Recovery
Engagement
The Solution is in the Community
Who We Are
Multi-state provider of
community-based mental health &
addictions services, 1800 staff,
75,000 clients served annually
Analytics & health IT technology,
research to prevent & cure mental
illness, program evaluation
Developer of personal
health record-enabled
“care units” – helping
patients with addictions,
cancer, mental illness and
other diseases track
treatment plan progress,
outcomes, and engage
with care providers.
The Problem or why Change to
ROSC
Unmet Need for
Services
Funding Challenges
Traditional Care does
not match Client
needs.
Comprehensive Treatment Needs
Siloed Resources and Siloed
Funding
What is ROSC?
• ROSC = Recovery Oriented System
of Care (ROSC)
• A cost-effective, community-based,
whole-health approach to
addictions treatment
• Focus on increasing “Recovery
Capital” in addition to meeting
“treatment need”
• Focus on “Targeted Treatment”
• Uses Recovery Coaches, Peer
Support Specialists, Recovery
Engagement Centers, other
treatment providers, volunteers,
and other community resources in
an organized and focused way to
meet the need of each individual
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Traditional
Addictions Care
Recovery Oriented
Systems of Care
Focus on action stage of change.
Focus on pre-action stages of
change & building recovery capital.
Progress through service
continuum in linear manner.
Clients work with a team to meet
their needs.
Serial episodes of disconnected
care (4 times in IOP, 3 in
residential).
Continuity of healing relationships
across episodes, programs,
agencies and systems.
Client blamed/discharged for
relapse.
Responsibility is placed on the
services milieu & lack of recovery
capital.
Limited aftercare.
Continued support and early reengagement.
Pain based motivation.
Hope based motivation.
Recovery Capital
Personal Recovery Capital
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Physical Capital = health, shelter, food, transportation, etc.
Human Capital = values, knowledge, credentials, education,
problem solving, self-awareness, self-esteem, self-efficacy
(ability to manage self in high risk situations)
hopefulness/optimism, purpose/meaning in life,
interpersonal skills
Family/Social Recovery Capital
•
•
Family Capital = Recovery supportive intimate relationships,
family and family of choice relationships, and social
relationships
Community capital = Access resources in the community to
support recovery and community engagement
Cultural Recovery Capital
•
Cultural Capital = local availability of culturally-prescribed
pathways of recovery that resonate with particular
individuals and families
ROSC Care is Sensitive to Client Needs
Community Engagement
Bloomington, Indiana REC
While the REC, in its former life, was an
inpatient facility that saw under 100 consumers a
year, as the hub of the ROSC, it now serves 4200
walk-in consumers per year. Services requested
by consumers are:
The Centerstone Recovery
Engagement Center (REC) is a
low-barrier point of entry into
the recovery Community and
involves Recovery Coaches, Peer
Mentors, Peer Specialists and
volunteers.
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•
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20% Support Service
8% Employment
7% Housing
20% Support Groups
20% Recovery Coaching
4% Service Inquiries
35% Informal Support
This is a hub of recovery that is not based
in a facility but is instead a part of the
community. The ability to partner and
leverage other community resources and
supports allows us to provide
comprehensive services and address the
diverse needs and interests of clients.
Barriers to Expanding ROSC
Geographic and transportation
barriers to accessing the REC.
 Some clients lack the resources to
make it to a physical location
consistently.
 Some clients need basic support in
domains of scheduling and follow-up.
 Some clients are reluctant to seek
help.
Virtual Engagement is the next step in increasing
community connections, encouraging engagement, and
offering a diversity of supports.
eROSC
SAMHSA-2011 CSAT
Health IT grant
Purpose of eROSC:
• Encourage client
engagement
• Increase community
connections
• Offer a diversity of
supports
• Improve outcomes
eROSC: Meeting Stakeholder Needs
People with Addictions:
• ROSC helps people with addiction challenges achieve change
through abstinence and improved health, wellness, and quality
of life.
