Dr. Collins said that new and expanded alcohol and other drug (AoD) treatment, support and prevention services that will begin this fiscal year are intended to help meet some of the needs identified in recent community meetings convened about treatment strategies available to those with addictions.
He reported new and expanded treatment and support services for those with severe mental illnesses also were approved at the June MHAS board meeting.
To access the new and expanded services described below, as well as all MHAS Board-supported behavior health services, other than emergency services, an individual first needs to make an appointment for a Diagnostic Assessment (DA) at the board’s contract treatment provider, Firelands Counseling & Recovery Services (FCRS) of Huron County. ADA is an evaluation to determine the nature and extent of a person’s health problem - be it physical or behavioral - and to define the optimal type, level and duration of treatment for an individual. Same day access is available so that most of the time an individual who calls FCRS between 8 and 9 a.m. on weekdays is given an appointment for a DA that day.
New and expanded AoD service
Opioid Detoxification and Residential Treatment Services, offered initially last fiscal year, have been expanded this year by a 90 percent increase in funds. A DA will be completed to assess the eligibility of a person for these services. If eligible, a treatment plan will be developed to design outpatient drug/alcohol treatment after the detoxification services are completed. While withdrawal from substances such as alcohol or barbiturates can result in medical emergencies requiring medical interventions in a general hospital, a person’s withdrawal from opioids generally is not a serious medical condition. Even so, some individuals may be assisted with the time-limited discomfort of opioid withdrawal- that usually subsides on the second or third opioid-free day by being removed to environments not associated with their opioid use and by receiving reassurance and general nursing care. Ceasing to use opioids is a first step in a lengthy treatment process.
Medication Assisted Treatment (MAT) with Vivitrol, which is non-euphoric and non-addictive, also was offered initially last fiscal year. Its availability will be augmented this year by a 150-percent increase in funds in that line item to assist those struggling with opioid addictions that need additional efforts outside of traditional behavior health therapies. MAT also will be available to persons in the jail since Medicaid is not billable for anyone incarcerated.
Certified Peer Mentors will be a new addition to the treatment team supporting those with substance use disorders this fiscal year. Those in receipt of MAT, for example, will be assisted not only by medical professionals but also by a treatment team that may include behavioral health counselors, case managers and Peer Mentors. The Peer Mentors will offer encouragement and support throughout the treatment process, which may include attending AA/NA meetings with recovering individuals and reinforcing treatment strategies, in order to assist individuals to remain in treatment.
Overcoming cravings and changing one’s lifestyle can be so difficult that being surrounded by supportive outpatient services often is necessary to help someone persevere with treatment. Research shows that the longer a person with a substance use disorder is engaged in treatment, the better the outcome.
AoD outreach is another new service that will be utilized to assist those with addictions stay in treatment. Since individuals with substance use disorders often drop out of treatment for one reason or another until problems compel them to return, assisting them to engage or re-engage in treatment before serious legal, health or family problems occur may give them better chances to recover. However, the time spent trying to track down these individuals to keep them engaged in treatment is not Medicaid-billable. Consequently, the board will begin to pay for this enhanced outreach to individuals who start treatment but drop out in the hope of engaging them in treatment for longer durations and thereby improving their opportunities for successful recoveries.
Recovery Housing is newly available to clients with substance use disorders. An individual who may be assisted by living with others desiring to sustain sobriety needs to begin treatment at FCRS, as explained above, and after a period of sobriety may be interviewed by a recovery housing administrator. The housing administrator will explain the expectations of a person who wants to enter recovery housing. Expectations include evidence of a period of sobriety prior to admission into recovery housing, willingness to comply with rules of the house including sustained abstinence from substances, sustained AoD treatment and peer support and willingness to continue, or begin, work with the plan that the individual will be self-supporting in the house within a number of months.
Naloxone funding newly will be available to local law enforcement organizations due to the increased doses of this drug used per individual who overdoses on highly potent opioids. Board funds for Naloxone (Narcan) will be made available after the OhioMHAS Naloxone Funds that flow to communities through county Health Departments are depleted. For the 2nd fiscal year in a row, OhioMHAS set aside $500,000 for Health Departments in Ohio to access Naloxone for first responders. The funds made available to Huron County Public Health for this purpose are the same amount this year as last year: $2,176. The board has contracted with FCRS to make available to each interested local law enforcement agency funds for the purchase of Naloxone and materials about AoD treatment services available in Huron County.
Dissemination of AoD Information has been expanded by 72 percent for the new fiscal year to provide the community with more information about the prevention and treatment of substance use disorders and about access to services.
Dr. Collins also reported that a high level of successful AoD treatment outcomes was achieved by Firelands Counseling & Recovery Services (FCRS) again this year. He explained the board contracts annually for an independent peer review (IPR) of a representative sample of FCRS cases. The June 2016 IPR found Firelands achieved a 58-percent rate of goals met, which more than doubled the state average of 28.5 percent for successful AoD treatment outcomes, showing that FCRS is a premier provider of addiction treatment services in Ohio and that tax payer levy dollars are being well spent. FCRS treated 522 individuals for substance use disorders last year.
New and expanded mental health services
Emergency Services provided by FCRS will be funded at higher levels for the new fiscal year. These include:
- Crisis intervention services, which saw a 20-percent increase in use by adults and children last year with 969 crisis interventions provided, and with youths having received 229 of these for a 45-percent increase over the 157 interventions provided to youths in the previous year;
- After-hours crisis intervention subsidy to sustain three clinical crisis teams instead of two for improved timeliness of response to persons in crises; and
- Inpatient Services for the additional persons in crises who meet criteria for psychiatric hospitalizations.
Integrated Mental Health and Primary Care Services will be Board-funded 650 percent more than in the previous year so this service can continue when the three-year federal SAMHSA grant to FCRS for integrated health care ends this autumn. The Board has prioritized this service because individuals with Severe Mental Illness (SMI) have been found to have life expectancies 25 years fewer than individuals without SMI, often due to untreated physical health care needs.
Incredible Years Program support by the board will be new this year. This program, provided to children in the Willard Head Start Programs, had been funded by a Children’s Trust Fund Grant that ended this year. The Incredible Years is evidence-based to reduce conduct problems in youths 4 to 8 years old.
MH Outreach will be a new service, delivered by case managers to persons discharged from psychiatric hospitalizations in order to increase their engagement in outpatient treatment, which is correlated with fewer re-hospitalizations.
Finally, Dr. Collins said that Firelands Counseling and Recovery Services’ Willard office will move into the Mercy Health-Willard Hospital this summer, making the three FCRS offices that provide behavioral health treatment services to Huron County residents located on the campuses of the three hospitals, Fisher-Titus Medical Center, The Bellevue Hospital and Mercy Health-Willard Hospital. FCRS’ toll free telephone number is 1-800- 242-5393 and its board-funded Crisis Hotline is 1-800-826-1306. The Board’s Web-site is huron.oh.networkofcare.org.