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February 10, 2016

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

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Francine Sinkoff, Editor

HHS Proposes Changes to the Rules Governing the Confidentiality of Substance Use Disorder Records

U.S. Department of Health and Human Services (HHS) Secretary Sylvia M. Burwell today announced proposed revisions to the Confidentiality of Alcohol and Drug Abuse Patient Records regulations, 42 CFR Part 2. The goal of the proposed changes, which will be published in the Federal Register on February 9, 2016, is to facilitate information exchange within new health care models while addressing the legitimate privacy concerns of patients seeking treatment for a substance use disorder.

The current rules governing the confidentiality of substance use disorder records, often referred to as "Part 2," were promulgated in 1975, during a time of great concern that the potential use of substance use disorder treatment information in criminal prosecutions would deter individuals from seeking needed treatment. These rules were last substantively updated in 1987.

HHS is proposing to modernize the existing rules because new models are built on a foundation of information sharing to support coordination of patient care; the development of an electronic infrastructure for managing and exchanging patient data; and an increased focus on performance measurement and quality improvement within the health care system.  Read more here.
Governor Cuomo Unveils New Tool to Guide New Yorkers to Addiction Treatment

Governor Andrew M. Cuomo last Friday launched a new web-based service that will help connect New Yorkers struggling with addiction to treatment. The New York State Office of Alcoholism and Substance Abuse Services' Bed Availability Dashboard
application collects bed availability from State-certified alcohol and substance use disorder treatment providers daily and makes it available in real-time on the agency's website. This new platform will help allow all New Yorkers to easily determine treatment bed availability all across the state.

The Bed Availability Dashboard allows New Yorkers to search for services in their region, as well as for treatment beds specific to age or gender. Providers will update information about available treatment beds on a 24/7 basis. The application will soon be updated to include outpatient services.  Read more here.
FDA Vows Changes to Prescription Opioid Drug Policies

The U.S. Food and Drug Administration on Thursday said that as a response to the nation's opioid drug abuse epidemic, the agency will change its policies on reviewing new painkillers and will carefully consider any new labeling for pediatric use of the drugs.  The agency said, overall, it was "reexamining the risk-benefit paradigm for opioids." A press release announcing the plan said the agency needed to consider the drug's wider public health effects.

In its first steps, the FDA vows to consult with independent advisory panels prior to the approval of some new pain relievers and improve access to naloxone and medication-assisted treatment options for patients with addiction issues.  The plan also addresses some of the concerns that have caused several lawmakers to block Califf's nomination to be the next FDA commissioner. The White House announced Califf was their pick back in September.  Read more here.
Senate Passes Bill to Better Track State Transfer of Sex Offenders

State Sen. Patrick M. Gallivan, R-Elma, says the Senate has again approved a bill (S.396) that would require New York State to notify a local municipality when a sex offender is transferred from a state facility to a community program or residence. The legislation was passed by the Senate in 2015, but failed in the State Assembly.

The legislation sponsored by Gallivan would amend the mental hygiene law to require the Commissioner of the Office of People With Developmental Disabilities to notify the chief executive officer of any municipality where a sex offender is transferred. The superintendent of schools in which the facility is located must also be notified.  Read more here.
CMS Finalizes New Medicaid Drug Reimbursement Rules

On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published final regulations in the Federal Register on Medicaid upper payment limits (UPLs) for covered outpatient drugs, as well as rebates that drug manufacturers must provide to states.   State Medicaid agencies must take into account "average manufacturers' prices" (AMPs) and other factors in calculating state Medicaid payments for covered outpatient drugs and dispensing fees to pharmacies that purchase medications, usually from wholesalers.  Based on data in reports generated by state Medicaid agencies, drug manufacturers must calculate rebates to states under methods specified in the rule.
The final rule deals with: requirements for state Medicaid agencies to report product-specific utilization, expenditure, and other data on medications that they pay for on a fee-for-service (FFS) basis and within capitation payments with managed care organizations (MCOs); requirements for manufacturers to disclose their AMPs and "best prices" for medications they produce; and requirements for calculating Medicaid drug rebates using both of those data sources and rebate percentages for each classification of such medications.  Read more here.


February 10, 3:30 - 5 pm, Center for Health Care Strategies, Inc.

