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July 19, 2018

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

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Francine Sinkoff, Editor

Students surveyed on drug use in Tioga County

Montgomery County mulls program for at-risk children

Children's Medicaid Health and Behavioral Health System Transformation Update

Click  here  to read the most recent update from the  Medicaid Redesign Team  on the Children's Medicaid Health and Behavioral Health System Transformation.
New York to Launch a New Way to Dispose of Your Medications

New York will soon have a statewide program for collecting old medication to ensure it's disposed of properly after Gov. Andrew Cuomo signed a bill into law this week. Cuomo approved the new drug takeback program last week, a year after he vetoed a similar program amid concerns the cost would be borne by pharmacists.

The new program requires drug manufacturers to cover the cost of collecting drugs at pharmacies and other facilities across the state in an effort to cut back on those people who flush old medications, which can contaminate water supplies. The Democratic governor signed the bill without comment after the Legislature approved it in June. Read more here.
Behavioral Healthcare Executive: 7 tips for better payer contracts

Experts debate 42 CFR Part 2's role in today's world

United Hospital Fund Launches Second Phase of Early Childhood Development Initiative to Address Social and Economic Factors Affecting Children's Health

Prior Suicide Attempts Associated With Poorer Clinical, Functional Outcomes in Adolescents, Young Adults

Predicting Suicide Attempts and Suicide Deaths Using Electronic Health Records

The Same Genes May Underlie Different Psychiatric Disorders

Long-Acting Injectables Effective in Patients With Comorbid Psychosis, Substance Use Disorder

These Pills Could Be Next U.S. Drug Epidemic, Public Health Officials Say
WEBINAR:  Raise the Age State Implementation Update

Tuesday, July 24, 2018 @ 1 0 am

There is a little more than two months before the implementation date of Raising the Age of Criminal Responsibility.
Beginning October 1, a 16-year-old that is charged with a non-violent felony or a misdemeanor will be considered an Adolescent Offender (AO), and will be protected from the adult incarceration population. Implementation of the new law will impact several county departments, and will require additional personnel and resources in probation departments, county attorney's offices, mental health services, and social services agencies. This change also has the potential to require counties to make financial investments in programs, services, and infrastructure. 

This webinar will be presented by the Executive Chamber, Office of Children and Families, New York State Division of Criminal Justice Services, and the Division of Budget.

To register for the webinar, click here.

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

Developing and Delivering Effective Suicide Prevention Messaging
July 25, 1 - 2:30 pm, SAMHSA

VBP Pilots Lessons Learned - Contracting
July 25, 2 - 3 pm, NYS DOH

July 26, 1 - 2 pm, CTAC

Best Practices for Successful Reentry for People with an Opioid Addiction
July 26, 2 - 3:30 pm, National Reentry Resource Center

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

Family Engagement in Substance Use Disorder Services
July 31, 1 - 2 pm, CTAC

Health and Human Services Partnership Success Story
July 31, 2:30 - 3:30 pm, Alliance for Strong Families and Communities

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

Introducing RASP: Relapse Assessment In Schizophrenia Patients
August 8, 12 - 1 pm, PsychU

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

Emerging Best Practices for People with an Intellectual/ Developmental Disability Co-Occurring with Serious Mental Illness
August 9, 1:30 - 2:30 pm, SAMHSA

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

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

An Update From NCQA©: Focusing On HEDIS® Behavioral Health Measures (Quality Measurement Series Part 1)
August 22, 12 - 1 pm, PsychU

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



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 
UB Health Team Looks to Boost Families Struggling with Disabled Loved Ones

Erie County Medical Center had the distinction last year of releasing a teen patient with severe autism from the behavioral health  emergency room - after 304 days.

The 16-year-old was one of hundreds with developmental disabilities in the region - and thousands across the nation - who fall into a gray area each year. Where to best help them when an explosive outburst requires emergency care: in a mental health or more typical hospital setting?

