Oregon SUD Care Cascade Figures

Visual representations of outpatient substance use disorder treatment pathways for individuals with housing challenges
Figure 1: Primary Care Entry Point Cascade

Target Population: Individuals with unstable housing accessing primary care services
Initial Contact & Screening
Entry Points
FQHCs, Community Health Centers, Mobile Clinics
                    <div class="content-box">
                        <div class="content-label">Screening Tools</div>
                        <div class="content-text">AUDIT, DAST-10, PHQ-9, Housing Stability Assessment</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Key Challenges</div>
                        <div class="content-text">Inconsistent addresses, transportation barriers</div>
                    </div>
                </div>
                <div class="oregon-highlight">
                    <strong>Oregon Resources:</strong> Coordinated Care Organizations (CCOs), Oregon Health Plan enrollment
                </div>
            </div>
            
            <div class="arrow">↓</div>
            
            <div class="stage">
                <div class="stage-number">2</div>
                <div class="stage-title">Assessment & Diagnosis</div>
                <div class="stage-content">
                    <div class="content-box">
                        <div class="content-label">Providers</div>
                        <div class="content-text">LCSW, CADC, Integrated Care Teams</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Process</div>
                        <div class="content-text">DSM-5-TR criteria, severity evaluation, co-occurring disorders</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Coordination</div>
                        <div class="content-text">Housing case managers, benefits enrollment</div>
                    </div>
                </div>
                <div class="barrier-highlight">
                    <strong>Barriers:</strong> Limited integrated services, waiting lists for specialized care
                </div>
            </div>
            
            <div class="arrow">↓</div>
            
            <div class="stage">
                <div class="stage-number">3</div>
                <div class="stage-title">Treatment Planning</div>
                <div class="stage-content">
                    <div class="content-box">
                        <div class="content-label">Treatment Components</div>
                        <div class="content-text">Outpatient counseling, MAT evaluation, group therapy</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Housing Integration</div>
                        <div class="content-text">Continuum of Care coordination, transitional housing</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Support Services</div>
                        <div class="content-text">SNAP/TANF enrollment, transportation, childcare</div>
                    </div>
                </div>
            </div>
            
            <div class="arrow">↓</div>
            
            <div class="stage">
                <div class="stage-number">4</div>
                <div class="stage-title">Active Treatment</div>
                <div class="stage-content">
                    <div class="content-box">
                        <div class="content-label">Frequency</div>
                        <div class="content-text">Weekly individual, bi-weekly groups, flexible scheduling</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">MAT Services</div>
                        <div class="content-text">Buprenorphine/naloxone, naltrexone through primary care</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Wraparound</div>
                        <div class="content-text">Peer support, housing navigation, telehealth options</div>
                    </div>
                </div>
            </div>
            
            <div class="arrow">↓</div>
            
            <div class="stage">
                <div class="stage-number">5</div>
                <div class="stage-title">Recovery Maintenance</div>
                <div class="stage-content">
                    <div class="content-box">
                        <div class="content-label">Monitoring</div>
                        <div class="content-text">Monthly check-ins, clinical drug screening as indicated</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Housing Stabilization</div>
                        <div class="content-text">Permanent supportive housing, rental assistance programs</div>
                    </div>
                    <div class="content-box">
                        <div class="content-label">Long-term Support</div>
                        <div class="content-text">Employment services, alumni groups, crisis planning</div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    
    <!-- CASCADE 2: EMERGENCY/CRISIS BAR CHART -->
    <div class="cascade-section cascade-2">
        <h2 class="cascade-title">Figure 2: Emergency Department/Crisis Entry Point Bar Chart</h2>
        <p><em>Target Population: Individuals experiencing homelessness with acute SUD-related presentations</em></p>
        
        <div class="chart-container">
            <div class="bar-chart">
                <div class="chart-title">Patient Engagement Across Crisis Care Cascade Stages</div>
                <div class="bars-container">
                    <!-- Y-axis labels -->
                    <div class="y-axis-labels">
                        <div class="y-label">100%</div>
                        <div class="y-label">80%</div>
                        <div class="y-label">60%</div>
                        <div class="y-label">40%</div>
                        <div class="y-label">20%</div>
                        <div class="y-label">0%</div>
                    </div>
                    
                    <!-- Bars -->
                    <div class="bars-wrapper">
                        <div class="bar-group">
                            <div class="bar bar-1" data-value="100%"></div>
                        </div>
                        <div class="bar-group">
                            <div class="bar bar-2" data-value="85%"></div>
                        </div>
                        <div class="bar-group">
                            <div class="bar bar-3" data-value="70%"></div>
                        </div>
                        <div class="bar-group">
                            <div class="bar bar-4" data-value="55%"></div>
                        </div>
                        <div class="bar-group">
                            <div class="bar bar-5" data-value="40%"></div>
                        </div>
                    </div>
                    
