PEER RECOVERY COACHES IN SPECIALTY COURTS 2017 NADCP ANNUAL CONFERENCE 2017 NADCP ANNUAL CONFERENCE Ottawa County, Michigan Andy Brown; Emily Achterhof, Jane t L aing, Pris cilla Shafor; Anthony Sledge Summit County, Ohio Alex Dorman; Karli DeMell AGENDA Introductions & Overview Implementing a recovery coach program Recovery coaches! Evaluating impact and outcomes Introduction & Overview 1
OTTAWA COUNTY Rural jurisdiction with 3 population centers Population of 265,000 Demographics 86% Caucasian 9% Hispanic 5% Asian, African American, etc. ADULT DRUG TREATMENT COURT Started in 2005 100% Grant funded (state and federal dollars) Accepted over 250 participants Participant characteristics Average 2 felonies & 10 misdemeanors Acute SUD (alcohol, crack cocaine, opiates) MH symptoms (depression, borderline, bi-polar) ORIANA HOUSE INC. Oriana House provides quality and humane chemical dependency treatment and community corrections services to clients while contributing to safer communities 2
SUMMIT COUNTY FELONY DRUG COURT Turning Point Program Population Caucasian = 88% African American = 7% Other = 5% Male= 64% Unemployed= 62% Average age= 31 Offered Services Recovery Coach services VIDEOS Time for some videos! Implementing a Peer Recovery Coach Program 3
FUNDING ORIANA HOUSE Multiple funding sources due to the many different roles recovery coaches perform State Level Ohio Department of Rehabilitation and Correction City contracts in Akron Local Alcohol, Drug Addiction and Mental Health Board (ADM) funding Medicaid Beginning July 1 st 2017 Grant Funding Awarded a 3-year SAMHSA grant for Sept. 2017 Sept. 2020 Provides an additional recovery coach to the drug court participants FUNDING ADTC Awarded a 3-year $920,000 grant for FY15-17. Scope of project Provide Peer Recovery Coaches to drug court participants Enhance treatment services Training Help cover treatment costs for drug court participants Sustainable funding Medicaid / Block Grant / PA2 Capitated vs. Fee for Service Model FUNDING JUSTIFICATION Recovery Coaches and the 10 Key Components Key Component 4: Drug cour ts provide access to a continuum of alcohol, drug and other related treatment and rehabilitation ser vices. Key Component 6: A coordinated strategy governs drug cour t response to par ticipant s compliance. Key Component 10: Forging par tnerships among drug cour ts, public agencies, and community -based organizations generates local suppor t and enhances drug cour t program effectiveness. 4
FUNDING JUSTIFICATION Recovery Coaches and the Best Practice Standards Standard 5: Treatment providers are trained and super vised to deliver a continuum of evidence-based inter ventions Standard 6: Par ticipants receive complementary treatment and social ser vices for conditions that co-occur with substance abuse and are likely to inter fere with their compliance in Drug Cour t, increase criminal recidivism, or diminish treatment gains. RECRUITING & HIRING Essential functions of the job: Performs outreach work with clients Reports client s behaviors and attitudes to the supervising authority. Provides coaching and support to clients as challenges arise from everyday activities. Provides sober companionship Have extensive knowledge of local resources and access methods for all of them Must have an open mind to all pathways to recovery Must be able to work extremely flexible working hours TRAINING & QUALIFICATIONS Oriana House Trained and certified through the Ohio Department of Mental Health and Addiction Services (OMHAS) Maintain 30 hours of CEU s and recertify every two years. ADTC CCAR trained / Certified Peer Recovery Coach Mentor (CPRM) by standards of the Michigan Certification Board of Addiction Professionals. CCAR certified recovery coach trainers & ethics trainer 5
Peer Recovery Coach Models ABOUT THE COACHES Karli DeMell Oriana House Lead Recovery Coach at Oriana House Graduate of Medina County Drug Court in 2013 Yearlong program primarily based around the 12-step approach Nothing worked until Drug Court Drug Court administrator was in recovery herself and a certified RC Able to relate to us and our journeys in recovery The RC from the Medina Drug Court fueled me to do what I do today ABOUT THE COACHES Priscilla Shafor, BS, CADC, CPRM Adult Drug Treatment Court Person in long term recovery since 2001 Previous Work Experience Utilization Review Specialist; Psychiatric Technician; Community Re-Entry Case Manager Active community advocate for the recovery community Promote many pathways to recovery 6
ABOUT THE COACHES Anthony Sledge, CPRM Adult Drug Treatment Court Person in long term recovery since 1993 Work Experience Recovery Coach for Pine Rest Mental Health Inpatient Residential Program Active community advocate for the recovery community Promote many pathways to recovery CCAR MODEL Michigan Department of Health & Human Services (MDHHS) RECOVERY COACHES A recovery coach is NOT Sponsor Counselor Probation Officer Nurse/Doctor Priest/Minister/Rabbi Friend 7
RECOVERY COACHES Who is a recovery coach and what do they do? A recovery coach is anyone interested in promoting recovery by removing barriers and obstacles to recovery, and by serving as a personal guide and mentor for people seeking or in recovery. RECOVERY COACHES The four goals of a recovery coach (1) Promote recovery (2) Remove barriers (3) Connect people with recovery support services (4) Encourage hope, optimism and healthy living ROLE & RESPONSIBILITIES How we do the job (Ottawa County & Oriana House) Motivator and cheerleader Ally and Confidant Truth-Teller Role Model and Motivator Problem-Solver Resource Broker Advocate Community Organizer Lifestyle Consultant 8
