In Memoriam: ATPA remembers its friend Gary Winkel

Gary Howard Winkel

May 21, 1945 – September 5, 2014

Our Lady of Peace Church

237 East 62nd Street

October 23, 2014   5:30pm -7:00pm

 

GaryWinkel

 

Gary Howard Winkel, beloved husband, father, nephew, partner, friend and counselor, died September 5, 2014 in Buffalo, New York. Born in New York City, Gary attended grammar, middle and high school in South Orange, New Jersey, followed by Bard College in Annandale, New York.

He was a successful businessman in real estate sales, design, manufacturing and marketing of leather goods and, for the past 6 years, he was Director of Community-Based Program Development and Counselor (CASAC-T) at New York’s Parallax Center.

Gary’s father, Melville Leo Winkel, his mother, Dorothy Ostro Winkel, and brother Martin Winkel preceded him in death. Gary is survived by his two sons, Matthew Leo Winkel of New York, New York and Drew Taylor Winkel of Chicago, Illinois, and their mother, Brandy Towns Winkel of Grand Island, New York.

Testimony for Public Hearing Senator Phillip Boyle

Heroin & Prescription Drug Epidemic: Connecting Dots to Youth

November 13, 2013

philip-boyleNancy Beckett-Lawless

Seafield Center

7 Seafield Lane,

Westhampton Beach NY 11978

 

Committee: Senate Standing Committee on Alcoholism and Drug Abuse

 

Good Afternoon Senator Boyle and members of the Committee.  My name is Nancy Beckett-Lawless and I am Director of Provider Relations for Seafield Center.  I am Co-chair of the Managed Care Committees for two New York State provider organizations: ASAP – Association of Alcoholism and Substance Abuse Providers and ATPA – Addiction Treatment Providers Association.  I also Chair the Long Island Insurance and Managed Care Committee and am co-founder of the East End Clinical Connection, a group of behavioral health professionals who provide addiction and mental health treatment to residents living on the east end of Long Island.

 

First, I would like to recognize and thank Senator Boyle and his colleagues in the Senate, and the rest of the Legislature, for their support of the Attorney General’s successful initiative in passing a law at the forefront of the prescription drug epidemic, the  I-Stop Legislation, which we have already seen is effective in curbing the over prescribing and misuse of prescription pain medication.  I would also like to acknowledge the role New York State played in achieving Federal Parity by leading the way with the passage of Timothy’s Law in 2006 which preceded the successful passage of The Mental Health Parity and Addiction Equity Act of 2008. New York State always leads the way in assuring quality care is delivered to our most vulnerable citizens, and we thank you for that.

 

I am here today to ask you to step up one more time to help us close an unintended loophole created by Parity, the issue of medical necessity. The actions I suggest will not cost the State of New York any additional money, but could save the lives of countless young people who overdose from opiates when they are turned away from treatment too early …or not admitted to treatment at all…..because they cannot access the treatment benefits of their own insurance policy by not meeting the proprietary “medical necessity criteria” demanded by their Insurance Company or Managed Care Organization. Every Insurance Company has their own criteria and has a fiduciary interest in denying care!

Young people and others are being denied detox and inpatient rehab every day. *Give the example of the young person assessed in Mineola after his first overdose, approved for detox in a hospital for 3 days and then refused  INP, relapsed on the first night out, assessed again in Mineola for INP and again refused. Admitted to IOP on a Friday, overdosed the 3rd time on Sunday evening, died on the 3rd OD and was brought back with paddles only to be denied the 3rd time for not meeting medical necessity. His family sent him to Florida and when he returned he had no benefits left! He was taken off the parents insurance and put on Medicaid and what should have been the “payer of last resort” once again became the payer of “first resort.” Cost shifting due to medical necessity.

 

We need to do 2 things:  First create a definition of medical necessity that meets the needs of the residents of NYS and the State.  2nd We need to enforce the use of our State LOC determinator, LOCTDAR 2.0 or its equal, for all level of care placement by insurance companies doing business in NYS.

