Addressing Substance Abuse in the Child Welfare Population: Lessons Learned in Vermont

Size: px
Start display at page:

Download "Addressing Substance Abuse in the Child Welfare Population: Lessons Learned in Vermont"

Transcription

1 Agency of Human Services Alcohol and Drug Abuse Programs Blueprint for Health Addressing Substance Abuse in the Child Welfare Population: Lessons Learned in Vermont Tri-Branch Institute on Child Social and Emotional Well-Being July 1, 2014 Barbara Cimaglio Deputy Commissioner

2 Agency of Human Services A Perfect Storm Increasing Rates of Opioid Dependence Inadequate Network Capacity High Health Care Expenditures Poor Patient (Client) Outcomes Program & Funding Silos

3 The number of people treated in Vermont for opioids has increased since ,000 5,000 Number of people treated in Vermont by substance Alcohol Marijuana/Hashish Heroin/Other Opioids All Others 4,000 3,000 2,000 1,000 0 Source: Alcohol and Drug Abuse Treatment Programs 3

4 Agency of Human Services Tale of Two Programs Opioid Treatment Programs OTP Office Based Opioid Treatment OBOT Dispense Methadone Highly Regulated Specialized Programs Comprehensive Addictions Treatment Federally Established Protocols (daily dosing, take homes, assessment) ADAP Funding, Weekly Bundled Rate Prescribe Buprenorphine Physician with X-DEA License Patient caseload 30 First Year & 100 w/waiver after 1 yr Office Based Practices Primary care, Ob-GYN, Pediatric, Psychiatry DVHA Funding, Fee-For -Service

5 Care Alliance for Opioid Addiction Treatment Center Service Regions 5

6 The Care Alliance for Opioid Addiction A regional approach for delivering Medication Assisted Therapy to Vermonters who suffer from opioid drug addiction. The Care Alliance is designed to coordinate addiction treatment with medical care and counseling, supported by community health teams and services, to effectively treat the whole person as they make their way along the path to recovery. Medication Assisted Therapy (MAT) is an effective treatment for opioid addiction that involves prescribing medication methadone or buprenorphine in combination with counseling. 6

7 Agency of Human Services Hubs: Care for People with Complex Addictions and Co-occurring MH/SA Conditions 5 Regional Specialty Centers Providing: Methadone treatment Buprenorphine treatment for more complex patients Consultation for practices providing office- based opiate therapy Health Home Services and Coordinate Access to Health and Human Services Meet NCQA Patient-Centered Specialist Standards, Learning Collaborative

8 Agency of Human Services Spokes: Team Based Care for Office-Based Practice Physician, CHT RN + Clinician ~150 MD s in Diverse Practice Settings Prescribe Buprenorphine and provide Treatment Services Provide Treatment and Health Home Services Coordinate access to Health and Human Services Participate in regional learning collaboratives Alcohol and Drug Abuse Programs Blueprint for Health Practice setting specific care (Primary Care, Ob-Gyn, Pediatric, Psychiatry, Pain)

9 Agency of Human Services 6 Core Health Home Services Alcohol and Drug Abuse Programs Blueprint for Health Comprehensive Care Management Care Coordination Health Promotion Comprehensive Transitions of Care Individual and Family Support Services Referral to Community and Social Support Services

10 Department of Vermont Health Access Hub & Spoke Health Home for Opioid Addiction Care As Usual 5 Regional Centers Addictions Treatment Methadone OTP 125 Physicians Prescribing Buprenorphine OBOT Health Home ~ 6 FTE RN, MA / 400 Pts - OTP & OBOT - Methadone & Buprenorphine - 2 FTE RN, MA / 100 Pts - OBOT - Buprenorphine Comprehensive Care Management - Care Coordination - Health Promotion - Transitions of Care - Individual and Family Support - Referral to Community & Social Supports Advanced Primary Care Practices and Community Health Teams HUB SPOKES

11 STATEWIDE Substance Abuse Treatment Coordination Workgroup Screening policy for all Agency of Human Services programs Training for all direct service staff Community mapping of services Standardized referral mechanism Tracking outcomes Standardized definitions for case management 11

12 Staff for Family Services Division Specialized staff to focus on parents with SA issues Linkage to specialty care providers Case supervision 12

13 Community Model: ChARM (Children and Recovering Mothers) Team A Comprehensive Care Model for Opioid- Dependent Pregnant and Postpartum Mothers and their Babies in Vermont Key Elements of Success: Right Agencies and Right People MOU and Consent to Release Information and commitment to encourage participation Identify indicators Willingness to change practices 13

14 What is ChARM? ChARM is an inter-disciplinary and cross-agency team which meets monthly to coordinate care for pregnant and postpartum mothers with a history of opiate dependence, and their babies. The goal of ChARM is to improve the health and safety outcomes of babies born to women with a history of opiate dependence by coordinating medical care, substance abuse treatment, and social service supports 14

15 How Does ChARM Work? Multi-Agency Health Care Substance Abuse Treatment Public Health Child Welfare Community-based human services org. s Meets monthly Share relevant client/patient health, treatment, and social support needs; develop follow-up plan as needed 15

16 How Does ChARM Work? Empanelled as a multi-disciplinary child protection team under VSA Title (provision of VT child welfare statutes). Provides for sharing of information among team members for the specific purpose of case coordination to identify and treat suspected child abuse/neglect. Agreed on guidelines for reporting abuse/neglect concerns from meetings to VT DCF as mandated reporters 16

17 Growing Pains Issues and Conflicts: Who attends monthly meeting How much information can be shared No guiding documents for interagency process Role of child welfare agency and team members reporting suspected child abuse/neglect 2003: VT ADAP Women s Treatment Coordinator contracted with KidSafe Collaborative to facilitate; merged community-based Women at Risk group with interagency hospital-based meeting. 17