                    <!-- X-axis labels -->
                    <div class="x-axis-labels">
                        <div class="x-label">Crisis Stabilization</div>
                        <div class="x-label">Brief Intervention</div>
                        <div class="x-label">Rapid Access</div>
                        <div class="x-label">Stabilization & Engagement</div>
                        <div class="x-label">Transition & Recovery</div>
                    </div>
                    
                    <!-- Axis titles -->
                    <div class="axis-title-y">Engagement Rate (%)</div>
                    <div class="axis-title-x">Care Cascade Stages</div>
                </div>
            </div>
        </div>
        
        <div class="chart-legend">
            <h3>Stage Details:</h3>
            <div class="legend-grid">
                <div class="legend-item">
                    <div class="legend-color" style="background: #fd79a8;"></div>
                    <div class="legend-text">
                        <strong>Crisis Stabilization (100%):</strong> Hospital EDs, mobile crisis teams, emergency shelter placement
                        <div class="oregon-highlight">Oregon Resources: Project RESPOND, regional crisis services</div>
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #e84393;"></div>
                    <div class="legend-text">
                        <strong>Brief Intervention (85%):</strong> ED social workers, motivational interviewing, warm handoffs
                        <div class="barrier-highlight">Challenges: Limited bed capacity, frequent ED visits</div>
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #a29bfe;"></div>
                    <div class="legend-text">
                        <strong>Rapid Access (70%):</strong> Within 72 hours, IOP/PHP, emergency housing vouchers
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #74b9ff;"></div>
                    <div class="legend-text">
                        <strong>Stabilization (55%):</strong> 3-5 sessions/week, team approach, intensive case management
                        <div class="oregon-highlight">Oregon Integration: Regional behavioral health organizations</div>
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #0984e3;"></div>
                    <div class="legend-text">
                        <strong>Recovery (40%):</strong> 6-12 months services, housing progression, skills building
                    </div>
                </div>
            </div>
        </div>
    </div>
    
    <!-- CASCADE 3: CRIMINAL JUSTICE LINE GRAPH -->
    <div class="cascade-section cascade-3">
        <h2 class="cascade-title">Figure 3: Criminal Justice System Entry Point Line Graph</h2>
        <p><em>Target Population: Justice-involved individuals with SUD and housing instability over time</em></p>
        
        <div class="chart-container">
            <div class="line-chart">
                <div class="chart-title">Criminal Justice SUD Treatment Outcomes Over 24 Months</div>
                <svg class="line-graph" viewBox="0 0 800 400" xmlns="http://www.w3.org/2000/svg">
                    <!-- Grid lines -->
                    <defs>
                        <pattern id="grid" width="89" height="40" patternUnits="userSpaceOnUse">
                            <path d="M 89 0 L 0 0 0 40" fill="none" stroke="#e0e0e0" stroke-width="1"/>
                        </pattern>
                    </defs>
                    <rect width="100%" height="100%" fill="url(#grid)" />
                    
                    <!-- Y-axis labels -->
                    <g class="y-labels">
                        <text x="40" y="350" text-anchor="middle" class="axis-label">0%</text>
                        <text x="40" y="310" text-anchor="middle" class="axis-label">25%</text>
                        <text x="40" y="270" text-anchor="middle" class="axis-label">50%</text>
                        <text x="40" y="230" text-anchor="middle" class="axis-label">75%</text>
                        <text x="40" y="190" text-anchor="middle" class="axis-label">100%</text>
                    </g>
                    
                    <!-- X-axis labels -->
                    <g class="x-labels">
                        <text x="70" y="380" text-anchor="middle" class="axis-label">0</text>
                        <text x="170" y="380" text-anchor="middle" class="axis-label">3</text>
                        <text x="270" y="380" text-anchor="middle" class="axis-label">6</text>
                        <text x="370" y="380" text-anchor="middle" class="axis-label">9</text>
                        <text x="470" y="380" text-anchor="middle" class="axis-label">12</text>
                        <text x="570" y="380" text-anchor="middle" class="axis-label">15</text>
                        <text x="670" y="380" text-anchor="middle" class="axis-label">18</text>
                        <text x="770" y="380" text-anchor="middle" class="axis-label">24</text>
                    </g>
                    
                    <!-- Treatment Engagement Line -->
                    <polyline points="70,203 170,216 270,229 370,236 470,240 570,246 670,248 770,252" 
                              fill="none" stroke="#fdcb6e" stroke-width="3" class="line-1"/>
                    
                    <!-- Housing Stability Line -->
                    <polyline points="70,310 170,294 270,278 370,257 470,244 570,230 670,217 770,209" 
                              fill="none" stroke="#fd79a8" stroke-width="3" class="line-2"/>
                    
