Repackaging Coolmine: Introducing Change into a Traditional TC

1. Repackaging Coolmine: Introducing Change into a Traditional TC Paul Conlon, Chief Executive, Coolmine TC, Dublin, Ireland.

2. Contents • Brief history of Coolmine • Drugs policy in Ireland • The strategic challenges • Development of -‘A pioneering record-A dynamic Future’ • Implementation • Service developments • Networking • New funding • The next steps Coolmine – EFTC - June 2007

3. Brief History of Coolmine • Established 1973, - Ireland’s first voluntary treatment agency • Phoenix House (London) • Daytop Village (New York) from 1979 onwards Coolmine – EFTC - June 2007

4. Coolmine in the ‘Opiate Epidemic’ Years (1980-1985) • Prior to 1980, Dublin had no significant heroin use and virtually no injecting drug use • TC’s abstinence model was accepted as only valid treatment model • Statutory funding increased and Coolmine expanded its services and facilities significantly Coolmine – EFTC - June 2007

5. Coolmine in the Era of Harm Reduction • 1982: Ana Liffey Drug Project, Ireland’s first harm reduction agency • 1989 Merchant’s Quay Project • Coolmine's monopoly of statutory funding for voluntary service provision was broken • Difficult financial period in the late-1980 / early-1990s Coolmine – EFTC - June 2007

6. Drugs Policy Developments in Ireland • Late 1980s/early 1990s: Gradual introduction of Harm Reduction • 1996 the Govt. published ‘The First Report of the Ministerial Task Force on Measures to Reduce the Demand fo Drugs’ which lead to the creatation of formal drug policy structures • Building on Experience, Irelands National Drugs Strategy 2001 to 2008 • Focus on public health and harm reduction • 2005 Review recommended new focus on rehabilitation. Coolmine – EFTC - June 2007

7. Coolmine in the New Millennium (2004) • Some useful and productive links with European TCs and Local Irish Structures had been established • 2002 Evaluation had been completed by Rowdy Yates & Salvatore Raimo • Some changes had been made however structures and style still largely based on Daytop Model with considerable use of confrontation • Numbers low • ‘On the street’ image quite negative • Funding in decline Coolmine – EFTC - June 2007

8. Repackaging Coolmine • 2004 appointment of new chief executive • Brought considerable experience and track record in service development • Board’s interest in adapting to the changes in the external policy environment • Public policy environment: • Shifted significantly towards harm reduction • Coolmine needed to rethink its approach to treatment • Strategy Review due in 2005 signalling a renewed emphasis on rehabilitation. • Right timing for new approach Coolmine – EFTC - June 2007

9. The Strategic Challenges • Improve reputation; attract and retain new clients • Avoid demoralizing committed and experienced staff • Identify and preserve core values while changing practices and traditions out of keeping with the new policy environment • Persuade the policy-making community and service funders that the TC model still had a valuable contribution to make Coolmine – EFTC - June 2007

10. Actions Taken • Board expanded - wide spectrum of interests and experiences • New staff recruited, pay review & significant investment in training for all • Following extensive consultation -‘A pioneering record-A dynamic Future’was launched. • Greater engagement by Coolmine in the wider policy system • Full engagement with national, regional and local implementation structures Coolmine – EFTC - June 2007

11. Development of Strategic Plan • Extensive consultation process in 2005 facilitated by external change management consultant • Current clients and past graduates • Drug users in other services • All staff, management and board members • Peer organisations • Current and potential funders • Steering group established to prepare drafts for approval Coolmine – EFTC - June 2007

12. Identification of Core Values • Core value of the TC is value of abstinence as a treatment goal • Self help and mutual help are pillars of the therapeutic process • Programme needed to be structured and challenging • Length-of-stay needed to be sufficient to enable change to take place • Drug-free lifestyle does not mean that clients must all be drug-free on admission to TC programmes Coolmine – EFTC - June 2007

13. Key Service Objectives • Renewed emphasis on assertive outreach • Introduction of stabilisation and detox facilities • Residential services - evidence based • Length of programme • Quality of counselling • Professional and with 24/7 staffing • Reintegration programme • Dedicated aftercare services - including community based housing. Coolmine – EFTC - June 2007

14. Progress to date • New stabilisation day programme from Jan. 2006 • Community detox service for clients with facilitation within residentials • 24/7 staff in our residentials, April and Sept 2006 • Dedicated integration & aftercare team in May 2006 • Systematic care and case management • Three community based houses for reintegration • General improvement in reputation, client retention and funding situation. Coolmine – EFTC - June 2007

15. Countering Resistance to Organizational Change • Board has consistently supported the new strategy and chief executive • Building a strong management team with shared approach to change process • Use of HR policies and procedures to assert accountability in organisation and affirm change process • Ongoing use of external change management consultant to train and support implementation group in leading and tracking change and dealing with resistance Coolmine – EFTC - June 2007

16. Launch of Strategic Plan • A Pioneering Record – A Dynamic Future, Strategic Plan 2006 to 2008 launched by Noel Ahearn, Minister with responsibility for Irelands National Drugs Strategy • Strategy publicly endorsed by main funders, HSE, The Probation Service, Drugs Task forces and FAS – the Training and Employment Authority Coolmine – EFTC - June 2007

17. Implementation of Strategic Plan • Internal Strategic Plan Implementation Group established with remit to: • Prioritise local action plans with each team in conjunction with the local management • Be responsible for the implementation of key actions and managing change • To systematically track progress across 52 actions in the Strategic Plan • Provide leadership, to Troubleshoot and to challenge when and where necessary. Coolmine – EFTC - June 2007

18. Networks • EFTC members, Phoenix Haga, Trempoline, and De Kiem (Europe) • The Ley Community and Phoenix Alpha (UK) • Community of Communities quality network - two peer reviews • Active members - drugs task forces in Ireland • Voluntary Drug Treatment Network • Contributed to National Working Group on Rehabilitation • Partnerships Coolmine – EFTC - June 2007

19. Funding Streams • New funding for • Additional staff, 24/7 cover in residentials • Child care worker • Training • Information technology • Refurbishment of services • Negotiating Service Level Agreements with Funders • Reversed overall trend Coolmine – EFTC - June 2007

20. The Next Steps • Continue to provide ongoing support and leadership training to Strategic Plan Implementation Group • Continue to implement actions identified within the strategic plan and manage any difficulties and resistances. • Commence a research programme • Develop a new strategic plan for 2009 to 2015 which may see Coolmine providing additional services on a national basis Coolmine – EFTC - June 2007

21. Summary • Very much a work in progress • The image of Coolmine amongst service users, funders and policy makers has improved • New grants which radically improve the agency’s financial situation • Continue to build partnership relationships with peer organisations in order to meet client need • The Big Question: What about additional services on a national basis? Coolmine – EFTC - June 2007