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    Document Summary
    - Report Published -

    Senate Document No. 5
    PUBLICATION YEAR 2010

    Document Title
    Executive Summary of the Joint Subcommittee to Study Strategies and Models of Substance Abuse Treatment and Prevention (SJR 318, 2009)

    Author
    Division of Legislative Services, Joint Subcommittee to Study Strategies and Models for Substance Abuse Prevention and Treatment

    Enabling Authority
    SJR 318 (Regular Session, 2009)

    Executive Summary
    The Joint Subcommittee Studying Strategies and Models for the Treatment and Prevention of Substance Abuse in the Commonwealth pursuant to SJR 318 met four times during the 2009 interim to continue to (i) identify and characterize the nature of substance abuse in the Commonwealth; (ii) identify current state policies and programs targeting substance abuse prevention and treatment; (iii) examine the cost of such policies and programs to the Commonwealth; (iv) identify and examine policies and prevention programs from other leading states in the field of substance abuse and prevention; and (v) benchmark the Commonwealth's substance abuse prevention and treatment programs and policies against those of the leading states. To carryout this work, the joint subcommittee established three work groups - the Substance Abuse Prevention Work Group, the Substance Abuse Treatment and Recovery Work Group, and the Prescription Drug Work Group. Each work group met three times during the interim to identify issues and develop recommendations for presentation to the full joint subcommittee.

    The first meeting of the full joint subcommittee was held on Wednesday, August 23, 2009. At this meeting, the joint subcommittee received information on the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 from Ms. Carol McDaid; recent economic studies of the economic impact of substance abuse and substance abuse treatment activities from Mr. Rick Harwood, Director of Research and Program Applications with the National Association of State Alcohol and Drug Abuse Directors; and the impact of substance use disorders in Virginia, treatment efficacy and capacity, the need for effective treatment strategies, incorporation of evidence-based practices in Virginia's treatment and prevention systems, funding, services, costs, and funding options for prevention and treatment services in the Commonwealth from Ms. Jennifer Faison, representing the Virginia Association of Community Services Boards. Following the scheduled presentations, the joint subcommittee discussed draft work plans developed by the work groups.

    The second meeting of the full joint subcommittee was held on Wednesday, September 23, 2009. At this meeting, the joint subcommittee received additional information on the costs of substance abuse in the Commonwealth from Dr. Ted Miller, Ph.D., Principal Research Associate, Pacific Institute for Research and Evaluation; information on community coalitions and environmental strategies for the prevention of substance abuse from Mr. Rick McKeel, Executive Director, Community Coalitions of Virginia; and an update on the activities of the work groups.

    The third meeting of the full joint subcommittee was held on Tuesday, October 21, 2009. At this meeting, the joint subcommittee received a report on the need for a data collection and a youth survey developed by the Youth Survey Work Group for the Substance Abuse Prevention Work Group; information about outcomes of the federal grant funded SAARA Center Recovery Program, presented by Dr. James C. May, Ph.D., Project Evaluator for the Recovery Community Services Program Grant Program with the SAARA Center and Director of Substance Abuse Services for the Richmond Behavioral Health Authority; information about outcomes of grant funded programs linking community based recovery organizations with community services boards in the Commonwealth presented by Mr. Ken Batten, Director of the Office of Substance Abuse Services at the Department of Behavioral Health and Developmental Services; a review of the processes, procedures, and data evaluated by the Commission to estimate the costs of substance abuse in Virginia presented by Ms. Nathalie Molliet-Ribet, Project Leader, of the Joint Legislative Audit and Review Commission; and information about Project REMOTE and the Return to Work Program presented by Ms. Karen Smith, Coordinator of Project REMOTE with the Cumberland Mountain Community Services Board and Mellie Randall with the Office of Substance Abuse Services of the Department of Behavioral Health and Developmental Services. Following these presentations, the joint subcommittee briefly discussed the draft recommendations presented to the joint subcommittee by the work groups, deciding to continue discussion of the recommendations to the fourth meeting of the joint subcommittee.

    The Joint Subcommittee Studying Strategies and Models for Substance Abuse Prevention and Treatment met on Monday November 30, 2009 at the General Assembly Building in Richmond. At the meeting, the members of the Joint Subcommittee discussed and approved the following findings:

    * Funding should be made available to support a full range of substance abuse treatment and prevention services in the Commonwealth, including services offered and coordinated by the Department of Behavioral Health and Developmental Services, community services boards, public and private agencies and organizations, and anonymous recovery community organizations.

    * Localities should engage in a process of comprehensive, coordinated planning for substance abuse treatment and prevention services, which should focus on identification and mitigation of all risk factors that contribute to substance abuse across all age groups, be designed to address needs and risks identified through a community needs assessment, and include input from stakeholders.

