The South Dakota ROSC Model & SAMHSA’s Strategic

Initiatives: An Interesting Combination ?

Presented by: Kevin Kirby and Charlie DayFace It! Co-Founders & Board MembersNovember 2010 TM

Preview: The Case We Will Make for a National Model for

Grass-Roots Application

Sioux Falls – creating a ROSC that:

Draws upon conventional wisdom and historical experience

Aligns With SAMHSA’s Strategic Initiatives

Extends the reach of and builds sustainability into the conventional ROSC model by: Delivering value propositions to the private

sector Employers can solve this problem Health care reform is working in favor of

chronic disease management

Preview: The Case We Will Make for a National Model for

Grass-Roots Application

(continued)

The Sioux Falls ROSC extends the reach of and builds sustainability into the conventional ROSC model by:

Motivating EVERY sector of the community to be part of the solution

Eliminating stigma with “the mother of all” awareness programs

Steps SAMHSA Can Consider to

Further a Grass-Roots Model(think about during the presentation)

Support strategic efforts through state agencies to stimulate adoption of the model in likely communities

Support strategic efforts to help “Public Sector” models embrace elements of the “Grass-Roots” model (especially the “Workplace Initiative”)

Fund efforts to accelerate development & proliferation of the “Awareness Program” (to draw folks into treatment & recovery and the ROSC models)

Support efforts to create “Specialty Carve-Outs” made up of a spectrum of local providers to treat the chronic nature of the disease

Thumbnail Sketch of Sioux Falls MSA

MSA has +/- 240,000 residents (state pop. is +/- 820,000), +/- 88% Caucasian, +/- 4.6% unemployment rate

Largest employers: government, health care and financial services (mostly white collar labor force)

Strong sense of community & involved employers

Roughly 19,000 chemically dependent adults, 75%-80% of whom go to work and 75%-80% of whom are unlikely to get help

Centrally Located, Fast Growing Community

To dramatically increase both the numberof individuals and families in recovery andthe quality and accessibility ofservices by creating a recovery-orientedsystem of care.

www.faceitsiouxfalls.org

The Mission of Face It!

Genesis & Evolution of Face It!

“Co-founders” were Kevin Kirby & Charlie Day--Two lawyers with finance background (one

is in recovery)

“Stimulators” were CCAR, national thought leaders & SD Division of Alcohol & Drug Abuse (Gib Sudbeck)

“Creators” were community representatives who participated in 7 “town hall” meetings

Genesis & Evolution of Face It!

(cont’d)

“Creators” challenged to envision what a ROSC would look like in Sioux Falls in 5 years

--Adamant that employers be part of the solution

Face It! created in February 2009 to implement the vision--Overall timeframe from planning to launch

was 14 months--“Strategic” process was privately funded

(+/- $ 350,000)

Genesis & Evolution of Face It! (cont’d)

Feb 2009: Board nominated by community (most not in recovery) to reflect vision from town hall meetings

April 2009: §501(c)(3) status obtained

June 2009: Long-term strategy, business plan and budget (+/- $ 400,000 when fully operational) approved

July-Sept 2009: ED & 1 FTE hired

Oct 2009: Open highly visible RCO office space

Sept-Oct 2010: 2 more FTE’s & new ED (board chair retired as VP HR of a large bank to become ED)

Genesis & Evolution of Face It!

(cont’d)What Face It! Does:

Recovery Support Services (bring relevant CCAR programs to Sioux Falls…telephone recovery support is the first…and other responsive programs)

--Capturing volume related data --Workplace Initiative (more in a moment)

“Advocacy” -- stimulate “build out” of the “care side” of the ROSC

--Led by our region’s leading mental health provider

“Awareness” -- develop & implement “mother of all awareness programs” to draw folks into the ROSC

Commitment to financial & volunteer development

Genesis & Evolution of Face It! (cont’d)

The Operational Funding Model (during start-up & when operationally mature) Lends Itself To A Strategic Orientation:

1. Employer support (ongoing)

2. United Way/Economic Development

3. Private donations (board has development committee & is executing a plan)

4. Grants (one of the reasons we are collecting volume data and accumulating outcome measures with the University of Sioux Falls)

Face It!’s Workplace Initiative

Employer Group’s Mission Statement:

Believing that addiction is a chronic illness and that companies can be a part of creating a recovery oriented community in Sioux Falls, our companies join forces to use the winning elements of our wellness programs and services for the employees to open new doors and remove barriers to recovery.