ROLE & RESPONSIBILITIES How we do the job (Ottawa & Oriana House) Ottawa County & Oriana: All clients have access to a PRC. Ottawa County: All participants have a recovery coach and must meet regularly with them. Oriana: Clients are referred to meet with a PRC by a client s caseworker or counselor, or the Judge. Ottawa County & Oriana: PRCs participate in case staffing and review hearings. RCs can be asked to appear with a client in court This must be cleared with the drug court team first RECOVERY COACH GUIDELINES & BOUNDARIES 1. All scheduled home visits must be prior -approved by the Drug Court, on a case-by case basis. 2. Recovery coaches will conduct home checks/visit only in circumstances where there are no safety concerns of suspicion of illegal activity 3. Recovery Coaches will not act as a 12 -Step Sponsor for drug court participants or OAR clients. 4. If Recovery Coaches become aware of any illegal activity on the part of Drug Court participants and/or OAR clientele, they will immediately report it to the Drug Court/proper authorities. ROLE & RESPONSIBILITIES How we do the job Participant focused Case Management Case management: We coordinate and link services, address persons needs, monitor and communicate the service efforts; to achieve the goals of our program and treatment. Case management is the framework for us to asses the whole person. 9
RECOVERY COACH GUIDELINES & BOUNDARIES 5. Participants/Clients are encouraged to limit their phone calls/text messages to the Coaches to business hours of 8:00-5:00. As such, Recovery Coaches are not obligated to respond to after-hours, non-emergency contacts. 6. In the event of an emergency, all clients should call 911 or go to an emergency room rather than contact a Recovery Coach. Recovery Coaches are not expected or credentialed to provide emergency medical care. 7. Recovery Coaches are not expected to transport clients in their own vehicles, and requests to transport clients will be approved by the Clinical Supervisor. ROLE & RESPONSIBILITIES How we do the job Participant focused Case Management Case Management: Has Five key functions: (1) assessment; (2) planning; (3) linking; (4) monitoring; and (5) advocacy. These functions are linked to one another and incorporate information gathered at every stage of the case management process. A relationship with the individual - connecting a person with multiple needs to an increasingly complex social service delivery system. Needs are addressed; safety, food, and shelter, as well as emotional, medical, employment, education, and connection with others in the community. RECOVERY COACH GUIDELINES & BOUNDARIES 8. Recovery Coaches are encouraged to limit all out -of-theoffice contacts to public places in the community. 9. Recovery Coaches will follow the OAR Ethics Policy and will not develop social/dual relationships/contact with clients outside of their role within the clinical team. 10
CLINICAL & ADMINISTRATIVE SUPERVISION Recovery Coaches are employees of the treatment provider NOT the court (boundaries and perception issues). Weekly individual supervision session are provided by the Clinical Supervisor. Recovery Coaches sit in on Intensive Outpatient Groups and Residential Group sessions at least once weekly. Drug Court partners with local treatment provider on the drug court team. LESSONS LEARNED Potential to be taken advantage of by clients In Drug Court RCs may be used by clients in an attempt to avoid sanctioning Always work with the Drug Court team first before appearing in court Because RCs are also in the recovery community, it can be important to keep our programs separate from the client s program Boundaries between clients and RCs Occasionally limited communication with caseworkers when it comes to decision making with clients Evaluation & Outcomes 11
EVALUATION Research on the impact of recovery coaches is limited, but findings (qualitative and quantitative) suggest positive outcomes. Considerable need to improve research design and methods for evaluating recovery coach programs Programmatic perspective: Need for clear goals and objectives. Quantitative perspective: Data points to use. Qualitative perspective: interview protocols of recovery coaches and clients. EVIDENCE FOR RECOVERY COACHES Increased Satisfaction with the overall treatment experience Engagement in outpatient treatment and retention Hope, quality of life, and satisfaction with life Involvement in self-care planning Rates of family reunification Decreased Substance use Criminal justice involvement Depression and demoralization Number of admissions to and days spent in hospitals Average service cost per person in treatment Improved Social functioning and access to social supports Relationships with treatment providers and programming Housing stability Chances for long-term recovery Stress outcomes QUANTITATIVE EVALUATION Data points to collect (at minimum) Recovery Coach Specific Number of contact hours Per phase & total Type of contact (e.g., group, one-onone) Type of activity(s) used Recovery Coach Timeline Date service started and ended Recovery Coach Info Track assigned recovery coach Service provider Drug Court Specific Number of treatment hours # hours per treatment level (e.g., Residential, IOP, Group, Individual) Clinical focus per treatment level Positive drug tests Date & Substance Incentives and Sanctions Date(s) and type(s) Days/Dates in drug court and per phase 12
QUALITATIVE EVALUATION Interview protocols for qualitative research may vary per program and how the recovery coaches are used. Common approaches to gathering qualitative data are: Use an independent evaluator (if possible) Focus groups One-on-One interviews Surveys CONCLUSION Questions? CONTACT INFORMATION Andrew Brown Drug Court Coordinator 20 th Circuit Court Ottawa County, MI apbrown@miottawa.org 616.846.8352 Alex Dorman Research Specialist Oriana House Inc. Summit County, OH AlexJDorman@orianahouse.org 330.535.8116 ext. 4817 13