1. ROSC Implementation
Susan Jenkins, ADAA Recovery Oriented Systems of Care Division Director
April 2011

2. What is Maryland doing to move to a Recovery Oriented System of Care?

3. Maryland Implementation Plan
Goal: Assign Responsibility for Guiding Transformation
Goal: Engage Stakeholder Groups
Goal: Educate the System
Goal: Define Standards for Services
Goal: Change Funding Priorities
Goal: Collect Data that Measure Recovery Outcomes
Goal: Collaborate with other Agencies

4. Goal: Assign Responsibility for Guiding Transformation
Multiple step, comprehensive process benefits from cohesive leadership at state and community level

5. Progress to Date:
State Level - ADAA staff designated to coordinate, guided by steering committee
Steering Committee meets monthly, guides multiple ROSC transformation processes
Recovery Oriented Systems of Care Division created within ADAA – planning, standards development, technology transfer, technical assistance

6. ROSC Steering Committee
Standards Subcommittee
Finance Subcommittee
Outcomes Subcommittee
Provider Advisory Board
Consumer Advisory Board
Technology Transfer Subcommittee

7. ROSC Steering Committee
Nancy Rosen-Cohen (advocacy organization)
Arnold Ross (recovery community)
Yngvild Olsen (jurisdiction)
Lena Franklin – (provider)
Kathy Rebbert-Franklin (ADAA Deputy Director)
Laura Burns-Heffner (SDAAC Chair)
Virgil Boysaw (ADAA Prevention)
Sue Jenkins - (ADAA ROSC Division Director), Chair
Subcommittee Chairs

8. Subcommittee Chairs Standards – Sue Jenkins
Technology Transfer -Debbie Green
Outcomes – Chad Basham
Consumer Advisory Board – David Ennis
Provider Advisory Board – Bruce Meade
Finance – Fran Givens

9. Goal: Engage Stakeholder Groups
Involve system stakeholders in system planning, implementation, and evaluation
Who? Representatives of the recovery community and their families, advocates, treatment and support service providers

10. Goal: Engage Stakeholder Groups
State Level -
Involve stakeholders in planning, implementing and evaluating ADAA policies and practices
Require stakeholder involvement in planning, implementation and evaluation of local services funded by the State
Create opportunities for coalitions of traditional and nontraditional providers to obtain funding for combined services

11. Progress to Date: ROSC Steering Committee Consumer Advisory Board
Provider Advisory Board

12. Progress to Date: Change Teams
County level
Comprised of stakeholders
Recovery Community
Family Members
Treatment Providers
Other Service Providers, including Recovery Support Services
Responsible for guiding transformation to ROSC in each jurisdiction

13. Progress to Date: ROSC Implementation Plans
Each county/jurisdiction must complete program level and jurisdiction level self assessments
Assessments evaluate services compared to ROSC elements
Each county/jurisdiction must create ROSC change plan – condition of receiving funding from ADAA

14. Goal: Educate the System
Raise awareness and promote understanding of Recovery Oriented Systems of Care models throughout the prevention and treatment systems, service provider systems, recovery community and broader community.

15. Goal: Educate the System
State Level –
Offer courses and workshops to providers
Recruit and train trainers
Obtain curricula from other states, develop new curricula as needed
Become a clearinghouse for resource materials, speakers

16. Technology Transfer Subcommittee Learning Collaborative
Progress to Date:
Technology Transfer Subcommittee
Learning Collaborative
Training Network

17. Progress to Date: County Level Change Process
County Coordinator names ROSC Coordinator
ROSC Coordinator attends ADAA Learning Collaborative meetings
ROSC Coordinator convenes county level ROSC Change Team
County Coordinator completes program level and county level self assessments
With input from ROSC Change Team, County Coordinator develops ROSC Change Plan
Led by ROSC Change Team, county implements Change Plan

