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November 9, 2018

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

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Francine Sinkoff, Editor
After Raise the Age, Albany County facility is upgraded for new 'adolescent offenders'

Mobile Crisis Assessment Team of Columbia and Greene Counties wins statewide award

'Life-saving work:' Unshattered gives jobs to women recovering from drug addiction - Dutchess County

500 Students Trained on Substance Abuse Prevention - Broome County

Cayuga County budget workshop looks at criminal justice spending

Governor Cuomo Announces $2.3 Million to Support Youth Opportunities and Combat Violence in the City of Syracuse - Onondaga County

Community Schools program to expand - Oneida County

Grant will help UB scientists identify patients most at-risk for future opioid misuse - Erie County

BlueCross BlueShield of WNY issues $2.7 million in grant awards

NYS OASAS Announces Opening of New Addiction Treatment Program for Women in Niagara County
Behavioral Health Telehealth Options Expanded

Under the new 2019 Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services has removed restrictions in Medicare around originating sites for telehealth services used to treat substance use disorder (SUD) and co-occurring mental health disorders. Previously, patients were limited to telehealth appointments only when calling from specific locations, such as their primary care provider's office. The new rule removes these originating site geographic requirements and adds individuals' homes as permissible originating sites for telehealth services, greatly increasing access to SUD treatment, especially for individuals in rural and frontier communities.
Most Important Aspect of Congress' Opioid Bill: Medicare for OTPs

The 660-page opioid bill that passed Congress and was signed October 24 by President Trump has important provisions for opioid treatment programs (OTPs). The most significant provision expands coverage to Medicare patients. Starting in 2020, Medicare will be required to pay a bundled rate for medication-assisted treatment (MAT) in an OTP. This means that when patients turn 65 and lose their Medicaid or commercial insurance, getting Medicare instead, they will be able to stay in treatment.

Other aspects of H.R. 6, also called "Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act,'' or the ''SUPPORT for Patients and Communities Act," have ramifications for OTPs as well. Read more here.
Read the Latest Edition of OMH News

Click here to read the November issue.
CMS is Developing a Rule that Could Curtail Medicaid Transportation Access

Despite Warnings, FDA Approves Potent New Opioid Painkiller

Care Coordination Model With Bundled Interventions Dramatically Improved Care in East Baltimore

Teachers Are Serving As First Responders To The Opioid Crisis

Neonatal Abstinence Syndrome: Transforming Care for Newborns and Their Families

Smokers With Psychological Distress Much Less Likely to Quit

Can Prison Design Affect Inmates' Mental Health Outcomes?

Researchers Uncover A Circuit For Sadness In The Human Brain

Psychiatric Screening Tool for EMS Aims to Reduce Emergency Department Burden
OMH Statewide Virtual Town Hall Featuring Commissioner Ann Sullivan, MD - Nov. 13, 2018

Click  here to register for this event.

November 12, 12 - 1 pm, CTAC/MCTAC

Where to Start as a New CCBHC: Lessons from a First Round CCBHC Grantee
November 13, 3:15 - 4:15 pm, National Council for Behavioral Health

Using PSYCKES for Clinicians
November 14, 12:30 - 2 pm, OMH

Mitigating Medication Trauma in Complex Needs Populations
November 14, 2 - 3 pm, Center for Health Care Strategies, Inc.

November 14, 3 - 4 pm, The National Center for Complex Health and Social Needs

November 14, 3 - 4:30 pm, NAADAC, The Association for Addiction Professionals

November 15, 12 - 1 pm, PsychU

CMS Hospital Improvement Innovation Network (HIIN) Efforts in Rural Health
November 15, 1 - 2 pm, Centers for Medicare & Medicaid Services

What Will the Midterm Elections Mean for Healthcare?
November 15, 2 - 3:30 pm, Manatt Health

Fetal Alcohol Spectrum Disorders (FASD): Diagnosis and FASD-Informed Care
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 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



CLMHD Office Closed - Veterans Day
November 12

November 15, 3 - 4 pm, GTM

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

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Governor Cuomo Announces More Than $40 Million For Supportive Housing For Veterans, Survivors of Domestic Violence and Individuals With Mental Illness

Governor Andrew M. Cuomo this week announced more than $40 million has been awarded for 11 supportive housing projects for homeless New Yorkers. The projects will create a total of 276 supportive housing units for veterans, survivors of domestic violence and individuals with mental illness. The awards, made available through the New York State Office of Temporary and Disability Assistance's Homeless Housing and Assistance Program, will help fund supportive housing projects in Albany, Bronx, Niagara, New York, Ontario, Suffolk and Tompkins counties.

Nine of these projects have already received support from the Empire State Supportive Housing Initiative. Funding awarded through the initiative can be used to provide support services and operating funds. Read more here.
"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.  Check out our October edition here !
More Kids are Showing Up in ERs with Mental Health Crises
Sliding doors of emergency room in hospital
An increasing number of children are showing up in U.S. emergency rooms in the throes of a mental health crisis, researchers reported Friday. And the increases are seen in minority children, in particular.

It's not clear why, but the researchers say their findings are startling. They are seeing the same pattern across the country.

"It's really disheartening. Community resources for mental health, especially for youth, are incredibly scarce," said Dr. Anna Abrams, a pediatrician and researcher at Children's National Medical Center in Washington, D.C. "It's shocking, really."

Abrams is a pediatric emergency health physician studying disparities in health care at Children's.

"I started to see, in my clinical practice, increasing rates of mental health presentations," she told NBC News.

