The South Dakota ROSC Model & SAMHSA’s Strategic Initiatives: An Interesting Combination ?

1. The South Dakota ROSC Model & SAMHSA’s Strategic Initiatives: An Interesting Combination ? Presented by: Kevin Kirby and Charlie Day Face It! Co-Founders & Board Members November 2010 TM

2. Preview: The Case We Will Make for a National Model for Grass-Roots Application Sioux Falls – creating a ROSC that: • Draws upon conventional wisdom and historical experience • Aligns With SAMHSA’s Strategic Initiatives • Extends the reach of and builds sustainability into the conventional ROSC model by: • Delivering value propositions to the private sector • Employers can solve this problem • Health care reform is working in favor of chronic disease management

3. Preview: The Case We Will Make for a National Model for Grass-Roots Application (continued) The Sioux Falls ROSC extends the reach of and builds sustainability into the conventional ROSC model by: • Motivating EVERY sector of the community to be part of the solution • Eliminating stigma with “the mother of all” awareness programs

4. Steps SAMHSA Can Consider to Further a Grass-Roots Model(think about during the presentation) • Support strategic efforts through state agencies to stimulate adoption of the model in likely communities • Support strategic efforts to help “Public Sector” models embrace elements of the “Grass-Roots” model (especially the “Workplace Initiative”) • Fund efforts to accelerate development & proliferation of the “Awareness Program” (to draw folks into treatment & recovery and the ROSC models) • Support efforts to create “Specialty Carve-Outs” made up of a spectrum of local providers to treat the chronic nature of the disease

5. Thumbnail Sketch of Sioux Falls MSA • MSA has +/- 240,000 residents (state pop. is +/- 820,000), +/- 88% Caucasian, +/- 4.6% unemployment rate • Largest employers: government, health care and financial services (mostly white collar labor force) • Strong sense of community & involved employers • Roughly 19,000 chemically dependent adults, 75%-80% of whom go to work and 75%-80% of whom are unlikely to get help

6. Centrally Located, Fast Growing Community

7. The Mission of Face It! To dramatically increase both the number of individuals and families in recovery and the quality and accessibility of services by creating a recovery-oriented system of care. www.faceitsiouxfalls.org

8. Genesis & Evolution of Face It! • “Co-founders” were Kevin Kirby & Charlie Day --Two lawyers with finance background (one is in recovery) • “Stimulators” were CCAR, national thought leaders & SD Division of Alcohol & Drug Abuse (Gib Sudbeck) • “Creators” were community representatives who participated in 7 “town hall” meetings

9. Genesis & Evolution of Face It!(cont’d) • “Creators” challenged to envision what a ROSC would look like in Sioux Falls in 5 years --Adamant that employers be part of the solution • Face It! created in February 2009 to implement the vision --Overall timeframe from planning to launch was 14 months --“Strategic” process was privately funded (+/- $ 350,000)

10. Genesis & Evolution of Face It! (cont’d) • Feb 2009: Board nominated by community (most not in recovery) to reflect vision from town hall meetings • April 2009: §501(c)(3) status obtained • June 2009: Long-term strategy, business plan and budget (+/- $ 400,000 when fully operational) approved • July-Sept 2009: ED & 1 FTE hired • Oct 2009: Open highly visible RCO office space • Sept-Oct 2010: 2 more FTE’s & new ED (board chair retired as VP HR of a large bank to become ED)

11. Genesis & Evolution of Face It!(cont’d) What Face It! Does: • Recovery Support Services (bring relevant CCAR programs to Sioux Falls…telephone recovery support is the first…and other responsive programs) --Capturing volume related data --Workplace Initiative (more in a moment) • “Advocacy” -- stimulate “build out” of the “care side” of the ROSC --Led by our region’s leading mental health provider • “Awareness” -- develop & implement “mother of all awareness programs” to draw folks into the ROSC • Commitment to financial & volunteer development

12. Genesis & Evolution of Face It! (cont’d) The Operational Funding Model (during start-up & when operationally mature) Lends Itself To A Strategic Orientation: 1. Employer support (ongoing) 2. United Way/Economic Development 3. Private donations (board has development committee & is executing a plan) 4. Grants (one of the reasons we are collecting volume data and accumulating outcome measures with the University of Sioux Falls)

13. Face It!’s Workplace Initiative Employer Group’s Mission Statement: Believing that addiction is a chronic illness and that companies can be a part of creating a recovery oriented community in Sioux Falls, our companies join forces to use the winning elements of our wellness programs and services for the employees to open new doors and remove barriers to recovery. Employer Group’s Vision Statement: Our companies and community are united in the acceptance of and support for the journey of recovery from addiction; that services are accessible to all and the face of recovery is celebrated.

