Recovery and Integrated Services – Taking It to the Streets

1. Recovery and Integrated Services – Taking It to the Streets Panel Discussion facilitated by Karen Amon, John Kroneck and Kari Gulvas September 17, 2013

2. Panel Participants • Karen Amon – Co-Chair Regional RISC, BABH ACT and IDDT Clinical Program Manager • John Kroneck – Montcalm Health Promotion Coordinator, Cherry Street Health Services • Kari Gulvas – Co-Chair Regional RISC, Recovery Systems Coordinator, RCA/AAM/BABH • Leigha Compson –Recovery Coordinator, Wedgwood Christian Services • Geoffrey Jones – Chair Montcalm RISC, Montcalm Recovery Community • Haven Ward – Vice-Chair Montcalm RISC, Montcalm Recovery Community • Will Volesky – Kairos/Holy Cross Mental Health and Substance Use Provider

3. 4 Objectives for Today’s Session • Participants will understand the organizational dynamics of setting the foundation and framing the structure for integrated recovery services • Participants will understand the importance of combining the Recovery Oriented Systems of Care and the Integrated Services Workgroup to develop truly integrated mental health and substance use disorder services • Participants will understand the role of local providers in organizing and coordinating communities for effective integration • Participants will hear from members of local recovery communities regarding their experience of leading system change

4. Brief History of Us RCA SUD Side BABH MH Side • Regional Recovery Oriented Systems of Care (ROSC) developed 2010 • Inclusionary effort for Prevention professionals, Treatment professionals, Individuals in Recovery and interested Community Stakeholders • Developed and adapted Principles, Guiding Elements of Success, Mission and Vision • Regional Integrated Services Workgroup (ISW) developed 2006 • Membership included Huron Behavioral Health, Tuscola Behavioral Health, Shiawassee County CMH, Montcalm Behavioral Health and providers for Bay-Arenac Behavioral Health • Developed Purpose Statement with specific focus areas of concentration

5. Reorganization – 2012Regional ROSC – Regional ISW • Asked by Regional PIHP to consider reorganization/consolidation of all agency workgroups/ taskforces • RCA ROSC and BABH ISW met separately to analyze “common ground” • Common ground – “the only way to maximize services is by working together in partnership and collaboration” • Common ground – “healthy communities help to sustain recovery and promote wellness for all”

6. Reorganization – 2012Regional ROSC – Regional ISW • Groups met together to define common purpose – one “joint structure” to build upon • Joint agreement – improve communication, coordination, and partnership among all system stakeholders • Joint agreement – help systems provide person-centered integrated treatment and recovery services in a comprehensive, continuous, integrated way.

7. Reorganization – 2012Regional ROSC – Regional ISW • Developed joint Action Plan with goals/objectives – 3 workgroups support the Action Plan • Renamed the group – Recovery and Integrated Services Collaborative (RISC) • The Cornerstone for Change ---- Relationships, relationships, relationships are key!!!!!!

8. Regional RISC Success • New relationships built • Increased awareness and understanding • New education was shared • New understanding about limits of each system • Broader inclusion of co-occurring issues, trauma-informed services, evidence based practices and stage of change readiness

9. Outcomes to Date • Increased positive relationships --- proactive and progressive attitudes • Sitting at the table together on a regular basis • More people are receiving co-occurring treatment in both systems • Improved collaboration between the two systems • Local communities picking up the effort

10. Outcomes to Date • Identified “vulnerable” people and processes to enhance their episode of care (both systems) • Came up with best practices on how to work collaboratively • Better trained staff because of training between and across both systems (trauma, MI, Stages of Change, etc.) • Coordinated training between the two systems

11. Lessons Learned • Relationships are critical to succeeding • Must build on core of “trust” • Developing common language is key • Focus on the strengths of the group

12. Lessons Learned • Must have “action” along with visioning • Participants must be open to new learning - new ideas • Financial systems are still siloed – this is challenging • Passionate partners -- “Champions” are essential to success

