Event ID: 2450380
Event Started: 9/15/2014 12:44:49 PM ET
Please stand by for realtime captions.

Good morning Lord good afternoon depending on what part of the country you are joining us from. On behalf of the Department of Health and Human Services and our state and community partners in Texas, we would like to welcome you to recovery and health, echoing through the community. This webcast we believe will be thought-provoking and create some discussion and dialogue that hopefully will help you as individuals and members from the E site to continue to discussions-continue to have discussions about how we can continue to promote recovery and health. My name is Michael Duffy and I am the SAMHSA regional administrator and a person in long-term recovery. We have gathered together today and esteemed group, expert panelist that we believe will be able to demonstrate some of the great things that are happening in this country and this movement of recovery. You will have opportunity throughout the webcast to introduce questions or ask questions of the panelists and we would ask that you send those questions to the website that you see appearing on the screen to start us off today I would like for us to view a video that was produced across the country that reflects individuals and organizations having conversations about the work they're doing to promote recovery across the country so let's listen to this and we would ask that shortly after that you adhere to some of our national speakers. Please listen.

To really be successful in recovery, persons need to have approaches to touch on all aspects of their being,

The overall holistic care and approach to care that promotes long-term sustainable recovery.

There are many rules to recovery. Jobs, housing, [Indiscernible]

This whole belief in recovery is why I think SAMHSA is here.

At the age of 56 my father died of alcoholism. And years later I got an a program of recovery so today I am a person of long-term recovery.

Here I have support. Seven the associations of persons with addiction [Indiscernible]

I greet people when they come in and just give a warm smile and a handshake. And a smile is sometimes also needs.

Weep, a family and becoming a family, we stay clean together.

Latin American immigrant services specializes in working with recent immigrants from Latin America and presently developing an African outreach service.

We see children from the age of six or seven--

[Indiscernible] parents and kids but to tell us how much better they are and how great they are doing.

People do need to recover and to share that message and to carry the resources and the technical assistance across the country.

We are the visible, vocal agency that speaks to recovery, the champions recovery, that advocates recovery and pushes the systems and the healthcare systems to make sure they are delivering on the promise of recovery.

What a great way to begin our discussion. As we move forward today, I would like to introduce to people on the national front who, for over 40 years, have dedicated their lives to a promotion and advocacy of recovery and the first is Bill White. Many of you know them. He has authored 12 books. His landmark book, slaying the Dragon, is a history of addiction treatment and recovery in America. Our next national speaker is Harvey Rosenthal. He has spent over 40 years of his life ensuring that individuals with psychiatric disabilities have had an opportunity to make sure that they have patient's rights, that people are advocating for their recovery and supporting them in their journey of recovery. He has served as the first executive director of the New York Association of psychiatric rehabilitation services since 1993. Please listen as we begin our dialogue around recovery and health and the national perspective.

It is a pleasure for me to be able to walk Amy and to this webcast.--It is a pleasure for me to welcome you to this webcast. I am offering perspectives on. Services and a ten-year recovery advocates and historian in the first point by would like to make, fear recovery support services, as their unfolding nationally and internationally are part of a much larger recovery revolution that is unfolding in the United States and beyond. That revolution is indicated by several things. We have seen dramatic growth in recovering mutual aid societies in the United States and other countries and that expansion now encompasses secular spiritual and recovery societies and we have seen the emergence of grassroots recovery advocacy movement and grassroots recovery organization throughout the United States. Those organizations have begun to bring the faces and voices of people into recovery and mobilize people and recovery at a level that is historically unprecedented. This past year, for example, we have more than 130,000 people in recovery with their families and allies involved in recovery celebration events. Out of that movement has come the growth of new recovery support institutions. We're saying the growth of recovery organizations, recovery community centers, recovery residences and schools, ministries, sports venues, and the larger development of a much more elaborate culture of recovery emerging in the United States. We're also seeing the emergence of recovery as a new organizing paradigm for behavioral healthcare in the United States and as part of that we are seeing cause for and involvement in a fundamental restructuring of behavioral healthcare in the United States from acute and palliative models of intervention to models of assertive and sustained recovery support. In larger recovery oriented systems of care with a system being conceptual and not as a treatment agency or a treatment system but the creation of recovery landscapes and space on the larger community. We are seeing the emergence of a recovery research agenda to push and dry recovery evidence finally moving from a study of the problem to a study of the solution and learning and drawing lessons we are taking from the experience of personal and family recovery and if using that into new designs of long-term recovery support. With that we are saying recovery emerge as a policy framework around the world reflecting this kind of shift from a focus on pathology to a focus on the solution to long-term addiction recovery. Peter recovery support services are incredibly important to mention that has emerged out of these larger he-larger recovery developments. It is very important as we proceed to our discussion to find ways to link here recovery support services to these larger developments. Here recovery services provide a desperately needed bridge between the clinic and the community and to move from recovery initiation to long-term recovery support. A second perspective I would like to offer is to place peer recovery support services within the framework of long-term developmental stages of recovery. In my earlier writings I described the five stages. A time of pre-recovery that we might think of recovery incubation. And Jeff-recovery initiation and stabilization followed by a transition to stable recovery maintenance and then they move from maintenance to a focus on enhanced quality of personal and family life and long-term recovery and finally significant efforts to try to break intergenerational cycles of illness and related problems. Peer recovery support services provided critical framework for extending traditional models of intervention. Beyond acute stabilization to models of sustained recovery support. In effect, they provide a desperately needed bridge between recovery initiation and long-term processing of personal and family recovery. Peer recovery support services are going to be an increasingly important dimension of behavioral healthcare in the United States and internationally. I wish each of you and your organization my very best on your journey into the future and thank you for the opportunity to welcome you to this webcast.

