Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden,...

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Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January 30, 2015 Recovery Support Services

Transcript of Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden,...

Page 1: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

Kelly Champ, Northeast Regional Vice President, Optum Specialty Network ServicesPeter Ashenden, Director of Consumer and Family Affairs, OptumJanuary 30, 2015

Recovery Support Services

Page 2: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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.

Page 3: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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.

Page 4: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

Page 5: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

The Pillars of Peer Support

Page 6: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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)

Page 7: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

• 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

Page 8: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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.

Page 9: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 9

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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

Page 10: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 10

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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.

Page 11: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

Page 12: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

Page 13: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

Page 14: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 14

Engagement is THE Key to SUCCESS!

Page 15: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

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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

Page 17: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

Page 18: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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

Page 19: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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.

Page 20: Kelly Champ, Northeast Regional Vice President, Optum Specialty Network Services Peter Ashenden, Director of Consumer and Family Affairs, Optum January.

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