13. Lessons Learned • Active and conscious effort to continuously evaluate • Formal system processes are necessary • Having the right people in leadership • Leaders provide empowerment – guidance

14. “Taking It to the Streets” Enhancing Recovery in Montcalm County Newaygo County Mecosta County Isabella County Gratiot County Montcalm Kent County Ionia County Clinton County

15. Call for Pilot Projects

16. Joint Venture • Regional Recovery & Integrated Systems of Care • Recovery Community • Cherry Health Promotion Services • North Kent Guidance Services • Wedgwood Christian Services

17. Strategic Prevention Framework Assessment: Profile population needs, resources, and readiness to address needs and gaps. Evaluation: Monitor, evaluate, sustain, and improve or replace those that fail. Capacity: Mobilize and/or build capacity to address needs. Sustainability & Cultural Competence Implementation: Implement evidence-based prevention programs and activities. Planning: Develop a comprehensive strategic plan. A SAMHSA Best Practices Model

18. EXTENDED COMMUNITY SUPPORT LOCAL COMMUNITY FUNDING FUNDING SUPPORT RECOVERY COMMUNITY STEERING COUNCIL RCA & SERVICE PROVIDERS PEOPLE IN RECOVERY VOLUNTEERS RESOURCES FAMILIES RESOURCES RELATIONSHIPS RELATIONSHIPS

19. Montcalm RISC Goals Coordination of Services and Resources Education in the Community Community Resource Mapping Transitional Housing

20. Goal 1: COORDINATION OF SERVICES AND RESOURCES • Objective 1: Establishing and Maintaining a Steering Committee • Objective 2: Create a Usable and Flexible System Specifically for Recoverees and their Families

21. Goal 2: EDUCATION IN THE COMMUNITY • Objective 1: Resource Networking • Objective 2: Perform a Public Education Strengths and Gaps Analysis

22. Goal 4: TRANSITIONAL HOUSING • Objective 1: Develop Women’s Transitional Housing Availability • Objective 2: Identify Recovery-Friendly Landlords and Funding Options for Housing Needs

23. Goal 3: RESOURCE MAPPING • Objective 1: Mapping Community Assets and Needs with respect to the Four Key Support Areas • Objective 2: Increase Employment Opportunities for Recoverees • Objective 3: Focus for Family of Recovering Person

24. Recovery Supports Montcalm County RISC is committed to developing a system of supports that is holistic and flexible to meet the unique set of needs for each individual served. “Alcohol-and drug-dependent individuals with histories of homelessness, incarceration, and lack of social support for sobriety are particularly vulnerable to relapse without the provision of long-term community-based services that support sobriety,” (McAllister Henderson & Polcin, 2008, para. 3).

25. Recovery Supports • Our objective was to not only identify recovery resources in our community but also to map the resources. • The map can be used by helping professionals, (e.g., recovery coaches), family members, individuals in the community, and others.

26. Resource Mapping • Plotting resources on a map • Helps to locate resources that are closest to client homes more efficiently • Minimizes transportation issues • Analysis of the mapped resources creates the opportunity to advocate for new resources in underserved areas (i.e., “resource deserts”).

27. Case Example Julie is a twenty-something mother of two who is on probation with a substance use charge. She was recently released from jail and is staying with her aunt temporarily while she tries to find a place to live. Her aunt has been threatening to kick her out as she is struggling to provide basic needs for her own family. Julie is currently unemployed and has a spotty work history given her issues with the law and substance use patterns. She dropped out of school when she was an eleventh grader and has never had a driver’s license. Julie has been sober for about three months and states that she is motivated to continue her recovery to ensure she is able to retain custody of her two young children. Currently she is feeling overwhelmed as she struggles to provide food for her children and manage severe pain for some dental problems she has been experiencing. She is referred to a local agency for a substance use evaluation.

