Trump Administration Halts Contracted Work on NREPP and Shifts Evidence-Based Focus to SAMHSA's Policy Lab (UPDATED)

UPDATE (1/8/2018) – This morning, I received this statement from a SAMHSA spokesman:

Although the current NREPP contract has been discontinued, SAMHSA is very focused on the development and implementation of evidence-based programs in communities across the nation.  SAMHSA’s Policy Lab will lead the effort to reconfigure its approach to identifying and disseminating evidence-based practice and programs.

The Policy Lab is referred to on SAMHSA’s website and is led by Christopher Jones. The Policy Lab was created by the 21st Century Cures Act and is an evolution of SAMHSA’s Office of Policy, Planning and Innovation. Clearly, the issue with the change from NREPP isn’t with the term “evidence-based” since the above statement uses the term and the Cures Act requires evidence-based interventions. For the exact language of the Cures statute, scroll to the end of this post.
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(original post starts here)
Yesterday (Jan 4, 2018), a contractor for the Substance Abuse and Mental Health Services Administration alerted program participants that funding for work onnrepp the National Registry of Evidence-Based Programs & Practices had been terminated “for the convenience of the government.” According to a source with the contractor, the work was not terminated due to any problems with their work but because the administration did not want to continue it. According to my source, this action follows a freeze in the work which had been in effect since September, 2017.
The NREPP is an effort to alert the public and professional community about evidence-based practices in mental health treatment and prevention. According to SAMHSA’s 2018 budget justification, NREPP helps meet the requirements of the 21st Century Cures Act which requires the government to provide accurate information about what works in the treatment of mental illness and drug/alcohol addiction. SAMHSA is responsible to post this information on an agency website. SAMHSA requested $2.8-million in FY 2018 for NREPP.
According to an email I obtained which was later posted on Twitter by someone else, Development Services Group alerted their constituents that their contract to manage the NREPP’s contents and website had been terminated on December 28, 2017.
The email stated:

It is with great regret that we write to inform you that on December 28, 2017, we received notification from SAMHSA that the NREPP contract is being terminated for the convenience of the government.
This cancellation means that we can no longer make any updates to your program profile. We thank you for the help and cooperation you gave so that we could complete your review.
We are deeply saddened by the government’s sudden decision to end the NREPP contract, under which we have been able to provide and strengthen science-based information about mental health and substance use treatment and prevention programs, both nationally and internationally.
All comments and concerns should be directed to [email protected]

According to DSG, it isn’t clear what will become of NREPP. The reason the process of evaluating programs was given to a contractor was because SAMHSA did not have a sufficient number of staff to do the job. The website may remain but at present no additional guidance has come from SAMHSA. According to DSG, all materials are being returned to the government and not sent to another contractor.
My calls and emails to SAMHSA have not been returned.
It isn’t clear how SAMHSA will meet the mandates of the Cures Act without a functioning evidence-based program. Another open question is why the program was halted in the middle of the fiscal year without cause (“for the convenience of the government”).
(Updates will be added to this posts through the day)
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The entire text of the 21st Century Cures Act is here. For the section relevant to the Policy Laboratory and the work on evidence based practices and programs, see below.

SEC. 7001. ENCOURAGING INNOVATION AND EVIDENCE-BASED PROGRAMS.
    Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended by inserting after section 501 (42 U.S.C. 290aa) the
following:
``SEC. 501A. <<NOTE: 42 USC 290aa-0.>>  NATIONAL MENTAL HEALTH AND
                          SUBSTANCE USE POLICY LABORATORY.
    ``(a) In General.--There shall be established within the
Administration a National Mental Health and Substance Use Policy
Laboratory (referred to in this section as the `Laboratory').
    ``(b) Responsibilities.--The Laboratory shall--
            ``(1) continue to carry out the authorities and activities
        that were in effect for the Office of Policy, Planning, and
        Innovation as such Office existed prior to the date of enactment
        of the Helping Families in Mental Health Crisis Reform Act of
        2016;
            ``(2) identify, coordinate, and facilitate the
        implementation of policy changes likely to have a significant
        effect on mental health, mental illness, recovery supports, and
        the prevention and treatment of substance use disorder services;
            ``(3) work with the Center for Behavioral Health Statistics
        and Quality to collect, as appropriate, information from
        grantees under programs operated by the Administration in order
        to evaluate and disseminate information on evidence-based
        practices, including culturally and linguistically appropriate
        services, as appropriate, and service delivery models;
            ``(4) provide leadership in identifying and coordinating
        policies and programs, including evidence-based programs,
        related to mental and substance use disorders;
            ``(5) periodically review programs and activities operated
        by the Administration relating to the diagnosis or prevention
        of, treatment for, and recovery from, mental and substance use
        disorders to--
                    ``(A) identify any such programs or activities that
                are duplicative;
                    ``(B) identify any such programs or activities that
                are not evidence-based, effective, or efficient; and
                    ``(C) formulate recommendations for coordinating,
                eliminating, or improving programs or activities
                identified
[[Page 130 STAT. 1221]]
                under subparagraph (A) or (B) and merging such programs
                or activities into other successful programs or
                activities; and
            ``(6) carry out other activities as deemed necessary to
        continue to encourage innovation and disseminate evidence-based
        programs and practices.
    ``(c) Evidence-Based Practices and Service Delivery Models.--
            ``(1) In general.--In carrying out subsection (b)(3), the
        Laboratory--
                    ``(A) may give preference to models that improve--
                          ``(i) the coordination between mental health
                      and physical health providers;
                          ``(ii) the coordination among such providers
                      and the justice and corrections system; and
                          ``(iii) the cost effectiveness, quality,
                      effectiveness, and efficiency of health care
                      services furnished to adults with a serious mental
                      illness, children with a serious emotional
                      disturbance, or individuals in a mental health
                      crisis; and
                    ``(B) may include clinical protocols and practices
                that address the needs of individuals with early serious
                mental illness.
            ``(2) Consultation.--In carrying out this section, the
        Laboratory shall consult with--
                    ``(A) the Chief Medical Officer appointed under
                section 501(g);
                    ``(B) representatives of the National Institute of
                Mental Health, the National Institute on Drug Abuse, and
                the National Institute on Alcohol Abuse and Alcoholism,
                on an ongoing basis;
                    ``(C) other appropriate Federal agencies;
                    ``(D) clinical and analytical experts with expertise
                in psychiatric medical care and clinical psychological
                care, health care management, education, corrections
                health care, and mental health court systems, as
                appropriate; and
                    ``(E) other individuals and agencies as determined
                appropriate by the Assistant Secretary.
    ``(d) Deadline for Beginning Implementation.--The Laboratory shall
begin implementation of this section not later than January 1, 2018.
    ``(e) Promoting Innovation.--
            ``(1) In general.--The Assistant Secretary, in coordination
        with the Laboratory, may award grants to States, local
        governments, Indian tribes or tribal organizations (as such
        terms are defined in section 4 of the Indian Self-Determination
        and Education Assistance Act), educational institutions, and
        nonprofit organizations to develop evidence-based interventions,
        including culturally and linguistically appropriate services, as
        appropriate, for--
                    ``(A) evaluating a model that has been
                scientifically demonstrated to show promise, but would
                benefit from further applied development, for--
[[Page 130 STAT. 1222]]
                          ``(i) enhancing the prevention, diagnosis,
                      intervention, and treatment of, and recovery from,
                      mental illness, serious emotional disturbances,
                      substance use disorders, and co-occurring illness
                      or disorders; or
                          ``(ii) integrating or coordinating physical
                      health services and mental and substance use
                      disorders services; and
                    ``(B) expanding, replicating, or scaling evidence-
                based programs across a wider area to enhance effective
                screening, early diagnosis, intervention, and treatment
                with respect to mental illness, serious mental illness,
                serious emotional disturbances, and substance use
                disorders, primarily by--
                          ``(i) applying such evidence-based programs to
                      the delivery of care, including by training staff
                      in effective evidence-based treatments; or
                          ``(ii) integrating such evidence-based
                      programs into models of care across specialties
                      and jurisdictions.

