SJR 318: Joint Subcommittee Studying Strategies & Models for the Treatment & Prevention of Substance Abuse in the Commonwealth

August 26, 2009

The first meeting of the interim was held at the General Assembly Building in Richmond.

Presentations

Carol McDaid, Faces and Voices of Recovery
Ms. McDaid spoke on the implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008. Ms. McDaid explained that the Act mandates nondiscriminatory addiction and mental health coverage under employer-based health insurance plans, SCHIP, and Medicaid. While the Act does not require that all health insurance plans include additional mental health benefits, the Act will require that plans offering addiction and mental health coverage must do so in a nondiscriminatory manner so that co-pays, deductibles, day and visit limits, and annual and lifetime caps must be the same as those for medical and surgical benefits. The Act establishes a basic requirement for coverage that will preempt weaker state laws but will not interfere with state laws that require more comprehensive coverage.

Implementation of the Act can be expected to provide several benefits to states including:

• Reduced cost shifting from the private to the public sector.
• Increased access to treatment services.
• Medicalization rather than criminalization of behavioral health conditions.
• Reduced collateral costs of untreated addiction.
• Increased private investment and innovation in treatment services.

Ms. McDaid noted that draft federal regulations are currently circulating amongst impacted federal agencies, and that final regulations are expected by October 3, 2009. The requirements of the Act will become effective on January 1, 2010, regardless of whether final regulations have been promulgated. To prepare for implementation, and to ensure that the state is able to take full advantage of the benefits offered by Act, Ms. McDaid suggested that the state should:

• Prepare a detailed analysis of how Virginia's law and the federal parity law differ.
• Coordinate implementation planning with the Bureau of Insurance, the Department of Behavioral Health and Developmental Services, the Department of Medical Assistance Services, and other impacted agencies.
• Provide advance guidance to treatment providers, counselors, and state managed care contractors on what is expected of them under the new law.
• Inform consumers of their new rights and benefits based on the proposed state implementation.

Henrick Harwood, National Assoc. of State Alcohol and Drug Abuse Directors
Mr. Harwood discussed recent studies of the economic impact of substance abuse and substance abuse treatment activities. Mr. Harwood noted that costs associated with alcohol may run as high as $243 billion nationally and $6 billion in Virginia, and that costs associated with illicit drug abuse may run as high as $181 billion nationally and $3.5 billion in Virginia.

Mr. Harwood also provided information on cost offsets and the economic benefits of treatment and prevention activities.

Jennifer Faison, Virginia Association of Community Services Boards
Ms. Faison spoke on 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 in the Commonwealth as well as information about prevention activities. She noted significant waiting periods for services in the Commonwealth (an average of 25.4 days for treatment services). Ms. Faison also described the need to shift from an acute care model of intervention and services to a chronic disease/recovery management model. She stated that successful prevention and treatment interventions are less costly to the Commonwealth than the potential negative effects of failure to provide prevention and treatment interventions.

Ms. Faison suggested increasing funding by establishing a Substance Abuse Treatment and Prevention Fund to be funded by a percentage of net profits realized by the Alcoholic Beverage Control Board, or through allocation of revenue realized by new ABC stores and Sunday openings of ABC stores for prevention and treatment services. Ms. Faison also suggested increasing user fees on alcohol products and allocating these funds for prevention and treatment activities.

Discussion of Work Group Plans

The joint subcommittee discussed draft work plans developed by the Treatment and Recovery Model, Prevention, and Prescription Drug Abuse Work Groups. The joint subcommittee approved these work plans with limited changes. The work groups will continue their work as described in these plans, and will report to the full joint subcommittee at the next meeting of the full joint subcommittee.

Next Meeting

The next meeting dates will be posted on the joint subcommittee’s website and the General Assembly calendar as soon as information is available.

Chairman:
The Hon. Emmett W. Hanger, Jr.

For information, contact:
Sarah Stanton, Robie Ingram, DLS Staff