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April 13, 2018

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

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Francine Sinkoff, Editor
Governor Cuomo Announces New Initiatives to Combat Substance Abuse Among School-Aged Children and Student Athletes

Meth making a comeback in Capital Region

Capital Region coalition forms to fight growing opioid epidemic

Governor Cuomo Announces Grand Opening of New Women's Residential Addiction Treatment Facility in Albany

Montgomery County's New Certified Support Team To Help During Traumatic Events

Broome County welcomes first rehab facility with beds dedicated to detox

Mini Grants Available For Broome Opioid Overdose Prevention

Ithaca competing for grant to fight addiction at home - Tompkins County

Cornell awarded $650,000 grant to fight opioid abuse - Tompkins County

In Monroe County, 262 opioid overdoses in 90 days

Syracuse nonprofit bringing mobile opioid treatment to Oneida County

Onondaga County opioid overdose deaths fall 36 percent

BlueCross BlueShield donates $1 million for new Erie County Medical Center emergency department

Shortage of early intervention services for kids with special needs - Erie County

Save The Michaels to receive $425,000, state addiction spending hits record level - Western NY

Levittown fights drug use with coalition - Nassau County

White Plains, St. Vincent's plan integrated clinic - Westchester County

City Health Works gets $2M to expand coaching

As One NYer Dies of Drug Overdose Every Seven Hours; NYC Mayor Considering Safe Spaces for Illegal Drug Use

SAMHSA announces the launch of the Evidence-Based Practices Resource Center, which aims to provide communities, clinicians, policymakers, and others in the field with the information and tools they need to incorporate evidence-based practices into their communities or clinical settings. The Resource Center contains a collection of science-based resources for a broad range of audiences, including Treatment Improvement Protocols, toolkits, resource guides, and clinical practice guidelines. Recognizing the enormity of the opioid epidemic, the Resource Center includes an opioid-specific resources section.

PBS News: Giving Vulnerable Residents Help Before Mental Health Issues Land them in Jail

Each year, an estimated 2 million people suffering from mental illness are booked into county jails. In Kansas City, Missouri, like other places around the country, officials are looking for a better way to get those people the help they need to get back on their feet. John Yang reports in partnership with the Pulitzer Center on Crisis Reporting. Click here to view the video.
How Iowa is Overhauling Mental Health Care

Iowa lawmakers have passed sweeping new legislation that overhauls the state's mental health care delivery system. One big change: A requirement that mandates the creation of critical access centers for people experiencing an immediate mental health crisis. Mental health care advocates say they hope to get six critical access centers set up across the state, so there's one within 90 miles of every person in Iowa.

The legislation also requires a statewide mental health crisis hotline and would establish residential services for people with severe, persistent mental health conditions that require intensive care. The catch: The state hasn't approved any new funding for the legislation. Officials tell the Sioux City Journal that the 14 health care delivery regions in the state are expected to pay for the program for now, but that's not a long-term funding plan. Read more here.

Certified Community Behavioral Health Clinics: A New Approach To Providing Mental Health & Addiction Services
April 16, 12 - 1 pm, PsychU

Getting There from Here: Innovative strategies for addressing transportation needs of people with behavioral health conditions
April 18, 12 - 1 pm

Impact of ACEs and Adoption of Trauma-Informed Approaches in Integrated Settings
April 18, 1 - 2:30 pm, SAMHSA-HRSA Center for Integrated Health Solutions

Behavioral Health Disorders and Employment for Justice-Involved Adolescents
April 18, 1 - 2 pm, Transitions ACR

Enable Access to Client-Level Data in PSYCKES
April 19, 3 - 4 pm, NYSOMH

Using PSYCKES Recipient Search
April 24, 11 am - 12 pm, NYSOMH

April 26, 2 - 3:15 pm, NACo

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

May 2, 1 - 2 pm, Behavioral Healthcare Executive

May 3, 12 - 1 pm

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

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

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

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

June 6, 12 - 1 pm


APRIL 2018

Children & Families Committee Meeting
April 17: 11:30 am - 1 pm, GTM

Directors/Executive Committee Meeting
April 18: 9:30 am - 12:30 pm, GTM

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 
Inside Rochester City Schools, Mental Health Services Front and Center

Schools in the city of Rochester are outposts for mental health services, available for students and families alike to rely on. Inside Enrico Fermi School No. 17 on the west side, Hillside Children's Center counselor Anissa Grasley has an office in the lobby of the school.

