John R. Kasich, Governor Orman Hall , Director

1. John R. Kasich, Governor Orman Hall, Director

2. Introduction • Project Goal • Project Elements • Project Activities and Achievements PFR/ATTC NETWORK ALI PROJECT

3. ALI Project Goal The ALI Objective Develop increasingly more advanced leadership knowledge, skills and abilities among graduates from the PFR/ATTC Network Leadership Institutes in order to advance systems improvement.

4. Project Elements • The PFR/ATTC Network Advanced Leadership Institute (ALI) provides an opportunity for participants to gain graduate-level knowledge and skills in key leadership topics while completing innovative team projects designed to effect systems change at the local, state and national levels.Two cohorts of ALI “associates” participated in the program simultaneously between January 2011 and November 2011.  Participants in each cohort were involved in an extensive set of development experiences.

5. The Core Elements of the Advanced Leadership Institute Experience are: • Leadership Capacity Assessment • Leadership Instruction - through an intensive Immersion Training and Booster Session • Coaching and Advising • Personally-Relevant Professional Support Network • Structured Knowledge and Skill Application, along with Reflection • Personal Health, Revitalization and Self-Care • Systems Building -through development of relevant application team projects supported by a team coach • Resource Support • Recognition and Affirmation for Service and Success

6. PFR/ATTC NETWORK ALI PROJECT TEAMS Kansas City DC Rules of Engagement: Addressing the Needs of Service Members, Veterans and Their Families Medication-Assisted Treatment in the World of Health Care Reform: Short and Long Term Solutions SBIRT Toolkit: A Resource Tool for Behavioral Health Providers to begin Conversation with Federally Qualified Healthcare Centers Aligning and Building the Workforce • Integration with Primary and Behavioral Health Care • Recovery Oriented Systems of Care (ROSC) Framework the Criminal Justice System: A Case for Transformation • Real Hope for Adolescent Recovery • Addressing Trauma • Reduction of Health Disparities in Rural Settings Related to SUDs and Co-Occurring Disorders Link: www.ATTCnetwork.org/ALI

7. Today’s Highlighted Projects • Integration with Primary and Behavioral Health Care (KC- Team 1) • The Role of Medication-Assisted Therapy in the World of Health Care Reform: Short and Long Term Solutions (DC – Team 2) • Recovery Oriented Systems of Care (ROSC) Framework the Criminal Justice System: A Case for Transformation (KC – Team 2)

8. ALI Project Team MembersKC Team 1 • Integration with Primary and • Behavioral Health Care • Karen Mooney - Colorado Department of Human Services • Kim Brown - State of Kansas, Addiction and Prevention Services • Diane Bynum - Western Arkansas Counseling & Guidance Center • Kurt Snyder - Heartview Foundation, Bismarck, ND • Coach: Lynn Madden - APT Foundation, New Haven, CT

9. Project Description: Integration with Primary and Behavioral Health Care • The PFR/ATTC Network ALI team chose the following areas of focus: • Counselor access to the Prescription Drug Monitoring Database • Work with Federally Qualified Health Centers with focus on Screening, Brief Intervention and Referral to Treatment (SBIRT) and Access to Recovery (ATR) • Service integration across systems for pregnant women with substance use disorders (SUDs)

10. Project Activities & Achievements Outcomes Next Steps… One common funding stream with universal rules to cover both primary and behavioral health case services Replication of North Dakota’s PDMP program, in which SUD counselors have access for clinical purposes • SBIRT as rallying point to partner with FQHCs to integrate primary and behavioral health care • PDMP data base as a catalyst for integration between SUD treatment and PC • Integration is the outcome of implementation of SBIRT and counselor access to the PDMP

11. ALI Project Team Members DC Team 2: Medication-Assisted Treatment in the World of Health Care Reform: Short and Long Term Solutions • Kristina Monti-Beth Israel Medical Center • Kami Anderson Armstrong-Indiana Drug and Alcohol Commission • Coach: Angel Gonzelez, MD,

12. Project Description: The Role of Medication Assisted Treatment in the World of Health Care Reform This team project would focus on two areas: • Reduction of the stigma attached to the medications used to treat and maintain persons in recovery from SUDs; and • Acceptance of and incorporation of these medications and psychotropic medications used in the treatment of co-occurring disorders.

13. Project Description: The Role of Medication Assisted Treatment in the World of Health Care Reform Possible areas to be addressed: • How the other systems view the use of SUD medications; • How SUD providers view medications; • How SUD providers incorporate mental health medications; • How the physical health care world uses and incorporates both SUD and mental health medications;and • How educational and promotional messages are used to overcome stigma associated with MAT.

14. Project Activities & Achievements • Tool Kit • Policies and Procedures • Job Descriptions • Sample Forms • Recommendations/Solutions • Revision of Medical School Curriculum and Establishment of Residencies

15. ALI Project Team Members KC Team 2: Recovery Oriented Systems of Care (ROSC) Framework and the Criminal Justice System: A Case for Transformation • Teri Gardner - Ohio Department of Alcohol & Drug Addiction Services, Columbus, OH • Tadd Whallon - Adagio Counseling and Intervention, Indianapolis, IN • Alex Gonzalez - Valley Mental Health, Tooele, UT • Coach: Ray Martinez - Mi Casa Residential Services (Maap.Inc.), Elk Grove, CA

16. Project Description - Recovery Oriented Systems of Care (ROSC) Framework and the Criminal Justice System: A Case for Transformation As part of the PFR/ATTC Network ALI Team's project, the current substance use disorders treatment system was compared with a Recovery Oriented System of Care (ROSC). The team discusses implementation activities, project achievements, evaluation, follow-up and next steps in their presentation.

17. Project Activities & Achievements What are the Implications for Transformation? • Manage the growth of the prison population and reduce spending on corrections • Improve the cost-effectiveness of existing criminal justice system resources • Reinvest in strategies that can increase public safety • Grow towards a Public Health approach of a Recovery Oriented System of Care and Wellness for the CJ client, their families and communities • Partner Together: Utilize an approach for transformation; additive, selective or transformational • Imagine

18. Project Activities & Achievements What will we do differently? Recommend to start by addressing the following concerns: • Denial – Already doing recovery-focused treatment • Recovery management is a “new” name for work that has been going on for years • Projection of Blame – we can’t do any of this Recovery Management because no one will pay for it • Fiscal & regulatory barriers • Integrated care in a categorically segregated service world • Technology deficits • Stigma/Hope

19. Resources: • SheedyC. K., and Whitter M., Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know From the Research? HHS Publication No. (SMA) 09-4439. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2009. • Achara, I., Thriving in an Era of Change: Developing Recovery-Oriented Systems of Care, Achara Consulting, Inc. Great Lakes ATTC Webinar Series, September 29, 2011.

20. Web Site Resources: • www.ATTCnetwork.org/ALI • www.samhsa.gov • http://partnersforrecovery.samhsa.gov/ • http://www.attcnetwork.org/index.asp Tell me, I will forget Show me, I may remember Involve me, I will understand. -Chinese Proverb

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