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December 20, 2019

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

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Francine Sinkoff, Editor

CMS awards funding to combat opioid misuse among expectant mothers and improve care for children impacted by the crisis - New York is 1 of 10 States to Receive Award

A counterforce for hope amid the opioid crisis - Fulton & Montgomery

Origins of use: Identifying the cause in order to find a road to recovery - Fulton & Montgomery

Many paths to recovery - Fulton & Montgomery

De Blasio announces $100M plan to 'solve long-term homelessness' in 5 years - NYC

State delivers holiday gift to Unite Us - NYC

Genoa's first behavioral health pharmacy in NYC is its 500th in the U.S.

Chenango County board passes comprehensive transit plan

Merger plan for Tompkins County Public Health and Mental Health Departments approved

ARISE cuts ribbon on new Oswego HQ

Navigating The System: Erie County Hospitals

Navigating The System: Buffalo's Diversion Courts

Growing West Side methadone clinic saves lives, but some neighbors remain unhappy - Erie
Navigating The System: Improving Mental Health Care Across Agencies, Counties

As Erie County moves toward a model that diverts those with mental health and substance problems away from jails and prisons, it faces challenges in ensuring the quality of care through multiple agencies. 

The  sequential intercept model allows people to get access to services throughout the criminal justice process -whether that's when they're first arrested, in the holding center or in front of a judge. 

"The energy and the focus behind that is to make an effective intervention at any of those intercept points," said Michael Ranney, the former Erie County Commissioner of Mental Health.

Within that model, more organizations - ranging from the jails to nonprofits to hospitals - are meeting up to create a better line of communication so that a personalized care plan runs smoothly at different parts of the system. 

"What I found with the jail is that I was reading things, hearing things, questioning things and then I made an appointment, I went in and I had a conversation," said Cindi McEachon, executive director of Peaceprint of WNY. "It's amazing when you have open, respectful and objective dialogue, how much can get done." Read more here.

Innovative Approaches In Expanding Access To Behavioral Health Care

In Rural Areas, Buprenorphine Waiver Adoption Since 2017 Driven By Nurse Practitioners And Physician Assistants.

"In Case You Missed It" - CLMHD 
Recaps Key Information Issued by the State

The Conference has published the November edition of "In Case You Missed It (ICYMI)," a one-stop-shop highlighting key information released by our state partners. ICYMI provides a clear, concise recap of significant state guidance, regulations, and resources from OMH, DOH, OASAS, and OPWDD, as well as links to access documents and materials of importance. 

Click  here to read the November issue.
REGISTER NOW: Targeted Webinar for Pediatric Primary Care Providers, DCSs and C-SPOAs


PSYCKES Train the Trainer
January 7, 1 - 2 pm, OMH

Enable Access to Client-Level Data in PSYCKES
January 8, 10 - 11 am, OMH

Challenges and Opportunities for Co-Morbid Substance Use Disorder and Major Depressive Disorder
January 15, 12 - 1 pm, PsychU

Using PSYCKES for Clinicians
January 16, 10 - 11 am, OMH

Using PSYCKES Recipient Search
January 22, 11 am - 12 pm, OMH

Using PSYCKES Quality Indicator Reports
January 29, 11 am - 12 pm, OMH

Social Media and Ethical Dilemmas for Behavioral Health Clinicians
January 29, 3 - 4 pm, NAADAC



Office Closed - Christmas
December 25


Office Closed - New Year's Day
January 1

Executive Committee Meeting
January 8: 8 am, GTM

Membership Call
January 15: 9 - 10:30 am, GTM

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

Developmental Disabilities Committee Meeting
January 23: 1 - 2 pm, GTM

Mental Hygiene Planning Committee Meeting
January 27: 1 - 3 pm, GTM / In-Person in Albany

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Non-Profit Human Services Agencies Join Together to Urge Long Term Funding Support to Ensure Adequate Availability of Life Preserving Services

As New York City and private funders have been taking steps to better fund overhead costs for nonprofits, human services providers working with the state are asking Gov. Andrew Cuomo to boost their funding by 3% each year for the next five years.

