A Matter of Substance • January 2018

A Matter of Substance January 2018Quarterly Publication

Bureau of Substance Abuse

IDPH • Lucas State Office Building • 321 East 12th St., Des Moines, IA 50319 • www.idph.iowa.gov

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A Publication of the IDPH Bureau of Substance Abuse

Your Life Iowa – We’re Your Every Life Support

On October 23, 2017, IDPH launched the new Your Life Iowa website (https://YourLifeIowa.org).

This new dynamic and integrated website offers Iowans easy, reliable information and resources for help with gambling, drug and alcohol problems, suicidal thoughts and more via online chat, texting or phone 24/7/365.

We invite you to take a look around the new site and let us know what you think. Each section of the site was developed in a uniform way to help with navigation to easily find additional information and resources on each subject (Get Help, About, Health & Wellness, Recovery and Resources). There are FAQ pages, fun quizzes and self-assessment tools available. Also, check out the Prevention Resources and Find Help Near You. One of the new features added is the ability for licensed treatment providers to add a picture of their facility, a welcome video, and additional information they would like to display about each location (hours of operation, specialized services, insurance taken, etc.).

The previous website domains (1800BETSOFF.org, DrugFreeInfo.org) remain active; however, they will redirect the user to the corresponding page within the new YourLifeIowa.org website. Additionally, the DrugFreeInfo help line number still works (866.242.4111), but is now routed to Foundation 2. Management of the Your Life Iowa system was awarded to Foundation 2 this past July. We encourage providers and community organizations to update the information and links that they may have on their websites and update accordingly.

In order to raise awareness of the new Your Life Iowa website, marketing agency ZLR Ignition used its contract with IDPH to develop a launch campaign that includes an online banner placed directly on local news and television websites (i.e., KCCI.com, KTIV.com, WQAD.com and KWWL.com). Additionally, banners will be placed on websites through programmatic tactics. Programmatic advertising is the algorithmic purchase and sale of advertising in real time. Look for these banners on your mobile, desktop and tablet devices and link to the Your Life Iowa website. It is estimated there will be over two million views of the banner ads.

Billboards were posted in Des Moines, Cedar Rapids, Waterloo and the Quad Cities. Sixteen posters were posted for eight weeks starting mid-October, providing an estimated 849,574 views by those traveling in those cities.

Although not part of the current launch campaign, a 30 second PSA was developed, and is now available to be used locally and or embedded on websites. Click here to listen. Look for a Your Life Iowa brochure by the end of the year, as well as additional activities coming in March through June. If you have interest in using the available PSA and/or print materials, email IGTP@idph.Iowa.gov or go to https://YourLifeIowa.org/contact.

The website is one part of an integrated Your Life Iowa system that can be accessed via the website, online chat, helpline (all three previous helpline numbers remain active) or text. So take a look around, give us a call; We are Your Everyday Life Support. For more information, please contact Eric Preuss at Eric.Preuss@idph.iowa.gov.

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 2018

AmeriCorps Update!The Iowa Department of Public Health AmeriCorps

Substance Abuse Prevention program statewide initiative is underway for the 2017-2018 program year. This program focuses on building capacity of mentoring programs focusing on substance abuse prevention and substance abuse prevention agencies throughout the state of Iowa. This program year, members will be focusing their efforts on the opioid and prescription drug misuse crisis within the state of Iowa. The IDPH AmeriCorps Substance Abuse Prevention Program will focus on theory of change around education, community engagement and capacity building. These three components together address the long-term goal of reducing substance use and the Healthy Futures priority of addressing opioid and prescription drug abuse.

Members will be serving at the following host sites: Burlington Community School District Community Youth Concepts New Opportunities Area Substance Abuse Council (ASAC) Big Brothers Big Sisters of Siouxland Big Brothers Big Sisters of Clinton Mills County Public Health South Central Calhoun County School District Everybody Wins! Iowa Iowa Homeless Youth Center (Youth and Shelter Services)

Currently, we are still looking for members who are interested in serving for a full year with the IDPH AmeriCorps Substance Abuse Prevention program. For more information visit this website for open positions: https://serviceyear.org/idph/idph-ameri-corps-substance-abuse-/ or contact Amanda McCurley at Amanda.McCurley@idph.iowa.gov.

