LITS - Families and Consumers

Principle #1:

Dual Diagnosis is an expectation, not an exception. “Implies the need for an integrated system planning process, in which each funding stream, each program, all clinical practices, and all clinician competencies are designed proactively to address individuals with co-occurring disorders who present in each component of the system already” (Focus on system planning).

Strategy 1:

Re-establish the Behavioral Healthcare Taskforce as the policy making body to oversee the planning and change process, as outlined in the Co-occurring State Incentive Grant (COSIG) and the Co-occurring Policy Academy Plan.

	Action A Formalize Deputy Secretary of Department of Health and Hospitals (DHH) as chair of Taskforce
	Action B Established membership of Taskforce to include Governor Health Policy Advisor, Assistant Secretary of Office of Mental Health (OMH), Assistant Secretary of Office for Addictive Disorders (OAD), Director of Bureau of Health Financing, Chair of Mental Health Planning Council, Chair of Governor’s Commission on Addictive Disorders, Executive Director of Capital Area Human Services District, Private Provider representative (currently filled by LA Association of Ambulatory Healthcare representative), representative from Client Advisory Board, Assistant Secretary of Office of Public Health
	Action C Taskforce will utilize committees to develop recommendations and implement detailed work plans to carry out the planning and change process. Committees to include: Funding, Clinical Protocol, Workforce Development and Management Information Systems/ Evaluation. Committees will be charged by the Taskforce and committee chairs will attend Taskforce meetings and provide additional staff support as needed.
	Action D Primary staff to the Taskforce will include COSIG Project Directors, COSIG Project Coordinator, and COSIG Administrative Assistant.
	Action E Additional key staff are encouraged to attend Taskforce meetings.

Strategy 2:

Develop statewide written strategic plan and timeline to support the implementation and operation of Co-occurring Disorder Capability (CODC).

Action A Adopt CODC definition
Action B Revise current agency mission statements, target populations, and planning and service development activities to reflect CODC.
Action C Adopt ‘no wrong door’ policy to include the development of integrated screening, assessment, MIS, referral, follow up, and evaluation of the no wrong door concept (more detail provided in breakdown of principles 5, 7, 8).
Action D Assess current service system for gaps through the following:
	1.	Use of the Comprehensive, Continuous Integrated Systems of Care Outcome Fidelity and Implementation Tool (COFIT), the Comorbidity Program Audit and Self-survey (COMPASS), and the Co-occurring Disorders Education Competency Assessment Tool (CODECAT)
	2.	Local focus groups convened by Gov. Commission on Addictive Disorders
	3.	Input from Client Advisory Board
	4.	Work of the Clinical Protocol Committee
	5.	Consultations with experts in the field of co-occurring.
Action E Adopt and mandate set of core competencies and guiding principles (more detail provided in Principle 7)
Action F Refinement of existing services and development of specialized programs to obtain CODC (more detail provided in Principle 7)

Strategy 3:

Assure program resources equally support CODC for currently served target population. Because plan targets CODC for current caseloads and no expansion into the unserved population is expected, limited fiscal impact is to be expected.

Action A Maximize COSIG funds to ensure appropriate initial training and ongoing competency development.
Action B Identify resources to support drug screening within OMH system.
Action C Identify resources to provide psychiatric services and medications, primarily within OAD system.
	1.	Evaluate Medicaid funding through establishment of Addictive Disorder (AD) clinics as satellite Mental Health (MH) clinics
	2.	Input from Client Advisory Board
Action D Explore additional possible funding streams.

Strategy 4:

Support Local Systems of Care** and Local Steering Committees in development and implementation of CODC at the local level.

	Action A Through COSIG funds, provide group facilitators to serve as staff to the local committee, provide training, and technical assistance as needed.
	Action B Assure development and implementation of local CODC plan which will address administration and management, policy and funding, staffing and supervision, interagency service network, cross training, quality and outcomes management, management information systems.
	Action C Develop mechanism to ensure direct consistent flow of communication from the state level Taskforce to the Local Systems of Care & Local Steering Committees and from the Local Systems of Care & Local Steering Committees to the direct service staff, and visa versa. For the Human Service Districts and Authorities, flow of information occurs through the Executive Directors.