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January 11, 2017

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

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Francine Sinkoff, Editor

DSRIP Mid-Point Assessment Public Comment Day and PAOP Meeting

In accordance with the requirements in the Delivery System Reform Incentive Payment (DSRIP) Program, the Department of Health will hold a public comment day on the DSRIP Mid-Point Assessment process and findings on Tuesday, January 31, 2017. The public comment day will be held in Albany, New York in the Swyer Theater at The Egg from 10:30am - 5:00pm. No pre-registration is required. Please note that anyone wishing to speak must be signed up by 3pm at the onsite registration desk. Speakers will have up to 5 minutes for public comment.
On Wednesday, February 1st through Friday, February 3rd, the DSRIP Project Approval and Oversight Panel (PAOP) will meet with the DSRIP Performing Provider Systems (PPS) in Albany at the Empire State Plaza rooms 2 - 4to discuss the Independent Assessor's Mid-Point Assessment findings. The meeting is open to the public but there will be no public comment opportunity on these days. No pre-registration is required. 
All meetings will be webcast live and the link will be sent out when it becomes available.   Click here for  the full agenda and order in which the PPS will present. 

More information on the Mid-Point Assessment process, timelines, and reports can be found here
The Impact Of Health Homes For Children

Last week,  Open Minds reported on the New York State Department of Health (DOH) launch of health homes for children in the New York Medicaid plan (see  New York Medicaid Launches Children's Health Homes ). This is a relatively rare development in the world of health homes - while 20 state Medicaid programs currently have health home programs, only four have programs for children. 

An immediate question: What does this model mean for children and for child-serving provider organizations in the state of New York (or any of the four other states with health homes for children)? To answer that question, Monica Oss reached out to  OPEN MINDS Senior Associates Howard Shiffman and Paul Neitman.
Howard Shiffman noted that the competencies needed by provider organizations to be successful at health homes have been a part of the larger market for years.  Read more here.
We Need to Provide Better Mental health Treatment in Schools. Here's how to start.

According to recent statistics from the  National Institute of Mental Health, 1 in 5 kids in the United States has or has had a debilitating mental health disorder. In a classroom of 20 students (and that's considered "small" for some public schools), four of those children could be struggling at any given time with anxiety, depression, attention-deficit/hyperactivity disorder or another issue.

The  Centers for Disease Control and Prevention reported that, in 2012, 13 percent of children ages 8 to 15 had a diagnosable mental health disorder.
Each day, about 20 percent of the millions of children attending school are struggling with a mental health disorder. And yet, many of them suffer in silence.

By the time many clients get to me, they've been in survival mode for a good while. They've found ways to get through the anxiety, depression or inattention that sometimes threatens to overtake them, but their coping mechanisms tend to serve as temporary bandages. Eventually, these kids come unglued. That's when they seek help.
Read more here.
Portal Now Open for Making DSM
a 'Living Document'

Proposals for changes to DSM-5 can now be submitted at a publicly available portal on the APA website.

It is a first step toward creating the "living document" that the DSM-5 Task Force envisioned for the future of DSM, to keep up with emerging scientific data about mental illness and to revise the manual based on that new data in a timely, less costly, and less unwieldy way than in the past.

No w, with the digital age, changes can be made incrementally, as new information emerges, First said.   At the newly created portal , researchers, clinicians, and members of the public can submit proposals for changes to  DSM-5 , defined as the addition, deletion, or modification of diagnostic categories or criteria (including subtypes or specifiers) or the text.  Read more here.

January 18, 3 - 4 pm

This webinar is for the education of entry level electronic billing. This webinar will explain the basic steps for electronic billing. This is not a webinar to explain how to specifically send claims for HCBS service as that is a more detailed and advanced course.  