18 Key Issues Issues and Conflicts: Continued concern about sharing information protected by 42CFR and HIPAA VT Child Protection Team empanelment focuses on child; does not include pregnancy Agreed on need for release of information form for participants, to include all team members. Started work to develop Memorandum of Understanding between participating team member agencies in

19 Moving Forward Hospital dedicated OB and Neomed resources KidSafe s facilitation of team funded by ADAP Name changed to ChARM MOU established with all parties to allow for information sharing to coordinate care (2006). Includes: Patient Consent to Release Information VT DCF as a partner 19

20 Agreed Upon Sharing at Team Meetings Treatment: Methadone or buprenorphine, (dose); consistency of treatment; provider; problems Attendance at prenatal appointments, Neomed appointments Participation in substance abuse counseling Relevant medical and mental health information Child welfare involvement and status General psychosocial information and barriers to successful treatment/care: transportation, housing, family/household members using 20

21 Team Work! At each monthly meeting the team reviews a list of current cases, and prioritizes cases for discussion: All new pregnant patients All pregnant patients due in upcoming month Prioritized high risk prenatal patients All new babies / post-partum patients Prioritized high risk post-partum patients and their babies 21

22 Keys to Success Establishing a Connection Alleviation of fear: Our Care Notebook You are not alone Provide information; be clear Introductions to others on the team Respect Listen actively; reserve judgment Tell me about yourself - ask them for their stories: What are your dreams / goals Allow the story to change Recognize strengths and accomplishments 22

23 Follow Up CHARM Team: Continued case review/coordination to 12 months, based on team members prioritization: patient issues concerns, e.g. relapse, repeated no- show for appointments, parenting/child safety concerns, substance abuse treatment issues, incarceration, etc. Neonatal follow up clinic: Developmental screening 8-10 months Follow to months 23

24 Vermont Children s Hospital: Outpatient Methadone Treatment 78/476 = 16.4%

25 Key Elements of Patient Success Start prenatal care early in pregnancy Pregnant women receive pharmacological treatment for opiate dependence Engaged in substance abuse counseling Attend prenatal care appointments Attend Neomed Clinic appointments Family and social supports 25

26 Key Elements of Patient Success Partner: stable, safe, in treatment or no substance abuse Post-partum treatment plan Nurse home-visitor services Housing stability Other supports, e.g. WIC Breastfeeding - attachment Earlier assessment of potential ability to provide safe care of infant 26

27 Vermont s ChARM Successes Decreased gestational age of initial prenatal appointment and of start of opiate agonist therapy. Increased birth weight of infants. ( , Dr. Meyer) Residential services for moms and babies: expanded substance abuse inpatient and outpatient gender-specific, trauma informed tx. Connection with DOC; treatment for incarcerated pregnant women Linkages to community-based services Implementation of statewide Hub and Spoke model for MAT, with comprehensive access to services 27

28 Continuing Challenges Pt. access to MAT after delivery Transportation Lack of transportation; rural Transportation to MAT providers: long distances Medicaid transportation rules for children Housing Expansion of services statewide: improves access for patients but presents new challenges for information-sharing and care coordination Electronic case information-sharing 28

29 What Makes It All Work? LEADERSHIP AT ALL LEVELS Shared philosophy COMMUNICATION Memorandum of understanding clear roles Regular meetings standard tools Work on system issues together 29

30 It Takes A Village. Thanks to Sally Borden, KidSafe Collaborative Fletcher Allen Health Center Department of Children and Families Substance Abuse Treatment Providers THANK YOU!! 30

Increasing Access to Opioid Addiction Treatment

Increasing Access to Opioid Addiction Treatment Report to The Vermont Legislature Increasing Access to Opioid Addiction Treatment In Accordance with Act 75, 2013, Section 14b An Act Relating to Strengthening Vermont s Response to Opioid Addiction and

More information

Vermont s Experience A Systematic Approach to Health Care Integration Barbara Cimaglio, Deputy Commissioner. NASADAD 2015 Annual Meeting

Vermont s Experience A Systematic Approach to Health Care Integration Barbara Cimaglio, Deputy Commissioner. NASADAD 2015 Annual Meeting Vermont s Experience A Systematic Approach to Health Care Integration Barbara Cimaglio, Deputy Commissioner NASADAD 2015 Annual Meeting Background Goal of Health Care Reform Triple Aim: Better Population

More information

Vermont s Approach Treating the Opiate Epidemic Barbara Cimaglio Deputy Commissioner, Vermont Department of Health

Vermont s Approach Treating the Opiate Epidemic Barbara Cimaglio Deputy Commissioner, Vermont Department of Health Vermont s Approach Treating the Opiate Epidemic Barbara Cimaglio Deputy Commissioner, Vermont Department of Health State Experiences with Health Care Reform Grand America Hotel Salt Lake City, Utah October

More information

HOPE Helping Opiate- Addicted Pregnant women Evolve

HOPE Helping Opiate- Addicted Pregnant women Evolve HOPE Helping Opiate- Addicted Pregnant women Evolve Medical Director: Michael P. Marcotte, MD TriHealth-Good Samaritan Hospital Cincinnati Ohio MHAS MOMs Grant 2014-2016 Ohio MHAS MOMs Grant 2014-2016

More information

Summary: There are four major initiatives underway that address integration of substance abuse care with physical and mental health.