Grasley said that fear, anxiety, anger and sibling relationships are just some of the issues students bring with them. They can take an hour out of the school day for a session without parents having to drive them elsewhere for help."I can't think of one particular school in which we don't have a mental health profesional working there. We take it very seriously," Grasley said.

The Rochester City School District estimates that at least 40 percent of its students have had some kind of Adverse Childhood Experience, or ACE. A recent study estimates that number could be as high as 64 percent for all of Monroe County. An ACE is everything from physical or emotional abuse, to having an adult at home who is an alcoholic, drug user or has a mental illness. It could mean not having enough food in the house.  Read more here .
State Authorizes Another $525 Million in Capital Grants for Health and Behavioral Health Providers

Periodically over the years, and consistently since 2005, the New York State Department of Health (DOH) has received funding through the New York State budget process to provide capital support for infrastructure improvements at institutional providers. The rationale for this state funding has varied - at times, it has ostensibly been intended to incentivize certain actions (e.g., facility consolidation, development of information technology infrastructure, participation in value-based payment arrangements, etc.), but at other times, it has clearly represented a recognition of the fact that the depressed margins of healthcare providers often prevent them from making necessary investments in aging infrastructure.

These programs, including the original Healthcare Efficiency and Affordability Law for New Yorkers (HEAL-NY) Program, the Capital Facility Restructuring Program (CFRP), and the Essential Health Care Provider Support Program, among others, have usually focused on hospitals, but have included other Article 28 providers (nursing homes, clinics, etc.) as well as other types of providers more recently.  

Over time, DOH has refined its approach to such programs and the Request for Applications (RFA) language used to define that approach. Read more here.
A Harder Death for People With Intellectual Disabilities

Several weeks after my patient was admitted to the intensive care unit for pneumonia and other problems, a clear plastic tube sprouted up from the mechanical ventilator, onto his pillow and down into his trachea. He showed few signs of improvement. In fact, the weeks on his back in an I.C.U. bed were making my 59-year-old patient more and more debilitated.

Still worse, a law meant to protect him was probably making him suffer more.

When the prognosis looks this bad, clinicians typically ask the patient what kind of care they want. Should we push for a miracle or focus on comfort? When patients cannot speak for themselves, we ask the same questions of a loved one or a legal guardian.
This helps us avoid giving unwanted care that isn't likely to heal the patient.

This patient was different. Because he was born with a severe intellectual disability, the law made it much harder for him to avoid unwanted care. Read more here.
Can Uber & Lyft Answer The No-Show Problem?

A couple weeks ago, we looked at the pending revolution in non-emergency health care transportation (NEMT). It's an important revolution because Medicaid alone spent an estimated $2.9 billion on NEMT to provide 103.6 million NEMT trips in fiscal year 2013. The most common use of NEMT is to support behavioral health services - followed by dialysis, preventive services, specialist visits, physical therapy/rehabilitation, and adult day health care services. The revolution is that ride-sharing services-Uber and Lyft-have stepped into the space offering more convenient and affordable options for consumer transportation.

