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Monday, April 1, 2013

Strategic Plan for the Organization and Delivery of Substance Abuse Services in Maryland

The health care landscape has changed in the two years since the Maryland State Drug and Alcohol Advisory Council (SDAAC) developed its 2010-2012 Strategic Plan. Most significantly, the US Congress passed, and President Obama signed into law, the federal Affordable Care Act (ACA), which “offered states an unprecedented opportunity to change the face of health care.”[1] In response, Governor O’Malley established the Health Care Reform Coordinating Council (HCRCC) which defined Maryland’s vision, and created the blueprint, for health care reform in the State. An important HCRCC recommendation was that “DHMH examine different strategies to achieve integration of mental health, substance abuse, and somatic services. Potential avenues to be explored include statewide administrative structure and policy, financing strategies designed to encourage coordination of care, and delivery system changes.”[2]

Yet, it must be acknowledged that the field of substance abuse had been moving towards coordinated, comprehensive service delivery even before the 2010 passage of ACA and the recommendations of the HCRCC. In fact, the SDAAC Strategic Plan posits a recovery-oriented system of care as its “intended outcome…consistent with the vision for the Council articulates by its members on December 9, 2008.”[3] To help inform this process, Maryland can refer to the concept and definition of recovery refined by leaders in the behavioral health field. In May 2011, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) published the group’s working definition of, and set of principles for, recovery to “assure access to recovery-oriented services…as well as reimbursement to providers.”[4] The group defined recovery as “a process of change whereby individuals work to improve their own health and wellness and to live a meaningful life in a community of their choice while striving to achieve their full potential.” Infused throughout the Principles of Recovery are a focus on individual strengths, on relationships with peers, family and community, on hope and respect. Another “call” for collaboration and coordination” arises from the U.S. Department of Health And Human Services’ Strategic Framework on Multiple Chronic Conditions, which identifies behavioral health problems “such as substance use and addictions disorders, mental illness, dementia and other cognitive impairment disorders, and developmental disabilities” as “multiple chronic conditions.” [5]   > > > >  Read More