CCC Hooper Detoxification Stabilization Center. Accessing Services

Transcription

1 CCC Hooper Detoxification Stabilization Center Accessing Services

2 Overview Access / Admissions Subacute Program Discharge / Referral

3 Access / Admissions : Current Process 4 groups: Each triaged independently TRIAGE PROCESS Total 10 admissions daily if beds available Accessing Services Medical Emergencies Phone-In Referrals On Return List Walk-Ins Self Referred All individuals seeking admission are present in lobby during triage. Individuals may have been prescreened, referred, asked to return on day prior or walk in. Seizures, at risk, medical complications etc. Multnomah County contract: ICP, Drug Court, FIT Community Partner Referrals: Treatment Programs Met with RN for brief assessment and asked to return Family members, Twelve Step, prior knowledge, friends, etc. Contracted Services: Family Care, Care Oregon, Veterans(?), etc.

4 Current Phone-In Referrals Phone - In Referrals Multnomah County contract: ICP, Drug Court, FIT Community Partner Referrals: Treatment Programs, Community Agencies Contracted Services: Veterans(?), etc. Direct phone line Brief Assessment Screening Given appointment time for admission (usually within 48 hours) The Phone-In Referral can be expanded

5 Admission Process Admission Packets Vivitrol Pilot RN Interview Medications History Physical Exam Acupuncture Orientation Why Acupuncture Personal Property Inventoried If Insured billed Billing Individuals are transported to lab for liver function test Consents ROIs Physician Exam Shower, Property Lab Tests

6 Physician Required On Site Each Patient admitted into the Subacute Program MUST be examined by a Physician establishing a physician patient relationship prior to the dispensing of medications. Physician currently available Monday thru Friday 9am-1pm (approximately)

7 Subacute Withdrawal Protocols Alcohol Opiate Opiate Alcohol CNS Opiate Vivitrol Withdrawal monitored via the CIWA scale Librium (or Serax for patients with severe liver disease) for withdrawal symptoms Withdrawal monitored via the COWS scale Buprenorphine for withdrawal symptoms Withdrawal monitored via CIWA/COWS Librium and Buprenorphine for withdrawal symptoms Withdrawal monitored through vital signs and general clinical assessments Symptomatic management with vistaril, trazodone, ibuprofen Withdrawal monitored via COWS scale Naltrexone compressed opiate detoxification protocol for withdrawal symptoms Monthly Vivitrol injection

8 Counseling-Referral Assess Psych Social Assessment DSM IV Criteria Counsel Current Issues Motivational Interviewing Refer Review available options Direct referral if possible

9 Discharge Planning 23% 1,159 Individual Completions ( ) Self Help Mental Health Agency Limited referral availability Minimal window of opportunity Patient required to be medically stable Patients detox at a much faster rate and in larger numbers than treatment and housing can become available If direct referral not available then patient given specific directions for accessing treatment 22% 51% Other Community Agencies Outpatient 3% 1% Residential Care

10 Demographics 1,915 Unduplicated Admissions 1% 3% 1% Ethnicity White 5% African American 33% Gender 7% Native American Alaskan Native Asian/Pacific Islander Males Hispanic Mexican 67% Females Hispanic Puerto Rican Hispanic Cuban 83% Hispanic Other Southeast Asian Other

11 Demographics 1,915 Unduplicated Admissions 7% 17% Age Living Situation 32% % 67% Homeless (estimate) Not Homeless (estimate) 44% 51+

12 Recidivism ,399 Admissions 14% 4% 1% 1 admit 2 admits 902 first Admissions 3 admits 4 admits 81% 5 admits

13 Vivitrol Pilot Program Admission Demographics as of March 5, 2013 Total Admission: 35 individuals Age Gender 6% 11% 40% 43% % 63% Male Female Transgender

14 Vivitrol Pilot Program Admission Demographics as of March 5, 2013 Total Admission: 35 individuals Ethnicity 31 Living Situation % Homeless 94% Not Homeless

15 Vivitrol Pilot Program Individual Program Status as of March 5, 2013 There are 14 Active Participant in the Vivitrol Pilot Program

16 Vivitrol Pilot Program Hooper Aftercare/Housing as of March 5, 2013 Total Vivitrol Pilot 1 st Injection: 17 individuals Treatment Referral Housing Referral 8% 8% 17% 67% CCC Recovery Center Outpatient CCC Changepoint Drug Court Hooper 8% 92% ADFC Transitional Richard Harris Private Residence Every participant is referred to community self help support groups including Twelve Step Programs.

17 Vivitrol Pilot Program Notes a. Approximately 58% of the current participants are identified high utilizers of A&D community systems. Participants self reported the Vivitrol Program has decreased use of community resources. b. A participant reports this is most successful attempt with recovery and is requesting a fifth injection if possible. Participants reports feeling relieved of obsession to use opiates. c. Peer Support has improved post discharge stabilization. Peer Support Specialist are very effective with their ability to engage patients while in detox. Post detox, Peer Support Specialist provides individual support during the transition to community resources and support for stabilization within the community. d. An element of the program consists of the participants returning to Hooper twice weekly for check in and process groups.

18 Hooper Detox