Ohio Access to Recovery IV

Provider Manual

August 2015

Access to Recovery Staff Contact Information

ATR Project Director

Alisia Clark

30 E. Broad Street

36th Floor

Columbus OH 43215

(614) 644-8428

(614) 401-7775 cell

ATR Training Coordinator

Heather Pennington

30 E. Broad Street

36th Floor

Columbus OH 43215

(614) 644-8434

(614) 619-8631 cell

ATR Fiscal Coordinator

Robert Armintrout

30 E. Broad Street

11th Floor

Columbus OH 43215

(614)644-8288

ATR GPRA Coordinator

Vincent Hendershot

30 E. Broad Street

36th Floor

Columbus OH 43215

(614) 466-7460

(614) 266-6065 cell

A.What is ACCESS TO RECOVERY?

Access to Recovery (ATR) is a three year competitive $7,084,767 grant program awarded to the Ohio Department of Mental Health & Addiction Services funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). This initiative provides vouchers to a projected 4,362 adults for the purchase of recovery support services from a cohort of ATR approved providers.

Access to Recovery enhances substance abuse recovery for individual Ohioans by funding a broad array of client-centered, community based services and supports.

ATR Goals

Consumer Choice

The process of recovery is a personal one. Achieving recovery can take many pathways. With a voucher, people in need of addiction treatment and recovery support will be able to choose programs and providers that will best meet their needs. Increased choice protects individuals and encourages quality.

Successful Outcomes

Success will be measured by outcomes, principally abstinence from drugs and alcohol, and includes attainment of employment or enrollment in school, no involvement with the criminal justice system, stable housing, social support, access to care, and retention in services.

Increased Capacity

Access to Recovery increases the number of recovery support service providers (including faith based organizations) eligible to receive federal funding and expands the array of services available, including peer recovery coaching, employment skills training, spiritual support and other recovery support services.

Sustainable Systems

Access to Recovery provides the opportunity to develop sustainable referral networks, services, and models of care that honors the client’s familial, cultural, spiritual, economic and logistical needs.

Access to Recovery will offer the participants it serves a unique approach to recovery by providing them with recovery support services concurrent or directly following clinical treatment, and a choice in their path to wellness. Access to Recovery will further improve service delivery outcomes by:

  • Identifying centralized ATR enrollment sites (Benefit coordinators) that identify the needs of the participant and provides linkages to services that result in improved engagement and retention.
  • Providing recovery support services that address issues which directly and positively impact substance abuse, thereby improving long-term recovery efforts;
  • Identifying and strengthening integrated health referral pathways between the existing clinical provider network and federally qualified health centers;
  • Recruiting and expanding the recovery support provider network to include faith-based and community-based providers;
  • Fostering free, genuine and independent participant choice via the creation of an Access to Recovery provider directory which contains information regarding all eligible recovery support service providers for each recovery support service, as well as their contact information and hours of operation;
  • Developing a comprehensive web-based data collection and voucher management system that is data driven to assure that resources are maximized across the system.

SAMHSA’s DEFINITION of RECOVERY SUPPORT SERVICES

An array of non-clinical, adjunctive activities, resources, relationships and services designed to provide support and assistance to an individual as they reintegrate into the community, participate in clinical treatment or work to improve overall functioning as they maintain their long-term recovery goals.

Ohio’s ATR project is consistent with a recovery oriented system of care model that integrates substance abuse treatment, primary care and recovery support services.

ATR covered services are managed through an electronic Voucher Management System (VMS). The Benefit coordination providers enter electronic vouchers into the VMS for covered services. All ATR providers enter reimbursement information into the VMS when services have been provided. OhioMHAS reimburses the ATR provider for authorized services identified on the electronic voucher for services rendered.

OhioMHAS assures provider and participant input through stakeholder discussions, satisfaction surveys, and solicitation of client and staff feedback during site visits.

Participant Choice of Providers

Participants will access recovery support services by going to one of the approved, centralized Access to Recovery Benefit coordination sites and completing the enrollment process. This process consists of verifying eligibility, completing the initial GPRA interview, and the identification of service-related needs. Each ATRparticipant will be assigned a Benefit coordinator who will assist them with linkages to all choices made for the provision of services.

Under the terms of the Access to Recovery Program, SAMSHA requires that each participant be ensured “genuine, free, and independent choice of providers for needed recovery support services”. For the purposes of the Access to Recovery Program, choice is defined as “a participant being able to choose from among at least two or more ATR network providers qualified to render the services needed, among them at least one provider to which the participant has no religious objection.”

The federal funding for this grant is discretionary and ongoing funding is based on meeting identified targets and milestones. Further, funding is allocated to the state on an annual basis and will discontinue upon the end of this grant.

