Technical Assistance Project – Information for Staff
Key Terms to Understand
Chronic Care Model
The Chronic Care Model (CCM) was created by Dr. Ed Wagner of the MacColl Institute for Healthcare Innovation, Group Health Cooperative of Puget Sound. The CCM identifies the different systems in which chronic illnesses are treated, such as hospitals and families of chronically ill patients, and seeks to standardize the links between them. The goal is for patients and their primary caregivers to be informed about their own care, while provider teams are prepared and proactive. This is a contrast to the traditional model of managed care, in which patients, who are often uninformed about their own health care needs, are treated only after problems arise. By creating standard cooperation among systems of care, the CCM prevents problems from developing in the first place, while preparing for treatment in the event they do occur (Improving Chronic Illness Care, The Robert Wood Johnson Foundation). The CCM is important to the substance abuse treatment field because of the belief that substance abuse and dependence are chronic illnesses that must be continually monitored and treated for the lifetime of the patient. It is important for both patients and caregivers to recognize this. In its substance abuse field manifestation, the CCM is divided into six elements: community resources and policies, health care organization, self-management support, delivery system design, decision support, and clinical information systems (Thomas & McCarty, 2004). The CCM was first applied to the substance abuse treatment field when it was used to treat tobacco addiction in a study (Bodenheimer, Wagner, and Grumbach, 2002a, 2002b). For more information, refer to theICIR website.
Institute of Medicine's Continuum of Care Model
The Institute of Medicine recognizes that addiction is a chronic disease, and thus should be treated like other chronic diseases through a continuum of treatments and social services. The Continuum of Care Model calls for the creation of networks of service providers which can cater to the diverse types of substance abusers. These networks of service are not limited to treatment facilities, but include prevention and intervention services, as well as recovery and relapse prevention services. To assist with relapse prevention, the networks are enlarged to include all agencies that support those in recovery, such as educational facilities, religious organizations, and housing agencies. The Continuum of Care Model has four key stages: identification, assessment, treatment, and ongoing recovery management. These four stages reflect the dedication to the entire continuum of substance abuse services, from universal prevention to recovery assistance (National Conference of State Legislatures). For more information, and explanations of the four key stages, click here.
Framework for Prevention of Alcohol and Drug Problems
The Framework for Prevention of Alcohol and Drug Problems is a document released by the California Department of Alcohol and Drug Programs (ADP) in 1991 to set forth the State's prevention policies and strategies. It states that prevention is a constantly evolving process, and that prevention programs should encompass multiple community interests (White House Office of National Drug Control Policy). Additionally, the framework affirms CSAP's six strategies for prevention (a list of the strategies and their explanations can be found here). This framework is important to service providers because it provides them with established strategies around which to base their prevention programs. It is useful to organizations just starting prevention programs in need of ideas, as well as established prevention programs that simply need minor adjustments. A copy of the framework will be available in the NAPAFASA resource library. Additional information about the framework and ADP prevention practices can be found here and here. In 1998, ADP held a prevention summit, which resulted in the revised version of the document which is called The California Prevention Platform - A Framework for the Future. This document sets forth a series of eight "planks," which are steps that California should take in order to revitalize prevention efforts (California ADP). These "plans" are:
- Create a Representative Statewide Prevention Collaborative
- Assert State Leadership with a Prevention Services Division
- Incorporate a Youth-Development Model into Prevention and Actively Engage Youth in the Decision-Making Process
- Ground California State ATOD Policies in Research-Based Strategies and Programs within a Results-Based System
- Move Toward Professional Standards in the Field of Prevention by Developing Core Curriculum and Training Programs
- Maintain and Expand, as Appropriate, Contracts to Provide Technical Assistance
- Ensure Appropriate Utilization of Block Grant Prevention Sources
- Convene an Annual Prevention Training Summit
The full text of the prevention platform can be found here.