January 25, 12 - 1 pm

January 12, 12 - 1 pm, PsychU

January 13, 3 - 4 pm, Office of National Drug Control Policy

Medicaid ACO Programs: Promising Results from Leading-Edge States



RPC Leads & Coordinators Call
January 12:  8 - 9 am 

Chemical Dependency Committee
January 13:  11 am - 12:30 pm

Children & Families Committee
January 17:  11:30 am - 1 pm

Directors & Executive Committee Combined Meeting
January 18:  9:30 am - 12:30 pm

Executive Committee Call (State Budget)
January 24:  9 - 10 am

RPC Leads & Coordinators Call
January 26:  8 - 9 am 

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Governor Cuomo Presents 26th Proposal of 2017 State of the State:  Sweeping, Comprehensive Actions to Combat the Heroin and Opioid Epidemic in New York State

Governor Andrew M. Cuomo yesterday proposed a bold, multi-faceted proposal to combat every angle of the heroin and opioid crisis in New York State. The Governor's proposal builds on the success of the legislative package he signed in June to increase access to treatment, expand community prevention strategies and limit the over-prescription of opioids in New York. The proposals aim to eliminate insurance barriers and further expand access to effective treatment, curb overprescribing, and get fentanyl and other synthetic opioids off the streets.

"New York has made great strides in combatting the devastating epidemic of heroin and opioid addiction, but this crisis continues and we must continue to do everything in our power to combat each facet of this complex health emergency,"
Governor Cuomo said. "This multipronged plan addresses each component of heroin and opioid addiction - prevention, treatment, and recovery - in order to help break this cycle of misery and save lives."

The six-point plan put forward in Governor Cuomo's State of the State address is outlined here.
Governor Cuomo Announces Groundbreaking of $17 Million Mixed-Use Housing Development in New York City

Governor Andrew M. Cuomo last week announced the groundbreaking of a $17 million housing development in Jamaica, Queens. The mixed-use housing development will feature 44 units and provide tenants with behavioral health concerns a number of supportive mental health services to promote independence and self-sufficiency. The development is expected to be completed by late 2018 and will be operated by Transitional Services for New York, Inc.

The seven-story apartment building, located at 88-45 163rd Street, will be fully handicapped accessible. The building will feature 33 supportive housing units for men and women with serious mental illness, and 11 affordable housing units for low-income individuals or families who qualify.

To support this project, the New York State Office of Mental Health provided $10.3 million in interest-free construction financing and debt service, as well as a one-time Program Development Grant of $146,000 for start-up costs including equipment, furnishings, and staffing. New York State Homes and Community Renewal will also support the project with $6.5 million in Low-Income Housing Tax Credits.  Read more here.
NYS OASAS Announces Expansion of Services for New Yorkers Struggling with Problem Gambling

T he New York State Office of Alcoholism and Substance Abuse Services  announced
last week that inpatient, residential care for New Yorkers suffering from gambling addiction is now available at six NYS OASAS Addiction Treatment Centers (ATCs). The centers have been granted waivers allowing them to admit and treat individuals with problem gambling as their primary diagnosis.

The ATCs now have qualified problem gambling clinicians on staff to provide these inpatient services. Patients can be admitted for up to 30 days of treatment, and these facilities accept all patients regardless of their ability to pay. Problem gambling education also will be provided to patients at these six ATCs. Several ATCs also have established connections with local Gambler's Anonymous (GA) chapters, who will provide GA meetings on site at the ATCs.  Read more here .
Broome to Declare Heroin a "Health Emergency"

Broome County Executive Jason Garnar said the county is preparing to declare the local heroin epidemic a public health emergency.

Garnar last Thursday said the formal action is planned for next week.

Speaking on  WNBF Radio's Binghamton Now program, Garnar said he views the problems associated with heroin as a public health crisis.

During his campaign, Garnar had called on then-County Executive Debra Preston to make a public health emergency declaration after several dozen people died of overdoses in the first half of 2016.