14. Face It!’s Workplace Initiative (cont’d) Our Employers are Investing In Recovery Because It Makes Good Business Sense & Because They Believe In The Community: • Research suggests a significant return on investment • Retained, skilled & healthy workforce are key to enterprise success, community welfare, quality of life and economic growth • Anything that impedes an employee’s ability to contribute is a barrier and a cost

15. Face It!’s Workplace Initiative (cont’d) Employer Goals • Begin with a small group of committed employers with employee wellness/chronic disease management programs. • Provide a template of activities and proven ROI data to incent future employers to participate. • Share common belief that chemical dependency is a chronic disease and challenge ourselves to review our programs within that context. • Use the winning elements of current worksite wellness & disease management programs to incorporate understanding, education, acceptance and support for employees & their families on their journey of recovery from addiction.

16. Face It!’s Workplace Initiative(cont’d) Employer Goals (cont’d) • Develop template of activities for a wellness/chronic disease management program that other business enterprises could use as a design model based on their respective desires, resources and labor force make up. • Provide worksite education to promote awareness of the recovery benefits for employees and their families. • Develop a top-down approach to acceptance and support for employees with addictions. • Train enterprise leadership and employees on the prevalence of addiction as well as the need and options for recovery.

17. Face It!’s Workplace Initiative(cont’d) What Has Happened: • Organized in March 2009 after proposal by Face It! • 20 businesses committed to the initiative (more since) • HR & executive leadership from each company fully engaged • Monthly meetings with exceptional HR attendance • Multiple educational experiences from meeting with AA, EAP’s, providers, tours of detox, treatment facilities and much more • Wellness coaches trained and engaged in the model • Two health plans fully engaged in the model • Local university conducted baseline survey of employees

18. Face It!’s Workplace Initiative(cont’d) What Has Happened (cont’d): • Mandatory employee awareness sessions in the workplace • Face It! provides speakers relevant to the setting & other information • Recovering person’s story (from the extensive Face It! Speaker’s Bureau) • Employer resources and messaging of support • Handout materials • Engagement of our healthcare providers to begin collecting and integrating claims data • Development of employee peer support processes within the companies • Employees and families contacting Face It! for assistance

19. Face It!’s Workplace Initiative(cont’d) Partner Experience: Home Federal Bank • A self-insured community bank with operations in 3 states • Contact Mary Hitzemann (leader of the Workplace Initiative, former Home Federal VP HR & now Face It! Executive Director) for a “ground zero” explanation of what has happened

20. Face It!’s Workplace Initiative(cont’d) How Sioux Falls Employers Will Measure Success • Changes in claims experience (work closely with insurer) • Expect increases initially as those in need receive care • Examine trends in co-morbidity diagnosis/claims • Compare per member per year trend data with employers who do not manage chemical dependency as we do • Results of the repeat surveys by Univ. of Sioux Falls (research partner)

21. Face It!’s Workplace Initiative(cont’d) How Sioux Falls Employers Will Measure Success (cont’d) • USF identifying other possible trends in the community that have changed • Growth of the peer-to-peer support in workplace • Dialogue in management meetings • Eventually will collect data on absenteeism, etc.

22. The Workplace & Healthcare Reform: A Wonderful Strategic Opportunity for ROSCs & RCOs • Healthcare Reform has linked substance use disorder & mental health with chronic disease initiatives • Mental Health Parity & Healthcare Reform are pushing employers to have healthier employees & to incent employees to be healthier • The bottom line is Healthcare Reform is taking the ROSC movement from the “right thing to do” to a necessity

23. The Workplace & Healthcare Reform: A Wonderful Strategic Opportunity For ROSCs & RCOs (cont’d) The Strategic Opportunity: RCOs can help employers add chemical dependency support to workplace chronic disease management programs & thereby extend the “community of support” into the workplace.

