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June 7, 2017

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

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Francine Sinkoff, Editor

Registration Open for VBP Networking Events 

Register now for the upcoming value based payment networking events held in collaboration with the Regional Planning Consortiums (RPCs). These events will include a presentation that will review different partnership opportunities relevant to NYS Medicaid behavioral health providers, as well as an opportunity for providers to network among themselves. 
HHS Announces Over $70 Million in Grants to Address the Opioid Crisis

SAMHSA is accepting applications for over $70 million in grants over multiple years to help communities and healthcare providers prevent opioid overdose deaths and provide treatment for opioid use disorder.

Administered through SAMHSA, these funds will be made available through the following three grants:
  • Medication-Assisted Treatment and Prescription Drugs Opioid Addiction: Up to $28 million to five grantees to increase access of medication-assisted treatment (MAT) for opioid use disorder. MAT combines behavioral therapy and FDA-approved medication.
  • First Responders: Up to $41.7 million over four years to approximately 30 grantees to train and provide resources for first responders and members of other key community sectors on carrying and administering an FDA-approved product for emergency treatment of known or suspected opioid overdose.
  • Improving Access to Overdose Treatment: Up to $1 million over five years to one grantee to expand availability to overdose reversal medications in healthcare settings and to establish protocols to connect patients who have experienced a drug overdose with appropriate treatment.
Applications for these three grants are due Monday, July 31, 2017.  
New State Guidance Released on Health Care Privacy and Data Sharing

On May 11, 2017, the New York State Department of Health ("DOH") issued a new guidance statement ("Guidance Statement") about privacy protections and permissible data sharing under the Health Insurance Portability and Accountability Act ("HIPAA") and other applicable federal and state laws. While addressed explicitly to the extensive data sharing underway in New York State to implement the Delivery System Redesign Incentive Payment Program ("DSRIP"), the Guidance Statement has implications for data sharing outside DSRIP as providers across the State seek to meet incentives for value-based payment established by private payers and Medicare.

In general, the Guidance Statement provides a less restrictive interpretation of federal and state law than draft guidance issued by DOH in January 2017. However, the Guidance Statement is both more restrictive and more permissive of data exchange than applicable federal and state laws and regulations in some instances. Read more here.
Grants to Study Behavioral Interventions for Prevention of Opioid Use Disorder or Adjunct to Medication Assisted Treatment

The National Institutes of Health is accepting applications for up to $700,000 in available funds to examine the impact of behavioral interventions within the context of states' plans for use of the SAMHSA Opioid STR grant funds authorized under the 21st Century Cures Act. Applications that emphasize treatment of the comorbidity of OUD and chronic pain are of particular interest. 

Questions Linger Over Fatal Overdose Statistics

A recent bout of drug overdoses - two of which were fatal - in Northern Chautauqua County was enough to dash some hopes that the heroin epidemic was somehow turning a corner.  The episode, which led to the arrests of six individuals in Hanover last month, was also a reminder that heroin remains a deadly, day-to-day threat in the county and that a proper accounting of its victims is a must.

Earlier this year, the OBSERVER reported on the county's struggles with keeping track of fatal heroin- and opioid-related overdoses, a challenge, which according to county Health Commissioner Christine Schuyler, is the result of a  "complicated, inadequate and inconsistent system."

"I feel that an age-old conflict between politicians, law enforcement, the medical profession and coroners has led us to where we are now," Schuyler said.  "There is such variability in death investigations and certifications across counties and states in this country that no real comparisons can be made between anyone."

Unlike Erie County, which has a designated medical examiner's office, Chautauqua County has four coroners appointed by the County Legislature.   Read more here.
In Ohio, Groups Consider "Emergency Care Hub" for Mental Illness

A group of agencies that serve mental-health patients is considering opening a hub where they could work together to more quickly help people in crisis.   Now, people who visit emergency departments with mental-health problems often have to wait hours until doctors can determine whether they should be admitted or sent home.

The hub would be a place where police and paramedics could take patients, or where walk-ins could go if they suffer a psychiatric crisis. There, they could gain access to patient records and staff members could communicate with emergency departments and mental-health centers to steer patients to the care they need.   In some cases, that might mean sending them to inpatient care. In others, it would mean scheduling an outpatient appointment.

"We have hospital emergency departments, inpatient units, community mental-health centers, EMS and police and courts and jails, and a lot of folks who touch these patients," said Jeff Klingler, president and CEO of the Central Ohio Hospital Council. "But we don't really have a collaborative, comprehensive system for caring for these folks.  Read more here.

