The Great State Update – New York and North Carolina: Effective Partnerships to Treat Tobacco Addiction in Behavioral Health Settings

75 Minutes

Flavio Casoy, MD

Medical Director of Adult Community Services and Managed Care, NYS Office of Mental Health

Flavio Casoy is the Medical Director for Adult Community Services and Managed Care in the New York State Office of Mental Health. He completed college and medical school at Brown University in Providence, Rhode Island, general adult psychiatry residency at the University of California, San Francisco, and a fellowship in public psychiatry at Columbia University.

Susan Friedlander, LCSW

Director, Community Integration & Wellness, New York City Field Office – Office of Mental Health

Susan Friedlander, LCSW is the director of Community Integration and Wellness Initiatives at NYS OMH’s New York City Field Office. She received her B.A in Political Science from Kenyon College and her M.S.W. from New York University. Susan has broad experience in the mental health field and has worked as a practitioner in clinics, inpatient hospitals, and psychiatric rehabilitation programs. In 1993, she began her career with the NYS Office of Mental Health where she developed innovative interactive television programming at South Beach Psychiatric Center and later joined the NYC Field Office as part of the Assisted Outpatient Treatment team.

As a former tobacco user, she is passionate about assuring that people who participate in mental health services have access to stagewise tobacco interventions which support recovery and community inclusion. She provides training and technical assistance to OMH-licensed programs and collaborates with a variety of behavioral health organizations to support successful tobacco interventions. Susan is the lead developer of “Crushing Cravings”, a 12-session residential curriculum for tobacco users in pre-contemplation. She is currently adapting this approach for inpatient and clinic settings and is also actively working on integrating tobacco content in training curricula for Peer Specialists.



Maxine M. Smalling, MS, BS(N), RN

Chief Executive Nursing Officer State Operations and Community Health, NYS Office of Mental Health

Ms. Smalling is the Chief Executive Nursing Officer for the New York State Office of Mental Health (OMH) and a registered nurse with more than 27 years of clinical, administrative, and public health nursing experience

Since joining the OMH Executive Team, Ms. Smalling is providing nursing leadership to address nursing issues systemically, ensure the presence of a nursing voice in policy making and working collaboratively with the Chief Medical Officer and the Executive Leadership Team to set the agencies strategic policies and plans. As the Chief Executive Nursing Officer for State Operations and Community Health, Ms. Smalling provides leadership and consultation to the 24 Chief Nursing Officers at OMH facilities; specifically, to drive the professionalization of the nursing workforce and actively promoting the dissemination of evidenced–based clinical nursing practices system wide.

Ms. Smalling leads several major OMH mission critical initiatives to improve the quality of mental health care and address the physical health needs and outcomes for individuals living with a serious mental illness. Ms. Smalling led the successful implementation of Tobacco-free campus-wide policies on 21 of the 23 OMH State Operated Psychiatric Hospitals, and is a lead member of OMH Tobacco Steering Committee, leading strategies to drive TUD treatment, including uptake on the use of FDA medications to treat TUD throughout OMH inpatient units and clinics. Ms. Smalling is a member of a long standing partnership between NYS OMH, DOH Tobacco Control, OASAS, NYSDOHMH and NYSPI Center for Practice innovation, implementing strategies to drive the dissemination of evidenced based practices to treat TUD, to reduce the incidence of smoking in the population of individuals living with a serious mental illness(SMI). She collaborated with DOH-OHIP on getting approval for the Medicaid expansion of TUD benefits.

Ms. Smalling has a Bachelor of Science degree in Nursing from The Sage Colleges, a Master of Science in Nursing from Excelsior College and currently pursuing a Doctor of Nursing Practice (DNP) degree. She is a member of the American Nurses Association, American Psychiatric Nurses Association, the Northeast New York Professional Nurses Organization and the Sigma Global Nursing Excellence, Tau Kappa at-Large Chapter. Several awards include Psychiatric Nurse of the Year, North Central Bronx Hospital, Albany Common Council 2019, 10th Ward, Black History Month Honoree and on March 7, 2019, she was awarded the NYS Empire Star Public Service Award for exemplifying the highest standards of public service.

