Telecare's Alameda County, Calif. 'CHANGES' Program
             Lowers Average Annual Costs by 32 Percent per Client

    OAKLAND, Calif., Oct. 26 /PRNewswire/ -- A recent evaluation of the
CHANGES Dual Recovery Program based in Alameda County, Calif., found that
psychiatric hospitalizations of the program's first 142 enrolled clients
decreased by 40 percent, psychiatric emergency room contacts decreased 35
percent, and admissions to IMD's (Institutions for Mental Disease) decreased
34 percent.
    CHANGES' evidence-based and innovative practices are designed for
individuals dually diagnosed with serious mental illness and substance abuse
problems who have a history of difficulty staying connected to traditional
mental health and substance abuse services.
    The internal study found that these outcomes yielded savings of nearly
$900,000 for Alameda County during the one-year study period, when compared to
data before the program was initiated. These savings amounted to 32 percent
lower costs per client in the CHANGES program, a comprehensive dual-diagnosis
program opened in June 2001 as a joint effort between Alameda County
Behavioral Healthcare Services and Telecare Corporation, which conducted the
analysis.
    According to Telecare's medical director, Stephen Wilson, MD, clients
receive services that focus on empowering them to regain control of their
lives while at the same time decreasing system costs, including jail costs,
and inappropriate use of the county's overburdened acute and emergency
psychiatric services.
    "CHANGES uses evidence-based practices to address the complex needs of
those dually diagnosed with mental illness and substance abuse," said Wilson.
"Where previously there were no evidence-based practices, we have developed
innovative approaches," said Wilson. "We are finding that a client-centered
program that integrates outreach, services, and self-help can achieve
impressive results."
    According to national statistics, 50 percent of persons with severe mental
illness are also affected by substance abuse. Dually-diagnosed individuals
have much higher rates of relapse, hospitalization violence, incarceration,
homelessness, and serious infections (HIV), than do those with only severe
mental illness.
    "The traditional sequential or parallel approaches to caring for the
dually-diagnosed are ineffective," according to Scott Madover, PhD, program
administrator.  "At CHANGES we de-emphasize the two disorders and offer
clients an integrated, holistic approach that focuses on recovery of life
roles, not merely recovering from diseases."
    "CHANGES has revolutionized how we support individuals with dual-
diagnosis," said Marye Thomas, MD, director of Alameda County's Behavioral
Health Care Services.  "The old approach was fragmented and costly. In this
era of limited resources we must focus on behavioral health care programs that
improve quality of life, while at the same time reducing costs by avoiding
hospitalization, emergency rooms, or incarceration."
    The report also found that among clients served at CHANGES there was a:

    -- 7 percent improvement in functioning
    -- 11 percent reduction in harm
    -- 30 percent increase in clients living independently
    -- 57 percent decrease in the number of clients living in homeless
       shelters

    The primary diagnosis of those in the study was schizophrenia (51
percent), followed by depression and bipolar disorder (18 and 17 percent
respectively).  Thirty-nine percent abused more than one substance, 22 percent
abused alcohol, and 19 percent cocaine.
    Based in Alameda, Calif., Telecare works in partnership with local,
county, state and other behavioral health organizations to design and provide
a wide range of innovative, recovery-focused, outcomes-driven services and
supports for high-risk individuals with complex needs. Telecare is an
employee-and family-owned organization with over 1,900 employees and more than
50 programs in California, Texas, Oregon, and North Carolina.

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