February 15, 2013

Kelly A. Hansen, Executive Director an Affiliate of the New York State Association of Counties 41 State Street Albany, New York 12207 Suite 505

CONFERENCE ADVOCACY ON THE NYS SAFE Act CONTINUES The Conference is continuing its advocacy with state legislators and staff to ask for their support for amendments to the SAFE-Act to remove the DCS from the new MHL 9.46 reporting requirement to DCJS. This NYS SAFE Act requires “mental health professionals” (defined as a physician, psychologist, registered nurse or licensed clinical social worker) to report to the DCS or their designee any person they are treating who they believe is likely to engage in conduct that would result in serious harm to self or others. The DCS or designee at that point would be required to assess the practitioners report to determine if the DCS agrees that the person is likely to engage in such conduct, confirm that the reporter is in fact a “mental health practitioner” as defined under MHL 9.46 (a physician, psychologist, RN, or LCSW), and to then pass on the potentially dangerous individual’s name and other non-clinical information to the NYS Division of Criminal Justice Services. This new legal mandate takes effect on March 16, 2013. The 9.46 reporting requirement is an unfunded mandate to counties and we are pushing to have the DCS removed from this process as part of the state budget negotiations. There is no funding to Counties or NYC to hire the staff necessary to comply with this new reporting requirement. The Conference needs your help!! State Legislators need to hear from you and understand the local fiscal impact of this law. We STRONGLY encourage you and/or your County CEOs to contact your state Senator and Assemblymember in their districts in the coming week, as the Legislature is out of session and legislators will be in their districts until February 26th. The Conference’s memo can be found here and the links to the Senate and Assembly are here.

November 26, 2012 Volume 5 Issue 33

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HHS Provides Guidance to State Medicaid and Health Officials Recently, the Department of Health and Human Services Centers for Medicare & Medicaid Services (CMS) has provided

guidance to state Medicaid directors and health officials. This guidance has significant implications for individuals with

mental health and substance use disorders. The guidance covers:

• Application of the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA, Pub.L. 110-343) to Medicaid Managed Care Organizations, Children's Health Insurance Program, and Alternative Benefit (Benchmark) Plans; and

• Recommended healthcare quality measures for states to use as they assess their service delivery model for health homes, authorized by section 2703 of the Affordable Care Act. CMS intends to promulgate these quality measures in the rulemaking process. For the full text of the guidance letters and other information, click on the links below.

• Application of the Mental Health Parity and Addiction Equity Act to Medicaid MCOs, CHIP, and Alternative Benefit (Benchmark) Plans: Link

• Health Home Core Quality Measures: Link

State's Medicaid Faces Audit after $15B in Overbilling A congressional panel made a bipartisan request yesterday for federal auditors to examine New York State's $54 billion Medicaid spending and fraud oversight programs. The audit recommendation was triggered by findings of the U.S. House of Representatives Committee on Oversight and Government Reform that New York overbilled the federal government $15 billion on its developmentally disabled patient facilities. It said the state must repay an appropriate amount of the funds. Read more: Link Read more: Link 2

NY's Gun Control Law Has Mental Health Professionals Concerned Objections at hearing cite aspect of breaching code on mental health The Buffalo News/ 2/14/13 Just a day after hundreds of gun rights advocates rallied in Albany against Gov. Andrew M. Cuomo’s new gun-control law, others affected by the strictest-in-the-nation regulations weighed in with objections of their own at a hearing Wednesday in Buffalo. And many of those objecting

probably don’t own guns. Mental health advocates expressed concern over the legislation’s less publicized provisions, such as requiring doctors and counselors to report potentially violent clients to the state. That’s a serious breach of doctor-patient confidentiality, they said. Beyond that, he said, too many fingers are pointed at the mentally ill, following tragedies at Newtown, Conn., and elsewhere where gun violence has taken lives. “We have to stop associating violence with mental illness,” Houseknecht said. “This is the most insidious stereotype we perpetuate.” Houseknecht and others testified at a hearing convened by Assemblywoman Jane L. Corwin of Clarence and Sen. Patrick M. Gallivan of Elma. Both are Republicans who voted against the Cuomo bill last month. They were joined by other Republican and Democratic legislators who voted against the bill. Read the full article

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Commissioner Katherine G. Alonge-Coons, MSW/Rensselaer But you can call her “Mother Kathy”

s a teenager growing up in Nassau, NY, Kathy encountered many situations of crisis in her family life which drew her to seek the support of professionals at her high school. Her early personal experiences gave her a heightened appreciation for the professionals who help others develop

strong coping mechanisms and build emotional resiliency.