Hello my name is Harvey Rosenthal [Indiscernible] Bill White is one of my heroes and I am a person in recovery, I have about 45 years of recovery and the last 40 years I have worked in the field, first as a state hospital employee and I have worked in the outpatient clinic and [Indiscernible] [Indiscernible - low volume] [Indiscernible - low volume] and recovery based to providers [Indiscernible] [Indiscernible - low volume] to improve services and social conditions [Indiscernible - low volume] people with psychiatric disabilities and I began my recovery in a hospital so it meant a lot to me to begin in a hospital and work in a hospital and [Indiscernible - low volume] [Indiscernible - low volume] it is God's work and my spirituality is a pig focus in this work. [Indiscernible - low volume]

[Indiscernible - low volume]

I began working in the mid-70s and the message in that day was people would never recover. They would never work. They would never have relationships. People were discouraged from most major decisions and people would be prone to relapse and the expectation is that people would relapse and who were not believing people could cover and he frequently said, often this is the best they can do and [Indiscernible - low volume] there has been a lot of damage done because [Indiscernible - low volume]

So I worked in the field and was a person in the closet at that point and felt very differently [Indiscernible] on the path of recovery myself. I remember getting in trouble with supervisors talking about recovery and they said not to give false hope and people can't work and vocationally that was not an option and I was written up points for [Indiscernible - low volume]

On a very personal level and with a relationship and--except the diagnosis and take your medicine I have seen it happen in a number of ways. We have come a long way and we believe the word recovery is used in resilience and activation and engagement someone helping them with what they're going to do and we are seeing a greater integration recognizing people with mental health issues and people are dying [Indiscernible] integrated in care we are living at a time where a perfect storm for recovery because state and federal budgets don't want to pay for chronic illness reactive services for people to relax and believe that they will and [Indiscernible] not only costly , it is against the law because the Supreme Court decision says the state is-it is illegal to keep people and institutions which means that [Indiscernible] against the law and it is powerful because we can talk about recovery that [Indiscernible] in New York and around the country it is an exciting time because [Indiscernible] wants people to recover and wants to pay prepare support and wants providers to come out of the closet and they want and expect [Indiscernible] to work with people the responsibility is on us to help people recover and [Indiscernible] full lives and into the community.

Well we want to thank you so much for sharing with each of us and our listening audience today. Your perspective on where we are in this nation as a result of this movement of recovery and how it will impact not only individuals but the entire health of our community across this country. Thank you for being with us and sharing your thoughts. We are not going to--because of time, the opportunity to introduce each individual panelists but as we enter into our discussion and dialogue today you will have an opportunity to meet each one of them individually as a part of our discussion so let's go ahead and get started and I would like for you, as the Department of Health and human services regional director, more so than anyone on this panel you have the idea about the impact that the affordable care act has had in terms of changing our whole entire health care environment and I am just curious how you see here recovery support services being a part of that changing environment.