ATR Guiding Principles

Provider staff and volunteers must comply with both the guiding principles listed below and SAMHSA’s Guiding Principles of Recovery. Provider staff who are licensed or certified in a specific profession must comply with the code of ethics for their profession as well as with the guiding principles, whichever is the higher standard.

  • ATR clients and family members are treated with honesty, dignity, and respect.
  • Providers shall abstain from alcohol or other drug usage prior to or during the provision of ATR services.
  • Providers shall not accept commissions, gratuities, rebates, gifts, favors, or any other form of non-OhioMHAS payment for ATR services.
  • Providers shall not misrepresent themselves or their qualifications, licensing or other accreditation requirements, education, experience, or status.
  • Providers shall not perform services outside their area of expertise, scope of practice, training, or applicable license or other accreditation by the State of Ohio.
  • Providers who are unable to provide a service to a client will refer the client to a provider qualified to provide that service.
  • Providers shall not discriminate on the basis of color, age, gender, sexual orientation, national origin, socio-economic status, spiritual/faith beliefs, psychiatric or physical status, or culture, ethnic, or racial background.
  • Providers shall not participate in false or fraudulent activities including, but not limited to, submission of claims for services not rendered, submission of false data, knowingly assisting another provider to enter false claims or data, charging a client for all or any part of a service, and/or providing false representation of credentials, qualifications, insurance, or licensure documents.

Ohio’s Definition of Recovery

Recovery is the personal process of change in which Ohio residents strive to improve their health and wellness, resiliency, and reach their full potential through self-directed actions.

Through the Recovery Support Strategic Initiative, SAMHSA has delineated four major dimensions that support a life in recovery:

  • Health: overcoming or managing one’s disease(s) as well as living in a physically and emotionally healthy way;
  • Home: a stable and safe place to live;
  • Purpose: meaningful daily activities, such as a job, school, volunteerism, family caretaking, or creative endeavors, and the independence, income and resources to participate in society; and
  • Community: relationships and social networks that provide support, friendship, love, and hope.

Guiding Principles of Recovery

Recovery emerges from hope: The belief that recovery is real provides the essential and motivating message of a better future – that people can and do overcome the internal and external challenges, barriers, and obstacles that confront them. Hope is internalized and can be fostered by peers, families, providers, allies, and others. Hope is the catalyst of the recovery process.

Recovery is person-driven: Self-determination and self-direction are the foundations for recovery as individuals define their own life goals and design their unique path(s) towards those goals. Individuals optimize their autonomy and independence to the greatest extent possible by leading, controlling, and exercising choice over the services and supports that assist their recovery and resilience. In so doing, they are empowered and provided the resources to make informed decisions, initiate recovery, build on their strengths, and gain or regain control over their lives.

Recovery occurs via many pathways: Individuals are unique with distinct needs, strengths, preferences, goals, culture, and backgrounds including trauma experiences that affect and determine their pathway(s) to recovery. Recovery is built on the multiple capacities, strengths, talents, coping abilities, resources, and inherent value of each individual. Recovery pathways are highly personalized. They may include professional clinical treatment; use of medications; support from families and in schools; faith-based approaches; peer support; and other approaches. Recovery is non-linear, characterized by continual growth and improved functioning that may involve setbacks. Because setbacks are a natural, though not inevitable, part of the recovery process, it is essential to foster resilience for all individuals and families. Abstinence is the safest approach for those with substance use disorders. Use of tobacco and non-prescribed or illicit drugs is not safe for anyone. In some cases, recovery pathways can be enabled by creating a supportive environment. This is especially true for children, who may not have the legal or developmental capacity to set their own course.

Recovery is holistic: Recovery encompasses an individual’s whole life, including mind, body, spirit, and community. This includes addressing: self-care practices, family, housing, employment, education, clinical treatment for mental disorders and substance use disorders, services and supports, primary healthcare, dental care, complementary and alternative services, faith, spirituality, creativity, social networks, transportation, and community participation. The array of services and supports available should be integrated and coordinated.

Recovery is supported by peers and allies: Mutual support and mutual aid groups, including the sharing of experiential knowledge and skills, as well as social learning, play an invaluable role in recovery. Peers encourage and engage other peers and provide each other with a vital sense of belonging, supportive relationships, valued roles, and community. Through helping others and giving back to the community, one helps one’s self. Peer-operated supports and services provide important resources to assist people along their journeys of recovery and wellness. Professionals can also play an important role in the recovery process by providing clinical treatment and other services that support individuals in their chosen recovery paths. While peers and allies play an important role for many in recovery, their role for children and youth may be slightly different. Peer supports for families are very important for children with behavioral health problems and can also play a supportive role for youth in recovery.

Recovery is supported through relationship and social networks: An important factor in the recovery process is the presence and involvement of people who believe in the person’s ability to recover; who offer hope, support, and encouragement; and who also suggest strategies and resources for change. Family members, peers, providers, faith groups, community members, and other allies form vital support networks. Through these relationships, people leave unhealthy and/or unfulfilling life roles behind and engage in new roles (e.g., partner, caregiver, friend, student, employee) that lead to a greater sense of belonging, personhood, empowerment, autonomy, social inclusion, and community participation.

