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February 22, 2018

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

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Francine Sinkoff, Editor
Wayne County Chosen for 24/7 Drug Abuse Treatment Center

Wayne County has been chosen as a regional site for a 24/7 Open Access Center in the continuing battle against substance abuse.

The county's mental 
health department was recently awarded $450,000 by the state to expand access to substance abuse treatment in the county and surrounding counties of the Finger Lakes Economic Development Region. The center will serve Wayne, Ontario, Seneca, Yates, Livingston, Wyoming, Genesee, Orleans and Monroe counties.

"This Open Access Center will allow us to have a significant impact and better help the people in our community who are suffering from the ravages of heroin and opioid addiction, by making these services immediately available to anyone at any time - day or night - and also those suffering from a mental health problem will likewise be equally able to receive help and services right away," said Jim Haitz, Wayne County director of community mental health services. "Waiting to get help will be a thing of the past."  Read more here.
Getting Help at Niagara County Jail

Drug rehab center proposed for Queensbury - Warren County

Governor Cuomo Announces $4.5 Million Available to Expand Addiction Treatment Services in the Bronx and Brooklyn

New York City officials see progress in effort to curb opioid deaths

Battle against opioids shows signs of progress in Cattaraugus County

Adverse Experiences Affecting Students - Chautauqua County

Broome County appoints Opioid Overdose Prevention Coordinator

Funds Approved for Two Positions for Jail Mental Health Services - Tompkins County

SAMHSA: Clinical Guidance To Help Broaden Health Care Professionals' Understanding of Medications To Treat Opioid Use Disorder

SAMHSA has published new guidance to help expand healthcare providers' understanding of using medications to treat people with opioid use disorder (OUD). Treatment Improvement Protocol (TIP) 63, Medications for Opioid Use Disorder, reviews the use of the three U.S. Food and Drug Administration-approved medications to treat OUD: Methadone, Naltrexone, and Buprenorphine.

TIP 63 is the latest in a series of topic-specific best-practice guidelines that SAMHSA has developed to help educate and inform healthcare professionals of the most up-to-date practices for treating OUD, as part of the Agency's effort to combat the nation's opioid crisis.
New Educational Video Series on Adult Behavioral Health Medicaid Managed Care

The NYS Office of Mental Health (OMH), in partnership with the Office of Alcohol and Substance Abuse Services (OASAS), the NYC Department of Health and Mental Hygiene (DOHMH), and the Center for Practice Innovations have developed a series of educational videos intended to familiarize individuals and their physical and behavioral health providers with:
  • Medicaid Managed Care Health and Recovery Plans (HARPs);
  • Adult Behavioral Health (BH) Home and Community Based Services (BH HCBS); and
  • Health Home Care Management

The series also walks through the process of accessing Behavioral Health (BH) Home and Community Based Services, including the role of Care Managers, the Eligibility Assessment, and the Person-Centered Plan of Care. Click here to view the video series. 

April 25-27, 2018 in Saratoga Springs

Click here for registration and conference details.

Clinical Aspects of SBIRT
February 23, 2 - 3 pm, National Council for Behavioral Health

Criminal Justice, the Americans with Disabilities Act, and People with Mental Illnesses
February 26, 2:30 - 4 pm, National Association of State Mental Health Program Directors

What Are the Megatrends Shaping Data-Driven Healthcare?
February 27, 1 - 2 pm, Manatt Health

Social Determinants Of Behavioral Health: Addressing Suicide In The Community
February 28, 12 - 1 pm, PsychU

Strategies for Integrating Outcomes into Your Clinical Practice
February 28, 1 - 2 pm, Behavioral Healthcare Executive

