1. Shaping Our Future:Updates and Opportunities for the FieldGabrielle de la Guronnire Legal Action Center 2011 NCADD Advocacy Day September 8, 2011

2. Legal Action Center Advocacy for people with addiction histories, criminal records, and HIV/AIDS Thirty-five year history of policy analysis and advocacy Federal policy work Advocating for the expansion of services and resources for people with addiction histories, criminal records, and HIV/AIDS Fighting discrimination: eliminating legal and policy barriers in place for people with addiction histories and criminal records 3. Parity and Health Care Reform:A Time of Tremendous Opportunity Greater understanding of addiction aspreventable, treatable chronic health condition Federal parity statute and regulations (MHPAEA) arenow in effect for all covered plans Dramatic expansion of coverage of addictiontreatment SUD and MH benefits must be included in the ACAs essential health benefit package; these benefits must be offered: By private insurance plans participating in the health insurance exchanges Individual and small group plans, States can allow large employers to participate in the exchanges in 2017 For newly-eligible Medicaid enrollees, including 4. Parity and Health Care Reform: A Timeof Tremendous Opportunity (contd) All plans in the exchange must adhere to theprovisions of the federal parity law SUD and MH benefits provided to the Medicaidexpansion population also must comply withparity Building on the federal parity law:o SUD/MH benefits required and must beprovided at parityo Extension to individual and small groupplanso Requirement for SUD and MH benefits forthe Medicaid expansion population 5. Parity and Health Care Reform: A Timeof Tremendous Opportunity (contd) Inclusion of addiction in integratedcare initiatives Health homes and accountable care organizations Inclusion of substance useprevention in chronic diseaseprevention initiatives Identification of the addiction serviceworkforce as part of the healthworkforce 6. Huge Opportunities But Miles toGo The success of these laws depends ondecisions that will be made in thecoming days, months and years Decisions in Washington and by state and local policy-makers around the country There is a critical need for our fieldto educate and advocate to ensurethese laws are well implemented forthe people we serve 7. ACA implementation:Our Advocacy on Benefit Design Huge opportunity to expand coveragefor and access to care SUD/MH benefits required by notdefined in the ACA Key next steps in the process to definethe SUD/MH essential health benefit: Institute of Medicinereport due bythe end of the month Proposed regulations on the essentialhealth benefit (possibly) released byHHS by the end of the year Various opportunities for publiccomment 8. ACA implementation:Our Advocacy on Benefit Design (contd) Advocacy of the national SUD and MH groups:the Coalition for Whole Health Crafting a comprehensive SUD and MH benefit Coalition for Whole Health Essential HealthBenefits Recommendations paper; continuedneed for broad organizational sign-on www.lac.org; National Health Care Reform link Using the paper with other education andadvocacy tools with decision-makers in theAdministration and to engage our allies inCongress Parallel advocacy process needed inthe states 9. Our Advocacy onParity Implementation Interrelationship with ACA advocacyopportunity forhuge expansions in coverage by private insurance Continued challengesfighting violations of both theletter and spirit of the law Advocating for additional guidance at the federal level Monitoring compliance and encouraging strongfederal and state activity and response Gathering information about plan compliance; filingcomplaints for violations of the law; aggregatinginformation and sharing with the regulators Templates and other resources by the ParityImplementation Coalition:www.mentalhealthparitywatch.org Engaging our champions Continued tremendous need for education 10. Protecting Safety Net Funding Recognition that ACA coverage provisions do notgo into effect until 2014 We dont yet know which services will be includedin the SUD essential health benefit Huge need for continued strong federal fundingfor prevention, treatment, recovery supports andresearch before the ACA is fully implemented andbeyond During this interim period before expansion hasoccurred Through implementation of the ACA to cover theservices not included and the people who remainuncovered or underinsured 11. Our Advocacy on Strong Safety NetFunding Advocacy by the national drug and alcoholcommunity Fighting for highest possible funding forSAMHSA and the continuum Huge need for a continued push fromaround the country with Congress and theObama Administration; www.lac.org Need to ensure our system of care isstrong now and beyond 12. Our Advocacy: Now More Important ThanEver Continued outreach and education within and outside of our field Connecting our work in Washington with implementation efforts around the country Speaking with one cohesive voice Finding the best ways to engage our champions Advocating for the strongest possible SUD benefit through the ACA Protecting safety net programming Monitoring implementation and informing our federal partners about successes and non-compliance 13. Gabrielle de la Guronnire gdelagueronniere@lac-dc.org202-544-5478 (phone) 202-544-5712 (fax)www.lac.org www.hirenetwork.org