State Of Maryland Advisory Council On Mental Hygiene .

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State of MarylandAdvisory Council on Mental Hygiene/Planning CouncilMartin O’Malley, Governor – Anthony G. Brown, Lt. Governor – Joshua M. Sharfstein, M.D., Secretary, DHMHMARYLAND ADVISORY COUNCIL ON MENTAL HYGIENE/PL 102-321 PLANNING COUNCILAGENDAOctober 21, 20149:00 - 9:15INTRODUCTIONS, REVIEW AND ADOPTION OF MINUTES,ANNOUNCEMENTS9:15 – 9:30DIRECTOR’S REPORT – Brian Hepburn, M.D., Executive Director,Behavioral Health Administration (BHA)9:30 – 10:15A DISCUSSION OF SUICIDE PREVENTION EFFORTS INMARYLAND AND EVIDENCE-BASED PRACTICETOOLS/RESOURCES AVAILABLE – Cyntrice Bellamy,Chief, Community Operations, Suicide Prevention and Quality Assuranceand Brandon Johnson, State Coordinator of Suicide Prevention,BHA Office of Children and Adolescents Services10:15 – 10:30COUNCIL BUSINESS – FY 2014 Annual Report of the MarylandAdvisory Council on Mental Hygiene/PL 102-321 Planning CouncilMEETING ADJOURNED10:30 – 10:45EXECUTIVE COMMITTEE MEETINGENCLOSURES:Minutes of September 16, 2014 Attachment – PowerPoint Presentation - Exploring Behavioral Health IntegrationThrough DataMonthly meetings of the Joint Council are held on the third Tuesday of every month in theHAT room of the Tuerk Building at the Spring Grove Hospital Center.c/o Behavioral Health AdministrationSpring Grove Hospital Center – 55 Wade Avenue – Dix Building – Catonsville MD 21228 – (410) 402-8473TDD for Disabled – Maryland Relay Service (800) 735-2258Healthy People in Healthy Communities

State of MarylandBehavioral Health Advisory Council55 Wade Avenue – Catonsville, Maryland – 21228Behavioral Health Advisory CouncilMinutesSeptember 17, 2014State Drug and Alcohol Abuse Council Members: Gail Jordan-Randolph, Jodie Chilson,Carlos Hardy, Carmen Brown, John Winslow, Kathleen O’Brien, Herb Cromwell, Ann Geddes,Lawrence Simpson (by phone), Jeanne D. Cooper, Steve Davis,Christina Church for Patricia Arriazo, Tererence Proctor, Jim Hedrick, Pete SingletonMaryland Advisory Council Members:Mike Finkle (by phone), Joshana Goga, Dennis McDowell, Joanne Meekins (by phone),Robert M. Pender, Anita Solomon, John TurnerMaryland Advisory Council Members Absent: Gerald Beemer, Richard Blair,Sarah Burns, Chair; Jaimi L. Brown, M. Sue Diehl, Vice Chair; Michele Forzley,Edwin C. Oliver, Livia Pazourek, Charles Reifsnider, John Scharf, , Sherrie WilcoxIndividuals highlighted as such are resigned members who have not yet been replaced.PL 102-321 Council Members Present: T.E. Arthur, Coordinator; Anne Blackfield,Michael Bluestone, Naomi Booker, Eugenia W. Conolly, Herb Cromwell, Jan Desper,Jessica Honke for Kate Farinholt, Ann Geddes, Julie Jerscheid, Jon Kromm, Dan Martin,Kimberly Morris for George Lipman, Alexis Moss,Ebele Onwueme, Cynthia Petion,Tererence Proctor for Robert Anderson, Michelle Stewart, B. VanMetre for Nancy Feeley,Kathleen WardPL 102-321 Council Members Absent: Lynn Albizo, Chicquita Crawford, R. Terence Farrell,Vira Froehlinger, A. Scott Gibson, Frank Kolb, Michael Lang, William Manahan,Jacqueline Powell, Linda Raines, Sheryl Sparer, Jane Walker, Phoenix Woodyc/o Behavioral Health AdministrationSpring Grove Hospital Center – 55 Wade Avenue – Dix Building – Catonsville MD 21228 – (410) 402-8473TDD for Disabled – Maryland Relay Service (800) 735-2258Healthy People in Healthy Communities

