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July 6, 2016

Advancing Public Policies for People with Mental Illness, Chemical Dependency or Developmental Disabilities   

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Francine Sinkoff, Editor

CLMHD Releases 2016 End of Session Legislative Report

The last day of the legislative session was June 17, 2016. Click here for CLMHD's End of Session Legislative Report. This report includes bills of interest to the Conference members which were signed into law or passed by both houses of the legislature and are awaiting action by the Governor. Please feel free to share this report with your county executive or any other interested parties.
CMS Guidance on Changes to Provider Rates

Last week CMS released an informational bulletin on public notice requirements related to provider rate changes.   The purpose of this CMCS Informational Bulletin is to summarize procedures states must follow when making changes to provider payments under the Medicaid state plan and to emphasize the importance of public notice content and timing requirements. Specific to payment changes, there are three types of procedures:

* public notice policies that pertain to all proposed changes to provider payment rates or methodologies
* public input process policies, which apply when states reduce rates or restructure payments, and are designed to obtain input related access to care
* public input process policies that are specific to changes to institutional provider payment rates
You can access the full bulletin here.

Clinton County is Seeking a DCS!

Clinton County (NY) is seeking applicants for a permanent, full-time position as the Director of Community Services. This position serves as the  Chief Executive Officer of the local government unit responsible for community service programs, and for exercising general direction in the planning, coordination, and operation of services provided within the County for mentally ill, developmentally disabled, and chemically dependent. The Director reports to the Clinton County Community Services Board (CSB) and recommends action and polices for the purpose of establishing and maintain a comprehensive program.  For more information, click here.
Funding Available: MRT Access to Home for Medicaid

The Access to Home for Medicaid application is now available on the NYS Homes and Community Renewal website, . Applications are due no later than 4:00pm Wednesday, September 28, 2016. 

Applications must be submitted using the Community Development Online Application System (CDOL) available at: . You must pre-register for the CDOL system prior to submitting an application for funding
Applications will be accepted for programs that propose funding for one or more of the following activities in existing residential units:
  • Installations of ramps, lifts, and other similar measures to permit access to and from the exterior of a building;
  • Modifications to kitchens and bathrooms to provide access to persons with mobility limitations or disabling conditions; 
  • Interior accessibility modifications that will permit access within the unit for persons with mobility limitations or other disabling conditions; 
  • Installation of devices to permit a safe environment for persons with hearing or visual impairments; 
  • Architectural and engineering work, testing of assisted units for environmental, health and safety purposes, and other professional services necessary for the installation of accessibility modifications; 
  • Other activities required to install accessibility modifications. 
For more information, the Notice of Funding Availability can be found here.
NYS Releases Updated MCO Billing Department Contact Information

NYS released updated information for the plans' billing departments on June 28th, available  here.   MCTAC is currently working with the MCOs to update rest-of-state plan information on the matrix. As a reminder,  Rest of State providers that have not claims tested with each plan are
strongly encouraged to do so.   
How to Minimize the Impact of Staffing Shortages

The law of supply and demand does not always follow traditional economic patterns in the healthcare market. Greater access to behavioral healthcare services today-thanks in large part to the Affordable Care Act-has been a boon to providers, causing demand for their services grow.   Yet, as behavioral healthcare services grow, so does the need for qualified staff to provide those services.

Keeping up
In this case, high demand is impacting the ability of behavioral healthcare organizations to maintain an ideal level of staffing as they seek to scale up operations. In fact, many programs are struggling to attract top-quality clinicians to fill new or vacant positions and to retain the staff they already have. There is competition for good workers, and the pipeline of new recruits isn't as robust as some would like.

"We need to expand our workforce by at least 20,000 over the next two years in order to meet demand," says Andrew Kessler, principal with Slingshot Solutions in Annandale, Va. "We have see a lot of increases in access to care over the last few years, but the number of professionals to provide the care has not kept up."

What's more, the problem is likely to become more acute as the current field of qualified professionals starts to retire.  Read more here .



July 7, 1 - 2 pm

July 14, 1 - 2 pm
July 21, 1 - 2 pm

July 28, 1 - 2 pm

Other MCTAC Webinars:

July 12, 12 - 1 pm

August 24, 12 - 1 pm
September 21, 12 - 1 pm
October 26, 12 - 1 pm


July 14, 2 - 3 pm, OASAS, OMH, DOH

For providers that wish to integrate primary care and mental health and/or substance use disorder (behavioral health) services. This webinar will aim to address PPS and provider concerns surrounding integration, the application process, and an overview of the billing process by provider and application type.


