Welcome to the:
AAPNY COMMUNICATOR
ELECTRONIC NEWSLETTER
December 2005, Volume III
Visit our website at www.aapnycounselor.org
These emails and Newsletters are going out to all members of the
Association for Addiction Professionals of New York (AAPNY).
AAPNY is the New York state affiliate of
NAADAC, the Association for Addiction Professionals.
Membership information can be found at:
www.naadac.org or www.aapnycounselor.org
You can make local contact with AAPNY by emailing or calling us at: AAPNY@MSN.COM or 1-877-862-2769.
If you have information you want to share with AAPNY addiction professionals send it to AAPNY@MSN.COM and we'll include it in these upcoming newsletters and/or informational emails sent out on a regular basis. If you want an email address added or deleted from this network just let us know.
Here are the topics for this Newsletter.
- Greetings from the President
- June 2006 30th Annual Conference and Membership Meeting
- Website Update
- NAADAC Legislative Action Alert
- Responses from members to the Institute of Medicine Novembe r 2005 Report
- Highlights from Join Together & Alcoholism and Drug Abuse Weekly
- Regional Updates presented at our last Board Meeting
- Joining or Renewing Membership via Payroll Deduction
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Letter from the President:
2005 has drawn to a close and I am very pleased with what AAPNY has accomplished in the last 6 months. There is still a lot of work ahead of us for 2006 and we look forward to continuing our commitment to you, the membership. I wish to tip my hat and thank every member of the board for their hard work over the last six months. I especially want to thank the membership for becoming more active within the organization than ever before. The start of our electronic newsletter, “The Communicator,” along with the creation of a general email address, Aapny@msn.com, and through the development of our new website www.aapnycounselor.org has made it easier for the board to hear from the membership and for the membership to contact the board. Many of you have expressed reactions both optimistic and of concern regarding some off the articles found in our newsletter as well as to other information sent to you periodically which have an effect on our profession and those we serve. It is great to see this level of enthusiasm and interaction.
We have signed the contract for our 30th Annual Conference and Membership Meeting which will be held June 22nd, 23rd, and 24th at the Crowne Plaza in the heart of Albany. You can view the hotel and accommodations by visiting, www.cpalbany.com. Part of the contract negotiations will allow for free hotel parking for those attending whether it be for one day or for the full conference. I am pleased to announce that NAADAC will be providing a 6 hour workshop on Campral, (a pharmacological aid to help reduce the craving of alcohol, for those in treatment) during our conference. I am certain that this most informative and all day training will provide you with the most up to date information and data available. Hazelden has also stepped up to sponsor a plenary session by William Cope Moyers on the history of discriminatory practices against those who suffer from the brain disease of alcohol and drug addiction. In addition to these confirmed presentations, Forrest Laboratories has also agreed to present information on the use of Buprenorphine and Suboxone as a supplement for use in the treatment of those addicted to opiates. At this conference It is our goal to bring you the most up to date research and technology that is taking place. It is also our goal that when you leave any particular workshop that you will know to implement this research and technology in your treatment facility or private practice. We are currently engaged with Dr. Wesley Clark, Director of the federal Center for Substance Abuse Treatment (CSAT), to present at one of plenary sessions as well. The topic of his presentation has not yet been decided. This is truly going to be a GREAT way to celebrate our 30th Anniversary and the ONLY counselor’s organization in New York State. I hope to see each of you there as well. This is truly a monumental year for AAPNY.
In the last Communicator I talked about the Counselor Wellness/Peer Assistance Program which is being spearheaded by Bob Killar of OASAS. I asked for volunteers throughout the state who would be willing to work with impaired peers from within our own profession. The response was not as great as I would have expected. I am asking again that you please reconsider volunteering for this program. Bob and OASAS will provide all the necessary training. What better way to help ourselves than to help our own. If you are interested in assisting Bob and OASAS with this program, please email me at AAPNY@msn.com and put “Peer Assistance” in the subject line. For those without email please call our toll free number at 877 – 862 – 2769 and leave a message as to how you can be contacted. Again, it is necessary that you are a member of AAPNY/NAADAC and have a CASAC to participate in this training
May 2006 be peaceful and healthy for all of our membership
Regards,
Frank A. Naccarato
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SAVE THE DATE !!!!!
