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FY 2019 Annual Performance Plan and Report - Goal 2 Objective 3








  
  
    

  
      



Fiscal Year 2019

Released April, 2018



**Topics on this page:** Goal 2. Objective 3 | Objective 2.3 Table of Related Performance Measures

Goal 2.  Objective 3:  Reduce the impact of mental and substance use disorders through prevention, early intervention, treatment, and recovery support

Mental illness and substance abuse create health risks and place a heavy burden on affected individuals and their families.  Substance use disorders arise from the recurring use of alcohol and/or drugs, which lead to clinically and functionally significant impairments.  Mental disorders are health conditions that involve significant changes in thinking, emotion, and/or behavior and lead to distress and/or problems functioning in social, work, or family activities.  Mental and substance use disorders are illnesses that impact people’s ability to go about their daily lives in family, social, and professional settings and place individuals at risk of additional health problems.

HHS works closely with Federal, State, Tribal, local, territorial, and community partners and stakeholders, including faith-based and community organizations, to help identify and address mental health problems and substance use disorders.  The Department invests in programs and interventions focused on prevention, screening, and early detection of serious mental illness and substance abuse, including those related to opioid abuse.

Other HHS activities involve improving the provision of comprehensive, coordinated, and evidence-based community recovery supports for affected individuals and improving access to treatment options.  Continuing to advance research and work in these areas raises awareness and facilitates the adoption of best practices across communities to minimize the negative health impacts caused by mental and substance use disorders.

The Office of the Secretary leads this objective.  The following divisions are responsible for implementing programs under this strategic objective: ACF, ACL, AHRQ, CDC, CMS, FDA, HRSA, IHS, IOS, OCR, and SAMHSA.

Objective 2.3 Table of Related Performance Measures

Opioid Cluster

*Reduce the age-adjusted annual rate of overdose deaths involving prescription opioids per 100,000 population among states funded through Prescription Drug Overdose Prevention for States program (Lead Agency - CDC; Measure ID - 7.2.6)*14

FY 2012
			FY 2013
			FY 2014
			FY 2015
			FY 2016
			FY 2017
			FY 2018
			FY 2019Target
			N/A
			N/A
			N/A
			11.9 per 100,000 residents
			11.8 per 100,000 residents
			11.8 per 100,000 residents
			11.8 per 100,000 residents
			10.8 per 100,000 residentsResult
			N/A
			N/A
			13.3 per 100,000 residents
			N/A
			N/A
			Feb 28, 2018
			Feb 28, 2019
			Feb 28, 2020Status
			N/A
			N/A
			N/A
			Not Collected
			Baseline
			Pending
			Pending
			Pending

CDC has been tracking the rise of opioid overdose deaths and using the data to pivot to prevention activities to curb this alarming epidemic. Opioids were involved in over 42,249 deaths in 2016, and opioid overdoses were five times higher in 2016 than 1999. In response to this growing public health crisis, CDC has launched its Overdose Prevention in States (OPIS)15 effort as means to equip states with resources and expertise needed to reverse this epidemic. As a part of OPIS, CDC’s Prescription Drug Overdose Prevention for States (PfS) program funds 29 state health departments to advance and evaluate comprehensive state-level interventions for preventing opioid-related overdose, misuse, and abuse. This measure tracks progress in reducing overdose deaths involving all opioids among the 29 states funded specifically for PfS. In FY 2016 the baseline, age-adjusted annual rate of opioid overdoses was 11.8 per 100,000 residents among states funded for the PfS program. In FY 2018 and 2019, CDC will continue to track the rise of opioid overdose deaths to monitor the impact of its prevention activities.

*Increase the number of persons receiving outpatient Medication-Assisted Treatment (MAT) for Opioid Use Disorder from a substance use disorder treatment facility (Lead Agency - SAMHSA; Measure ID - 2.3.19K)*16

FY 2012
			FY 2013
			FY 2014
			FY 2015
			FY 2016
			FY 2017
			FY 2018
			FY 2019Target
			N/A
			N/A
			N/A
			N/A
			N/A
			N/A
			200,000.0
			220,000.0Result
			N/A
			N/A
			N/A
			163,787
			N/A
			N/A
			Dec 31, 2019
			Dec 31, 2020Status
			N/A
			N/A
			N/A
			Historic Actual
			N/A
			N/A
			Pending
			Pending

