Transcript The Future of Prevention

Health Reform:
Is Your Community
Ready for 2014?
Frances M. Harding, Director
SAMHSA’s Center for Substance Abuse Prevention
2011 School for Prevention Leadership
Washington, DC • October 20, 2011
Role of Prevention in Substance Use
and Mental Health Disorders

Behavioral health is essential for health

Addiction as a complex and chronic disease

Recovery as a process rather than an event

Ongoing contact and support to complement treatment

Natural supports such as friends, peers, and family

Evidence-based, multi-component prevention programs
Selected National Prevention
Strategy Actions
Communities can:
• Develop comprehensive prevention systems.
• Establish linkages.
• Conduct education, outreach, and training.
Health care systems, insurers, and clinicians can:
• ID and screen patients for excessive drinking.
• ID, track, and prevent inappropriate patterns of prescribing.
• Develop and adopt evidence-based guidelines for prescribing
opiates.
Health Reform
 More people will have insurance coverage.
 Theme: Prevent diseases, promote wellness
 Integrated care: New thinking—recovery, wellness, role of
peers, response to whole health needs
 New opportunities for behavioral health:
• Parity: Mental Health Parity and Addiction Equality Act
and within Affordable Care Act
• Tribal Law and Order Act
• National Action Alliance for Suicide Prevention
 Medicare and Medicaid changes
National Prevention Strategy
Priorities
Five Causes Account For
66% of All Deaths
• Tobacco Free Living
• Preventing Drug Abuse and
Excessive Alcohol Use
• Healthy Eating
• Active Living
• Mental and Emotional Wellbeing
• Reproductive and Sexual
Health
• Injury and Violence Free Living
Heart Disease
All Other
Causes
34%
5%
5%
Cancer
27%
Chronic Lower
Respiratory Disease
23%
Stroke
6%
Unintentional Injuries
Source: National Vital Statistics
Report, CDC, 2008
5
Health Reform: A Defining
Moment for Prevention
Emerging opportunities, growing complexity:
• Multiple client pathways—primary care, behavioral health,
schools, jails/prisons, child welfare
• Service coverage issues—third-party payment and Block
Grant funding
• Behavioral health integration in health homes
• Incentives for mutual integration of behavioral health and
primary health care activities
• Definition of prevention services and service models
• Dissemination of evidence-based practices
• Behavioral workforce training and support
Challenges— Community, State, and
National Leadership
Individuals Served by SSAs
Individuals Served by MHAs
Insured
39%
Uninsured
39%
Uninsured
61%
Insured
61%
90–95 percent will have the opportunity to be covered
by Medicaid or through insurance exchanges.
New Roles—Community Leadership
 Ensure your community’s voice is heard in the design and
execution of health reform.
 Develop or enhance strategic partnerships with nontraditional partners for prevention.
 Work with States to serve more than traditional Block
Grant populations.
 Focus on recovery support—help people get and stay well.
SAMHSA’s PRINCIPLES
PEOPLE
Stay focused on the
goal
PARTNERSHIP
Cannot do it alone
www.samhsa.gov
PERFORMANCE
Make a measurable
difference
Collaboration is the key!
www.samhsa.gov
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