1. The State of Addiction and Recovery Services in Tennessee September 25, 2018

2. Our Vision and Mission Vision Mission Goal
To be the nation’s most innovative and proactive state behavioral health authority for Tennesseans dealing with mental health and substance abuse problems.
Mission
Provide, plan for, and promote a comprehensive array of quality prevention, early intervention, treatment, habilitation, and recovery support services for Tennesseans with mental illness and substance abuse issues.
Goal
To increase recovery pathways for Tennesseans with mental illness and substance use disorders by moving the needle on access to quality, effective and efficient services.

3. Our Approach
To increase recovery pathways for Tennesseans with mental illness and substance use disorders by moving the needle on access to quality, effective and efficient services.
Research
Partnerships
Innovation
Practice

4. Tennessee: From Memphis to Mountain City
Tennessee shares borders with many states. Interstates bisect the state.
Tennessee’s geographic regions correspond to demographic differences in the three grand divisions of the state.

5. Tennessee: From Memphis to Mountain City
Our statewide network of providers connects people living with addiction to pathways to recovery.
Tennessee shares borders with many states. Interstates bisect the state.
Tennessee’s geographic regions correspond to demographic differences in the three grand divisions of the state.

6. Prevalence of Substance Use Disorder (ALL AGES) in Tennessee
2017 Tennesseans, ages 12+:
393,000 were estimated to have a substance use disorder
(6.86% of 5,721,780 Tennesseans, rounded to nearest 1,000)
Sources: The Annie E. Casey Foundation, KIDS COUNT Data Center ( ); National Survey on Drug Use and Health , 2016; CMHS Uniform Reporting System (URS) Output Tables 2017; U.S. Census population estimates for Tennessee 2016.

7. Prevalence of Substance Use Disorder in Tennessee Youth
2017 Tennesseans, youth age 12-17:
21,000 were estimated to have a substance abuse issue
(4.04% of 513,298 youth, rounded to nearest 1,000)
Sources: The Annie E. Casey Foundation, KIDS COUNT Data Center ( ); National Survey on Drug Use and Health , 2016; CMHS Uniform Reporting System (URS) Output Tables 2017; U.S. Census population estimates for Tennessee 2016.

8. Prevalence of Substance Use Disorder Among Adults in Tennessee
2017 Tennesseans, ages 18 and older:
372,000 were estimated to have Substance Use Disorder
(7.14% of 5,208,482 adults, rounded to nearest 1,000)
372,000
Substance
Use
Disorder
Sources: National Survey on Drug Use and Health , 2016; CMHS Uniform Reporting System (URS) Output Tables 2017; U.S. Census population estimates for Tennessee 2016.

9. Seeing the Beauty of Recovery
Video goes here
Less than 1 minute

10. Change in State Appropriations During the Haslam Administration
Total
253.3
260
212.5
222.9
205.9
204.4
190
194.5
194.9
Total Funding Increase: + $41 million or +12% | State funding Increase: + $70 million or +37%
Total new federal grants $119,895,564
TDMHSAS Budget in Millions, rounded to nearest tenth Other funding includes revenue from services provided, interdepartmental sources, and other sources

11. Total Department Budget: $380,236,100 State Fiscal Year 2018-2019
$144.6 Mental Health Institutes 38%
$260 State 68%
$78.5 Federal 21%
$41.7 Other 11%
$380.2 Total
$106.1 Community Mental Health 28%
$106.2 Community Substance Abuse 28%
$356.9 Total Services 94%
In millions

12. FY19 State Cost Increases Focusing on Substance Abuse
Substance Abuse Prevention and Treatment $9,250,000
Targeted Provider Rate Increase $6,000,000
Tennessee Recovery Navigators $750,000
Medication Assisted Treatment: Recovery Courts $1,000,000
Medication Assisted Treatment: County Jail Pilot $300,000

13. Federal Grant Funding During FY19
State Targeted Response to the Opioid Crisis Grants (Opioid STR)
May 1, 2017 – April 30, 2019
$13.8 million x 2 grant years = $27.6 million
State Opioid Response (SOR)
$18.5 million x 2 grant years = $37 million
Award just announced, working to operationalize

14. Innovation in Substance Abuse Services

15. Highlighted Examples of Substance Abuse Services Continuum
Community Coalitions
Media Campaign
Tennessee Prevention Network
Naloxone overdose prevention
Redline referral
Lifeline Peer Project
Regional Overdose Prevention Specialists
Prevention / Education
Outpatient
Residential Rehab & Halfway Houses
Detox
Medication Assisted Treatment
Treatment
Transitional Housing
Oxford Houses
Lifeline AA and NA meetings
Certified Faith recovery communities
TN Recover App
Addiction Recovery
DUI School
Recovery Courts
Criminal Justice Liaison Services
Criminal Justice Diversion

16. Current Innovative Substance Abuse Activities at TDMHSAS
Continued implementation of State Targeted Response grant
Operationalizing State Opioid Response grant
MAT Expansion Program
Community-based efforts in 40 counties
MAT for Recovery Court participants
MAT County Jail Pilot Project
Faith-based recovery forums
Project Lifeline
TN Recovery Navigators
Public-Private Partnership

