florida alcohol drug abuse association mary booker joan helms niatx conference june 2013
TRANSCRIPT
Florida Alcohol Drug Abuse AssociationMary Booker
Joan Helms
NIATx ConferenceJune 2013
Learn to engage and identify stakeholders Identify tools and benchmark process Develop and expand collaboratives Initiate and grow peer mentor networks Present outcomes to stakeholders Integrate and replicate outcomes
Current Budget Substance Abuse: $215,672,421 Mental Health: $760,060,545
Sources of Funding Substance Abuse
State: 40% Federal: 60% Mental Health (including State MH Facilities)
State: 81% Federal: 19%
Operational Structure Central Office: Guides State System of Care, Monitors progress Regional Offices (6): Manage regional systems of
care
Percent Funds in Contracted Services Mental Health:
Civil Facilities – 1 of 3 privatizedForensic Facilities – 2 of 4 privatizedSVPP – privatized
Substance Abuse: privatized
Managing Entities (Includes SA and Community MH) Current contracts: 7
FADAA, incorporated in 1981, is a non-profit membership association representing over 100 of Florida’s premiere community-based substance abuse and co-occurring treatment and prevention agencies, managing entities, community anti-drug coalitions and approximately 3,500 individual members.
Throughout its history, FADAA has been involved in leading industry change to better serve consumers and communities and has been at the forefront in creating responsive systems and tools to facilitate the transfer of evidence-based practices to the field and to initiate and expand continuous quality improvement activities.
FADAA is perceived as the “lead voice” by national, state and local policy makers, providers and the recovery community on substance abuse policy and related practice improvement.
The State and FADAA aggressively pursued grants to build the capacity for system improvements while removing regulatory and administrative barriers to client access to service:
• Robert Wood Johnson – Resources for Recovery
• Strengthening Treatment Access and Retention - State Implementation
• Robert Wood Johnson – Advancing Recovery
• Partnership for Quality Performance State Contract
In 2005, FADAA and DCF collaborated to establish new state Medicaid codes for substance abuse services and legislative authorization for a local match program to maximize reimbursement for substance abuse services.
In 2006, FADAA, DCF and 6 (initial) substance abuse provider agencies received a 3-year STAR-SI grant to improve client access and retention.
Reduce average time between an individual’s first contact for OP treatment and an initial screening/assessment by 25%.
Reduce average time between initial screening/assessment and delivery of first OP treatment service by 25%.
Increase the number of persons who complete detoxification and then enter OP treatment by 50%.
By the end of the 3-year project, the team included:
21 individual provider agenciesTwo managing entitiesStaff from the State Substance Abuse Mental Health Program Offices and the Florida Alcohol & Drug Abuse Association (FADAA)
Other accomplishments:
Implemented more than 50 improvement projectsProvided staff training in the use of change teams and rapid cycle process improvements30+ participants have been trained throughout Florida as Change Team LeadersEstablished 19 Peer Mentors and 5 Coaches within Florida
Year 1 Year 2 Year 3 Year 4 FIS
DACCO ACTS Bayview Mental Health
Bridgeway Center for Drug Free Living
Lakeview Family Resource Center
Centre for Women DATA CDAC
Manatee Glens Gateway Coastal EPIC Clay County
Meridian Jackson North River Region Lifestream DISC Village
Stewart Marchman
Lifestream Sutton Place River Region Gateway
The Village The Harbor Tri-County Human Services
Human Services Associates
The Village Meridian
River Region
Tri-County
Cadre of Peer Mentors (NIATx trained)
NIATx Process Improvement Training & Coaching
Florida Learning System Established
System of Care - Client Access & Retention Improved
NIATx Training for Family Intervention Specialists
Two year funding - $180,000 per year
Three providers (Operation PAR, Spectrum-Miami Behavioral Healthcare, River Region Human Services)
Focus on the use of medication (Nalotrexone), case management and support services for improved client outcomes
The State and its partners agreed to implement the evidenced based practice of providing Vivitrol to patients with alcohol addictions.
