Recovery-Oriented Systems of Care

Addiction researchers and treatment providers have increasingly advocated moving away from an acute-care model of treatment to embracing Recovery Oriented Systems of Care (ROSC) which emphasize person-centered and self-directed pathways to recovery with an emphasis on building on the strengths and resilience of individuals, families and communities.

In this collection we feature a selection of reports and state documents related to creating and implementing ROSCs. Included are:

  • A 2008 overview of the ROSC model from noted researcher William White
  • A 2009 Substance Abuse and Mental Health Services Administration (SAMHSA) report on the guiding principles and key elements of ROSCs as well as review of the published research that supports ROSCs
  • A one page document from SAMHSA listing the key elements of ROSCs
  • A guide to addressing stress and trauma in ROSC programs

In addition, policy manuals and implementation guides from 3 states or localities who have implemented ROSC models are included:

Finally, multiple documents from the State of Ohio which is currently in process of transforming its behavioral health system into a ROSC model by working with its County Behavioral Health Authorities. The Ohio documents include the following:

  • Presentation slides, a 2 page overview, and the state’s blueprint for transforming its behavioral health system into a ROSC including goals and action steps for implementation
  • An adaptation of the state’s blueprint for the Counties of Allen, Auglaize and Hardin which updates the state plan to add strategies, interventions and outcomes to the goal/action step format
  • Butler County, Ohio’s strategic plan for its ROSC transformation
  • A reference guide for County Behavioral Health Authorities that explains current state laws that affect ROSC transformation efforts
  • A copy of an assessment tool used to measure county readiness to adopt ROSC concepts and a report on the assessment findings
  • A 2016 progress report on ROSC transformation efforts, and
  • A copy of Hancock County’s ROSC implementation evaluation plan.

Note: We are working to include additional resources about ROSC and ROSC implementation in states and addiction treatment programs. If you have materials to include in this collection, please let us know by visiting our call for submissions page.

Policymakers & Community Leaders

Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices

Source: Northeast Addiction Technology Transfer Center, Great Lakes Addiction Technology Transfer Center, Philadelphia Department of Behavioral Health and Intellectual disAbility Services

Noted researcher William White prepared this 2008 overview of Recovery Oriented Systems of Care (ROSC) model. The report traces the history of addiction treatment and why the system needs to move to a more recovery-focused model. This report is considered one of the foundational documents of the ROSC movement.

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Policymakers & Community Leaders
Payers & Providers

Guiding Principles and Elements of Recovery-Oriented Systems of Care: What Do We Know from the Research?

Source: Substance Abuse and Mental Health Services Administration (SAMHSA)

This 2009 report from the Substance Abuse and Mental Health Administration includes a working definition of recovery, 12 guiding principles of recovery, and 17 elements of Recovery Oriented Systems of Care (ROSC). The report also reviews the research to date on recovery that supports the ROSC principles.

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Policymakers & Community Leaders
Payers & Providers
Patients & Caregivers

National Summit on Recovery Conference Report: Description of Systems of Care Elements

Source: Substance Abuse and Mental Health Services Administration (SAMHSA)

More substance use disorder treatment providers are adopting the principles of a recovery-oriented, systems of care approach to treatment. This one page document describes the elements of a recovery-oriented system of care framework.

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Policymakers & Community Leaders
Patients & Caregivers

Colorado’s Statewide Strategic Plan for Substance Use Disorder Recovery: 2020-2015

Source: Colorado Health Institute et. Al.

Colorado’s statewide strategic plan for substance use disorder recovery for 2020-2025 was developed after a review of the literature on evidence-based and promising practices in recovery and consultation with an advisory committee and stakeholder engagement meetings. The report defines and describes recovery as part of the continuum of care and outlines 3 objectives for building up Colorado’s capacity to support recovery:

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Payers & Providers
Patients & Caregivers

Practice Guidelines for Recovery-Oriented Behavioral Health Care

Source: Connecticut Department of Mental Health and Addiction Services

Connecticut was one of the first states to adopt a Recovery Oriented Systems of Care (ROSC) model for addiction treatment and is commonly cited as a model for other states to follow. This document provides guidelines for addiction treatment providers to adopt ROSC principles in their

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Policymakers & Community Leaders

Philadelphia Behavioral Health Services Transformation – Practice Guidelines for Recovery and Resilience Oriented Treatment

Source: Philadelphia Department of Behavioral Health and Intellectual disAbility Services

The city of Philadelphia was an early adopter of the Recovery Oriented Systems of Care model for substance use disorder and mental health treatment. These 2011 practice guidelines provide an overview of the Philadelphia framework and provide strategies for organizations and providers

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Policymakers & Community Leaders
Payers & Providers

Michigan’s Recovery Oriented System of Care – An Implementation Plan for Substance Use Disorder Service System Transformation

Source: Bureau of Substance Abuse and Addiction Services, Behavioral Health and Developmental Disabilities Administration, Michigan Department of Community Health

Michigan prepared this 2011 implementation plan for transforming its substance use disorder treatment system into a Recovery Oriented Systems of Care (ROSC) model. Michigan was a leader in adopting the ROSC model.