During recent discussions with provider organization managers, their interest in "convenient and cheap" transportation is to address the problem with "no shows." Some estimates put the no-show rate at 30% nationwide, at a cost of $200 per no-show and $150 billion lost annually. Read more here.
SAMHSA Funding Opportunity:
Project AWARE State Education Agency Grant

Due Date : Monday, June 4, 2018

SAMHSA is is accepting applications for Project AWARE (Advancing Wellness and Resiliency in Education) State Education Agency grants totaling up to $210 million over the next five years. The purpose of this program is to build or expand the capacity of State Educational Agencies, in partnership with State Mental Health Agencies overseeing school-aged youth and local education agencies to:
  • Increase awareness of mental health issues among school-aged youth;
  • Provide training for school personnel and other adults who interact with school-aged youth;
  • Connect school-aged youth, who may have behavioral health issues, and their families to needed services.
SAMHSA expects that this program will focus on partnerships and collaboration between state and local systems to promote the healthy development of school-aged youth and prevent youth violence. SAMHSA expects to fund up to 23 grantees with up to $1.8 million per year for up to five years. Click here to learn more about this opportunity.
5 Ways to Make the Most of Pay for Success

Congress recently passed legislation that knocks down one of the main barriers that governments have faced in undertaking innovative pay-for-success (PFS) projects. Under PFS contracts, private investors who fund the scale-up of a promising program are repaid only if the intervention is successful. However, until now state and local governments seeking to make repayments based on budgetary savings generated by the project could not draw on the cost savings that flow to the federal government from the success of social-service programs.

The federal government's renewed support for PFS will likely inject new momentum into the movement. But to accelerate progress on the most urgent social challenges, governments need to seize on PFS as a steppingstone to reinventing how social-service agencies function more broadly. Based on our experience helping to launch many of the U.S.-based PFS projects, including most of those led by state governments, there are five key steps state and local governments need to take to make the most of the $100 million in newly available federal PFS funding. Read more here.
AP-NORC Poll: Most Americans See Drug Addiction as a Disease

A slim majority of Americans see prescription drug addiction as a disease that requires medical treatment, but most would not welcome those suffering from the problem into their neighborhoods, workplaces or families.

New survey results reveal Americans' complex view of addiction as the deadliest drug epidemic in U.S. history ripples through communities nationwide. More than 1 in 10 Americans say they have had a relative or close friend die from an opioid overdose, according a recent survey by The Associated Press-NORC Center for Public Affairs Research.

The wave of addiction has dragged down the national life expectancy, strained local budgets and challenged officials at every level of government. A study by the Kaiser Family Foundation released Thursday found large employers spent a record $2.6 billion to treat opioid addiction and overdoses in 2016, an eightfold increase since 2004. Read more here.
The Next Naloxone? Companies, Academics Search for Better Overdose-Reversal Drugs

Dr. Nora Volkow has heard a frightening scenario play out around the country. People are administering naloxone to synthetic opioid drug users who have overdosed. But the antidote doesn't work well. So they give another dose. And it's only after multiple doses - four, five, even six times - that drug users finally come to their senses.

Naloxone is the only widely available drug to reverse opioid overdoses. But anecdotal reports of its limitations against synthetic opioids are on the rise. Spurred by that public health threat - as well as a booming commercial market for the antidote - drug companies, researchers, and health officials are eagerly eyeing the development of new treatments to augment the use of naloxone or, in some cases, potentially replace it.

"The strategies we've done in the past for reversing overdoses may not be sufficient," Volkow, director of the National Institute for Drug Abuse, said in a recent speech at the 2018 National Rx Drug Abuse and Heroin Summit. "We need to develop alternatives solutions to reversing overdoses."

Those alternatives are taking a variety of forms. One biotech company is studying a drug with similar mode of action as naloxone - an opioid antagonist - but one that lasts roughly four times longer. Read more here.
CVS to Offer Discount to the Uninsured for Anti-Overdose Drug

CVS Health will offer a discount on the anti-overdose drug Narcan to uninsured customers, the company announced Thursday.

CVS will apply a manufacturer's coupon for Narcan nasal spray for patients without insurance. It will reduce the cost to $94.99, which the company said is the lowest price available for people without insurance.

The list price for a carton containing two nasal sprays is $125. Narcan is the only FDA-approved naloxone nasal spray, but naloxone can also be distributed by an auto-injector, which is manufactured by Kaleo Pharmaceuticals.

CVS's announcement coincided with a rare public health advisory from Surgeon General Jerome Adams calling on more Americans to carry naloxone. 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.