PANEL DISCUSSION FACILITATED BY KAREN AMON, JOHN KRONECK AND KARI GULVAS

SEPTEMBER 17, 2013

Recovery and Integrated Services – Taking It to the

Streets

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

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

Brief History of Us

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

RCA SUD Side BABH MH Side

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”

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.

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!!!!!!

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

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

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

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

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

Lessons Learned

Active and conscious effort to continuously evaluate

Formal system processes are necessary

Having the right people in leadership

Leaders provide empowerment – guidance

“Taking It to the Streets”

Enhancing Recovery in Montcalm County

Isabella County

Mecosta County

Newaygo County

Kent County

Ionia County

Gratiot County

Clinton County

Montcalm

Call for Pilot Projects

Joint Venture

Regional Recovery & Integrated Systems of Care

Recovery Community Cherry Health Promotion

ServicesNorth Kent Guidance

ServicesWedgwood Christian Services

Strategic Prevention FrameworkAssessment:Profile population needs, resources, and readiness to address needs and gaps.

Capacity:Mobilize and/or build capacity to address needs.

Planning:Develop a comprehensive strategic plan.

Implementation:Implement evidence-based prevention programs and activities.

Evaluation:Monitor, evaluate, sustain, and improve or replace those that fail.

A SAMHSA Best Practices Model

Sustainabili

ty &

Cultural

Competenc

e

STEERINGCOUNCIL

STEERINGCOUNCIL

RCA & SERVICEPROVIDERS

RCA & SERVICEPROVIDERS

VOLUNTEERSVOLUNTEERS

RECOVERYCOMMUNITYRECOVERYCOMMUNITY

LOCAL COMMUNITYLOCAL COMMUNITY

FUNDINGFUNDINGSUPPORTSUPPORT

RESOURCESRESOURCES

RELATIONSHIPSRELATIONSHIPS

FAMILIESFAMILIES

PEOPLE IN RECOVERYPEOPLE IN RECOVERY

EXTENDED COMMUNITYEXTENDED

COMMUNITY

FUNDINGFUNDING

RESOURCESRESOURCES

RELATIONSHIPSRELATIONSHIPS

SUPPORTSUPPORT

Montcalm RISC Goals

Community

Resource Mapping

Transitional Housing

Coordination of

Services and

Resources

Education in

the Communi

ty

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

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

Goal 2: EDUCATION IN THE COMMUNITY

Objective 1: Resource Networking

Objective 2: Perform a Public Education Strengths and Gaps Analysis

Goal 2: EDUCATION IN THE COMMUNITY

Objective 1: Resource Networking

Objective 2: Perform a Public Education Strengths and Gaps Analysis

Goal 4: TRANSITIONAL HOUSING

Objective 1: Develop Women’s Transitional Housing Availability

Objective 2: Identify Recovery-Friendly Landlords and Funding Options for Housing Needs

Goal 4: TRANSITIONAL HOUSING

Objective 1: Develop Women’s Transitional Housing Availability

Objective 2: Identify Recovery-Friendly Landlords and Funding Options for Housing Needs

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

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

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).

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.

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”).

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.

Resource Mapping Model

Substance use literature identifies four primary categories of support that are instrumental in recovery:EmotionalInformationalInstrumentalAffiliation

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.

Resource Mapping Model

The map creation process involvedUtilizing the model’s four main categories as a foundationDeveloping resource subcategories for each categoryIdentifying specific resources

for each subcategoryRequesting ongoing input

and feedback from the community.

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)

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).

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).

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).

Resource Map Category Summary

Resource Maps

To view the map for each category, click on the desired button below:

Resource Booklet

Next Steps

Distribution and awarenessMaintenance planCollecting feedbackAdvocacy for new resourcesEmployment 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).

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.

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 Gulvaskgulvas@babha.org(989) 497-1384

Resource Map

Each map is color coded by subcategory.

Resource Maps

Clicking on one pin displays the resource details

Resource Map

Clicking on the resource title takes you to the resource website

Resource Map

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

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.

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.

Case Example

Case Example

Case Example

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.

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 Gulvaskgulvas@babha.org(989) 497-1384