JULY 2016

Mental Hygiene Planning Committee
July 7:  11 am - 1 pm
GTM Only

Children & Families Committee
July 12:  11:30 am - 1 pm

Directors / Executive Committee Combined Meeting
July 26:  9:30 - 11:30 am
GTM Only

Developmental Disabilities Committee
July 27:  12 - 1 pm
GTM Only

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Governor Cuomo Awards $10.5 Million to Support New Centers to Help Those in Recovery From Addiction

Governor Andrew M. Cuomo last week announced $10.5 million in funding over five years to support six new Recovery Community and Outreach Centers in communities across New York. The new centers, funded by the New York State Office of Alcoholism and Substance Abuse Services, will provide health, wellness and other critical support for individuals and families who are recovering from a substance use disorder or are seeking recovery services.

"Addiction devastates the lives of far too many New Yorkers and their families,"  Governor Cuomo said.  "These new centers will provide the necessary resources and support to those seeking recovery and will help us build a stronger and healthier New York for all."

These model recovery centers are the latest addition to the Governor's multi-pronged approach to addressing substance use disorders in New York State. The Governor's Heroin Task Force has heard from New Yorkers about the importance of ongoing, locally-based recovery services. These new centers will respond directly to that need expressed by Task Force meeting participants. The centers will engage peers and volunteers to assist those in recovery on their path toward wellness. Center staff will provide resources and host activities that foster a lifetime of wellness for individuals, families and community members. New York State Office of Alcoholism and Substance Abuse Services Commissioner Arlene González-Sánchez announced the awards at a press conference today at the Family & Children's Association in Mineola, New York, joined by representatives from the recovery community.  Read more here.
OPWDD Announces New Priority Categories for Housing Opportunities  

Last week OPWDD announced that they have revised the priority categories for offering housing opportunities in group homes that provide 24/7 support, to make sure that people living at home with their families have equal access to those opportunities based on their need. 

Last year, OPWDD began using a process called the Certified Residential Opportunities (CRO) protocol to create consistency in the management of certain housing opportunities. This process looked at overall need for these opportunities and helped us to plan ahead to meet this need using a priority system based on each person's circumstances, formerly known as Priority 1,2 or 3.  

The new priority levels, which will replace Priority 1, 2 and 3, are being identified as Emergency Need, Substantial Need and Current Need. Emergency Need will include people that have or are at risk of having no permanent place to live or whose health and safety are at risk. Substantial Need will include people whose family members or other caregivers are unable to continue to care for the person and people subject to court mandate, transitioning from a residential school, moving from a developmental center or leaving a skilled nursing facility. Current Need will include people who have a current need for housing, but the need is not an emergency. A full list of these changes can be viewed on the  OPWDD website. Read more here.
Trends in Medicaid: Looking Back At 15 Years of Kaiser Surveys of State Medicaid Programs

A new issue brief from the Kaiser Family Foundation highlights key trends from 15 years of findings from our annual budget survey of state Medicaid programs. The brief synthesizes findings on enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care; and more recent data on managed care and delivery system reform. Each year states make a range of policy changes to Medicaid to comply with new federal rules and address an array of policy goals.

Three key findings emerge from the surveys:
  • Changes in the economy have significant effects on Medicaid programs, with spending and enrollment rising during downturns, while state revenue and budgets grow tighter.
  • States have generally moved to expand Medicaid eligibility and streamline enrollment processes over time.
  • State Medicaid programs are evolving over time, implementing initiatives, including managed care and more community-based care, to improve delivery of services and control costs. 
Click here for the full report.
New Report Covers Criminal Justice Policy Reforms in 46 States
On May 26, 2016, the Vera Institute published Justice in Review: New Trends in Sentencing and Corrections 2014-2015. "In 2014 and 2015, 46 states enacted at least 201 bills, executive orders, and ballot initiatives to reform at least one aspect of their sentencing and corrections systems," the Vera Institute writes.
"[M]ost of the policy changes focused on three areas: creating or expanding opportunities to divert people"-especially individuals who have substance abuse or mental health conditions and/or who are homeless-"away from the criminal justice system; reducing prison populations by enacting sentencing reform, expanding opportunities for early release from prison, and reducing the number of people admitted to prison for violating the terms of their community supervision; and supporting reentry into the community from prison...this report serves as a practical guide for other state and federal policymakers looking to effect similar changes in criminal justice policy."
For more information and to download the free report, click here. Also available for free download is the American Friends Service Committee's Inalienable Rights: Applying international human rights standards to the U.S. criminal justice system. For more information and to download a free copy, click here.  
UHF Report:  Effective Value-Based Payment for Children Requires Different Quality Measures than Those for Adults