Thank you very much for putting this group together. To me, it has been an opportunity to use this as an example of building collaboration with an incredible talent and community level that we have that has made a significant difference state resources and federal--you have set a model as has SAMHSA. So thank you for that. SAMHSA and the definition of recovery has talked about health and home and community and purpose and it is clear to me that this is an example but the affordable care act starting with the health piece has expanded the resources to mental health and if you look at pieces like access, resources, workforce, how do we make it happen? If you look at access first I am amazed at the expansion that people have the idea that mental health services have been made an important piece of the affordable care act and the other important piece, pre-existing conditions no longer excludes anyone. The other pieces young people are covered up to 26 years of age so that means they can be retained on their family's insurance oftentimes went off issues have an early attempt location as young children and it expands resources to them and I think that access point is like bringing people to the doorsteps of the idea of resources is a way to welcome people inside and if you look at the way that the ACA has expanded collaboration between HRSA Emma community service levels and made that possible that is one of the resources that has been able to invite people in any way that is meaningful to them at a very human personal level. The other piece that is very important, it is not just inviting people in the setting down and engaging them and enrolling them for example and one of the strength of the system is the peer support. Community health workers are addressed in the ACA as a bona fide group that is eligible for reimbursement. The incident-Institute of medicine acknowledges that resource because it provides a bridge for community members to the healthcare system that is trusted because there was somebody they trust somebody they have a common experience with somebody who truly understands so I think what the ACA has done is to bring people to the doorstep and have them seated with someone that they can trust. The other important thing about the peer support peace is the research shows us that recovery is sustainable. If you engage people by peer support, people understand. So I am very encouraged about this as an example of what can be created at a community level with all of these incredible services and resources and I have flawed SAMHSA for pulling this group together and making it available. Thank you for your leadership and for the role that you play in ensuring that part of that essential health benefit for mental health and substance abuse is provided to those who are still in need of those services and I am convinced that peer support of a model would take that engagement so thank you for your leadership.

We have worked together on a number of opportunities including suicide prevention but I think as you work with all of these state and health officers within the region and in thinking of a public health system I am always curious how you would envision the use of peer support specialist and a public health setting.

I think from my perspective, as the regional health administrator we work together with states and communities and I have always, felt that somebody who is closest to the patient has a similar background is an excellent opportunity for them to be treated and educated whether it be diabetes or cardiovascular disease or behavioral health for any kind of addiction. In the states I worked directly with the health officers for the five states, Texas, New Mexico, Louisiana, and in the most recent meetings we have had, 13 states, including region four, that behavioral health and addiction has become very important topics for us to discuss during our get-togethers. I just returned from the Association of State and health territory officers meeting and I can assure you that behavioral health and now the issue of prescriptive drugs that are use, in particular, opioids, is a topic of high importance in that area. Now from a closer perspective in the region we have extensive experience of working with [Indiscernible] and community health workers and a variety of different areas in particular to do with suicide prevention we have worked with them clinically on a public health perspective and flu vaccines during the time we had the kind of and we are trying to reach as many community members as we could and [Indiscernible] to the border, certainly others could say the same thing with the Peer people that speak the same language. It's very a fortune to us in this area so I see many ways in which the support system could be intertwined with everything else we do and I find it extremely important and I know in my own family I had a brother that was a victim of multiple drugs and several runs through the penal system and I worked in the federal Bureau of prisons and saw that so I certainly am familiar with it and [Indiscernible] certainly those that are in recovery.

Thank you. I appreciate your leadership from a public health perspective and thank you for sharing some of your experience with individuals living towards recovery. One of the major issues we all recognize and SAMHSA and on this panel is the fact that this is a public health issue. It is not a criminal justice issue and for us to begin to think about how we address behavioral health issues certainly will provoke overall health. Not only individuals but communities as well. Would you agree? As the Deputy regional administrator for HRSA I know that we have had many opportunities to not only do on-site visits but to partner as a result of the SAMHSA HRSA Center for integrated health solutions and really beginning to help integrate behavioral health and I am always anxious to hear your views in terms of how you perceive the utilization of support specialists in primary care settings.

Thank you for organizing this important event. Welcome to everyone on the webcast. It is a pleasure for me to be here today representing health resources and services administration in terms of community health workers, as you know we supported overseas need for federally qualified health programs and they have [Indiscernible] with community health workers essentially they are liaisons to train health care system and the community it serves and we know that issues have yesterday with chronic care and difficulties providers had in getting patients to follow [Indiscernible] the issue with the fact that communities and providers were separated and did not often have good lines of communication. The community health workers are able to get the word to the community because they live in the community they are seen as peers by the community and their available to provide information and that we have not had a high level of formal education they have training to make them certified as community health workers and they need to develop a core set of competencies and the needs know how to communicate and listen to the people of the community and advocate for the community and the need to be up to build relationships and teach folks how to get access to services and they need to have power to be able to solve problem for themselves in terms of certified peer report. We know they have training that are similar to community health workers and many of them certified peer support and they're able to get the word out to the community and in terms of mental health and substance abuse of course they have had the same experience that the peers have so they're able to bring that message to community in terms of mental illness to show them there is a way to recover and to maintain recovery and they can show the path forward and some hope for the future.

