Accessing Substance Use Services

Presenters Lisa Tepper Bates Gina Florenzano, Sarah Chess Connecticut Coalition to End Homelessness Shelly Nolan, Department of Mental Health and Addiction Services Gina Florenzano, Sarah Chess Connecticut Coalition to End Homelessness

Collaboration + Resources + Data = Ending Homelessness Systems are Working! Collaboration + Resources + Data = Ending Homelessness CT was the first state to end chronic homelessness among Veterans in 2015 CT was the second state to end all homelessness amongst all Veterans in February of 2016 As of December 2016, all chronically homeless individuals in CT were matched to housing!

House Keeping Because this is a webinar, attendees are muted Please type any questions you have into the Questions or Chat Box We are recording this webinar and will send out the link to everyone who registered later today

DMHAS funded LOCs Medically Managed Detox (4.2) Medically Monitored Detox (3.7 D) Intensive Residential (3.7) Intensive Residential Co-occurring Enhanced (3.7E) Intermediate (3.5) Intermediate (Pregnant and Parenting) Long term Care (3.3) Halfway House (3.1) Recovery Houses

Authorization Process Most SA Residential admissions are authorized via ABH (Advanced Behavioral Health) for Husky D clients Residential services are not covered by Medicaid but reimbursed through a grant program Detox admissions, Residential for Husky A clients & MAT services are authorized via Beacon Health Options (formerly Value Options) LOC is determined based upon clinical presentation and ASAM criteria It is RARE that there are no open beds, despite what we hear. Clients can access services any where in the state. In some cases a change of scenery may be helpful.

Detox LOC Two types: medically managed and medically monitored Medically Managed- 24 hour medical and nursing supervision on site due to the significant history (HX) of use, psychiatric symptoms (TX), or types of substances used. Only 2 DMHAS operated: Blue Hills and Merritt Hall (CVH) provide this LOC Medically Monitored- 24 hours nursing supervision is provided with access to on-site medical evaluation by a medical provided (MD not required on-site 24/7)

Medically Monitored Detox Providers RNP-First Step (Bridgeport) Cornell Scott-Hill Health Center SCRC (New Haven) Rushford (Middletown) SCADD (New London) Stonington (N. Stonington) ICRC- formally ADRC (Hartford) MCCA (Danbury)

Overdose Risk Following an opioid detox a client is at higher risk for overdose as their tolerance has been decreased Understanding safe use practices and being open to talking about relapse is important and in many cases life saving Connection to aftercare is essential to continue to enhance support network Medication Assisted Treatment (MAT) can help with cravings

Intensive Residential LOC Residential program for individuals with substance abuse or co-occurring disorders Expectation of 30hrs of treatment per week Client must be able to actively participate in a variety of psycho-ed and treatment groups Psychiatric and medical conditions should be stable Usually post-detox LOS- 28 days (avg)

Intensive Residential Providers CASA (Bridgeport) RNP-Horizons (Bridgeport) CVH (Middletown) Rushford- ITP (Middletown) ICRC -formally ADRC (Hartford) Blue Hills (Hartford) Farrell (New Britain) MCCA-McDonough (Danbury) McCall-Carnes Weeks (Torrington)

Co-occurring Enhanced (3.7) Specialized Mental Health program to treat individuals with more significant Co-Occurring disorder On-site psychiatric services Expectation of 30 hours of treatment per week with a focus on co-occurring disorders LOS- 28 days (avg) Three programs: New Prospects (Recovery Network of Programs)-co-ed - Bridgeport McAuliffe (CT Renaissance) -males only- Waterbury Milestone (CHR)- females only - Putnam

Intermediate Treatment LOC Residential program for individuals with substance abuse or co-occurring disorders Expectation of 20hrs of treatment per week Again, client must be able to engage in this level of service Psychiatric and medical conditions should be stable LOS- up to 90 days

Intermediate LOC Providers APT (Bridgeport/New Haven) Liberation Programs- Liberation House (Stamford) Rushford- Stone Haven (Middletown) CHR-Thomas Murphy (Willimantic) Perception- Perception House (Willimantic) SCADD-Lebanon Pines (Lebanon) Youth Challenge (Hartford) CNV Help (Waterbury) CT Renaissance- East (Waterbury) ICRC- formally ADRC (Hartford)

