- Email: [email protected]
Integration of substance use disorder treatment with primary care in preparation for health care reform
Abstracts / Drug and Alcohol Dependence 140 (2014) e169–e251
trial-to-trial PE learning signals as strongly as the Controls in the striatum, medial orbitofrontal cortex, and insula. Conclusions: Better tracking of PE signals in controls compared to SDI suggests that a possible mechanism of poor decision-making in substance dependence may involve disruptions in PE learning processes. Group differences in striatal and OFC suggest that frontal–striatal pathways may represent targets for future therapies in drug addiction. Financial support: National Institute of Drug Abuse DA024104 and DA02774. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.617 CJDATS2 local change team initiatives for improving assessment for drug treatment in correctional systems L.R. Taylor 1 , Gerald Stahler 2 , Matthew Hiller 1 1 Department of Criminal Justice, Temple University, Philadelphia, PA, United States 2 Geography & Urban Studies, Temple University, Philadelphia, PA, United States
Aims: CJDATS2 is a NIDA-funded national initiative to implement and evaluate organizational and process improvement strategies within correctional systems. Goals for this multisite project include identifying and addressing gaps in assessment, service planning, and service delivery for offenders as they transition from correctional custody to community treatment. Each research site includes representatives from a partnered prison system and a community treatment provider to form a local change team (LCT). In collaboration with an external facilitator, the LCT then identifies areas for improvement in the process of offender assessment, and develops a Process Improvement Plan (PIP) to address these needs. This paper provides a brief overview of the Assessment component of the CJDATS2 initiative, and describes the strategies selected by the LCTs to improve the assessment and case planning process. Methods: CJDATS2 includes 9 research centers. Using the Organizational Process Improvement Intervention (OPII), each site formed an LCT and developed a Process Improvement Plan. The authors examine the goals and objectives of these plans to identify common themes and the range of interventions identified by the LCTs for improving the assessment process within correctional systems. Results: Among the targeted areas in the Process Improvement Plans were strategies for improving the conveyance of assessment information from prison to community corrections systems, adopting new assessment instruments for substance abuse as well as other areas of offender functioning, and developing new methods for consolidating and integrating assessment information in case plans for improved continuity of care. Conclusions: The OPII may prove useful in creating dialogue between agencies regarding high priority treatment needs in the substance abuse assessment process and in outlining the steps to address these needs. Financial support: This study was funded by the National Institute on Drug Abuse (NIDA). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.618
e223
Integration of substance use disorder treatment with primary care in preparation for health care reform Cheryl Teruya, Darren Urada Integrated Substance Abuse Programs, UCLA, Los Angeles, CA, United States Aims: As a result of the Affordable Care Act, substance use disorder (SUD) services are expected to become more integrated with primary care. However, the data on the state of integration is currently limited. Our aims are to: Describe the state of SUD services and integration in federally qualified health centers (FQHCs). Examine barriers and facilitators of integration from the provider/other stakeholder perspectives. Recommend changes in policy to support integration efforts. Methods: Mixed quantitative and qualitative research methods were used to investigate specific SUD-related practices and the integration with primary care. A web-based survey was conducted among FQHCS in 5 California counties. Descriptive data analyses were performed to characterize the nature of the services and models/levels of SUD service integration. Providers/other stakeholders from three FQHCs (n = 18) were interviewed to gain a more indepth understanding of integration efforts. Qualitative data were analyzed using Atlas.ti. Results: Fourteen FQHCs completed the survey (78% response rate). Half of the FQHCs reported close collaboration between SUD and primary care, but the other half indicted only minimal or basic levels of integration. SUD services are generally not as well integrated with primary care as mental health services are, are rated as less effective, and are separated from primary care services physically and temporally; use of common evidence-based practices is moderate. Barriers to SUD integration include inadequate workforce training, billing restrictions/requirements, and limited specialty SUD services in the community for patient referrals. Facilitators of integration include easy access to behavioral health specialists, providers with the right “fit”, and an organizational culture supportive of innovation. Policy recommendations will be presented. Conclusions: Some integration of SUD services with primary care is occurring, but SUD practices vary widely, and there is more work to be done. Policy changes are needed to support and facilitate integration. Financial support: California Program on Access to Care #KKN06A. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.619 Adolescent and emerging adult marijuana triers and non-users: The difference in potential HIV risk Sneha Thamotharan, Krista Lange, A. Herrick, M. Sferra, S. Fields Psychology, Texas A&M University, College Station, TX, United States Aims: The combination of substances and risky sexual behavior increases the likelihood of contracting HIV. Two behaviors that have been linked to one another include marijuana use and risky sex. Previous research has attempted to examine decision making as an underlying behavioral mechanism contributing to increased risk behavior during adolescence. The present study aimed to examine
