building bridges in the substance use disorders continuum of care

Building Bridges in the Substance Use Disorders

Continuum of Care

A Networking Opportunity to Enhance Collaboration Among Prevention, Treatment & Recovery

May 14, 2014

Objectives• Raise awareness for the value of collaboration

within the RROSC partners

• Identify strategies to collaborate in a way that benefits our purpose of helping the individuals and communities we serve, build common language and expand networking for the full circle of care

• Welcome

• Resiliency & Recovery Oriented Systems of Care

• Prevention & Treatment Systems Overview

• “Day in the Life…” Presentations

• Small Group Activities

• Lunch

• Group Activity (continued)

• Closing

Agenda

Optimizing Resources in a Changing Healthcare Landscape

Joseph P. HardingDirector, NH Bureau of Drug & Alcohol Services

jpharding@dhhs.state.nh.us

DHHS is determining how to best leverage existing resources to meet service quality objectives within the context of a dramatically changing healthcare landscape and continuing unprecedented fiscal challenges

• Affordable Care Act

• New Hampshire Health Protection Program (HPP)

• Medicaid Care Management

• DHHS Redesign

Optimizing Resources in a Changing Healthcare Landscape

• Whole person, individual/family centered

• Optimize the utilization of resources

• Maximize quality of products and services

• DHHS moving to better integration/coordination of internal organizational resources

• Promote effective approaches among external systems including better coordination, collaboration, and integration of community services

Guiding Principles

Fiscal StrategySaving Lives / Saving Dollars

New Hampshire Needs a Comprehensive Approach to Addressing the Misuse of Alcohol & Drugs

• Effective Interdiction Efforts (as put forth by the NH Criminal Justice Community)

• A Comprehensive Public Health Approach, including:– Environmental Strategies – targeting the general population

– Prevention Services - targeting at risk groups

– Early Intervention Strategies – targeting individuals misusing

– Treatment services – targeting individuals addicted

– Recovery support services – supporting long-term recovery

Current Capacity

What Part of a Comprehensive Approach Does NH HPP Support?

NH HPP will provide resources to support:o Early Intervention

• Screening, Brief Intervention, Referral to Treatment

o Treatment Services• Withdrawal management

• Medication Assisted Treatment

• Full range of SUD treatment service

o Recovery Support Services• Limited cost effective approach to managing a chronic health

condition

What Parts of a Comprehensive Approach are NOT Covered by NH HPP?

• Environmental Strategies o Targeting the general population

• Prevention Serviceso Targeting at risk groups

• Recovery support serviceso Supporting long-term recovery

• Support the Regional Public Health Networks in facilitating the development of a comprehensive approach at the regional/community level (environmental strategies, early intervention, treatment & recovery supports)

• Provide resources for community-based prevention serviceso All GC funding for prevention services had been eliminated in SFY-2012o Have since added resources for Partnership for Success Initiative (Federal grant)

and Life of an Athlete (Governor’s Commission)• DHHS and partners Implementing the NH HPP• Support infrastructure development at Community Health Centers and

other primary care settings for critical services, including:o SBIRT(screening, brief intervention, referral to treatment) o MAT (Medication assisted treatment)

• Provide infrastructure support for expanding service capacity across the specialty substance use disorder treatment system

• Expand training/technical assistance for workforce development

Resources Needed to Support a Comprehensive Approach

Resiliency & Recovery Oriented System of Care

A Vision for New Hampshire

Lindy Sue Keller, MS, MLADC

Resources and Development Administrator

lskeller@dhhs.state.nh.us

RROSC• Framework for organizing and coordinating

multiple strategies, services, supports and systems, to deliver person-centered services and community-directed approaches that promote personal and community health and wellness.

Resiliency & Recovery Oriented System of Care

Treatment

Prevention

Person

CommunityRROSC

RecoverySupports

Intervention

Are person-centered and community-driven

Engage a diverse array of stakeholders

Expand the community’s ability to be proactive in prevention and responsive to its members who are in or seeking recovery

Offer a comprehensive array of strategies and services that can be combined and adjusted to enhance community wellness and meet individuals’ chosen paths of recovery

Resiliency & Recovery Oriented Systems of Care

New Hampshire Prevention System

Valerie T. Morgan, BS, CPS

Administrator Prevention Services

Valerie.morgan@dhhs.state.nh.us

OverviewResources & Prevention Scope

The NH Bureau of Drug and Alcohol Services (BDAS) is the state’s leader in many efforts and manages several federal grants:• The Federal Substance Abuse Prevention and Treatment

Block Granto Prevention, early intervention, treatment and recovery

support services • Partnership for Success• State Epidemiological Outcomes Workgroup (SEOW)

-NH’s System for Substance Abuse Prevention Efforts and Services Brochure 2013

BDAS

Public & Private Partnership

New Hampshire Charitable Foundation

• In 2012, the foundation approved an ambitious, 10-year strategy dedicated to the prevention of substance use disorders.

