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A Candid Conversation on the Recovery-Oriented System of Care

In early August, SoberHood interviewed BRC Recovery CEO, Marsha Stone, for its RecoveryPeople podcast. Marsha recently turned the tables to interview SoberHood’s Executive Director, Jason Howell. Follow the conversation below between Marsha and Jason on the newest, chronic approach to treating addiction: The Recovery-Oriented System of Care. Marsha: The first time I met you was at a presentation you gave at Austin Recovery on the Recovery-Oriented System of Care (ROSC) movement. What is a simple explanation of ROSC? Jason: ROSC is the formal and informal networks and collaborations between organizations or agencies that focus on an individual’s or community’s recovery from mental health and substance abuse including prevention, early intervention, service engagement and long-term recovery support. Sounds like something we should be doing all along, right? Historically, recovery has been peer supported and community-based. Overtime, the approach to addiction has become episodic acute treatment (hospitalization, detox, rehab) or incarceration. And while the treatment and criminal justice industries have their roles to play, they alone do not provide a chronic care or holistic approach. Addiction is a chronic disease that requires a chronic approach to achieve cost effective recovery outcomes. ROSC is that chronic care approach.Recovery Oriented System of Care chart Marsha: At BRC Recovery, ROSC seems so logical because we have always focused on supporting residents long-term. Mark Houston designed our intensive program and continuum of care because he saw the acute care system failing. Help me understand why other organizations are slow to embrace ROSC. Jason: Well, that is a big question that I will do my best to answer. Mark, like many others in recovery along with insurance companies and researchers, started demanding something “better” because the recovery outcomes generated by our current system are not acceptable. How did we get so far off track? Well at the risk of over generalizing, I would say that funding and policies have shaped service delivery and industry norms away from what’s best for an individual’s recovery. People get what is paid for. What I mean by that is funding pays based on something. If insurance pays for 28 days, programs are developed around 28 days even though there is no evidence that 28 days is the right dose. A treatment industry and its policies evolve around treatment days. In the homeless and housing world, the metric is days housed regardless of recovery outcomes. In criminal justice, the metric is recidivism. I could go on and on, but each one of these industries develops a particular perspective and policies that may not overlap. You can think of them as silos. ROSC is an opportunity to rethink those policies and gain a common focus around an individual’s recovery. I did not know Mark Houston well, but my sense is that he chose a self-pay sustainability model to have the freedom to focus on recovery outcomes. Since BRC Recovery has continued that self-pay model, you have been able to focus on providing a continuum of care that supports someone in long-term recovery. Marsha: So what you are telling me is that BRC Recovery was ROSC before ROSC was cool. Jason: LOL. I am hearing a Barbra Mandrell song in my head right now, which dates me a bit. I would say that BRC Recovery has been focusing on recovery and delivering a continuum of peer-based recovery support services for a long time. ROSC lives in the networks and collaborations that BRC Recovery has with other organizations and agencies to promote recovery for individuals, their families and the community at large. Thank you to Jason for taking the time to chat. You can learn more about SoberHood by visiting their website.