Employer Group’s Vision Statement:

Our companies and community are united in the acceptance of and support for the journey of recovery from addiction; that services are accessible to all and the face of recovery is celebrated.

Face It!’s Workplace Initiative

(cont’d)

Our Employers are Investing In Recovery Because It Makes Good Business Sense & Because They Believe In The Community:

Research suggests a significant return on investment

Retained, skilled & healthy workforce are key to enterprise success, community welfare, quality of life and economic growth

Anything that impedes an employee’s ability to contribute is a barrier and a cost

Face It!’s Workplace Initiative

(cont’d)Employer Goals

• Begin with a small group of committed employers with employee wellness/chronic disease management programs.

• Provide a template of activities and proven ROI data to incent future employers to participate.

• Share common belief that chemical dependency is a chronic disease and challenge ourselves to review our programs within that context.

• Use the winning elements of current worksite wellness & disease management programs to incorporate understanding, education, acceptance and support for employees & their families on their journey of recovery from addiction.

Face It!’s Workplace Initiative

(cont’d)Employer Goals (cont’d)

Develop template of activities for a wellness/chronic disease management program that other business enterprises could use as a design model based on their respective desires, resources and labor force make up.

Provide worksite education to promote awareness of the recovery benefits for employees and their families.

Develop a top-down approach to acceptance and support for employees with addictions.

Train enterprise leadership and employees on the prevalence of addiction as well as the need and options for recovery.

Face It!’s Workplace Initiative

(cont’d)What Has Happened:

• Organized in March 2009 after proposal by Face It!

• 20 businesses committed to the initiative (more since)

• HR & executive leadership from each company fully engaged

• Monthly meetings with exceptional HR attendance

• Multiple educational experiences from meeting with AA, EAP’s, providers, tours of detox, treatment facilities and much more

• Wellness coaches trained and engaged in the model

• Two health plans fully engaged in the model

• Local university conducted baseline survey of employees

Face It!’s Workplace Initiative

(cont’d)What Has Happened (cont’d):

Mandatory employee awareness sessions in the workplace Face It! provides speakers relevant to the setting & other

information Recovering person’s story (from the extensive Face It!

Speaker’s Bureau) Employer resources and messaging of support Handout materials

Engagement of our healthcare providers to begin collecting and integrating claims data

Development of employee peer support processes within the companies

Employees and families contacting Face It! for assistance

Face It!’s Workplace Initiative

(cont’d)

Partner Experience: Home Federal Bank

A self-insured community bank with operations in 3 states

Contact Mary Hitzemann (leader of the Workplace Initiative, former Home Federal VP HR & now Face It! Executive Director) for a “ground zero” explanation of what has happened

Face It!’s Workplace Initiative

(cont’d)

How Sioux Falls Employers Will Measure Success

Changes in claims experience (work closely with insurer) Expect increases initially as those in need receive

care Examine trends in co-morbidity diagnosis/claims Compare per member per year trend data with

employers who do not manage chemical dependency as we do

Results of the repeat surveys by Univ. of Sioux Falls (research partner)

Face It!’s Workplace Initiative

(cont’d)

How Sioux Falls Employers Will Measure Success (cont’d)

USF identifying other possible trends in the community that have changed

Growth of the peer-to-peer support in workplace

Dialogue in management meetings

Eventually will collect data on absenteeism, etc.

The Workplace & Healthcare Reform:

A Wonderful Strategic Opportunity for ROSCs & RCOs

Healthcare Reform has linked substance use disorder & mental health with chronic disease initiatives

Mental Health Parity & Healthcare Reform are pushing employers to have healthier employees & to incent employees to be healthier

The bottom line is Healthcare Reform is taking the ROSC movement from the “right thing to do” to a necessity

The Workplace & Healthcare Reform:

A Wonderful Strategic Opportunity For ROSCs & RCOs (cont’d)

The Strategic Opportunity:

RCOs can help employers add chemical dependency support to workplace chronic disease management programs & thereby extend the “community of support” into the workplace.

The Workplace & Healthcare Reform:

A Wonderful Strategic Opportunity For ROSCs & RCOs (cont’d)

The Ideal Environment: An existing ROSC

Employers with a commitment to wellness, chronic disease management and retaining employees

An “integrated healthcare delivery system” (a model where physicians, clinics, hospitals & a health plan are under 1 roof)

A community with a tradition of problem-solving

The University of Sioux Falls: Face It!’s Academic

Partner Participants are the schools of business

administration and social work

Role with the Workplace Initiative Use scientific baseline surveys to measure

attitudes & awareness as well as change over time

Over time: measure change & drill down into data

Role In Validating Efforts of the ROSC to the Community Similar efforts planned in conjunction with (for

example) providers, health plans and local gov’t

Regarding the Awareness Program Leverage data developed

The Awareness Program(think Susan G. Komen caliber

dealing with SUD)

• System transformation alone will not solve the problem. Stigma must be eliminated.

