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March 23, 2018

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

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Francine Sinkoff, Editor
NYTimes: When the Death of a Family Farm Leads to Suicide - Madison County

New York City Expands Plan to Combat Opioid Epidemic With Additional $22M Annual Investment

Sullivan County ranked near bottom of health rankings, but officials laud progress

Albany group's opioid-crisis project focuses on Sullivan County

In rural communities, debate rages over locations for addiction treatment centers - Orange County

Providers raise the bar for opioid treatment on Long Island

Saratoga County opioid overdose program recognized

Herkimer Co. participating in Rural Impact Counties Challenge

Tompkins cops catch up on mental health
OMH announces a new procedure for Submission of Comprehensive Prior Approval Review (PAR) Applications

In accordance with Mental Hygiene Law, Rules, and Regulations, a Comprehensive PAR application is required when a service provider or proposed provider seeks to establish a new program or make significant changes to an existing, licensed program.

OMH announced on March 15, 2018 a revised Comprehensive PAR review process, under Part 551, which is available to current OMH providers of service. OMH has developed a fully electronic version of the Comprehensive PAR Application component of the Mental Health Provider Data Exchange (MHPD), which providers currently use to submit Administrative Action and EZ PAR applications. The new submission process provides paperless communication between the applicant and reviewers and enables providers to submit applications and attach documents necessary for review of their projects. Read more here.

Governor Cuomo Awards Nearly $1 Million to Establish Four Community-Based Addiction Recovery Centers in New York City

Governor Andrew M. Cuomo this week awarded nearly $1 million in funding to establish four new addiction support centers, known as youth clubhouses, in New York City. The clubhouses will provide addiction prevention and recovery services to young adults struggling with substance abuse. The clubhouses, to be located in the Bronx, Brooklyn, Queens and Staten Island, are part of the Governor's multi-pronged efforts to combat addiction in New York State.

Youth clubhouses provide a community-based, non-clinical setting to promote long-term recovery through skill building, recreation, education, wellness, evidence-based prevention programs, and other social activities. With this new funding, there will be 15 youth clubhouses operating across the state, including one in every region of upstate New York and every New York City borough.  Read more here.
Regional Planning Consortiums (RPCs) Are Hiring!

Regional Planning Consortiums (RPCs) are hiring two part-time Regional Coordinators: 
Job Responsibilities: RPC Regional Coordinators monitor, manage and coordinate all elements and aspects of their region's NYS Regional Planning Consortium. RPC Project Coordinators report directly to the State Project Director; however, they have a day-to-day reporting responsibility to the region's RPC Co-Chairs.

To learn more about these opportunities, click here.
NY Providers On Track to meet Workforce Investment Goals

As the state looks to cut avoidable hospital admissions by 25%, a state Department of Health report shows that participants in its Delivery System Reform Incentive Payment program met midway spending targets for retooling their workforce.

The state's 25 Performing Provider Systems committed to spend $415 million over five years and had spent $247.5 million through September, the halfway mark of the program.

When the state began DSRIP in 2015, health care providers acknowledged that they would need to dramatically reshape
their workforce to succeed in reducing hospital visits. Read more here.

March 28, 1 - 2 pm, Manatt

March 28, 1 - 2 pm, Behavioral Healthcare Executive

Using ADA and Olmstead Principles to Divert People with Mental Illness from the Criminal Justice System
March 28, 2 - 3 pm, NRI 

Making Physical Health & Well-Being Matter for Transition-Age Youth
April 5, 2 - 3 pm, National Council for Behavioral Health

Using PSYCKES for Clinicians
April 10, 1 - 2:30 pm, NYSOMH

Why True Integration Requires a Primary Focus on Behavioral Health
April 11, 1 - 2 pm, Behavioral Healthcare Executive

Saving Lives: What You Can Do to Help Reduce Tobacco Use in Community Mental Health Settings
April 11, 2 - 3:30 pm

America's Multidimensional Opioid Crisis: Status, Solutions and Next Steps
April 12, 12 - 1:30 pm, Manatt

