Building Bridges in the Substance Use Disorders Continuum of Care

1. Building Bridges in the Substance Use Disorders Continuum of Care A Networking Opportunity to Enhance Collaboration Among Prevention, Treatment & Recovery May 14, 2014

2. Objectives • Raise awareness for the value of collaboration within the RROSC partners • Identify strategies to collaborate in a way that benefits our purpose of helping the individuals and communities we serve, build common language and expand networking for the full circle of care

3. Agenda • Welcome • Resiliency & Recovery Oriented Systems of Care • Prevention & Treatment Systems Overview • “Day in the Life…” Presentations • Small Group Activities • Lunch • Group Activity (continued) • Closing

4. Optimizing Resources in a Changing Healthcare Landscape Joseph P. Harding Director, NH Bureau of Drug & Alcohol Services jpharding@dhhs.state.nh.us

5. Optimizing Resources in a Changing Healthcare Landscape DHHS is determining how to best leverage existing resources to meet service quality objectives within the context of a dramatically changing healthcare landscape and continuing unprecedented fiscal challenges • Affordable Care Act • New Hampshire Health Protection Program (HPP) • Medicaid Care Management • DHHS Redesign

6. Guiding Principles • Whole person, individual/family centered • Optimize the utilization of resources • Maximize quality of products and services • DHHS moving to better integration/coordination of internal organizational resources • Promote effective approaches among external systems including better coordination, collaboration, and integration of community services

7. Fiscal StrategySaving Lives / Saving Dollars New Hampshire Needs a Comprehensive Approach to Addressing the Misuse of Alcohol & Drugs • Effective Interdiction Efforts (as put forth by the NH Criminal Justice Community) • A Comprehensive Public Health Approach, including: • Environmental Strategies – targeting the general population • Prevention Services - targeting at risk groups • Early Intervention Strategies – targeting individuals misusing • Treatment services – targeting individuals addicted • Recovery support services – supporting long-term recovery

12. Current Capacity

13. What Part of a Comprehensive Approach Does NH HPP Support? NH HPP will provide resources to support: • Early Intervention • Screening, Brief Intervention, Referral to Treatment • Treatment Services • Withdrawal management • Medication Assisted Treatment • Full range of SUD treatment service • Recovery Support Services • Limited cost effective approach to managing a chronic health condition

14. What Parts of a Comprehensive Approach are NOT Covered by NH HPP? • Environmental Strategies • Targeting the general population • Prevention Services • Targeting at risk groups • Recovery support services • Supporting long-term recovery

15. Resources Needed to Support a Comprehensive Approach • Support the Regional Public Health Networks in facilitating the development of a comprehensive approach at the regional/community level (environmental strategies, early intervention, treatment & recovery supports) • Provide resources for community-based prevention services • All GC funding for prevention services had been eliminated in SFY-2012 • Have since added resources for Partnership for Success Initiative (Federal grant) and Life of an Athlete (Governor’s Commission) • DHHS and partners Implementing the NH HPP • Support infrastructure development at Community Health Centers and other primary care settings for critical services, including: • SBIRT(screening, brief intervention, referral to treatment) • MAT (Medication assisted treatment) • Provide infrastructure support for expanding service capacity across the specialty substance use disorder treatment system • Expand training/technical assistance for workforce development

16. Resiliency & Recovery Oriented System of CareA Vision for New Hampshire Lindy Sue Keller, MS, MLADC Resources and Development Administrator lskeller@dhhs.state.nh.us

17. Resiliency & Recovery Oriented System of Care RROSC • Framework for organizing and coordinating multiple strategies, services, supports and systems, to deliver person-centeredservicesand community-directed approaches that promote personal and community health and wellness.