I appreciate you being part of the panel today and we look forward to continued collaboration as we begin to think about how we improve and support recovery with an environment of primary care setting. And we have two people on the panel today who have had that down in the trenches, real-life experiences in making this work. Henry and Andrea, thank you for being part of this. Andrea you're the executive director of a community mental health Center and Henry, you are the executive director of a federally qualified healthcare Association. So could you share what it is like in the real world where you began to incorporate recovery is a part of the care you provide.

Our collaboration started back in 2008 when a physician called and asked if they could get some help with a person in crisis and I had been on the site for 20 years before I came over and made some phone calls and that team was there within 15 min. and took care the patient hours with her providers and that patient is doing very well and Andrea was talking to a judge and she said I know this guy and he has ideas similar to what you are doing so we started talking and we quickly realized the obvious two different organizations but we looked at the mission and they were similar and we realize that together we could serve the community working as one and [Indiscernible] 2007 and one thing I kept hearing, [Indiscernible] and I said what are they sending them for? High blood pressure and diabetes. That is what we do, to get them connected and we have staff that don't think that way anymore. We provide training a lot of things occurred the staff met in huddles in the morning and they communicate with each other every day and they are there together, working as a Terry and to serve the people-I'm working as a team to serve the people that need it the most. And for me, a source of pride, when you hear them talk, that is no longer [Indiscernible] it is our staff. It is our people we are serving and there was a presentation made not long ago on the staff was content-[Indiscernible] and the people say to the [Indiscernible] our staff have integrated all the way up to the top from talks the CFO and the clinicals and on a daily basis they communicate when it is necessary to ensure that [Indiscernible] we did the needs of the people and our boards are very active and we keep them informed and they met one time and that was a nice experience and because of that we were able to do things that we feel are unique and [Indiscernible] organizations working together.

Thanks for inviting us to the conversation. One of the 39 community centers having the pleasure and privilege and one of the things we do this continue looking at our staffing and I just tried to replace the vacant positions that he had individuals to partner together and reinforce our team and our practice and our system of care and so we're looking at our staffing and we noticed we were fortunate enough to have some peers who were working with and we always look at East success and in our case we found for major keys to success in the first is that we started this process we recognize we needed a cultural change we found that we were a system of care that was providing treatment at an individual rather than engaging that person and those family members that are an integral part of the treatment system.

We reinforce our system to make sure we engaged in trauma informed person centered recovery oriented care and those things really are the foundation points for us to make sure we're moving our system forward and another key component is making sure we have ongoing education and information not just going to the peers who are certified in extraordinary numbers but education about what our peer system means and how we can reinforce it in innovative ways. And the third key is never say no to a fertility and we found that our peers are amazing advocates. They bring a person in not because they understand the question that is being asked that they understand because they have walked the walk of another system of care and I can navigate down through that so we have a phenomenal group of navigators and case managers and health workers and [Indiscernible] that are invaluable to our system and in many cases, close to Fort Hood, an entity that we work with that we have family partners who are great advocates and not just those other families but for the children who are being raised and so we are grateful that we have this opportunity to make sure we have education and the fourth key is partnership this one is not unique and it is a strong way to make sure that persons received the care they needed and so the access to primary health care and behavioral healthcare without having to get an appointment and go to another provider is a truth that way to make sure our system is providing and is looking at fulfilling the lives of this person that we serve as a lawyer asked what is the greatest strength or the greatest success? And I would have to say reducing the stigma of illness and raising awareness for all chronic illnesses and I go back to a very personal situation about 100 years ago, when I was young, I spent a great deal of time at Texas Children's Hospital in Houston and my best friend had leukemia sites that many days in the hospital room and we talked and visited that the thing I remember the most, were the voices of the adult family members the parents, they were talking about cancer and they were talking about leukemia and the effects of diabetes and such hushed tones that we knew something was wrong and we new Hope was not imminent. So what resonated with me was that once later the same kids around the soccer fields and tumbling and making sure everyone was having a great time you could see the same parents that were speaking looking at that like that is my kid out there being successful and not just surviving cancer, leukemia, and diabetes, but thriving and that is the kind of hope our peer support specialist at all levels are giving to us they're telling us not only is there hope and recovery but it is expected.

