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April 27, 2016

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

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Francine Sinkoff, Editor

Are Policies Improving for Telemedicine Providers?

The Ce nter for Connected Health Policy is out with its latest summary of state telemedicine laws and Medicaid policies. It's up and down for providers: many states are beginning to expand reimbursement; others are placing limits. And, since July 2015, there aren't any changes in the number of Medicaid programs providing reimbursement for remote patient monitoring.

Click here for the report.
Commonwealth Fund Report: Implementing New York's DSRIP Program

New York is one of eight states currently implementing DSRIP initiatives. But as the one with the largest and most comprehensive effort to transform its care delivery system, New York's early experiences with DSRIP are informing Medicaid policy at CMS and in states across the country, according to a  Commonwealth Fund report  on the program published last week. 

CMS already made it clear that New York's DSRIP waiver design should serve as a baseline for other states, according to the report. The Commonwealth Fund highlighted the most pressing questions that are emerging in New York, including those about the relationship between managed care organizations and PPSs. The details of those contracts have largely been left to the PPSs and MCOs to figure out in New York, but in some other DSRIP states there has been more guidance. Minnesota, for instance, imposed specific contract requirements regarding patient attribution, shared savings or loss calculations and other considerations, according to the report. Commonwealth also highlighted the uncertainty about what will remain of the relationships between PPS providers once the waiver runs out, and concerns about the level of consolidation that may result from value-based payment incentives.

Integrated Care Webinar Series by the National Council for Behavioral Health

The Medicaid Redesign Team is excited to share four short educational videos created by the National Council for Behavioral Health for the DSRIP Program. These pre-recorded videos are intended to assist PPS and network providers with implementing best practices for integrated care.  
  • Warm Handoff - Motivational Interviewing - 5:17 minutes
  • Warm Handoff - Anxiety - 5:59 minutes
  • Morning Huddle - 4:07 minutes
  • Brief Intervention - 5:50 minutes 
The series can be accessed via this link to the Webinars and Presentations page on the NYS DSRIP Website, specifically under National Council for Behavioral Health Educational Video Series on Integrated Care. The webinars are also available in the DSRIP Digital Library.

OASAS Announces New SBIRT Distance Learning Course

A new distance learning course on Screening, Brief Intervention and Referral to Treatment (SBIRT) has been created as part of the NYSBIRT II SAMHSA grant (TI025102) to NYS OASAS. SBIRT is an evidence-based approach to identifying patients who use alcohol and other drugs at risky levels with the goal of reducing and preventing related health consequences, disease, accidents and injuries. 

This 4-hour, self-paced, interactive and user-friendly online module will give healthcare professionals the information, motivation, tools and resources that they need to conduct SBIRT in a variety of practice settings.   All New York State licensed and/or certified providers are invited to register via CPI's Learning Management System (LMS) and those that score an 80% or higher on each section will pass the course, receive credit and be certified to bill Medicaid for SBIRT services. This course is not available to those outside of New York State.

To register for the course, please click here For general questions regarding this SBIRT training, please contact Aubrey Feldman, NYSBIRT Project Coordinator at .


May 25, 12 - 1 pm

May 25, 1 - 3 pm, National Empowerment Center
June 22, 12 - 1 pm

June 30, 12 - 1 pm

July 27, 12 - 1 pm
August 24, 12 - 1 pm
September 21, 12 - 1 pm
October 26, 12 - 1 pm

April 27, 2 - 3:30 pm, SAMHSA-HRSA

May 4, 2:30 - 4 pm, SAMHSA-HRSA

May 12, 1 - 2 pm, National Council for Behavioral Health



MAY 2016
Spring Full Membership Meeting & CLMHD 40th Anniversary Dinner
May 2 - 3: The Desmond, Albany

Mental Hygiene Planning 
May 5:  11 am - 1 pm
GTM Only

Children & Families Committee

OMH Agency Meeting
May 23:  10 am - 12 pm
44 Holland Ave., Albany

OASAS Agency Meeting
May 23:  1 - 3 pm
1450 Western Ave., Albany

CLMHD Mentoring Workshop
May 25:  10 am - 4 pm
DoubleTree by Hilton Hotel, Syracuse

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Do Local Governments Have a Role to Play in Mental Health?

The advertisements on public transportation don't usually warrant a second glance, let alone a conversation. But on the New York subway last week, a new series of banners went up, asking people to start talking. "Depression doesn't define me," one reads. Another one: "Addiction can affect anyone and is treatable." At the bottom of all of them is this line: "Let's talk openly about mental health issues. Together we can heal."
The ThriveNYC campaign coincides with a growing worldwide recognition that mental health concerns must be addressed. One in four people will be affected by mental health concerns in their lifetime; at a conference
held in Washington, D.C. from April 13-14 of this year, the World Bank and World Health Organization brought together hundreds of doctors, aid groups, and government organizations in an effort to move mental health to the forefront of the global agenda. Speaking to NPR , Dr. Shekhar Saxena, who oversees WHO's mental health and substance abuse sectors, said that a failure to treat just depression and anxiety costs the world $1 trillion per year. "We believe that all countries need to pay more attention to mental health," he said.  Read more here.
Report:  Most DSRIP Networks Perform Well

With   data now available  from the first three quarters of DSRIP, most Performing Provider Systems appear on track to collect the lion's share of their first-year awards. Among the 25 PPSs, 12 were awarded all of their achievement values, or AVs. The worst-performing PPS, Advocate Community Providers, was on track to earn 93% of its AVs, according to an  analysis from COPE Health Solutions , a consulting firm. Achievement values are a group of metrics used to grade the PPSs to determine their DSRIP payments. While the third-quarter report does not dictate payouts, it acts as a sort of progress report ahead of the full-year reports, which do affect awards, and are scheduled to be published July 6. Where the networks more commonly struggled was in the speed and scale portion of scoring, with 12 PPSs missing at least one AV in that area. Montefiore's Hudson Valley Collaborative, for instance, was on track to earn only one of seven available AVs related to speed and scale. Those were the only AVs it missed, earning 167 of 173 AVs, or 97%. Some PPSs, including NYC Health + Hospitals' OneCity Health, did not specify such incremental speed-and-scale target goals. That PPS received all 167 AVs available.