March 1, 12 - 1 pm, CTAC

March 6, 2 - 3 pm, Center for Health Care Strategies

March 8, 2 - 3 pm, Alliance for Strong Families & Communities

March 28, 1 - 2 pm, Manatt


MARCH 2018

OMH Agency Meeting
March 2: 10 am - 12 pm
44 Holland Ave., Albany

OASAS Agency Meeting
March 2: 1 - 3 pm
1450 Western Ave., Albany

Officers, Chairs & Regional Reps Call
March 7: 8 am

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

Directors/Executive Committee Meeting
March 21: 9:30 am - 12:30 pm, GTM

Developmental Disabilities Committee Meeting
March 22: 1 - 2:30 pm, GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
OPWDD Final Draft Waiver Transition Plan Available for Viewing

The Office for People With Developmental Disabilities (OPWDD) recently shared the Final Draft Waiver Transition Plan which lays out New York State's path to a more flexible service system that is responsive to the changing needs of people with developmental disabilities and their families. The Transition Plan is required for OPWDD's move to New York State's 1115 Waiver, and for the development of Care Coordination Organizations which will provide Health Home Care Management services.

The Final Draft Waiver Transition Plan reflects changes based on feedback from stakeholders, including:
  • The renaming of the Care Management opt-out option to "Basic HCBS Plan Support";
  • An extended timeframe for completion of the initial Life Plan to align with each individual's person centered review schedule;
  • Modification to the Health Home Checklist to include a signature line for the individual, family member or guardian;
  • Clarification on the impact on children enrolled in the OPWDD Care At Home (CAH) Waiver; and
  • Additional detail surrounding Phase II & III implementation plans. 

A comprehensive summary of the 1115 Transition Plan Response to Public Comment document that includes the State's response is available here.  This document will be submitted to the Centers for Medicare and Medicaid Services for review and final approval.  

Cayuga County Seeks State Funding for Jail Inmates' Substance Abuse Treatment

The New York State Association of Counties wants the state to provide $12.8 million annually to local governments for treatment and transition of county jail inmates tackling substance abuse disorders.  Those costs currently rest on counties' shoulders, and Cayuga County Community Services Director Ray Bizzari said officials have been lobbying for the state to take off some of the financial burden.

The matter came up before the Cayuga County Legislature's Ways and Means Committee Tuesday night, where local lawmakers considered a resolution supporting the association's request.  
Legislator Andrew Dennison asked Bizzari how the county funds those programs now. Bizzari said an approximately $30,000 grant from the state Office of Alcoholism and Substance Abuse pays for Vivitrol, a drug that can help treat drug and alcohol addiction. The county's mental health and jail budgets have been able to cover other related costs for now, but Bizzari said that will not be able to continue in the long run.
Legislators did not have an official cost to the county Tuesday night, but Bizzari added that about $130,000 goes toward staffing for drug treatment services.

According to the resolution, studies have shown that inmates receiving treatment in jail are less likely to go back to jail. In Albany County, for example, the jail implements a heroin addiction recovery program to provide treatment to those incarcerated and support after release. The jail's recidivism rate dropped 28 percent. Read more here.


To learn more about CLMHD's statewide effort to fund jail-based substance use disorder treatment and transition services, click here.
Trump's FY 19 Budget Proposes Medicaid Cuts, MH Reductions

President Trump released his FY 2019 budget proposal that restructures the Medicaid program and cuts other critical
mental health programs and services. Many in the field think his proposal is a rehash of last year's attempts by lawmakers to 
overhaul the Affordable Care Act (ACA) and dismantle the Medicaid program.

While the White House budget includes funding for opioid treatment and an expansion of the Certified Community
Behavioral Health Clinics (CCBHC) demonstration project, there are other concerns for the field. The White House
budget request includes ending the Medicaid expansion and cutting $83 billion to Social Security over 10 years. It also
implements work requirements for Medicaid beneficiaries and increased cost-sharing.

The proposal would cut $112 million to mental health programs of regional and national significance. About $50 million
of that funding is from primary behavioral health integration. Read more here.
States, Not Feds Likely to Lead on Medicaid Value-Based Payments

Now that the Trump administration has given providers a clearer picture of where its priorities lie in the world of value-based payments related to the Medicaid program, providers should be prepared for states and not the feds to lead on innovations that may offer opportunities and challenges moving forward, a new white paper  issued by Leavitt Partners says.

