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August 30, 2018

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

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Francine Sinkoff, Editor

Open Access Center Launches in Wayne County

Wayne Behavioral Health Network-Wayne County-Open Access Center will begin services on August 30th.   The Open Access Center is designed to provide service to the 9 counties comprising the NYS Finger Lakes Economic Develop Region (Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Wayne, Wyoming and Yates) and assists those with a heroin or other opioid addiction problem, as well as assisting those who are struggling with a mental health problem.  The goal is to assess the individual and determine their immediate needs and the level of care most appropriate for them based on those presenting needs, and then assist them by referring and linking them to the appropriate level of services with a care provider. 
The Open Access Center will start with a "soft" opening, with operating hours on 8/30 thru 9/2 running from 7am - 3pm. After being closed on 9/3 for the Labor Day Holiday, beginning on 9/4 we will operate during the hours of 7am -10pm seven days per week.  The plan is to ramp up our hours to 24/7 over the next few weeks.  Click here for a program flyer.

Business of Healthcare Podcast:  A Public Health Approach to Substance Abuse & Mental Health

"We are in an epidemic of opioid and other drug use in this country and there are solutions. I'm a public health doctor I know that there are solutions," says says Dr. Lloyd Sederer. "Many people know that there are solutions and we're not using them very much. We have little adoption of the kind of things that work."

Sederer is a Professor at the Columbia Public Health School, a medical journalist, a book/film/TV reviewer and the Chief Medical Officer for the $4 billion New York State Office of Mental Health.

Sederer advocates for a public health approach to this crisis in in his recent book, The Addiction Solution: Treating Our Dependence on Opioids and Other Drugs. Sederer joined BOH host Matthew Hanis during NATCON18. Click here to listen.
At $1,650 per month, the first digital pill will soon roll out to certain Medicaid patients with mental illness

Breakthrough sensor to help people with bipolar disorder monitor lithium levels

AHRQ-based Discharge Program Toolkit: Re-Engineered Discharge (RED) 

A variety of forces are pushing hospitals to improve their discharge processes to reduce readmissions. Researchers at the Boston University Medical Center (BUMC) developed and tested the Re-Engineered Discharge (RED). Research showed that the RED was effective at reducing readmissions and posthospital emergency department (ED) visits. 

The Agency for Healthcare Research and Quality contracted with BUMC to develop this toolkit to assist hospitals, particularly those that serve diverse populations, to replicate the RED.
Preparing the Field of Disabilities Services for Managed Care

Last week kicked off a series of webinar trainings designed to help providers of services to people with disabilities prepare for and transition to Managed Care.
New York completed its first significant step in the transition with regional implementation of Care Coordination Organizations (CCOs) throughout the state.  The Managed Care Community of Practice, a project of the NY Alliance for Inclusion and Innovation, will aid further in the transition by offering training, technical assistance and resources to all providers of services to people with I/DD. Read more here.

August 30, 2 - 3 pm,  School Mental Health Resource and Training Center

August 30, 2 - 3 pm, National Council for Behavioral Health

August 30, 2 - 3:30 pm, SAMHSA-HRSA

September 5, 11:30 am - 1 pm, SAMHSA

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

The Intersection of Criminal Justice and Mental Health Olmstead Learning Community
September 5, 2 - 3 pm, SAMHSA

September 6, 12 - 1 pm, MTM Services

September 10, 12 - 1 pm, PsychU

September 10, 2 - 3:30 pm, Center for Health Care Strategies

Best Practices for Serving and Supporting Transgender Patients in Integrated Care Settings: Perspectives from the Nation's Largest Medical System
September 11, 3 - 4 pm, SAMHSA-HRSA

Myths, Realities, & Best Practices for Psychiatrists Treating Justice-Involved Populations in Community Care
September 12, 11 am - 1 pm, SAMHSA

How do you help an organization become more Family-Driven?
September 12, 12 - 1 pm, CTAC/MCTAC

Tracking Telehealth Reimbursement Trends
September 13, 1 - 2 pm, Manatt Health

Cultural Competence in Psychiatry
September 13, 4 - 5:30 pm, NAMI
Utilization Management for Children and Family Treatment and Support Services
September 18, 10 - 11 am, CTAC/MCTAC

Advancing Value-Based Payment in Medicaid Managed Long-Term Services and Supports: Opportunities for Community-Based Care
September 18, 1:30 - 3 pm, Center for Health Care Strategies

September 26, 12 - 1 pm, PsychU

innovaTel Telepsychiatry: Back to School: Helping Children and Parents
October 17, 1 - 2 pm, National Council for Behavioral Health



Executive Committee Call
September 5: 8 am

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

AOT Coordinators Meeting
September 13: 10 - 11:30 am, 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 
Providers Look to Shift Mental Health Patients from ED to Community-Based Care

Comfortable furniture, soft lighting and a relaxed atmosphere resembling a quiet time at home is probably one of the last images that springs to mind when discussing where to send someone needing emergency treatment during a mental health crisis.

