, OUR PARITY RULES, THINGS OF THAT NATURE.
THIS IS NOW MORPHING FOR THE NEXT FOUR YEARS FOR US INTO THIS
ISSUE OF INTEGRATION. SO HEALTHCARE AND HEALTH SYSTEMS INTEGRATION.
BOTH AT THE COMMUNITY PREVENTION LEVEL,
AT THE TREATMENT LEVEL AND AT THE COMMUNITY OR -- COMMUNITY
SUPPORTS - RECOVERY SUPPORTS - LEVEL SO THAT INTEGRATION INITIATIVE
YOU'LL WANT TO LOOK AT AND GIVE US SOMEFEEDBACK ON.
TRAUMA JUSTICE IS STILL THERE. WE HAVE DONE A LOT, BUT WE HAVE MORE TO DO.
RECOVERY SUPPORT WE HAVE A LOT MORE TO DO.
BUT HAVE GOOD STARTS IN SOME OF THOSE AREAS AND, THEN, HEALTH INFORMATION
TECHNOLOGY - WE HAVE ALSO DONE A LOT IN THAT AREA BUT HAVE QUITE A BIT MORE
WE WANT TO DO SO WILL CONTINUE TO BE OUR WORK FOR NEXT FOUR YEARS. AND, THEN, FINALLY,
WE'VE ADDED WORKFORCE. THIS IS AN AREA WE HAVE BEEN DOING QUITE A BIT ABOUT, BUT
HRSA IS REALLY THE KEY LEADER IN WORK FORCE AND WE HAVE TEAMED UP WITH THEM
ON A LOT OF THINGS. BUT WE
UNDERSTAND, ESPECIALLY WITH THE NOW IS THE TIME PROPOSAL, AND
SOME OF THE DATA ISSUES AND SOME OTHER THINGS - PEERS - WE NEED TO DO
THAT WE NEED TO ADD WORK FORCE AS A PRIORITY STRATEGY FOR US FOR THE NEXT FOUR YEARS.
UNDER-GIRDING THOSE SIX STRATEGIC
INITIATIVES ARE SOME WORK SAMHSA IS DOING TO TRY TO CHANGE ITSELF.
SO A RECOGNITION THE SAMHSA OF
THE LAST 20 YEARS OR 21 YEARS IS NOT THE SAMHSA OF THE NEXT 20 YEARS.
THAT WE NEED TO BE A DIFFERENT SAMHSA
IN THE NEXT 20 YEARS. SO WE HAVE A NUMBER OF WHAT WE
CALL INTERNAL OPERATING STRATEGIES.
THEY ARE SHOWN ON THE BOTTOM OF THIS SLIDE IF YOU ARE ABLE TO SEE THEM.
BUSINESS OPERATIONS, DATA, COMMUNICATIONS,
HEALTH FINANCING, POLICY, RESOURCE INVESTMENT, AND STAFF DEVELOPMENT.
THOSE ARE ALL INTERNALLY FOCUSED ON HOW WE DO
THOSE THINGS. THE STRATEGIC INITIATIVES THAT YOU
WILL SEE IN LEADING CHANGE 2.0 ARE EXTERNALLY FACING IN TERMS OF
THE WORK WE'RE TRYING TO DO WITH THE FIELD.
FINALLY, I WANT TO SHOW YOU THIS PICTURE, THERE'S BEEN A LOT OF
DISCUSSION ABOUT IT OVER THE LAST, LITERALLY, COUPLE OF WEEKS
AND THE EXECUTIVE LEADERSHIP TEAM AT SAMHSA AND STAFF AT SAMHSA ARE TRYING
TO START TO THINK WHAT WE MEAN BY THIS.
WE UNDERSTAND THAT SAMHSA SHOULD BE DOING MORE THAN ESSENTIALLY
TRYING TO GET A GRANT OUT THE DOOR.
THAT IS A VERY CRITICAL THING TO DO, BUT THE GRANTS ARE A MECHANISM, NOT THE END
IN AND OF THEMSELVES. THE GRANTS ARE PART OF OUR EFFORT
TO ADVANCE BEHAVIORAL HEALTH OF THE NATION.
WHILE CMS IS DOING A LOT, ACF IS DOING A LOT, HRSA IS DOING A LOT, AND EVERYBODY IS DOING A LOT
ABOUT BEHAVIORAL HEALTH THESE DAYS. INCLUDING THE MILITARY AND
THE VETERANS ADMINISTRATION AND OTHERS, THAT WE REALLY NEED TO
THINK ABOUT HOW OUR GRANT MAKING PROCESS TAKES THINGS THAT WE'RE
LEARNING AND TAKES THEM TO SCALE TO THE EXTENT THEY ARE EVIDENCE-
BASED AND THEY ARE MAKING A DIFFERENCE IN THE WORLD.
SO THAT'S WHAT THIS SLIDE IS ABOUT. I'M GOING TO LEAVE IT FOR
YOU FOR THE MOMENT ONLY TO SAY THAT WHAT WE'RE TRYING TO DO IS
THINK ABOUT THAT AND THINK ABOUT OUR ROLE AS -- IN SAMHSA -- IN THAT PROCESS.
SO BEFORE I QUIT HERE I WANT TO
TELL YOU JUST A COUPLE OF OTHER THINGS THAT ARE INITIATIVES YOU
MAY WANT TO LOOK AT IN OTHER OPERATING DIVISIONS' BUDGETS IN HHS.
SO ONE OF THE THINGS YOU MAY
WANT TO LOOK AT IS - I'VE ALREADY MENTIONED IT - WITHIN CDC, IS THEIR
$16 MILLION DOLLAR PRESCRIPTION DRUG PROGRAM THAT WILL WORK WITH OURS.
THE ADMINISTRATION ON COMMUNITY
LIVING HAS A NEW ELDER ABUSE PROGRAM THEY'RE GOING TO TRY TO
DO RESEARCH AND DATA AND GRANTS AROUND. AND THAT OBVIOUSLY HAS
IMPLICATIONS FOR TRAUMA AND MENTAL HEALTH AND SUBSTANCE ABUSE
ISSUES FOR THOSE INDIVIDUALS.