• Approximately $1.2 million dollars per year will be allocated from the portfolio in furtherance of this strategy - Prevention.

Prevention Part of a Continuum

Regional Public Health NetworksSubstance Misuse Prevention (SMP)

• BDAS and Division of Public Heath Services 2014 combined contracts

• SMP Leadership Teams – advise substance misuse prevention

• One Full Time Equivalent Coordinator

• Professional credentialing: Certified Prevention Specialist

• Three-Year Strategic Plans & One-Year Work Plans

• Align with State 5 year plan: Collective Action-Collective Impact

• Priority Problem Areaso Alcohol misuseo Marijuana useo Prescription drug misuse

• Priority Populationso Youtho Young adultso Pregnant and parenting womeno Military personnel and their familieso Justice involved youth and young adultso Individuals needing but not receiving treatmento Individuals with co-occurring disorders

5 Year Plan – Priorities & Populations

SAMHSA Evidenced-Based Planning Model

• Profiling needs and response capacityAssessment

• Mobilizing and building needed capacityCapacity

• Developing a prevention planPlanning

• Using programs, policies, and strategies based on what is known to be effectiveImplementation

• Considering program effectiveness and sustaining what works wellEvaluation

Business

Government

Communities & FamiliesEducation

Safety & Law Enforcement

Health & Medical

6 Sector Model

Public Health Advisory Council

PHAC role is to advise the Regional Public Health Network:

• Identifying regional public health priorities based on assessments of community health

• Guiding the implementation of programs, practices and policies that are evidence-based to meet improved health outcomes

• Advancing the coordination of services among partners

New Hampshire Treatment System

Jaime E. Powers, MS

Administrator Clinical Services

Jaime.powers@dhhs.state.nh.us

Contracted Substance Abuse Treatment Services

• 17 contracted treatment providerso Block Grant, Governor’s Commission, General Funds

• 5 Levels of Careo Outpatiento Intensive Outpatiento Short-Term Residentialo Transitional Livingo Long-Term Residential for Pregnant & Parenting Women

Priority Populations

• Pregnant & Parenting Women

• Injection Drug Users

• Criminal Justice Involved Individuals

• Veterans & Other Military Members

• Individuals with Co-Occurring Disorders

Eligibility Requirements

• Substance Use Disorder

• Financial Eligibilityo Sliding fee scale

o Medicaid, NH Health Protection Plan, Other Coverage

• Level of Care

Opiate Treatment Programs

• Oversight of clinical serviceso CARF/SAMHSA, DEA,

and Board of Pharmacy

• 3 Agencieso Community Substance

Abuse Centers

o Habit OPCO

o Metro

• 8 locationso Concord

o Hudson

o Keene

o Manchester (2)

o Newington

o Somersworth

o West Lebanon

Targeted to begin July 1, 2014

• Substance Use Disorders services being phased ino Outpatient, Intensive Outpatient, and Partial Hospitalizationo Clinically Managed Residentialo Medically Monitored Withdrawal Management, Opioid

Treatment Programs, and Office Based Medication Assisted Treatment

o SBIRT & Screeningo Recovery Support Services & Case Managemento Crisis Management

NH Health Protection Program

• Critical part of building a Resiliency and Recovery Oriented System of Care

• Existing formal network is limited

• Working to identify and support existing organizations and encourage network development

Recovery System

“A Day in the Life…”

In what ways can you collaborate with others in your region(s) to enhance the work you currently do to further impact the individuals and communities you serve?

Within your region(s) how can you engage the recovery community and nurture partner relationships?

Small Group Activity

Q1

Q2

Share - 1 idea for how you will collaborate

with others in your region(s)- 1 way you are going to engage the

recovery community and partnerships in your region(s).

Large Group Report Out

THANK YOU