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February 15, 2019

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

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Francine Sinkoff, Editor
School stress: schools deal with rise in mental health issues among students - Tug Hill Seaway

Gouverneur Hospital getting $1.6 million grant for major renovation of inpatient suite - St. Lawrence County

North country's suicide prevention coalitions receive $30K for region

Rensselaer City School District receives $420K federal grant for mental health services - Rensselaer County

NYU College of Dentistry Opens Oral Health Center for People with Disabilities - NYC

Alcohol & Drug Council is opening a treatment and referral facility in Lansing, plans 40 beds in future - Tompkins County

Monroe County releases six-month 2018 overdose statistics

Seneca snags more funding to fight opioid epidemic

Noyes Health to use $2M in state grants to expand imaging, mental health services in Dansville, Avon - Livingston County

Update: S&S Behavioral Health Unit to stop admitting Monday - Yates County

Genesee County to get new inpatient addictions center

Drug deactivation devices to be distributed across Western New York

$30 million investment is a hands-down win for Children's Psych Center - WNY

Drug forum draws full house in Lockport - Niagara County

Cheektowaga uses new snowplow in effort to prevent suicides - Erie County
Is Autism Truly a Spectrum? New Research Suggests Classification More Complex

A new Stony Brook University-led study that compared two large independent samples of children and adolescents totaling about 6,000 people with and without diagnosed autism reveals that autism may be better understood as several interrelated spectra rather than a spectrum. The study is published in the  Journal of the American Academy of Child and Adolescent Psychiatry.

According to the lead researchers - Stony Brook University Professor Matthew Lerner and graduate student Hyunsik Kim - the study findings may have vast implications with the way professionals classify autism and better understand and map the array of experiences of autistic people. Read more here.
First Big Depression Advance Since Prozac Nears FDA Approval

The U.S. Food and Drug Administration is on the brink of approving a breakthrough drug that could upend the way severe depression is treated.

Johnson & Johnson's esketamine, a close chemical cousin of the anesthetic ketamine, cleared a major hurdle on Tuesday when a panel of outside experts recommended that the FDA approve the treatment. The fast-acting antidepressant, administered via a nasal spray, is being tested in major depressive disorder and suicidal thinking. If approved, it would be the first major therapeutic advance for depression since the introduction of Prozac in 1987. Read more here.
Healthcare Connect Fund

The Universal Service Administrative Company (USAC) Healthcare Connect Fund provides assistance to healthcare providers for eligible expenses related to broadband connectivity at a flat discounted rate of 65%. Participants can apply as a member of a consortium or a stand-alone entity.

Application Deadline: May 31, 2019 

Click HERE for more information.
HHS will test paying ambulances for trips to alternative sites, telemedicine

TIME Magazine: The Public Is Angry About the Opioid Crisis. We Need to Listen

Nearly 1 in 7 US kids and teens have a mental health condition - half go untreated, study says

Extra Support for Suicidal Teens Can Cut Risk of Dying Young

Study: Rising concern that synthetic opioids contaminate other drugs, too
Podcast: A Neuroscientist Explores The Biology Of Addiction In 'Never Enough'
Changes in behavior, including addiction, that happen during adolescence can be lasting because that's when the brain is forming permanent structures.
Since age 13, neuroscientist Judith Grisel struggled with alcohol, marijuana and cocaine. But along the way, she also became interested in the neuroscience of addiction.  Now it has been 30 years without using drugs or alcohol for Grisel, a professor of psychology at Bucknell University, where she studies how addictive drugs work on the brain. Her new book is  Never Enough: The Neuroscience and Experience of Addiction.

Click here to listen to an interview with Judith Grisel on NPR's Fresh Air podcast.
Federal Judge: State Fails to Provide Prompt Mental Health Care to Poor Children

A federal judge sharply rebuked the state for failing to provide prompt mental health services to low-income children, saying that constant delays can lead to violent physical outbursts, removal from homes, and traumatizing and unnecessary hospital stays.

Massachusetts has repeatedly violated its own standard of providing certain mental health treatment to seriously ill children on Medicaid within 14 calendar days, with thousands of children having waited weeks, putting them at risk for "devastating setbacks,'' US District Court Judge Michael Ponsor found.

Ponsor questioned whether even 14 days is too long to wait when a child is in crisis. Read more here.
NASHP Issue Brief: States Use Policy Levers and Emerging Research to Address Antipsychotic Use in Children in Foster Care

State policymakers must often take action during an emerging crisis even when evidence identifying the best policy approach is not be available. This report,  Evidence-Based Policymaking Is an Iterative Process: A Case Study of Antipsychotic Use among Children in the Foster Care System, explores successful state responses to dramatic increases in antipsychotic prescription rates in Medicaid-enrolled children in foster care. It highlights several strategies, including payment reforms, delivery system innovations, and quality supports for clinical care.