THERE IS A MAJOR WORK FORCE INITIATIVE USING LARGELY MANDATORY
DOLLARS BUT IT'S POSITIONING THOSE DOLLARS, ABOUT
$14.6 BILLION OVER A TEN YEAR PROGRAM, TO REALLY INCREASE AND
EXPAND THE NUMBER OF NATIONAL
HEALTH SERVICE CORE SLOTS. THERE'S ABOUT - PER MARY WAKEFIELD -
8,900 OR SO WORK FORCE SLOTS NOW. THEY'RE GOING TO INCREASE THAT TO ALMOST 15,000
WORK FORCE SLOTS AND GRADUATE MEDICAL EDUCATION IS
GOING TO EXPAND TO ABOUT 13,000 NEW RESIDENCY SLOTS FOR BOTH
PRIMARY CARE AND SPECIALTY IF WE CAN SHOW THEM THE NEED.
SO THIS IS A REASON WHY OUR DATA INITIATIVE, SMALL THOUGH IT MAY BE,
WILL BE REAL CRITICAL TO BEING ABLE TO ACCESS SOME OF THOSE DOLLARS.
FINALLY, ACF AND CMS TOGETHER HAVE A NEW INITIATIVE AROUND
REDUCING PSYCHOTROPIC - USE OF PSYCHOTROPICS- TO CONTROL THE
BEHAVIOR OF CHILDREN IN THE WELFARE PROGRAM.
THIS IS A TWO-PART PROGRAM WHICH CMS WILL PROVIDE INCENTIVES TO
STATES FOR IMPROVING THEIR PRACTICES.
AND DECREASING THE AMOUNT OF PSYCHOTROPIC MEDICATION BEING
USED FOR YOUNG PEOPLE IN THE WELFARE SYSTEM.
AS YOU KNOW, THAT AMOUNT IS HUGELY ABOVE OTHER PLACES THAT YOUNG PEOPLE ARE.
AND ACF WILL HAVE GRANTS TO STATES
FOR THAT PURPOSE. SO YOU MAYBE WANT TO REFER TO
THE CHILD WELFARE SYSTEMS IN THOSE STATES. SO YOU MAYBE WANT
TO BE WATCHING THAT AS WELL, TO THE EXTENT YOUR MEMBERS WORK WITH
THOSE PARTS OF THE SYSTEM.
ALRIGHT. I THINK, WITH THAT, I'M GOING STOP AND WE'LL TAKE SOME QUESTIONS.
BEFORE I DO, IF THE OPERATOR CAN
HEAR ME, CAN YOU TELL ME HOW MANY PEOPLE WE HAVE ON THE LINE?
HI, WE CURRENTLY HAVE 78 PEOPLE ON THE LINE.
OKAY. THANK YOU. THOSE FOLKS ON THE LINE WILL BE
ABLE TO ASK QUESTIONS AS WELL AS THOSE OF YOU IN THE ROOM.
I'M GOING TO SIT DOWN OVER HERE AND KANA AND I, EITHER ONE, CAN
ANSWER QUESTIONS. SO WE'LL START WITH FOLKS IN THE ROOM AND DO
REMEMBER THAT THERE IS TWO MICROPHONES - THERE ARE TWO MICROPHONES - HERE
AND YOU WILL NEED TO USE THEM SO PEOPLE ON THE LINE CAN HEAR.
EXCUSE ME, IF THE FOLKS ON THE LINE WOULD LIKE TO ASK A
QUESTION, PLEASE PRESS STAR 1 AND REMEMBER TO UNMUTE YOUR PHONE
AND RECORD YOUR FIRST AND LAST NAME CLEARLY WHEN PROMPTED.
TO WITHDRAW YOUR QUESTION PRESS STAR 2.
ONCE AGAINM IF YOU'D LIKE TO ASK A QUESTION, PRESS STAR 1 AND RECORD YOUR NAME.
Q. HI I'M ROB MORRISON, WITH THE NATIONAL
ASSOCIATION OF STATE ALCOHOL AND DRUG ABUSE DIRECTORS.
THANK YOU VERY MUCH FOR THIS BRIEFING.
GOING OVER A LOT OF INFORMATION. I KNOW YOU HAVE BEEN DOING THIS
FOR COUPLE OF DAYS NOW SO WE APPRECIATE IT.
NUMBER 2, I THOUGHT I WAS FAMILIAR WITH ACRONYMS BUT I
HEARD A FEW NEW ONES SO THIS IS GOOD, IT'S ALWAYS A LEARNING EXPERIENCE.
LIKE TO APPLAUD THE ADMINISTRATION
ON A NUMBER OF FRONTS FOR THIS BUDGET, IN PARTICULAR,
THE PROPOSED INCREASE IN CENTER FOR SUBSTANCE ABUSE PREVENTION.
AS YOU MENTION THE TOP PRIORITY AT SAMHSA.
IT'S EXCITING TO SEE THE PROPOSAL ON OVERDOSE AND PRESCRIPTION
DRUG ABUSE. ALSO APPRECIATE THE PRIMARY CARE
AND ADDICTION SERVICES INTEGRATION.
PCASI - IS THAT RIGHT? YES.
THAT'S FANTASTIC.
THANK YOU VERY MUCH FOR THOSE, LOOK FORWARD TO WORKING WITH YOU
SPECIFICALLY TO EDUCATE DECISION MAKERS ON THE BENEFITS OF THIS
PROGRAM BECAUSE IT'S RIGHT ON TARGET.
JUST A FEW QUESTIONS ON SPECIFIC PROGRAMS, IF YOU HAVE THAT INFORMATION.
ONE -- TWO IN PARTICULAR -- UNDER CRIMINAL JUSTICE
LINE IF YOU HAVE ANY ADDITIONAL INFORMATION ON THE
REDUCTIONS WHERE IT MIGHT HIT. PARTICULARLY, I THINK THE DRUG
COURT LINE WE'RE INTERESTED IN AND PREGNANT POSTPARTUM WOMEN LINE
WITHIN CSAP. BUT AGAIN, THANKS FOR THIS BRIEFING. THOSE
ARE FANTASTIC INITIATIVES AND I KNOW OUR BOARD WILL BE MEETING
THIS THURSDAY AND FRIDAY SO WE'LL TALK MORE ABOUT IT, SO THANKS.
I'M GOING TO LET KANA TALK ABOUT THE PROGRAMS BUT I KNOW PART OF THE
DIFFICULTY HERE IS YOU DON'T HAVE THE CJ IN FRONT OF YOU YET.