That is fantastic. One thing that thrills me when I hear you talk, it is hard to top who works where and you have a heart for recovery and improving healthcare outcomes want to thank you for being a model in the state of Texas and we're glad to have you be part of the panel today.

I know working for the Center for Medicaid and Medicare for all the money is,

That is what they tell us.

Everyone across the country is asking how do you go about funding peer recovery support? So I was wondering if you could talk to us about the approaches that CMS is taking to support recovery and recovery support services.

I would recommend that organizations work closely with their state. Medicaid is a state operated program that the centers for Medicare and Medicaid services oversee. But there are a variety of ways you could get the funding. One way is early and periodic screening, diagnostic treatment programs. That is a benefit that is afforded to individuals under the age of 21 and it is geared towards prevention screening and of coarse the--diagnosis rape. Another benefit is [Indiscernible] federal dissipation which is enhanced--or the federal government provides an enhanced incentive to the state to incentivize recovery of these programs. There is also a state plan amendment and health, home and community based services. That is to allow the individual to live highest level of practicability in the community. I am pretty sure this is one of the main ones everyone will want to be familiar with. With the home and community-based services we have a program and HHS has elaborated with HUD and we provided additional monies to optimize resources and to prevent duplication of funding for beneficiaries who want to live in a community and have services and be effective with those services and have providers who are familiar with their diagnosis and are able to help treat them peer support would fall into that category and another program would be the alternative benefit plan offered under the Medicaid program as well. The research and demonstration waiver are usually offered for five years and initially and then states have the option to increase that for an additional five years. Also, another program is managed care organizations. It is where the primary care providers have a system and they offer all of them in one area. And that is geared towards prevention.

As I said previously, there options to have enhanced--I would recommend organizations work closely with the state because states offer a wide Friday of flexibility as long as they are adhering to the federal guidelines that all this information can be found on our website at www.Medicare.gov.

Thank you, Janice, I appreciate that overview of attentional opportunities that exist around funding and peer recovery support services. I think it is clear that CMS has been leading the way in terms of innovation and many of us are extremely grateful because we believe it enhances access and ultimately [Indiscernible]. If enough it is the funding discussion but we have a question from our listening audience and I would like to direct this to Andrea or Henry, it has to do with the announcement of the $295 million to expand services in the primary care health centers and the question was do you see as a part of those funds how peer recovery support services could be part of that funding and I would like to get a response.

As you know [Indiscernible] has provided several grants through HRSA for expanding services and the one you just mentioned was announced Friday where there will be 295 1/2 billion dollars available to community health centers to expand services and provide new services that were not available before dental, oral health, pharmacy and behavioral health services so those funds will be available throughout the country and territories and before that there was a grant announcement in August that was intended to expand patient centered medical homes and so the qualifying health centers are gearing up to provide patient centered services so they can be more comprehensive and they can take care of the patients needs on a wide system where they could provide those services and Courtney Moore closely and finally in July there was a grant announcement that says $65 million--meant to expand behavioral health services so the Romany health centers throughout the country that were awarded those funds. So a great opportunity to think about how we fund to support as part of that expansion of behavioral health. Free support.

Like I mentioned before community health--workers are in excellent position to use for those funds.

Very cost effective.

We just want to thank you because we feel incentivized and motivated to move forward and that's workforce will be strengthened by tran11 helping to bring in new case managers and a focus on children services as well.

One of the thoughts I had, how can peer reports become part of our case management so that people that are neediness or truly they have somebody who has walked in there path?

Great opportunities. We look forward to seeing more peer recovery support services and people hired in that capacity

As the state has given consideration to creating the cover he oriented systems of care you have been one of the leaders in the state health system on the behavioral health side for addiction. Could you share with us some of the work you are doing at the state level?

First I would like to thank [Indiscernible] behavioral health services to engage and at the beginning [Indiscernible] moving forward to implement the recovery--systems that are strength-based and resilient to families and communities and the take on the ideas of responsibility for the sustained health and will almost recovery from addiction disorders and improving quality of life. Try not to focus on them individually in those communities that creating a sustained framework which is what we developed and they could look different thing or you are,-depending on where you are, the development of peer recovery models and statewide services and as a result of strict recent-most recent proposal for platforming dollars and treatment organizations standalone recovery organizations and community-based organizations and throughout all of those organizations are hoping is that we should benefit those recovery service is not just on the individual, but on the return of investment from a state perspective some of the keys to success in-either moving forward one of the pixies has been the commitment from the one of the big keys is not a commitment from our local community stakeholders and financial consultants that we work with and the biggest support we have had have been our local ATT CV have been helpful in moving us forward in one of the initial projects we started with the collaboration between DHS and CHC 11 of our systems [Indiscernible] we developed a model around [Indiscernible] which has been extremely successful. Education and training have been a huge--and challenges for the developing recovery probably will continue as-Evan goes forward and as we go forward& See the data that hopefully--from the work we're doing around the 4.4 main dollars will probably show some benefits that have recovery support services impact people's lives and recovery going forward and we are pretty certain that as a result of the funding that continues to fund more recovery support services.

