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October 5, 2017

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

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Francine Sinkoff, Editor

OMH Statewide Virtual Town Hall Featuring  Commissioner Ann Marie Sullivan, M.D.

OMH is conducting a Statewide Virtual Town Hall on November 8, 2017 from 1:00 to 3:00 p.m. with Commissioner Ann Sullivan, M.D. She will be presenting and taking feedback on several key priorities under the OMH Strategic Plan.

The town hall will be held online via  WebEx to maximize access for public participation, with one site at OMH Central Office for attendees who are unable to access the event online.

This event will provide the public an opportunity to learn more about the OMH vision for the future, including progress on the Commissioner's top policy and planning priorities presented at last year's town hall. Comments and questions can be presented both online and live for those attending at the OMH site.

Click HERE to register for the Town Hall.
Medicaid Redesign Team Releases New Whiteboard Video 

The Medicaid Redesign Team recently released another video in its whiteboard series. In the video titled, " What CBOs Need to Know to Be Successful in VBP," New York State Medicaid Director, Jason Helgerson, describes the top 5 things that Community Based Organizations (CBOs) need to know in order to be successful in the move to Value Based Payment (VBP). He also discusses how CBOs can get involved in the transition to VBP. 

Click HERE to view the video.

3 Technology Features To Improve
Behavioral Health Environments

Governor Cuomo Announces Bidding for $89 Million in Construction Projects to Re-Purpose Four Facilities to House Youth Under Raise the Age

Governor Andrew M. Cuomo recently announced that bidding has started for $89 million in construction projects to expand capacity at two former juvenile justice facilities, re-purpose a decommissioned correctional annex, and update a current medium security male facility to serve 16- and 17-year-olds under his landmark Raise the Age legislation. The new law changes the way 16- and 17-year-olds are processed in the criminal and youth justice systems and changes the placement they may receive. The law becomes effective for 16-year-olds on October 1, 2018, and for 17-year-olds one year later.

The New York State Office of Children and Family Services, which operates the state's juvenile justice facilities, and the State Department of Corrections and Community Supervision, which will now operate adolescent offender facilities, will require more beds to accommodate the additional youth placed in their custody. In order to do so, the agencies will re-purpose four locations throughout the State.   The Office of General Services will solicit bids for an estimated $41 million in construction projects at two former juvenile justice facilities owned by the Office of Children and Family Services. Read more here.
State and Federal Support of Trauma-Informed Care: Sustaining the Momentum

Policymakers increasingly recognize the impact of trauma and adverse childhood experiences (ACEs) on lifelong physical, emotional, and social health and are beginning to support efforts for incorporating trauma-informed care (TIC) into the health and social service sectors. Proposed state and federal legislative, regulatory, and contracting policies aimed at reducing trauma and toxic stress and promoting resiliency and trauma-informed practices are burgeoning. By building on this momentum, federal and state policymakers can further opportunities for encouraging multi-sector implementation of trauma-informed models.

This blog post looks at how proposed state and federal legislative, regulatory, and contracting policies aim to reduce trauma and toxic stress.  Read more here.
How Childhood Trauma Affects the Brain
abandoned teddy bear
It is not news that people abused as children are more exposed to clinical depression, anxiety, and a higher risk of death from suicide. But now, researchers have begun to reveal what happens in the brain following this kind of trauma.
According to data provided by the Children's Bureau of the United States Department of Health and Human Services, there was a 3.8 percent increase in reported child abuse cases in the country between 2011 and 2015. This amounts to 683,000 cases of child abuse in 2015 alone in the U.S.

Research suggests that this type of trauma in childhood leaves deep marks, giving rise to issues including post-traumatic stress disorder, depression, anxiety, and substance abuse.

Now, a team from the McGill Group for Suicide Studies at the Douglas Mental Health University Institute and McGill University in Montreal, Canada, aims to decipher how a history of abuse can impact key brain mechanisms, affecting mental health.  Read more here.

October 10, 10 - 11 am, MCTAC  

October 10, 2 - 3:30 pm, National Reentry Resource Center 
October 12, 2 - 3:15 pm, Stepping Up 

October 16, 1 - 2:30 pm, CHCS

October 19, 1 - 2 pm, EHR Intelligence

October 19, 2 - 3:15 pm, Stepping Up

October 24, 3:30 - 5 pm, National Academy for State Health Policy

October 25, 9:15 - 10:45 am, National Academy for State Health Policy

October 30, 12:30 - 2 pm, CHCS

November 7, 12 - 1 pm, PsychU



Office Closed - Columbus Day
October 9

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

Mental Hygiene Planning Committee Meeting
October 17:  1 - 3 pm,  GTM

Directors & Executive Committee Combined Meeting
October 18:  9:30 - 12:30 pm

OMH Agency Meeting 
October 24:  9 am - 12 pm
44 Holland Ave., Albany

OASAS Agency Meeting
October 24:  1 - 4 pm
1450 Western Ave., Albany


Officers, Chairs & Regional Reps Call
November 1:  8 am

Office Closed - Veterans' Day
November 10

Directors & Executive Committee Combined Meeting
November 15:  9:30 - 12:30 pm

Children & Families Committee Meeting
November 21:  11:30 am - 1 pm,  GTM

Office Closed - Thanksgiving
November 23 & 24

Mental Hygiene Planning Committee Meeting
November 28:  1 - 3 pm,  GTM

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
SHIN-NY 2020 Roadmap: How Health Information Exchange Improves Healthcare