Annual Conference and Membership Meeting:
AAPNY Annual Conference and Membership Meeting will be:
JUNE 22, 23, 24, 2006
CROWNE PLAZA
ALBANY, NEW YORK
SAVE THE DATE !!!!!
NAADAC 2006 Advocacy Action Day and Workforce Development Summit
The annual Advocacy in Action Day and Leadership Summit
MARCH 23, 24, 24, 2006
Holiday Inn on the Hill, Washington, DC
SAVE THE DATE !!!!!
REGION VII
LIACA ONE DAY CONFERENCE
Date: Saturday March 11, 2006
Time: 8 a.m. - 5 p.m.
Location: Suffolk Community College, Brentwood, New York
Dr. Michael Eisenberg
"SUBOXONE AND OTHER MEDICATIONS FOR OPIUM DEPENDENCE AND CHEMICAL ADDICTIONS"
Gerald Roucoulet, MDV, CASAC, MAC
"NEW APPROACHES WITH INTERVENTION"
Sean Harrington, AC and Robert McClellan, CSW, CASAC
"IDENTIFICATION AND TREATMENT FOR DUAL DIAGNOSIS"
Rudy Rios, EAP, CASAC
"ANXIETY AND THE CASAC EXAM"
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AAPNY Website:
If you haven’t done so recently, please visit the APPNY website at www.aapnycounselor.org. The site has truly grown over the last several months. A member asked that the most current and archived copies of The Communicator will be available on the site for their viewing. I will be in contact with the webmaster about implementing this for anyone who would like to reference it while viewing the site. Ferd Haverly has worked hard on changing the language on the site to make it more inclusive of all addiction professionals. Thank you Ferd for all of your work on this Please send us any comments and/or recommendations to Aapny@msn.com.
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NAADAC LEGISLATIVE ALERT:
Please take the time to read this as it may have a MAJOR effect on our profession here in New York and across the nation. This was taken from the New York Times on December 20, 2005.
If you would like to voice your concerns or support of this please do so via email to Aapny@msn.com
The following Bill was passed on December 21, 2006 in the U.S. Senate by a vote of 51 to 50 with Vice President Chaney casting the deciding vote.
Budget Accord Could Mean Payments by Medicaid Recipients
By ROBERT PEAR, NY Times
Published: December 20, 2005
WASHINGTON, Dec. 19 - The final Congressional agreement on a budget bill gives states sweeping new authority to impose premiums and co-payments on Medicaid recipients, freezes doctors' pay under Medicare and toughens work requirements for welfare recipients.
In negotiations over Medicaid, the health program for more than 50 million low-income people, House Republicans generally prevailed over the Senate.
The agreement between the two chambers, approved on Monday by the House, incorporates many recommendations from governors of both parties, who had sought new power to rein in the soaring cost of Medicaid.
Under the agreement, states can charge premiums and higher co-payments for a wide range of Medicaid benefits, including prescription drugs, doctors' services and hospital care.
States can scale back benefits, capping or eliminating coverage for services that federal law now guarantees. In addition, states can end Medicaid coverage for people who fail to pay premiums for 60 days or more. Pharmacists can refuse to fill prescriptions, and doctors and
hospitals can deny services, for recipients who do not make the required co-payments.
The agreement also makes it more difficult for older Americans to qualify for Medicaid coverage of nursing home care after transferring assets to their children or other relatives for less than fair market value.
In general, Medicaid would not cover long-term care for any person with home equity of more than $500,000, although a state could choose to set the ceiling at a higher level, up to $750,000.
The Congressional Budget Office said the budget bill would save the federal government $26.5 billion in Medicaid and $22.3 billion in Medicare over the next 10 years.Drug makers and health insurance companies escaped largely unscathed. Negotiators rejected several provisions of the
Senate bill that would have cut their payments.
Under the final agreement, all states have to ensure that half their welfare recipients are engaged in work or related activities like searching for employment. Under the current law, a reduction in a state's caseload leads to a reduction in its work requirements, and administration officials said the number of welfare recipients had fallen so far in some states that the federal law imposed no meaningful work requirements.
Republicans hailed the final budget bill as evidence of their determination to rein in the automatic growth of benefit programs. Representative Joe L. Barton, Republican of Texas, the architect of the Medicaid provisions, said the higher co-payments were needed to "encourage personal responsibility" among low-income people.
