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December 7, 2018

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

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Francine Sinkoff, Editor
Twin Counties collaborate on addiction, recovery campaign - Columbia/Greene Counties

Enough fentanyl to kill 500,000 people seized near Binghamton - Broome County

LIFEPlan CCO NY Formally Opens Utica Office - Oneida County

Monroe County 'a canary in the coal mine' for looming state crisis in early childhood therapy

New apartment complex in Henrietta supports people with disabilities - Monroe County

Overdose cases are dropping in Western New York

Progress report on new addiction hotline - Western NY

$135K secured to launch program for vets with PTSD, TBI in Cattaraugus County

Cattaraugus, 10 other counties to build 'Raise the Age' facility in Bath

'We'll get you through this': Primary care practices add mental health specialists - Erie County

Antidepressants overtake painkillers among Erie's Medicaid prescriptions
"In Case You Missed It" - CLMHD
Recaps Key Information Issued by the State

The Conference has begun issuing "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 edition.
Creating a Better Way to Treat Opioid Use Disorder in EDs

An innovative, cost-effective program at more than a dozen hospitals in Western New York provides medication-assisted treatment to opioid use disorder patients in emergency departments (EDs) and rapidly transitions them into long-term treatment at a community clinic, all within about 48 hours.

Quick Access to Medication-Assisted Treatment
program, designed to expand emergency access to medication-assisted treatment, was developed by emergency medicine physicians at the Jacobs School of Medicine and Biomedical Sciences.

Now operating in 13 hospitals in Western New York, the program is serving as a model for similar programs that other regions and states want to develop. Read more here.
Charting A Pathway To Better Health - In Toledo and other communities nationwide, a new approach to care coordination is reaching patients where they live.

America Doesn't Understand Gateway Drugs

Telemedicine underused in treating addiction

For many teens, the battle with opioid addiction starts with wisdom teeth

Monthly Injections of Naltrexone, Opioid Antagonist, Superior to Oral Design

School-Based Counselors Help Kids Cope With Fallout From Drug Addiction

Infective Endocarditis: A New Consequence of the Opioid Epidemic

Major Brain Scan Study Sheds Light on OCD Behaviors

Joint Commission will require hospitals to screen for suicide risk
NYS OASAS RFA:  Recovery Community Center Initiative

NYS OASAS, through its fiscal agent, the Research Foundation for Mental Hygiene, Inc. (RFMH), is a recipient of a State Opioid Response Grant (SOR) from the Substance Abuse and Mental Health Services Administration (SAMHSA). The SOR Grant will be supporting several OASAS initiatives including bringing Opioid Use Disorder Treatment services into state and local correctional settings. Applicants must demonstrate that they have experience delivering recovery support services related to the services they are proposing to deliver in response to this RFA and must have the ability to sustain services independently beyond the grant funding period.

Funding Available: $2,187,000 million is available which is anticipated to serve five (5) or more programs with operating budgets not to exceed $350,000 per site. 

Expected Timetable for Key Events:
  • Application Deadline: 1/2/19
  • Anticipated Evaluation and Selection: 1/11/19
For more information, click here.
January Deadlines Approaching for SAMHSA Grant Applications

Grants to Expand Substance Abuse Treatment Capacity in Family Treatment Drug Courts
Due Date: Friday, January 4, 2019
Purpose: to expand substance use disorder (SUD) treatment services in existing family treatment drug courts, which use the family treatment drug court model in order to provide alcohol and drug treatment to parents with a SUD and/or co-occurring SUD and mental disorders who have had a dependency petition filed against them or are at risk of such filing. Services must address the needs of the family as a whole and include direct service provision to children (18 and under) of individuals served by this project.  SAMHSA plans to issue 25 grants of up to $425,000 per year for up to 5 years.

Due Date: Friday, January 4, 2019
Purpose:  To expand SUD treatment services in existing adult problem solving courts, and adult Tribal Healing to Wellness courts, which use the  treatment drug court model in order to provide SUD treatment (including recovery support services, screening, assessment, case management, and program coordination) to defendants/offenders.  SAMHSA plans to issue 25 grants of up to $400,000 per year for up to 5 years.
We Need More Data on Medicaid ACOs to Determine Drivers of Success

" Provider Payment Reform: Right Course, Wrong Students?," a recent blog post authored by Chris Koller, President of the Milbank Memorial Fund, argues that while delivering high-value care to vulnerable populations is the "right coursework" for the US health care system, the "courses" (value-based payment (VBP) programs) should be targeted toward primary care practices, as opposed to specialists and hospitals. The blog post draws on recent research on the Medicare Shared Savings Program (MSSP), which found that accountable care organizations (ACOs ) led by primary care providers (PCPs) or with  officially designated patient-centered medical homes (PCMHs),
tend to perform better on cost and quality than those without these characteristics. 

Koller's blog post presented a thoughtful discussion of Medicare ACO efforts and the evidence on the effect of primary care, yet was largely silent on  Medicaid ACOs. Read more here.

