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August 31, 2017

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

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Francine Sinkoff, Editor

Important Update for Rest-of-State Adult BH HCBS Providers

Please see the following message  from OMH Rehabilitation Services Unit:

Letters were distributed via email to all Rest-of-State Designated Providers of Adult BH HCBS. It has been brought to our attention that the End-of-Hiatus letters and Attestation of Readiness forms which were sent out to Rest-of-State Providers were erroneously dated 07/01/17. This was due to an error in our database that generated the letters. Please note that the correct date on the letters should be 08/15/17. Rest-of-State Providers must submit their Attestations of Readiness by 09/15/17. If you did not receive a letter or are unable to open the attachment, please email us at Thank you in advance for your patience and understanding.

Extended Feedback Period for DRAFT Transition Plan for the Children's Medicaid System Transformation

Building on our past work and the submission of the 1115 MRT Waiver Children's Amendment to Centers for Medicare and Medicaid Services (CMS) on May 8, 2017, New York State has developed the DRAFT Transition Plan for the Children's Medicaid System Transformation.   The draft Transition Plan, which is also subject to approval by CMS, is being shared with interested stakeholders for review and comment. 
We received several requests for an extension to provide feedback on the DRAFT Transition Plan for the Children's Medicaid System Transformation. Please note comments are now due no later than September 8, 2017, and must be submitted to . In the subject line please indicate "Draft Children's Transition Plan Comments".  In your comments, please indicate the section and page number to which your comment refers.
Integrated Primary-Care Models Expand Access to Opioid Abuse Treatment

Patients with substance use disorder had greater access to treatment and were more likely to refrain from using drugs when cared for within a primary care setting that had an integrated behavioral health component compared to patients who only received a referral to see an addiction treatment specialist, according to a new study .

The study, published Monday in  JAMA Internal Medicine, found 39% of patients treated in a collaborated primary care model received addiction treatment versus just 17% of the group who received standard primary care. Also, 32% of patients in the collaborated model reported remaining abstinent from opioids or alcohol after six months compared to 22% of patients in standard primary care.

"These findings suggest that treatment for opioid and alcohol use disorders can be integrated into primary care, and that primary care-based treatment is effective for opioid and alcohol use disorders," the study concluded.  Read more here.
Making Smoking Cessation Work For People With Mental Illnesses And Other Vulnerable Populations

The prevalence of cigarette smoking among adults is now at a modern low of 15 percent, and youth rates are also down for high school seniors, with only 3.4 percent smoking daily. Yet this is not a time to become complacent and move on to other public health problems. As many as 40 million people still smoke, and half of them will die prematurely as a result. Furthermore, smoking rates remain high among the most vulnerable populations, such as people with mental illnesses or substance use disorders, necessitating policies and strategies targeted specifically at them, as well as support for tobacco control at the federal, state, and local levels.

Smoking rates have declined much faster among prosperous, well-educated people than they have among the less fortunate. As a result, smoking is now concentrated among special populations: People with mental illnesses have smoking rates that range from 30 percent to more than 50 percent, depending on the specific diagnosis. People with substance use disorders have even higher rates-from about 50 percent for those who abuse alcohol to more than 77 percent for those who abuse heroin.  Read more here.

September 5, 4 - 5 pm, SAMHSA-GAINS Center

September 6, 10 - 11 am, OMH

September 7, 12 - 1 pm, National Council for Behavioral Health

September 8, 2 - 3 pm, OMH

September 12, 2:30 - 3:30 pm, National Council for Behavioral Health

September 13, 2:30 - 3:30 pm, National Council for Behavioral Health

September 14, 12 - 1 pm, PsychU

September 19, 1 - 2 pm, Pathways RTC

Enable Access to Client-Level Data in PSYCKES
September 20, 10 - 11 am, OMH

September 28, 12 - 12:30 pm, PsychU

October 12, 2 - 3:15 pm, Stepping Up 

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


Officers, Chairs & Regional Reps Call
September 6:  8 - 9 am

Fall Full Membership Meeting
September 11 - 12
Crowne Plaza, Lake Placid

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

Officers, Chairs & Regional Reps Call
October 4:  8 - 9 am

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

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Governor Cuomo Announces New Actions to Strengthen the Fight Against Heroin and Opioid Addiction

Governor Andrew M. Cuomo on Tuesday announced two new actions to expand addiction treatment and recovery services for people across New York. A Request for Applications makes up to $4.5 million in funding available to develop nine Open Access Centers across the state and a Request for Information has been released that seeks input on the development of two pilot recovery high schools. These actions were announced at the grand opening of a new $8.4 million outpatient addiction treatment center in Rochester, and are key elements of the Governor's State of the State address and 2018 FY State Budget.

