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April 27, 2018

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

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Francine Sinkoff, Editor
Naloxone program gains approval in Tompkins County

Elmira hospitals part of project to cut Medicaid costs - Chemung County

Broome 911 Dispatch Utilizing Faster Care for Mental Illness

Mental health satellite office opens inside Wayne Central High

Local program helping young adults with autism find work - Monroe County

Violence, drugs, suicide - survey shows Buffalo students face myriad issues - Erie County

Project's goal: Prescribing fewer opioids - Mohawk Valley

School substance abuse counselors go beyond "Just Say No" - Jefferson County

Plan to close Inwood psychiatric unit sparks fear among Allen Hospital doctors, staff - NYC

NYC Launches Crisis Prevention and Response Task Force

Mount Sinai St. Luke's seeks to document nonmedical problems that impact patient health

Nassau Queens PPS lowers emergency room visits from Creedmoor campus - NYC

Governor Cuomo Announces Grand Opening of $100 Million Affordable Housing Development in Brooklyn - NYC

Residents Encouraged to Install Suicide Prevention Smartphone APP - Ulster County
One Size Doesn't Fit All: The Need for Local Approaches to Improve Neighborhood Health

Three years ago, NYSHealth launched a new priority area, Building Healthy Communities, focused on improving access to healthy, affordable foods and safe places for physical activity in six diverse neighborhoods throughout New York State: Clinton County; Brownsville, Brooklyn; East Harlem, Manhattan; Near Westside, Syracuse; North End, Niagara Falls; and Two Bridges, on the Lower East Side of Manhattan.

The brief has a particular focus on the Medicaid population within these communities, who often have poorer health outcomes and can benefit greatly from initiatives such as Building Healthy Communities. Although there are core commonalities across the six communities-such as lack of economic security and high levels of poverty and unemployment-there is a great deal of variation in geographic, demographic, and health-related characteristics. The immense diversity of the vulnerable populations in these six communities lends credence to the notion that there is no one-size-fits-all approach to building healthier communities. Read more here.

How outpatient and inpatient mental health providers can work better together

Vox: How Much Alcohol Is Too Much? The Science Is Shifting

NYS OASAS Announces Free Statewide Naloxone Training Sessions

The New York State Office of Alcoholism and Substance Abuse Services (OASAS) last week announced that it will conduct a series of free naloxone training sessions to be held across the state. The trainings are supported by a grant from the Substance Abuse and Mental Health Services Administration. During the sessions, participants will learn how to recognize, respond to, and reverse an opioid overdose using naloxone.

The dates, times, and locations of each training session can be found here.

April 30, 12 - 1 pm, SAMHSA's Gains Center

May 2, 1 - 2 pm, Behavioral Healthcare Executive

Engagement via a Crisis or Pre-Crisis Tool within a Wellness Recovery Action Plan
May 2, 1 - 2 pm, SAMHSA

May 3, 12 - 1 pm

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

Supporting Evidence-Based and Promising Practices - Trauma-Informed CBT
May 9, 3 - 4 pm

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

Exploring the Impact of Trauma on Parenting
May 15, 12 - 1 pm, CTAC

Avoiding Burnout: Learning To Live & Work Well In Health Care
May 17, 12 - 1 pm, PsychU

Addressing Behavioral Health Needs of Older Veterans: In our Communities and in Partnership
May 22, 12 - 1 pm

Social Media/Technology for Outreach and Engagement
May 23, 1 - 2 pm, SAMHSA

Redefining Care Management in Medicaid Managed Care
May 24, 3 - 4 pm, Manatt Health

How Media & Movies Shape Our Perception Of Serious Mental Illness
May 31, 12 - 1 pm, PsychU

The Interplay Between Sleep & Bipolar Disorder
June 5, 12 - 1 pm, PsychU

June 6, 12 - 1 pm


APRIL 2018

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 
First report Released from the Federal "Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC)

" The Way Forward: Federal Action for a System That Works for All People Living With SMI and SED and Their Families and Caregivers" report was released to Congress this week. This mandated report details major barriers to treatment for individuals with serious mental health conditions and recommends ways to address the unmet needs of people with serious mental health conditions. 

The report presents:
  • The current status of federal activities in behavioral health
  • A summary of advances in care and treatment
  • Research and strategies to improve services for individuals with serious mental health conditions
Click here to view the report.
HHS Releases Mental Health and Substance Use Disorder Parity Action Plan

This week, HHS released the  Mental Health and Substance Use Disorder Parity Action Plan, required by Section 13002 of the 21st Century Cures Act. The Action Plan includes recent and planned actions from HHS, the Department of Labor, and the Department of the Treasury related to ongoing implementation of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) based on written comments from stakeholders and input from a public listening session held in July 2017.

MHPAEA applies to employment-based large group health plans and health insurance issuers choosing to provide mental health and substance use disorder coverage and requires that limitations on such benefits not be more restrictive than limitations on medical and surgical benefits.
Read more here.
How Much of a Struggle Is It to Get Mental Health Care in Rural Areas?
Tallgrass Prairie National Preserve, Kansas
Despite the growing demand for mental health care in the U.S., the supply of providers is in no way keeping up. According to the Department of Health and Human Services, the nation needs to add 10,000 providers to each of seven separate mental health care professions, including psychiatrists, psychologists and mental health counselors, by 2025 to meet the expected growth in demand. And the shortage is especially acute outside the big cities.

Take Wisconsin, for example. "Finding a provider in some parts of the state is a big challenge," says Dr. Jerry Halverson, chief medical officer for Rogers Behavioral Health in Oconomowoc. "We are basically in a constant recruiting mode. We have an in-house recruiter who works every day to attract psychiatrists, [nurse practitioners] and therapists," says Halverson, who is a consultant to the American Psychiatric Association's Council on Healthcare Systems and Financing.