17. TDMHSAS Opioid State Targeted Response: $13.8 million x2 years
Treatment services will reach up to 4,380 additional individuals
Prevention: $2,480,090
Reduce Overdose deaths & Increase Treatment access
Training for 900 professionals and stakeholders
Overdose Rapid Response System
Distribution of 7,420 naloxone kits to public 3,000 to law enforcement
Medication assisted treatment
Treatment for pregnant women
Treatment and recovery services for individuals
-10+ Regional Overdose Prevention Specialists
-Naloxone Distribution
-Overdose Response System
-Pain Management Training
-Media Campaign
Treatment: $9,872,105
-Continuum of Treatment for Uninsured
-Medication Assisted Treatment (MAT)
-Tele-Treatment
-Treatment for Pregnant Women
Recovery: $1,000,000
-Addiction Recovery Program

18. TDMHSAS Prevention and Education on Opioid Misuse
Blue: coalitions
Dark blue: enhanced opioid coalitions
Funded 44 substance abuse prevention coalitions; of those, 22 coalitions have an enhanced focus on opioid use prevention
Funded 10+ regional overdose prevention specialists:
Naloxone distribution, signs and symptoms of overdose
Pain management
Participated in the development of a Rapid Overdose Response System with: Tennessee Department of Health and Tennessee Bureau of Investigation
Compiled substance abuse data from 9 state and community agencies through the State Epidemiological Outcomes Workgroup (SEOW)
Provided over 39,000 Screening, Brief Intervention, and Referral to Treatment (SBIRT) from 2012 to 2016 in primary care settings

19. TDMHSAS Increased Screenings and Treatment Services
Redline received more than 11,000 calls for treatment referrals in the last year
Provided treatment to 23,059 individuals without insurance through TDMHSAS state and federal appropriations.
Funded Medication Assisted Treatment (MAT)
Expanded tele-treatment
Expanded treatment for pregnant women

20. TDMHSAS Recovery Supports
Oxford House: 399 beds Transitional Housing
Pastoral/Spiritual Support Faith Communities AA & NA Meetings
Lifeline
Addiction Recovery Services
Case Management Recovery Skills and Activities Employment Skills Relapse Prevention Spiritual Support
Health and Wellness
Transportation
Addiction Recovery Program and Faith Based Initiatives
343 Recovery Congregations
Sober Living Beds
Certified 343 faith-based “Recovery Congregations / Organizations”
Provided 2,466 Lifeline recovery trainings
Referred 1,600 people to treatment
Started 334 new recovery meetings

21. Specialized Courts 77 Recovery Courts operating in Tennessee
46 Adult (Including 2 Residential Recovery Court Programs)
6 Juvenile Recovery Courts
2 Family Recovery Courts
9 Veterans Treatment Courts
4 Designated DUI
9 Mental Health Courts
1 Human Trafficking Court

22. TN Recovery Oriented Compliance Strategy (ROCS)
New for this fiscal year
Serves the Lower Risk/High Need population
Individuals who don’t meet recovery court criteria
Release or Sentencing Option for the Court
Judge can decide to impose Behavioral Health treatment recommendations as conditions of pre & post disposition release
Piloting 5 TN-ROCS program sites in FY 2019 

23. Prevention Treatment Law Enforcement
TN Together is the state’s comprehensive plan to address the ongoing opioid epidemic through three primary levers:
Prevention
Treatment
Law Enforcement

24. TN Together Bill Signing: June 29, 2018
Video goes here

25. Department of Correction
Re-Purposed 512 Beds at West Tennessee State Prison in Henning
Currently, 359 of the 512 beds are filled with inmates receiving substance abuse treatment services
An entire compound dedicated to treatment in an intensive, residential therapeutic community
One-time 60 day sentence reduction credit
TDOC policy revisions were effective July 1
Available to inmates upon successful completion of the 9-12 month intensive, residential therapeutic community
Credit not available for 85% and 100% sentences and most sex offenses

26. Decreasing MMEs Dispensed
43% Decrease
Source: Tennessee Department of Health

27. Prescribing Limits in Effect

28. Commission on Pain & Addiction Medicine Education
19 members, 5 months, 12 competencies
Broad input while in draft form
20 of the 22 healthcare schools in TN have committed to adopt and implement

29. Tennessee Recovery Navigators
Tri-Cities and Memphis already seeing patients
152 patients served between June 1 - August 15
Counties of Residence: Carter, Greene, Hardeman, Hamblen, Hawkins, Knox, Shelby, Sullivan, Unicoi, Washington

30. Public Private Partnership
First of its kind cohort of non-profit and for-profit treatment providers, medication assisted treatment (MAT) providers, hospitals
Developed and ranked areas of immediate impact
Urgent admissions to addiction treatment providers
Workforce strategy to address high-need positions
Recovery housing for people in MAT regimens

31. TN Together Media Campaign
Television: More than 27 Million total impressions
23.8M Impressions in Nashville TV Market
2M Impressions in Knoxville TV Market
1.6M Impressions in Tri-Cities TV Market
Will add Memphis and Chattanooga markets by year’s end
Statewide Digital: more than 14 M impressions
Ads running statewide on websites and social media
East & Middle TN Newspapers: 3.5 M impressions
Statewide Radio: Titans Radio Network During Football Season
Numbers through 8/31/18

32. Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it's the only thing that ever has.
- Margaret Mead
Questions?