Hosts: UCLA Integrated Substance Abuse Programs (ISAP) & CA Dept. of Alcohol and Drug

SUMMARY REPORT

MEETING 11

Date: Wednesday, March 28, 2012

Time: 10:30AM – 12:00PM

Hosts: UCLA Integrated Substance Abuse Programs (ISAP) & CA Dept. of Alcohol and Drug Programs (ADP)

Topic: A Vision for the Future: Workforce Investment; Essential Benefits and Parity Update

Presenter: -- Mady Chalk, PhD

Director, Center for Policy Analysis and Research, TRI

Review of ILC Meeting 10

UCLA ISAP

·  The tenth ILC meeting, conducted on February 22, 2012, involved a presentation by Lily Alvarez and Darren Urada on the integration initiatives in Kern County. Special thanks to presenters Lily Alvarez and Darren Urada who described their program and experiences and responded to questions posed in an open forum from meeting attendees. Thank you all for your participation. A summary from this meeting has been posted on the UCLA ILC webpage: http://www.uclaisap.org/Affordable-Care-Act/html/learning-collaborative/index.html

Logistics

§  Summary and materials discussed from the previous ILC meetings are available at http://www.uclaisap.org/Affordable-Care-Act/html/learning-collaborative/index.html. Subsequent meeting materials will continue to be posted on this site.

§  The next ILC meeting will be on April 25, 2012 from 11:00AM to 12:00PM. UCLA has invited Larissa Mooney, MD to discuss Medication Assisted Treatment.

§  All further meetings are scheduled to be held at 11:00AM (PT) on the 4th Wednesday of every month, unless otherwise noted.

ILC Meeting 11 Topic:

A Vision for the Future: Workforce Investment; Essential Benefits and

Parity Update

Topic Introduction – Darren Urada, PhD, UCLA ISAP

§  The topic for today’s learning collaborative is to hear about future workforce investments as well as an update on essential benefits and parity. We thank Dr. Mady Chalk for presenting on this topic and hope this will be a learning opportunity for those in the audience but also for the speaker. Questions and trouble shooting among the group are encouraged.

Mady Chalk, PhD

Director, Center for Policy Analysis and Research, TRI

Summary

Current Issues Surrounding SUD Workforce

·  Workforce:

§  Increasing demand for higher skills, flexibility in services, and expanding roles in staff as new types of patients in new types of settings increase.

§  Lack of technology in SUD treatment facilities that other health care institutions use.

·  Workforce demand:

§  Relatively short longevity and high turnover rate in workforce.

§  Treating SUD as a chronic illness and adapting treatment so that its patient centered.

§  Scientific advances require new skills and flexibility in staff and organization.

·  Workforce supply:

§  Declining enrollment in professional schools, poor minority representation in health care profession and lack of unified plans for investment in workforce development are hindering a fully developed workforce.

Comparative Industry Models:

·  Honda Flexifactories:

§  Factory that is capable of changing its item of production with relative ease, low cost, and great rapidity.

§  Capable of making more than one model simultaneously, employees are expected to be flexible, and operate as a network that balances capabilities.

·  Flexi Treatment Programs:

§  Capable of changing administrative/organizational approaches, treatment models, or components of treatment with relative ease.

§  Forms a vital bridge between individual clinicians, technologies, and organizational strategies for coping with shifting referrals and treatments.

§  FlexiClinicians: capable of adapting treatment approaches/services to individual clients with relative ease, provide similar quality of care for a diverse patient population, and function on a team with a diversity of skill sets.

·  Biggest advantage of this model is flexitxprograms can balance services between programs so that each facility does not have to offer diminished services when it can simply outsource services.

·  Semi-Conductor Industry:

§  A knowledge-based industry that has used advances to double computing power about every 18 months, it faces technological challenges that threaten the industry, and relies on employees to devise clever solutions to these problems.

§  This industry must compete in a “high-velocity” environment where uncertainty is created by tech change, fluctuations in demand, and regulatory decisions.

§  Workers in this industry are skilled and educated which allow them to create, interpret, analyze, and transform to create value form knowledge.

·  Implications for Addiction Treatment:

§  Concerns: increased rate of development of new technologies (e.g. medications for cocaine and meth), increased complexity of process of care, and greater emphasis on management issues relative to technical issues.

§  Organizational and infrastructure support will be needed if new technologies are introduced as quickly as they are developed.

·  Example: multi-organizational coordination with primary care

§  Managerial capabilities: must expand to manage the volume of clients (including new clients from expansion with health care reform), must manage pace of clients moving through PC and specialty care, must implement multi-org collaboration, and must bring in new types of human resources.

§  As science advances, product (treatment and recovery) complexity will increase and issues will emerge at an increasing pace.

§  Performance improvement of care process, individual clinician’s practice, and infrastructure for service delivery will be a necessary component to long-term goals.

§  Treatment programs should develop their areas of strength and outsource areas of weaknesses while still maintaining flexibility.

§  There may be an increasing trend toward specialized treatment programs that then could link in a highly collaborative way to create the combined capabilities needed to offer a complete continuum of care (patient-focused, adapted, and flexible) at a reasonable cost.

·  Areas where failure is likely to occur:

§  Getting stuck in the past

§  Losing track of useful information about scientific advances

§  Not wanting to try new processes and revisit old decisions

§  Staying stuck in process and not making new decisions

§  Not adapting to the new reality that identifies substance use disorders as a chronic health condition.

Discussion:

Q: Minority-owned community health centers do not like the proposition of being absorbed into a large primary health system. These communities like to have “a piece of the action” in terms of providing health care to their communities, although it may disrupt/slowdown the service continuum.

