RecoveryNet

1. RecoveryNet ACCESS TO RECOVERY III Maryland

2. What is ATR • Access to Recovery (ATR) is a “high-priority” federal initiative that provides vouchers to individuals to purchase services and supports linked to their recovery from substance use disorders. • ATR is a SAMHSA system transformation grant designed to build recovery support networks within communities. • ATR emphasizes the expansion of capacity within systems of care. • ATR projects involve clients in directing their own care and give them choices among appropriate providers.

3. ATR Impact on Outcomes According to GPRA results outcome data are promising.At six months post admission to ATR services, • 80% were abstinent from substance use, • 46% were stably housed, • 51% were employed, • 87% were connected to support networks, • and 96% reported no involvement with the criminal justice system.

4. ATR III in Maryland • Four year Access to Recovery (ATR) grant, Maryland RecoveryNet – awarded by to the Maryland Alcohol and Drug Abuse Administration for approximately $3.2 million per year. Million 2011 2012 2013 2014 Time

5. Numbers to be Served

6. Targeted Population(s) • In Maryland in FY 2009 8,000 individuals were diagnosed with substance use disorders severe enough to warrant treatment in publicly funded residential programs • Average of cost of $37,704 per residential treatment episode. • The percentage that follows through with outpatient treatment is under 26% • A revolving door recovery is often the result.

7. Eligibility • The RecoveryNet target population is adults (18 years or older) with a diagnosed substance use disorder who are enrolled in residential addiction treatment (ASAM Level III.7, Level III.5, or Level III.3) in a publicly funded bed. • Eligible population includes inmates in Department of Public Safety and Correctional Services Residential Substance Abuse Treatment programs, and returning Iraqi or Afghanistan veterans who are enrolled in Department of Veterans Affairs residential addiction treatment programs.

8. Eligibility Criteria • Resident of Maryland and planning to reside in Maryland after discharge from the residential program. • Current ASI or TAP bio-psycho-social assessment • Documented need for RecoveryNet services • Request for RecoveryNetservices • Income at or below 200% of the Federal Poverty • Agree to conditions of RecoveryNet initiative • If participating in the Residential Substance Abuse Program, must be scheduled for release from the facility into the community within 60 days of discharge from the treatment program. • Agree to work with a Care Coordinator as a RecoveryNetvouchered service • Agree to enroll in another level of treatment or in Continuing Care with a Level I Outpatient program

9. Portal Programs: ATR Gateway • Individuals in publically-funded residential treatment slots. • ASAM Levels; • III.7, • III.5, and • III.3 • including programs within the Department of Corrections and the Veterans Administration, who are being discharged into their home communities.

10. RecoveryNet: Maryland’s Provider Network RecoveryNet is designed to build networks of treatment and support services within communities throughout the State, by encouraging community and faith-based providers to offer services to people in early recovery. • Possible Recovery Support Services include: • *Care Coordination • Halfway House beds • Family Counseling • Pastoral Counseling • Employment Readiness Counseling • Recovery Housing rent reimbursement • Childcare • Transportation • *required for each ATR participant

11. Maryland’s ATR Process Residential Treatment Program (ATR Portal) ATR Regional Coordinator VMS Residential Counselor/ Discharge Planning Care Coordination

12. Provider Services Care Coordinators • Halfway House beds • Recovery Housing rent reimbursement • Transportation • Pastoral Counseling • Childcare • Family Counseling • Employment Readiness Counseling

13. ATR Regional Break-out ATR Region 3 Eastern Shore and Southern Counties ATR Region 2 Central and Western Counties ATR Region 1 Baltimore City

14. ADAA-Funded Residential Treatment 2004 2327 2122 Outlook and Outcomes: At a Glance FY 2009

15. Projected Eligible Participants by Region Based on Data reported in FY 09 to SMART/WITS system by publically funded Residential Treatment Programs (Levels III.3, III.5 and III.7

16. ATR Administrative Structure Acting Project Director - Deborah Green • IGSR • Jurisdictional Addiction and Prevention Coordinators • Statewide ROSC Coordinator • Office of Education and Training for Addiction Services Region 2 Dena Trail Region 3 Interviews Pending Region 1 Karol Harmon

17. Regional ATR Coordinator Manage Regional Resources Develop/Disseminate Reports • Maintain regular contact with Jurisdictional Tx Coordinators • Recruit Providers • Assist Providers with Application Process • Provide Technical Assistance to Providers • Conduct Provider Site Visits • Adjust/Issue Vouchers as requested by Care Coordinator • Notify Care Coordinators of pending GPRA (Dx/Follow-up) • Coordinate/Deliver Technical Assistance to Care Coordinators • Monitor Waste, Fraud and Abuse • Submit required reports to State Project Director