Summary: There are four major initiatives underway that address integration of substance abuse care with physical and mental health. Summary: Section E.306.2(b)(1) requires the Secretary of Administration and the Chief of Health Care Reform to submit a report on current and additional strategies to achieve a more comprehensive health

More information

Opioid Use in Pregnancy: A Community s Approach, The Children and Recovering Mothers (CHARM) Collaborative

Opioid Use in Pregnancy: A Community s Approach, The Children and Recovering Mothers (CHARM) Collaborative Opioid Use in Pregnancy: A Community s Approach, The Children and Recovering Mothers (CHARM) Collaborative Nancy K. Young, PhD Sally Borden, MEd Karen Shea, MSW Agenda Overview of the Issue Medication

More information

Alcohol and Drug Abuse Program Division Overview

Alcohol and Drug Abuse Program Division Overview Alcohol and Drug Abuse Program Division Overview Presented to House Human Services Committee Barbara Cimaglio, Deputy Commissioner, Alcohol and Drug Abuse Programs January 9, 2015 ADAP Organizational Chart

More information

Opioid Addiction Treatment Programs

Opioid Addiction Treatment Programs Report to The Vermont Legislature Opioid Addiction Treatment Programs In Accordance with Act 75, 2013, Section 15a Submitted to: Submitted by: Prepared by: House Committees on Human Services, Health and

More information

John R. Kasich, Governor Orman Hall, Director

John R. Kasich, Governor Orman Hall, Director John R. Kasich, Governor Orman Hall, Director 2 3 Epidemics of unintentional drug overdoses in Ohio, 1979-2011 1,2,3 1800 1600 1400 1200 1000 800 Prescription drugs are causing a larger overdose epidemic

More information

Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas

Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas Presentation to Senate Health and Human Services Committee: Prescription Drug Abuse in Texas David Lakey, MD Commissioner, Department of State Health Services Lauren Lacefield Lewis Assistant Commissioner,

More information

Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report

Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report Report to The Vermont Legislature Substance Abuse Treatment Services Objectives and Performance Measures Progress: First Annual Report In Accordance with Act 179 (2014) Sec. E.306.2 (a)(1) Submitted to:

More information

Subject: Health; food and drugs; treatment of opiate addiction. Statement of purpose: This bill proposes to require the department 6of health to

Subject: Health; food and drugs; treatment of opiate addiction. Statement of purpose: This bill proposes to require the department 6of health to 2012 Page 1 of 8 1 2 3 4 5 H.627 Introduced by Representative Pugh of South Burlington Referred to Committee on Date: Subject: Health; food and drugs; treatment of opiate addiction Statement of purpose:

More information

Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio

Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio Governor s Cabinet Opiate Action Team Promoting Wellness and Recovery John R. Kasich, Governor Tracy J. Plouck, Director Opiate Addiction in Ohio: An Update on Scope of Problem Ashland Ohio November 14,

More information

Subject: Health; food and drugs; treatment of opiate addiction. Statement of purpose: This bill proposes to require the department 6of health to

Subject: Health; food and drugs; treatment of opiate addiction. Statement of purpose: This bill proposes to require the department 6of health to 2012 Page 1 of 6 1 2 3 4 5 H.627 Introduced by Representative Pugh of South Burlington Referred to Committee on Date: Subject: Health; food and drugs; treatment of opiate addiction Statement of purpose:

More information

Residential Substance Abuse Treatment: Impact of Concurrent Utilization Review

Residential Substance Abuse Treatment: Impact of Concurrent Utilization Review Report to The Vermont Legislature Residential Substance Abuse Treatment: Impact of Concurrent Utilization Review In Accordance with Act 179 (2014), Section E.300.2, An Act Relating to Making Appropriations

More information

TESTIMONY. March 17, 2014. Rutland, VT

TESTIMONY. March 17, 2014. Rutland, VT Community Solutions to Breaking the Cycle of Heroin & Opioid Addiction TESTIMONY Harry Chen, MD, Commissioner of Health March 17, 2014 Senate Committee on the Judiciary Franklin Conference Center at the

More information

This module will assist participants to:

This module will assist participants to: BUPRENORPHINE TREATMENT: A Training For Multidisciplinary Addiction Professionals Module V: Coordinated Care Effective Coordination of Care Effective coordination combines the strengths of various systems

More information

The Effectiveness of Vermont s System of Opioid Addiction Treatment

The Effectiveness of Vermont s System of Opioid Addiction Treatment Report to The Vermont Legislature The Effectiveness of Vermont s System of Opioid Addiction Treatment In Accordance with Act 135 (2012), An Act Relating To the Treatment of Opioid Addiction, Section 1

More information

The Opiod Addiction Treatment System

The Opiod Addiction Treatment System Report to The Vermont Legislature The Opiod Addiction Treatment System In Accordance with Act 135 (2012, Adj.), Section 1(c) An Act Relating to an Opiod Addiction Treatment System Submitted to: Submitted

More information

Title: Opening Plenary Session Challenges and Opportunities to Impact the Opioid Dependence Crisis

Title: Opening Plenary Session Challenges and Opportunities to Impact the Opioid Dependence Crisis The American Association for the Treatment of Opioid Dependence, provider #1044, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org,

More information

Magee-Womens Hospital

Magee-Womens Hospital Magee-Womens Hospital Magee Pregnancy Recovery Program: History Pregnancy Recovery Center A Medical Home Model Approach to Strengthen Families Bawn Maguire, MSN, RN Programmatic Nurse Specialist Stephanie

More information

Substance Abuse Treatment Services Objective and Performance Measures

Substance Abuse Treatment Services Objective and Performance Measures Report to The Vermont Legislature Substance Abuse Treatment Services Objective and Performance Measures In Accordance with Act 179 (2014) Sec. E.306.2 Submitted to: Submitted by: Prepared by: Joint Fiscal

More information

Established in 1974 Non-Profit Federal Block Grant recipient Accept Medicaid, Private Insurance, and Self-Pay.

Established in 1974 Non-Profit Federal Block Grant recipient Accept Medicaid, Private Insurance, and Self-Pay. Established in 1974 Non-Profit Federal Block Grant recipient Accept Medicaid, Private Insurance, and Self-Pay. Patients are not denied treatment if they do not have the ability to pay for services Schedule

More information

ACUTE TREATMENT SERVICES (ATS) FOR SUBSTANCE USE DISORDERS LEVEL III.7

ACUTE TREATMENT SERVICES (ATS) FOR SUBSTANCE USE DISORDERS LEVEL III.7 ACUTE TREATMENT SERVICES (ATS) FOR SUBSTANCE USE DISORDERS LEVEL III.7 Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance

More information

STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP)

STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP) STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP) Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications.

More information

Web-Based Resources. Locating Treatment

Web-Based Resources. Locating Treatment Web-Based Resources Locating Treatment http://dpt2.samhsa.gov/treatment/ -- This is the Substance Abuse and Mental Health Services Administration s (SAMHSA) page for locating both public and private opiate

More information

Collaborative Care for Pregnant Women with Substance Use Disorders

Collaborative Care for Pregnant Women with Substance Use Disorders Collaborative Care for Pregnant Women with Substance Use Disorders Alane O Connor DNP Maine Dartmouth Family Medicine Residency MaineGeneral Medical Center Dartmouth Medical School Vanderbilt University

More information

Opioid/Opiate Dependent Pregnant Women

Opioid/Opiate Dependent Pregnant Women Opioid/Opiate Dependent Pregnant Women The epidemic, safety, stigma, and how to help. Presented by Lisa Ramirez MA,LCDC & Kerby Stewart MD The prescription painkiller epidemic is killing more women than

More information

Title: The Certified Medication Assisted Treatment Advocate (CMA) Training Course

Title: The Certified Medication Assisted Treatment Advocate (CMA) Training Course The American Association for the Treatment of Opioid Dependence, provider #1044, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB) www.aswb.org,

More information

From the street to the NICU. Richard Christensen, PA, CAS

From the street to the NICU. Richard Christensen, PA, CAS From the street to the NICU Richard Christensen, PA, CAS Treatment works Truths Disconnect with pregnant women seeking treatment Disconnect between community and science Medication is not a stand-alone

More information

Pregnant Women with Opioid Addiction. Velma V. Taormina MD MSE FACOG Gaston County DHHS Medical Director March 11, 2016

Pregnant Women with Opioid Addiction. Velma V. Taormina MD MSE FACOG Gaston County DHHS Medical Director March 11, 2016 Pregnant Women with Opioid Addiction Velma V. Taormina MD MSE FACOG Gaston County DHHS Medical Director March 11, 2016 The Vision 2012--Christi Bartell, MD noticed an increased number of newborns showing

More information

The Need for Medication-Assisted Treatment (MAT)

The Need for Medication-Assisted Treatment (MAT) Presenters Erin Hall MSOT Hon. Kyle B. Haskins Closed Doors or Welcome Mat? Opening the Way for Medication-Assisted Treatment in Family Drug Courts Oklahoma Specialty Court Conference Thursday September

More information

American Society of Addiction Medicine

American Society of Addiction Medicine American Society of Addiction Medicine Public Policy Statement on Office-based Opioid Agonist Treatment (OBOT) BACKGROUND Methadone maintenance treatment of opioid addiction was developed in 1965 and implemented

More information

UTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) GENERAL PROGRAM REQUIREMENTS

UTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) GENERAL PROGRAM REQUIREMENTS UTAH DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH SUBSTANCE USE DISORDER SERVICES MONITORING CHECKLIST (FY 2014) Program Name Reviewer Name Date(s) of Review GENERAL PROGRAM REQUIREMENTS 2014 Division

More information

Pregnancy Care Program to Improve Maternal and Infant Health Outcomes

Pregnancy Care Program to Improve Maternal and Infant Health Outcomes Pregnancy Care Program to Improve Maternal and Infant Health Outcomes Report to: Joint Fiscal Committee Agency of Human Services Douglas A. Racine, Secretary September 26, 2011 Introduction/Background

More information

POLICY AND PROCEDURES FOR PROVIDING NARCOTIC ADDICTION TREATMENT TO PREGNANT OPIOID DEPENDENT INMATES INCARCERATED IN THE COUNTY JAIL

POLICY AND PROCEDURES FOR PROVIDING NARCOTIC ADDICTION TREATMENT TO PREGNANT OPIOID DEPENDENT INMATES INCARCERATED IN THE COUNTY JAIL PURPOSE POLICY AND PROCEDURES FOR PROVIDING NARCOTIC ADDICTION TREATMENT TO PREGNANT OPIOID DEPENDENT INMATES INCARCERATED IN THE COUNTY JAIL To outline the procedures used in recognizing and providing

More information

National Perspectives in Medication Assisted Treatment

National Perspectives in Medication Assisted Treatment National Perspectives in Medication Assisted Treatment Addiction Medicine Asheville March 21,2014 Melinda Campopiano, MD Medical Officer Substance Abuse & Mental Health Services Administration Guten Appetit

More information

MEDICALLY MONITORED ACUTE TREATMENT SERVICES. Brief Guide for Providers

MEDICALLY MONITORED ACUTE TREATMENT SERVICES. Brief Guide for Providers MEDICALLY MONITORED ACUTE TREATMENT SERVICES Brief Guide for Providers Introduction: Pregnant women are a priority population for substance abuse treatment services. The Bureau of Substance Abuse Services

