ÿþ<html> <head> <title> U.S. Medicine Institute - Federal Health Update </title> <script type="text/javascript" src="../javascript/ddtabmenu.js"></script> <script type="text/javascript"> //SYNTAX: ddtabmenu.definemenu("tab_menu_id", integer OR "auto") ddtabmenu.definemenu("ddtabs4", 0) //initialize Tab Menu with ID "ddtabs1" and select 1st tab by default </script> <link rel="stylesheet" type="text/css" href="../css/style.css" /> <link rel="stylesheet" type="text/css" href="../javascript/ddcolortabs.css" /> </head> <body style="text-align:center"> <table width="800px" border="0" cellpadding="0" cellspacing="0"> <tr> <td style="text-align:center" valign="top"> <a href="../index.html"><img src="../images/banner.gif" style="border:0;"/></a> </td> </tr> <tr> <td valign="top"> <div id="ddtabs4" class="ddcolortabs"> <ul> <li><a href="../index.html">Home</a></li> <li><a href="../forums.html">Forums</a></li> <li><a href="../roundtables.html">Roundtables</a></li> <li><a href="../partners.html">Partner Organizations</a></li> <li><a href="../sponsor.html">Sponsorship Information</a></li> <li><a href="../aboutus.html">About USMI</a></li> </ul> </div> <div class="ddcolortabsline">&nbsp;</div> </td> </tr> </table> <table width="750px" border="0" cellpadding="0" cellspacing="0" style="height:560px;"> <tr> <td style="text-align:left;" valign="top"> <a href="../newsletter_archive.html">< Back to Federal Health Update Archives</a> <div style="border:0;width:750px;height:560px;overflow-x:hidden;overflow-y:auto;text-align:left;"> <table width="700px" border="0" cellpadding="0" cellspacing="0" style="text-align:center;"> <tr> <td colspan="2"> <br /><h4>FEDERAL HEALTH UPDATE</h4> <h5>January 11, 2008</h5> <p /><i>Produced by Kate Connelly Theroux in collaboration with the U.S. Medicine Institute for Health Studies (USMI) <p />To subscribe, please visit <a href="../subscriber.cfm">http://usminstitute.org/subscriber.cfm</a>.</i> <p />Sponsored by <br /><a href="http://www.triwest.com/" target="_blank"><img src="../images/newsletter/TriWestLogoNEW.jpg" border="0"/></a> <p />Additional sponsorship by </td> </tr> <tr> <td style="text-align:right;"><a href="http://www.USFamilyHealthPlan.org" target="_blank"><img src="../images/newsletter/NewUSFHP_logo.jpg" border="0"/></a></td> <td style="text-align:center;"><a href="http://www.expressscripts.com/" target="_blank"><img src="../images/newsletter/redu2colorPMS.jpg" border="0"/></a></td> </tr> <tr> <td colspan="2" style="text-align:left;"> <b><a name="top">Menu</a></b> <ul type="square"> <li><a href="#cong">Congressional Schedule</a></li> <li><a href="#mhc">Military Health Care News</a></li> <li><a href="#vhc">Veterans Health Care News</a></li> <li><a href="#hcare">Health Care News</a></li> <li><a href="#reserve">Reserve/Guard</a></li> <li><a href="#reports">Reports/Policies</a></li> <li><a href="#leg">Legislation</a></li> <li><a href="#hill">Hill Hearings</a></li> <li><a href="#meetings">Meetings / Conferences</a></li> </ul> </td> </tr> <tr> <td colspan="2" style="text-align:left;"> <ul> <h1> <font face="Arial Black" size="3"><a name="cong">Congressional Schedule</a></font> </h1> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The Senate and House convened this week.&nbsp; No votes were taken or committee meetings held.</font> </li> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font> </p> </ul> <ul> <p> <font face="Arial Black" size="3"><a name="mhc">Military Health Care News</a></font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">TRICARE Management Activity announced that start of the Warrior Navigation &amp; Assistance Program (WNAP).&nbsp; This is a new advocacy unit, which provides guidance to Active Duty and Guard and Reserve Service Members in TRICARE s South Region as they transition through the MHS. </font></li> </ul> <ul> <p> <font face="Arial" size="2">Established by Humana Military Healthcare Services (HMHS), the managed care support contractor for TRICARE s Southern Region, the WNAP offers one-on-one assistance with many unique health care challenges service members may face.&nbsp; Issues may include access to care; or simply the need for information on all available resources  be it the MHS, Veterans Affairs (VA) or other community assets. </font> </p> </ul> <ul> <p> <font face="Arial" size="2">A dedicated toll-free number can be used by Service Members transitioning through the health care system.