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August 9, 2017

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

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Francine Sinkoff, Editor

Inside the First Court Designed to Keep  Opioid Addicts Alive

Buffalo is responding to New York's opioid epidemic by opening the nation's first opioid intervention court that treats participants more like patients than defendants.

Unlike standard drug courts, Buffalo's opiate intervention court gets eligible defendants into court-supervised addiction treatment programs almost immediately and places any drug-related charges on hold for a minimum of 30 days. Successful completion of the program can lead to charges that are reduced or even dropped.

The court is overseen by Craig D. Hannah, a judge whose philosophy is informed by his own struggles with drug addiction and a rejection of the mass incarceration culture encouraged by the drug epidemics of the 1970s and '80s. Hannah's priority is keeping his participants alive. "Our goal is to make sure they're here the next day, tomorrow, next week, next year," he told VICE News.

Click here to watch a special report about the court on HBO's VICE News.
DSRIP Demonstration Year 2 Progress

DSRIP Year 2 (DY2) closed on March 31, 2017 with positive statewide performance results. Through DY2, PPS have earned a total of $2.4 billion, which is 95% of all available funds. Notable progress towards the DSRIP program goal of achieving a 25% reduction in avoidable hospital use by DSRIP Year 5 was demonstrated through a 14.9% reduction in Potentially Preventable Readmissions and an 11.8% reduction in Potentially Preventable ER Visits. If the current reduction rates are maintained, New York will achieve the goal of a 25% reduction by DSRIP Year 5. Additionally, PPS have successfully met all requirements for 31 projects in total and have successfully implemented 95% of all DY2 project requirements.
While there is work to be done, the results from DSRIP Year 2 are a reason to be optimistic that the DSRIP goal will be achieved.   Click here for a presentation by NYS Medicaid Director, Jason Helgerson, from a recent all PPS meeting held in New York City. 

Apply Now: Substance Abuse Program Grant

The Hanley Family Foundation is accepting pre-proposals for grants to support organizations whose primary focus is to help individuals recover from, or avoid, substance use disorder. Due to the lack of treatment services, opportunities to support new or expanding programs that will allow more people to seek recovery are particularly welcome, but prevention-oriented projects are not being sought at this time.

The  foundation's website provides further details about the grants. A letter of inquiry (LOI) must be submitted first; upon review, selected applicants will be invited to submit a full proposal. LOIs are accepted on a rolling basis.
UChicago Health Lab and Community Partners Open Center for Individuals Exiting Jail

The  University of Chicago Health Lab, in partnership with the Cook County Sheriff's Office,  Treatment Alternatives for Safe Communities and  Heartland Health Outreach, has opened the Supportive Release Center to provide short-term, critical services to individuals with mental health issues who are exiting jail.

The new center, located adjacent to the Cook County Jail in Chicago's Little Village neighborhood, provides assistance for those who suffer from mental illness and are discharged from the system-sometimes late at night-without clean clothes, a shower, a meal or a place to go. Up to one-third of people exiting the jail suffer from mental illness.

The center began serving released individuals on June 5 and so far has served about 70 people.   Read more here .

August 15, 12 - 1 pm, National Committee for Quality Assurance (NCQA)

August 16, 3 - 4:30 pm, Rural Behavioral Health

Medicaid Coverage and Financing of MAT, Current Status and Promising Practices
August 17, 3:30 - 5 pm, SAMHSA

August 22, 3 - 4 pm, SAMHSA's GAINS Center
Monday, August 28, 1 - 2:30 pm, OMH

September 6, 10 - 11 am, OMH

September 8, 2 - 3 pm, OMH

September 12, 2:30 - 3:30 pm, National Council for Behavioral Health

September 14, 12 - 1 pm, PsychU

Enable Access to Client-Level Data in PSYCKES
September 20, 10 - 11 am, OMH

September 28, 12 - 12:30 pm, PsychU



Officers, Chairs & Regional Reps Call
September 6:  8 - 9 am

Fall Full Membership Meeting
September 11 - 12
Crowne Plaza, Lake Placid

Children & Families Committee Meeting
September 19:  11:30 am - 1 pm

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Governor Cuomo Announces No-Cost or Lower-Cost Naloxone Available at Pharmacies Across New York

Governor Andrew M. Cuomo recently announced a first-in-the-nation program to provide no-cost or lower-cost naloxone at pharmacies across New York. Beginning August 9, 2017, individuals with prescription health insurance coverage, including Medicaid and Medicare, will receive up to $40 in co-payment assistance, resulting in reduced cost or no cost for this lifesaving medicine. Uninsured individuals and individuals without prescription coverage will still be able to receive naloxone at no cost through New York's network of registered opioid overdose prevention programs.

Naloxone is a medicine used to reverse opioid overdoses. Reducing the cost of this lifesaving medication builds on Governor Cuomo's previous  action  to make naloxone available in pharmacies without a prescription which began in January 2016. Previously, New Yorkers could only receive naloxone with a prescription or through a registered opioid overdose prevention program.  Read more here.
CMS Considers Telehealth for New Models of Behavioral Healthcare

Federal officials are looking at telehealth in their search for new models of care for Medicare and Medicaid beneficiaries with behavioral health issues.

The Centers for Medicare & Medicaid Services has scheduled a September summit to develop a payment and delivery model for behavioral healthcare that can be supported through  CMS' Innovation Center.

