September 2, 2021
Dealing With Mental Health Crisis One Zoom Call at a Time

The sergeant had so little use for the tablet that she did not bother to grab it from the seat of her squad car when she ran into the house where a suicidal man was screaming and slamming his head against the floor.

But when she saw the man might harm himself, his family or her officers with knives he was threatening to use, she sent an officer to retrieve the tablet. She turned it on, handed it to the man and told him to talk to the woman whose face appeared on the screen. And then she watched as the man immediately calmed down.

"When I saw how this tool pacified him, I was like, holy smokes, this is incredible,” said Cook County Sheriff's Police Sgt. Bonnie Busching. Read more here.
Replacing Police In Mental Health Crises: These NYers Have A Plan

For many New Yorkers experiencing a mental health crisis, having the police called did not end well. The list is long and includes Deborah Danner, Saheed Vassell, Mohamed Bah, Eleanor Bumpurs.

All were fatally shot by responding NYPD officers. Others complained of being brutally mistreated. Of them, a few have come together to demand change.

The group CCIT-NYC, or Correct Crisis Intervention Today - New York City, was formed to demand replacing police in mental health emergencies with EMTs and trained responders who themselves have a background of mental health issues, known as peers. Read more here.
Many ERs Fail People Who Struggle With Addiction. These New Approaches Might Help

For years, Kayla West watched the opioid epidemic tear through her eastern Tennessee community. As a psychiatric nurse practitioner, she treated people with mental illness but felt she needed to do more to address addiction.

So in 2020, when the state created a position to help hospitals improve addiction care in the emergency room, West jumped at the opportunity.

She knew that many people with substance use disorders land in the ER, and that starting medications for opioid use — like buprenorphine (often known by the brand name Suboxone) — could double a person's chance of staying in treatment a month later. Read more here.
Loopholes Leave Gaps in Mandated Coverage for Mental Health

One 16-year-old spent 28 days in treatment for substance abuse but was forced to leave once his parents’ insurance coverage ran out.

Weeks later, he wound up back in the hospital. His parents are now shelling out thousands of dollars for another program, depleting all the money they had saved for his college tuition.

And the family of a dangerously depressed teenager chose to continue hospitalizing their child despite the refusal by their insurance plan, for West Virginia state employees, to cover more than 30 days of hospital care in a year, leaving them with tens of thousands of dollars in unpaid medical bills.

The pandemic has fueled a soaring need for mental health and substance abuse services, revealing deepening gaps in coverage under the Mental Health Parity and Addiction Equity Act of 2008, the landmark law intended to eliminate a double standard in insurance coverage. Exemptions under state or local government coverage for employees like teachers and police officers and potentially illegal workarounds put in place by employers and insurers, coupled with lax oversight, have resulted in unequal access to care for millions of people. Read more here.
Pandemic Unveils Growing Suicide Crisis for Communities of Color

Rafiah Maxie has been a licensed clinical social worker in the Chicago area for a decade. Throughout that time, she’d viewed suicide as a problem most prevalent among middle-aged white men.

Until May 27, 2020. That day, Maxie’s 19-year-old son, Jamal Clay — who loved playing the trumpet and participating in theater, who would help her unload groceries from the car and raise funds for the March of the Dimes — killed himself in their garage.

“Now I cannot blink without seeing my son hanging,” said Maxie, who is Black.

Clay’s death, along with the suicides of more than 100 other Black residents in Illinois last year, has led locals to call for new prevention efforts focused on Black communities. Read more here.
Communities across the U.S. are launching new responses to emergency calls. They are redefining who answers calls for service involving mental health or substance use crises, homelessness, “quality-of-life” issues, and other low-level situations.

Taking the Call will bring people together from across the U.S. to explore how jurisdictions are serving as laboratories for innovation to ensure that emergency calls receive the appropriate response. The conference will explore the opportunities and challenges of these community responder models and whether or how the approach may improve community health, lessen the burden on law enforcement, and reduce unnecessary justice system contact.

Taking the Call will be presented virtually on October 20-21, 2021. Read more here.
Breen HCP Protection Act Enters Home Stretch

On August 6, the US Senate called a brief halt to their internecine battles and unanimously passed the act. Aimed to dramatically increase support and reduce the stigma of seeking mental health assistance among health care professionals, the bill is named in honor of Dr. Lorna Breen, a New York City emergency room physician who cared for Covid patients at the height of the horrific NYC outbreak in 2020. Breen contracted the virus herself and committed suicide after returning to treat the sick New Yorkers who continued pouring into city hospitals (and all too often ended up housed in refrigerated morgue trucks).

This landmark legislation is the first to allocate specific funds towards grants for training students, residents, and health care professionals in evidence-informed strategies to reduce and prevent suicide, burnout, mental health conditions, and substance use disorders. Read more here.
Click here to read the Summer 2021 issue of OMH News!
Medicaid Non-Emergency Transportation Benefit: Stakeholder Perspectives on Trends and Innovations
This week, HMA's In Focus section reviews key takeaways from the report, Medicaid Non-Emergency Transportation Benefit: Stakeholder Perspectives on Trends and Innovations, prepared by Health Management Associates (HMA) for the Medicaid and CHIP Payment and Access Commission (MACPAC). The report was written by Principal Sharon Silow-Carroll, Principal Kathy Gifford, Senior Consultant Carrie Rosenzweig, Consultant Anh Pham, and former Managing Principal Kathy Ryland (retired).

