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Shaping Our Future:
Updates and Opportunities for the
             Field
  Gabrielle de la Guéronnière Legal Action
                   Center
       2011 NCADD Advocacy Day
             September 8, 2011
Legal Action Center
 Advocacy for people with addiction
 histories, criminal records, and HIV/AIDS
  Thirty-five year history of policy analysis and
   advocacy
  Federal policy work
    Advocating for the expansion of services and
     resources for people with addiction
     histories, criminal records, and HIV/AIDS
    Fighting discrimination: eliminating legal and
     policy barriers in place for people with addiction
     histories and criminal records
Parity and Health Care Reform:
A Time of Tremendous Opportunity
 Greater understanding of addiction as
  preventable, treatable chronic health condition
 Federal parity statute and regulations (MHPAEA) are
  now in effect for all covered plans
 Dramatic expansion of coverage of addiction
  treatment
    SUD and MH benefits must be included in the
     ACA’s essential health benefit package; these
     benefits must be offered:
      By private insurance plans participating in the
       health insurance exchanges
        Individual and small group plans, States can
         allow large employers to participate in the
         exchanges in 2017
      For newly-eligible Medicaid enrollees, including
Parity and Health Care Reform: A Time
of Tremendous Opportunity (cont’d)
   All plans in the exchange must adhere to the
    provisions of the federal parity law
   SUD and MH benefits provided to the Medicaid
    expansion population also must comply with
    parity
     Building on the federal parity law:
      o SUD/MH benefits required and must be
        provided at parity
      o Extension to individual and small group
        plans
      o Requirement for SUD and MH benefits for
        the Medicaid expansion population
Parity and Health Care Reform: A Time
of Tremendous Opportunity (cont’d)
 Inclusion of addiction in integrated
  care initiatives
  Health homes and accountable care
   organizations
 Inclusion of substance use
  prevention in chronic disease
  prevention initiatives
 Identification of the addiction service
  workforce as part of the health
  workforce
Huge Opportunities But Miles to
Go…
  The success of these laws depends on
  decisions that will be made in the
  coming days, months and years
   Decisions in Washington and by state and
   local policy-makers around the country
  There is a critical need for our field
  to educate and advocate to ensure
  these laws are well implemented for
  the people we serve
ACA implementation:
Our Advocacy on Benefit Design
 Huge opportunity to expand coverage
  for and access to care
 SUD/MH benefits required by not
  defined in the ACA
 Key next steps in the process to define
  the SUD/MH essential health benefit:
   Institute of Medicine—report due by
    the end of the month
   Proposed regulations on the essential
    health benefit (possibly) released by
    HHS by the end of the year
   Various opportunities for public
    comment
ACA implementation:
Our Advocacy on Benefit Design (cont’d)
 Advocacy of the national SUD and MH groups:
  the Coalition for Whole Health
 Crafting a comprehensive SUD and MH benefit
 Coalition for Whole Health Essential Health
  Benefits Recommendations paper; continued
  need for broad organizational sign-on
    www.lac.org; National Health Care Reform link
 Using the paper with other education and
  advocacy tools with decision-makers in the
  Administration and to engage our allies in
  Congress
 Parallel advocacy process needed in
  the states
Our Advocacy on
Parity Implementation
 Interrelationship with ACA advocacy—opportunity for
  huge expansions in coverage by private insurance
 Continued challenges—fighting violations of both the
  letter and spirit of the law
 Advocating for additional guidance at the federal level
 Monitoring compliance and encouraging strong
  federal and state activity and response
   Gathering information about plan compliance; filing
    complaints for violations of the law; aggregating
    information and sharing with the regulators
   Templates and other resources by the Parity
    Implementation Coalition:
    www.mentalhealthparitywatch.org
 Engaging our champions
 Continued tremendous need for education
Protecting Safety Net Funding
 Recognition that ACA coverage provisions do not
  go into effect until 2014
 We don’t yet know which services will be included
  in the SUD essential health benefit
 Huge need for continued strong federal funding
  for prevention, treatment, recovery supports and
  research before the ACA is fully implemented and
  beyond
   During this interim period before expansion has
    occurred
   Through implementation of the ACA to cover the
    services not included and the people who remain
    uncovered or underinsured
Our Advocacy on Strong Safety Net
Funding
  Advocacy by the national drug and alcohol
  community
   Fighting for highest possible funding for
    SAMHSA and the continuum
   Huge need for a continued push from
    around the country with Congress and the
    Obama Administration; www.lac.org
   Need to ensure our system of care is
    strong now and beyond
Our Advocacy: Now More Important Than
Ever
  Continued outreach and education—
   within and outside of our field
  Connecting our work in Washington with
   implementation efforts around the
   country
  Speaking with one cohesive voice
  Finding the best ways to engage our
   champions
  Advocating for the strongest possible
   SUD benefit through the ACA
  Protecting safety net programming
  Monitoring implementation and
   informing our federal partners about
   successes and non-compliance
Gabrielle de la Guéronnière
     gdelagueronniere@lac-dc.org