In a notice posted July 21  in the Federal Register, CMS officials indicated they're looking to design "a potential payment or service delivery model to improve healthcare quality and access, while lowering the cost of care for Medicare, Medicaid or CHIP beneficiaries with behavioral health conditions." Such a model might make use of telehealth to improve provider participation, involve payer partnerships or qualify as an Advanced Alternative Payment Model (APM).  Read more here.
Opioid Users Are Filling Jails. Why Don't Jails Treat Them?
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NEW HAVEN - When Dave Mason left jail in October 2015 after his 14th criminal conviction, the odds were good that he would soon end up dead.

A man with a longtime heroin addiction, Mr. Mason was entering one of the deadliest windows for jailed users returning to the streets: the first two weeks after release, when they often make the mistake of returning to a dose their body can no longer handle.

Standing outside the New Haven Correctional Center, clutching his few belongings in a brown paper bag, Mr. Mason appeared precariously close to taking that path. His ride never showed up. He had no money, no contact with his family and nowhere to live.

But instead of panhandling for cash to score drugs, he went to a methadone clinic, determined to stay clean.  Read more here.
New Model Gives More Accurate Picture of Opioid, Heroin Fatalities

Researchers have developed a correction procedure to refine state-by-state mortality rates to better identify the number of deaths from opioid and heroin use. There were 36,450 fatal overdoses nationwide in 2008 and 47,055 in 2014, but half of the overdose fatalities reported unspecified drugs and in one-fifth to one-quarter, it was the only drug-related designation included.

The study,  published in the August edition of the American Journal of Preventive Medicine, shows a new, more accurate picture of the rates of opioid and heroin deaths across the country.   Researchers found that the corrected mortality rates were 24 percent higher for opioids and 22 percent higher for heroin nationally.

"A crucial step to developing policy to combat the fatal drug epidemic is to have a clear understanding of geographic differences in heroin- and opioid-related mortality rates," Christopher J. Ruhm, of the Frank Batten School of Leadership and Public Policy at the University of Virginia, said in a press release. "The information obtained directly from death certificates understates these rates because the drugs involved in the deaths are often not specified."  Read more here.
Department of Health Launches Value Based Payment (VBP) Learning Resources

The NY Department of Health has launched an on-line learning program they call VBP University. VBP University is an educational resource designed to raise awareness, knowledge and expertise in the move to Value Based Payment (VBP). VBP University combines informational videos and PAGE 18 August 2, 2017 supplemental materials that stakeholders interested in VBP can use to advance their knowledge of the topic. 

The program consists of four semesters, and individuals who successfully complete all four semesters will be awarded a certificate of completion. 
  • Semester One: Background and foundational information on VBP 
  • Semester Two: Topic specific information such as governance, business strategy, stakeholder engagement, finance, and data
  • Semester Three: VBP Contracting
  • Semester Four: VBP Bootcamps 

Participation in a VBP bootcamp is required in order to complete the certification process. Bootcamps will be scheduled for October and November of this year. The Department currently has posted the curriculum for the first semester of VBP University. Read more here.

For Homeless on Heroin, Treatment can be Elusive with No Identification 
Homeless and on heroin, but turned away from treatment
Nearly two decades of using heroin and a year of living on the streets of Philadelphia had led Steven Kemp to a simple conclusion: It was time to get sober. But when he staggered into a detox facility on a recent Friday night, his head brimming with the thought that suicide would end the pain, he was told he couldn't be admitted because he didn't have a photo ID.

Kemp said he was turned away from the hospital and spent the night stealing enough small items to trade for a handful of Xanax. He swallowed the pills, cooked up some heroin and injected the drug into his arm with the intention of killing himself.

"If somebody goes in and says 'I need help,' they should get it," said Kemp, 35. "I understand people have to get paid but you're supposed to be a health professional, you took an oath."

As the nation's heroin and painkiller epidemic rages, small but vulnerable populations of homeless people are sometimes turned away from the nation's already-threadbare system of drug treatment centers because they do not have valid photo identification.  Read more here.
Payer Collaboration Can Address Social Determinants of Health
Payers collaborate to address social determinants of health
Billions in overspending on medical costs are attributed to social determinants of health (SDOH), and SDOH can identify if beneficiaries covered by insurance plans are at risk for adverse health conditions outside their coverage.

SDOH include all of the factors that impact an individual's health outside of their traditional contact with the healthcare system.  These include societal and environmental conditions like socioeconomic status, education level, language fluency, cultural differences, employment status, and level of access to healthcare.

According to a new report from AHIP, these determinants have an extremely potent effect on an individual's overall health.
Open Minds:  The Top Priorities For Innovation Are...

In a time of disruption - both financial and technological - the ability to innovate is key to the sustainability of health and human service organizations. Typically, these innovations are focused on some part of the value equation, increasing the competitive advantage of the organization.

But innovation is slow and takes hard work in the field. Answering the big question - what is the state of innovation in the health and human service market today? - has been the focus of a lot of my work in recent months.   Recently I had the opportunity to speak to someone who is spending a lot of time thinking about innovation in the field - Peggy DeCarlis, MSSA, LCSW-C, Senior Vice President and Chief Operating and Innovation Officer of New Directions Behavioral Health. 

There were a couple of big takeaways from our discussion. Her role includes directing the organization's clinical and network strategic focus, so it was interesting to consider her "top priorities" for innovation. 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.