WE'RE ALL STRUGGLING WITH THAT. SO IT SHOULD BE OUT HOPEFULLY
FRIDAY SO BY THE TIME YOUR MEETING GETS DONE YOU'LL HAVE IT
IN FRONT OF YOU AND CAN LOOK AT IT.
PPW IS SLATED FOR LEVEL FUNDING, SO THERE'S NO REDUCTION THERE. AND
CRIMINAL JUSTICE, I BELIEVE IT'S IN OUR OTHER CRIMINAL JUSTICE ACTIVITIES.
SO NOT THE DRUG COURT PORTION.
GOOD AFTERNOON, ANDREW KESSLER
WITH IC&RC, REPRESENTING SUBSTANCE ABUSE PROFESSIONALS
IN BOTH PREVENTION AND TREATMENT.
AND I FIND MYSELF IN UNFAMILIAR TERRITORY BECAUSE FOR
THE LAST FIVE YEARS I HAD TO ASK WHAT ABOUT WORK FORCE AND NOW I
FIND MYSELF SAYING THANK YOU SO MUCH FOR YOUR COMMITMENT TO WORK FORCE.
YOU MENTIONED, SEVERAL TIMES, YOUR COLLABORATION WITH
HRSA, WHICH WE APPLAUD AND LOOK FORWARD TO.
WILL YOUR COLLABORATIONS BE WITH THE BUREAU OF HEALTH
PROFESSIONALS? WILL IT BE WITH SEVERAL DIFFERENT BUREAUS IN HRSA?
SHOULD I ASK MARY WAKEFIELD, INSTEAD?
CAN YOU TELL US WHICH DIVISIONS IN HRSA WILL BE FOCUSING ON THAT COLLABORATION.
KANA MAY WANT TO SAY MORE, BUT I THINK IT'S FAIR TO SAY MOST OF THEM.
WE WORK WITH THEM AROUND THE
FQHCs AND WHAT THEIR WORK FORCE IS BEING TRAINED TO DO.
WE'RE CERTAINLY WORKING WITH THEM AROUND DATA EFFORTS AND
THEY HAVE GOT SOME NEW PEOPLE IN THAT AREA.
I WAS ON A STAGE THIS WEEK WITH MARCIA BRAND, WHO'S THE DEPUTY THERE AND
WE WERE TALKING ABOUT THAT SO WE HAVE MORE WORK TO DO THERE TOGETHER
AND THEN THE WHOLE AREA OF
HEALTH PROFESSIONALS IS DEFINITELY SOMETHING THAT WE'RE
LOOKING AT. THEY'RE DOING A BUNCH MORE AROUND RECRUITING AND
TRYING TO GET BEHAVIORAL HEALTH PROFESSIONALS IN THE NATIONAL
HEALTH SERVICE CORPS AREA AS WELL.
SPECIFICALLY THE BEHAVIORAL HEALTH
WORK FORCE EDUCATION AND TRAINING GRANTS, WHICH ARE COMING OUT THIS
YEAR AS PART OF NOW IS TIME WILL BE WITH THE BUREAU OF HEALTH PROFESSIONALS.
OKAY. OTHER QUESTIONS IN THE ROOM? YOU SHOULD HAVE HAD ALL THOSE
NUMBERS SO QUICKLY, YOU CAN SEE
THEM EASILY. I KNOW THIS IS REALLY HARD TO
GET ALL THESE NUMBERS WITHOUT THEM IN FRONT OF YOU.
WHAT WE USED TO CALL A POCKET GUIDE IS ACTUALLY BIGGER THIS YEAR.
BECAUSE SOME OF US ARE AGING AND
CANNOT SEE THE LITTLE ONE ANY MORE SO IT'S A LITTLE BIT BIGGER.
SO YOU WILL HAVE THAT AS YOU LEAVE THE ROOM, THERE WILL BE SOME OF
THOSE AVAILABLE FOR YOU. OKAY.
I DON'T SEE ANOTHER HAND IN THE ROOM SO OPERATOR IF YOU HAVE GOT
SOMEONE ON THE LINE WHO HAS A QUESTION.
YES, OUR FIRST QUESTION COMES FROM
SHELLEY BANIA. YOU HAVE AN OPEN LINE.
THANK YOU SO MUCH.
THANK YOU FOR THE OPPORTUNITY FOR THIS FORUM TODAY.
MY NAME IS SHELLEY BANIA AND I'M A CONCERNED CITIZEN OUT OF MICHIGAN.
MY QUESTION IS ALSO VERY MUCH A DETAILED QUESTION.
I'M CURIOUS TO KNOW IF YOU CAN ANSWER WHAT THE
SPECIFIC BUDGET LINE REQUEST FOR THE FETAL ALCOHOL SPECTRUM DISORDER
CENTER FOR EXCELLENCE WILL BE WITH FISCAL YEAR 15.
IT'S LEVEL FUNDED, IT HAS BEEN
FUNDED FOR THE LAST THREE YEARS INCLUDING IN 2013
AND 14 AT WHAT IS IT, -- IT'S LEVEL FUNDED --
IT'S AT $1 MILLION SO LEVEL FUND WITH THE 14 ENACTED AND CLOSE TO
LEVEL FUNDED WITH THE 13 PRESIDENT'S BUDGET REQUEST.
I THANK YOU FOR THAT.
AND I DO RECOGNIZE THAT IT IS STILL
A SIGNIFICANT REDUCTION FROM YEARS PRIOR.
I AM JUST WONDERING IF YOU CAN COMMENT ON THE DECISION IN THAT
OR SOME HELPFUL INFORMATION FOR US THAT ARE WORKING TO PREVENT FASD -- WORKING
WITH FAMILIES THAT ARE LIVING WITH THIS LEADING PREVENTABLE
DISORDER. IF YOU CAN PROVIDE SOME INPUT OR FEEDBACK ON WHAT THAT
DECISION MAKING PROCESS WAS FOR THAT REDUCTION BOTH IN 14 AND, NOW, 15.
I DO APPRECIATE YOU KEPT THE
LEVEL AT A MILLION BUT I'M CURIOUS THE CHANGE OVER THE LAST FEW YEARS.