Kathy’s grandfather was a strong role model. “He was very supportive of women’s rights, advanced education and the importance of women having a career path.” With his encouragement and support she pursued education in social work. “I had a growing passion through my faith to serve others and assist those in need. My career path was launched with these strong underpinnings.” Born in Hudson, N.Y. at Columbia Memorial Hospital, Kathy grew up in Nassau, and graduated from Columbia High School, East Greenbush in 1977.“ I am a homegrown Rensselaer County Director of Community Services!” After graduating from Siena College with a BA in Sociology, Kathy received her MSW from the University at Albany and followed that with a Masters of Divinity from St. Bernard’s School of Theology and Ministry in 2006. Yes, Kathy is an ordained Episcopal Priest serving as a bi-vocational in the capacity of Vicar at Grace Church in Waterford, N.Y. This is a non-stipendiary position for a mission oriented parish with an average Sunday attendance of 62. A unique feature of her ministry is the use of puppets in presenting the weekly sermon theme to the children of the parish. “I have recruited other adults in the parish to join me in this ministry.” But what do we call her, Vicar? Pastor? Reverend? “Truthfully my parishioners call me Mother Kathy. It is considered to be a title of endearment.” Mother Kathy it is. Before being named Commissioner of Mental Health for Rensselaer County Kathy held the positions of Children & Youth ICM; Children & Youth SPOA; Director of Children’s services and Director of Program Operations (totaling 25 years). In addition she worked in children’s prevention programs and as a school social worker. Recently she has been involved in establishing and co-leading the Waterford Area Long Term Care Coalition (W.A.L.C.C.) which is a grass roots effort to develop community wide disaster preparedness, and long term recovery assistance in response to those negatively impacted by Hurricane Irene. In her down time Kathy can be found working out at Curves, needle working, weaving, quilting and reading. She and her husband Earl have been married for 30 years and have two grown daughters that live nearby. “I am humbled to be called to serve Rensselaer County in this capacity and pray for the grace, wisdom and discernment to serve those in need of behavioral health services. I have always enjoyed trying to figure out dilemmas in order to improve the lives of others. This job has many intricate problems to resolve; which I greatly enjoy solving! Even though frustration enters the situation; it is important to have leaders who are committed to the resolution of these issues. In both my ministry and career, I seek to empower and equip people to live to their fullest potential.”

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National Policy News: Mental Health in Schools Act Introduced in Congress Public schools across the country would have access to $200 million to expand the availability of comprehensive school-based mental health services under legislation recently introduced in Congress. The Mental Health in Schools Act (S. 195/H.R. 628) would provide grants of up to $1 million each for schools to partner with local mental health professionals to establish on-site mental health care services for students. The bill expands the scope of the Safe Schools/Healthy Students Program; by having licensed mental health professionals working on-site in schools, districts will be better able to provide prevention and early intervention services for students. Funding would be distributed through a competitive grant process by the Substance Abuse and Mental Health Services Administration (SAMHSA), which will set guidelines and measure the outcomes of the funded programs. New Legislation Would Reauthorize Garrett Lee Smith Suicide Prevention Programs Each year, 38,000 Americans die by suicide. New legislation introduced with bipartisan support would provide funding to reauthorize and expand suicide prevention activities in the U.S. The bill would:

• Reauthorize and revise the Suicide Prevention Resource Center, a research, training, and technical assistance resource center to prevent suicides;

• Expand the Garrett Lee Smith program’s focus from youth suicides to suicides among all ages, particularly among groups that are at high risk for suicide;

• Reauthorize a program of grants for the development of state or tribal youth suicide early intervention and prevention strategies; and

• Reauthorize and expand a grant program to enhance services for students with mental health or substance use disorders at institutions of higher education.

The Garrett Lee Smith Memorial Act currently supports active youth suicide prevention grants in 40 states, 38 tribes or tribal organizations, and 85 institutions of higher education. For more details about the reauthorization act, see this fact sheet from Senator Reed’s office.

Dispute Develops Over Discount Drug Program The program, known as 340B, requires most drug companies to provide hefty discounts — typically 20 to 50 percent — to hospitals and clinics that treat low-income and uninsured patients. But despite the seemingly admirable goal, the program is now under siege, the focus of a fierce battle between powerful forces — the pharmaceutical industry, which wants to rein in the discounts, and the hospitals, which say they might have to cut services without them. Read/ Document: White Paper on 340B Hospitals and Graphic: A Popular Discount Drug Program Under Fire

Sharp Drop in Drink Deaths Follows Alcohol Price Rise Increasing the minimum price of alcohol by 10 percent can lead to immediate and significant drops in drink-related deaths and may also have long-term beneficial health effects, according to a study published on Thursday. Read

NYS Conference of Local Mental Hygiene Directors

CLMHD News Page 5 Reports Show Fewer Adolescents Getting Substance Abuse Prevention Messaging According to a new SAMHSA report, the percentage of adolescents receiving substance abuse prevention messages from the media fell significantly from 2002 to 2011. A companion SAMHSA report shows that adolescent attitudes about the risk of substances like alcohol and marijuana also changed significantly. Read

Health Insurance Exchanges Are Top Priority on U.S. Agenda The public's health care agenda places creation of a health insurance exchange or marketplace as a top priority, according to a report published by the Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health. Read

Washington Takes On Bullying A Washington, D.C. task force has compiled a model bullying prevention policy for agencies that serve youth. Read

The Drug Laws That Changed How We Punish New York Gov. Nelson Rockefeller had been a champion of drug rehabilitation, job training and housing. Then, he did a dramatic about-face and backed strict sentences for low-level criminals. Forty years ago, New York enacted tough laws in response to a wave of drug-related crime. They became known as the Rockefeller drug laws, and they set the standard for states looking to get tough on crime. But a new debate is under way over the effectiveness of such strict sentencing laws. Read

Health and Human Services Fraud Report Attorney General Eric Holder and Health and Human Services (HHS) Secretary Kathleen Sebelius released a new report showing that for every dollar spent on health care-related fraud and abuse investigations in the last three years, the government recovered $7.90. This is the highest three-year average return on investment in the 16-year history of the Health Care Fraud and Abuse (HCFAC) Program. Report

OASAS Announces OPT Grants: The New York State Office of Alcoholism and Substance Abuse Services announced that two outpatient treatment providers will receive a three-year grant funded by the Substance Abuse And Mental Health Services Administration (SAMHSA) to serve adolescents and their families who have a substance abuse disorder or co-occurring substance abuse and mental health disorders. Commissioner Gonzalez-Sanchez Announces Two Three-Year Grant Awards to Expand Adolescent Services in New York State

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On Thursday, February 28, 2013, OPWDD will hold the fifth in a series of workshops to showcase innovative ideas in development by collaborating groups of nonprofit agencies as they look for ways to support people with developmental disabilities under the People First Waiver. This Innovative Ideas workshop will be held via statewide videoconference from 9:30 am until noon, and will be followed by a brief discussion period at each videoconference site in which participants will offer feedback to OPWDD. Two groups are scheduled to present at this workshop. Representatives from the InterAgency Council of Developmental Disabilities Agencies, Inc. (IAC) will highlight its efforts to leverage the purchasing power of member agencies to access pricing and service contracts as well as plans to share resources to maximize efficiencies in its administrative and operational systems. In addition, staff from Happiness House, a western New York based nonprofit agency affiliated with the Finger Lakes Cerebral Palsy Association, will provide an overview of its partnership with the B. Thomas Golisano Foundation on a non-certified transitional residence consisting of eight efficiency apartments. This home, which serves adults with Traumatic Brain Injuries (TBI) as well as adults with intellectual/developmental disabilities, has been a catalyst in providing lifelong opportunities for individuals with disabilities as they strive toward independence in the community. Registration is limited, and will be on a first-come, first-served basis. The deadline for registration is Tuesday, February 26, 2013 at 5pm. To sign up to participate in this workshop, please e-mail the People First Waiver liaison in your area. The following videoconference sites will be available for viewing the workshop:

· Bernard Fineson: Queens (Room 2)

· Brooklyn: Brooklyn (Large Conference Room)

· Broome: Binghamton (Theater)

· Capital District: Schenectady (Building 3, Room 6)

· Central New York: Syracuse (Northern Concourse – Regional Training Center)

· Finger Lakes: Rochester (25 Leaf)

· Hudson Valley: Thiells (Building 5, Room 2)

· Long Island: Commack (Small Conference Room)

· Metro New York: Bronx (Videoconference Room 140)

· Metro New York: Manhattan (Activities Center)

· Staten Island: Staten Island (Building 13K, Training Room)

· Sunmount: Tupper Lake (Building 3, 2nd Floor Conference Room)

· Taconic: Kingston

· Western New York: West Seneca (Building 16, Meeting Room 1-153)

Following the workshop, OPWDD will provide a video of the workshop, presentation materials and a meeting summary on the People First Waiver webpage.

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Health Reform Policy Academy: Where Implementation Stands Now February 21, 2013 2:00 – 3:15 P.M. Many key provisions of the Affordable Care Act are set to take effect in the coming year. With health insurance exchanges in each state open for enrollment in the fall, could counties be involved in public outreach and assistance? What are some of the implications for counties in states that do not expand Medicaid? The webinar will also explore questions related to funding for local prevention initiatives and potential impacts on county behavioral health services. Register SAMHSA Webinar: Medicaid Eligibility, Enrollment, and Outreach: Changes Coming to the HCH Community February 27, 2013 Register

27 FEB

Webinar: Guide to Screening, Brief Intervention, and Referral to Treatment (SBIRT): An Introduction to Screening This webinar will introduce health professionals to the use of valid, brief screening tools and determining recommended level of intervention based on level of risk.

28 FEB

Webinar: Patient Privacy and Confidentiality in the Changing Health Environment: HIPAA, 42 CFR Part 2 and Health Care Reform This webinar will discuss the essentials of Federal Regulation 42 CFR Part 2, the interplay between 42 CFR Part 2 and Health Insurance Portability and Accountability Act (HIPAA) regulation in settings where primary care and substance abuse/mental health services are integrated, and substance abuse documentation and information sharing using electronic health records. For additional background on understanding privacy regulations in the behavioral health field. Read: SAMHSA News Volume 20, Number 1.

SAMHSA's Free Promotional Materials:

You're in Control: Using Prescription Medicine Responsibly: Not Worth the Risk (Poster)Empowers college-aged youth to take control and make smart decisions about their medications by recognizing the risks of prescription drug abuse and using medications responsibly. Includes resources to learn more and to find treatment. Poster measures 11x17. Inventory#: SMA12-4678B3POSTER

You're in Control: Using Prescription Medicine Responsibly: Not Worth the Risk (for College Students) Educates college-aged people about the risks with using prescription drugs or over-the-counter drugs nonmedically. Explains how to keep them safely away from other students and offers tips for how to cope with the stress and pressure of college demands. Inventory#: SMA12-4678B3

Talking to Your Kids About Prescription Drug Abuse: Not Worth the Risk (for Parents) Arms parents with the information they need to explain the dangers of prescription drug abuse to their teens. Describes the risks of nonmedical prescription drug abuse and offers practical advice to parents for talking with their teenagers. Inventory#: SMA12-4676B1

Prescription Drugs: They Can Help But Also Hurt: Not Worth the Risk (for Teens)Explains to teens the dangers of misusing and abusing prescription drugs and over-the-counter drugs. Reviews some of the myths of prescription drug abuse, lists warning signs of substance abuse, and explains what to do if someone has a problem and needs help. Inventory#: SMA12-4677B2

You're in Control: Using Prescription Medicine Responsibly: Not Worth the Risk (Flyer)Empowers youth to take control and make smart decisions about their medications by recognizing the risks of prescription drug abuse and using medications responsibly. Includes resources to learn more and to find treatment.

