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

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.

Increase knowledge of Recovery Support services for Addiction. 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.

New SAMHSA Definition Working Definition of Recovery A process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. Principles of Recovery Four major domains that support 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.

The Pillars of Peer Support Separator slide

Five Core Tenants of the Pillars of Peer Support Education  Certification Employment Professionalism Community Advocacy Daniels, A., Bergeson, S., Ashenden, P., Fricks, L., Powell, I., Pillars of Peer Support: Advancing the Role of Peer Support Specialists in Promoting Recovery The Journal of Mental Health Training, Education and Practice (2012)

Pillars of Peer Support (POPS) 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 reports are available for download at: www.pillarsofpeersupport.org

What Are Peer Coaches? Peer recovery coaches balance three overarching services roles: Personal guide and mentor for individuals in or seeking recovery Connector to instrumental recovery support resources which includes housing, employment and professional and non-professional services 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.

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

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.

The member has difficulty accessing behavioral health or medical care 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

The member has difficulty maintaining 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

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

Engagement is THE Key to SUCCESS!

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

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

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

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

Recovery involves three critical elements: Recovery Supports Addiction Recovery Support distinguishes the singular goal toward which all efforts are directed. Recovery involves three critical elements: Sobriety (abstinence from alcohol, prescribed medications, and unprescribed drugs) Improvement in global health (physical, emotional, relational, and ontological—life meaning and purpose) Citizenship (positive participation in and contribution to community life) Support involves the provision of informational, emotional, instrumental, and/or affiliation.

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