New Hampshire Alcohol & Drug Abuse Counselors Association

Dedicated to Advancing Addiction Professionals in New Hampshire


  • September 03, 2019 9:51 AM | Anonymous

    HHS 42 CFR Part 2 Proposed Rule Fact Sheet

    The 42 CFR part 2 regulations serve to protect patient records created by federally funded programs for the treatment of substance use disorder (SUD). SAMHSA is currently proposing to revise part 2, to facilitate better coordination of care for substance use disorders which will also enhance care for opioid use disorder (OUD). These provisions will be an important part of the Federal response to the opioid epidemic, while maintaining part 2 confidentiality protections.

    What's Not Changing Under the New Part 2 Rule: The proposed rule will not alter the basic framework for confidentiality protection of SUD patient records created by federally funded treatment programs. Part 2 will continue to prohibit law enforcement use of SUD patient records in criminal prosecution against the patient. Part 2 will also continue to restrict the disclosure of SUD treatment records without patient consent, other than as statutorily authorized in the context of a bona fide medical emergency; or for the purpose of scientific research, audit, or program evaluation; or based on an appropriate court order for good cause.

    What Is Changing Under the New Part 2 Rule: The proposed rule will modify several sections of part 2, as follows:

    Provision What Is the Proposed Change? Why Is This Being Changed?
    Applicability and Re-Disclosure Treatment records created by non-part 2 providers based on their own patient encounter(s) will not be covered by part 2, unless any SUD records previously received from a part 2 program are incorporated into such records. Segmentation or holding apart of any part 2 patient record previously received can be used to ensure that new records created by non-part 2 providers will not become subject to part 2. To facilitate coordination of care activities by non part-2 providers.
    Disposition of Records When an SUD patient sends an incidental message to the personal device of an employee of a part 2 program, the employee will be able to fulfill the part 2 requirement for "sanitizing" the device by deleting that message. To ensure that the personal devices of employees will not need to be confiscated or destroyed, in order to sanitize per part 2.
    Consent Requirements An SUD patient may consent to disclosure of his part 2 treatment records to an entity (e.g., the Social Security Administration), without naming a specific person as the recipient for the disclosure. To allow patients to apply for benefits and resources more easily, for example, when using online applications that do not identify a specific person as the recipient for a disclosure of part 2 records.
    Disclosures Permitted w/ Written Consent Disclosures for the purpose of "payment and health care operations" are permitted with written consent, in connection with an illustrative list of 17 example activities. In order to resolve lingering confusion under part 2 about what activities count  as "payment and health care operations," the list of examples will be moved into the reg text from the preamble.
    Disclosures to Central Registries and PDMPs Non-OTP (opioid treatment program) providers will become eligible to query a central registry, in order to determine whether their patients are already receiving opioid treatment through a member program.

    OTPs will be permitted to enroll in a state prescription drug monitoring program (PDMP), and permitted to report data into the PDMP when prescribing or dispensing medications on Schedules II to V, consistent with applicable state law.
    The revised central registry and PDMP provisions will help to prevent duplicative enrollments in SUD care, duplicative prescriptions for SUD treatment, and adverse drug events related to SUD treatment.
    Medical Emergencies Declared emergencies resulting from natural disasters (e.g., hurricanes) that disrupt treatment facilities and services will meet the definition for a "bona fide medical emergency," for the purpose of disclosing SUD records without patient consent under part 2. To ensure clinically appropriate communications and access to SUD care, in the context of declared emergencies resulting from natural disasters.
    Research Disclosures for research under part 2 will be permitted by a HIPAA covered entity or business associate to individuals and organizations who are neither HIPAA covered entities, nor subject to the Common Rule (re: Research on Human Subjects). To facilitate appropriate disclosures for research, by streamlining overlapping requirements under part 2, the Privacy Rule and the Common Rule.
    Audit and Evaluation Part 2 will be revised to clarify that some specific situations fall within the scope of permitted disclosures for audits and/or program evaluation. To resolve current ambiguity under part 2 about what activities are covered by the audit and evaluation provision.
    Confidential Communications The standard for court ordered disclosures of SUD records for the purpose of investigating "an extremely serious crime" will be revised, by dropping the phrase "allegedly committed by the patient." To correct an earlier technical error from the 2017 rule-making, in which this phrase was inadvertently added to regulatory text without notice or public comment.
    Undercover Agents and Informants Court-ordered placement of an undercover agent or informant within a part 2 program will be extended to a period of 12 months, and courts will be authorized to further extend the period of placement through a new court order. To address DOJ concerns that the current policy is overly restrictive to some ongoing investigations of part 2 programs.
  • August 22, 2019 4:13 PM | Anonymous

    Do you strive to be a leader in the profession and give back to the SUD community?

