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From State Down: Improving How We Do Business

From State Down: Improving How We Do Business. Suzan Swanton, LCSW-C Executive Director Maryland State Drug and Alcohol Council www.maryland-sdaac.org. Sec., DHMH Sec, DPSCS Sec., DJS Sec., DHR Sec., DBM Sec., GOC Superintendent, MSDE Exec. Dir., GOCCP. State Senator State Delegate

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From State Down: Improving How We Do Business

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  1. From State Down: Improving How We Do Business Suzan Swanton, LCSW-C Executive Director Maryland State Drug and Alcohol Council www.maryland-sdaac.org

  2. Sec., DHMH Sec, DPSCS Sec., DJS Sec., DHR Sec., DBM Sec., GOC Superintendent, MSDE Exec. Dir., GOCCP State Senator State Delegate District Court Judge Circuit Court Judge 7 members of public Dir., ADAA Dir., MHA Dir, DPP Asst. Sec. for Treatment, DPSCS State Council: Members

  3. Purpose • Develop comprehensive, coordinated and collaborative approach to use of State resources • Coordinate delivery of prevention, intervention and treatment resources • Promote collaboration and coordination of programs with LDAACs

  4. Duties • Strategic Plan • Recommend systemic improvements • Identify promising practices • Recommend coordination and collaboration strategies • Allocation Formula

  5. Health Officer Regional Dir, DJS Regional Dir., DPP State’s Attorney Public Defender Chief, Police/Sheriff Pres, local Bd. of Ed. County Exec. , etc. Rep, County Council Adm. Judge, Cir. Ct. Adm. Judge, Dist. Ct. 1 consumer 2 providers Prevention provider Ind. Knowledgeable Warden, local detention center Local Councils

  6. What is “best practice” ? Gold Standard • Multiple randomized clinical trials Second Tier • Consensus reviews of available science Third Tier • Expert opinion based on clinical observation (Drake, et al. 2001. Implementing evidence based practices in routine mental health service settings. Psychiatric Services, 52, 179 – 182)

  7. Best Practice: Government Level • Blueprint for the States: Policies to Improve the Way States Organize and Deliver Alcohol and Drug Prevention and Treatment • Join Together Inc. – Boston University’s School of Public Health • www.jointogether.org

  8. Why do we need to improve how we do business? • 13% of State’s budget spent on the consequences of drugs and alcohol • < 4% spent on treatment and prevention • 96% spent on avoidable consequences

  9. And more reasons… • 70% - State child welfare budgets spent on AOD related problems • 77% - State criminal justice budgets • 25% - State Health budgets

  10. Six Recomendations • Leadership • Structure • Resources • Measurement and Accountability • Legislation • Sustain State Focus and Attention

  11. LEADERSHIP • Continuous leadership from State executive, legislative and judicial branches • State Plan • Governor: hold State agencies accountable • Legislative Leaders know and educate on cost and consequences • Chief Judges – know and educate

  12. STRUCTURE • State Council with appropriate agencies • Cabinet Level –Single State Agency • Encourage Collaboration among providers

  13. RESOURCES • Funding • Secure and Retain Skilled Professionals

  14. MEASUREMENT AND ACCOUNTABILITY • Create a unified data • Track progress • Annual reports that track the costs and consequences of AOD problems • Pay more to providers that achieve better results

  15. LEGISLATION • Formal Review process • Legislation reflects current understanding of disease? • Legislation inhibits recovery and re-entry? • Best practices in reducing underage drinking ? • Balance between alcohol availability and public safety and health ?

  16. SUSTAIN STATE FOCUS AND ATTENTION • Permanent and highly visible board • Local organizations that monitor and report local problems and progress • Providers and State work together to incorporate best practices into state standards

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