Staff Spotlight

Amanda McCurley joined the IDPH Bureau of Substance Abuse in October 2016 as the IDPH

Substance Abuse Prevention Program AmeriCorps Program Director. This program focuses on building capacity of mentoring programs focusing on substance abuse prevention and substance abuse prevention agencies throughout the state of Iowa. This program year, members will be focusing their efforts on the opioid and prescription drug misuse epidemic.

Amanda holds a bachelor’s degree in Family Services from the University of Northern Iowa, a paralegal certificate from Capital University Law School, and a Master of Social Work from The Ohio State University. Amanda started her career as a participant in national service through the Lutheran Volunteer Corps serving as a legal advocate to individuals seeking restraining orders at the Milwaukee County Courthouse in Milwaukee, WI. Amanda then went on to work in a creditors’ rights law firm as a paralegal manager for six years before returning to school to get her MSW. Since then, Amanda has been the program director for two different AmeriCorps programs in the state of Iowa. She spends most of her free time with her husband (Dan) and two daughters (Mabel and Harriet). Amanda enjoys knitting, crocheting and watching reality TV. For more information on the IDPH Substance Abuse Prevention Program AmeriCorps program, visit https://idph.iowa.gov/substance-abuse/AmeriCorps-substance-abuse-prevention or contact Amanda at Amanda.McCurley@idph.iowa.gov.

Amanda McCurley

Iowa Department of Public Health

AmeriCorp seeks members for the Substance Abuse Prevention program to serve for one year.

Take Note:

Important

information!

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A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 2018

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Take Note:

Important

information!

The opioid crisis led to special focus areas to reduce opioid use disorders.

IDPH Five-Year Substance Abuse Prevention Strategic Plan

In August 2017, the Iowa Department of Public Health gathered subject matter experts from across the state

to participate and contribute to the five-year substance abuse prevention strategic plan development and implementation. This plan incorporates three federal grants from the Substance Abuse and Mental Health Services Administration: the Partnerships for Success grant, the Strategic Prevention Framework for Prescription Drugs grant, and the prevention set aside portion of the Substance Abuse Prevention and Treatment Block Grant, often referred to as the Comprehensive Substance Abuse Prevention grant.

The framework of the planning effort was to create one strategic plan that encompasses all grant driven efforts. To start, there were four short-term action teams formed to assist with key elements of the plan:1. Workforce Development2. Continuous Quality Improvement3. Evidence-Based Practices Workgroup4. Public Education and Prescription Monitoring Program

The four teams reviewed assessment data on alcohol, opioids and marijuana for the state of Iowa, determined the population of focus, created guiding principles to provide a framework on ground rules of how the plan would be implemented by IDPH and its partners, and then outlined the program structure around the Strategic Prevention Framework model.

These steps led to the creation of performance indicators and a work plan with strategies centered on the four key elements. Due to the current opioid crisis, a special focus area with strategies to reduce opioid use disorder was added along with the Strategic Prevention Framework for Prescription Drugs public education plan. Finally, a five-year implementation timeline for each of the deliverables was created.

The substance abuse prevention strategic plan will be the guiding document for the IDPH prevention department for the next five years and is available to view on the IDPH website.Click here

Highlight IGTP Webinar SeriesThe Iowa Gambling Treatment and Prevention Grant

(IGTP) through the Iowa Department of Public Health - Bureau of Substance Abuse will be sponsoring the webinar series “Looking to the Horizon – Shaping the New Age of Problem Gambling Prevention, Treatment and Recovery” beginning in January 2018. The series will include six webinars intended to assist in the expansion and enhancement of current IGTP efforts in Iowa. The monthly webinars will take place on the fourth Wednesday of each month from 1 - 2:30 PM starting in January and concluding in June. Topics will span the continuum of care (prevention, treatment and recovery) and will be presented by leading experts from across the country. Designed for clinicians, educators, public administrators, public health, law enforcement, policy makers, primary care providers, other community providers and those interested in learning more on the topic, the series will provide up-to-date information and resources to enhance participant knowledge on problem gambling and problem gambling service delivery.

Please “save the dates” for this webinar series. For more information or to register, please visit www.TrainingResources.org. The webinar series is sponsored by the Iowa Gambling Treatment Program. For more information about the Iowa Gambling Treatment Program, please contact Eric Preuss at Eric.Preuss@idph.iowa.gov.