&nbsp; Calling 888-4GO-WNAP provides direct access to a multi-disciplinary team with the mission to assist Service Members and/or their family members. </font> </p> </ul> <ul> <p> <font face="Arial" size="2">The WNAP incorporates four elements: tools and information for the Service Members; program management; clinical programs; and provider education and resources.&nbsp; </font> </p> </ul> <ul> <p> <font face="Arial" size="2">Resources on the </font><a href="http://www.humana-military.com/" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>HMHS Web site</u></font></a><font face="Arial" size="2"> include the  Information and Resources for Combat Veterans brochure.&nbsp; Health care providers can find tools and resources addressing the unique needs of Service Members returning home from deployment. </font> </p> </ul> <ul> <p> <font face="Arial" size="2">Care management initiatives include behavioral health support and assistance with seamless transition for Service Members and families for the care they need, when they need it.&nbsp; There is also expanded outreach to Guard and Reserve members with transition coordinators delivering detailed TRICARE benefit education. </font> </p> </ul> <ul> <p> <font face="Arial" size="2">WNAP services via the toll-free line are available to those who live in the TRICARE Southern Region which includes South Carolina, Georgia, Florida, Alabama, Mississippi, Tennessee, Oklahoma, Arkansas, Louisiana and all but the southwestern corner of Texas.&nbsp; Web site tools and information are available to anyone worldwide with computer access. </font><a href="http://www.tricare.mil/pressroom/news.aspx?fid=358" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.tricare.mil/pressroo<wbr></wbr>m/news.aspx?fid=358</u></font></a></p> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font></p> </ul> <ul> <p> <font face="Arial Black" size="3"><a name="vhc">Veterans Health Care News</a></font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The health care system of the Department of Veterans Affairs (VA) received a highly favorable review in an </font><a href="http://www.cbo.gov/ftpdocs/88xx/doc8892/12-21-VA_Healthcare.pdf" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>interim report</u></font></a><font face="Arial" size="2"> recently published by the Congressional Budget Office (CBO). &nbsp;The report credits organizational restructuring and management systems, performance measurement and information technology (IT) as contributors to VA's success. &nbsp;It also outlines ways in which VA can continue serving as a model for other health care systems. &nbsp;</font> </li> </ul> <ul> <p> <font face="Arial" size="2">The report, completed at the request of the chairmen of the House Committee on Veterans Affairs and the Subcommittee on Military Construction, Veterans Affairs, and Related Agencies of the House Committee on Appropriations, reviews the quality of VA s health care, examines VA s achievements and looks at lessons learned from both its management initiatives and application of information technology.&nbsp;</font></p> </ul> <ul> <p> <font face="Arial" size="2">Key factors cited in the report included VA s restructuring efforts to permit more shared decision making between VA s central office, regional managers and facility directors; measuring performance, process and outcomes; and system-wide use of health information technology.</font></p> </ul> <ul> <p> <font face="Arial" size="2">The improvement in VA s health care quality in recent years has been well-documented in a number of independent studies including those by the Institute of Medicine (IOM). &nbsp;VA s accomplishments are all the more noteworthy as they came during a period of increased demand for services.</font></p> </ul> <ul> <p> <font face="Arial" size="2">From 1999 through 2007, enrollment in the VA health care system, mandated by the Veterans Eligibility Reform Act of 1996, swelled from just over three million to nearly eight million veterans. Consequently, the number of veteran patients treated each year increased from approximately 3.2 million to more than five million.</font></p> </ul> <ul> <p> <font face="Arial" size="2">The CBO report pointed to VA s structure as an integrated health care system that allows the use of two important tools: incentives given to managers and providers to meet quality of care and practice guideline targets; and health IT systems that provide reminders about tests and treatments recommended by the practice guidelines. &nbsp;It also examined the low cost of care for veterans as an incentive for seeking care.