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August 31, 2016

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

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Francine Sinkoff, Editor

Justice Dept. Focuses on Police Treatment of Mentally Ill

Justice Department lawyers investigating police agencies for claims of racial discrimination and excessive force are increasingly turning up a different problem: officers' interactions with the mentally ill.

The latest example came in Baltimore, where a critical report on that department's policies found that officers end up in unnecessarily violent confrontations with mentally disabled people who in many instances haven't even committed crimes.

The report cited instances of officers using a stun gun to subdue an agitated man who refused to leave a vacant building and of spraying mace to force a troubled person - said by his father to be unarmed and off his medications - out of an apartment.

Though past federal investigations have addressed the problem, the Baltimore report went a step further: It was the first time the Justice Department has explicitly found that a police department's policies violated the Americans with Disabilities Act. The finding is intended to chart a path to what federal officials hope will be far-reaching improvements, including better training for dispatchers and officers, diversion of more people to treatment rather than jail and stronger relationships with mental health
specialists.  Read more here .
Chautauqua System of Care Meeting 2016

The 2016 Conference on System of Care Evaluation and Social Marketing will be held on September 15 and 16, 2016, at the Chautauqua Institution, Chautauqua, NY. Registration will begin at 8 am and the programming will end at 4:30 pm.

To register, please click here.
Confused About MACRA? The National Council's Got You Covered!

Over the last month, the National Council held three webinars to shed some light on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the sweeping reforms it makes to payments under Medicare Part B.

The first webinar, "MACRA 101," provided an overview of CMS's proposed Quality Payment Program, which completely overhauls how Medicare Part B clinicians will be paid starting in 2019. The MACRA proposed rule outlines two possible paths to payment-Advanced Alternative Payment Models (APMs), and the Merit-Based Incentive Payment System (MIPS). Because Advanced APMs must use certified electronic health record technology (CEHRT) and assume "more than nominal financial risk," it will not be an option for the vast majority of clinicians. In 2017, CMS predicts that 92 percent of eligible clinicians-including behavioral health care providers-will be subject to MIPS.

The second webinar therefore provided an in-depth look at MIPS and how clinicians will be assessed when it goes into effect on January 1, 2017.  Read more here.


MCTAC is offering a second round of
in-person   small business initiative regional forums specifically geared toward smaller agencies that have little to no experience billing Medicaid or managed care. The trainings will be offered on the following dates: 
  • 9/19/16, Hudson Valley
  • 9/21/16, Albany
  • 9/28/16, Syracuse
  • 9/29/16, Rochester
  • 9/30/16, Buffalo 
Behavioral Health Information Technology (BHIT) for Adult HCBS 101: An Introductory Webinar
September 14, 11 am - 12 pm
September 21, 12 - 1 pm

October 26, 12 - 1 pm

NEW:  Value Based Payment for Medicaid Child Health Services
September 21, 2:30 - 4 pm
The first webinar will highlight relevant data and research, explore the impact of the social determinants of health, and review the implications of healthcare reform for child-serving providers.   
Part II: Measuring Value in Children's Healthcare
September 29, 2:30 - 4 pm
Part two will address how to measure value when it comes to children's healthcare with a focus on measure selection for reporting outcomes and how outcomes align with proposed value-based payment models. Finally, the presenters will explain key differences of value based payment between adult and children's services and strategies for managing multiple payment models.  



Officers & Chairs - Call In
September 7:  8 - 9 am

RPC Advisory Call
September 15:  8 - 9 am

Fall Full Membership Meeting
September 26 - 27
Woodcliff Hotel & Spa, Fairport


Officers & Chairs - Call In
October 5:  8 - 9 am

OMH Agency Meeting &  Director's & Executive Committee Meeting - In Person
October 17:
10 am - 12 pm ( 44 Holland Ave., Albany - 8th Fl.)
1 - 3 pm ( 41 State Street, Ste. 505, Albany)

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
NYS OASAS Invites Substance Use Disorder Prevention Experts to National Conference in Buffalo

NYS OASAS recently announced that registration is open for the 
National Prevention Network Conference to be held September 13-15
 in Buffalo. The conference, to be held at the Buffalo Niagara Convention Center in downtown Buffalo, offers an opportunity for addiction specialists and researchers from across the nation to network and discuss best practices in alcohol and substance use prevention. Attendees will have the opportunity to learn more about prevention in an era of health systems reform, emerging drug issues and trends, building prevention partnerships and collaborations, prevention-focused media messaging, and prevention workforce development.
The conference will feature multiple presentations and workshops all focused on the conference theme: " Advancing a Prevention Agenda in an Era of Health Systems Reform."  The keynote address on 9/13 features Dr. Jeff Levi, Professor of Health Management & Policy at the Milken Institute School of Public Health at George Washington University, where his work focuses on the intersection of public health, the health care systems and the multi-sector collaborations required to improve health.
Click  here   to register for the conference.
DOH Releases Value Based Payment for Providers Video

