ROSC- Recovery Oriented Systems of Care

c'est moi at African American Health Fair Denver

The following  information was cut and pasted from the SAMHSA website. It is the up-to-date information regarding healthcare reform with regard to substance abuse and mental health treatment. This particular information is of particular interest to me because I work in these fields. And these issues intersect in my life every day in many ways. I believe (through and through) that these issues are worth spending my days around. Some people I know and some people I care about have struggles with these issues that swallow up their lives. So the idea of equal access to treatment is almost worth the national debt. 

But along with parity comes the idea that treatment for both mental health and substance abuse have a mandate to improve their efficacy to coincide with their accessibility. In their current state, these treatment modalities offer stigma, uncertainty, an extremely low percentage of successful outcomes, options that are designed for the providers benefit and not the recipients- i.e. 28 day in-patient- 90 day outpatient- etc,  the focus of substance abuse and mental health will need to expand from treatment to recovery/resilience if it is to be taken seriously. As science moves us forward in understanding, it reveals to us that the brain effects caused by substance and chemical imbalance are lifetime issues for the majority of us and we need to look towards caring for those issues with longterm solutions. Recovery-Oriented Systems of Care are the options that the movers and shakers are looking towards. We might have much better outcomes when we start to treat the whole person for the whole of their lives. ps- if you are inteterested in recovery i recommend you start reading the work of william white at www.williamwhitepapers.com

On October 3rd, 2008, the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 was signed into law. This new Federal law requires group health insurance plans (those with more than 50 insured employees) that offer coverage for mental illness and substance use disorders to provide those benefits in no more restrictive way than all other medical and surgical procedures covered by the plan. The Mental Health Parity and Addiction Equity Act does not require group health plans to cover mental health (MH) and substance use disorder (SUD) benefits but, when plans do cover these benefits, MH and SUD benefits must be covered at levels that are no lower and with treatment limitations that are no more restrictive than would be the case for the other medical and surgical benefits offered by the plan.

The Mental Health Parity and Addiction Equity Act:
Eliminates the practice of unequal health treatment. This practice has kept individuals with untreated substance use and mental health disorders from receiving critically important treatment services. Providing parity provides insurance coverage for substance use and mental health disorders equally to other chronic health conditions like diabetes, asthma, and hypertension.

Improves access to much needed mental health and substance use disorder treatment services through more equitable coverage. Millions of Americans with mental health (MH) and/or substance use disorders (SUD) fail to receive the treatment they need to get and stay well. The lack of health insurance coverage for MH and SUD treatment has contributed to a large gap in treatment services. Improving coverage of MH and SUD services will help more people get the care they need.

Recovery-Oriented Systems of Care (ROSC) is a coordinated network of community-based services and supports that is person-centered and builds on the strengths and resilience of individuals, families, and communities to achieve abstinence and improved health, wellness, and quality of life for those with or at risk of alcohol and drug problems. SAMHSA/CSAT

Note: Prevention Services also play a major role in developing ROSC.

ROSC will require developing supports and services that provide self-directed approaches which respect the role of personal choice and commitment in pursuit of health and wellness. Developing a ROSC also requires helpinging engage people and families in support networks in their communities, to ease their integration back into the community and get their lives back on track. Linking people to services and supports helps sustain long-term recovery. The services and supports may include resources such as:

• recovery centers in your community;
• recovery activities and websites;
• peer support;
• mutual help groups;
• faith based supports;
• housing;
• transportation;
• education and vocational;
• mental health services;
• medical care, including HIV Services;
• financial and budget counseling;
• legal, and advocacy services;
• alcohol/drug and gambling services;
• prevention for children and adolescents; and

• parenting and family services.

