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April 5, 2018

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

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Francine Sinkoff, Editor
New Law Requires Districts to Offer Mental Health Education to Students

School-based health centers to recoup most of last year's budget cuts

St. Lawrence County calls on state to help fund addiction treatment program for jail inmates

Opioid Scourge Causing 'Heartbreak' Locally, Nationally - Fulton County

Steuben County plans to expand services for inmates with substance abuse problems

Cocaine returns to Central New York in shadows of opioid epidemic - Onondaga County

[Oneida County Executive] Picente: Mental health care a priority in 2018

University Police Department Commits to Help People Through Mental Health Crises - Cortland County

Governor Cuomo Announces Western New York Children's Psychiatric Center Will Remain in West Seneca

Care + Crisis hotline to re-open via Niagara County

City Hospitals Tackle Opioid Addiction In Hard Hit Nabes

Partnerships Between New York City Health Care Institutions and Community-Based Organizations

Northwell Health and Engel Burman Group to build 134,000 s/f, $90 million substance abuse facility - Suffolk County
January 2018 CMS Medicaid & CHIP Eligibility and Enrollment Report

According to CMS's monthly Medicaid/
CHIP eligibility and enrollment  report, 74 million individuals were enrolled in Medicaid and CHIP in January 2018. Nearly 16.4 million additional individuals were enrolled in Medicaid and CHIP in January 2018 as compared to the period prior to the start of the first Marketplace open enrollment period (July - Sept. 2013), in the 49 states that reported relevant data for both periods, representing over a 29 percent increase over the baseline period.  Click  here for the report.

SAMHSA is Accepting Applications for up to $23.7 Million in Grants to Treat Serious Mental Illness

The Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for its Assertive Community Treatment grants. The grants will be used to improve behavioral health outcomes by reducing the rates of hospitalization and death for people with a serious mental illness (SMI). SAMHSA expects that the program will also reduce the rates of substance use, homelessness and involvement with the criminal justice system among people with SMI.

The purpose of the Assertive Community Treatment grant is to establish, expand and maintain Assertive Community Treatment programs. The Assertive Community Treatment Model provides around-the-clock support in the form of teams who are available to respond to a home or other setting and avoid crises caused by the symptoms of SMI.
SAMHSA expects to award up to seven grants of up to $678,000 per year for up to five years. The actual amount may differ depending on the availability of funds. Read more here.
HARP/Adult BH HCBS Educational Materials Available

NYS has released the following Educational Materials for Behavioral Health Medicaid Managed Care:
These materials are available for anyone to use in outreach and education to individuals eligible for and/or enrolled in Medicaid Managed Care Health and Recovery Plans and BH HCBS. All print materials have been translated into nine additional languages that include: Arabic, Traditional Chinese, French, Haitian-Creole, Italian, Korean, Russian, Spanish, and Urdu.

Access these resources on the  OMH Managed Care Consumer Education Webpage!

Beyond Cost and Utilization: Rethinking Evaluation Strategies for Complex Care Programs
April 9, 2 - 3:30 pm, Center for Health Care Strategies

State Strategies for Supporting Sustainable Investments in Social Interventions
April 9, 2 - 3 pm, Manatt

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

Certified Community Behavioral Health Clinics: A New Approach To Providing Mental Health & Addiction Services
April 16, 12 - 1 pm, PsychU

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

Impact of ACEs and Adoption of Trauma-Informed Approaches in Integrated Settings
April 18, 1 - 2:30 pm, SAMHSA-HRSA Center for Integrated Health Solutions

Behavioral Health Disorders and Employment for Justice-Involved Adolescents
April 18, 1 - 2 pm, Transitions ACR

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

May 2, 1 - 2 pm, Behavioral Healthcare Executive

May 3, 12 - 1 pm

Supervising Peer Support Staff: What does it take?
May 9, 12 - 1 pm

Addressing Emergency Department Psychiatric Boarding: A Continuum of Solutions
May 15, 12 - 1 pm

June 6, 12 - 1 pm


APRIL 2018

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

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

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

MAY 2018

Children & Families Committee Meeting
May 15: 11:30 am - 1 pm, GTM

Mental Hygiene Planning Committee Meeting
May 15: 1 - 2:30 pm, GTM

Developmental Disabilities Committee Meeting 
May 17: 1 - 2:30 pm, GTM

Agency Meeting: NYS OASAS
May 23: 10 am - 12 pm
1450 Western Ave., Albany

Agency Meeting: NYS OMH
May 23: 1 - 3 pm
44 Holland Ave., Albany

Office Closed: Memorial Day
May 28

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Funding for Jail-Based Addiction Treatment and Transition Services Included in Final NYS Budget 

The NYS Conference of Local Mental Hygiene Directors is proud to announce that our proposal seeking State funding to County Mental Health Departments to develop jail-based substance use disorder treatment and transition services was included in the final 2018-19 enacted State Budget. An appropriation of $3.75 million has been approved to move forward with this program.