Human services organizations have spent  years pushing for the state to boost its financial support, particularly for their workforce. The state budget has not included cost-of-living adjustments for their organizations for the past decade, advocates said, which means their state funding has not kept pace with rising costs in health care and other expenses. The result: declining services and increased use of waiting lists. Read more here.

Mahopac H.S. is First in NYS to Offer Course in Addiction & Recovery with Counselor Certification

When students learn the facts about what's happening with substance abuse, addiction and recovery in their local environment, they have a stake in the vitality of it. This is what two Mahopac High School educators are determined to prove next semester.

In an unprecedented feat, Davia Bugge, MHS student assistance counselor, and Valarie Nierman, Mahopac Central School District health coordinator and high school health teacher, have designed a half-credit class, "Substance Abuse, Addiction, and Recovery," for junior and senior students that not only provides an instructive immersion in substance abuse awareness, prevention and treatment, but also enables a viable career path opportunity. Read more here.
Carlucci & Rivera Release Senate Report on Troubling Suicide Crisis in NYS

Senator David Carlucci (D-Rockland/ Westchester) and Senator Gustavo Rivera (D-Bronx) released a joint report on Friday highlighting a troubling suicide crisis in NYS, which is affecting people from all ethnicities, genders, and age groups across our state.

The report cites that suicide is the 12th leading cause of death in New York and one person dies by suicide every five hours in the State. This year alone, three people committed suicide by jumping to their deaths from the Verrazano Narrows Bridge in New York City. Twelve NYPD officers committed suicide in 2019, including two retired officers, causing the Department to declare a mental health emergency. Reports are now public concerning the crisis of Black youths committing suicide at an alarming rate, and Latinas, LGBT people, white middle-aged men, Asian immigrants, and the elderly are experiencing devastating record high numbers of people committing suicide. Read more here.
Emergency Department Study Reveals Patterns of Patients at Increased Risk for Suicide

A new study found that people who presented to California emergency departments with deliberate self-harm had a suicide rate in the year after their visit 56.8 times higher than those of demographically similar Californians. People who presented with suicidal ideation had suicide rates 31.4 times higher than those of demographically similar Californians in the year after discharge. The findings, published in JAMA Network Open, reinforce the importance of universal screening for suicide risk in emergency departments and the need for follow-up care. The study was funded by the National Institute of Mental Health (NIMH), part of the National Institutes of Health.

More than 500,000 people present to emergency departments each year with deliberate self-harm or suicidal ideation - both major risk factors for suicide. However, little is known about what happens to these people in the year after they leave emergency care. Read more here.
New York Recommends Pediatric Preventive Care Improvements in its First 1,000 Days on Medicaid Report

By age three, a child's brain has grown to 80 percent of its adult size and experiences during the first 1,000 days are critical to healthy brain development and social, emotional, cognitive, language, and physical development. Preventive measures 
taken in the first few years of life can have a significant and lasting impact on a child's future health outcomes and overall success. New York is honing strategies to support healthy development during the first 1,000 days through primary care and trauma prevention strategies. 

In October 2019, New York released recommendations from its  Final Report of the First 1,000 Days Preventive Pediatric Care Clinical Advisory Group as part of the First 1,000 Days on Medicaid redesign initiative, which was launched in July 2017. It recognizes the critical role that Medicaid can play in the early life of children to help set them up for future success. The initiative also aims to work collaboratively with education programs and other sectors to deliver better results for children in New York.  Read more here .
Consensus Workgroup Publishes Recommendations to Improve Care in the Justice System

The Consensus Workgroup on Behavioral Health Issues in the Criminal Justice System, a coalition of twelve national advocacy organizations including the National Council, recently released 
federal policy recommendations to the 116th Congress and the Trump Administration. Some recommendations include addressing diversion tactics, effective practices during incarceration, workforce development, federal research and coordination, juvenile justice reform, and more.

