Dear Friends and Colleagues:
Attached an interesting article from Sundays Miami Herald (04/15/07) emphasizing the critical shortage of judges at Miami Dades Drug Court forcing it to stop the acceptance of new cases due to the high case load.
All of us know that the success rate of people who graduate from the drug court program in terms of recidivism is remarkable.
Substance abuse and dependence is a brain disease and need to be treated medically. Nonviolent crime related to substance abuse and/or dependence should be addressed via legal and medical means and locking those nonviolent offender s up will not resolve their problems.
We all should write our local legislators to increase funding for drug courts and FSAM will play a leading role in this efforts.
Yours
Bernd
Posted on Sun, Apr. 15, 2007
Drug Court puts new cases on hold
BY LISA ARTHUR
Miami-Dade's heralded Drug Court has closed its doors to new defendants until August to give its overwhelmed judge time to whittle down his load of 2,000 cases.
The moratorium went into effect April 9, said Judge Stanford Blake, administrative judge for the criminal division.
''It's purely a numbers game,'' he said. ``There is a point in time when a case load gets too big for one person to handle and we don't have funds for another judge.''
The moratorium is a troubling development for what has been a judicial model for at least 1,400 other drug courts in 47 states and several countries.
The Drug Court, started in 1989 as the first court of its kind in the United States, has allowed thousands of defendants to go through treatment and rehabilitation programs instead of being sent to prison.
''This moratorium is very sad,'' said Judge Jeffrey Rosinek, who runs Drug Court. ``The program really works and this means that for the next four months, hundreds of men and women who could work to change their lives won't be able to take advantage of it. They'll go to court, cop a plea and be right back on the street.''
Rosinek's caseload is about three times the size of a typical circuit judge. Though he doesn't have to take time out to preside over trials, Drug Court defendants are constantly monitored and most take 18 to 24 months to complete the year-long program because of relapses.
Defendants who qualify for Drug Court have been charged with felony drug possession or purchase. Once enrolled in Drug Court, defendants go into treatment programs and have to pass regular drug screening tests. They also receive counseling, job training and other support services. Violent offenders aren't allowed into the program.
The temporary moratorium, which was first reported last week by the Daily Business Review, won't apply to pregnant women, homeless people and juveniles who are charged as adults, said Blake. Judges also will have the option of postponing until August the cases of defendants who would qualify for Drug Court so they could take advantage of the program.
The long-term solution, said Rosinek and Blake, is more resources so that the county can open a second Drug Court. In addition to a judge, the state would have to earmark money for prosecutors, public defenders and court clerks.
''It's one of those problems where you throw a pebble in a lake and watch the ripples,'' Blake said. ``It's a systemwide problem, not just a judge shortage problem.''
Other solutions might include coming up with a streamlined program that ``can give meaningful but shorter treatment and identifying if there are people who have been in the program longer than they need to be.''
Without a permanent solution, Rosinek said, the county could soon find itself back in a crisis.
''There's nothing out there that is going to stop the caseload from climbing -- it will skyrocket again,'' said Rosinek. ``The long-term solution is bringing a judge on board and adding another drug court with all the staff it needs.''
Sunday, April 15, 2007
Sunday, April 8, 2007
Call for Parity
An editorial published in a recent edition of the AMA News calls for mental health parity. This issue is a crucial component in our struggle for recognition of substance abuse and dependence as a disease that requires equal attention in treatment as any other diseases (Diabetes, Heart Disease) do. Unfortunately, the proponents of mental health parity often forget that substance abuse and dependence is part of mental health care. We need to remind them and lobby for our interests and those of our patients.
Yours truly,
Bernd
OPINION
Time to pass mental health parity
The AMA is part of a coalition that supports new Senate legislation to close some gaps in the law requiring equal insurance coverage for mental illness.
Editorial. March 12, 2007.
Cancer. High blood pressure. Depression. Heart disease. All are serious medical conditions that affect millions of Americans. All are treatable. So shouldn't they all be covered equally by health plans?
The sad fact is that insurers have long singled out one of those diseases -- depression -- for lesser coverage. Benefits for mental illness in general often come up short in comparison with those for physical conditions.