IT IS CONSISTENT - WE MADE THIS CHANGE, I BELIEVE, STARTING IN
12 OR 13. SO THE 13 REQUEST WAS THE FIRST TIME THAT
IT CAME IN AT REDUCED LEVEL. WE WANT TO FOCUS ON PREVENTION
EFFORTS, PREVENTING FASD AND AS WELL AS DISSEMINATING BEST PRACTICES
ABOUT HOW TO WORK WITH PEOPLE WHO ARE AFFECTED BY FASD
AND THEIR FAMILIES. SO WE'RE MAINTAINING THE FASD
CENTER FOR EXCELLENCE. AND WHAT WE'RE NOT ABLE TO DO IS
FUND SERVICES SITES THAT WE HAD BEEN DOING UNDER THE PREVIOUS
CENTER OF EXCELLENCE.
I WOULD ADD TO THAT, SHELLEY, THANKS FOR THE QUESTION, IS IN LOTS
OF PLACES WE ARE BEING ASKED TO LOOK AT NOT JUST SAMHSA BUT ALL
ACROSS THE DEPARTMENT ASKED TO LOOK AT, AS PEOPLE HAVE ADDITIONAL
COVERAGE AND ADDITIONAL OPPORTUNITIES FOR GETTING DIRECT SERVICES WE ARE BEING
ASKED TO FOCUS IN AREAS WHERE WE ARE EITHER TESTING NEW PROGRAMS OR TRYING
TO TAKE PROGRAMS TO SCALE OR TRYING TO EXPAND PROGRAMS THAT
WE HAD PUT IN PLACE TO TRY TO HELP STATES TAKE THOSE TO OTHER
COMMUNITIES, ET CETERA.
SO YOU WILL NOTICE, AS YOU LISTEN, THAT THERE ARE SEVERAL PLACES WHERE WE'VE ACTUALLY
EITHER REDUCED OR COMPLETELY ELIMINATED PROGRAMS IN PART
THROUGH THAT EFFORT OR BECAUSE OF THAT EFFORT.
OTHER OPERATING DIVISIONS ARE FACING THAT SAME DILEMMA IN ORDER TO
STAY WITHIN THE AGREEMENTS THAT CONGRESS MADE BETWEEN SENATOR
MURPHY AND CONGRESSMAN RYAN ABOUT GROWTH AND AMOUNT OF
DOLLARS THAT WOULD BE AVAILABLE FOR THE GOVERNMENT AS A WHOLE.
SO, TOUGH CHOICES HAVE BEEN MADE MANY YEARS AND MANY PROGRAMS, IF
I HAD MY DRUTHERS IF WE ALL HAD OUR DRUTHERS WE'D HAVE MORE OF
EVERYTHING IN EVERY PLACE BUT THAT'S JUST NOT REAL
IN TERMS OF THE FEDERAL GOVERNMENT'S BUDGET.
SO WE'RE TRYING TO BE VERY FOCUSED IN, AS KANA SAID, IN OUR EFFORTS AROUND PREVENTION,
AROUND TECHNICAL ASSISTANCE, AROUND HELPING PEOPLE KNOW
WHAT'S THE BEST WAY TO PROVIDE THOSE SERVICES REGARDLESS HOW
THEY'RE FUNDED.
NEXT QUESTION, ON THE PHONE, OPERATOR?
NEXT QUESTION COMES FROM DIANE CLARK.
HI. GOOD AFTERNOON. THANK YOU FOR THIS OPPORTUNITY.
MY QUESTION IS, DO YOU FORESEE ANY FOCUSED FUNDING EITHER FOR PREVENTION
OR TREATMENT INITIATIVES DUE TO THE NATIONAL MARIJUANA
INITIATIVES THAT ARE HAPPENING?
GOOD QUESTION. LET ME START BY ANSWERING IT IN
THIS WAY, THE DEPARTMENT - THE DEPARTMENT AS A WHOLE -- HHS
OR HEALTH AND HUMAN SERVICES HAS A BEHAVIORAL HEALTH COORDINATING COUNCIL.
THAT COUNCIL CREATED, THIS YEAR, A
SUB-COMMITTEE ON MARIJUANA BECAUSE OF ALL THE ISSUES GOING ON.
THAT INCLUDES EVERYBODY FROM SAMHSA TO NIAAA AND NIDA.
THE RESEARCH INSTITUTES WHO ARE INTERESTED IN THESE ISSUES. IT ALSO
INCLUDES FDA WHO OF COURSE ARE LOOKING AT HAVING TO REGULATE MEDICINAL USE ISSUES
IN STATES THAT HAVE MADE THOSE DECISIONS. IT ALSO INCLUDES CDC,
IT INCLUDES ACF AND A NUMBER OF OTHER -- OFFICE OF
ASSISTANT SECRETARY FOR HEALTH -- A NUMBER OF PEOPLE. WES CLARK, FROM OUR AGENCY
AS WELL AS ANAND PAREKH, FROM THE ASSISTANT SECRETARY FOR HEALTH'S
OFFICE ARE CO-CHAIRING THAT SUB-COMMITTEE. THEY ARE IN THE
PROCESS OF DOING AN INVENTORY. IN FACT, THEY FINISHED, I THINK, A FIRST
DRAFT INVENTORY OF ALL THE WORK HHS IS DOING IN THIS AREA
INCLUDING DATA AND SURVEILLANCE AND A LOT OF OTHER ISSUES.
WE ARE FOCUSING ON PREVENTION ISSUES AND WE HAVE MADE IT CLEAR
THAT STATES COULD USE THEIR SPF GRANTS TO CHOOSE SOMETHING -- WE
IDENTIFIED PRESCRIPTION DRUG ABUSE AN UNDERAGE DRINKING AS THE TWO
PRIORITIES BUT IF A STATE WANTED TO SHOW ANOTHER DRUG WAS
BECOMING AN ISSUE FOR THEM, AND THEY WANT TO ADDRESS IT THEY COULD .
I THINK ONE OR TWO, OF THE STATES DID CHOOSE MARIJUANA.
AND WE THINK FRANKLY PROBABLY ADDITIONAL STATES WILL BE
STARTING THE MAKE THOSE CHOICES. WE ALSO HAVE THE WORKPLACE DRUG
TESTING PROGRAM LOOKING AT ISSUES HOW MARIJUANA IS OR AT
LEAST THE ACTIVE INGREDIENTS IN MARIJUANA, HOW THEY'RE TESTED FOR,
AND WHAT THE LIMITS ARE, ARE ALL ISSUES THAT SAMHSA IS
INVOLVED WITH SO ALL THIS IS TO SAY WE DON'T HAVE A NEW GRANT
PROGRAM THAT IS SPECIFICALLY TARGETED TO
MARIJUANA, RIGHT NOW, BUT THERE ARE CLEARLY AREAS IN PLACES WHERE MARIJUANA
IS BEING ADDRESSED IN A NUMBER OF WAYS BOTH IN SAMHSA AND THE LARGER DEPARTMENT.
