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As part of my work with our local HEARTS/MARC (Healthy Environments And Relationships That Support/Mobilizing Action for Resilient Communities) collaborative, I have been approached with an interesting question. One that I hope this community will help with. 

1) Are you aware of any Managed Care Organizations or Health Management Organizations who are using a trauma informed lens to improve company culture?

2) Are there any articles, briefs, slide decks, multi-media resources that talk about implementing a trauma informed lens to improve the culture in a managed care environment (or a more business minded environment in general)?

3) It strikes me that the original ACE study was done as a collaborative effort between the CDC and Kaiser (an HMO!), after quite a bit of searching around I am still not able to find how Kaiser might have used the results of the ACE study to inform their own organizational culture or practice. If you have any information on this, please also point me in the right direction... 

Thank You In Advance! ~Jackie

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In my not so humble two cents:
Trauma informed = recovery oriented = prevention focused = patient centered. All the same. In general, things that promote good outcomes also promote good trauma management. Some ACES types might argue different, but if they were right, I would agree with them.

1. ACOs should fund social determinants - housing, transportation, etc.
2. look at self-directed spending. Texas and Judith Cook improved recovery rates and lowered costs.
3. Look at housing. I said it again cause it's really important. Look up permanent supporting (the gold plated option) and look up some legal tent cities (the community organizer option.)
4. ACOs should make a pot of money for "prevention." Lots of ACOs are doing it. Look up "value based funding."
5. Like at the Medicaid side for mental health, they are doing it way better than the private employer side. On the Medicaid side, you can get drugs and therapy, but also peer support, supported employment, day treatment, job coaching, case management, social skills training, etc. All you get with private pay is drugs and chit chat. (The corollary to this is that if your loved ones needs mental health labels and drugs, take them to your local public mental health center for more advanced care.)
6. Fund recovery oriented substance use treatment. De-tox for $6,000 and then dump them back on the streets, what? Look at FacesAndVoicesofRecovery.org Spend a few hundred on community wrap around so you don't have to pay over again for the $6,000.
7. One of the best things an MCO or HMO could do to say money and improve outcomes is to STOP paying for shock treatments. They don't beat placebo and they cause a lot of long term harm. 
8. Look at medication withdrawal syndromes and try to help people learn how to safely taper off psych drugs. They don't improve long term outcomes.

On and on...just look up best practices in general. Look on MadInAmerica.com for the programs. Look at the programs listed on Foundation for Excellence in mental health care. 

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