Advancing Recovery. Maine s s State Provider Partnership for Quality Addiction Care

Transcription

1 Advancing Recovery Maine s s State Provider Partnership for Quality Addiction Care The Office of Substance Abuse (OSA) & The Maine Association of Substance Abuse Programs, Inc. (MASAP)

2 The Maine Project To increase the number of people treated for addiction To increase the number of people completing treatment To improve outcomes with increased use of medication assisted therapy To improve outcomes with additional supports through case management and wrap around services

3 The Partners The Office of Substance Abuse (OSA) Kim Johnson, Director Linda Frazier, Manager, Treatment Team The Maine Association of Substance Abuse Programs (MASAP) Ruth Blauer, Executive Director MASAP Member Agencies The Maine Alliance for Addiction Recovery (MAAR) Deb Dettor, Coordinator The City of Portland Dr. Bankole Kolawole, Minority Health Coordinator

4 The Maine Team

5 Participating Agencies Medication Assisted Therapies Phase One Acadia Family Center Acadia Health Care Addiction Resource Center Aroostook Mental Health Center Catholic Charities Maine Community Concepts Counseling Services, Inc. Crisis & Counseling Services Crossroads for Women Day One Maine General Medical Center Kennebec Valley Mental Health Center Milestone Foundation Open Door Recovery Center Phoenix Academy of Maine Serenity House Tri County Mental Health Center Wellspring, Inc. Youth & Family Services City of Portland Public Health Division

6 Provider Team Members

7 State-wide Aim The State of Maine will Significantly increase the number of people in treatment Significantly increase the number of people that complete treatment Improve the outcomes of those people who receive treatment by increasing the use of medication assisted therapy and by providing additional supports through case management and wrap around services.

8 Target EBC Medication Assisted Therapies Case Management & Wrap Around Services

9 Target Populations Individuals whose addiction can be treated with medication assisted therapy Opiate Opiate addicts Alcoholics Underserved minority populations throughout Maine

10 Baseline Measures Treatment Admissions for Heroin Addiction by MAT

11 Baseline Data Treatment Admissions for Prescription Opiates by MAT

12 Baseline Data Familiar w. Prescribe Familiar w. Prescribe Familiar w. Prescribe Satisfied w. Not Comments Naltrexone Naltrexone Acamprosate Acamprosate Suboxone Suboxone Efficacy Satisfied yes not in SA settingno no yes yes yes Naltrexone, only for hospital use yes yes yes yes yes no yes Recently certified for Suboxone yes yes yes yes yes yes yes yes yes yes yes yes no yes Recently certified for Suboxone yes yes yes yes yes yes yes yes no yes no yes no n/a n/a Clients respond well to program provided no no no no yes yes yes Extremely effective for detox yes yes yes yes yes no yes In conjunction with treatment programs yes no yes yes yes yes yes no no no no no no n/a n/a Treats adolescents with psychotropics yes yes yes yes yes no not very Alone, they do not work yes yes yes yes yes no not very His practice uses Suboxone yes yes yes no yes no yes yes yes yes yes yes yes yes yes yes yes yes yes yes yes yes yes yes no yes no not very Most have MI, so it's difficult to say if it wor yes no yes no yes yes yes I think Suboxone is wonderful

13 Baseline Data But in a survey of 10 random files, in each of these provider agencies, only Suboxone was identified as a medication being used for agency clients.

14 Baseline Data Status at Discharge Treatment Complete Treatment Complete Left AMA

15 Status at Discharge Women who did not receive Childcare Assistance Baseline Data 68% Completion with assistance vs. 52% Completion without Status at Discharge Women Who Did Receive Childcare Assistance

16 Baseline Data Status at Discharge for Women who did not Receive Prenatal Services Status at Discharge for Women Who Did Receive Prenatal Services 71% completion with assistance vs. 43% completion without

17 Business Case Research shows that medication improves retention and outcomes Our own data shows that wrap services improve retention Improved retention leads to improved outcomes and lower costs to society

18 Problem to be Solved, e.g., Barriers to EBP Implementation Medication Assisted Therapy Provider attitude change Leadership Prescribers Providers Recovery community attitude change State funding mechanisms Medicaid Grant State wide access to medication assisted therapy

19 System Changes Made Data system in process of adding medications to medication assisted therapy question at discharge (programming to be complete Jan. 1, 2007) Licensing regulations rewritten in conjunction with providers to be promulgated by Dec. 1, 2006

20 System Changes Under Consideration Medication Assisted Treatment Buy in from providers & individuals seeking and in recovery Focus groups - provider agencies Survey & focus groups recovery community Obtain additional dollars for MAT Change contracts for FY07 contracts earmarking $5000 for medications ions for four early adopter agencies Identify specific changes to contracts based on population and medsm Cost out changes to assess contractual needs related to specific meds and quantity Continue push for additional MAT funding for FY08 budget Identify potential medication purchasing strategies for providers Work with Medicaid regarding current and future meds All proposed meds included in formulary Prior authorization policies Ensure that OSA is a member of the DUR process

21 System Changes Under Consideration Case Management & Wrap Around Services Case Management Model identification Refugee and minority outreach model Continuing care for individuals with severe and ongoing dependency/usage Recovery specialist model for child welfare (Sacramento model)

22