kelly champ, northeast regional vice president, optum specialty network services peter ashenden,...
TRANSCRIPT
Kelly Champ, Northeast Regional Vice President, Optum Specialty Network ServicesPeter Ashenden, Director of Consumer and Family Affairs, OptumJanuary 30, 2015
Recovery Support Services
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 2
Introductions:
Introductions
Name: Let us know who you are?
Where: Let us know where you are located?
What: Let us know what you do in your work place?
Why: Let us know what your expectations from today’s
overview are.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 3
Objectives
Increase knowledge of Recovery Support services for
Addiction.
Understand the differences between Recovery Support
services and mutual aid groups.
Illustrate Engagement Tools for those Seeking or are in
Addiction Recovery.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 44
New SAMHSA Definition
A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
Four major domains that support recovery:
Principles of Recovery
Person-driven Occurs via many pathways Is holistic Is supported by peers Is supported through relationships Is culturally-based and influenced Is supported by addressing trauma Involves individual, family, and
community strengths and responsibility Is based on respect Emerges from hope
Health: Overcoming or managing one's disease(s) as well as living in a physically and emotionally healthy way.
Home: A stable and safe place to live.Purpose: Meaningful daily activities, such as
a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income, and resources to participate in society.
Community: Relationships and social networks that provide support, friendship, love, and hope.
Working Definition of Recovery
The Pillars of Peer Support
1. Education 2. Certification3. Employment4. Professionalism5. Community
Advocacy
Five Core Tenants of the Pillars of Peer Support
Daniels, A., Bergeson, S., Ashenden, P., Fricks, L., Powell, I., Pillars of Peer Support: Advancing the Role of Peer Support Specialists in
Promoting RecoveryThe Journal of Mental Health Training, Education and Practice (2012)
• Developed the 25 Pillars of Peer Support (States billing Medicaid)
Phase 1
• Promoted Peer Support Services in states that do not bill Medicaid for reimbursement
Phase 2
• Whole Health Peer Support Services and Health Reform
Phase 3
• (9/2012) Establishment of Standards for Excellence in Peer Support Services
Phase 4
• (2013) The Role of Peers in Building Self-Management with Mental Health, Addiction and Family/Child Health Settings
Phase 5
• (10/2014) Effective Supervision of Peer Specialists
Phase 6
Pillars of Peer Support (POPS)
Pillars of Peer Support reports are available for download at: www.pillarsofpeersupport.org
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 8
What Are Peer Coaches?
Peer recovery coaches balance three overarching services roles:
1. Personal guide and mentor for individuals in or seeking recovery
2. Connector to instrumental recovery support resources which includes housing, employment and professional and non-professional services
3. Liaison to formal and informal community supports, resources and recovery supporting activities
The peer recovery coach highlights his/her own “lived” experience.
Family members may also be qualified as peers.
Peer coaches should have specific knowledge and skills that enable them to develop peer practice in ways that help and do not harm, and are authentic process and path of recovery, as determined by the person that is served.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 9
9
What Roles do Peer Coaches have in the system?
They are NOT:
A physician A talk therapist A case manager
They are/can be:
A support system A role model A provider of hope A coach for WRAP or other engagement tools A translator between “doctor talk” and the consumer A cheerleader
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 10
10
Why use a Peer Coach as a part of a Healthcare team?
Isolation: These are illness of isolation, when we isolate we get worse. A peer supporter can reduce isolation and connect consumers with other peers.
Support: Often we have stressed family and friend relationship because of the symptoms of the illness. A peer can provider support and access to other peers for needed support.
Internal stigma: These are also illnesses of shame. A peer can normalize the experience and reduce the internal stigma that gets in the way to staying in treatment.
External stigma: Society still sees mental illnesses are frightening and shameful Having a peer who is in recovery can reduce the fear of external stigma.