"With these latest efforts and the opening of a new outpatient center in Rochester, New York continues to break down barriers for residents in need of treatment and recovery services," Governor Cuomo said. "We will continue the fight to break this vicious cycle of addiction and make critical funding available in order to support a stronger, healthier New York for all."  

"As co-chair of the NYS Heroin and Opioid Task Force, I have heard from families all across New York who have felt the impact of this deadly addiction," said Lieutenant Governor Kathy Hochul. "This administration is taking aggressive actions to combat addiction, provide resources, and support the vital recovery of our families and communities. Open access centers will secure the supportive environments that our communities need and provide families with a place to turn in times of crisis."   Read more here .
Request for Applications (RFA): Open Access Centers

The New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) announces the availability of funding and is seeking applications from eligible applicants to support the development of Open Access Centers in the following New York State Economic Development Zones (EDZ): Western New York, Finger Lakes, Southern Tier, Mohawk Valley, North Country, Capital Region, Mid-Hudson, New York City and Long Island.  Awards resulting from this procurement are to establish 24 hours a day, 7 days a week (24/7) access to immediate engagement, assessment and referral for all substance use disorder (SUD) services and interventions. 
The primary goal is to establish Open Access Centers, available 24/7 to anyone in need of services and interventions for their addiction. Open Access Centers will not require certification and therefore can be implemented immediately in all communities. It is anticipated that providers will work together to identify a convenient and accessible location, where staff will be on-hand 24/7 to immediately engage with individuals, family members and/or law enforcement, etc. for the provision of SUD services and interventions. Staff should also be available or on-call to provide an immediate assessment and referral (and "warm handoff") to the appropriate level of care.
Eligible Applicants: 
  • County Local Governmental Units (LGUs) planning to directly provide the services required in this Request for Applications (RFA)
  • Not-for-Profit agencies - must be prequalified in the NYS Grants Gateway when submitting an application.
Application Deadline: 
5:00PM, October 31, 2017
Full RFA can be found here.
OPWDD Announces 455 New Certified Residential Opportunities to Be Developed Under Multi-Year Housing Strategy

Please read the following message from OPWDD Acting Commissioner Delaney:

The Office for People With Developmental Disabilities (OPWDD) provides housing supports to more than 41,000 people with developmental disabilities, helping the individuals we serve to live full and active lives in the community. As part of the Transformation Panel listening sessions and other opportunities for public comment, I have heard repeated concerns from families and self-advocates seeking residential services, particularly where the family caregiver is aging or experiencing significant difficulty caring for their loved one at home. One of the key recommendations of the Transformation Panel was the implementation of a multi-year housing strategy designed to ensure that sufficient new opportunities can be developed so that families can assist their loved ones in moving into a housing opportunity before a crisis arises.
In furtherance of that recommendation, I am pleased to announce that OPWDD's Regional Offices have issued five regional Requests for Services (RFS') for the creation of 455 new certified residential opportunities. In addition to these 455 opportunities, more new development of certified opportunities is expected in the future to further meet demand as we continue to evaluate need. Each of these new opportunities will provide certified housing with person-centered supports tailored to each person's needs. These additional residential services are being created primarily to assist people living at home who need to transition to OPWDD residential services in the community.
As you may know, OPWDD has reached out to people with developmental disabilities, their families, providers and advocates as partners in transforming the OPWDD system. We have done this by holding public forums, offering opportunities for public comment on key policy initiatives, and implementing the recommendations of the Transformation Panel. The multi-year housing strategy reflects these conversations and recommendations, as well as work conducted through our Residential Request List review initiative. As we put the multi-year housing strategy into action, we will be able to provide even more possibilities for people with developmental disabilities to find a place to call home.
Providers are encouraged to respond to the RFS' and begin working with families who may be interested in and need certified residential services, in cooperation with OPWDD's Regional Offices. OPWDD also has resources to support additional non-certified residential opportunities. We encourage providers to come forward to their Regional Offices to develop additional non-certified opportunities.
Thank you for your continued support as we work to provide residential supports that maximize independence and meet people's needs.
Providers Feel the Pain of Slow Medicaid Mental Services Rule Rollout

David Ramsey's hospitals and emergency departments in West Virginia see the effects of the opioid epidemic every day. Medicaid beneficiaries battling addiction and psychiatric disorders crowd into his emergency departments even though the CMS has launched a nationwide policy to pay for substance abuse treatment and stays at inpatient psychiatric facilities.

