Presented by: Sara Cozad, LCSW - Assistant Deputy Director Adult Services Angela Boarman - Project Director Division of Mental Health and Addiction

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1 Presented by: Sara Cozad, LCSW - Assistant Deputy Director Adult Services Angela Boarman - Project Director Division of Mental Health and Addiction

2 Sheriffs: Help needed to cope with mentally ill September 15, 2014 INDIANAPOLIS - A sheriff says county jails have become the "insane asylums" for Indiana as state inpatient care for the mentally ill has disintegrated.

3 The numbers Nationally 650,000 released annually Indiana releases 18,000 from DOC CJS is largest referral source to SA tx Estimated 6,500 level 5 s & 6 s to be diverted

4 Seriously Mentally Ill 14.5% men, 31% women in jails 16% of prisons 9% probation, 7% parole General Public is 5.4% Adults with a serious mental illness (SMI) are defined by SAMHSA as persons age 18 and over, who currently or at any time during the past year, have had a diagnosable mental, behavioral, or emotional disorder of sufficient duration to meet diagnostic criteria specified within the [DSM-IV], resulting in functional impairment which substantially interferes with or limits one or more major life activities (CSAT, 1998, p. 265).

5 Addiction 53% of State and 45% of Federal prisoners 75% of prisoners returning to prison 68% of jail inmates General Public is 8.8% According to SAMHSA, substance use disorders occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment, such as health problems, disability, and failure to meet major responsibilities at work, school, or home.

6 Treatment Needs Criminogenic and treatment needs Balance public safety with access to care Implications for CJS Implications for Treatment Providers Treatment advances public safety, health and personal recovery

7 Effective Interventions Individualized approach Risk and needs assessment to inform plan Intensive and targets behavioral change Targets multiple criminogenic needs Higher risk offenders have increased benefit

8 Reducing Recidivism Educational and Vocational Program Substance Abuse Treatment Drug Courts Sex Offender Treatment Cognitive Behavioral Therapy

9 Cognitive Behavioral Therapies Motivational Interviewing Moral Reconation Therapy Aggression Replacement Training Reasoning and Rehabilitation Relapse Prevention Therapy

10 Recidivism with Treatment Average Recidivism 20% reduction overall 8.2% reduction in felony reconvictions for general offenders 6.3% reduction for returns to prison 4.7% reduction of reconvictions

11 Treatment Works

12 Treatment Best Practices Individualized assessment, treatment planning, and linkage to services Length of Time Types of Programming Funding Resources Critical collaboration with Community Supervision

13 Mental Health and Addiction Forensic Treatment Fund HEA Funds specifically to support services for those without insurance coverage who are involved in the criminal justice system (see eligibility checklist) RECOVERY WORKS

14 Forensic Treatment Fund Two Funding Priorities: Pre-Incarceration Diversion Services & Post-Incarceration Re-Entry Services

15 Recovery Works Reimbursement Voucher Reimbursement for the service is not available to an individual if the services being provided are covered under: A policy of accident and sickness insurance A health maintenance organization contract The Medicaid program* The federal Medicare program or any other federal assistance program

16 Recovery Works Reimbursement* If the service is covered by Medicaid, the billing agency may qualify for: A reduced rate payment equivalent to the agency s Medicaid Match amount.

17 Recovery Works Services Mental Health & Substance Use Assessment Psychiatric Evaluation Individual, Family and Group Therapy Individual, Family and Group Skills Training Case Management Medication Evaluation, Training and Support Medication Assisted Treatment Psych Medications Detoxification Supportive Employment Transitional Housing Assistance Community Support Services Recovery Supports Transportation

18 Process Flow

19 Recovery Works Referral Process Eligibility Screening Collect supporting documentation Assist participant in selecting treatment provider Complete Referral Form Submit Referral Form and supporting documentation to the Treatment Provider Wait for feedback from Treatment Provider & review Individualized Recovery Plan

20 Recovery Works Eligibility Criteria Eligibility Questions Yes No Is the individual a resident of Indiana? Eligible Ineligible Is the individual at least 18 years old? Eligible Ineligible Is the individual a member of a household with an annual income not exceeding 200% of the federal income poverty level? Has the individual entered the criminal justice system as a felon or with a prior felony conviction? Eligible Eligible Ineligible Ineligible

21 Recovery Works Referral Documentation Collect supporting legal documentation to inform the overall bio-psycho-social assessment process: IRAS Court orders Pretrial diversion documentation Supervision program documentation Supporting information deemed useful*

22 Recovery Works Designated Treatment Providers Certified/Licensed DMHA Provider DMHA will provide a list of all Designated Recovery Works Treatment Agencies Website forthcoming Agencies may be added ongoing Provider assessment of Capacity Provider assessment of Training Needs

23 Recovery Works Designated Treatment Providers What if my typical referral source is not a designated provider? Criminal Justice Providers may refer to whomever is preferred The vouchers can only be used to pay for services provided/contracted by a Designated Recovery Works Provider

24 Recovery Works Referral Form

25 Recovery Works Referral Form

26 Recovery Works Referral Form

27 Designated Recovery Works Provider Expectations Accept Referral Form from Criminal Justice Provider (CJP) and contact referred participant within two (2) business days to schedule assessment Treatment Provider will not schedule assessment until CJP provides supporting documentation with completed referral form Offer appointment to participant within five (5) business days of referral. Notify CJP regarding outcome of contact

28 Designated Provider Expectations Continued Obtain all necessary participant consent and release of information forms Complete bio-psycho-social assessment Guide participant through the development of an Individualized Recovery Plan (IRP) and share with CJP Engage participant, refer accordingly, & collaborate with all members of the treatment team

29 Recovery Works Individualized Recovery Plan

30 Designated Provider Expectations Continued Provide services based on IRP If unable to provide recommended services in IRP, partner with another agency Submit billing through WITS for voucher reimbursement for services Maintain an ongoing record of all contact and attempted contacts Communicate frequently with the Criminal Justice Provider

31 Ongoing Collaboration Criminal Justice Provider and Designated Recovery Works Treatment Providers will determine best method of communication Weekly calls Monthly written reports Weekly face to face staffing

32 Recovery Works - Indiana s Forensic Treatment Program It is A funding source for treatment for those involved with the criminal justice system A supplement to community supervision strategies that will decrease recidivism Access to individualized treatment and recovery services It is not A Diversion or Re-entry Program A stand-alone solution to community placement for forensic populations A punitive measure as discipline for criminal acts

33 Recovery Works Timeline Date August 18, 2015 September 21, 2015 September 21, 2015 October 5, 2015 October 23, 2015 October 26, 2015 October 30, 2015 November 1, 2015 Project Development Item Memo to eligible treatment providers formally announcing Recovery Works Host first webinar to explain to providers the application process to become Designated Recovery Works Provider Open Application process for providers to become Designated Recovery Works Provider Host first webinar with Criminal Justice Providers to review Recovery Works referral process and provider expectations Host first webinar with any approved Designated Recovery Works Providers to review Recovery Works Provider Manual Host first Voucher System Training with any approved Recovery Works Provider Recovery Works Voucher System Go Live Recovery Works Services and Voucher Claiming begins

34 Questions?

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