Click here to see more details about where and what the various PPSs are doing.

Opioid Replacement Drugs Out of Reach for Many in Upstate

When Melissa Ives was recovering from a brutal motorcycle accident, the opioid medication she was prescribed helped mask the pain. But eventually, those pills ran out so she turned to a cheaper alternative - heroin.

"I was addicted for five years," Ives said. "I could do up to 40 bags a day of heroin and it's just a miracle I'm not dead. I am grateful to be walking and talking."

Ives, who lives in Fulton, attributes her recovery to the treatment she received in  Syracuse, where many drug abusers in central New York turn because there are few clinics in the area with comparable services.
One of those detoxification clinics is at Crouse Hospital, where they offer an opioid replacement called methadone. It's administered daily under the supervision of health professionals. The hospital's chemical dependency treatment director Monika Taylor said people from 17 counties in central New York travel to Crouse to get the daily dosage.

"Right now, we have a wait list of about 380 patients for this particular treatment," Taylor said. "So, for the methadone program there is probably at this point a 9-12 month wait before somebody can get admitted."

Taylor said this is not your typical wait list.
"There are definitely people that are continuing to use while they are out there waiting to get into the program and we have heard of people dying that are on the wait list."  Read more here.
Justice Dept. Seeks Better Interactions with Mentally Ill

The Justice Department hopes to launch a pilot program this summer to help police agencies better deal with people with mental illness, Deputy Attorney General Sally Quillian Yates said last Tuesday.

She said the federal government is committed to addressing a "mental health crisis" that continues to strain the criminal justice system and leave ill-equipped police departments, courts and jails unable to keep up with the demand for services from mentally ill Americans.

"Requiring our strained criminal justice system to do double duty as front-line mental health facilities is not only inefficient, it is totally inconsistent with our values and who we are as a country," Yates said in prepared remarks for a Washington summit on mental illness. "This is not the treatment our fellow citizens deserve."

The intersection of the mental health and criminal justice systems is attracting growing attention, with concerns about the adequacy of services and treatment flaring after episodes of mass violence carried out by troubled individuals with mental-illness histories.

The Justice Department is working to address the problems by encouraging better police interactions with people struggling with mental illness, as well as mental-health treatment for suspects both inside and outside prison. The department is also promoting the use of specialized mental-health courts and diverting some suspects to treatment instead of jail, plus improved treatment for those who wind up behind bars.

The Bureau of Justice Assistance, the department's grant-giving arm, has awarded more than $80 million in grants since 2004 to support mental health and substance abuse treatment. It's now developing a curriculum for police forces to create and train specialized crisis intervention teams which will be responsible for de-escalating dangerous situations. Yates cited the example of one such team in Portland, Oregon, where an officer managed to talk a knife-wielding man off a parking garage ledge after determining he was hungry and providing him with a sandwich.

The goal is to create different training modules with a range of best practices, and to launch a pilot program in certain localities this summer, she said.

--The Washington Post
Hospitals Test Putting Psychiatrists on Medical Wards

Some leading hospitals have begun placing psychiatrists and other mental-health professionals into medical units to identify psychological problems early in a patient's stay.  

Mental-health professionals working on the front lines with medical doctors improve care and help reduce the time patients need to stay in the hospital, studies suggest. Some practitioners also say the approach might cut the likelihood patients will need to be readmitted.

Hospitals traditionally call upon psychiatrists as consultants when needed-often during a crisis, such as when a patient becomes unmanageable.

Johns Hopkins Hospital in Baltimore in April launched a program to screen patients for psychological problems shortly after they are admitted. About 20% of the nearly 50,000 patients the hospital discharges a year have mental-health disorders in addition to their physical ailments, the hospital says.

At NewYork-Presbyterian/Columbia University Medical Center, in New York City, psychiatrists join the morning rounds with interns and residents to stop by patients' bedsides in some medical units. And Brigham and Women's Hospital in Boston last fall assigned a psychiatrist to a medical intensive-care unit.   Read more here .
U.S. Suicide Rate Surges to a 30-Year High

Suicide in the United States has surged to the highest levels in nearly 30 years, a federal data analysis has found, with increases in every age group except older adults. The rise was particularly steep for women. It was also substantial among middle-aged Americans, sending a signal of deep anguish from a group whose suicide rates had been stable or falling since the 1950s.

The suicide rate for middle-aged women, ages 45 to 64, jumped by 63 percent over the period of the study, while it rose by 43 percent for men in that age range, the sharpest increase for males of any age. The overall suicide rate rose by 24 percent from 1999 to 2014, according to the National Center for Health Statistics, which released  the study on Friday.

The increases were so widespread that they lifted the nation's suicide rate to 13 per 100,000 people, the highest since 1986. The rate rose by 2 percent a year starting in 2006, double the annual rise in the earlier period of the study. In all, 42,773 people died from suicide in 2014, compared with 29,199 in 1999.   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.