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April 12, 2017

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

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Francine Sinkoff, Editor

OMH Releases Statewide Comprehensive 5-Year Plan 

OMH has released its Statewide Comprehensive Five-Year Plan for 2016-2020.  Also known as the "5.07 Plan" (after section 5.07 of NYS Mental Hygiene Law), the 2016-2020  Comprehensive Plan includes a review of consumers, services and  programs, and gross expenditures within the New York State public mental  health system. The 5.07 Plan also reviews several top priorities for OMH  policy and planning efforts in the current and upcoming years. 

Click here to read the Statewide Plan.
Position Available:  Hudson, NY

Full-time Licensed Social Worker and/or CASAC to work in busy NYS OASAS-licensed outpatient chemical dependency clinic in Hudson, NY.   Good benefits, pleasant work environment, equal opportunity employer.  Send resume to
Suicide 'Postvention' Team Launched in Clinton County

The Clinton County Suicide Postvention Response Team is now up and running.

The group of skilled, trained volunteers was born from the efforts of an ad hoc committee of the Clinton County Community Services Board, Board President Richelle Gregory said, and went live Saturday.

Their goal is to provide "postvention services to families, faith-based groups, schools and work places, etc., who have lost a loved one to suicide in Clinton County" in order to promote healing and reduce risk, according to a Clinton County Coalition to Prevent Suicide press release.

"Why postvention? Because it serves as a powerful prevention strategy," Coalition Chair Amanda Bulris said at a recent press conference.  Read more here.
Public Comment: VBP Patient Confidentiality Workgroup Recommendations Report

A Recommendations Report for the
Value Based Patient Patient Confidentiality Workgroup
has been finalized and posted to the VBP website for public review here.

The public comment period will occur for the next 30 days concluding on May 5, 2017. During this period, any comments can be sent to
Niagara County Pushes for New County-Wide Ambulance Service

Officials in Niagara County want Mercy EMS to provide county-wide ambulance services.

The non-profit would replace Twin City and American Medical Response, which are currently providing services to the county.
The conflict started in the summer of 2016, when American Medical Response pulled out of the majority of Niagara County.

Now the county wants Mercy EMS to take over county-wide.  

Director of Mental Health in Niagara County, Laura Kelemen, feels poor response times are impacting an especially vulnerable patient population .

For a mental emergency call, which Kelemen said come equally from urban and rural areas in Niagara County, an ambulance service is called.

Kelemen stated response times for rural mental health patients have been so bad so that law enforcement has had to help. Read more here.
Is Utilization Management the Enemy or the Friend of Good Psychiatric Clinical Services? 

In many an agency, hospital and insurance company, the Utilization Management or Utilization Review teams are seen as the antithesis of clinical services. 

Tasked with reducing expenses for the organization, determining the right level of care for a patient, and helping move the patient through the continuum of care from highest and most expensive to lowest and least expensive, the UM/UR departments are the bean counters of clinical organizations.  Clinicians often see them as getting in the way, as being stingy with the services that are available.  They are the "No" team.  No, this patient cannot stay longer, no this patient cannot be admitted to this facility or that after care program.

But is this true?  Is there any good that comes from these accountant types?  Do they even understand what the clinicians are trying to do out here?  Read more here.
Inside The Hole: What Happ ens To The Mind In Isolation?
Imagine a concrete room, not much bigger than a parking space. No window. You're in there 23 hours a day, 7 days a week; you don't know when you'll get out of this room. A month? A year? A decade?

Our minds don't do well with that kind of solitude and uncertainty.

Keramet Reiter, a criminology professor at UC Irvine, has spent more than a decade researching solitary confinement. In her new book,  "23/7: Pelican Bay Prison and the Rise of Long-Term Solitary Confinement," she writes about the lives of people who end up in solitary units, some for years.

Reiter says inmates living in isolation crave things we might take for granted, such as the touch of another person or the sight of the moon. They often find it hard to differentiate one day from the next, because the lights are always on in their cells. Tracking weeks, months, or even years often becomes difficult.  Read more here.
PsychU Podcast:   What You Should Know About Behavioral Health Facility Accreditation

Interview with Michael Johnson, Managing Director of CARF International, a non-profit organization that accredits rehabilitation facilities for human services organizations. CARF stands for the Commission on Accreditation of Rehabilitation Facilities. Mr. Johnson discusses the importance of accreditation for behavioral healthcare facilities in the context of today's challenging healthcare environment.

Click here  to listen to the podcast.



