Learning Collaborative January 11, 2010

Outline Review self-assessment purpose Jurisdictional and program differences Highlights of self-assessment tools Questions and Answers

Self-Assessment Purpose Baseline source of information regarding jurisdictional and individual program’s alignment with recovery- oriented system of care Track progress over time in adopting recovery principles and system components Annual completion expected Educational purpose Inform discussions with system stakeholders Gain insight for your ROSC change plan

What Self-Assessments Are Not… NOT tied to funding (at this point) NO judgment passed on responses (at this point) NOT research tools

Tips for Completing 1. For your jurisdiction and program’s use – be honest 2. Don’t worry if your jurisdiction or program doesn’t currently have or do something 3. Think about how effective you are in these areas 4. Take advantage of open-ended questions 5. Not asking for agreement or disagreement with items 6. ADAA will provide requested data elements

Jurisdictional and Program Differences Jurisdictional Self-Assessment: Wear your purchaser of care, oversight, and system monitoring hat Think about services at system and community level Program Self-Assessment Wear your administrative and clinical provider hat Think about services at program and patient level

Highlight #1 ROSC Element – Attraction Outreach 1. Jurisdiction engages in outreach activities NeverSometimesAlways Describe: ________________________________________________________ Explanation/Clarification: Provide examples of your planned, systematic efforts to connect to individuals and families and engage them in services

Highlight #2 ROSC Element – Access Screening and Evaluation 1. Evaluation for level of care occurs prior to admission to treatment NeverSometimesAlways

2. Staff who provide evaluations for level of care are organizationally separate/independent from any specific level of care NeverSometimesAlways Explanation/Clarification: Current practice often links intervention to level(s) of care provided by a program. To provide individualized menu of services, assessment and determination of interventions should be made independent of specific program services available.

ADAA Data Element ROSC Element – Continuity of Care Data: % successfully linked to another level of care _______________ Data Source: Table 1 JurisdictionDisenrollments Linked to Another Level of Care n% Northern Pennsylvania

Highlight #1 ROSC Element – Access Screening and Evaluation 1. Evaluation for level of care occurs prior to admission to treatment NeverSometimesAlways Explanation/Clarification: Current practice often links intervention to level(s) of care provided by a program. To provide individualized menu of services, assessment and determination of interventions should be made independent of specific program services available.

Highlight #2 ROSC Element - Engagement Intake 1. A reminder phone call is made to each prospective patient the day prior to scheduled intake appointment NeverSometimesAlways 2. Intake no-show rate: ______ Explanation/Clarification: These questions may not apply to programs that do not operate with scheduled intake appointments. In this case, please write N/A next to the question and provide a brief description of how individuals are ensured intake.

Highlight #3 ROSC Element - Engagement 4. Redundant paperwork to be completed by the patient has been eliminated None Some All Explanation/Clarification: Paperwork that captures same information has been consolidated and patients do not have to sign multiple forms that serve same purpose. For example, multiple release of information forms to different agencies can be consolidated into one universal release of information form.

ADAA Data Elements ROSC Element - Engagement Data: Program dropout rate is________________ Program administrative discharge rate is________ Data Source: Table 3 ID #ClinicID Disenroll- ments Client Left Before Completing Administratively Discharged n % n % 23Health Inc

Data Element ROSC Element - Engagement Program length of stay (% over 90 days in an episode) is_________ Data Source: Table 4 ID #ClinicIDEpisodes In Treatment 90+ Days n% 23Health Inc

Highlight #4 ROSC Element – Assessment Questions 1-4 The items stress key, basic issues of assessment that should be very familiar Lack of consistency in these components signifies a program in very early stages of alignment with ROSC

Highlight #5 ROSC Element – Service Delivery Elements 6. Program provides case management NeverSometimesAlways Describe staffing, services to which patients are linked, and tracking: _______________________________________________ Explanation/Clarification: Since case management is central to ensuring effective retention, continuity of care, and linkages to other services, detailed description is encouraged.

Highlight #6 ROSC Element – Service Delivery Elements 7. Program offers services provided by peers. Yes No Alumni mentors Recovery coaches Other: _____________________________ Explanation/Clarification: Involvement of the recovery community is central to ROSC so completion of this item is critical to identify current state of peer engagement.

Highlight #7 ROSC Element – Service Delivery Elements 15. Program provides continuing care NeverSometimesAlways Describe: _______________________________________________ Explanation/Clarification: Continuing care refers to monitoring and support services provided after formal, acute treatment no longer necessary.

ADAA Data Elements ROSC Element – Service Delivery Elements Data: % female patients _________________ % African-American patients __________________ % Hispanic patients _____________________ % opiate dependent patients ________________ % patients receiving family services ______________ Average # family services provided per patient________ % received mental health services ________________ % referred to AA/NA ________________ Data Source: Table 5 ID #Clinic ID Dis- enrollments % Females % African American % Hispanic % Opiate Dependent % Receiving Family Services Avg Family Services (of those receiving) % Treated for mental Health Problems % Referred to AA/NA 56HIT

ADAA Data Element ROSC Element – Continuity of Care Data: % successfully linked to another level of care _______________ Data Source: Table 2 ID#ClinicIDDisenrollments Linked to Another Level of Care n% 78Frank Treatment

Highlight #8 ROSC Element – Recovery Environment 2. Program partners with prevention services NeverSometimesAlways Describe: _______________________________________________ Explanation/Clarification: Consider how your program builds upon and aligns with existing prevention activities and strategies that work to make communities healthy and recovery-oriented. This could include a focus on family, school, and other community activities.

Highlight #9 ROSC Element – Recovery Environment Includes appearance and maintenance of physical facilities in which services are provided Includes reception of individuals and families seeking services Website and informational pamphlets Telephone contact Front desk staff

Take-Home Messages 1. For your jurisdiction and program’s use 2. Don’t worry if your jurisdiction or program doesn’t currently have or do something 3. Think about how effective you are in these areas 4. Remember – baseline assessment

Self-Assessment and Organizational Change What information sources will you use to complete self-assessments? How will you engage others in self-assessment process? How can you and others use information obtained through self-assessments?