Integration

Develop Long-Term Plans for Sustainable Change

Agencies or systems working towards system change or integration should consider creating a long-term plan for their work. Creating a plan formalizes the shared vision of integration and encourages partners to address specific areas such as:

• areas of conflict between the systems or agencies,
• differences in how the agencies or systems function, and
• barriers to coordinated care.

Plans also create a roadmap for effecting change by aligning goals, strategies and action steps across agencies and systems. By completing a plan, systems and agencies commit and invest in system integration. Even as agency leaders and staff experience turnover, the roadmap remains to help new staff understand the vision and pick up on tasks. Building capacity and the infrastructure needed to integrate systems takes time and focus. A plan sets up a way to build towards a lasting change.

A successful, transformative long-term plan must show:

• Presence of leadership and authority from each system or agency
• Willingness to invest time and resources to transform systems
• Commitment to change
• Meaningful participation by individuals with co-occurring disorders and their families
• Commitment to cultural competence
• Steps that promote sustainability
• Mechanisms for demonstrating effectiveness such as benchmarks and outcomes
• Ability to hold the agency or system accountable for performance

States undertaking this work have learned that integration requires short- and long-term planning, with concrete goals and realistic timelines. States have learned that embedding changes into policies, administrative rules and procedures is an important vehicle for sustainability. Another valuable way to guide planning for integration efforts is to set up demonstration projects to model the systems change. Plans for sustainable change must also pay careful attention to resource requirements.

Some Models

• Connecticut developed planning tools such as a logic model, a diagram of activities, a timeline of events, a map of co-occurring locations, and a system model.
• Michigan developed its long-term plan for systems integration using a cross-agency working committee. Michigan also developed clarifications for funding sources and availability to align funding goals.
• Pennsylvania's planning document to integrate services for co-occurring systems of care includes their vision, guiding principles, and strategies.

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Resources and Links

• Connecticut DMHAS Co-Occurring Disorders Initiative

  This page contains links to the various plans and tools the Connecticut's DMHAS has created for its Co-occurring Disorders Initiative, including policy statements, program rules, and systems maps.

• Memorandum regarding Clarification of Funding and Reporting Matters in Relation to Persons with Co-Occurring Disorders and the Provision of Substance Abuse and Mental Health Services

  This memorandum from the State of Michigan clarifies how the state's service organizations should respond to apparent conflicts in funding, demographic, and reporting matters for individuals with co-occurring mental health and substance use disorders and the provision of substance use and mental health services across three systems of care.

• Draft Recommendations of Co-Occurring Disorder Advisory Committee, Commonwealth of Pennsylvania

  This report includes the long-term plan for providing services for co-occurring disorders in Pennsylvania, including vision, goals, guiding principles, strategies and expectations.