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


JUNE 2017

CSPOA / DOH / OMH Monthly Call
June 15:  3 - 4 pm, GTM

Children & Families Committee Meeting
June 20:  11:30 am - 1 pm, GTM

Directors & Executive Committee Meeting
June 21:  9:30 am - 12:30 pm, GTM

JULY 2017

Officers, Chairs & Regional Reps Call
July 5:  8 - 9 am

Mental Health Committee Meeting
July 13:  11 am - 12:30 pm, GTM

Chemical Dependency Committee Meeting
July 14:  11 am - 12:30 pm, GTM

Children & Families Committee Meeting
July 18:  11:30 am - 1 pm, GTM

Directors & Executive Committee Meeting
July 19:  9:30 am - 12:30 pm, GTM

CSPOA / DOH / OMH Monthly Call
July 20:  3 - 4 pm, GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
The Challenges To Voluntary 'Collaboration' Between County Corrections & Mental Health Programs

A couple weeks ago, news in Pennsylvania caught my eye - Pennsylvania is joining the Stepping Up Initiative (SUI) to reduce the number of people with mental illnesses in county jails. My colleague Monica E. Oss covered that development in,  'Stepping Up' To The Problem Of Mental Illness In Corrections Facilities .

If you are unfamiliar with it, the Stepping Up Initiative is a national effort to divert consumers with behavioral health issues (including those with co-occurring substance use disorders, as well as serious mental illness or serious and persistent mental illness) from jails and into treatment. As part of the program, SUI provides strategic planning and service implementation assistance to provider organizations with a heavy focus on metrics-based management (see  Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask).

As part of this p lanning and implementation assistance, the SUI program asks six questions that county leadership can use to craft a local plan.   Read more  here .
Inpatient Days Down 40% in MRT Supportive Housing

The SUNY Research Foundation's first evaluation reports of the Medicaid Redesign Team (MRT) Supportive Housing initiative were recently announced.
The MRT created numerous supportive housing programs to provide vulnerable high-cost Medicaid members with rental subsidies,  new capital construction and pilot projects to test new models of care. Since 2012, over 11,000 high acuity Medicaid members have been served. Early findings demonstrate that investments in social determinants, such as housing, can have a profound impact on health care costs and utilization, including:
  • 40% reduction in inpatient days
  • 26% reduction in emergency department visits
  • 15% reduction in overall Medicaid health expenditures

For more information and to view these reports, click here.

Forbes:  U.S. Psychiatrist Shortage Intensifies

The nation's healthcare system doesn't have enough psychiatrists to treat an increasing number of patients who have gained access to behavioral health treatment thanks to expanded mental health coverage in recent years.

"Since the passage of the Affordable Care Act, more Americans are now insured and are seeking treatment," says  Dr. Atul Grover, executive vice president of the Association of American Medical Colleges. "Mental health parity laws have resulted in better behavioral health coverage than there was 20 years ago. In addition, demand is higher because there is greater awareness of, and willingness to talk about, mental health issues."

Psychiatrists are now the second most highly recruited physicians after family physicians, according to the  2017 Review of Physician and Advanced Practitioner Recruiting Incentives. The report, released Monday by physician staffing firm MerrittHawkins, tracks the more than 3,200 physician and advanced practitioner recruiting assignments the firm conducted from April 1, 2016 to March 31, 2017.  Read more here.
Buffalo Opens Nation's First Opiate-Centered Court

Buffalo is now home to the nation's first treatment court focusing solely on opiate addiction.  T he Opiate Intervention Court opened May 1. City Court Judge Craig Hannah  is running the court under the guidance of fellow City Court Judge Robert Russell Jr., who runs the drug court in Buffalo. So far, there are 43 participants.

"Just because someone has lost their way doesn't mean we can't get them back," Hannah said during a press conference May 31. "That's our purpose with this."

Participants in the court are screened for the program in the morning by court staff before they are arraigned. If the staff determines that a defendant has an opiate addiction issue, they can be placed into the court, instead of criminal court. Defendants meeting the criteria for opiate addiction begin treatment right away, Russell said.   Read more here .
Erie County Moves to Fund Private Sector to Help Fight Opioid Epidemic

Erie County Legislators last week decided they will pay private and non-profit addiction treatment centers to step up their fight against the county's opioid epidemic, rather than spending the money, at least all of it, in house.   But opponents of the decision say it's a move that's far too slow - and more people could die because of it.

"The efforts that we've made are fine," said Legislator Joseph Lorigo, C-West Seneca. "But they're not enough."

