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November 9, 2016

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

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Francine Sinkoff, Editor

August 2016 CMS Medicaid & CHIP Eligibility and Enrollment Report

According to CMS's most recent monthly Medicaid/ CHIP eligibility and enrollment
report, over 73.1 million individuals were enrolled in Medicaid and CHIP in August 2016. Nearly 326,887 additional individuals enrolled in Medicaid and CHIP since July 2016. Click  here for the report.

More Than Half in U.S. Have Chronic Health Problem 

More than half of Americans have at least one chronic disease, mental illness or problem with drugs or alcohol, according to a new study.

"The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity, the co-occurrence of two or more chronic medical conditions," said the study authors, Elizabeth Lee Reisinger Walker and Dr. Benjamin Druss.
They emphasized that people with multiple health issues need more access to care and better coordination among their health care providers.

The Emory University researchers examined public health records to find out what percentage of U.S. adults have chronic medical conditions, mental illness or substance abuse problems, and how many were also living in poverty.

Chronic medical conditions looked at in the study included asthma, cirrhosis, diabetes,
heart disease, hepatitis, high blood pressure, HIV/AIDS, lung cancer,
pancreatitis and stroke, according to the report.

The study, published online recently in Psychology, Health & Medicine, found that nearly 40 percent had at least one chronic medical condition. In addition, about 18 percent had been diagnosed with a mental illness in the past year, and about 9 percent abused drugs or alcohol during that time. Read more here.
Governor Cuomo Announces $1 Million in Funding for New Clubhouses to Support Teens and Young Adults Battling Addiction

Governor Andrew M. Cuomo last week announced nearly $1 million in annual funding to create adolescent substance use disorder clubhouses in the Capital Region, North Country, Central New York and Southern Tier. 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.

The four organizations receiving funding will use evidence-based prevention strategies and help individuals in recovery develop social skills that promote prevention, long-term health, wellness, recovery and an addiction-free lifestyle. A variety of services and activities will be available, including tutoring and help with homework, college and job preparation, community service opportunities, peer mentoring, and sports, fitness and group entertainment activities. The addition of these new clubhouses is the latest of the Governor's efforts to combat addiction and support recovery in communities throughout the state. The clubhouses will begin offering programs in January 2017.   Read more here .
Mental Health Center of Denver's New House for Youth is the "Cool" Version of a Mental Health Clinic

At the community mental health center east of downtown, people scheduled for therapy appointments stamp out cigarette butts on the sidewalk after a few last drags. Inside, others picking up prescriptions sit in a hospital-like waiting area, some with everything they own stuffed in backpacks and shopping bags. Fairly often, someone shouts or sings or talks to themselves.

Teenagers don't like it here much.

So they don't come often - to the Mental Health Center of Denver's clinical offices or to its adult psychiatric rehab center south of downtown, where instructors teach culinary job skills in a cafe and art classes in a basement studio. In fact, the age group least likely to seek and get help at the mental health center is 17 to 25, about the same age range when many serious mental health issues - including depression, anxiety, bipolar disorder and schizophrenia - typically first emerge.

That's why the mental health center opened a new kind of "cool" youth clinic, a house with bean bags and an espresso machine, where clients ages 14 to 26 can join a drum circle in the basement, take an art class and, on a recent October afternoon, carve pumpkins on the front porch.

The center purchased Denver's historic Flower-Vaile House, an 1889 two-story Queen Anne with elaborate porches and purple trim, for $1 million in 2015. The house, which opened full time a year ago, is unique in Colorado and beyond. It's called simply " Emerson St."

Instead of lying on a couch and telling a therapist about trauma, teens can sit side by side with their therapist and talk as they play Wii. Even the lingo is less intense - it's a "meet-and-greet," not an assessment, and it's called "goal-setting" instead of a clinical "treatment plan." Youths are welcome to check it out during "pop-in" hours, or sign up for a creative writing or guitar class, though it's not just a hang-out house, so they eventually have to engage in clinical and group therapy.  Read more here.



Documentation Training Series
CTAC will be offering a 6-part webinar series on the broad principles and core competencies of documentation for direct service providers and supervisors. The first webinar of the series will be on 11/16 from 12-1 PM. Learn more and register  here

2-Part Children's HCBS Webinar Series
November 16, 10 - 11 am
Includes service definitions and overviews of: Comprehensive Care Coordination, Habilitation, Habilitative Skill Building, Caregiver/Family Supports and Services, Respite, Community Self-Advocacy Training and Supports.

