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November 16, 2018

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

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Francine Sinkoff, Editor
Children's Home of Jefferson County expanding staff, beds for Raise the Age

BHSN adds primary care to Center for Wellbeing - Clinton County

Clinton County detox center now open for business

Albany recovery center opens for people battling range of addictions

Student veterans: SUNY looks to boost campus mental health care - Ulster County

A Mural On Mental Health Comes to Crown Heights - NYC

Crisis Crossroads: MAT expansion a crucial part of 'road to stability' - Oswego County

In Buffalo emergency departments, a better way to treat opioid use disorder - Erie County

Early Intervention services continue to disappear in Rochester, statewide

Buffalo researchers find "highly effective" treatment for children with autism - Erie County
SAMHSA Funding Opportunities

The Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment is accepting applications for two FY 2019 Grants to Expand Substance Abuse Treatment Capacity.

Expand Substance Abuse Treatment Capacity in Adult Treatment Drug Courts and Adult Tribal Healing to Wellness Courts
The purpose  of this program is to expand substance use disorder treatment services - which include recovery support services, screening, assessment, case management, and program coordination -in existing courts. The  solicitation 
provides  further details about the program. Applications are due January 4, 2019. 


Expand Substance Abuse Treatment Capacity in Family Treatment Drug Courts
The purpose of the program is to expand substance use disorder (SUD) treatment services in existing family treatment drug courts, which use the family treatment drug court model to provide alcohol and drug treatment  to parents with a SUD and/or co-occurring SUD and mental illnesses who have had a dependency petition filed against them, or are at risk of such filing. The  solicitation   provides further details about the program. Applications are due by January 4, 2019.
CMS to ask if HIPAA is a barrier to care coordination

Hospitals are ill-equipped to treat behavioral health, ECRI finds

Facebook, Google and Twitter Formed Tech Together to Fight the Opioid Crisis

US has highest rate of drug overdoses, study says

Opioid crisis poses challenge for vets

Childbirth In The Age Of Addiction: New Mom Worries About Maintaining Her Sobriety

Study: Suicidal Patients on Prescribed Drugs Should Be Closely Monitored

Glutamate Levels May Predict Outcomes of Patients at Risk of Psychosis

Saliva-based RNA panel distinguishes children on autism spectrum from non-autistic peers
Counties Ask for State Help With Coroner Costs

The cost to counties for coroner and medical examiner services is expected to rise 7.7 percent this year in New York, according to new analysis.

The New York State Association of Counties is requesting the state reimburse counties for 50 percent of their autopsy costs, as these services are expected to exceed $121 million by the end of the year. Prior to a change in state law adopted in 2011, counties were able to get up to 36 percent of their coroner and medical examiner costs reimbursed by the state.

"This is a quintessential state mandate. Counties across the state are responsible for administering a coroner or medical examiner program. These costs used to be eligible for partial state reimbursement, but that funding has since gone away, leaving counties to make up the difference," said NYSAC Executive Director Stephen Acquario in a statement. Read more here.
New Resources on Building Workforce Development for Opioid Crisis

The ATTC Network Coordinating Office has created three competency-based guides for building workforce capacity to address the opioid crisis.

These digital guides offer links to the latest tools and information for:

November 19, 12 - 1 pm, CTAC/MCTAC

PSYCKES Train the Trainer
November 21, 12 - 1 pm, OMH

Leveraging Medicaid Managed Care to Advance Value-Based Purchasing
November 27, 1 - 2 pm, Manatt Health

Risk-Need-Responsivity: Applications across Behavioral Health and Criminal Justice
November 27, 1 - 2:30 pm, SAMHSA's GAINS Center

Integrating Behavioral Health and Primary Care: Solutions That Work
November 29, 12 - 1 pm, CTAC/MCTAC

December 5, 11 am - 12 pm, MCTAC/CTAC

December 6, 2 - 3:15 pm, National Association of Counties

December 6, 3 - 4:30 pm, OMH

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

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

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 20, 3 - 4 pm, OMH



Children & Families Committee Meeting
November 20, 11:30 am - 1 pm, GTM

CLMHD Office Closed - Thanksgiving
November 22 - 23

CLMHD Directors Meeting
November 28, 9:30 - 11 am, GTM


Executive Committee Call
December 5:  8 am

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 
CMS May Allow Hospitals to Pay for Housing Through Medicaid

HHS Secretary Alex Azar on Wednesday said Medicaid may soon allow hospitals and health systems to directly pay for housing, healthy food or other solutions for the "whole person." 

In a speech supported by the Hatch Foundation for Civility and Solutions and Intermountain Healthcare in Washington, Azar said Center for Medicare and Medicaid Innovation officials are looking to move beyond existing efforts to partner with social services groups and try to manage social determinants of health as they see appropriate. 

HHS spends over $1 trillion a year on healthcare for seniors and low-income people through Medicare and Medicaid, which far outstrips spending on other federal programs, Azar said. 

Kaiser Permanente CEO Bernard Tyson said Azar's comments were an example of how the conversation was going in the right direction in terms of how healthcare providers should think about social determinants as part of the whole healthcare ecosystem. But without knowing more of the plan's details, Tyson said the move will likely come through a public-private partnership. Read more here.
CMS Announces New Medicaid Demonstration Opportunity to Expand Mental Health Treatment Services

This week, the Centers for Medicare & Medicaid Services (CMS) sent a letter to State Medicaid Directors that outlines both existing and new opportunities for states to design innovative service delivery systems for adults with serious mental illness (SMI) and children with serious emotional disturbance (SED). The letter includes a new opportunity for states to receive authority to pay for short-term residential treatment services in an institution for mental disease (IMD) for these patients. CMS believes these opportunities offer states the flexibility to make significant improvements on access to quality behavioral health care.

