About Texas Opioid Treatment Alliance

Texas Opioid Treatment Alliance (TOTA) is a private, non-profit 501(c)(3) corporation, incorporated in 1999.  TOTA was initially formed as an alternative methadone provider association for the state of Texas. However, with limited interest from narcotic treatment programs for a duplicative and competitive provider association, the Board of Directors convened in 2002 and decided to change the mission and activities of the agency.  The initial change involved TOTA consulting with Texas methadone clinics and their patient groups to help them develop peer driven patient assistance groups.  Nevertheless, as the TOTA staff began traveling through Texas working with clinic personnel and patients, immediate evidence that the clinics and patients had other equally pressing needs became apparent. 

First, indigent treatment was only available in a few select areas of the state, and often, those services were monopolized by a select few service providers and in the more populated areas.  Second, many of the rural clinics had not taken new "state-funded" methadone clients for several years due to funding limitations.  At the annual meeting in 2003, the Executive Management and Board of Directors decided to add “access” and "parity" to the mission.  The leadership believed TOTA needed to place more emphasis on an equal distribution of services and dollars for indigent methadone treatment.  As management began the process of providing technical assistance and training, leadership found that many of the providers were small clinics that did not have the ability or desire to manage large contracts with government funding entities.  As the year progressed, the Executive Team approached the Board with the idea of creating a network of providers, where TOTA would be the fiduciary agent to the Texas Department of State Health Services (DSHS) and subcontract the treatment services to the clinics. 

In late 2003, the management team conducted a treatment needs assessment looking at gaps in services related to opiate treatment options.  The analysis revealed three areas of Texas that needed intervention and a more equal distribution of services and two areas that had no funding at all.  In 2004, as a result of the assessment, TOTA applied for substance abuse treatment block grant funding via Texas Department of State Health Services funding on behalf of six clinics and was awarded the grant in regions 11, 4, and 6.  In 2010, TOTA was able to increase the amount of funding and expand services to include all forms of medication-assisted treatment for opiates.  Since 2004, the corporation has operated and expanded the service network with great success.  Persons addicted to opiates have more than one treatment option, and now, services are provided in previously under- or un-served parts of rural Texas.

In August of 2005, TOTA’s as a result of Hurricane Katrina, TOTA began disaster coordination services.  Over the last five years TOTA has increasingly become the leader in helping clinics plan for disaster.  Additional TOTA is now formally part of the state disaster behavioral health coordination team.  

In 2010, TOTA was made aware of an increasing trend of pregnant and postpartum mothers on methadone having their parental rights violated by hospital, healthcare providers and child welfare agencies.  To better understand this issue, TOTA conducted a survey of patients and clinic staff and found an alarming trend of discrimination, resulting in poor access to prenatal care and poor bonding outcomes.  As a result, TOTA began the Maternal, Infant, and Child Health Program to provide intensive case management services to this population.  Services are provided by social workers in an effort to ensure access to prenatal and post-partum care for mothers and their children.  In addition, education and advocacy with hospitals and healthcare providers is presented.  In 2011, TOTA partnered with the March of Dimes to begin a pilot of the “Becoming a Mother” curriculum with both pregnant mothers and women on MMT who are considering getting pregnant.

In a look toward the future, a continued strengthening of service networks will increase access to medication-assisted therapies. Additionally, specialty treatment programs will be created for persons detoxing from MMT programs to bridge the gaps between MMT and abstinence using a recovery model.  TOTA is developing a recovery support program that includes peer counseling, recovery coaching, web-based crisis intervention, and a staff of stable MMT patients.  An expansion of disaster management training and technical assistance, as well as an increase in Maternal, Infant, and Child Health Initiatives, will extend the impact of prospective services.

2011 Major Projects

• Expansion of Disaster Behavioral Health to all 74 clinics in Texas including disaster management planning, CERT training (CERT), Mental Health First Aid training, Psychological First Aid training, FEMA training, and coordination with DSHS related to disaster behavioral health planning and policy development for MMT 
• Expansion of Pregnant and Post-Partum Case Management Program including a partnership with the March of Dimes, the Texas Department of State Health Services, and the County Hospital Districts; developing a “Medical Home” model with local FQHC’s
• Expansion of treatment services including roll out of new evidence-based practice related to medication assisted therapies, development of outpatient treatment programs for persons leaving MMT, and development of recovery support systems; inclusion of technology and computer-assisted therapies
• Medicaid Reimbursement Advocacy Project; working with clinics, patient groups and Texas Medicaid to ensure equitable rates of reimbursement for MMT and the associated psychological and medical care; providing technical assistance to MMT clinics in the Medicaid application, documentation, service provision, and billing process

Board of Directors

Executive Management & Staff

Rhonda G. Patrick, LCSW, MPA
Chief Executive Officer
Rhonda Patrick is a Licensed Clinical Social Worker, with an extensive background and understanding in business and program management associated with the delivery of social services. With over 20 years of clinical, administrative and governmental experience in the field of public services provision, she has a culmination of education and experience that includes providing high level consulting services for state agencies, research organizations, and non-profit programs.  She provides executive consultation services to community based organizations primarily regarding program design, implementation, and evaluation, revenue development and administration of agencies. She currently oversees millions of dollars in grants and also has experience in community mobilization efforts including assessing community needs.  Ms. Patrick is the visionary of TOTA and has been since assuming leadership in 2001.  She is responsible for the design, implementation and funding of all program and services and is commit to the mission of access, advocacy, and parity.

Jayson Jones, MA, MARE, LCDC
Program Services Director
Jayson Jones, is a substance abuse professional with a Master’s of Arts in Counseling from Sam Houston State University, and a Master’s of Arts in Religious Education from Southwestern Baptist Theological Seminary.  He has been a substance abuse counselor for over 22 years.  He has worked as Minister of Youth at Bear Creek Baptist church in Cleveland, Texas.  Jayson has worked in many levels of psychiatric and substance abuse treatment as a counselor at many treatment programs in Texas.  Jayson is the project lead for the expansion of our Disaster Management Programs and participate in all local and statewide disaster coordination events.

Christen Dobbs, LMSW
Program Manager
Christen Dobbs is a Licensed Master Social Work, with over 5 years of business and program management experience and has outstanding organizational skills that are a great contribution to TOTA.  She comes to us in a time of growth, leading the expansion of our Maternal, Child, and Infant Health Program.  In addition she will be leading the rollout of our web based recovery support program.

Mary Kay Kidd
Fiscal Manager
Mary Kay Kidd has over 30 years of experience in the business realm, including working for the FDIC and several success start-up IT companies. Coming out of retirement, her skills in accounting and business management are a positive addition to the effectiveness of our team.

Wendy Martinez, MBA
Technology Manager
Wendy Martinez has extensive experience in managing data, electronic medical record development, and Learning Management Systems (LMS). This has helped her develop an in depth knowledge base of how effective programs should operate.  With years of experience in data management and 5 years in the technology & management fields, she manages our electronic and technology infrastructure.