• A culture of recovery must be one in which we understand and treat SUD the same as we do any other chronic disease.

• Goal is to reach those (+/- 75%) who suffer from the disease and are unlikely to ever get help and draw them into the local RCO/ROSC model

• Employs “best of class” research and creative talent to design and deliver messaging to attack the barriers of shame and stigma

• We intend to license to RCOs anywhere

• Local RCOs could adapt to their particular needs consistent with the qualitative standards of the license

The Awareness Program(cont’d)

Research Phase: Theme Development

4 Qualitative Focus Groups

2 Qualitative Focus Groups/ 2 Triad Groups

500 Sample Benchmark Survey

6 Qualitative Focus Groups

400 Sample Benchmark Survey

4 to 6 weeks to complete (process has begun)

Survey work to follow first wave of ads to test efficacy

The Awareness Program(cont’d)

Creative Messaging & Media Phase

Focusing on Telling “the story of self”

Community Relations Program

Workplace Activities

TV, Radio & Newspaper Ads

Internet Advertising

Social Media Organizing

Special Events

The Awareness Program (cont’d)

Key to the Awareness Program is sustainability at the local level Research phase will not disappear because

it supports continuing evolution of creative phase

Greater sustainability if RCOs find natural partners in their communities to “own” and fund the Awareness Program Think of those associated at the community

level with events like “Race For The Cure,” etc.

The Advocacy Initiative

Goal is to unify the clinical & non-clinical provider resources into system of care that reflects the chronic nature of the disease

Initiative being led by Face It! board member, Avera Behavioral Health & Avera Health System

From the perspective of a payor/insurance company, the model will resemble a “specialty carve out” Avera Behavioral Health expects to be

accountable for the “quality” of the model Should further the goals of Health Care Reform

ALL sectors to be a part of the solution

“Newco – a bold, world-class,

innovative supplement to the good work that precedes

it

Independent (not part of Face It!), 501(c)(3) organization

National board of directors

Applying proven tools from social movements, political campaigns, grass-roots mobilizations, social networking and chronic disease management

3 areas of emphasis Proliferation of the South Dakota model to Affiliate

Communities Licensure of its Awareness Program Repository of evidence-based practices for Affiliates

Newco Funding Model

Start-up funding from private local and national donations

Recover costs for helping local RCOs/ ROSCs with strategic initiatives relating to exploring and/or implementing the South Dakota model

No charge expected for licensing “Awareness Program” to RCOs

On-going private donations (large & small)

National corporate partner support expected based on proliferation of awareness campaign and outcomes data from Newco “affiliates”

The South Dakota Model & SAMHSA’s Strategic

InitiativesSAMHSA’s Mission

To reduce the impact of substance abuse & mental illness on America’s communities

SAMHSA’s Strategic Initiatives

Prevention of Substance Abuse & Mental Illness

Trauma & Justice

Military Families

The South Dakota Model & SAMHSA’s Strategic

Initiatives (cont’d)

Health Care Reform

Housing & Homeless

Health Information Technology, Electronic Health Records & Behavioral Health

Data, Outcomes & Quality: Demonstrating Results

Public Awareness & Support

Summary Thoughts on theSouth Dakota Model

It extends the “community of support” into the workplace for purposes of mission and financial sustainability

It promotes the goals of Health Care Reform

It is intended to be private-sector funded

It is “data driven” – both to demonstrate ROI to a broad range of “investors” and to identify and proliferate best practices in the field

Has an evidence-based, world-class awareness program intended to draw those unlikely to ever get help into the local ROSC/RCO model

Drives the provider community to be knitted into a network

Newco is available to help communities, RCOs & ROSCs study the model

Face It! & Newco Contact Information

Face It! or Newco Kevin Kirby

Ph: 605-929-6115 or kevin.kirby@mac.com Charlie Day

Ph: 605-366-0211 or charlestday@att.net

Face It! (www.faceitsiouxfalls.org) Mary Hitzemann (Executive Director)

Ph: 605-274-7852 or mary@faceitsiouxfalls.org