A new United Hospital Fund report focuses on the quality measures to consider as part of value-based payment arrangements for children's health care. Rolling children's care into broader reform efforts rooted in value-based payment requires close consideration of how value in children's health care is defined and how it is measured.

The report presents four central lessons for New York as the State considers quality measures for value-based payment for children: (1) Government and public programs, particularly Medicaid, have good reason to continue leading the development and use of children's health quality measures; (2) Establishing a process that creates incentives that go beyond what is currently measured can help the State incorporate increasingly ambitious goals; (3) Ensuring that children with special needs receive high-quality care under a value-based payment arrangement is critically important and potentially complex; and (4) Value-based payment quality measures could encourage child primary care providers to integrate or coordinate oral and behavioral health services and address social determinants of health.   Click HERE for the full report.
Innovative Scheduling Changes Increase Savings, Intake and Client Engagement

In just three years, View Point Health, a Metro Atlanta-based community behavioral health care agency, has transformed their clinical practice by implementing a rapid-cycle change model under the guidance of MTM Services. View Point Health provides mental health, addictive disease and developmental disability services serving as the public safety net for a three county area with a total population of more than 1 million.

In an effort to increase efficiency, access to services and client engagement, View Point Health implemented open access within their outpatient centers. By reassigning staff and rerouting phone lines, a centralized scheduling system was created to manage appointments, no-shows and follow-up appointments. The shift to open access resulted in an estimated $32,682 in monthly savings and $392,184 in yearly savings. Between January 17, 2012, and March 30, 2012, outpatient intake increased by 14 percent. 

Active interaction with clients encouraged on-going participation in treatment, increased engagement with interventions and enhanced treatment outcomes. Collaborative documentation and the results of a survey indicated positive trends in client engagement, customer service and provider accountability. Read more here.
NYSDOH Issues Medicaid CAG VBP Recommendation Report for HARP Subpopulation

The New York State Department of Health (NYSDOH) has issued notice that its Behavioral Health Medicaid Clinical Advisory Group (CAG) has issued their recommendations for inclusion in value-based payment (VBP) programs.   The Behavioral Health Clinical Advisory Group (CAG) has produced a Recommendation Report for the  HARP subpopulation.  

The CAG reports have been posted for public comment on the Medicaid Delivery System Reform Incentive Payment (DSRIP) Web site here.   The public comment period commenced on June 24th and will end on July 24th.  
Doctors Wrestle With Mixed Messages When Deciding Whether To Prescribe Painkillers

Steve Diaz, an emergency medicine doctor at Augusta's MaineGeneral Health, says he knows what patients want when they come to him in pain. Drugs. And preferably strong ones.  

"The only thing they think of is, 'Do I get a pill?'" he said.

And with abuse of prescription painkillers like OxyContin, methadone and Percocet soaring, the instinct, public health experts say, should be to say no. Or at least, not necessarily. The Centers for Disease Control and Prevention put out  a new guideline this spring, advising doctors to prescribe the highly addictive drugs, known as opioids, in smaller doses and only when truly needed.
But another federal policy - a provision of the 2010 federal health law  linking hospital payments to patient satisfaction  surveys - may be complicating efforts to curb opioid prescribing as part of the nation's effort to address the painkiller abuse epidemic.

As part of these surveys, amidst questions about night-time noise levels and hospital staff proficiency, patients can evaluate how doctors managed their pain, and if clinicians did all they could to treat it. That's setting up a system, doctors say, where physicians' ratings can get caught between patient demands and sound medical judgment.  Read more here .
The Conference of Local Mental Hygiene Directors advances public policies and awareness for people with mental illness, chemical dependency and developmental disabilities.  We are a statewide membership organization that consists of the Commissioner/ Director of each of the state's 57 county mental hygiene departments and the mental hygiene department of the City of New York.