Orlando, Florida June 22-25, 2008. Recovery in the Community: An Emerging Framework- A Recovery-Oriented Systems Approach SAAS National Conference & NIATx Summit. Partners for Recovery. Jack Stein Director, Division of Services Improvement CSAT. Shannon Taitt PFR Coordinator CSAT.
June 22-25, 2008Recovery in the Community: An Emerging Framework- A Recovery-Oriented Systems ApproachSAAS National Conference & NIATx Summit
Partners for Recovery
Director, Division of Services Improvement
Abt Associates Inc.
Any problems faced by the individual substance user cannot be seen in isolation from their family, local community and society.
- Scottish Advisory Committee on Drug Misuse, 2008.
A Recovery-Oriented Systems Approach be seen in isolation from their family, local community and society.
Recovery-oriented systems support person-centered and self-directed approaches to care that build on the strengths and resilience of individuals, families, and communities to take responsibility for their sustain health, wellness, and recovery from alcohol and drug problems.
The science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations - public and private - communities and individuals.
Describing Recovery-Oriented Systems be seen in isolation from their family, local community and society.
Recovery-oriented systems include:
Outcomes be seen in isolation from their family, local community and society.
Systems of Care
Community Individual Family
Ongoing Systems Improvement
The field faces many challenges:
Different values, approaches, & perspectives
Insufficient and inefficient use of resources
Cumbersome, fragmented, and inflexible systems
Access, engagement, retention and appropriate services
…but we have a lot to build upon be seen in isolation from their family, local community and society.
Recovery-Oriented Systems Elements & Goals be seen in isolation from their family, local community and society.
Enhancing Current Systems be seen in isolation from their family, local community and society.
Many of the elements are not new.
Systems enhancements include:
Increased Responsiveness to Clients Recovery-Oriented Approach
Applying Recovery-Oriented Research Recovery-Oriented Approach
Engaging Recovery-Oriented ApproachYou in the Change Process
Collaboration among informal & formal systems
Systems change requires conceptual clarity, overcoming resistance, organizational commitment, strong leadership, definition of roles, transparency, and an infrastructure to support the process, including staff and education and training.
A perfect plan is not necessary to begin the process.
Change agents in your State will assist you with the implementation process.
Constant communication is essential.Lessons Learned from State and Community Activities
Pursue efforts where you can achieve early success and promote those accomplishments.
Use all tools available to you, such as peer-to-peer services and case management.
Conduct evaluation and performance measurement at the beginning of the implementation process.
Invest in a good grant writer to leverage resources.Recommendations from States and Communities
CSAT’s Regional Recovery Meetings: Noteworthy Steps States are Prepared to Take (cont’d)
AK Services & Activities
2007 CSAT TCE/HIV Grantees
States with 2007 Grantees
In 2005 there were an estimated 394,224 ED visits that involved alcohol in combination with another drug.
Alcohol was most frequently combined with one or more of the following: cocaine, marijuana, and heroin.
SOURCE: Office of Applied Studies, SAMHSA, Drug Abuse Warning Network, 2005 (04/2006 update).
20% At-Risk Drinkers
35% Low Risk Drinkers
Adapted from Babor,T,F., Higgins-Biddle,J.C., (2001), Brief Intervention for Hazardous and Harmful Drinking: A manual
for use in primary care . p 33. WHO/MSD/MSB/01.6b World Health
Embeds screening, brief intervention & treatment of substance abuse problems within primary care settings such as emergency centers, community health care clinics, and trauma centers;
Identifies patients who don’t perceive a need for treatment;
Provides them with a solid strategy to reduce or eliminate substance abuse; and
Moves them into appropriate services.
Screening:Very brief screening that identifies substance related problems
Brief Intervention:Raises awareness of risks and motivation of client toward acknowledgement of problem
Brief Treatment:Cognitive behavioral work with clients who acknowledge risks and are seeking help
Referral:Referral of those with more serious addictions
Reimbursement for screening & brief intervention is available through commercial insurance CPT codes, Medicare G codes and Medicaid HCPCS codes:Coding for SBI ReimbursementFebruary 2008
The data below represent follow-up from the SBIRT programs as of 3/24/08. Sample selection was random and collected at intake and 6 months post intake.
Important to note: Results are from SBIRT early implementation and reflect a more severely involved substance abuse population.
Recovery support services in conjunction with clinical treatment help to establish a more comprehensive treatment response.
The recovery-oriented project focuses on reducing the acute and severe relapses that substance abusing clients often experience.
ATR has helped mobilize community networks and build collaborative partnerships that result in more choices and more services for clients with substance abuse issues.
Faith-based organizations have expanded the concept of choice by offering faith-based options to clients who may have a more spiritual approach to their recovery
Traditional Healing Practices, e.g.:
DOJ: Drug courts may be sources of referrals into the program
DOL: Prisoner Reentry Program
HUD: Housing services (direct housing services such as rent payments are not permissible under ATR)
ATR provides a platform to develop linkages with other federal agencies/programs which can help to leverage ATR funds or serve as a source of referrals/services:
74.3% of clients who reported using substances at intake into ATR were abstinent from substance abuse at discharge.
Source: SAMHSA data reported by ATR 2004 grantees through the Services Accountability
Improvement System (SAIS). 12/31/07
Source: Bureau of Labor Statistics
Annual Conference Report of the Recovery Community Services Program – Conference report discussing emerging indicators of quality for peer recovery support services. The report can be accessed via: http://rcsp.samhsa.gov/lessons/index.htm
Recovery-oriented Tool-kit – Tool-kit on policies, administrative rules, strategic plans, practice guidelines, vision statements, workforce competencies, training outlines, surveys, protocols, and literature review
Educating State Legislators on Recovery-Oriented Systems –Developing website, fact sheet, three web-assisted audioconferences, presenting at Health Chairs Meeting and drafting issue brief
Resources on the PFR website –Recovery-oriented resources will continue to be posted on the PFR website at www.pfr.samhsa.gov.Federal Recovery-Oriented Activities (cont’d)
SHIN 1-800-729-6686 for publication ordering or information on funding opportunities
800-487-4889 – TDD line / www.samhsa.gov
Questions & Comments Program –