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September 8, 2016

SEPTEMBER IS NATIONAL RECOVERY MONTH!
Now in its 27th year, Recovery Month highlights the achievements of individuals who have reclaimed their lives in long-term recovery and honors the treatment and recovery service providers who make recovery possible. Recovery Month also promotes the message that recovery in all of its forms is possible and encourages citizens to take action to help expand and improve the availability of effective prevention, treatment, and recovery services for those in need.

Advancing Public Policies for People with Mental Illness, Chemical Dependency or Developmental Disabilities   
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Francine Sinkoff, Editor
[email protected]


OASAS 2 for 1 Webinar:  County Planning with State Websites

OASAS will present a 2 for 1 webinar on Thursday, September 29, 2 - 3 pm. Come learn about how the Kids' Well-being Indicators Clearinghouse (KWIC) and the Mental Hygiene County Planning System website can help you in your daily work. If you spend your days talking about - Data, Performance, Outcomes, Planning and Accountability - then this is the webinar for you!

One, the KWIC website is a public one-stop shop for planning and community assessment with population indicators and an extensive local mapping tool.  Two , the Mental Hygiene County Planning System is a secure web-based system where counties submit a single, integrated local services plan to all three state Mental Hygiene agencies at once. Counties, state agency staff and the public can use the system to access local plans as well as other data and resources related to substance use, mental health, and developmental disabilities. 

Participants will be given a special tour of these 2 websites in 1 hour. This 2 for 1 webinar is presented by the Council on Children and Families in partnership with the Office of Alcoholism and Substance Abuse Services. To register click here.
Upcoming Consolidated Fiscal Report (CFR) Training Sessions

This fall the New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) and its interagency partners, Office of Mental Health (OMH), Office for People With Developmental Disabilities (OPWDD), and State Education Department (SED), will be conducting training sessions on completing a Consolidated Fiscal Report (CFR). While this training is specifically for the January 1, 2016 - December 31, 2016 CFR, the information is generally applicable for July-June filers as well.
 
Click HERE for training details including who should attend, how to register for a session, and the locations and times of training sessions.   OASAS strongly encourages providers to attend these training sessions for CFR updates, provider-specific issues, and general CFR preparation guidance.
Funding Opportunity for Independent Living Centers and Community-Based Organizations

Authorized by the Patient Protection and Affordable Care Act (ACA), New York State's Balancing Incentive Program (BIP) has expanded the State's Aging and Disability Resource Centers (NY Connects) to broaden the populations for which it provides information, assistance and linkage to Long Term Services and Supports (LTSS).
 
To increase the access to LTSS as an alternative to institutional care, New York State Office of the Aging (NYSOFA) has issued a Request for Applications (RFA) for a BIP funding opportunity to partner with NY Connects.  Up to six Independent Living Centers (ILCs) and/or community-based organizations will be chosen in six regions across the State. 
 
The RFA was issued on August 25th, 2016.  Submission of applications is through Grants Gateway.
Schuyler Center and UHF Release New Report Proposing Value-Based Payment Models for Children in Medicaid

This  report , commissioned by UHF and the Schuyler Center for Analysis and Advocacy and written by Bailit Health, sets out a new, child-centered approach to value-based payment in Medicaid. As New York continues to shift Medicaid payments from fee-for-service to value-based payment systems, it raises the question of how these payment changes should apply to the nearly 40 percent of Medicaid enrollees who are children and adolescents.
NEW MCTAC WEBINARS:  
Value Based Payment for Medicaid Child Health Services
September 21, 2:30 - 4 pm
The first webinar will highlight relevant data and research, explore the impact of the social determinants of health, and review the implications of healthcare reform for child-serving providers.   
 
Part II: Measuring Value in Children's Healthcare
September 29, 2:30 - 4 pm
Part two will address how to measure value when it comes to children's healthcare with a focus on measure selection for reporting outcomes and how outcomes align with proposed value-based payment models. Finally, the presenters will explain key differences of value based payment between adult and children's services and strategies for managing multiple payment models. 
NCCP Report:  Using Medicaid to Help Young Children and Parents Access Mental Health Services - Result of a 50-State Survey

The  National Center for Children in Poverty has just released a new report,  Using Medicaid To Help Young Children and Parents Access Mental Health Services: Results of a 50-State Survey. The report presents findings on Medicaid coverage and related policies (e.g., rules about eligibility, screening and treatment practices) for key services:  Early childhood mental health services in pediatric, home, and early care and education settings; dyadic treatment; parenting programs; maternal depression screening during well-child visits; and behavioral health case management/care coordination. 

The report concludes with recommendations that highlight ways the results can be used by diverse stakeholders to strengthen supports for young children's mental health. 
Important Changes in DSM-5 to Become Effective October 1

Each year on October 1, the International Classification of Diseases, Tenth Edition, Clinical Modification (ICD-10), is updated to reflect diagnostic  changes in medicine. Since 2010, no major updates have been permitted so that physician practices, facilities, and payers in the United States could update their systems during the transition from ICD-9 to ICD-10, which went into effect on October 1, 2015.

