DHS News April 2014
DHS Bureau of Drug
and Alcohol implements “Recovery Oriented System of Care”
The Department of Human Services, under the guidance of Latika
Davis-Jones, Administrator of the Bureau of Drug and Alcohol Services, is
working to transform the way people with substance use disorders progress
Davis-Jones heads a leadership team that is planning
implementation of a recovery framework that ensures clients receive the support
they need throughout their journey to find a successful, lasting end to
addiction and mental health problems.
For the past two years, Latika and DHS staff in the Office
of Behavioral Health (OBH), along with representatives of Community Care
Behavioral Health, Allegheny Health Choices Inc. and providers, has been moving
forward the Recovery Oriented Systems of Care (ROSC) approach.
In presentations, Latika and Michael Gruber, OBH Systems
Transformation Specialist, explain the ROSC “framework.” Based in part on a system used by
Philadelphia and in Connecticut, ROSC embraces a chronic disease model of
treatment that pulls together drug and alcohol and behavioral health systems
into one system designed to be seamless in its support for the patient. This
method recognizes the current trend for a more holistic approach to
administering behavioral health services.
“Traditionally, people trying to overcome addiction and/or
mental health problems have been treated in systems that primarily operate
independently. There is not always a ‘warm handoff’ between, for example, a
rehabilitation treatment program and the next level of care, which could be
outpatient counseling,” Latika said.
While integrating recovery support, ROSC also develops peer
leadership; promotes community health, wellness and recovery capital;
facilitates cross-system partnerships; and aligns administrative structures.
It uses a single point of accountability; certified peer
specialists; wellness coaching and such in-community supports as housing,
mobile medication and drop-in centers.
Statistics presented by the ROSC workgroup show that the
current system, which treats episodes of substance use disorder, has a low retention
rate. Only half of all people who enter intensive treatment remain in it after
28 days and by 90 days, only 23.6 percent of cases are continuing care. Relapse
rates are greater than 50 percent, and follow-ups are conducted for a maximum
of 27 percent of cases.
“Treating a chronic
health condition in an acute care model doesn’t work well,” said Latika, who
holds a doctorate in social work and teaches at the University of Pittsburgh.
Stats from Philadelphia show a 36 percent decrease in crisis
utilization for people in a ROSC-framed system and a decrease in costs for
inpatient psychiatric services of close to a half a million dollars in a
Connecticut’s figures are even more dramatic. They include a
46 percent decrease in the number of people served statewide; a 62 percent
decrease in acute care treatment; and a 40 percent increase in outpatient care.
In the coming months, Latika and others will be talking more
to those involved in both substance use disorder and mental health treatment to
make them understand the urgency behind the need to switch to ROSC. Modifications to language, practices,
regulatory environment and policy and procedures will be required as well as
building community support.
Invitations have been sent to 22 people, asking them to
serve on a Recovery Advisory Committee to further assist with developing the
vision and mission for the ROSC transformation process in Allegheny County.
Stakeholders, providers, representatives of the criminal justice and, consumers,
advocates are among those who will be on the committee.
“We believe they will be the sounding board, the champions
of this work,” Latika said. “We are
going to raise the bar.”
For more information on ROSC, contact Latika at 412-350-3857
or via e-mail.
The Department of Human Services Recovery Oriented Systems
of Care workgroup has been asked by the Office of National Drug Control Policy
to be part of its learning community to share its experiences in planning and
implementing the treatment framework.
The Allegheny County group is the only group in Pennsylvania invited to
participated, said Latika Davis-Jones, Administrator of the DHS Bureau of
Alcohol and Drug Services.
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