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 20184

2018 Iowa Youth Survey RegistrationThe Iowa Youth Survey (IYS) is the most frequently

used source of data regarding Iowa’s youth. IYS data are used for reporting at the school, community and state levels for informed policy, strategy development and surveillance; funding at the local and state levels; and research. The IYS will be administered during October 2018 to sixth, eighth, and 11th grade students across Iowa. Registration will begin in late February 2018. The IYS website, www.IowaYouthSurvey.Iowa.gov, will be utilized to disseminate information about the 2018 survey, including training information, forms and directions. This site is also where publicly available reports from previous iterations are posted. For questions about the 2018 Iowa Youth Survey, please contact us at IowaYouthSurvey@idph.iowa.gov.

Building the Capacity to Serve FamiliesThe Residential Treatment for Pregnant and Postpartum

Women is a three-year (09/30/2015-09/29/2018) grant awarded to the Iowa Department of Public Health (IDPH) by the Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment (SAMHSA CSAT). The purpose of this program is to expand the availability of comprehensive, residential substance use disorder treatment, prevention and recovery support services for pregnant and postpartum women and their minor children, including services for non-residential family members of both the women and children. The Iowa Pregnant and Postpartum Women’s Residential Treatment (Iowa PPW) program is implemented at four established residential treatment programs in major cities in the state of Iowa: Area Substance Abuse Council (Cedar Rapids), Heartland (Council Bluffs), House of Mercy (Des Moines) and Jackson Recovery Center (Sioux City).

In September of 2017, the Iowa PPW programs began the implementation of two practices (24/7 Dad’s curriculum and a Children’s Coordinator) with the goal of enhancing the family centered model of care provided at each location for fathers and children of the women receiving care at each program. The Children’s Coordinator will assess each program’s “family friendliness” and build upon the assessment to identify and implement strategies to enhance the family model of care. The Children’s Coordinator will serve as a liaison to the program for family members and children, assess each individual family’s need for services, and assist the family in accessing and coordinating services. The 24/7 Dad’s is a National Fatherhood Initiative that provides a curriculum to guide skill development for fathers. Expanding services to fathers involved with clients in substance use disorder treatment programs helps the whole family to grow, heal and learn. For more information, visit https://idph.iowa.gov/substance-abuse/programs/ppw or contact Jennifer Robertson atJennifer.Robertson@idph.iowa.gov.

Take Note:

Important

information!

Eliminate Stigma From the Inside Out

We seem to be constantly trying to change the public’s perception of substance use disorders and of

people who have them. At best, progress is slow. The terms “stigma” and “shame” both apply. Stigma may be what is inflicted upon us by others. Shame is what we carry. To read the whole article from the Addiction Professional website click here

Shame is what

we carry

Nov. 27, 2017 Michael Weiner, PhD, MCAP

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 2018

ODMHSA and IDPH team members at

the peer-to-peer site visit in Oklahoma

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Important

information!State Targeted Response Media Campaign

Public service announcements, radio spots, posters, online banner ads

and online search ads began across the state in November to raise awareness about the opioid crisis in Iowa. As part of an ongoing effort by IDPH to pro-mote the prevention and treatment of opioid use disorder, this campaign was made possible by the Substance Abuse and Mental Health Services Administration (SAMHSA) grant for Iowa’s Opioid State Targeted Response (STR). The campaign will continue through March of 2018.

For posters in English or Spanish to put up in your community, please contact Monica Wilke-Brown at Monica.Wilke-Brown@idph.iowa.gov.

Licensure Standards FAQPlease submit any licensure questions to SUD.PG.License@idph.iowa.gov.

Q: I have hired a temporary CADC (tCADC) and would like to know if they have certain restrictions

to providing treatment services at our licensed treatment program.

A: Licensure would consider a temporary/provisionally certified or licensed professional to provide the same

services (within their scope of practice, of course) that other qualified addictive disorder professionals provide. Licensure standards would require the temporary or provisionally certified or licensed staff person meet all requirements of the temporary or provisional certification or license, and that they must be supervised by a staff person meeting one of the following requirements:

1. Be certified or licensed as a substance use disorder or problem gambling counselor by a national or state organization approved by the division.2. Be licensed as a marital and family therapist or a mental health counselor under Iowa Code chapters 154D and 147, an independent social worker under Iowa Code chapters 154C and 147, or another independent professional authorized by the Iowa Code to diagnose and treat mental disorders as specified in the most current Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association3. Be licensed as a master social worker under Iowa Code chapters 154C and 147.4. Be licensed as a bachelor social worker under Iowa Code chapters 154C and 147.