Part Two: Children's HCBS Refresher and Services Overview
November 18, 10 - 11 am
Includes service definitions and overviews of: Prevocational Services, Supported Employment, Palliative Care, Non-Medical Transportation, Adaptive and Assistive Equipment, Accessibility Modifications, and Customized Goods and Services. 

November 15, 12 - 1 pm

November 17, 12 - 1 pm




Office Closed - Veterans Day
November 11

RPC Advisory Committee 
November 17:  8 am
GTM Only

Office Closed - Thanksgiving
November 24, 25


RPC Advisory Committee 
December 1:  8 am
GTM Only

Officers & Chairs - Call In
December 7:  8 am

RPC Advisory Committee 
December 8:  8 am
GTM Only

Children & Families Committee
December 13:  11:30 am - 1 pm
GTM Only

RPC Advisory Committee 
December 15:  8 am
GTM Only  

Directors/Executive Committee
December 20:  9:30 - 11:30 am
GTM Only

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Governor Cuomo Announces Expansion of Addiction Treatment and Prevention Services on Long Island

Governor Andrew M. Cuomo last week announced the expansion of addiction treatment and prevention services on Long Island with the groundbreaking of a $4.6 million community residence center in Brentwood, Suffolk County and New York's first bilingual adolescent substance use disorder clubhouse now open in Freeport, Nassau County.

Women's Community Residence Addiction Treatment Center - Brentwood, Suffolk County

Outreach Development Corporation has broken ground on a new addiction treatment center in Brentwood. The facility will have 25 residential beds for adult women, recreational space, and state-of-the-art clinical and treatment program areas. The community residence treatment center will serve women from Nassau and Suffolk counties, and from other parts of the state.

Bilingual Adolescent Clubhouse - Freeport, Nassau County

In addition, New York State's first bilingual adolescent substance use disorder clubhouse opened recently in Freeport, Nassau County. The clubhouse, located at 46 Pine Street, is run by  HELP Services, Inc. and employs experienced staff to work with young Spanish-speaking New Yorkers in need of support and services. Club HELP will offer a variety of services to youth, ages 12-17, including peer support activities, group discussions, and events to help maintain a sober and substance-free lifestyle.  Read more here.  
OASAS Releases 2017 Needs Assessment and Priority Outcome Analysis

OASAS has recently made available the 2017 Needs Assessment and Priority Outcome Analysis in the Mental Hygiene County Planning System (CPS). The Needs Assessment Report and Priority Outcomes Forms are the primary documents that LGUs use, as part of local services planning, to communicate and identify their local needs and their strategies to address those needs.   This report provides a summary analysis of the Needs Assessment Reports and Priority Outcomes Forms associated with the OASAS service system in the 2017 Local Services Plans. Click  here  for the report.
N.Y. AG Cuts Deal to Extend Heroin Antidote Discount

State agencies and municipalities will continue to get a discounted price for a heroin antidote through a deal cut by state Attorney General  Eric Schneiderman 's office.

The attorney general has negotiated an extension of a discount with naloxone maker  Amphastar Pharmaceuticals through January 2018. Under the deal, Amphastar will provide state agencies and municipalities with a $6 rebate per dose, a discount off the retail price of about 20 percent. More than 200 state municipalities have saved $1.6 million on 278,000 syringes of naloxone since the original deal with Amphastar went into effect in February 2015, according to the attorney general's office.

Naloxone reverses the effects of an overdose of heroin or other opioid, including prescription painkillers like oxycontin and hydrocodone. The state has been grappling with an epidemic of heroin and opioid abuse.

The rebate is available to all public entities, including the state  Health Department, county governments, and the drug treatment centers and harm reduction programs they fund.

Office of Mental Health Announces Grand Opening of Crisis-Respite House for North Country Children

The New York State Office of Mental Health last week announced the grand opening of the St. Lawrence Psychiatric Center Child and Adolescent Crisis Respite House, a new short-stay residential program for children in Ogdensburg, New York. The program provides a safe reprieve for children in crisis, as an alternative to inpatient psychiatric admissions. This program addresses an identified need for alternative and community-based mental health services in the North Country and builds upon the success of other crisis-respite programs developed throughout the state.

"Sometimes children dealing with behavioral health concerns need a short-term home away from home while they cope with a crisis," said Office of Mental Health Commissioner Dr. Ann Sullivan. "This type of program gives the child and the family the ability to decompress and stop the escalation of problematic behaviors while avoiding more intensive services. It attempts to maintain a child's normal routine while addressing a potential emotional or behavioral crisis that exists in the child's life. Simply put, the crisis respite house will help keep children with their families, while giving both children and parents time to cool off."
Read more here .
N.Y. Seeks Permission to Use Medicaid Funds for Inmates

New York wants to use federal Medicaid funds to cover the care of prison inmates. Experts say it's likely the CMS will approve the waiver. 