I think it is great that you're not only thinking about opportunities at the state level via the federal government of the state is still have and saying we believe in and support recovery and recovery oriented systems of care and I want to applaud you for the position you have taken and your leadership in that area. Thank you.

On the mental health side my understanding is you use some of your mental health transportation dollars to do some phenomenal work.

Texas was awarded a mental health transformation Grant and with those dollars, different enterprises supporting veterans courts, communities and other things and most importantly a program called via hope. And the recovery of mental health has been driven by the consumer and people with experience of people that have their have really pushed the system to create via hope which provides peer training, family partner certification training and really works with the centers and PC state hospitals to evolve in evolution and the system of care not a chance generation that evolution to one of the actuality to where a person is really working collaboratively towards their own goals and--and recovery at organizational level or at a personal level is a liberation project it changes the dynamic considerably the language changes people become empowered staff feel gratified because there is more action not only between the staff of us of--and that is critical that we further with [Indiscernible] group to to work with recovery coaches and I think together all of that at the base level has brought forward and supported the recovery movement. Trauma is a common dialogue at the end of the day that we are going to be talking about that will remove everything forward from this point, I want to stress that recovery coaches and peers are highly skilled practitioners that are not inexpensive working extenders they come by their experience and a very hard way through the door of hard knocks and that deserves respect from other coworkers and people they work with financially as well so that is how the mental health transformation Grant spent its money and via hope has its own 501(c)(3) and is continuing to work with all of the local mental health authorities and state hospitals to incorporate patient patient centered planning and recovery Center practice and continue training and family partners and all areas trauma focused care emotional CPR so they can [Indiscernible]

That is a great success story.

Again, consumer and lived experience that is the most important thing and we know them the biggest banks because our job depends on them so thank you everybody that is listing three

That amount has been this brief discussion about we have another question that has come in from our listening audience and I will open it up for, but it says, what suggestions do you have for successfully integrating peer recovery support services in the larger treatment systems so there is clarity with the roles and a clear understanding of professionally directed services and peer-based recovery support services. So that delineation issue as you said honoring and respecting.

That is important and that is a big debate if you are certified if you are losing your even ground, how exactly does that work within the system within larger systems I think they have to be very clear about hiring policies supervision policies scope of practice policies for what it is peers and other members of the staff to the can help narrow down the confusion is part of the education process that has to go with a recovery center and culture because you can't just drop in on a provider TypePad service array and expect human resource management and everything else to--it is a process of culture change all the way to the human resource manual and your hiring practices.

Anybody else?

Along the same lines, as we have built the criminal organizations that we have found it we have tried real hard to [Indiscernible] to talk to providers about the ideas of not doing add-on services and it is really important as the clients think that transition from treatment to the community of recovery.

So there is a need for training the staff the organization and peer workers being integrated into as well as most of them at the same time who does what how we can be effective working together

It is not in being competition with or assuming any professional responsibility put expecting-respecting one another.


Patient is the center of the whole team and everyone [Indiscernible] health workers doctors nurses everybody is vital on that team.

Thank you so much. I appreciate your comments.

We would like to hear from a pioneer in the Texas community in the development of recovery community organizations. Can you share with us some of your experiences? My understanding is you are one of five accredited recovery organizations in the nation.

That's right.

It did not start out that way.

