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December 14, 2016

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

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Francine Sinkoff, Editor

Laura Kelemen, LCSW-R, Elected 2nd Vice Chair of CLMHD 

The Conference is pleased to announce the recent election of Laura Kelemen, LCSW-R, Niagara County, to the position of 2nd Vice Chair of the Conference.   Laura is the Director of Mental Health & Substance Abuse Services for Niagara County, where in addition to being the Director of Community Services (DCS), she also oversees a broad spectrum of direct services, including outpatient mental health & substance abuse treatment, crisis services/mobile crisis outreach, and hospital diversion. 

Prior to taking the DCS position in 2014, Laura served as the Executive Director and Forensic Interviewer/Trainer for the Child Advocacy Center of Niagara. Working for local non-profit human service agencies, she has acquired more than 15 years of program management and leadership experience. In these roles she has facilitated the implementation of evidence-based practices for mental health and trauma treatment and has secured expanded funding in high priority need areas. 

Laura serves on a number of local and state boards, including the Niagara County Opiate Addiction/Overdose Strategy Implementation Standing Committee, the Niagara County Behavioral Health/Justice Committee, OMH Evidence Based Practice Project Advisory Board and the NYS Preventive Health and Health Services Block Grant Advisory Council.  Please join us in welcoming Laura Kelemen to the board!
Open Positions in Columbia County

The Columbia County Department of Human Services/Mental Health Center and
Twin County Recovery Services, Inc. are each seeking to fill  Behavioral Health Care Coordinator positions.  For more details about these jobs, click here .   

Boston Globe:  San Antonio's Mental Health System Provides Striking Example Of Success

A coalition in San Antonio has built a crisis center for psychiatric and substance abuse emergencies and a 22-acre campus for the homeless that resembles a community college. To date, more than 100,000 people have been diverted from jail and emergency rooms to treatment, local officials say, resulting in a savings of nearly $100 million over an eight-year period. Thousands of emergency responders in San Antonio and Bexar County have been trained to manage mental health crises. Read more here.
Pets Help People Manage The Pain Of Serious Mental Illness

Any pet owner will tell you that their animal companions comfort and sustain them when life gets rough. This may be especially true for people with serious mental illness, a study finds. When people with schizophrenia or bipolar disorder were asked who or what helped them manage the condition, many said it was pets that helped the most.

"When I'm feeling really low they are wonderful because they won't leave my side for two days," one study participant with two dogs and two cats, "They just stay with me until I am ready to come out of it."
Another person said of their pet birds: "If I didn't have my pets I think I would be on my own. You know what I mean, so it's - it's nice to come home and, you know, listen to the birds singing and that, you know."

Many people with serious mental illness live at home and have limited contact with the health care system, says Helen Brooks, a mental health researcher at University of Manchester in the United Kingdom and the lead author on the study, which was 
published Friday in the journal BMC Psychiatry. So they're doing a lot of the work of managing their conditions.  Read more here.
Online 'Playbook' for High-Need Patients Released 

A new online " playbook ," designed to improve the care provided to patients with complex needs, including medical, behavioral, and social issues, was launched last week at the inaugural meeting of the National Center for Complex Health and Social Needs. This new organization is led by Jeffrey Brenner, MD, who is nationally recognized for his work with high-need patients in Camden, New Jersey.

Developed by experts at the Institute for Healthcare Improvement " The Playbook: Better Care for People With Complex Needs " is described as a resource to help health system leaders and insurers improve care for patients with complex medical and social issues. It offers insights about high-need patients, examples of successful approaches to care, guidance on making the business case for these models, and opportunities for policy and payment reform.
Read more here.
How to Handle the Holidays at Your Treatment Center

The year-end holidays require careful management for residential treatment centers. Current clients might be addressing emotional issues the holidays raise, meanwhile, the season often spurs a wave of new arrivals seeking treatment. Staff in recovery also need additional support as they meet their own self-care needs separately from the treatment for their clients.

Beyond the clinical scope, treatment center operators must manage everyday matters such as staffing levels, meals, visitation schedules and policies.

As the 2016 holidays approach, executives have some key questions to consider- challenges that depend on treatment philosophy, patient needs and the populations they serve.  Read more here.



Webinar #3: 12/14/16; 12-1 PM
CTAC is offering a 6-part webinar series on the broad principles and core competencies of documentation for direct service providers and supervisors. 

