ABCDE
1
NGA Recommendation
(27 recommendations)
Color & DescriptionCategoryStatus Change
2018 > 2020
2
Last Edit: July 2020
3
Federal Support and Coordination
4
1
5
Congress and the Administration should increase federal funding to states for SUD related activities, streamline the grant process (extend duration), and increase flexibility in grants/funding.Yellow - Warning, Caution AheadNational Coordination
6
2
7
Increase coordination and communication between agencies - via inter-agency task force or executive agency.Yellow - Some CoordinationNational Coordination
8
Data and Information Sharing
9
3
10
Congress should align 42 CFR Part 2 with the Health Insurance Portability and Accountability Act (HIPAA) to bring substance use disorder (SUD) info with other types of health data.Yellow - Little MovementTreatment & Recovery
11
4
12
The Office of the National Coordinator for Health Information Technology within Health & Human Services should require that electronic health record (EHR) vendors make their systems interoperable with all state prescription drug monitoring programs (PDMPs).Red - Very Little MovementPrescription MedicineOrange > Red
13
5
14
The Administration should issue guidance to facilitate more open data sharing. Congress should provide the Department of Justice (DOJ) with increased federal funding for trainings and technical assistance that support state law enforcement and public health data and information sharing initiatives.Green - New Funding AvailableLaw Enforcement & Medical Response
15
Prevention and Early Intervention
16
6
17
The Administration should develop an evidence-based national campaign to promote prevention and reduce stigma.Green - CompletedPublic Awareness; Family Outreach & Support
18
7
19
The Drug Enforcement Agency should create new requirements that health care providers register with their state PDMP and complete training to prescribe opioids (similar to what is required to prescribe medication assisted treatment (MAT)) - using Center for Disease Control’s (CDC) prescribing guideline in training.Red - No federal movementPrescription MedicineOrange > Red
20
8
21
Health & Human Services should invest in additional research and evaluation of non-pharmacological therapies for pain and guidance to assist states in making appropriate coverage decisions in Medicaid and other state administered health programs.Yellow - Signs of ProgressPrescription Medicine
22
Treatment and Recovery
23
9
24
The Administration should expedite approval of Medicaid Institute for Mental Diseases (IMD) waivers. Congress should enact legislation creating an exception to IMD exclusion for those receiving SUD treatment.Green - Steady ProgressTreatment & Recovery
25
10
26
Health & Human Services (HHS) should strengthen federal oversight and ensure the Mental Health Parity and Addiction Equity Act (MHPAEA)/parity violations do not limit access to substance use disorder (SUD) treatment.Yellow - UncoordinatedTreatment & Recovery
27
11
28
Expand access to evidence-based SUD and mental health services for justice-involved populations. Specifically, medicaid coverage for medicaid-eligible individuals who are incarcerated pending disposition or nearing release. CMS should grant states (under 1115 authority) partial waivers of inmate exclusion otherwise barring states form receiving federal Medicaid funding in these circumstances.Red - Needs Funding, Culture and Attitude ChangeTreatment & Recovery
29
12
30
Health and Human Services should revise Medicare coverage requirements to cover methadone at community outpatient treatment programs.Green - CompleteTreatment & Recovery
31
13
32
The Health Resources and Services Administration (HRSA) should expand definition of approved sites where primary care providers can be reimbursed for providing medication assisted treatment (MAT) and other behavioral health interventions to include substance use disorder (SUD) treatment facilities.Yellow - Needs More WorkTreatment & Recovery
33
14
34
Health & Human Services (HHS) should issue guidance encouraging universal screening of pregnant women as part of comprehensive obstetric care. HHS should also issue comprehensive standards for treating neonatal abstinence syndrome.Green - Moving ForwardTreatment & Recovery
35
15
36
Provide guidance (HHS) on best practices for care following an overdose to treating hospitals (ex - initiating MAT).Green - Some progressPrescription Medicine
37
16
38
The Drug Enforcement Agency should remove the requirement for medical residents to apply for federal waiver to prescribe buprenorphine - already practicing under physician supervision.Yellow - Slow moving, but gaining popularityPrescription MedicineRed > Yellow
