FY 2024 Annual Performance Plan and Report - Strategic Goal 1: Objective 1.4

Fiscal Year 2024
Released March, 2023

Topics on this page: Objective 1.4: Drive the integration of behavioral health into the healthcare system to strengthen and expand access to mental health and substance use disorder treatment and recovery services for individuals and families | Objective 1.4 Table of Related Performance Measures

Objective 1.4: Drive the integration of behavioral health into the healthcare system to strengthen and expand access to mental health and substance use disorder treatment and recovery services for individuals and families

HHS supports strategies to drive the integration of behavioral health into the healthcare system to strengthen and expand access to mental health and substance use disorder treatment and recovery services for individuals and families across all settings.  HHS is enhancing the ability to serve those in need of behavioral health services by exchanging data, information, and resources while expanding evidence-based integrated systems of behavioral and physical healthcare to improve equitable access to quality care.  HHS is also engaging and educating healthcare providers, healthcare professionals, paraprofessionals, other health workforce professionals, and students in these professions to build their practice competence and capacity to address the behavioral and physical health needs of individuals, families, caregivers, and communities.

The Office of the Secretary leads this objective.  The following divisions are responsible for implementing programs under this strategic objective: ACL, ASPE, AHRQ, CDC, CMS, FDA, HRSA, IHS, NIH, OASH, OCR, OGA, and SAMHSA.  In consultation with OMB, HHS has determined that performance toward this objective is progressing.  The narrative below provides a brief summary of progress made and achievements or challenges, as well as plans to improve or maintain performance.

Objective 1.4 Table of Related Performance Measures

The number of people trained for the support of the recovery community organizations and peer support networks was above the initial target for this program.  Because of the COVID-19 pandemic the Peer Recovery Center of Excellence adjusted their activities to mainly virtual training and technical assistance which provided the environment for many additional participants to attend their trainings and activities.  Over 4,700 participants attended events during this period however only 541 responded to the post event data collection form.  This program was funded on August 2020 and the training and events center around focus areas: Clinical Integration of Peers into Non-Traditional Settings, Recovery Community Organization Capacity Building, Peer Workforce Development, and Evidence-Based Practice and Practice-Based Evidence Dissemination.  Early 2021 this program started accepting Technical Assistance (TA) requests from anyone in need of support related to substance use disorder peer support services.  As the pandemic emergency continues, the majority or training and technical assistance will be delivered virtually.  The Peer Recovery Center of Excellence target for FY 2022 increased slightly to account for supplemental funds that were awarded to provide technical assistance to support infrastructure development, training, and other supports to SAMHSA’s Minority AIDS Initiative grantees, including the Prevention Navigators, and other grantees and recipients who are interested in integrating peer recovery strategies into their prevention approaches.

This measure supports AHRQ’s ongoing work to create accurate data for monitoring and responding to the opioid crisis.  AHRQ maintains two large databases capable of monitoring data relevant to the opioid overdose epidemic – the Healthcare Cost and Utilization Project (HCUP) and the Medical Expenditure Panel Survey-Household Component (MEPS-HC).

HCUP includes the largest collection of longitudinal hospital care data in the United States and HCUP Fast Stats displays that information in an interactive format that provides easy access to the latest HCUP-based statistics for healthcare information topics.  More information on HCUP can be found on the HCUP website at https://hcup-us.ahrq.gov/.  HCUP is able to produce national estimates on Opioid-Related Hospital Use based on data from the HCUP National Inpatient Sample (NIS) and the HCUP Nationwide Emergency Department Sample (NEDS).  HCUP is able to produce State-level estimates on Opioid-Related Hospital Use based on data from the HCUP State Inpatient Databases (SID) and HCUP State Emergency Department Databases (SEDD).  HCUP is also able to produce data on the rate of births diagnosed with NAS (newborns exhibiting withdrawal symptoms due to prenatal exposure to opioids) by State.  State-level statistics on newborn NAS hospitalizations are from the HCUP State Inpatient Databases (SID).  National statistics on newborn hospitalizations are from the HCUP National (Nationwide) Inpatient Sample (NIS).

The MEPS-HC collects nationally representative data on health care use, expenditures, sources of payment, and insurance coverage for the U.S. civilian noninstitutionalized population.  The MEPS-HC is cosponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS).  More information about the MEPS-HC can be found on the MEPS Web site at http://www.meps.ahrq.gov/.  MEPS-HC data can be used to produce Statistical Briefs that examine a wide range of measures of opioid use and expenditures including the percentages of adults with any use and frequent use of outpatient opioids during the year.

For the outpatient use of opioid measure, in FY 2022 MEPS has produced two Briefs on outpatient opioid use, one for non-elderly and one for elderly adults overall, looking at socioeconomic characteristics including sex, race-ethnicity, income, insurance status, perceived health status, Census region and Metropolitan Statistical Area (MSA) status.  In FY 2023, that Brief will be updated and, if relevant, new analyses of trends or using additional data sources may be added.

AHRQ updated the website interactive maps that provide trends in opioid-related inpatient stays and emergency department visits at the national and State levels and a Neonatal Abstinence Syndrome (NAS) Among Newborn Hospitalizations interactive heat map that visualizes the rate of births diagnosed with NAS by State with 2018 data.

The Rural Communities Opioid Response Program (RCORP) is a multi-year initiative administered by HRSA that funds community-based grants and technical assistance to reduce the morbidity and mortality of substance use disorder (SUD), including opioid use disorder (OUD), in rural communities.  Since its inception in FY 2018, RCORP has served over 1,800 counties in 47 states and two territories.  Given the initiative’s initial focus on OUD, and the limited availability of DATA 2000-waivered providers in rural communities, increasing the number of providers willing and able to provide Medication-Assisted Treatment (MAT) was a key focus area and objective of RCORP’s inaugural grant awards.  In FY 2021, 2,872 providers provided MAT in areas served by RCORP grant recipients, an increase of nearly 200 providers over the previous year.  HRSA has expanded the scope of the RCORP initiative to include other substances of concern (e.g., methamphetamine) as well as broader behavioral health challenges in rural communities.  Consequently, HRSA expects that the number of RCORP grant recipients focused solely on MAT provision will decrease and has set targets that reflect that change.

Outreach events are an effective way to proactively address civil rights and HIPAA compliance in provider communities.  As part of HHS efforts to integrate behavioral health into the health care system, OCR is training and providing technical assistance to health care providers, health care professionals, and paraprofessionals to increase awareness of civil rights protections for individuals in recovery from substance use disorder, including individuals receiving medications for Opioid Use Disorders.  The outreach events also  provide technical assistance and training on protecting the confidentiality and care coordination of behavioral health through HIPAA.  Information provided during these events will help to eliminate discriminatory barriers and expand access to mental health and substance use disorder treatment and recovery services for individuals and families. OCR is exceeding its target goals and providing outreach to hundreds of health care providers and attorneys across the country, along with child welfare system personnel who are trained through a video series.