Recovery Program Transformation & Innovation Fund

Transcription

1 College of Social Work University of South Carolina Recovery Program Transformation & Innovation Fund Semi-Annual Report of Program Implementation by Funded Agencies April 2017 Williams, L., Petiwala, A., DeHart, D., Iachini, A., & Browne, T. (2017). Recovery Program Transformation and Innovation Fund: Semi-annual report of program implementation by funded agencies. Submitted to South Carolina Department of Health and Human Services. Columbia, SC: University of South Carolina, College of Social Work.

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3 CONTENTS OVERVIEW OF THE RECOVERY PROGRAM TRANSFORMATION & INNOVATION FUND INITIATIVE FUNDED PROJECTS BY PRIORITY AREA 5 Priority Area 1: Improving Service Access Priority Area 3: Enhancing Collaboration and Integration of Services 2015 FUNDED PROJECTS BY PRIORITY AREA 8 Priority Area 1: Collaboration and Integration of Services Priority Area 2: Workforce Development Priority Area 3: Re-application or Supplemental Funds 2015 Mini-Grant Initiative 2016 FUNDED PROJECTS BY PRIORITY AREA 12 Priority Area 1A: Medication Assisted Treatment Priority Area 1B: Integration of Behavioral Health Services Priority Area 1C: Adolescent/Family Services Priority Area 1D: Infrastructure Investment UNIVERSITY OF SOUTH CAROLINA TECHNICAL SUPPORT TEAM ACTIVITIES 15 RPTIF ACCOMPLISHMENTS BY THE NUMBERS 16 CONCLUSIONS 17 Recovery Program Transformation & Innovation Fund iii

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5 OVERVIEW OF THE RECOVERY PROGRAM TRANSFORMATION & INNOVATION FUND INITIATIVE The Recovery Program Transformation & Innovation Fund (RPTIF) is a collaborative initiative designed to support innovative projects that enhance addictions treatment and recovery services in South Carolina (SC). Funds from this initiative stem from SC lawsuits against pharmaceutical firms for misrepresentation, violation of regulations, etc. The state has allocated the funds toward evidence-based projects that address substance use treatment and recovery needs within communities. Through RPTIF, the Department of Alcohol and Other Drug Abuse Services (DAODAS) funds projects throughout SC, in partnership with the Department of Health and Human Services and the University of South Carolina, College of Social Work (USC CoSW). The RPTIF initiative began with proposal requests in 2013, funding eleven projects in the winter of Support was awarded to projects in three service areas: increasing service access, increasing service engagement, and improving collaboration and integration of services. Round 1 projects received funding for months and concluded in Project Counties: $1.8 million awarded Counties with 1 project: Greenville, York, Clarendon, Marlboro, Dillon, Marion, Horry, Charleston Counties with 2 projects: Spartanburg, Richland/Lexington Oconee Cherokee Greenville York Spartanburg Pickens Union Chester Lancaster Chesterfield Marlboro Anderson Laurens Fairfield Kershaw Darlington Dillon Newberry Abbeville Lee Marion Greenwood Richland Florence Saluda McCormick Lexington Sumter Edgefield Calhoun Clarendon Williamsburg Aiken Orangeburg Georgetown Horry Counties with 1 project Counties wtih 2 projects Barnwell Bamberg Allendale Hampton Jasper Dorchester Berkeley Colleton Charleston Beaufort Recovery Program Transformation & Innovation Fund 1

6 In 2015, Round 2 of funding was awarded to fifteen agencies to address collaboration and integration of services, workforce development, or supplemental funds for projects that were initiated in Round 1. These projects received funding for months and concluded in Project Counties: $2.2 million awarded Counties with projects: Greenville, Pickens, Anderson, Abbeville, Newberry, Saluda, Fairfield, Barnwell, Colleton, Sumter, Clarendon, Berkeley, Charleston, Florence, Horry Oconee Cherokee Greenville York Spartanburg Pickens Union Chester Lancaster Chesterfield Marlboro Anderson Laurens Fairfield Kershaw Darlington Dillon Newberry Abbeville Lee Marion Greenwood Richland Florence Saluda McCormick Lexington Sumter Edgefield Calhoun Clarendon Williamsburg Aiken Orangeburg Georgetown Horry Barnwell Bamberg Dorchester Berkeley Allendale Hampton Colleton Charleston Jasper Beaufort 2

7 Round 3 of funding was awarded in 2016; seven agencies received funds and are currently implementing their projects in the areas of medication assisted treatment, integration of behavioral health services, adolescent/family services, and infrastructure investment. These projects are ongoing and are expected to conclude this year Project Counties: $900,000 awarded Counties with projects: Berkeley, Laurens, Lexington/Richland, Orangeburg, Dorchester, Pickens, Colleton Oconee Cherokee Greenville York Spartanburg Pickens Union Chester Lancaster Chesterfield Marlboro Anderson Laurens Fairfield Kershaw Darlington Dillon Newberry Abbeville Lee Marion Greenwood Richland Florence Saluda McCormick Lexington Sumter Edgefield Calhoun Clarendon Williamsburg Aiken Orangeburg Georgetown Horry Barnwell Bamberg Dorchester Berkeley Allendale Hampton Colleton Charleston Jasper Beaufort Recovery Program Transformation & Innovation Fund 3

8 In this report, we provide a brief summary of impacts from the RPTIF initiative in Rounds 1, 2, and 3. A cumulative summary of accomplishments is provided at the conclusion of the report. Oconee Cherokee Greenville York Spartanburg Pickens Union Chester Anderson Laurens Fairfield Abbeville Greenwood McCormick Newberry Lancaster Chesterfield Marlboro Kershaw Darlington Dillon Lee Marion Richland Florence Saluda Lexington Sumter Edgefield Calhoun Clarendon Williamsburg Aiken Orangeburg Georgetown Horry ROUND 1 ROUND 2 ROUND 3 Barnwell Bamberg Allendale Hampton Jasper Dorchester Berkeley Colleton Charleston Beaufort 4

9 2014 FUNDED PROJECTS BY PRIORITY AREA RPTIF Round 1 projects were funded in 2014 to address three priority areas: improving service access, improving service engagement, and enhancing collaboration and integration of services. Here we describe the impact demonstrated in final agency project reports and in follow-up site visits completed by the USC Technical Support Team. More detailed descriptions of each project can be found in the 2015 RPTIF Annual Report. Priority Area 1: Improving Service Access Three agencies implemented projects in the priority area of improving service access. Clarendon County Behavioral Health Services partnered with Clarendon Memorial Hospital and Hope Health to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT) services. Forrester Center for Behavioral Health (formerly Spartanburg Alcohol and Drug Abuse Commission (SADAC)) collaborated with the Spartanburg Detention Center to implement SBIRT screenings. When it became evident that the offering of additional services was beneficial, Forrester began a women s day treatment program. Trinity Behavioral Care upgraded technology services to connect staff and coordinate treatment between county offices. A new phone system and videoconferencing equipment were included in the upgrades. Projects in this service area experienced multiple successes, which included strengthening agency connectedness through updated technology as well as screening thousands of clients to determine the severity of their substance use. Several projects also resulted in strengthened collaboration with partnering agencies. A challenge experienced among the SBIRT projects was ensuring that clients who were referred to treatment actually engaged in treatment services. To aid in a smooth referral process, agencies utilized technology to remind clients of their treatment appointments. Within the detention center, it was found that an on-site clinician with knowledge of other community agencies aided center staff and inmates/clients in navigating the referral process. SBIRT projects were implemented in multiple settings, with success in screening a large number of individuals for substance use. Establishing procedures for tracking screening and referral rates is an important consideration for ongoing efforts. Recovery Program Transformation & Innovation Fund 5

10 Priority Area 2: Improving Service Engagement One agency implemented a project within the priority area of improving service engagement of clients and families. Lexington Richland Alcohol and Drug Abuse Commission coached family members to support their loved ones in the Community Reinforced Approach to Family Treatment (CRAFT) program. Agency staff relate the success of the project to having the ability to initiate the project on a small-scale at one location. This approach provided clinicians with CRAFT therapy model training, after which they were able to identify potential barriers before implementation at both settings took place. Staff also received training that included coaching and taped sessions on implementation of the model. The agency observed that the therapy model requires that individuals seeking treatment and their families both engage in services, which can present a challenge. Family engagement plays an important role in agency services. Agency staff recommended that future projects offer family services on a small scale before expansion occurs. Priority Area 3: Enhancing Collaboration and Integration of Services Six agencies were awarded funding for enhancing collaboration and integration of services. Several of these built on existing efforts to develop family care centers (FCCs) across the state. Keystone Substance Abuse Services initially used funds to enhance substance use treatment services through York County s Family Care Center and hired three Peer Support/Substance Abuse Specialist for the project. However, the FCC model was not viable. After closing the FCC, staff and peer support services were merged with Keystone s existing women s programs. Forrester Center for Behavioral Health originally collaborated with Glenn Springs Academy to develop a FCC. Again, the FCC model was not viable. Following the closing of the FCC, Forrester developed a day treatment program for women which offered individual, group, and family therapy. 6

11 The Phoenix Center constructed a building to contain the Family Recovery Center at Serenity Place, the agency s residential treatment center. The facility also provided peer support services, parenting education, educational services, and case management programs. Shoreline Behavioral Health Services strengthened their relationship with Horry County Department of Social Services through establishing a liaison position. The goal of this position was to aid in improving services for families who were at risk of separation. Lexington Richland Alcohol and Drug Abuse Commission partnered with Epworth Children s Home, Richland and Lexington county social services, and additional agencies to enhance their FCC model of treatment. To provide additional support for women in the FCC program, peer support staff were hired. Charleston County Department of Alcohol and Other Drug Abuse Services collaborated with the Jenkins Institute for Children and DSS to execute an FCC model. The FCC was not viable and closed after the end of the RPTIF funding period. There were multiple successes as a result of implementing projects in this priority area, which included strengthening partnerships with community organizations and increasing program space to provide treatment support to women and children. All of the projects focused on improving women s programming services. However, many of the projects experienced considerable challenges, particularly in partnering for development of FCCs. Partnering agencies found it difficult to outline roles and responsibilities that supported the missions and goals and accountability structures of each participating organization. Establishing strong lines of communication and anticipating barriers early in the process may support stronger, more manageable partnerships. The expansion of women s treatment services was challenging for some integration and collaboration projects. The establishment of clear roles and open communication during the early stages of planning may support similar efforts in the future. Recovery Program Transformation & Innovation Fund 7

12 2015 FUNDED PROJECTS BY PRIORITY AREA Agencies funded in 2015 are wrapping up their projects in the priority areas of collaboration and integration of services, workforce development, and re-application or supplemental funds. Here, we provide a brief overview of each funded project, as well as progress thus far. Priority Area 1: Collaboration and Integration of Services Projects funded in 2015 (RPTIF Round 2) derived from three priority areas: collaboration and integration of services, workforce development, and re-application or supplemental funds. The 2016 RPTIF Annual Report provides more detailed descriptions of each.. Cornerstone Commission on Alcohol and Drug Abuse increased its capacity to meet the needs of the community by building a new facility. SBIRT services were also implemented with inmates at the Abbeville Detention Center, and a clinical counselor was hired to meet agency growth demands. Ernest E. Kennedy Center enhanced communication and collaboration by making technological improvements in two office locations. Circle Park Behavioral Health Services improved the agency-wide technology infrastructure to strengthen administrative organization, increase communication with the Chrysalis Center Women s Residence, and enhance overall service delivery. Westview Behavioral Health Services implemented Step Up 2 Success, through which adults and youth, who were involved with the criminal justice system, increased their self-awareness and problem-solving skills. Through program activities, caregivers of minors also gained a better understanding of adolescent growth processes and tools to support their children. Behavioral Health Services of Pickens County partnered with the Department of Social Services to implement Recover Together, providing 8

13 substance use counseling, in-home support, and community referrals to families, some of whom were at risk of losing custody of their children. Saluda Behavioral Health System extended their Safe Schools/Healthy Students program services, which provide mental health treatment to students and families in the community. The program also extended support to the community s Hispanic population by hiring a bilingual social worker. Accomplishments within this priority area included increasing the ability to communicate and deliver services through technology, providing parents with tools that strengthened their caregiving skills, and serving as both a referral source and treatment provider for incarcerated inmates with substance use issues. Collaborations that were strengthened through project implementation were especially helpful in extended service access to rural populations. Infrastructure projects provided technology tools to agencies that enhanced agency reach and accessibility for clients. Future efforts might plan for timeline delays that often occurred with such projects. Priority Area 2: Workforce Development Anderson-Oconee Behavioral Health Services installed new technological hardware and software to increase its ability to train staff and provide clinical supervision across two office locations. Axis I Center of Barnwell provided staff and partnering agencies with career development and self-care opportunties through the Professional Learning Community and workshops. The project also funded capital improvements to the facility, which increased the agency s capacity to serve clients. Charleston Center improved their workforce through training and licensure opportunities for staff. The clinical skills of workforce members were further enhanced via evidence-based trainings, which included Trauma-Focused Cognitive Behavioral Therapy and Motivational Interviewing. Recovery Program Transformation & Innovation Fund 9

