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July 20, 2017

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

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Francine Sinkoff, Editor
Two Million Dollar Federal Grant Announced to Fight Opioid Epidemic in Erie County

State senate hosts opioid task force hearing in Erie County

Tompkins County Jail expansion study released

Sullivan County launches drug-addiction helpline

Three Generations of Opioid Addiction - Chautauqua County
New York´s 1115 Waiver Programs Public Comment Days

The Department of Health is pleased to announce dates for the 2017 Public Comment Days on New York's 1115 Waiver programs.   The 1115 waiver is designed to permit New York to use a managed care delivery system to deliver benefits to Medicaid recipients, create efficiencies in the Medicaid program, and enable the extension of coverage to certain individuals who would otherwise be without health insurance.  In addition, New York's goals in implanting its 1115 waiver include improving access to health services and better health outcomes for New Yorkers through multiple programs. More information on the 1115 waiver and its programs is available here

The Upstate Public Comment Day will be held on August 14, 2017 in Albany at the SUNY Albany School of Public Health from 1 pm - 4 pm. Any updates related to the forum will be sent via the MRT Listserv. Any written public comment may be submitted through August 23, 2017 . Please include "1115 Public Forum Comment" in the subject line.

The Downstate Public Comment Day has been scheduled for November 16, 2017. Further information regarding the forum's program and location will be announced closer to the event.

Where is Painkiller Use Booming in Upstate NY, Despite National Crackdown?

As doctors nationwide prescribe fewer prescription painkillers, people in Central and Northern New York are getting their hands on more of the potentially addictive drugs, federal data shows.

Per capita prescribing rates for opioids, or pain relievers, increased by anywhere from 6 percent in Onondaga County to 160 percent in Lewis County between 2010 and 2015, according to data obtained from the federal Centers for Disease Control and Prevention by the  Empire Center, an Albany think tank.

During that same period the average U.S. opioid prescribing rate dropped 18 percent. The state prescribing rate, which is significantly lower than the national rate, fell 0.6 percent between 2010 and 2015. Read more here.
SAMHSA Report Shows the Usage of Non-Medical Pain Relievers Across the Nation

A new report by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that 4.31% of people aged 12 or older in the U.S. used prescription pain relievers non-medically in the past year. When taken without a physician's direction, prescription opioid pain relievers can lead to a higher risk of serious adverse consequences such as substance use disorder, overdose, or death.

The report also shows variations in use by state, indicating that rates of past year nonmedical use of prescription pain relievers among those aged 12 or older ranged from 3.4% in Minnesota to 5.31% in Oklahoma.

SAMHSA research has found that the vast majority of people who take prescription pain relievers do not misuse them, however their non-medical misuse is second only to marijuana use as the nation's most prevalent illicit drug problem. Read more here.

July 27, 2 - 3 pm, SAMHSA

August 8, 2:30 - 3:30 pm, National Council for Behavioral Health

August 10, 12 - 1 pm, MCTAC

HEDIS® Behavioral Health Measures: An Update From NCQA©
August 15, 12 - 1 pm, National Committee for Quality Assurance (NCQA)

August 16, 3 - 4:30 pm, Rural Behavioral Health

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

September 14, 12 - 1 pm, PsychU

September 28, 12 - 12:30 pm, PsychU



Officers, Chairs & Regional Reps Call
August 2:  8 - 9 am


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

Directors & Executives Combined Meeting
September 20:  9:30 am - 12:30 pm

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 

Counties Brace for Impacts as 'Raise the Age' Becomes Law

The recently enacted legislation that boosts New York's age of criminal responsibility to 18 years old is expected to have broad impacts on multiple agencies within county governments across the state, according to a new analysis of the measure.

A recent  report issued by the New York State Association of Counties predicts the "Raise the Age" measure pushed through the Legislature by Gov. Andrew Cuomo will cause probation departments and agencies providing social services and mental health counseling to expand their staffs.

The measure will also require new county investments in local courts, youth detention placement and correctional facilities, the report pointed out. The intent of the law is to keep younger offenders from having to serve time with adult criminals, thus preventing 16-and 17-year-olds from being placed into county jails.

NYSAC noted that beginning on Oct. 1, 2018, counties must provide a specialized secure detention facility for 16- and 17-year-olds who are in custody for criminal offenses. Read more here.
How Multi-Sector Health Partnerships Evolve

When Mercer Medical Center in Trenton, New Jersey, planned to close its doors more than 10 years ago, many in the community were alarmed by the likely impact on health services available to the city's large, low-income population. Encouraged by Mayor Douglas Palmer and the State Department of Health, two hospitals, a federally-qualified health center, and the city health department came together to consider how best to meet the needs of Trenton residents.
At the time, many of these providers knew one another more as competitors than as collaborators. But they recognized a shared commitment to Trenton's most vulnerable residents and set aside potential rivalries to form the Trenton Health Team. Today, that team links more than 60 behavioral, social service, educational, and faith-based organizations to pursue better community health outcomes.

Such partnerships are springing up across the nation, bringing new people and their diverse experiences to the table. Representatives of health systems, insurance companies, health departments, and patient groups are now seated together. As important, they are joined by sectors that haven't traditionally considered health to be part of their mission, like community development, education, environment, transportation, business, housing, and law.