Developing a Recovery Oriented System of Care that is built on the strengths and resilience of individuals, families and communities who are actively taking responsibility for their health and wellness drives the continued efforts to build a foundation for recovery in our future .

pieces of me

image credit.. damien blottiere

Common to my recovery advocacy work and my work in recovery management is the proposition that there are multiple pathways of long-term addiction recovery. I recently collaborated with Ernie Kurtz on a monograph that tries to convey what we know about such pathways and styles of recovery from the standpoint of history and science [20]. In this work, we plotted variations in the frameworks of recovery (religious, spiritual and secular), the scope and depth of recovery, styles and contexts of recovery initiation, and differences in recovery identity and relationships. We also tried to answer the questions of when recovery was stable and durable and whether recovery was ever completed. Our goals were to both summarize current knowledge about recovery for addiction counselors and recovery advocates and to stimulate future recovery-focused research...William L White

 

it has been a zany month. i got pneumonia at the end of february and was basically out of commission for 2 weeks. i then worked 19 days in a row including some training for the rosc intervention i am championing at my workplace. 

it has not been overwhelming, but it has been a lot. 

my sponsor reported that he was in the hospital all week with a carcinoma scare. he went to the emergency room on monday and the hospital kept him for observation all week. he has already undergone esophageal surgery (highly dangerous) and this new development is not without concern. it is definitely one of those times when my personal lack of power is magnified. 

we have decided to start the recovery rally 2012 on september 8. we are hoping to secure civic center park this year. the last couple of years, the rally has not been held downtown. we consciously made an effort to separate ourselves from a similar event (now dark) that left a tainted footprint in its wake. the rally committee meetings should begin in april. i hope we can create an event for memory as it will be the return to downtown denver. 

just feeling a little sassy this morning. my friend robbie posted this on fb and i was flooded with some memories of days gone by. i still think spp is a hoot and i know i had some crazy good times. and i certainly don't have any misgivings about having no desire to recreate those days.

evolution of recovery.. beyond the status quo

˜The concept of recovery capital reflects a shift in focus from the pathology of addiction to a focus on the internal and external assets required to initiate and sustain long-term recovery from alcohol and other drug problems.... 

Steve Gumbley

i spent yesterday at a training presented by afr and attc. its focus was a concept named (rosc) recovery oriented systems of care. its focus is that of the changing face of addiction treatment coinciding with the seismic shift called healthcare reform.

the presentation seemed validating in many ways with a shift in focus from treatment to recovery. and modifying my approach to my work to fit into this model should not require decades of reconstruction. and that is a major issue, really. the industry of drug and alcohol treatment will need to make drastic changes to stay afloat with this federally mandated tsunami called reform.

the beauty of the concept is that the patient/client gets the benefit. there is a longer view of the support that a person seeking recovery will have access. the time involved in recovery shifts from the classic (without evidence) 28 days and 90 days to 3 years for a stronger possibility of long-term recovery.

steve gumbley (the current board president of favor) presented in the afternoon segment. he shared some of his story of 25 years with recovery and discussed the idea of public responsibility with such a personal journey. this was a concept i had not considered thus far, although it is not too far from my own philosophy.
i am sharing the slides here. a couple of things that i take from this day are 1) in 3 months of treatment we may very well see a client only about 10 hours. this seems like a cruel joke with regard to the change that is expected from the client. 2) that treatment might really only be a triage, and that recovery support pathways are where the real work is done. 3) that mental health, physical health, emotional health are all involved in a person's recovery and need to be tended if they are to grow. 4) providers, counselors, nurses, physicians might be more effective if they were to expand a client's recovery capital as much as possible before releasing them from care.

as a person living in recovery, i am acutely aware that my recovery involves three levels of sobriety- physical sobriety, emotional sobriety, and spiritual sobriety. it makes sense that that treatment providers generally take this concept to a higher (pun intended) level. we need to address all these areas to assure our clients a better chance at a healthier recovery.

if you work in treatment, you definitely need to know about these concepts as this is the direction that samhsa has the money going. if you are in recovery, or seeking recovery, please consider these concepts. they are completely designed with people in recovery at the table. the language of recovery is changing and the business of treatment is evolving. no doubt it is way overdue... a million thanks to the obama administration for moving beyond the status quo.

Recovery Frameworks Steve G Nov2011 Recovery Management Steve G Nov2011 Recovery and Treatment_Steve G_Nov2011