May 11, 1 - 2 pm

June 8, 12 - 1 pm


April 14, 2 - 3:30 pm, SAMHSA

April 17, 2 - 3:30 pm, SAMHSA-HRSA 

April 18, 1 - 2:30 pm, Center for Health Care Strategies

April 20, 2 - 3:30 pm, SAMHSA

April 26, 2 - 3:30 pm, SAMHSA

April 26, 1 - 2 pm, Remarkable Health

April 27, 12 - 1 pm, PsychU

April 28, 2 - 3 pm, NYS DOH Division of Long Term Care


APRIL 2017

Children & Families Committee
April 18:  11:30 am - 1 pm, GTM

RPC Leads & Coordinators Call
April 20:  8 - 9 am,  GTM

MAY 2017

Officers, Chairs & Regional Reps Call
May 3:  8 - 9 am, GTM

RPC Leads & Coordinators Call
May 4:  8 - 9 am, GTM

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

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

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
New York State Announces Opening of $16.6 Million Mixed-Use Housing Development in Rochester

The New York State Office of Mental Health and New York State Homes and Community Renewal recently announced the opening of a $16.6 million housing development in Rochester. Alexander Commons will offer affordable and supportive housing options with on-site behavioral health services provided by East House. 

The three-story building has 60 living units, with 30 one-bedroom apartments dedicated for individuals recovering from mental illness. The remaining 30 units are available to low-income individuals or families who qualify. Each unit offers an open floor plan, with energy efficient kitchen appliances. The building is fully accessible to the disabled, with ample parking and a landscaped courtyard, providing recreation space for residents.  Alexander Commons is staffed 24 hours per day, 7 days a week. Read more here.
Albany Police Divert 40 Repeat Low-Level Offenders Into Social Services

For years, Victor shoplifted to support his opioid addiction. At his worst, he was shooting up the contents of 30 to 40 baggies of heroin a day.  Victor, whose name has been changed to protect his confidentiality, was homeless and suffering from several untreated but serious medical issues.

He had a 40-page rap sheet filled with petty crimes by the time he was arrested for shoplifting inside an Albany department store last year. Yet another arrest would do him no good.   The police agreed.   Now, months later, Victor has a home, attends an addiction treatment program and sees doctors.

Last year, 40 people struggling with mental illness, substance abuse and poverty were diverted from the criminal justice system into public health services by Albany's Law Enforcement Assisted Diversion program. All but one of the participants stayed with the program. They are housed, receiving treatment and learning new skills.

The harm-reduction data, and accompanying participant stories, were released in a report Tuesday morning that details the LEAD program's first year of operation. Read more here.
PPS Job Title Vacancy Rate Snapshots Show Workforce Trends

The MRT Department has released a new report titled "Performing Provider Systems (PPS) Job Title Vacancy Rate Snapshots, Demonstration Year 1 (DY1)" to give a high-level overview of job title vacancy rates as reported in the PPS Compensation and Benefits Survey Reports for the 22 job titles considered to be most involved in health care transformation.  The information in the report can be used to inform DSRIP workforce trends, regional patterns and shortages by job title and/or region. 

This report and other workforce related documents can now be found on the new Workforce Documents and Reports webpage here.
DSRIP Year 3 Timeline Released

DSRIP Year 3 began on April 1, 2017. There has been great work done so far by all 25 Performing Provider Systems (PPS), but there is still more to do in order to achieve DSRIP goals. The year ahead is an extremely important one for PPS, as DSRIP is now shifting from pay for reporting to performance accountability. DSRIP year 3 is a pivotal turning point in the program and we are optimistic that we will successfully transform the state's health care system, bend the Medicaid cost curve, and ensure access to quality care for all Medicaid members. The DSRIP year 3 timeline is now available here.
American Telemedicine Association Practice Guidelines for Child and Adolescent Telemental Health Now Available Online
The American Telemedicine Association (ATA) recently released new practice guidelines for child and adolescent telemental health. Based on clinical and empirical research, the guide will be used as an educational tool and operational reference for patient care.

The  telemental health guidelines for children and adolescents provide clinical information for the delivery of mental health and behavioral services by a licensed health care provider through real-time videoconferencing. The document includes a guideline for the practice of clinical telemental health with youth, as well as additional telemental health considerations for young people and an extensive review of the evidence base.
Heroin, Opioid Overdoses: Nalaxone Use on the Rise in Dutchess County

It was a spring-like day on March 29 when 21-year-old Dwayne Joyner found an unconscious man laying atop an elevated windowsill of Chase Bank in the City of Poughkeepsie.

Joyner ran to Nubian Directions where he got a naloxone kit. He had been trained to use the opioid antidote the previous day at Nubian Directions. Joyner gave the man the antidote and he was revived.

In November, pharmacist Sara Kissinger administered two doses of naloxone and revived an unconscious woman who had overdosed in the Rite Aid parking lot in the city.