United States of Trump?

Believe it or not, this isn’t in Alabama.
The part of Western Pennsylvania where I live is a conservative place. Republicans outnumber Democrats and Trump did well here. Some people here like Trump so much they put up a flag with his name on it.
Trump flag clip
Instead of the American flag which Trump wants everybody to stand for, this Trump supporter has hoisted a banner for a little Trump worship.
As for me, I prefer the good old American flag and place my political hope in the genius of the founders who devised a system which I hope will weather the Trump storm and someday return sanity to the land.
 

Could There Be a More Perfect Tweet?

If there’s a tweeting contest for 2017, I enter fellow Patheos blogger Hemant Mehta’s tweet.


The layers of this tweet would take political pundits many hours on CNN, FOX, and CNBC to unravel. At once, it nails Donald Trump and Roy Moore and succinctly expresses their immaturity and incompetence. And it captures the Twilight Zone that is our current national government.
Here is a screen cap of the tweet with Trump’s tweet in case it all doesn’t show up in the embedded tweet above.
childish tweet
For those who have been vacationing off planet, the Roy Moore story has taken social media by storm. He has denied molesting a 14 year old girl when he was in his 30s but the Washington Post story was well researched and has numerous GOP colleagues calling for him to get out of the Alabama Senate race. Now he has threatened to sue the Post.
I doubt he will sue. He and his accusers would testify under oath. If everything is as it seems to be, his accusers would debunk the stories about money changing hands in exchange for their story.  In print and subsequent interviews, his accusers seem credible. Furthermore, Moore would have to take the stand. He hasn’t been terribly convincing with his public statements. I don’t think it would go well for him unless of course he is completely innocent.
In this story, the shocking thing isn’t that people believe he could be innocent. False allegations do happen. Sometimes accusers lie. Many people only know Moore in a context where he is an honorable public servant. Naturally, they want to believe the best about him. What has been shocking to me is that too many Republican leaders have said they would support him even if the allegations were true.

W.H. Chief of Staff John Kelly Can't Get the Confederacy Right

no Confederate flagAs has been widely reported, White House Chief of Staff John Kelly last night on the Laura Ingraham Show said Robert E. Lee was an honorable man and the Civil War was fought because the North and South couldn’t compromise. Kelly was brought into the White House to keep Trump from stepping on verbal landmines. However, he has stepped on a few of his own in recent days.
The unforced historical error comes amid two indictments and the revelation yesterday of an even more damning guilty plea from a former Trump campaign foreign policy advisor George Papadopoulos relating to the Robert Mueller’s Russia investigation.
Some historical matters arouse little passion, some are critical to get right. Anything involving slavery and the Confederacy and understandably critical to get right. And it isn’t difficult. Lee fought for the South in the Civil War which was fought to keep African slavery as a moral good. All the compromising took place before the war and was evil. See, not hard.
A good social media place to look at for a response to Kelly is Ta-Nehesi Coates thread on Lee and the Civil War.
For more from past posts, see below:
Robert E. Lee on slavery – This post contains a letter from Lee to his wife.
The Vice-President of the Confederacy Alexander Stephens on slavery as the reason for the Confederacy – This post contains the words of a speech by Stephens declaring slavery as integral to the new Confederacy.
Unfortunately, it appears that Kelly may have read too much history from David Barton. Barton believes Lee was a good guy and isn’t in favor of removing the Confederate statues. Even though Barton correctly attributes the cause of the Civil War to slavery, he falters on many other alt-right talking points.
UPDATE:
And of course, Sarah Huckabee Sanders, W.H. Spokesperson came out and defended Kelly’s comments.


