WHAT IS OASAS AND WHAT ARE
WE DOING?
STEVEN KIPNIS, MD, FACP, FASAM
Addiction in New York State
• Drug or Alcohol Addiction
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1.8 million New Yorkers + impacted families, friends, employers
10% of our population – One in 10
• OASAS system treated:
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260,000 last year
less than 15% of those in need
NY Problem Gambling
OASAS SURVEY
• Adults
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5% are problem gamblers
Roughly 900,000 New Yorkers
• Youth
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10% ages 12-17 need treatment – 140,000 youths
Additional 10% (140,000) at risk and may need treatment
What Is OASAS?
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Nation’s 2nd largest addiction services system
999 employees
60% employed in the 13 ATCs
$1.7 billion in Medicaid, Federal Block Grant and state funds
1,550 prevention and treatment programs
Treatment system serves 110,000 persons daily
90% in outpatient or methadone programs
The OASAS Treatment System
OASAS Mission
To improve the lives of all New Yorkers
by leading a premier system of addiction
services through prevention, treatment,
recovery.
The OASAS Destinations
• Mission Outcomes
Effective, results-oriented
• Provider Engagement/Performance
A Gold Standard
• Leadership/External Impact
Premier status
• Talent Management
Field of Choice
• Financial Support
Stewardship
Mission Outcomes
Establish an effective, science-based system which integrates prevention,
treatment and recovery.
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Decrease in the negative consequences of drug, alcohol
abuse and problem gambling
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Increase the number of persons served who remain abstinent
and successfully manage their addictions throughout
recovery.
3
Increase the number of persons served who improve their
overall health including engaging in healthy lifestyles.
Provider Engagement and Performance
Develop a “gold standard,” system of service provision
4
Increase the number of prevention and treatment providers and
communities actively implementing evidence-based practices
and achieving consumer-level outcomes.
5 Increase service providers’ achievement of the OASAS gold
standard performance approach, which includes consumer
outcomes, performance improvement techniques, regulatory
compliance, and use of evidence-based practices.
Leadership/External Impact
Be the state resource on addiction and lead the nation in the field of chemical
dependence
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Increase recognition of OASAS as a leader and expert, increasing
visibility statewide and nationally.
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Increase understanding and awareness of addiction as a chronic and
treatable disease.
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Increase influence on national, state and local policy and practice.
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Decrease in the number of alcohol and substance abuse related
consequences in the Public Health, Public Safety, Public Welfare and
Public Education systems.
Talent Management
Become a“ Field of Choice” for attracting, selecting and developing talent
10 Increase the racial and ethnic diversity of staff at all levels of the field.
11 Increase the number of credentialed staff working in the field.
12 Increase in full knowledge expertise and retention of high
performing staff
throughout the field.
13 Increase the number and percentage of system wide staff who bring forth
innovative ideas that benefit our field, and agree to test them through rapid
cycle improvement.
Financial Support
A system with strong return on taxpayer investment and stewardship of
resources.
14 Secure and maintain adequate funding resources from federal
and state governments and private foundations.
15 Implement a system that insures strong return on taxpayer
investment.
Topics of Interest
• Chronic Disease
Topics of Interest
• TBI
Topics of Interest
• Tobacco
Topics of Interest
• Buprenorphine – OASAS
authorization is no longer needed
Topics of Interest
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MAP
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KEVIN J. ARMINGTON, M.D.
JEFFREY BORENSTEIN, MD
BETH K. BOYARSKY, M.D.
LAWRENCE S. BROWN, JR. M.D.
GREGORY C. BUNT, MD
MICHAEL L. EISENBERG, MD, MPH
PHILIP A. GIANELLI, MD
MARC N. GOUREVITCH, MD
LYNDA KARIG HOHMANN, PH.D., M.D., MBA
HILLARY KUNINS, MD, MPH, MS
STEVEN KIPNIS, M.D.
HERBERT D. KLEBER, M.D.
ANDREW J. KOLODNY, M.D.
