2. NMHU 3 rd Annual Alcohol & Substance Abuse Treatment Conference May 12-15, 2014

3. The Affordable Care Act: Four Key Strategies

5. Prevalence of Behavioral Conditions Among Medicaid Expansion Population: New Mexico 5 CI = Confidence Interval Sources: 2008 - 2010 National Survey on Drug Use and Health (Revised March 2012) 2010 American Community Survey

6. New Mexico Medicaid Expansion Projections: Medicaid Expansion = 170,472  SMI (4.3%) = 7,330  SERIOUS PSYCH DISTRESS (11.2%) = 19,093  SUD (8.4%) = 14,320  TOTAL = 40,743

7. Prevalence of Behavioral Conditions Among Health Insurance Exchange Population: New Mexico 7 CI = Confidence Interval Sources: 2008 - 2010 National Survey on Drug Use and Health (Revised March 2012) 2010 American Community Survey

8. New Mexico Marketplace Exchanges Projections: MARKETPLACE EXCHANGES = 157,091  SMI (2.8%) = 4,399  SERIOUS PSYCH DISTRESS (6.1%) = 9,583  SUD (17.6%) = 27,648  TOTAL = 41,630

9. New Mexico Data  Marketplace Plan Selection = 32,062  Medicaid/CHIP Enrollment = 60,378  Total = 92,440  30 % BH Disorders = 27,732 of 82,373

10. Enrollment Resources  SAMHSA Enrollment Webpage o http://www.samhsa.gov/enrollment/ http://www.samhsa.gov/enrollment/  State Reform Exchange Decisions o http://www.statereforum.org/node/10222 http://www.statereforum.org/node/10222  Enroll America Best Practices o http://www.enrollamerica.org/best-practices-institute http://www.enrollamerica.org/best-practices-institute  Healthcare.gov o http://www.healthcare.gov/marketplace/index.html http://www.healthcare.gov/marketplace/index.html  HHS Partners Resources o http://www.cms.gov/Outreach-and- Education/Outreach/HIMarketplace/index.htm l http://www.cms.gov/Outreach-and- Education/Outreach/HIMarketplace/index.htm l

11. SAMHSA HEALTH REFORM TOOLKITS  http://tiny.cc/CommunityPrevention http://tiny.cc/CommunityPrevention  http://tiny.cc/ConsumerPeerFamily http://tiny.cc/ConsumerPeerFamily  http://tiny.cc/HomelessServices http://tiny.cc/HomelessServices  http://tiny.cc/CriminalJusticehttp://tiny.cc/CriminalJustice  http://tiny.cc/TreatmentProviders http://tiny.cc/TreatmentProviders  http://tiny.cc/GettingReady http://tiny.cc/GettingReady (GENERAL)

12. Changing Health Care Environment  Prevention/Wellness rather than illness  SA/MH Services are Essential Health Benefit  Quality rather than Quantity – saving costs through better care rather than less care  Inclusive – Goal is to provide access to care  Public Payers’ Roles changing  Implications for the Workforce

13. Opportunities  ACA – new enrollment and payment opportunities  Emerging science  Healthcare integration  Parity – MHPAEA Final Rule  AG’s call for treatment rather than incarceration for SA  ↑ understanding of BH role in health promotion, prevention, treatment and costs  President’s/nation’s attention to MH issues o www.mentalhealth.gov www.mentalhealth.gov o www.creatingcommunitysolutions.org www.creatingcommunitysolutions.org

14. DAILY DISASTER OF UNPREVENTED AND UNTREATED M/SUDs Any MI: 45.9 million 39.2 % receiving treatment SUD: 23.1 million 11.2 % receiving treatment Diabetes: 25.8 million 84 % receiving treatment Heart Disease: 81.1 million 74.6 % receiving screenings Hypertension: 74.5 million 70.4% receiving treatment 14

15. Region 6 Profile StateCapitalPopulation 1 Pop. Density 2 Joint SUD Prevalence 3 SMI Prevalence 4 Suicide Rate 5 ArkansasLittle Rock2,915,91856Yes6.945.4115.5 LouisianaBaton Rouge4,533,372104.9Yes7.663.7812.3 New MexicoSanta Fe2,059,17917Yes9.154.5120.1 OklahomaOklahoma City3,751,35154.7Yes9.155.0616.5 TexasAustin25,145,56196.3Yes8.133.3311.7 United States Washington, DC 308,745,53887.4N/A8.53.912.1 1 U.S. Census 2010 resident population, all ages 2 U.S. Census 2010 3 SAMHSA, NSDUH 2010-2011, Table 19. Dependence on or Abuse of Illicit Drugs or Alcohol in Past Year among Persons Aged 18 or Older (Substance Use Disorder). 4 SAMHSA, NSDUH 2010-2011, Table 22. Serious Mental Illness in Past Year among Persons Aged 18 or Older (revised October 2013). 5 CDC, National Vital Statistics System-Mortality (NVSS-M) 2010, per 100,000