Since the start of 2017, Dutchess County Sheriff's Office deputies have administered the antidote on 10 occasions  - 10 lives saved in a little over three months, according Sgt. Vincent Stelmach, coordinator of the Dutchess County Drug Task Force.

In the last two years, stories like these have become common. Emergency medical technicians, police, firefighters and ordinary people have used naloxone to save the lives of hundreds amid an opioid-addiction crisis.

The deadly grasp of heroin and opioid addiction throughout Dutchess County has claimed over 220 lives through the past five years. But with the increasing availability of life saving resources, deaths and hospitalizations have been trending down, while naloxone use has been on the rise in Dutchess County and New York state, according to an exclusive Poughkeepsie Journal analysis of New York Department of Health data.  Read more here.
Oswego Adapts to Growing Opioid Crisis 

As people continue to die from heroin and opioid addiction in central and northern New York, communities like Oswego County are offering new treatment programs to combat the crisis. 

Oswego County District Attorney Greg Oakes, who also serves as the county coroner, says at least 22 people died from a heroin or opioid overdose in the county last year. He says that is compelling local leaders to search for new solutions.

"That's at least 22 of friends, neighbors, children, parents from this community that we have lost," Oakes said. "This is not just a public safety issue, but it is very much a public health issue."

Oakes is part of a new program with the Oswego Police Department and Farnham Family Services, a local therapy-based treatment clinic, that allows those suffering from drug addiction to turn themselves and their drugs in to city police. Under the Rapid Evaluation for Appropriate Placement (REAP) initiative, addicts won't be arrested as long as they complete a treatment evaluation with Farnham within five days. Read more here.
Private Insurers in New York See Surge in Claims Related to Opioid Addiction

Private insurance claims for emergency room visits, substance use treatment and other services related to opioid addiction surged in New York state between 2007 and 2014, well before the latest coverage mandates took effect,  new data show .

During that period, the number of claims related to opioid abuse and dependence-two similar but distinct diagnoses-increased 487%, with the sharpest increase taking place between 2011 and 2014, according to a report provided to Crain's by the health care transparency group Fair Health, which has the largest private health claims database in the country.

The state's problem with heroin and opioid painkillers, which mirrors a nationwide trend, has been well-documented, but Fair Health's data identify some alarming local pain points.

For instance, between 2007 and 2014, New York City experienced an 2,600% increase in private insurance claims for treating pregnant women for drug dependence, far outpacing the rest of the state and country.

Such claims, which include dependence on opioids and other drugs, increased about 292% in the city's suburbs during that period; nationwide, they rose about 511%, according to a separate Fair Health report
. Read more here.
SUNY Considers 24/7 Mental Health Telecounseling 

The State University of New York found something alarming, but not entirely surprising, when it commissioned a task force to study mental health issues across its 64 campuses two summers ago.

Nearly half of the more than 19,000 students who responded to a survey reported having an anxiety disorder. More than one-third of the students reported having depression. And more than one-quarter indicated they had some other significant mental health disorder, including but not limited to schizophrenia, and bipolar, dissociative, eating, obsessive-compulsive and post-traumatic stress disorders.

Over an 18-month investigation, the task force was also able to confirm what members had long suspected - that every campus was having trouble keeping up with the demand for help, whether through full-fledged counseling centers or advising and referral services.

In hopes of meeting the demand statewide, SUNY trustees voted this month to move forward with a $1.5 million plan to pilot a telecounseling program at five campuses this fall with a goal of eventually expanding the service to every campus. The program would rely on trained mental health professionals at SUNY's four health centers to provide support via phone or video to students who are in crisis and can't get an appointment nearby.  Read more here.
For Telehealth, The ROI Is Where You Plan For It

Like most technologies in the health and human service space, return-on-investment (ROI) depends on the stakeholder and the situation. The recent ROI studies of telehealth are a great example. On the plus side of the ledger, rural health care, transportation costs, and readmissions cost offsets. On the negative side of the equation, increased costs due to increased access to care. The data is interesting.

Telehealth decreases costs for hospitals in rural health settings

According to a March report from NTCA-The Rural Broadband Association, the ROI for telehealth in rural communities is good (see  Anticipating Economic Returns Of Rural Telehealth), and it can save hospitals in rural parts of the country an average of $81,000 annually, while saving consumers $24,000 in travel costs and $17,000 in lost wages. The national average estimates for annual cost savings include:
  • $5,718 in consumer travel expense savings
  • $3,431 in consumer lost wages savings
  • $20,841 in hospital cost savings
Traveling savings were estimated using average distance traveled per consumer, the average cost per mile, and the number of encounters per year. Lost wages were estimated using the average cost per mile and distance with the average hourly wage rate and time spent raveling, per consumer. 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.