1. The Consumer’s Role in Whole Systems Change Linda J. Frazier, RN, CHES, MA Treatment Manager Maine Office of Substance Abuse, DHHS

2. Addiction is a Chronic, Treatable Medical Condition Drug Dependence, A Chronic Medical Illness: Implications for Treatment, Insurance, and Outcomes Evaluation by A. Thomas McLellan et al. JAMA, October 4, 2000, Volume 284, No. 13.

3. Asthma, Hypertension, Diabetes, Heart Disease, Addiction & SUD Addiction/SUD clients compliance with treatment is equal to or better than other chronic conditions Continuum of severity and LOC Compliance with tx plan key focus Assess early, monitor, intervene at appropriate level

4. The Consumer is Central Five Key Principles: Evidence-based predictors of change - #1 Understand and involve the customer Compliance Literature – Study by Todd M & David Gustafson including literature review – * Note to self - Todd, Citation Help Please! Across Standards for Treatment Plan – HealthCare, SA/MH, Clients

5. Compliance Factors* Social Cognitive - Client attitudes/beliefs, perceived risk of health decline, perceived control Regimen Effect – role in tx plan, results, complexity of following plan, side effects Provider Communication - engagement Contextual Factors – SES, $, Insurance, co- pay amount Past use history – serum levels, monitoring, refill records

6. Don’t Sell Them What You Have… Sell Them What They Need Billboard, Heathrow Airport October 2008

7. MAT Key Activities Partnership & Shared Aims Surveys, Chart Audit, Focus Groups – Provider Staff & Consumers Implementation of Non Discrimination Language in July 2007 Contracts Implementation of Pay for Performance Contracts July 2007 Changes to TDS Data System July 2007 – Added questions on EBP, MAT, GPRA data fields

8. $$$$$$$ Stipends for Participation in the RWJ Advancing Recovery Initiative – Coaching, Learning Session Participation State General Funds for MAT Medicaid Reimbursement for Suboxone without Prior Authorization for Addiction Treatment Co-sponsorship & Support for Development of ROSC & CHOW Program Education & Training Incentives for Access and Retention Measures OP/IOP

9. RIDER E: PROGRAM REQUIREMENTS (SUBSTANCE ABUSE SERVICES) NON-DISCRIMINATION 13.Providers receiving grant funds from OSA will not discriminate against clients who are using legitimate medications to assist their recovery and will not have policies that allow them to refuse admission to treatment or to discharge clients from treatment based on the use of legitimate addiction medications.

10. Shared NIATx Aims Reduce Waiting Times Reduce No-Shows Increase Admissions Increase Continuation Rates

11. Successful Whole Systems Change Will Require Trust & Respect Identified Common & Shared AIMS AND Mutual Accountability & Transparency Common Shared Language – Between professional fields and the recovery community Cultural Competency Positive Role Models, Access to Coaching/Recovery Support