16. MENTAL HEALTH & ADDICTION EQUITY ACT (MHAEPA) The Mental Health Parity and Addiction Equity Act requires insurance groups that offer coverage for mental health or substance use disorders to provide the same level of benefits that they do for general medical treatment. Visit "Parity" to learn more.Visit "Parity" to learn more.

17. Mental Health Parity and Addiction Equity Act (MHPAEA) A group health plan and a health insurance issuer offering health insurance coverage in the group or individual market must ensure that Financial requirements (such as copays and deductibles) applicable to mental health or substance use disorder (MH/SUD) benefits are no more restrictive than andTreatment limitations (such as visit limits) the predominant requirements or limitations applied to substantially all medical/surgical benefits.

18. MHPAEA/ACA: Projected Reach Individuals who will gain MH, SUD, or both benefits under the ACA including federal parity protections Individuals with existing MH and SUD benefits who will benefit from federal parity protections Total individuals who will benefit from federal parity protections as a result of the ACA Individuals currently in individual plans 3.9 million7.1 million11 million Individuals currently in small group plans 1.2 million23.3 million24.5 million Individuals currently uninsured 27 millionn/a27 million Total32.1 million30.4 million62.5 million *These estimates include individuals and families who are currently enrolled in grandfathered coverage

19. 2015 BUDGET/WORKFORCE  SAMHSA 2015 PROPOSED BUDGET

20. PROTECTING THE HEALTH OF CHILDREN AND COMMUNITIES  Now Is the Time – $130 M (+ $15.0 M)  $115 M continued from FY 2014  Science of Changing Social Norms (+ $4 M)  Peer Professionals (+ $10 M)  Workforce Data (+ $1.0 M)

21. STRENGTHENING & INTEGRATING CARE  Primary Care and Addiction Services Integration (PCASI) – + $20 M Allow addiction treatment providers to offer an array of physical health and addiction treatment services Modeled after Primary/Behavioral Health Care Integration (PBHCI) program

22. LEADING CHANGE 2011 – 2014 8 STRATEGIC INITIATIVES LEADING CHANGE 2.0: 2015 – 2018 Out for public comment this month Will contain 6 initiatives Will guide the next 4 years Final early fall

23. SAMHSA’s Strategic Initiatives 2011 – 2014 1.Prevention 2.Trauma and Justice 3.Military Families 4.Recovery Support 5.Health Reform 6.Health Information Technology 7.Data, Outcomes & Quality 8.Public Awareness & Support Business Operations DataCommunications Health Financing Policy Resource Investment Staff Development SAMHSA’s Strategic Initiatives 2015 – 2018 1.Prevention 2.Health Care and Health Systems Integration 3.Trauma and Justice 4.Recovery Support 5.Health Information Technology 6.Workforce SAMHSA OF THE FUTURE – FY 2014 AND BEYOND SAMHSA’s Strategic Initiatives

24. SAMHSA’S THEORY OF CHANGE INNOVATION Proof of concept Services Research Practice-based Evidence TRANSLATION Implementation Science Demonstration Programs Curriculum Development Policy Development Financing Models and Strategies DISSEMINATION Technical Assistance Policy Academies Practice Registries Social Media Publications Graduate Education IMPLEMENTATION Capacity Building Infrastructure Development Policy Change Workforce Development Systems Improvement WIDESCALE ADOPTION Medicaid SAMHSA Block Grants Medicare Private Insurance DOD/VA/DOL/DOJ/ED ACF/CDC/HRSA/IHS SURVEILLANCE EVALUATION

25. “NOT YOUR GRANDMOTHER’S SAMHSA” Leadership & Voice – Influencing Public Policy Data & Surveillance Practice Improvement Grant Making w/ a Designated Purpose Regulation/Guidelines Public Awareness/Education

26. Thank you! Michael Duffy SAMHSA Regional Administrator-HHS Region VI (AR, LA, NM, OK, TX) US Dept. of Health and Human Services 1301 Young Street Suite 1030 Dallas, Texas 75202 michael.duffy@samhsa.hhs.gov Office: 214-767-0522