Oregon Supported Employment Center for Excellence(OSECE) Conference

1. Oregon Supported Employment Center for Excellence(OSECE) Conference Health Systems Division (HSD) Peer Delivered Services(PDS) October 5, 2016

2. Presenters Shawn Clark Oregon Health Authority (OHA) Health Systems Division (HSD) Peer Delivered Services Coordinator Shawn.Clark@state.or.us (503) 945-9720 Ally Linfoot Clackamas County Behavioral Health Division Peer Services & Recovery Coordinator ALinfoot@co.clackamas.or.us Office: 503.742.5951 | Cell: 503.260.3386

3. Peer Delivered Services : Who, What, Where, When and How • People will understand current Peer Delivered Services(PDS) in Oregon and help identify the Vision  • People will hear about hope, resilience and recovery  • People will understand the scope of practice for Peer Support and Peer Wellness Specialists(PSS/PWS)   • People will know what PDS can do to support people getting and keeping work • People will learn about the Office of Consumer Activities( OCA) and be able to access Technical Assistance • People will understand a disciple that is a uniquely an option for people with lived experience • People will learn about specific Peer Run Programs and the outcomes of those programs

4. Ally LinfootPeer Support & Recovery CoordinatorClackamas County Behavioral Health Divisionalinfoot@Clackamas.usOffice: 503-742-5951Cell: 503-260-3386

5. Logic Model - Values • Cultural diversity • Inclusive and welcoming of under-represented communities • Community inclusion • Self-direction, empowerment, and choice • Participatory process • Leadership development • Reduction of isolation and discrimination • Wellness and resilience • Community building • Persistence • Whole Health Recovery • Peer support providers and organizations as equal partners • Prevention, Education, Outreach and Peer In-reach • Collaboration/partnership between systems, addictions, corrections, families, CSX, young adults in transition, across the lifespan • Creation of a trauma informed system • Cultural Responsiveness

6. Elements of Peer Support Services - Roles

7. Measures and Outcomes 1. Reduce recidivism to higher levels of care, corrections, juvenile justice, Oregon Youth Authority 2. Reduce utilization of traditional mental health and addiction services 3. Help increase the effectiveness of traditional mental health and addiction servcies 4. Satisfaction surveys will indicate care is self-directed and individuals and families feel heard, honored and respected 5. Peer Support Programs become an alternative to traditional mental health services 6. Seamless referrals to peer support programs from traditional mental health and addiction services 7. MHO screening activities will show a % of referrals to peer support programs 8. Improved quality of life 9. Increased participation in formal education 10. Increase in overall wellness (whole health) 11. Increase in natural supports 12. Increased alternative health practices 13. Increased involvement in system advocacy activities 14. Community and civic engagement 15. Cost savings 16. A more informed public (elimination of discrimination) 17. Community inclusion 18. Support network for peer specialists 19. Continuing education for peer specialists 20. Training and education for system professionals on the role of peer supports 21. Reduction/elimination of misdiagnosis due to cultural barriers and misunderstanding

8. What are Peer Delivered Services? Frances Purdy, MEd JD Family Partnership Specialist frances.s.purdy@state.or.us 503-957-9863 cell 503-945-5783 desk

9. Family Support Specialists assists parents to • Identify the individual family members’ values, dreams, and vision • Communicate parental long and short term goals • Identify hope, self-help skills and natural supports • Clarify what is known to make a decision or plan • Find information for the unknown • Make decisions for short and long term goals • Participate in service plans • Practice and evaluate actions • Be an advocate for self, family, and community

10. Family Support Specialists • Model concepts and skills to parents for them to promote resiliency and recovery with their children: hope, personal empowerment, respect, social connections, self-responsibility, and self-determination • Assist parents to support and teach youth/young adults to progressively increase their capability to sustain living independently

11. Youth Support Specialists assist Youth to • Identify values, goals and vision • Communicate long and short term employment/educational goals • Identify hope, self-help skills and natural supports • Work collaboratively within a team of teachers, case managers, etc. • Be an advocate for self, friends, family and community

12. Serving All • NAMI • Warm Line • Centerstone Crisis Walk-in Total Cost for Peer Support Services 2016: $2.4 mil. The Results – 14 Peer Support Programs

13. The Numbers – All Served Total Served: 5012 1:1 Peer Services: 3601 Drop-ins: 1411 Support Groups & Workshops for individuals served: 2821 Outreach activities to system and community partners: 219 Staff training activities: 46 NOTE: The above numbers do not include Warmline Engagement Rate: 87% Report improved overall wellness (whole health): 83% Report improved quality of life: 79% Report an increase in natural supports: 73% Feel accepted in the community: 47% Report they would have returned to a higher level of care if not for PDS: 61% People Served Experience of Services

14. The Numbers – Children & Fams 1:1 Family Support: 438 Family Reunifications: 45 16 children originally had a permanency plan of adoption Child Welfare: 257 Juv Justice or OYA: 20 Adult Addiction Tx: 48 Adult Court: 143 Other: 70 Children & Family Programs: Engagement Rate: 84% Report improved quality of life: 82% Report an increase in natural supports: 82% Feel accepted in their community: 30% Increased wellness: 84% People Served Experience of Services System Involvement Parent Programs

15. Estimated cost savings to system based on Warm Line calls: $283,003 Cost Savings: Data is from FY14 This cost savings was determined using only the data submitted by 3 of our 14 peer support programs.