39
17
40
Congress should extend buprenorphine prescribing privileges (via the Comprehensive Addiction and Recovery Act) to Advanced Practice Registered Nurses (APRNs).Green - CompletedPrescription Medicine
41
18
42
Health & Human Services and the Drug Enforcement Agency, via exceptions under the public health emergency declaration, should issue policy guidance on providing Medication Assisted Treatment (MAT) via telehealth and encourage providers to use it. Congress should provide a permanent fix to ensure rural populations can access MAT after the public health emergency declaration expires - (currently prohibited by Ryan Haight Online Pharmacy Consumer Protection Act).Yellow - Progress, But Gaps Still ExistPrescription Medicine
43
Enhancing Support for Public Safety
44
19
45
Congress should increase Justice Assistance Grant Program (JAG) funding for state and local narcotic interdiction efforts and officer safety programs, increase funding and emphasize the role of preparing for and connecting individuals to community-based treatment programs, and increase funding (for the National Institute of Corrections, SAMHSA, and the Office of Justice Programs) to develop and provide MAT for justice-involved populations.Yellow - Momentum but needs more effortLaw Enforcement & Medical ResponseRed > Yellow
46
20
47
The federal government should offer more assistance to accelerate state crime lab testing and share real-time drug data. Increase federal coordination and funding for state medical examiner offices to increase understanding and provide a more targeted public safety and public health response by states.Yellow - Needs StandardizationLaw Enforcement & Medical Response
48
21
49
Increase federal efforts to strengthen electronic customs relation and to develop better chemical screen devices.Yellow - Essential, But DifficultLaw Enforcement & Medical Response
50
22
51
The Office of National Drug Control Policy (ONDCP) should continue to engage and convene additional federal and non-federal agencies to better understand the priorities of both public health and public safety entities at all levels of government.Red - ONDCP Leadership VacuumLaw Enforcement & Medical Response
52
23
53
ONDCP should continue and/or increase federal support for regional High Intensity Drug Trafficking Areas (HIDTAs) and state law enforcement efforts, and scale up and replicate innovative partnerships at state and local level - nationwide. Increase federal grant dollars for state fusion centers and other state law enforcement entities requiring more personnel and analysts. Increase flexibility in grant funding to meet dynamic challenges, such as direct investments in state and local narcotic interdiction initiatives. Expand the role of HIDTAs to allow more robust assistance to state and local law enforcement led prevention efforts.Yellow - More Funding NeededLaw Enforcement & Medical Response
54
24
55
The federal government should ensure concerns and key issues from state law enforcement are incorporated into larger federal supply reduction efforts. Future Drug Enforcement Agency (DEA) and the Organized Crime Drug Enforcement Task Forces (OCDETF) Program priorities and strategies should incorporate state law enforcement concerns about illicit opioid distribution, targeting transnational criminal organizations and violent gangs, emerging and existing markets, and reinforce DEA’s ability to regulate distributors suspected of misconduct.Orange - UnknownLaw Enforcement & Medical Response
56
25
57
The federal government should support research, development, and court admissibility of a simple, accurate and cost-effective roadside testing method for drugged driving (including marijuana) to reduce risk to the motoring public.Orange - UnknownLaw Enforcement & Medical Response
58
26
59
The federal government should increase support for National Guard Counterdrug Program to allow greater program capacity, providing states with funds to partner with local agencies and community groups and augment state use of this program to cut illicit drug supply.Green - Partnerships GrowingLaw Enforcement & Medical Response
60
27
61
Continue to coordinate with existing prevention programs in schools and avoid increasing stigma and fear around punitive approaches for those who need access to treatment. Expand federal support for new and additional resources to support training officers in schools, community engagements, and other educational activities.Yellow - Limited InfrastructureFull-Spectrum Prevention