But an initiative being developed by the mental health clinic of Schenectady, N.Y.-based health system Ellis Medicine will try to change traditional perceptions of how mental healthcare is delivered in a clinical setting by making its environment less clinical.

By year-end, the clinic plans to open a new outpatient treatment facility based on a community model that experts say provides individuals experiencing a psychiatric episode with a better environment to receive treatment than a hospital emergency department.

This "living room" concept has been around for a number of years. Nonmedical, community-based organizations traditionally run similar programs across the country free of charge. 

The Ellis model would serve as more of a hybrid of both the hospital and community settings that will offer the same type of relaxed setting as the community programs, but also offer patients access to clinical resources.

Over the next year, the initiative hopes to track its effectiveness in diverting psychiatric patients from the ED and lowering their anxiety levels, according to Mary May, clinical manager at Ellis Mental Health Clinic. Read more here.
CMS Initiative to Create Pediatric APMs to Address Opioid Crisis

The recently announced Integrated Care for Kids (InCK) initiative will require Medicaid and local providers to develop alternative payment models to combat the opioid crisis for children. 

A new CMS Innovation Center initiative will call on local stakeholders and Medicaid agencies to develop alternative payment models that address the impact of the opioid crisis for children, CMS recently  announced.

Medicaid and local providers will have the opportunity to create sustainable alternative payment models that address behavioral health risk factors among youths under the newly-created Integrated Care for Kids (InCK) initiative.

The initiative is "a child-centered local service delivery and state payment model aimed at reducing expenditures and improving the quality of care for children covered by Medicaid and the Children's Health Insurance Program (CHIP) through prevention, early identification, and treatment of priority health concerns like behavioral health challenges and physical health needs," CMS explained in a  fact sheet. Read more here.

CMS plans to release a Notice of Funding Opportunity for the initiative in the fall of 2018. The federal agency will provide $16 million to each approved application for the seven-year model period.

To learn more about this initiative, CMS is holding a webinar on September 5 and 6: Integrated Care for Kids (InCK) Model - Overview
Governor Cuomo Signs Legislation to Expand Use of Rehabilitation and Diversion Services to Combat Heroin and Opioid Epidemic

Governor Andrew M. Cuomo last week signed legislation (A.10403/S.8760) to help in the fight against the heroin and opioid epidemic by diverting substance-dependent individuals who are involved in the criminal justice system. This legislation provides another form of support to prosecutors and law enforcement officers as they seek treatment and counseling for people who are addicted to opioids. These diversion models include law enforcement assisted diversion, known as LEAD, and other programs treating substance abuse and addiction.

The legislation expands the allowable use of funding from seized or forfeited assets by law enforcement and the Office of Alcoholism and Substance Abuse. LEAD programs provide law enforcement officers and other criminal justice officials with the ability to divert people from the criminal justice system into substance use treatment, health or mental health services, housing assistance or other services. Specially-trained officers collaborate with prosecutors, defense attorneys, counselors, service providers, and other community leaders to avoid incarceration. Read more here.
Governor Signs Two Autism Bills

Gov. Andrew M. Cuomo has signed into law two pieces of autism legislation sponsored by a local assemblyman.

Last week, the governor signed a bill authorizing the state Office for People with Developmental Disabilities to create a standardized identification card, and another mandating that early screening for autism be a recommended part of routine early-childhood pediatric exams.

Both bills were sponsored by Assemblyman Angelo Santabarbara, D-Rotterdam, who has a 16-year-old son with autism. Read more here.
SAMHSA Funding Opportunity: Rural Opioids Technical Assistance Grant Program

The Substance Abuse and Mental Health Services Administration is seeking applications for the FY 2018 Rural Opioid Technical Assistance Grants (Short Title: ROTA). The purpose of this program is to develop and disseminate training and technical assistance for rural communities on addressing opioid issues affecting these communities. It is expected that grantees will facilitate the identification of model programs, develop and update materials related to the prevention, treatment and recovery activities for opioid addictions, and ensure that high-quality training is provided.

Learn more and apply. Applications are due by September 20, 2018.
Why New York Spends More on Health Care than Other States

State governments across the country spent a combined $605 billion on health care, or about $1,880 per resident in 2015, a new study shows.

New York alone spent $57.6 billion, or about $3,000 per person, the second-highest total in the nation, behind New Mexico.