States are required to provide non-emergency medical transportation (NEMT) to Medicaid beneficiaries with no other means of transportation. In December 2020, following the completion of this study, Congress added a requirement for states to provide NEMT to the Social Security Act (the Act) through the Consolidated Appropriations Act of 2021 (P.L. 116-260). Previously, NEMT was mandated by federal regulations derived from the general statutory requirement that states must “ensure necessary transportation” for Medicaid
beneficiaries to assure access “to and from providers” (42 CFR 431.53). Within these guidelines, states have significant flexibility in how they deliver the NEMT benefit to best meet the unique challenges and needs of their beneficiaries, including the delivery system model, reimbursement approach, and transportation modes. Read more here.
What Does Patient-Centered Care Truly Mean?

Patient-centered care may be the healthcare buzzword of the past decade, with industry leaders spouting off the phrase as a panacea for all of medicine’s biggest challenges.

It’s a natural progression: putting patients seemingly at the center of their own healthcare should yield a better patient experience, more targeted and personalized therapies, and a more streamlined process for patient access and billing.

But like all buzzwords, the phrase “patient-centered care” may have been obscured by its overuse. What does patient-centered care truly mean for medicine, and where does healthcare face both challenges and opportunities in using patient-centered care to support its overall value-based care goals? Read more here.
CCBHC Model Puts ‘Building Blocks into Place for Value-Based Payment Success’

The Certified Community Behavioral Health Clinic (CCBHC) model has been shown to reduce hospitalizations, cut costs and improve employee recruitment and retention for participants. And on top of all that, it can also help set providers up for success in value-based care models.

“CCBHC funds can really help organizations put those building blocks into place for value-based payment success in the future,” Heidi Arthur, the principal of Health Management Associates (HMA), said. “We know that because they’re already demonstrating significant savings, and it’s those kinds of savings that really make the case for targeted investments under value-based payment arrangements.”

Arthur made those comments Thursday during a recent webinar hosted by her organization. HMA is a health care research and consulting firm that helps clients with a wide variety of projects, including CCBHC applications and implementation. Read more here.
SUD Stakeholders’ Call to Payers: Contingency Management Key to Treating Stimulant Use Disorder

The opioid epidemic isn’t the only drug-related crisis sweeping the country. Stimulant use is also on the rise, with deaths attributable to those drugs increasing 10-fold between 2009 and 2019. And, in 2020, overdose deaths involving cocaine and psychostimulants such as meth increased 26.5% and 34.8%, respectively, according to the CDC.

From a regulatory standpoint, opioid use disorder (OUD) tends to overshadow stimulant use disorder, as it affects more people. But still, stimulants caused more than 20,000 overdose deaths in 2020. Plus, stimulant use disorder can’t be mitigated by medication-assisted treatment, which is largely considered the gold standard for opioid use disorder (OUD).

Instead, an incentive-based treatment called contingency management has proven to be the best course of action for stimulant use disorder. But despite strong evidence that the practice improves patient retention, care transitions and outcomes, relatively few behavioral health providers offer the treatment. Read more here.

Navigating Around The Giants

Today, I attended the OPEN MINDS Health Plan Partnership Summit: An Assessment Of Payer Partnership Priorities In The “Next Normal” with its focus on the state of collaborations between health plans and provider organizations. Opening the summit, our co-chairs—OPEN MINDS Vice President Richard Louis III and OPEN MINDS Senior Associate Cathy Gilbert—provided an overview of the current health plan landscape (see Health Plan Partnership State-of-the-State). They emphasized three developments that are shaping health plan and provider partnerships—the growing health plan footprint, the digital evolution, and the focus on integrated care. Read more here.

September 8, 12 - 1 pm, National Council for Mental Wellbeing

September 8, 1:30 - 3 pm, CMS

September 10, 12 - 1 pm, American Association of Suicidology

September 10, 12 - 1 pm, PsychU

September 14, 12 - 1 pm, PsychU

September 15, 2 - 3 pm, National Council on Aging

September 15, 3 - 4:30 pm, NAADAC

September 16, 12 - 1:30 pm, Suicide Prevention Center of NY

September 16, 12:30 - 2 pm, SAMHSA's GAINS Center

September 22, 2 - 3 pm, National Association for Mental Wellbeing

September 28, 29, 30, OMH/Suicide Prevention Center of NY

September 29, 11:30 am - 1 pm, FOR-NY

September 30, 10 am - 6 pm, American Association of Suicidology


September 6

Mental Hygiene Planning Committee Meeting
September 8: 1 - 3 pm

Addiction Services & Recovery Committee Meeting
September 9: 11 am - 12 pm

LGU Clinic Operators Call
September 14: 10 - 11:30 am

Children & Families Committee Meeting
September 21: 11:30 am - 1 pm

Membership Call
September 22: 9 - 10:30 am

Developmental Disabilities Committee Meeting
September 30: 1 - 2:30 pm


LGU Billing Staff Call
October 7: 2 - 3 pm

Mental Health Committee Meeting
October 7: 3 - 4 pm

October 11

LGU Clinic Operators Call
October 12: 10 - 11:30 am

Addiction Services & Recovery Committee Meeting
October 14; 11 am - 12 pm

Children & Families Committee Meeting
October 19: 11:30 am - 1 pm

CLMHD Fall Full Membership Meeting
October 21-22 in Saratoga Springs, NY. Virtual option will be available.

Mental Hygiene Planning Committee
October 27: 1 - 3 pm
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.

Affiliated with the NYS Association of Counties (NYSAC)