Medicaid recipients can be charged 10 percent of the cost of any item or service if their family incomes were 100 percent to 150 percent of the federal poverty level, $12,830 to $19,245 for a family of two. Recipients with incomes above that can be required to pay 20 percent of the cost of any item or service. Total co-payments for all people in a family cannot exceed 5 percent of family income.
Senator Jeff Bingaman, Democrat of New Mexico, said, "It's very disappointing that Congressional leaders would decide to cut health care benefits and coverage to children, while imposing a greater cost-sharing burden on the poor, disabled and elderly."
AARP, the lobby for older Americans, denounced the final agreement. "It protects the pharmaceutical industry, the managed care industry and other providers at the expense of low-income Medicaid beneficiaries and Medicare beneficiaries who will foot the bill," said William D. Novelli, chief executive of AARP.
Lawrence E. Davidow of Suffolk County, N.Y., president of the National Academy of Elder Law Attorneys, whose members advise older people and their families, said, "I'm horrified and surprised that Congress would turn its back on middle-class senior citizens who look to Medicaid as a safety net to pay for long-term care." Under the agreement, Mr. Davidow said, "it's more likely that people who need long-term care will lose their homes and everything they have worked a lifetime to acquire, because they'll have to use their assets to pay for nursing home care."
The Bush administration announced last month that it would cut fees paid to doctors treating Medicare patients by 4.4 percent in 2006. It said the cut was required by a statutory formula. Congress decided instead to freeze doctors'fees next year. That would increase Medicare spending over the next five years by $7.3 billion above the amounts expected under the current law, the budget office said. Beneficiaries would pay some of the cost through higher premiums.
Under the agreement, states will not have to provide Medicaid recipients with all the services now required by federal law, but can offer a more modest package of benefits resembling commercial insurance. The agreement also gives states new authority to charge co-payments as a way to discourage the use of high-cost drugs and the use of hospital emergency rooms for nonemergency care.
House Republican aides said they meant to preserve one of the most important Medicaid benefits, known as "early and periodic screening, diagnostic and treatment services," for children younger than 19. The bill appears to be ambiguous on whether that is an option or a requirement for states, but Senate Republicans said it was intended to be a requirement.
Please feel free to send your thoughts on this to Aapny@msn.com
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The following are some responses I received from the membership regarding the article from the Institute of Medicine Report dated November 2005. The article gave a “Thumps Up for Parity Recommendations” and a “Thumbs Down for Merging SA and MH Issues.” If you would like another copy of the report please email me at AAPNY@msn.com and I will forward you a copy of the report.
Membership responses to the Institute of Medicine November 2005 Report:
Barry Schecter writes:
Health Insurance, Stigma, and the Increase of Suffering
Thinking about the way insurance affects treatment of addiction zeroed in on the daily struggle I see in my work. It is my belief and many others doing the same work, that stigma is the greatest block to recovery. There is a direct connection between insurance companies presenting as a barrier to treatment and stigma. As a professor at SUNY Cortland in Cortland, NY, I have been teaching a graduate drug studies class for teachers. The key to change is changing people’s perception about addiction. One of my goals is to stress addiction and the treatment recovery process as a health care issue.
Imagine telling a patient that presents at the emergency room for chest pain that they have to try outpatient services because they haven’t failed at that level first? That would sound ludicrous, right? But isn’t that standard operating procedure for the disease of addiction?
It is stigma that allows that to continue. It is the belief that the individual made bad choices, and if we can somehow get “them” to stop making bad choices, they will be better. Again, the heart attack victim may have made bad choices, maybe not, but we treat first the presenting issue and then try to help create a behavioral change. The reality is, that the percentage of heart surgery patients that make the necessary behavioral changes after 1 year is similar to the percentage that make the behavioral changes necessary to sustain abstinence (DiClemente, 2005).
As long as the treatment dollars go into the criminal justice system instead of the health care system, as long as we allow insurance companies and ourselves to not treat addiction as a health care issue, the longer we increase the suffering of the patient. My experience with other clinicians is that they chose this field to lessen suffering. WE need to join together to make a difference. Education of ourselves and the general public to change the prevailing concept of addiction is needed. Any society which promotes drug usage (drinking alcohol) is destined to have a good number of those that become addicted. Look at any sporting event, we clearly promote drug usage. It is very simple; the number of persons addicted is proportional to the numbers that try drugs. They will need to be treated.