    Well, now you can!

    NHADACA currently has two positions open on the Board of Directors.

    We are looking for a Connecticut Valley Representative and an At Large Representative (which can be from anywhere across the state).

    For more information, check out the website's Board of Directors page!

    If you're interested in becoming part of NHADACA's board, reach out to Amelia.

  • August 22, 2019 11:32 AM | Anonymous

    The Department of Defense (DOD) today released the 2019 VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide(link is external). This clinical practice guideline (CPG) is the result of a thorough review of recently published evidence for suicide interventions by a multidisciplinary panel of experts. The CPG’s recommendations are intended for dissemination among and implementation by providers who care for military service members and veterans. 

    Below is a summary of the CPG’s main recommendations for the identification of suicide risk, evaluation of risk level, and management of patients at risk for suicide. Providers are encouraged to consult the full CPG for more details about these recommendations.

    Identification of suicide risk (Algorithm A)

    An evidence-based, recommended screening tool – such as item 9 of the Patient Health Questionnaire-9 – should be administered to individuals who …

    • Exhibit warning signs, such as suicidal ideation or recent self-directed violence (suicide attempt or intentional self-injury)
    • Are identified as at-risk for suicide by computer-driven prediction models (e.g., VA’s REACH VET program(link is external))
    • Present in a setting in which routine suicide screening is used (e.g., behavioral health)

    If the suicide screen is positive or if there is evidence that suggests the need for additional screening or evaluation, then the provider assesses for safety concerns like access to a firearm or a detailed suicide plan. 

    • For individuals with safety concerns that require immediate management, initiate management procedures for High Acute Risk for suicide
    • For all other individuals with suicide risk, initiate evaluation procedures

    Evaluation by provider (Algorithm B)

    The evaluation is used to gather information to determine the patient’s current suicide risk level so that management procedures matched to that risk level can be initiated.

    A comprehensive evaluation of suicide risk must include an assessment of:

    • Current suicidal ideation
    • Ability to maintain safety
    • Intent to die by suicide
    • Prior suicide attempt(s)
    • Current psychiatric conditions and symptoms
    • Prior psychiatric hospitalization
    • Recent bio-psychosocial stressors
    • Availability of firearms

    The provider will map the results of his/her evaluation to the following risk levels:

    High Acute Risk

    • Suicidal thoughts with intent to die by suicide
    • Requires external assistance to maintain personal safety

    Intermediate Acute Risk

    • Suicidal thoughts with intent to die by suicide
    • Ability to independently maintain personal safety

    Low Acute Risk

    • No current suicidal thoughts, specific suicide plan, or preparatory suicide behaviors
    • Ability to independently maintain personal safety

    Management of patients at acute risk of suicide (Algorithm C)

    Below are a subset of the CPG’s recommended actions for providers, organized by suicide risk level.

    High Acute Risk

    • Initiate direct observation of the patient and ensure patient has no access to lethal means (e.g., sharps, cords, tubing, toxic substances, firearms)
    • Hospitalization of the patient is typically required for safety, including involuntary hospitalization
    • During hospitalization, initiate evidence-based treatment aimed at reducing suicide risk
    • Discharge only if risk level has sufficiently decreased
    • Following discharge, consider checking in on the patient via telephone, home visit, or mail (depending on your clinic’s policy and procedures) and assisting the patient with engaging in case management services as well as counseling or other psychosocial interventions

    Intermediate Acute Risk

    • Hospitalization may be indicated after considering the ability to maintain safety as well as the risks and benefits of outpatient and inpatient care
    • Outpatient management should include frequent contact with the patient, a carefully constructed safety plan, and the involvement of the patient’s support network whenever possible
    • Mental health treatment should address co-occurring conditions and concerns
    • Re-evaluate risk level regularly and adjust management plan accordingly

