COURT BASED ADDICTION AND DRUG SERVICES PROGRAM Ripley County - PowerPoint PPT Presentation

COURT BASED ADDICTION AND DRUG SERVICES PROGRAM Ripley County Courts and Margaret Mary Health

What i is CADS? Court Addiction and Drug Consists of 4 Phases Services Program Primary providers are one Typical program length is Licensed Independent Social between 6-8 months Worker and one Peer Recovery Coach

CADS Readiness Ph Phase Notable Partnerships: Choices Emergency Response Team, Court Services Team • Participant meets weekly for drug screens and Motivational Interviewing • Participant receives unannounced home visits with additional drug screens • Participant is connected with Medicaid and healthcare services • Serves as a program primer and active patient wait list

Notable Partnerships: Choices Emergency Response Team, Court Services Team, Primary Care and Psychiatry Phase hase 1 1 • 9 hours a week of intensive group therapy by Intensive LCSW Outpatient Program • Individual therapy and counseling • Medically Assisted Treatment and Psychiatric consultation • Continued case management services • Continued drug screens and home visits

Notable Partnerships: P2P, Peer Support Specialists and sponsors, Court Services Team • Participant attends fewer therapy sessions- begins to “wean out” of program Ph Phase 2 • Participant continues to receive weekly drug Step Down screens and home visits • Participant begins peer counseling group known as Peer2Peer

Phase 3 e 3 Peer Support , , Re-entry a and Sustainability ty • Participant meets with dedicated case manager for employment interview training, resume training, stipends for work equipment, uniforms, and help with childcare coordination • Participant continues to attend peer support sessions • Participant meets with Clinical Dietician to address affordable nutrition options (food desert), overall health and wellness, child nutrition, and any remaining food insecurity • Participant continues to receive home visits and drug screens

We have served 50 participants to 0 overdoses, 0 deaths date Succe Su ccess ss 12% of participants failed a Urine 68% of patients complete the Drug Screen at some point, program without a single failed received wrap around or Metri trics cs Urine Drug Screen enhanced services, and completed the program successfully Total success rate = 78%

78% Hepatitis C positive (50% of those were new diagnoses) Part rticipant 1 new HIV+ De Demograp aphics cs 26% of participants are between the ages of 18-24, 48% are between the ages of 25-34, 6% are over 34

25% of participants face some form of housing insecurity 30% face chronic food insecurity (verses 13.3% of rural households on average) Additio ional l Met etrics Domestic Violence 100% of participants reported a first degree relative with a substance abuse disorder

The average ACE score for the group was 8/10 According to research, individuals with an ACE score of 4+ and who don’t receive treatment are… 460% more likely to suffer from depression 1,220% more likely to attempt suicide 390% more likely to contract chronic pulmonary lung disease 2x as likely to suffer from cancer Have an average of 20-year shorter life spans Adver erse C e Childhood ood E Even ents

• Cognitive Behavioral Therapy (CBT) • CBT is a type of psychosocial treatment that has been proven to be very effective at treating various mental illnesses. CBT focuses on identifying and changing unhealthy Therapeutic cognitive distortions to improve personal coping strategies. Modaliti ties • CBT has been shown to be very effective at treating substance abuse disorders with one study showing 60% of the 120 patients examined providing negative drug screens at 52 weeks • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2897895/#R7

Nurturing Program Paren enting g Family system trauma from substance abuse and Therapy incarceration Generational trauma

Dietetic Consultation ISDH Cooking Matters Nutrition education for low income parents One study found that ASI psychological and medical domain scores improved by 68% and 56% when dieticians consulted with substance abuse treatment participants https://www.sciencedirect.com/science/article/abs/pii/S0002822304000094

Support all paths to Subutex for pregnant Medicati tion recovery women Assisted Tre reatment Vivitrol availability for Expanding suboxone all patients access via Telepsych

Peer Support is critical in We support all types maintaining of recovery support treatment groups engagement 12 step programs Peer Specialists in (NA, AA), 12 step Peer S Supp pport group and case non-spiritual management programs, faith- settings based programs P2P average 25 weekly participants

Indiana Risk Assessment System (IRAS) High Risk for Mental Health and Substance Abuse How w Department of Child Protective Parti ticipants ts Services En Enter C r CAD ADs Condition of bond, probation condition and/or community correction condition

Ho Home V e Visits and D Drug 3 Drug Home visits Weekly case Screens per and management Screen eens week unannounced and services drug screens coordination

Therapeutic sanction Administrati tive Direct commitment sanction Sancti ctions Violation referral to the Court(s)

• District Attorney doesn’t make decision about who enters the program- therapists do based on level of care What m makes • Participants do not get a reduced sentence or charge as a result of completing CADS DS differ eren ent • Participants complete the program post-release than Drug ug while on probation or home detention Court? rt? • Program also works with the Civil Court to provide services to adult participants involved with Child Protective Services • Cheaper

Only 1 graduate went on to receive new drug charges after successfully completing the program 88% of participants were referred Succe uccess M Metrics cs for substance abuse, 12% were for alcohol –related offenses 96% attendance rate to all program phases

Billing and Medicaid Cultural transition Challenges Challenges and Le Lessons Learn rned Balancing several Community support unlikely partnerships simultaneously

Margaret Mary Health- free standing 25 bed Critical Access Hospital Ripley County Circuit and Superior Courts Ripley County Court Services Team Choices Emergency Response Team/Safety Pin Complete Li List t of Community The Department of Child Services Partners Indiana WorkOne (unemployment office) The peer support community The faith community Our local and state elected officials

Thank y k you! Nikki King, MHSA Lindsey Gessendorf, LCSW Manager of Behavioral Health Clinical Addictions Therapist and Addiction Services Margaret Mary Health Margaret Mary Health Lindsey.Gessendorf@mmhealth.org Nikki.king@mmhealth.org Shannon Schmaltz, MS Director of Court Services Ripley County Courts schmaltz@ripleycounty.com This product was supported by the Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), U.S. Department of Health and Human Services (HHS). The information, conclusions and opinions expressed in this product are those of the authors and no endorsement by FORHP, HRSA, or HHS is intended or should be inferred.