February 17, 2 - 3:30 pm, National Reentry Resource Center and the American Probation and Parole Association

Three-Part Contracting Series for Rest-of-State (ROS) Adult Behavioral Health Providers

Part I: Webinar - Feb. 10, 10 am - 11 am
Contracting basics, foundational information, and an overview/use of contracting tools with Adam Falcone, JD, MPH, Feldesman Tucker Leifer Fidel LLP 

Rules of the road, timelines, and protections from the State with Andrew Cleek, PsyD and Boris Vilgorin, MPA

Transforming the Children's Medicaid System Webinar Series


CLMHD Office Closed - Lincoln's Birthday
February 12 

CLMHD Office Closed - Washington's Birthday
February 15

Children & Families Committee
February 16:  11:30 am - 1 pm
GTM Only

OMH Agency Meeting
February 22:  10 am - 12 pm
44 Holland Ave., 8th Fl, Albany

OASAS Agency Meeting
February 22:  1 pm - 3 pm
1450 Western Ave., 4th Fl, Albany

MARCH 2016
Officers & Chairs - Call In
March 2:  8 am

Mental Hygiene Planning - In Person
March 3:  11 am - 2 pm
Syracuse, NY

Children & Families Committee
March 15:  11 am - 12 pm

Director's Meeting - In Person
March 22:  10:30 am - 12 pm
41 State St., Ste. 505, Albany

Executive Committee - In Person
March 22:  12:30 - 2 pm
41 State St., Ste. 505, Albany

Developmental Disabilities Meeting
March 30:  11 am - 12 pm
GTM Only

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
CLMHD Testifies at Joint Legislative Joint Fiscal Committees 2016-17 Mental Hygiene Budget Hearing  

Last Wednesday, Kelly Hansen, Executive Director of CLMHD, testified on behalf of the Conference at the Joint Legislative Budget Hearing on Mental Hygiene in Albany.  Here are highlights of some of the issues for which the Conference advocated:
  • Restore Behavioral Health Transformation Funding Cut:  The Governor and Legislature committed to investing $120 million in funding to support the transition of behavioral health services for adult and children into Medicaid Managed Care. This year's Executive Budget would reduce this essential investment from $115 million to $95 million. 

  • Restoration to Competency Treatment for Felony Defendants:  
    The Executive Budget would amend Section 730.10 of the Criminal Procedure Law (CPL)  to allow volunteering counties to establish jail based restoration to competency programs for felony defendants. At this time, we are not aware of any county that would be interested in creating these units. As an alternative, the conference supports legislation (S.2465/A.5846) which would place a 30 day limit on the fiscal responsibility of counties to pay for defendants receiving  competency restoration services provided by state-operated mental hygiene facilities pursuant to a CPL 730 court order. Given that all courts are now unified into a single statewide system, that the state has custody of all individuals receiving treatment under a CPL 730 court order, and that counties are seeing many of these defendants coming directly from state operated facilities, CLMHD believes there is no reason that counties should be held accountable for costs that are completely out of their control.
  • Substantial Investment Needed for Children's Managed Care Readiness:  The children's behavioral health system will be undergoing major reforms which include: the establishment of children's health homes, the transition to Medicaid Managed Care; the expansion of State Plan Medicaid services for children; and an increase in the availability of Home and Community Based Waiver Program Services for children. For this comprehensive transformation to be implemented successfully, a substantial investment is needed by the state to support provider readiness and workforce development, build information technology infrastructure, and establish performance metrics.The Conference recommends readiness funding for the followingpriorities: expanded role of Children & Youth Single Point of Access (C&Y SPOA)under children's Medicaid Redesign; Evidence Based Practice start-up; and data metric development in preparation for managed care and value-based payments. 

Please see links above for full text and video from the hearing. 

Todora Confirmed as Sullivan Health and Family Services Commissioner

The man who took over Sullivan County's troubled Division of Health and Family Services following last winter's mess can now drop "acting" from his job description.  The Sullivan County Legislature confirmed Joseph Todora as Commissioner of the division on January 28, 2016.

The breakdown that last year resulted in several problems including a huge backlog of unprocessed HEAP applications, led to the dismissal of the former commissioner. 

Todora assumed the duties last February. The county also brought William Moon out of retirement to serve as deputy commissioner.
While this year, the operation has made big strides, Todora said the work is far from done.

"Make sure that our communication is much better and that our work with the public has been much better, and, healing some of issues that we have with some of our partners in the community who help us work with the people who are disabled or poor," Todora said. "I think we're moving in the right direction and I look forward to continuing that over the next five years."  Read more here.
Erie County:  Anti-Addiction Clubhouses to Offer Young Adults a Springboard into Drug-Free Life

Young adults from the age of 18 to 21 will soon have a unique place to go for help in the struggle against addiction.  Buffalo-based Restoration Society, Inc. will be leading a group of Western New York agencies in the creation of "Youth Clubhouses."

