LITS - Families and Consumers

Principle #2:

All individuals with co-occurring psychiatric and substance disorders (ICOPSD) are not the same; the national consensus four quadrant model for categorizing co-occurring disorders (NASMHPD, 1998) can be used as a guide for service planning on the system level. With resources and requirements of the COSIG, Quadrants 2 and 3 have been prioritized for action. Activities in Quadrants 1 and 4 remain as long-term goals. (Focus on organizing actions by quadrant model).

Strategy 1:

Focus on Quadrant 2 – Hi MH, Lo SA (currently in Mental Health System)

Action A Ensure that current agency mission statements encompass the treatment of persons with co-occurring disorders. *The use of ‘Local System of Care*’ in this document is to signify that statutorily created local governance entities (LGE’s) are the recognized authority in the designated geographic area. The LGE executive director is responsible for operations and meeting/exceeding outcomes as established by DHH. The board and executive director comprise the local governance structure (Current LGE’s are CAHSD, FPHSA, JPHSA, and MHSD).
Action B Revise definition of target population to include those with co-occurring substance use disorders, provided agency level of severity criteria is met.
Action C Charge the Division of Research, Evaluation and Information Technology to ensure that all service planning initiatives support CODC.
Action D Develop a mechanism to ensure all new and existing programming supported by OMH resources (fiscal and/or personnel) supports CODC.
Action E Incorporate developed core competencies into job descriptions and annual Planning and Performance Reviews (PPR).
Action F Development of needed specialized programs to attain CODC (see Principle 7 for detailed plan)
	1.	Identify target population whose needs exceed the scope of adopted clinical practice guidelines due to co-occurring disorders
	2.	Obtain expert consultation regarding program development, including service design, funding streams, and potential cross-agency partnerships.
	3.	Charge Division of Program Development to manage development and implementation process.
Action G Coordinate services with medical care
	1.	Incorporate queries regarding health status and access to medical care into intake process
	2.	Refer/link to appropriate medical home (primary care physician) if no current access
	3.	Ongoing coordination with medical service provider

Strategy 2:

Focus on Quadrant 3 – Lo MH, Hi SA (currently served in Addictive Disorder System)

Action A Ensure that current agency mission statements encompass the treatment of persons with co-occurring disorders.
Action B Revise definition of target population to include those with co-occurring mental disorders, provided agency service criteria is met.
Action C Charge the Division of Research, Evaluation, and Information Technology to ensure that all service planning initiatives support CODC.
Action D Develop a mechanism to ensure all new and existing programming supported by OAD resources (fiscal and/or personnel) supports CODC.
Action E Incorporate developed core competencies into job descriptions and annual Planning and Performance Reviews (PPR).
Action F Development of needed specialized programs to attain CODC (see Principle 7 for detailed plan)
	1.	Identify target population whose needs exceed the scope of adopted clinical practice guidelines due to co-occurring disorders
	2.	Obtain expert consultation regarding program development, including service design, funding streams, and potential cross-agency partnerships.
	3.	Charge Division of Program Development to manage development and implementation process.
Action G Coordinate services with medical care
	1.	Incorporate queries regarding health status and access to medical care into intake process
	2.	Refer/link to appropriate medical home (primary care physician) if no current access
	3.	Ongoing coordination with medical service provider

Strategy 2:

Focus on Quadrant 1 - Lo MH, Lo SA (currently served in primary care settings)

Action A Collaboration and support of Primary Care Initiative (Closing the Gap)
	1.	Maintain Taskforce representation in Closing the Gap activities
	2.	Ensure plan development within each initiative is complimentary, not contradictory or duplicative of the other
Action B Collaboration with current prevention initiatives

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:

Focus on Quadrant 4 – Hi MH, Hi SA (currently presenting in emergency rooms, jails, homeless shelters)

	Action A Engage and collaborate with LSU, Louisiana Hospital Association, and Coroner’s Office and local systems of care to develop comprehensive response system for referral and follow-up
	Action B Collaboration, within local systems of care, with law enforcement and justice system, including the Louisiana Association of Sheriffs
	Action C Identify and support current initiatives focused on crisis intervention services.