Halverson says that all medical professionals, not just those in mental health, tend to cluster in cities. "That makes sense, because that's where the most patients will be," he explains. In rural areas, there may not be enough patients to reach the "critical mass" needed to maintain a practice. Read more here.
3 Ways to Expand Access to Mental Health Care Beyond Adding More Psychiatrists

About once a shift, I see a patient who has been unnecessarily - and often to his or her dismay - routed to my hospital's locked psychiatric emergency unit in the process of simply trying to figure out where to go for routine psychiatric care. I've evaluated an attorney, a medical student, an internationally renowned musician, and many others who didn't need to go through the unpleasant and potentially scary process of sitting through an extensive evaluation in an austere, security-monitored environment. Their journeys took them to this daunting unit not for lack of acumen or social or financial resources, but because finding the correct mental health care pathway can be bewildering and wrong turns are common.

Nonetheless, they're among the fortunate minority who receive care. An estimated 40 million Americans experience mental illness in a given year. More than half of them do not, or cannot, get treatment.

For most Americans who seek treatment for issues like depression, anxiety, bipolar disorder, schizophrenia, and obsessive-compulsive disorder, navigating the way to mental health care is a challenging endeavor. Why? The dearth of providers, the uncoordinated panoply of practitioners with disparate and confusing titles and qualifications, and the costs of care have created a disorienting health care jungle where untreated mental illness is prevalent. It doesn't have to be that way. Read more here.
The High Cost of Taking Away Prisoners' Medicaid Coverage

For Lori Stone, getting out of prison has always been a little nerve-racking.
She's been in and out of jail since she was 18. Every time she's been released, she's lost her disability benefits and her Medicaid coverage. That meant she couldn't afford her rent or her medication for her bipolar disorder until she was able to re-enroll, which could take weeks or months -- even if she went to all her appointments on time.

"That would put me into a bad spell of being depressed, and my moods would be bad," says Stone, 37, over the phone from the Douglas County Jail in Omaha, Nebraska. "And then I would end up doing something stupid like shoplifting to get alcohol. It's just a vicious cycle."

That critical gap in safety net programs, which has set Stone up for failure again and again, is a harsh reality for millions of people released from prison every year - and one that counties are now trying to get fixed.

Local jails and prisons are required to provide prisoners with adequate health care. But the interruption of federal and state programs inmates had been depending on can cause major problems, making it more likely that people will cycle in and out of jail. Read more here.
Kaiser Family Foundation Issue Brief:  The Opioid Epidemic and Medicaid's Role in Facilitating Access to Treatment

The opioid epidemic continues to escalate, with 1.9 million non-elderly adults having an opioid addiction in 2016. Opioid addiction is often associated with co-morbid physical and mental health conditions and high levels of health care services utilization.  These issues have worsened throughout the past decade as the opioid epidemic has escalated. 

Medicaid has historically filled critical gaps in responding to public health crises, and helps to address the opioid epidemic by providing access to coverage and necessary health care. The program covers a disproportionate share of individuals with opioid addiction and facilitates access to numerous treatment services. Additionally, as of February 2018,
33 states have adopted the Medicaid 
expansion, with enhanced federal funding, to cover adults up to 138% of the federal poverty level ($16,753/year for an individual in 2018). All Medicaid expansion benefit packages must include behavioral health services, including mental health and substance use disorder services, which has increased access to care for many people with opioid addiction.

Based on data from the 2016 National Survey on Drug Use and Health, this brief describes non-elderly adults with opioid addiction, including their demographic characteristics and insurance statuses, and compares receipt of various treatment services among those with Medicaid to those with private insurance and those who are uninsured. It also describes Medicaid financing for opioid treatment and the ways in which Medicaid promotes access to treatment for enrollees with opioid addiction. Read more here.
DSRIP DY3 Q3 Reports Released

The Medicaid Redesign Team announced this week that the Independent Assessor (IA) has completed its reviews of the Delivery System Reform Incentive Payment (DSRIP) program Year 3, Quarter 3 reports, covering Performing Provider Systems (PPS) activity from October 1, 2017 to December 31, 2017. Beginning with this quarterly report, the first and third quarterly reports for the remaining DSRIP years will focus on PPS updates on funds flow and partner engagement. Full PPS progress updates will be included in the second and fourth quarterly reports of each remaining DSRIP year. 

The fourth quarterly report for DSRIP Year 3 is due from the PPS on April 30, 2018 and the IA will complete final adjudication by June 30, 2018. The results of the fourth quarterly report will be released in early July.

The DY3 Q3 reports for each PPS can be accessed through the PPS section of the DSRIP website here.
Payers, Orgs Provide Feedback on CMS Value-Based Care Reform

CMS has received over 1,000 comments from healthcare payers and expert organizations that suggest the agency's efforts to implement value-based care reform will require changes to provider accountability, chronic disease management, and scaled technology investments.

CMS's Innovation Center (CMMI) previously issued a Request for Information (RFI) from health plans, medical associations, and analysts to evaluate strategic improvements for lowering costs while improving outcomes in Medicare and Medicaid programs.

The agency found that organizations generally concurred that improving provider accountability, chronic disease care, patient healthcare choices, and value-based provider incentives are keys to the agency's reform goals.  In addition, healthcare organizations suggested that utilizing innovative technologies may reduce associated burdens of integrating value-based payment models into healthcare systems.

Healthcare payers, including Anthem and UnitedHealthcare, were among the organizations that submitted feedback  to CMMI. 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.