APA has advocated that changes be made to ICD-10 to reflect the updated diagnoses in DSM-5. These include changes to align the terminology used in DSM-5 with that used in the mental health chapter of ICD-10. In response, the Fiscal Year 2017 version of ICD-10, which takes effect October 1, will include most ofDSM-5's terminology.

In some cases, new codes have been added to ICD-10 to accommodate the new diagnoses that were added to DSM-5. The new codes will allow more accurate diagnostic recording, improved communication among clinicians, and better means for collecting prevalence data.

As of October 1, the codes for the DSM-5 disorders in the chart below will no longer be valid. The new codes listed in the chart must be used in their place.

A printable version of the list is available here  and includes the diagnoses in both alphabetical order and the order in which they appear in the DSM-5 classification.




UPCOMING TRAININGS

MCTAC
MCTAC is offering a second round of
in-person   small business initiative regional forums (9/19 - 9/30) specifically geared toward smaller agencies that have little to no experience billing Medicaid or managed care. 

September 14, 11 am - 12 pm
 
September 21, 12 - 1 pm

October 26, 12 - 1 pm

OTHER TRAININGS

 
CALENDAR OF EVENTS

SEPTEMBER 2016

RPC Advisory Call
September 15:  8 - 9 am

Fall Full Membership Meeting
September 26 - 27
Woodcliff Hotel & Spa, Fairport


OCTOBER 2016

Officers & Chairs - Call In
October 5:  8 - 9 am

OMH Agency Meeting &  Director's & Executive Committee Meeting - In Person
October 17:
10 am - 12 pm ( 44 Holland Ave., Albany - 8th Fl.)
1 - 3 pm ( 41 State Street, Ste. 505, Albany)


Contact CLMHD for all Call In and Go To Meeting information, 518.462.9422 
OMH Announces Loan Repayment Program to Attract Psychiatrists to New York Psychiatric Centers

The New York State Office of Mental Health last week announced that applications are being accepted for the Doctors Across New York (DANY) Psychiatrist Loan Repayment Program. This incentive offers up to $150,000 in tax-free reimbursement for psychiatrists with active student loan debt who agree to serve at a New York State Office of Mental Health psychiatric center for at least five years.

The DANY program is a state-funded initiative launched by the Department of Health. It was created in 2008 in response to the increasing physician shortage in New York State. The Office of Mental Health (OMH) has received approval for its own segment of the program dedicated to address OMH's psychiatrist recruitment and retention crisis.  OMH will be providing a total of $1.5 million in funding for this program during the 2016-2017 fiscal year and will seek similar funding in future budgets. The OMH Psychiatrist Loan Repayment Program will support psychiatrist recruitment and retention at facilities where the OMH Commissioner determines there is a critical need.

Opportunities exist in OMH psychiatric centers throughout New York State and applications will be accepted electronically on a continual basis. Physicians who are currently in a psychiatric residency program are encouraged to apply.   For more information about the Psychiatrist Loan Repayment Program, click here.
NYSDOH Issues Latest Medicaid Program Update

The New York State Department of Health (NYSDOH) has issued its latest update on the Medicaid program in New York.  This month's update features items on new Medicaid clinic reimbursement policies involving dental hygienists who are participating in collaborative practice arrangements in hospital facilities licensed under Article 28 of the New York State Public Health Law, Medicaid managed care implementing an opioid prescription fill limit of four prescriptions every 30 days, change to Medicaid reimbursement policies for Medicare Part C copayments and coinsurance liabilities, and another update on the electronic health record (EHR) incentive payment program (among other topics).  To read the latest NYSDOH Medicaid update, click here.
NY DMH Responder - Summer Issue

The summer issue of the  DMH Responder 
represents a look back at some of the articles that have been published in the past that are still timely and valuable. Click here to read the issue.
WEBINAR:  FIDA Advertising & Outreach Update

The NYSDOH Division of Long Term Care will provide an update for any interested stakeholders on the advertising campaign, outreach strategies, and success stories of the Fully Integrated Duals Advantage (FIDA) program, via webinar on Friday, September 16, 2016 from 2 - 3 pm.  To register, click HERE.
Rural America Finally Gets Mental Health Help 

W ith 717 square miles to call its own, Codington County, S.D., is home to a handful of lakes and 28,000 people. As in any rural county, government resources are stretched thin, which made the costly overcrowding at the county jail all the more frustrating.

Codington didn't have an acute crime problem. Rather, the lack of mental health resources kept the same people cycling through county services: hospital emergency departments, social services and, eventually for many, the county jail.

What was happening in Codington County is typical of what is taking place in many rural counties -- and in urban ones as well. A significant portion of jail inmates are mentally ill. In Chicago's Cook County, for instance, estimates run as high as 30 percent of jail inmates suffering from mental illness, much of it undiagnosed and untreated. But the problem is particularly acute in rural areas where access to mental health care -- be it clinics, primary care or specialty services -- is especially limited. "In a small, rural area you might not have access to a hospital, especially a hospital that has a behavioral health worker," says Paul Mackie, president-elect of the National Rural Mental Health Association. "So law enforcement is the de facto response to mental health issues in rural areas."