The biggest driver of state government health care costs has been Medicaid, the program for millions of low-income and disabled Americans.

More than 6 million New Yorkers are enrolled in Medicaid, or  about one third of the state's population.

Other major categories of health spending include state-run hospitals and medical schools, as well as community wellness, substance abuse and pollution control programs. Read more here.
NY Times: States Show the Way on the Opioid Epidemic

The opioid epidemic is far from contained - the national death toll from drug overdoses climbed to a record high last year. But some states and cities are bucking the trend and showing how governments can get a grip on the worst drug crisis in American history.

In 2017, overdose deaths in the United States jumped 10 percent, to about 72,000, the Centers for Disease Control and Prevention said last week. The new data show that people are dying from opioids that are more potent and more dangerous than were available in years past. The C.D.C. also found that many people who overdose are simultaneously using multiple drugs like heroin, fentanyl, methamphetamines, 
cocaine, and benzodiazepine, an anti-anxiety medicine, and that the crisis has spread across the country, from rural and suburban areas to cities.

Given all this grim news, the areas where overdose deaths are decreasing - Hawaii, Massachusetts, North Dakota, Oklahoma, Rhode Island, Utah, Vermont and Wyoming, per the C.D.C. - stand out. Read more here.
Suicide By Opioid: New Research Suggests Overdoses Should Be Classified As Self-Harm

There has been a steady stream of headlines declaring that  life expectancy in the United States is decreasing.  And the often-cited reason is the climbing number of opioid-related deaths.

Those two facts piqued the interest of a group of researchers who sought to reframe the way these trends can be viewed.

"We have a problem that is otherwise being underestimated," said Ian Rockett, an injury epidemiologist and professor emeritus at West Virginia University.

Suicide rates have been steadily climbing, Rockett said, but their numbers are likely even higher. He said too often opioid-related drug overdoses aren't classified as suicides, and he thinks they should be. These deaths are often deemed by medical examiners as "accidental injury deaths" unless a suicide note is found. This classification doesn't take into account that suicide and drug overdoses both arise from "purposeful" behaviors.  Read more here .
Foster Parents Often Struggle To Find Doctors To Treat The Kids In Their Care

Sherri and Thomas Croom have been foster parents to 27 children - from newborns to teenagers - during the past decade.

That has meant visits to dozens of doctors and dentists for issues ranging from a tonsillectomy to depression.

While foster parenting has innumerable challenges, health care coverage for the children isn't one of them. Medicaid, the federal-state health insurance program for the poor, picks up the tab for nearly all children in foster care and often continues to cover them if they are adopted, regardless of their parents' income. And as a result of the 2010 Affordable Care Act, foster kids who have Medicaid when they reach 18 can keep the coverage until they turn 26.

"We would not be able to foster without Medicaid," says Sherri Croom, 41, of Tallahassee, Fla. "It pays for everything."

Yet Croom and other foster parents say that even with the coverage, they struggle to meet the extraordinary health needs of their children. Part of the trouble is that too few doctors accept Medicaid, most notably mental health specialists. Families also face the challenge of coordinating treatment decisions between government welfare agencies and foster kids' biological parents. Read more here.
Hospitals Tackling Social Determinants Set the Course

Dealing with cold winters was not Chimera Campbell's biggest challenge after moving from Florida to Chicago in 2012. The 39-year-old couldn't manage her asthma, and that led to frequent emergency visits to Mount Sinai Hospital, a part of Sinai Health System. "I was in the ER constantly with chest tightness, pain and having problems breathing," Campbell said, estimating she visited the ER six times a year.

Then, Campbell received a phone call from a staffer for the safety-net system asking whether a community health worker could visit her home and identify and get rid of any environmental factors that could be aggravating her asthma. Campbell agreed and the worker, Kim Artis, discovered that household dust and secondhand smoke were the culprits.

Systems adopting such unconventional approaches to managing chronic disease are becoming less unusual as the concept of addressing social determinants of health sweeps the industry. Read more here.
National Conference on Alcohol & Addiction Disorders (NCAD): Executives Drive Home Value of Data and Ethics

The use of data to support providers' bottom lines and drive outcomes, the reputation of the addiction treatment industry at large, and a push for patient-centered integrated care were among the topics on the executive agenda at the National Conference on Alcohol & Addiction Disorders on Tuesday in Anaheim.  Here are the highlights:

Diving into data-driven culture

Becoming a data-driven organization can reveal inefficiencies in marketing, dispel organizational beliefs and shock staff and management alike, Daniel Gemp, CEO of Dreamscape Marketing, told attendees. But responsibly managed and intelligently analyzed data can also bring tremendous positive impact, he added. Gemp shared some action items for providers looking to make the leap. 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.