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February 3, 2016

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

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Francine Sinkoff, Editor

NYSAC and NYSCEA Submit State Budget Testimony 

Last week, the New York State Association of Counties (NYSAC) and the New York State County Executives Association (NYSCEA)
submitted The County Perspective on the 2016-17 Executive State Budget Proposal to the Joint Legislative Fiscal Committees. Click here to read the full testimony.
New Medicaid Rule Requires Face-to-Face Doc Visits Before Home Health Services

Beginning July 1 physicians must document a face-to-face encounter with a patient to validate Medicaid  coverage for home health services  and medical equipment.

A similar rule has long been in effect for Medicare. The  final regulations imposing a similar rule for Medicaid come nearly five years after the CMS first proposed the policy under a provision of the Affordable Care Act. 

To validate the need for coverage under the new rule, a physician must document that a face-to-face encounter took place no more than 90 days before or 30 days after the start of services. 

For a patient to get medical equipment, a physician or authorized provider must document that an encounter took place no more than six months before the equipment was received.  Read more here.
SAMHSA to Offer 6-Week EHR Boot Camp Series

Join SAMHSA for its inaugural live, online training series to help get substance use and mental health treatment organizations into shape to thrive in a digital health care environment!

This series is designed to help behavioral health leaders increase their understanding of electronic health records (EHRs) and prepare to implement EHR systems within their organizations. Participants will learn about the benefits of EHRs and have the opportunity to get their questions answered and concerns addressed alongside other substance use and mental health treatment leaders. Health information technology experts will offer step-by-step instructions to participants to help them navigate the planning, implementation and go-live stages of EHR adoption and problem solve the barriers to successful implementation.

Each weekly session will present fundamental considerations and resources to guide the EHR decision-making and implementation process.

WHAT: Six-week series of live, interactive weekly training sessions 

WHEN: Wednesdays, February 10 - March 16, 3:00pm - 4:00pm ET 



QUESTIONS? Please contact

Take advantage of this opportunity to get your questions answered and make an informed decision.


February 19, 11 am - 12 pm

Three-Part Contracting Series for Rest-of-State (ROS) Adult Behavioral Health Providers

Part I: Webinar - Feb. 10, 10 am - 11 am
Contracting basics, foundational information, and an overview/use of contracting tools with Adam Falcone, JD, MPH, Feldesman Tucker Leifer Fidel LLP 

Rules of the road, timelines, and protections from the State with Andrew Cleek, PsyD and Boris Vilgorin, MPA

Transforming the Children's Medicaid System Webinar Series


Officers & Chairs - Call in
February 10:  8 am

CLMHD Office Closed - Lincoln's Birthday
February 12 

CLMHD Office Closed - Washington's Birthday
February 15

Children & Families Committee
February 16:  11:30 am - 1 pm
GTM Only

OMH Agency Meeting
February 22:  10 am - 12 pm
44 Holland Ave., 8th Fl, Albany

OASAS Agency Meeting
February 22:  1 pm - 3 pm
1450 Western Ave., 4th Fl, Albany

MARCH 2016
Officers & Chairs - Call In
March 2:  8 am

Mental Hygiene Planning - In Person
March 3:  11 am - 2 pm
Syracuse, NY

Children & Families Committee
March 15:  11:30 am - 1 pm

Director's Meeting - In Person
March 22:  10 am - 12 pm
41 State St., Ste. 505, Albany

Executive Committee - In Person
March 22:  12:30 - 2 pm
41 State St., Ste. 505, Albany

Developmental Disabilities Meeting
March 30:  11 am - 12 pm
GTM Only

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Obama Seeks $1 Billion to Fight Heroin Epidemic

President Obama will propose $1.1 billion in funding over the next two years to fight the opioid and heroin epidemic. The funding request in his 2017 budget proposal would address the harrowing epidemic, which has ravished communities in all corners of the U.S.

Under the budget proposal, Obama would designate $920 million for expanded access to medical-assisted treatment for opioid addiction, which marries behavioral therapy and medication to help abusers recover. The budget would also call for $500 million worth of investments in prescription-drug monitoring programs at the state level, increasing the development and use of the opioid-reversal treatment naloxone, and supporting law enforcement efforts to target drug distribution.

The proposal would more than double the amount of funding that is currently going toward the epidemic; the majority of the new funds would go toward closing what Health and Human Services Secretary Sylvia Burwell calls the "treatment-gap." A 2012 study found that while an estimated 2.4 million Americans are dependent on opioids,  only about 1 million had access to medication-assisted treatment. Obama signed a budget in December that allocated $400 million to address the epidemic, a jump of $100 million from 2014, and funding has increased as the epidemic has grown. But the Obama administration says more is needed to confront the epidemic.  Read more here.
Governor Cuomo Awards $1.6 Million to Support New Clubhouses for Teens and Young Adults Battling Addiction 

Governor Andrew M. Cuomo last week announced more than $1.6 million in annual funding to create first-of-their-kind adolescent substance use disorder clubhouses in seven regions across New York State. These community-based clubhouses will promote peer-driven supports and services in a non-clinical setting for young New Yorkers in recovery or at risk for substance use disorders. This new and innovative model for providing addiction services is the latest of the Governor's comprehensive efforts to combat addiction and support recovery in communities throughout the state.