December 14, 12 - 1 pm

December 15, 12 - 1 pm

Are you worried about how to manage risk in a managed care environment? Not sure how changes in Medicaid will impact your agency?  Join MCTAC and Whitney Magee Phelps of Greenberg Traurig for a webinar on risk management! 

December 19, 10 - 11 am

Representatives from NYS OMH, OASAS, DOH, and OCFS will review the designation process and application for providers interested in offering children's State Plan Amendment (SPA) services and Home and Community Based Services (HCBS).
Adult Behavioral Health HCBS Non-Medical Transportation: Roles and Process
January 9, 1 - 2 pm

This state-led webinar and interactive presentation regarding Non-Medical Transportation will be led by the DOH Transportation Unit.  Presentation will include roles and process, review allowable vs non-allowable trips, and include time for discussion/Q&A. I ntended for Health Home Care Managers, Health Plans, Transportation Managers and other stakeholders interested in adult non-medical transportation for Rest of State .




RPC Advisory Committee 
December 15:  8 am
GTM Only  

Directors/Executive Committee
December 20:  9:30 - 12:30 pm **
GTM Only

Office Closed - Christmas
December 26

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

Pictured L-R:  NYS Assemblymember Didi Barrett; Kelly Hansen, Executive Director, CLMHD; NYS Senator Sue Serino; Margaret Hirst, LCSW, Director of Community Services, Dutchess County; Debra Holland, Director of Government Relations, CLMHD.

The Conference met jointly last week with Assemblymember Didi Barrett and Senator Sue Serino to discuss Behavioral Health Medicaid Managed Care issues, the establishment of Regional Planning Consortiums, and the Assisted Outpatient Treatment (AOT) program. As members of their respective legislative mental health committees, Barrett and Serino are interested in how to improve the behavioral health delivery system in New York.

The CLMHD visit included a tour of the new Dutchess County Crisis Stabilization Center, which is set to open early next year.  The 24/ 7 facility will serve as a  voluntary walk-in and police drop-off hub for individuals in crisis from mental health or substance abuse issues.  The goal of the center is to help divert people from hospitals and jails and to assess and link people to ongoing services as quickly as possible.  This innovative center has the potential to serve as a state model for improving behavioral health services.
Regional Planning Consortium Gains Momentum in Tug Hill Seaway  

Katie Molanare, Tug Hill/Se away RPC Coordinator, reveals the current nomination slate for the region's RPC board.

On December 12, 2016 the Tug Hill/Seaway Region held its Second RPC Stakeholder Meeting.  The weather outside was frightful but inside the attendees were given an overview of the RPC's and reviewed the region's current nomination slate. A huge thank you goes out to the DCS's in this region; Patricia Fralick, Roger Ambrose, Suzanne Lavigne and RPC Coordinator Katie Molanare. To learn more about the Regional Planning Consortiums in your region please visit our website at:
21st Century Cures Act Becomes Law, Improves U.S. National Mental Health Efforts

When President Obama signed the 21st Century Cures Act on December 13th, he signed into law one of the most sweeping efforts to provide additional programs and funding for health conditions and innovation in America, including cancer, Alzheimer's disease, opioid addiction, medical devices, access to new drugs, and mental health. The Cures Act includes the major provisions of the Senate mental health compromise bill,  Mental Health Reform Act of 2016, as well as a few additional provisions from the House's over-reaching  Helping Families in Mental Health Crisis Act of 2016 bill.

While the bill goes a long way in helping fix certain components of mental health care in the nation, it does little for the vast majority of people who suffer from mental health concerns and receive outpatient treatment. Click here to review the highlights of what just became law.
NYC Launches Mental Health Programs for Older Residents

New York City has launched mental health programs aimed at improving the lives of older residents.

The initiative will offer mental health services at 15 senior centers this year. Another 10 centers will get services next year.
Trained volunteers will visit homebound seniors. The Department of Aging says the goal is to prevent social isolation, which increases the risk of health issues, including depression and anxiety.

The volunteers will work with coordinators at case management agencies. Residents who need help will get referrals.

First Lady Chirlane McCray said Wednesday that her own parents suffered from untreated mental health problems. McCray says stigma and lack of resources kept them from getting help.

Deputy Mayor Richard Buery (BYUR'-ee) says New Yorkers are living longer- and it's important to make sure they thrive.

