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June 26, 2020
CLICK HERE for Links to State Guidance and Updates on COVID-19
Advancing Public Policies for people with Mental Illness, Substance Use Disorder and/or Intellectual/Developmental Disabilities
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Francine Sinkoff, Editor

'Bring your Narcan:' How a Poughkeepsie teacher saved her Newburgh neighbor - Dutchess

Contact Tracing Helps Methadone Program Expand - NYC

Housing Works secures more funding for opioid-treatment initiative - NYC

Buffalo City Mission receives $20,000 from Citi & National Disability Institute to support direct services for homeless with disabilities - Erie

UB Grant Expands Mental, Substance Use Care in Rural WNY
Coordinated-Care CCO Groups Decry $75M Funding Cut

A group of seven care-coordination organizations that serve more than 100,000 New Yorkers with disabilities is calling on the state to preserve $75 million in funding scheduled to be slashed July 1.

The 16% annual gross funding cut to the CCOs was recently put forth by the state Office for People With Developmental Disabilities. Though New York was already facing a budget deficit before Covid-19 struck, the staggering cut is expected to lead to layoffs and dramatic reductions in services that individuals with disabilities have come to depend on, the group said.

"Needless to say, to have a rate reduction of 16% during Covid we think is intolerable," said Lewis Grossman, CEO of Advance Care Alliance, the CCO that serves the city, Westchester and Long Island.

Though the organizations were aware of a possible 15% rate reduction, it wasn't a separate line item in the state budget, Grossman noted. Read more here.
Counties Step Up Mental Health Services

Three months into the COVID-19 pandemic, more than two million U.S. residents have seen the virus take root in their lungs, but a much larger share have felt it affect their minds.

As the tolls of physical distancing and economic uncertainty, along with anxiety resulting from the many unknowns of the novel coronavirus, add up to emotional stress and turmoil, effective mental health services have proven crucial to keeping residents functioning while they wait out a return to a somewhat familiar life.

Nearly one-third of Americans have been reporting signs of anxiety or depression since the pandemic began, according to the Household Pulse Survey by the National Center for Health Statistics and the Census Bureau. A poll by the Kaiser Family Health Foundation found that 45 percent of adults across the country say that worry and stress related to the pandemic are hurting their mental health.

Long-term, research by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care and the Well Being Trust found that as many as 75,000 more people will die from drug or alcohol misuse and suicide throughout the decade if policymakers ignore the collateral damage from the pandemic as it affects Americans' emotional well-being.
But as counties grapple with how best to provide mental health services, they are uncovering new challenges and also new adaptations that could pay off down the road. Read more here.
Telehealth's Virus Boom Prompts Task Force to Guide Its Future

Telehealth's popularity during the virus outbreak prompted a team of health-care leaders to band together to brainstorm recommendations to ensure the virtual services remain safe and beneficial for patients.

The Taskforce on Telehealth Policy includes health plans, health-care providers, consumer advocates, and health quality experts from the public and private sector, the group  said last Thursday.

After languishing for years, telehealth exploded as patients turned to electronic visits with health-care providers to avoid infection during the Covid-19 pandemic. There is widespread agreement that telehealth, which traditionally cost significantly less than in-person visits, is here to stay. Policy changes have been made by the Trump administration and states to allow for greater use of telehealth and to increase compensation rates to match in-person visits. Read more here.
With $136 Million In Fresh Funding, DispatchHealth Aims To Bring Back House Calls

Impact of COVID-19 on SDoH and SDoMH Revealed in National Study

Teens' Poor Sleep Tied to Later Depression, Anxiety

'Nature Deficit Disorder' Is Really a Thing

Navigating System Cultures across the Sequential Intercept Model (SIM)
June 26, 2:30 - 4 pm, SAMHSA's GAINS Center

Addiction Services in Corrections in a COVID-19 World
June 29, 1 - 2:30 pm, National Council for Behavioral Health

Leveraging SBIRT to Enhance Youth Tobacco Use Prevention
June 29, 2 - 3 pm, National Council for Behavioral Health

Improving Cultural Competence across the Sequential Intercept Model (SIM)
June 29, 2:30 - 4 pm, SAMHSA's GAINS Center

System-Wide Strategies for Re-Housing in the COVID-19 Era
June 30, 12 - 1 pm, Camden Coalition of Healthcare Providers' National Center for Complex Health and Social Needs, the National Alliance to End Homelessness, and the Corporation for Supportive Housing (CSH) 

Technology Based Outreach To Increase Access To Care And Support In Times Of Crisis
June 30, 1:30 - 2:30 pm, Mental Health America

PSYCKES Train the Trainer
July 1, 10 - 11 am, OMH

July 1, 1 - 2 pm, National Council for Behavioral Health

July 1, 2:30 - 4 pm, National Association of State Mental Health Program Directors

Using PSYCKES from Home
July 8, 1 - 2 pm, OMH 

July 8, 3 - 4:30 pm, NAADAC 

Law Enforcement Responses to People with Opioid Use Disorders
July 9, 3 - 4 pm, SAMHSA's GAINS Center

