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Transforming North Carolina's Substance Abuse Services: A Systemic Approach to Recovery

This session explores North Carolina's groundbreaking efforts to transform its substance abuse service delivery system. Driven by legislative mandates and stakeholder collaboration, the initiative emphasizes consumer choice, community involvement, and coordinated care. With a focus on access and support for those with the most urgent needs, the reformed system seeks to ensure service consistency across the state. Key elements include the establishment of consumer/family advisory committees, enhanced Medicaid coverage for addiction services, and improved service pathways to better address the needs of vulnerable populations.

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Transforming North Carolina's Substance Abuse Services: A Systemic Approach to Recovery

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  1. CROSS SYSTEM FINANCING STRATEGIES LEARNING NETWORK SESSION #4 March 20th and 21st, 2007 Santa Fe, New Mexico FLO STEIN, CHIEF, COMMUNITY POLICY MANAGEMENT NC Division of Mental Health, Developmental Disabilities and Substance Abuse Services

  2. North Carolina’s System Transformation • The system for the delivery of substance abuse services had not changed in thirty years. • The North Carolina General Assembly passed legislation requiring the design of a new system. The Republicans, Democrats and others. • The Office of the Governor. • The County Commissioners.

  3. Stakeholders • The Recovery community • Families • The Substance Abuse Federation • Addiction Professionals of North Carolina • The National Association of State Alcohol and Drug Abuse Directors • Partners for Recovery

  4. Access to Recovery • Consumer Choice • Measured Results • Increased Capacity

  5. Access • People to enter and exit services/supports in the same way no matter where they live. • All parts of the system to offer same kinds of information about what is offered and where to get it.

  6. Who will get served? • Some core functions available to all; some available to communities. • Services/supports will be targeted to people most in need.

  7. Core functions • Service coordination - throughout local system. • Community benefits: • Consultation • Prevention • Education

  8. Core functions • Pathways to access services/ supports: • Screening • Referral • Assessment • Emergency Services

  9. Targeted populations • Priority groups within target populations: • People with the most urgent needs. • People from racial or ethnic minorities with service/support needs. • People with more than one disorder.

  10. How services/supports delivered • Consumers & families “at the table.” • The state system: • Leadership, policymaking, monitoring. • The local system: • Local management entities. • Performance contracts • Provider communities.

  11. Consumer/family advisory committees • LocalCFACs - Each area/county program established a committee at the beginning of local planning efforts. • StateCFAC - Division sponsoring a statewide committee of representatives drawn from the local committees.

  12. Consumer/family advisory committees • MEMBERSHIP • 100% consumers & family members. • Equal representation of all disability groups, each to include a man, a woman & a youth/family member. • Membership representative of community race & ethnicity.

  13. Customer Focus • Work with you clients to prepare them for a role in governance. • Preparation for service on CFAC. CFACs will assist the LME determine services to be provided • In a competitive market, consumer opinions of your service can influence your ability to do business. • Recovery Community and Peer supports

  14. Providers • Provider Action Agenda • Any willing, qualified provider • Provider Endorsement • Organized networks, providing ASAM continuum and services to those with co-occurring disorders

  15. Service Changes • Practice Improvement Collaborative (Governors Institute web page) Practice the NIDA Clinical Node • New service definitions • Person centered planning • Recovery supports

  16. Independent Practice • Independent practitioners—The NC Certification Board will need our assistance. • Effective October 1, 2006 Licensed Clinical Addiction Specialists and Licensed Clinical Supervisors will be able to directly enroll with Medicaid and practice independently.

  17. Medicaid • Expanded Medicaid coverage for addiction services. • It is up to us ensue that more of our clients are screened for eligibility. Systematic application for benefits. • Working with CMS for increased support for an array of services for addictive disorders.

  18. Facility Licensure • Effective July 2006 outpatient addiction programs will no longer require Facility licensure is required prior to opening • Licenses only required for addiction programs and could not be transferred to new locations or entities. • Facility license continues to be required for day program and 24 hour programs

  19. North Carolina School for Alcohol and Drug Studies • Foundation Board designs the school to address NC workforce needs. • Courses offered this year focus on a number of new skills and services

  20. Join the Voices for Recovery Now • 17h Annual National Alcohol and Drug Addiction Recovery Month –September2006 • Focus will be on access to recovery for the large number of Americans who have difficulty obtaining treatment.

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