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May 11, 2017

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

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Francine Sinkoff, Editor

NYS Behavioral Health VBP Readiness Program - Notification of Interest Webinar:   May 18th

The New York State Office of Mental Health (OMH) and Office for Alcoholism and Substance Abuse Services (OASAS) announce the launch of the NYS Behavioral Health (BH) Value Based Payment (VBP) Readiness Program. The NYS BH VBP Readiness Program represents a unique opportunity to strengthen community-based behavioral health providers throughout New York State, and prepare them to be successful in NYS' transformation of the health care delivery system.

OMH and OASAS are accepting "Notifications of Interest" until June 5th
from BH providers intending to apply for the program. Responses will help inform the State of provider interest, and will assist in finalizing the specifications of the NYS BH VBP Readiness Program.   This webinar will walk through the Notification of Interest process and provide an opportunity for questions and answers.  Slides and recording of this webinar will be posted online to the MCTAC website at a later date. 

Click here to register for the webinar.
Decisions in Recovery: A New Shared Decision-Making Tool for Medication-Assisted Treatment

Opioid use disorder is one of the most serious public health challenges facing our nation, affecting nearly 2.4 million Americans in 2015. Unfortunately, many who need treatment are not receiving it. Giving people access to information on treatment options could be the first step to entering treatment and recovery.  One of these treatment approaches is medication-assisted treatment (MAT), which combines approved medication with recovery support, lifestyle changes, and professional treatment. 

SAMHSA's new online tool,  Decisions in Recovery: Treatment for Opioid Use Disorder, helps people with opioid use disorder learn about using MAT treatment options to strengthen their recovery.  This tool features content on the stages of medication-assisted recovery, how to build a recovery support team, and recovery resources.   Read more here.
Have the Conversation: Raising Awareness about HIV in Behavioral Health Setting

It's 4:30 on Thursday afternoon. Your client, a young man who struggles with depression is here for his standing monthly appointment and starts telling you about last Friday night. He talks about how much fun he had, hooking up with a stranger at a bar while intoxicated. From what he is saying, it sounds like he plans to go out again tomorrow seeking a similar experience.

In this situation, would you consider referring your client for an HIV test? Are you prepared to ask your client about condom usage?

If your answer is no, that's understandable. It can feel challenging to address client questions about sex, HIV and STDs and many providers feel uncomfortable initiating these conversations. Especially because the conversation doesn't always present naturally, as it did in this scenario. In the behavioral health field, we need to start having conversations about sexual health with all our clients, regardless of demographics.  Read more here.



May 23, 12 - 1 pm

June 8, 12 - 1 pm


May 16, 12 - 1 pm, PsychU

May 17, 1 - 2 pm, NYS Office of Information Technology Services

May 17, 3 - 4:30 pm, Rural Behavioral Health

May 23, 12 - 1 pm, National Council on Behavioral Health

May 25, 1 - 2:30 pm, Center for Health Care Strategies

Managing Benzodiazepines: Best Practices and Alternatives
May 31, 12 - 1 pm, SAMHSA-HRSA
June 6, 2 - 3:30 pm, Manatt

June 15, 3 - 4 pm, SAMHSA-HRSA
June 21, 3 - 4:30 pm, Rural Behavioral Health

August 16, 3 - 4:30 pm, Rural Behavioral Health


MAY 2017

Chemical Dependency Committee Meeting
May 12:  11 am - 12:30 pm, GTM

Children & Families Committee Meeting
May 16:  11:30 am - 1 pm, GTM

Directors & Executive Committee Meeting
May 17:  9:30 am - 12:30 pm, GTM

CSPOA / DOH / OMH Monthly Call
May 18:  3 - 4 pm, GTM

OMH Agency Meeting
May 23:  10 am - 12 pm
44 Holland Ave., 8th Fl., Albany

OASAS Agency Meeting
May 23:  1 - 3 pm
1450 Western Ave., 4th Fl., Albany

CLMHD Office Closed
May 29:  Memorial Day

Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
New York is Midway Through Monumental Medicaid Redesign

With attention focused on attempts by Congress and the Trump administration to repeal and replace the Affordable Care Act, another major effort to reform health care gets overlooked.

New York is midway through a monumental initiative begun in 2011 to redesign the costly Medicaid program, the largest purchaser of health services in the state for its 6.2 million beneficiaries.

Jason Helgerson, director of the state's Medicaid program, stopped in Buffalo on Wednesday to talk about the effort. He also repeated his warnings that the GOP health care bill that has advanced to the Senate, the American Health Care Act, could have a dire impact on patients, hospitals and taxpayers.

"The Republican plan is a massive step backward in social justice and the core objective of expanding coverage in this country's history," Helgerson said. "I get the main point of reducing spending on health care. But there are far better ways to address that."  

