cover image 2
May 5, 2017

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

Connect With Us:
Like us on Facebook   Follow us on Twitter    View our profile on LinkedIn
Francine Sinkoff, Editor

NYS OASAS Announces $250,000 to Connect More New Yorkers to Addiction Services

The New York State Office of Alcoholism and Substance Abuse Services (OASAS) today announced the award of $250,000 to expand access to addiction treatment services and recovery supports in Albany County. The  Addictions Care Center of Albany was awarded $100,000 to implement a Family Support Navigator Program to assist families as they access substance use disorder care for a loved one. The Catholic Charities'  Project SAFE Point was awarded $150,000 to establish a Peer Advocate Program to work with local emergency room providers to identify and implement best practices for engaging individuals and patients within that setting with the goal of directing them to the most appropriate treatment and recovery supports following an opioid/drug overdose or substance use disorder crisis.

"Addiction services in this community have been greatly enhanced by the addition of these two innovative programs. We are now better able to address the immediate needs of families seeking assistance and better respond to the immediate needs of individuals in crisis or in the aftermath of overdose.These are potentially lifesaving programs," said Albany County Department of Mental Health Director and Director of Community Services Dr. Stephen Giordano.

The main purpose of the Family Support Navigator Program is to help patients and their families understand the progression of addiction and how to navigate the insurance and treatment systems.  Read more here.
6 Insights on State Telehealth Legislation, Reimbursement

The Center for Connected Health Policy, a nonprofit telehealth policy resource organization, published its fifth annual State Telehealth Laws and Reimbursement Policies report. The report details telehealth policies, laws and regulations in all 50 states and Washington, D.C. To prepare the report, the Center for Connected Health Policy analyzed state laws, administrative codes and Medicaid provider manuals through March 2017. Click here to read about the six report findings.
Better Oversight, Research Needed to Realize Potential of Digital Technologies

Trust and transparency-that's what is missing from the burgeoning market for digital mental health applications, psychiatrists John Torous, M.D., and Laura Roberts, M.D., wrote in a recent  editorial
in JAMA Psychiatry. 

More than 10,000 mental health-related smart phone applications are available to download, and that number increases daily, the authors noted, but what's needed is better market oversight and research to help the public to better understand which apps are actually effective (while protecting patient privacy) and which are not. They highlighted the  APA App Evaluation Model
as an example of what's necessary to lend trust and transparency to the digital mental health marketplace.  Read more here.
How Technology Improves Operations

Although the industry has been slow to adopt electronic health records, those who do implement enterprise systems find that they help clinicians to do their jobs better. Real-time reporting, cloud-based solutions and data analytics are just a few reasons providers cite as ways EHRs assist in their day-to-day operations.

Phil McQueen, vice president of IT at Great Circle, a community mental health program in Missouri, says the benefits of an electronic system are superior to the old paper administrative methods. The behavioral health organization works with children and families and offers a wide variety of programs, ranging from foster care case management, educational programs, residential services and physical and mental healthcare. In the 1990s, the organization created software akin to an EHR, but it couldn't overcome its own limitations. That's what led to a six-month ramp up to a new EHR.   Read more here .

Interoperability, that oft-promised, long sought-after state of data fluidity, has yet to fully arrive in patient records. Too often, patient data move only after someone-a patient, a nurse, a doctor-makes a few phone calls and faxes, stumbling a few times.

Better standards, alliances among vendors, and new interdependent technologies promise to change that, making data travel with patients as they move through the healthcare system, thereby reducing the burden on providers and achieving the patient-centric part of the triple aim.  Read more here.
In the Long Run: Models for Supporting Your Patients After Discharge

As the industry looks to control costs and improve outcomes, many facilities are adding post-treatment support services to their treatment programs. These are a few of the models being adopted by providers. 

Alumni Support Programs
Many treatment centers now offer programs for their alumni to connect after treatment has ceased and the long process of recovery continues. These programs have formalized what Rich Knutson describes as his "self-organized, self-supported" buddy system in  The Fix . His organization worked better than Alcoholics Anonymous, he says, because they all knew each other from rehab and held each other accountable. Together, he says, they learned how to "have fun sober." 

Telehealth Care
Telehealth models offer online, video or telephone support as needed to help patients get ongoing, virtual, care. New and existing companies are getting into the "telehealth" game with insurance companies agreeing to pay for at least some form of virtual healthcare. Providers, payers and employers can all partner with telehealth companies such as American Well to provide ongoing virtual support, something that,  Forbes Reports , the behavioral health industry desperately needs.   Read more here.


