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May 28, 2021

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Don't Miss These Headlines:
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This Mental Health Awareness Month, NASMHPD Thanks You
As we approach the end of Mental Health Awareness Month, we would like to take an opportunity to express our deep gratitude and appreciation to each and every one of you for your tireless effort and dedication to the work you do every day.
 
Your jobs are demanding, complex, and challenging, and we recognize the unique difficulties this year has posed. You have handled these new complexities with innovation, patience, creativity, and perseverance. You dedicate yourselves to those you serve, and it makes an immense difference in the lives of your communities.

 We hope during this Mental Health Awareness Month and throughout the year, you are able to take time to care for yourselves, care for your mental health, and care for each other. We are here to support you in this effort in any way we can.

With gratitude,
The NASMHPD Staff
 

How Montana Is Redesigning Crisis Services in a Rural Landscape


The #CrisisTalk team sat down with the team responsible for helping redesign crisis services in Montana. They share the challenges they’ve faced with the pandemic, overcoming vast distances of rural land, and innovations that are paving the way for change, including mobile crisis services and a brand new Lifeline member call center.
Read the May 18 #CrisisTalk.

The Troubling History of 911 and How 988 Can Avoid the Same Missteps


The 911 system is plagued with blind spots—those inherent to the current 911 process and others shaped by systemic and personal biases, says Dr. Rebecca Neusteter, executive director at University of Chicago’s Health Lab. She shares the troubling history of 911 and how 988 can avoid the same missteps. Read the May 25 #CrisisTalk.
 
988 Model Legislation is Available. Please find the latest version of 988 Model Legislation here on the NASMHPD website.

HHS Announces $3 Billion in American Rescue Plan Funding for SAMHSA Block Grants, Establishes Behavioral Health Coordinating Council

On May 18, the Substance Abuse and Mental Health Services Administration (SAMHSA) distributed $3 billion in American Rescue Plan funding. The Community Mental Health Services Block Grant (MHBG) Program and Substance Abuse Prevention and Treatment Block Grant Program (SABG) will disperse $1.5 billion each to states and territories (with the latter also awarding money to a tribe). This follows the March announcement of supplemental funding of nearly $2.5 billion for these programs.

With the nation’s mental and substance use disorder needs squarely in focus, Department of Health and Human Services (HHS) Secretary Xavier Becerra is establishing a new Behavioral Health Coordinating Council (BHCC). The Assistant Secretary for Mental Health and Substance Use and the Assistant Secretary for Health will serve as the co-chairs of this coordinating body, which is comprised of senior leadership from across the Department. The BHCC’s primary goal is to facilitate collaborative, innovative, transparent, equitable, and action-oriented approaches to addressing the HHS’ behavioral health agenda.

Read the full HHS press release.

Racism and Psychiatry: Contemporary Issues and Interventions
On May 20, 2021, Dr. Morgan M. Medlock, M.D., MDiv, M.P.H., Editor of Racism and Psychiatry: Contemporary Issues and Interventions, presented on this invaluable resource on a NASMHPD Meet Me Call. Dr. Medlock is the Director of the Comprehensive Psychiatric Emergency Program for the District of Columbia’s Department of Behavioral Health. Her presentation can be viewed above.


APA Statement on the Anniversary of George Floyd's Killing


As state behavioral health agencies and federal partners work to create a more equitable behavioral health system, the American Psychiatric Association released a Statement on the Anniversary of George Floyd's Killing on May 25th, affirming that "The American Psychiatric Association and psychiatry were forced to confront our own past, and to examine how racism had entwined itself into our current operations, and how racism was impacting our patients on a daily basis. We began important conversations and took actions to reform our organization and to help our member psychiatrists better serve Black, Indigenous, and people of color (BIPOC) patients." Read the statement.

CMS Issues Guidance on American Rescue Plan Funding for Medicaid Home and Community Based Services
The Centers for Medicare & Medicaid Services (CMS) issued guidance on how states can receive enhanced funding, provided through the American Rescue Plan Act of 2021 (ARP), to increase access to home and community-based services (HCBS) for Medicaid beneficiaries. These benefits provide critical services to millions of older adults and individuals with disabilities, allowing them to receive health services in their homes and communities, rather than in nursing homes and other institutions. This guidance is a key tool to assist states in leveraging federal resources to increase health equity in Medicaid beneficiaries’ access to HCBS, positive health outcomes, and community integration.
 
Section 9817 of the ARP provides states with a temporary 10 percentage point increase to the federal medical assistance percentage (FMAP) for certain Medicaid HCBS from April 1, 2021 through March 31, 2022 to improve HCBS under the Medicaid program. The guidance that was issued to states via a State Medicaid Director Letter outlines the eligible services and parameters for which states can claim the increased FMAP and provides examples of activities that states can implement to enhance, expand, or strengthen HCBS.

HHS Announces $14.2 Million from American Rescue Plan to Expand Pediatric Mental Health Care Access

On May 20, 2021, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced the availability of $14.2 million from the American Rescue Plan to expand pediatric mental health care access by integrating telehealth services into pediatric primary care. The funding will expand Pediatric Mental Health Care Access (PMHCA) projects into new states and geographic areas nationwide, including tribal areas. Read the press release.

Brooks-LaSure Confirmed as CMS Administrator
On May 25, 2021, the Senate confirmed Chiquita Brooks-LaSure to the position of Administrator for the Centers for Medicare and Medicaid Services (CMS). The 55-44 vote largely split along party lines, with five Republicans joining Democrats to confirm Brooks-LaSure, a longtime health policy expert who helped create and implement the Affordable Care Act (ACA). Brooks-LaSure will be the first Black woman to run CMS and is expected to utilize regulatory actions to fill in ACA gaps going forward.

CMS Data Shows Vulnerable Americans Forgoing Mental Health Care During COVID-19 Pandemic

The Centers for Medicare & Medicaid Services (CMS) released data on May 14, 2021, highlighting the continued impact the COVID-19 Public Health Emergency (PHE) is having on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and utilization of health services. The data show that, from March through October 2020, beneficiaries have forgone millions of primary, preventive, and mental health care visits due to the COVID-19 PHE, compared to the same time period in 2019. Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound. View the data snapshot.

State Spotlight: Georgia DBHDD Hosts Self-Care Events for Staff Throughout Pandemic

The COVID-19 pandemic has led state behavioral health agencies across the country to examine how they can best support the mental health and wellbeing of not only the individuals their systems serve, but also their leadership and staff. In a time when many behavioral health systems are faced with workforce recruitment and retention challenges, creating support mechanisms for staff and leadership is important. To address this need throughout the pandemic, The Georgia Departments of Behavioral Health and Developmental Disabilities and Public Health have hosted twice-weekly webinars, called their 2x2 Series: Self-Care Tips and Support for Managing Life. 

These engaging and interactive sessions are open to participants not just from the state of Georgia, but nationwide, and are described as “just the break you need from a challenging workday”.  They are designed to promote wellness and provide self-care tips and support for managing life during these unprecedented times.  The 2x2 Series is held live on Tuesdays and Thursdays, and each session provides attendees with mental health tips about managing stress, grief, work/life balance, and wellness. Recent webinars have covered topics such as Emotional Regulation, Effective Communication, Meditative Techniques, Easy and Healthy Meals on a Budget, and Adaptive Leadership. Learn more about the 2x2 Series, view past recorded events, and sign up for future events here.

NASMHPD Resources for Addressing Co-Occurring Mental Health and Substance Use with Crisis Services
As state behavioral health systems address crisis services, the following two resources on substance use disorders and co-occurring issues may be helpful:

Addressing Substance Use in Behavioral Health Crisis Care: A Companion Resource to the SAMHSA Crisis Toolkit
Rebecca Boss, M.A., Tyler Sadwith, and Brian Daly, M.D.

Integrated Systems and Services for People with Co-Occurring Mental Health and Substance Use Conditions: What’s Known, What’s New, and What’s Now?
Kenneth Minkoff, M.D. and Nancy H. Covell, Ph.D
 


The team at the IPS Employment Center has defined the Individual Placement and Support (IPS) approach to supported employment. The center’s activities focus on employment for people with serious mental illnesses. The center offers training, educational materials, and consultation services.  Learn more about training available through the IPS Employment Center.

New ACPM Tobacco Cessation Resources for Youth

We know that youth report using diverse tobacco products, including cigarettes, e-cigarettes, cigarillos, hookah, smokeless tobacco, and a variety of new and emerging products. Nicotine exposure during adolescence can harm the developing brain and can lead to a lifetime of nicotine addiction and tobacco use. Nicotine exposure can also prime the adolescent brain for addiction to other drugs. Helping youth quit using tobacco products is critical for protecting their health now and in the future. Access new youth tobacco cessation resources from the American College of Preventive Medicine.

Division Spotlight: CoE-PHI Presentation to Legal and Finance and Policy Divisions on Federal Privacy Laws 
On Monday March 29th, 2021, the Center of Excellence for Protected Health Information (CoE-PHI) hosted a two-hour webinar for the members of the NASMHPD Legal and Finance and Policy Divisions meant to increase State Agency Leaders’ awareness of what they need to know about federal privacy laws and applicability to their work. The presentation identified the basic requirements of 42 CFR Part 2 and HIPAA, outlined key Substance Use Disorder (SUD) privacy law provisions, and described how to access resources and TA provided by the CoE-PHI. View the recorded presentation.

NASMHPD Learning Opportunities
Webinar: Align State Outcome Monitoring Measures for First Episode Psychosis Care with National Standards

Register here.
June 2, 2021, 3:00pm – 4:30pm Eastern

NRI is working with NASMHPD and Westat to support the NIMH-funded Early Psychosis Intervention Network (EPINET).  EPINET encompasses eight Regional Hubs, more than 100 early psychosis clinics across 17 states, and the EPINET National Data Coordinating Center. Last fall, EPINET finalized the Core Assessment Battery (CAB), which is a group of standardized measures and individual items that assess key domains of early psychosis psychopathology, recovery, contextual factors, and treatments that are implemented and evaluated across the EPINET clinics. 

This webinar will provide more information for state agencies about EPINET and the CAB, and will share information about how your state and state’s Coordinated Specialty Care programs can join EPINET to streamline your outcome monitoring and align with national efforts.

On-Demand Webinar Recordings:
TTI Informational Exchange Recording: Peer Support. What a Difference it Makes. Peer support workers are people who use their experience to help others in similar situations. Through shared understanding, respect, and mutual empowerment, peer workers support the healing of individuals in need. Whether in crisis, behavioral health or criminal justice settings, peers play a valuable role in providing hope , encouragement, and support. This session was presented by peer staff in crisis and forensic settings. View the recording.
Town Hall Series Recordings: Innovative Practices to Support Behavioral Health Peer and Direct Care Staff during COVID-19 Crisis. NASMHPD hosted a Town Hall series to learn about innovative practices for outreach and support of peer and direct care staff during the epidemic. These forums were led by peers and direct care staff from hospital and community settings around the country. View the recordings.
SAMHSA-Sponsored Webinar Recording: Targeting Housing Resources to Support Reentry of People with Serious Mental Illness. This webinar explored strategies to target housing resources to assist people with serious mental illness in transitioning smoothly from jail or prison to their communities, achieving stability and support, and avoiding re-incarceration. View the recording.
SAMHSA-Sponsored Webinar Recording: Planning for Care Transitions: Using Best Practices to Improve Care for Individuals with Suicide Risk. This presentation focused on the critical role of safe care transitions in comprehensive suicide prevention. Essential components of care transitions, and specific recommendations applicable to a variety of care settings, for improving practices and implementing evidenced-based interventions were discussed. View the recording.

Don't Miss These Headlines
Decoupling Crisis Response from Policing — A Step Toward Equitable Psychiatric Emergency Services
E. Rafla-Yuan, D. Chhabra & M. Mensah | The New England Journal of Medicine

The Pandemic’s Impact on Children’s Mental Health
E. Anderson | Kaiser Family Foundation

Johns Hopkins University to Begin Sending Mental Health Providers on Security Calls
M. Cohn | Baltimore Sun

Disparities in COVID-19 Vaccination Coverage Between Urban and Rural Counties — United States, December 14, 2020–April 10, 2021
CDC's Morbidity and Mortality Weekly Report (MMWR)

Most Older Adults Have Experienced Trauma, and There’s Something We Can Do About It
S. Rood Wernick | The Jewish Federations of North America

Pain in the Nation: Alcohol, Drug, and Suicide Epidemics
M. Warren | Trust For America's Health & Well Being Trust

Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future
W. Koma, J. Cubanski & T. Neuman | Kaiser Family Foundation
 
No-Cancel Culture: How Telehealth Is Making It Easier to Keep That Therapy Session
E. Berger | Kaiser Health News

States Loosen Medical Regulations Post-Pandemic
A. Greenblatt | Governing

Cognitive Behavior Therapy Reduces Mood Symptoms in Patients with Functional GI Disorders
K. Burba | Healio