A collective effort by the Conference, the NYS Sheriffs' Association and the NYS Association of Counties, strengthened by support of the Executive and Legislature, resulted in this major achievement. This funding is a significant first step in to expanding necessary access and resources to treating individuals in our local correctional facilities who are suffering from addiction.

Kelly Hansen, Executive Director of the Conference, stated, "The time of incarceration actually provides a unique and time-limited opportunity to offer treatment when a person is clean and sober and maybe more receptive to starting treatment. The handful of counties that do have jail-based SUD treatment have seen significant reductions in recidivism in those who received treatment. This funding will reduce recidivism and improve public safety, and most importantly, help individuals struggling with addiction to find lasting recovery. We look forward to working with counties and sheriffs to help implement jail-based addiction treatment and transition programs throughout the state."

To learn more about the Conference's proposal for funding jail-based addiction treatment and transition services, click here.
The Pew Charitable Trusts: New Momentum for Addiction Treatment Behind Bars

From the moment they are arrested, people with an addiction to heroin and prescription painkillers and those who are taking medications to beat their addictions face the prospect of painful opioid withdrawal.
At least a quarter of the people in U.S. prisons and jails are addicted to opioids.
Those who are released rejoin their communities with  dangerously reduced tolerance and nothing to blunt their drug cravings, making them highly susceptible to a deadly overdose.

But new scientific evidence and a recently announced federal investigation may soften prison officials' long-held opposition to medication-assisted treatment.

Rhode Island is the only state that provides all three FDA-approved addiction medications, methadone, buprenorphine and a long-acting, injectable form of naltrexone known as Vivitrol, to all inmates. A recent study in the medical journal JAMA Psychiatry found that opioid  overdose deaths dropped by nearly two-thirdsamong recently incarcerated people in the first year of a new program that screens and provides addiction medicines to all state inmates.  Read more here .
Long-Awaited Detox Center Proposal Announced by Alcohol and Drug Council of Tompkins County
Schumer at the Alcohol and Drug council
The Alcohol and Drug Council of Tompkins County may soon be able to address one of the area's most glaring needs in fighting the opioid epidemic, after announcing their proposal of a detox center at a joint press conference with U.S. Senator Chuck Schumer (D-NY).

The announcement comes on the heels of the passage of the federal spending bill in Congress, which assigned $3 billion more than last year to the fight against the opioid crisis, something President Donald Trump has deemed a public health emergency but has yet to make any declaration that would release actual funding to fight the crisis. Read more here.
Payers Form Coalition to Address Social Determinants of Health

A group of commercial payers and other healthcare organizations have formed a coalition to explore how addressing the social determinants of health can lower care costs and improve outcomes. A number of large payer companies have joined the Aligning for Health (AFH) coalition, including the BlueCross BlueShield Association, CareSource, Humana, UPMC Health Plan, and WellCare.

AFH stakeholders cited research that suggests social factors including access to healthy food, safe housing, and financial security account for nearly 70% of all health outcomes. Addressing these social factors can have positive effects on healthcare outcomes, costs, and utilization, the coalition said.

Rhonda Mims, Senior Vice President and Chief Public Affairs Officer at WellCare, said,
"In 2017, we referred 33,000 people to 106,000 community based-programs and services," Mims said. "A 2016 study by the Robert Wood Johnson Foundation's National Coordinating Center for Public Health Systems and Services Research showed our model led to a 17% decrease in emergency department use, 26% reduction in emergency spending, a 53% decrease in inpatient spending, 23% decrease in outpatient spending." Read more here .
Reflections From A Departing Medicaid Director
Jason Helgerson Pens Health Affairs Blog

Nothing lasts forever. That statement applies to the tenure of Medicaid directors just like it applies to every other aspect of our lives. This week, it applies directly to me because this coming Friday will be my last as New York State's Medicaid director.

