1 / 14

Improving Continuation from Detox into Treatment – Advancing Recovery in Colorado

Improving Continuation from Detox into Treatment – Advancing Recovery in Colorado. Erik Stone, MS, CAC III Signal Behavioral Health Network Joseph Contreraz, CAC III Denver CARES. The Problem. High admissions to non-medical detoxification programs (~ 50,000 per year)

ova
Download Presentation

Improving Continuation from Detox into Treatment – Advancing Recovery in Colorado

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Improving Continuation from Detox into Treatment – Advancing Recovery in Colorado Erik Stone, MS, CAC III Signal Behavioral Health Network Joseph Contreraz, CAC III Denver CARES

  2. The Problem • High admissions to non-medical detoxification programs (~ 50,000 per year) • Clients typically have minimal to mild withdrawal, are brought by law enforcement, stay in detox for a day or so (AH average LOS is 1.4) • Average of less than 10% enter treatment within 30 days of discharge from detox

  3. Advancing Recovery Partners • Signal – Managed service organization (MSO) funding substance abuse detox and treatment services • State Division of Behavioral Health (DBH) – Single state agency; licensing authority • Arapahoe House – Metro Denver provider of outpatient and residential services; has 3 detox facilities • Denver Health – Denver provider of outpatient and residential services; has 1 detox facility • Advocates for Recovery – Advocacy organization for the recovery community in Colorado

  4. Baseline and Goals • Arapahoe House – Aurora Baseline continuation rate is 4.9%; goal is 14.9% • Denver CARES – Denver Baseline continuation rate is 2.7%; goal is 12.7%

  5. Measuring Detox Continuation • Unique clients, not admissions • Who live in metro Denver • Who are recommended for formal substance abuse treatment • Who enter treatment at a Signal provider within 30 days of discharge from detox • And who have a treatment service within 15 days of admission to treatment

  6. State/Payer Changes • Creation of fiscal incentives for detox continuation • Improved reporting on continuation from detox into treatment • Creation of statewide standardized protocol for DUI referrals

  7. Levers for State/Payer Changes • Inter-organizational capability analysis • Bringing DBH, State Judicial, local Judicial districts into the planning process • Reaching out to private DUI providers to turn opponents into willing participants • Purchasing and contracting analysis • Development of fiscal incentives in MSO/State contract • Incentives in Signal contracts with providers for 09-10 contract year → $65K for continuation from detox into tx, from residential into lower levels of care, and for OP lengths of stay > 90 days

  8. Provider Changes • Updating referral information • Providing incentives to staff for OP intakes • Having OP staff come to detox; assess clients • Allowing detox staff to schedule OP intakes • Waiving intake fees for detox clients transferring within agencies • Outreach to DUI service providers

  9. Levers for Provider Changes • Intra-organizational operations analysis • Walk through discoveries → Insurance review barriers, lack of immediate intake appoinments, paperwork duplication • Internal barriers change team created • Inter-organizational capability analysis • Outreach to DUI service providers • Development of preferred providers → Create a partnership with outside providers; agreements for tracking clients, calling no shows, reporting enrollment status; availability of intake slots and warm handoffs; flexibility in fee collection

  10. Success Stories • Clients are getting into treatment more consistently and much faster • Staff morale is increasing as clients get into treatment; as staff are rewarded for referrals and admissions

  11. Role of Incentives • AR funds used to create incentive pools rather than simply paying for participation; providers created incentive plans each year • Results are mixed Useful tool for jump starting & managing project, but • Significant cultural differences between providers • Surprisingly difficult to identify effective levels of incentive • Need faster linkage between performance and incentive • Incentives not sufficient to modify workflow

  12. Next Steps • Continue to work towards continuation goals • Spread continuation project to other detox facilities in Signal network → Provide incentives in 09-10 contract year • Approve DUI Detox protocol; write into state policy; spread statewide • Focus on other populations such as injecting drug users, pregnant women, women with dependent children

  13. Contact Information Erik Stone, MS, CAC III Signal Behavioral Health Network 455 Sherman St., #455 Denver, CO 80203 720-263-4853 estone@signalbhn.org

More Related