No one has the ability to transform health in the United States by working alone. Coming together and thinking about systems, not just individual projects, are key to creating healthier communities. As partnerships become more common, it's important to understand how they develop over time, and what it takes for them to work.  Read more here.
OMH Transformation Plan Status Report - April 2017

The Office of Mental Health issues monthly and annual reports that include State Psychiatric Center (PC) descriptive metrics; descriptions and status of community service investments; and psychiatric readmissions rates to hospitals and emergency rooms for State PC, Article 28, and Article 31 hospital discharges.

Click here to access the April 2017 report which contains the most current data available.
For Opioids' Youngest Victims, Is Help Too Little, Too Late?

Police in East Liverpool, Ohio, last fall wanted to show the graphic toll of opioid overdoses, so they made the decision to post some photos to Facebook. The shocking images, which an officer had taken during a traffic stop, were graphic and heart-wrenchingly poignant. A man and a woman sit unconscious in the front seat of an SUV, slumped at impossible angles, mouths agape. Meanwhile, a 4-year-old blond child -- the woman's grandson -- stares from the back seat.

The controversial photos went viral, and have now been seen by millions.  What happened in East Liverpool was only one of the latest in a string of incidents where parents and guardians overdosed while their children watched. As a growing number of people have become addicted to prescription opioids and heroin, many child protection agencies are seeing a surge in abuse and neglect cases. Read more here.
Can Big Data Cure America's Opioid Abuse Nightmare? 

State and cities across the U.S. are being overwhelmed by the most devastating drug overdose crisis in American history.  91 Americans die every day from an overdose of prescription opioids or heroin, according to the CDC.  33,000 died from overdoses in 2015.  More than half a million have died since 2000.  Government officials are increasingly turning to data for answers to the massive public health crisis.

On a sweltering weekend in August last summer, first responders in Cincinnati, Ohio, a bustling mid-sized American city on the Ohio River, were summoned 30 times to assist citizens who had overdosed on heroin and needed medical attention.  Seventy-eight more overdoses and at least three deaths were reported during a 48-hour period on the first two days of the following week.  By the end of the day on Thursday, 174 people in total had been treated; 3 had died.

In order to get a better handle on this and future crises, the City of Cincinnati began analyzing emergency medical services (EMS) response data to identify trends and geographic "hotspots," helping public safety identify key areas for strategically deploying personnel and medical resources.  Read more here .
Designing Care Models to Treat High-Need, High-Cost Patients

A recent  report from the National Academy of Medicine (NAM) explored how healthcare organizations can identify high-need, high-cost patients and implement care models that appropriately address the needs of the population to reduce healthcare spending.
While high-need, high-cost patients only represent about 5 percent of all patients, their healthcare costs account for almost one-half of the nation's healthcare spending.

Based on the discussions held in three workshops between July 2015 and October 2016, NAM researchers uncovered key characteristics of the patient population and ways for healthcare organizations to identify the patients within their systems.

They agreed that stakeholders should pinpoint high-cost and need patients by using total accrued healthcare costs, the intensity of care utilized in a specific period, and functional limitations. Examples of functional limitations include restrictions regarding daily living, such as dressing, bathing, and self-feeding, as well as limitations with instrumental activities, including maintaining an independent lifestyle.  Read more here.
Small Hospitals, Systems Grapple with Value-Based Reimbursement

Approximately 67 percent of small hospitals and health systems do not plan on undertaking value-based reimbursement initiatives in 2017, a recent Ernst & Young LLP Advisory Health  survey revealed.
The survey of 700 healthcare professionals from organizations with annual revenues of at least $100 million also found that 61 percent of hospitals and health systems with annual revenues between $500 million and $999 million do not anticipate engaging in additional value-based reimbursement models in 2017.

In contrast, only a small portion of large hospitals and health systems with annual revenues exceeding $1 billion do not expect to add value-based reimbursement initiatives to their plate this year.  About 23 percent of organizations with at least $1 billion in annual revenue, 14 percent of organizations with at least $2.5 billion in annual revenue, and 8 percent of organizations with over $5 billion in annual revenue selected this option. Read more here.
Redesigning New York's Most Notorious Jail 

The Rikers Island Correctional Facility, a complex of 10 jails and about 10,000 detainees located northeast of LaGuardia Airport, is a longstanding political flashpoint in New York City. For decades, civic leaders have debated shuttering the facility because of its notoriously corrupt reputation, brutal mistreatment of detainees, and inhumane conditions. Critics say it's impossible to close, citing insufficient infrastructure-but proponents are pressing forward, with Mayor Bill De Blasio supporting a move to close the jail.

Considering how deep and pervasive the problems are, can better design help? Or are architects out of their depth? "Fundamental to creating a more just system is the need for modernized jail facilities that reflect our commitment to safety and humanity for inmates and staff, and improved public safety outcomes through rehabilitation," former Chief Judge and Chairman of the Independent Commission Jonathan Lippman argues in a news release. "It's been a core component of the commission's work from day one."

How does the Commission envision using urban design and architecture to help reform New York City's jail system?  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.