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April 6, 2016

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

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Francine Sinkoff, Editor
[email protected]


2017 Mental Hygiene Local Services Plan Guidelines Released

The 2017 Mental Hygiene Local Services Plan Guidelines have been  released and posted in the online County Planning System (CPS) under "Plan Guidelines." They provide guidance and information on the fully integrated and uniform mental hygiene local planning process with state agencies, OASAS, OMH and OPWDD. The Guidelines also provide detailed instructions on completion of the 2017 LGU and OASAS Provider Planning Forms and reflect the collaborative efforts of the Mental Hygiene Planning Committee, which includes the three Mental Hygiene state agencies, The Conference of Local Mental Hygiene Directors and several county directors and planners.

All OASAS provider planning forms must be completed and certified by the local goverenmental unit no later than Monday, April 4, 2016. All county plans must be completed and certified in CPS no later than June 1, 2016.

Click here for the Guidelines.
DSRIP Year 2 Timeline Updates

DSRIP Year 2 began on April 1, 2016 and the Timeline has been updated to reflect the recent announcement of Public Comment Days on New York's 1115 Waiver programs.  Also updated were the dates for the PPS Regional Learning Symposiums and the deadline for the Value Based Payment Roadmap Public Comment period. 
 
Click here to view the DSRIP Timeline.
CMS Issues Final Guidance for QHPs

States have been awaiting the final guidance regarding 2017 certification standards for Qualified Health Plans (QHPs) since the Centers for Medicare and Medicaid Services (CMS) issued its proposals at the end of last year.   With the release of the final 2017 Benefit and Payment Parameter regulations (regulations) and the final 2017 Letter to Issuers in the Federally-Facilitated Marketplaces (Letter) on February 29th, CMS put the final pieces in place and provided clarity that will allow states to move forward with QHP review.  Read more here.
 
DOH Issues 2015 Annual Opioid Poisoning, Overdose and Prevention Report

The 2015 Annual Opioid Poisoning, Overdose and Prevention Report to the Governor and NYS Legislature was released last week and is now available on the NYSDOH website.  

This report is the first of an annual report required pursuant to Subdivision (5) of Section 3309 of the Public Health Law, as amended in 2014.  It provides an overview of opioid-related mortality and morbidity and other consequences of heroin and prescription opioid misuse across the state over the last five years. It also summarizes new and expanded initiatives and collaborative cross-disciplinary efforts to identify, assess, and address those problems, as well as the legal and regulatory developments that opened the way for them.

This report reflects the work of many state and local government agencies, which have collected, shared and examined data to identify where and to whom opioid overdoses are occurring, and to help inform timely, effective public health and public safety policy and practices to reduce the related deaths, disease, and social harms affecting New York's communities. 

Click here for the report.
New York State Launches New Initiative to Treat Problem Gambling

The New York State Office of Alcoholism and Substance Abuse Services last week announced a new, multi-year program to train counseling professionals to better enable them to deliver problem gambling treatment and support services. Many individuals seek private practitioners for help to address problem gambling and this new training program ensures that private practitioners are knowledgeable about problem gambling and will increase access to treatment and support services. The Problem Gambling Training Partnership, funded by NYS OASAS, will offer training on assessment and treatment for a gambling disorder to social workers, mental health counselors, marriage and family therapists and psychoanalysts throughout New York State.

The new program is part of a statewide collaboration between NYS OASAS and the New York Council on Problem Gambling (NYCPG). The NYCPG will work with the New York State Chapter of the National Association of Social Workers (NASW-NYS), the New York Mental Health Counselors Association (NYMHCA), the New York Association for Marriage and Family Therapy (NYMFT), and the National Association for the Advancement of Psychoanalysis (NAAP) to implement this new initiative. These five professional organizations partnering in this effort represent nearly 20,000 counseling professionals across the state.

The program will provide evidence-based training on best practices related to problem gambling prevention, treatment and support services through in-person training institutes, webinars and print materials, and clinical support. Training programs will begin in May and be offered regionally throughout the state. This new funding, totaling more than $350,000 in 2016 also will enable the associations to develop a public awareness campaign to inform the public about problem gambling and the availability of counseling services.  Read more here.