February 20, 10 - 11 am, OMH

What Do Providers Want to Know About Peer Support Services?
February 20, 11 am - 12:30 pm, Academy of Peer Services (APS)

Being Mindful about Adjunctive Therapies and Their Contributions to Treatment
February 20, 12 - 1 pm, Hazelden Betty Ford Foundation

Addiction Services 101 - The basics: Recovery Support Services, Medication Assisted Treatment, and Addiction Treatment
February 20, 1:30 - 2:30 pm, Corporation for Supportive Housing

Innovative Crisis Response Models
February 27, 2 - 3:30 pm, SAMHSA's GAINS Center

February 27, 3 - 4 pm, NAADAC

March 1, 1 - 2:30 pm, Center for Health Care Strategies, Inc.

March 27, 1 - 2 pm, Manatt Health



CLMHD Offices Closed 
February 18

Children & Families Committee Meeting
February 19: 11:30 am - 1 pm, GTM

Developmental Disabilities Committee Meeting
February 21: 1 - 2:30 pm, GTM

CLMHD BH Portal Webinar: PSYCKES Quality Indicators
February 27: 12 - 12:30 pm, GTM

MARCH 2019

Executive Committee Call
March 6: 8 am

Regional Reps Call
March 13: 8 am

CLMHD BH Portal Webinar: NYS OMH County Profiles
March 13, 12 - 12:30 pm, GTM

Children & Families Committee Meeting
March 19: 11:30 am - 1 pm, GTM

CLMHD Membership Call
March 20: 9 - 10:30 am, GTM

March 20: 3 - 4 pm, GTM

CLMHD BH Portal Webinar: OASAS Admissions
March 27, 12 - 12:30 pm, GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Two Years of Progress in South Seneca Addiction, Mental Health

When it comes to creating awareness around mental health issues and substance use disorders, officials believe positive ground has been made in the last few years. 

Margaret Morse, Director of Community Services for Seneca County, agrees. Morse celebrated her two-year anniversary leading community service efforts in Seneca on Jan. 31. Reflecting on those years she said progress had been positive, but plenty of work remains. "I think we've done some great work when it comes to awareness, and in the clinic setting we've made some great strides in terms of services offered," she explained. Part of that has been bringing the information and available resources to the Board of Supervisors to help them understand the challenges, as well as the progress, in these issues.

"The Mental Health Department has experienced a huge amount of support from the [Board of Supervisors]. We're really appreciative of that support, too," Morse said. The support of funding and staffing has allowed the department to make progress in places where it previously struggled. Read more here.
NYS OASAS Announces New Campaign to Raise Awareness of Availability of Addiction Services

The New York State Office of Alcoholism and Substance Abuse Services this week announced the launch of the "Know the Facts" campaign. This multi-faceted PSA campaign will dispel myths, provide facts, and raise awareness about addiction services in New York State, and will help direct people to addiction services and help.

The "Know the Facts" campaign will address facts related to topics that include the availability of treatment in New York State, insurance coverage and paying for treatment, and the support that is available for people in recovery. The campaign highlights that 23 million people are living in recovery, and there is hope for people who are suffering from addiction. The campaign will run statewide in English and Spanish, through March 25. It will consist of ads on the radio, New York City Subway, Staten Island Ferry, bus interiors, public billboards, and banner ads online and on social media. Campaign materials can be found  here .
Capital Region's First 'Opioid Intervention Court' Established

The City of Troy has established an Opioid Intervention Court. The program is different from the traditional Drug Court in that it's designed to provide immediate assistance to a defendant in the throes of addiction.

Supervising City Court Judge Christopher Maier said he, along with Administrative Judge Thomas Breslin and Supervising County Court Judge Debra Young established the program as part of the Unified Court System's statewide efforts to address the Opioid Epidemic. 

"This is really an immediate response by the court system to those individuals who are in crisis. We're looking to save lives. We're looking to intervene as quickly as possible to prevent people from an overdose," said Judge Maier.

Judge Maier is in his 15th year of working with defendants in Troy's Drug Court. He said this new program will focus on getting non-violent offenders who are battling heroin or opioid addiction the help they need; however, he said it is not an escape from prosecution. Read more here.
USDA and HHS Partner to Create Recovery Housing in Rural Communities

U.S. Department of Agriculture (USDA) Assistant to the Secretary for Rural Development Anne Hazlett and Department of Health and Human Services (HHS) Assistant Secretary for Mental Health and Substance Use Dr. Elinore McCance-Katz this week announced USDA and HHS will partner to create addiction recovery transitional housing in rural communities.

McCance-Katz said, "We know that the opioid crisis has hit rural communities hard, and we need to leverage all possible partnerships to support these communities. Housing plays a vital part in the recovery process for those living with opioid use disorders." Read more here.
Pew Charitable Trust: Opioid Use Disorder: Challenges and Opportunities in Rural Communities
Truck on road
  The increasing number of drug overdose deaths in the United States has hit rural areas particularly hard. Between 1999 and 2015, overdose deaths increased 325 percent in rural counties.  In 2015, they surpassed the death rate in urban areas. Additionally, nonfatal prescription opioid overdoses are concentrated in states with large rural populations. Helping to drive this trend in rural areas are high opioid prescription rates and challenges accessing medication-assisted treatment (MAT), the gold standard for treating opioid use disorder.

