Recovery Engagement

The Solution is in the Community

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.

Analytics & health IT technology, research to prevent & cure mental illness, program evaluation

Multi-state provider of community-based mental health & addictions services, 1800 staff, 75,000 clients served annually

Who We Are

Unmet Need for Services

Funding Challenges

Traditional Care does not match Client needs.

The Problem or why Change to ROSC

Comprehensive Treatment Needs

Siloed Resources and Siloed Funding

• 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

What is ROSC?

Traditional Addiction Care/Recovery Oriented Systems of Care

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 re-engagement.

Pain based motivation. Hope based motivation.

Recovery Capital Personal Recovery Capital• 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

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.

• 20% Support Service• 8% Employment• 7% Housing• 20% Support Groups• 20% Recovery Coaching• 4% Service Inquiries• 35% Informal Support

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.

Community Engagement

Virtual Engagement is the next step in increasing community connections, encouraging engagement, and

offering a diversity of supports.

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.

Barriers to Expanding ROSC

SAMHSA-2011 CSAT Health IT grant

Purpose of eROSC: • Encourage client

engagement• Increase community

connections•Offer a diversity of

supports• Improve outcomes

eROSC

eROSC: Meeting Stakeholder NeedsPeople 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)

• 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.)

e-ROSC Recovery Center (Private Site)

• Recovery Plan• Weekly Update• Secure Message Center• Personal Calendar• Recovery Capital Scale

My Personal Health Record(Participant controlled)

• Medications• Conditions• Allergies• Immunizations• Apt Notes• Procedures• Notifications• Providers• Procedures• Observations• Emergency info• Tools

E-ROSC Environment Overview

Recovery Engagement Center

Recovery Engagement Center

Recovery Engagement Center

Recovery Support Tools

Recovery Tools are those materials that are used by the Client and the

Recovery Coach to plan, organize and direct Recovery Supports.

Recovery Engagement Center

My Personal Health Record is a client owned method of tracing, maintaining and coordinating health information.

Recovery Engagement Center

Centerstone

CenterStone Website

Recovery Engagement Center

Recovery Engagement Center

• Risk and Protective Scores can be tracked over time and visually represented on the Client’s secured E-ROSC page.

Measurement Outcomes of TMAC

CenterStone Website

Recovery Engagement Center

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.v-recover.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

• 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)

• Top Referral Traffic Sources:• Facebook• Centerstone.org• Twitter

V-Recover.com Utilization Data (June 1-August 30, 2012)

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 grantNote 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.