More information

Disclosure. C.R. Sullivan, MD 1. Carl R. Sullivan, M.D. Professor and Director Addictions Program csullivan@hsc.wvu.edu. The West Virginia Model

Disclosure. C.R. Sullivan, MD 1. Carl R. Sullivan, M.D. Professor and Director Addictions Program csullivan@hsc.wvu.edu. The West Virginia Model West Virginia University School of Medicine BEHAVIORAL MEDICINE & PSYCHIATRY Morgantown, WV Carl R. Sullivan, M.D. Professor and Director Addictions Program csullivan@hsc.wvu.edu Disclosure Reckitt Benckiser

More information

Licensure of Substance Abuse Treatment Programs Required Amendments

Licensure of Substance Abuse Treatment Programs Required Amendments Licensure of Substance Abuse Treatment Programs Required Amendments Public Health Council August 12, 2015 Jim Cremer, Deputy Director Erica Piedade, Director of Quality Assurance & Licensing, Overview

More information

BUPRENORPHINE TREATMENT

BUPRENORPHINE TREATMENT BUPRENORPHINE TREATMENT Curriculum Infusion Package (CIP) Based on the Work of Dr. Thomas Freese of the Pacific Southwest ATTC Drug Addiction Treatment Act of 2000 (DATA 2000) Developed by Mountain West

More information

Considerations in Medication Assisted Treatment of Opiate Dependence. Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT

Considerations in Medication Assisted Treatment of Opiate Dependence. Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT Considerations in Medication Assisted Treatment of Opiate Dependence Stephen A. Wyatt, D.O. Dept. of Psychiatry Middlesex Hospital Middletown, CT Disclosures Speaker Panels- None Grant recipient - SAMHSA

More information

IN THE GENERAL ASSEMBLY STATE OF. Ensuring Access to Medication Assisted Treatment Act

IN THE GENERAL ASSEMBLY STATE OF. Ensuring Access to Medication Assisted Treatment Act IN THE GENERAL ASSEMBLY STATE OF Ensuring Access to Medication Assisted Treatment Act 1 Be it enacted by the People of the State of Assembly:, represented in the General 1 1 1 1 Section 1. Title. This

More information

4. Program Regulations

4. Program Regulations MassHealth Substance Abuse Treatment Manual Subchapter Number and Title Table of Contents Transmittal Letter SAT-15 Page iv Date 07/01/06 4. Program Regulations 418.401: Introduction... 4-1 418.402: Definitions...

More information

Performance Standards

Performance Standards Performance Standards Co-Occurring Disorder Competency Performance Standards are intended to provide a foundation and serve as a tool to promote continuous quality improvement and progression toward best

More information

The Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office

The Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office The Federation of State Medical Boards 2013 Model Guidelines for Opioid Addiction Treatment in the Medical Office Adopted April 2013 for Consideration by State Medical Boards 2002 FSMB Model Guidelines

More information

U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health

U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health TESTIMONY of the American Medical Association before the U.S. House of Representatives Committee on Energy and Commerce Subcommittee on Health Re: Examining Legislative Proposals to Combat our Nation's

More information

Substance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates

Substance Abuse During Pregnancy: Moms on Meds. Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates Substance Abuse During Pregnancy: Moms on Meds Jennifer Anderson Maddron, M.D LeConte Womens Healthcare Associates 2010 National Survey on Drug Use and Health An estimated 4.4% of pregnant women reported

More information

130 CMR: DIVISION OF MEDICAL ASSISTANCE

130 CMR: DIVISION OF MEDICAL ASSISTANCE 130 CMR 418.000: SUBSTANCE ABUSE TREATMENT SERVICES Section 418.401: Introduction 418.402: Definitions 418.403: Eligible Recipients 418.404: Provider Eligibility 418.405: Scope of Services 418.406: Service

More information

Substance Abuse Treatment and Child Welfare

Substance Abuse Treatment and Child Welfare Substance Abuse Treatment and Child Welfare Robert Morrison, Executive Director of the National Association of State Alcohol and Drug Abuse Directors (NASADAD) NASADAD Members Every state and territory

More information

ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;03/13;06/14;07/15

ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;03/13;06/14;07/15 ST. CLAIR COUNTY COMMUNITY MENTAL HEALTH Date Issued: 07/09 Date Revised: 09/11;/13;06/14;07/15 WRITTEN BY Jim Johnson Page 1 REVISED BY AUTHORIZED BY Jessica Moeller Debra Johnson I. APPLICATION: THUMB

More information

Massachusetts Department of Public Health Guidelines for Community Standard for Maternal/Newborn Screening For Alcohol/Substance Use

Massachusetts Department of Public Health Guidelines for Community Standard for Maternal/Newborn Screening For Alcohol/Substance Use The Commonwealth of Massachusetts Executive Office of Health and Human Services Department of Public Health 250 Washington Street, Boston, MA 02108-4619 DEVAL L. PATRICK GOVERNOR TIMOTHY P. MURRAY LIEUTENANT

More information

Opioid Treatment Programs at the Baltimore City Detention Center

Opioid Treatment Programs at the Baltimore City Detention Center Opioid Treatment Programs at the Baltimore City Detention Center Greg Warren, MA, MBA Director of Substance Abuse Services Maryland Department of Public Safety and Correctional Services OTP Interventions

More information

Alcohol and Drug Abuse Treatment Centers

Alcohol and Drug Abuse Treatment Centers Division of State Operated Healthcare Facilities Alcohol and Drug Abuse Treatment Centers Jenny Wood Interim ADATC Team Leader HHS LOC Mental Health Subcommittee February 24, 2014 ADATC Locations R.J.

