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More Addiction Patients Can Take Methadone at Home, But Some States Lag Behind

Despite methadone’s effectiveness, a labyrinth of state and federal rules — meant to guard against its misuse — keeps it inaccessible to many people who desperately need it.

Yet addiction treatment in the United States is poised for change. This year, the federal Substance Abuse and Mental Health Services Administration, known as SAMHSA, made permanent a set of pandemic-era rules that loosened several restrictions, including those on take-home doses of methadone. It’s a move that a broad consensus of academics, advocates and providers says will improve treatment access and success rates. Having the flexibility to take medication at home can mean patients can get to work or get their kids to school on time. They can deal with family emergencies and unexpected travel. And they avoid the stigma of waiting in line at a clinic. In theory, the new federal rules make more take-home methadone doses available to a wider subset of patients. But what’s less clear is how the rules will trickle down to states. There’s concern states that didn’t preserve the relaxed regulations they had during the pandemic might be slow to adopt them now. “A number of states will have to revise their regulations if they’re going to be in alignment with what SAMHSA has released,” Mark Parrino, founder and president of the American Association for the Treatment of Opioid Dependence Inc., a national trade group that supports the new federal regulations. “What could delay implementation would be the state regulators.”

Later this month at his group’s annual conference, SAMHSA will convene a closed-door meeting of regulators from all 50 states to discuss the new federal rules and how states might bring their own standards into compliance, Parrino said.

It’s all happening as the opioid crisis, driven by rising fentanyl overdoses, has prompted a chorus of physicians and advocates to call for loosening methadone restrictions even further — a move that leaders at many opioid treatment programs oppose.

 

Key House Committee Advances 2-Year Telehealth Extension Bill

The House Ways and Means Committee passed the Preserving Telehealth, Hospital, and Ambulance Access Act by a vote of 41-0 after lawmakers raised concerns about the need for more guardrails and hospice recertification.

The move sets up the legislation for passage by the full House later this year. This extension will maintain many of the current Medicare telehealth flexibilities through the end of calendar year 2026.

"While we prefer Medicare telehealth flexibilities be made permanent, we understand the dynamics and applaud the Committee for a two-year extension of many of the critical flexibilities without arbitrary and unnecessary guardrails such as in-person requirements,” said Kyle Zebley, senior vice president, public policy, at the ATA and executive director of ATA Action. “This is a clear sign that our bipartisan telehealth supporters are at work, determined not to leave the American people without access to safe, effective, quality healthcare where and when they need it. But this is not over yet. There will be additional markups and other committees need to weigh in, as we continue to push for telehealth permanency.”

 

Peer Support Specialists Drive Value as Behavioral Health Providers Embrace New Workforce

Peer support services are rapidly gaining mainstream acceptance thanks to recent federal initiatives, new reimbursement opportunities and the fallout from the opioid crisis.

Peers have a unique ability to drive sustained patient engagement, industry insiders said at Behavioral Health Business’ VALUE conference. This makes the peer support model cost-effective for providers looking to shift away from fee-for-service models and toward value-based care.

Peer support specialists are people with lived experience of behavioral health conditions who are now in recovery and can offer support to people currently grappling with similar conditions. They are not clinically trained and do not offer diagnoses or treatments.

Industry leaders observe that Peer models are gathering momentum nationwide, especially over the last five years, coupled with certification processes now existing in every state and are Medicaid reimbursable in 35. The Substance Abuse and Mental Health Services Administration (SAMHSA) considers peer support to be a best practice.

 

Ohio School Safety Summit Registration Now Open

The Ohio School Safety Center is pleased to announce that registration for the 2024 Ohio School Safety Summit July 31-Aug. 1, 2024, at the Greater Columbus Convention Center is now available.
This summit will provide an opportunity to foster cross-discipline conversations regarding student safety and wellness. Conference presentations and training opportunities will include experts in each of the following critical areas: physical security, emergency management, mental health, school climate, suicide prevention, critical incident response, cyber safety, transportation, and threat assessment.
This event is free and open to the public. Additional details like the speaker list and agenda, hotel blocks, and parking, are available on the summit website.
 

Ohio Observes May as Mental Health Awareness Month

In recognition of May as Mental Health Awareness Month, the Ohio Department of Mental Health and Addiction Services (OhioMHAS) is encouraging increased public awareness and usage of the 988 Suicide and Crisis Lifeline.

“We want all Ohioans to know they are not alone; there is always hope, and help is just a phone call, text, or chat conversation away,” said OhioMHAS Director LeeAnne Cornyn. “Just like 911 is synonymous with help for a police, fire, or medical emergency, our goal is to promote 988 as the go-to resource for immediate support during an emotional crisis.”  

Beginning in May, OhioMHAS is launching a public awareness campaign that includes radio, television, social media, and out-of-home messages in communities throughout Ohio, with a goal of making more people familiar with the potentially lifesaving resource.

Launched in July 2022, the easy-to-remember, three-digit number provides 24/7, free, and confidential support to anyone experiencing thoughts of suicide, a mental health or substance use crisis, or other severe emotional distress.

Ohio 988 is a direct connection to compassionate, accessible care and support for anyone experiencing mental health related distress, and functions as a front door to the community crisis system Ohio has been working hard to implement under Governor Mike DeWine’s leadership. Use of the service has increased as awareness has grown organically over time. In 2023, counselors at Ohio’s 19 call centers responded to nearly 163,000 contacts, which includes calls, texts, and chats.

Last fall, OhioMHAS led a messaging campaign that focused on increasing awareness through various social media platforms. While those efforts helped to boost awareness -- Ohio’s call centers are currently averaging more than 13,400 contacts per month -- state officials expect to see that number expand as awareness of 988 increases. According to a baseline survey, slightly more than one-third (36%) of Ohioans expressed familiarity with 988. While that number more than doubles the national rate of 17%, state officials hope this year’s campaign helps cement 988 as a valuable and trusted resource.

“No one plans a crisis in their life any more than planning a heart attack. The goal of the campaign is to increase awareness of the number to call when a crisis occurs,” stated Ohio’s 988 Administrator Doug Jackson. “988 is simple to remember and is a resource for Ohioans that not only helps people during tough times…it saves lives.”

Learn more about Ohio 988 and access a free, customizable toolkit at mha.ohio.gov/988.

 
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