"You can treat them and get them out but still, a lot of families at that point are beyond being able to handle things anymore," said Dr. Michael Cummings, associate medical director in charge of the ECMC Regional Center of Excellence for Behavioral Health. "You can't imagine how hard it is to acknowledge to yourself that leaving a child in an emergency room is better than taking them home."

The hospital, New York State and a quartet of regional nonprofit foundations believe they have found an answer for most parents, and patients, in such shoes - the  Access to Psychiatry through Intermediate Care (APIC) program, a team that makes house calls to challenged families in 17 upstate counties. Read more here.
NYS Medicaid Director Says Providers Should Apply DSRIP Lessons More Broadly
State Medicaid Director Donna Frescatore said Wednesday that it's time for health care providers to take stock of what has worked in its DSRIP Medicaid-reform program and apply those lessons to other populations.

The five-year, $7.4 billion program is in its fourth year, and participants are now receiving payments based on whether they are able to show high-quality outcomes while reducing avoidable hospital use. Frescatore said the rate of preventable readmissions dropped 15.2% in the first three measurement years of the program. She highlighted ways that providers have worked with community-based organizations to address social factors, such as housing and nutrition, that affect health.

"How do we take what we've learned here and make it more broadly available, maybe even outside the Medicaid program?" she said during a keynote speech at the United Hospital Fund's Medicaid conference. She noted that people earning too much to qualify for Medicaid, such as those who qualify for the Essential Plan, still have many of the same social needs.

What's unclear is how providers would pay to experiment with programs that could help commercially insured New Yorkers stay healthier without the billions in support provided by DSRIP. Frescatore said in an interview after her speech that value-based payment contracts with insurers could help support such a plan.

-Crain's Health Pulse 7.19.18
New York Medicaid Providers Reach New Value Based Payment Contracting Designation

The New York State Department of Health (DOH) this week announced that NYU Langone Independent Practice Association (IPA) has been designated as an Innovator under Medicaid's Value Based Payment (VBP) Roadmap, a key component to the Delivery System Reform Incentive Payment Program (DSRIP). NYU Langone IPA is the second organization to be designated as an Innovator by the Department joining Montefiore (MACO-IPA) which was designated earlier this year.

Innovators contract at the most advanced payment levels with managed care organizations to improve quality of care for a defined group of patients while sharing in financial gains and risks. By taking on additional management and administrative functions, providers approved as Innovators are eligible for an increased portion of the monthly payment made by Medicaid to the Managed Care Plan. New York's Roadmap is unique in requiring Innovators to include community-based organizations and address social determinants of health interventions such as housing, food insecurity or transportation. Read more here.
CMS Approval of Annual Update to VBP Roadmap

The Centers for Medicare and Medicaid Services
 (CMS) has approved the third annual update of the New York State Value Based Payment (VBP) Roadmap.
The VBP Roadmap update process incorporates feedback from key stakeholders throughout New York State's healthcare system as well as feedback from the public.
Highlights from the recently approved version of the VBP Roadmap include:
  • Design for the Programs of All-Inclusive Care for the Elderly (PACE) program
  • Guidance related to use of quality measures for VBP
  • An emphasis on the role of Community Based Organizations (CBOs) and social determinants of health interventions while ensuring that interventions fall within 5 key social determinants domains. 
The year 3 VBP roadmap is now available on the NYS DOH website under the 'VBP Roadmap' tab here .
Issue Brief: Medicaid and the Criminal Justice System

Medicaid and the criminal justice system share responsibility for providing health care to justice-involved populations. With a few exceptions, Medicaid is the payer of health care services for eligible and enrolled individuals who are subject to parole and probation, while correctional institutions, including federal and state prisons and local jails, must pay for health care costs while individuals are confined to their facilities.