AND OBVIOUSLY WORKING WITH DEA AND
DOJ ON THEIR ISSUES TO THE EXTENT THEY'RE HAVING TO WATCH
THE DATA, ET CETERA, DOING SOME WORK WITHIN OUR SURVEILLANCE
AREA TO SEE WHAT WE CAN TELL ABOUT THOSE STATES THAT HAVE PASSED
THE LAWS. THERE'S ABOUT HALF THE STATES NOW WHO HAVE DONE - EITHER MEDICINAL USE OR
RECREATIONAL USE, MARIJUANA LAW OR BOTH. AND THERE ARE ADDITIONAL
LOCAL COMMUNITY CITIES, COUNTIES AND OTHERS THAT ARE EXAMINING IT, AS WELL.
SO IT'S CLEARLY A BIG ISSUE.
WE'RE TRYING TO FOCUS ON THE UNDERAGE USE AND UNDER THE
UNDER THE INFLUENCE USE AND THE PREVENTION ISSUES THAT ARE ASSOCIATED WITH THOSE THINGS.
ANYTHING ELSE UP TO ADD?
HOPEFULLY THAT'S HELPFUL. I DON'T KNOW WHERE THIS WILL GO
IN THE FUTURE, I WAS TOYING IN MY MIND THE OTHER DAY WE HAVE
HAD SUCH GREAT REACH AND SUCH GREAT IMPACT BY OUR UNDERAGE
DRINKING CAMPAIGN, "TALK. THEY HEAR YOU." THAT OUR CENTER FOR
SUBSTANCE ABUSE PREVENTION LEADS, ALONG WITH OUR OFFICE OF COMMUNICATIONS
BUT WE HAVE SPECIAL MONEY FROM CONGRESS TO
DO THAT CAMPAIGN. SO, PERHAPS AS CONGRESS LOOKS AT THE
MARIJUANA ISSUES THEY'RE LOOKING AT, MAYBE THEY WILL THINK ABOUT
PROVIDING THAT KIND OF INFORMATION OR SUPPORT FOR A
SIMILAR CAMPAIGN, I DON'T KNOW IF THEY WERE THINKING YOU CAN ASK THEM.
ALL RIGHT.
OTHER QUESTIONS ON PHONE?
AT THIS TIME THERE ARE NO QUESTIONS IN THE QUEUE. ONCE AGAIN,
IF YOU WOULD LIKE TO ASK A QUESTION, PRESS STAR 1 AND RECORD YOUR NAME.
ANYBODY ELSE IN THE ROOM WHILE SOMEBODY ON THE PHONE IS
PRESSING STAR 1? ANYBODY ELSE HAVE A QUESTION? YOU ALL ARE VERY QUIET TODAY.
IT'S HARD TO BELIEVE, THAT A BEHAVIORAL HEALTH STAKEHOLDER GROUP IS THIS QUIET.
YES, RIGHT OVER OVER HERE.
HI, DEBBIE PLOTNICK, MENTAL HEALTH AMERICA.
CAN YOU ELABORATE A LITTLE BIT ABOUT THE
$10 MILLION DOLLARS FOR PEER SERVICES? WILL THAT BE ACROSS ALL THE PROGRAMS?
MY NOTES SAY THERE'S 1 MILLION
FOR DATA COLLECTION, IS THAT TO BUILD THE EVIDENCE BASED-PRACTICE?
THE 1 MILLION FOR WORK FORCE DATA IS MUCH BROADER THAN PEERS.
IT IS NOT -- JUST PEERS.
THE PEER PROGRAM, KANA, DO YOU WANT TO COMMENT? THE PEER PROFESSIONAL PROGRAM WILL
LOOK AT MENTAL HEALTH AND SUBSTANCE ABUSE. IT WILL LOOK AT PREVENTION
AS WELL AS TREATMENT AND RECOVERY SUPPORTS
AND ENGAGE PARENTS, YOUTH, AS WELL AS ADULTS WHO ARE IN RECOVERY.
SO IT IS A BROADER RANGE ON THAT ONE.
SO FAMILY -- RIGHT. EXACTLY.
AND THEN THE -- AND THIS PROGRAM WILL HAVE THE OPPORTUNITY TO
DISTINGUISH ITSELF FROM THE BEHAVIORAL HEALTH WORK FORCE
EDUCATION AND TRAINING EFFORT WHICH IS A LITTLE BIT BROADER IN IT'S
BEHAVIORAL HEALTH PARAPROFESSIONALS, SO IT WOULD INCLUDE
COMMUNITY HEALTH WORKERS, MENTAL HEALTH AIDS,
ET CETERA, WHO DON'T NECESSARILY HAVE A LIVED EXPERIENCE WITH OUR PEER
PROFESSIONAL PROGRAM WE'RE LOOKING AT SUPPORTING A LITTLE BIT OF INFRASTRUCTURE
DEVELOPMENT, MAYBE STATES AND COMMUNITY COLLEGES THAT WANT
TO DEVELOP A CERTIFICATION, PROGRAM AND DEVELOP TRAINING PROGRAMS
AND ADOPT THOSE TYPES OF PROFESSIONALS WHERE THEY 13:53:03:18
DIDN'T HAVE THEM BEFORE.
I DIDN'T SAY, WHEN I TALKED ABOUT THE WORK FORCE INITIATIVE,
BUT YOU'LL SEE THAT DOCUMENT IN A MONTH OR SO, AND YOU CAN GIVE US SOME
FEEDBACK ABOUT IT IN THE PUBLIC COMMENT PERIOD BUT ANNE HERRON,
AS MANY OF YOU KNOW WAS GOING TO LEAD OUR WORK FORCE INITIATIVE.
MIRIAM DELPHIN-RITTMON HAS BEEN LEADING IT,
BUT SHE, UNFORTUNATELY, HAS TO GO BACK TO YALE.