</font></p> </ul> <ul> <p> <font face="Arial" size="2">VA has an electronic health record for every patient, which provides up-to-date information about a patient at the point of care, including his or her history, allergies, and medications. &nbsp;It also consists of relevant diagnoses and laboratory tests, enabling providers to avoid duplicate tests and adverse drug interactions. Research indicates that computer reminders and prompts can significantly improve adherence to clinical guidelines, particularly for preventive care.<b>&nbsp;</b></font></p> </ul> <ul> <p> <font face="Arial" size="2">The final report is expected in early 2008.</font><font face="Times New Roman" size="3"> </font><a href="http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1443" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www1.va.gov/opa/pressrel<wbr></wbr>/pressrelease.cfm?id=1443</u></font></a></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The Internal Revenue Service has agreed with the U.S Tax Court decision, which ruled that payments provided to veterans under two specific programs of the Department of Veterans Affairs (VA) -- the Compensated Work Therapy (CWT) and Incentive Therapy (IT) programs -- are no longer taxable.&nbsp; This reverses a 1965 ruling that these payments were taxable and required VA to report payments as taxable income.&nbsp; Veterans who paid tax on these benefits in the past three years can claim refunds. </font></li> </ul> <ul> <p> <font face="Arial" size="2">Recipients of CWT and IT payments no longer receive a Form 1099 (Miscellaneous Income) from VA. Veterans who paid tax on these benefits in tax years 2004, 2005 or 2006 can claim a refund by filing an amended tax return using IRS Form 1040X. &nbsp;Nearly 19,000 veterans received CWT benefits last year, while 8,500 received IT benefits.</font></p> </ul> <ul> <p> <font face="Arial" size="2">The CWT and IT programs provide assistance to veterans unable to work and support themselves. &nbsp;Under the CWT program, VA contracts with private industry and the public sector for work by veterans, who learn new job skills, strengthen successful work habits and regain a sense of self-esteem and self-worth. &nbsp;Veterans are compensated by VA for their work and, in turn, improve their economic and social well-being.&nbsp;</font></p> </ul> <ul> <p> <font face="Arial" size="2">Under the IT program, seriously disabled veterans receive payments for providing services at about 70 VA medical centers. </font><a href="http://www1.va.gov/opa/pressrel/pressrelease.cfm?id=1441" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www1.va.gov/opa/pressrel<wbr></wbr>/pressrelease.cfm?id=1441</u></font></a>&nbsp;<br /> </p> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font></p> </ul> <ul> <p> <font face="Arial Black" size="3"><a name="hcare">Health Care News</a></font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">According to the Centers for Medicare and Medicaid (CMS), health care spending growth in the United States accelerated slightly in 2006, increasing 6.7 percent compared to 6.5 percent in 2005.&nbsp; This was the slowest rate of growth since 1999.&nbsp; Health care spending, however, continues to outpace overall economic growth and general inflation, which grew 6.1 percent and 3.2 percent, respectively, in 2006.</font> </li> </ul> <ul> <p> <font face="Arial" size="2">In 2006, health care spending reached a total of $2.1 trillion, or $7,026 per person, up from $6,649 per person in 2005, according to a report by the Centers for Medicare &amp; Medicaid Services (CMS).&nbsp; The health spending share of the nation s Gross Domestic Product (GDP) remained relatively stable in 2006 at 16.0 percent, up by only 0.1 percentage point from 2005.&nbsp;</font></p> </ul> <ul> <p> <font face="Arial" size="2">Out-of-pocket spending grew 3.8 percent in 2006, a deceleration from 5.2 percent growth in 2005.&nbsp; This slowdown is attributable to the negative growth in out-of-pocket payments for prescription drugs, mainly due to the introduction of the Medicare Part D benefit.&nbsp; Out-of-pocket spending accounted for 12 percent of national health spending in 2006; this share has steadily declined since 1998, when it accounted for 15 percent of health spending.