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Policymakers & Community Leaders

ROSC in Michigan: An Interview with Deborah Hollis

Source: William L. White

Noted recovery researcher William White interviewed Deborah Hollis about Michigan’s program to develop a Recovery Oriented System of Care (ROSC) approach to addiction treatment.

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Payers & Providers
Patients & Caregivers

Recovery is Beautiful – Developing a Better Understanding

Source: Ohio Association of County Behavioral Health Authorities

This 2 page document briefly explains Ohio’s plan to transform its behavioral health system by adopting the Recovery Oriented Systems of Care (ROSC) model.

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Payers & Providers
Patients & Caregivers

Recovery is Beautiful: A BluePrint for Ohio’s Community Mental Health and Addiction System

Source: Ohio Association of County Behavioral Health Authorities

The blueprint for Ohio’s 5-year plan to transform the state’s mental health and addiction treatment system to a Recovery Oriented Systems of Care (ROSC) model. The report includes descriptions of the ROSC model and action steps for county agencies to implement ROSC in their communities.

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Policymakers & Community Leaders

A Strategic Plan 2015-2020: A BluePrint for Ohio’s Community Mental Health

Source: Mental Health and Recovery Services Board of Allen, Auglaize, and Hardin Counties

The Mental Health and Recovery Services Board of Allen, Auglaize, and Hardin counties created this strategic plan to implement Recovery Oriented Systems of Care (ROSC) in their communities from 2015 to 2020. The plan includes background information on ROSC and a step by step action plan for implementation.

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Policymakers & Community Leaders

Butler County Mental Health and Addiction Recovery Services Board – Strategic Plan

Source: Butler County Mental Health and Addiction Recovery Services Board

This is the strategic plan for Butler County, Ohio to implement a Recovery Oriented System of Care during the years 2016 to 2018. The report includes an analysis of the readiness assessment and key stakeholder recommendations, and then presents the strategic plan for implementation.

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Payers & Providers

Behavioral Health Handbook

Source: Ohio Association of County Behavioral Health Authorities

This 2016 reference guide identifies and explains the laws in Ohio that oversee the operational duties and responsibilities of community alcohol, drug addiction, and mental health boards. The guide was prepared by the Ohio Association of County Behavioral Health Authorities to assist boardsas they transition to Ohio’s Recovery Oriented Systems of Care model for treatment.

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Policymakers & Community Leaders

Recovery Oriented Systems of Care (ROSC) in Ohio

Source: Ohio Association of County Behavioral Health Authorities

Ohio created an assessment process to determine the degree to which county’s had adopted Recovery Oriented Systems of Care principles and identify areas or strength and opportunities for improvement. This 2019 report provides the results of the 2018 assessment.

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Policymakers & Community Leaders

Recovery Oriented Systems of Care Self Assessment – Stakeholder Assessment

Source: Ohio Association of County Behavioral Health Authorities

This form provided by the Ohio Association of County Behavioral Health Agencies can be used to assess stakeholder readiness to adopt Recovery Oriented Systems of Care by assessing readiness in 6 domains: degree of focus on clients and families; ensuring timely access to care; promoting

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Payers & Providers
Patients & Caregivers

Progress on the BluePrint for Ohio’s Community Mental Health and Addiction System

Source: Ohio Association of County Behavioral Health Authorities

Ohio launched its behavioral health transformation with the publication of a blueprint for creating Recovery Oriented Systems of Care (ROSC) in Ohio communities. This 2016 report describes the progress made in their 5-year plan with updates from county’s on their progress.

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Policymakers & Community Leaders

Assuring Safety, Wellness and Recovery in Hancock County – Building Recovery through Evaluation: Establishing an Evaluation Plan Year 01

Source: Hancock County Board of Alcohol, Drug Addiction and Mental Health Services

As Ohio works with its counties to implement Recovery Oriented Systems of Care (ROSC) through their County Boards of Alcohol, Drug addiction and Mental Health Services the state required counties to design implementation and evaluation plans. This 2014 document from Hancock County, Ohio provides options for evaluating patient and program outcomes during the ROSC implementation process.

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