1. Improving Access & Retention in the Substance Abuse Treatment System

2. Diagram of Calls No insurance Freddy Phone disconnected No insurance “Government #” USDHHS Help line Lucy: have bed available Cash up front NJ Dept. of Addiction Services Voicemail Call #6 Call #1Call #2Call #3 Call #4 Live program monitor Detox- 3-5 days Call #5

3. Barriers to Treatment $ Organizational - Inefficiency - Fragmented levels of care - Inadequate performance expectations

4. Systems Reengineering  Assess  Data  Redesign  Results

5. Expected Results  Decrease in time from call to admission  Increase in admissions  Increase in retention

6. Program Components: $9.5 million  Grant Program: $6.1 million, 16-20 sites Redesign admission & care processes Peer learning networks Communications  Evaluation: $1 million  National Program Office: $2.4 million

7. NPO Activities Year 1 Develop & disseminate tools Communicate with national associations Organize national treatment program meetings Years 2-4 Manage 2 rounds of grants Provide technical assistance to sites and others

8. NPO Attributes  Understanding of health system redesign process  Community-based alcohol & drug treatment experience  Good management track record

9. Challenges  Motivating the field  Diverse field of applicants  Dissemination & adoption of models

10. The Responsive System Access within 24 hours 24 hours Bed/slot available Unavailable: connect to interim care Positive treatment outcome Retentionstrategy

11. Four Project Aims Reduce Waiting Times Reduce No-Shows Increase Admissions Increase Continuation Rates

12. The Five Principles Focus on key issue Choose powerful leader Seek ideas from outside the organization, outside field Use rapid cycle change Understand the customer

13. Paths to Recovery STAR State Pilot Project Self Initiated Members NIATx Projects STAR - SI Advancing Recovery NIATx 200