Transcript Slide 1

MA Access to Recovery
Presentation for RSAT Webinar
August 21, 2013
Presenters:
Rebecca Starr, ATR Project Director
Beth Fraster, ATR Assistant Project Director
What is ATR?
A program that helps people who have alcohol and other
drug problems (SUD’s) on their road to recovery.
The Access to Recovery (ATR) Program was started by
SAMHSA because they realized that:
•Clinical interventions may not be sufficient to aid the
individual in the recovery process
•There are multiple pathways to recovery
•Non-traditional organizations can also provide vital support
for people in recovery
•Therefore a combination of both clinical treatment and a
system of recovery support services is crucial to support
the recovery of people with substance use disorders.
What are some typical
RECOVERY SUPPORTS?
» Transportation
» Basic Needs
» Spiritual Counseling
» Recovery Coaching
» Job Readiness
» Job Training
» Education
These supports help participants get over
the bumps in the road when they leave jail
Mission of ATR
• Presidential initiative to provide vouchers
to individuals with Substance Use
Disorders to purchase specified services
• Support client choice and increase array of
faith- and community-based services
Federal Funding from SAMHSA
(Substance Abuse & Mental Health
Services Administration)
Which States Currently
have this ATR Funding?
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
Alaska
Arkansas
California
Colorado
Connecticut
District of Columbia
Florida
Hawaii
Idaho
Illinois
Indiana
Iowa
Massachusetts (us!)
Maryland
Missouri
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
Montana/Wyoming
New Hampshire
New Mexico
New York
Ohio
Oregon
Pennsylvania
Rhode Island
Utah
Washington
Wisconsin
Key Elements of ATR in
Massachusetts
• Targets a criminal justice population
• Operates in two counties: Hampden County and Suffolk
County
• Uses only recovery support service providers
• Uses central intake model
• Limits total amount each participant can spend
• Targeted number of individuals to enroll (as specified by
Federal government)
–
–
–
–
Year 1: 967
Year 2: 2,929
Year 3: 3,043
Year 4: 2,062
– TOTAL= 9,001 individuals by the end of the 4 years of the grant
Eligible Participants Must:
• Have a problem with alcohol and/or other
drugs
• Be willing to work on recovery
• Be residents of Hampden or Suffolk County
• Be 18 years old or older
• And meet one of the two following criteria:
– Have been incarcerated in a MA facility within last
2 years
– Served in the U.S. Military
Participant flow
Referral
to
Program
• Self
• CJ agencies
• Community
agencies
• Faith-based
organizations
Enrollment
• ATR
Coordinator
Vouchers
Issued
• ATR
Coordinator
Services
Provided
• ATR
Providers
MA ATR
Participant Characteristics
January 2011 – March 2013
Demographics and CJ Involvement
(N=5,739)
Age (N=5,739)
Mean age: 36.4 years
Education Level (N=5,739)
Alcohol and Illicit Drug Use
at Intake (N=5,739)
MA ATR
Participant Outcomes – Years 2-3
October 2011 – March 2013
Abstinence, Employment/Ed, Housing &
No Consequences Improved
Mean Days of Alcohol and
Other Drug Use Decreased
(N=2,279)
No Arrests and Social Connection
Steady and Positive
MA ATR
Service Use and Costs – Years 1-3
January 2011 – March 2013
Participants & Total Cost of
Services
Participants
Amount
N
%
$
%
ATR Coordination
Transportation
Basic Needs
5,616
4,938
4,249
99.3 1,808,980
87.3
771,458
75.1 1,184,845
27.7
11.8
18.1
Bed Days in Recovery Homes
Housing Support
Bundled Re-entry Service
Employment Service
Ed/GED/Tax Service
Recovery Coaching
Total
823
720
652
534
151
106
5,656
14.6 1,620,548
12.7
422,533
11.5
62,746
9.4
583,962
2.7
61,681
1.9
17,024
6,533,245
24.8
6.5
1.0
8.9
0.9
0.3
Benefits of ATR –
Participant Level
• Provides access to needed goods and
services post-incarceration
• No waiting time
• Increases support network for participants
Benefits of ATR – System
Level
• Brings new providers into recovery network
• Promotes a recovery oriented system of care
(ROSC)
• Creates new strategies for follow-up and
retaining participants
• Introduces recovery coaching
Reach for the Needs Program
Access to Recovery Reach for
the Needs Program:
• Offered opportunities for
employment readiness
and training programs to
promote skill building,
increase confidence and
connections to job
opportunities
What is SE-Supported
Employment?
