Cross System Planning & Action Reaps Statewide Benefits

1. Cross System Planning & Action Reaps Statewide Benefits

2. Welcome and Introductions The Session Goal is to Showcase: • collaborative efforts… • the power of partnerships… • and the community spirit at work!

3. Getting Started • Acknowledgement that substance misuse and abuse is not only a problem but an epidemic in WV • That the epidemic is gaining momentum fast and requires rapid and impactful action and intervention • Understanding and analyzing current available data • Identifying key partners and potential collaborations • Designing a strategy for comprehensively assessing prevalence, gaps and need across the SA continuum statewide • Assembly of an internal experienced and knowledgeable Team and recruitment of other experts needed to guide and implement the planning process

4. Reorganization and Integration • Reorganization and integration of the former Offices of Behavioral Health Services (OBHS) and Health Facilities (OHF) • Emphasizing function rather than disability and improving planning and collaboration between facility and community-based services • Established the Office of Consumer Affairs and Community Outreach to promote increased consumer and family involvement in behavioral health service planning and delivery

5. Making Data Informed Decisions • WV State Epidemiological Outcomes Work Group-22 State Agencies/ Organizations • WV Behavioral Health Profiles 2011, 2012 • Regional & Community Profiles • Program Snapshots • State-Wide Multi-Domain Youth Survey • Work Force Capacity Assessment • Comprehensive Needs Assessment & Planning Process (Community Voice) • State, Regional, Key Leaders • Regional Data & Planning Teams

6. Process of Discovery • Assessment of WV Behavioral Health Services Continuum • SA, MH & IDD----Federal/External Technical Assistance • State Agency Partners and Provider/Associations and Key Leaders • Regional forums • Regional focus groups with key informants • Qualitative and Quantitative data informed Needs/Gaps identification • State Level Planning • Goals/Strategies Development • Implementation Responsibility

7. Common Priorities

8. Executive Leadership • Executive Order 5-11 signed by Governor Tomblin on September 6, 2011 • Created six Regional Taskforces • Created the Governor’s Substance Abuse Advisory Council (GACSA) • Called for action to implement the Statewide Substance Abuse Strategic Action Plan • Appointed DHHR to coordinate and facilitate requirements set forth in the E.O.

9. Leadership and Substance Abuse Plan Implementation • GACSA • RTF’s • Partnerships

10. Executive Charge -GACSA • To provide guidance regarding implementation of the approved Statewide Substance Abuse Strategic Action Plan for the improvement of the statewide substance abuse continuum of care • Identify Recommend priorities for the improvement of the substance abuse continuum of care Receive input from local communities throughout West Virginia Provide recommendations to the Governor regarding improvements to: • Enhancing substance abuse education • Enhancing opportunities to collect and utilize data including data sharing • Policy and legislative action

11. Executive Charge RTF’s Purpose as set forth is to provide the Advisory Council with recommendations • for additional support for substance abuse services, programs, realignment or additional funding strategies, • advocate for legislative action; • and recommend initiatives to support the overarching goals in SA Plan Action Plan

12. Regional Task Force Meetings

13. ReceivingSupport from All Levels

14. SA Strategic Plan Updates Prevention is critical at all levels from children to high school and college youth • Provided $1.8 M to 6 Regional Prevention Grantees to build effective coalitions and support prevention services in 55 Counties to provide evidence based programs and practices to decrease Prescription Drug Abuse, Drug Exposed Pregnancies and other regionally identified problems. • Partnered with SAMHSA and CADCA to provide match funding for 3 VETCORPS positions working in coordination with prevention organizations to provide outreach to Service Members, Veterans and Families in Region 2, 5 & 6. • Interstate Prescription Drug Alliance-OH, TN, KY

15. SA Plan Updates… Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a critical service and must be reimbursed by Medicaid and insurance payers • Expanded Screening, Brief Intervention and Referral to Treatment (SBIRT) services to over 55 active sites serving 96,762 individuals during 2011 and 2012 (Regional Jails, Education, Hospitals) • Partner and provide funding to support WV Teen and Juvenile Drug Courts (EI Model)

16. SA Plan Updates $7.5M New State funding to support infrastructure and substance abuse services development statewide • Public Inebriate AFA • Out-Patient AFA Adolescent • Intensive Out-Patient • Detox/Crisis Stabilization AFA NEW • Short Term Residential • Long Term Residential • Non-Treatment Recovery Homes/Facilities AFA • Peer /Recovery Supports AFA

