July 18, 2016 SHARE TWEET Meet Jane – A Center of Excellence Patient Like Governor Tom Wolf on Facebook: Facebook.com/GovernorWolf Substance Use Disorder, The Blog Centers of Excellence help ensure that people with opioid-related substance use disorder stay in treatment to receive follow-up care and are supported within their communities. Care management teams coordinate care and provide warm transitions to new parts of the treatment process.A common misconception about the Centers of Excellence is that they are only physical locations where people can walk in and receive treatment. While most of the centers will provide direct treatment, in reality when we use the term “center” we are referring to a central, efficient hub around which treatment revolves. These centers will have navigators to assist people with opioid-related substance use disorders though the medical system, and ensure they receive behavioral and physical health care, as well as any evidence-based medication-assisted treatment needed.To better explain how Centers of Excellence work, let’s use an example.Meet Jane. Jane is suffering from opioid use disorder. When she decided to get treatment for her illness, she sought initial help at a health care facility – like a hospital, her primary care physician, or with a behavioral health specialist. Let’s say Jane went to her primary care physician – Dr. Smith.With informed consent, Dr. Smith notifies the Center of Excellence team that Jane is seeking treatment. A Center of Excellence health team professional – let’s call this person Tim – arrives on site and completes an assessment of Jane to determine her specific needs. Tim then develops a treatment plan for Jane that recommends the appropriate level of care.Tim then ensures coordination of Jane’s care with a Center of Excellence team. If Jane consents, her family can also be involved in Jane’s care. Other members of her Center of Excellence team may include behavioral and physical health care providers, community-based care navigators, and community-based resources that can help Jane obtain food, housing, and apply for jobs.Tim sets Jane up with Dr. Mansfield – a drug and alcohol (D&A) provider that will help Jane with her opioid use disorder. But in addition to her opioid use disorder, Jane also has anxiety and asthma. In order to help treat Jane as a whole person, Tim connects Jane with Dr. Boyer, a mental health provider that can help treat Jane’s anxiety, and Dr. Nolan, a physical health provider that can help treat Jane’s asthma.Behavioral health providers include mental health providers as well as D&A providers. D&A providers – like Dr. Mansfield – help provide evidence-based treatment which would include recovery supports, cognitive behavioral therapy, drug and alcohol counseling, rehabilitation services, and detoxification. Mental health providers – like Dr. Boyer – would provide evidence based treatment consisting of counseling or talking therapies and medications for conditions such as anxiety, severe depression, bipolar disorder, and schizophrenia.Physical health providers – like Dr. Nolan – would provide treatment for conditions such as diabetes, high blood pressure, asthma, heart attack, and seizures but could also treat anxiety and depression.Both physical health and behavioral health physicians that have specific training can provide medication assisted treatment for opioid use disorder with medications such as methadone and buprenorphine.Jane will receive all available supports coordinated by her Centers for Excellence team such as referral to employment services, housing support, legal support, and faith based resources. The care team, which is led and coordinated by Tim, oversees everything from the evaluation to the referral process, through follow-up care.This is how Jane receives the treatment she needs and starts on the path to recovery through the Centers of Excellence. Working with Tim, her family, Dr. Smith, Dr. Mansfield, Dr. Boyer, and Dr. Nolan, Jane is able to get the care that she needs.Investing in Addiction TreatmentGovernor Wolf’s 2016-2017 budget included $10 million in behavioral health funding and $5 million in Medical Assistance funding, totaling $15 million. This will allow DHS to draw down $5.4 million in federal funding for an overall total of $20.4 million.This critical funding will enable the Department of Human Services, during phase one, to implement 20 Opioid Use Disorder (OUD) Centers of Excellence that will treat approximately 4,500 people like Jane that currently are not able to access treatment.The Department is also working with its actuaries to determine the number of additional centers that can be funded with the $5 million in state Medical Assistance funds and $5.4 million in federal funds by analyzing the impact they will have on Medicaid managed care rates. The Department of Human Services will announce any additional Medicaid-funded OUD Centers of Excellence in August. By: Sarah Galbally, Secretary of Policy and Planning SHARE Email Facebook Twitter
Danish labour market pension fund PenSam said it has switched weightings in its passively-managed listed global equities portfolio to take account of climate factors, by adopting the MSCI All Country World Index (ACWI) Climate index for the whole €4.8bn allocation.Torsten Fels, PenSam’s chief executive officer, said: “The MSCI Climate Change Indexes consider both the opportunities and risks associated with the transition to a low carbon economy, enabling PenSam to integrate climate risk considerations in the global equity portfolio.”Announcing the move, index provider MSCI said its climate change Indices re-weighted securities based on MSCI’s low carbon transition score, which kept track of a company’s exposure to low carbon transition risk, carbon emissions and fossil fuel reserves as well as its exposure to opportunities including alternative energy and clean technology.A spokeswoman for the €20bn Danish pension fund confirmed to IPE that it had adopted the index for both listed Danish and foreign equities, adding that the fund had only a minor exposure to Danish equities. PenSam previously used the MSCI ACWI, she said.Alvise Munari, global head of client coverage at MSCI, said: “It is critical that the investment industry leads the transition to a low carbon economy, before climate change becomes a major threat to financial stability.”MSCI was trying to aid this transition, he said, by developing tools that analysed “next-generation data” to support clients’ integration of sustainability into their investment processes.The ACWI Climate Change Index is based on the MSCI ACWI, including large and mid-cap securities across 23 developed and 26 emerging market countries, said MSCI.Last June, French utility company EDF announced that it was adopting the index for its €28.1bn nuclear plant decommissioning fund, and was planning to switch some of its passive investments into indexed funds using the new MSCI indices.