More information

Appendix D. Behavioral Health Partnership. Adolescent/Adult Substance Abuse Guidelines

Appendix D. Behavioral Health Partnership. Adolescent/Adult Substance Abuse Guidelines Appendix D Behavioral Health Partnership Adolescent/Adult Substance Abuse Guidelines Handbook for Providers 92 ASAM CRITERIA The CT BHP utilizes the ASAM PPC-2R criteria for rendering decisions regarding

More information

Treatment of opioid use disorders

Treatment of opioid use disorders Treatment of opioid use disorders Gerardo Gonzalez, MD Associate Professor of Psychiatry Director, Division of Addiction Psychiatry Disclosures I have no financial conflicts to disclose I will review evidence

More information

Management of Substance Use in the Pregnancy Medical Home Setting Sara McEwen, MD, MPH Executive Director, Governor s Institute

Management of Substance Use in the Pregnancy Medical Home Setting Sara McEwen, MD, MPH Executive Director, Governor s Institute Management of Substance Use in the Pregnancy Medical Home Setting Sara McEwen, MD, MPH Executive Director, Governor s Institute 1 Webinar Objectives Describe SBIRT approach to manage substance use in pregnancy

More information

STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP)

STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP) STRUCTURED OUTPATIENT ADDICTION PROGRAM (SOAP) Providers contracted for this level of care or service will be expected to comply with all requirements of these service-specific performance specifications.

More information

SENATE... No. 2142. The Commonwealth of Massachusetts. In the Year Two Thousand Fourteen

SENATE... No. 2142. The Commonwealth of Massachusetts. In the Year Two Thousand Fourteen SENATE.............. No. 2142 Tuesday, May 13, 2014 Text of the Senate Bill to increase opportunities for long-term substance abuse recovery (being the text of Senate, No. 2133, printed as amended). The

More information

AOD Women s Services - Directory of Resources Table of Contents

AOD Women s Services - Directory of Resources Table of Contents Contra Costa County Behavioral Health Division Alcohol and Other Drugs Services Administration 1220 Morello Ave, Suite 200 Martinez, CA 94553 Phone: (925) 335-3330 Fax: (925) 335-3318 http://cchealth.org/aod

More information

MEDICATION-ASSISTED DRUG TREATMENT AND CHILD WELL-BEING

MEDICATION-ASSISTED DRUG TREATMENT AND CHILD WELL-BEING MEDICATION-ASSISTED DRUG TREATMENT AND CHILD WELL-BEING Lena Lundgren, Ph.D.¹ Nancy K. Young, P.h.D.² Therese Fitzgerald, M.S.W.¹ Cat Oettinger, B.A. ¹ ¹ Center on Work and Family, Boston University ²

More information

Joel Millard, DSW, LCSW Dave Felt, LCSW

Joel Millard, DSW, LCSW Dave Felt, LCSW Joel Millard, DSW, LCSW Dave Felt, LCSW 1. Provide an overview of the effectiveness of medication assisted treatment, to include a discussion of the different types of medications and how they are used

More information

4.401 Substance Use Partial Hospitalization Program (Adults and Adolescents)

4.401 Substance Use Partial Hospitalization Program (Adults and Adolescents) 4.40 STRUCTURED DAY TREATMENT SERVICES 4.401 Substance Use Partial Hospitalization Program (Adults and Adolescents) Description of Services: Substance use partial hospitalization is a nonresidential treatment

More information

Washington State Interagency Opioid Working Plan

Washington State Interagency Opioid Working Plan Washington State Interagency Opioid Working Plan INTRODUCTION January 2016 Washington State is currently experiencing an opioid abuse and overdose crisis involving prescription opioids and heroin. Approximately

More information

Pregnancy and Addiction: A World View of the Problem, Current Treatments and Future Research

Pregnancy and Addiction: A World View of the Problem, Current Treatments and Future Research Pregnancy and Addiction: A World View of the Problem, Current Treatments and Future Research Hendree E. Jones Associate Professor, Department of Psychiatry Johns Hopkins University Outline I. World view

More information

TREATMENT MODALITIES. May, 2013

TREATMENT MODALITIES. May, 2013 TREATMENT MODALITIES May, 2013 Treatment Modalities New York State Office of Alcoholism and Substance Abuse Services (NYS OASAS) regulates the addiction treatment modalities offered in New York State.

More information

Goal Statement To administer and manage contracted services to eligible persons in need of health care services to promote health maintenance.

Goal Statement To administer and manage contracted services to eligible persons in need of health care services to promote health maintenance. HEALTH SERVICES To administer and manage contracted services to eligible persons in need of health care services to promote health maintenance. Number of medical encounters provided in the urgent care

More information

Medication Assisted Treatment

Medication Assisted Treatment Medication Assisted Treatment Tanya Hiser, MS, LPC State Opioid Treatment Authority Bureau Of Prevention, Treatment, & Recovery State of Wisconsin Elizabeth Collier, MSW, CSAC, ICS, LCSW TANF Best Practice

More information

PERINATAL SERVICES NETWORK GUIDELINES 2009 FOR NON DRUG MEDI-CAL PERINATAL PROGRAMS

PERINATAL SERVICES NETWORK GUIDELINES 2009 FOR NON DRUG MEDI-CAL PERINATAL PROGRAMS PERINATAL SERVICES NETWORK GUIDELINES 2009 FOR NON DRUG MEDI-CAL PERINATAL PROGRAMS TABLE OF CONTENTS I. PERINATAL PROGRAM REQUIREMENTS............................ 1 A. Target Population.............................................