BHA Staff Present: Brian Hepburn, Rachel Faulkner, Robin Poponne, Iris Reeves, Greta CarterGuests and Others:Tim Santoni, University of Maryland-Systems Evaluation Center;Daphne Klein, On Our Own of Prince George’s County;Amy Woodrum, Mental Health Association of Maryland;Susan Bradley, Behavioral Health Administration;Diana Seybolt, University of Maryland-Systems Evaluation Center;Zereana Jess – Huff, ValueOptions Maryland;Erik Roskes, DHMH, Office of Forensic Services;Jacqueline Pettis, ValueOptions Maryland;Sharon Ohlhaver, Behavioral Health Administration

MARYLAND BEHAVIORAL HEALTH ADVISORY COUNCILMinutes of September 17, 2014Page 4INTRODUCTIONS/ADOPTION OF MINUTES:The combined meeting of the Maryland Advisory Council on Mental Hygiene/PL 102-321Planning council (Joint Council) and the State Drug and Alcohol Abuse Council (SDAAC) wascalled to order by Joint Council Coordinator, T.E. Arthur. Attendees introduced themselves.Respective minutes were reviewed and approved.ANNOUNCEMENTSUnless otherwise notified, the next Combined Council meeting will take place on Wednesday,December 17, 2014 in the Dix Lower Level Conference Room. The Joint Council will hold itsregularly scheduled monthly meeting on Tuesday, October 21, 2014 in the Tuerk Building,H.A.T. Room. SDAAC members are welcome to attend the October meeting and informationwill be emailed within the next few weeks. Please note, the location, the HAT Room in theTuerk Building, does not have teleconferencing capability.Until October 3rd, the proposed legislation to establish a Behavioral Health Advisory Councilwill be available for informal comment on the MHA/BHA and the ADAA/BHA Web sites.After this, the next opportunity for comment will be the legislative hearing.NAMI MD will hold its annual conference on October 17 – 18 at the Sheppard Pratt ConferenceCenter in Baltimore. Sessions and workshops will include topics such as accessing benefits,healthcare reform, and advocacy training. For more information, please contact NAMIMaryland at 410.884.8691 or visit namimdevents@namimd.org.On October 1, BHA will host the Twenty-Sixth Annual Suicide Prevention Conference, LifeMatters: Reach Out, We are Here, at Martin’s West, Baltimore. Please see the University ofMaryland Web site, trainingcenter.umaryland.edu/ , for details.The Maryland Rehabilitation Association (MRA) Division of Rehabilitation Services (DORS)Training Conference, Rehabilitation: Then Now, will take place on October 30-31 at the NorthBaltimore Plaza Hotel. Registration is open until October 8 and is accessible through theMaryland Division of Rehabilitation Services Web site www.dors.state.md.us .The Mid-Atlantic Behavioral Health Conference, Seizing the Opportunity: High ImpactApproaches & Outcomes, will take place at the Westin Hotel in Annapolis on November 3-4,2014. The conference will provide attendees from Maryland, Delaware, Washington, D.C., NewJersey, Pennsylvania, and Virginia to network with colleagues and companies who support a vastarray of efforts to improve behavioral health. Registration is available through a link on theMaryland Addictions Directors Council’s (MADC) Web site at madc.homestead.com/In recognition of National Recovery Month, the On Our Own (OOO) of Howard County willhost two events. On Friday, September 26, 2014 at the OOO of Howard County, 6440 DobbinRoad, Suite B, Columbia, Maryland, the documentary film, The Anonymous People, will beshown from 6:00 to 8:30 pm. The film is about the more than 23 million American living inlong-term recovery from addiction to alcohol and other drugs. This event is co-sponsored byValueOptions Maryland (VO), Howard County Health Department, and the Howard County