In addition, the individual must be fully certified or licensed within two years of the date on which the person began to provide licensed program services.

Peer Support Services at Oklahoma Site VisitThe Iowa Department of Public Health’s State Youth

Treatment-Implementation (SYT-I) grant participated in a peer-to-peer site visit with the Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) on October 17-18, 2017. This two-day site visit provided representatives from the Iowa Department of Public Health and SYT-I funded providers the opportunity to explore Oklahoma’s Peer Recovery Support Services structure. Heartland Family Service, Prelude Behavioral Services and YSS were the SYT-I funded providers in Iowa who participated in the site visit. JBS International coordinated this experience. The site visit provided a robust learning environment that outlined the creation and benefits of implementing a Peer Recovery Support Services model in Oklahoma for youth and young adults.

For more information, contact Cara Weis, SYT-I Project Director, at Cara.Weis@idph.iowa.gov.

XXXXXX

What if you came home and found that your kids got into your painkillers? With naloxone, an overdose can be temporarily reversed until they get to the emergency room. Visit our website for info, treatment and support.

THE MOST PAINFUL PARTOF ANN’S SURGERYWAS WHEN HER SONGOT INTO HER PILLS.

YourLifeIowa.org 1.855.581.8111

WE’RE YOUR EVERYDAY LIFE SUPPORT.

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 20186

The following 10 initiatives are proven approaches that have been adopted by numerous states to combat the

opioid epidemic. The initiatives have been put into a report card format so individuals can evaluate Iowa’s efforts to address opioid misuse in the state and potential areas of improvement.

Naloxone Information and Training of TrainersIDPH hosted a “training of trainers” on November 28,

2017 for individuals interested in learning how to teach others the appropriate response to an opioid overdose. As the primary objective, attendees learned how to conduct a comprehensive 10-15 minute training using a standardized curriculum that they can take back to their agency or community on responding to an opioid overdose, including how to use naloxone. Over 100 treatment and prevention professionals, first responders, stakeholders and community members were trained. This training was made possible through funding from the Substance Abuse and Mental Health Services Administration (SAMHSA) and a collaboration between Iowa’s Opioid State Targeted Response (STR) and the Strategic Prevention Framework for Prescription Drugs (SPF-Rx) grants.

State of Iowa Opioid Initiatives Report Card

Measure Yes No

1. State has a Prescription Monitoring Program 2. Prescribers are required to use the

Prescription Monitoring Program X

3. Prescription Monitoring Program has 24-hour upload from pharmacies X

4. State utilizes prescription limits for opioids X

5. State has a Syringe Services Program X

6. State has a Good Samaritan Law X7. State has Expanded Naloxone Access

8. State has dedicated funding for Naloxone X9. State has Medicaid coverage for all forms

of medication assisted treatment

10. State requires training on CDC Guidelines for Managing Chronic Pain X

For more information on opioid related efforts at IDPH, please visit the Bureau of Substance Abuse webpage at https://idph.iowa.gov/substance-abuse.

Opioid Epidemic Report Card

In 2016, there were 86 opioid overdose deaths and 180 opioid-related deaths. So far in 2017, provisional data shows that there have been 69 opioid overdose deaths and 145 opioid-related deaths. Because of the time it takes for data to be reported and validated, the numbers for 2017 will likely eclipse the number of deaths in 2016. While Iowa is making strides in addressing opioid misuse in the state, there are several efforts being made by other states that show significant promise to reduce opioid misuse and overdose/related deaths. IDPH has prepared a report card that highlights some of these practices and Iowa’s efforts. For more information on opioid-related efforts by IDPH, please contact Kevin Gabbert, ATR/MAT-PDOA Project Director at Kevin.Gabbert@idph.iowa.gov.

Naloxone training

So far in 2017, data

show that there have

been 69 opioid overdose

deaths and 145 opioid-

related deaths.

Take Note:

Important

information!

Expanded Naloxone Access

Medicare Coverage

Prescription Monitoring Program

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 20187

Iowa has been part of the National Violent Death Reporting System (NVDRS) since 2014. This

surveillance system collects information from three data sources to obtain a more complete understanding about the circumstances that contribute to violent deaths in Iowa. Last June, Iowa completed entry on 2015 deaths that occurred in the seven largest counties. Beginning in 2016 and going forward, violent deaths from all counties in Iowa will be included.

A snapshot of the number and types of deaths is provided in the table below.