trial-to-trial PE learning signals as strongly as the Controls in the striatum, medial orbitofrontal cortex, and insula. Conclusions: Better tracking of PE signals in controls compared to SDI suggests that a possible mechanism of poor decision-making in substance dependence may involve disruptions in PE learning processes. Group differences in striatal and OFC suggest that frontal–striatal pathways may represent targets for future therapies in drug addiction. Financial support: National Institute of Drug Abuse DA024104 and DA02774. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.617 CJDATS2 local change team initiatives for improving assessment for drug treatment in correctional systems L.R. Taylor 1 , Gerald Stahler 2 , Matthew Hiller 1 1 Department of Criminal Justice, Temple University, Philadelphia, PA, United States 2 Geography & Urban Studies, Temple University, Philadelphia, PA, United States
Aims: CJDATS2 is a NIDA-funded national initiative to implement and evaluate organizational and process improvement strategies within correctional systems. Goals for this multisite project include identifying and addressing gaps in assessment, service planning, and service delivery for offenders as they transition from correctional custody to community treatment. Each research site includes representatives from a partnered prison system and a community treatment provider to form a local change team (LCT). In collaboration with an external facilitator, the LCT then identifies areas for improvement in the process of offender assessment, and develops a Process Improvement Plan (PIP) to address these needs. This paper provides a brief overview of the Assessment component of the CJDATS2 initiative, and describes the strategies selected by the LCTs to improve the assessment and case planning process. Methods: CJDATS2 includes 9 research centers. Using the Organizational Process Improvement Intervention (OPII), each site formed an LCT and developed a Process Improvement Plan. The authors examine the goals and objectives of these plans to identify common themes and the range of interventions identified by the LCTs for improving the assessment process within correctional systems. Results: Among the targeted areas in the Process Improvement Plans were strategies for improving the conveyance of assessment information from prison to community corrections systems, adopting new assessment instruments for substance abuse as well as other areas of offender functioning, and developing new methods for consolidating and integrating assessment information in case plans for improved continuity of care. Conclusions: The OPII may prove useful in creating dialogue between agencies regarding high priority treatment needs in the substance abuse assessment process and in outlining the steps to address these needs. Financial support: This study was funded by the National Institute on Drug Abuse (NIDA). http://dx.doi.org/10.1016/j.drugalcdep.2014.02.618
e223
Integration of substance use disorder treatment with primary care in preparation for health care reform Cheryl Teruya, Darren Urada Integrated Substance Abuse Programs, UCLA, Los Angeles, CA, United States Aims: As a result of the Affordable Care Act, substance use disorder (SUD) services are expected to become more integrated with primary care. However, the data on the state of integration is currently limited. Our aims are to: Describe the state of SUD services and integration in federally qualified health centers (FQHCs). Examine barriers and facilitators of integration from the provider/other stakeholder perspectives. Recommend changes in policy to support integration efforts. Methods: Mixed quantitative and qualitative research methods were used to investigate specific SUD-related practices and the integration with primary care. A web-based survey was conducted among FQHCS in 5 California counties. Descriptive data analyses were performed to characterize the nature of the services and models/levels of SUD service integration. Providers/other stakeholders from three FQHCs (n = 18) were interviewed to gain a more indepth understanding of integration efforts. Qualitative data were analyzed using Atlas.ti. Results: Fourteen FQHCs completed the survey (78% response rate). Half of the FQHCs reported close collaboration between SUD and primary care, but the other half indicted only minimal or basic levels of integration. SUD services are generally not as well integrated with primary care as mental health services are, are rated as less effective, and are separated from primary care services physically and temporally; use of common evidence-based practices is moderate. Barriers to SUD integration include inadequate workforce training, billing restrictions/requirements, and limited specialty SUD services in the community for patient referrals. Facilitators of integration include easy access to behavioral health specialists, providers with the right “fit”, and an organizational culture supportive of innovation. Policy recommendations will be presented. Conclusions: Some integration of SUD services with primary care is occurring, but SUD practices vary widely, and there is more work to be done. Policy changes are needed to support and facilitate integration. Financial support: California Program on Access to Care #KKN06A. http://dx.doi.org/10.1016/j.drugalcdep.2014.02.619 Adolescent and emerging adult marijuana triers and non-users: The difference in potential HIV risk Sneha Thamotharan, Krista Lange, A. Herrick, M. Sferra, S. Fields Psychology, Texas A&M University, College Station, TX, United States Aims: The combination of substances and risky sexual behavior increases the likelihood of contracting HIV. Two behaviors that have been linked to one another include marijuana use and risky sex. Previous research has attempted to examine decision making as an underlying behavioral mechanism contributing to increased risk behavior during adolescence. The present study aimed to examine