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September 21, 2016

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


OMH Shared Space Guidance

The New York State Department of Health (DOH), the New York State Office of Mental Health (OMH) and the New York State Office of Alcoholism and Substance Abuse (OASAS) have finalized guidance on space arrangements between two or more providers. This document provides guidance to Article 28, Article 31 and Article 32 providers that wish to integrate services through shared space arrangements with other licensed or private medical practices and describes the application process for various types of shared space arrangements.  This guidance can be found on the DOH website here.
Consider the Details When Integrating Behavioral Healthcare

With more emphasis on performance and value-driven care, healthcare leaders are looking to integrate behavioral health into traditional settings, drive efficiency, reduce costs and improve patient outcomes.

While the big picture changes and transitions are important to a successful integration, the real areas that will determine success or failure can be found in the details such as resource management, organization policies, treatment planning and coordination of care.
The need for integration

According to a study from  Health Affairs, mental disorders are the most costly conditions in the United States, totaling $201 billion in 2013. In fact, 70% of all primary care patient visits are related to behavioral health, and studies suggest one in five will be diagnosed with a mental health disorder.

We know that there is a behavioral health component to many physical health presentations and when a mental illness is mixed in, treatment costs can double or triple for patients with a medical condition. For example, Substance Abuse and Mental Health Services Administration (SAMHSA)  data shows the cost of treating a patient with diabetes is $9,500 per year on average. When the diagnosis includes a mental illness, the treatment costs jump to just under $37,000 annually.

This staggering increase is counteracted by integrating behavioral health into traditional health settings. The Improving Mood: Promoting Access to Collaborative Treatment ( IMPACT) study found when behavioral health is integrated into primary care settings, patient outcomes improve and cost of care goes down. The data revealed investment in an integrated care model results in a $6.50 return on every $1 spent.

Value-based care models that incorporate behavioral health require a significant amount of teamwork across providers as well as with patients, and are known as collaborative care models.  Read more here.
4 Steps to Prepare for Health Information Exchange (HIE) Participation

The benefits for a behavioral healthcare organization tying into a health information exchange (HIE) are clear and practical. The path to being ready for participation in an HIE, however, is a bit more complicated.

The quick and efficient sharing of patient health information with electronic health records (EHRs) makes it easier to provide a better-informed, higher quality of care, which, in turn, allows behavioral health providers to be ideally positioned for a value-based payment model. Such a smooth operation requires significant groundwork first, though, as providers need to address items ranging from their existing information infrastructure to workflows to state and federal privacy policies and laws.

Two experts spoke recently with Behavioral Healthcare to share their insights on the primary challenges behavioral healthcare providers face in positioning themselves to participate in an HIE and the steps they can take to ensure a successful transition. Read more here.
Implications of SBIRT for Early Identification of Substance Use Disorder

Everyone in the addiction treatment recovery industry knows that too many Americans never receive addiction treatment because their disorders go completely undiagnosed. Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based practice that has been clinically shown to identify, reduce and prevent substance misuse and the disease of addiction and ultimately reduce healthcare costs. While implementation barriers still exist, the Affordable Care Act has created valuable opportunities for the expansion of SBIRT utilization across various healthcare settings.

SBIRT is an early intervention approach that can be used in primary care settings to identify individuals at risk for substance use disorder. This approach targets individuals with non-dependent substance use to provide intervention prior to the need for more extensive treatment. Healthcare practitioners are encouraged to utilize SBIRT for patients who may not be actively seeking treatment for substance abuse, but who are at risk for developing medical complications or whose substance use may interfere with other responsibilities such as work and family matters.

Early intervention for patients with the potential for being diagnosed with substance use disorder is a priority for federal and commercial health plans. While there are obviously benefits of early treatment for the patient, utilizing SBIRT has the potential to lower costs to healthcare programs by shortening the time needed for treatment by identifying the issue at a less severe stage and reducing the likelihood of the patient developing costly comorbidities as the result of long-term substance abuse.  Read more here.




