Do you CARA? A Deep Dive Into the Comprehensive Addiction and Recovery Act Joel White, President

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1 Do you CARA? A Deep Dive Into the Comprehensive Addiction and Recovery Act Joel White, President

2 AGENDA By The Numbers PDMPs in CARA Action Since Enactment Questions? 02 CARA Basics 04 What Else is Included? 06 Next Steps

3 By The Numbers

4 By The Numbers In 2015, the five states with the highest rates of death due to drug overdose were: West Virginia (41.5 per 100,000) New Hampshire (34.3 per 100,000) Kentucky (29.9 per 100,000) Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000). Opioids were involved in 33,091 deaths in That equates over 90 deaths per day in Overdose deaths have quadrupled since Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.

5 CARA Basics Culmination of over three years of work by bipartisan sponsors Passed the Senate, 92-2 and the House, With President Obama s signature, CARA became P.L on July 22, 2016 Includes: Prevention Education Treatment Law Enforcement Recovery State Incentives Authorizing funding language For PDMPs, meant to address core challenges: Interoperability Information in workflow and Real time information

6 PDMPs in CARA Legislative Language Section 109: Reauthorization of NASPER for controlled substances monitoring systems Section 201: Comprehensive Opioid Abuse Grant Program including developing, implementing, or expanding a PDMP Section 601: State Demonstration Grants for Comprehensive Opioid Abuse Response including PDMPs Section 911: Improvement of Opioid Safety Measure by VA Goals Provide resources to states to establish, maintain and improve PDMPs Promote data sharing/interoperability Encourage more timely data and regularly updated PDMPs Legislati ve Languag e Goals Authoriz ing Funds Authorizing Funds Section 109: Authorizes $10 million annually for FY Section 201: Authorizes $103 million annually for FY Section 601: Authorizes $5 million annually for FY for Comprehensive Opioid Abuse Response Programs

7 PDMPs in CARA Establish, Maintain and Improve PDMPs Secretary charged with awarding state grants for Comprehensive Opioid Abuse Response May include: establishing, maintaining, or improving a comprehensive prescription drug monitoring program to track dispensing of schedule II, III, or IV controlled substances Provides support for local governments to establish a PDMP where a state PDMP does not exist Example: St. Louis, Missouri

8 PDMPs in CARA Promote data sharing/interoperability Under NASPER, The State shall report on interoperability Specifically identifies data sharing as a qualified activity for grant funding Establishes data sharing as a Priority Consideration for the awarding of grants ensures the capability of data sharing with other States, where applicable, such as by making data available to a prescription monitoring hub

9 PDMPs in CARA Encourage more timely data and regularly updated PDMPs Included as a Priority Consideration for the awarding for the awarding of grants ensures that data recorded in the prescription drug monitoring program database of the State are regularly updated, to the extent possible Included in NASPER: in order to ensure that health care providers have access to the accurate, timely prescription history information that they may use as a tool for the early identification of patients at risk for addiction in order to initiate appropriate medical interventions and avert the tragic personal, family, and community consequences of untreated addiction

10 What Else is Included?: Different Pieces to the Puzzle Prevention 1 Pain Management Task Force, NIH Research, Opioid Advisory Committee Education Awareness Campaigns, Informational Materials and Resources Treatment & Recovery MAT, Medication Access, Evidence-Based Demonstration Projects Law Enforcement First Responder Training, Prescription Take Backs, Treatment Courts Miscellaneous Partial Fills, Opioid Safety Improvements, GAO Reports (NAS)

11 July 22, 2016 Action Since Enactment Comprehensive Addiction and Recovery Act (CARA) becomes law November 16, 2016 SAMHSA implements CARA provision allowing nurse practitioners and physician assistants to prescribe medication-assisted treatment December 20, 2016 Department of Justice begins accepting applications for drug court/recovery support services January 25, 2017 Department of Justice begins accepting applications for Comprehensive Opioid Abuse Site-Based Grant program September 29, 2016 Continuing resolution provides $37 million in start-up funding for CARA December 10, 2016 Continuing resolution funds 21st Century Cures Act; provides $500 million in opioid-related appropriations January 17, 2017 SAMHSA begins accepting applications for FY 2017 Recovery Community Service Program Statewide Network Grants

12 Next Steps & Considerations Continued. Funding. Analysis Optimization of Programs Program Implementation & Rulemaking Where Do We Go From Here?

13 Questions?

14 YOUR CONTACTS Joel White President (202) Jennifer Pielsticker Director, Government Affairs (202) Horizon Government Affairs th Street, NW, Suite 700 Washington, D.C