Cover image 3
July 12, 2018

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

Connect With Us:
Like us on Facebook   Follow us on Twitter    View our profile on LinkedIn
Francine Sinkoff, Editor
Governor Cuomo Announces $4 Million Expansion of Residential Addiction Treatment Services in New York City

Governor Cuomo Announces Locations, Expanded Services and Partnerships for Vital Brooklyn's $210 Million, 32-Site Ambulatory Care Network

Albany County's jail gets $200K for treatment for substance abuse

North Country program aims to help homeless addicts - Clinton County

Breaking the cycle: State money allocated for drug counseling inside county jails - Jefferson County

Mental Health Association of the Southern Tier Opens Short-Term Crisis Respite House - Broome County

DA: 13 overdose deaths in Broome County in first half of 2018

Crisis Crossroads: County treatment capacity grows with focus on harm reduction - Oswego County

DOH approves Olean health center expansion - Cattaraugus County

Buffalo's mental health court takes unique approach with low-level offenders - Erie County

Bassett addiction program earns state award for quality - Central NY

Monroe County may be on pace for fewer heroin and opioid deaths this year
NYS Children's Health and Behavioral Health Services Medicaid Transformation Billing & Coding Manual Released

New York State Children's Health and Behavioral Health Services Medicaid Transformation Billing and Coding Manual has been released. The information contained in the billing manual, subject to required State and Federal approvals, reflects the billing structures for the Children's System Transformation scheduled to begin on January 1, 2019. TBD Billing criteria will be updated by the State. Future updates will only supplement current information, not change what is already in place.

Click here to access the billing manual.
Why Alcohol Is Still the Most Dangerous Drug

With More Opioid Use, People Are More Likely To Get Caught Up In The Justice System

Lifetime sentence: Incarcerated parents impact youth behavior

Parents who had severe trauma, stresses in childhood more likely to have kids with behavioral health problems

Moving Addiction Care to the Mainstream - Improving the Quality of Buprenorphine Treatment

Texas Clinics Busting Traditional Silos Of Mental And Physical Health Care
Behavioral Health News Summer 2018 "Spotlight on Research" Issue 

Click here  to view the summer issue.
Watch Live Online: Sessions from the 83rd National Association of Counties Annual Conference

Addressing Substance Use Disorder in your County - Prevention and Education
July 12, 4:30 - 5:30 pm

July 13, 1 - 2:30 pm

July 18, 10 - 11:30 am, OMH

Integrating Supplemental Payments in Managed Care
July 19, 1 - 2 pm, Manatt Healthcare

Staff Self-Care in Crisis Response and Suicide Prevention
July 23, 2 - 3:30 pm, National Council for Behavioral Health

Enable Access to Client-Level Data in PSYCKES
July 24, 10 - 11 am, OMH

July 25, 12 - 1 pm, PsychU

July 26, 1 - 2 pm, CTAC

Using PSYCKES Quality Indicator Reports
July 31, 1 - 2 pm, OMH

From ACEs to Assets: Supporting the Growth of Resilience to Improve Education, Health, and Wellness Outcomes
August 1, 12 - 1 pm, CTAC

Stepping Up Four Key Measures #2: Shortening the Length of Stay in Jail for People with Mental Illnesses
August 2, 2 - 3:15 pm, National Association of Counties

PSYCKES Access and Implementation
August 9, 11 am - 12 pm, OMH

Using PSYCKES for Clinicians
August 14, 1 - 2:30 pm, OMH

Using PSYCKES Recipient Search
August 21, 11 am - 12 pm, OMH

PSYCKES Mobile App for iPhones & iPads
September 5, 1 - 2 pm, OMH


JULY 2018

Children & Families Committee Meeting
July 17: 11:30 am - 1 pm, GTM


Mental Hygiene Planning Committee Meeting
August 7: 1 - 3 pm, GTM

Children & Families Committee Meeting
August 21: 11:30 am - 1 pm, GTM


Officers, Chairs & Regional Reps Call
September 5: 8 am

Developmental Disabilities Committee Meeting
September 6: 1 - 2:30 pm, GTM

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

Mental Hygiene Planning Committee Meeting
September 18: 1 - 3 pm, GTM

Fall Full Membership Meeting
September 24 - 25, Rochester

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
When Battling Addiction, Is Jail Time the Problem or the Only Solution?

The opioid crisis has precipitated a sea change in the way people think and talk about substance abuse - from criminal behavior that must be prosecuted to a disease requiring medical treatment. At the same time, growing recognition of the failure to stop drug addiction through "tough on crime" policies has intensified support for alternatives to incarceration, ranging from
drug treatment courts and safe injection sites to legalization of the drugs themselves. Despite the widely shared belief that we can't arrest our way out of the opioid crisis, questions still remain about whether and to what extent jail is ever the solution. For some families, the answer is not so obvious.

Despite increased awareness of opioid abuse as a public health problem rather than a law enforcement issue, some - although not all - public officials have doubled down on the existing "tough on crime" approach. At the federal level, policymakers have been widely criticized for reinstating harsh 
mandatory minimum sentences for nonviolent  drug offenders and considering the strengthening of penalties for trafficking in fentanyl. Similar legislation imposing a ten-year minimum sentence on first offenders  who make, sell, or transport illicit opioids and authorizing law enforcement to charge drug dealers with homicide has been considered in states like Arizona and New York, respectively. Read more here .
Behind Bars, Mentally Ill Inmates Are Often Punished For Their Symptoms  
By some accounts, almost half of the incarcerated population in the U.S. suffers from mental illness.
By some accounts, nearly half of America's incarcerated population is mentally ill - and journalist Alisa Roth argues that most aren't getting the treatment they need.