Even with passage of the 1996 mental health parity act, barring different dollar limits on annual and life-time benefits, discrimination remained. Higher patient cost-sharing, limits on the number of days in the hospital, and caps on the number of outpatient mental health visits are still common.
That double standard would end if new mental health parity legislation introduced in the Senate passes Congress and is signed into law.
The bipartisan bill is the culmination of more than a year of negotiations between lawmakers, mental health organizations and the traditional foes of such measures: insurers and the business industry.
It has the strong support of the Coalition for Fairness in Mental Illness Coverage, which includes the American Medical Association, the American Psychiatric Assn. and several other health care and patient advocacy groups.
Under this legislation, group health plans no longer would be able to charge higher deductibles, co-payments or other out-of-pocket costs for mental health care. Patients no longer would face tighter restrictions on the number of days in the hospital or outpatient visits. Substance abuse is included in its protections.
Compromises were involved. The measure acknowledges the concerns of insurers and the business community. These groups have long argued that mandating equal benefits for mental illness would make health insurance prohibitively expensive.
The legislation includes one-year exemptions for health plans that experience an increase in actual total plan costs of more than 2% in the first plan year after the measure's implementation or 1% in years thereafter. It also exempts employers with fewer than 50 workers. The legislation would override state laws that differ from it on financial and treatment requirements, physician reimbursement, management of benefits, in- and out-of-network coverage, and cost exemptions.
An estimated 26% of Americans 18 and older -- about one in four adults -- have a diagnosable mental disorder in any given year, according to the National Institute of Mental Health. When applied to Census Bureau figures, that translates into 57.7 million adults.
The stigma historically associated with mental illness and exacerbated by insurance coverage policies has prevented many people from seeking help. This carries a huge economic toll. The combined indirect and related costs of mental illness, including lost productivity, lost earnings due to illness and social costs, are estimated to total at least $113 billion annually, says Mental Health America, an advocacy group.
By putting mental health benefits more on par with medical and surgical coverage, the Senate bill could help end the stigma and would encourage people to get medical care.
Mental illness is very treatable. Between 70% and 90% of people with serious mental illnesses have a significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatment, according to the National Alliance on Mental Illness.
More than a decade has passed since the first mental health parity law was adopted. The Senate consensus legislation, sponsored by Sens. Edward Kennedy (D, Mass.), Pete Domenici (R, N.M.) and Mike Enzi (R, Wyo.), finally could fill many loopholes left by that measure.
There is action on the House side as well. Reps. Patrick Kennedy (D, R.I.) and Jim Ramstad (R, Minn.) are crafting a bill they plan to introduce this spring. President Bush has voiced support for mental health parity in the past.
All this bodes well for success this year. It is time for Congress to finish the job.
Yours truly,
Bernd
OPINION
Time to pass mental health parity
The AMA is part of a coalition that supports new Senate legislation to close some gaps in the law requiring equal insurance coverage for mental illness.
Editorial. March 12, 2007.
Cancer. High blood pressure. Depression. Heart disease. All are serious medical conditions that affect millions of Americans. All are treatable. So shouldn't they all be covered equally by health plans?
The sad fact is that insurers have long singled out one of those diseases -- depression -- for lesser coverage. Benefits for mental illness in general often come up short in comparison with those for physical conditions.
Even with passage of the 1996 mental health parity act, barring different dollar limits on annual and life-time benefits, discrimination remained. Higher patient cost-sharing, limits on the number of days in the hospital, and caps on the number of outpatient mental health visits are still common.
That double standard would end if new mental health parity legislation introduced in the Senate passes Congress and is signed into law.
The bipartisan bill is the culmination of more than a year of negotiations between lawmakers, mental health organizations and the traditional foes of such measures: insurers and the business industry.
It has the strong support of the Coalition for Fairness in Mental Illness Coverage, which includes the American Medical Association, the American Psychiatric Assn. and several other health care and patient advocacy groups.
Under this legislation, group health plans no longer would be able to charge higher deductibles, co-payments or other out-of-pocket costs for mental health care. Patients no longer would face tighter restrictions on the number of days in the hospital or outpatient visits. Substance abuse is included in its protections.