Kim Bayha, CTTS

Tobacco Prevention & Control Program Supervisor at Mecklenburg County Public Health in the Office of Policy & Prevention

Kim Bayha, CTTS is the Tobacco Prevention & Control Program Supervisor at Mecklenburg County Public Health in the Office of Policy & Prevention, where she oversees comprehensive tobacco control efforts in a large urban community (Charlotte, NC). She has a Bachelor of Science degree in Public Health from UNC-Chapel Hill’s Gillings School of Global Public Health and has over 30 years of experience in public health education programs in community, governmental and school settings, with expertise in tobacco prevention and control and an emphasis on policy, systems and environmental changes. In 2017, Kim became a certified tobacco treatment specialist (CTTS) with national certification in tobacco treatment practice. Prior to joining Mecklenburg County in 2014, Kim managed tobacco control efforts in Union County, NC through the health department and for the school system as the Manager of the Tobacco Reality Unfiltered (TRU) youth initiative.

Stephanie Gans LCAS, MSW, NCTTP

NC Division of Public Health, Tobacco Prevention and Control Branch

Stephanie Gans LCAS, MSW, NCTTP leads the statewide effort to eliminate tobacco-related health inequities among North Carolinians with behavioral health conditions at the NC Division of Public Health Tobacco Prevention and Control Branch. This collaborative effort resulted in NC DHHS requiring Medicaid-managed care plans to ensure that most contracted providers had tobacco-free campuses by December 1st, 2022. She provides statewide expert training and technical assistance to promote evidence-based tobacco use treatment and QuitlineNC in medical and behavioral health settings. Prior to working in public health, Stephanie worked in community-based behavioral health settings in medication-assisted treatment and with people with severe and persistent mental illness.

Webinar Objectives
  1. Describe New York State’s multi-pronged approach to address Tobacco Use Disorder in the population with serious mental illness.
  2. Explain two ways to effectively tear down silos and improve coordination between multiple State and Local agencies.
  3. Identify two strategies for building support for tobacco-free behavioral health settings at the organization, local, and state level.
  4. Describe two strengths and limitations of working with managed care organizations to implement 100% tobacco-free settings.
Instructions for CME/CE Credit

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ACCME Accreditation

The University of California, San Francisco (UCSF) School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

UCSF designates this live activity for a maximum of 1.25 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the webinar activity.

Advance Practice Registered Nurses and Registered Nurses: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 CreditTM issued by organizations accredited by the ACCME.

Physician Assistants: The National Commission on Certification of Physician Assistants (NCCPA) states that the AMA PRA Category 1 CreditTM are acceptable for continuing medical education requirements for recertification.

California Pharmacists: The California Board of Pharmacy accepts as continuing professional education those courses that meet the standard of relevance to pharmacy practice and have been approved for AMA PRA category 1 CreditTM. If you are a pharmacist in another state, you should check with your state board for approval of this credit.

California Psychologists: The California Board of Psychology recognizes and accepts for continuing education credit courses that are provided by entities approved by the Accreditation Council for Continuing Medical Education (ACCME). AMA PRA Category 1 CreditTM is acceptable to meeting the CE requirements for the California Board of Psychology. Providers in other states should check with their state boards for acceptance of CME credit.

California Behavioral Science Professionals: University of California, San Francisco School of Medicine (UCSF) is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for behavioral health providers. UCSF maintains responsibility for this program/course and its content.

Course meets the qualifications for 1.25 hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. Provider # 64239.


The UCSF office of continuing medical education is accredited by the California Consortium of Addiction Programs and Professionals (CCAPP), to provide continuing education credit for California addiction counselors. UCSF designates this live, virtual activity, for a maximum of 1.25 CCAPP credits. Addiction counselors should claim only the credit commensurate with the extent of their participation in the activity. Provider number: 7-20-322-0722.


This UCSF CME activity was planned and developed to uphold academic standards to ensure balance, independence, objectivity, and scientific rigor; adhere to requirements to protect health information under the Health Insurance Portability and Accountability Act of 1996 (HIPAA); and include a mechanism to inform learners when unapproved or unlabeled uses of therapeutic products or agents are discussed or referenced.

All speakers, planning committee members and reviewers have disclosed they have no relevant financial relationships to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Kimberly Bayha, CTTS, Anita Browning, Flavio Casoy, MD, Christine Cheng, Brian Clark, Susan Friedlander, LCSW, Stephanie Gans LCAS, MSW, NCTTP, Pamela Ling, MD, MPH, Jennifer Matekuare, Ma Krisanta Pamatmat, MPH, Catherine Bonniot Saucedo, Maxine Smalling, MS, BS(N), RN, and Aria Yow, MA.


Additional Resources Cited in the Webinar