A Publication of the IDPH Bureau of Substance Abuse

Treatment Outcomes in IowaThe Consortium for Substance Abuse Research and

Evaluation (Consortium) has worked on the Outcomes Monitoring System project (OMS) for IDPH since 1999. The OMS project provides an independent evaluation of substance use disorder treatment outcomes in Iowa. Research assistants at the Consortium conduct follow-up interviews with randomly selected clients from IDPH- funded treatment agencies approximately six months after discharge from treatment. Of those admitted to treatment in 2016, alcohol and methamphetamine were the most common primary substances at admission (33% and 32% respectively), followed by marijuana (27%).

In general, treatment outcomes were very positive. Over 58% of the clients reported arrests at admission, whereas less than 15% reported arrests at follow-up. Fewer than half of the clients were employed at admission; however, over two-thirds of clients indicated employment at follow-up. Hospitalizations for substance use problems were reduced by over half during the follow-up period. There were statistically significant associations between discharge status and outcomes at follow-up: clients who were successfully discharged were more likely to be abstinent and arrest-free in the six-months after discharge and employed at follow-up. Many of the annual OMS reports, trend and special reports are freely available for public viewing here: http://iconsortium.subst-abuse.uiowa.edu/Projects/OMS.html.

Because the vast majority of violent deaths in Iowa are suicides, the program Advisory Committee recommended that a special report on suicide deaths be done. This report is published on the program webpage (https://idph.iowa.gov/disability-injury-violence-prevention/iavdrs). A few findings are described below, taken from the CY2015 data: Suicides accounted for 75% of the violent deaths in Iowa in 2015. Males accounted for 70.1% of suicide deaths and females accounted for 29.9% of suicide deaths in 2015. Asphyxiation was the manner of death in 43.1% of suicides, followed by firearm use (33.9%), and poisoning (19.0%). The age group with the largest proportion of suicide deaths was people ages 45-64 (35% of the deaths). Young adults (ages 25-44) comprised 33% of suicide deaths and youth (ages 10-24) comprised 23%. Older adults (65 years or older) were 9% of all suicide deaths. The most frequently cited circumstances for all ages were depressed mood (83%), mental health problem (54%), history of mental illness treatment (42%), history of suicidal thoughts (37%), suicide note left (32%), intimate partner problem (29%), current mental illness treatment (28%), history of suicide attempt (27%), suicide intent disclosed (25%), and argument (24%). There were some differences by age groups related to circumstances.

These included: 43% of youth ages 10-24 disclosed their intent prior to the suicide, compared to only 25% in young adults and 20% in the middle-aged group. Older adults did not disclose an intent prior to the suicide. 47% of older adults left a suicide note; whereas only 30% of youth did. Intimate partner problems contributed to more circumstances among youth and young adults than to those in the other two age groups. As more cases are completed in the system each year, analysis will help identify strategies that can be used to prevent these deaths. Knowing the high correlation of depression and other mental health problems underlies the importance of effective depression screening in medical settings and the need to properly assess suicide risk. Other strategies include ways to restrict means access. For questions, contact Violence Prevention Coordinator, Tiffany Conroy at Tiffany.Conroy@idph.iowa.gov.

Iowa Violent Death Reporting System & Overview of Suicide Report

Year Suicide Homicide Undetermined Unintentional Firearm

Total

2015 174 46 13 1 2342016 471 85 53 10 6192017* 378 89 36 0 503

Percent** 75.4% 16.2% 7.5% 0.8% 1,356* As of 12/04/17 ** Average percent of total deaths

Important

information!

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 2018

2012 2013 2014 2015 2016 2017Men 3,959 4,670 5,090 5,413 5,605 5,951Women 3,163 3,680 4,054 4,098 4,565 4,910

0

2,000

4,000

6,000

8,000

10,000

12,000

Num

ber

of A

dmis

sion

s

Fiscal Year

Any Mention of Methamphetamines at Admission

8

Admissions to SUD treatment related to methamphetamine (any mention) have increased by approximately 50% from fiscal year 2012 to 2017,

totaling more than 10,000 mentions in 2017.

Take Note:

Important

information!

Admissions to Substance Use Disorder treatment related to methamphetamine (any mention) have increased by approximately

50 percent from fiscal year 2012 to 2017 totaling more than 10,000 mentions in 2017. This increase does not appear to be tied to gender vs. sex, as admissions for both men and women have increased similarly (see graph below). IDPH continues to monitor this trend and will be digging deeper into the data to attempt to identify what may be fueling this increase in methamphetamine-related treatment admissions and answer why here and why now.

