Tài liệu Recovery Net Final docx

ACCESS TO RECOVERY III
MARYLAND
RecoveryNet
What is ATR

Access to Recovery (ATR) is a “high-priority” federal
initiative that provides vouchers to individuals to
purchase services and supports linked to their
recovery from substance use disorders.

ATR is a SAMHSA system transformation grant
designed to build recovery support networks within
communities.

ATR emphasizes the expansion of capacity within
systems of care.

ATR projects involve clients in directing their own
care and give them choices among appropriate
providers.
ATR Impact on Outcomes
According to GPRA results outcome data are
promising. At six months post admission to ATR
services,

80% were abstinent from substance use,

46% were stably housed,

51% were employed,


87% were connected to support networks,

and 96% reported no involvement with the criminal
justice system.
ATR III in Maryland

Four year Access to Recovery (ATR) grant,
Maryland RecoveryNet – awarded by to the
Maryland Alcohol and Drug Abuse Administration for
approximately $3.2 million per year.
2011 201420132012
Million
Time
Numbers to be Served
Targeted Population(s)

In Maryland in FY 2009 8,000 individuals were
diagnosed with substance use disorders severe
enough to warrant treatment in publicly funded
residential programs

Average of cost of $37,704 per residential treatment
episode.

The percentage that follows through with outpatient
treatment is under 26%

A revolving door recovery is often the result.
Eligibility


The RecoveryNet target population is adults (18
years or older) with a diagnosed substance use
disorder who are enrolled in residential addiction
treatment (ASAM Level III.7, Level III.5, or Level
III.3) in a publicly funded bed.

Eligible population includes inmates in Department
of Public Safety and Correctional Services
Residential Substance Abuse Treatment programs,
and returning Iraqi or Afghanistan veterans who are
enrolled in Department of Veterans Affairs residential
addiction treatment programs.
Criteria

Resident of Maryland and
planning to reside in
Maryland after discharge
from the residential program.

Current ASI or TAP bio-
psycho-social assessment

Documented need for
RecoveryNet services

Request for RecoveryNet
services

Income at or below 200% of
the Federal Poverty


Agree to conditions of
RecoveryNet initiative

If participating in the
Residential Substance Abuse
Program, must be scheduled
for release from the facility
into the community within 60
days of discharge from the
treatment program.

Agree to work with a Care
Coordinator as a RecoveryNet
vouchered service

Agree to enroll in another level
of treatment or in Continuing
Care with a Level I Outpatient
program
Eligibility
Portal Programs: ATR Gateway
Individuals in publically-funded
residential treatment slots.
ASAM Levels;
•
III.7,
•
III.5, and
•

III.3
including programs within the
Department of Corrections and the
Veterans Administration, who are
being discharged into their home
communities.
RecoveryNet: Maryland’s Provider Network
RecoveryNet is designed to build networks of treatment and support
services within communities throughout the State, by encouraging
community and faith-based providers to offer services to people in
early recovery.
Possible Recovery Support Services include:
•
*Care Coordinaon
•
Halfway House beds
•
Family Counseling
•
Pastoral Counseling
•
Employment Readiness Counseling
•
Recovery Housing rent reimbursement
•
Childcare
•
Transportaon
*required for each ATR parcipant
Maryland’s ATR Process

Residential Treatment
Program (ATR Portal)
ATR Regional
Coordinator
Residential Counselor/
Discharge Planning
Care Coordination
VMS
Provider Services
•
Halfway House beds
•
Recovery Housing rent reimbursement
•
Employment Readiness Counseling
•
Family Counseling
•
Pastoral Counseling
•
Childcare
•
Transportaon
Care Coordinators
ATR Regional Break-out
ATR Region 2
Central and Western
Counties
ATR Region 3
Eastern Shore

and Southern
Counties
ATR Region 1
Baltimore City
ADAA-Funded Residential Treatment
Outlook and Outcomes: At a Glance FY 2009
2327
2122
2004
Projected Eligible Participants by Region
Based on Data reported in FY 09 to SMART/WITS system by publically funded
Residential Treatment Programs (Levels III.3, III.5 and III.7

ATR Administrative Structure
Region 1
Karol Harmon
Region 3
Interviews Pending
Region 2
Dena Trail
Acting Project Director -
Deborah Green
•
IGSR
•
Jurisdictional
Addiction and
Prevention
Coordinators
•

Statewide ROSC
Coordinator
•
Office of
Education and
Training for
Addiction Services
Manage Regional Resources Develop/Disseminate Reports
•
Maintain regular contact
with Jurisdictional Tx
Coordinators
•
Recruit Providers
•
Assist Providers with
Application Process
•
Provide Technical
Assistance to Providers
•
Conduct Provider Site
Visits
•
Adjust/Issue Vouchers as
requested by Care
Coordinator
•
Notify Care Coordinators
of pending GPRA

(Dx/Follow-up)
•
Coordinate/Deliver
Technical Assistance to
Care Coordinators
•
Monitor Waste, Fraud and
Abuse
•
Submit required reports to
State Project Director
Regional ATR Coordinator
Regional Coordinator Relationship Chart

