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Broward’s ResponseTo the Opioid EpidemicCOLLABORAVTIVE EFFORTS
State Opioid Response (SOR) GrantSuzette B. Fleischmann, LMHCDepartment of Children and FamiliesSubstance Abuse and Mental Health Southeast Regional (SER) Director This grant was made available to the State ofFlorida, as a no-compete opportunity, in responseto the Presidential Declaration of a NationalOpioid Epidemic. Approximately 50 million per year for 2 yearswas made available to the State of Florida.
Memorial Healthcare SystemTargeted Programs for the Treatment of Substance Use DisordersAlberto Augsten, PharmD, DABATClaudia P. Vicencio, Phd, LCSW, LMFTThe Mothers In Recovery Program Started in May 2015 to address a community need to treat pregnantwomen with substance use disorders 4,000 Neonatal Abstinence Syndrome in 2016 in Florida, 1,000%increase in the last decade, MIR program designed to reduce rates ofNAS Programmatic & community needs called for a change in thestandard of care
MIR Program WorkflowED Admission Outreach OB Work-up Initiate Social Work ServicesInpatientInduction 5-7 days Psychiatric stabilization Setting up outpatient & supportOutpatientStabilization 14-21 days for detox Supportive housing Intensive OutpatientProgram OB/GYN care MAT post delivery
Mothers In Recovery Outcomes(May 2015 – September 2018)113 Mothers served93% babies born drug free (88/95)Postpartum Recovery Rates: 3 months:92% 6 months:66% 12 months: 54%Florida State estimates each NAS babycosts 144,681 in Medicaid & other socialrelated expenditures
Medication Assisted Treatment atMemorialComprehensive approach, includes medication plusbehavioral interventions and psychotherapy. Screening and assessment considers all clinicallyappropriate forms of treatment. Monitoring for illicit drug use, including illicit use ofmedication-assisted treatment medication is a keycomponent of the program. Multi-disciplinary team coordinates assessment, servicedelivery, care coordination and discharge planning. Accessible treatment with multiple points of entry.
Phased Treatment & Interventions1)Engagement – start treatment, develop a plan of care regarding MAT 2)Induction – relieve symptoms of withdrawal 3)Memorial Outpatient Behavioral Health Center, 6 days a week or transfer toanother providerMaintenance – address trauma and quality of life issues, build a lifeworth living 5)Behavioral Health Transition Clinic at MRHStabilization – control cravings and develop a recovery strategy 4)Emergency Department at MRHOutpatient individual, groups & Medication managementLong-term rehabilitation/Discontinuation – monitor for “somatic”rebound effect, identify and address psychological and social relapserisk factors.
MAT OUTCOMES 243 patients (June 2017 to October 2018)with 67 active patients 95% are drug free at 3 months158 discharged cases41% (n 65) discharged successfully52% (n 82) discharged in first 2 weeks oftreatment
Susan B. Anthony Center, IncOmrit Shimoni, LMHC, CEO Licensed by the Florida Department of Children andFamilies to provide Residential Level 2, Residential Level5, Intensive Outpatient Treatment, Outpatient Treatmentand Aftercare services. Recovery & Resiliency Services are provided to clientsduring their residential stay and in the communitythrough the Aftercare program after graduation from theProgram. The services are intended to provide supportand continued education to the mothers so that they willbe successful in their recovery, their children’s lives andbreaking the cycle of addiction and mental healthdisorders.
Susan B. Anthony Center, IncProgramming and Services Assessment Services will be provided to clients in their current setting (i.e. jail,hospital, homeless shelter, etc.) while they are waiting to enter the Program todetermine their appropriateness for the level of care provided by the Program byutilizing the LOCUS and/or ASAM assessments. Additionally, other in-depthassessments are provided to the clients to help determine their individualtreatment needs during their stay in the Program. Residential Services will be provided to clients residing in Agency housing andwill include, but is not limited to, the following: 24-hour supervision,transportation, parent/child bonding activities, drug testing, therapy andassistance for food and supplies. Therapeutic services include individual, group and family services to assist themothers in learning recovery skills and improving their mental health functioning.Clients will be stepped down as it is deemed medically necessary by a qualifiedprofessional.
