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Co-occurring

Co-occurring. 70% of all Howard Center adult outpatient clients in FY17 and 67% in FY18 had both MH & SUD diagnosis Understanding and treating the interplay of disorders is crucial to best outcomes and is considered best approach (SAMHSA)

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Co-occurring

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  1. Co-occurring • 70% of all Howard Center adult outpatient clients in FY17 and 67% in FY18 had both MH & SUD diagnosis • Understanding and treating the interplay of disorders is crucial to best outcomes and is considered best approach (SAMHSA) • Clients are able to have treatment needs met with one provider versus multiple providers • Lower costs for integrated treatment

  2. Successes • Co-occurring focus has remained a priority and is standard operation at HC adult outpatient • HC is both the Preferred Provider and Designated Agency in Chittenden County • 60% of current OP staff are dually licensed • Co-occurring approach very much embedded in our values and culture • Multiple groups/treatment options tailored to co-occurring approach • Evidence-Based screening, assessment, diagnosis and treatment for both SUD and MH • Innovative programs developed to best serve client (SASH pilot, Reach-Up program, treatment courts) • Close partnerships and collaborations in Franklin Grand Isle where we are not the DA • Children and adult outpatient programs at HC recently integrated to bring more SUD focus/expertise to family work

  3. Challenges • MH services and SUD services are managed by different departments each with different regulatory, compliance, reporting, auditing and outcomes measures • Two distinct funding streams - different billing and administrative rules • ADAP not currently at the table for payment reform with DMH/DVHA • In many regions the designated agency and preferred provider are different entities – only able to draw down one funding stream • Staff compensation and staff retention • Varying and distinct licensure requirements • Training opportunities/CEU’S that satisfy only one license or approach • 42 CFR poses challenges to partnerships amongst agencies and other providers • Co-occurring treatment with children, elders and families is not as developed • Limited residential/intensive co-occurring programs • Challenges with engagement due to transportation, child care, etc. • Limited access to psychiatry

  4. Opportunities • Continue to better align regulatory requirements and outcome measures for MH and SUD treatment • Single clinical license with “specialty” sub license (s) • Co-occurring trainings and CEU development to satisfy multiple license requirements • Increased college coursework dedicated to co-occurring focus • Find a way to include SUD treatment in payment reform with MH • Increased emphasis/shift towards integrating child/family with adult treatment using co-occurring approach. • Improved or increased local partnerships amongst agencies/providers • Shared understanding of confidentiality/universal release template • Improved compensation with incentives for obtaining multiple licenses • Increased/improved community presence or integration into primary care, corrections, family/child care centers, schools, etc.

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