SAMHSA monitors this data to track advances in opioid surveillance pertaining to prevention, diagnosis, intervention, treatment, and recovery. This includes advances in access to services and supports for adults with SMI and children with SED. As the states further develop their systems with increased resources from the state targeted response grants and Medication-Assisted Treatment Prescription Drug and Opioid Addiction (MAT-PDOA) grants; Medicaid systems increase their focus on opioids; and technical assistance and outreach efforts from across HHS promote MAT, SAMHSA expects to see increases in the number of people receiving outpatient MAT for opioid use disorder from a substance use disorder treatment facility. MAT consists of provision of Methadone, Buprenorphine and Extended-release Naltrexone. MAT helps people manage their opioid addiction and supports their engagement in positive activities; while also greatly reducing the risk of overdose death. The most recent available data reported indicated that in FY 2015, 163,787 people received outpatient Medication-Assisted Treatment (MAT) for Opioid Use Disorder from a substance use disorder treatment facility. The next available data report for FY 2016, is expected in December 2018. In FY 2018 and 2019, SAMHSA will continue to monitor the use of MAT and its impact on SMI.

*Increase the availability of electronic clinical decision support tools related to safe pain management and opioid prescribing (Lead Agency - AHRQ; Measure ID - 2.3.8)*

Fiscal Year
			Target
			Result
			StatusFY 2012
			N/A
			N/A
			N/AFY 2013
			N/A
			N/A
			N/AFY 2014
			N/A
			N/A
			N/AFY 2015
			N/A
			N/A
			N/AFY 2016
			N/A
			N/A
			N/AFY 2017
			N/A
			N/A
			N/AFY 2018
			Develop at least one new electronic clinical decision support tool related to safe pain management and opioid prescribing
			Sep 30, 2018
			In ProgressFY 2019
			Test, revise, and disseminate at least one new electronic clinical decision tool related to safe pain management and opioid prescribing and
				Partner with stakeholders to identify additional evidence-based electronic clinical decision tools related to safe pain management and opioid prescribing and make them publicly available
			Sep 30, 2019
			In Progress

In FY 2017, AHRQ’s Health Services Research, Data, and Dissemination portfolio made substantial contributions to the Department’s comprehensive opioids strategy through public dissemination of systematic evidence reviews on non-opioid pain management and the use of naloxone by emergency medical service personnel, in addition to publishing a collection of over 250 field-tested tools to support the delivery of Medication Assisted Treatment (MAT) in primary care settings. Using AHRQ data platforms, AHRQ produced a series of analyses which documented trends in health care utilization fueled by the opioid epidemic at state and national levels and which uncovered the diverse ways the opioid crisis is manifesting itself across the country. In FY 2017, AHRQ also continued to support investigator-initiated health services research on the prevention and treatment of opioid addiction by health care delivery organizations, as well as targeted health services research expanding access to MAT in rural communities through primary care.

In FY 2018, AHRQ will develop new electronic clinical decision support (CDS) CDS in the clinical domain of safe pain management and opioid prescribing, an initiative that began in FY 2017.  The CDS will include shareable, interoperable specifications for integration into electronic health records as well as implementation guidance.  The CDS will be developed with input from a CDS Connect work group consisting of stakeholders from multiple perspectives, including patients, providers, health IT developers, and others.

In FY 2018 and continuing in FY 2019, the CDS for safe pain management and opioid prescribing will be tested, revised, and disseminated through the CDS Connect platform.  All resources developed within the project will be publicly-available at https://cds.ahrq.gov.  In addition, AHRQ plans to work with stakeholders to disseminate other safe pain management and opioid prescribing CDS tools and resources developed elsewhere.  For example, CDC and ONC will continue to develop opioid-related CDS that may be suitable for dissemination through CDS Connect.