The seven organizations receiving funding will help individuals in recovery develop social skills that promote prevention, long-term health, wellness, recovery and a drug-free lifestyle. A variety of services and activities will be available, including homework help and tutoring, college and job preparation, community service opportunities, sports and fitness activities, group entertainment activities, and peer mentoring. Youth and family advisory board members at each clubhouse will help shape activities and programming.

New York State Office of Alcoholism and Substance Abuse Services Commissioner Arlene González-Sánchez  said,
"Adolescents  and young adults that have battled addiction need to be supported every step of the way as they recover so that they can sustain long-term recovery. These clubhouses will not only give young people the support they need, but also will provide a safe environment where they can stay active with peers and family, while maintaining a sober, drug-free lifestyle." 

Click here to learn more about the Clubhouse grant winners.
Variations In A Gene Provide Clues About Schizophrenia

Schizophrenia might be linked to a 
gene that tells the immune system to destroy too many connections in the brain, according to the results from a massive gene-focused research effort.

Scientists at Harvard University and the Broad Institute studied the genomes of 64,785 people around the world and found that those with the debilitating psychiatric disease were much more likely to possess mutations of a common gene, according to the findings published last
Wednesday in the journal  Nature.

People with schizophrenia - more than 21 million worldwide - tend to have less gray matter and fewer connections in their brain than healthy peers. But scientists aren't sure why. The research, for the first time, suggests that variations in a gene called complement component 4, or C4, for short, could be important. The gene had previously been known to help the immune system target infections.

A mutant form of the gene makes proteins that tag an excess number of brain synapses for destruction. This explanation meshes neatly with the tendency of schizophrenia to
arise during adolescence, a period during which even healthy brains are busy pruning lots of connections.   Read more  here .
More than Half of ACOs Lack Behavioral Data

Despite investments in health information technology (HIT), accountable care organizations (ACOs) still face interoperability challenges that make it difficult to integrate data across the healthcare continuum. For example, according to a recent survey by eHealth Initiative and Premier, Inc., more than half (53%) of ACOs have not integrated data from behavioral health providers.

Behavioral health and substance abuse data's complex informed patient consent rules and other legal restrictions complicate integration, according to the survey report. A number of respondents rate behavioral health as harder to integrate than other types of data (10%).

ACOs also continue to struggle with integrating disparate clinical sources. Findings show that 39% of ACOs integrate data from one to 10 health information systems, 44% integrate data from 11 to 50 systems, and 11% from more than 50 systems.  Read more here.
Five Emerging Medicaid Accountable Care Organization Priorities

State Medicaid agencies are increasingly looking to accountable care organizations (ACOs) as a way to  improve health care quality and reduce costs . As additional
states pursue Medicaid ACOs, both existing and newly designed models are becoming more sophisticated by expanding their scope of services, focusing on specific patient populations with complex needs, and weaving ACOs more fully into state health care environments.

Six states - Colorado, Iowa, Massachusetts, North Carolina, Rhode Island, and
Washington  - are furthering their Medicaid ACO programs with the assistance of the Center for Health Care Strategies' (CHCS) Medicaid ACO Learning Collaborative, which is supported by The Commonwealth Fund. In working with CHCS, these states and others identified five critical issues to focus on to ensure long-term ACO success:
  1. Caring for Complex Populations. 
    Early ACO financial success hinges on successful care management for patients with complex social and medical needs. New Jersey's
    Medicaid ACO program 
    a payment model that focuses on this high-need population. States have also designed their ACO programs to integrate with Medicaid health home programs that provide care coordination payments for beneficiaries with multiple chronic conditions. 
  2. Leveraging Existing Medicaid Initiatives. In addition to health homes, states are looking both to support Medicaid ACOs with existing programs and to support existing efforts with ACOs. Some states are using federal State Innovation Model (SIM) resources to help their Medicaid agencies advance ACO efforts by investing in health information technology or developing partnerships with organizations in communities served by ACOs. A number of states also participate in the Delivery System Reform Incentive Payment program and can integrate those innovations to drive ACO development, as New York is planning to do.  Read more here.

Community Groups Worry About Being Left Out of Medicaid Reform

Anthony Feliciano is popular these days. He is the director for the Commission on the Public's Health System, a Manhattan-based nonprofit that advocates for medically underserved populations.   In that role, he has been approached by several of the largest health systems in the state, which have asked what the community he serves needs to improve its collective health. Feliciano spends a few minutes on the phone and patiently answers their questions.
He's told they might follow up. Some do, some don't.

The state's largest health systems have a renewed focus on population health because of the Delivery System Reform Incentive Payment program, a $7.3 billion plan to change how health care is delivered.  The goal of the program is to reduce avoidable hospitalizations by 25% over five years, which means hospital administrators need to reach people before they walk through their door.  The program was set up to encourage groups of providers to work together, including hospitals, physicians and community-based organizations - like Feliciano's - that serve special populations within a community.

Working with community-based organizations was a requirement laid out in the program. But Feliciano says he came to realize that his brief phone calls amounted to a health system's idea of engagement.  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.