17. SA Plan Updates… Focus on recovery, such as recovery coaches, drop-in recovery centers, a non-treatment youth recovery home • Provide funding to support 9 non-treatment recovery homes,11 Oxford Houses and 1 Recovery Facility • Participated in National Peer Support Specialist Training preparing for Statewide implementation of Peer Support Specialists/Recovery Coaches • Entered into a 3-year public/private partnership with the Bureau for Maternal Child and Family Health, WV Community Voices (WV Perinatal Partnership) and Benedum Foundation to support OBGYN practices/hospitals in providing early intervention and recovery supports to pregnant women to decrease the number of drug exposed babies

18. SA Plan Updates… Focus on Workforce training and certification specific to addictions and recovery training and certification specific to addictions and recovery • Provided Conference Support for the WV Council on Suicide Prevention, WV Association of Alcohol and Drug Abuse Counselors, WV SADD Conference: School and Community Based Youth Initiative, Expanded School Based Mental Health and WV Families Conference • Developed 20 awareness and educational presentations for professionals and communities training organizations/agencies

19. SA Plan Updates… Education and training in all health professions are essential to stopping the supply and demand problems with substance abuse in West Virginia • Provided “Physician Engagement in SA Initiatives” training in all regions • Partnering with physicians and associations to offer Statewide Physicians Conference September 2013 • Partnered and provided funding for North Western Regional Health Education Center to provide substance abuse training for Medical Residents and Youth Stipends

20. SA Plan Updates… Improvements to the Statewide Prescription Monitoring Program, such as inclusion of methadone clinics and Veterans Administration (VA) hospitals in the program • SB437 • SAMHSA Grant-EHR Connected to PDMP • Opioid Treatment Centers (Rule)

21. SB437-Education & Regulation • Decreases prescription reporting time in the Controlled Substances Database from 7 days to 24 hours • Establishes an advisory council to recommend enhancements to the prescription database and advise on the feasibility of real-time reporting • Creates a review committee to flag irregular prescribing patterns by physicians and abnormal usage by patients • Codifies new licensing regulations to protect legitimate pain clinics and make sure those with real chronic pain can find treatment

22. SB437-Education & Regulation • Requires penalties for operating a chronic pain clinic without a license • Tightens requirements for dispensing controlled substances from doctor offices • Requires “best practice” prescribing education for health care professionals as well as education in anti-drug diversion • Tightens reporting requirements for methadone treatment centers and requires random, monthly drug test for patients • Defines the existence of a valid practitioner-patient relationship prior to dispensation of prescriptions • Implements a real-time, stop-sale tracking system for pseudoephedrine purchases to block the sale of excess product when attempted

23. Seeing the Successes • 60 Regional Substance Abuse Taskforce meetings held (10 in all 6 regions) with more than 3000 people in attendance • Regional recommendations from all Taskforces to the GACSA to the Governor regarding system needs and recommended improvements (Policy & Program)

24. GACSA Recommendations • Prevention is critical at all levels from children to high school and college youth • Education and training in all health professions are essential to stopping the supply and demand problems with substance abuse in West Virginia • Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a critical service and must be reimbursed by Medicaid and insurance payers • Focus on recovery and community supports

25. Successes • Governors Comprehensive Substance Abuse Bill initiated and passed (SB 437) • Required Health Education & Regulation • Other Legislation: Workforce and Drug Testing • $7.5M New State funding to support infrastructure and substance abuse services development statewide • GACSA recommendations for allocation of funding prepared for Governor’s consideration (SBIRT, Treatment, Recovery Coaches) • Significant grassroots efforts completed by Taskforce members statewide • Renewed hope that a difference is being made

26. Partner Accomplishments • Public /Private Partnership between State Agencies, WV Perinatal Partnership and Benedum Foundation (3-Year Moms and Babies Recovery Project) • State Police-FDA/Synar/Distracted Driving • Physician /Education Engagement • Coordination of School and Community Based Prevention Services (Public Health, BBHHF, Education) • Single State Multi-Domain School Survey • SBIRT Expansion in Schools, Hospitals & Regional Jails • Recovery to Work • WVPH & WV Restore • Peer/Recovery Support Initiatives

27. What We Have Learned • System-wide assessment involving multiple partners is key – take your time and be patient • Establishing and sustaining relationships with partners statewide is critical • Top down – bottom up approach is central to WV’s success • Data informed decision making must guide process • Funding is one part of success – grassroots efforts and collaborations are impactful and cost effective • Be flexible and develop strategies that are flexible • Track successes so that all levels must SEE THEMSELVES in the successes • Keep the end always in focus – peoples lives depend on it

29. Questions? Kathy Paxton, Director WV Division on Alcoholism and Drug Abuse Kathy.L.Paxton@wv.gov