*By 2020, evaluate the efficacy of new or refined interventions to treat opioid use disorders (OUD) (Lead Agency - NIH; Measure ID - SRO-4.9)*

Fiscal Year
			Target
			Result
			StatusFY 2012
			N/A
			N/A
			N/AFY 2013
			N/A
			N/A
			N/AFY 2014
			N/A
			N/A
			N/AFY 2015
			N/A
			N/A
			N/AFY 2016
			N/A
			N/A
			N/AFY 2017
			N/A
			N/A
			N/AFY 2018
			Initiate at least one study to improve identification of OUD or evaluate the comparative effectiveness of available pharmacotherapies for OUD treatment
			Dec 31, 2018
			In ProgressFY 2019
			Conduct 1 preclinical study and 1 clinical trial to develop non-opioid based medications to treat OUD that may avoid the risks of opioid dependence and overdose
			Dec 31, 2019
			In Progress

The misuse of and addiction to opioids such as heroin and prescription pain medicines is a serious national problem. This issue has become a public health epidemic with devastating consequences, including increases in opioid use disorders (OUDs) and related fatalities from overdoses, rising incidence of newborns who experience neonatal abstinence syndrome because their mothers used these substances during pregnancy, and increased spread of infectious diseases including HIV and hepatitis C (HCV). This measure highlights one facet of NIH-funded research in providing scientific evidence to inform the public health response to the opioid crisis.

Mental Illness Cluster

*Increase the percentage of youth ages 12-17 who experienced major depressive episodes in the past year receiving mental health services (Lead Agency - SAMHSA; Measure ID - 2.3.19O)*

FY 2012
			FY 2013
			FY 2014
			FY 2015
			FY 2016
			FY 2017
			FY 2018
			FY 2019Target
			N/A
			N/A
			N/A
			N/A
			N/A
			N/A
			43.0 %
			45.0 %Result
			N/A
			N/A
			N/A
			N/A
			40.9%
			Dec 31, 2018
			Dec 31, 2019
			Dec 31, 2020Status
			N/A
			N/A
			N/A
			N/A
			Historic Actual
			Pending
			Pending
			Pending

As states and the Federal Government strengthen their implementation and enforcement efforts related to parity and the Interagency Serious Mental Illness Coordinating Committee (SMICC) coordinates and drives Federal efforts to address the needs of children and youth with serious emotional disturbances, we will see reductions in the percentage of youth with major depressive episodes in the past year who are not receiving mental health services. This measure reports percentage of youth ages 12-17 who experienced major depressive episodes in the past year receiving mental health services. The data supports evaluations of the effect Federal programs related to SMI have on public health, including public health outcomes. There are effective medications and psychosocial interventions which can improve functioning and control the symptoms of depression, making receipt of these services critical. The most recent available data reported shown that in FY 2016, 40.9 percent of youth ages 12-17 who experienced major depressive episodes in the past year receiving mental health services. The next available data report for FY 2017 is expected in December 2018.

*Increase the percentage of adults with Serious Mental Illness (SMI) receiving mental health services (Lead Agency - SAMHSA; Measure ID - 2.3.19L)*

FY 2012
			FY 2013
			FY 2014
			FY 2015
			FY 2016
			FY 2017
			FY 2018
			FY 2019Target
			N/A
			N/A
			N/A
			N/A
			N/A
			N/A
			66.0 %
			68.0 %Result
			N/A
			N/A
			N/A
			N/A
			64.8 %
			Dec 31, 2018
			Dec 31, 2019
			Dec 31, 2020Status
			N/A
			N/A
			N/A
			N/A
			Historic Actual
			Pending
			Pending
			Pending

As states and the Federal Government strengthen their implementation and enforcement efforts related to parity and the Interagency Serious Mental Illness Coordinating Committee coordinates and drives Federal efforts to address SMI, SAMHSA expects to see reductions in the percentage of people with SMI who are not receiving mental health services. It is important for people with SMI to receive treatment so that they can better control their symptoms and improve their level of functioning. This measure reports percentage of adults with SMI receiving mental health services. The data can support recommendations for actions that agencies can take to better coordinate the administration of mental health services for adults with SMI and children with Serious Emotional Disturbance (SED). The most recent available data reported shown that in FY 2016, 64.8 percent of adults with SMI received mental health services. The next available data report for FY 2017 is expected in December 2018.

[14] Targets and results have been adjusted for 2018 using data from the 29 funded states. The performance metrics reflect age-adjusted rates of overdose deaths involving all opioid analgesics per 100,000 population.

[15]  https://www.cdc.gov/drugoverdose/states/index.html.

[16] MAT includes provision of Methadone, Buprenorphine, and extended-release Naltrexone.

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Content created by Office of Budget (OB) Content last reviewed September 19, 2022 Back to top
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