Meth Treatment Increases

Save the Date - Training“Tour of Motivational Interviewing” through Addiction Technology Transfer Center (ATTC): www.TourofMI.org Thursday, June 30, 2016, through Monday, December 31, 2018 http://www.healtheknowledge.org/.

What They Never Taught You in School About Substance Use, Addiction, Opioid Use Disorder: January 18 or January 19, 2018 - Coralville, Iowa.Description: This training will cover the biopsychosocial aspects about substance use, Opioid Use Disorder and addiction and how to assess and intervene. The ASAM Criteria: Treatment Criteria for Addictive, Substance- Related, and Co-Occurring Conditions will help participants understand how levels of addiction treatment are determined, information to consider as prescribers who are determining opioid prescriptions, and the resources of treatment.Audience: Physicians, Physician Assistants, ARNP, Dentists, Pharmacists, Social Workers, Substance Abuse Providers, Nurses https://www.trainingresources.org.

Substance Abuse Prevention Skills Training (SAPST)Feb. 28 - March 1, Part 1, March 28-29, Part 2Register at www.counterdrugtraining.comThe goal of the SAPST is to assist professionals in the field to gain understanding of prevention principles and the application of evidence-based prevention strategies and programs.

Veteran’s Memorial-Community Choice Credit Union Convention Center, Des Moines, IA

Keynote Speakers: Corey Waller, Kevin Hill Early Registration: $140

Registration to open mid-February at www.trainingresources.org Contact becky@trainingresources.org for more information

Sponsored by the Iowa Department of Public Health, Division of Behavioral Health

41st Annual Governor’s Conference on Substance Abuse

APRIL18

WEDNESDAY

APRIL

19THURSDAY

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 20189

Impact of Brain Injury This article is the second in a series on brain injury and substance use.

Approximately one out of five people who have sustained a brain injury will also have some form

of problematic substance use. Having a brain injury can make it difficult for individuals to receive appropriate rehabilitation due to social, cognitive and behavioral changes related to their brain injury.

There are common characteristics of brain injury that can lead to an individual as being labeled as “difficult” or “non-compliant” in treatment or other settings. Some of these characteristics are similar to characteristics of substance use, such as having difficulty remembering, difficulty with balance and coordination, mood swings, personality changes, slurred speech, difficulty with organization and planning, and impulsive behavior.

Because no two brain injuries are exactly alike, it is helpful to have information about the part of the brain that was injured to better understand the injury’s impact on the individual.

The brain is made up of four lobes of the cerebrum (frontal, parietal, temporal and occipital), the cerebellum and brain stem. Each area can be associated with particular function of the brain. It is also important to remember that an injury to the right side of the brain will impact the left side of the body, and vice versa. Knowing more about the individual’s brain injury, including the area of the brain that was injured and injury’s severity, can provide insight into the cognitive, physical, emotional and behavioral challenges the individual might experience.

The following illustration lists the function or behavior associated with each area of the brain:

The Brain Injury Alliance of Iowa has information and training available for individuals and providers who are interested in learning more about brain injury, including their brain injury informational kit (also known as the brain injury “tote bag”). Visit their website at www.BIAIA.org or call 855-444-6443. For more information and support on brain injury, please contact Maggie Ferguson, IDPH Brain Injury and Disability program manager at 515-281-8465 or by emailing Brain.Injury@idph.iowa.gov.

1 in 5 people who

have had a brain

injury will also

have a form of

substance abuse.

Important Note!

For more information about the IDPH Bureau of Substance Abuse, visit http://idph.iowa.gov/bh. For questions related to “A Matter of Substance,” contact the editors: Cara Weis: Cara.Weis@idph.iowa.govJanet Nelson: Janet.Nelson@idph.iowa.gov Lori Hancock-Muck: Lori.Hancock- Muck@idph.iowa.gov

“What Do You Throw Away” Media Campaign Update Since 2010, IDPH has supported and disseminated an

underage drinking prevention media campaign called “What Do You Throw Away.” The campaign has been used by a variety of agencies and states and has won several national awards. The campaign focuses on messages shared by Iowa youth regarding what you can throw away if you drink. These messages were listed on bottle caps.