December 10, 3 - 4:30 pm, Safety and Justice Challenge

Using PSYCKES Quality Indicator Reports
December 11, 3 - 4 pm, OMH

December 11, 4 - 5 pm, Center for Health Care Strategies

Understanding Data and Business Intelligence Dashboards in Children's Behavioral Health
December 12, 12 - 1 pm, CCSI

Information Sharing During the Opioid Crisis: Challenges and Solutions
December 12, 1 - 2 pm, Manatt Health

Reducing Recidivism for People with Mental Illnesses in Jails
December 12, 2 - 3:15 pm, Stepping Up

December 12, 3 - 4:30 pm,  NAADAC, The Association for Addiction Professionals

Enable Access to Client-Level Data in PSYCKES
December 13, 11 am - 12 pm, OMH

December 13, 12 - 1 pm, HANYS

State Of The Union: A Critical Look At The Policy & Legislation Impacting U.S. Behavioral Health Care
December 13, 12 - 1 pm, PsychU

December 14, 12 - 1 pm, National Council for Behavioral Health

December 18, 3 - 4 pm, The National Center for Complex Health and Social Needs

Family Matters: Transitioning Towards a Family-centered Approach in Drug Courts
December 18, 3:30 - 5 pm, SAMHSA's GAINS Center

December 20, 3 - 4 pm, OMH



Mental Hygiene Planning Committee Meeting
December 14, 1 - 3 pm - IN PERSON
1450 Western Ave. 4th Floor, Albany (WebEx info available)

Children & Families Committee Meeting
December 18, 11:30 am - 1 pm, GTM

CLMHD Office Closed - Christmas
December 25

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
'I Want to Live Like a Human Being': Where NY Fails its Mentally Ill
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The stench from Abraham Clemente's apartment in Flatbush, Brooklyn, this summer was overwhelming. Maggot-infested scrambled eggs were strewn across the floor; a cantaloupe was so spoiled, it seemed to be melting. Feces were ground into the carpet.

Mr. Clemente, who is 69 and has schizophrenia, kept the shower and sink running for the "oxygen." He blamed a kitchen fire on a doll nailed to a cabinet. He believed he could crush and smoke his antipsychotic medication to achieve its intended effect.

Yet the state of New York determined Mr. Clemente was capable of living on his own.
He is one of hundreds of severely mentally ill New York City residents who have been moved out of institutions into private apartments over the past four years under a landmark 2014 settlement. The approach is meant to be a national model for the rights of the mentally ill to live independently. Read more here.
Now Mental Health Patients Can Specify Their Care Before Hallucinations and Voices Overwhelm Them

CHARLOTTE, N.C. - Steve Singer, who has bipolar and borderline personality disorders, knows when he's on the verge of a mental health crisis. The female voice he hears incessantly in his head suddenly shuts up, and the hula hoop he gyrates while walking to the grocery store stops easing his anxieties.

That's when he gets to a hospital. Usually, talking briefly with a nurse or social worker calms him enough to return home. But this year a hospital placed him on a locked ward, took his phone, and had an armed guard watch him for 20 hours before a social worker spoke with him and released him.

"I get the heebie-jeebies thinking about it," said Mr. Singer, 60. "They didn't help me, they hurt me."

Deeply upset, he turned to something he'd never known existed: He completed a psychiatric advance directive, a legal document declaring what treatment he does and doesn't want. Read more here.
Governor Cuomo Announces More Than $9 Million in Federal Funding Secured to Expand Opioid Addiction Treatment Services in New York State

Governor Andrew M. Cuomo this week announced more than $9 million in federal funding has been secured to expand opioid addiction treatment services across the state. This funding includes $5.7 million to expand access to medication assisted treatment, $2.1 million to develop new recovery centers in areas of high need, and over $1.3 million for specialized treatment and recovery programs. These initiatives are being funded through the State Opioid Response Grant, which is administered by the Substance Abuse and Mental Health Services Administration.

"As the opioid epidemic continues to impact communities across the state, we are as committed as ever to expanding and enhancing programs that provide critical options for treatment," Governor Cuomo said. "We will continue to take aggressive action to combat this crisis and work to ensure these lifesaving services are available to any New Yorker who needs them." Read more here.
As Raise the Age Starts, Juvenile Cases Have Dropped

New York's long-sought Raise the Age law is a reality. The first phase of the new law took effect in October, increasing from 16 to 17 the age at which someone can be tried on criminal charges as an adult. That age will be upped to 18 in 2019.

The law was several years in the making. And while advocates and lawmakers pushed for its passage, something else was going on as well -- a sharp drop in the number of youths being declared as juvenile delinquents.

Fewer and fewer youngsters over the past several years have been arrested and adjudicated as juvenile delinquents. Read more here.

