INTEGRATED RECOVERY Lessons Learned: Implementing IDDT

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INTEGRATED RECOVERYLessons Learned
Implementing IDDT

• Organizational / System Aspect
• 2 County Examples
• Debbie Innes-Gomberg, Ph.D. -Los Angeles
• Adrian Carroll, MFT - Stanislaus
• January 19, 2007

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Organization-Wide and IDDT Team Specific

• IDDT provides principles and tools that can be
  used organization-wide to improve Co-occurring
  capability throughout

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Organization-Wide and IDDT Team Specific

• IDDT provides principles and tools that can be
  used organization-wide to improve Co-occurring
  capability throughout
• As well as build specific enhanced IDDT teams

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Organization-Wide Elements

• Commitment
• Philosophy
• Training
• Access policy
• Time unlimited
• Outcome monitoring
• Self-help
• Housing and employment
• Residential services
• Levels of care
• Steering committee

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System Elements that Support IDDT Specific
Programs

• Client to staff ratio
• Supervising to the model
• Team approach
• Enhanced trainings
• Quality management
• Fidelity monitoring
• Specific Outcomes
• Quality Improvement (forms, processes)
• Access to housing (wet, damp, dry)

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Use of IDDT in Larger System Change Efforts in
L.A.

• Los Angeles Countys Adult Systems of Care
  Transformation
• Creating a continuum of recovery-oriented
  services
• Using stages of change to guide service delivery
  and treatment planning
• Creating strategies for client flow through the
  continuum of services

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COUNTY OF
LOS ANGELES DEPARTMENT OF MENATL HEALTH
ADULT SYSTEMS OF CARE TRANSFORMATION-RECOVERY-
BASED LEVELS OF OUTPATIENT CARE
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Use of IDDT Model Elements to Enhance Service
Delivery in L.A.

• Focus on person-centered treatment planning
• Team-based services
• Stage-based assessment and interventions based on
  readiness for change

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SAMHSA 4 Quadrants

• Target population for IDDT are those COD
  individuals with Serious Mental Illness

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Stanislaus experience

• Recovery focus
• Integrated system vs. Integrated treatment
• Wellness Recovery Center
• Exit strategies as a recovery concept
• Identify internal experts and early adopters
• Recovery Milestones

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Stanislaus experience

• Stages of change model
• -SATS (AOD)
• -MH stages based on Milestones (MH)
• -Stage-based treatment
• -Staff change model

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Stanislaus experience

• System Transformation
• -MHSA FSP, 2034, ACT
• -Wellness Recovery level of care
• -LOCUS LOC system, caseload ratio
• -Normalizing use of Primary Care Physician
• Levels of Care

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Stanislaus experience

• Client flow through System
• -Early expectations
• -Ease of re-admission
• -SSI concerns
• -PCP relationships
• -Peer support throughout
• -Recovery conversation
• -Transparency of treatment process
• -Measurement and accountability

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Team Structure

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SUPPORT WHEEL
Phone Numbers
Use In A Circular Manner So Not To Burn Out Any
One Source
My Recovery
Be Selective In Choosing Support Phone Numbers
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Stanislaus experience

• IDDT as model for implementing any EBP
• -Levels of implementation
• Fidelity Scales as a guide and measure
• Promotes team approach
• -Multidisciplinary
• -AOD, Psychiatrist, RN, CM, Clinician, EH
• Stages
• -provides conceptual framework to bridge
  MH/AOD, Harm reduction recovery
• -Consumer centered

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Summary of Lessons Learned

• QUESTIONS