Cristal Gary, lead author and principal at Leavitt, tells Provider that for much of last year there was a lull in the Medicaid space as the new leaders of the Centers for Medicare & Medicaid Services (CMS) formulated a strategy on how they would pursue value-based payments. The Obama administration had created policies led by CMS to move away from fee-for-service to value-based models with new programming and related funding, she says.

"But what we saw for a good part of 2017 after the [presidential] transition was a pause in a lot of state activity on waivers and decision making in general as people waited for signals from CMS," Gary says.

By the end of the year, the wait was over, with the one big takeaway from CMS' new direction being that "we expect less leadership at the federal level in actively moving to value-based payments, with fewer requirements from CMS," Gary says. Instead, long term and post-acute care providers, and all stakeholders in the Medicaid program, should focus on what states decide to do to incorporate value-based payment strategies in an environment where the feds provide less funding.  Read more here.
Manatt Health Care: Hospitals and Health Systems Prepare for a Value-Based Future

Hospitals and health systems are actively working to service their communities in numerous ways, including through the adoption of initiatives that control costs, improve outcomes and enhance patient-centered care. Many are working with payers to establish value-based payment (VBP) arrangements to support these goals. There is a wide range of approaches to VBP, from programs that incentivize public reporting on quality metrics to prospective payments for all of the healthcare needs of a given population.

With no single VBP destination, hospitals and health systems are evaluating which models may best support their organizational and community needs. In a new TrendWatch report prepared for the American Hospital Association, Manatt Health provides information to help hospitals and health systems evaluate which VBP model(s) may support their organizational goals and shares insights from seven hospitals and health systems participating in different VBP arrangements. Read more here.
NYSOMH Call for Participation in Focus Groups for Supervisors of Peer Specialists

Supervisors of Peer Specialists are invited to participate in two upcoming focus groups on  March 26 and March 29, 2018.  These focus groups are part of a study that is being conducted by the New York State Office of Mental Health-funded Academy of Peer Services research team. Results will be used to develop additional courses for supervisors in the online Academy of Peer Services as well as supports and topics for dialogue in the Ask the Supervisor series that is part of the Academy's Virtual Community of Practice. 

Click here for more information.
NYSDOH Announces Package of Innovative State Regulatory Initiatives That Will Improve Access to Health Care and Reduce Overall Costs

The New York State Health Department this weekannounced a series of sweeping recommendations that will improve the delivery of health care in New York State. Major recommendations include measures to integrate primary care, behavioral care and substance abuse treatment in a single setting; and deliver telehealth to patients at any location, including their homes.

The recommendations announced today are the result of the first phase of the State Department of Health's Regulatory Modernization Initiative (RMI) and can be found in thereport, entitled "Spurring Health Care Innovation Through Regulatory Modernization: Putting Patients First".

Regulatory reforms will include:
  • Integrating primary and behavioral health services. 
  • Allowing patients to access care more conveniently by expanding the use of telehealth services. 
  • Putting patients at the center of a coordinated, cohesive health care system by easing care transitions. 
Read more here.
The Commonwealth Fund: Enabling Sustainable Investment in Social Interventions - A Review of Medicaid Managed Care Rate-Setting Tools

It is now widely recognized that social factors, such as unstable housing, lack of healthy food, unsafe neighborhoods, and unemployment, have a substantial impact on health care outcomes and spending, particularly with respect to lower-income populations. As the nation's largest payer for health care services for low-income populations, many of whom have substantial social service needs, Medicaid is front and center when it comes to these issues. State Medicaid agencies are increasingly focusing on how the program can cover and reimburse for nonclinical interventions, particularly in managed care, now the dominant service delivery model in Medicaid.

This report identifies practical strategies that states can deploy to support Medicaid managed care plans and their network providers in addressing social issues. Based on a literature review and on interviews with state officials, health plan leaders, actuarial experts, and other stakeholders, we identify options for states to consider if they are interested in incorporating the cost of social interventions into Medicaid managed care rates.  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.