&nbsp; Out-of-pocket spending relative to overall household spending, however, has remained fairly flat since 2003.</font></p> </ul> <ul> <p> <font face="Arial" size="2">The CMS found that overall private spending growth slowed in 2006.&nbsp; Private health insurance premiums grew 5.5 percent in 2006, which was the slowest rate of growth since 1997.&nbsp; Benefit payment growth also slowed, from 6.9 percent growth in 2005 to 6.0 percent in 2006.&nbsp; The slower growth reflects, in part, a decline in private health insurance spending on prescription drugs.&nbsp; The ratio of net cost of private health insurance (the difference between premiums and benefits) to total private health insurance premiums was 12.3 percent in 2006, slightly lower than 12.7 percent in 2005.&nbsp;</font></p> </ul> <ul> <p> <font face="Arial" size="2">At the aggregate level in 2006, businesses (25 percent), households (31 percent), other private sponsors (3 percent), and governments (40 percent) paid for about the same share of health services and supplies as they did in 2005.&nbsp; However, spending shifts did occur within major sponsor categories due to implementation of the Medicare Part D benefit.&nbsp; Medicare s share of federal spending increased from 29 percent in 2005 to 34 percent in 2006, while Medicaid s share decreased from 45 percent to 40 percent.&nbsp; For households, the share of Medicare spending attributable to payroll taxes and premiums increased slightly in response to first-time Medicare Part D premiums.&nbsp; Conversely, the out-of-pocket spending share decreased slightly due, in part, to the newly available prescription drug coverage through Medicare Part D.</font></p> </ul> <ul> <p> <font face="Arial" size="2">Spending growth for most personal health care services slowed in 2006.&nbsp; Hospital spending, which accounts for 31 percent of total health care spending, grew 7.0 percent in 2006, a decrease of 0.3 percentage points from 2005 and a continued deceleration from 2002 (when growth was 8.2 percent).&nbsp; The 2006 growth rate was partially driven by lower utilization of hospital services, especially within Medicare as fee-for-service inpatient hospital admissions declined.</font></p> </ul> <ul> <p> <font face="Arial" size="2">Spending for physician and clinical services also slowed, increasing 5.9 percent in 2006, which is 1.5 percentage points slower than in 2005 and the slowest rate of growth since 1999.&nbsp; The slowdown was driven by a deceleration in price growth, fueled by a near freeze on Medicare payments to physicians (whose fee schedule update was 0.2 percent in 2006) that influenced private payers as well.</font></p> </ul> <ul> <p> <font face="Arial" size="2">In addition, spending growth for both nursing home and home health services slowed.&nbsp; For freestanding nursing homes, spending grew 3.5 percent in 2006 a deceleration from 4.9 percent in 2005 and the slowest rate of growth since 1999.&nbsp; This deceleration is partially attributable to a reduction in nursing home price growth.&nbsp; Spending growth for freestanding home health care services decelerated from 12.3 percent in 2005 to 9.9 percent in 2006, also partially due to a reduction in price growth.&nbsp; Despite the 2006 deceleration, home health care continues to be the fastest growing component of all personal health care spending.</font></p> </ul> <ul> <p> <font face="Arial" size="2">The implementation of the Medicare Part D prescription drug benefit affected a variety of indicators, including rates of growth of prescription drug spending and the share of drug spending accounted for by Medicare.&nbsp; The Medicare Part D benefit contributed to an increase in total Medicare spending, which grew 18.7 percent in 2006 compared to 9.3 percent in 2005. In addition, Medicare Advantage spending as a share of total Medicare spending increased from 14 percent in 2005 to 18 percent in 2006, in part due to a 25 percent increase in Medicare Advantage enrollment over the same period.&nbsp; At the same time, traditional fee-for-service enrollment declined 3.8 percent and its share of total Medicare spending fell from 86 to 82 percent.</font></p> </ul> <ul> <p> <font face="Arial" size="2">Prescription drug spending growth accelerated for the first time in six years from a low of 5.8 percent in 2005 to 8.5 percent in 2006.