ATOD Section Chair’s Column

June 2009

By Ann Mahony

A lot has happened in the Alcohol, Tobacco and Other Drug Section since our last issue of the Section’s online newsletter.  Our last newsletter was disseminated just days after the Obama administration took the helm.  The initial meetings, framework and leaders in the discussion surrounding health reform have been introduced with Kathleen Sebelius serving as the Secretary of Health and Human Services and Nancy-Ann DeParle heading the Office of Health Reform.  The country still feels far away from an operational plan, yet the summer months ensure lively and hopefully productive debate.  Although tobacco issues are front and center given the focus on primary prevention, the place of alcohol and other drugs  on the agenda is still unclear.  For those struggling with how to make alcohol and other drugs prevention and treatment part of the discussion, I’ll reference a recent discussion I had with Connecticut’s Commissioner of Mental Health and Addiction Services, Dr. Thomas Kirk.  We talked about his principle when putting his substance abuse and mental health agenda forward.  Dr. Kirk works toward ensuring that substance abuse and mental health issues are always part of and integral to the discussion, whether the meeting’s focus is public health, health reform, criminal justice or youth and families.  By doing so, substance abuse and mental health issues are indeed becoming integral to these areas.  Because the connections are put in the context of the larger state’s agenda, progress is being made to enact higher alcohol excise taxes to pay for alcohol prevention and treatment programs.  There is some discussion at the federal level that this may make sense as a health reform funding stream.    

In April the ATOD leadership team convened in Washington for three purposes: first, to plan the program for the ATOD Section annual meeting; second, to meet with APHA staff to update each other on key issues; and third, to discuss the Section’s internal agenda for the upcoming year.  On the first topic, Linda Bosma, the ATOD program chair and incoming Section chair, did a superb job organizing the abstracts by content.  This year Linda and I worked to conduct outreach not only by content area such as alcohol and drugs but also by strategic areas.  We are working toward designing sessions that have cross-cutting themes such as environmental policy strategies which include guns, obesity, and physical activity in order to foster exchange and demonstrate the use of evidence-based practice and lessons learned across the public health field at large. Details highlighting the process and themes appear in Linda’s article in this issue. 

Next, Dr. Georges Benjamin, APHA’s Executive Director, laid out APHA’s health reform emphasis which is to shift from a focus on treating illness to providing community-based health promotion and preventive health services, which will measurably improve health and control costs.  The APHA Agenda for Health Reform highlights the most critical changes we must make to improve the public’s health, based on longstanding APHA policies and the best current evidence, all of which are consistent and integrated into the ATOD Section’s annual meeting themes.  We need to invest in population-based prevention, education, and outreach strategies that have been proven to prevent disease and injury and improve social determinants of health.  Another APHA health reform priority is to address the chronic under-funding of the nation’s public health system.  

A rich discussion of technology opportunities for members of the ATOD Section was led by ATOD’s Mark Parascondola and Andrea Frydl. Thanks to Mark and Andrea, there is now an ATOD Facebook page.  If you have a Facebook account, send your e-mail address to Andrea Frydl at frydlal@mail.nih.gov so you can be invited to the group.  The mid year meeting ended with a presentation by Carol McDaid of Capitol Associates on the Mental Health Parity and Substance Abuse Equity Bill, which was passed in October of 2008.  Under this legislation, 149 million people will be covered for mental health and substance abuse care.  Coverage will reach those who are employed by large employer health plans, Medicaid managed care and SCHIP.  By definition, a large employer employs 50 or more employees with health coverage.  The overriding message Carol conveyed was that to ensure your advocacy position, always go into a large publicly negotiated process knowing and asking for exactly what you want, along with factual information, which allows you to gain as much as possible.  The opportunity to provide public comments was sought via the Federal Register to guide the development of the regulation.  The opportunity for public comments in now closed.  As is always the case, the devil will be in the details to develop the regulation.