Emphasizing the potential for universal access to health information, the  New York eHealth Collaborative (NYeC), in conjunction with the  New York State Department of Health, released the SHIN-NY  2020 Roadmap: Improving Health in Our Communities. Developed in conjunction with  New York State and with stakeholder input, the report highlights the significant progress already underway and details the vision for the next phase of the Statewide Health Information Network for  New York (SHIN-NY).

The SHIN-NY is comprised of  New York State's eight regional health information networks connected together to share patient information - including medical records, test results, x-rays, and prescriptions-with providers across the care continuum. When a patient opts in to the network, allowing their data to be accessed electronically, they enable their care team to access key patient data in real time, saving time and resources, and improving care. Organizations using the SHIN-NY are already seeing a significant impact: fewer hospital readmissions and emergency department visits-major goals of state and federal initiatives to improve patient care and rein in costs; and reductions in unnecessary lab tests and x-rays.

On behalf of  New York State , NYeC and the regional networks have been collaborating with healthcare stakeholders - including state agencies, providers from large academic medical centers to small private practices, long-term care, behavioral health, home care, health plans, industry associations, and patient advocates - to advance the SHIN-NY and its mission of improving healthcare through universal exchange of health information.  Read more here.
State Attorneys General Seek More Beds for Drug Treatment

A bipartisan coalition of state attorneys general on Monday called on Congress to allow Medicaid funding to flow to larger drug treatment centers, potentially expanding the number of addicts who can get help as the nation grapples with an overdose crisis.\

The government lawyers for 38 states and Washington, D.C., sent a letter to congressional leaders requesting the change. They say it's needed to help fight the opioid abuse and overdose epidemic, which continues to claim tens of thousands of lives a year.

"If we have any hope of reversing this terrible trend, we need every treatment option at our disposal," said the letter, which was spearheaded by Ohio Attorney General Mike DeWine, a Republican, and Pennsylvania's Josh Shapiro, a Democrat.

They noted that people "often develop opioid addiction through prescribed medical usage, with no intent by the patient to engage in abusive behavior, simply because of the addictive properties of opioid drugs."  Read more here.
Governor Cuomo Announces Aggressive New Actions to Combat the Fentanyl Crisis

Governor Andrew M. Cuomo last week announced a series of aggressive new actions to combat the fentanyl crisis in communities across New York State. The Governor will advance legislation to add 11 fentanyl analogs to the state controlled substances schedule, giving law enforcement the ability to go after the dealers who manufacture and sell. To further protect New Yorkers, the Governor is also directing the New York State Department of Financial Services to take immediate action to Advise Insurers Against placing arbitrary limits on the number of naloxone doses covered by an insurance plan.   Read more here .
When a Mental Health Emergency Lands You in Jail
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Early last year, two suicidal patients showed up at a hospital emergency room in Pierre, S.D., seeking help. Although the incidents happened weeks apart, both patients ended up in an unexpected place: jail.

Across the country, and especially in rural areas, people in the middle of a mental health crisis are locked in a cell when a hospital bed or transportation to a hospital isn't immediately available. The patients are transported from the ER like inmates, handcuffed in the back of police vehicles. Laws in five states - New Mexico, North and South Dakota, Texas and Wyoming - explicitly say that correctional facilities may be used for what is called a "mental health hold." Even in states without such laws, the practice happens regularly.

"It is a terrible solution...for what is, at the end of the day, a medical crisis," said John Snook, executive director of the Treatment Advocacy Center, a national group that advocates for the severely mentally ill. Research shows that the risk for suicide, self-harm and worsening symptoms increases the longer a person is behind bars.  Read more here.
The High Price of Failing America's Costliest Patients

Even patients with whom I have the best rapport would probably rather not see me so often.   Sometimes I readmit a patient I cared for just weeks before in the hospital. "Nice to see you again," I offer with a smile. The usual response, loosely paraphrased: I'd rather be anywhere else.

This reflects not some deep deficiency in my bedside manner (I think), but rather an essential truth about medicine: People want health, not health care. And those who require the most health care and get the least health - high-need, high-cost patients with multiple or severe medical conditions - feel this most acutely.