Healthcare Providers:
• ROSC Improves operational efficiency,
• eROSC’s PHR component helps providers meet Meaningful Use
Stage 2 requirements
• ROSC supports new payment models.
Payers:
•
•
ROSC reduces costs
ROSC has better long-term outcomes.
Communities:
• Easy-to-Access, coordinated care for people with addictions
• Creates strong community partnerships
• Promotes volunteerism & community service
Comprehensive Consumer Engagement
The 3 Domains of v-Recover.com
v-REC (Public Site)
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Public Calendar
Announcements
Community Resources
Our View / What we
Provide
Real Recovery
Gallery
The Rec Family
About
• Moderated Discussion
• Live Chat (with a
Recovery Coach or
volunteer)
• Request an appointment
• Addicted / Need Help?
• Terms of Service and
Privacy Policy
• Code of Conduct
The 3 Domains of v-Recover.com
(cont.)
My Personal Health Record
(Participant controlled)
e-ROSC Recovery Center
(Private Site)
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Recovery Plan
Weekly Update
Secure Message Center
Personal Calendar
Recovery Capital Scale
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Medications
Conditions
Allergies
Immunizations
Apt Notes
Procedures
Notifications
Providers
Procedures
Observations
Emergency info
Tools
E-ROSC Environment Overview
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Recovery Support Tools
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Recovery Tools are those materials that
are used by the Client and the Recovery
Coach to plan, organize and direct
Recovery Supports.
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My Personal Health Record is a client
owned method of tracing, maintaining
and coordinating health information.
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Measurement Outcomes of TMAC
• Risk and Protective Scores can be tracked over time and
visually represented on the Client’s secured E-ROSC page.
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E-ROSC Evaluation Plan: Key
Implementation Questions
• Who is referred to E-ROSC?
• Are clients satisfied with E-ROSC?
• To what extent do the case managers and clients use the
Recovery Plan as a tool?
• Tracking use of Recovery Plan and correlation with indicators and
outcomes
• Does E-ROSC increase access to community supports and
resources, and facilitate transition in service utilization
patterns?
• Services tracking system—collaboration between evaluators and
recovery coaches
• What are the patterns of use of the private and public www.vrecover.com sites?
V-Recover.com Utilization Data
(June 1-August 30, 2012)
METRIC
DATA
Total Visits
2,129
Percent New Visits
47%
Number of Unique Visitors
999
Page Views
5,611
Average Pages Viewed/Visit
2.64
Average Visit Duration
4 minutes, 24 seconds
V-Recover.com Utilization Data
(June 1-August 30, 2012)
• Top Referral Traffic
Sources:
• Facebook
• Centerstone.org
• Twitter
• Top visiting states
and cities (2,103
U.S.-originated
visits):
• Nashville, Tennessee
(n=916)
• Indiana (n=448;
Bloomington, Indianapolis,
Columbus, Bedford,
Connersville, Richmond)
• Michigan (n=295; Ann
Arbor, Saginaw, Novi)
V-Recover.com Virtual Open House
Data (August 15, 2012)
METRIC
DATA
Total Visits
420 (U.S. = 418, Germany = 2)
Percent New Visits
71.2%
Number of Unique Visitors
353
Page Views
909
Average Page Viewed/Visit
2.16
Average Visit Duration
5 minutes, 8 seconds
What’s next?
• Vocational Rehabilitation for recent release (Note 1)
• Integrated behavioral/physical health
• Depression/Anxiety
• Chronic pain
• ???
_______________
Note 1: Presently funded under DOL grant
Note 2: This Substance Abuse e-ROSC program is available
as a package, supported by Centerstone, National Council
and White Pine Systems.
Conclusion
E-ROSC is the logical response to the
economic, regulatory and technological world
today.
E-ROSC contributes to sustainability of
Behavioral Health delivery models.
E-ROSC allows us to penetrate markets we
have been unable to access previously
E-ROSC will improve outcomes and lower
cost, giving value to everyone.