Transcript The Consumer`s Role in Whole Systems Change

The Consumer’s Role in
Whole Systems Change
Linda J. Frazier, RN, CHES, MA
Treatment Manager
Maine Office of Substance Abuse, DHHS
Addiction is a Chronic, Treatable
Medical Condition
Drug Dependence, A Chronic Medical
Illness: Implications for Treatment,
Insurance, and Outcomes Evaluation by
A. Thomas McLellan et al. JAMA,
October 4, 2000, Volume 284, No. 13.
Asthma, Hypertension, Diabetes,
Heart Disease, Addiction & SUD
 Addiction/SUD clients compliance with
treatment is equal to or better than other
chronic conditions
 Continuum of severity and LOC
 Compliance with tx plan key focus
 Assess early, monitor, intervene at
appropriate level
The Consumer is Central
 Five Key Principles: Evidence-based
predictors of change - #1 Understand
and involve the customer
 Compliance Literature – Study by Todd
M & David Gustafson including literature
review – *Note to self - Todd, Citation Help Please!
 Across Standards for Treatment Plan –
HealthCare, SA/MH, Clients
Compliance Factors*
 Social Cognitive - Client attitudes/beliefs,
perceived risk of health decline, perceived
control
 Regimen Effect – role in tx plan, results,
complexity of following plan, side effects
 Provider Communication - engagement
 Contextual Factors – SES, $, Insurance, copay amount
 Past use history – serum levels, monitoring,
refill records
Don’t Sell Them What You
Have…
Sell Them What They Need
Billboard, Heathrow Airport
October 2008
MAT Key Activities
 Partnership & Shared Aims
 Surveys, Chart Audit, Focus Groups –
Provider Staff & Consumers
 Implementation of Non Discrimination
Language in July 2007 Contracts
 Implementation of Pay for Performance
Contracts July 2007
 Changes to TDS Data System July 2007 –
Added questions on EBP, MAT, GPRA data
fields
$$$$$$$
 Stipends for Participation in the RWJ Advancing
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Recovery Initiative – Coaching, Learning Session
Participation
State General Funds for MAT
Medicaid Reimbursement for Suboxone without Prior
Authorization for Addiction Treatment
Co-sponsorship & Support for Development of ROSC
& CHOW Program
Education & Training
Incentives for Access and Retention Measures
OP/IOP
RIDER E: PROGRAM REQUIREMENTS
(SUBSTANCE ABUSE SERVICES)
NON-DISCRIMINATION
13. Providers receiving grant funds from OSA
will not discriminate against clients who are
using legitimate medications to assist their
recovery and will not have policies that allow
them to refuse admission to treatment or to
discharge clients from treatment based on the
use of legitimate addiction medications.
Shared NIATx Aims
Reduce Waiting Times
Reduce No-Shows
Increase Admissions
Increase Continuation Rates
Successful Whole Systems
Change Will Require
 Trust & Respect
 Identified Common & Shared AIMS AND
Mutual Accountability & Transparency
 Common Shared Language – Between
professional fields and the recovery
community
 Cultural Competency
 Positive Role Models, Access to
Coaching/Recovery Support