Warren W. Hewitt, Jr. DrPH, M.S. Center for Substance Abuse Treatment Substance Abuse Mental Health Services Administration U.S. Department of Health & Human Services

2. SYNCing Government Agencies
with NHAS and VHAP
Warren W. Hewitt, Jr. DrPH, M.S.
Center for Substance Abuse Treatment
Substance Abuse Mental Health Services Administration
U.S. Department of Health & Human Services
SYNChronicity
Sheraton Crystal City
Arlington, Virginia
April 20, 2012

3. SAMHSA Implementation of NHAS and VHAP
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4. SAMHSA Implementation of NHAS and VHAP
 Minority AIDS Initiative Targeted Capacity Expansion
HIV grants
• Building community capacity to treat behavioral health
disorders (substance abuse and co-occurring disorders)
racial and ethnic minorities at high risk of or living with
HIV/AIDS.
– Tertiary care for behavioral health disorders
– Secondary prevention of HIV
• Rapid HIV Testing of all entering behavioral health
treatment.
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5. SAMHSA Implementation of NHAS and VHAP
• Case-managed referral to ART for those who test positive,
• Test, Concurrent Treatment (Behavioral Health and
ART), and Sustain Recovery.
 Integrated Behavioral Health Network Cooperative
Agreements
• In FY 2011, SAMHSA awarded cooperative agreements
totally $42.6 million over three years to 11 MSAs highly
impacted by HIV/AIDS.
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6. Integrated Behavioral Health Primary Care Networks
 MAI –TCE: Integrated Behavioral Health/Primary Care
Network (IBHPCN) Cooperative Agreements.
• IBHPCNs were funded to ensure that individuals who were
at high risk for or had a mental and/or substance use
disorder who are also at high risk for or are living with
HIV/AIDS received appropriate services in integrated
behavioral health and primary care settings.
• Test, Concurrent Treatment (Behavioral Health and
ART), and Sustain Recovery.
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7. Integrated Behavioral Health Primary Care Networks
A total of 11 cooperative agreements were made
to the following jurisdictions:
 New York, New York  Miami, Florida
 Philadelphia, Pennsylvan  Atlanta, Georgia
ia  Chicago, Illinois
 Baltimore, Maryland  Dallas, Texas
 Washington, D.C.  Los Angeles, California
 San Juan, Puerto Rico  San Francisco, California
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8. SAMHSA Implementation of NHAS and VHAP
 Addiction Technology Transfer Center - Creating lasting
behavioral health care system change by translating,
disseminating and promoting the adoption and
implementation of effective and culturally sensitive clinical
practices.
• Central East ATTC – Workshop The Role of OTP Healthcare
Providers in the Prevention and Treatment of Hepatitis C
in OTP patients (October 2011);
• Pacific Southwest ATTC - Training at the STD/HIV Update
for Clinicians Serving Diverse Populations at the Phoenix
Indian Medical Center (August 2012)
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9. SAMHSA Implementation of NHAS and VHAP
• Pacific Southwest ATTC - Cross-Collaborative Training with
a focus on interventions to improve health care services
related to HIV infection.
• Pacific Southwest ATTC - Making Connections: Preventing
HIV, Hepatitis, and Tuberculosis Among Substance-Using
Populations (June 2012);
• Pacific Southwest ATTC - Training Series on Treatment of
TB, STDs, HIV, Hepatitis C and Substance Abuse on the
Border (2011-2012)
• Pacific Southwest ATTC - Training on HIV in 2011: Current
Trends and Best Practices;
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10. SAMHSA Implementation of NHAS and VHAP
• Central East ATTC- “Trainer’s Guide For the Community-
Based Outreach Model to Prevent HIV and Hepatitis
Among Drug Users.”
• Central East ATTC- Keeping It Real Conference---Street-
Level Intervention Strategies for Addiction, HIV/AIDS, and
Hepatitis
• Mid-Atlantic ATTC - What’s New Update
STD, HIV, TB, Hepatitis, Family Planning and Addictions
(February, 2012).