&nbsp; Roughly half of this growth was due to increased use of prescription drugs, partly a result of coverage now available under Medicare Part D, as well as new indications for existing drugs, growth in therapeutic classes, and increased use of specialty drugs.</font></p> </ul> <ul> <p> <font face="Arial" size="2">However, a higher generic dispensing rate in 2006 helped to restrain prescription drug spending growth, which despite the acceleration still remained well below the average annual growth of 13.4 percent per year that occurred between the years 1995 and 2004.&nbsp; </font> </p> </ul> <ul> <p> <font face="Arial" size="2">Total prescription drug spending in 2006 was $216.7 billion, compared to $199.7 billion in 2005.&nbsp; Public funding sources, including Medicare and Medicaid, accounted for 34 percent of total drug spending, whereas in 2005 their share was approximately 28 percent.&nbsp; In addition to an increase in the share of prescription drug spending funded by public sources, the implementation of Medicare Part D also shifted Medicaid funding to Medicare for dually eligible individuals.&nbsp; Medicare s share of total prescription drug spending increased from 2 percent in 2005 to 18 percent in 2006.&nbsp; Private funding for prescription drugs, including private health insurance and out-of-pocket spending, declined by 1.3 percent from 2005 to 2006; as a result, the private share fell from 72 percent in 2005 to 66 percent in 2006.</font></p> </ul> <ul> <p> <font face="Arial" size="2">The health care spending data can be found on the CMS Web site at </font><a href="http://www.cms.hhs.gov/NationalHealthExpendData/01_Overview.asp" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.cms.hhs.gov/National<wbr></wbr>HealthExpendData/01_Overview<wbr></wbr>.asp</u></font></a><font face="Arial" size="2">.&nbsp;</font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The U.S. has the highest rate of preventable deaths among 19 industrialized nations, and although the U.S. rate has declined over the past five years, it is doing so at a slower rate than other countries, according to a London School of Hygiene &amp; Tropical Medicine analysis published in the journal <i>Health Affairs</i>. </font></li> </ul> <ul> <p> &nbsp; &nbsp;<font face="Arial" size="2">The study, </font><a href="http://content.healthaffairs.org/cgi/content/abstract/27/1/58" target="_blank"><font color="#0000ff" face="Arial" size="2"><i><u> Measuring the Health of Nations, </u></i></font></a><font face="Arial" size="2"> examined preventable deaths in people younger than age 75 caused by 30 conditions that could have been treated with medical or surgical interventions, including tuberculosis, thyroid disease, appendicitis, tetanus infections, abdominal hernia, colon cancer, measles and epilepsy. The analysis also included deaths in people younger than age 50 caused by leukemia, cervical cancer and diabetes. The report focused on people whose lives would have been extended with widely available medical treatment.</font></p> </ul> <ul> <p> &nbsp; &nbsp;<font face="Arial" size="2">According to the study, if the rate of preventable deaths in the U.S. improved to the average of the top three countries -- France, Japan and Australia -- 101,000 fewer U.S. residents would die annually.</font></p> </ul> <ul> <p> &nbsp; &nbsp;<font face="Arial" size="2">In 1997-1998, the U.S. rate of preventable deaths was 15th of the 19 countries, with 115 preventable deaths per 100,000 people, compared with 110 deaths per 100,000 people five years later, a 4.4 percent improvement. The largest improvements were seen in Ireland, the U.K. and Austria, all of which have reduced smoking, improved diets and increased access to care. Ireland also has improved access to some heart disease treatments, such as bypass surgery and anti-clotting drugs.</font></p> </ul> <ul> <p> &nbsp; &nbsp;<font face="Arial" size="2">The other countries included in the study were Canada, Denmark, Finland, Germany, Greece, Italy, the Netherlands, New Zealand, Norway, Portugal, Spain and Sweden. Of the countries examined, the U.S. is the only one without universal health care coverage.