Getting There from Here: Innovative strategies for addressing transportation needs of people with behavioral health conditions
April 18, 12 - 1 pm

Enable Access to Client-Level Data in PSYCKES
April 19, 3 - 4 pm, NYSOMH

Using PSYCKES Recipient Search
April 24, 11 am - 12 pm, NYSOMH

April 26, 2 - 3:15 pm, NACo


APRIL 2018

Mental Hygiene Planning Committee
April 3: 1 - 2:30 pm, GTM

Officers, Chairs & Regional Reps Call
April 4: 8 am

Children & Families Committee Meeting

Directors/Executive Committee Meeting
April 18: 9:30 am - 12:30 pm, GTM

CLMHD Spring Full Membership Meeting
April 30 - May 1, Saratoga Springs

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Donna Frescatore to Take Over as State Medicaid Director

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Donna Frescatore, who has led NY State of Health - the state's online insurance exchange - for the last five years, will become the next state Medicaid director, replacing Jason Helgerson when he leaves next month.

The move offers the state a Medicaid director intimately familiar with New York's complicated waivers and a long-time veteran of state government. Frescatore will remain in her position as NY State of Health director where she will continue to earn an annual salary of $183,000. State officials said they plan to hire a new Medicaid director by 2019. Read more here.
NYS Makes it Easer for Hospitals to Open Detox Beds, but It's Not Clear if They'll Do So

In an effort to increase access to addiction treatment services in the wake of the opioid crisis, the New York State DOH is giving hospitals an opportunity to add more in-patient detox beds.

The Office of Alcoholism and Substance Abuse Services (OASAS) is temporarily waiving a certification requirement that would allow hospitals to add d etox beds through the end of this year. 

Monroe County currently only has 25 such beds, even though addiction specialists say the need is four to five times that amount.

But it's not clear if any local hospitals are planning to take advantage of the state waiver. Read more here.

Click here to view recently released guidelines from NYS OASAS.
DSRIP Workforce Impact Analysis Report

At the start of DSRIP, Performing Provider Systems (PPS) made workforce spending commitments to support DSRIP goals and priorities of $415M over 5 years.  As of DSRIP Year 3 Quarter 2, PPS have spent $247.5M on workforce initiatives.

The PPS have reported 3.5 years of data identifying how workforce investments impact delivery system transformation, such as strengthening and integrating behavioral health and the shift from institutional to community- and home-based healthcare. The summary report is located on the DSRIP website here
DSRIP Mid-Point Assessment Final Summary

In February 2017, the Independent Assessor (IA) presented its Mid-Point Assessment recommendations to the Project Approval and Oversight Panel (PAOP). Following PAOP's review, the IA released the final Mid-Point Assessment recommendations to the PPS who were required to develop Mid-Point Assessment Action Plans to address the items identified in the recommendations. The PPS were required to submit the Action Plans for IA review and approval with updates on the PPS progress towards completing the Action Plans as part of the DY3, Q1 and DY3, Q2 PPS Quarterly Reports. Through the Action Plans, the PPS were asked to demonstrate a plan for addressing the recommendations, the process the PPS would implement to correct the area of concern, and the timeline for completion of all tasks. All Action Plan activities were required to be completed by no later than the end of DY3, Q2 (September 30, 2017).

Click here to view a summary of the results of PPS efforts on the Mid-Point Assessment Action Plans following the close of DY3, Q2.
New Whiteboard Video - DSRIP Year 4

In the video titled, "DSRIP Year 4: Start a Movement," New York State Medicaid Director, Jason Helgerson, gives an overview of the DSRIP year 4 theme and goals including the focus on performance, the move to Value Based Payment, and planning for the future.   To view the video, click here .
2018 Robert Wood Johnson Foundation County Health Rankings Released

were released last week. Each year, County Health Rankings & Roadmaps (CHR&R)-a collaboration between the Robert Wood Johnson Foundation (RWJF) and the University of Wisconsin Institute for Population Health-ranks nearly every county in the U.S on a number of vital health factors. The annual rankings serve as not only a measuring stick for assessing community wellbeing, but also a catalyst to spark conversations around how geography-including both the physical and social environment-can affect health. 