She decided to see if the same thing was happening nationally. She looked at data from 45 children's hospitals across the country from 2012 to 2016.

"We saw about a 55 percent increase over the entire period in mental health presentations," Abrams said. Read more here.
SAMHSA Releases FY2019-2023 Strategic Plan

The SAMHSA Strategic Plan FY2019-FY2023 provides a roadmap to carry out the vision and mission of SAMHSA over the next four years.

In order to achieve its mission, SAMHSA has identified five priority areas to better meet the behavioral health care needs of individuals, communities, and service providers. The five priority areas are:
  1. Combating the Opioid Crisis through the Expansion of Prevention, Treatment, and Recovery Support Services.
  2. Addressing Serious Mental Illness and Serious Emotional Disturbances.
  3. Advancing Prevention, Treatment, and Recovery Support Services for Substance Use.
  4. Improving Data Collection, Analysis, Dissemination, and Program and Policy Evaluation.
  5. Strengthening Health Practitioner Training and Education.
Read the full  Strategic Plan, including measurable goals and objectives.
Community-Based Primary Care, Home Care, And Behavioral Healthcare Workforce Advocates Call On The Governor For Immediate Investments

This week, in response to the news that New York's hospitals and nursing homes are getting approximately $675 million for Medicaid rate increases to cover workforce salary and benefits, leaders from membership associations representing New York's community-based primary care, home care, and behavioral healthcare workforce are pressing not to be ignored. A group of 11 organizations called on the Cuomo Administration to deliver an immediate investment in primary care, home care, and behavioral healthcare workers who touch the lives of millions of New Yorkers every day.
The group repeated a recurring request that at least 25% of health care investments be directed toward less costly community care. Twenty-five percent of $675 million (state share) would be about $169 million.
Unaddressed rising job vacancies and turnover rates have resulted in a full scale access to care crisis for community-based primary care, home care, and mental health and substance use disorderservices. Read more here.
USDA and ONDCP Release Rural Resource Guide to Help Local Communities Fight the Opioid Crisis

On October 30, the White House Office of National Drug Control Policy (ONDCP) and the U.S. Department of Agriculture (USDA) released the  Rural Resource Guide to Help Communities Address Substance Use Disorder and Opioid Misuse. This resource guide, developed by USDA and ONDCP-led Rural Federal Opioid Interagency Working Group, can be used to help build resilient communities and address opioid misuse in rural areas. 

NACo serves as a member of USDA's Rural Opioid Working Group, which is currently developing a series of resources to add to USDA's Community Opioid Misuse Toolbox. The toolbox will provide a full suite of resources designed to support grassroots strategies for addressing the opioid crisis at the local level. This toolbox is completely free and available to the public and can be found on  USDA's Rural Opioid Misuse Webpage. Other programs currently available on the website include the Community Assessment Tool, which helps local leaders assess the causes and impact of opioid misuse in their communities.
The Costs of Heroin and Naloxone: a Tragic Snapshot of the Opioid Crisis

The pricing and availability of drugs - legal and illegal - illuminate how markets chase profits and reward innovation. A comparison of heroin (and other illicit opioids) with naloxone, the lifesaving antidote for opioid overdoses, offers a devastating peek into the overdose epidemic that is ravaging the United States.

Let's start with the price of heroin. In the early 1980s, a gram of pure heroin cost about $2,200. Today that same amount costs less than $500, nearly an 80 percent decrease. A bag of heroin today will set you back about $5, the cost of a pumpkin spice latte. And prices continue to fall with the introduction of new and more powerful synthetic opioids, such as fentanyl.

Compared to heroin, which requires lengthy cultivation of poppy plants and cumbersome processing, fentanyl and its ilk are relatively cheap to make. Read more here.
Tech Capabilities In An Era Of Integration & Value

Most specialty provider organization executive teams are looking at the twin challenges of retooling their services lines for success in a market moving toward integrated care coordination and value-based reimbursement. The question is what does this mean for the technology infrastructure of these organizations?

The following organizations have extensive experience with the new market model. LifeWorks NW is a Portland, Oregon-based $44 million behavioral health organization. They are a designated certified community behavioral health center (CCBHC) providing integrated care. And, LifeWorks NW is paid a case rate for mental health services (what Ms. Beveridge calls, "fee-for-service on steroids") and fee-for-service for addiction treatment services. Oregon is currently in the process of gearing up for its next Medicaid managed care procurement cycle and its expected that the state will include value-based reimbursement (VBR) requirements.

Mental Health Center of Denver is a $98.5 million behavioral health organization in the city of Denver, with a long track record in providing behavioral health services under a capitated financial model. It also provides supportive housing and has opened up an innovative community center at its Dahlia Campus that includes an urban farm, dental care, early childhood education, health services, and community spaces. Read more here.
What Are the Barriers and Drivers for Technology in Mental Health Treatment?

The issue of behavioral health - and deficiencies in effective treatment solutions - is a critical problem in the country's healthcare system. And what pretty much all stakeholders agree is that there's much needed in the way of improvement.

In order to battle that stigma Tilenius, the CEO of health coaching startup Vida Health said the company has reframed mental health as chronic condition much in the vein of hypertension or diabetes, which people are more familiar with.

She highlighted that one in three people will have a chronic physical condition and one in four will face a serious mental health or neurological disorder in their life.

"Our system doesn't really look at it that way, there's not claim codes for therapy in every health plan," Tilenius said. "If you look at other systems around the world, there's more reimbursement and understanding about the importance of these preventative measures for lowering healthcare costs." 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.