Managed Long-Term Care VBP Clinical Advisory Group (CAG) 

The Managed Long-Term Care VBP Clinical Advisory Group (CAG) has produced the Long-Term Care Recommendation Report.
This CAG report has been posted for public comment on the DSRIP Website here.  The public comment period will commence on December 12, 2016 and will end on January 9, 2017.
The CAG Recommendation Reports provides definition and associated quality measures for each VBP arrangement.  The CAG Recommendation Reports inform providers and payers of the details of each arrangement, further supporting their transition to VBP.  Each report represents the final output from each respective CAG for that specific arrangement.  Recommendations from the CAG will be further explored throughout the early phases of VBP implementation.  Based on lessons learned through VBP implementation, each CAG may be reconvened to continue discussions of VBP arrangement definition and quality measures.
Please submit any written comments by January 9th to
Cattaraugus County Health Department to Shift Focus to Mental Health, Substance Abuse

The new Cattaraugus County Health Department's Community Health Assessment and Improvement Plan will add a focus next year of promoting mental health and preventing substance abuse.

It replaces the current promotion of healthy and safe environments after feedback from surveys, stakeholder interviews and focus groups. Kathy Roach, project manager for Strategy Solutions, Erie, Pa., outlined the plan for members of the Board of Health on Wednesday.

The Health Assessment and Improvement Plan continues a second priority - preventing chronic diseases - that was included in the 2013-16 plan.

The plan includes a community collaboration between the county Health Department and Olean General Hospital, Roach explained. Both have agreed to develop and implementation plan, she said. Fifteen community agencies will be partnering with the Health Department.  Read more here.
Cayuga Medical Center Receives Approval for Expansion

The Town of Ithaca Planning Board last week unanimously approved the final site plan for an addition to Cayuga Medical Center at 101 Dates Drive.

The project calls for a 6,000-square-foot addition to the second floor of the north wing of CMC, which is the behavioral health unit, and a renovation to the 12,350-square-foot space on the first floor. The project, which was introduced to the board for the first time Tuesday, received quick approval because of minimal impact to soil, stormwater facilities and existing utilities.

"The need for behavioral health services has been growing in recent years," a letter from the hospital to the planning board read. "The Cayuga Medical Center (CMC) inpatient behavioral health unit serves all of Tompkins County and is the sole hospital in the county."   Read more here.
Rising Price of Opioid OD Antidote Could Cost Lives

Escalating prices of the drug naloxone may threaten efforts to reduce  opioid-related deaths across America, a team from Yale University and the Mayo Clinic warns.

Naloxone is a drug given to people who overdose on prescription opioids and heroin. If administered in time, it can reverse the toxic and potentially deadly effects of "opioid intoxication."

The research team called attention to skyrocketing prices for the lifesaving
  • Hospira (a Pfizer Inc. company) charges $142 for a 10-pack of naloxone -- up 129 percent since 2012.
  • Amphastar's 1 milligram version of naloxone is used off-label as a nasal spray. It's priced around $40 -- a 95 percent increase since September 2014.
  • Newer, easier-to-use formulations are even more expensive -- a two-dose package of Evzio (naloxone) costs $4,500, an increase of more than 500 percent over two years.
Naloxone is part of a wave of precipitous price hikes affecting old and new medicines. These drugs include Mylan's EpiPen injectors for life-threatening allergic reactions and insulin for diabetes made by Eli Lilly and Company, Novo Nordisk and Sanofi U.S. Read more here.
One-Third of Long-Term Users Say They're Hooked on Prescription Opioids

One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers, according to a  new Washington Post-Kaiser Family Foundation survey .

Virtually all long-term users surveyed said that they were introduced to the drugs by a doctor's prescription, not by friends or through illicit means. But more than 6 in 10 said doctors offered no advice on how or when to stop taking the drugs. And 1 in 5 said doctors provided insufficient information about the risk of side effects, including addiction.

The survey raises sharp questions about the responsibility of doctors for an epidemic of addiction and overdose that has claimed nearly 180,000 lives since 2000. Opioid deaths surged to more than 30,000 last year, according to new data from the U.S. Centers for Disease Control and Prevention, with deaths from heroin alone surpassing the toll from gun homicides.

Doctors have been widely blamed for sparking the crisis by overprescribing highly addictive opioids to treat everyday pain. The survey suggests that they are still doing too little to stop it.

"Why isn't it 100 percent?" demanded Gary Mendell, founder of Shatterproof, a grass-roots group dedicated to reducing addiction in the United States, referring to the share who say doctors have counseled them on stopping the medication. "It's unbelievable that it's not 100 percent."  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.