Peer Support Services
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1 Peer Support Services
2 Humble Beginnings Founded as EVAC in 1982 Medical Model Supported by Volunteer Structure Transitioned from EVAC to Community Bridges in 2001 Allocated 2.5 Peers in 2004 SAMHSA BluePrints Grant in Peers today and growing
3 750 Employees, 30 Locations Peer Support & Outreach (306 Peers) Access Point / Transition Point (x2) (Crisis Entry Point) Crisis Stabilization & Medical Detoxification (x3) Residential Treatment (x3) Rural Stabilization & Recovery Units (SRU s) (x6) Psychiatric Services (Telemed to all locations) Medically Supervised Treatment Telemed Statewide (Hard-wired at each location) Housing the Homeless (300 units available) Veterans Outreach (3 programs) Outpatient Behavioral Health Programs ( 11 locations) Outpatient Opioid Medical Detox (including Prescription Medication) Permanent Supportive Housing for Women (3 four-plexes; 13 various locations) Women s and Children s Programs (56-bed Residential; 80 member OP) Prevention & Community Education
4 Who is a CBI Peer? Individual who is in recovery for 1 year or more from AOD. Has a solid foundation built in the recovery process. SMI or GMH and active in the recovery community Culturally Diverse Recovery Orientated Staff Representative of individuals served Meet the requirements and completed CBI Peer Certification Program
5 Recovery in Leadership 56% of Executive and Senior Leadership 98% of Managers and Supervisors Peer Panels and Advisory Groups Medical Practitioner Group Support/Partnership
6 Structure of Support for Peer Models of Care
7 Scope of Work In ED support of SA/MH patients (per request) Mobile Teams of EMTs/Paramedics and Peer Support (Maricopa County/Alarm Room Dispatch) Crisis Mobile Team with Clinicians and Peer Support (Rural Arizona) Crisis Navigator Program (Maricopa County)
8 Goals Connect patients in ED to the correct service quickly without usual issues Provide a warm transfer to ongoing support and/or services Relieve medical staff to do medical stuff Assist in creating opportunities to change
9 Building Support Cost Savings/Avoidance Relieve medical staff to do medical stuff Ability to demonstrate reduction in recidivism through connection to support (FO infrastructure/peer Run Partnerships) Lack of community resources that are available to support a complex population (FO/Peer Run Partnerships) Existing connections to medical infrastructure to provide support and continuity of care
10 Reimbursement Models AHCCCS/RBHA Contracts City Grants/Contracts Hospital MOUs Tribal Grants/Contracts FFS Structure (next level development)
11 How and Why of Working
12 Peer Run Access to Care Line 600-1,000 calls per day 24/7 support Dispatches Outreach Teams Disposition Calls 23-Hour Crisis 939 Access Point 347 Community Referral 246 External Transport Dispatch 208 Hang Up 151 Information (Recovery, Linkage to Recovery Support Services) 7332 Internal Transport Dispatch 179 OP Support 561 OP Detox Support 340 Referral to GMH/SA Provider
13 Community Response Team (PD, Fire and Hospital Geo Access & Diversion) EV Community-based Outreach WV Community-based Outreach CRT
14 WV AP/TP Observation Chairs 23 Residential 16 CCARC 23-Hr Crisis 32 Inpatient 16 ABR 23-Hr Crisis 4 Inpatient 10 ATC Calls Community- Based Outreach 7-day follow-up med check-up Ambulatory Detox Physical Health Psych Suboxone Opiate Unscript CFH EVARC 23-Hr Crisis 11 Inpatient 16 Project Rose H3 H3 Vets OIF/OEF a CFE Homeless/Navigator/Housi ng HCH/FQHC CASS Psych/ Blueprints Physical/ 24/7/365 Ambulatory EMTs Detox a EV AP/TP Ambulatory Detox Physical Health Psych Suboxone Opiate Unscript Observation Chairs 40 Residential 16
15 Community-Based Outreach Teams EMT & PSS In Field Brief Medical/Behavioral Health Assessment and Support Services Review with Triage RN Transports from Field(8,157) 7/12 to 7/13 Hospital: 3,473 PD: 1,479 Fire: 2,417 Urgent Psych: 788
16 DIVERTED FROM HOSPITALS DIRECT COMMUNITY SUPPORT Qtr1 Qtr2 Qtr3 Qtr4 TOT FY 12/13 Qtr1 Qtr2 Qtr3 Qtr4 TOT MARICOPA MEDICAL CENTER ST LUKE S HOSPITAL BANNER DESERT BANNER THUNDERBIRD ST JOSEPH S HOSPITAL ARIZONA REG MEDICAL CTR PHOENIX BAPTIST HOSPITAL SCOTTSDALE- OSBORN BANNER SAMARITAN BANNER ESTRELLA MARYVALE HOSPITAL JOHN C LINCOLN NO MTN CHANDLER REGIONAL JOHN C LINCOLN DEER VLY WEST VALLEY HOSPITAL BANNER GATEWAY BANNER SCOTTSDALE PARADISE VALLEY HOSPITAL BANNER BAYWOOD MT VISTA MERCY GILBERT VETERANS HOSPITAL DEL E WEBB HOSPITAL ARROWHEAD COMMUNITY HOSP SCOTTSDALE-SHEA BOSWELL MEMORIAL BANNER IRONWOOD PHOENIX INDIAN HOSPITAL GILBERT HOSPITAL FLORENCE HOSPITAL VALLEY HOSPIAL SCOTTSDALE- THOMPSON PEAK INDIAN HOSPITAL PARADISE VALLEY-NEW VISION CASA GRANDE REGIONAL MAYO CLINIC MESA LUTHERAN HOSPITAL WICKENBURG HOSPITAL AZ STATE HOSPITAL RURAL HOSPITALS TOTAL 1,240 1,203 1,166 1,227 4,835 CBI TRANSPORTS TOTAL ,437
17 ATC Triage RNs 24/7 assistance for MAT patients Avoids higher levels of care Provides education/access to Medical or Behavioral Practitioner Phone and telemed support to all CBI sites and mobile teams Triage patients from Hospital Emergency Rooms: 4,835 triaged out of Hospital Emergency Rooms
18 CASS Co-Location EMTs and Peer Support Co-Located 24/7/365 Dispatched by shelter staff in lieu of 911 calls (38% reduction in 911 calls since program began in December of 2012) Review with Triage RN/Physician Facilitate Telemed with NP or Physician 24/7/365 from CASS Coordinate transfer to CBI Facility, UPC, or Hospital EMTs respond to an average of 66 calls a day Program began on December 1 st 2012
19 Co-located in October 2012 Bridges gap medical/ behavioral health One Stop Shop Immediate access psychiatric and substance use services Peer Navigation Services 152 enrolled patients FQHC Co-Location
20
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