Title: Where the Heck are We Going?: Prevention's Emerging Road Map
1Where the Heck are We Going? Prevention's
Emerging Road Map
- Carlos A. O. Pavao, MPA
- Southeast Regional CAPT
- October 7, 2011
2What is the Purpose of the CAPT?
To strengthen the capacity of States, Tribes,
Jurisdictions, and other CSAP grantees. To
strengthen the knowledge, skills, and expertise
of the prevention workforce to implement the SPF
and related accountability systems for measuring
performance
3An Integrated CAPT System
- The CAPT combines centralized core capacity to
ensure overall program direction, management
efficiency, and consistency with a decentralized
regional network systemRegional Resource
Teamslocated in each of the five National
Prevention Network regions.
4CAPT Regions
NE
WA
WA
CENTRAL
ME
ME
ND
MT
MN
VT
NH
WI
OR
NY
MA
Northern Mariana Islands
SD
ID
RI
MI
MI
CT
WY
WY
PA
IA
NJ
DE
IN
NV
OH
NV
IL
IL
NE
Guam
UT
UT
MD
WV
WV
Marshall Islands
CA
District of Columbia
CO
VA
CO
KS
KY
KY
MO
MO
NC
Palau
TN
TN
AZ
AZ
OK
SC
NM
NM
AR
SE
AL
GA
MS
Micronesia
Puerto Rico
TX
TX
LA
LA
Hawaii
FL
FL
American Samoa
WEST
US Virgin Islands
SW
Designates tribal grantee
5SAMHSAs Strategic Prevention Framework
6Learning Objectives
- As a result of participating in this workshop
participants will be able to - Outline the key concepts of the Institute of
Medicine's report, Preventing Mental, Emotional
and Behavioral Disorders Among Young People, and
its implications for prevention practice. - Describe the eight SAMHSA Strategic Initiatives,
their prevention implications, and their
relationship to prevention of substance abuse
7Learning Objectives (contd)
- As a result of participating in this workshop
participants will be able to - Provide a brief description/overview of
Affordable Care Act and its implications for
prevention
82009 Institute of Medicine Report
92009 Institute of Medicine Report
- Scope of Prevention redefined (include health
promotion) - MEB (mental, emotional, and behavioral disorders)
encompasses mental illness, substance abuse and
associated problems and behaviors - Neuroscience and Prevention Collaborations (the
testing of hypotheses across disciplines) - Collaboration Across Agencies (opportunities for
cross-disciplinary and multi-agency research to
streamline funding and reflect a comprehensive
developmental approach)
102009 Institute of Medicine Report
- Focus on Implementation and Dissemination (moved
from efficacy to effectiveness trials and studies
of implementation approaches) - Community Relevance (develop partnerships to
evaluate interventions). - Inclusion of analysis of costs and cost
effectiveness/cost benefit
11Prevention of Mental, Emotional, and Behavioral
(MEB) Disorders/Problems
- MEB includes DSM-IV diagnosable mental illness
and substance abuse and problems associated with
them (such as violence, aggression, and
antisocial behavior). - More than ½ of adults reporting MEB disorders
during their lifetime report onset occurred in
childhood or adolescence. - 14-20 of young people report with MEB disorders
in any given year
12Prevention - Interventions that occur prior to
the onset of a disorder that are intended to
prevent or reduce risk for the disorder.
13SAMHSAs Strategic Initiatives
http//store.samhsa.gov/shin/content//SMA11-4629/0
1-FullDocument.pdf
14SAMHSAs Strategic Initiatives
- Prevention of Substance Abuse and Mental Illness
- Trauma and Justice
- Military Families
- Recovery Support
- Health Reform
- Health Information Technology
- Data, Outcomes, and Quality
- Public Awareness and Support
Leading Change A Plan for SAMHSAs Roles and
Actions 2011-2014 http//store.samhsa.gov/shin/con
tent//SMA11-4629/01-FullDocument.pdf
15SAMHSAs SSIs
- Align with HHS Strategic Plan
- (1) improving the Nations behavioral health,
- (2) transform health care in America, and
- (3) achieve excellence in operations.
- Public Health Approach (population level -
achieve nationwide improvements in health)
16SAMHSAs SSIs continued
- Accountability - Evidence Based (improve
practices / demonstrate change - reduce the
impact of mental and substance use disorders on
Americas communities) - Diversity - address the disparities in access,
quality, and outcomes of care for vulnerable
populations that historically have been
underserved or inappropriately served.
17SAMHSAs SSIs
- http//store.samhsa.gov/shin/content//SMA11-4629/0
1-FullDocument.pdf
18Affordable Care Act
- Signed March 23, 2010
- The Affordable Care Act (ACA) expands coverage of
preventive services both within private health
insurance plans and within Medicare and Medicaid,
so more people can benefit from these services.
19Preventive Services What's Covered Under the
Affordable Care Act?
- As of September 23, 2010, the health reform law
requires new private health insurance plans to
fully cover the costs of 45 recommended
preventive services. - As of January 1, 2011, the new law will also
require coverage for a new annual wellness visit
under Medicare and eliminates cost sharing for
recommended preventive services covered by
Medicare. - Additionally, the new law gives state Medicaid
programs financial incentives to cover preventive
services for adults and supports initiatives to
improve public understanding of the benefits of
lifetime preventive services.
20Opening New Doors
- What does all this mean for prevention?
21What does this mean forSubstance Abuse
Prevention (SSI)
- Need to develop a behavioral health workforce
focused on the prevention of substance abuse and
mental illness and the promotion of health and
wellness. - Need for all to adopt evidence-based practices
deliver health education related to prevention. - Build capacity to support the development of
Prevention Prepared Communities (PPCs)
22What does this mean for Substance Abuse
Prevention?
- How can we position ourselves to take advantage
of the opportunities presented by the Affordable
Care Act and the growing evidence base behind
prevention? - Affordable Care Act is also putting a heavy
focus on prevention and promotion activitiesat
the community, State, Territorial, and Tribal
levels. What opportunities might this open for
those of us at the state and local levels?
23Major Trends We can Prepare for
- Health Care Reform (Selective and Indicated
Interventions) - Reduced Resources (Funding)
- Linkages to Primary Care
- Medical Home Model of Service Delivery
- Electronic Records
- Fee for Service Delivery System/Client Pays
24Major Trends (contd)
- Focus on Behavioral Health Care
- Prevention Across All Behavioral Issues
- Recovery Oriented Systems of Care (Completing the
Circle of Care) - Systems Linkages by Necessity
25Resources Must Read
26Resources Continued
27Resources Continued
1994 IOM Report
28For more information
Carlos A. O. Pavão, MPA SAMHSA CSAP's Southeast
Region CAPT 160 Clairemont Avenue, Suite
200 Decatur, GA 30030 Tel 678-954-5823 Email
cpavao_at_edc.org