PETROS LEVOUNIS, MD
NAYYERA BATOOL MALIK, MD, MSC
THOMAS J. MARKOSKI, DO, CASAC, CAS
[email protected]
DAVID M. OCKERT, PH.D.
ROBERT RAICHT, MD
STEPHEN ROSS, M.D.
EDWIN SALSITZ, M.D.
BRIAN F. SANDS, MD
MICHAEL M. SCIMECA, M.D., FAPA
JEFFREY A. SELZER, MD
SHARON L. STANCLIFF, M.D.
ROBERT WHITNEY, M.D.
NORMAN W. WETTERAU
Topics of Interest
• MAP
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Medical Director requirements and list
Detox algorithm – 48 Hour Bed
Buprenorphine FAQ
Topics of Interest
• Addiction Med Site
o http://www.oasas.state.ny.us/admed/edseries.cfm
Topics of Interest
• SBIRT and Medicare
Topics of Interest
• CARN and Addiction Med Specialist
of the year
Topics of Interest
• Ambulatory Patient Groups
Topics of Interest
• MTAG
• Phase One Implementation: Present - April 2009
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Goal # 1:
• NYS will transform opioid treatment into a patient-centered, comprehensive
outpatient service that provides individualized care.
o Objective #1:Improve the quality and outcomes of opioid treatment program
services.
o Objective #2: Increase patient access to OTP and medication assisted treatment
services.
o Objective #3: Increase patient access to buprenorphine medication.
o Objective #4:Increase the employment rates of patients in OTP and reduce the
number of patients supported by public assistance.
Topics of Interest
• MTAG
• Phase One Implementation: Present - April 2009
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Goal #2:
• NYS will align regulations with clinical practice, financing,
public acceptance, and recovery-oriented principles and
standards.
o Objective #5:Improve fiscal flexibility and ability to fund
comprehensive array of quality OTP services.
o Objective #6:Reduce the myths and stigma associated with
opioid treatment.
Topics of Interest
• MTAG
• Phase One Implementation: Present - April 2009
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Goal #3:
• NYS will expand access to medication assisted treatment for
opioid dependence throughout New York State’s treatment
system.
o Objective #7:Create One outpatient treatment system,
operating under one set of regulations, that integrates evidence
and consensus-based practices, (e.g., medication assisted
treatments and psychosocial counseling) into a patientcentered, recovery-oriented system of care.
o Objective #8:Provide effective public health marketing
explaining the value of opioid treatment services.
Topics of Interest
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MTAG
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Phase Two Implementation: April 2009 - December 2010
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Establish one outpatient treatment system.
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Change the reimbursement methodology for outpatient programs,
based on the APG system, to fund comprehensive medication-assisted
treatments in outpatient programs.
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Explore innovative models for delivering addiction services to persons in
need.
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Implement a comprehensive, statewide Public Education Campaign via
public service announcements and capacity building inclusive of elected
officials, community agents, patients and family members.
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Implement recovery-based treatment services which are patient
centered; encompass both patient choice and patient "voice" in the
treatment process.
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Evaluate entire transformation process to determine efficacy and
address deficiencies if any.
Topics of Interest
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Co-Occurring Disorders
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Screening
• We are strongly encouraging all OMH and OASAS clinics to screen all clinic recipients for co-occurring
substance use or mental health disorders:
• For OASAS clinics, these are: Modified Mini Screen (MMS); Mental Health Screening Form III (MHSFIII); and K-6 (Kessler).
• For OMH clinics, these are: Modified Simple Screening Instrument for Substance Abuse (MSSI-SA);
CAGE-AID; and ASSIST.
Assessment
• All clinics are also strongly encouraged to assess all individuals who screen positive on one of the
above instruments.
Regulatory Reform
• Although the concept of dual certification (i.e., certification of a single program by both OASAS and
OMH) has been discussed, we conclude that integrated treatment is possible within a provider's
existing certification. This is referred to as “single certification,” i.e., services associated with substance
use and mental disorders may be provided in an integrated manner for persons with co-occurring
disorders in a single setting certified by either OMH or OASAS.
Topics of Interest
• Budget
[email protected]