The campaign was recently updated to include new graphics on beer cans. A variety of new materials are now available, including a television commercial, radio ads, billboard copy, posters and social media ads. The new commercial can be found at https://youtu.be/Qketn7FQjuk and the campaign website can be found at www.what-doyouthrowaway.org. If you would like to access the campaign materials to use in your community, contact Julie Hibben at Julie.Hibben@idph.iowa.gov.

WHAT GETS CRUSHED WHEN YOU DRINK?Underage drinking comes at a cost.

You have some pretty awesome hopes and dreams for your life. Don’t pour them down the drain by drinking when you’re underage. It’s just not worth it.

whatdoyouthrowaway.org

Important

information!

A Matter of SubstanceA Publication of the IDPH Bureau of Substance Abuse

A Matter of Substance • January 2018

UCS Healthcare’s Unique Approach to Offering Walk-In Assessments for Substance Use Disorder and Mental Health Therapy

Seven years ago, UCS Healthcare made an organizational shift that allowed walk-in, on-demand assessment and

immediate entry into substance use disorder treatment. Recently, because of the success of this process, UCS has applied it to mental health care assessments on a walk-in basis as well.

Why walk-ins?UCS Healthcare, based in Des Moines with locations in Ankeny and Knoxville, has provided services in central Iowa for more than 20 years. The non-profit health care clinic specializes in substance use disorder treatment including medication assisted treatment, mental health therapy, psychiatric care and primary medical care. UCS saw the opportunity for walk-in assessments in 2010 based on several factors.

“Our no-show rates were high for appointments,” said Mike Polich, chief executive officer and executive director, UCS Healthcare. “Our counselors were frustrated because we knew patients were not receiving the care they needed. We thought walk-ins could be the answer, but we had to change our schedules and processes system-wide to accommodate this shift.”

After making the decision to provide walk-in assessments, the team at UCS tried and adapted several different approaches over the last seven years.

Team Day: Two years ago, UCS implemented a Team Day approach. Each day, two counselors are assigned to walk-in assessments. All other counselors have scheduled sessions and take walk-ins if an appointment cancels. This method works well for UCS – the Team Day counselors have back up support and patients spend less time waiting. Today, UCS Healthcare offers walk-in assessments Monday – Friday from 9 a.m. to 4 p.m.

What we learnedAs with any change, some team members were resistant to accommodating walk-ins at first, as it meant uncertainty in their schedules. It was important to listen to concerns and ideas. The projected long-term benefits of the walk-in process were apparent. However, without continual discussions and buy-in along the way from patients, counselors and stakeholders, implementing the walk-in process could have caused more harm than good.

“I can’t say enough about the commitment modeled by our team during this process,” said Polich. “Our walk-in process was adapted over a period of seven years. The team took complete

Provider Spotlight:ownership of making it work because they saw the benefits for our patients and for our agency.” Benefits of walk-in assessmentsOverall, UCS has realized multiple benefits of serving walk-ins. Counselors focus on intakes and crisis services on their Team Day and on treatment delivery for existing patients on non-team days. This reduces burnout of counselors because of schedule consistency.

The UCS Patient Support Services team knows exactly which counselors are available, reducing uncertainty and unnecessary churn in getting patients served. New patients are able to be assessed and start treatment the same day versus making a return trip or setting up another appointment.

Counselors at UCS receive incentives based on productivity. Throughout the week, counselors are able to fill their schedule with walk-ins in the event scheduled appointments don’t show up or cancel at the last minute. This assists Team Day counselors to manage the patient flow, helps UCS reduce patient wait times and reduces overall stress.

An unintended but important side effect of the Team Day walk-in process is the pride and teamwork fostered across providers. When UCS manages a high number of walk-ins on a given day and available counselors jump in to help the designated team, virtual and literal high-fives ripple through the halls at UCS.

The measurements tell the story. In December 2015, the average number of monthly assessments was 105. After one year using the Team Day model, the average was 126 patients assessed each month, a 20 percent increase.

Applying the process agency wide Now that UCS has implemented the Team Day approach to walk-ins for patients seeking substance use disorder treatment, the clinic tests the model on other programs within its integrated service offering. Patients may be assessed for substance use disorder, see a physician, update needed prescriptions, schedule a psychiatric appointment and attend their first group therapy session all on the same day. Recently, the UCS Healthcare licensed mental health therapists started using the approach to patients seeking mental health assessments on a walk-in basis.

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The measurements tell

the story. After one

year using the Team

Day model there was

a 20% increase.