NYS DOH has shared the latest installment in its NYS Value Based Payment video series called, "VBP For Providers".  The video  highlights how VBP will reshape our healthcare system and the important role providers play within VBP.  More information on VBP can be found on the DOH website here.
A Small Town Struggles With A Boom In Sober Living Homes

When Phillip decided to stop using heroin, he knew sticking around home was a recipe for failure.

"It's just, like, a heroin epidemic on Long Island where I'm from. So I had to get away from that and now I'm in Prescott, Arizona," Phillip says. NPR agreed not to use his last name because he is struggling with addiction and fears it might hurt his chances of future employment.

Phillip and a handful of other young people are filtering through the line at a soup kitchen at the Prescott United Methodist Church just before noon. They are grabbing a bite to eat before their next meeting of recovering addicts nearby.

"Everybody here is basically, I feel like, in recovery and they're more serious about it," says Phillip.

Not like back home in New York, he says, where people shoot up in the parking lot before meetings.

You hear similar stories from others who come to this idyllic mountain community to shake their addiction. Outdoor recreation, a mild climate, scenic vistas and a welcoming attitude toward those in recovery is touted in a promotional video by a group called Drug Rehab Arizona.  Read more here.

States that expanded Medicaid coverage under the Affordable Care Act have unprecedented opportunities to connect adults released from prison or jail with needed physical and behavioral health services and social supports. This population - disproportionate­ly male, minority, and poor - suffers from high rates of mental illness and substance use disor­ders. Providing critical health services and social supports for these individuals can potentially slow the revolving door of recidivism plaguing the justice system and reduce avoidable health care costs.

This brief, made possible through the  Milbank Memorial Fund's Reforming States Groupexamines how innovative state and county authorities are improving health services for the justice-involved, mainly through comprehensive care coordination interventions to ensure access to physical and behavioral health services and social supports as individuals transition into their communities. Some of these interventions - in both expansion as well as non-expansion states - include peer supports, case management, and integrated mental health, substance use, and social supports.  Click here to read the brief.
What Works: Alternatives to Physical Restraint

Sometimes the best ideas come from those who have been in the weeds the longest.
With a history of using traditional, physical, crisis-management tactics, Grafton Integrated Health Network, a Winchester, Va.-based not-for-profit behavioral health and special education services provider, found it could no longer advocate for the approach. By 2003, the organization had a direct-care staff turnover rate of 54%. Numerous injuries to staff members by patients in crisis also drove up its worker's compensation insurance premium to an untenable $2.5 million. Relations between staff and clients were strained.

"There was seclusion, restraint, timeout, restitution-everything you could imagine when you think of restrictive practices," says Kim Sanders, executive vice president at Grafton. "Over time, as that culture grew, it was highly controlling and somewhat negative. We had staff who felt like helpless, hopeless victims. They were working with the toughest individuals who couldn't be served in schools or live with their families. They'd come in day in, day out, and get hurt or injured."

Sanders, who has been with Grafton since 1989, experienced firsthand the challenges direct-care staff faced: Among her past roles, she served as a residential instructor from 1990 to 1993, providing residential care and supervision of students with severe disabilities and maladaptive behaviors.  Read more here .
Integrating Mental, Physical Health Services Leads to Better Outcomes, Lower Costs, Study Shows

Integrating mental, physical health services leads to better outcomes, lower costs, Intermountain study shows Research tracked 113,452 adult patients who received care from 2003 through 2013 in 113 primary care practices.

An Intermountain Healthcare study conducted at 27 team-based medical practices and 75 traditional practices revealed that delivering integrated mental and physical healthcare in team-based primary care settings yields better results for patients and also reduces the rates healthcare utilization and lowers cost.
The research, which tracked 113,452 adult patients who received care from 2003 through 2013 in 113 primary care practices Intermountain Healthcare, is published in the Journal of the  American Medical Association, accompanied by an editorial in JAMA that heralded the benefits of integrated mental health care.

The decade-long study - one of the largest of its kind, according to Intermountain - was led by Brent James, MD, the health systems's chief quality officer and executive director of the Intermountain Institute for Healthcare Delivery Research.   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.