Implementing a Statewide Recovery-Oriented System of a Statewide Recovery-Oriented System of Care: ... sense of identity apart from one’s ... Civic Leaders, Clergy

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  • Implementing a Statewide Implementing a Statewide RecoveryRecovery--Oriented System of Care: Oriented System of Care:

    From Concept to Reality From Concept to Reality NASMHPD Research Institute, February 2005NASMHPD Research Institute, February 2005

    Thomas A. Kirk, Jr., PhD, CommissionerConnecticut Department of Mental Health and Addiction Services

    Arthur C. Evans, Jr., PhD, Director of Behavioral Health and Mental Retardation

    City of Philadelphia and University of Pennsylvania

    Wayne F. Dailey, PhD, Senior Policy Advisor Connecticut Department of Mental Health and Addiction Services

    http://www.phila.gov/http://www.phila.gov/

  • Getting StartedGetting Started

    What moved us to do this?What approach are we taking?Whats the present status of the recovery-oriented system in Connecticut?What challenges remain ahead?What lessons have we learned?What are your ideas about things we should consider?

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  • Why Focus on Why Focus on Recovery Now?Recovery Now?

    CT Governors Blue Ribbon Commission Federal emphasis and expectation

    Presidents New Freedom Commission SAMHSA

    Expectations of consumers and people in recovery

    Expanding research base showing improved effectiveness of treatments and natural supports

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  • DMHASDMHAS Systemic Systemic Approach to RecoveryApproach to RecoveryDevelop core values and principlesEstablish a conceptual and policy framework Build competencies and skillsChange programs and service structuresAlign fiscal and administrative policies in support of recoveryMonitor, evaluate and adjust

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  • Equal opportunity for wellnessRecovery encompasses all phases of careEntire systems to support recoveryInput at every levelRecovery-based outcome measuresNew nomenclature System wide training culturally diverse, relevant and competent servicesConsumers review funding

    Commitment to Peer Support and to Consumer-Operated servicesParticipation on Boards, Committees, and other decision-making bodiesFinancial support for consumer involvement

    Recovery Core ValuesRecovery Core ValuesDirection

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  • Recovery Core ValuesRecovery Core Values

    Participation No wrong door Entry at any time Choice is respected Right to participate Person defines goals

    Programming Individually tailored care Culturally competent care Staff know resources

    Funding and Operations No outcomes, no income Person selects provider Protection from undue influence Providers don't oversee themselves Providers compete for business

    Participation Funding-Operations

    Programming

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  • CommissionerCommissioners Policy Statement # 83s Policy Statement # 83

    Defines recovery

    Establishes objectives for recovery-oriented system

    Commits DMHAS to statewide systems transformation

    Signing the Commissioners Policy on Recovery

    September 16, 2002

    Promoting a Recovery-Oriented Service System

  • Recovery DefinedRecovery Defined

    We endorse a broad vision of recovery that involves a process of restoring or developing a positive and meaningful sense of identity apart from ones condition and a meaningful sense of belonging while rebuilding a life despite or within the limitations imposed by that condition.

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  • A RecoveryA Recovery--Oriented Oriented SystemSystem

    A recovery oriented system of care identifies and builds upon each individuals assets, strengths, and areas of health and competence to support achieving a sense of mastery over his or her condition while regaining a meaningful, constructive, sense of membership in the broader community.

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  • Starting over again

    Making changes, having

    goals

    Making choices

    Havinghope

    Staying clean and

    sober

    Having same rights as others

    Doing everyday things

    Getting well/getting

    better

    Be looked at as whole people

    Looking forward to life

    Voices of RecoveryVoices of Recovery

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  • Individual responsibility and control

    Individual and family

    participation

    Strength based treatment focus

    Collaborative treatment

    process

    Culturally relevant

    Holistic and Hopeful

    Driven by recovery outcomes

    MH and SA services are

    tools

    Promotes highest level of

    autonomy

    Supporting RecoverySupporting Recovery

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  • Recovery Practice Guidelines

    Recovery-Oriented Value- Driven

    Practitioner(Clinical)

    Program(Provider)

    System(Policy)

    Culturally competent

    Fidelity to model

    Convey Hope and Respect

    Person-Centered

  • Strategies for ChangeStrategies for Change

    Multi-year implementation processBig tent approach to consensus buildingUse technology transfer strategies to Identify develop, implement and sustain best practicesIncorporate existing initiatives Re-orient all systems to support recovery Transition to recovery-oriented performance outcomes in non-punitive approach

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  • Building the SystemBuilding the System

    Service Enhancement

    Control and Participation

    Education, training and workforce development

    Laying the foundation

    Recovery Steering

    Committee

    CSAT Consultation

    CMHSConsultation

    DMHASAdvisoryCouncil

    Provider Recovery

    Assessment

    Person Centered

    Recovery Plan

    Advance Directives

    OlmsteadInitiatives

    Flexible Service Funding

    VocationalServices

    Housing Supports

    Peer DirectedServices

    Recovery Institute

    Public Education

    Commissioners Policy StatementQuality System of Care

    Cultural Competency

    Training

    Advocacy

    Community

    Cultural

    CompetencyAnchors

  • Implementation Plan: ExamplesImplementation Plan: Examples

    Phase I Phase II Phase III

    Philosophical/Conceptual

    Build Consensus on Definitions

    Identify Implications Dog & Pony Shows

    Address stigma within other systems and the community

    Competencies, Skills & Programs

    Evaluate Approaches Baseline Assessment

    Skills Training Centers of Excellence (Pilot Recovery Practices)

    Advanced trainingTA/Knowledge Transfer

    Fiscal/Administrative

    Identify Barriers & Incentives

    Solution-focused workgroups Develop Fiscal Support

    Performance Measures Implement Policy/Resource Changes

    Utilize a consensus process throughout the implementation

  • Phase 1 Determine DirectionPhase 1 Determine DirectionDevelop Concepts & Design Model Principles and core values Recovery definition Literature reviews, obtain outside consultation, White papers Commissioners Policy (committin