UPCOMING TRAININGS

MCTAC

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

October 26, 12 - 1 pm

OTHER TRAININGS

 
CALENDAR OF EVENTS


SEPTEMBER 2016

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

RPC Advisory Call
September 29:  8 am
  

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 
Governor Cuomo Announces Grand Opening of $14.4 Million Affordable Housing Development in Ontario County

Governor Andrew M. Cuomo recently announced the grand opening of the $14.4 million Trolley Station Apartments in Canandaigua, Ontario County. The 48-unit supportive housing development, operated by DePaul Community Services, offers residential based services for low-income individuals and residents with behavioral health issues.

Located at the intersection of County Route 28 and Parkside Drive in Canandaigua, the newly constructed Trolley Station Apartments feature 26 units designated for individuals with behavioral health issues and another 22 units available to low-income individuals and families who qualify. The 49,090 square-foot building also features a lobby, reception and security station, community room, kitchen and a central courtyard.

The Trolley Station Apartments offer mostly one-bedroom units with four two-bedroom units available, including 12 apartments that are handicapped accessible. In addition, individuals who require behavioral health services will receive comprehensive support provided on-site by DePaul Community Services to assist residents with household management skills. Residents will receive support through medical, educational, vocational and social services.

The New York State Office of Mental Health provided a $150,000 Program Development grant, approximately $2.5 million in interest-free construction financing, and over $300,000 in funding to support annual service and operation expenses. Additional support was provided by New York State Homes and Community Renewal with $441,657 in Low Income Housing Tax Credits.  Read more here.
Child & Adolescent Needs and Strengths (CANS)-NY Manual Update

NYS Department of Health recently uploaded a draft version of the CANS-NY manual for the 0-5 population and the 6-21 population onto the Department of Health Children's Health Home Website here .  The draft can also be found on the Children's Behavioral Health Transition to Managed Care website here .
CMS Releases Draft List of Essential Community Providers for 2018 Plan Year

Health care providers have until October 15 th  to be added to the Essential Community Provider list for the 2018 benefit year. The list is used by Qualified Health Plans in the Affordable Care Act's insurance marketplaces to meet ACA contracting requirements. QHPs operating in the health care marketplace must contract with at least 30 percent of the available "essential community providers" in their service area to ensure network adequacy for consumers.

Essential Community Providers are safety net providers who serve predominantly low-income, medically underserved individuals. While community-based mental health and addiction treatment providers are not currently included in the  definition of ECP's, health plans may count community behavioral health providers towards the 30 percent requirement. Additionally, community behavioral health providers may meet the definition of ECP under another eligible provider type, such as Federally Qualified Health Centers (FQHCs) or Ryan White providers.

Provider organizations that want to be added to the Essential Community Provider list must  submit this petition by October 15th. Not sure if your organization is on the list?   Click here for the draft list. For additional information, please  click here.
HHS awards over $87 million for health centers' IT enhancements

Last week, Health and Human Services (HHS) Secretary Sylvia M. Burwell announced more than $87 million in funding for 1,310 health centers in every U.S. state, the District of Columbia, Puerto Rico, the Virgin Islands and the Pacific Basin.

The funding will support health information technology enhancements to accelerate health centers' transition to value-based models of care, improve efforts to share and use information to support better decisions, and increase engagement in delivery system transformation. To support these goals, all purchases or upgrades of electronic health record systems made with the funding must use technology that is certified by the Office of the National Coordinator for Health Information Technology. This is the first significant investment since 2009 directly awarded to health centers to support the purchase of health information technology. 

This funding comes from the Affordable Care Act's Community Health Center (CHC) Fund, which was extended with bipartisan support in the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. The increased use of health information technology is part of the administration's efforts to build a health care system that delivers better care, smarter spending and healthier people.

For a list of these fiscal year 2016 Delivery System Health Information Investment Awards recipients, click here.
NYSHealth Launches 2017 Special Projects Fund Request for Proposals

The New York State Health Foundation (NYSHealth)  2017 Special Projects Fund Request for Proposals (RFP) is now available. Applicants must submit an online inquiry form to determine whether a proposed project fits the funding criteria. There are two funding cycles for the Special Projects Fund. Deadlines for the online inquiry form are September 27, 2016 and March 15, 2017. Selected organizations will be invited to submit full proposals, with deadlines of November 18, 2016 and May 17, 2017.

