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June 7, 2018

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

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Francine Sinkoff, Editor
Fed up with opioid deaths, stores donate penny a gallon to help - Albany County

Wars only part of many traumas - finding sufficient mental health care for refugees ongoing struggle - Capital Region

Rensselaer County drug court program showing signs of success
County teams up on opioid, heroin plan - Allegany County

Ad campaign aimed at discouraging opioid use - Franklin County

Here's why Broome County saw no fatal overdoses for second month

Governor Cuomo Announces Projects to be Funded Through the Alliance for Economic Inclusion Anti-Poverty Initiative - Onondaga County

Opioid overdose deaths in Erie County drop almost 15 percent for 2017

Lee Foundation grants aim to train, retain UB psychology and psychiatry students in Western New York

State funding grant advances low-income senior housing on East Side - Erie County

Recalling treatment at Buffalo's former mental institution - Erie County

Veteran support in Orleans County

Combating the opioid epidemic with science - Monroe County

Why families of kids with autism are moving to Rochester - Monroe County

Monroe County has the third highest number of D.W.I. arrests in the state

Rockland Will Get $314K Grant For Substance Abuse, Mental Health

How Rockland County plans to sever links between opioid prescriptions and the morgue

Some things I learned from attending a class on Narcan - Suffolk County

NYS OASAS Announces Expansion of Residential Treatment Program for Veterans in New York City
NYS Developmental Disabilities Planning Council Announces Funding Opportunities

Community of Practice: Reentry for Youth with Developmental Disabilities
The DDPC announces funding to select one grantee in the amount of up to $1,500,000 ($300,000 per year for 5 years) to establish a statewide Community of Practice on Reentry for Youth with Developmental Disabilities and up to 4 county-level grant projects focused on the establishment of reentry supports for youth (ages 14-24) with intellectual, developmental, and other disabilities (ID/DD). 

DDPC announces the availability of one (1) grant up to $300,000 ($100,000 per year, for 3 years) to develop and implement a Process and Impact Evaluation. The DDPC is seeking proposals from qualified applicants to evaluate the process, program implementation, and long- term impact of a DDPC sponsored 5-Year Supported Decision-making (SDM) pilot program that has been developed and is being currently implemented by Hunter College, in partnership with the New York Alliance for Inclusion and Innovation and The Arc Westchester. 

Deadlines for Letter-of-Intent Submission & Proposal Submission for Both Grants
* RFP Posting Date:  June 6, 2018
* Letter of Intent Due Date: June 22, 2018
* Proposal Due Date: July 20, 2018
How social determinants of health and analytics can aid suicide prevention

'This place is crazy' - a look inside mental illness treatment in New York's Attica prison

More than half of mental health visits are with psychiatrists

CMS Releases Report: 2016 Medicaid Expenditures for Long-Term Services and Supports 

This week the Centers for Medicare & Medicaid Services (CMS) announced that the report on Medicaid Expenditures for Long-Term Services and Supports (LTSS) in federal fiscal year (FY) 2016 is now available. Federal and state spending on Medicaid LTSS totaled approximately $167 billion in FY 2016, a 4.5 percent increase from $159 billion in FY 2015.

Home and community-based services (HCBS) have accounted for almost all Medicaid LTSS growth in recent years, while institutional expenditures have remained close to the FY 2010 amount. HCBS spending increased 10 percent in FY 2016, greater than the five percent average annual growth from FY 2011 through 2015. Institutional service spending decreased two percent in FY 2016 following an average annual increase of 0.3 percent over the previous five years. LTSS provided through managed care continued to grow as states have expanded the use of managed LTSS delivery systems. Managed LTSS expenditures were $39 billion in FY 2016, a 24 percent increase from $32 billion in FY 2015.  For the full report, click here.
'The Police Aren't Just Getting You In Trouble. They Actually Care.'