Steve Martino, Assistant V.P. at CASA, Columbia University writes:
The most succinct response I can give to the IOM November report is "progress, not perfection". We shall see just how many of the recommendations are actually implemented.
Chaka Brightman of the Cultural Consultant Group writes:
Licensure for CASACs, Substance Abuse Practitioners (SAP) Now!
“In response to growing awareness of the human and economic toll of mental illness, the Clinton administration proposed, and Congress subsequently passed, the Mental Health Parity Act of 1996. As drafted, the bill essentially required health plans that provide mental health coverage to provide those benefits at the same level as physical health coverage. As passed, however, the bill contained several provisions that allowed insurers to maintain their benefit packages at prior levels and excluded substance abuse treatment benefits. Spurred by the passage of the act, lawmakers in many states sought full parity in all health plans between mental health and physical benefits….”Delaney, Tracey and Crean, Eileen, “Mental Health and Substance Abuse Parity”(Washington, D.C., HPTS, NCSL, 2002) https://www.htps.org.
So, New York parity was granted for mental health and the substance provision was dropped in order for the bill to pass. Where does that leave CASACs now? How long must we wait for justice? We are doing the job now, same liability. We need recognition and compensation now. We need the ability to advocate for our consumers now.
Currently, Licensed Certified Social Workers (LCSW), Certified Rehabilitation Counselors (CRC), and Licensed Mental Health Counselors (LMHC) are able to advocate for their clients. CASACs address the problems and issues of the four core racial/ethnic populations: Hispanics, American Indians/Alaska Natives, African Americans, and Asian/Pacific Islanders, (Center for Mental Health Services, CMHS, 2005) www.mentalhealth.samhsa.gov. These groups represent those who suffer most from health disparities (U.S. Department of Health and Human Services, Office of the Surgeon General, 1999). This population needs the highest qualified staff to address their issues in a culturally competent way (Office of Minority Health, 2005). We are suffering from institutional discriminatory practices to limit parity to only mental health and other practitioners.
We cannot advocate for our consumers effectively as non-licensed providers because we don’t have the final signature authority on our work. Those who are licensed can change our treatment plan and affect the outcome of patient safety because they are not trained to make competent clinical decisions in substance use disorders. Social Workers are not licensed by the State of New York to provide this level of care.
CASACs are required to fulfill Department of Transportation (DOT), Center for Medicaid and Medicare Service (CMS), Quality Improvement Organizations, Health Resources and Service Administration Third-Party Reimbursement (HRSA) and Center for Disease Control and Prevention (CDC), American Society of Addiction Medicine (ASAM), American Health Information Management Association (AHIMA), OASIS (822) regulations and standards simultaneously. We do this job without a license and have the same liability. We are required to carry malpractice insurance and can be sued in a court of law without ever having the ability to bill for the services we provide.
CASACs are being denied the ability to bill for current procedural codes (CPT) (AHIMA.Org 2005) in preventive medicine, care and treatment of Substance Use Disorders. These services are in our required scope of knowledge. Our jobs are being placed in jeopardy due to budget cuts and administrative planning. Facilities using a Sustainability Predictor*(SPI) would find that they will not be able to maintain a 4% operating budget with mostly unlicensed staffing using current Medicaid rates (OASIS, 2005). It takes two licensed persons to support one non-billing staff at a minimum. Therefore, facilities are forced to maintain the employment of persons who can bill as opposed to those who might better serve their clientele.
Finally, process improvement goals for quality behavioral healthcare can only be realized with licensed CASACs. (OASAS, 2005) (NAHQ, 2005). CASACs, medical doctors, and psychiatrists are the only professions authorized in the State of New York to make level of care determinations for substance use disorders. Without a license, we do this job, carry the same clinical liability, and make less money. We would have greater impact for our consumers as licensed CASAC today.
Chaka Brightman, MA, CASAC
Cultural Consultant Group, L.P
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HIGHLIGHTS FROM JOIN TOGETHER & ALCOHOLISM AND DRUG ABUSE WEEKLY
NY: Rockefeller Overhaul
Yields Few Releases
12/15/2005
Only 142 drug
offenders have been released from New York prisons since a ballyhooed overhaul
of the state's Rockefeller-era drug laws went into effect, the New York Times reported Dec. 15.