</font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">On Jan 4 2008, the U.S. Food and Drug Administration announced two major changes in the agency's senior leadership team. Stephen F. Sundlof, D.V.M., Ph.D., is moving from director of FDA's Center for Veterinary Medicine (CVM) to director of FDA's Center for Food Safety and Applied Nutrition (CFSAN). Bernadette Dunham, D.V.M., Ph.D., who is deputy director of CVM, will assume directorship of CVM. </font></li> </ul> <ul> <p> <font face="Arial" size="2">For more than a decade, Dr. Sundlof has served as the director of CVM. In that capacity, with his background as a toxicologist, he has overseen the regulation of feed, including food additives, and drugs intended for animals. These include animals from which human foods are derived, as well as food and drugs for pets (or companion animals) and other non-food-producing animals such as zoo animals, parakeets, hamsters, and aquarium fish.</font></p> </ul> <ul> <p> <font face="Arial" size="2">Dr. Sundlof has extensive experience in the food safety and protection arena, including service on numerous domestic and international committees on food safety, where he served as chairman and led the development of new international policies and safety standards. He also provided significant input into the development of the FDA's Food Protection Plan issued in November 2007, a strategic and comprehensive approach to improve food safety and defense in the United States. He was instrumental in putting in place robust animal feed programs to prevent Bovine Spongiform Encephalopathy (BSE), also called mad cow disease, from entering the U.S. feed system. There have been no cases of mad cow disease in the United States resulting from a failure of the feed system. This depth and breadth of experience makes him well suited to serve as director of CFSAN.</font></p> </ul> <ul> <p> <font face="Arial" size="2">Dr. Dunham has worked closely with Dr. Sundlof in her role as deputy director of CVM since 2006. She has played a critical role, and provided executive leadership, in coordinating and establishing center policy in research, management, scientific evaluation, compliance, and surveillance. While serving as CVM deputy director, Dr. Dunham also was the director for CVM's Office of Minor Use and Minor Species Animal Drug Development, the office that oversees drug development for minor species, such as zoo animals, ornamental fish, parrots, ferrets, guinea pigs, sheep, goats, catfish, and honeybees. That office also oversees drug development for uncommon diseases in major species, such as cattle, pigs, chicken, turkeys, horses, dogs and cats.</font></p> </ul> <ul> <p> <font face="Arial" size="2">Drs. Sundlof and Dunham assumed their new roles on Jan 7 and will report directly to Dr. von Eschenbach. </font><a href="http://www.fda.gov/bbs/topics/NEWS/2008/NEW01771.html" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.fda.gov/bbs/topics<wbr></wbr>/NEWS/2008/NEW01771.html</u></font></a></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">Three new overview papers from the Substance Abuse and Mental Health Services Administration (SAMHSA) provide information about how epidemiology, services integration and systems integration research and practices can be best utilized in helping people with co-occurring substance use and mental disorders. </font></li> </ul> <ul> <p> <font face="Arial" size="2">These overview reports are the final in a series developed by SAMHSA s Co-Occurring Center for Excellence (COCE), a leading national public health resource in the field of understanding and disseminating crucial information about addressing this problem.&nbsp; The series is based on the best available science, research and practices and is primarily geared for a wide array of mental health and substance abuse treatment service professionals, although they provide useful information to the general public as well. </font> </p> </ul> <p> &nbsp; &nbsp;<font face="Arial" size="2">The three overview papers include: &nbsp; </font> </p> <ul> <ul type="DISC"> <li><font face="Arial" size="2"><i>Services Integration: Overview Paper 6</i> defines and explains how services integration practices can help merge previously separate substance abuse treatment and mental health clinical services provided at the individual level to people with co-occurring disorders. Combining and coordinating these treatments at the level of direct contact with individual clients can better ensure that their full range of treatment needs are addressed.&nbsp; This approach emphasizes that successful treatment of co-occurring disorders is very often based on providing all the client s treatment needs as concurrently as possible.