18. Regional Coordinator Relationship Chart

19. Residential Treatment Program Counselors • Determine Eligibility and Assess Needs • Notify/Communicate with Regional Coordinator • Assist Patient with ATR Application • Administer Admission GPRA* • Assist Patient with Service/Provider Selection • Assist Patient with Recovery Planning • Generate/Issue Vouchers • Contact Care Coordinator • Facilitate Patient Care Coordinator Introduction *Government Performance and Results Act

20. Care Coordination Comprehensive care coordination is provided to clients to identify their needs, plan services, link the services system with the client, monitor service delivery, and evaluate the effort. • Coordinate/facilitate delivery of RecoveryNet Services • Assist with Recovery Planning • Access resources outside of ATR scope that meet client needs • Administer Discharge and follow-up GPRA • Communicate with outpatient Tx • Referral and access to more intensive level of care if needed. • Administer Client Satisfaction Survey

21. ATR Participant • Completes ATR Intake with Residential Counselor • Identifies ATR services needed • Chooses providers • Provides collateral contact information • Agrees to work with Care Coordinator • Agrees to complete Admission, Discharge and Six-month Follow-up GPRA’ s • Agree to attend OP/Continuing Care

22. Service Definitions: Clinical The RecoveryNet emphasizes client choice and increases the array of available community- and faith-based services, supports, and providers. All services are designed to assist recipients in remaining engaged in their recovery while promoting independence, employment, self-sufficiency, and stability. Halfway House Residential Treatment – Clinically managed low intensity treatment programs offering treatment services at least 5 hours per week directed toward preventing relapse, applying recovery skills, promoting personal responsibility, and reintegration. Marital/Family Counseling- Services provided to engage the whole family system to address interpersonal communication, codependency, conflict, marital issues and concerns, parenting issues, family reunification, and strategies to reduce or minimize the negative effects of substance abuse use on the relationship. Pastoral Counseling- Services provided to encourage spiritual growth, resolve conflict arising from spiritual disconnection, and facilitate progress in recovery through an integrated faith-based and psychological approach.

23. Service Definitions: Recovery Support Care Coordination- Comprehensive medical and social care coordination is provided to clients to identify their needs, plan services, link the services system with the client, monitor service delivery, and evaluate the effort. Recovery Housing- These services provide a safe, clean, and sober environment for adults with substance use disorders. Lengths of stay may vary depending on the form of housing. Job Readiness Counseling- This activity is directed toward improving and maintaining employment and may include skills assessment, job coaching, career exploration, résumé writing, interviewing skills, and tips for retaining a job. Childcare- These services include care and supervision provided to a client’s child(ren), less than 14 years of age and for less than 24 hours per day, while the client is participating in treatment and/or recovery support activities. Transportation- Commuting services are provided to clients who are engaged in treatment- and/or recovery support-related appointments and activities and who have no other means of obtaining transportation.

24. ATR Service Rate Table Average per person amount: $1620. Maximum per person amount: $2000. (over $2500. triggers administrative review) All vouchers default to expire within 30 days of issue date unless otherwise approved and indicated *Care Coordination is a function of centralized intake and provider designated regionally thought an agreement with a local health department or its designated entity.

25. ATR Service “Dose” Table *Adjusted with authorization by Reg. Coordinator Average per person amount: $1620. Maximum per person amount: $2000. (over $2500. triggers administrative review) All vouchers default to expire within 30 days of issue date unless otherwise approved Not yet available

26. Voucher Management System SMART/WITS VMS Voucher issued Payor (ASO) issues check for Service rendered and mails to service provider Service Rendered and entered in VMS

27. Who pays for this? • It starts as a grant-funded treatment episode • Discharge planning/referral is already required and paid for as part of the treatment episode. • Training for Residential Counselors (Portal Programs) on the Voucher Management System and GPRA Administration paid for through the ATR Grant • Technical Assistance and Help Desk activities are also ATR grant funded. • We all contribute, time, effort and patience.

28. What’s in for me? • One stop shopping for referral resources • Increased capacity for those entering the Treatment System • Partnering with Care Coordinators who work to enhance recovery begun in the Treatment episode • We all become architects in building Recovery Oriented Communities • Better Outcomes! ! For Programs, Counselors, and Recovering Individuals

29. For More Information Maryland’s RecoveryNet; • www.dhmh.state.md.us/adaa/ATR • Project Director- Debbie Green – 410.402.8592 dgreen@dhmh.state.md.us Access to Recovery at SAMHSA; • www.atr.samhsa.gov • Questions??????