In 2015, police in towns across eastern Massachusetts began to embrace a new way to respond to a public health crisis with a rapidly escalating death toll. That spring, the exasperated police chief in the fishing town of Gloucester, Mass., announced that anyone who showed up at the police station and asked for help overcoming an opiate addiction would get it, without fear of arrest, no matter where they lived or whether they had insurance. Police, he said, would get them into treatment.

In the Gloucester program's first year, 376 people took the chief up on his offer.
The New England Journal of Medicine
took notice: Almost 95% of addicts got a direct referral to treatment-compared to a 63% referral rate for a treatment-placement program at Boston Medical Center.  Read more here .
Academy of Peer Services (APS)
Virtual Learning Community Live Event

A Tale of Two Consortia
Wednesday, June 20, 2018
2:00 - 3:00 PM

In this session, you will learn about the Regional Planning Consortium (RPC), a network of 11 regional boards comprised of stakeholders who work closely with State agencies to guide behavioral health policy in the region, problem solve regional service delivery challenges, and recommend priorities for reinvestment of Medicaid savings. You will also learn about the New York City Peer and Community Health Workforce Consortium (NYC.PCHWC), an initiative of ThriveNYC to improve mental health services in New York City by expanding the use of peers and community health workers to connect New Yorkers to services and promote recovery.

Register through Eventbrite Connection information to the meeting will be provided when you register. 

June 12, 12 - 1 pm, SAMHSA

June 12, 3 - 4 pm, Manatt Health

Interpersonal Approaches to Treating Depression in Adolescents and Adults
June 13, 12 - 1 pm, CTAC

How Community Supervision Agencies Can Develop and Implement Collaborative Comprehensive Case Plans
June 13, 2 - 3 pm, National Reentry Resource Center

Effectively Employing and Supervising Youth Peer Advocates
June 14, 1 - 2 pm, CTAC

June 18, 12 - 1 pm, PsychU

Motivational Interviewing: Clinical Updates within Substance Abuse Treatment
June 19, 12 - 1 pm, CTAC

June 19, 3 - 4 pm, National Council for Behavioral Health

Using PSYCKES for Clinicians
June 21, 3 - 4:30 pm, OMH

June 26, 11 am - 12 pm, OMH

Addressing the Mental Health Needs of Children with Incarcerated Parents
June 27, 12 - 1 pm, CTAC

June 27, 1 - 2 pm, Manatt Health 


JUNE 2018

Mental Hygiene Planning Committee Meeting
(Rescheduled from June 26)
June 18: 1 - 3 pm, GTM

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

Directors/Executive Committee Meeting
June 20: 9:30 am - 12:30 pm, GTM

JULY 2018

Office Closed: Independence Day
July 4

Officers, Chairs & Regional Reps Call
July 11: 8 am

Developmental Disabilities Committee Meeting
July 12: 1 - 2:30 pm, GTM

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

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
How to Calculate What Opioid Overdoses Cost Government

As governments grapple with the rising cost of the opioid crisis, one group may have found a way to predict how high those costs will go.

For every three fatal overdoses, a local government's public safety costs can increase by an average of 1 percent, or $150,000, according to research from the data platform OpenGov. What's more, once deaths start spiking, government costs tend to steadily increase at that rate for about three years until they begin to plateau.

The findings give local governments an idea of what to expect financially as they respond to rising overdose deaths. The data were gathered from 20 cities and counties across five states considered to be on the front lines of the crisis -- Kentucky, Maryland, Massachusetts, Ohio and Pennsylvania -- and released exclusively to Governing.
According to the research, the reason for the three-year gap between the spike in overdose deaths and the spending peak is because that's about how long it has taken governments to recognize what's happening and develop a response. Read more here.
A.G. Underwood Releases Report Highlighting Office's Work Enforcing Mental Health Parity Laws, Protecting New Yorkers

To mark the end of Mental Health Month, Attorney General Barbara D. Underwood last week released a report detailing the work of the office's Health Care Bureau in enforcing state and federal mental health parity laws over the past five years - which have helped transform the industry and resulted in over $2 million in restitution to consumers. The report, " Mental Health Parity: Enforcement by the New York State Office of the Attorney General," summarizes the results to date of the Attorney General's Office's industry-wide initiative to ensure that all New Yorkers have access to behavioral health services, such as substance abuse treatment - including the enforcement of eight national settlement agreements with seven health plans.