Vivitrol is only administered in conjunction with psychosocial interventions
Partner agencies:◦ Identified and implemented client screening and selection
criteria◦ Developed a medication protocol;◦ Provided educational training regarding Vivitrol to over 130
staff;◦ Initially provided Vivitrol to 10 clients;◦ Tracked client progression.
The State reviewed and selected evidenced based practice to enhance case management services to substance abuse clients.
Partners reported experiencing the following barriers to implementing the program:◦ Obtaining the medication◦ Prohibitive costs◦ Getting Vivitrol on the Medicaid formulary
Partners reported that staff were fully supportive of the program due to the information received from the medication representatives and staff comfort with administering medication in conjunction with counseling.
NATIONAL INITIATIVESSAMSHA Paths to
RecoveryRWJ/NIATx
FADAA
RWJ Resources to Recovery, Advancing Recovery, STAR-SI
Florida Learning System
Florida DCFCollaborative Partners
Provided guidance on the progress of the grant as appropriate
Monitored data collection and reporting
Assisted with the revision of regulations and policies that impede service delivery and process improvements
Supported the peer learning network
Disseminated project results
Florida Learning SystemFlorida Learning System
NIATx SAAS SAMHSA The National Council for Behavioral Health Florida Department of Children & Families Florida National Guard Florida Certification Board Florida State University
Local Level PartnersLocal Level Partners SA, MH and Prevention Providers Managing Entities Community Anti-Drug Coalitions
Partnership for Quality Performance State Contractual Work Plan
State and National Level Partners
Provider Commitment
Pros Cons
Fluid, flexible – meets on the ground technical service needs
Like a contract
Easy to make changes
No formal contract amendment required
Amount of detail
Tracking
Monitoring partners
Organizational system changes
Data system refinements
Improve client engagement and retention
Increase use of evidence-based practices and assessment
Contract linkages
NIATx resources
Buy-in Trust building Elimination of turf issues Time-consuming Resistance Communication History with individuals, organizations Risk taking Sharing information
Research based grants Transformation Creativity Flexibility Acknowledgement & recognition of what
issues partner’s are dealing with Group dynamics Drawing on talent of providers
Three Key Roles:
Use their experience and expertise during site visits, telephone and online technical assistance to the providers
Identify promising process improvement strategies, tools, and products to be disseminated through the repository
Continue to participate in and expand the peer learning network
Provide Technical Assistance◦ Provider Sites◦ State
Tiered approach with increasing levels of expertise
Knowledge Experience Strengths
Standardize approach
Develop network – on-line data base
Adjust State’s data
Create financial incentives
Use evidence-based practices
Use uniform, evidence-based assessment
Address regulatory and policy barriers
Implement system performance management/CQI
Sustaining successes
Implementing rapid change cycles in interagency matters
Diffusing lessons learned and new processes across provider sites
State/Districts◦ Integrate successful changes
DCF SAMHPO District Office
◦ Provide leadership for Florida Learning System
FADAA/Providers◦ Active participant in Florida Learning System◦ Integrate changes in provider infrastructure
Managing Entities ◦ Integrate changes into Association and agency
infrastructure
Core competencies (PI, Peer Mentors)
Define role of managing entities
o Dissemination of education
o Replicating projects
o Mentoring
Integrated QI approach within and across managing entities
Engage networks Increase participation of provider agencies Recruit and train additional peer mentors Increase staff competencies in
performance improvement Participation by all provider networks Capacity to implement process
improvements at state and local areas Systems integration
Tremendous talent and leadership exists at the provider level.
Improvements are demonstrated quickly at the provider level.
State level change is slower - but not impossible.
State budget and procurement practices can be difficult but leveraging resources are critical.
National partners are essential (e.g., NIATx).
Mary Booker, Assistant [email protected], ext. 115
Joan Helms, Director of Research & Practice [email protected], ext. 107
NIATx Conference PowerPoint Presentationhttp://www.fadaa.org/documents/NIATx_Conf.ppt