Occupational skills training for adults with:
•Limited workforce histories
•Obsolete skills
•Gaps in work histories due to incarceration
•CORI
Reach for the Needs
• Provide monetary stipends to participate –
reducing barriers
• Provided supportive services
RFN Guiding Principles
Important for successful outcomes, RFN Program
must:
• Support recovery process and promote
connections to recovery community
• Provide case management and support
services
Reach for Needs Participants
Data From April 1, 2012 – March 15, 2013
406 ATR Participants
involved with RFN
Summary of
Similarities/Differences
RFN/Non-RFN
Similar
•
•
•
•
Demographics
Clinical
Background
Income &
Employment
RFN/Non-RFN
Dissimilar
• 10-15% rates of
alc/drug use.
• High self-reported
trauma, depression,
anxiety.
RFN slightly younger.
RFN more males.
RFN more Blacks.
RFN less diverse in
education
• Fewer RFN using
medication for
pysch/emotional issues.
• RFN fewer receiving
disability
• RFN fewer employed
• RFN lower income
Enrollment
• 9 agencies providing services
– 18 programs across the 9 providers
• 407 clients served to date
• 532 program enrollments to date
– (Some clients have enrolled in multiple
programs)
RFN Completion Rate by
Category
80%
70%
60%
50%
40%
30%
80%
69%
64%
20%
10%
0%
Total (n=532)
Job Readiness
Programs (n=368)
Occupational Skills
Programs (n=164)
MA ATR- Reach for the Needs
Client Outcomes
0
10
20
30
In Own Housing (GPRA)
Baseline
Followup
Non-RFN ATR
RFN
0
10
20
30
Employed (GPRA)
Baseline
Followup
Non-RFN ATR
RFN
RFN Employment Status by
Category (Provider)
45%
40%
Employed at
START
35%
30%
25%
20%
40%
15%
29%
24%
10%
5%
2%
0%
Total
1%
Job Readiness
Programs
7%
Occupational Skills
Programs
RFN Participant
Satisfaction (Participant, n=103)
Statement
Strongly
Agree/ Agree
I felt respected at this program.
98%
I feel connected to the staff at this program.
88%
The program met my expectations.
85%
The program helped me feel ready to hold a
job.
84%
The Future of the ATR Grant
Funding for another round of this grant ATR 4 - is in the Presidential budget.
– It is in the budget for a decreased amount of
money
– It will be up to Congress whether this passes
or not
What You Can Do
If your state already has an ATR grant:
– Reach out to your SSA (Single State Authority)
and urge them to apply again for an ATR 4
• http://www.samhsa.gov/grants/ssadirectory.pdf
– Encourage them to include the re-entry
population as one of their targets for the next
round
What you can do
If your State does NOT have an ATR grant:
– Reach out to your SSA and encourage them
to apply when the new RFP comes out
– Urge them to include the re-entry population
as one of their target groups and say you will
partner with them
A New Profession
Recovery Coaching:
Update from the Field
Beth Fraster, LICSW
Access to Recovery
Opportunities
• Concentrate our resources
• Learn from our experiences
• Develop a workforce
• Develop new relationships
Access to Recovery
Recovery Coaching
Massachusetts Definition: A recovery coach is anyone
interested in promoting recovery by removing barriers and
obstacles to recovery and serving as a personal guide and
mentor for people seeking or already in recovery. A
recovery coach links the recoveree to “indigenous
communities of recovery and address complex cooccurring problems that inhibit successful recovery.” (This
definition and these terms are adapted from William White and the C-CAR
Recovery Coach Academy.)
Access to Recovery
Recovery Coaching
ATR Recovery Coach Requirements
• The coach must work under the auspices of an
approved ATR Provider
• The provider that hires the coach must provide
the coach with supervision on a regular basis
• All coaches and supervisors must have gone
through specialized training from the Recovery
Coach Academy (or a similar training accredited
by BSAS)
What we set out to learn:
• To understand the needs of organizations, supervisors and
coaches as they develop and implement recovery coach
programming as a new service delivery system.
