The%20Business%20Case%20for%20Incorporating%20Peer%20Advocacy%20Services%20in%20an%20Outpatient%20Program

1
The Business Case for Incorporating Peer
Advocacy Services in an Outpatient Program

• Sherrifa Bailey, L.M. S.W
• Adolescent and TAY Supervisor, Odyssey House Inc.
• Mary Callahan, L.C.S.W-R
• Senior Manager, Director of Outpatient Services,
  Odyssey House Inc.

2
House Keeping

• Introductions
• Bathroom Locations
• Cell Phones
• Questions??

3
Points to Consider

• Does it makes sense for an 822 program to
  integrate Certified Peer Advocates into their
  Treatment Program?
• Does it assist with retention?
• Is it fiscally viable?

4
Overview of Odyssey House Grant Funded Programs
using Recovery Coaching

• OH ROCS
• NY SAINT
• BYRN
• BIP SOARS
• BRSS 2015/2016

5
OH ROCS

• Population Served Individuals in early recovery
  recently completing residential substance abuse
  treatment
• Numbers Served 330 individuals in early recovery
  over the three years of the grant (2010-2013)
• Primary Project Objectives
• To implement a peer based mentoring program
  structured using the CCAR Recovery Coaching Model
  and Recovery Plan
• To implement Contingency Management to support
  the delivery of recovery-oriented services
• To improve the quality and intensity of community
  based recovery for the individuals served
• To achieve outcomes of abstinence, to reduce
  recidivism, increase retention, maintain
  employment/education and housing
• To achieve improved self-esteem and quality of
  life

6
Table 1 Treatment retention and completion for
OHROCS participants vs. non- participants
enrolled at the Odyssey House Outpatient Program
Measures ROCS Cohort (n103) Comparison Group (n265) Difference Difference Rate
Length of Stay (in days) 144 86 58 67.40
Completion rate (Percent of clients who completed outpatient program 36.90 17.10 19.80 115.80

• Includes clients that have been discharged,
  clients still in treatment are included
• Comparison Group includes all adult BOP
  clients that did not enroll in the OH ROCS program

7
Table 2 Select GPRA Outcomes for OHROCS
participants at 6 month follow up (N144)
GPRA Measures Intake 6-Month Follow-Up Rate of Change
Abstinence 72.2 86.1 19.2
Employment-Education 25 42.4 69.4
Stability in Housing 58.3 61.8 6
Experienced Depression 27.2 14.3 37
Experienced Anxiety 28.3 15.8 44.1
Trouble Understanding, Concentrating or Remembering 14.6 6.5 55.6
8
Table 3 Change in Self-Esteem and Quality of
Life for OHROCS participants at 6-month follow
up.
Measure Reporting Improvement at Follow Up
Self- Esteem (Rosenberg Scale) N108 64
Quality of Life (QOLI) N99 61
9
NY SAINT Program

• Population Served Adolescents 12-18 years old
  who are at risk for abusing drugs and/or alcohol
• Numbers Served 95 Adolescents over 27 months
• Primary Project Objectives
• To implement the Evidence Based Practice of Seven
  Challenges
• To implement Recovery Coaching Model and Wellness
  Planning
• To implement contingency management to support
  delivery of recovery oriented services and family
  participation
• To improve the quality of community based
  recovery for the adolescent population
• To achieve the outcome of healthy decision making
  and enhancing positive choices in the realm of
  education, employment, and other quality of life
  decisions

10
NY SAINT Program
Average length of stay pre coach unsuccessful treatment episodes Months 3.5
Average length of stay with coach including successful completions Months 4.9
11
NY- SAINT Outcomes Year to Date
3 Month GPRA Follow- Up Rate 93 Improved self-esteem and reduced substance use
6 Month GPRA Follow-Up Rate 84 Improved self-esteem and reduced substance use
12
New York Community Trust Bronx Youth Recovery
Network

• Population Served Young adults 18-27 years old,
  who are abusing drugs and/or alcohol
• Numbers Served 82 young adults over 1 year
• Primary Project Objectives
• To create a learning collaborative where young
  adults work with counselors and recovery coaches
  to identify why they are abusing drugs and/or
  alcohol and to implement healthy decision making
  practices
• To implement contingency management to support
  the youths engagement with recovery oriented
  community services
• To achieve the outcome of eliminating or reducing
  drug use, and enhancing positive lifestyle
  changes in the realm of education, employment and
  quality of life decisions
• To provide prevention education in the community
  to the at risk adolescent population

13
NYCT BYRN
Average length of stay pre coach unsuccessful treatment episodes Months 2.8
Average length of stay with coach and with successful completion Months 3.5
14
Analysis of BYRN Data

• Data Analyzed using URICA (University of Rhode
  Island Change Assessment) Scale

Time in BYRN Program N Average URICA Change
Greater than 3 months 8 1.64
Less Than 3 months 10 -1.44
15
Bringing Recovery Support to Scale (BRSS
2014-2015)

• Population Served Individuals interested in
  being in and entering early recovery
• Numbers Served approximately 120 individuals
  over 12 months
• Primary Project Objectives
• To guide the OH ROCS peer council in researching
  evidence based or other recovery models to build
  engagement and peer support
• To provide for travel to other recovery
  communities to aid in the understanding of
  various recovery tools
• To provide funding for activities that enhance
  recovery