New York received a waiver in 2015 from the federal government that allows the state to keep $8 billion of $17.1 billion in savings the state expects to see over five years from Medicaid reform. The state plans to reinvest the money in projects that seek to reduce avoidable hospital use by 25 percent and that transition most hospital and doctor Medicaid payments from fee-for-service to a value system tied to performance goals. 
Read more here.
New VBP Whiteboard Video

The Medicaid Redesign Team recently released another video in its whiteboard series. In the video titled, "Value Based Payment (VBP) and The Year Ahead," New York State Medicaid Director, Jason Helgerson, gives an overview of progress to date on VBP, including an update on the percent of Medicaid payments that are currently value based. He also describes ways to move into VBP arrangements and what is next for VBP in the year ahead. 

Click here to view the video.
As #MentalHealthMonth Begins, Counties Across the Country Show Progress in Tackling Mental Illness in Their Jails

May marks #MentalHealthMonth, a nationwide effort to raise awareness about mental illnesses and their impact. With an estimated 2 million people with mental illnesses being admitted to jails each year according to  research , communities are discussing ways to tackle this issue at the local level.

Some counties have already begun addressing this crisis by joining Stepping Up. Launched in May 2015 as a partnership between The Council of State Governments Justice Center, The National Association of Counties, and The American Psychiatric Association Foundation, the national initiative has rallied more than 360 counties to pass local resolutions to reduce the number of people with mental illnesses in their jails. Guided by Stepping Up's  Six Questions County Leaders Need to Ask, these counties are working toward identifying how their system can improve outcomes for people entering their jails.  Read more here.
Study: Clubhouse Model Dramatically Reduces Medicaid Costs of People With Serious Mental Illnesses

Fountain House, the creator of the Clubhouse model back in the late 1940's, has released a very impressive and timely NYU study that demonstrates that a group of clubhouse members with extensive service needs that had amounted to over $18,000 the year before joining the program, reduced their use of Medicaid funded services by $783 per month. This drop in Medicaid utilization amounted to a 21% reduction in total cost of care than had been anticipated during their first year as members. These findings bolster the value of clubhouse services in an value based environment. 
Latest Opioid Fight: As Fentanyl Spreads, States Step Up Responses

A billboard on a main highway tallies the number of residents in this mostly rural county who have overdosed on prescription painkillers, heroin and other illicit opioids this year: 96 overdoses, 15 of them fatal.

What the sign doesn't say is that a large and growing number of those deaths are the result of fentanyl, a fast-acting drug that is 50 times stronger than heroin and can kill users within seconds. Cheap and easy to produce, it is used by drug dealers to intensify the effects of heroin and other illicit drugs, often without the users' knowledge.

The presence of fentanyl in the illicit drug supply has put law enforcement officials and the medical community on high alert in more than a dozen states, accelerating the battle against opioids on all fronts.

States, counties and cities are responding to this latest crisis by doing more of what they already were doing: stockpiling the overdose reversal drug naloxone, funding more drug treatment, and ramping up police surveillance of drug trafficking. In addition, a handful of states are stiffening penalties for selling the lethal drug.  Read more here.
Public Restrooms Become Ground Zero In The Opioid Epidemic

A man named Eddie threads through the mid-afternoon crowd in Cambridge, Mass. He's headed for a sandwich shop, the first stop on a tour of public bathrooms.

"I know all the bathrooms that I can and can't get high in," says Eddie, 39, pausing in front of the shop's plate glass windows, through which we can see a bathroom door.

Eddie, whose last name we're not including because he uses illegal drugs, knows which restrooms along busy Massachusetts Avenue he can enter, at what hours and for how long. Several restaurants, offices and a social service agency in this neighborhood have closed their restrooms in recent months, but not this sandwich shop.

"With these bathrooms here, you don't need a key. If it's vacant you go in. And then the staff just leaves you alone," Eddie says. "I know so many people who get high here."

At the fast food place right across the street, it's much harder to get in and out.

Eddie is homeless and works at a restaurant. Public bathrooms are one of the few places where he can find privacy to inject heroin. He says he doesn't use the drug often these days. Eddie is on methadone, which curbs his craving for heroin, so he only uses the drug occasionally to be social with friends.   Read more here .
Health Care Labor Force Growth (& Competition) In Surprising Places

Recruiting is usually on the list of strategic issues for managers of health care provider organizations. And for good reason. Between 2000 and 2016, while overall private sector employment grew by 9.8%, health care employment grew by 42.0%. This caused health care services' share of total private sector employment to rise from 9.8 percent in 2000 to 12.6% in 2016 as reported in a report by Deloitte,  Driving Healthy Employment Growth: A Look at Occupations in Health Care. In raw numbers, U.S. health care employment rose by 4.6 million jobs.

So where was the growth in health care employment? The Deloitte analysis looked at five sub-sectors: outpatient care centers, hospitals, home health agencies, physician offices, and skilled nursing facilities. The highest growth as a percentage was in home health care services, a 115.1% increase. But the highest growth in numbers was in hospital employment, from 4,000,000 to 5,000,000 employees.  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.