CMS currently offers states the flexibility to pursue similar demonstration projects under Section 1115 (a) of the Social Security Act, regarding substance use disorders (SUDs), including opioid use disorder. To date, CMS has approved this authority in 17 states, where it is already improving outcomes for beneficiaries. For example, early results in Virginia show a 39 percent decrease in opioid-related emergency room visits, and a 31 percent decrease in substance-use related ER visits overall after implementation of the demonstration. With this new opportunity, CMS will be able to offer a pathway forward to the 12 states who have already expressed interest in expanding access to community and residential treatment services for the full continuum of mental health and substance use disorders. Read more here.
NYS Announces Public Listening Sessions on Accessible Ride Sharing Services for Customers with Disabilities

The New York State Transportation Network Company Accessibility Task Force today announced that five public listening sessions will be held across the state to examine the availability of accessible ride sharing services for people with disabilities. Through these listening sessions, the task force will analyze current service options, the need and demand for accessible services, and identify opportunities and barriers to increasing these options for customers with disabilities.

The task force was established through 
legislation passed last year to bring ride sharing services to Upstate New York and Long Island. Members of the task force include representatives from organizations that serve people with disabilities and representatives from transportation network companies such as Uber or Lyft. Read more here.
OMH BH Managed Care Update: November 2018

Click here to read the November 2018 issue of OMH's Behavioral Health Managed Care Update.
With Hospitalization Losing Favor, States Allow Outpatient Mental Health Treatment
Margaret Rodgers lives with depression and bipolar disorder. After suicidal thoughts and a near attempt, Rodgers went before a judge and entered assisted outpatient treatment, also known as involuntary outpatient commitment. She now sees a therapist once a week, and a nurse at AltaPointe Health Systems Inc., a community health center, gives her a shot of an antipsychotic drug once a month.
When mental illness hijacks Margaret Rodgers' mind, she acts out.

Rodgers, 35, lives with depression and bipolar disorder. When left unchecked, the conditions drive the Alabama woman to excessive spending, crying and mania.

Last autumn, Rodgers felt her mind unraveling. Living in Birmingham, she was uninsured, unable to afford treatment and in the throes of a divorce. Although Rodgers traveled south to her brother's house in Foley, Ala., for respite, she couldn't escape thoughts of suicide, which one day led her to his gun.

"I hit bottom," she recalled. But she didn't pull the trigger.

Rodgers told her brother about the close call. News of the incident reached her mother, who then alerted authorities to Rodgers' near attempt.

Within days, Rodgers was handcuffed and hauled in front of a judge who ordered her to undergo mental health treatment - but not a hospital commitment. Instead, the judge mandated six months of care that included weekly therapy sessions and medication, all while Rodgers continued living with her family.

Rodgers entered assisted outpatient treatment, also known as involuntary outpatient commitment. Read more here.
SAMHSA Releases New Treatment Locator for Early Serious Mental Illness
Early Serious Mental Illness Treatment Locator
SAMHSA this week unveiled a new confidential and anonymous way to connect people with recent onset of serious mental illness, including first episode psychosis, to treatment.

The ESMI Treatment Locator is a resource for persons and their family members who are seeking treatment facilities to get effective care for illnesses such as psychosis, schizophrenia, bipolar or delusional disorder, and other conditions. This information can be a lifeline to people who urgently need help.

These facilities offer evidence-based programs, medication, therapy, family and peer support, assistance with education and employment, and other services. Program listings include eligibility criteria, age range and diagnoses treated, services provided, location and contact information. Searches can be sorted by state.
Should Childhood Trauma Be Treated As A Public Health Crisis?

When public health officials get wind of an outbreak of Hepatitis A or influenza, they spring into action with public awareness campaigns, monitoring and outreach. But should they be acting with equal urgency when it comes to childhood trauma?

A new  study published in the Journal of the American Medical Association suggests the answer should be yes. It shows how the effects of childhood trauma persist and are linked to mental illness and addiction in adulthood. And, researchers say, it suggests that it might be more effective to approach trauma as a public health crisis than to limit treatment to individuals.

The study drew on the experiences of participants from the Great Smoky Mountains Study, which followed 1,420 children from mostly rural parts of western North Carolina, over a period of 22 years. They were interviewed annually during their childhood, then four additional times during adulthood. Read more here.
Federal Mental Health Parity After 10 Years: Toward A Data-Driven Approach To Compliance

On October 3, 2008, President George W. Bush signed the $700 billion Emergency Economic Stabilization Act. The bill included the landmark Mental Health Parity and Addiction Equity Act (MHPAEA), which prohibits health insurance coverage of mental health and substance use disorder treatment that is more restrictive than coverage of medical and surgical treatment. How are we doing 10 years down the road?

Assessing MHPAEA compliance can be challenging due to the complexities of the US health insurance system, the shared federal and state MHPAEA enforcement framework, and the nuances of comparatively evaluating nonquantitative treatment limitations (NQTLs). NQTLs include medical management processes, benefit exclusions, and provider network admission standards, such as reimbursement rates and licensure requirements. That said, the data-driven approach to MHPAEA compliance described below might help ensure fidelity to the law while promoting a more efficient and effective mental health and substance use disorder treatment system. The dozens of peer-reviewed studies that have used readily available data sets to analyze the impact of and compliance with MHPAEA offer a useful roadmap. 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.