More information

9/8/2014 EPIDEMIOLOGY PUBLIC HEALTH INTERVENTIONS FOR NEONATAL ABSTINENCE SYNDROME DISCLOSURE OBJECTIVES. No financial COI to disclose

9/8/2014 EPIDEMIOLOGY PUBLIC HEALTH INTERVENTIONS FOR NEONATAL ABSTINENCE SYNDROME DISCLOSURE OBJECTIVES. No financial COI to disclose PUBLIC HEALTH INTERVENTIONS FOR NEONATAL ABSTINENCE SYNDROME DISCLOSURE No financial COI to disclose Eric Reynolds MD MPH OBJECTIVES To discuss the epidemiology and current scope of the Neonatal Abstinence

More information

Pregnant Women and Substance Abuse:

Pregnant Women and Substance Abuse: EXECUTIVE SUMMARY Pregnant Women and Substance Abuse: Testing Approaches to A Complex Problem June 1998 Embry M. Howell Craig Thornton Nancy Heiser Ian Hill Renee Schwalberg Beth Zimmerman Ira Chasnoff

More information

Supplemental Manual for Substance Abuse Treatment Services(SATS) RULES OF PRACTICE AND PROCEDURE

Supplemental Manual for Substance Abuse Treatment Services(SATS) RULES OF PRACTICE AND PROCEDURE ARKANSAS DEPARTMENT OF HUMAN SERVICES DIVISION OF BEHAVIORAL HEALTH SERVICES OFFICE OF ALCOHOL AND DRUG ABUSE PREVENTION Supplemental Manual for Substance Abuse Treatment Services(SATS) RULES OF PRACTICE

More information

Addressing Substance Use in Pregnancy

Addressing Substance Use in Pregnancy Addressing Substance Use in Pregnancy Stefan Maxwell, MD Director, NICU, CAMC Women and Children s Hospital Chair, Drug Use in Pregnancy Committee West Virginia Perinatal Partnership July 31, 2013 WV Early

More information

VERMONT2007. Vermont Prescription Monitoring Program. Report to the Legislature on Act 205 January 15, 2008

VERMONT2007. Vermont Prescription Monitoring Program. Report to the Legislature on Act 205 January 15, 2008 VERMONT2007 Vermont Prescription Monitoring Program Report to the Legislature on Act 205 January 15, 2008 108 Cherry Street, PO Box 70 Burlington, VT 05402 1.802.863.7341 healthvermont.gov Vermont Prescription

More information

Addiction Psychiatry Fellowship Rotation Goals & Objectives

Addiction Psychiatry Fellowship Rotation Goals & Objectives Addiction Psychiatry Fellowship Rotation Goals & Objectives Table of Contents University Neuropsychiatric Institute (UNI) Training Site 2 Inpatient addiction psychiatry rotation.....2 Outpatient addiction

More information

Getting from Good to Great in Home Visiting: Systems Coordination

Getting from Good to Great in Home Visiting: Systems Coordination Getting from Good to Great in Home Visiting: Systems Coordination PEW HOME VISITING CAMPAIGN WEBINAR SERIES A series of five webinars highlighting promising practices in administering state home visiting

More information

Opioid Agonist Therapy: The Duration Dilemma Edwin A. Salsitz, MD, FASAM Mount Sinai Beth Israel, New York, NY March 10, 2015

Opioid Agonist Therapy: The Duration Dilemma Edwin A. Salsitz, MD, FASAM Mount Sinai Beth Israel, New York, NY March 10, 2015 Q: I have read 40 mg of methadone stops withdrawal, so why don t we start at 30mg and maybe later in the day add 10mg? A: Federal Regulations stipulate that 30mg is the maximum first dose in an Opioid

More information

Chapter 18 Behavioral Health Services

Chapter 18 Behavioral Health Services 18 Behavioral Health Services INTRODUCTION The State of Arizona has contracted the administration of the AHCCCS mental health and substance abuse services program to the Arizona Department of Health Services

More information

Steps To Addiction Recovery Treatment

Steps To Addiction Recovery Treatment Make the S.T.A.R.T. Steps To Addiction Recovery Treatment A Guide to Start the Conversation about Substance Use Disorder, Treatment Options, & Referral to Quality Treatment Programs in Your Local Area

More information

The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section

The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section The Heroin and Prescription Drug Abuse Prevention and Reduction Act Section by Section TITLE I: PREVENTION SUBTITLE A- PRESCRIBER EDUCATION PRACTITIONER EDUCATION This subtitle requires practitioners who

More information

Best Practices in Opioid Dependence Treatment

Best Practices in Opioid Dependence Treatment Best Practices in Opioid Dependence Treatment Anthony L. Jordan Health Center Linda Clark, MD, MS Medical Director Alana Ramos, BS Suboxone Clinic Manager Case Studies Nicole White female 27 years of age

More information

DEPT: Behavioral Health Division UNIT NO. 6300 FUND: General 0077. Budget Summary

DEPT: Behavioral Health Division UNIT NO. 6300 FUND: General 0077. Budget Summary 2 Budget Summary Category 2014 Budget 2014 Actual 2015 Budget 2016 Budget 2016/2015 Variance Expenditures 1 Personnel Costs $71,051,105 $68,846,318 $63,170,918 $61,866,902 ($1,304,016) Operation Costs

More information

Maryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012

Maryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012 Maryland Medicaid Program Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance or MA. MA is a joint

More information

OUTPATIENT SUBSTANCE USE DISORDER SERVICES FEE-FOR-SERVICE

OUTPATIENT SUBSTANCE USE DISORDER SERVICES FEE-FOR-SERVICE OUTPATIENT SUBSTANCE USE DISORDER SERVICES FEE-FOR-SERVICE Brief Coverage Statement Outpatient Substance Use Disorder (SUD) Fee-For-Service (FFS) Treatment Services are available for the treatment of substance

More information

Develop strategies to increase provider participation.