 

New York State has designated the Office of Alcoholism and Substance Abuse Services (OASAS) as the single state agency responsible for the coordination of state-federal relations in the area of addiction services. Section 32.01 of Mental Health Law authorizes the Commissioner to adopt and promulgate any regulation necessary to implement and effectively exercise the powers and perform the duties conferred by Article 32 of the Mental Hygiene Law. Section 32.07 (4) (e) of the NYS Mental Hygiene Law discusses the regulatory power of the Commissioner and gives “the Commissioner, in consultation with the Commissioner of Health, the ability to adopt standards including the necessary rules and regulations including ……..determining the necessity or appropriate level of admission, controlling the length of stay and the provision of services, and establishing methods and procedures for making such determination.”  OASAS regulations provide for the use of the LOCADTR 2.0 or equal, to determine the level of care placement.

 

So…by law OASAS has the authority to determine medical necessity utilizing LOCADTR 2.0 or equal. Therefore, if we amend existing NYS Mental Hygiene Law to include a provision which states; All insurance companies doing business in NYS are required to use NYS Level of Care determinator , the LOCATDR 2.0 or any tool approved by OASAS, when making medical necessity decisions and level of care recommendations.

How else can we further expand existing NYS Law to insure NYS residents with Substance Use Disorder (SUD) will receive

appropriate care within the guidelines of Federal Parity?  To answer this question let us first look at how NYS currently defines medically necessary treatment.

 

  • According to NYS Social Services, 365-a, New York Law defines “medically necessary medical, dental, and remedial care, services, and supplies” in the Medicaid program as those necessary to prevent, diagnose, correct, or cure conditions in the person that cause acute suffering, endanger life, result in illness or infirmity, interfere with such person’s capacity for normal activity, or threaten some significant handicap and which are furnished an eligible person in accordance with State Law.

 

Officials in the state’s Medicaid agency report that this definition applies to both fee-for-service and managed care populations.

 

In this definition lies a problem. These criteria are not sufficiently clear or unambiguous.

 

Today I would like to recommend we develop a new definition of medical necessity for NYS law that would be a model definition of Medical Necessity meeting the needs of the residents and the State.

 

I am going to give you examples of what 2 States have implemented that have been upheld over time and proven not to cost those States considerable money:

In 1999 The Stanford Research Project presented preliminary findings to a workshop of key stakeholders in California and developed a model definition for medical necessity that was adopted by State Medicaid Program and private plans.

They defined “Medical Necessary” shall mean health care services that a physician, exercising prudent clinical judgment, would provide to a patient for the purpose of preventing, evaluating, diagnosing or treating, an illness, injury or disease or its symptoms, and that are;

a) In accordance with generally accepted standards of medical practice.

b) Clinically appropriate, in terms of type, frequency extent, site and duration, and considered effective for the patients illness, injury or disease.

c) Not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic result for the diagnosis or treatment of that patient’s illness, injury or disease.

 

For our consideration today “generally accepted standards of medical practice” mean standards and guidelines outlined by our own NYS Department of Health, NYS Office of Alcohol and Substance Abuse Services and NYS Office of Mental Health.

 

Another example: In 1988 Pennsylvania enacted Act 152 legislation under the Department of Public Welfare which established placement criteria for use by Drug and Alcohol Programs “governing the type, level, and length of care or treatment” of drug and alcohol clients including hospital detoxification, as basis for standards for services provided. This criteria was updated in 1999 with the development of Pennsylvania Client Placement Criteria which remains in effect today. In 1989 Pennsylvania enacted ACT 106 which to date remains hugely successful and has been upheld through passage of Federal Parity.  PA Act 106 requires all commercial group plans, HMO’s and Children’s Health Insurance to provide mandated minimums on detox, rehab and outpatient treatment when authorized by a licensed physician or licensed psychologist and referred to a licensed in-state program.

 

This Law not only meets Federal Parity requirements but exceeds them, has been upheld, and remains in effect today.

 

The recommendation for a new definition of medical necessity is all about unifying the language when anyone writes a policy to provide insurance coverage for New Yorkers. This step will cost NYS exactly “zero dollars” to the taxpayer and if done appropriately will reduce premiums and costs to the plans by keeping people out of emergency rooms with overdoses, heart attacks caused by drug use, countless admits due to alcohol and drug related accidents, and less dollars needed to fund the criminal justice system.  Simple language levels the playing field and is good social policy for NYS.

 

How often does the Legislature get to craft policy that saves lives, supports the health and welfare of the citizenship and does not cost the taxpayers a single dollar!

 

Thank you for your time and consideration.

