Mobile Engagement Services (M.E.S.) A Penn Foundation Model Presented By: Gordon Hornig, LSW

Learning Objectives: Define Mobile Engagement Service (MES) and Identify the Four (4) points of intervention. Understand the effectiveness of Mobile Engagement Services within the target population of Heavy treatment utilizers, MAT recipients, and Children and Youth Intake referrals. Demonstrate effective integration of the MES model with Drug and Alcohol facilities , Criminal Justice system, and local internal medicine practices.

Instilling Hope. Inspiring Change. Building Community General Overview 1998 General Outreach Revolving Door Clientele 2003 Interventions and Prevention High Risk Population Identified 2016 Instilling Hope. Inspiring Change. Building Community

Mobile Engagement Strategy “4 Point Intervention” System Level Engagement Motivate Stabilize Monitor

The Interventions Engagement Motivate Stabilize Monitor

The Interventions Engagement Level Engagement Motivate Stabilize Draw the “SYSTEM” into open and honest dialogue Stage of Change = Pre-contemplation/Contemplation Key Tasks: Foster a working relationship Identify the need Phone or face to face interventions Engagement Motivate Stabilize Monitor

The Interventions Motivation Level Engagement Motivate Stabilize A vision for change is developed for the “movers’ of the system. Stage of Change = Contemplation/Preparation Key Tasks: Motivational Interviewing A “Client Centered Approach” Explore and resolve ambivalence “A LIFETIME ACHIEVEMENT” Engagement Motivate Stabilize Monitor

The Interventions Stabilization Engagement Motivate Stabilize Monitor A service plan is created/developed Movement from Chaos to healthy change Stage of Change = Preparation/Action Key Tasks: Becoming involved in 12 step and community help Family Education programs Church support Harm reduction participation Regular attendance at either MH or AOD treatment Traditional Levels of care Engagement Motivate Stabilize Monitor

The Interventions Monitoring Engagement Motivate Stabilize Monitor Promote Permanency in healthy change Quick intervention when regression occurs Stage of Change = Maintenance Key Tasks: Check ins Relapse prevention reminders Updating of coping skills Engagement Motivate Stabilize Monitor

Service Delivery Phone Contact Face-to-face Contact Limited Transportation Contacts Team Consult Contacts

Staffing: Level I worker Level II worker Provides engagement and related services. The MES I worker is generally not mobile, but provides site-based pre-screen assessments, client triage, handles phone engagement responsibilities, and may coordinates admissions into the program. However, at the discretion of the MES Coordinator, the MES I Worker may perform mobile services under close supervision Meets BDAP criteria for position of Counselor Assistant (704.8 section (a)-degree/license qualifications) Level II worker Meets BDAP criteria for position of Counselor (704.7 section (a)-degree/license qualifications)

Continuing Education: Partnership with the Bucks County Drug and Alcohol Commission 1. Motivational Interviewing 2. Trauma Informed care 3. Boundary Setting & Confidentiality 4. Paraphernalia & Drug Identification

Target Population Heavy Treatment Utilizer’s Previous Failures in Treatment AMA, AFA, Therapeutic Discharges Multi-Disadvantaged & Co-Occurring MAT Recipients Multi Service Individuals Adolescents Homeless C&Y Intakes

Agency Integration Penn Foundation Aldie Foundation Today Inc. Children & Youth Probation/Parole/Corrections Medical Assistance ½ houses and Recovery Houses Internal Medicine/MAT sites/Hospitals

Case Examples: Heroin Epidemic Pregnant Female 69 year old Transitional Age/Young Adult