SHE WAS ON A TWO YEAR SABBATICAL WITH US FOR COUPLE OF YEARS BUT
THIS IS HER LAST WEEK AND SHE'LL GOING BACK, AND ANNE HERRON
IS GOING TO LEAD THAT INITIATIVE FOR US.
OKAY. OPERATOR, ARE THERE OTHER PEOPLE IN THE QUEUE?
OUR NEXT QUESTION COMES FROM PATRICIA JORDAN.
GOOD AFTERNOON. THANK YOU SO MUCH FOR THE PRESENTATION.
MY QUESTION RELATES TO INTEGRATION OF
PRIMARY CARE AND BEHAVIORAL HEALTHCARE.
IT SEEMS THAT MOST FUNDING HAS FOCUSED ON INTEGRATING BEHAVIORAL HEALTHCARE
TO PRIMARY CARE AND MAKES FUNDING AVAILABLE OR ON THE HORIZON
FOR INTEGRATING BEHAVIORAL -- PRIMARY-- HEALTH CARE INTO BEHAVIORAL HEALTH CARE.
BOTH OF THE PROGRAMS I TALKED ABOUT TODAY, THE PRIMARY BEHAVIORAL HEALTHCARE
INTEGRATION AND THE PCASI, THE NEW PCASI PROGRAM - BOTH ARE ABOUT BRINGING
HEALTHCARE INTO BEHAVIORAL HEALTH SETTINGS.
NOW, WE HAVE AN INTEGRATED HEALTH SYSTEM CENTER OR CENTER FOR INTEGRATED
HEALTH SYSTEMS SOLUTIONS, CIHS, ANOTHER ACRONYM, THAT'S A TECHNICAL
ASSISTANCE CENTER THAT WE FUND WITH HRSA AND WE THINK OF THAT
AS A BI-DIRECTIONAL INTEGRATION. SO, LOOKING AT TAKING IT EITHER DIRECTION
BUT OUR GRANT PROGRAMS AT LEAST THOSE TWO, PBHC AND PCASI,
ARE ACTUALLY BRINGING PRIMARY CARE INTO BEHAVIORAL HEALTH SETTINGS.
OKAY. COULD YOU GIVE ME THE ACRONYM AGAIN FOR PCASI? UNFORTUNATELY, I MISSED THAT SECTION.
PCASI, PBHCI IS PRIMARY BEHAVIORAL HEALTHCARE INTEGRATION.
AND PCASI IS PRIMARY CARE ADDICTION SERVICES INITIATIVE -- INTEGRATION.
OKAY, TERRIFIC.
THANK YOU SO MUCH, PAM.
THANK YOU. THESE ACRONYMS ARE NEW ENOUGH THAT
WE'RE STILL STRUGGLING WITH THEM.
BUT PRETTY SOON WE'LL KNOW THE ACRONYM AND WE WON'T KNOW WHAT THEY MEAN.
WE'LL JUST KNOW WHAT THE PROGRAM IS. BUT YOU'RE WORKING THROUGH IT VERY WELL.
GREAT. THANK YOU.
OPERATOR ANYBODY ELSE?
YES, OUR NEXT QUESTION COMES FROM ANN MAHONEY.
GOOD AFTERNOON. I HAVE TWO QUESTIONS RELATED TO
TWO DIFFERENT PROGRAMS. AND THE FIRST -- WELL, THE OVERALL
QUESTION IS, AT THE BEGINNING OF YOUR PRESENTATION
YOU MENTIONED THAT FOR THOSE PEOPLE IN THE ROOM HERE IS A
SUMMARY OF THE PRESENTATION WITH THE BUDGET DOLLARS. WILL THAT BE MADE
AVAILABLE ONLINE OR COULD WE REQUEST THEM?
THIS IS SOMETHING WE CALL OUR POCKET GUIDE. THERE'S A FEW OF THEM WE MAKE AVAILABLE TO ASSOCIATION
GROUPS AND OTHERS TO TRY TO GET OUT TO THEIR MEMBERSHIPS, SO IT'S
REALLY JUST A SUMMARY OF THE BUDGET. THE LARGER BUDGET WILL ACTUALLY
BE AVAILABLE ONLINE ON FRIDAY. SO FOR THOSE OF YOU WHO ARE NOT HERE IN THE ROOM,
THAT WILL BE YOUR BEST WAY TO GET THOSE.
WE WERE, LITERALLY, COPYING THESE OFF THIS MORNING SO FORGIVE US. THIS ROLL OUT
ON THE BUDGET HAS BEEN A LITTLE DIFFERENT THAN PRIOR YEARS.
SO WE APOLOGIZE FOR THAT. WE KNOW IT'S HARD TO ASK
QUESTIONS WHEN YOU DON'T HAVE STUFF IN FRONT OF YOU, AS WELL.
BUT THOSE THINGS ARE COMING.
THANK YOU. YOU'RE FORGIVEN ON THAT.
SO MY NEXT QUESTION IS, ON THE - YOU MENTIONED - THE HEALTHY TRANSITIONS PROGRAM
FOR PEOPLE IN 16 TO 25-YEAR-OLD AGE COHORT.
AND IN THE AREAS OF MENTAL HEALTH AND SUBSTANCE USE PROBLEMS.
CAN YOU DEFINE WHAT MECHANISMS THE MONEY WILL BE -- THE $40 MILLION DOLLARS WILL
BE MADE AVAILABLE? IS THAT A GRANT PROGRAM OR DATA
COLLECTION [YES, SURE] OR OR A, B, AND C?
SO, HEALTHY TRANSITIONS IS A PROGRAM THAT'S BEGINNING IN 2014. IT'S PART
OF THE PRESIDENT'S NOW IS THE TIME INITIATIVE.
AND IT WILL BE GRANTS TO STATES. WE ANTICIPATE 15 TO 17 GRANTS TO STATES,
TO WORK WITH THEIR COMMUNITIES AND IDENTIFY
INNOVATIVE MODELS FOR ENGAGING AND INCREASING
ACCESS TO YOUNG PEOPLE AND THEIR FAMILIES WHO ARE EXPERIENCING MENTAL
HEALTH AND/OR SUBSTANCE ABUSE PROBLEMS.
SO THIS GOES -- TERRIFIC. THANK YOU.
OKAY. THEN THE NEXT QUESTION I HAVE IS
YOU MENTIONED $15 MILLION DOLLARS THAT WOULD GO TO MENTAL HEALTH, FIRST AID.