Will me thank you and everybody else my colleagues for being here. I am in long-term recovery and I have not had a drink about call in 25 years and it was only because of that I could be a father today and have friends and relationships and only physical long-term recovery I have been a--and this started back in 1998 with SAMHSA and I have to say I grew up with SAMHSA woman put up the first peer-to-peer recovery organization that was really for three years pretty much the recovery movement from that efficacy all over--from that efficacy all of the country we advocated through our legislators and people around the country like Sen. [Indiscernible] so many [Indiscernible - low volume] I have to give credit to Dr. Clark is a grave heat-he gave us freedom to push the envelope to promote recovery services and the grant was over in 2001 and from that [Indiscernible - low volume] recovery organization to eliminate stigma and discrimination associated with addiction so that was the beginning of the advocacy movement and in 2002 we had a paradigm shift [Indiscernible - low volume] however going to advocate recovery support services? Everything among peer recovery support services [Indiscernible - low volume] advocate for themselves , family, community, and how the whole country is advocating for more help than recovery and so that was a good beginning as a peer organization and the created our own. Every center and sends 2002 if you recovery community center and peer driven organization and that means recovery coaches from that training, formalized and we have certified recovery coaches and new rules-rules, we caught call them traveling companions and navigators we have over 10 sites because people want peers. They want to be there for those, to connect and relate and we have to promote recovery and when I grew up in Harlem and watching my family and the community go through turmoil and addiction I never did see anybody. Nobody said I am in recovery, nobody said that. And I thought I was going to die like my dad. And that's the way we do it and so today it has to be recovery organization to see all of the addiction and mental health and it was up to us to promote recovery so to see how SAMHSA Department of State health services that was exciting to see how they put that through the [Indiscernible - low volume] and it was to see how we could take it to the next level. It is very a portend to build relationships around recovery and about recovery so we can reduce the stigma and discrimination because families and communities are dying and will light, I need a billboard on [Indiscernible - low volume] but where is recovery? That is our job. Peers go where no man has gone before. Cable providers are not point to be there in the industry it is up to us. The ACA, healthcare reform, and it has to be done on the ground. People have to enroll in health care on the community centers on the grounds that not only do we have a menu of services that recover-recovery will change that to shake Rattle and enroll. So every month we can do recovery at the big screen and every month we showed [Indiscernible - low volume] on addiction or mental health challenges so it is about promoting recovery and getting the word out and how to get those people to [Indiscernible - low volume] three and how to get those people to [Indiscernible - low volume] 37 I am so glad that you are a face and a voice for recovery. It is an honor to have you on the panel and I am so glad you are on the ground in Martin Luther King and when I retire I am going to come over there.

Great. Glad to have you. I thank you for being part of our discussion today. I just received a question from twitter about families for. The first asks how we will some sort families and the second one asks what type of training will the peers go through to help with the family aspect of recovery. We talk a lot about recovery for the individual but we know that individuals who are not in recovery and that is a psychiatric disorder or an addictive disorder, definitely impacts family and loved ones. We heard that from some of our panelists today so any thoughts for the twitter question? We certify family partners who specifically work with families that have children in the system and our particular also talks about the family assistance piece of a lot of resources out there comes a lease-when it comes to families, would talk about national alliance on illness, also, University of Texas Southwest has a family program and our organization we just started, they have licensed family therapist and also recovery community organization and there are many has to recovery we have to have-we have a family program that they can engage the family and take that family even though there are resources for recovery.

You mentioned the school of hard knocks as her that experience comes from and the benefit of the recovery on the pathway to illness and I would call it, that experience is not for the attributes in active engagements that have that family recovers and how that looks like so regardless of the name or form that if you recovery specialist takes on any side of the aisle, I know the University of Texas user peer one-mentors to help families know what that process looks like. The healing process. It is not just for an individual if they have a family and they deserve to talk about that experience as well so there is a plethora of services the family and recovery can provide a naked opportunity. Tran5.--They get that opportunity to hear recovery services.

When I worked in that world they would come into seek help for a person that was in addiction or in trouble of some sort and sometime she would be the first to recognize their pH, situation or something going on as well.

Great faith

Three has not had a chance to hear from you, Robert, but we are thrilled you're here in front of the panel. I would like for you to share with us the work he has been doing on the college campus.