&nbsp;</font> </li> <li><font face="Arial" size="2"><i>Systems Integration: Overview Paper 7 </i>outlines the benefits of developing public health infrastructures that systematically integrate mental health and substance abuse treatment programs to better meet the full needs of people with these disorders.&nbsp; The paper encourages integrated system planning, continuous quality improvement analysis activities and other practices that lead to more effective, comprehensive public health services for meeting the health needs of this client community.&nbsp;</font> </li> <li><font face="Arial" size="2"><i>The Epidemiology of Co-Occurring Substance Use and Mental Disorders: Overview Paper 8 </i>is presented in two parts.&nbsp; Part 1 provides the general public with a basic understanding of the field of epidemiology and how it has been used to shed light on the problem of co-occurring disorders.&nbsp; In particular, it focuses on three major studies that are regularly referenced as prime sources of information on the nature and scope of this problem.&nbsp; Part 2 is geared more to the scientific community and provides more detailed technical information on these three studies.&nbsp; </font></li> </ul> </ul> <ul> <p> <font face="Arial" size="2">SAMHSA is creating these training materials as part of the plan outlined in its <i>November 2002 Report to Congress on the Prevention and Treatment of Co-Occurring Substance Abuse Disorders and Mental Disorders.</i> Previously published short papers address a wide range of other issues and practices related to addressing the needs of people with co-occurring disorders. More information about the Co-Occurring Center for Excellence and the short papers can be found at </font><a href="http://www.coce.samhsa.gov" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>www.coce.samhsa.gov</u></font></a><font face="Arial" size="2"> . </font> </p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">Physician-owned specialty hospitals are poorly equipped to handle emergency care, according to an HHS Office of Inspector General (OIG) </font><a href="http://www.oig.hhs.gov/oei/reports/oei-02-06-00310.pdf" target="_blank"> <font color="#0000ff" face="Arial" size="2"><u>report</u></font></a><font face="Arial" size="2"> released on Jan 10, 2008. The IOG report reviewed 109 physician-owned hospitals to assess physician-owned specialty hospitals ability to manage medical emergencies. The IOG found that while 55 percent had emergency departments (ED) and the majority of those hospitals had only one ED bed. The report also found that seven percent of physician-owned hospitals do not meet Medicare requirements that a registered nurse be present at all times and that a physician be on call if none are on site.</font> </li> </ul> <p> &nbsp; &nbsp;<font face="Arial" size="2">In addition, the report found:</font></p> <ul> <ul type="DISC"> <li><font face="Arial" size="2">22 percent&nbsp; of the hospitals did not address in written policies how emergency situations should be evaluated and handled, which is required by CMS;</font> </li> <li><font face="Arial" size="2">34 percent of the hospitals rely on dialing 911 to obtain emergency care for patients; and</font> </li> <li><font face="Arial" size="2">Fewer than one-third of hospitals had a physician on site at all times.</font> </li> </ul> </ul> <p> <font face="Arial" size="2">The IOG recommended that CMS develop a system to identify and regularly track physician-owned specialty hospitals; ensure that hospitals meet the current Medicare CoPs that require a registered nurse to be on duty 24 hours a day, 7 days a week and a physician to be on call if one is not onsite; ensure that hospitals have the capabilities to provide for the appraisal and initial treatment of emergencies and that they are not relying on 9-1-1 as a substitute for their own ability to provide these services; and require hospitals to include necessary information in their written policies for managing a medical emergency, such as the use of emergency response equipment and the life-saving protocols to be followed. </font>&nbsp;<br /> </p> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font></p> </ul> <ul> <h1> <font face="Arial Black" size="3"><a name="reserve">Reserve/Guard</a></font> </h1> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The total number of Guard and Reserve currently on active duty has <b>increased</b> by 2,421 from the last report to 