R A U L G A R C I A , L M S W
S U B S T A N C E U S E D I S O R D E R S P R O G R A M C O O R D I N A T O R , T C S O
C O - C H A I R , A U S T I N R O S C I N I T I A T I V E
The Implementation of Long Term
Recovery Services in TCSO
Objectives
Key Learning Points
Understand the key aspects of a recovery oriented system of
care
Understand the evolution of implementation and future
components of adding ROSC Principles
Understand the keys to community collaboration
Lessons learned as take aways to implementing ROSC
Recovery Oriented
Systems of Care
What is ROSC? What does it mean?
Recovery Oriented Systems of Care
Networks of organizations, agencies, community members that
coordinate a wide spectrum of services to prevent, intervene in, and treat behavioral health issues
Most Important Factors
Integration
Recovery focus for all health conditions
Disease Management Model
Chronic Care
Long Term Recovery Focus
2-5 years of Recovery
Community Collaboration
Important Factors in Understanding ROSC
Support of Life in
Recovery
Home
Health
Purpose
Community
Guiding Principles
Hope
Person Centered
Multiple Pathways
Holistic
Supported by Peers
Relationships and Social
What is translatable in Public Service?
Continuum of Care
ROSC
Pre-Recovery EngagementROSC
Treatment Initiation and StabilizationROSC
Recovery MaintenanceROSC
Enhancement of Quality of Life in Long-term RecoveryWhat is ROSC doing in the Austin Community?
Austin ROSC Initiative A collection of stakeholders working to create a recovery oriented system of care Not an entity or organization
History
Started in 2011
Initial Phase of Education Philadelphia Field Study Current Phase of Action
Process Education Collaboration Transformation Current Focus Project Oriented
Offer assistance in the following
Referral Networks Policy and Practice
TCSO Substance Use Disorders
Programs
Historical Perspective of
TCSO Substance Use Disorders Programs
Drug and Alcohol Program
Relapse Prevention
Education
12 Step Meetings
Changes
Need for Separate Programs
Looked for Expansion of Community Connections
Creation of the Rise Up Program
Current Programming
Assessment Process
TCU Drug Screening II Form
Key factor was motivation
Programs/Outpatient Services
POWER Program Education Based Rise Up Program Cognitive Based 12 Step Program AA, CA, NA Fellowships
Recovery Support Programs
Recovery Support Group Recovery Yoga
Moving in a new direction…
Learned from ROSC Principles
What we were doing
Creating a Philosophical Shift in Practice
Addressing the understanding of long term recovery
Understanding of multiple pathways/person centered approach to
recovery
Holistic Approach to finding recovery
What we weren’t doing:
Understanding the risk of untreated substance use disorders
Understanding that true integration was recovery approach for all
heath conditions
Need for inclusion of community partners Ongoing provision of services after release
Looking through a different lens…
Historically looked through a mental health lens
Depression Mania
Psychosis
Now looking through a Substance Use Lens
Anxiety
Poor Decision Making Impulse Control
We have to begin to see these as equal
Treating Substance use the same as mental health Stop blaming the victim
Changes for the Future
Transition from Jail to Community Model
Initiating services at Booking Five Phase Model
Four Levels of Service
Development of Treatment Program
Targeting high risk substance dependent individuals Looking for Jail Diversion
Development of Substance Use Clinical Team
Assigned Acute Unit
Mirror Mental Health Services
Integration Focus
Community Partners
“Warm Hand Offs”
Key Factors in Implementation
Educating staff
Overcoming bias and stereotypes Same for any condition
Combination Approach
Bottom up initially Top down now
Understand how applying principles translates in work
already done
Understand how to improve policy not change policy
Practice will change policy
Most importantly how are we working with others to help
Austin ROSC Initiative and
Creating Connections
Setting the Stage
Aligning Concepts: Changing
how we think
Aligning Practice: Changing how we
use language and practices at all levels; implementing values based change
Aligning Context: Changing regulatory
environment, policies and procedures, community support
PRACTICE
CONTEXT CONCEPTS
Community Collaboration Goals
Creating Leadership
Sheriff Greg Hamilton buying in and leading charge for change
Accountability for all community partners and collaborations to engage ROSC
Principles
Making Connections
Connecting with established partners Creating direct service connections inside
Helping identify the places in continuum is vital
Everyone has a place to help Getting out of just what you do
Person Centered Approach
Client Perspective
Fragile
Engaging Complex System
Case Manager Perspective
Empathy
Community Collaboration Efforts
Travis County Sheriff’s Partners
Becoming the guiding organization in the community to
incorporate ROSC Prinicples into all practice
Austin ROSC Pilot/Networking Project
Effort to practice ROSC in our community
Creating first ROSC Oriented Referral Network in Austin
Network for Organizations
Sobriety Center Support
Creating Leadership to help guide development through ROSC
Lessons Learned
No direct answers
Ask questions
Are we truly working with organizations across the continuum? What can we do?
What can we do with others?
Allow the process to be its own
People and organizations will challenge conventional wisdom
Work to strengths
Let organizations take center stage
“Go with the willing”
Bridge the gap between providers and recovery support
Questions?
"Give a man a fish and you feed him for a day.
Teach a man to fish and you feed him for a
lifetime.“
How to get involved?
Travis County Sheriff’s Office
Mary Moran, ReEntry Administrator
Raul Garcia, Substance Use Disorders Program Coordinator
Susan Perryman-Evans, Programs Manager
Austin ROSC Initiative
Raul Garcia, Co-Chair Pat Malone, Co-Chair
Jason Howell, Education and Advocacy Coordinator