 
CALENDAR OF EVENTS

APRIL 2016
Mental Hygiene Planning 
April 7:  11 am - 1 pm
GTM Only

Children & Families Committee
April 19: 12:30 - 1:30 pm
GTM Only


MAY 2016
Spring Full Membership Meeting & CLMHD 40th Anniversary Dinner
May 2 - 3: The Desmond, Albany

Officers & Chairs - Call In
May 4:  8 am

Mental Hygiene Planning 
May 5:  11 am - 1 pm
GTM Only

Children & Families Committee
May 17:  11:30 am - 1 pm
GTM Only

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

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

CLMHD Mentoring Workshop
May 25:  10 am - 4 pm
DoubleTree by Hilton Hotel, Syracuse


Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
Highlights of 2016-17 NYS Enacted Budget

The enacted 2016-17 State Budget passed on April 1, 2016. Debbie Holland, CLMHD's Director of Government Relations, has prepared a brief look at some highlights of the budget.

Children's Managed Care Readiness
Legislative Funding to CLMHD
 
The Conference is thrilled that the NYS budget has  allocated   $175,000 for the design of a data collection plan and analysis of children's behavioral health services to evaluate service effectiveness, identify performance outcome measurements, and quality benchmarks in preparation for alternative payment methodologies.  CLMHD
collaborated  with the NYS Coalition for Children's Behavioral Health, NYS Council for Community Behavioral Healthcare, Families Together in NYS and the Schuyler Center for Analysis and Advocacy on this proposal and will jointly facilitate children's provider and family representative involvement in designing the plan for data collection and analysis. 

 

Statewide Health Care Facility Transformation Program
Art. 31 & 32 Clinics are Eligible
  • Provides $200 million in capital funding in support of projects that replace inefficient and outdated facilities as part of a merger, consolidation, acquisition or other significant corporate restructuring activity that is part of an overall transformation plan intended to create a financially sustainable system of care.
  • Eligible applicants include: hospitals; residential health care facilities; D&TCs, health clinics and mental hygiene clinics.
  • A minimum of $30 million of total awarded funds must be made to community-based health care providers which are defined as D&TCs, Art 31 and Art 32 OMH and OASAS clinics, primary care providers and home care providers.
  • Reinstates the Health Care Facility Transformation Program for Oneida County.
Extension of Medicaid APG Rates 
Extends APG Rates under Medicaid Managed Care and Child Health Plus for behavioral health providers through June 30, 2018.
 
Federal Waiver to Allow Medicaid to Individuals Immediately Prior to Release from Incarceration 
Allows the state to apply to CMS for federal authority to provide Medicaid for high needs inmates in prisons and jails for transitional coordination services during the 30 days prior to release.
 
Social Work Licensure Extension 
Extends the social work and mental health practitioner licensure exemption for two years, until July 1, 2018. The Governor had proposed a five year extension.
 
Mental Health Clinic Uncompensated Care Pool 

The Enacted Budget does not include $54.4 million to cover the federal share of uncompensated care funding for D&TCs and Article 31 mental health clinics.  Also, the Enacted Budget does not remove the requirement that federal matching funds be in place in order for the state share of funding to be paid to mental health clinics.  As a result of the federal financial participation requirement, mental Health clinics have not received any uncompensated care payments in 2015 and are experiencing a shortfall of $20 million (state and federal share).  The Conference will continue to strategize with other impacted organizations and lobby the state and CMS to resolve this issue.

 

Click here for more details.
ThriveNYC Establishes Permanent and Mental Health Council

Mental health is complex - addressing treatment, prevention and mental well-being likewise requires a sophisticated approach. 
New York City has made a significant move unto that end, establishing a permanent mental health council. The conglomerate of 20 city agencies will prioritize and coordinate policies to promote good mental health for New Yorkers.  

The new council comes by way of 
ThriveNYC ,  a strategy and set of initiatives for a comprehensive approach to mental health involving multiple city agencies. Spearheaded by McCray, ThriveNYC attempts to destigmatize mental illness and provide better access to care.  