Additional article of interest:  The Kids 'Left Behind' By New York's Raise the Age Law
Report: New York School Psychologists Spread Thin

Some schools in New York are struggling to find enough school psychologists, according to a report from the New York State School Boards Association. But even in districts that meet the minimum federal guidelines, administrators want more psychologists on staff.

The Penfield Central School District's ratio of 603 students per psychologists fits well within the recommendations from the National Association of School Psychologists.  Even so, Superintendent Thomas Putnam said he wants more.

Putnam is quoted in the report, released Tuesday, saying that the time psychologists need to spend on administrative tasks for students with special needs takes away from their ability to address the "social-emotional needs of all students." WXXI News reached out to Putnam and the district but didn't hear back.

Those sentiments are common across the state. Read more here.
Jail Ordered to Give Inmate Methadone for Opioid Addiction in Far-Reaching Ruling

BOSTON - In a ruling that could have tremendous consequences for the country's correctional system, a federal judge said this week that a Massachusetts man facing a jail sentence could not be denied access to treatment for his opioid addiction.

Judge Denise J. Casper of the United States District Court in Massachusetts issued a preliminary injunction on Monday, saying that Geoffrey Pesce was likely to prevail in his argument that such a refusal violated the Americans with Disabilities Act and was cruel and unusual punishment.

"One thing this ruling says is that, one way or another, either by legislation or by legal mandate, jails and prisons are going to have to do this," Michael Botticelli, the executive director of the Grayken Center for Addiction at Boston Medical Center, said of Judge Casper's order. Read more here.
Public Comment for 2019 VBP/ QARR Measure Specifications

The New York State Department of Health is pleased to announce the draft technical specifications for newly proposed quality measures for both the 2019 Value Based Payment (VBP) Quality Measure Set and the 2019 Quality Assurance Reporting Requirements (QARR). The public comment period will occur for the next 30 days. We welcome your feedback on the proposed new measures. We are seeking specific comments to targeted questions per measure, as well as comments on whether you support, support with modifications, or do not support the use of this quality measure. Comments related to the measure intent and measure feasibility are also encouraged.
The draft technical specifications, the New York State Value Sets, and the Public Comment Submission Form are posted here. Comments and questions specifically relating to the measures should be submitted in writing via the Public Comment Submission Form to by December 21, 2018.
Insurance Coverage for Adults With Behavioral Health Conditions Still a Work In Progress

Good health insurance coverage is a fundamental prerequisite of good healthcare, including behavioral health. Yet, prior to the passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and the Patient Protection and Affordable Care Act (ACA) of 2010, many adults with mental health or substance use conditions either had no health insurance or health insurance with very limited behavioral healthcare benefits. Even when behavioral healthcare benefits actually were available in insurance plans, people with these conditions often were "redlined" and denied insurance coverage.

Several types of health insurance were available for adults and families prior to the ACA. Private insurance included large and small group plans offered through employers, and individual plans purchased separately. Public plans included Medicaid for disabled persons in poverty and for children, and Medicare for workers who are disabled, their beneficiaries, and retirees. Among all of these plans, only large employer-based plans were required by MHPAEA to offer mental health and substance use benefits at parity with medical and surgical benefits, and only if such optional benefits were included in these plans. Read more here.
Child ER Utilization Rising. Why & What's To Be Done?

Two recent stories caught my eye - one national, and the other out of Connecticut - that document a rise in emergency room (ER) utilization attributed to behavioral health issues in children.

At the national level, recent findings presented at the American Academy of Pediatrics National Conference & Exhibition showed that pediatric emergency department (PED) visits for mental health problems increased by 55.8% between 2012 and 2016 (from 50.4 PED visits per 100,000 children in 2012 to 78.5 PED per 100,000 in 2016), and that PED visits for mental health problems were twice as high for minority children than non-minorities. The researchers concluded that the findings support the need for improving access to outpatient mental health resources, particularly for minority children and youth.

In Connecticut, behavioral health-related crisis visits to ERs by Medicaid-covered children has increased 20% from 2014 to 2016, from 12,100 to 14,448, with researchers concluding that the high number of second visits (10.4% of the youths made a second emergency room visit within seven days and 25.6% within 30 days) suggests that the youth and/or family needs were not met at the visit, or by services after discharge.

The studies did not delve into explanations for this rise, and reasons are unclear. Access to care could be one possibility. Read more here.
Standardized Outcomes Tracking On the Rise

The field of addiction treatment has traditionally relied on the experience of a clinician during treatment, but a new emphasis on outcomes measures by both insurers and accrediting bodies is placing an increased focused on measurable, quantitative outcomes for patients while they are in treatment and during follow-up.

As of Jan. 1 of this year, the Joint Commission also now requires behavioral healthcare centers seeking accreditation to conduct outcomes assessments through the "use of a standardized tool or instrument." 

Hayes says treatment centers that don't hire appropriate staff or devote the necessary resources today to incorporate effective measurement practices will be "left behind" as the field continues to push toward more effective and standardized methods of outcomes tracking. 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.