18. Learning Collaborative
Comprised of the ROSC Coordinator from each county
ROSC Coordinator is responsible for guiding ROSC implementation within their jurisdiction
Meet regularly at the ADAA to:
receive training and technical assistance in the ROSC model and change process,
Complete program and jurisdiction level self-assessments and use them to develop ROSC implementation plan for their jurisdiction, and
implement the plan

19. Progress to Date:
Each county has a ROSC Change Plan based on program and jurisdiction self-assessments and is in the process of implementation
Next Learning Collaborative meeting on May 17 features Bev Haberle (PRO-ACT) speaking on Peer Recovery Support roles and services
Field trip to Philadelphia on May 6

20. ROSC Training Network
Trainers who have received training and curricula in basic ROSC principles
Available to present on ROSC topics throughout Maryland
Will develop new ROSC training as the need arises

21. Progress to Date:
Trainers were trained in June 2010, and have provided a variety of presentations upon request across the State
New training cohort planned for September 2011

22. Goal: Define Standards for Services
State Level –
Operationalize characteristics of recovery-friendly services at all levels of treatment, and for all types of recovery support services.
Provide self-assessment tools that service providers can use to evaluate their programs and develop improvement plans
Connect program self assessment and development of a change plan to funding opportunities

23. Progress to Date: Standards Subcommittee Continuing Care Workgroup
Recovery Housing Workgroup
Peer Recovery Support Workgroup

24. Progress to Date: New Services
ADAA grant funds may now be used for…
Continuing Care
Offered by outpatient programs
Telephone support
Includes relapse risk assessment
Recovery Housing
Paid for on a fee-for-service basis

25. Goal: Change Funding Priorities
State Level –
Apply for Access to Recovery grant funds that will enable ADAA to pay for recovery support services
Buy services that demonstrate alignment with a recovery oriented system of care

26. Progress to Date: Access to Recovery Grant Maryland RecoveryNet
$3.2 million statewide each year for four years
Clinical and Recovery Support Services for individuals leaving residential treatment programs
Halfway house treatment, marital/family counseling, recovery housing, pastoral counseling, care coordination, childcare, transportation, job readiness counseling

27. Progress to Date: RFP - Recovery Community Center
Developing an Request for Proposals to fund a Recovery Community Center
Services to be determined by the target population
Must be operated by a Recovery Community Organization
Target implementation: January 2012

28. Goal: Collect Data that Measure Recovery Outcomes
Modify the existing data system (SMART) to enable us to collect and analyze data that measure milestones in the process of recovery

29. Goal: Collect Data that Measure Recovery Outcomes
State Level –
Redefine what constitutes an episode of treatment
Measure and reward successful linkages among services
Obtain data from nontraditional and recovery support service providers
Define recovery outcomes beyond current measures

30. Progress to Date: Changes in Measurement
An episode of treatment is now considered to include the entire time a patient spends in treatment with no break in service longer than 30 days
Linkages between detoxification and subsequent care, and linkages between intensive outpatient and subsequent care are now a part of ADAA performance measures
Measurement of self-help group participation is captured at the time of disenrollment
Continuing Care data tracks recovery activity past Level I treatment

31. Goal: Collaborate with Other Agencies
State Level –
Identify and resolve conflicting policies and practices to remove barriers to utilization of services
Collaborate to jointly fund clusters of services

32. Progress to Date: Collaboration
Dialogue between ADAA, Mental Hygiene Administration, and Developmental Disabilities Administration about mutual recovery-oriented goals for the populations we serve
Dialogue with Medical Assistance regarding the needs of people in recovery and the potential for reimbursement of recovery support services

33. Progress to Date: Collaboration – ATR Grant
ATR grant will enable us to provide services to individuals leaving residential facilities within the Department of Public Safety and Correctional Services, and Department of Veteran’s Affairs.
We will have opportunities to collaborate with agencies that license recovery support providers such as childcare, care coordination, and pastoral care.

34. What is Maryland doing to move to a Recovery Oriented System of Care?
Visit our Website:
Sue Jenkins: