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March 2, 2016

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

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Francine Sinkoff, Editor
fs@clmhd.org
OMH Transformation Plan Status Reports

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.

The 2015 Year-End Report outlines the progress and impacts of investments through calendar year 2015.

For the most current data available, click here for the December 2015 Monthly Report.
Center for Health Care Strategies (CHCS)
As a result of a CHCS collaboration with 13 early-adopter states to design, launch, and improve their Medicaid ACO models, a new CHCS report, 
Program Design Considerations for Medicaid Accountable Care Organizations [ACOs], presents a roadmap for establishing Medicaid ACO programs. It explores the experiences of early state Medicaid ACOs and suggests best directions for other states, including evaluating the current environment; defining program goals and framework; and developing a structural model. 
December 2015 CMS Medicaid & CHIP Eligibility and Enrollment Report

According to CMS's monthly Medicaid/
CHIP eligibility and enrollment report, 71.8 million individuals were enrolled in Medicaid and CHIP in December 2015. Nearly 134,531 additional individuals have enrolled in Medicaid and CHIP since November 2015. Click here for the report.
SAMHSA 2016 National Behavioral Health Barometer 

The 2016 National Behavioral Health Barometer presents individual reports for each state and a summary national report presenting data including prevalence rates of youth and adult substance use, serious mental illness, suicidal thoughts, and people seeking treatment for these disorders. It also includes analyses using several demographic categories such as gender, age, income level, health insurance status and race/ethnicity. These data can help decision-makers identify behavioral health differences among these groups and can help when developing programs to address potential health disparities. Click here to read or download the report.
Digital Health Innovation Super-Utilizer Challenge: Themes and Lessons

Despite the growing digital health market, relatively few products are designed to meet the unique needs of low-income, high-need, high-cost individuals. To address this gap, CHCS, with support from Kaiser Permanente Community Benefit, held the first of three national Super-Utilizer Health Innovation Challenges in 2015 to explore the potential for digital health products for this population. This brief examines submissions from the first challenge and reveals insights that may help guide the development of digital tools for people with complex needs. Read more here.

 
CALENDAR OF EVENTS

MARCH 2016
Mental Hygiene Planning - In Person
March 3:  11 am - 2 pm
Syracuse, NY

Children & Families Committee
March 15:  11:30 am - 1 pm
TBD

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


APRIL 2016
Officers & Chairs - Call In
April 6:  8 am

Mental Hygiene Planning 
April 7:  11 am - 2 pm
GTM Only

Children & Families Committee
April 12:  11:30 am - 1 pm

Director's Meeting 
April 19:  9:30 am - 11 am
GTM Only

Executive Committee 
April 19:  11 am - 12:30 pm
GTM Only


Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Ithaca's Plan To Open A Safe Site For Heroin Users Faces Legal Hurdles

The mayor of Ithaca, N.Y., wants to create a place where people can use heroin or other drugs injected drugs under supervision, in an effort to combat soaring deaths from overdoses. But that's a lot easier said than done.

The idea is that people addicted to heroin or other injection drugs would show up at the facility. They're provided with clean needles, and trained medical staff stands vigilantly by with naloxone, an opioid overdose antidote, to prevent overdose deaths. Medical personnel don't help users get high, but would give care and referrals to addiction treatment programs.

But since the drug use is illegal, both the city and staff risk breaking laws, too.

If Mayor Svante Myrick wants the injection site to see the light of day, there are major legal hurdles he's going to have to surmount, says Leo Beletsky, a professor of law and health sciences at Northeastern University in Boston. The facility needs some kind of authorization or exemption from the state of New York, either by changing state law or as an executive action from the governor. Then Ithaca will need similar exemption at the federal level.

If Myrick can't get any of those things, there's another option he's looking to pursue.

In 1992, the New York State Department of Health issued a state of emergency allowing public funding of needle exchange programs. "And they gave localities the power to make their own rules," Myrick, who says his father was an addict, told Shots. "I think we're in a similar state of emergency. We can't wait any longer." He hopes the state agrees. Read more here.
New York Nonprofits in the Aftermath of FEGS: A Call to Action
Nonprofit human services organizations are responsible for delivering essential government services to approximately 2.5 million New Yorkers each year, but too many face financial distress. The Human Services Council has just released a new report, New York Nonprofits in the Aftermath of FEGS: A Call to Action, which identifies chronic problems and offers solutions for strengthening this valuable sector.  