The heads of thousands of sane historians explode.
To follow on social media, click the following links:
Facebook (blog posts and news)
Facebook (Getting Jefferson Right – history news)
Twitter

The National Anthem Controversy and the McCain-Flake Report on Paid Patriotism

Paid Patriotism
As a memory refresh, here is what President Trump said about athletes who take a knee during the playing of the national anthem before sporting events. Primarily he aimed this at professional football players. Watch:

In the clip above, Trump called on National Football League team owners to fire protesting players and asserted that owners should tell respond, “‘Get that son of a bitch off the field right now. Out! He’s fired. He’s fired!” when a player protests during the anthem.
These comments have ignited another firestorm with Trump at the center.
What gets lost in the battle between protest supporters and opponents is the fact that prior to 2009, players on the field for the anthem during primetime wasn’t routine (for more specifics on the history of the anthem and the NFL, see this article). In fact, since then and until recently, many pre-game ceremonies are purchased with tax payer funds. Based on a report by Senators John McCain and Jeff Flake, “paid patriotism” has benefited NFL teams at a hefty cost to tax payers. In fact, the Department of Defense has paid sports teams to put on patriotic displays in order to aid recruitment. From the report:

Dear Taxpayer,
In 2013, a roaring crowd cheered as the Atlanta Falcons welcomed ϴϬ National Guard members who unfurled an American flag across the Georgia Dome’s turf. Little did those fans—or millions of other Americans—know that the National Guard had actually paid the Atlanta Falcons for this display of patriotism as part of a $315,000 marketing contract.
This unfortunate story is not limited to professional football, but is repeated at other professional and college sporting events around the nation. In fact, these displays of paid patriotism are included within the $6.8 million that the Department of Defense (DOD) has spent on sports marketing contracts since fiscal year 2012.
Consider this: Honoring five Air Force Officers put $1,500 into the pockets of the L.A. Galaxy. In another example, taxpayers footed the $10,000 bill for an on-field swearing-in ceremony with the World Series finalist New York Mets. And the list goes on. By paying for such heartwarming displays like recognition of wounded warriors, surprise homecomings, and on-field enlistment ceremonies, these displays lost their luster. Unsuspecting audience members became the subjects of paid-marketing campaigns rather than simply bearing witness to teams’ authentic, voluntary shows of support for the brave men and women who wear our nation’s uniform. This not only betrays the sentiment and trust of fans, but casts an unfortunate shadow over the genuine patriotic partnerships that do so much for our troops, such as the National Football League’s Salute to the Service campaign.
While many professional sporting teams do include patriotic events as a pure display of national pride, this report highlights far too many instances when that is simply not the case. When our offices first discovered this practice, we sought to better understand it from DOD and introduced an amendment to the 2016 National Defense Authorization Act to end these taxpayer funded salutes to the troops.
The United States Senate’s oversight has worked. DOD has banned paid patriotism and the NFL has called on all clubs to stop accepting payment for patriotic salutes.
However, more work remains. Despite our success curbing this inappropriate use of taxpayer funds, DOD still cannot fully account for the nature and extent of paid patriotism activities. In fact, more than a third of the contracts highlighted in this report were not included in DOD’s list; instead, our offices discovered the additional contracts through our own investigative work. In the end, two-thirds of the contracts found by our offices or reported by DOD contained some form of paid patriotism. Direct and persistent sunlight is the best way to ensure that such activities are not continued. What follows is not an exhaustive list of all DOD sports marketing contracts, but a selection of clear examples where taxpayers—not the teams—paid for patriotism and VIP perks. It is time to allow major sports teams’ legitimate tributes to our soldiers to shine with national pride rather than being cast under the pallor of marketing gimmicks paid for by American taxpayers.

No wonder some players feel the anthem is an appropriate vehicle to express their opinions. The DOD and NFL have been using those pre-game events to conduct business and put on a show. Now that athletes want to exercise their First Amendment rights with no cost to anyone, they are demonized for it.
In any case, requiring players to stand for the national anthem is a recent practice. One should not argue that the players who take a knee or do something other than stand are violating a time honored tradition.
Personally, I think peaceful protest is noble and should not be discouraged. In any case, America is not a totalitarian regime where ideological compliance with the rulers is required. For this reason, Donald Trump’s encouragement to NFL owners to fire protesting players is especially distressing.