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Jessica Bass, LCSW, CAC III, Program Manager Outpatient and Offender Services Arapahoe House. AIM (Plan). Baseline use of Vivitrol was 0 Limited referrals for any MAT; some use of antabuse for alcohol dependent clients.
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Jessica Bass, LCSW, CAC III, Program Manager Outpatient and Offender Services Arapahoe House
AIM (Plan) • Baseline use of Vivitrol was 0 Limited referrals for any MAT; some use of antabuse for alcohol dependent clients. • Goal was to increase use of Vivitrol in Intensive Residential Treatment (IRT) program for clients stepping down into outpatient • Started screening clients in February 2009
Change (Do) Barrier → Clinician lack of knowledge/bias towards MAT • Surveyed staff to find out knowledge and comfort level with MAT • Provided training on the benefits of MAT and Vivitrol specifically • Incorporated education on MAT into clinical supervision groups Barrier → Lack of agency procedures for screening clients and delivering Vivitrol • Started screening all alcohol dependent clients for appropriateness for Vivitrol • Enhanced education around Vivitrol and other MAT in client residential curriculum • Got donation of Vivitrol from Alkermes; arranged for doctor/nurse to see clients • Creating reports to track when clients are due for their next dosage • Improved coordination between IRT and OP staff as clients transition
RESULTS (study) • Screening all alcohol dependant clients in IRT • 15 clients have started on Vivitrol since March 09 • OP clients are beginning to get screened and 2 have started on Vivitrol • Clients are reporting high levels of satisfaction!
NEXT STEPS (Act) • Continue to educate staff and client • Develop stable funding sources • Utilize patient assistance program through • More education/advocacy needed on cost-benefit of paying for MAT → Outreach to private insurers • Increase Medicaid utilization; formed change team with provider and Medicaid representatives to resolve barriers around licensure and billing issues • Working with child welfare and other referral sources to educate on the benefits of MAT and get these services added to contracts
IMPACT (Business Case, Lessons Learned) Arapahoe House Vision • All types of MAT fully integrated into treatment for clients at all levels of care • Finding sustainable payer sources • Network of providers to collaborate with for prescribing medication Lessons Learned • Need to keep up with new medications and constantly educate staff about the landscape of options • Need to continue dispelling myths about MAT for clients