    * Jail- and community-based recovery and reentry programs for offenders should be developed and funded in the Commonwealth, to reduce rates of recidivism and bring about fiscal savings for the Commonwealth.

    * Drug courts should be established in all localities throughout the Commonwealth, and should be funded by the General Assembly.

    * Community services boards should be required to make information about substance available and appropriate substance abuse services, including medication assisted treatment, available to all persons in need of substance abuse treatment services.

    * Funding should be made available to allow all community services boards to provide medication assisted treatment and required wrap-around and support services available to all persons for whom such treatment is appropriate.

    * Community services boards should be required to establish and maintain access to a prescriber authorized to provide medication assisted treatment to ensure that all persons for whom such treatment is appropriate have access to treatment, once funding for medication assisted treatment has been provided.

    * The work of the Department of Health Professions to initiate and establish interoperability between Virginia's Prescription Monitoring Program and other states' programs should be recognized, and the Department should be urged to continue efforts to pursue interoperability.

    * The importance of the Prescription Monitoring Program as a tool for the identification and mitigation of substance abuse problems in the Commonwealth should be recognized, and the Department of Health Professions should be urged to take steps to ensure that prescribers and pharmacists are aware of the Program and its importance in combating substance abuse in the Commonwealth.

    * Educational opportunities on the topics of pain management, prescription drug abuse, and substance abuse treatment and prevention generally should be made available to prescribers and pharmacists.

    * The Bureau of Insurance should take steps to educate service providers, insurance providers, consumers, and members of the public about the impact of federal substance abuse parity laws, and prepare advance guidance for treatment providers, counselors, and state managed-care contractors regarding the effect of these laws.

    * A resolution should be introduced asking the Bureau of Insurance to collect and make available to the Joint Subcommittee (if continued) or the General Assembly information regarding the impact of federal addiction benefit parity laws on state insurance laws and practices, and any complaints of discriminatory or inappropriate practices related to these laws.

    * A letter should be drafted and sent to the Department of Behavioral Health and Developmental Services and community services board throughout the Commonwealth urging the Department and the community services boards to partner with recovery organizations in the provision of substance abuse services.

    * A letter should be drafted to the Virginia Congressional Delegation urging members of the delegation to take action to eliminate or increase the bed limit imposed on residential substance abuse service providers for purposes of Medicaid reimbursement eligibility.

    * A resolution should be introduced, requesting the Department of Health Professions to collect and make available to the Joint Subcommittee (if continued) and the General Assembly information on use of the Prescription Monitoring Program, and the work of the Department of Health Professions to identify and address practices

    The Joint Subcommittee also accepted a recommendation that the Joint Subcommittee Studying Strategies and Models for Substance Abuse Prevention and Treatment should be continued for an additional year, through the 2010 interim, to allow additional time for investigation and development of recommendations. The Joint Subcommittee determined that during the 2010 interim, the Joint Subcommittee and its workgroups should work with stakeholders to:

    * Develop a comprehensive list of priorities for improvement of substance abuse prevention and treatment services in the Commonwealth.

    * Continue to explore options for funding a full range of treatment services including services for adolescents, pregnant and parenting women, and the elderly.

    * Explore options for the development and implementation of a voucher model for delivery of substance abuse services.

    * Explore options for developing a mechanism for reimbursing recovery organizations.

    * Coordinate with the Department of Education to identify barriers to implementation of a random, anonymous, statewide, school-based survey to collect information about substance use and abuse trends, and to facilitate implementation of such a study.

    * Explore options for development and funding of jail- and community-based recovery and reentry programs for offenders, in order to reduce rates of recidivism and bring about fiscal savings for the Commonwealth.

    * Receive and review information about the defunded SABRE program to identify effective elements of that program that should be re-implemented in the Commonwealth.

    * Explore options for developing a mechanism to ensure that all necessary wrap-around and support services are provided by physicians providing medication assisted substance abuse treatment.

    * Explore options to facilitate the sharing of information contained in the Prescription Monitoring Program amongst pharmacists and prescribers, in order to identify and mitigate substance abuse problems.

    * Explore options to increase access to the Prescription Monitoring Program in pharmacies throughout the Commonwealth, and to increase use of the Program.

    * Explore options for increasing availability of educational opportunities focused on the topics of pain management, prescription drug abuse, and substance abuse treatment and prevention generally to prescribers and pharmacists.

    * Explore options for and costs associated with establishing student assistance professional positions in schools throughout the Commonwealth, including development of training and certification requirements for student assistance professionals and requirements for student assistance programs.

    * Explore options for continuing the work undertaken by the Joint Subcommittee, through a permanent agency or entity, in the future.