MARYLAND BEHAVIORAL HEALTH ADVISORY COUNCILMinutes of September 17, 2014Page 5Mental Health Authority (Core Service Agency). On Saturday, September 27, from 1-3 pm atOOO Howard County, there will be a “Reach out, Speak up, Recovery Celebration” which willfeature family fun activities and information about recovery from behavioral health challenges.If you have information for a conference or special event relating to behavioral health, you maysend the information to Susan Bradley, BHA Office of Epidemiology and Evaluation, atsusan.bradley@maryland.org . Ms. Bradley will use BHA’s Twitter account to disseminate theinformation to the public.THE DEPUTY SECRETARY, BEHAVIORAL HEALTH AND DISABILITIES:Brian Hepburn, M.D., Executive Director, Behavioral Health Administration, introduced GayleJordan-Randolph, M.D., DHMH Deputy Secretary, Behavioral Health and Disabilities to presentthe following update on the status and priority issues of the recently formed Behavioral HealthAdministration (BHA) of Maryland:Dr. Jordan-Randolph gave a brief outline of activities that led up to the merger of the mentalhealth and substance use administrations including the consolidation of the Office ofForensics/Community Aftercare (OFS) which now encompasses mental health, substance use,and developmental disabilities. She acknowledged Dr. Erik Roske, Clinical Director of the OFS,who is bringing his clinical expertise to all aspects of the OFS including mental health,community-based addictions services, financial aspects, and other areas of significance.The administrative services organization (ASO) contract has been awarded toValueOptions Maryland (VO), which was also the ASO for the former Mental HygieneAdministration. With the ASO in place, the Department/Administration can support: The registration of providers The maintenance of access to services Efficient and consistent reimbursements Capture and availability of dataPerformance measures are built-in to the contract. Also, the establishment of the ASO facilitatesDHMH/BHA plans for further integrating community-based addictions and mental healthservices.With the increased sharing of information, there may also be concerns around privacy/HIPAAissues. Transfer of data through VO is one level of communication. Dr. Jordan-Randolphemphasized the importance of communication on multiple levels of the behavioral health system,including consumers, providers, facilities, the ASO, and medical personnel. Each provider andeach consumer has responsibility to communicate appropriate information. Consumers mustcommunicate with their providers and providers must support the process by reviewing accessedinformation, incorporating into the clinical process, keeping accurate documentation, approvingrelease of information, giving feedback to consumers, and reinforcing a friendly environment sothat consumers will continue to be comfortable sharing personal information.

MARYLAND BEHAVIORAL HEALTH ADVISORY COUNCILMinutes of September 17, 2014Page 6Zereana Jess-Huff, CEO of VO Maryland, supported Dr. Jordan-Randolph’s remarks and saidher organization was looking forward to this new era and offered her personal assurance to thesubstance use community of her commitment to facilitating a smooth as possible transition. Shetold the membership she was open for meetings, and contact for questions as the process movesforward.PRESENTATION: EXPLORING BEHAVIORAL HEALTH INTEGRATIONTHROUGH DATA - Tim Santoni, University of Maryland, Systems Evaluation Center andWilliam Rusinko, Behavioral Health Administration (BHA), Office of Epidemiology andEvaluationTim Santoni opened the presentation by giving a perspective of the data trends and array ofservices offered by the former Public Mental Health System based on FY 2013 data (the lastcomplete data set). William Rusinko offered similar information for the former Alcohol andDrug Abuse Administration, also based on FY 2013 data. Data was presented on the followingareas: Array of services Facility Average daily population (ADP), admissions and enrollments Expenditures Service utility (data includes people often served in more than one service) Levels of care Numbers served Outlook and Outcomes (substance use ad hoc reports) Sources of funding (FY 2013)Please see Attachment for detailed informationA question was asked concerning trends in substance use and trends based on cultural differencesin Maryland. Mr. Rusinko and various Council members shared the following highlights: Heroin use is increasing and prescription opioids are also on the rise. People often movefrom prescription opioids use to heroin use Heroin and cocaine account for the high number of multiple admissions tofacilities/hospitals Baltimore City was leading the nation in heroin use and that the older individuals tendedto inhale the substance rather than inject, in response to the HIV epidemic. Heroininjection is increasing among younger individuals Heroin is easily accessible and is more likely to be less expensive than cigarettes Penthenol is also inexpensive, stronger than heroin, and more likely to trigger anoverdose In the suburbs of Maryland, heroin is not as popular, although heroin injection issignificantMr. Santoni and Mr. Rusinko presented data snapshots examining characteristics and serviceusage of consumers, focusing on those over the age of 15, who utilized both mental health andsubstance use services.