Socially Anxious Kids Feel Relief With Online CBT
K. Grant | MedPage Today

Resource Roundup
Supporting Individuals with Co-Occurring Mental Health Support Needs and Intellectual/Developmental Disabilities. The National Association of State Directors of Development Disability Services, NADD, and NASMHPD collaborated on this report, which features summaries of a roundtable series that addressed the following three areas: State organizational structure, financing, payment approaches, and policies; Access to skilled clinical capacity and specialized support/training for direct support; and Identification and design of effective service modalities.
Issue Brief: Disaster Response and Opportunity for Sustained Improvement. This Issue Brief, authored by Debra Pinals, M.D., is derived from a 2019 technical assistance paper, Beyond the borders: Lessons from the international community to improve mental health outcomes. This excerpt offers a brief overview of highlighted examples of earlier disasters experienced in the international community and provides references that aim to further illuminate strategies and inspire ongoing crucial dialogue in an effort to improve mental health in the United States, even while responding to a crisis.
Improving Access to Behavioral Health Crisis Services with Electronic Bed Registries. These 23 fact sheets and summary report, Improving Access to Behavioral Health Crisis Services with Electronic Bed Registries, can serve as blueprints or guides to states and localities to design and implement bed registry platforms critical to coordinating crisis care.
NAMD Report: Medicaid Forward - Behavioral Health. This framework offers states options to consider to promote the health and wellbeing of members and expand access to behavioral health services. It includes strategies along a continuum of need, ranging from upstream prevention and health promotion for all Medicaid beneficiaries to increasing access to behavioral health treatment for unique subpopulations in Medicaid.
Millbank Issue Brief: Building State Capacity to Address Behavioral Health Needs Through Crisis Services and Early Intervention. To help ensure patients experiencing a behavioral health crisis are able to get the right care at the right time in the right place, states such as Arizona, Georgia, and Tennessee have developed behavioral health crisis models of care that provide early intervention and divert individuals in crisis from hospitals, jails, and prisons. This model assembles a network of services comprising three components: a 24-hour regional or statewide crisis call center hub; community-based mobile crisis teams that evaluate and stabilize the individual; and facilities designed to stabilize patients for eventual recovery.
COVID-19 Vaccine Resources. NASMHPD has compiled various resources that may be useful to state behavioral health leadership as they work to effectively and equitably distribute COVID-19 vaccines. View them here.
SAMHSA Resource: Crisis Services: Meeting Needs, Saving Lives. SAMHSA has published Crisis Services: Meeting Needs, Saving Lives, composed of SAMHSA’s National Guidelines for Behavioral Health Crisis Care: Best Practice Toolkit and related papers on crisis services.
COVID-19 Information for SAMHSA Discretionary Grant Recipients. SAMHSA is allowing flexibility for grant recipients affected by the loss of operational capacity and increased costs due to the COVID-19 crisis. These flexibilities are available during this emergency time period. Flexibility may be reassessed upon issuance of new guidance by the Office of Management and Budget post the emergency time period. Learn more.
NASMHPD's EIP Resource Center. The Early Intervention in Psychosis virtual resource center, made possible by the Robert Wood Johnson Foundation, is designed to provide reliable information for practitioners, policymakers, individuals, families, and communities in order to foster more widespread adoption and utilization of early intervention programming for persons at risk for (or experiencing a first episode of) psychosis. Visit the resource center. These TA resources were developed with support from SAMHSA.
Crisis Service Resources: NASMHPD's 2020 Technical Assistance Coalition Working Papers. NASMHPD's 2020 TAC papers continue the Beyond Beds theme, highlighting different aspects of crisis services: 


EPINET is a national learning health care system from the National Institutes of Mental Health (NIMH) that links early psychosis clinics through standard clinical measures, uniform data collection methods, data sharing agreements, and integration of client-level data across service users and clinics. Clients and their families, clinicians, health care administrators, and scientific experts now have the opportunity to partner within EPINET to improve early psychosis care and conduct large-scale, practice-based research. Learn more about EPINET. Download a shareable flyer about EPINET. 
Visit the SMI Adviser website for evidence-based education, consultation, and resources on serious mental illness (SMI). Request a free clinician-to-clinician consultation. Access dozens of online courses and earn free continuing education credits. Learn about the My Mental Health Crisis Plan app. See data on serious mental illness in the U.S. Find resources on COVID-19, clozapine, and long-acting injectables.

New Resources:

COVID-19 Vaccines and SMI
The rollout of vaccines for COVID-19 presents an opportunity to protect the health of individuals who have SMI. SMI Adviser created this guide to offer simple tips for mental health clinicians on how to talk about the COVID-19 vaccines with this population.
 
Suicide and Serious Mental Illness
SMI Adviser and the Suicide Prevention Resource Center (SPRC) worked together to create this guide. It provides an overview of the considerations and suicide prevention measures at the intersection of suicide and SMI.
NASMHPD Staff
NASMHPD Board of Directors
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National Association of State Mental Health Program Directors
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