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11. SAMHSA Implementation of NHAS and VHAP
 SAMHSA Hepatitis A and B (TWINRIX) Vaccination Initiative
• The initiative seeks the prevention of hepatitis B virus
(HBV) and hepatitis A virus (HAV) infections by vaccination
of individuals at risk because of substance
abuse/dependency;
• The population covered will be persons receiving
prevention or treatment services from
– SAMHSA’s regulated Opioid Treatment Programs (OTPs),
– physicians approved to use buprenorphine, and
– SAMHSA current grantees under the Minority AIDS Initiative
• Continuing viral hepatitis education for OTPs.
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12. SAMHSA Implementation of NHAS and VHAP
 Rapid HIV Testing Incorporated into SAMHSA Grant
Announcements:
• Joint Adult Drug Court Solicitation to Enhance
Services, Coordination, and Treatment FY 2012
Competitive Grant Announcement;
• Offender Reentry Program;
• Grants to Expand Substance Abuse Treatment Capacity for
Juvenile Treatment Drug Courts;
• Grants to Expand Substance Abuse Treatment Capacity for
Adult Drug Courts;
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13. SAMHSA Implementation of NHAS and VHAP
 Rapid HIV Testing Incorporated into SAMHSA Grant
Announcements:
• Grants to Develop and Expand Behavioral Health
Treatment Court Collaboratives;
• Services Grant Program for Residential Treatment for
Pregnant and Postpartum Women; and
• Cooperative Agreements to Benefit Homeless Individuals.
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14. SAMHSA Implementation of NHAS and VHAP
The main objective of this
Treatment Improvement
Protocol (TIP) is to improve care
for clients with SUDs by
increasing knowledge of viral
hepatitis among staff in
behavioral health programs.
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15. SAMHSA Collaboration with Federal
Partners
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16. Engagement of Federal Partners to Implement
NHAS and VHAP
 Enhanced Comprehensive HIV Prevention Planning
(ECHPP) Implementation.
 Core Indicators working group.
 NHAS Implementation.
 African American Inventory.
 Interagency Coordination, e.g., SAMHSA IBHNs and
CDC ECHPP Cooperative Agreements.
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17. SAMHSA Strategies to Implement NHAS
and VHAP
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18.  SAMHSA’s Strategic Initiatives
• Prevention of Substance Abuse and Mental Illness
• Trauma and Justice
• Military Families
• Recovery Support
• Health Reform
• Health Information Technology
• Data, Outcomes, and Quality
• Public Awareness and Support
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19. SAMHSA Strategies to Implement NHAS and VHAP
 Strategic Initiative 1: Prevention of Substance Abuse
and Mental Illness Disorders
• Prevention can reduce the burden of disease (DALYS) and
the impact that behavioral health disorders have among
those with other co-occurring diseases including HIV/AIDS
and viral hepatitis.
• Prevention of behavioral health disorders is vital element
in the strategy to address HIV and viral hepatitis.
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20. SAMHSA Strategies to Implement NHAS and VHAP
 Strategic Initiative2: Trauma and Justice
• Trauma and violence are ubiquitous among those with
mental illness and co-occurring substance abuse disorders.
• Many of those at risk or living with HIV or viral hepatitis
are affected by trauma and violence and suffer from
Acute Stress Disorder, Post Traumatic Stress Disorder and
Major Depression.
• Addressing the pervasive and harmful effects of violence
and trauma is important to those who have behavioral
health disorders and are at risk for or living with HIV and
viral hepatitis.
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21. SAMHSA Strategies to Implement NHAS and VHAP
 Recovery Support
• Effective treatment and recovery are secondary HIV;
• People with a mental or substance abuse disorder can
recover; and
• Sustaining recovery among those with a mental or
substance abuse disorder is associated with reduce risk of
relapse, and greater adherence to psychotropic and ART
medications.
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22. Syncing Locally
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23. Syncing Locally
 Community engagement all segments of the affected
community;
 Listen and learn, don’t be prescriptive;
 Involve those in recovery;
 Keep it Real and Relevant
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24. Responding to Change
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25. Responding to Change
 Change is inevitable.
 The HIV/AIDS pandemic has been in a state of
change from the initial cases in Los Angeles and New
York. Why should things be any different?
 HIV/AIDS and viral hepatitis have taught us to be
fluid, flexible and resilient.
 These strategies will no doubt change the context
and conversation, and we will do what we have
always done adapt and change.
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26. Thank you.
warren.hewitt@samhsa.hhs.gov
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