In 2013, after receiving consumer complaints regarding health plans' coverage of behavioral health treatment, the New York Attorney General's Office launched a mental health parity initiative and began investigations into various health plans. Since then, the office has entered into eight national settlement agreements with seven health plans, and has overseen the enforcement of these agreements. Read more here.
State Surpasses DSRIP Targets for Year Three

The state has met all the milestones required in year three of the Delivery System Reform Incentive Payment program, avoiding the loss of any funds, according to the  latest quarterly report from the state Health Department on the $8 billion initiative.

Perhaps most notably, Medicaid spent only $181.65 per member per month on in-patient and emergency room visits statewide-about $25 less than the target spending level. The state also met 12 of the 16 targets for delivery system improvement, or about 75%. The state had to meet only half of those goals in order to achieve the DSRIP requirements. Read more here.
Crawl, Walk, Run To VBR

Payers and health plans are pushing for reimbursement models that move away from fee-for-service and move to paying for "value." Recently, o ur health plan faculty members reiterated that while primary care is further along than specialty care in this evolution, specialty care wouldn't be left behind for long-most of the faculty saw specialty care reimbursement moving to value-based models within a three to four year window .

Our recent health plan survey,  Trends In Behavioral Health: A Reference Guide On The U.S. Behavioral Health Financing & Delivery System, supports this sense of market timing-42% of health plans are using episodic or bundled payments for specific acute care episodes, including 95% of commercial health plans use episodic payments, 2% of Medicare health plans, and 47% of Medicaid health plans. And 93% of health plans have behavioral health provider partner models that utilize a FFS reimbursement structure that also includes a pay-for-performance (P4P) component.
The reasons for the shifting reimbursement preferences of health plans are straightforward. The focus on value can improve consumer outcomes, reduce administrative complexity, and reduce health care spending. Read more here.
OTDA Funding Opportunity: Emergency Needs for the Homeless (ENHP) 

The New York State Office of Temporary and Disability Assistance (OTDA) is requesting proposals from nonprofit entities to be considered for funding through the Emergency Needs for the Homeless Program (ENHP). ENHP funding is used to enhance the quality and quantity of emergency services currently available to people who are homeless or at risk of becoming homeless. Funds will be made available to support programs that meet the emergency needs of homeless individuals and families, and those at risk of becoming homeless in social services districts with a population in excess of 5,000,000.

Click HERE to view the RFP.
CMS Unveils Scorecard to Deliver New Level of Transparency within Medicaid and CHIP Program

This week, the Centers for Medicare & Medicaid Services (CMS) released the first ever Medicaid and Children's Health Insurance Program (CHIP) Scorecard, a central component of the Administration's commitment to modernize the Medicaid and CHIP program through greater transparency and accountability for the program's outcomes.  For the first time, CMS published state Medicaid and CHIP quality metrics along with federally reported measures in a Scorecard format.

The first version of the Scorecard includes measures voluntarily reported by states, as well as federally reported measures in three areas: state health system performance; state administrative accountability; and federal administrative accountability. The metrics included in the first Scorecard reflect important health issues such as well child visits, mental health conditions, children's preventive dental services, and other chronic health conditions. Read more here.
Why The Recovery Industry Is Paying More Attention To Dual Diagnoses

For decades, addiction recovery was focused on helping people get clean and stay sober. There was lots of talk of willpower and surrendering, but not much discussion of mental health, past trauma and adverse childhood experiences.

