DOC Vivitrol Pilot. Program Goals Identified. Cross Divisional Committee. Cross Division Committee Work: Work Continued

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Dorthy Gilmore
5 years ago
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DOC Vivitrol Pilot 2015/17 biennium budget provided 1.6 million dollars to allow the department to create an opiate addiction program with the key component being Vivitrol.

Cross Divisional Committee Member included staff from the Divisions of Adult Institutions, Community Corrections, Management Services and Reentry.

1 DOC Vivitrol Pilot 2015/17 biennium budget provided 1.6 million dollars to allow the department to create an opiate addiction program with the key component being Vivitrol. Cross-division committee was created to gain education regarding this intervention and to implement utilizing best practice. Cross Divisional Committee Member included staff from the Divisions of Adult Institutions, Community Corrections, Management Services and Reentry. Multi-disciplinary representation included program providers, medical staff, community corrections staff, budget staff. Work began in August Program Goals Identified Pilot participants receive AODA treatment and medication assisted treatment to abstain from opiate use Reduce number of AODA-related probation violations Decrease incidence of opioid-abuse relapse Reduce recidivism rates of program participants Decrease rates of overdose among program participants Cross Division Committee Work: Gathered information about the medication Gathered information about therapy Discussed policies and procedures that already exist Analyzed the current population/need in DOC Decided on a target population to fit the budget Discussed contracted services in the community Work Continued Held a vendor conference to solicit community providers Lengthy discussion about data collection/procedure Community providers contracted for services in the pilot Discussed and developed training for all areas impacted by the pilot in DCC and DAI 1

2 Pilot Program Begins April 2016, the first injection was given to a DCC offender The first month, there was 7 participants that received their first injection Who can participate? Program initiation can happen while still in prison, on community supervision or releasing from a county jail to community supervision Participants must volunteer and may withdraw at any time Anyone on supervision in Region 4 with an identified opiate addiction. Inmates completing ERP releasing to Region 4. Inmates releasing to Region 4 from KMCI, TCI, FLCI, RGCI, WCC and OSCI Additional Requirements: High motivation for abstinence. Current opiate user or history of use. Commitment to treatment while receiving injections (NON-NEGOTIABLE) Cooperate with weekly drug tests Weekly meetings with agent when on supervision DAI initial process Inmates are screened by case manager Inmates with an opiate history are informed about vivitrol and given handouts Inmate is given the opportunity to volunteer After a level of interest is confirmed a referral for medical clearance is completed for HSU and the Agent of Record is notified. Inmate is then assigned a vivitrol agent for continued community follow-up (CONTINUED) DAI initial process (CONTINUED) When the exam is complete, the status of that exam is documented and the Social Worker is informed A release of information is signed for the community vendor First injection is scheduled for several days prior to their scheduled release date Agent Responsibility Make appropriate referrals to treatment to ensure they begin ASAP upon initiation of the program or release from DAI Supervise offenders at an enhanced supervision level which requires weekly drug testing, meetings with agents and various other collateral contacts Provide transportation to the first community injection appointment 2

Vivitrol Supervision Mandatory ENS supervision for first 120 days Max for 120 days Medium for 120 days UAs required WEEKLY during ENS and bimonthly for duration (regardless of supervision level) UAs

3 Vivitrol Supervision Mandatory ENS supervision for first 120 days Max for 120 days Medium for 120 days UAs required WEEKLY during ENS and bimonthly for duration (regardless of supervision level) UAs confirmed through tx provider or clinic are acceptable Must be noted in COMPAS Response to Violations They will happen. Respond to them in an evidence basedmanner (VSG) Things to look out for: Meth use, increased or new Test-runs (using opiates one last time to see if the shot really works. It does.) Violations cont. ANY OPIATE USE WHILE ON VIVITROL IS SERIOUS Offenders will not experience a high, but the drug is still in their system. Tolerance will already be lower, especially if they were incarcerated prior to their injection, or they have received several and not used. They will overdose and die, without feeling any effect from the drug. Data Collection Participant demographics Number of injections Participation in treatment Program Completion/termination and withdrawal Risk Level DAI vs DCC Participation by county 3

4 DAI Data DCC Data 4

5 2018 Jail Health Care Conference DAI & DCC Combined Data 5

Completion of Program Offenders are considered graduates of the Pilot once they have received 12 injections and successfully completed counseling.

6 Completion of Program Offenders are considered graduates of the Pilot once they have received 12 injections and successfully completed counseling. Agents should work with offenders to continue ongoing services upon completion. First Graduation Ceremony was 06/12/2017 Lesson Learned Establish data collection procedure early Involve front-line staff Develop entrance criteria in conjunction with defining target population to ensure highest success rate of the program Build on strengths/skills staff already have from drug court, etc. Contract community providers earlier establishment Establish Medicaid and Medicare process 6

Barnstable County Sheriff s Office. Vivitrol Pre-Release Program. Dr. Steven Descoteaux, MD Director of Health Services

Barnstable County Sheriff s Office Vivitrol Pre-Release Program Dr. Steven Descoteaux, MD Director of Health Services Jessica Burgess,MSN, RN Assistant Director of Health Services Gail Dufault, LPN Transitional