    Low Acute Risk

    • Patient can be managed in primary care
    • Outpatient mental health may be indicated, especially with co-occurring suicidal ideation and psychiatric symptoms
    • Focus care on strengthening protective factors and mitigating risk factors
    • Re-evaluate risk level regularly and adjust management plan accordingly
  • July 23, 2019 2:29 PM | Anonymous

    The New Hampshire Division of Public Health Services, in collaboration with the New Hampshire Board of Licensing for Alcohol and Other Drug Use Professionals, will be collecting key practice and capacity data from New Hampshire-licensed alcohol and drug counselors (LADCs/MLADCs) who are due to renew their license, with an online survey. The survey coincides with the board’s license renewal cycle, and will be available to complete at the time the renewal cycle opens until the close of the cycle (6/30).

    Pursuant to RSA 330-C:9-a, licensees will be “required, as part of the license renewal process,” to complete the survey. However, providers may also opt out of participation by completing the NH Health Professions Data Center (HPDC) the opt-out form found on the HPDC website.

    The data will be used for functions requiring accurate statewide data on provider supply and capacity. It will serve as a key resource in statewide healthcare workforce assessment, healthcare access planning, informing educational and training programs, emergency preparedness, and recruitment and retention initiatives including the National Health Service Corps and the New Hampshire State Loan Repayment Program. 

    The survey link will be available on the same website you will access to renew your license. The survey link will also be available on the New Hampshire Department of Health and Human Services’ Health Professions Data Center page, as soon as the survey opens. Providers can also locate the survey by searching for “NH Alcohol and Drug Counselor Survey” in a web browser. 

    Contact Danielle Weiss, Primary Care Workforce Program Manager, at Please do not contact the Board or NHADACA with technical questions regarding the survey.

  • July 16, 2019 1:35 PM | Anonymous

    View this email in your browser

    Treating Addiction Together

    Learn and apply American Society of Addiction Medicine (ASAM) Criteria with an expert team! 


    • Increase your knowledge and skills to utilize ASAM criteria? 
    • Have access to an expert multidisciplinary team of SUD treatment providers? 
    • Develop a learning community of SUD treatment providers throughout NH? 
    • Utilize ongoing case-based discussions of participant-identified patients using ASAM criteria? 

    Learning community participants will include various professionals working in substance use disorder treatment settings and looking to improve their practice using ASAM criteria. 

    • Eight-month initiative
    • October 2019 - June 2020
    • Every other week 
    • Noon for 1 hour 
    • No cost for participants! 

    Interested in participating? 
    Space is limited! Apply soon! Responses are reviewed on a rolling basis. 


    Note: Continuing education credits will be applied for based on the licensure needs of selected participants. 

    Questions? Contact the NH Center for Excellence:

    Copyright © 2019 NH Center for Excellence, All rights reserved.
    You are receiving this email because you have previously worked with the NH Center for Excellence.

    Our mailing address is:

    NH Center for Excellence

    501 South St # 2

    Bow, NH 03304-3416

    Add us to your address book

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  • July 16, 2019 11:02 AM | Anonymous

    Brought to you by your NHADACA Ethics Committee

    “This is a landmark moment in our fight to hold drug companies responsible for their role in the opioid crisis,” Virginia Attorney General Mark Herring said in a news release. “We will not allow anyone to put profits over people, or to exacerbate or exploit the opioid crisis for their own benefit. The Virginia Medicaid Fraud Control Unit’s expertise, capacity, and diligent investigation, combined with strong relationships with local, state, and federal partners, helped make this resolution possible.”

    To review the full article, please click below:

  • July 16, 2019 10:55 AM | Anonymous

    IC&RC is looking for volunteers to assist with the maintenance of its Clinical Supervisor (CS) program.

    This volunteer position gives individuals the opportunity to provide direct input on what content should be tested on IC&RC’s Clinical Supervisor examination. It is an excellent opportunity for professional growth and networking. CEs are also awarded for participation.

    We have one activity scheduled in August:

    Purpose: To review the newest version of the IC&RC CS examination to ensure content is correct, no questions are duplicative in content, and no items answer each other.


    September 16th Webinar from 10am -2pm ET

    September 30th Webinar from 10am -2pm ET

    In addition to the webinars above, an independent review of the examination will also be required. The review material will be available from Aug. 12-Sep. 9. The review must be completed to participate in the webinars.


