Health Reform: Is Your Community

Ready for 2014?

Frances M. Harding, DirectorSAMHSA’s Center for Substance Abuse Prevention

2011 School for Prevention LeadershipWashington, DC • October 20, 2011

Role of Prevention in Substance Use and Mental Health Disorders

Behavioral health is essential for health

Addiction as a complex and chronic disease

Recovery as a process rather than an event

Ongoing contact and support to complement treatment

Natural supports such as friends, peers, and family

Evidence-based, multi-component prevention programs

Selected National Prevention Strategy Actions

Communities can:• Develop comprehensive prevention systems.• Establish linkages.• Conduct education, outreach, and training.

Health care systems, insurers, and clinicians can:• ID and screen patients for excessive drinking.• ID, track, and prevent inappropriate patterns of prescribing.• Develop and adopt evidence-based guidelines for prescribing

opiates.

Health Reform

More people will have insurance coverage. Theme: Prevent diseases, promote wellness Integrated care: New thinking—recovery, wellness, role of

peers, response to whole health needs New opportunities for behavioral health:

• Parity: Mental Health Parity and Addiction Equality Act and within Affordable Care Act

• Tribal Law and Order Act• National Action Alliance for Suicide Prevention

Medicare and Medicaid changes

National Prevention StrategyPriorities

• Tobacco Free Living• Preventing Drug Abuse and

Excessive Alcohol Use• Healthy Eating• Active Living• Mental and Emotional Well-

being• Reproductive and Sexual

Health• Injury and Violence Free Living

Source: National Vital Statistics Report, CDC, 2008

5

Health Reform: A Defining Moment for Prevention

Emerging opportunities, growing complexity:•Multiple client pathways—primary care, behavioral health, schools, jails/prisons, child welfare•Service coverage issues—third-party payment and Block Grant funding•Behavioral health integration in health homes•Incentives for mutual integration of behavioral health and primary health care activities •Definition of prevention services and service models•Dissemination of evidence-based practices•Behavioral workforce training and support

Challenges— Community, State, and National Leadership

Individuals Served by SSAs

Uninsured61%

Insured39%

Individuals Served by MHAs

Insured61%

Uninsured39%

90–95 percent will have the opportunity to be covered by Medicaid or through insurance exchanges.

New Roles—Community Leadership

Ensure your community’s voice is heard in the design and execution of health reform.

Develop or enhance strategic partnerships with non-traditional partners for prevention.

Work with States to serve more than traditional Block Grant populations.

Focus on recovery support—help people get and stay well.

SAMHSA’s PRINCIPLES

www.samhsa.gov

Collaboration is the key!

www.samhsa.govwww.samhsa.gov/about/cbhsq.aspxwww.samhsa.gov/about/cmhs.aspxwww.samhsa.gov/about/csap.aspxwww.samhsa.gov/about/csat.aspx