Washtenaw SUD System Transformation Initiative celebrates early wins

Story by Lovella Calica, WHI Social Work Intern

Since November 2018, dozens of representatives from Washtenaw-area organizations that are deeply involved in the prevention and treatment of substance use disorders (SUD) have been participating in an SUD system transformation process hosted by the Washtenaw Health Initiative, as part of its State Innovation Model (SIM) work in Livingston and Washtenaw counties. The process, formerly called ABLe change, was launched and led by community psychology experts at Michigan State University.

After a productive meeting in May, seven action teams—comprised of substance use disorder treatment providers, community mental health organizations, hospitals, law enforcement agencies, public health entities, and more—set out to complete key tasks during a 100-day challenge. Then, on September 25, the group met again to highlight their accomplishments and outline next steps.

One action team focused on the importance of integrating people on the recovery spectrum into the SUD transformation planning and decision-making process.

In demonstrating their commitment to this value, Home of New Vision brought individuals in recovery to participate in the meeting. Home of New Vision (HNV) is a local non-profit that serves those with substance use disorders, providing a wide array of services designed to fit their individual needs.

“Home of New Vision is dedicated to including recovery coaches in everything,” says Curtis Thornton, clinical director of Home for New Vision and a Certified Advanced Alcohol and other Drug Counselor (CAADC) and Certified Clinical Supervisor (CSS) with 20 years of experience. “There is a commitment to have individuals who have been impacted through their own need at the table.”

In addition, there are plans in progress to create a peer advisory group (made up of people in recovery or on the recovery spectrum) that will be hosted by WRAP, the Washtenaw Recovery Advocacy Project. As Home of New Visions’ recovery community organization (RCO), WRAP works to support recovery by bringing together community members, individuals in recovery, family members, and allies through community education and events.

“WRAP is a great place to give back and get involved, no matter where an individual might be on the recovery spectrum, from the first day or years into their journey,” says Matt Hill, the WHI SUD program manager.

  • WHI members are encouraged to work with WRAP leadership to ensure that people on the recovery spectrum are engaged in SUD system changes by emailing sszczotka@homeofnewvision.org.

One of the more important aspects of the meeting was agreement on some of the language related to work in the SUD sphere. Historically, the term “addiction” has been used to describe people with this chronic disease. This term, and others like it, has negative connotations. The stigma team, along with many other leaders in this field, have adopted person-first language such as “people in recovery” or “people on the recovery spectrum” to include individuals who are considering treatment, those who are currently in rehabilitation, and those who have gone through treatment.

WRAP, one of the two-dozen organizations that participated in the SUD system transformation process, offers recovery messaging training. The goal of this training is to acquire a new set of language and tools to help reduce stigma and create a more positive image of recovery.

  • WRAP will host a recovery messaging training event on January 17, 2020. Learn more on their website or by contacting Sara Szczotka at sszczotka@homeofnewvision.org.

Another action team was tasked with identifying and defining shared values for all organizations in the SUD prevention and treatment space. They created a draft shared values statement, which will be critical in guiding the future of this work. The entire group gave in-depth feedback and agreed to seek involvement from people in recovery to define words and concepts that may be used in the statement, such as equitable, patient-centered, and holistic. They unanimously agreed to be direct about their intention to utilize a “coordinated system of services.”

To add to the summer successes, the SUD treatment intake process, specifically the birth month assignment for initial screening, was discussed at length by several organizations including the Community Mental Health Partnership of Southeast Michigan, Dawn Farm, Home of New Vision, and the Washtenaw County Community Mental Health agency.

These partners shared the history of using birth month to assign individuals to treatment providers for initial screening, and sought to learn more from attendees about improvements they expected from modification of the process. Before the birth month assignment process was instituted, they said, individuals seeking care would sometimes complete initial screenings at both treatment providers, thus doubling the screening cost. For many years in a row, this resulted in the public system running out of funds before the fiscal year was over, leaving many individuals who were ready and seeking treatment to have to wait months until a new fiscal year started and funds were available again. This group of providers will seek further conversations with partners who refer patients and clients for treatment to learn more about the desired outcomes of referrals from those partners.

“The ABLe change process has done a really good job of getting people talking,” said Nicole Adelman, director of clinical and substance use disorder services at the Community Mental Health Partnership of Southeast Michigan. “Agencies are coming together having conversations that need to be had. Everyone wants people to have access to the services they need. We are all working toward the same end goal and there’s positive movement.”

Responding to a dire need for information, one team created a document that identified the array of organizations providing SUD services for Washtenaw County residents. This extensive document provides contact information for over 100 organizations, peer groups, meetings, coaches, treatment centers, and more for both adults and youth.

Less than a week after the SUD transformation meeting, the Washtenaw Opioid Summit welcomed about 250 people at Washtenaw Community College. In the lead up to the event, SUD system transformation action team members were able to connect with organizers and ensure that reducing stigma was the major theme of the summit. “This nuanced conversation needed to happen in order for cultural change to occur, and focusing on it at the opioid summit was important and well received”, says Carrie Rheingans, Washtenaw Health Initiative project manager.

As with any systems change process, transforming the Washtenaw SUD system will take more than just one year. This work will continue under the leadership of the Washtenaw Health Initiative’s Mental Health and Substance Use Disorder Work Group (MHSUD).

Federal funding tied to Michigan’s State Innovation Model grant, which ends on January 31, 2020, was used to hire community psychology experts from Michigan State University to train community partners in systems change methodology to address substance use disorder. However, MSU experts will continue mentoring Washtenaw County leaders to improve the local SUD system.

The WHI MHSUD Work Group will ensure that the SUD system transformation work is tied to other community initiatives, as well, such as activities related to the Public Safety and Mental Health Millage and the WHI Opioid Project. WHI members and other interested community members and leaders are encouraged to join the work to transform our local SUD system. Contact WHI SUD Program Manager Matt Hill to get involved (hillmat@med.umich.edu).