16
Bringing Recovery Support to Scale (BRSS
2015-2016)

• Certified Peer Advocate partnered with a
  Certified Peer Specialist
• Tasked with educating OMH and OASAS licensed
  programs throughout NYS regarding the benefits of
  Peers in promoting and sustaining community based
  recovery
• Utilizing a power point presentation to educate
  Senior Management and line staff about Peer
  Support services

17
Serving Older Adults Recovery System (SOARS)

• Population Served Individuals 50 years old and
  over in early recovery and/or engaged in
  substance abuse treatment
• Target Number of Clients 90 adults 50 or older
  over 14 months (Current enrollment 85)
• Primary Project Objectives
• To deliver 6 months of intensive case management
  in the participants homes and communities
• Connect or enhance participants access to
  community based long term support services (LTSS)
• To provide 6 months of coordinated peer delivered
  recovery coaching in the community
• To strengthen the continuum of care

18
Analysis of BIP SOARS Data(N 85)
Percent of Participants receiving Recovery Coaching Average number of Recovery Services delivered monthly Percent of Participants accomplishing 3 or more goals in their Recovery Plan of community based referrals which resulted in engagement in services of Participants who attended a community based meeting with their Coach of Participants who became or remained stably housed in the community
100 205 87 85 88 51
19
Where Are We Now?
20
HARP Substance Use Eligibility Criteria

• 1 inpatient rehab stay with SUD as primary
  diagnosis in the past year
• 2 detox admissions within the past year
• 2 inpatient hospital admissions with primary
  SUD diagnosis or SUD DRG and secondary SUD
  diagnosis in the past year
• 2 ER visit with primary SUD diagnosis or SUD
  related secondary substance use diagnosis in the
  past year

21
Peer Services Side by Side
22
ODYSSEY HOUSE, INC.    
Out Patient    
Salary and Fringe for Recovery Coach Certified Peer Advocate  
FY2015    
ACCT ACCOUNT DESCRIPTION 2015
    Budget
     
Expenditures    
SALARIES    
7000 SALARIES  
  SALARIES 25,480
TOTAL SALARY   25,480
     
TOTAL FRINGE   12,816
TOTAL PERSONNEL SERVICES   38,296
     
     
CONTRACTUAL    
7301 LEGAL FEES 90
7302 ACCTG./AUD. 180
7304 PEST CONTROL 72
7305 PLACEMENT ADS 9
7320 DATA PROCESSING 450
7325 MCTMT - METRO TAX 126
TOTAL CONTRACTUAL   927
23
SUPPLIES    
7401 OFFICE SUPPLIES 360
7406 DUPLICATING PRINTING 90
7408 COMPUTER SOFTWARE 90
TOTAL SUPPLIES   540
     
UTILITIES    
7601 TELEPHONE 355
7611 ELECTRIC 277
TOTAL UTILITIES   632
     
EQUIPMENT    
7802 OFFICE EQUIP. RENTAL 120
7803 EQUIPMENT LEASE 6
7811 EQUIP. MAINT. REPAIR 42
7812 EQUIPMENT INSTALLATION 6
7851 EQUIP. PURCHASES (CAP) 2,000
TOTAL EQUIPMENT   2,174
     
TRANSPORTATION    
8021 LOCAL TRANSP. STAFF 500
8031 VEHICLE PARKING 31
8040 VEHICLE LEASING 117
8050 VEHICLE REPAIRS 135
TOTAL TRANSPORTATION   783
24
MISCELLANEOUS    
8301 GENERAL/PROF. LIABILITY INS. 135
8303 CRIME BOND INSURANCE 10
8305 OFFICER DIRECTOR LIAB 14
8306 UMBRELLA INSURANCE 63
8308 MALPRACTICE INSURANCE 99
8309 PROPERTY INSURANCE 99
8503 MEETINGS 41
8504 REGISTRATION FEES,SEMINARS 90
8505 MEMBERSHIP 9
8506 PUBLICATIONS 18
8507 POSTAGE FREIGHT 72
8530 STORAGE 9
TOTAL MISC.   658
TOTAL O. T. P. S.   5,713
TOTAL EXPENSES   44,009
Revenue    
     
  Annual Visits (4/hr) 4,046
  Uncollectible Visits (405)
  Net Annual Visist 3,641
     
Total NYSDOH REVENUE 52,800
  Uncollectible Claims (5,280)
  Net Revenue 47,520
     
Excess(Deficit)   3,511
     
     
  Total Visits at 4 per Hour 1011.50
  Monthly Visits To Breakeven 84.29
25
More Things to Consider

• Integration of Certified Peer Advocates and/or
  Recovery Coaches into the multi-disciplinary team
• Is it Different to supervise a Peer versus a
  Clinical staff person?
• Should Peers do toxicology testing on a Mentee?
• Considerations in developing systems to assure
  best practice in matching Peers with Mentees
• What does a Certified Peer Advocate job
  description look like?

26
Q. E. D quod erat demonstrandum
27
Odyssey House, Inc.

• Outpatient Services
• 953 Southern Blvd. Suite 301
• Bronx, NY 10459
• Phone [phone]
• www. odysseyhouseinc.org
• http//odysseyhouse.blogspot.com/2014/08/in-news-r
  ecovery-services-for-older.html
• HCBS Billing Manual
• http//www.nyaprs.org/e-news-bulletins/2015/007016
  .cfm
• Contact for becoming a Certified Peer Advocate
• www.asapnys.org

28
Contact Information

• Sherrifa Bailey
• sbailey2_at_odysseyhouseinc.org
• Mary Callahan
• mcallahan_at_odysseyhouseinc.org