The Drug Law Reform Act of 2004, which amended the state's mandatory sentencing
laws, was expected to open the door for hundreds of offenders to win their
release from prison. But the state's Legal Aid Society said that hasn't
happened so far; only about 30 percent of prisoners eligible for shortened sentences
have been released.
The law "has not resulted in a whole heck of a lot in terms of real impact
on folks who were serving long sentences," said Gabriel Sayegh, a policy
analyst for the Drug Policy Alliance.
The state governor's office defended the law, saying that it was not intended
to release all long-term drug offenders, a.k.a. "A-1 felons."
"Our goal was to give 100 percent of the A-1's the opportunity to be
resentenced," said Chauncey G. Parker, director of criminal justice for
New York Gov. George Pataki.
The Legal Aid Society said that some district attorneys are opposing sentencing
requests and asking judges to impose long prison terms, limiting the law's
impact.
Congress Slashes Drug Court Program to $10 Million
Despite our triumphs this past year, despite
the U.S. General Accounting Office releasing a report earlier this year
supporting the effectiveness of drug courts, despite our mounds of research on
the effectiveness of the drug court approach, the Congress has decided to slash
the Drug Court Discretionary Grant Program to $10 million. Many programs have
been reduced to assist in the hurricane relief efforts. However, the drug court
appropriation is lower than anticipated.
The NADCP Board of Directors and staff are actively working with the Congress
to restore the Fiscal Year (FY) 2006 funding for drug courts. Although the FY
2006 appropriation for the Department of Justice has been finalized, the
Congress still has several other mechanisms which can be utilized to restore
the funding. However, this will only happen if the Congress hears from drug
court professionals and graduates across the nation.
I ask you to take a minute to let your Members of Congress know of your
disappointment and to urge them to restore FY 2006 funding. If they hear from
you, if they hear from the 1600 plus drug courts, from the over 16,000 drug
court professionals, from the over 16,000 annual drug court graduates, and from
the over 70,000 current program participants they will realize the true meaning
of their action. Go to www.nadcp.org and click on the link entitled "Restore Drug Court Funding" to send your letter today.
Tobacco Lawsuits Have
Rocky Past, Hopeful Future
12/21/2005
Although lawsuits
against the tobacco industry have failed to satisfactorily reform industry
practices or improve public health, recent legal developments provide hope for
positive change, stated Dr. Richard Feldman, a former state health commissioner
and director at St. Francis Hospitals and Health Centers, in an Indy Star opinion piece on Dec. 20.
The 1998 settlement for $246 billion in damages penalized the tobacco companies
and provided all 50 states with funding for tobacco prevention and cessation
programs, but less than 5 percent of this money ended up being used to support
prevention programs, nowhere near the funding levels recommended by the Center
for Disease Control and Prevention.
Another lawsuit, filed by the U.S. Department of Justice (DOJ) in 1999,
demanded $280 billion from the tobacco industry for reimbursement of health
care costs and penalties under the Racketeer Influenced and Corrupt
Organizations (RICO) Act. However, courts decided that the DOJ could not seek
such reimbursement, and that RICO could only be used to prevent future wrongful
acts.
The Justice Department then sought $130 billion to fund a national smoking
cessation program, until the Bush administration lowered the proposed remedy to
$14 billion for the cessation program and a counter marketing campaign, despite
the DOJ's compelling case.
Six public health organizations were recently granted "plaintiff
interveners" status to represent the interests of the public health
community and the public. The interveners, including the American Cancer
Society, the American Heart Association and the Campaign for Tobacco-Free Kids,
are demanding $5 billion a year for the smoking cessation program and $600
million annually for a public education campaign. The organizations also
require that the industry prohibit misleading or youth-targeted marketing, aim
to reduce youth smoking rates, and penalize tobacco companies if target rates
are not achieved.
The court has yet to reach a decision on this potentially reformative case.
