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September 4, 2020

CLICK HERE for Links to State Guidance and Updates on COVID-19
Advancing Public Policies for people with Mental Illness, Substance Use Disorder and/or Intellectual/Developmental Disabilities
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Francine Sinkoff, Editor

Aetna and Landmark Health Working Together to Bring In-Home Health Services to Individual Medicare Advantage Members in New York

Local professor addresses the pandemic's impact on the opioid epidemic - Rensselaer

Ulster County executive declares public health emergency over fentanyl deaths

Ahead of school reopening, advocates urge NYC to halt suspensions and specify mental health supports

Telehealth keeps I/DD patients close with their docs during pandemic - Madison/Cortland

More Than $900,000 Coming to Western New York To Fight Violence Against Women
Rep. Katko Announces $250K in Federal Funding to Help Address Youth Substance Abuse in Central NY

U.S. Rep. John Katko (NY-24) this week announced $250,000 in funding from the Centers for Disease Control (CDC) has been awarded to Confidential Help for Alcohol and Drugs, Inc. (CHAD) in Auburn, NY, and Farnham, Inc., in Oswego, NY, to address youth substance abuse.  Both organizations provide critical substance abuse treatment programs to the Central New York community.

The funding is available through CDC's Drug Free Communities (DFC) Support Program, a program that provides funding to community-based organizations that work to address youth substance abuse.  With the COVID-19 pandemic exacerbating the already rapidly growing substance abuse epidemic, the DFC program provides critical funding to organizations which treat substance use disorders, particularly in our nation's youth. CHAD and Farnham, Inc. will use these funds to expand substance use disorder treatment services in order to meet increased local need during the ongoing pandemic. Read more here.

Addiction treatment shrinks during the pandemic, leaving people with nowhere to turn

College students brace for the 'second curve' of COVID-19 - its mental health impact

Pandemic's Emotional Hammer Hits Hard

To Build Emotional Strength, Expand Your Brain

About Half of Waivered Clinicians Prescribe Buprenorphine for Opioid Use Disorder

Only One Antipsychotic Linked With Reduced Suicidal Outcomes
COVID-19 Reinforces A Renewed Call to Make Suicide Prevention a National Priority

A new national survey of over 2,000 U.S. adults ages 18 and older shows that the majority of those surveyed (81%) say that, as a result of the pandemic, it's more important than ever to make suicide prevention a national priority. Conducted by The Harris Poll on behalf of the National Action Alliance for Suicide Prevention (Action Alliance), the American Foundation for Suicide Prevention (AFSP), the Suicide Prevention Resource Center (SPRC), and Education Development Center (EDC), the survey data also show 52% report being more open to talking about mental health as a result of COVID-19. 

The survey, which builds upon similar surveys conducted in 2015 and 2018, shows respondents overwhelmingly believe suicide can be prevented (93%). While 95% of those surveyed said they would do something if someone close to them was thinking about suicide, most people (69%) identified barriers that keep them from discussing suicide with others, such as not knowing what to say (31%), feeling they don't have enough knowledge (28%), or not feeling comfortable with the topic (19%). These findings underscore the importance of equipping all Americans with the necessary tools and resources to feel empowered to have conversations about mental health and suicide prevention, and to take steps to care for their own mental health. Additionally, this data points to the critical role technology plays in providing support and services, particularly important given today's social distancing rules in the wake of the pandemic. Read more here.

Cultural Humility Series, Part VIII: Social Responsibility in the Addiction Profession
September 9, 3 - 5 pm, NAADAC

Using PSYCKES for Clinicians
September 10, 2:30 - 4 pm, OMH

Understanding and Addressing Criminal Thinking
September 11, 2 - 3:30 pm, SAMHSA's GAINS Center

PSYCKES Mobile App for iPhones & iPads
September 15, 10 - 11 am, OMH

The Intersection of Farming Culture and Suicide Prevention
September 16, 12 - 1 pm, NYS Suicide Prevention Coalition Academy

September 17, 12 - 1 pm, The Joint Commission

Caring for Individuals with Intellectual and Developmental Disabilities
September 23, 12 - 1 pm, HANYS

September 23, 12 - 1 pm, NYS Suicide Prevention Coalition Academy

Using PSYCKES Quality Indicator Reports
September 23, 3 - 4 pm, OMH

September 23, 3 - 4 pm, National Council for Behavioral Health

Lifeline Webinar: Tools, Training and Tips for Call Center Success
September 24, 2 - 3 pm, National Council for Behavioral Health

Integrated Care Programs for Dually Eligible Individuals in the Era of COVID-19: Response Efforts and Policy Recommendations
September 24, 2 - 3:30 pm, Center for Healthcare Strategies, Inc.