Even if there is access to care, there are cultural stigmas to mental illness that are particularly acute in rural areas and may keep people from seeking care. In a small community where everyone knows everyone, many don't want their car seen in the parking lot of a behavioral health specialist.  Read more here.
Bridging the Electronic Health Information Highway and Promoting Interoperability for Medicaid Providers

The Centers for Medicare and Medicaid Services (CMS) recently expanded the scope of the Health Information for Economic and Clinical Health Act (HITECH) 90/10 funding available to encourage the adoption and promote the use of electronic health record (EHR) technology and health information exchange (HIE). This new funding source provides Medicaid agencies with the ability to accelerate the exchange of information across the continuum of Medicaid providers and gather important clinical and administrative data elements for robust program planning; improvements in quality of care; and managing costs.   

This new funding source allows Medicaid agencies to facilitate HIE connections between Medicaid providers even if the provider does not meet the definition of an eligible professional.  Activities that are now open for CMS funding include HIE architecture support and on-boarding for Medicaid providers that don't meet the eligibility criteria for the incentive payments.  Initially, CMS limited matching funds to support for HIE for eligible professionals and eligible hospitals.  The initial funding opportunity for HIE excluded post-acute providers, substance abuse treatment providers, home health providers, correctional health providers and other health care providers.  Medicaid HITECH funds can now support HIE onboarding and systems for all of these Medicaid providers.  Read more here.
Mental Health In Schools: A Hidden Crisis Affecting Millions Of Students

You might call it a silent epidemic.

Up to  one in five kids living in the U.S. show signs or symptoms of a mental health disorder in a given year.

So in a school classroom of 25 students, five of them may be struggling with the same issues many adults deal with: depression, anxiety, substance abuse.

And yet most children -  nearly 80 percent - who need mental health services won't get them.

Whether treated or not, they do go to school. And, the problems these children face can play a big role in the major problems found in schools: chronic absence, low achievement, disruptive behavior and dropping out.

Experts say schools could play a role in identifying students with problems and helping them succeed. And yet it's a role many schools are not prepared for.

Educators face the simple fact that, often because of a lack of resources, there just aren't enough people to tackle the job. And the ones who are working on it are often drowning in huge caseloads. Kids in need can fall through the cracks.  Read more here.
Providing A Safe Space And Medical Monitoring To Prevent Overdose Deaths 

According to the  Centers for Disease Control and Prevention (CDC), more people died from drug overdoses in 2014 than in any year on record. Most of these deaths-78 every day-involved an opioid. Closer to home in Boston, deaths from opioid overdoses increased by 50 percent from 2014 to 2015 ( Note 1). In our practice, Boston Health Care for the Homeless Program (BHCHP), based on the corner of Massachusetts Avenue and Albany Street (the epicenter of Boston's drug activity), opioid overdoses have become the  leading cause of death among our patients.

Overdoses were happening multiple times each week in our lobby, clinic bathrooms, and on the sidewalks and alleys adjacent to our building. Despite significant existing services aimed at the prevention and treatment of substance use disorders (SUD), we were not effectively engaging some of the highest-risk people with SUD. There was recognition among our staff, board of directors, and patients that in addition to improving screening for SUD, expanding access to opioid agonist therapy, broadly distributing naloxone (the rescue drug to reverse opioid overdoses), improving opioid prescribing practices, and expanding housing opportunities, we also needed to reduce the harms associated with ongoing drug use and provide a safe alternative to the street for people who are over sedated. Our goals are to respond with a new service that:
  1. Prevents fatal overdose;
  2. More effectively connects highest-risk individuals with addiction treatment; and,
  3. Addresses the impact of SUD on our patients, our organization, and our neighborhood.
Read more here.
Depression Treatment Often Doesn't Go To Those Most In Need

Most Americans who screen positive for depression don't receive treatment, a study finds, while most who did receive treatment don't appear to have the disorder.

"Over the last several years there has been an increase in prescription of antidepressants," says Mark Olfson, professor of psychiatry at the Columbia University Medical Center and lead author of the  study, which was published Monday in JAMA Internal Medicine. "In that context, many people assumed that undertreatment of depression is no longer a common problem."

But Olfson found the opposite to be true after analyzing data from Medical Expenditure Panel Surveys in 2012 and 2013 that asked people if they had been screened for depression. Of the 46,417 adults surveyed, 8.4% answered in ways that suggested they had depression, but only 28.7% of the people who appeared depressed received any treatment for it.

"The findings highlight that there are continuing challenges in aligning depression care with patient needs," Olfson says.
Those in the lowest-income group were five times more likely to appear to have depression compared with those in the highest income group, with 18.2% of lowest-income adults screening positive compared to 3.7% of the highest-income group. But higher-income people were more likely to get treatment.  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