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Implementing an Integrated System of Care Model in the State of Maine

The State of Maine has had a long-standing concern for the needs of people with co-occurring disorders. Over 20 years ago, a Maine Reimbursement Task Force was formed for the purpose of addressing the needs of individuals with co-occurring disorders more effectively. This task force brought together a group of leaders representing providers, consumers, policy makers, and funders to think through changes in policy and treatment approaches. National experts were brought in to advise and provide education. Grants then were given to collaborative networks across the state to develop common language and integrated assessment tools for mental health and substance abuse. The state continued this initiative through funds from the Robert Wood Johnson Foundation to expand one of the networks and create the first Assertive Community Treatment (ACT) team in Maine, a co-occurring ACT team complete with vocational specialist and consumer team members. The Cumberland County Dual Diagnosis Collaborative was the successful recipient to head up this work. This collaborative evolved to become the Co-Occurring Collaborative Serving Maine (CCSME) and has worked steadily for 15 years to provide and engage the community in training and networking on co-occurring issues. Psychiatric Services credits CCSME with improving the local delivery of services and bringing change to the way that agencies work together (Ridgely, Lambert, Goodman, Chichester, & Ralph, 1998). Despite many years of progress by CCSME in creating a local service network and providing training to improve practice, most of the work occurred