New system streamlines process of getting substance use disorder treatment in Washtenaw County

A new phone number provides a convenient single point of access for individuals seeking substance use disorder treatment in Washtenaw County.
​​This article is part of a series about mental health in Washtenaw County. It is made possible with funding from Washtenaw County's Public Safety and Mental Health Preservation Millage.

For the past year, a new phone number has provided a convenient single point of access for individuals seeking substance use disorder treatment in Washtenaw County to receive an assessment and referrals for further treatment.
The new system is open to Washtenaw County residents with Medicaid as well as those without insurance. The hotline at (734) 544-3050 is monitored by Washtenaw County Community Mental Health (WCCMH) staff. When people call the hotline and identify that they're seeking substance use disorder treatment, they're transferred to a team of substance use screeners, who are master's degree-level mental health professionals. 1,865 people were screened for substance use disorder needs in 2022. Screenings, referrals, and treatment authorizations were given to callers on the same day their requests were received.
Melisa Tasker, program administrator for WCCMH, oversees the team that manages the hotline. She says screeners "provide a screening and referral and authorization for a contracted provider, depending on the level of treatment the person is requesting or qualifies for." Screeners are available Monday through Friday, but callers can access the hotline 24 hours a day, seven days a week. "We are available on the weekends and after hours for severe cases," says Tasker.
Challenges with the old system

The single point of access replaces an old system that was "very confusing for people," according to Nicole Adelman, substance use services director with the Community Mental Health Partnership of Southeast Michigan.
Under the previous system, individuals seeking treatment for substance use disorders were instructed to call one of two treatment providers, Home of New Vision and Dawn Farm. The provider was assigned based on the individual's birth month.
According to Matthew Hill, project manager with the Center for Health and Research Transformation (CHRT), "if you had an odd birth month, you would call one provider. If you had an even birth month, you would call the other provider. That was originally to try to eliminate bottlenecks in the system."
Matthew Hill, project manager for CHRT. 
But the system "create[ed] a lot of confusion amongst individuals," Hill says. "People were assuming that just based on birth month, you're forced to go to one or the other [treatment provider]."
In fact, a person’s birth month only dictated where they received their initial assessment; they could still receive treatment from a variety of providers. But the confusion remained. 

"We had a lot of concerns and complaints from community members and providers," Adelman says.
The new system has sought to address these complaints with a single point of access. Hill describes WCCMH, which runs the hotline, as "a neutral assessment arm," or "one entity that can organize referrals across multiple different agencies to make sure that all of a person’s needs are getting met."
Identifying needs, connecting to treatment

According to Tasker, individuals who call the new hotline are asked a standardized series of questions. 

"We’re trying to get an idea of the level of severity of their substance use," she says. "There are certain criteria that need to be met for each level of care. So we talk through how someone’s doing, what they’re looking for, what their current situation looks like. We spend a lot of time trying to navigate how to best help them. Once we do that, we try to identify a provider that might meet their needs."
Often, callers are hoping to access treatment as quickly as possible, Tasker says. In those cases, WCCMH contacts "lots of [treatment] providers to see the quickest turnaround time to get someone into a detox bed or a residential bed."
 Nicole Adelman, substance use services director with the Community Mental Health Partnership of Southeast Michigan.
According to Adelman, the time between receiving an initial assessment and beginning care has decreased significantly. Under the old system, "it was taking a long time for people to get through the access system and into treatment," she says.
Adelman says that under the new system, that time period has gone down to three or three and a half days. (Turnaround time was not tracked under the previous system.)
The system also includes a follow-up process for all callers authorized for treatment services. WCCMH provides a referral and authorization but isn’t always able to connect hotline callers directly with treatment providers. In those cases, Tasker says, "it's up to the individual to call the provider and get that intake scheduled," but WCCMH is "keeping track and we're making follow-up calls a day or two later to ensure that they've gotten connected [with treatment providers]."
Advantages of the new system

According to Tasker, "It's been a real benefit to be part of this [new] process because we often have individuals who have a co-occurring disorder and our screeners can actually authorize and schedule for mental health outpatient services at the same time."
Tasker says that means that "if someone is calling and they're needing substance use treatment and they're also needing mental health treatment, [WCCMH] can take care of that." 
Adelman confirms this idea. 
Melisa Tasker, program administrator for WCCMH.
"You don’t have to say, ‘If you have a mental health issue, you go here, [and] if you have a substance use issue and need help, you go here.’ So [the new system] allows for streamlining of those services."

Hill cites "the expanded hours of operation" as a major advantage of the new system. The 24/7 hotline means "you can call and get an assessment somewhat quicker than the old system," he says.
"We've got a lot of really positive feedback from staff that it's been a good process," Tasker adds.
The ABLe Change Process

The idea for the new access system was developed as part of the ABLe Change Process, which consisted of two large convenings sponsored by the Washtenaw Health Initiative.
The convenings, which took place in 2018 and 2019, were attended by dozens of local stakeholders. Hill, who also took an active role in the ABLe Change Process, says the convenings encouraged "stakeholders to envision what their ideal system would look like and then take action steps to move towards that ideal system."
Both Tasker and Hill confirm that, in Hill’s words, "having a common coordinated intake" was "identified as needing to be addressed in the ABLe Change Process."
During the convenings, participants were split up into action teams. The Common Coordinated Intake Team "was looking at how we might be able to easily navigate a system that allows for immediate engagement into services," Hill says.
Tasker calls the "central point of access" the "biggest outcome" of those convenings.
Looking ahead

Hill says that treatment center staffing shortages represent one challenge that the new system unfortunately can't address. Adelman echoes that statement. 

"Like everywhere else, there tends to be staffing challenges," she says.
Still, Adelman says the feedback she’s received regarding the new system has been "primarily positive," adding that WCCMH "has done well."
Overall, Tasker says, "I think that this switch was really positive and I anticipate that it's going to continue to provide a positive impact on the community."

Natalia Holtzman is a freelance writer based in Ann Arbor. Her work has appeared in publications such as the Minneapolis Star Tribune, the Los Angeles Review of Books, Literary Hub, The Millions, and others.

All photos by Doug Coombe.
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