Pregnant and Parenting (3.5) LOC Specialized LOC with the purpose of providing support to women during pregnancy or the reunification process Children can reside with mom in the program Funded under the Federal Block Grant

Women’s Services Providers Liberation Programs- Families In Recovery Program (Norwalk) The Connection Mother’s Retreat (Groton) Hallie House (Middletown) CHR- New Life (Putnam) APT- Amethyst House (New Haven) ICRC-formerly ADRC- Coventry House (Hartford) Wellmore (Waterbury)

Long-term Care MCCA-Trinity Glen (2 programs) Men’s Program (Sharon) Women’s Program (Kent) Programed is geared towards individuals who have attempted many layers of other treatment in the past and have been unable to maintain recovery Clients must be able to participate in 20 hours of treatment including a work therapy component Program length of stay: 6months- 1 year

Halfway House LOC Low intensity LOC with focus on re-integration Expectation of 4 hours of treatment per week Focus is on building independence skills and promoting personal responsibility Many individuals work, take classes, volunteer, etc. LOS is up to 90 days

Half Way House Providers CASA (Bridgeport) Connection (Middletown) SCADD *Coit St (New London) * Bank St (New London) *Main St (Norwich) ICRC- formerly ADRC- Clayton House (Glastonbury) McCall- McCall House (Torrington)

Recovery Houses This is not a sober house This LOC differs from Halfway House (3.1) given that the recovery house provides a “safe” place for individuals awaiting beds at a higher/lower LOC Up to a 90 day LOS Treatment often occurs in the community- OTP, IOP, or PHP (verify with the program what their expectation is) Individuals often are working, pursuing education, etc

Recovery Houses CASA-Bridgeport The Connection-New Haven Columbus House-New Haven CHR- Willimantic ICRC- formerly ADRC - Hartford RNP- Tina Klem- Bridgeport Mercy- Hartford MCCA-Sobering Center- Danbury Wellmore- Morris House & Therapeutic Shelter- Waterbury

Medication Assisted Treatment Naltrexone (Vivitrol) Buprenorphine (Suboxone) Methadone Opioid Addiction

Why MAT? Residential treatment may not be the answer for everyone Research shows that the mortality rate of untreated individuals using heroin is 15 times higher compared to individuals receiving methadone maintenance treatment (who have a similar mortality rate to the general public). *Source: Beacon Health Options White Paper on Opioid Crisis

CT Methadone Clinics

Clinics Offering Suboxone APT Foundation , New Haven Bristol Hospital, Bristol CASA, Bridgeport CHR, Enfield Community Health Services, Hartford (FQHC) Community MH Affiliates (CMHA), New Britain CT Addiction Medicine; Rocky Hill Cornell Scott/Hill Health, New Haven (FQHC) Middlesex Hospital /Behavioral Health IOP, Middletown McCall Center for Behavioral Health, Torrington Natchaug OP/ “Care Plus”, Groton New Era, New Haven & Bridgeport Norwalk Community Health Center (FQHC) Perception Programs, Willimantic/ Danielson Recovery Network of Programs, Bridgeport Rushford Waterbury Hospital OP Wellmore /Staywell, Waterbury Wheeler Clinic, Hartford

Connection to care Access Line Beacon Health Options Resources Information on walk-in assessment centers throughout the state at www.ct.gov/dmhas/walkins or 1-800-563-4086 Warm hand off to detox services Beacon Health Options Resources http://www.ctbhp.com/medication-assisted- treatment.html Includes Interactive Map of all MAT providers

DMHAS CSD Contacts Lauren Siembab, LADC,Division Director Phone: 860-418-6897 Email: lauren.siembab@ct.gov Shelly Nolan, MS, LPC, Regional Manager Phone: 860-418-6835 Email: shelly.nolan@ct.gov Gina Florenzano, MS, LPC, Regional Manager Phone: 860-418-6659 Email: gina.florenzano@ct.gov Rhonda Kincaid, M.Ed, Regional Manager Phone: 860-418-6886 Email: rhonda.kincaid@ct.gov Linda Jordan, Behavioral Health Specialist Phone: 860-418-6899 Email: linda.jordan@ct.gov

Questions?