Graduate Seminar Project David Beling M.S. CADC, ADS

1. Graduate Seminar ProjectDavid Beling M.S. CADC, ADS

2. LEI AREAS OF FOCUS • Creativity and Innovation = Implementing a new program into an existing one. • Strategic Thinking = Taking a global view of the needs and resources needed to complete this task as well as possible outcomes. • Conflict Management = Handling the resistance to change from staff.

3. KENT/SUSSEX DETOXIFICATION CENTEREllendale Delaware

4. A UNIQUE PROBLEM • TOO MUCH BED SPACE? • NOT ENOUGH CLIENTS?

5. 20 bed facility • 2005 daily census = 14.8 • 2006 daily census = 12.2 • An average of 8 clients per week are turned away from Tx for various reasons

6. What was the major inhibitor to clients getting services? • In July 06 an intake audit was conducted • Audit results: 5 clients per week were denied treatment due to having Medicaid. • Kent/Sussex detox Center is State funded and does not accept people with insurance.

7. Should Kent/Sussex Detox begin accepting Medicaid clients? • July 06 a preliminary meeting was held with representatives from The Department of Substance Abuse and Mental Health (DSAMH), the fiscal and budget departments from the state, and representatives from Medicaid.

8. The results of that meeting? • Medicaid needed us just as bad as we needed them!

9. LOGISTICS • 8-06 a meeting was held with the medical staff from Kent/Sussex Detox Center and the medical staff from Kirkwood Detox Center. Delaware only has two detoxification centers and Kirkwood currently supports Medicaid clients. • The purpose of the meeting was to design standard protocol that is consistent between both centers and supportive of Medicaid requirements.

10. TIMETABLE FOR MEDICAID IMPLEMENTATION • It was expected that Kent/Sussex detox would have necessary changes in place and ready to accept their first Medicaid eligible clients with open arms by 12-06

11. Resistance to Change • As with any impending possible change the staff were not very happy with the idea. • Everyone thought the worst and blamed me (The new guy) for bringing in “new ideas.”

12. LEADERSHIP SKILLS DON’T FAIL ME NOW!!

13. It is no longer a leadership project. It is a MUST! • Friday September 15th 2006 a man from Delaware called the Kent/Sussex detox Center inquiring about being admitted for alcohol abuse. The phone interview revealed he had Medicaid and he was denied treatment in the program. • He hung himself that night in his backyard and was not found until the night of the 17th. • Staff quickly became more open minded about the changes that were to be made to accommodate Medicaid.

14. Way ahead of schedule? • In late September 06 medical staff shortages at some local area hospitals thrust Kent/Sussex detox into a position to begin taking Medicaid clients. • There was about an hour to prepare. • ESTJ’s need order and scheduling! • We do not like unorganized and unplanned tasks!

15. Where is Ben Zander when you need him?!!

16. Lucky us! • Due to the emergency Medicaid agreed to temporarily accept our current protocols on all treatment. • All we had to do was learn the billing process as it happened.

17. FINAL STEPS • December 12th 2006 Kent/Sussex Detox, members of DSAMH, and Medicaid personnel met to finalize the plans to move forward in the application process.

18. The waiting game…. • It was supposed to take 30-60 days for the application to be approved and as expected it is going to be closer to 60.

19. Unexpected benefits: • Intake policy and procedure reviews • Eliminated barriers to treatment • Less Red Tape • More uniformity • Better able to serve more people in the state of DE

20. LEI SKILLS ADDRESSED: • Creativity and Innovation • Strategic Thinking • Conflict Management