NYSHealth Special Projects Fund awards are one-time, nonrenewable funding opportunities consistent with the Foundation's mission to improve the health of all New Yorkers but outside of its main priority areas. Read details on the 2017 Special Projects Fund RFP and frequently asked questions.
Why Do Suicidal Patients Wait Hours for a Hospital Bed? 

On an evening in Boston in 2013, Brie Bullinger Durant, scared that she would hurt herself, checked into an emergency room.
Durant, who grew up in the area, managed her depression and anxiety for years with therapy and medication. But on this night, she was having intense thoughts of suicide and turned to the ER for help.

A doctor asked her question after question, and she felt nervous over seeming numb and withdrawn. She kept thinking: please don't send me home.

"I felt like I was going to answer the questions, and they would see me and see how composed I was, and think, 'Oh, she's okay, we're going to send her home.' That was probably my biggest fear," she said.

Health workers and lawmakers are working to accommodate patients like Durant as America endures a suicide surge, with suicide deaths rising from 29,000 people to 43,000 people between 1999 and 2014. Some have tried to increase the number of psychiatric beds available to suicidal patients, a disappearing resource in recent years that forces patients like Durant to wait longs hours for care. Meanwhile, others are assessing whether the hospital is even the right place to start consideri ng treatment.

Legislation aimed at making psychiatric beds more accessible have collected bipartisan support. The Helping Families in Mental Health Crisis Act, which was introduced by Rep. Tim Murphy (R-PA), passed the in the House in July with a nearly-unanimous vote of 422-2. It proposes each state create an online database of psychiatric beds with real-time information about what beds are available. Right now, not all state databases are updated constantly, which can hinder placement, Scott Dziengelski, legislative director for Murphy, said.  Read more here.
NAEMT Survey Reveals Inadequacies in Mental Health Care for EMS

The National Association of Emergency Medical Technicians (NAEMT)  has published a new report, the  2016 National Survey on EMS Mental Health Services , to inform all EMS stakeholders about the current level of  mental health services  provided to EMS practitioners. The report gives a snapshot of the services EMS agencies provide to help their EMS practitioners cope with the stress of their job, maintain their mental wellbeing, and also to seek help  when they need it .

The findings report is the product of a yearlong review by NAEMT's EMS Workforce Committee, which studies the issues that impact the ability of our nation's EMS workforce to provide quality emergency and mobile healthcare.

Nearly 2,200 responses were received from all 50 states and Washington, D.C. Some of the most revealing responses indicated  EMS mental health is an urgent issue, and that far more needs to be done to address it. "The survey shows that the EMS profession has significant work to do in demonstrating to the EMS workforce that their struggles and concerns matter, and in ensuring that EMS professionals know where to turn when they are struggling," said Sean Britton, director of public health in Broome County, N.Y., a member of the NAEMT Board of Directors, and a member of the NAEMT EMS Workforce Committee. 

Click here to read the full NAEMT report.
More Child Suicides Are Linked to A.D.D. Than Depression, Study Suggests

Attention deficit disorder is the most common  mental health diagnosis among children under 12 who die by suicide, a  new study has found.

Very few children aged 5 to 11 take their own lives, and little is known about these deaths. The new study, which included deaths in 17 states from 2003 to 2012, compared 87 children aged 5 to 11 who committed suicide with 606 adolescents aged 12 to 14 who did, to see how they differed.   The research was published on Monday in the journal Pediatrics.

About a third of the children of each group had a known mental health problem. The very young who died by suicide were most likely to have had attention deficit disorder, or A.D.D., with or without accompanying
hyperactivity.   By contrast, nearly two-thirds of early adolescents who took their lives struggled with  depression .

Suicide prevention has focused on identifying children struggling with depression; the new study provides an early hint that this strategy may not help the youngest suicide victims.  

"Maybe in young children, we need to look at behavioral markers," said Jeffrey Bridge, the paper's senior author and an epidemiologist at the Research Institute at Nationwide Children's Hospital in Columbus, Ohio. 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.

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