    • Passed the IC&RC Clinical Supervisor Examination
    • Actively providing clinical supervision
    • No more than 10 years of experience as a Clinical Supervisor
    • Intermediate computer skills
    • Ability to complete self-directed, independent assignments

    As an individual who recently passed the IC&RC Clinical Supervisor examination, I invite you to apply for this opportunity.


    Please note, a resume is required to apply.

    The application deadline is July 31st.



    Rachel R. Witmer

    Assistant Director

    717-540-4457 Ext. 105

  • July 15, 2019 9:01 AM | Anonymous

    New analysis of Medicaid plans reveals that 40 states still require prior authorization on OUD Meds:

    Report highlights findings and recommends

    Medicaid adopt Medicare model

    As the opioid-related overdose epidemic continues to escalate in our country, timely access to FDA-approved medications for the treatment of opioid use disorder (OUD) is more important than ever. An analysis by the Legal Action Center shows that 40 state Medicaid programs still have prior authorization requirements on some or all buprenorphine-naloxone medications covered on their preferred drug list. As Medicaid provides health coverage for 40% of non-elderly adults with OUD, expanding access to these life-saving medications is critical. 

    The report, authored by LAC’s Vice President of Health Initiatives, Ellen Weber, and LAC's 2019 Liman Fellow, Arka Gupta, builds upon SAMHSA’s 2018 report and details the gaps in coverage and prior authorization barriers to buprenorphine medications in all state Medicaid programs. The report also highlights new research from RTI International that examines how Medicare plans have eliminated such barriers based on guidance from the Centers for Medicare and Medicaid Services (CMS) and serves as a model for Medicaid to follow.

    With an estimated 130 Americans losing their lives each day to opioid-related overdose, it is absolutely crucial that we break down barriers to OUD medications, which have been proven to cut a patient’s risk of death in half.  

    "Clear guidance from CMS could immediately and significantly reduce barriers in the Medicaid program," says Ellen. "The imperative to increase access to care is clear and pressing."


    About the Legal Action Center: Established in 1973, the Legal Action Center is the only non-profit law and policy organization in the United States whose sole mission is to fight discrimination against people with histories of addiction, HIV/AIDS, and/or criminal records, and to advocate for sound public policies in these areas. 



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  • July 15, 2019 8:53 AM | Anonymous

    Missed one of our live webinars...

    but still need training on 42 CFR Part 2?

    Gain access to one of our webinars today and watch them

    at your convenience!

    Purchase unlimited 24-hour or 48-hour access to the Legal Action Center’s highly-acclaimed webinars and learn from leading experts on 42 CFR Part 2. Includes all downloadable handouts required to take the course.

    Introduction to Confidentiality:

    42 CFR Part 2 & HIPAA

    A Comprehensive, 3-Hour Course


    Taught by attorneys Anita Marton & Jacqueline Seitz

    Join LAC for a video course providing a basic introduction to the federal laws governing privacy of substance use disorder (SUD) treatment records: 42 CFR Part 2 and HIPAA. The video covers three hours of material, in two segments. Each segment covers fundamental aspects of these laws and how they apply to real world situations. The course reflects the 2017 and 2018 amendments to 42 CFR Part 2, while also covering longstanding provisions.

    Only $109 – 48 hours of UNLIMITED access!

    42 CFR PART 2: What changed under the Final Rules in 2017 and 2018?

    A Comprehensive, 2-Hour Course


    Taught by attorneys Sally Friedman & Jacqueline Seitz

    Join LAC for a video course covering the recent changes to federal privacy law for substance use disorder patient records, 42 CFR Part 2. In 2017 and 2018, the U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration (SAMHSA) published two Final Rules amending 42 CFR Part 2. Substance use disorder treatment programs covered by 42 CFR Part 2, as well as people and organizations who receive information from such programs, are required to comply with the new amendments to the regulations. This video course is designed to educate participants about the 2017 and 2018 Final Rules, and to help substance use disorder treatment programs comply with the new requirements.

    Only $79 – 24 hours of UNLIMITED access!

    Questions about our 42 CFR Part 2 products can be sent to: Alisha Scott at


  • July 09, 2019 1:31 PM | Anonymous

    Clinician well-being is essential for safe, high-quality patient care.