State programs help physicians recover:
Alcoholism and Drug Abuse Weekly, December 19, 2005
Although the substance abuse rate among physicians is the same as that among the general public, around 10 to 15 percent, their recovery rate is nearly 4 times higher, at about 90 percent. Boston. COM reported on December 3 that this impressive recovery rate is in part due to state physician’s health programs, which guide individuals through treatment and when necessary, help them regain their medical licenses. Dr. Matthew Hopkins, a 38-year old psychiatrist in New Hampshire, owes his own recovery to the New Hampshire Medical Society’s Physician Health Program. Hopkins was addicted to alcohol and the drug
Adderall, used to treat attention deficit/hyperactivity disorder (ADHD), and had begun writing his own prescriptions when his own doctor would not. The N.H. program required him to spend months at a rehabilitation facility, attend sessions with a therapist and submit to random drug testing, which program director Sally Garhart calls a “crucial” component of the program. Hopkins not only regained his career, but discovered his new calling: addiction psychiatry. He now has a full schedule helping other substance
abusers: three mornings at the veteran’s hospital running group sessions and a clinic for heroin addicts; two days at Dartmouth Hitchcock seeing patients and holding group sessions at the medical center’s heroin clinics; and on Fridays, working with Dartmouth College students struggling with alcohol or drug problems “I want people to know that this is something that can happen to anyone,” Hopkins said. “I like to look at myself as an example of someone who’s in recovery, who’s done it and put my life back together.”
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Regional Reports and updates from our last Board Meeting:
Region I: Roberta reported that the number of students wanting to become involved with AAPNY continues to grow and they are expressing interest in getting involved in prevention work.
Region II: Submitted a report on their recent training on Addiction Treatment and Legal System: How to Maximize Collaboration and Improve Patient Outcome. It was reported that this training was successful with 23 professionals in attendance.
Regions III & IV: No report given
Region V: The next regional luncheon was scheduled for 12/15 at ACCA. James Maney was scheduled to present on problem gambling and 1 CEU would be made available for those attending. The region continues to attract large crowds at these luncheons and membership in the region is now approximately 27 members.
Region VI: Reported that a workshop was presented and well attended in November 2005. The next workshop will be scheduled in spring 2006.
Region VII: A workshop presented in November 2005 on Self Esteem and the Recovery Process 22 people attended. The next workshop will be on December 12, 2005 on Addiction Recovery and Human Development. A one day conference will be held on March 11, 2006. Please see the Save the Date section of this newsletter
Region VIII: No Report Given
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Membership and Renewals via Payroll Deduction:
The following information is supplied by NAADAC. So many times I hear people say that they can’t afford to pay the annual dues for membership or renewal. What a great opportunity we have to now spread our annual dues payment over a 12 month period. Please read the following article and see if this is something that may interest you or others that have been postponing joining or renewing their membership.
Talk to Your Employer about Payroll Deduction
A New Way to Pay Your Membership Dues
NAADAC encourages its members to look at payroll deduction as an affordable option for paying your NAADAC membership dues. Speak with your employer about automatic payroll deductions that can make things easier for you.
The benefits of payroll deduction:
- Easier to pay small amounts rather than a larger one-time payment.
- Saves time and takes little effort.
- It ensures that you have money set aside for your membership and you don’t have to worry about your membership lapsing.
The payroll deduction plan works like this:
1. Take this form to your employer and work out a payment plan based on your annual membership dues.
2. Make your monthly payments for 12 months.
3. When your NAADAC membership renewal form arrives, take it to your employer and have them send a check to NAADAC.
4. Enjoy the benefits of NAADAC membership for another year!
Visit the membership section of the NAADAC website at www.naadac.org or call 1-800-548-0497 for the breakdown of your state’s membership fees.
For more information on paying your membership fees by payroll deduction, contact Donovan Kuehn at dkuehn@naadac.org or 1-800-548-0497 ext 125.
Your state affiliate membership fee is:
New York $145 Membership Fee
$12.09 for 12 monthly payments
$6.05 for 24 bi monthly payments
$5.58 for 26 bi-weekly payments
Payroll Deduction Authorization Form
I authorize the deduction from my paycheck of $____________________ for membership in NAADAC, The Association for Addiction Professionals.
I authorize the deduction from my paycheck of a tax deductible donation of $____________________ to the NAADAC Education and Research Foundation (NERF).
This is a ð one time ð recurring donation.
I authorize the deduction from my paycheck of a donation of $____________________ to the NAADAC Political Action Committee (PAC).
This is a ð one time ð recurring donation.
I authorize this deduction to begin on ______________, 200____.
________________________
Print Name
________________________
Signature
________________________
Date