AGAIN, MY QUESTION IS WHAT
MECHANISMS WILL THAT $15 MILLION DOLLARS GO THROUGH?
WITH MENTAL HEALTH FIRST AID, THIS
IS ALSO PART OF PRESIDENT'S NOW IS THE TIME INITIATIVE SO IT'S SOMETHING THAT
WE'RE STARTING IN 2014. WHAT WE'VE PROPOSED IS IT WILL BE $5 MILLION DOLLARS IN
PARTNERSHIP WITH OUR PROJECT AWARE FUND WHICH IS TAKING THE SAFE SCHOOLS/
HEALTHY STUDENTS PROGRAM TO SCALE-- TO PREVENT VIOLENCE,
REDUCE BULLYING INCREASE ACCESS TO MENTAL HEALTH SERVICES AND
IMPROVE SCHOOL CLIMATE. SO, THE MENTAL HEALTH FIRST AID
WILL BE THE PIECE THAT IMPROVES MENTAL HEALTH LITERACY.
FOR SEA - STATE EDUCATION AGENCY- MENTAL HEALTH ORGANIZATION AND
THEIR COMMUNITIES. AND THEN WE ALSO ARE LOOKING AT
PROVIDING GRANTS TO LOCAL EDUCATION AGENCIES OR LOCALITIES TO DO MENTAL HEALTH
FIRST AID AT THE LOCAL LEVEL. FOR ADULTS AS WELL AS -- FOR TEACHERS AS
WELL AS OTHER ADULTS AND ORGANIZATIONS THAT WORK WITH
YOUNG PEOPLE.
TERRIFIC. THANK YOU PAM AND KANA.
YOU'RE WELCOME. I'M PROBABLY GOING TO STEP
INTO AN AREA THAT I PROBABLY SHOULDN'T, BUT I WILL ANYWAY.
FOR 2015 SOME PIECE OF THAT MAY CHANGE, MENTAL HEALTH FIRST AID
IS A PROGRAM WHERE YOU CAN GET PEOPLE TRAINED,
AND THEN THEY CAN TRAIN OTHER PEOPLE. SO, PORTIONS OF THAT, OR
HOW THAT PLAYS OUT IN 2015 MAY EVOLVE.
SO WATCH FOR THAT AS WELL. SO, WATCH FOR THE 14 STUFF COMING OUT
THAT'S VERY SPECIFIC TO THE PLAN THAT THE PRESIDENT PROPOSED AND
WE ARE IMPLEMENTING FOR 14. THE GRANTS FOR THOSE SHOULD BE OUT AND
POSTED IN THE NEXT TWO MONTHS AND THEN WATCH FOR 15 BECAUSE IT
MAY EVOLVE OVER TIME. SO THERE MAYBE OTHER
OPPORTUNITIES AS WE GO.
THANKS.
OKAY. OPERATOR, MORE?
A COUPLE MORE. OUR NEXT QUESTION COMES FROM LEE ANN GRASIS.
HELLO. YES. SO I AM A COMMUNITY COORDINATOR OF A COALITION
FUNDED UNDER THE SPF DOLLARS FROM WASHINGTON STATE.
WE HAVE DEVELOPED OUR STRATEGIES IN OUR SMALL, RURAL COMMUNITY
OF FORKS, AND WANTED TO INCLUDE BULLYING PREVENTION AND SUICIDE PREVENTION.
AND I KNOW IT'S ALIGNED WITH SOME OF YOUR TOP PRIORITIES.
BUT ALTHOUGH THAT MONEY IS SPECIFIC FOR SUBSTANCE ABUSE REDUCTION,
WE ARE NOT ALLOWED TO PUT IT IN OUR STRATEGIC PLAN.
IS THERE A WAY THAT WE CAN WORK AROUND THAT AND GET BULLYING PREVENTION
AND SUICIDE PREVENTION AS PART OF THAT?
THERE ISN'T A WAY TO DO THAT
WITH YOUR SPF DOLLARS BECAUSE YOUR STRATEGIC PREVENTION
FRAMEWORK PARTNERSHIP FOR SUCCESS DOLLARS ARE SPECIFICALLY FOR
SUBSTANCE ABUSE PREVENTION.
BUT WHAT WE ARE DOING IN 15 IS THE BUILDING BEHAVIORAL HEALTH
COALITIONS PROGRAM WHICH WILL OFFER MENTAL HEALTH FUNDING AS
WELL AS SUBSTANCE ABUSE FUNDING TO ALLOW COMMUNITIES TO LOOK AT
SOME OF THE SHARED RISK FACTORS OR FOR DFC GRANTS, FOR EXAMPLE, TO
APPLY FOR MENTAL HEALTH FUNDING TO DO EXACTLY WHAT YOU JUST DESCRIBED.
OKAY. THANK YOU. WE SEE THE LINK WITH SUBSTANCE ABUSE AND SUICIDE
WHEN IT COMES TO BULLYING.
SO, THANK YOU. I APPRECIATE YOUR TIME.
I APPRECIATE YOUR COMMENT, TOO.
WE -- ACTUALLY IN OUR PREVENTION
INITIATIVE, WHICH IS BEING LED BY FRAN HARDING, WHO'S OUR SUBSTANCE ABUSE
PREVENTION CENTER DIRECTOR, BUT SHE'S LEADING OUR PREVENTION EFFORTS
AGENCY WIDE. SHE AND -- WITH HELP FROM PAOLO DEL VECCHIO,
WHO'S HEAD OF OUR CENTER FOR MENTAL HEALTH SERVICES, ARE TRYING LOOK AT THINGS LIKE WHAT'S THE
RELATIONSHIP BETWEEN SUICIDE AND SUBSTANCE ABUSE, WHAT IS THE
DATA TELL US. WE KNOW THAT FRANKLY ABOUT CLOSE TO A THIRD
OF PEOPLE WHO DIE BY SUICIDE HAVE BLOOD/ALCOHOL LEVELS FOR
ALCOHOL THAT ARE HIGHER THAN THE LEGAL LIMITS.
WE HAVE A LITTLE BIT INFORMATION ABOUT THAT ON THE SUBSTANCE
ABUSE SIDE BUT NOT AS MUCH AS WE LIKE.