HSC's final report identifies three major problems with New York's human services delivery system and makes a series of recommendations designed to work together to strengthen it.
  1. Programs should be developed in consultation with human services providers in order to drive more meaningful results. Such engagement would help to ensure that the sector is prepared to effectively participate in new cost-saving approaches such as the State-driven move to Managed Care in the Medicaid system. Additionally, compliance procedures should be examined to ensure they are supporting meaningful government oversight.
  2. The nonprofit human services sector suffers from chronic funding issues in which payment rates and program expectations are routinely misaligned, which impedes its ability to deliver high-quality services. Government and philanthropy should fund core functions and indirect costs, and account for cost increases and mandates that strip money from programs.
  3. The nonprofit sector does not have the tools to assess the risks associated with contracts and programs. Nonprofits and their boards must adopt financial evaluation tools and risk assessment methods to better evaluate risk, and the sector should develop rating systems to evaluate government agencies and individual procurements to inform providers, boards, and the public of problematic practices. 
Read the full report here. 
Shortage Of Addiction Counselors Further Strained By Opioid Epidemic
As the drug-related death toll rises in the United States, communities are trying to open more treatment beds. But an ongoing labor shortage among drug treatment staff is slowing those efforts.

Each year, roughly one of every four substance-abuse clinicians nationally chooses to leave the job, according to recent research. And that's not just turnover - leaving one job for another in the same field.
As an Institute of Medicine report documented in 2006, there's been a shortage of addiction workers for decades. And the demand is only increasing; the Affordable Care Act and other federal laws have given millions more people insurance to help them pay for those services. If only there were enough counselors to treat them.

Amelie Gooding runs Phoenix House in Keene, New Hampshire, and says she's been short a full-time counselor for a year and half.  "Everybody thinks, 'Oh, there aren't enough beds!' " Gooding says. "But there's not enough treatment staff to open more beds."

Because she's understaffed, Gooding has to leave three of her 18 residential beds empty, and she cut her outpatient groups down to 50 percent capacity.  So where have all the counselors gone?

"For me, it got to be too heavy," says former counselor Melissa Chickering, who used to work for Gooding at the Phoenix House and still lives in the area.  Clinical directors would give their right arm to hire someone with Chickering's long resume, Gooding says. She has a master's degree in social work and 10 years of experience. Instead, the valued counselor now spends her days teaching courses in psychology and health sciences at local New Hampshire colleges.

The problem with addiction treatment, Chickering says, is you take on your clients' pain. Plus, she says, she found the lack of funding and coordination from the state criminal.  Read more here.
PBS Documentary:  Chasing Heroin

PBS's searing, two-hour investigation, which aired recently, places America's heroin crisis in a fresh and provocative light -- telling the stories of individual addicts, but also illuminating the epidemic's years-in-the-making social context, deeply examining shifts in U.S. drug policy, and exploring what happens when addiction is treated like a public health issue, not a crime.  Click here to watch.
HHS Proposes Adding Behavioral Health to EHR Program

If the Department of Health and Human Services has its way, it will be adding behavioral health providers to the Electronic Health Record Incentive Programs.

That category of providers includes psychiatric hospitals; community mental health centers; residential and outpatient mental health and substance abuse disorder treatments facilities; as well as psychologists.

Currently, federal rules prohibit behavioral health providers treating mental and substance abuse disorders from receiving incentive payments for implementing EHRs that meet Meaningful Use criteria. However, in its Fiscal Year 2017 budget submission to Congress last week, HHS included a legislative proposal to add certain behavioral health providers to the EHR Incentive Programs.

The proposed inclusion of behavioral health providers comes on the heels of a bill introduced last year by Reps. Tim Murphy (R-Penn.) and Eddie Bernice Johnson (D-Texas). That bill, called the Helping Families in Mental Health Crisis Act, would allow behavioral health and addiction treatment providers to receive payments though the EHR Incentive Programs. 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.

Affiliated