Compromises were involved. The measure acknowledges the concerns of insurers and the business community. These groups have long argued that mandating equal benefits for mental illness would make health insurance prohibitively expensive.
The legislation includes one-year exemptions for health plans that experience an increase in actual total plan costs of more than 2% in the first plan year after the measure's implementation or 1% in years thereafter. It also exempts employers with fewer than 50 workers. The legislation would override state laws that differ from it on financial and treatment requirements, physician reimbursement, management of benefits, in- and out-of-network coverage, and cost exemptions.
An estimated 26% of Americans 18 and older -- about one in four adults -- have a diagnosable mental disorder in any given year, according to the National Institute of Mental Health. When applied to Census Bureau figures, that translates into 57.7 million adults.
The stigma historically associated with mental illness and exacerbated by insurance coverage policies has prevented many people from seeking help. This carries a huge economic toll. The combined indirect and related costs of mental illness, including lost productivity, lost earnings due to illness and social costs, are estimated to total at least $113 billion annually, says Mental Health America, an advocacy group.
By putting mental health benefits more on par with medical and surgical coverage, the Senate bill could help end the stigma and would encourage people to get medical care.
Mental illness is very treatable. Between 70% and 90% of people with serious mental illnesses have a significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatment, according to the National Alliance on Mental Illness.
More than a decade has passed since the first mental health parity law was adopted. The Senate consensus legislation, sponsored by Sens. Edward Kennedy (D, Mass.), Pete Domenici (R, N.M.) and Mike Enzi (R, Wyo.), finally could fill many loopholes left by that measure.
There is action on the House side as well. Reps. Patrick Kennedy (D, R.I.) and Jim Ramstad (R, Minn.) are crafting a bill they plan to introduce this spring. President Bush has voiced support for mental health parity in the past.
All this bodes well for success this year. It is time for Congress to finish the job.
Alcohol Treatment Guide
NIAAA has released an updated guide, “Helping Patients Who Drink Too Much: A Clinicians Guide, for physicians treating patients with alcohol problems.”
For the first time, the publication includes instructions for primary care physicians and nurses who wish to provide medication-based therapy to patients with alcohol dependence.
Other new features include a handout that describes strategies to help patients reduce their drinking or to quit, a web page with resources for physicians and patients, and information about the recently approved monthly injectable version of naltrexone.
The guide is available at http://www.niaaa.nih.gov/guide
For the first time, the publication includes instructions for primary care physicians and nurses who wish to provide medication-based therapy to patients with alcohol dependence.
Other new features include a handout that describes strategies to help patients reduce their drinking or to quit, a web page with resources for physicians and patients, and information about the recently approved monthly injectable version of naltrexone.
The guide is available at http://www.niaaa.nih.gov/guide
NIH Addiction Fellowship
OPEN POSITION: NIH funded fellowship at the SUNY at Buffalo, Departmen of Family Medicine. Slot is vailbale July 1st, 2007
DESCRIPTION: NIH(NRSA) Fellowship "Addiction Research in Medical Settings"; 2-3 year NIH funded research fellowship, > $110,000 ($45K NRSA stipend + $30K clinical work supplement+$35K NIH Loan Repayment ); family health coverage, travel allowance.
REQUIREMENTS: US Citizen, graduate from acredited residency program, evidence of potential for publication, committed to a NIH -funded addiction clinical research career in academic primary care or psychiatry.
CONTACT: e-mail CV & Career Statement to Laurene TumielB_erhalter,PhD at tumiel@buffalo.edu
DESCRIPTION: NIH(NRSA) Fellowship "Addiction Research in Medical Settings"; 2-3 year NIH funded research fellowship, > $110,000 ($45K NRSA stipend + $30K clinical work supplement+$35K NIH Loan Repayment ); family health coverage, travel allowance.
REQUIREMENTS: US Citizen, graduate from acredited residency program, evidence of potential for publication, committed to a NIH -funded addiction clinical research career in academic primary care or psychiatry.