Determine Eligibility and
Assess Needs

Notify/Communicate
with Regional
Coordinator

Assist Patient with ATR
Application

Administer Admission
GPRA*

Assist Patient with
Service/Provider
Selection


Assist Patient with
Recovery Planning

Generate/Issue Vouchers

Contact Care Coordinator

Facilitate Patient Care
Coordinator Introduction
Residential Treatment Program Counselors
*Government Performance and Results Act
Care Coordination
•
Coordinate/facilitate delivery of RecoveryNet Services
•
Assist with Recovery Planning
•
Access resources outside of ATR scope that meet client needs
•
Administer Discharge and follow-up GPRA
•
Communicate with outpatient Tx
•
Referral and access to more intensive level of care if needed.
•
Administer Client Satisfaction Survey
Comprehensive care coordination is provided to clients to identify their needs, plan
services, link the services system with the client, monitor service delivery, and
evaluate the effort.

ATR Participant
•
Completes ATR Intake with Residential Counselor
•
Identifies ATR services needed
•
Chooses providers
•
Provides collateral contact information
•
Agrees to work with Care Coordinator
•
Agrees to complete Admission, Discharge and Six-
month Follow-up GPRA’ s
•
Agree to attend OP/Continuing Care
Service Definitions: Clinical
The RecoveryNet emphasizes client choice and increases the array of available
community- and faith-based services, supports, and providers. All services are
designed to assist recipients in remaining engaged in their recovery while
promoting independence, employment, self-sufficiency, and stability.
Halfway House Residential Treatment – Clinically managed low intensity
treatment programs offering treatment services at least 5 hours per week directed
toward preventing relapse, applying recovery skills, promoting personal
responsibility, and reintegration.
Marital/Family Counseling- Services provided to engage the whole family system
to address interpersonal communication, codependency, conflict, marital issues and
concerns, parenting issues, family reunification, and strategies to reduce or
minimize the negative effects of substance abuse use on the relationship.
Pastoral Counseling- Services provided to encourage spiritual growth, resolve

conflict arising from spiritual disconnection, and facilitate progress in recovery
through an integrated faith-based and psychological approach.
Service Definitions: Recovery Support
Care Coordination- Comprehensive medical and social care coordination is
provided to clients to identify their needs, plan services, link the services system
with the client, monitor service delivery, and evaluate the effort.
Recovery Housing- These services provide a safe, clean, and sober environment
for adults with substance use disorders. Lengths of stay may vary depending on
the form of housing.
Job Readiness Counseling- This activity is directed toward improving and
maintaining employment and may include skills assessment, job coaching, career
exploration, résumé writing, interviewing skills, and tips for retaining a job.
Childcare- These services include care and supervision provided to a client’s
child(ren), less than 14 years of age and for less than 24 hours per day, while the
client is participating in treatment and/or recovery support activities.
Transportation- Commuting services are provided to clients who are engaged in
treatment- and/or recovery support-related appointments and activities and who
have no other means of obtaining transportation.
ATR Service Rate Table
Average per person
amount: $1620.
Maximum per
person amount:
$2000.
(over $2500. triggers
administrative
review)
All vouchers default
to expire within 30
days of issue date

unless otherwise
approved and
indicated
Service Descripon Unit of Service Payment Rate
*Care Coordinaon Unit = 15 minutes
**Total units = 24
Unit rate =
$12.00
Total amount = $288.00
Recovery Housing Assistance Unit = 1 da.
Total units = 30
Unit rate = $26.66
Total available amount =
$800.00
Job Readiness Counseling Unit = 15 min.
session
Total units = 36
Unit rate = $7.00
Total available amount =
$252.00
Childcare Unit = 1 hour
Total units = 56
Unit rate = $8.00
Total available amount =
$448.00
Transportaon Unit = one mile
Total units = 400
Unit rate = .50 per mile
Total available amount =
$200.00

Addicon Treatment – Halfway
House
Unit = 1 da.
Total units = 30
Unit rate = $33.33
Total available amount =
$1000.00
Family or Couples Therapy - Unit = 1½ hour session
Total units = 6
Unit rate = $60.00
Total available amount =
$360.00
Pastoral Counseling Unit = 15 min. session
Total available units
=36
Unit rate = $10.00
Total available amount =
$360.00
*Care Coordination is a
function of centralized
intake and provider
designated regionally
thought an agreement with
a local health department
or its designated entity.
ATR Service “Dose” Table
Service Average Recommended
Dose to start
*Maximum
authorizaon

period/amount
Halfway House 4 weeks 4 weeks
Family /Couples
Counseling
4/one hour sessions 6 sessions
Pastoral
Counseling
4/one hour sessions 6 sessions
Recovery
Housing
4 weeks 8 weeks
Childcare 25 hours 56 hours
Job Readiness
Counseling
6 hours/24 -15 min
units
*12 hours
Transportaon $.50 per mile 200 miles/$100
Care
Coordinaon
6 hours/24 - 15 min
units
*Individualized
Average per person
amount: $1620.
Maximum per person
amount: $2000. (over
$2500. triggers
administrative review)
All vouchers default to

expire within 30 days of
issue date unless
otherwise approved
Not yet available
*Adjusted with
authorizaon by
Reg. Coordinator