Recovery Engagement The Solution is in the Community
Who We Are Multi-state provider of community-based mental health & addictions services, 1800 staff, 75,000 clients served annually Developer of personal health record-enabled “care units” – helping patients with addictions, cancer, mental illness and other diseases track treatment plan progress, outcomes, and engage with care providers. Analytics & health IT technology, research to prevent & cure mental illness, program evaluation
The Problem or why Change to ROSC Unmet Need for Services Funding Challenges Traditional Care does not match Client needs.
What is ROSC? • ROSC = Recovery Oriented System of Care (ROSC) • A cost-effective, community-based, whole-health approach to addictions treatment • Focus on increasing “Recovery Capital” in addition to meeting “treatment need” • Focus on “Targeted Treatment” • Uses Recovery Coaches, Peer Support Specialists, Recovery Engagement Centers, other treatment providers, volunteers, and other community resources in an organized and focused way to meet the need of each individual
Recovery Capital Personal Recovery Capital • Physical Capital = health, shelter, food, transportation, etc. • Human Capital = values, knowledge, credentials, education, problem solving, self-awareness, self-esteem, self-efficacy (ability to manage self in high risk situations) hopefulness/optimism, purpose/meaning in life, interpersonal skills Family/Social Recovery Capital • Family Capital = Recovery supportive intimate relationships, family and family of choice relationships, and social relationships • Community capital = Access resources in the community to support recovery and community engagement Cultural Recovery Capital • Cultural Capital = local availability of culturally-prescribed pathways of recovery that resonate with particular individuals and families
Community Engagement The Centerstone Recovery Engagement Center (REC) is a low-barrier point of entry into the recovery Community and involves Recovery Coaches, Peer Mentors, Peer Specialists and volunteers. 20% Support Service 8% Employment 7% Housing 20% Support Groups 20% Recovery Coaching 4% Service Inquiries 35% Informal Support Bloomington, Indiana REC While the REC, in its former life, was an inpatient facility that saw under 100 consumers a year, as the hub of the ROSC, it now serves 4200 walk-in consumers per year. Services requested by consumers are: This is a hub of recovery that is not based in a facility but is instead a part of the community. The ability to partner and leverage other community resources and supports allows us to provide comprehensive services and address the diverse needs and interests of clients.
Barriers to Expanding ROSC • Geographic and transportation barriersto accessing the REC. • Some clients lack the resources to make it to a physical location consistently. • Some clients need basic support in domains of scheduling and follow-up. • Some clients are reluctant to seek help. Virtual Engagement is the next step in increasing community connections, encouraging engagement, and offering a diversity of supports.
eROSC SAMHSA-2011 CSAT Health IT grant Purpose of eROSC: • Encourage client engagement • Increase community connections • Offer a diversity of supports • Improve outcomes
eROSC: Meeting Stakeholder Needs People with Addictions: • ROSC helps people with addiction challenges achieve change through abstinence and improved health, wellness, and quality of life. Healthcare Providers: • ROSC Improves operational efficiency, • eROSC’s PHR component helps providers meet Meaningful Use Stage 2 requirements • ROSC supports new payment models. Payers: • ROSC reduces costs • ROSC has better long-term outcomes. Communities: • Easy-to-Access, coordinated care for people with addictions • Creates strong community partnerships • Promotes volunteerism & community service
The 3 Domains of v-Recover.com (cont.) e-ROSC Recovery Center (Private Site) My Personal Health Record (Participant controlled) Medications Conditions Allergies Immunizations Apt Notes Procedures Notifications Providers Procedures Observations Emergency info Tools • Recovery Plan • Weekly Update • Secure Message Center • Personal Calendar • Recovery Capital Scale
Recovery Engagement Center Recovery Tools are those materials that are used by the Client and the Recovery Coach to plan, organize and direct Recovery Supports.
Recovery Engagement Center My Personal Health Record is a client owned method of tracing, maintaining and coordinating health information.
Measurement Outcomes of TMAC • Risk and ProtectiveScores can be tracked over time and visually represented on the Client’s secured E-ROSC page.
E-ROSC Evaluation Plan: Key Implementation Questions • Who is referred to E-ROSC? • Are clients satisfied with E-ROSC? • To what extent do the case managers and clients use the Recovery Plan as a tool? • Tracking use of Recovery Plan and correlation with indicators and outcomes • Does E-ROSC increase access to community supports and resources, and facilitate transition in service utilization patterns? • Services tracking system—collaboration between evaluators and recovery coaches • What are the patterns of use of the private and public www.v-recover.com sites?
V-Recover.com Utilization Data (June 1-August 30, 2012) • Top Referral Traffic Sources: • Facebook • Centerstone.org • Twitter • Top visiting states and cities (2,103 U.S.-originated visits): • Nashville, Tennessee (n=916) • Indiana (n=448; Bloomington, Indianapolis, Columbus, Bedford, Connersville, Richmond) • Michigan (n=295; Ann Arbor, Saginaw, Novi)
What’s next? • Vocational Rehabilitation for recent release (Note 1) • Integrated behavioral/physical health • Depression/Anxiety • Chronic pain • ??? _______________ Note 1: Presently funded under DOL grant Note 2: This Substance Abuse e-ROSC program is available as a package, supported by Centerstone, National Council and White Pine Systems.
Conclusion • E-ROSC is the logical response to the economic, regulatory and technological world today. • E-ROSC contributes to sustainability of Behavioral Health delivery models. • E-ROSC allows us to penetrate markets we have been unable to access previously • E-ROSC will improve outcomes and lower cost, giving value to everyone.