Sincerely,

Nancy Beckett-Lawless

2013 Bridge Back To Life Golf Outing

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Please join us on Tuesday August 13th at the beautiful Willowcreek CC in Mt. Sinai for our 7th Annual Golf Outing.

All proceeds go to the Matthew J. DeMoore Scholarship Fund at Bridge Back to Life, which we use to assist our at-risk adolescent populations.

The list of nominees to the Joint Behavioral Health Advisory Council and the Advisory Council of the Justice Center

Clinical-Supervision

ATPA Member Patrice Moore Wallace has been selected to the Joint Behavioral Health Advisory Council and the Advisory Council of the Justice Center.

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Senate Standing Committee on Mental Health and Developmental Disabilities
Senator David Carlucci, Chair
10:00 AM, Wednesday, June 19, 2013
Room 124 CAP

The Mental Health and Developmental Disabilities Committee will consider the following nominations:

Jeffrey A. Wise, as Executive Director, Justice Center for the Protection of People with Special Needs (TO APPEAR)

Alfred Kingon, as member Justice Center Advisory Council (NOT APPEARING)
William T. Gettman, Jr, as member of Justice Center Advisory Council and as member of Behavioral Health Services Advisory Council (NOT APPEARING)
Walter J. Joseph Jr., as member of Justice Center Advisory Council (NOT APPEARING)
Tanya L. Hernandez, as member of Justice Center Advisory Council (NOT APPEARING)
Shirley B. Flowers, as member of Justice Center Advisory Council (NOT APPEARING)
Scott Salmon, as member Justice Center Advisory Council (NOT APPEARING)
S.Earl Eichelberger, as member of the Justice Center Advisory Council (NOT APPEARING)
Ronald S. Lehrer, as member of the Justice Center Advisory Council (NOT APPEARING)
Robert L. Weisman, DO, Justice Center Advisory Council (NOT APPEARING)
Peter Pierri, as member of the Justice Center Advisory Council (NOT APPEARING)
Norwig Debye-Saxinger, as member of the Justice Center Advisory Council (NOT APPEARING)
Michael Arsham, Justice Center Advisory Council (NOT APPEARING)
Mary E. Bonsignore, as member of the Justice Center Advisory Council (NOT APPEARING)
Lisa Gerbasi Goring, as member of the Justice Center Advisory Council (NOT APPEARING)
Leslie A. Hulbert, as member of the Justice Center Advisory Council (NOT APPEARING)
Judith A. ORourke, as member of the Justice Center Advisory Council (NOT APPEARING)
Joseph L. Rich, as member of the Justice Center Advisory Council (NOT APPEARING)
Jeremy E. Klemanski, as member of the Justice Center Advisory Council (NOT APPEARING)
Harvey B. Rosenthal, as member of the Justice Center Advisory Council (NOT APPEARING)
Glenn Liebman, as member of the Justice Center Advisory Council (NOT APPEARING)
Gabrielle Horowitz-Prisco, as member of the Justice Center Advisory Council(NOT APPEARING)
Eva S. Dech, as member of the Justice Center Advisory Council (NOT APPEARING)
Euphemia Strauchn-Adams, as member of the Justice Center Advisory Council and the Behavioral Health Services Advisory Council (NOT APPEARING)
Denise A. Figueroa, Justice Center Advisory Council (NOT APPEARING)
Delores McFadden, Justice Center Advisory Council (NOT APPEARING)
David Allen Lamphere, Justice Center Advisory Council (NOT APPEARING)
Clint Perrin, Justice Center Advisory Council (NOT APPEARING)
Christopher Tavella, Ph.D, Justice Center Advisory Council (NOT APPEARING)
Brian P. McLane, as member of the Justice Center Advisory Council (NOT APPEARING)
Belinda Lerner, Justice Center Advisory Council (NOT APPEARING)