September 29, 12 - 1 pm, PsychU

Breaking Through to the Other Side: A Survivor's Story
September 30, 12 - 1:30 pm, NYS Suicide Prevention Coalition Academy



Addiction Services & Recovery Committee (ASR) Meeting
September 13: 11 am - 12 pm, GTM

CLMHD Membership Call
September 16: 9 - 10:30 am, GTM

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

Children & Families Committee Meeting
September 18: 11:30 am - 1 pm, GTM

Contact CLMHD for all Call In and Go To Meeting (GTM) information, 518.462.9422 
NYSAC Podcast Focuses on "Resiliency, Recovery, and County Mental Health Services"

Steven J. Acquario, Esq.
The New York State Association of Counties (NYSAC) produces County Conversations, a weekly podcast series with current and topical information focused on county government. Each episode features a discusson on topics pertinent to county government, like updates on policies and interviews with people providing innovative solutions to local issues.

The most recent episode features a conversation on mental health services amid the COVID-19 pandemic. 

Katherine Alonge-Koons, LCSW-R
NYSAC's executive Director Stephen Acquario is joined by Katherine Alonge-Coons, Commissioner of the Rensselaer County Department of Mental Health, and Chair of the NYS Conference of Local Mental Hygiene Directors. Discussion involved reactions to isolation and social distancing measures, the funding challenges faced by county mental health services, and an increase in demand for these services. 

Click here to listen to the 90-minute episode.
Pandemic Drives New York's Medicaid Enrollment Up
Bill de Blasio visits NYC Health+Hospitals Elmhurst.
Rising Medicaid spending had proven to be a strain on New York's budget before the pandemic, fueling a significant part of the state's $6 billion budget gap. Gov. Andrew Cuomo approved cuts to the program in April, though their impact was hampered by restrictions on changes to Medicaid stipulated under federal COVID-19 relief legislation. But as the pandemic is driving New Yorkers who have lost their jobs and health insurance to enroll in the program, costs may rise even further. 

New York's spending on Medicaid is expected to increase by 6% this year, according to an analysis from the Empire Center for Public Policy published in late August, reaching an $80.3 billion total for fiscal year 2021. Much of that increase is being fueled by factors which have boosted spending in recent years, such as growing coverage of more costly home care, said Bill Hammond, a senior fellow for health policy at the think tank. Read more here.
Governor Cuomo Announces the Availability of Up to $158 Million to Advance Action Plan Combating Homelessness

Governor Andrew M. Cuomo this week announced the release of two requests for proposals for programs that build and support homeless housing across the state. Combined, the Homeless Housing and Assistance Program and the Empire State Supportive Housing Initiative make available $158 million for projects that will house New Yorkers experiencing homelessness and provide supportive services aimed at addressing the root causes of housing instability. This funding continues the work of the Governor's unprecedented $20 billion, five-year housing plan, which is creating or preserving 100,000 units of affordable housing and has spurred the development of more than 6,600 of supportive housing units across the state. 

New York State's Homeless Housing and Assistance Program (HHAP) is providing up to $128 million in capital funding for projects that propose to build supportive housing units or to repair emergency shelters -an amount that is double the prior year's allocation. In addition, the Empire State Supportive Housing Initiative (ESSHI) is accepting proposals for up to $30 million for the ongoing services and operation of supportive housing for individuals experiencing homelessness and with special needs, conditions, or other life challenges. Read more here.
Empire State Supportive Housing Initiative (ESSHI) 

New York State is issuing this RFP, for the development and operation of at least 1,200 new units of Supportive Housing for persons identified as homeless with special needs, conditions or other life challenges. This RFP seeks to award the fifth year's commitment of Governor Cuomo's plan to develop 6,000 units over five years. NYS will award service and operating funding for units of housing developed to support the needs of individuals residing in the units.