Leaving aside the moral compulsion to improve the quality and efficiency of their care, there is an overwhelming financial imperative to do so. It's well known that the country's staggering health care costs are not evenly distributed. Just 1 percent of patients account for 20 percent of costs, and 5 percent of the population accounts for nearly half the nation's health care spending.
But exactly who these patients are - and how we can better meet their needs - is less clear.  Read more here.
Autism Action Plan Moving Forward in the New York Legislature

It's something one lawmaker at the Capitol has been passionate about for years.   Now Assemblyman Angelo Santabarbara's Autism Action Plan is moving forward.
Inside the Capitol, the very first meeting of the Autism Spectrum Disorder Advisory Board is underway.

That group of people will help come up with a plan that will best help those with autism across the state.

Santabarbara has made his passion for helping those with autism widely known. His son Michael falls on the spectrum.

He has two pieces of legislation currently on the table.  One that would give ID cards to those on the spectrum explaining their disorder, and another that would train emergency first responders how to identify and interact with someone with autism. Read more here.
Many Young Adults With Autism Also Have Mental Health Issues

College involved "many anxiety attacks and many trips home" for Daniel Share-Strom, an autistic 27-year-old motivational speaker in Bradford, Ontario. It wasn't just the challenge of organizing his assignments and fighting the disability office for the extra time he needed for tests. It was also managing all the aspects of daily life that most people not on the autism spectrum take for granted.

"Relationships are so much harder to understand or initiate when by default you don't really know what certain facial expressions mean or what certain actions mean," Share-Strom says.

Young adults on the autism spectrum are more likely to also have been diagnosed with a psychiatric condition, such as depression, anxiety and attention deficit hyperactivity disorder (ADHD) than are typically developing people or those with other developmental disabilities,  a study  finds. And managing those multiple conditions can make the transition to young adulthood especially difficult.  Read more here.
National Health Service Corp Designation Provides NYS Office of Mental Health Staff Student Loan Assistance 

The NYS Office of Mental Health announced that 19 additional outpatient sites have been designated as National Health Service Corp (NHSC) approved locations. The designation comes with numerous benefits - including student loan repayment and scholarship programs - that will help recruit and retain talented staff for underserved areas of the state.

The NHSC's mission is to build healthy communities by supporting qualified health care providers dedicated to working in underserved areas. OMH now has a total of 35 approved NHSC sites serving adults, adolescents and children and an additional 13 sites serving forensic populations.  Read more here.
Looking Beyond Technology to Shape the Emergency Department of the Future

Not long ago, I attended a lecture given by a highly regarded emergency physician. His talk, "The Future of Emergency Medicine," focused on how advances in  telemedicine
will transform emergency care. The following week, as I walked down a corridor at the back of my hospital, I passed seven telemedicine robots, each with a hastily scrawled "Out of Order" note taped to its screen. That captured my uneasy feelings about how interacting with a patient via internet video link would work in the poor neighborhoods served by my emergency department.

I work with a loose-knit group of emergency physicians who embrace a different future for emergency care. Called  social emergency medicine, it fully integrates patients' social contexts into their emergency care. This approach doesn't just make note of the fact that a patient with asthma may witness a shooting on her street corner, but incorporates how her exposure to community violence may profoundly affect how she recovers - and also helps her think through strategies to cope.  R ead more here .
Teenage Suicide is Extremely Difficult to Predict - That's Why Some Experts are Turning to Machines for Help

In any given week, Ben Crotte, a behavioral health therapist at Children's Home of Cincinnati, speaks to dozens of students in need of an outlet.   Their challenges run the adolescent gamut, from minor stress about an upcoming test to severe depression, social isolation and bullying.

Amid the flood of conversations, meetings and paperwork, the challenge for Crotte - and mental health professionals everywhere - is separating hopeless expressions of pain and suffering from crucial warning signs that suggest a student is at risk for taking their own life.

It's a daunting, high-pressure task, which explains why Crotte was willing to add another potentially useful tool to his diagnostic kit: an app that uses an algorithm to analyze speech and determine whether someone is likely to take their own life.

It's name: "Spreading Activation Mobile" or "SAM."  Read more here.
Addressing Language Barriers in Patient-Provider Communication

Meaningful patient-provider interactions are at the heart of a valuable clinical encounter, allowing providers to fully engage patients in the healthcare experience. But in an increasingly diverse healthcare industry, language barriers and limited English-proficiency can significantly hinder patient-provider communication.

Limited English-speaking proficiency is a widespread problem across the country. Eight percent of the 52 million Medicare beneficiaries have limited English proficiency, according to a 2017 CMS 

Beneficiaries in urban areas are four times as likely to face language barriers as patients living rural regions, with two percent of urban-dwelling patients having limited English proficiency and eight percent of urban beneficiaries having the same limitations.  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.