CONTACT: e-mail CV & Career Statement to Laurene TumielB_erhalter,PhD at tumiel@buffalo.edu
Message From Your FSAM President
OPEN LETTER FROM YOUR NEW FSAM PRESIDENT:
Dear Friends and Colleagues:
During its scheduled meeting on March 2nd, 2007 the Executive Board of the Florida Society of Addiction Medicine accepted the resignation of President-Elect Joe Molea,MD and voted unanimously my person as your new President for the term 2007-2009.
I am a board-certified family physician practicing in North Miami Beach, certified in Addiction Medicine (ASAM) and am a certified MRO. I have served on the FSAM Board as the Chairman of Scientific Planning Committee and Information Technology Committee, am an AMA Delegate for the Florida Medical Association (FMA), Co-Chair of the FMA Accreditation and CME Committee, Immediate Past Chair of the AMA International Medical Graduates Section, Board Member of the Florida Academy of Family Physicians, Vice-President of the Dade County Medical Association, and the President of the North Dade County Rotary Club.
As your new President I seek your support to work towards the achievement of the following goals:
1.Reorganize FSAM as a full-service membership organization promoting the interest of healthcare professionals involved in addiction care, research and treatment.
2.Promote excellence of care in addiction medicine through education and training of physicians and other allied healthcare professionals.
3.Achieve cooperative relationships with other medical specialties to foster the integration of screening and intervention modalities in patient care.
4.Create a FSAM Political Action Committee (PAC), educate political decision makers about the importance of sustainable funding mechanism for community based addiction treatment modalities and advocate for the promotion of addiction care and research in primary care.
5.Establish a planning committee to design a strategic plan outlining the vision of our organization for a state-wide drug control and treatment program.
We need your support to realize the above mentioned goals. For that purpose we will utilize a List server, online newsletters and surveys to facilitate your input and will redesign our web site.
Furthermore, I want to solicit your input by forming several committees dealing with education, research, membership development, public relation and legislative issues.Please e-mail us and indicate your interest to participate in those committees.
Our new FSAM Executive Board is comprised of a team of dedicated and experienced fellow colleagues and we are all looking forward to your critique and input.
Yours truly,
Bernd Wollschlaeger,MD,FAAFP
E-mail: info@miamihealth.com
Phone: (305) 940-8717
Dear Friends and Colleagues:
During its scheduled meeting on March 2nd, 2007 the Executive Board of the Florida Society of Addiction Medicine accepted the resignation of President-Elect Joe Molea,MD and voted unanimously my person as your new President for the term 2007-2009.
I am a board-certified family physician practicing in North Miami Beach, certified in Addiction Medicine (ASAM) and am a certified MRO. I have served on the FSAM Board as the Chairman of Scientific Planning Committee and Information Technology Committee, am an AMA Delegate for the Florida Medical Association (FMA), Co-Chair of the FMA Accreditation and CME Committee, Immediate Past Chair of the AMA International Medical Graduates Section, Board Member of the Florida Academy of Family Physicians, Vice-President of the Dade County Medical Association, and the President of the North Dade County Rotary Club.
As your new President I seek your support to work towards the achievement of the following goals:
1.Reorganize FSAM as a full-service membership organization promoting the interest of healthcare professionals involved in addiction care, research and treatment.
2.Promote excellence of care in addiction medicine through education and training of physicians and other allied healthcare professionals.
3.Achieve cooperative relationships with other medical specialties to foster the integration of screening and intervention modalities in patient care.
4.Create a FSAM Political Action Committee (PAC), educate political decision makers about the importance of sustainable funding mechanism for community based addiction treatment modalities and advocate for the promotion of addiction care and research in primary care.
5.Establish a planning committee to design a strategic plan outlining the vision of our organization for a state-wide drug control and treatment program.
We need your support to realize the above mentioned goals. For that purpose we will utilize a List server, online newsletters and surveys to facilitate your input and will redesign our web site.
Furthermore, I want to solicit your input by forming several committees dealing with education, research, membership development, public relation and legislative issues.Please e-mail us and indicate your interest to participate in those committees.
Our new FSAM Executive Board is comprised of a team of dedicated and experienced fellow colleagues and we are all looking forward to your critique and input.
Yours truly,
Bernd Wollschlaeger,MD,FAAFP
E-mail: info@miamihealth.com
Phone: (305) 940-8717
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