But a year after that Medicaid policy became effective nationwide, Ramsey's hospitals have seen no relief. Each week, Ramsey's Charleston Area Medical Center has to ask a local court to conduct mental hygiene hearings that Medicaid patients need in order for the state to approve their transfer to a free-standing psychiatric hospital that can provide them better care for their severe mental health or substance abuse issues.

In the meantime, those patients are spending hours or days in his emergency departments, unable to get the level of care they need. Unlike general acute-care hospitals, free-standing psychiatric facilities have staff that specialize in a gamut of mental illnesses.  Read more here.

What Does 'Value-Based' Look Like In The I/DD Field?

Since publishing our last few pieces on the changes in the I/DD market - The Future Of IDD Is In The Home, Strategy In The I/DD Market, and The I/DD Market Evolution - we've had a number of OPEN MINDS Circle member requests to provide some concrete examples of performance measures, service guidelines, and value-based reimbursement (VBR) arrangements.

As it happened, the New York Office for People With Developmental Disabilities (OPWDD), in conjunction with the New York Department of Health (DOH), plans to launch care coordination organization health homes (CCO/HHs) for consumers with developmental disabilities in July 2018 (see New York Medicaid To Launch Health Homes For People With Developmental Disabilities). It is a perfect example of this shift in the market.

The Consumers & Eligible Provider Organizations
The CCO/HH program will enroll consumers with an I/DD whose condition results in a substantial handicap to their ability to function normally in society. Eligible conditions include but are not limited to mild to profound intellectual disabilities, speech and language disorders due to hearing loss, autistic disorders, epilepsy, and cerebral palsy. Individuals with I/DD who do not have a substantial handicap may enroll in the CCO/HH program if they have another chronic condition.  Consumers may opt-out of the program, but must have their home- and community-based services (HCBS) case management services provided through the CCO/HH.  Read more here.
States Add a Human (Services) Touch to 'Stat' 

In the 1990s, the New York City Police Department launched a new management approach, called CompStat, that has since transformed the way many governments operate across the country.   It requires regular reports from bureaucrats and meetings about the performance statistics that they collect. The aim of such "Stat" programs is to achieve better outcomes: whether that means repairing potholes faster, driving the murder rate down or improving the water quality.

More than 20 large cities and a handful of counties now have Stat programs. Only a few of them apply the data-driven approach to human services.

One of the pioneers of Stat programs for human services is Reggie Bicha. In 2009, he created KidStat, a program focused on child welfare in Wisconsin. Two years later, he joined Colorado Gov. John Hickenlooper's administration to establish C-Stat.   Bicha, who oversees C-Stat and the state's human services department, about how Colorado went from being one of the worst to one of the best states at getting benefits to unemployed and low-income people, and how it has nearly eliminated the use of physical interventions in state psychiatric hospitals.  Read more here.
An Untapped Opportunity For Health Care Progress: Redesigning Care For High-Need Patients

While uncertainty and debate about health care reform remains, there is near-universal agreement on the need to improve care delivery and health outcomes and decrease the rate at which spending continues to grow. An underrecognized but crucial component to achieving these goals is redesigning care for "high-need patients"-in other words, the small cohort of patients with complex needs who represent the greatest usage of the health care system.

Currently, 1 percent of patients account for more than 20 percent of health care expenditures, and 5 percent account for nearly half of the nation's spending on health care, according to the  Agency for Healthcare Research and Quality. Driving these costs for high-need patients are the functional limitations that impact patients' daily living and ability to cope with health challenges, leading to their use of health care and social services that are often too late and poorly matched to their needs.

A 2014 survey conducted by the Commonwealth Fund found that high-need patients are  highly susceptible to lack of coordination within the health care system and are more likely to experience cost-related barriers to accessing care, compared to other older adults.  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.