States currently either terminate or suspend Medicaid coverage upon incarceration as law prohibits people in prison from receiving Medicaid federal funds. There is a provision that covers inpatient treatment provided by a medical facility not associated with the prison.

This scenario occurs in instances where a person goes to a hospital while in prison and remains there for over 24 hours.

Under a waiver request, New York state's Health Department wants federal Medicaid matching funds to provide care management and other supportive services to incarcerated individuals in the 30 days prior to their release. Eligible individuals would receive care management, clinical consultation services, and coverage of certain medications, including those treating behavioral health and substance use disorders. 

These changes aim to enable continuity of care and an easier transition to community-based services and health home enrollment upon release. The CMS is taking comments on  the waiver request through Nov. 20.  Read more here .
NYS Justice Center Trains State Police on Best Practices for Forensic Interviewing of Vulnerable New Yorkers

The NYS Justice Center for the Protection of People with Special Needs partnered with the New York State Police Bureau of Criminal Investigations (BCI) to train State Police investigators in Forensic Interviewing Best Practices for Vulnerable Populations. The training, which began October 25 and concluded October 28 at the State Police Training Academy in Albany, provided information about the developmental and emotional needs of people who have disabilities or special needs, and taught skills for interviewing those individuals who become victims or witnesses.

Forensic Interviewing Best Practices for Vulnerable Populations was developed by the Justice Center's Office of the Special Prosecutor/Inspector General and Office of Incident Reporting and Investigations along with well-known experts in the fields of working with people with disabilities and forensic interviewing. Recognized and approved by the NYS Department of Criminal Justice Services (DCJS), the training program is part of the Justice Center's ongoing effort to change the way the criminal justice system responds to allegations of abuse and neglect involving vulnerable victims to ensure these individuals have the same protections as the general population. Since the training began in the fall of 2014 many representatives from local law enforcement agencies and district attorney's offices, along with many of the Justice Center's investigative and prosecutorial staff, have attended the course.

Twenty-four BCI investigators who work in regions across New York State participated. The Justice Center's Forensic Interviewing Best Practices for Vulnerable Populations program is part of the agency's ongoing training and education efforts to help to ensure successful investigations and prosecutions of cases of abuse and neglect of vulnerable New Yorkers. Read more here.
Medicare Fee Schedule Reforms Payment for Behavioral Health, Chronic Disease

CMS last Wednesday finalized the 2017 Medicare Physicians' Fee Schedule, which features a host of payment reforms to promote the transformation to value-based care. 

Besides final eligibility rules for the diabetes prevention program, the new schedule comes with several new codes that recognize some complex cases-especially those involving patients with multiple chronic conditions-take more time to resolve and involve planning and consulting functions, not just writing a prescription. 

The new codes will improve payment for clinicians "who are making investments of time and resources to provide coordinated and patient-centered care," the CMS statement said. The entire schedule involves codes for billing visits, surgical procedures, diagnostic tests, therapy services, and preventive care. 

Three key changes that will be new under the 2017 schedule promote principles of coordinated care, and especially the collaborative care model, which seeks to put behavioral health and primary care under one roof. This care model offers more convenience and less stigma for patients while also ensuring that medical and mental health needs are aligned-and that providers are talking to one another. Read more here.
Opioid Epidemic Takes Toll On Grandparents Of Children Suddenly Left Without Parents

The number of grandparents who are raising their grandchildren is going up and increasingly it's because their own kids are addicted to heroin or prescription drugs, or have died from an overdose. For some, it's a challenge with little help available.

In 2005, 2.5 million children were living with grandparents who were responsible for their care. By 2015, that number had risen to 2.9 million.

Child welfare officials say drug addiction, especially to opioids, is behind much of the rise in the number of grandparents raising their grandchildren, just as it was during the crack cocaine epidemic of the 1980s and '90s. An estimated 2.4 million people were  addicted to opioids at last count.

Caseworkers in many states say a growing number of children are neglected or abandoned by parents who are addicted. That has forced them to take emergency steps to handle a growing  crisis in foster care - and often to turn first to grandparents for help.

Federal law requires that states consider placing children with relatives  in order to receive foster care  and adoption assistance. And grandmothers and grandfathers often are the first - and best - choice when state and local caseworkers have to take a child out of a home and find someone else to take custody, said Angela Sausser, executive director of the Public Children Services Association of Ohio, a coalition of public child safety agencies in the state.  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.