May 10, 1 - 2 pm, Health Management Associates

May 11, 1:30 - 3 pm, Center for Healthcare Strategies

May 11, 2 - 3:15 pm, Stepping Up Initiative

May 16, 12 - 1 pm, PsychU

May 17, 2 - 3:15 pm, Stepping Up Initiative

June 6, 2 - 3:30 pm, Manatt
June 21, 3 - 4:30 pm, Rural Behavioral Health

August 16, 3 - 4:30 pm, Rural Behavioral Health


MAY 2017

Mental Health Committee Meeting
May 9:  10 - 11:30 am, GTM

Chemical Dependency Committee Meeting
May 12:  11 am - 12:30 pm, GTM

Children & Families Committee Meeting
May 16:  11:30 am - 1 pm, GTM

Directors & Executive Committee Meeting
May 17:  9:30 am - 12:30 pm, GTM

CSPOA / DOH / OMH Monthly Call
May 18:  3 - 4 pm, GTM

OMH Agency Meeting
May 23:  10 am - 12 pm
44 Holland Ave., 8th Fl., Albany

OASAS Agency Meeting
May 23:  1 - 3 pm
1450 Western Ave., 4th Fl., Albany

CLMHD Office Closed
May 29:  Memorial Day

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Highlights of 2017-18 NYS Enacted Budget

The enacted 2017-18 State Budget passed on April 9, 2017. Debbie Holland, CLMHD's Director of Government Relations, has prepared a brief look at some highlights of the budget. 

OPWDD, OMH and OASAS Workforce Salary Increases
Beginning January 1, 2018, OPWDD, OMH and OASAS direct care workers will receive a 3.25% salary increase. Beginning April 1, 2018, OPWDD, OMH and OASAS direct care workers will receive an additional
3.25% salary increase and clinical care workers will receive a 3.25% wage increase.
These increases will total $55 million in new funding for the OPWDD, OMH and OASAS workforce, which is in addition to the funding included in the Enacted Budget to help offset the cost of the increase in the minimum wage.  The Conference was one of 11 other statewide and regional behavioral health organizations that came together to successfully advocate for this long overdue workforce pay hike.

Health Homes Serving Adults
The Enacted Budget includes a cut of $40 million (All Funds) for Health Homes serving adults beginning  October 1, 2017. This reduction will fully annualize in 2018-19 to a cut of $80 million (All Funds).  This cut will reduce the rate for outreach and engagement from $135 per member per month to
$100, limit outreach from three to two months and require face to face contact within the second month and eliminate cycles of outreach.  Over the two years, $60 million of this funding will be reinvesting into the Health Home program.  DOH is interesting in bringing in peers to increase engagement and enrollment in Health Homes.

State Psychiatric Center Downsizing and Community Reinvestment
The Enacted Budget accepts the Executive proposal to reinvest $5.5 million (fully annualized to $11 million) in new funding into the community due to the closure of 100 state psychiatric beds.  This funding proposal represents a reinvestment of $110,000 into the community for every inpatient bed that is closed.  Reinvestments would be made prior to any bed closures, and before any reduction in bed capacity is
implemented a bed must be vacant for 90 days.  When fully implemented, this would bring the total amount of reinvestment funding committed since SFY 2014-15 to $92 million annually.  While there are no planned closures of state psychiatric centers in 2017-18, the Enacted Budget does include the planned merger of Western New York Children's Hospital with the Buffalo
Psychiatric Center.

Click here to read CLMHD's Enacted Budget Analysis.
NY Lawmakers Split on Court-Ordered Mental Health Treatment

Five months into his son's new court-ordered plan for schizophrenia, Vince Lagnese noticed that the 25-year-old was returning to his old self. Instead of pacing the backyard, talking to himself and smoking cigarettes for hours, he began revisiting old hobbies such as jazz guitar and discussing current events.

"The only word I can think of is miraculous," says Lagnese, of New York City's Queens borough. "I have no doubt that without the assisted outpatient treatment, he would be lost to us. He would be homeless, dead or in prison."

More than 4,000 New York residents are treated each year under Kendra's Law, a controversial program that requires a person dealing with serious mental illness to attend outpatient psychiatric treatment as a condition for living in the community.

It was passed in 1999 on a trial basis after 32-year-old Kendra Webdale was pushed in front of a subway train by a man with untreated schizophrenia. It is has since been temporarily reauthorized twice, but New York lawmakers have balked at making the 18-year-old law permanent. It is set to expire in June unless lawmakers grant yet another extension.   Read more here .
NY Medicaid Reform Program Provides Collaboration Model for Hospitals

New York health-care providers are working together under a Medicaid waiver program that looks to improve care, reduce costs and potentially provide cover from federal antitrust laws.

Just how much the health of Medicaid beneficiaries will be improved and how much antitrust law protection the providers will enjoy remains to be seen. Early indications, however, support the conclusion that patients, providers and the state are satisfied that there is real clinical integration between providers that have contracted together to serve Medicaid managed care populations.