Click here for the RFP.
Modifying the Focus of Medicaid Value-Based Payment in the Context of COVID-19

Medicaid programs play a key role in supporting the health care system's transition to the new normal created by the COVID-19 crisis. States and managed care organizations (MCOs) are considering how to stabilize the finances of provider organizations and support new care delivery capabilities, including telehealth. This work includes assessing the impacts of the COVID-19 pandemic on value-based payment (VBP) programs and adapting these models to a new health care context.

VBP arrangements - provider payment models that move away from fee-for-service to alternative arrangements that incentivize value - are increasingly widespread in Medicaid. Most Medicaid programs either incentivize VBP through Medicaid managed care targets and/or have implemented state-designed VBP programs. COVID-19 has put an unprecedented financial strain on providers and is shifting the underlying care delivery structure. Given the wide-ranging impacts of the pandemic on the health care system, states and MCOs need to reassess the design of existing VBP models and consider altering the focus of VBP approaches for 2020, 2021, and possibly beyond. Read more here.
The Rising Incidence of Burnout Among Mental Health Professionals
Any frequent flyer understands this concept: in the event of an emergency, first put on your own mask. Then help others. The principle is that it's impossible to care for others unless and until your own essential needs are first met. Yet, increasingly, psychiatric professionals are failing to prioritize their own "masks" of stress management and self-care. This has led to an increased prevalence of burnout among psychiatric professionals, according to findings of a study published in the American Journal of Psychiatry.

While acknowledging that burnout can be difficult to define, for the purposes of this review, the study authors regarded burnout as, "Emotional exhaustion, depersonalization, and decreased personal efficacy...[it] conceptualizes burnout as a response of individuals to a stressful workplace." Read more here.
The Drawbacks of Treating Social Work Like a Business

An increased focus on business practices in human services organizations hurts the work social workers in New York City do, according to a study
published in the journal Social Work in August.

The majority of the 3,000 respondents from across New York City's human services sector surveyed as part of the study reported seeing a shift toward a business-oriented approach. Almost 80% of respondents said time spent documenting took time away from their clients and 70% said that a focus on the bottom line interfered with service quality.

"I don't think that any social service agency doesn't believe in some level of accountability, or some level of efficiency or some level of tracking outcomes," said Jennifer Zelnick, one of the study's co-authors and professor at the Touro College Graduate School of Social Work, "but what we have here and what I discovered in my study was an overreliance on these things to the detriment of the worker and to the client." Read more here.
Telehealth Payments: What's Keeping You Up At Night?

There is almost universal agreement that the use of telehealth will continue after the pandemic recedes. The path to more telehealth was paved by the emergency telehealth regulatory changes enacted by the U.S. Department of Health and Human Services (HHS) as part of the Public Health Emergency declaration for the pandemic. The new telehealth rules were adopted by most health plans. And on July 23, 2020, HHS extended the emergency period for 90 days, through October 23, 2020. Most health plans followed suit, with some extending the new rules through December 2020.

The big question is whether these rules will become policy post pandemic. Making the HHS regulations permanent would take an act of Congress. And most health plans have not announced their intentions. But the devil is in the details, so to speak. Will all telehealth continue to be covered? What about telephonic visits? Will virtual care delivered by any type of professional, from and to any location-and for all types of services-be covered? Will acceptance of intrastate licensure become widely adopted? And, most importantly, how will telehealth be paid for? Fee-for-service? At the same rates as face-to-face? In payment bundles? These are the questions that keep executives of provider organizations up at night.

At the recent 2020 OPEN MINDS Management Best Practices Institute, we gathered some of the executives of health plans who will be making these decisions together to provide some perspectives-and their view of what the future holds. The executive roundtable, Telehealth - What Will The Payers Change Post-COVID-19? Let's Ask Them, featured Roberta Montemayor, Regional Network Manager OptumHealth Behavioral Solutions; Amy Pearlman, Vice President, Clinical Provider Strategy, Beacon Health Options; and Sean Schreiber, Executive Vice President, Network & Community Health, Alliance Health (a Medicaid managed care organization). Their short answer to the questions above-"we're not ready to commit" to permanent rules for telehealth. But the discussion provided some interesting insights on the key issues that will drive those decisions. 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.