28. Resource Mapping Model Substance use literature identifies four primary categories of support that are instrumental in recovery: • Emotional • Informational • Instrumental • Affiliation

29. Resource Mapping Model • The objective of categorizing resources is to help individuals in recovery identify key supports needed to maintain sobriety. • By organizing recovery resources into four main categories, matching individuals with resources is more efficient.

30. Resource Mapping Model The map creation process involved • Utilizing the model’s four main categories as a foundation • Developing resource subcategories for each category • Identifying specific resources for each subcategory • Requesting ongoing input and feedback from the community.

31. Resource Category: Emotional Supports Emotional Supports are defined as “demonstrations of empathy, caring, and concern in such activities as peer mentoring and recovery coaching as well as recovery support groups”. (Kaplan, 2008)

32. Resource Category: Affiliation Supports Affiliation Supports are defined as opportunities “to establish positive social connections with others in recovery so as to learn social and recreational skills in an alcohol-and drug-free environment.” (Kaplan, 2008).

33. Resource Category: Instrumental Supports Instrumental Supports are defined as “concrete assistance in task accomplishment, especially with stressful or unpleasant tasks (e.g., filling out applications, obtaining public benefits) or providing supports such as child care, transportation to support group meetings, and clothing closets” (Kaplan, 2008).

34. Resource Category: Informational Supports Informational Supports are defined as “provision[s] of health and wellness information, educational assistance, and help acquiring new skills, ranging from life skills to employment readiness and citizenship restoration (e.g., voting rights, driver’s license)” (Kaplan, 2008).

35. Resource Map Category Summary

36. Resource Maps To view the map for each category, click on the desired button below:

37. Resource Booklet

38. Next Steps • Distribution and awareness • Maintenance plan • Collecting feedback • Advocacy for new resources • Employment Network Montcalm County RISC’s commitment to diversity is critical to the success of a recovery system and thus the success of recovering individuals, for “treatment professionals and researchers now believe that there are many aspects of recovery and there are numerous pathways to follow. There is no single solution that works for everyone,” (Promises Treatment Centers, n.d., para. 3).

39. References Kaplan, L., (2008). The Role of Recovery Support Services in Recovery-Oriented Systems of Care. Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration. DHHS Publication No. (SMA) 08-4315. McAllister Henderson, D., & Polcin, D. (2008). A clean and sober place to life: Philosophy, structure and purported therapeutic factors in sober living houses. Journal of Psychoactive Drugs. 40(2). 153. Nishimura, N., Priest, R., Pruett, J. 2007. The role of meditation in addiction recovery. Counseling and Values. 52(1). 71. Promises Treatment Centers. (n.d.). How to build and maintain a solid system in recovery.

40. Closing • Questions? • Contact Information • Montcalm RISC montcalmrisc@gmail.com (616) 232-6891 • Leigha Compson lcompson@wedgwood.org (616) 255-6334 • RCA RISC • www.riverhaven-ca.org • (989) 497-1344 • Kari Gulvas • kgulvas@babha.org • (989) 497-1384

41. Resource Map Each map is color coded by subcategory.

42. Resource Maps Clicking on one pin displays the resource details

43. Resource Map Clicking on the resource title takes you to the resource website

44. Resource Map Clicking on the resource address takes you to a new page to get driving directions to the site.

45. Case Example • The results of the assessment indicate that Julie meets diagnostic criteria for substance use. • Weekly counseling is recommended and Julie agrees to participate. The first counseling session is scheduled. • Treatment goals are established, some of which are supported through the assignment of a recovery coach.

46. Case Example • Julie is introduced to a recovery coach who begins meeting with her individually. • To support her treatment plan, Julie’s specific recovery support needs are assessed by the recovery coach. • Plans to meet the needs are developed using the resource map.

47. Case Example

48. Case Example

49. Case Example

50. Case Example Throughout the process, Julie’s recovery coach uses the Montcalm County Recovery Supports Resource Directory. • To date, the directory contains over 725 resources! • It’s available electronically online as well as in booklet form.