Beyond the rankings, CHR&R provides practical tools and resources for communities looking to build a culture of health. The redesigned  What Works for Health tool highlights evidence-based programs and policies to aid counties in setting and reaching their health goals. The CHR&R  Action Center houses comprehensive guidance regarding not only assessing community needs, but developing strategic communication plans and evaluating current programming. 

To view New York's county rankings, click here.
Policy Brief on Re-Entry of Persons with SMI and Complex Needs

California Health Policy Strategies published a detailed report examining the medical and behavioral health needs of people who are reentering their communities following incarceration. The authors make recommendations on how to overcome barriers to improving care and lowering costs, especially for those who have complex care needs, a serious mental illness, or both. 

Click here to view the report.
Report: New York Had 29% Increase in Drug Deaths from 2015 to 2016, the Largest Annual Increase in Drug-Related Deaths in Six Years

A new analysis of Center for Disease Control data by the Rockefeller Institute of Government shows a 29% increase in drug deaths in New York State from 2015 to 2016, the largest annual increase in the 2010-16 period. 

While the analysis found decreases in annual deaths in several counties, overall the opioid epidemic worsened throughout the state, contrary to recent reports of a potential slowdown. Policymakers across the nation have grappled with how to address the epidemic. The solutions have varied from the president of the United States declaring the problem a national public health emergency to once-unthinkable solutions in many communities, like safe injection sites.

"The data continue to show that New York's opioid crisis is deepening, despite well-intentioned interventions at every level of government," said Rockefeller Institute President Jim Malatras. "This will not come as a shock to anyone on the front lines of the crisis. Why the nation continues to struggle to slow the drug epidemic is a question that the Rockefeller Institute of Government is taking on. We're examining problems with the data, which is critical to help fully understand the problem, as well as the policy disconnect between local responders and local, state, and federal lawmakers to help them move from problem to solution." Read more here.
How Many Opioid Overdoses Are Suicides?

Mady Ohlman was 22 on the evening some years ago when she stood in a friend's bathroom looking down at the sink.

"I had set up a bunch of needles filled with heroin because I wanted to just do them back-to-back-to-back," Ohlman recalls. She doesn't remember how many she injected before collapsing, or how long she lay drugged-out on the floor.

"But I remember being pissed because I could still get up, you know?"

She wanted to be dead, she says, glancing down. A wisp of straight brown hair slips from behind an ear across her thin face.

At that point, says Ohlman, she'd been addicted to opioids - controlled by the drugs, she says - for more than three years.

"And doing all these things you don't want to do that are horrible - you know, selling my body, stealing from my mom, sleeping in my car," Ohlman says. "How could I not be suicidal?" Read more here.
The Evolution Of Successful Value-Based Contracting

It's always interesting to "kick the tires" on a value-based contracting model that is up and running-and working. Our team had that opportunity at The 2018 OPEN MINDS Performance Management Institute in the session, How To Develop A Value Based Reimbursement Agreement: The Centerstone/Passport Health Case Study, featuring Liz McKune, Vice President, Health Integration at Passport Health Plan and Kelley Gannon, Chief Operating Officer, and Debbie Cagle-Wells, Chief Marketing Officer at Centerstone.

In their presentation, they discussed two separate shared savings incentive programs that started in June 2017. One is based on a population management incentive that is looking at the health of the membership that receive services from Centerstone. In this model, Dr. McKune discussed the process of establishing several baseline clinical measures, with incentive payments tied to reduction in medical hospitalization, emergency department utilization, and reduction in inpatient behavioral health stays. Under this model, savings are shared if there is a reduction in spending in those three areas and if quality metrics are achieved, such as improvements in follow-up after hospitalization for mental illness; documentation of body mass index (BMI) with a plan to address BMI; tobacco use screening and cessation; and communication with primary care providers and referring providers at the initiation and discontinuation of treatment.

The other shared savings program-for individuals with serious mental illnesses-is in the pilot stage and is focused on savings related to reduced medical inpatient stays, reduced emergency department utilization, and reduced behavioral health inpatient stays. 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.