24. The Workplace & Healthcare Reform: A Wonderful Strategic Opportunity For ROSCs & RCOs (cont’d) The Ideal Environment: • An existing ROSC • Employers with a commitment to wellness, chronic disease management and retaining employees • An “integrated healthcare delivery system” (a model where physicians, clinics, hospitals & a health plan are under 1 roof) • A community with a tradition of problem-solving

25. The University of Sioux Falls: Face It!’s Academic Partner • Participants are the schools of business administration and social work • Role with the Workplace Initiative • Use scientific baseline surveys to measure attitudes & awareness as well as change over time • Over time: measure change & drill down into data • Role In Validating Efforts of the ROSC to the Community • Similar efforts planned in conjunction with (for example) providers, health plans and local gov’t • Regarding the Awareness Program • Leverage data developed

26. The Awareness Program(think Susan G. Komen caliber dealing with SUD) • System transformation alone will not solve the problem. Stigma must be eliminated. • A culture of recovery must be one in which we understand and treat SUD the same as we do any other chronic disease. • Goal is to reach those (+/- 75%) who suffer from the disease and are unlikely to ever get help and draw them into the local RCO/ROSC model • Employs “best of class” research and creative talent to design and deliver messaging to attack the barriers of shame and stigma • We intend to license to RCOs anywhere • Local RCOs could adapt to their particular needs consistent with the qualitative standards of the license

27. The Awareness Program(cont’d) Research Phase: Theme Development • 4 Qualitative Focus Groups • 2 Qualitative Focus Groups/ 2 Triad Groups • 500 Sample Benchmark Survey • 6 Qualitative Focus Groups • 400 Sample Benchmark Survey • 4 to 6 weeks to complete (process has begun) • Survey work to follow first wave of ads to test efficacy

28. The Awareness Program(cont’d) Creative Messaging & Media Phase • Focusing on Telling “the story of self” • Community Relations Program • Workplace Activities • TV, Radio & Newspaper Ads • Internet Advertising • Social Media Organizing • Special Events

29. The Awareness Program (cont’d) • Key to the Awareness Program is sustainability at the local level • Research phase will not disappear because it supports continuing evolution of creative phase • Greater sustainability if RCOs find natural partners in their communities to “own” and fund the Awareness Program • Think of those associated at the community level with events like “Race For The Cure,” etc.

30. The Advocacy Initiative • Goal is to unify the clinical & non-clinical provider resources into system of care that reflects the chronic nature of the disease • Initiative being led by Face It! board member, Avera Behavioral Health & Avera Health System • From the perspective of a payor/insurance company, the model will resemble a “specialty carve out” • Avera Behavioral Health expects to be accountable for the “quality” of the model • Should further the goals of Health Care Reform • ALL sectors to be a part of the solution

31. “Newco – a bold, world-class, innovative supplement to the good work that precedes it • Independent (not part of Face It!), 501(c)(3) organization • National board of directors • Applying proven tools from social movements, political campaigns, grass-roots mobilizations, social networking and chronic disease management • 3 areas of emphasis • Proliferation of the South Dakota model to Affiliate Communities • Licensure of its Awareness Program • Repository of evidence-based practices for Affiliates

32. Newco Funding Model • Start-up funding from private local and national donations • Recover costs for helping local RCOs/ ROSCs with strategic initiatives relating to exploring and/or implementing the South Dakota model • No charge expected for licensing “Awareness Program” to RCOs • On-going private donations (large & small) • National corporate partner support expected based on proliferation of awareness campaign and outcomes data from Newco “affiliates”

33. The South Dakota Model & SAMHSA’s Strategic Initiatives SAMHSA’s Mission • To reduce the impact of substance abuse & mental illness on America’s communities SAMHSA’s Strategic Initiatives • Prevention of Substance Abuse & Mental Illness • Trauma & Justice • Military Families

34. The South Dakota Model & SAMHSA’s Strategic Initiatives (cont’d) • Health Care Reform • Housing & Homeless • Health Information Technology, Electronic Health Records & Behavioral Health • Data, Outcomes & Quality: Demonstrating Results • Public Awareness & Support

35. Summary Thoughts on theSouth Dakota Model • It extends the “community of support” into the workplace for purposes of mission and financial sustainability • It promotes the goals of Health Care Reform • It is intended to be private-sector funded • It is “data driven” – both to demonstrate ROI to a broad range of “investors” and to identify and proliferate best practices in the field • Has an evidence-based, world-class awareness program intended to draw those unlikely to ever get help into the local ROSC/RCO model • Drives the provider community to be knitted into a network • Newco is available to help communities, RCOs & ROSCs study the model

36. Face It! & Newco Contact Information Face It! or Newco • Kevin Kirby • Ph: 605-929-6115 or kevin.kirby@mac.com • Charlie Day • Ph: 605-366-0211 or charlestday@att.net Face It! (www.faceitsiouxfalls.org) • Mary Hitzemann (Executive Director) • Ph: 605-274-7852 or mary@faceitsiouxfalls.org