The Mental Health Council is composed of 20 members, including McCray and Buery, as well as representatives from the Department of Aging and the Police Department. The council will serve as an advisory group to the mayor on relevant initiatives, advocate for programs designed to overcome barriers to treatment, make recommendations on legislation regarding mental issues, and work with a network of organizations to provide superior mental health care.
President's Task Force Aims To Help End Discrimination In Mental Health Coverage

Tucked in  remarks  the president made last Tuesday on the opioid epidemic was his announcement of a new  task force on mental health parity  - aimed at ensuring that people with mental illnesses and substance abuse problems don't face discrimination in the health care system.

Despite a landmark 2008 law intended to do just that, enforcement has been paltry, and advocates say discrimination has continued.

Advocates say parity has long been an "empty phrase" and it has taken the administration far too long to address the problem. They say insurers have been subverting the law in subtle ways, and the government has not aggressively acted to stop them.

In a 2015 survey by the National Alliance on Mental Illness, an advocacy group for people with mental illness and their families, many patients said they were denied payment because treatment was deemed "not medically necessary" twice as often for mental health as for other medical conditions. Only a handful of states, including California and New York, have been investigating whether insurers are complying with the parity law. Meanwhile, the federal government has taken few if any public enforcement actions, as Kaiser Health News reported  last year.  Read more here.
State Seeks to Bend the Rules to Allow Medicaid Coverage for Inmates

When a person enrolled in Medicaid goes to jail, their benefits under that public health insurance plan are suspended for most services, and many people end up falling through the cracks of the health system upon release.  But a state program designed to link inmates to health care providers in the community has motivated legislators to seek new exceptions to the rules.

In this case, the neighborhood providers are health homes, which are designed to help high-needs Medicaid enrollees access not only primary care and mental health services but also basics like transportation and housing. Health homes receive lists of Medicaid beneficiaries from the state indicating who they're responsible for serving, but tracking them down isn't always easy.

Since late 2012, the Brooklyn Health Home and a handful of others across the state have been involved in a pilot project to work with local correctional facilities to identify and connect with members who are incarcerated, so they can begin to coordinate their housing and health services prior to their release, and hopefully prevent them from returning to jail.

"The risk of relapse, of recidivism, of hospitalization are so high in those first months out of incarceration," said Sebastian Solomon, director of New York state policy at the Legal Action Center, which coordinates the state's work group on health homes and criminal justice. "People are often lost to the system if they aren't connected to care immediately."

But the state Health Department didn't release the $5 million that was dedicated to the program in last year's budget due to concerns about violating federal and state Medicaid laws. As a result, most of the health homes have had to stall their participation.  Read more here.
HHS Takes Steps To Increase Access to Opioid Use Disorder Treatment Medication

HHS is proposing a new rule to allow physicians to prescribe the opioid use disorder treatment medication buprenorphine to an increased number of patients. The proposed change is designed to strike a balance between expanding access to this important treatment, encouraging use of evidence-based medication-assisted treatment (MAT), and minimizing the risk of drug diversion.

If adopted, the proposal would allow for a qualified and currently waivered physician to prescribe buprenorphine for up to 200 patients. Buprenorphine is a U.S. Food and Drug Administration-approved drug used as part of MAT, a comprehensive way to address the recovery needs of individuals that combines the use of medication with counseling and behavioral therapies to treat substance use disorders. Buprenorphine-because of its lower potential for abuse-is permitted to be prescribed or dispensed in physician offices, significantly increasing its availability to many patients. When taken as prescribed, buprenorphine is safe and effective.

HHS welcomes public comment on this proposed rule, which will be open for 60 days starting Wednesday, March 30, 2016.
Click here to review and comment on the proposed rule.
How the Epidemic of Drug Overdose Deaths Ripples Across America

Deaths from drug overdoses have jumped in nearly every county across the United States, driven largely by an explosion in addiction to prescription painkillers and heroin.  Some of the largest concentrations of overdose deaths were in Appalachia and the Southwest, according to new county-level estimates released by the Centers for Disease Control and Prevention.

The number of these deaths reached a new peak in 2014: 47,055 people, or the equivalent of about 125 Americans every day.   The death rate from drug overdoses is climbing at a much faster pace than other causes of death, jumping to an average of 15 per 100,000 in 2014 from nine per 100,000 in 2003.

The trend is now similar to that of the human immunodeficiency virus, or H.I.V., epidemic in the late 1980s and early 1990s, said Robert Anderson, the C.D.C.'s chief of mortality statistics.  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