Hope: Having a role model of a peer who has been there and has moved into wellness is a powerful symbol of hope for consumers struggling with symptoms.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 11
Who Qualifies for the Peer Coaching Services?The member has a severe and persistent behavioral health condition or substance related disorder, and any one of the following criteria are met:
The member has difficulty accessing behavioral health or medical care
The member is being discharged
The member has difficulty managing activities of daily living including:
• Mbr primarily relies on emergency room services
• Mbr has had 2 or more inpatient admissions within the last year (MH)
• Mbr has had 2 months or greater LOS in IOP and/or 2 or more tx episodes in a 12 month period (SA)
• From a lengthy stay in a hospital or facility-based program
• Or being released from incarceration
• Personal finance;• Personal hygiene;• Nutrition and meal preparation• Home maintenance;• Childcare; or• Legal, housing, transportation, and
other community service needs
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 12
Who Qualifies for the Peer Coaching Services?The member has a severe and persistent behavioral health condition or substance related disorder, and any one of the following criteria are met:
The member has difficulty
maintaining
The member lives in an unsafe environment
The member doesn’t have family or social supports
• employment• or meeting educational
goals
• Homeless• Group Home• Shelter
• or they are unable to help the member utilize care
• or manage the member’s behavioral health condition or substance related disorder
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 13
Overview of Peer Support Services and Recovery
In this model, the Peer: Helps the consumer with the development of their goals
Supports the consumer in creating and implementing health strategies
Monitors progress toward the goals
Helps the consumer brainstorm to overcome barriers
Acts as facilitator, teacher and coach, and provides encouragement
For example, if the consumer's health goals are to eat three low fat meals a day, the peer coach may help them find some resources for recipes, might help them plan a week of meals and help them shop, might help them cook, might check in each day to see what barriers they are facing
Or, if the consumer wants to add wheel chair exercises each day, the peer finds a resource to teach the exercises, helps the peer set up a routine that works for them, does the exercise with the peer several times, checks in each day on how they are doing
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 14
Engagement is THE Key to SUCCESS!
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 15
Valuable Methods of Engaging an Individual
Meet the person where they are comfortable in the community
Let them know that you too are a person with the lived experience of a substance use issue
Using the person centered assessment support the development of the recovery plan
Identify the resources to meet the recovery goals
Provide linkage and support with needed resources to meet the recovery goals
Average length of stay is 3 to 6 months
Average face to face time with the individual is 3-5 hours per week and is subject to the needs of the person
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 16
What are the Advantages of Engagement?
Recovery Support Services are social vehicles for recovery.
These services help people initiate and maintain recovery and enhance their quality of life by:
Improving health and wellness
Building recovery capital (internal and external supports that reinforce recovery)
Helping individuals play an active role in managing their recovery
Improving health and recovery outcomes in diverse communities
Reducing relapse rates
Lifting barriers and increases access to medical and other supportive services
Reducing the onset, duration and intensity of symptoms associates with several addiction in adults and at-risk children and adolescents
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 17
Advantages of Engagement to Recovery Supports
Recovery Planning focuses on these major components:
Recovery from substance use (abstinence)
Living and financial independence
Employment and education
Relationships and social supports
Medical health
Leisure and recreation
Independence from legal problems and institutions
Mental awareness and spirituality
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 18
Peer Recovery Support Services
Develop the capacity and infrastructure of the organized recovery community to become a full partner and participant
Explore range of options regarding paid and volunteer peers
Expand Peer Recovery Support Services (PRSS) and increase service menu options and points of access
Integrate Peer Recovery Support Services (PRSS) into recovery community and diverse service settings, including treatment
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 19
Recovery Supports
Addiction Recovery Support distinguishes the singular goal toward which all efforts are directed.
Recovery involves three critical elements:
A. Sobriety (abstinence from alcohol, prescribed medications, and unprescribed drugs)
B. Improvement in global health (physical, emotional, relational, and ontological—life meaning and purpose)
C. Citizenship (positive participation in and contribution to community life)
Support involves the provision of informational, emotional, instrumental, and/or affiliation.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 20
Where are Peer Support Services Located?
Recovery Community Organizations
Recovery Community Centers
Faith Based Organizations
Recovery Schools
Criminal Justice Systems
Emergency Room Departments
Recovery Houses / Oxford Houses
Addiction and Mental Health Agencies
Recovery Ministries
Access to Recovery Grants