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April 3, 2020
Advancing Puglic Policies for people with Mental Illness, Substance Use Disorder and/or Intellectual/Developmental Disabilities
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Francine Sinkoff, Editor

Expanded tele-mental health services available - Franklin

How the Capital Region is fighting addiction during a pandemic

Four Winds Saratoga Springs providing face-to-face group and individual therapy via the internet - Saratoga

NYS launches COVID-19 Emotional Support Helpline; Coronavirus Creates Stressful 'New Normal' - Putnam

Social services to county: We're still open - Nassau

Treating Substance Abuse in the Era of Social Distancing - Monroe

Seneca County Community Counseling Achieves Long-Term Mission Just in Time
Seneca County Community Counseling achieves long-term mission just ...
Social distancing comes with a lot of challenges. People are social creatures, so they crave interaction. During a pandemic like the one impacting most of the globe - Governor Andrew Cuomo called on mental health professionals across New York to create 'networks' for the community to leverage.

How does that happen, though, in a world where social interaction is strongly discouraged - if not outright banned?

Margaret Morse, Director of Community Services for Seneca County says the timing of this pandemic flowed with a long-term mission that Seneca's merged mental health and substance abuse clinic had been working toward. Read more here.

VA Uses Mobile Health Clinics for Mental Healthcare Access

Flattening The Mental Health Curve

'Every clinician is also a patient': Study shows psychological impact of COVID-19 pandemic on health care workers

Targeting Unhealthy Lifestyles May Increase Longevity in Those With Severe Mental Illness

CDC Report: Autism Rates Continue to Increase

AA meetings, addiction counseling move online as social-distancing guidelines limit group gatherings

COVID-19 Crisis May Help Trigger Addiction Relapse

California's New Attack On Opioid Addiction Hits Old Roadblocks
The Addiction Technology Transfer Center (ATTC) Network, the Center for Excellence on Protected Health Information (CoE-PHI), the National Consortium of Telehealth Resource Centers, and the Center for the Application of Substance Abuse Technologies (CASAT) at the University of Nevada - Reno (UNR) are facilitating a FREE, national online discussion and resource sharing opportunity for substance use disorder (SUD) treatment providers and peer support specialists faced with transitioning their services to the use of telephone and videoconferencing methods in response to COVID-19 social distancing guidelines.

The series will feature:
  • Live, one-hour sessions every week for at least 5 weeks via Zoom video conferencing (we may add more weeks based on demand!). Each session will include at least 45 minutes of peer-to-peer conversation and information exchange and "Top Five" tips and lessons learned
  • Access to experienced providers and others with expertise in providing services using videoconferencing (telehealth) and telephone for SUD treatment and recovery support
  • Access to professionals with expertise in protected health information and 42CFR Part 2
  • Training tools, checklists, and other relevant resources
Click here for more information.
Academy of Peer Services Virtual Learning Community
Academy of Peer Services
Statewide resources for peer support and supervision. Click here to view information which is updated daily.

April 7, 12 - 1 pm, PsychU

April 7, 1 - 2:30 pm, Mental Health Technology Transfer Center Network

April 8, 12 - 1 pm, PsychU

A Framework for Performance Measurement in Mental Health Crisis Services Webinar
April 14, 2 - 3 pm, SAMHSA's GAINS Center

Peer Recovery Support Series, Section III: Understanding the Pathway and the Process
April 15, 3 - 5 pm, NAADAC

Opioids and Child Maltreatment: Neighborhood Factors To Protect Families
April 16, 1 - 2 pm, Child Maltreatment National Peer Learning Team

April 20, 12 - 1 pm, PsychU

Integrating Peer Support to Expand the Workforce for Individuals with Behavioral Health Challenges - Part 2
April 20, 1:30 - 2:30 pm, SAMHSA's GAINS Center

April 29, 1 - 2 pm, LexisNexis Risk Solutions - Health Care


APRIL 2020

Children & Families Committee Meeting
April 21: 11:30 am - 1 pm, GTM

MAY 2020

Executive Committee Meeting
May 6: 8 am, GTM
Developmental Disabilities Committee Meeting
May 14: 1 - 2:30 pm, GTM

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

CLMHD Full Membership Call
May 20: 9 - 11:30 am, GTM

CLMHD Office Closed - Memorial Day
May 25

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
COVID-19 - Links to State Guidance and Updates

State agencies have been posting updates to COVID-19 resources quite frequently. To ensure you have access to the most up to date information, below are links to areas on State Agency websites where COVID-19 information and resources are housed. Be sure to check these sites on a regular basis to keep informed.

NYSAC Special Bulletin - NYS Budget

NYSAC is still processing everything and as of writing this report, the Medicaid negotiations remain open.

Some initial highlights:
The Budget contains a provision granting the State Budget Director broad authority to unilaterally reduce reimbursements to local governments based on available state revenue, reported monthly.

According to the language, if the Financial Plan is out of balance by more than one percent (about $1 billion) during any measurement period, the budget director can adjust all appropriations, including capital and operating aid.

For counties, this means the state will make cuts across the board, including reimbursement to counties for the range of programs we fund and provide at the local level, if revenues fall below this threshold. Read more here.
A Pandemic Lesson on Treating the Mentally Ill
FILE - People walk past a man sleeping on Broadway at John Street in the Financial District on April 21, 2018.
A floridly psychotic person with no insight into his mental illness, homeless on the streets of Miami without soap or sanitizer, contracts COVID-19. Is that grounds for involuntary commitment - and if so, where, for how long, and can it include forced medication? This was an issue one of us, Miami-Dade County Judge Steve Leifman, just faced in a call from a local official. It brought home a stark reality: Of all the population groups in the United States vulnerable to the coronavirus pandemic, those with serious mental illness (SMI) are especially at risk, and we have a system utterly unprepared to deal with it.