Clinical integration is an important component of the New York program, called the Medicaid Delivery System Reform Incentive Payment (DSRIP) program, because it is one recognized vehicle for providers to collaborate to provide care more efficiently and be able to jointly contract with payers without being charged with fixing prices in violation of federal antitrust laws. Read more here.
DSRIP Year 3: A Look at the Year Ahead

During this presentation, New York State's Medicaid Director, Jason Helgerson, talks about the Delivery System Reform Incentive Payment (DSRIP) Program year 3 theme and goals. He also describes how the program's shift to the performance phase is this year's main focus. More information can be found here.
On Rx Drug Monitoring, States Take Doctors' Recommendations

'Clunky." "Difficult to use." "Not worth the effort." These are the common complaints leveled over the years at prescription drug monitoring programs. PDMPs are state-maintained electronic databases that doctors, pharmacists and other health-care professionals use to keep tabs on their patients' prescription drug habits. They're considered vital in efforts to curb the opioid epidemic that has ravaged so much of the country. A physician can see, for instance, if a patient has been "doctor shopping" to get unneeded prescriptions. "This is probably the best tool we have to find out whether a patient is in crisis, and it also helps us identify doctors that are just prescribing too many pills," says James Gessner, president of the Massachusetts Medical Society.

It's a tool, though, that doctors love to hate. A common gripe is that it takes more than 20 mouse clicks to see a patient's prescription information. Doctors also complain that databases take up to a week or longer to update. But a movement to make PDMPs more functional has picked up considerable steam. Several states have recently upgraded their systems while also adding features to give doctors a more comprehensive look at a patient.  Read more here .
A.G. Schneiderman Launches New Law Enforcement Campaign To Crack Down On Violent Heroin And Opioid Traffickers In Suburban And Upstate New York

Responding to the heroin epidemic's rising death toll in New York's suburban and upstate communities, Attorney General Eric T. Schneiderman today announced the launch of the Suburban and Upstate Response to the Growing Epidemic ("S.U.R.G.E.") Initiative, a new law enforcement effort spearheaded by the Attorney General's Organized Crime Task Force that aims to disrupt New York's widening heroin and opioid distribution networks. Specifically, the S.U.R.G.E Initiative will target gangs and individuals who deal heroin and opioids and commit acts of violence in suburban and upstate communities across New York State. To carry out this mission, the OAG's Organized Crime Task Force, which has partnered with all levels law enforcement to arrest more than 750 individuals in metro areas across the state since 2010, will work closely with federal, state, and local law enforcement to investigate, arrest, and prosecute those criminals who target suburban and upstate areas.

Last week, AG Schneiderman and Syracuse Police Chief Frank Fowler announced the first successful takedown under the SURGE Initiative, arresting and indicting 52 people in Operation Bricktown, a multipronged investigation that dealt a major blow to one of Syracuse's most violent drug dealing street gangs.  Read more here.
Kaiser Family Foundation Brief Examines Per Enrollee Medicaid Spending for Seniors and People with Disabilities, Which Varies Greatly By State

Medicaid coverage of acute and long-term care for more than 6 million low-income seniors and 10 million nonelderly people with disabilities accounts for nearly two-thirds of overall Medicaid spending, although such enrollees represent less than a quarter of people on Medicaid.  Much of Medicaid's spending on seniors and people with disabilities also depends on state decisions about whom to cover and which services to pay for, which is a big reason why Medicaid spending per enrollee for these populations varies greatly from state to state.

A new issue brief from the Kaiser Family Foundation documents that variation and explains how the American Health Care Act's proposed caps on per enrollee Medicaid spending could lock-in these spending differences. The brief also notes that because most age and disability-related Medicaid coverage pathways, as well as many services such as community-based long-term care, are provided at state option, states could potentially cut back on them if faced with federal Medicaid funding reductions over time.
Spike in Mentally Ill LA Jail Inmates Leads to New Policies

LOS ANGELES (AP) - Perhaps the largest group of mentally ill inmates in the U.S. resides in Los Angeles in one of the world's largest jail complexes.   Over the past seven years, the jail's population has spiked almost 50 percent - with nearly every inmate having both mental illness and substance abuse problems - and officials suspect the rise is due to methamphetamine use.

The Twin Towers Correctional Facility is home to about 4,000 mentally ill inmates. The increase in the number of mentally ill prisoners - about 30 percent of the county's total jail population - has led the sheriff's department to adapt its policies as deputies and clinicians work to treat people dealing with both psychiatric disorders and substance abuse.

Los Angeles County Sheriff Jim McDonnell has blamed the surge on meth use, but doctors say it's often difficult to distinguish whether the patients had underlying conditions and then started using drugs, or if their chronic drug use led to psychiatric disorders.   Sheriff's officials say they've started training deputies specifically in dealing with mental illness and focusing on treatment instead of punishment.  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.