Lawrence S. Brown, Jr, M.D., as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
John Kastan, Ph.D, as member of the Behavioral Health Services Advisory Council(NOT APPEARIN G)
Jennifer Falk Havens, MD, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
James P. Scordo, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
Howard P. Meitiner, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
Grant E. Mitchell M.D., as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
Glenn Andrew Martin, M.D, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
Tino Hernandez, as member of the Behavioral Health Services Advisory Council (Does not need to appear)
Deborah Mayo, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
April Critelli (Lt. Colonel), as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Andrew S. Roberts, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
Stephanie Orlando, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Sharon R. Gillette, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Scott S. Lavigne, as member of the Behavioral Health Services Advisory Council (NOT APPEARING)
Robert Cruz, as member of the Behavioral Health Services Advisory Council(NOT APPEARING )
Ralph G. Fasano, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Paul N. Samuels, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Patrice Wallace- Moore, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Michael Norman Martin, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Maura A. Kelley, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Kunsook Song Bernstein, Ph.D, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
Katherine Breslin, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )
John D. Lee, as member of the Behavioral Health Services Advisory Council (NOT APPEARING )

Job Posting – CEO of Gateway Rehab

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BACKGROUND

Gateway Rehabilitation Center (Gateway Rehab), a private, not-for-profit organization, is a positive force in the prevention, treatment, education and research of substance abuse and alcoholism. Since 1972, the center has thrived under the guiding spirit of its founder and medical director emeritus, Abraham J. Twerski, M.D. This renowned author and physician first opened Gateway Rehab as a 28-day, abstinence-based alcohol and drug dependence treatment center for adults. Dr. Kenneth Ramsey has led the organization for 36 years, growing it from a one-site fledgling facility to a robust financially stable $30 million organization with more than 20 sites.  Today, Gateway Rehab is an internationally recognized leader in addiction treatment offering an array of services for adolescents, youth, and adults with a compassionate and individualized approach.

The mission of Gateway Rehab is to help all affected by addictive diseases to become healthy in body, mind and spirit. The center took root in the Pittsburgh region, growing to treat about 1,200 adults a year. In 1992, the mission expanded to help youth with substance abuse problems. In 2012, Gateway Rehab opened its Youth Services Center, conveniently located just minutes from the Pittsburgh International Airport. This facility is exclusively for adolescents and offers gender-specific treatment in a serene environment.

 

With a strong financial foundation, the organization is led by a committed Board of Directors with a staff of nearly 700 employees treating 1,700 patients on any given day in Pennsylvania and Ohio. The services of Gateway Rehab are broad and all-encompassing for adults and adolescents:  detox, in-patient, out-patient, half-way houses, corrections, Employee Assistance Programs and after-care. In addition, there is a value on prevention and research. Please visit www.gatewayrehab.org for additional information on this incredible organization.

 

POSITION OVERVIEW

As a result of the announced retirement of our longtime leader, the Gateway Rehab Board of Directors seeks to hire the organization’s next President & CEO and has retained Vantagen to assist with this process. The President & CEO reports to the Board of Directors, and is responsible for the organization’s consistent achievement of our mission and business objectives. This position leads the organization with a senior management team of seven professionals, many of whom are long term dedicated employees.

 

We seek a leader with empathy and compassion for the people served by our mission.  Strategic thinking, innovation and courage are required to catalyze the delivery of outstanding client outcomes.  In an ever-evolving landscape of healthcare reform, we seek an experienced leader that can navigate the Affordable Care Act and its impact on the operations and treatment delivery systems of Gateway Rehab. With financial savvy, our next President & CEO will need to be experienced in seeking out and negotiating partnerships that will benefit our mission. As an ethical leader, the President & CEO must have demonstrated ability to lead an accomplished team of professionals accustomed to achieving exceptional results.

 

The President & CEO is primarily responsible for the following:

 

Leadership and Management

  • Manage overall administration and quality of Gateway Rehab – its programs, projects, human resources, policies and procedures, finances, and facilities.
  • Plan and direct all investigations and negotiations pertaining to joint ventures and organization partnerships, with approval of the Board of Directors.
  • Identify and communicate emerging topics in Healthcare Reform. Interpret the impact of county, state and federal changes in healthcare policy to Staff and Board.
  • Work collaboratively with Management and Board to develop annual and long-range goals and strategies for the organization.
  • Understand, assess, minimize and communicate the risks associated with business processes, transactions, operations, and healthcare trends.
  • Regularly meet with the executive team to ensure that operations are in accordance with policies.  Establish and administer plans and policies by implementing Board decisions. Respond to internal and external demands.
  • Maintain financial stability through effective resource allocation, and financial and program management.