Today, that has changed dramatically, says Hanna LeBaron, the clinical director at Maple Mountain Recovery, a  trauma-informed addiction treatment center outside Salt Lake City.

"We all agree there are underlying issues to substance abuse and addiction," LeBaron says. "We're actually looking into them now and starting to treat underlying issue.

LeBaron says that in her 18 years of working in the treatment industry, providers have begun paying more attention to the root cause of addiction. For many people with substance use disorder, that is mental illness. In fact, the National Institute on Drug Abuse  estimates that 60 percent of people with substance use disorder also have a diagnosable mental health disorder. 

Understanding this can help practitioners treat substance use disorder more effectively, equip people with tools to stay in recovery long term, and help people without addiction empathize with those who are struggling.  Read more here.
Issue Brief: Emerging Drug Trends & Prevention

United States national drug control policy is historically reactive, addressing the latest crisis long after it is established. Prevention is the best policy tool available for addressing emerging drug problems, but it is most effective before problems become well-entrenched. Three emerging trends could prove damaging if ignored: (1) cocaine use by young adults is increasing and cocaine-involved overdoses have exploded, (2) heroin and synthetic opioids are driving opioid overdose deaths, and (3) the country is increasingly accepting of marijuana. In light of these trends, Carnevale Associates, LLC offers five recommendations to develop prevention infrastructure and facilitate proactive solutions. 

Read the brief here .
Suicide Rates Rise Sharply Across the United States, New Report Shows

Suicide rates rose in all but one state between 1999 and 2016, with increases seen regardless of age, gender, race and ethnicity, according to a  report released Thursday by the Centers for Disease Control and Prevention. In more than half of all deaths in 27 states, the people had no known mental health condition when they ended their lives.

In North Dakota, the rate jumped more than 57 percent. In the most recent period studied (2014 to 2016), the rate was highest in Montana, at 29.2 per 100,000 residents, compared with the national average of 13.4 per 100,000.

Only Nevada recorded a decline - of 1 percent - for the overall period, although its rate remained higher than the national average.

Increasingly, suicide is being viewed as not just a mental health problem but a public health one. Read more  here.
They're Out of Prison. Can They Stay Out of the Hospital?

San Francisco - The night Ronald Sanders turned his life around, he had been smoking crack for two days in a tiny, airless room. His infant son, Isaiah, was breathing in the fumes. "His chest was beating really hard," Mr. Sanders recalled. "So I pray: 'If my son makes it through the night, that's it.'"

Mr. Sanders quit using drugs and stopped cycling in and out of prison more than two decades ago. He is now a community health worker who helps people getting out of prison deal with a host of medical, psychiatric and substance abuse disorders.

As the country tries to shrink its aging prison population, the inmates being released after years locked away often have mental illnesses and addictions that can land them back in prison if untreated. Mr. Sanders and other former prisoners are central players in an approach to helping these men and women that is expanding in California and North Carolina, among other states. By year's end, Los Angeles County plans to have hired 220 such workers to help released inmates navigate life outside. Read more here.

As the health care system moves toward more sophisticated value-based payment (VBP) models, those seeking to improve efficiency continue to look to primary care as the key to prevention and better health management. And for good reason: greater use of primary care is associated with lower costs, higher patient satisfaction, fewer hospitalizations and emergency department visits, and lower mortality.

The logic behind successful VBP initiatives, however, often presumes a strong primary care system-where people can easily access primary care and get the care they need. However, low-income and vulnerable individuals have consistently lower utilization of, and access to, high-quality primary care services, as well as worse health outcomes than the general population. Moreover, primary care providers often feel under-prepared, under-resourced, and under-staffed to meet the diverse needs of low-income patients.

State Medicaid agencies have made progress with models such as the patient-centered medical home (PCMH) and 
Comprehensive Primary Care Plus (CPC+), but the typical primary care practice still falls short of meeting the unique health and social service needs of low-income populations. 
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.