July 14, 1 - 2 pm, National Council for Behavioral Health

Using PSYCKES Recipient Search
July 15, 2 - 3 pm, OMH

Integrated Mental Health and Physical Health Mobile Crisis Response
July 22, 2 - 3 pm, SAMHSA's GAINS Center

Enable Access to Client-Level Data in PSYCKES
July 23, 3 - 4 pm, OMH

Data Sharing among Criminal Justice and Behavioral Health Partners: Mechanisms and Platforms for Efficient Data and Information Sharing
July 28, 12 - 1 pm, SAMHSA's GAINS Center

PSYCKES Mobile App for iPhones & iPads
July 29, 2 - 3 pm, OMH

July 29, 3 - 4 pm, National Council for Behavioral Health

Supporting Reentry for People with Mental and Substance Use Disorders: Establishing Recovery Housing
July 30, 12:30 - 2 pm, SAMHSA's GAINS Center


JULY 2020

OASAS Agency Day
July 1: 9:30 - 10:30 am, GTM

OMH Agency Day
July 1: 12 - 2 pm, GTM

OPWDD Agency Day
July 1: 2:30 - 4 pm, GTM
CLMHD Office Closed - Independence Day
July 3

Addiction Services & Recovery Committee (ASR) Meeting
July 9: 11 am - 12 pm, GTM

Developmental Disabilities Committee Meeting
July 9: 1 - 2:30 pm, GTM

Mental Hygiene Planning Committee Meeting
July 14: 1 - 3 pm, GTM

Children & Families Committee Meeting
July 21: 11:30 am - 1 pm, GTM

Contact CLMHD for all Call In and Go To Meeting (GTM) information, 518.462.9422 
New York State Department of Health Announces Counties Across the State to Receive Million from Enhanced Medicaid Funds in Response to COVID-19 Pandemic 

The New York State Department of Health on Wednesday announced the allocation to counties of $323 million in enhanced Medicaid matching funds initially provided for in the Families First Coronavirus Response Act.

The federal statute, for the duration of the COVID-19 pandemic period, increased Medicaid reimbursement by 6.2 percent.

"While COVID-19 infection rates are dropping and New York State has effectively flattened the curve, we're still feeling the significant human and financial toll of this virus," said New York State Health Commissioner Dr. Howard Zucker. "Governor Cuomo has been a fierce advocate for increased federal funding, and while this allotment will help the state and counties support programs important to our pandemic response, more federal funding is critically needed."

The projected six-month benefit (January - June 2020) to localities is estimated to be $323 million. The allocation amounts available  here are estimates, and the final support for each county will be based spending levels and could be impacted by further changes to federal guidance.
Since fiscal year (FY) 2016, New York State has taken over all growth in Medicaid costs from local governments, holding their collective annual contribution at $7.6 billion. The enhanced FMAP support they will now receive will lower this contribution.
Swamped Mental Health and Addiction Services Appeal for COVID Bailout
Video meeting
Mental health and addiction treatment centers and counselors have been overwhelmed with work during the coronavirus pandemic and economic crash. But many are struggling to stay afloat amid confusion and delays over the federal bailout for the health care industry.

Some have waited months for the release of promised aid. Others held out and didn't apply, believing they'd get a better deal in a future round of funding aimed at centers that see mostly low-income patients. As a result, nearly a third haven't received any of the $175 billion HHS is doling out to hospitals and other health providers on the front lines of the coronavirus response. And now, they're appealing to the government for help.

Centers caught in a financial squeeze are shedding staff or unable to buy protective gear while trying to serve a flood of new patients and transition some existing patients to online visits. Meanwhile the burden of a global pandemic and mass unemployment is driving up demand: Calls to a federal mental health crisis hotline have increased ten-fold during the pandemic compared to a year ago - a trend experts could derail the progress the government has made on the opioid crisis. Read more here.

Additional article of interest:  Mental health, Addiction Services Clamoring for Coronavirus Funds
As Suicide, Addiction Death Projections Soar Amid COVID-19, Treatment Centers Struggle to Stay Alive Too

In early March, Zoraida Diaz was coming to twice-weekly yoga classes here at Community Health Resources' offices. She's in recovery from colon cancer and alcoholism while in treatment for severe anxiety and depression. 

Carla Mitchell showed up for intensive PTSD therapy, happy to be free from her stressful home life and the racist taunts she hears walking in her neighborhood. 

And Tara Kulikowski, who has schizoaffective and bipolar disorders, lupus and is in recovery from drug addiction, organized craft classes and other activities at CHR's nearby "We Can Clubhouse." 

By mid-March, however, the answer was "we can't" for all in-person encounters at Connecticut's largest mental health and addiction treatment facility and thousands like it across the U.S. 

Amid projections of soaring suicide, drug and alcohol deaths from the pandemic-spawned social and economic collapse, centers like these and their patients are struggling to keep going. Read more here.