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• Video: Veteran uses hip-hop to help soldiers with PTSD • Teen births plummet to record low • How Parents Can Learn To Tame A Testy Teenager • Stressed Out Americans Want Help, But Many Don't Get It • White House: middle class will take biggest hit from sequester cuts • Evidence thin for helping kids after trauma

• Raising Personable Children, Even If They're Glued To Phones • Relax! You'll Be More Productive • Treating Sweet Sorrow: Diabetes and Depression • Insomnia: When Counting Sheep Doesn't Work • What Makes You Feel Fear? • With Guns, Killer and Victim Are Usually Same • Suspect in Botched Shooting Bought Gun Legally Despite Mental Illness • For Some Landlords, Real Money in the Homeless • Preschool Special Ed: Important Program Mired by Costly Problems • Precursor Symptoms to Autism Detected in 6-Month-Old Infants • New gun law still splits the state • Odell urges Putnam residents to visit hospitalized vets • Jefferson County legislators plan to take time in opposing NY SAFE Act • Madison County comes out against New York gun law • Wyoming officials rip new state gun law • Southern Tier sheriffs raise questions about NY gun control • Oswego County legislators to meet in opposition to new state gun laws • Gun ban in Monroe County offices proposed • Westchester lawmakers approve gun violence prevention resolution • The Journal of Behavioral Health Services & Research. Volume 40 Number 1 is now available on SpringerLink • Broome lawmakers start talks to crack down on bath salts • Few States Look to Extend Preschool to All 4-Year-Olds • The State of the 4-Year-Olds • Drug Prices Jump Again • Final HIPAA Rules a Major Step Forward, but There's More Work To Be Done

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Save the Dates:

Albany, Best Western/Airport:

Saratoga Springs Holiday Inn:

Meeting Calendar FEBRUARY Director’s Meeting - 2/26/13 10:30 a.m. – Noon, 41 State St., Suite 505 Go to Meeting Access Available - contact CLMHD for access Executive Committee Meeting - 2/26/13 12:30 p.m. - 2:00 p.m. 41 State St., Suite 505 Go to Meeting Access Available- contact CLMHD for access MARCH Officer’s & Chairs Conference Call -3/13/13 8:00 a.m. – 9:00 a.m. Call In Only - contact CLMHD for access CLMHD COMMITTEE DAY - 3/18/13 Pease join us for this daylong session that will provide an overarching agenda addressing the inter-related changes and their impact on all three of these disabilities NO CALL IN OPTION AVAILABLE 10:00 a.m. – 3:30 p.m. Best Western Airport/Albany Wolf Road: Directions AGENDA: Executive Committee 10:00 a.m. – 10:45 a.m. CD Committee 11:00 a.m. – 12:00 p.m. Lunch 12:00 p.m. -1:00 p.m. DD Committee 1:00 p.m. – 2:00 p.m. MH Committee 2:00 p.m. – 3:30 p.m. Health Home Issues Conference Call – 3/21/13 4:00 p.m. – 5:00 p.m. Call In Only - contact CLMHD for access

NYS Conference of Local Mental Hygiene

Directors Staff

Kelly A. Hansen

Executive Director kh@clmhd.org

Jeremy Darman

Director, Governmental Relations jd@clmhd.org

Betsy Gorman

Communications Associate bg@clmhd.org

Betsy Mulvey

Technical Assistance Manager bm@clmhd.org

Vicky Quinn

Executive Assistant/Office Manager vq@clmhd.org

Jed Wolkenbreit

Counsel jbw@clmhd.org