Roth has visited jails in New York, Chicago, Los Angeles and Atlanta and a rural women's prison in Oklahoma to assess the condition of mentally ill prisoners. She says correctional officers are on the "front lines" of mental health treatment - despite the fact that they lack clinical training.

"Most of [the correctional officers] will talk about how this is not what they signed up for," Roth says. "Most of them have not had much training in dealing with mental illness - or they've had none at all."

Roth chronicles her findings in the book, 

Click HERE to read the article or listen to NPR's Fresh Air podcast.
Tompkins County is Hiring a Clinical Director

Tompkins County Mental Health Department has a full-time 40-hour opening for a Director of Mental Health Clinic. This position provides overall management and supervision to our programs, services and staff and comes with full benefits. $39.24/hr at Hire (approximately $81.619 Annual) and increases to $42.62/hr (approximately $88,650 annual) after nine months of employment.

For more information, click here.
Warm Handoffs Do Not Improve Attendance at Behavioral Health Intake Appointments

Researchers at Boston Medical Center have found that warm handoffs are not associated with improved attendance at behavioral health intake appointments.

It has been theorized that warm handoffs could build patients' trust in behavioral health
clinicians and reduce patients' stigma about behavioral health care, potentially translating to improved attendance at behavioral health appointments. 

Instead, researchers found that the most significant predictor of attendance at an initial intake was time from referral until appointment, consistent with other studies in specialty mental health and other clinical settings. Read more here.
OPWDD Acting Commissioner Delaney Announces Launch of Care Coordination Organizations

I am pleased to report that this past weekend, Care Coordination Organizations (CCOs) began providing care management services for over 100,000 people. Over 97% of the people already receiving care coordination chose the more comprehensive Health Home Care Management service, signaling overwhelming support for more flexibility, more innovation and more customization in the planning of their services.

With Health Home Care Management, people will now be able to plan their disability, health and wellness services all in one place. Thanks to the dedication and hard work of former Medicaid Service Coordinators, many of whom are now Care Managers in the new system, nearly everyone selected their new CCO and type of care management service by the July 1 deadline.

By separating the management of care from the provision of services, the launch of CCOs is probably the most exciting advancement we have made in our system to date. Read more here.
Harm Reduction Services as a New Medicaid Benefit in NYS

Effective July 1, 2018, Medicaid fee-for-service (FFS) and Medicaid Managed Care (MMC) plans will begin covering harm reduction services (HRS). This change applies to mainstream MMC, HIV Special Needs Plans (HIV SNP) and Health and Recovery Plans (HARP). HRS will be delivered by New York State Department of Health (NYS DOH) authorized and waivered syringe exchange programs (SEP) that are enrolled as Medicaid providers. Read more here.
What Montefiore's 300% ROI from Social Determinants Investments Means for the Future of Other Hospitals

Montefiore Health System in the Bronx has tackled the social determinants of health by investing in housing, a move that has cut down on emergency room visits and unnecessary hospitalizations for an annual 300 percent return on investment.

"The lowest I've seen is 300 percent ROI, some years it's higher," said Henie Lustgarten, consultant and president of the Bronx Health & Housing Consortium, an organization Montefiore helped to develop.

Investing in the social determinants of health is becoming more commonplace even as hospitals and physicians ask whether it is their place to step outside of traditional care to not only look at, but try to fix, other reasons that keep patients from getting better. Read more here.
The Future Has Arrived For VBR

"I can't think of a recent conversation at Anthem that didn't include value-based care. But, we can't do value-based payment on an island. All insurance companies are interested in discussing a village concept of value-based care with consumer-centric provider organizations that have the infrastructure to do that. There are relationships all along that pathway, and while most organizations can't be the whole village, they can be a significant piece of it."

These remarks-made by Charles Gross, Ph.D., Vice President, Behavioral Health, Anthem, Inc., are words to the wise for any provider organization executive team developing strategy for the years ahead (assuming they are planning on health plan revenue as part of their income stream).

From the health plan perspective, there are some major hurdles to overcome. Dr. Gross discussed three key concerns-each of which have implications for provider organization strategy. 
  1. Achieving network adequacy. Getting access to care, particularly access to psychiatrists and other high-demand specialists is an issue, and "better" (read: more attractive) payment models 
  2. Finding provider organization with the scale and capabilities to manage value-based contracts. There are some specific organizational capabilities needed to manage value-based arrangements and some requirements in terms of financial stability
  3. Developing a medical/behavioral health integration model. Many current VBR models have focused gainsharing on the primary care side of the equation-and a new model is needed that extends that gainsharing to behavioral health partners 
Read more here.
Revisiting the Rationale and Evidence for Peer Support

A recent issue of Psychiatric Times featured an opinion piece by D.J. Jaffe who argued that there is little empirical support for the effectiveness of paid peer-support staff-persons in recovery from mental illnees who are trained to provide support to others-on the outcomes of "homelessness, arrest, incarceration, violence, and needless hospitalization."1 In this article, we rebut Mr Jaffe's argument by revisiting the rationale and evidence base for peer support.

While we agree that the government needs to fund more research on this important topic, we argue that stating that peer support "lacks evidence" is simply not accurate. In fact, as we will explain below, over 30 studies have found positive effects in numerous outcome domains. But first it is important to understand the nature and intended impact of this form of service delivery. 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.