Report recommends changes to substance abuse treatment system

Changing Minnesota’s substance use disorders treatment system from an acute, episodic model of treatment to a chronic disease model of health care would expand the continuum of care and improve integration with other services, including primary care. This change would also align the state’s model of care for substance abuse treatment with current research-informed practices endorsed by federal officials.

Those are among key findings in a report to the Legislature issued by the DHS Alcohol and Drug Abuse Division. The report, titled Minnesota’s Model of Care for Substance Use Disorder (PDF), reflects the work of a steering committee of statewide stakeholders and constituents that met from September 2012 to February 2013. The group responded to the 2012 Legislature direction to “develop a model of care to improve the effectiveness and efficiency of Minnesota’s current service continuum for chemically dependent individuals.”

The federal Affordable Care Act and Mental Health Parity and Addictions Equity Act provide opportunities for more people to be treated for substance use disorder, the report noted.

Among challenges identified is a lack of timely treatment assessments and authorizations to access treatment, which can deter people from getting timely help. Also, diversity and capacity of the treatment workforce in Minnesota needs to be increased, the report says.

As initial steps toward improving the substance use disorder continuum of care, the report recommends:

  • • Changing current rules requiring providers to discharge or terminate service to instead allow ongoing monitoring and re-intervention to help prevent relapse and encourage resumption of recovery.
  • • Implementing a pilot between DHS and three counties to test a new assessment and access process that will provide improved access to treatment services and follow-up care. Client outcomes will be measured for future policy-making purposes.
  • • Implementing effective strategies to increase the substance use disorder workforce diversity to more accurately reflect all populations served.
  • • Operating a financially sustainable service delivery system that includes new services responsive to the chronic nature of substance use disorder.
  • The recommendations are consistent with recommendations in the Minnesota State Substance Abuse Strategy, issued last fall by DHS in partnership with several other agencies. Among those recommendations are that opportunities for early intervention should be created in primary health care and other settings and that supports for people in recovery should be expanded beyond treatment.

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