Thank you to tran24 fidelis panel together, there a lot of officials and advocates and your work has laid the framework for what we are able to do with the University of North Texas and colleges and high schools around the country and without the work you have done, I would not be alive today so thank you for the work you have done and I want to thank everyone watching at home. A person that allows it to be a face and voice for recovery saying you tuning in Bharat recovery ballot-rallies across the nation, making recovery visible set of thank you for tuning in and I get the benefit of being at the University of North Texas if I found recovery a year and a half is a drug-free school act and the only resources available, looking at zero-tolerance and prevention but nothing was looking at people that have crossed over the moderate to heavy drinking or the had an active mental health illness or ones that were in recovery, there were no resources or services. Everything was focused on [Indiscernible - low volume]. Because of the framework you have provided like faces and voices to help you recovery, I sit on the board of another advocacy organization, we created a program with students started from the ground up-creating resources for ourselves and you are able to create something and particular demand content so we created here recovery as a student collegiate recovery even though at this point the only have the prevention piece that was focused on punitive measures and not the tail end of have to get pullout there was an intense amount of support when we created the organization and I want to thank the president of the University for the work they have done in allowing grassroots organization to become an officially endorsed program not as the collegiate recovery program that of 120 that exist across these countries and the beauty of what we do is allow clinical aspects to be referred out of those services and resources can be provided but Association empowerment model looks at substance abuse disorders but all other quality-of-life concerns because it is not one or the other it follows multiple pathways and the talk about road to recovery and pathways to recovery and that takes many forms regardless of the quality-of-life concerns and not only because of the endorsements for the administrators and faculty and staff, we have allowed everyone to come to the table said this is my recovery this is what I do to find it improve quality of life self advocacy and success and now we have 630 student members and faculty and to respect each other to say I am recovery here is what I do how can I help you of this is an environment that is touted as higher education and abstinence hostile environments and what we are seeing is a recovery environment because there is a paradigm on colleges and universities in high school that you are not leading a life surrounded by use of drugs and alcohol and engaging in behavior that is popularized the media, that you are not in this framework, you are seen as something else other than or a normative experience. We have change that paradigm. We are starting to see if the knowledge is a recovery hostile environment are embracing each other and peers find success in for so long most, physical health, mental health, and academic success. Longitudinal success. We graduated 17 alumni that are in Red River school or in the field and public institutions, these things are happening the work you are doing the work we have done the success. Had to help peers recover and recovery high schools and mentors your coaches going into high school to mentor adolescents and they can hope to thrive and go on to college and we are changing things overnight because people are speaking out and speaking up. Joe talked about faces and voices and in my organization-as we look forward to what is coming next I would encourage everyone to stay tuned to the moderate recovery movement that is uniting organizations and people of long-term recovery and sometimes they call themselves--for whatever reason and people in recovery and anyone across the board coming together to unify this movement that integrates all aspects. Thank you for having me.

It is great to have you and we were talking earlier what is the percentage of relapse? Send back it is less than 6% it is less than 10 and some studies Penn State, Texas Tech, one of the longest and largest and integrating--it is necessary and empowering for students and those that choose the pathway to recovery, we are a racing lower than 10% relapse rates and this is a huge success we should all be proud of. Thank you for being part of our discussion today for the work they do on a daily basis. Seven we go back and long ways a number of years you have been involved in recovery and promoting and advocating recovery oriented systems of care and your work in addiction technology transfer centers thanks to you and everyone on the broadcast today, had it not been for a TTC and the marvelous work that your colleague, Marie Nichols stated, we would not be doing this webcast today very so thank you for your support and for the work that you do could you share with us about how you envision me involvement and this national recovery?

Thank you for your kind words and I want to congratulate you for your leadership in bringing this panel together. [Indiscernible - low volume] nice conversation and it takes a lot of work and I want to congratulate--taking this kind of approach and as you mentioned before recovery systems of care same kind of effort and I would encourage the viewers to have-get people together that don't sit down together and also criminal justice programs city government, employment programs. They all have things in common with regards to recovery. We don't talk to each other very much grade self at his left to mention a couple of things very I know time is running short great that things that we could possibly help with or play a role in your recovery efforts, number one, a TTC has been a partner of the state and talk about the problems and priorities and one thing they do is workforce development recovery coaches and peer workers they need training, they need supervision and support their organization. And also one key interactive [Indiscernible - low volume] screening. Referral of treatment. So ATC has been involved in this treatment for a long time and get on the Internet and search for ATTC they have a lot of great resources. [Indiscernible - low volume] a big change for a lot of treatment programs and this makes another key strength facilitating movement through this process may have a manual on that [Indiscernible - low volume] so these things and others, the ATTC will work with you on and they will enjoy partnering with you.

Thank you for your work and the ATTC and we know that in region six, ATTC is a real asset part of recovery and I hate to say it, but our hour and a half has passed very quickly and I want to thank each of you for being a very vital part of this discussion and we at 10 to 10 to archive this webcast of your watching as an individual and think you would like to have your community have a similar discussion, we will archive this on our website so that it later date you can show the webcast has grown discussion and a lot of you have facilitated guys but they have provided will be developing as a result of their own discussion I want to thank all of you for joining us today and would encourage you to have-the address posted on the screen and I want to thank each of you for joining us today and we are convinced that together we can begin at the state, community and local level to change as a result of perforating recovery and recovery oriented systems of care we can change the healthcare outcomes in this country and thank you all for being part of this webcast.

[Event concluded]