As I prepare to depart my position, I can't help but look back and contemplate all that I have learned and experienced. I have had the honor of having this position in New York for more than seven years. Before arriving in New York, I also had the pleasure to serve as Wisconsin's Medicaid director. I am not sure what it says about me-between these two consecutive appointments, I am leaving office as the nation's longest-serving Medicaid director.

During my 11 years as a Medicaid director, I have seen the program grow and transform. I have seen Medicaid face its most serious political challenge with the threat of Affordable Care Act (ACA) repeal, where it not only survived but the fight increased its public appreciation and support to very high levels. Read more here.
Opioid Manufacturers to Pay New York $100M a Year

Opioid manufacturers will be forced to pay a combined $100 million annually to help cover New York's costs for state-funded drug and alcohol treatment programs.

The surcharge on pharmaceutical companies was included in  a portion of the $168 billion state budget approved Friday afternoon by the state Legislature.

The measure requires all companies who manufacture or distribute opioids in New York state to split the $100 million annual surcharge based on their share of the market in New York.

The money will be deposited into a "stewardship fund," which will be used to defray the cost of the state's alcoholism and substance-abuse programs, as well as a prescription-monitoring initiative meant to flag those who obtain opioid prescriptions from multiple doctors. Read more here.
The Formerly Incarcerated Are Becoming Opioid-Overdose First Responders 

By putting naloxone into the hands of people just released from state prisons, New York hopes to curb this terrible crisis.

Prison can be the worst place to be for a person struggling with addiction, but the devastation of mass imprisonment and the burden of drugs are inseparable today, as the two scourges pervade the same communities. In New York, where a massive prison population intersects with an exploding opioid crisis, authorities hope to turn a place of crisis into a seedbed for rescue. A new pilot project aims to equip incarcerated people with tools and skills to act as emergency responders for overdose victims.
The hope is that they will return to their neighborhoods to help people in their communities stay safe, while they stay free.

Though the opioid epidemic swelling across the country is typically associated with white rural regions, it has permeated both cities and suburbs in New York. Opioid-related overdoses hit thousands of people each year (statewide, deaths linked to opioids rose from about 1,600 to 2,100 annually from 2013 to 2015), including those related to prescription medication and others from heroin or its even more deadly cousin fentanyl. Additionally, thousands of overdoses lead to hospitalizations annually. 

In an effort to combat the crisis, state correctional and public-health authorities have begun collaborating on a unique harm-reduction initiative to equip people released from state prisons with naloxone kits.  Read more here.
Address the Emerging SMI and Opioid Crisis

Evidence from the field suggests that a new, more complex health problem is emerging for persons who have serious mental illness (SMI). Today, a large and growing proportion of these individuals also use or are dependent upon opioids. Anecdotal reports from the field suggest that up to half of adults with SMI in our urban areas, particularly those with schizophrenia or bipolar disorder, have this comorbidity.

The devastating effects of opioids are well known. With today's much stronger formulation of prescription opioids that include fentanyl or k-fentanyl (a particularly strong version of fentanyl produced in China), one can become addicted with the use of as few as three or four pills. Street opioids, such as heroin laced with impure k-fentanyl, can lead to death with a single use. Overdose and death are very common; naloxone can save lives, but is not yet broadly available to persons with SMI, especially those who are homeless and live on the streets.

And other equally tragic effects can occur as well. Within as short as 30 days of starting to use opioids, the likelihood doubles that one also will develop depression. And the reverse also is true: a person with depression has twice the likelihood of using or becoming dependent upon opioids. Read more here.
How to Break New Ground in the Search for Autism Biomarkers

Finding biological markers for psychiatric conditions is the holy grail of mental health research. Clinicians currently rely on subjective measures to diagnose these conditions and track an individual's response to treatment. Replacing these subjective measures with objective ones called 'biomarkers' would be nothing short of transformative1.

Decades of research into genes, proteins and the brain have generated promising leads for biomarkers. For instance, we now have a long list of genes implicated in autism risk. But these findings have yet to improve the way clinicians diagnose autism and monitor the condition over time.

Our current diagnostic categories do not reliably map to an individual's underlying biology. For instance, two people with a diagnosis of autism may have different genetic risk factors. They may also differ in their features. The field has responded by looking for biologically defined subtypes of autism. For example, we know that autism in a person with mutations in the gene CDH8 tends to look different from the condition in someone with a mutation in SCN2A.

Researchers have also begun to examine features that span diagnostic boundaries. For instance, certain features of autism are also seen in people with attention deficit hyperactivity disorder and anxiety disorders. 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.