This fact sheet describes some of the challenges rural communities face in providing access to evidence-based treatment and strategies used by federal and state agencies to enhance treatment capacity, including how one rural community responded to the opioid epidemic by addressing the specific needs of its residents. 
Sheriffs Addressing the Mental Health Crisis in the Community and in the Jails

developed by the Major County Sheriffs of America in partnership with the National Commission on Correctional Health Care - identifies innovative practices that have proven successful in reducing the arrest and incarceration of individuals living with mental illness in jurisdictions across the country. The report includes case studies of seven jurisdictions and resources developed by law enforcement executives and experts in the field.The programs have shown promise in several areas: diverting those who live with mental illness away from the criminal justice system; supporting individuals in the court system; identifying and treating those who have been incarcerated; and helping individuals successfully reenter their communities after discharge. 
Discharged, Dismissed: ERs Often Miss Chance To Set Overdose Survivors On 'Better Path'

The last time heroin landed Marissa Angerer in a Midland, Texas, emergency room - naked and unconscious - was May 2016. But that wasn't her first drug-related interaction with the health system. Doctors had treated her a number of times before, either for alcohol poisoning or for ailments related to heavy drug use. Though her immediate, acute health issues were addressed in each episode, doctors and nurses never dealt with her underlying illness: addiction.

Angerer, now 36 and in recovery, had been battling substance use disorder since she started drinking alcohol at age 16. She moved onto prescription pain medication after she broke her ankle and then eventually to street opiates like heroin and fentanyl.

Just two months before that 2016 overdose, doctors replaced an infected heart valve, a byproduct of her drug use. She was discharged from the hospital and began using again the next day, leading to a reinfection that ultimately cost her all 10 toes and eight fingers. Read more here.
Unnecessary ED Visits From Chronically Ill Patients Cost $8.3 Billion

About 30% of emergency department visits among patients with common chronic conditions are potentially unnecessary, leading to $8.3 billion in additional costs for the industry, according to a new analysis.

The  report, released Thursday by Premier, found that six common chronic conditions accounted for 60% of 24 million ED visits in 2017; out of that 60%, about a third of those visits-or 4.3 million-were likely preventable and could be treated in a less expensive outpatient setting.

The frequency of unnecessary ED visits from the chronically ill is unsurprising given the fee-for-service payment environment the majority of providers remain in, said Joe Damore, senior vice president of population health consulting at Premier. On average, only 10% of providers' payment models are tied to value-based models, he said, so providers don't have an incentive to effectively manage patients to prevent disease progression and promote wellness. Read more here.
Pay for Results: A New Way for States to Access Federal Funding for Social Determinants of Health Interventions

This week, the U.S. Department of the Treasury announced a significant funding opportunity for states and local governments looking to invest in social determinants of health (SDOH). The opportunity stems from a little-known provision in the Bipartisan Budget Act of 2018: the Social Impact Partnerships to Pay for Results Act (SIPPRA).  Of the $100 million appropriated under the Act, the Department of the Treasury has allocated $66,290,000 to finance outcomes-based payments for "social impact partnership projects."

While the title of the Act refers to "paying for results," the Act largely adopts concepts from  Pay for Success (PFS), a financing and contracting approach that leverages private capital and ties payment to outcomes. PFS can help governments define desired outcomes and, by accounting for benefits and cost savings across different agency budgets, address the "wrong pockets" problem. With access to privately funded upfront working capital, community-based organizations can ramp up capacity - to provide more services to more people and build the infrastructure needed to interface with other community partners, such as health care organizations. Read more here.
HHS Proposes New Rules to Improve the Interoperability of Health Information

The U.S. Department of Health and Human Services (HHS) this week proposed new rules to support seamless and secure access, exchange, and use of electronic health information. The rules, issued by the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), would increase choice and competition while fostering innovation that promotes patient access to and control over their health information. The proposed ONC rule would require that patient electronic access to this electronic health information (EHI) be made available at no cost. Read more here.
Addiction Treatment Providers Go Mobile
Patients using tools developed by Pear Therapeutics can take assessments using their smartphones.
Addiction treatment experts say there's a huge need to expand high-quality outpatient care, including medication-assisted treatment, to Americans with opioid and other substance use disorders. After inpatient care, however, patients often can't access or don't stay connected to outpatient therapy, which contributes to a very high relapse rate.

There are also too few outpatient centers offering medication-assisted treatment, or MAT, and a shortage of clinicians trained in evidence-based substance-use disorder therapies. So there's growing interest in empirically validated, mobile app-based therapeutic tools that allow providers to offer therapy, skills training and support to their patients in between face-to-face visits. 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.