Garnar said Rebecca Kaufman, the newly-appointed county health department director, will be overseeing the  Broome Opioid Abuse Council .  Read more here.
Inside a Killer Drug Epidemic: A Look at America's Opioid Crisis

Opioid addiction is America's 50-state epidemic. It courses along Interstate highways in the form of cheap smuggled heroin, and flows out of "pill mill" clinics where pain medicine is handed out like candy. It has ripped through New England towns, where people overdose in the aisles of dollar stores, and it has ravaged coal country, where addicts speed-dial the sole doctor in town licensed to prescribe a medication.

Public health officials have called the current opioid epidemic the worst drug crisis in American history,  killing more than 33,000 people in 2015. Overdose deaths were nearly equal to the number of deaths from car crashes. In 2015, for the first time, deaths from heroin alone  surpassed gun homicides.

And there's no sign it's letting up, a team of New York Times reporters found as they examined  the epidemic on the ground  in
states across the country. From New England to "safe injection" areas in the Pacific Northwest, communities are searching for a way out of a problem that can  feel inescapable.  Read more here.
EHR Use, Care Coordination Key to Integrated Primary Care

As integrated primary care and behavioral healthcare services come to the forefront, healthcare organization leaders must establish strong EHR use to enable better care coordination between the two specialties, finds a  study published in the Journal of the American Board of Family Medicine.

According to the research team, integrated primary and behavioral healthcare is increasing in popularity, both because it is better supported by value-based payment systems and because it delivers necessary treatment to those managing behavioral health disorders.

Sixty-seven percent of individuals with behavioral health disorders do not receive the care that they need, but when their care is  integrated into the primary care setting , that issue typically improves.

"Most patients with BH conditions, including children, are seen in medical settings, most commonly primary care (PC), presenting the need and opportunity to replace separated systems of care that do not adequately meet the needs of patients with integrated, 'whole-person' care," the researchers explained.

As integrated care models continue to emerge, the research team sought to identify best practices for their establishment and growth. To that end, the team conducted feedback interviews with 11 Colorado-based primary care practices integrating behavioral health into their workflows.  Read more here.
Is Mental Health Declining in the U.S.? 

The 1990s and 2000s were glorious decades to be a psychiatrist. It seemed as though each year several new, potentially life-changing medications were brought to market. Options became available to tackle long-standing, treatment-resistant disorders. It did not hurt that big pharma had deep pockets to promote the new offerings. Stigmas were falling, more people were seeking help than ever before, and just about any psychiatrist could brag about patients who, with the right medication and a little time, returned looking more confident and reporting fewer symptoms.

Today the shine has dimmed. The mental health of the nation may have even declined in the past 20 years. This trend is what Thomas Insel, former director of the National Institute of Mental Health, calls one of the "inconvenient truths" of mental illness. Suicide rates per 100,000 people have increased to a 30-year high. Substance abuse, particularly of opiates, has become epidemic. Disability awards for mental disorders have dramatically increased since 1980, and the U.S. Department of Veterans Affairs is struggling to keep up with the surge in post-traumatic stress disorder (PTSD).

The most discouraging assessment came in 2013 from an in-depth analysis by the U.S. Burden of Disease Collaborators. Hundreds of investigators gathered data on 291 diseases and injuries between 1990 and 2010. Combining premature death and disability to calculate the burden of each disease, they found that the toll of mental disorders had grown in the past two decades, even as other serious conditions became more manageable. Read more here.
Should Religious Leaders Help Bridge the Mental Health Care Gap?

When Randy Simmonds graduated from college and went on to the seminary, he was sure that being a pastor was his calling in life. But in his first job as a youth director at a large church in Louisiana, his confidence was shaken by something that his masters of divinity hadn't prepared him for. "There were multiple crises every week with these kids and their families," he says. "Death, substance abuse problems, family issues. I really liked the counseling, but I wasn't equipped for it -- I only had two classes in counseling while in seminary."

Simmonds' situation is one that's familiar to clergy across the country. When a person is emotionally distressed and decides to seek counseling, research shows they are much more likely to talk to a faith leader than a psychologist or a psychiatrist. And often that faith leader finds himself untrained and unprepared to properly handle the weighty mental health issues he may be faced with.
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.