                    <!-- Court Compliance Line -->
                    <polyline points="70,206 170,214 270,211 370,214 470,218 570,214 670,211 770,203" 
                              fill="none" stroke="#74b9ff" stroke-width="3" class="line-3"/>
                    
                    <!-- Recovery Outcomes Line -->
                    <polyline points="70,318 170,301 270,286 370,267 470,240 570,217 670,204 770,191" 
                              fill="none" stroke="#00b894" stroke-width="3" class="line-4"/>
                    
                    <!-- Data points -->
                    <g class="data-points">
                        <!-- Treatment Engagement points -->
                        <circle cx="70" cy="203" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="170" cy="216" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="270" cy="229" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="370" cy="236" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="470" cy="240" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="570" cy="246" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="670" cy="248" r="4" fill="#fdcb6e" class="point"/>
                        <circle cx="770" cy="252" r="4" fill="#fdcb6e" class="point"/>
                        
                        <!-- Housing Stability points -->
                        <circle cx="70" cy="310" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="170" cy="294" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="270" cy="278" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="370" cy="257" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="470" cy="244" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="570" cy="230" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="670" cy="217" r="4" fill="#fd79a8" class="point"/>
                        <circle cx="770" cy="209" r="4" fill="#fd79a8" class="point"/>
                        
                        <!-- Court Compliance points -->
                        <circle cx="70" cy="206" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="170" cy="214" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="270" cy="211" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="370" cy="214" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="470" cy="218" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="570" cy="214" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="670" cy="211" r="4" fill="#74b9ff" class="point"/>
                        <circle cx="770" cy="203" r="4" fill="#74b9ff" class="point"/>
                        
                        <!-- Recovery Outcomes points -->
                        <circle cx="70" cy="318" r="4" fill="#00b894" class="point"/>
                        <circle cx="170" cy="301" r="4" fill="#00b894" class="point"/>
                        <circle cx="270" cy="286" r="4" fill="#00b894" class="point"/>
                        <circle cx="370" cy="267" r="4" fill="#00b894" class="point"/>
                        <circle cx="470" cy="240" r="4" fill="#00b894" class="point"/>
                        <circle cx="570" cy="217" r="4" fill="#00b894" class="point"/>
                        <circle cx="670" cy="204" r="4" fill="#00b894" class="point"/>
                        <circle cx="770" cy="191" r="4" fill="#00b894" class="point"/>
                    </g>
                </svg>
                
                <div class="line-legend">
                    <div class="legend-item-line">
                        <div class="legend-line" style="background: #fdcb6e;"></div>
                        <span>Treatment Engagement</span>
                    </div>
                    <div class="legend-item-line">
                        <div class="legend-line" style="background: #fd79a8;"></div>
                        <span>Housing Stability</span>
                    </div>
                    <div class="legend-item-line">
                        <div class="legend-line" style="background: #74b9ff;"></div>
                        <span>Court Compliance</span>
                    </div>
                    <div class="legend-item-line">
                        <div class="legend-line" style="background: #00b894;"></div>
                        <span>Recovery Outcomes</span>
                    </div>
                </div>
            </div>
        </div>
        
        <div class="chart-legend">
            <h3>Trajectory Analysis:</h3>
            <div class="legend-grid">
                <div class="legend-item">
                    <div class="legend-color" style="background: #fdcb6e;"></div>
                    <div class="legend-text">
                        <strong>Engagement Rate:</strong> Percentage actively participating in treatment
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #fd79a8;"></div>
                    <div class="legend-text">
                        <strong>Housing Stability:</strong> Percentage in stable housing arrangements
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #74b9ff;"></div>
                    <div class="legend-text">
                        <strong>Compliance Rate:</strong> Percentage meeting all court requirements
                    </div>
                </div>
                <div class="legend-item">
                    <div class="legend-color" style="background: #00b894;"></div>
                    <div class="legend-text">
                        <strong>Recovery Outcomes:</strong> Percentage showing sustained recovery indicators
                    </div>
                </div>
            </div>
            
            <div class="timeline-notes">
                <h4>Key Milestones:</h4>
                <ul>
                    <li><strong>Month 0-1:</strong> Justice system screening, court-mandated evaluation</li>
                    <li><strong>Month 2-6:</strong> Treatment court participation, intensive monitoring</li>
                    <li><strong>Month 7-12:</strong> Compliance monitoring, progress evaluation</li>
                    <li><strong>Month 13-18:</strong> Graduation preparation, aftercare planning</li>
                    <li><strong>Month 19-24:</strong> Post-graduation support, independent living</li>
                </ul>
                <div class="oregon-highlight">
                    <strong>Oregon Programs:</strong> Justice Reinvestment Initiative, specialty courts, reentry services integrated throughout timeline
                </div>
            </div>
        </div>
    </div>
</div>