Last August, Erie County launched an entire taskforce dedicated to fighting the opioid epidemic, which continues to worsen.  That year, it's believed 300 people died from opiate overdoses.  I n the first six months of this year, 66 people are confirmed to have died the same way, with another 110 deaths suspected.  Read more here .
Rise in Mental Health Needs in Genesee Co.

Business is booming, but it's the business of aiding lives wracked with depression, anxiety and addiction.  

The clinic run by Genesee County's Mental Health Department served more 2,400 unique individuals, providing more than 15,900 units of service, Director Ellery Reaves told county legislators Monday. This year is already at 1,500 unique clients and 8,800 service units.

Reaves noted some positives - providers are seeing a benefit from a decreasing stigma about seeking treatment; and a single point of access policy moves people into assistance from a variety of sources. But damage from addictions to both social media and opioids are growing in Genesee County and other rural areas.   Read more here .
$185,000 In Funding Announced For Veterans' Peer-To-Peer Program in Putnam County

Having spoken with veterans in VA hospitals and in the community, Senator Terrence Murphy sought funding to help assist those affected by Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI). Flanked by Senator Sue Serino and Putnam County Executive MaryEllen Odell at the Veterans of Foreign Wars Carmel Post 1374 in Carmel, Senator Murphy announced that he had secured $185,000 in funding for the Joseph P. Dwyer Peer Support Services Program in Putnam County.

The Program is driven by the camaraderie that comes from a shared experience of life in the military. The goals of the Program include helping returning veterans adjust to civilian life, pursue outreach and education, to provide peer support, encourage a connection among family, friends, and community, and to provide access to suicide prevention/intervention initiatives.  Read more here.
Nearly 22 People Suffer Opioid Overdoses in Suffolk County Over 2 Day Span

Roughly 22 people suffered opioid overdoses in Suffolk County in just the past two days, authorities said Saturday.

At least one person died in what Long Island police said was a 60% uptick in opioid overdoses over the usual 48-hour window.

"This is now the time to intervene and get your loved one help," said Suffolk County Police Commissioner Timothy Sini.

The incidents took place across the county and involved the full range of opiates - prescription pills, heroin and the powerfu
l synthetic drug fentanyl, authorities said.
Read more here.
Sex Offender and Mental Health Law on Trial in Orange County

Mirna Laguerre sat alone in court and cried while a prosecutor described her son as a dangerous sexual offender deemed unfit for society. Then 28-year-old Raul, who has spent almost half his life locked up, pleaded for freedom.

The Orange County courtroom scene has all but defined the mother and son separated by a horrific crime and controversial mental-health law.

They have both described spending guilt-ridden years striving for justice and forgiveness since Raul Laguerre Jr. brutalized a woman in 2003, bludgeoning her into unconsciousness before sodomizing her.

Those details and more will likely reemerge when Laguerre's trial kicks off Monday for his potential release from civil commitment, the little known law that allows for locking up sex offenders beyond their criminal sentences.  Read more here.
New Holistic Schizophrenia Treatment Program Comes to Broome County

A new holistic team approach to treating young adults with schizophrenia is now in Binghamton.   New York State Office of Mental Health Commissioner Dr. Ann Sullivan joined local dignitaries Wednesday morning to cut the ribbon for the OnTrackNY program.

OnTrackNY has been in the state since 2013 with Binghamton hosting its 20th location within the Community Treatment and Recovery Center on Clinton Street.  The program  targets teens and adults up to age 30 who are first experiencing psychotic symptoms with a goal of helping them to achieve their life goals of getting an education, pursuing a career and having a family.  Read more here.
Tours of Old Main Building Being Offered Again in Utica

The state Office of Mental Health will provide free educational tours of the historic Old Main Building at the Mohawk Valley Psychiatric Center in Utica, state Assemblyman Anthony Brindisi, D-Utica, announced Friday.

The tours will take place this spring fall and, with, assistance from the Landmarks Society of Greater Utica, will focus on the history of the National Register of Historic Places-listed building and the formative role it played in the country's early mental health system.

"The building has been preserved in a way that truly pays homage to the original architecture," said Ann Sullivan, state Office of Mental Health commissioner, in a news release. "But perhaps more importantly, the tours highlight the evolution of New York's public mental health system that really began at this facility."  R ead more here .
NY Disaster Mental Health (DMH) Summarizes Recent Conference Information

The most current issue of the DMH Responder Newsletter features summaries and highlights from the recent Institute for Disaster Mental Health at SUNY New Paltz conference, "Psychosocial Response to Pandemic Disasters, Infectious Diseases, and Bioterrorism."  

T he newsletter describes some of the key points covered by the invited presenters but also includes links to archived versions of several of the day's presentations.
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.