This issue brief describes how Medicaid and the State Children's Health Insurance Program (CHIP) interact with the criminal justice system, including the roles of Medicaid and the correctional system in providing health care; CHIP eligibility rules for justice-involved youth; and state efforts to enroll individuals in Medicaid and address the health care needs of the justice-involved population.
Bridging The Gap - Integrated Space

A primary care provider and a behavioral health provider discuss patient treatment plans in a shared interprofessional pod.

The majority of behavioral health diagnoses are made in the primary care setting, placing primary care physicians in an ideal position to create a cohesive treatment plan for patients with concurrent physical and behavioral health conditions. For example, a patient who suffered a heart attack may also require care for depression, a common comorbidity that if treated properly can significantly reduce the odds of a future heart attack.

However, primary care physicians may lack the time and expertise required to provide prolonged support for more complex behavioral health conditions, driving the need to integrate behavioral health and primary care services in a single setting. Healthcare organizations around the country are beginning to adopt this practice, recognizing that coordinated care reduces the burden on the primary care provider, improves health outcomes and cost effectiveness, and ultimately enhances quality of care.

To help support these outcomes, designers are optimizing built environments where clinicians can easily collaborate in a single space and deliver integrated treatment plans. Read more here.
How to Integrate Clinical Care with Mental, Behavioral Healthcare

As the industry continues its shift from volume to value, healthcare organizations should consider innovative strategies for incorporating mental and behavioral healthcare services with the clinical environment.

Delivering high-quality, preventive care requires
clinicians to treat the whole patient, on both the physical and behavioral level.

Research has shown that mental health issues are strongly correlated with chronic disease, and that leaving mental illness untreated can result in a wide range of issues, including medication non-adherence, increased mortality, and higher care costs.  With nearly  one in five US adults  
experiencing a mental illness each year, holistic patient care that blends clinical and mental healthcare is a critical component of success for population health management.

Although the healthcare industry has made strides in merging physical and behavioral services, integration remains a difficult task. Read more here.
A Simple Emergency Room Intervention Can Help Cut Suicide Risk

Many people who attempt suicide end up in an emergency room for immediate treatment. But few of those suicide survivors get the follow-up care they need at a time when they are especially likely to attempt suicide again.

Now, a study shows that a simple intervention conducted by staff in emergency departments can reduce the risk of future attempts. The intervention involves creating a safety plan for each patient and following up with phone calls after discharge.

The  study, which was published Wednesday
in JAMA Psychiatry, included 1,200 patients at five Veterans Affairs hospitals around the country. The findings offer a way for hospitals and clinics to help reduce the rising numbers of death  by suicide across the country. Read more here.
Can Permanent Housing Improve Health Outcomes?

A new report details what we know - and
what we don't know - about how permanent supportive housing might improve health outcomes for people experiencing homelessness.


The background: Permanent supportive housing provides a home to people experiencing homelessness, but also offers mental health services, medical care, and help developing skills for everyday life.


The findings: The authors found major limitations in the research, such as limited follow-up periods and inconsistent definitions. The study did find PSH can improve outcomes for people with HIV/AIDs, but found scarce evidence for its effect on other conditions. 


The call to action: There's a clear need for more research on the impact of PSH, particularly in patients with diseases that might be exacerbated by a lack of stable housing, the authors say. The report also urges HUD and HHS to collaborate with nonprofits, charities, and local governments to increase access to PSH.

The Staffing Equation For Community-Based Services

Managing a team of clinical professionals in the community is different than managing a team in at a fixed location. And the differences-in culture, technology, and process-are increasingly "must have" skills for health and human service provider organizations. Across all market segments, but particularly with the consumers with the most complex support needs, we're seeing the growth of the volume of care outside the institutional and clinic settings. Consumer preference, cost pressures, performance requirements, and value-based reimbursement are all contributing to the increase in community-based care.

This leads to the question-are your staff (and your managers) prepared to serve consumers where they are?  

Experts suggest paying particularly close attention to four key areas-attract the staff suitable for working in the field, develop new business practice for community-based settings, leverage mobile technology, and address the unique safety issues of community-based work.  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.