18. Recovery Supports Treatment Person Community RROSC Intervention Prevention

19. Resiliency & Recovery Oriented Systems of Care • Are person-centered and community-driven • Engage a diverse array of stakeholders • Expand the community’s ability to be proactive in prevention and responsive to its members who are in or seeking recovery • Offer a comprehensive array of strategies and services that can be combined and adjusted to enhance community wellness and meet individuals’ chosen paths of recovery

20. New Hampshire Prevention System Valerie T. Morgan, BS, CPS Administrator Prevention Services Valerie.morgan@dhhs.state.nh.us

21. OverviewResources & Prevention Scope

22. BDAS The NH Bureau of Drug and Alcohol Services (BDAS) is the state’s leader in many efforts and manages several federal grants: • The Federal Substance Abuse Prevention and Treatment Block Grant • Prevention, early intervention, treatment and recovery support services • Partnership for Success • State Epidemiological Outcomes Workgroup (SEOW) -NH’s System for Substance Abuse Prevention Efforts and Services Brochure 2013

23. Public & Private Partnership New Hampshire Charitable Foundation • In 2012, the foundation approved an ambitious, 10-year strategy dedicated to the prevention of substance use disorders. • Approximately $1.2 million dollars per year will be allocated from the portfolio in furtherance of this strategy - Prevention.

24. Prevention Part of a Continuum

26. Regional Public Health NetworksSubstance Misuse Prevention (SMP) • BDAS and Division of Public Heath Services 2014 combined contracts • SMP Leadership Teams – advise substance misuse prevention • One Full Time Equivalent Coordinator • Professional credentialing: Certified Prevention Specialist • Three-Year Strategic Plans & One-Year Work Plans • Align with State 5 year plan: Collective Action-Collective Impact

27. 5 Year Plan – Priorities & Populations • Priority Problem Areas • Alcohol misuse • Marijuana use • Prescription drug misuse • Priority Populations • Youth • Young adults • Pregnant and parenting women • Military personnel and their families • Justice involved youth and young adults • Individuals needing but not receiving treatment • Individuals with co-occurring disorders

28. SAMHSA Evidenced-Based Planning Model

29. 6 Sector Model • Health & Medical • Business • Safety & Law Enforcement • Government • Education • Communities & Families

30. Public Health Advisory Council PHAC role is to advise the Regional Public Health Network: • Identifying regional public health priorities based on assessments of community health • Guiding the implementation of programs, practices and policies that are evidence-based to meet improved health outcomes • Advancing the coordination of services among partners

32. New Hampshire Treatment System Jaime E. Powers, MS Administrator Clinical Services Jaime.powers@dhhs.state.nh.us

34. Contracted Substance Abuse Treatment Services • 17 contracted treatment providers • Block Grant, Governor’s Commission, General Funds • 5 Levels of Care • Outpatient • Intensive Outpatient • Short-Term Residential • Transitional Living • Long-Term Residential for Pregnant & Parenting Women

35. Priority Populations • Pregnant & Parenting Women • Injection Drug Users • Criminal Justice Involved Individuals • Veterans & Other Military Members • Individuals with Co-Occurring Disorders

36. Eligibility Requirements • Substance Use Disorder • Financial Eligibility • Sliding fee scale • Medicaid, NH Health Protection Plan, Other Coverage • Level of Care

37. Opiate Treatment Programs • Oversight of clinical services • CARF/SAMHSA, DEA, and Board of Pharmacy • 3 Agencies • Community Substance Abuse Centers • Habit OPCO • Metro • 8 locations • Concord • Hudson • Keene • Manchester (2) • Newington • Somersworth • West Lebanon

38. NH Health Protection Program Targeted to begin July 1, 2014 • Substance Use Disorders services being phased in • Outpatient, Intensive Outpatient, and Partial Hospitalization • Clinically Managed Residential • Medically Monitored Withdrawal Management, Opioid Treatment Programs, and Office Based Medication Assisted Treatment • SBIRT & Screening • Recovery Support Services & Case Management • Crisis Management

39. Recovery System • Critical part of building a Resiliency and Recovery Oriented System of Care • Existing formal network is limited • Working to identify and support existing organizations and encourage network development

40. “A Day in the Life…”

41. Small Group Activity In what ways can you collaborate with others in your region(s) to enhance the work you currently do to further impact the individuals and communities you serve? Within your region(s) how can you engage the recovery community and nurture partner relationships? Q1 Q2

43. Large Group Report Out Share • 1 idea for how you will collaborate with others in your region(s) • 1 way you are going to engage the recovery community and partnerships in your region(s).

44. THANK YOU