Additional article of interest:  The Hidden Deaths Of The COVID Pandemic
Behavioral Health: A Payer-Based Strategy For Improving Access And Quality During COVID-19 And Beyond

The personal and societal costs of behavioral health disorders, including mental health and substance use, are well documented, significant, and growing in the United States. The coronavirus pandemic is only exacerbating the problem. Even before the pandemic, the effects were dire-rising suicide rates, dramatic increases in drug overdose deaths, and substantially lower life expectancy among people with serious mental illness. These grim statistics paint a portrait of a behavioral health care system in crisis, and one that is grossly inadequate to meet the national demand that is only growing in the wake of COVID-19.

Access to behavioral health care is limited by several system-level factors. Nationally, there is a shortage of behavioral health providers that is unlikely to improve within the next decade. Of existing providers, many do not join insurance networks due to relatively low reimbursement, and patients often decline treatment when faced with high out-of-pocket costs. Several evidence-based treatments exist within behavioral health, but few providers deliver these interventions with fidelity. Despite the national call for measurement-based behavioral health care, use of outcome measures is limited by lack of provider adoption or technology infrastructure to measure and report outcomes at scale. As a result, less than half of Americans with behavioral health disorders access care. Even when they do, quality is not measured, and there is reason to suspect that quality is poor. Read more here.
Council of State Governments Justice Center: Financing the Future of Local Initiatives

The Council of State Governments Justice Center | LinkedIn
Local leaders face plenty of hurdles in funding and sustaining their efforts to reduce the number of people in jails who have mental illnesses or substance use disorders. They might struggle to work across sectors to leverage available resources or encounter difficulties interpreting complex regulations about federal funding eligibility and usage. Meanwhile, the sheer number of available federal funding opportunities can be overwhelming.

To respond to this need, CSGJC created  Financing the Future of Local Initiatives, a set of tools that helps jurisdictions plan for financial sustainability:
  1. Getting Started: A Guidebook for Sustainability and Scaling takes local leaders through the process of identifying funding to support data-driven strategies. 
  2. The Find a Federal Funding Opportunity database simplifies the often complex world of federal funding opportunities and is intended to help users pinpoint potential funding resources for their initiatives. Learn more about using the database.
  3. Jurisdictions around the country are testing out ways to sustain initiatives at the intersection of criminal justice and behavioral health. Read about the real-world application of these tools.
State Bar Association Task Force Focuses on Attorney Well-Being, Substance Abuse

For years, studies have shown that lawyers experience higher levels of stress and substance abuse compared to other professions, and the New York State Bar Association is attempting to take an active role in helping solve the issue by creating an Attorney Well-Being Task Force.

The task force, which will be made up of nine working groups, will attempt to advance an innovative and comprehensive culture of wellness in the legal community.

"Studies have shown rates of mental illness, fatigue, physical health problems, and substance use for attorneys that far exceed the national averages for other professions," said NYSBA President Scott Karson. "We need to eliminate the stigma associated with mental health treatment and make it easier for all lawyers to seek out the help that they need. Read more here.
The Pandemic's Mental Toll: More Ripple Than Tsunami
Feelings of anxiety and helplessness often rise during natural disasters but rarely become chronic, health experts note, and the prevalence of severe mental disorders is unlikely to change.
The psychological fallout from the coronavirus pandemic has yet to fully show itself, but some experts have forecast a tsunami of new disorders, and news accounts have amplified that message.

The World Health Organization warned in May of "a massive increase in mental health conditions in the coming months," wrought by anxiety and isolation. Digital platforms such as Crisis Text Line and Talkspace regularly reported spikes in activity through the spring. And more than half of American adults said the pandemic had worsened their mental health, according to a recent survey by the Kaiser Family Foundation.

But this wave of new mental problems is still well offshore, and it could yet prove to be a mirage. Psychiatrists and therapists who work with people in the wake of earthquakes, hurricanes and other disasters noted that surges in anxiety and helplessness were natural reactions that seldom become traumatic or chronic. Read more here.
Getting To Whole Person Addiction Treatment
Our coverage of primary care physicians' views of addiction treatment and medication assisted treatment (MAT) brought quite a few comments from readers. A recent study found that even though two thirds of physicians believe that addiction treatment is more effective with medication than without (67.1%)-and that consumers can safely use those medications (63.7%)-only 20% of physicians reported an interest in treating opioid use disorders (OUDs).

Add to this picture a primary care landscape where physicians seldom screen for addiction of their own accord, and nurse practitioners and physician assistants feel little responsibility or comfort addressing the issue at all. Only about 57% of primary care clinical professionals report screening consumers for any kind of addiction, only 46% provide any kind of intervention, and only 47% provide a referral for treatment.

The good news is that there are a number of "change management" models to increase the success of addiction treatment services in primary care. Read more here.

Additional article of interest:  Fire Up Your Hybrid For The Recovery Race
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.