MARYLAND BEHAVIORAL HEALTH ADVISORY COUNCILMinutes of September 17, 2014Page 7This discussion and ensuing comments on medically assisted therapies such as vivitrol andmethadone, led to a desire by Council members to have a ”Substance Use 101” session thatwould better inform Council members of important basic substance use issues affecting thebehavioral health population.Additionally, there was discussion of various data systems currently in use throughout thesystem. The Statewide Maryland Automated Record Tracking (SMART) system, popular in thepast, is gradually becoming replaced by various electronic medical records systems moreaccessible to providers. In the past, the Treatment Episode Data Set (TEDS) was encouraged fora substance use data sharing system. Discussions are still in process in search of an adequateunified data system. Many changes will be incorporated into the ASO system to attempt to useone integrated system.Another method of reporting substance use and mental health data is Data Shorts, a projectrelease by the Behavioral Health Administration in collaboration with the University ofMaryland, Systems Evaluation Center (SEC). Periodically (approximately each month), onesheet of graphs and a short accompanying narrative is developed and disseminated, eachfocusing on a different aspect of behavioral health integration. For example, the Data Short forJuly 18, 2014 showed three graphs comparing: the types of service used by everyone in thePublic Mental Health System with those in the cohort active in both mental health and substanceuse systems; a comparable analysis for substance use service utilization, also looking at serviceutilization for the cohort of individuals active in both systems; and third graph showing thepercentage of the cohort who received more than one type of service within each of the twosystems. Anyone who is interested in viewing past and current data shorts can visit theMHA/BHA Web site and follow the link.COMBINED COUNCIL BUSINESS: Proposed Regulations of the Behavioral HealthAdvisory Council Workgroup toward the establishment of one Behavioral Health CouncilRachael Faulkner, Director of Office of Governmental Affairs and Communications, BHA,discussed the components of the proposed DHMH-sponsored legislation to establish aBehavioral Health Advisory Council. The document has been reviewed by BHA and DHMHleadership. As stated above, excerpts of the draft legislation (it is not standard procedure to sharethe entire document outside of the agency leadership while in draft format) will be available forinformal public comment until October 3 on both MHA/BHA and ADAA/BHA Web sites. Afterthat the draft will be submitted to the Governor’s legislative office for review.The proposed legislation is subject to be edited at any point. However, thus far, most of theelements resulting from the input of the Behavioral Health Advisory Council Workgroup andmembership of both Councils have remained in the document. The membership section hasgenerated the most discussion. All attempts have been made to maintain parity between mentalhealth and substance use within this segment. If any unnamed organizations wish to be included,their representatives may come to the legislative hearing in 2015 and request inclusion.

MARYLAND BEHAVIORAL HEALTH ADVISORY COUNCILMinutes of September 17, 2014Page 8Ms. Faulkner stated that some details, such as selection of officers, committees, among otherissues will be further addressed in by-laws. Committees already established, such as thePlanning, Workforce Development, Cultural and Linguistic Competency, Prevention, and theInteragency Forensic Services Committee will most likely continue. There seemed to be interestin adding Child &Adolescent and criminal justice, among others. Establishing such issues in Bylaws rather than in legislation helps to keep the legislation flexible. Changes in by-laws can bemore easily made in a more timely fashion.Ms. Faulkner commented that this has been a notable project because the Department sees this asa DHMH-sponsored bill proposed on behalf of the two current Councils. The target date for thenew Council to formally begin is October 1, 2015.The Combined Councils, once again, commended the Behavioral Health Advisory CouncilWorkgroup for the hard work and also thanked the BHA support staff and Ms. Faulkner for theirwork and collaboration in this process.The meeting was adjourned.

MARYLAND BEHAVIORAL HEALTH ADVISORY COUNCIL Minutes of September 17, 2014 Page 4 INTRODUCTIONS/ADOPTION OF MINUTES: The combined meeting of the Maryland Advisory Council on Mental Hygiene/PL 102-321 Planning council (Joint Council) and the State Drug and Alcohol Abuse Council (SDAAC) was called to order by Joint Council Coordinator, T.E. Arthur.

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