Recent data from the Department of Justice show that over half of all people incarcerated in jails and prisons report experience with mental illness, and around half meet criteria for drug dependence. The numbers are even more staggering for youth - around 70% of youth  detained in the juvenile justice system have a diagnosable mental health condition, 3.5 times the rate of their peers. Read more here .
Governor Cuomo Unveils 2nd Proposal of 2020 State of the State: Banning Fentanyl Analogs to Further Combat the Opioid Epidemic

Governor Andrew M. Cuomo on Tuesday unveiled the 2nd proposal of his 2020 State of the State agenda: legislation banning fentanyl analogs - a deadly synthetic opioid that is 50 to 100 times more potent than morphine - by making them subject to the same criminal sale or possession penalties as other controlled substances. 

The legislation will also empower the New York State Health Commissioner to ban any new fentanyl analogs that have been added to the federal schedule of controlled substances, allowing the State to deal with these deadly substances in real time rather than play catch up. 

The Governor will also propose a series of actions to expand access to medication assisted treatment for opioid use disorder in hard to reach communities. Medication assisted treatment entails using medications in combination with education and counseling to treat substance use disorders. Read more here.
A New Drug Scourge: Deaths Involving Meth Are Rising Fast

TULSA, Okla. - The teenager had pink cheeks from the cold and a matter-of-fact tone as she explained why she had started using methamphetamine after becoming homeless last year.

"Having nowhere to sleep, nothing to eat - that's where meth comes into play," said the girl, 17, who asked to be identified by her nickname, Rose. "Those things aren't a problem if you're using."

She stopped two months ago, she said, after smoking so much meth over a 24-hour period that she hallucinated and nearly jumped off a bridge. Deaths associated with meth use are climbing here in Oklahoma and in many other states, an alarming trend for a nation battered by the opioid epidemic, and one that public health officials are struggling to fully explain.

The meth problem has sneaked up on state and national leaders. In Oklahoma, meth and related drugs, including prescription stimulants, now play a role in more deaths than all opioids combined, including painkillers, heroin and fentanyl,  according to the Centers for Disease Control and Prevention. Read more here.
Partnering With Community-Based Organizations to Create Value in Healthcare

The intensifying focus on social determinants of health and value-based payment is driving new relationships between healthcare providers and community-based  organizations. 
People who are high utilizers of healthcare services often have complex medical, behavioral and social needs. The social determinants drive more than 80% of health outcomes. Yet up to 88% of the U.S. healthcare budget goes to providing medical services, leaving many patients' needs unaddressed as they stay in a cycle of requiring more clinical care.

Today, healthcare providers are looking at the capacity that community organizations have to address their patients' social needs and work alongside them to improve population health. This interest has been heightened by New York becoming the first state to require value-based payment contractors to implement at least one social determinants intervention and include a minimum of one social/human service agency. Read more here.
Making VBR a Success: What Health Plans Can Do

Adoption of value-based reimbursement (VBR) models is glacial-slow to occur but changing the delivery system in its wake. In the field, what I find interesting is that two different conversations are happening: Health plan executives talk about the lack of readiness of provider organizations while managers of provider organizations talk about the difficulty in moving VBR proposals forward with health plan customers. How do we make these partnerships evolve more smoothly? I think observations and advice from Alyna T. Chien, M.D., MS, Harvard Medical School, and Professor Meredith B. Rosenthal, Harvard T.H. Chan School of Public Health in the report,  A 3D Model For Value-Based Care: The Next Frontier In Financial incentives And Relationship Support) provide a great foundation for that discussion.

The authors present a three-part framework for considering the health plan shift to VBR - financial incentives for reduced spending, financial incentives for improving quality, and infrastructure support for their partner provider organizations. Their infrastructure support includes performance management information (both access to raw data and analyzed data), limitations on financial exposure from risk contracts, care coordination tools, technical assistance, and infrastructure payments. 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.