14 Clarendon Behavioral Health Services partnered with the Williamsburg County Department of Alcohol and Drug Abuse to provide employees with training, financial incentives, and self-care activities. Clinical and support staff increased their knowledge and skills for the benefit of both clients and agency operations. Colleton County Commission on Alcohol and Drug Abuse supported clinical and administrative staff to increase their education and certification levels. Clinicians reported learning strategies for empowering their clients. The Phoenix Center increased the competency of counselors through Motivational Interviewing training to approximately 100 clinicians in upstate South Carolina. Agency staff reported mastering these skills is helpful in strengthing counselors engagement with clients. Priority Area 3: Re-application or Supplemental Funds Fairfield Behavioral Health Services created Brighter Day, an intensive outpatient treatment program. In addition to creating a care/reoccurance plan, clients participated in life skills lessons and peer recovery support. Shoreline Behavioral Health Services collaborated with the Department of Social Services and implemented the Child Welfare Cross-System Process Improvement Initiative. This approach provided staff at both agencies with cross training that increased the skills of staff and provided them with resources to better support clients with substance use disorders. Sumter Behavioral Health Services provided more services to clients and strengthened their relationship with partnering agencies through hiring additional staff members. Capital improvements to their residential facility were also completed, which assist in delivery of eduational and family-building programs to clients. 10

15 Accomplishments made within this priority area included increasing collaboration with partners, supporting staff skill and knowledge building through training, and implementing an intensive outpatient treatment program. Though collaboration can be challenging for providers, it yields great benefits for the individuals and families in the community. When implementing workforce development opportunities, leaders should exercise flexibility with work schedules to support staff in their professional development efforts. Workforce development projects provided staff with professional development opportunities to increase knowledge and skills. Future efforts might identify in-house trainers to sustain teaching efforts Mini-Grant Initiative The Mini-Grant Intiative was intiated in 2015 and supported eight agencies with strong potential projects that needed some refined planning. Through Community of Practice (CoP) meetings and on-site support, the USC Technical Support team aided agencies in refining their grant proposals. Three CoP meetings were held with all Mini-Grant agencies and focused on working together across agencies to review and refine their ideas across each step of planning a grant proposal. Topics addressed included developing a strong problem statement, researching and using data to support project need, and developing sustainability and evaluation plans. During this extended planning period, these organizations received a small amount of funding to hire consultants, cover travel expenses for CoP meetings, and/or provide staff release time. The vast majority of agencies received funding for their Round 2 projects following their participation with the Mini-Grant Initiative. Recovery Program Transformation & Innovation Fund 11

16 2016 FUNDED PROJECTS BY PRIORITY AREA Agencies funded in 2016 are currently in the process of implementing their projects in the priority areas of medication assisted treatment, integration of behavioral health services, adolescent/family services, and infrastructure development. There were no projects funded in the expansion grant priority area Priority Area 1A: Medication Assisted Treatment Priority Area 1A focuses on medication assisted treatment services. One agency is implementing a project in this area. Colleton Commission on Alcohol and Drug Abuse (CCADA) is enhancing Medication Assisted Treatment (MAT) practice within the community and implementing a Continuum of Care process to support patients engaging in opioid recovery. They are collaborating with a physician and Carolina Medical Center to enhance the MAT practice while promoting CCADA behavioral health services for opioid use disorders. The agency also will develop a continuum of care to support patients in opioid recovery. Within the early stages of implementation, CCADA has completed over 100 service hours, developed a client recovery group, designated a Certified Addictions Counselor to provide services to MAT clients, and ensured that all staff have completed medication training. Priority Area 1B: Integration of Behavioral Health Services Priority Area 1B focuses on strengthening behavioral health services or recovery support to adults through partnerships with criminal justice, healthcare, or insurance providers. Two projects received funding in this area. 12

17 Behavioral Health Services of Pickens County partnered with the Pickens County Sherriff s Office and Anderson-Oconee-Pickens Department of Mental Health to offer services to offenders with substance use and mental health issues. These services require consultation with county judges, defense attorneys, and municipal court staff. The agency hopes that individuals who need services will engage in treatment prior to, during, and post-incarceration. Since implementing the program, several detainees have sought treatment following a release. Behavioral Health Services of Pickens County continues to build strong relationships with stakeholders and educate the criminal justice community on the importance of these services for positive long-term outcomes. GateWay Counseling Center discovered that half of their clients do not have a primary care provider and that the top two diagnoses given at Laurens County Community Care Center (LC4) are behavioral health related. To address these concerns, the two agencies have partnered to create three workforce positions, including a Behavioral Health Therapist, a Licensed Practical Nurse, and a Navigator. Through the inter-agency collaboration, it is anticipated that GateWay clients will have access to basic healthcare services, while LC4 patients will gain access to behavioral health services. During the project, staff will also increase their knowledge and skills by receiving training in mental health recognition, diagnosis, and treatment. Priority Area 1C: Adolescent/Family Services Priority Area 1C is for agencies that have involved schools, juvenile justice, social services, or housing services in providing behavioral health or recovery support initiatives to youth. Two projects received funding in this area. The Ernest E. Kennedy Center observed that staff needed additional experience in working with adolescents with substance use disorders. Sixteen days of staff and community training were offered, such as Modified Interpersonal Group Psychotherapy, Motivational Interviewing, Family Therapy, and Art Therapy. In addition to agency practitioners, Berkeley County school district counselors, parents, and children are also participating in trainings. Agency leaders have noted positive results from trainings thus far, and employees are applying learned skills in their work with families. Recovery Program Transformation & Innovation Fund 13