92,673. The totals for each service are Army National Guard and Army Reserve, 72,343; Navy Reserve, 5,039; Air National Guard and Air Force Reserve, 6,281; Marine Corps Reserve, 8,684; and the Coast Guard Reserve, 326. </font><a href="http://www.defenselink.mil/" target="_blank"> <font color="#0000ff" face="Arial" size="2"><u>www.defenselink.mil</u></font></a> </li> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font></p> </ul> <ul> <p> <font face="Arial Black" size="3"><a name="reports">Reports/Policies</a></font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The Institute of Medicine (IOM) published <i> Workshop Summary. Neuroscience Biomarkers and Biosignatures: Converging Technologies, Emerging Partnerships, </i> on Jan. 10, 2008.&nbsp; The report is a summary of the public workshop in which experts from multiple areas discussed the most promising and practical arenas in neuroscience in which biomarkers will have the greatest impact. The main objective of the workshop was to identify and discuss biomarker targets that are not currently being aggressively pursued but that could have the greatest near-term impact on the rate at which new treatments are brought forward for psychiatric and neurological disorders. </font><a href="http://www.iom.edu/CMS/3740/35684/50415.aspx" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.iom.edu/CMS/3740<wbr></wbr>/35684/50415.aspx</u></font></a> </li> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font></p> </ul> <ul> <p> <font face="Arial Black" size="3"><a name="leg">Legislation</a></font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">No legislation was proposed.</font> </li> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font> </p> </ul> <ul> <p> <font face="Arial Black" size="3"><a name="hill">Hill Hearings</a></font></p> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The Senate Veterans' Affairs Committee will hold an oversight hearing on <b>Feb. 5, 2008</b>, to examine veterans disability compensation, focusing on the work of the Senior Oversight Committee.</font> </li> <li><font face="Arial" size="2">The Senate Veterans' Affairs Committee will hold a hearing on <b>Feb. 13, 2008</b>, examine proposed budget estimates for fiscal year 2009 for Veterans programs.</font> </li> </ul> <ul> <p align="right"> <font color="#0000ff" face="Arial" size="2"><a href="#top">Back to Top</a></font></p> </ul> <ul> <h1> <font face="Arial Black" size="3"><a name="top">Meetings / Conferences</a></font> </h1> </ul> <ul type="DISC"> <li><font face="Arial" size="2">The State of the MHS - The 2008 Annual TRICARE Conference will be held on <b>Jan. 28-31, 2008,</b> in Washington D.C. </font><a href="http://www.tricare.mil/conferences.cfm" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.tricare.mil/conferen<wbr></wbr>ces.cfm</u></font></a> </li> <li><font face="Arial" size="2">The 8th Annual Madigan Pediatric Update Conference will be held on <b>Feb. 8-9, 2008</b>, in Fort Lewis, Wash. </font><a href="http://www.hjf.org/events/linkevent.html" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.hjf.org/events<wbr></wbr>/linkevent.html</u></font></a> </li> <li><font face="Arial" size="2">The 2008 HIMSS Annual Conference will be held on <b> Feb. 24-28, 2007</b>, in Orlando, Fla. </font><a href="http://www.himssconference.org/?src=hhpf" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.himssconference.org<wbr></wbr>/?src=hhpf</u></font></a> </li> <li><font face="Arial" size="2">The Family Readiness Leadership Course will be offered on <b>Feb. 23-24, 2008,</b> in Amarillo, Texas.&nbsp; </font><a href="http://www.guardfamily.org" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>www.guardfamily.org</u></font></a> </li> <li><font face="Arial" size="2">The American Medical Directors' Association's (AMDA) 2008 Annual Symposium will be held on <b>March 6-9, 2008,</b> in Salt Lake City, Utah. </font><a href="http://www.amda.com/education/annsym08/" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.amda.com/education<wbr></wbr>/annsym08/</u></font></a> </li> <li><font face="Arial" size="2">The 2008 American Medical Women s Association Annual Meeting will be held on <b>March 7-8, 2008</b>, in Anaheim, Calif.&nbsp; </font> <a href="http://www.womenshf.com/index.cfm" target="_blank"><font color="#0000ff" face="Arial" size="2"><u>http://www.womenshf.com/index<wbr></wbr>.cfm</u></font></a> </li> <li><font face="Arial" siz