Susan B. Anthony Center, IncProgramming and Services Case Management Services assess clients’ and their childrens’ needs and linksthem to resources in the community, including assisting them with obtaininghousing, food assistance, Medicaid, and temporary financial assistance. Career and Education Services are also provided to assist the clients inmaintaining supportive services, their recovery and potentialemployment/educational opportunities. Intensive Outpatient and Outpatient Treatment Services will be provided toclients regardless of their ability to pay, on an individual and group basis tofurther assist the mothers in learning recovery skills and improving their mentalhealth functioning. Aftercare Services will be provided to clients who meet eligibility criteria.Aftercare Treatment services are provided on an individual and group basis toassist the mothers in preventing relapse and encouraging social connectedness intheir new environment upon discharge from residential services.
Banyan Health SystemsMegan Betancourt, LCSWClinical Director of Broward OutpatientOperations Hours of Operation: Monday – Thursday: 8AM – 8PM Friday: 8:30AM – 5PM Saturdays 8AM – 2PMServices Offered: Psychiatric Services Substance Abuse Residential Level II Outpatient Therapy (OP) Services Case Management Peer Support Services Peer-run MAT support groups
New Client Process FlowBanyan Health Systems Referral received A peer is assigned Peer will attempt engagement and provide education within 24 hours Peer and candidate schedule psychiatric evaluation Psychiatric evaluation is completed, MAT eligibility is determined If eligibility for MAT is met A case manager is assigned Peer continues to work with client A biopsychosocial is conducted to determine the need for other therapeutic services (SA Res II,Intensive OP, OP) If eligibility is not met for MAT services Will receive assessment for non-mat services
Henderson Behavioral HealthFamily Engagement ProgramThe Family Engagement Program (FEP), is acollaboration effort amongst the BrowardBehavioral Health Coalition (BBHC), the BrowardCounty Sheriff’s Office (BSO) Child ProtectiveInvestigation Section (CPIS), Henderson BehavioralHealth (HBH), Banyan Health Systems, Susan B.Anthony, BARC, Ft. Lauderdale Hospital, House ofHope/Stepping Stones, and Memorial Health CareSystem.
Henderson Behavioral HealthFamily Engagement Program FEP utilizes Peer Advocates. The role of the Peer Advocate is to help the identified caregiverwith an allegation of substance/alcohol use in the early intervention process as a result of thecurrent open investigation with CPIS. The early intervention process will include a substance abuse evaluation and drug test at afacility in the BBHC network, or that will accept their health insurance. Peer Advocates enter all documentation and notes into FSFN and collaborate with ChildAdvocates when appropriate. After the assessment and drug test are complete, the Peer Advocate distribute a copy of thecompleted assessment and drug test results to the CPI. Peer Advocates will help in successfully engaging the family in the recommendations for thelevel of care from the initial assessment. Peer Advocates will work in identifying any barriers to treatment such as child care,transportation, work schedule and help to eliminate barriers when possible. For example, childcare referrals can be made from the CPI to expedite and provide funded child care through ELC.FEP has access to flex funds for emergency funding such electric bill assistance, and bus passaccess. After the caregiver is successfully linked to ongoing treatment, FEP closes the referral as linkedto treatment with the specific provider and the completed assessment, lab results, closingsummary, and releases of information are uploaded to the FSFN file cabinet.
Broward AddictionRecovery Center (BARC)Dr. Dale Fahie 4,500clients are admitted 1,800clients receive medically superviseddrug & alcohol withdrawal treatment 800residents participate in non-residentialday treatment programs--NOTE:2015 BARC DATA
Broward AddictionRecovery Center (BARC)Medication Assisted TreatmentThe use of FDA-approved medications, incombination with counseling andbehavioral therapies, to provide a “wholepatient” approach to the treatment ofsubstance use disorders and preventopioid overdose.
Broward AddictionRecovery Center (BARC) JointCommission Accredited Lifetime Achievement AwardRecipient (Broward CountyRecovery Month 2015) CertifiedHIV Testing Site
PANEL DISCUSSIONQUESTIONS?
Anthony, BARC, Ft. Lauderdale Hospital, House of Hope/Stepping Stones, and Memorial Health Care System. . NOTE: 2015 BARC DATA. Broward Addiction Recovery Center (BARC) Medication Assisted Treatment The use of FDA