Develop strategies to increase provider participation. Critical Component: Access to Health Insurance and Medical Homes Goal 1: Comprehensive Medical Home for Mother and Child * A. Increase the percentage of mothers and children 0-5 who have access to a medical

More information

2015 OPIOID TREATMENT PROGRAM DESCRIPTIONS

2015 OPIOID TREATMENT PROGRAM DESCRIPTIONS 2015 OPIOID TREATMENT PROGRAM PROGRAM DESCRIPTIONS Contents Opioid T reatment Program Core Program Standards... 2 Court Treatment (CT)... 2 Detoxification... 2 Day Treatment... 3 Health Home (HH)... 3

More information

Chapter 3 Maternal Child Health Subchapter 4. Home Visiting Rule

Chapter 3 Maternal Child Health Subchapter 4. Home Visiting Rule Chapter 3 Maternal Child Health Subchapter 4 Home Visiting Rule 1.0 Authority This rule is adopted pursuant to Act No. 66 of the Acts of the 2013 Sess. (2013) (An act relating to home visiting standards.),

More information

Chapter 12: Substance Abusing Pregnant Women, Substance Exposed Children and Their Families

Chapter 12: Substance Abusing Pregnant Women, Substance Exposed Children and Their Families Chapter 12: Substance Abusing Pregnant Women, Substance Exposed Children and Their Families Introduction Substance abuse includes the abuse of alcohol, tobacco and other drugs. Prenatal substance abuse

More information

Flagship Priority: Mental Health and Substance Abuse

Flagship Priority: Mental Health and Substance Abuse 10 Colorado s winnable battles Flagship Priority: Mental Health and Substance Abuse ELEVATING HEALTH AND ENVIRONMENT Mental and emotional well-being is essential to shaping a state of health for Coloradans.

More information

FISCAL IMPACT STATEMENT. LS 7351 NOTE PREPARED: Feb 6, 2015 BILL NUMBER: SB 464 BILL AMENDED: Feb 5, 2015

FISCAL IMPACT STATEMENT. LS 7351 NOTE PREPARED: Feb 6, 2015 BILL NUMBER: SB 464 BILL AMENDED: Feb 5, 2015 LEGISLATIVE SERVICES AGENCY OFFICE OF FISCAL AND MANAGEMENT ANALYSIS 200 W. Washington, Suite 301 Indianapolis, IN 46204 (317) 233-0696 http://www.in.gov/legislative FISCAL IMPACT STATEMENT LS 7351 NOTE

More information

Quality Management. Substance Abuse Outpatient Care Services Service Delivery Model. Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA)

Quality Management. Substance Abuse Outpatient Care Services Service Delivery Model. Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) Quality Management Substance Abuse Outpatient Care Services Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) The creation of this public document is fully funded by a federal Ryan White

More information

FDA Presentation: Maternal Perspective on Opioid Medication Assisted Therapy

FDA Presentation: Maternal Perspective on Opioid Medication Assisted Therapy FDA Presentation: Maternal Perspective on Opioid Medication Assisted Therapy Lorraine A. Milio, M.D. Obstetrical Director Center for Addiction and Pregnancy Assistant Professor Maternal-Fetal Medicine

More information

Ohio Legislative Service Commission

Ohio Legislative Service Commission Ohio Legislative Service Commission Bill Analysis Brian D. Malachowsky H.B. 378 130th General Assembly () Reps. Smith and Sprague BILL SUMMARY Prohibits a physician from prescribing or personally furnishing

More information

Testimony of The New York City Department of Health and Mental Hygiene. before the

Testimony of The New York City Department of Health and Mental Hygiene. before the Testimony of The New York City Department of Health and Mental Hygiene before the New York City State Assembly Committee on Alcoholism and Drug Abuse on Programs and Services for the Treatment of Opioid

More information

American Society of Addiction Medicine

American Society of Addiction Medicine American Society of Addiction Medicine Public Policy Statement on Treatment for Alcohol and Other Drug Addiction 1 I. General Definitions of Addiction Treatment Addiction Treatment is the use of any planned,

More information

Public Act No. 15-226

Public Act No. 15-226 Public Act No. 15-226 AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR MENTAL OR NERVOUS CONDITIONS. Be it enacted by the Senate and House of Representatives in General Assembly convened: Section 1. Section

More information

ANCILLARY STABILIZATION AND WITHDRAWAL. The Why And How Of Stabilizing The Patient In A Comprehensive Treatment Setting

ANCILLARY STABILIZATION AND WITHDRAWAL. The Why And How Of Stabilizing The Patient In A Comprehensive Treatment Setting ANCILLARY STABILIZATION AND WITHDRAWAL The Why And How Of Stabilizing The Patient In A Comprehensive Treatment Setting About CASAColumbia A science-based, multidisciplinary organization Focused on transforming

More information

OUTPATIENT SERVICES. Components of Service

OUTPATIENT SERVICES. Components of Service OUTPATIENT SERVICES Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications. Additionally, providers contracted

More information

Outpatient and Intensive Outpatient Narrative

Outpatient and Intensive Outpatient Narrative Los Angeles County Department of Public Health Substance Abuse Prevention and Control (SAPC) will implement an initial benefit package of Substance Use Disorder (SUD) services within the initial twelve

More information

Pregnancy Care Management Standardized Plan Working together to improve the health of mothers and babies.

Pregnancy Care Management Standardized Plan Working together to improve the health of mothers and babies. Working together to improve the health of mothers and babies. The Pregnancy Care Management outlines methods and standards for pregnancy care managers to follow, working together with Pregnancy Medical

More information