    Brought to you by your NHADACA Ethics Committee.

    However, clinicians of all kinds, across all specialties and care settings, are experiencing alarming rates of burnout. Among the most telling of statistics, more than 50 percent of U.S. physicians report significant symptoms. Burnout is a syndrome characterized by a high degree of emotional exhaustion and depersonalization (i.e., cynicism), and a low sense of personal accomplishment at work.

    Clinician burnout can have serious, wide-ranging consequences, from reduced job performance and high turnover rates to—in the most extreme cases—medical error and clinician suicide. On the other hand, clinician well-being supports improved patient-clinician relationships, a high-functioning care team, and an engaged and effective workforce. In other words, when we invest in clinician well-being, everyone wins.

    Supporting clinician well-being requires sustained attention and action at organizational, state, and national levels, as well as investment in research and information-sharing to advance evidence-based solutions. 

    Browse or click below to learn more about the Action Collaborative.


    In 2017, the National Academy of Medicine launched the Action Collaborative on Clinician Well-Being and Resilience, a network of more than 60 organizations committed to reversing trends in clinician burnout. The Collaborative has three goals:

    1. Raise the visibility of clinician anxiety, burnout, depression, stress, and suicide
    2. Improve baseline understanding of challenges to clinician well-being
    3. Advance evidence-based, multidisciplinary solutions to improve patient care by caring for the caregiver. 

    The Action Collaborative is composed of five working groups that will meet over the course of four years to identify evidence-based strategies to improve clinician well-being at both the individual and systems levels. Products and activities of these five working groups include an online knowledge hub, a series of NAM Perspectives discussion papers, and an all-encompassing conceptual model that reflects the domains affecting clinician well-being. 

    Download our one-pager to share >>


    Action Collaborative Leadership
    Victor Dzau, chair
    Darrell Kirch, co-chair

    Thomas Nasca, co-chair

    Action Collaborative Staff
    Charlee Alexander, Program Officer
    Ivory Clarke, Associate Program Officer
    Marc Meisnere, Associate Program Officer
    Mariana Zindel, Research Associate
    Imani Rickerby, Senior Program Assistant
    Kyra Cappelucci, Communications Officer
    Sharyl Nass, Board Director

    Action Collaborative Working Groups
    Please click here to view members of our five working groups. 


    Gender-Based Differences in Burnout: Issues Faced by Women Physicians 

    Women now account for an increasingly large percentage of medical school students and practicing physicians, yet there is still a scarcity of research on how gender-related differences can affect clinician burnout and well-being. Recognizing gender-related differences is critical in designing effective strategies to improve clinician well-being and to identify, treat, and prevent burnout. This recently-released discussion paper examines how gender-related differences can manifest, and some strategies for ensuring well-being for all health professionals. Read more >>

    Expressions of Clinician Well-Being 

    The National Academy of Medicine recently called on artists of all skills and abilities to explore what clinician burnout, clinician well-being, and clinician resilience looks, feels and sounds like to people across the country. 100 pieces of artwork were selected by a panel of reviewers to be displayed in a digital gallery. Explore the digital art gallery >>

    Clinician Well-Being Knowledge Hub is Live!

    The Action Collaborative on Clinician Well-Being and Resilience is proud to announce the launch of the Clinician Well-Being Knowledge Hub, a comprehensive resource repository for those seeking to promote clinician well-being at their organizations and in their personal lives. Visit the knowledge hub>>

    Help us share the knowledge hub by clicking here.

    Establishing Clinician Well-Being as a National Priority, Meeting 5 | May 28-29, 2019

    The Action Collaborative hosted a public meeting on May 28-29, 2019 in Chicago, IL. Recorded videos and slide sets will be posted soon. Please check back. Event page >>

    Establishing Clinician Well-Being as a National Priority, Meeting 4 | October 4-5, 2018

    The Action Collaborative hosted a closed working meeting on October 4-5, 2018 in Washington, DC.  Event page >>

    Establishing Clinician Well-Being as a National Priority, Meeting 3  |  May 2, 2018

    The third meeting of the Action Collaborative on Clinician Well-Being and Resilience was held in Washington, DC on May 2, 2018. Event page >>

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