An  estimated 45% of those who are homeless have a mental illness; a quarter have one defined as serious. Read more here.
As COVID-19 Isolates Patients, Telehealth Becomes LIfeline for Behavioral Health
virtual visit
As more Americans are urged to stay at home amid the COVID-19 crisis, it's not just physical health that's going largely digital-it's behavioral health, too.

Social distancing can go against some of the key advice for treating behavioral health disorders, such as spending time with loved ones and getting outside, said Shilagh Mirgain, Ph.D., a psychologist at the University of Wisconsin School of Medicine and Public Health.

"I think some people can feel quite vulnerable that some of their safety nets or coping methods ... may be at risk,"  Mirgain
told  FierceHealthcare. 

The Centers for Medicare & Medicaid Services waived certain payment requirements to ease access to telehealth in Medicare, and major national insurers are waving copayments and cost-sharing for telehealth visits related to COVID-19. As such, people seeking psychiatric care are also logging on for video visits in large numbers. Read more here.
Mobilizing Project ECHO to Build Provider Capacity in Response to COVID-19

As Congress and the Department of Health and Human Services place increasing emphasis on the role of telehealth in the COVID-19 response, the predominant focus has been on provider-to-patient interactions. This is both necessary and important, but telehealth strategies can also enable critical provider capacity-building efforts that support rapid evolution of clinical protocols for testing and treatment.  Telementoring - virtual collaborative learning and capacity building for providers - typically includes a multidisciplinary team of experts at one end and multiple teams of on-the-ground providers, often in rural and underserved communities, on the other end.

An Existing Telementoring Infrastructure
Real-time, regular communications channels between medical experts, public health officials, and front-line community providers ensures that information is flowing - in both directions - to share emerging learning and the most-current protocols for response. Project ECHO, launched in 2003 by the University of New Mexico's School of Medicine, is a virtual telementoring model with more than 240 hubs- typically academic medical centers - operating in 48 states and reaching nearly 70,000 community providers. During this current crisis, it is absolutely critical that states and communities have opportunities to leverage existing national networks, like  Project ECHO, particularly to reach rural and underserved communities around the country. Read more here.
How Behavioral Health Care Rules Are Evolving For COVID-19

As the COVID-19 crisis deepens, the U.S. medical system is facing significant uncertainty and is at risk of being overwhelmed. To promote social distancing, protect vulnerable populations, and relieve the pressure on in-person medical services, government and private payors are rapidly implementing various strategies to enable health care providers to continue to care for patients and manage significant increases in demand during the public health emergency.

During this time of significant uncertainty, social unrest and isolation, the need for behavioral health services is likely to increase as individuals with mental health and substance use disorders, or SUDs, are particularly vulnerable and in need of continued and potentially enhanced levels of treatment.

In-person addiction treatment services are being halted at a time when they may be most needed in order to provide support and avoid relapse during times of increased stress due to social isolation, economic stress and unemployment. In addition, behavioral health patients may face challenges obtaining new or continued prescriptions for much needed medications, including controlled substances. Read more here.
What Changes Are Shaping Opioid Treatment Programs During the COVID-19 Pandemic?

With the  coronavirus (COVID-19) pandemic reaching exponential gains, it would be irresponsible to not align with the recommendations of limiting in-person interactions and practicing social distancing as much as feasible. However, this could prove to be challenging for patients with  opioid use disorder (OUD), especially for those on agonist maintenance. Prescriptions for such are limited in duration and, depending on the setting, may not be issued at all but rather administered daily at a facility.

Fortunately,  telemedicine and the reduction of medicolegal barriers surrounding controlled substance prescriptions have helped Office Based Opioid Treatment programs (OBOTs). A challenged remained for those patients who receive maintenance care (mostly methadone) from Opioid Treatment Programs (OTPs) in which they are required to present daily for administration. These patients would have increased exposure via public transportation, waiting rooms at the facility, and interactions with staff, nurses, and physicians. To complicate matters, patients may be part of the high risk group for COVID complications, ie, elderly, patients with medical comorbidities, immunocompromised patients, and pregnant women. Read more here.

CARES Act in the States: Targeting New Health Funding in a Time of Crisis

The landmark $2 trillion Coronavirus Aid, Relief and Economic Security Act (CARES), enacted last week, includes critically important new funding to help states in their fight to combat  COVID-19. Governors and legislatures, most adjourned to comply with social distancing bans on public gatherings, will need to make quick but informed decisions about how best to target these resources.

Policymakers will need to weigh the extraordinary needs states are confronting against the federal criteria stipulating when and how states can spend these dollars and consider all the funding that will soon be available directly or indirectly to states in order to make difficult decisions amid many competing interests. The massive new law includes direct payments to individuals, unemployment assistance, and an array of other supports, including significant new funding for health services.

Much attention is directed to Title V of the Coronavirus Relief Fund, which directs $150 billion to support states and must be made available to states within 30 days of enactment of the law. Read more here.
The Pandemic Emergency: Effects On Community-Based Organizations

When it comes to the current crisis, every health and human service organization is in a different position. Hospitals are swamped. Nursing homes and assisted living programs have enacted quarantines and other measures to prevent exposure. But where are community-based specialty provider organizations in this? It's tough out there.

A new survey of the members of the California Council of Community Behavioral Health Agencies (CBHA), found that the past few weeks have had a significant impact on consumers, the professionals who serve them, and the community-based provider organizations. I noted four key takeaways in the survey results:

Consumer health status 33% of respondents indicated that they have clients who are too sick to engage in treatment. However, many indicated that they are unsure what the reason for lack of engagement is for many of their clients and if it is COVID-19 related or not. Additionally, one agency indicated that they have lost contact with many of their clients who are experiencing homelessness. 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.