16. Federal A&D • Sub-recipient • Mental Health Block Grant • Adult • Children • Beer and Wine Tax • County General Fund • Service Element 63 • MHS 37 Funding Mechanisms – Braid It!

17. What Was • 2007 Peer Support Specialists (PSS) • 2011 Traditional Health Workers Community Health Workers Doulas PSS/Recovery Mentors Peer Wellness Workers Personal Health Navigators

18. Certified Traditional Health Workers (THWs) • Peer Support Specialists 958 • Peer Wellness Specialists 38 • Community Health Workers 406

19. Certification • Be a peer in recovery for at least two years (Addictions) • Complete an approved training program • Apply for certification • Pass a background check • Become Certified for three years • Earn 20 continuing education hours

20. What is • 75 Peer Run Organizations • 25 OHA Approved Peer Support and Peer Wellness Training Programs • Office of Consumer Activities(OCA) – shout out to Mike HlebchukOCA Director and Libbie Rascon OCA Coordinator Libbie Rascon OCA Coordinator Desk: (503) 947-5009 Cell:  (971) 600-8180 Fax: (503) 947-2341 E-mail: Libbie.D.Rascon@state.or.us

21. 2016 MetroPlus Substance Use Disorder Peer Delivered Services Survey There are an estimated 4,308 addiction/co-occurring peer clients that receive Substance Use Disorder (SUD) specific peer services in Multnomah, Washington and Clackamas counties, served by 304 peers.

22. What is • Peer Run Organizations • Peer Drop In Centers • Peer Club Houses • Community Based Organizations • Community Mental Health Programs • Recovery Centers • Integrated Health Centers

23. Measures and Outcomes Tracking System (MOTS) • Informed 11, 000 • Received 3000 • Planned 1,100 (2014-9/2016)

24. SUDs and Criminal Justice • Service Element #63 • All but one County • 320 served to date • Programs still under development “We had 8 men that are now fathers and taking care of their children and living substance free.”

25. Additional Training Oral Health Requirement • (a) Basic dental anatomy; • (b) Caries and periodontal disease process; • (c) Infection and communicable disease; • (d) Basic oral hygiene and disease prevention for different ages; and • (e) Healthcare system navigation, access and coverage, including Medicaid

26. Vision “Vision is the art of seeing things invisible” Jonathan Swift “Peer-based models of care can have a transforming effect on larger systems of care and on our society by enhancing long-term addiction recovery outcomes and elevating public and professional perceptions of hope for recovery.” William White

27. What do you think about? Medicaid Recovery Oriented System of Care(ROSC) https://www.oregon.gov/oha/OHPB/Documents/Waiver%20Renewal%20Submission.pdf USDOJ Oregon Performance Plan http://www.oregon.gov/oha/bhp/Pages/USDOJ-Agreement.aspx SAMHSA Peer Delivered Services http://www.samhsa.gov/section-223/care-coordination/person-family-centered

28. Oregon Performance Plan Medicaid Management Information System (MMIS) • 24% Block Grant 2015-2016 • Base line from July 2016 • 20% from baseline of July 2017 • 40% from baseline of July 2016

29. Advocacy Efforts • Professional Organization Oregon Consumer/Survivor Coalition • Oregon Family Support Network (OFSN) • Addiction Counselor Certification Board of Oregon (ACCBO) • Oregon Consumer Advisory Council (OCAC) • AMHPAC and CSAC • CCO Advisory Councils

30. Legislation • Naya Family Center • Oregon Community Health Worker Association (ORCHWA) • Amend 3650 • Funding for 100 positions statewide Greatest Health Inequities • Require CCO’s provide PDS

31. Vision for the Process • Difference between Licensing and Certification • Discussion “Currently, the only threat to the volunteer peer movement appears to be exclusionary credentialing requirements” 2016 MetroPlus+ SUD PDS Survey

32. PSS and PWS part of all Teams? • Supported Employment “Vocation…would include finding out the place where the need of the world coincides with your own gifts, where that which you can give is joyfully received.” James Carroll • Assertive Community Treatment Add a requirement they must have a PSS/PWSon the team? • Supported Housing • Peer Run Respite Care/Center

33. Specialties • Forensics • Peer Bridgers • Dual Diagnosis • ACCBO Peer Recovery Counselor Certification • Recovery House Managers • Supervision

34. Facilitation Centers MetroPlus+ Yamhill/Polk/ Marion Coos People who are involved with the criminal justice system, are without homes, are living in rural/poor areas, people in medically assisted treatment, older adults and young adults in transition

35. Supervision Now and in the Future Clinical Mutual Other Models “Over half of peers believe an experienced peer should be the minimum qualification for SUD peer supervisors. Over half of supervisors believe a CADC should be the minimum qualification for SUD peer supervisors.” Health Share Report on MetroPlus

36. Including the Community • Refugee PSS Training Program Approved • Spanish Language Recovery Peer Mentors Graduated • Tribal PSS Training Program in Development

37. Links that May be Helpful Office of Equity and Inclusion (OEI) Traditional Health Workers • http://www.oregon.gov/oha/oei/Pages/Traditional-Health-Worker-Program.aspx Addiction Counselor Certification Board of Oregon • http://www.accbo.com/ Health Systems Division Peer Delivered Services • http://www.oregon.gov/oha/amh/pd/Pages/index.aspx Support and Services for Young Adults in Transition • http://www.oregon.gov/oha/amh/youth-hub/Pages/index.aspx PeerBlasthttp://drupal.llnest.com/