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February 28, 2020

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

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Francine Sinkoff, Editor

Project targets root causes of poor health in poorer areas of Capital Region

After Schalmont [Overdose], schools try for comprehensive outreach - Schenectady

Study questions current hypotheses surrounding duration of untreated psychosis - Suffolk

SAFE Glen Cove Coalition: Adolescent Opioid Overdose - Nassau

MHAST's mobile crisis team is changing how police handle mental health cases. Here's how. - Southern Tier

Governor Cuomo Announces Groundbreaking for $9.7 Million Affordable and Supportive Housing Development in Canandaigua - Ontario

Emptied-out correctional facility is location of new experiment for inmates and deputies - Monroe

Oneida County Jail inmates learn to administer naloxone
Inside Rochester's 24-Hour Addiction Treatment Center
Image result for Inside Rochester's 24-hour addiction treatment center
There's a place in Rochester where someone struggling with drug or alcohol addiction can go 24 hours a day, seven days a week to get help - Open Access Center.

It's the only facility of its kind in Monroe County since it opened its doors two years ago. The center helps direct people to addiction treatment services by giving immediate engagement and assessment for people suffering from all types of substance use.

Mark Johnson is a senior peer advocate who works Delphi Rise's Open Access in Rochester. When walking through the doors, Johnson is one of the first people to offer help.
Read more here.
Columbia County is Hiring
Behavioral Health Social Worker

Mental-Health Researchers Ask: What Is 'Recovery'?

Preventing mental health disorders may be key to thwarting the opioid crisis

Buprenorphine Effectively Treats OUD, But Most Patients Quit Treatment Too Early-Risking Relapse, Overdose, and Other Potentially Fatal Events

Teaching Children How to Reverse an Overdose

Meth is Flooding the Streets - and It's Uglier than Ever

Philadelphia Nonprofit Opening Nation's First Supervised Injection Site Next Week

Engaging with schizophrenia: Experts argue for new approaches to treatment

Second type of schizophrenia discovered

Getting Quality Autism Therapy From Thousands of Miles Away
NQF Releases Quality Measurement Priorities for Opioids and OUD

This report   considers issues related to acute and chronic pain management and substance use disorders (SUD). It answers two guiding questions: (1) What are the priority gaps in QM science that need to be filled in order to reduce opioid use disorders (OUD) and opioid overdose deaths without undermining effective pain management? (2) What existing and conceptual measures should be deployed in the following types of federal medical payment programs to best address the opioid crisis moving forward: Merit-Based Incentive Payment System (MIPS), alternative payment models (APMs), the Medicare Shared Savings Program (SSP), the Hospital Inpatient Quality Reporting Program (IQR), and the Hospital Value-Based Purchasing Program (VBP)? 
This State Has Figured Out How to Treat Drug-Addicted Inmates

CRANSTON, R.I. - On a gray, bone-chilling morning earlier this month, 18 men in a medium-security prison walked into an empty lunchroom and sat at stainless steel topped tables, placing both hands palms down, as if they were about to receive a manicure.

Over the next few minutes, they received the anti-addiction medication buprenorphine under their tongues, administered by a nurse and double-checked by guards - with military precision. Then they were strip-searched before returning to their cells.

This half-hour routine happens every day, part of a program developed at the Rhode Island Department of Corrections to ensure that the clear strips of buprenorphine the inmates need to maintain recovery and stay focused on rehabilitation aren't diverted to black markets inside or outside the prison.

Nationwide, two-thirds of the country's  2.3 million inmates
are addicted to drugs or alcohol, according to the National Institute on Drug Abuse. But only a small fraction of those who need treatment behind bars receives it. Read more here.
SAMHSA Releases "National Guidelines for Behavioral Health Crisis Care - A Best Practice Toolkit"

The National Guidelines for Crisis Care - A Best Practice Toolkit advances national guidelines in crisis care within a toolkit that supports program design, development, implementation and continuous quality improvement efforts. It is intended to help mental health authorities, agency administrators, service providers, state and local leaders think through and develop the structure of crisis systems that meet community needs. 

This toolkit includes distinct sections for:
  • Defining national guidelines in crisis care;
  • Tips for implementing care that aligns with national guidelines; and
  • Tools to evaluate alignment of systems to national guidelines.