• To build statewide capacity to offer Recovery Coaching as a
service to enhance and improve the quality and quantity of
options for those on the path to recovery.
 To increase the recovery coach workforce in Hampden and
Suffolk counties.
 To increase the recovery coach supervisory workforce in
Hampden and Suffolk counties.
What we set out to learn:
• To qualify the outcomes of those receiving recovery coaching
and observe differences between them and their ATR counterparts.
• To codify this process and develop products to assist in a full
scale process to increase and pay for recovery coaching across
the State
Recovery Coach Academies
Since 2011
• Implemented 10 RCA
• Trained over 350 people
• Certified over 100 CCAR
trainers
• 40 ATR affiliated Coaches
• Coaches working for
organizations with other
funding
Recovery Coaching
Accomplishments
We have served 113 people
Using $18,263
Average $168
Range in time is 7 minutes to 31 hours per person
Average time is 6 hours
Recovery Coach
Learning Communities
•
•
•
•
•
•
•
Meets monthly online/webinar and phone
Participant driven
Scenarios followed by discussion
Facilitated
Provides support and guidance
Develops network and community
Topics discussed have included:
•
•
•
•
•
•
Cultural Competency
Ethics and Boundaries in the coaching relationship
Safety and safety planning
Creating and using wellness/recovery plans
Flying with motivation – inspiring motivation
Using supervision
Agency
Learning Communities
• Meets quarterly online/webinar and phone
• Topics emerge from recovery coach field and agency
needs
• Share information about research and policy development
• Topics have included:
• Developing policies
• Ethics and boundaries
• Supervision
• Record Keeping
• 42CFR
ON-LINE RECOVERY
COACH COMMUNITY
Providers and Extended
Recovery Support Services
Presentation with providers to promote collaboration
5 presentations reaching over 100 people
Trainings with case managers and administrators
reaching 50 people
Developed relationships with Faith-Based community
outreach to 20 Faith-Based Organizations
trained 75 recovery coaches
10 Faith-Based ATR Providers
Secured SAMHSA TA Dollars to Educate Community on
Recovery Coaching within the Context of a ROSC
Develop Standards
Supervision
Identified the need to review/revise the standards and policies
Our Process
• Gathered information via Learning Communities
• Developed recommendations to BSAS ( Requires
completion & approval
• Dissemination
Adaption of policies at agency level – provider level
What we’ve learned
• Coaches and Agencies are in the right place
• Most potential participants do not know about recovery
coaching
• We need more support from referral sources
• It is difficult for Recovery Coaches to market their services
to potential participants who are scattered and difficult to
meet
• Venue makes a difference
What we’ve learned
Heard from Supervisors, Directors, Administrators their need
for more information re:
•
•
•
•
•
•
Staffing Issues
Resource
Getting referrals – how to market to potential recoverees
Supervision challenges
Training and workforce development
There is continued interest and willingness
What we have learned:
• Heard from our Coaches – their need for more information re:
• Ethics and Boundaries
• Cultural Competency
• Staying Consumer Centered/Strength based
• Understanding ATR – working collaboratively with
Coordinators
• Getting referrals – the challenge of marketing to the
ATR population
• Sharing information with other coaches
• Coaching focused supervision
Issues for Consideration and
Action
• Supervision
• Credentialing
• Transitioning Post ATR
• Future of Recovery Coaching as a Menu Option
• Workforce Needs?
• Oversight?
• Places for Integration
• Outpatient
• Recovery Centers
¡Gracias!
Thanks!
PREA Basics: What RSAT
Sites Need to Know
September 18, 2013
2:00 – 3:00 p.m. EDT
This webinar will familiarize participants with the history of the Prison
Rape Elimination Act of 2003 (PREA). Since the passage of the federal
law, implementation efforts have focused on developing standards at the
national level and policies at the state and local levels. PREA law was
universally supported by bipartisan effort; however, the controversy
begins when facilities and jurisdictions need to define, develop
procedures and policies to prevent, and address it. This webinar will
outline progress we have made in implementation and standards over the
last 10 years. The presenter, a former PREA administrator, will discuss
the PREA basics and the impact they may have for RSAT programs.
Presenter: Niki Miller