 

Community Relations and Fundraising

  • Serve as the chief liaison with the community, other organizations, private and public funders, and other constituents. Interpret and represent the organization in the community.
  • Work with the Vice President, Development and Public Information to increase broad based private support to increase philanthropic funding. Identify and cultivate relationships that will advance the development and resource acquisition efforts of Gateway Rehab.
  • Participate in national, regional and affinity groups in order to stay connected and aligned within the Addiction and Recovery community.

 

Board and External Relations

  • Support the work of the Board of Directors and all relevant committees. Serve as the intermediary between Board and Staff. Identify, recruit and maximize the contributions of new and existing board members. Direct the continued education and organizational development of the Board of Directors.
  • Through the Board’s committee structure, provide guidance and authorization to carry out major plans, standards and procedures, consistent with established policies and Board approval.

 

PERFORMANCE OBJECTIVES

The current and future challenges facing all healthcare and in particular, addiction treatment services, are numerous. In the near term the President & CEO will be expected to continue to deliver outstanding client outcomes while meeting and successfully addressing the following challenges:

 

  1. The impact of the Affordable Healthcare Act on Gateway Rehab services and finances.
  2. The evolution of Gateway Rehab’s treatment delivery models to be inclusive of varied client needs.
  3. A facility upgrade to reflect the high level of personalized care offered through treatment.
  1. Creating a culture of philanthropy internally and externally to meet the financial demands that complement the current revenue streams.

 

 

 

KNOWLEDGE, SKILLS AND COMPETENCIES

The successful President & CEO candidate will be an experienced and tested leader who possesses a combination of the following:

  • Bachelor’s and Master’s degrees required.
  • Substantial successful experience as a senior manager within a healthcare organization or organization similar in size, scope and scale of impact.
  • Knowledge and understanding of the current and evolving landscape of healthcare and healthcare reform.
  • Prior experience initiating and launching successful partnerships for mutual gain.
  • A demonstrated passion for the unique nature of addiction and recovery and the mission of Gateway Rehab.
  • Strong financial acumen, management ability and an ethical servant leader approach to work.
  • Integrity and trust beyond reproach. Composure in all situations, even when under stress. Adheres to an appropriate and effective set of core values and beliefs. Is strategically agile – can anticipate future consequences and trends accurately. A visionary who doesn’t lose sight of daily operations.
  • Personal values that include generosity, compassion, honesty, enthusiasm, energy, stamina, humility and a sense of humor.
  • Interpersonal skills including the ability to motivate, negotiate, and persuade stakeholders into a course of action in a community context. Excellent communication skills, including verbal, written and public speaking.
  • Prior demonstrated successful experience with identifying and securing private and public funding through fundraising and government/community relations.
  • A sense of entrepreneurial opportunism, with the ability to flex and adapt with changing conditions.
  • Generous with time and willingness to do all that it takes to stay “on top” of the many faceted parts of the nonprofit sector and the community at large.
  • Adept at building effective teams and motivating others to achieve more, particularly in complex and dynamic organizations. Demonstrated ability to manage and resolve conflict.
  • Evidence of continuously seeking (or encouraging others to seek) opportunities for different and innovative approaches to addressing organizational problems and challenges.

 

COMPENSATION

This position offers a highly competitive salary, and a generous benefits package, consistent with other nonprofit organizations of similar size, scope and scale.

 

TO APPLY

Individuals wishing to speak confidentially about this opportunity may contact Michelle Pagano Heck, Senior Consultant, Vantagen at michelle.heck@vantagenllc.com. Qualified individuals may apply confidentially by submitting resume, cover letter and compensation requirements as MS Word attachments to: resumes@vantagenllc.com. Please reference the following in the subject line of your email:  Gateway Rehab, President & CEO, #253-MH687

 

If you do not receive an email confirmation of your submission within 3 business days, please contact Dawn Kopp at Dawn.Kopp@VantagenLLC.com or 412-315-6332.

Please direct all inquiries related to this position to Vantagen and do not contact Gateway Rehab.

Gateway Rehab is an equal opportunity employer.

ATPA members in the News 3.26.2012

 

• Gary Butchen appointed to be on Optum BHO Advisory Board for NYC metropolitan area

• Patrice Wallace-Moore appointed to be on CCBH Advisory Board for MidHudson area

• John Hailey appointed to be on Value Behavioral Health/LIJ-North Shore Advisory Board for Long Isalnd