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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 through recovery.

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 one-year period.

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.

National recognition

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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