A: How you balance ownership and owning part of the field with survival and what needs to happen in terms of networks is important.

Closing Remarks – Darren Urada, UCLA ISAP

§  Thanks again to Dr. Chalk for presenting today. It is always helpful to hear from experts in the field of addiction policy. Thank you for volunteering your time and sharing with the group.

§  The next ILC Meeting is scheduled on Wednesday, April 25, 2012 at 11:00am.

§  Please remember to reference the website which holds all information and materials disseminated from the ILC: http://www.uclaisap.org/Affordable-Care-Act/html/learning-collaborative/index.html.

APPENDIX 1 – ATTENDEES

COUNTY PARTICIPANTS

MBA

Ø  Amador (Pat Bartosiewicz, Jennifer Magee, Sherry Parkey)

Ø  Del Norte (Jill Fullington)

Ø  Calaveras (David Sackman)

Ø  Colusa (Deana Fleming)

Ø  Glenn (Erin Valdez, Thomas Waggoner)

Ø  Inyo (Linda Benson)

Ø  Lake (Linda Morris)

Ø  Lassen (Linda Morris, David Rothery, Anita Harsh, Sue Bandouski)

Ø  Mariposa (Linda Murdock)

Ø  Mono (Robin Roberts)

Ø  Modoc (Tara Shepherd)

Ø  San Benito (Alan Yamamoto)

Ø  Sierra (Rhonda Grandi)

Ø  Siskiyou (Randy Davis)

Ø  Tehama (Susan McVean)

SMALL

Ø  Butte (Dean True, Marion Reeves)

Ø  El Dorado (Shirley White)

Ø  Humboldt (Helene Barney)

Ø  Kings (Brenda Randle)

Ø  Madera (Sonja Bentley, Cesar Velasquez)

Ø  Mendocino (Leslie Kirkpatrick)

Ø  Merced (Manuel Jimenez, Natalie Vasquez, Kathleen Reyes, Tabatha Weeda)

Ø  Napa (Karen McElroy, Lisa Montanez, Connie Moreno-Peraza)

Ø  Nevada (Mary Lowe)

Ø  Shasta (David Reiter)

Ø  Sutter & Yuba (Nancy Lee)

Ø  Yolo (Mark Brian)

MEDIUM

Ø  Kern (Lily Alvarez)

Ø  Marin (Michael Hodges, DJ Pierce)

Ø  Monterey (Robert Jackson)

Ø  Placer (Amy Ellis, Cheryl Renwita)

Ø  San Joaquin (Vic Singh, Curt Willems)

Ø  Santa Barbara (J. Doyle)

Ø  Santa Cruz (Bill Manov)

Ø  Solano (Andrew Williamson)

Ø  Sonoma (Derrick West)

Ø  Stanislaus (Madelyn Schlaepfer)

Ø  Tulare (Michelle Reynoso)

LARGE

Ø  Alameda (Tom Trabin)

Ø  Contra Costa (Karen Fearn)

Ø  Fresno (Dennis Koch)

Ø  Los Angeles (John Viernes)

Ø  Orange County (Brett O’Brien)

Ø  Riverside (Karen Kane)

Ø  Sacramento (Lisa Scott-Lee, Maria Morfin, Melinda Avey, Paul Tanner)

Ø  San Bernardino (Dianne Sceranka, Vicki Baumbach, Gary Atkins)

Ø  San Diego (Marshall Lewis, Angie DeVoss, Susan Bower)

Ø  San Francisco (Alice Gleghorn)

Ø  San Mateo (Clara Boyden, Keith Clausen)

Ø  Santa Clara (Michael Hutchinson, Nubia Torres, Robert Gardner)

Ø  Ventura (Patrick Zarate)

ORGANIZATION PARTICIPANTS

Ø  ADPI (Victor Kogler)

Ø  CAADPE (Albert Senella)

Ø  CADPAAC (Tom Renfree)

ADP Participants

Ø  Michael Borunda

Ø  Cynthia Castillo

Ø  Craig Chaffee

Ø  Tina Chiginsky

Ø  Debra Connick

Ø  Michael Cunningham

Ø  Jessica Delgado

Ø  Darien De Lu

Ø  Mary Dodson

Ø  Jonathan Graham

Ø  Theresa Gulley-Reed

Ø  Cynthia Guest

Ø  Gayle Hirahara

Ø  Sally Jew-Lochman

Ø  Janine LaMar

Ø  Marjorie McKisson

Ø  Maurilio Mendez

Ø  Dave Neilsen

Ø  Katrina Parker

Ø  Nanette Rufo

Ø  Suzi Rupp

Ø  Gigi Smith

Ø  Denise Wallace Warrick

Ø  Kevin Wortell

Ø  Marcia Yamamoto

Ø  Angela Zamora

Ø  Trinidad Perez

UCLA Participants

Ø  Richard Rawson

Ø  Darren Urada

Ø  Valerie Pearce Antonini

Ø  Sherry Larkins

Ø  Desiree Crevecoeur-MacPhail

APPENDIX 2 – Agenda and Relevant Materials

·  Overview of Meeting 10

·  Introductions

§  Mady Chalk, PhD

·  Topic Discussion – A Vision for the Future: Workforce Investment; Essential Benefits and Parity Update

·  Q and A

Materials for this meeting

§  PPT Presentation – Mady Chalk, PhD

Copies of materials can be found at UCLA ISAP’s ACA Resources Website:

http://www.uclaisap.org/Affordable-Care-Act/html/learning-collaborative/index.html.