18 Lexington Richland Alcohol and Drug Abuse Commission recognized that families involved with the Department of Social Services (DSS) face multiple barriers to successful outcomes and therefore are implementing Peer Support for DSS-engaged clients. Through providing vulnerable families with additional support to navigate DSS involvement and substance use treatment, LRADAC hopes to enhance client access to services, improve client engagement outcomes, and decrease barriers to success. LRADAC will utilize two clinical counselors to adapt a parenting group curriculum and to provide clients with case management, screening, and assessment services. Priority Area 1D: Infrastructure Investment Priority Area 1D supports agencies in improving the accessibility of services for clients through enhanced or added facility space or upgraded technology. Two projects are receiving funding in this area. Dorchester Alcohol and Drug Commission (DADC) will increase service engagement and address barriers to access for rural clients through upgraded technology. By collaborating with the Trident Technical College Quick Jobs Training Center for upgrades, the DADC will deliver high-quality telehealth services to a disadvantaged population at a more centralized location. The agency is hopeful that increasing accessibility and delivering services in a lessstigmatizing manner will strengthen participation in treatment services. Tri-County Commission on Alcohol and Drug Abuse is expanding access to clients through opening a centrally located office in eastern Orangeburg County. Clients who live in more rural areas often experience transportation and financial barriers to services, and the Santee Expansion will meet the needs of those individuals. Leaders anticipate strong participation rates from clients who live in these areas. Two staff members will be stationed at the new location in Santee. The site will also serve as shared space for community partners to meet with clients, which will strengthen collaboration and bridge the referral process. 14

19 UNIVERSITY OF SOUTH CAROLINA TECHNICAL SUPPORT TEAM ACTIVITIES Each year, the USC team provides direct technical assistance to agencies and disseminates information about substance use treatment and recovery and the RPTIF initiative to local, state, and national stakeholders. The USC team has showcased project accomplishments to substance use treatment providers at state and national conferences. The USC team also publishes practitioner briefs and scholarly articles to ensure that lessons learned from these projects are available to the field. Accomplishments include: 20 CONFERENCE PRESENTATIONS 6 CONFERENCE TRAININGS 8PEER-REVIEWED PUBLICATIONS WEBINARS PRACTICE BRIEFS Recovery Program Transformation & Innovation Fund 15

20 RPTIF ACCOMPLISHMENTS BY THE NUMBERS SERVICES 34 HIRED STAFF 29 UPDATED POLICIES & PROCEDURES 23 COMMUNITY PRESENTATIONS 8 NEWSPAPER ARTICLES 5,421 individuals screened to determine substance use severity 452 individuals referred to substance use treatment services or other community supports 665 clients engaged in services 16 8 TECHNOLOGY UPGRADES DATA TRACKING SYSTEMS 116 PARTNERSHIPS ESTABLISHED 116 $4.9 TRAININGS OFFERED MILLION DOLLARS AWARDED 7STAFF CERTIFICATIONS OR DEGREES RECEIVED 2PHYSICAL INFRASTRUCTURE IMPROVEMENTS 16

21 CONCLUSIONS The RPTIF initiative has successfully engaged a majority of 301 agencies across the state of South Carolina. These projects have drawn upon unique strengths of individual county agencies as well as forged links among agencies across the state. The impacts have enhanced accessibility, integration, and quality of substance abuse and recovery services, as well as provided professional development opportunities for substance abuse treatment professionals throughout the state. Support from the USC team has assisted in increasing the capacity of county agencies in planning and implementing funded projects that will benefit SC communities. As the project continues, technical support from the USC team will be focused on assisting sites in planning for sustainability of their efforts beyond the RPTIF funding period. Recovery Program Transformation & Innovation Fund 17

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24 For further information, contact: Lauren Williams, RPTIF Program Coordinator 1512 Pendleton Street Room 115 Columbia, SC rptif.cosw.sc.edu This Project was supported by contract number A A with the South Carolina Department of Health and Human Services (SCDHHS). Points of view in this document are those of the authors and do not necessarily represent the official position or policies of SCDHHS.