NZ Doctor 3 September 2015“One day my daughter didn’t come home on the bus.” Chilling for any parent. In this instance and without parental knowledge or consent, a mother’s 15-year-old daughter had been taken during school hours to another town for an abortion.This was only revealed to the family when the daughter attempted suicide, after a year of depression, self-hatred, anger, alcohol and substance abuse. To make matters worse her daughter will face infertility after an apparent “botched abortion”.It’s always a risk writing in any form about this subject. Damned if you do and damned if you don’t when it comes to the pro and anti groups and even some health professionals themselves (stay away from politics and moral judgments they say).So I’ll come clean and say, while we have very messy abortion laws in New Zealand, I am much more concerned about what is happening to the health of our very young women. I’ll use the word “chilling” again. And this is why.Impact of the Health Information Privacy CodeIt is a wellknown fact that abortions are mainly carried out because of possible permanent injury to a woman’s (or girl’s) mental health.It is also now widely known that parents of 11 year olds or older must sign consent forms for basic first aid care and dental treatment in schools, but an abortion (it is said approximately 50 each year) can be carried out without the knowledge or consent of parents even though they are legally responsible until their child is 18.The Health Information Privacy Code means school counsellors are unable to share information with a parent or the school, and an 11 year old can make an abortion decision herself. Imagine at the age of 11 having tests and scans, seeing two certifying consultants and expected to sign a form saying she understands and consents without parental support and guidance and the likely mental health ramifications?Abortion: hard to faceThis conundrum stretches out to general practice and all of primary healthcare. One way or another these young women attend school (school nurses), or youth services, general practice, public health nurses, and yet abortion continues to be incredibly hard to talk about and we just continue to duck and dive as if it has nothing to do with general practice or primary healthcare.But it does. It always has but you’d never know it. Abortion, now one of the most common medical surgical procedures that women of childbearing age face, continues to have this secret file on it which, even though classed as a medical treatment, has little to do with illness. It’s mostly performed on well women unless it is mental illness which we are studiously avoiding to confront.Practice nurses say they have no interest in the politics or morality of the abortion issue. And is it really the role of a school nurse to take a student to an abortion service? No more than stealthily taking her to an alcohol or other drug service and not advising the parent their daughter is drinking to excess.http://m.nzdoctor.co.nz/blog-detail.aspx?n=68861
Ghana revived their campaign at the 2013 African Youth Championship by beating Benin 1-0 in Ain Temouchent on Tuesday.The Black Satellites won the Group A contest 1-0 to record their first win of the competition ahead of the decisive final group match against hosts, Algeria on Friday.Ebenezer Assifuah’s second half goal separated the West African neighbours.And the goal was the attacker’s second at the competition after scoring in Ghana’s opening game, a 2-1 defeat to Egypt.After countless misses in the first half, the young attacker finally scored when he nodded home a freekick from Moses Odjer.Ghana will play hosts Algeria in their final Group match on in Ain Temouchent. The Black Satellites now have three points and need a win in the final group fixture to advance in the competition.The eight-team finals will see the top four teams qualifying to represent Africa at the 2013 FIFA U-20 World Cup in Turkey.