BECAUSE NOT EVERY ONE WHO DIES BY SUICIDE ENDS UP WITH A
TOXICOLOGY SCREEN OR AN AUTOPSY, SO, WE'RE LOOK AT THOSE
RELATIONSHIPS AND, CERTAINLY, IN THE BEHAVIORAL HEALTH TRIBAL GRANTS
THERE IS A RECOGNITION BY BOTH US AND BY CONGRESS AND, FRANKLY, THE
TRIBES TOLD US THIS, THAT SUBSTANCE ABUSE AND SUICIDE
TOGETHER ARE ONE OF THEIR BIGGEST ISSUES THEY WANTED TO ADDRESS
TOGETHER. SO, I THINK WE DO SEE SOME OF THOSE RELATIONSHIPS,
AND ABSOLUTELY WANT TO MAKE THAT POSSIBLE FOR THOSE
OF YOU OUT THERE DOING IT AND YET AT THE SAME TIME WE WANT TO STAY TRUE
TO THE WAY CONGRESS APPROPRIATED THE DOLLARS FOR
PARTICULAR THINGS. OKAY.
I THINK, OPERATOR, YOU TOLD US THERE WAS ANOTHER QUESTION?
YES.
OUR NEXT QUESTION COMES FROM CATHY HOTELING.
YES. I HAD A FOLLOW-UP COMMENT AND -- TWO COMMENTS
REGARDING THE CENTER FOR EXCELLENCE - THE FASD.
I APPRECIATE THE NEED FOR PREVENTION BUT, ALSO, AS A PARENT OF A
DAUGHTER WHO IS ALMOST 20, I'M PAINFULLY AWARE OF THE GROWING NEED
FOR SERVICES, ESPECIALLY TRANSITIONAL SERVICES AND HOUSING
FOR FOLKS LIKE HER AS MORE AND MORE INDIVIDUALS ARE DIAGNOSED
WITH FASD WITH A GROWING AWARENESS OF THAT.
ALSO YOU JUST SPOKE TO THE LINK BETWEEN SUICIDE AND ALCOHOL ABUSE
AND I WOULD SUGGEST THAT THERE IS A THREE-WAY LINK AND THAT IS
SUICIDE, ALCOHOL ABUSE, AND FASD WITH THE PERSON ATTEMPTING OR
COMPLETING SUICIDE, NOT ONLY HAVING AN ALCOHOL PROBLEM BUT ALSO HAVING A DIAGNOSEABLE
FETAL ALCOHOL SPECTRUM DISORDER.
THANK YOU FOR THAT COMMENT. WE ARE
ALSO DOING ADDITIONAL WORK THAT ISN'T SPECIFIC TO FASD, SO LET
ME NOT SUGGEST THAT IT IS BUT IN WORKING WITH ADMINISTRATION ON
COMMUNITY LIVING AROUND TRYING
TO MAKE SURE THAT THEIR WORK AROUND COMMUNITY EFFORTS OR COMMUNITY
DISABILITY EFFORTS INCLUDES PEOPLE WITH BEHAVIORAL HEALTH ISSUES.
SO TO THE EXTENT THAT HOUSING ISSUES, RECOVERY SUPPORTS,
COMMUNITY SUPPORTS, THEY HAVE BEEN, ACTUALLY, EXCELLENT AT
INCORPORATING US AND BRINGING US IN AND PULLING US INTO
CONVERSATIONS IN THE WHITE HOUSE AND IN OTHER PLACES ABOUT SOME OF
THOSE ISSUES. SO, WE APPRECIATE THE COMMENT AND
WE WILL CONTINUE TO TRY TO MAKE THAT EFFORT.
IF I COULD JUST ADD ONE THING.
OFTEN INDIVIDUALS WITH FASD DO NOT
FIT IN TO YOUR TYPICAL IDD DIAGNOSIS OR WITH THE MENTAL
HEALTH DIAGNOSIS IN TERMS OF LIVING SITUATIONS. REALLY NEITHER
SEEMS TO REALLY FIT THEM VERY WELL AND COULD BE DETRIMENTAL
FOR DIFFERENT REASONS. THAT'S WHERE SOME OF MY INTERESTS LIE.
THANK YOU VERY MUCH FOR TAKING MY CALL.
YEAH. YOU'RE ABSOLUTELY RIGHT. AND WE HAVE SOME OTHER DISABILITY GROUPS
OR OTHER GROUPS THAT HAVE ISSUES, LET ME NOT EVEN CALL IT DISABILITY
GROUP BUT OTHER GROUPS THAT HAVE CONDITIONS OR ISSUES
WHERE THEY HAVE THOSE NEEDS BUT DON'T FIT THE NEAT LITTLE
CONVERSATIONS OR NEAT BOXES THAT IT TAKES TO GET ACCESS
TO CERTAIN THINGS. SO, IT'S A BIGGER ISSUE. AND
THE ADMINISTRATION FOR COMMUNITY LIVING I THINK UNDERSTANDS THAT AND IS
TRYING TO EXPAND SOME OF THAT CONSTRUCT AND CONCEPT AND, FRANKLY,
THERE'S SOME ADVOCACY IN THE
WHITE HOUSE FOR THAT ISSUE AS WELL.
ALRIGHT, OPERATOR, DO YOU HAVE ANYBODY ELSE
ON THE PHONE WITH A QUESTION?
NO. AT THIS TIME, THERE ARE NO QUESTIONS IN THE QUEUE.
OKAY. ANYBODY ELSE IN THE ROOM? ALL RIGHT.
WELL YOU ARE THE QUIETEST BEHAVIORAL HEALTH STAKEHOLDER
GROUP THAT WE HAVE HAD IN A LONG TIME BUT I'M GOING TO ASSUME
IT'S BECAUSE THERE'S A LOT GOING ON AND YOU DON'T HAVE ALL THE
MATERIAL IN FRONT OF YOU YET. WHEN YOU DO, IF THERE ARE QUESTIONS
OR COMMENTS, I THINK MOST OF YOU KNOW HOW TO REACH US
BUT WE ARE AVAILABLE AND CAN TRY TO HELP YOU WORK THROUGH THE BUDGET.
SO APPRECIATE ALL OF YOUR EFFORTS
AND ALL OF YOUR ATTENTION
AND THANK YOU FOR BEING HERE.
OPERATOR, THANKS TO EVERYONE ON THE PHONE.
APPRECIATE ALL OF YOU, AS WELL.