Using PSYCKES Recipient Search
March 3, 3 - 4 pm, OMH

Telepsychiatry: The CCBHC Staffing Solution
March 4, 1 - 2 pm, National Council for Behavioral Health

PSYCKES New Features Training: QI Trends, HARP HCBS, PCP, and More!
March 5, 10 - 11 am, OMH

Building Youth Engagement and Involvement: Learn How YOUTH POWER! Can Support You
March 5, 11:30 am - 12:30 pm, CTAC/MCTAC

Sleep Disturbances and Depression: Understanding the Relationship to Improve Patient Outcomes
March 11, 12 - 1 pm, PsychU

Using PSYCKES for Clinicians
March 11, 2:30 - 4 pm, OMH

PSYCKES Mobile App for iPhones & iPads
March 17, 11 am - 12 pm, OMH

Reducing Access Disparities in Mental Health Treatment with Technology
March 23, 12 - 1 pm, CTAC/MCTAC
Using PSYCKES Quality Indicator Reports
March 26, 2 - 3 pm, OMH

School Safety and Collaboration: Building a Behavioral Health and Justice Response
March 26, 2 - 3:30 pm, CSG Justice Center

Justice Center Code of Conduct Training
Various locations, Justice Center for the Protection of People with Special Needs

Opioids and Child Maltreatment: Neighborhood Factors To Protect Families
April 16, 1 - 2 pm, Child Maltreatment National Peer Learning Team


MARCH 2020

Agency Day - OASAS
March 4: 9:30 - 11:30 am, 1450 Western Ave., Albany

Agency Day - OMH
March 4: 12:15 - 2 pm, 44 Holland Ave., Albany

Agency Day - OPWDD
March 4: 2:15 - 4 pm, 44 Holland Ave., Albany

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

Developmental Disabilities Committee Meeting
March 19: 1 - 2:30 pm, GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
CLMHD Sponsors Systems of Care Forum in Mid-Hudson

Michael Orth, MSW, Commissioner of the Westchester County Department of Mental Health moderates the panel discussion

Panel discussion included a variety of SOC stakeholders

On Thursday, February 27 , the Conference held a Children's Systems Forum in Poughkeepsie to educate various Systems of Care (SOC) stakeholders around the SOC framework for a collaborative approach in addressing children and family's needs locally and how the revised C-SPOA (Children's Single Point of Access) roles and responsibilities can contribute to the SOC and cross systems approach. 
CLMHD Children & Families Committee created the forum as a vehicle to provide updates and background on the changes to the C-SPOA role, as well as to facilitate some county planning relative to collaborative goal setting and how C-SPOAs can be a resource in reaching local goals. A variety of important SOC stakeholders participated in the event, including County Directors of Community Services, County C-SPOAs, Managed Care Plans, Health Homes, Care Management Agencies, Local Department of Social Services, Juvenile Justice/Probation, County Youth Bureau, Schools/BOCES, Local Hospitals, Care Coordination Organizations, Family and Youth Support, DSRIP/PPS/CBO, and Regional and State representatives. 

This Children's System Forum was designed to assist with the understanding of the various system changes and the impact it has had on the service delivery system (i.e. HCBS/waiver transition, Family First Prevention Services Act and PINS legislation). Following the success of this event, the Conference plans to hold additional forums across the state in the coming months.
NY to Ban Mental Health Question on State Bar Application

New York State's court system will remove questions about mental health history from its bar application, Chief Judge Janet DiFiore announced Wednesday.

After debate and study, the court system plans to revise the application, DiFiore said in her 2020 State of Our Judiciary address.

"The amended application will no longer ask intrusive questions about a candidate's mental health conditions or treatment history," she said in her  prepared remarks. "Instead, the application will focus on disclosure of behavior and conduct that is relevant to a candidate's fitness to practice law."

The presence of mental health questions on the bar exam, and stigma around mental illness, have proven to be barriers to treatment within the legal profession, according to a New York State Bar Association report. DiFiore said the mental health and well-being of New York's lawyers is of "paramount importance." Read more here.

Governor Cuomo Releases List of Healthcare Networks That Will Be Impacted by Trump Administration's $8 Billion in Cuts to New York State Healthcare System

Governor Andrew M. Cuomo on Tuesday released a list of healthcare networks that will be impacted by the federal government's $8 billion cut to New York's healthcare system. Yesterday, the Governor  delivered  remarks
addressing  these planned cuts for New York State - the Trump Administration's latest assault on the state.

"This past Friday we learned of the Trump administration's latest assault on the state of New York - $8 billion in cuts to our healthcare system. Healthcare should be beyond politics and it is unconscionable that the federal administration is politicizing the lives of New Yorkers - primarily senior citizens," Governor Cuomo said. "The healthcare networks on this list will bear the brunt of these short-sighted cuts, and as a result some of our most vulnerable New Yorkers will suffer. Make no mistake: New York will marshal all our allies, including our congressional delegation, to fight these cuts tooth and nail until New York receives the full funding we deserve."