202-544-5478 (phone) 202-544-5712 (fax)

            www.lac.org
         www.hirenetwork.org

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Gabrielledela gueronierre

  • 1. Shaping Our Future: Updates and Opportunities for the Field Gabrielle de la Guéronnière Legal Action Center 2011 NCADD Advocacy Day September 8, 2011
  • 2. Legal Action Center  Advocacy for people with addiction histories, criminal records, and HIV/AIDS  Thirty-five year history of policy analysis and advocacy  Federal policy work  Advocating for the expansion of services and resources for people with addiction histories, criminal records, and HIV/AIDS  Fighting discrimination: eliminating legal and policy barriers in place for people with addiction histories and criminal records
  • 3. Parity and Health Care Reform: A Time of Tremendous Opportunity  Greater understanding of addiction as preventable, treatable chronic health condition  Federal parity statute and regulations (MHPAEA) are now in effect for all covered plans  Dramatic expansion of coverage of addiction treatment  SUD and MH benefits must be included in the ACA’s essential health benefit package; these benefits must be offered:  By private insurance plans participating in the health insurance exchanges  Individual and small group plans, States can allow large employers to participate in the exchanges in 2017  For newly-eligible Medicaid enrollees, including
  • 4. Parity and Health Care Reform: A Time of Tremendous Opportunity (cont’d)  All plans in the exchange must adhere to the provisions of the federal parity law  SUD and MH benefits provided to the Medicaid expansion population also must comply with parity  Building on the federal parity law: o SUD/MH benefits required and must be provided at parity o Extension to individual and small group plans o Requirement for SUD and MH benefits for the Medicaid expansion population
  • 5. Parity and Health Care Reform: A Time of Tremendous Opportunity (cont’d)  Inclusion of addiction in integrated care initiatives  Health homes and accountable care organizations  Inclusion of substance use prevention in chronic disease prevention initiatives  Identification of the addiction service workforce as part of the health workforce
  • 6. Huge Opportunities But Miles to Go…  The success of these laws depends on decisions that will be made in the coming days, months and years  Decisions in Washington and by state and local policy-makers around the country  There is a critical need for our field to educate and advocate to ensure these laws are well implemented for the people we serve
  • 7. ACA implementation: Our Advocacy on Benefit Design  Huge opportunity to expand coverage for and access to care  SUD/MH benefits required by not defined in the ACA  Key next steps in the process to define the SUD/MH essential health benefit:  Institute of Medicine—report due by the end of the month  Proposed regulations on the essential health benefit (possibly) released by HHS by the end of the year  Various opportunities for public comment
  • 8. ACA implementation: Our Advocacy on Benefit Design (cont’d)  Advocacy of the national SUD and MH groups: the Coalition for Whole Health  Crafting a comprehensive SUD and MH benefit  Coalition for Whole Health Essential Health Benefits Recommendations paper; continued need for broad organizational sign-on  www.lac.org; National Health Care Reform link  Using the paper with other education and advocacy tools with decision-makers in the Administration and to engage our allies in Congress  Parallel advocacy process needed in the states
  • 9. Our Advocacy on Parity Implementation  Interrelationship with ACA advocacy—opportunity for huge expansions in coverage by private insurance  Continued challenges—fighting violations of both the letter and spirit of the law  Advocating for additional guidance at the federal level  Monitoring compliance and encouraging strong federal and state activity and response  Gathering information about plan compliance; filing complaints for violations of the law; aggregating information and sharing with the regulators  Templates and other resources by the Parity Implementation Coalition: www.mentalhealthparitywatch.org  Engaging our champions  Continued tremendous need for education
  • 10. Protecting Safety Net Funding  Recognition that ACA coverage provisions do not go into effect until 2014  We don’t yet know which services will be included in the SUD essential health benefit  Huge need for continued strong federal funding for prevention, treatment, recovery supports and research before the ACA is fully implemented and beyond  During this interim period before expansion has occurred  Through implementation of the ACA to cover the services not included and the people who remain uncovered or underinsured
  • 11. Our Advocacy on Strong Safety Net Funding  Advocacy by the national drug and alcohol community  Fighting for highest possible funding for SAMHSA and the continuum  Huge need for a continued push from around the country with Congress and the Obama Administration; www.lac.org  Need to ensure our system of care is strong now and beyond
  • 12. Our Advocacy: Now More Important Than Ever  Continued outreach and education— within and outside of our field  Connecting our work in Washington with implementation efforts around the country  Speaking with one cohesive voice  Finding the best ways to engage our champions  Advocating for the strongest possible SUD benefit through the ACA  Protecting safety net programming  Monitoring implementation and informing our federal partners about successes and non-compliance
  • 13. Gabrielle de la Guéronnière gdelagueronniere@lac-dc.org 202-544-5478 (phone) 202-544-5712 (fax) www.lac.org www.hirenetwork.org