Jack Gustaferro (3rd from right) stands with Restoration Society leadership, Erie County Commissioner of Mental Health Michael Ranney (3rd from left), and patrons of Restoration Society's Empowerment Academy in downtown Buffalo.

Restoration Society's recently retired Chief Executive Officer Jack Gustaferro said the clubhouses will be operated by their members, using a method known as "mutual self-help."

Those services and resources will include support groups, job training, education opportunities, and recreational activities. The clubhouse members who use them will be called upon to offer input on which programs are helpful, and which are worth discontinuing.

Michael Ranney, Commissioner of Mental Health for Erie County, said the clubhouses are going to be an excellent addition to the local continuum of care. He said the program's proactive approach is like nothing else the region has seen before.

"I see this as reaching a very vulnerable population. That age that agencies are working with - up to young people of age 21 - if we can prevent and work with individuals of that age group than we may be successful in helping them not go any further in the addictions, and stop, and lead a productive life," said Ranney.  Read more here.
Art Johnson, Broome County Commissioner, Named Head of State Association
Congratulations to Art Johnson, LCSW, Commissioner of the Broome County Mental Health Department, for his recent induction as President of the New York Public Welfare Association (NYPWA) in the presence of roughly 300 attendees at NYPWA's 2016 Winter Conference in Albany on January 28.  Mr. Johnson is the Commissioner of Social Services for Broome County.

Debra A. Preston, Broome County Executive, administered the oath of office at the event and offered words of praise for Commissioner Johnson.  "Commissioner Johnson has done a great deal for the people of Broome County, and continues to have the best interest of the people in mind," County Executive Preston noted.  "We want to thank Art for this wonderful accomplishment and to let the people of New York State know they are in very good hands."

Commissioner Johnson has worked for the county for seventeen years-first becoming the county Mental Health Commissioner in 1999 and then accepting the dual role of DSS Commissioner in 2002.  As NYPWA President, Commissioner Johnson pledged to work hard to represent all of the local departments of social services across New York State.  He also looked forward to working with state agency and legislative leaders on both budget and policy priorities. In addition, Commissioner Johnson took the time to individually thank County Executive Preston, his staff-and, most of all, his wife Nancy.

"One of the great things about working in our field is that there is always someone there to help you.  Whether you work in Temporary Assistance, Medicaid, CPS, Foster Care, Child Support, a legal unit or are a Commissioner," Commissioner Johnson explained. "The staff from NYPWA and my colleagues from other counties are always there to help.  This is an amazing dynamic that doesn't exist in every other profession."
In closing, the Commissioner offered the following: "Each New Year brings with it unique challenges.  The NYPWA board, staff and I all look forward to working with our members and state partners this year."

The New York Public Welfare Association represents New York State's 58 local departments of social services.  The NYPWA is an influential leader in social welfare policy development and implementation.  The mission of the association is to improve the quality and effectiveness of social welfare policy so that it is accountable to taxpayers and protective of vulnerable people.  For more information about the NYPWA please visit
Mental Illness and Incarceration: Disrupting the Link

Early intervention programs may be the key to preventing people with serious mental illness from ending up in prison, according to a report released this week by the VERA Institute of Justice. Currently, more than half a million people who are mentally ill are incarcerated in U.S. prisons and jails on any given day, the report states, noting that it is equivalent to the number of people held in "deplorable"
conditions in psychiatric institutions during the 1950s.

"The driving idea is a simple one: To invest in people early on to avert or halt a trajectory of interaction with the criminal justice system," write authors Leah G. Pope, Kim Hopper, Chelsea Davis and David Cloud in the report, entitled "First-Episode Incarceration: Creating a Recovery-Informed Framework for Integrated Mental Health and Criminal Justice Responses." The authors add: "At a basic level, prevention and early intervention may be less about designing totally new programs than about integrating existing elements of effective practice into a comprehensive program."

Examples provided by the study included designing programs that help homeless clients find housing, and offer enough flexibility to allow them to enroll in school or vocational training and foster a sense of empowerment. The recommendations were developed based on feedback from 11 practitioners nationwide-including policymakers, academics and other professionals-who work at the intersection of mental health and criminal justice.  

Read the report 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.