Click here to view a list of healthcare networks, known as Performing Provider Systems, that will be impacted by the federal cuts in healthcare.

DSRIP denial's biggest blow might be lack of $1.5B for social determinants
Implementing Value-Based Reimbursement in Behavioral Healthcare 
BlueCross BlueShield Western New York's value-based reimbursement model will bring upside risk to behavioral healthcare.
behavioral healthcare, opioids, substance abuse care, value-based care, value-based reimbursement
Residents of western New York will have access to the region's first behavioral healthcare provider group with a value-based reimbursement arrangement, BlueCross BlueShield of Western New York announced in a statement emailed to journalists.

BlueCross BlueShield entered into the value-based reimbursement arrangement with Value Network. The provider group has over 100 providers in behavioral healthcare in Western New York.

"BlueCross BlueShield of Western New York is proud to partner with the region's leading behavioral health care providers to introduce the first payment model designed to directly enhance quality care for our members with mental health and/or substance use disorder diagnoses," said Thomas Schenk, MD, senior vice president and chief medical officer at BlueCross BlueShield of Western New York. 

Thus, it is significant that when BlueCross BlueShield allied with Value Network, it brought 23 providers into its network who have been licensed through OASAS as well as the New York State Office of Mental Health and the Home and Community Based Service Providers (HCBS).

The contract includes an upside risk agreement and follows the payer's Best Practice approach to value-based reimbursement for primary care providers. Read more here.
2020 VBP Quality Measure Sets Available

The 2020 VBP Quality Measure Sets are now available on the Value Based Payment (VBP) Resource Library website.

The 2020 VBP Quality Measure Sets were reviewed and approved by the VBP Workgroup in 2019 as part of the Annual Measure Review Cycle. Measure sets were compiled in collaboration with State agency partners, including the Office of Mental Health (OMH) and the Office of Addiction Services and Supports (OASAS). 

The following 2020 measure sets are now available on the VBP website:  
  • ChildrenĀ“s Quality Measure Set
  • Health and Recovery Plan (HARP) Measure Set (special needs population type arrangement)
  • HIV /AIDS Measure Set(special needs population type arrangement)
  • Integrated Primary Care (IPC) Measure Set
  • Maternity Measure Set
  • Total Care for the General Population (TCGP) Measure Set
The 2020 quality measure sets can be found by clicking on this link and looking under the VBP Quality Measures subheading tab.

For questions regarding the 2020 Quality Measure Sets please contact:
Addressing Social Determinants: Scaling Up Partnerships With Community-Based Organization Networks

As health care payment models become more value-based, health care systems are increasingly interested in approaches that address both medical needs and social determinants of health. 

This isn't surprising. Services delivered in the home and in the community that prevent falls, address food insecurity and transportation issues, manage chronic disease, support employment and economic independence, reduce social isolation, and address other non-medical risk factors have been shown to  improve health outcomes and reduce the cost of care. This is particularly true for "high-need, high-cost" people who have complex health conditions and social risk factors and who often have significant functional limitations.

Integrating these services into health care requires robust planning and assessment, expert knowledge and navigation of a complicated social service system, ongoing case management, and accountability for service delivery and outcomes. Incorporating these services requires health care payers and providers to "build" internal organizational capacity or "buy" it from existing service providers. When making that decision, there are many factors for health care organizations to take into consideration, not the least of which are local factors in the communities and markets they serve. Read more here.

States Test New Approaches For Justice-Involved Populations 

We pay a high price for incarceration. There's a $182 billion annual price tag attached to the 2.3 million people in prison and jails - and $12.3 billion of that is attributed to health care. And recidivism rates are estimated at 49% within eight years of release.

The reason costs are so high? Approximately 50% of inmates have chronic health conditions such as heart problems, diabetes, or hepatitis, and 64% of inmates have a serious mental illness such as bipolar disorder, schizophrenia, or a brief psychotic disorder, there are high rates of substance use disorders (SUD), and co-occurring disorders. Our data shows that inmates released to the community seek emergency care, are hospitalized more frequently, their mortality rates are 12 times higher than the general public.

To address these issues, states are testing ways to improve the system. California debuted a program to screen for and treat inmates with SUDs. Rollout began in January and offers participants medicated assisted treatment (MAT), comprehensive cognitive behavioral interventions, and safe, therapeutic housing. It will focus on whole-person treatment from incarceration through return to the community. 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.