Recovery is culturally-based and influenced: Culture and cultural background in all of its diverse representations including values, traditions, and beliefs are keys in determining a person’s journey and unique pathway to recovery. Services should be culturally grounded, attuned, sensitive, congruent, and competent, as well as personalized to meet each individual’s unique needs.

Recovery is supported by addressing trauma: The experience of trauma (such as physical or sexual abuse, domestic violence, war, disaster, and others) is often a precursor to or associated with alcohol and drug use, mental health problems, and related issues. Services and supports should be trauma-informed to foster safety (physical and emotional) and trust, as well as promote choice, empowerment, and collaboration.

Recovery involves individual, family, and community strengths and responsibility: Individuals, families, and communities have strengths and resources that serve as a foundation for recovery. In addition, individuals have a personal responsibility for their own self-care and journeys of recovery. Individuals should be supported in speaking for themselves. Families and significant others have responsibilities to support their loved ones, especially for children and youth in recovery. Communities have responsibilities to provide opportunities and resources to address discrimination and to foster social inclusion and recovery. Individuals in recovery also have a social responsibility and should have the ability to join with peers to speak collectively about their strengths, needs, wants, desires, and aspirations.

Recovery is based on respect: Community, systems, and societal acceptance and appreciation for people affected by mental health and substance use problems – including protecting their rights and eliminating discrimination – are crucial in achieving recovery. There is a need to acknowledge that taking steps towards recovery may require great courage. Self-acceptance, developing a positive and meaningful sense of identity, and regaining belief in one’s self are particularly important.

B. ATR Participant Eligibility

Eligibility Criteria for ATR Participants
Criminal Justice Involved Adults / Active and Inactive Military Service Members or Veterans with any discharge status
Resident of one of the ATR counties (or being released to one of the ATR counties) / Resident of one of the ATR counties
Age 18 or older / Age 18 or older
A positive screening for a substance use disorder (substance use disorder can be in remission) as evidenced by a bio-social assessment with a diagnosis completed within the past 12 months from the enrollment date. Individuals that have not had an assessment completed in the past 12 months can receive an assessment from the BC. / Substance use disorder or substance use disorder (can be in remission)
Income must be 200% or below the federal poverty guidelines. / Demonstrated need for ATR covered services.
Criminal justice-involved, living in the community (or being released to the community cannot be on transitional control), may or may not be under supervision, CJ activity within 10 years of discharge for a misdemeanor or felony. / Not required to have criminal justice involvement
Individuals may be currently engaged with an AoD Treatment agency or Specialty Docket Court or any individual that meets the above criteria (Adult, CJ Involvement, Resident, 200% Poverty Level, and Diagnosed) / N/A

Benefit coordination providers must maintain documentation of the following in each participants file:

  • Client eligibility documentation as necessary (proof of income, CJ Case number),
  • GPRA locator form,
  • Assessment and Recovery Support screening tool,
  • signed client participation policy (if treatment services are funded by ATR),
  • signed client choice form,
  • signed releases of information
  • ATR referral form
  • Any copies of receipts for GAP Funds disseminated

C. ATR Provider Eligibility

ATR Provider Application Process

Prospective providers may submit a 2015 ATR IV Provider Application to the local ADAMH Board during the established application window posted on both the local ADAMH board website and the OhioMHAS website. The application will be scored by the local ADAMH Board. The ADAMH Board will recommend potential providers to OhioMHAS based on the scores. OhioMHAS and the local ADAMH Board will conduct a site visit to the prospective provider agency and determine if the provider will participate in the ATR grant.

The organizations that are chosen to participate in the ATR grant will then receive and sign the ATR IV Provider Agreement, and if applicable Memorandums of Understanding with the local ADAMH Board. Please review the ATR IV Provider Agreement and the ATR Guiding Principles to ensure your agency can comply with all expected policies and procedures prior to submitting an application. The chosen ATR providers will receive training on the ATR process, enrollment procedures and voucher management system. OhioMHAS reserves the right to deny any application when there are sufficient numbers of ATR providers.

All eligible ATR applicants must be able to demonstrate the ability to work with the electronic voucher management system by ensuring the following requirements are met:

Category / Requirement
Operating System Version / Windows 7+
Computer Processor
memory / HHI
Browser Version / Internet Explorer 10+ with current service packs
Virus Protection / Required. Virus definitions must be kept current
Printer / Required for printing reports
E-mail / Internet e-mail access
Bandwidth / Fastest network connection available and economic to you. Recommend DSL or cable modem.

ATR Provider Program Administration and Organization Expectations

All Recovery Support providers participating in the Access to Recovery program must:

  • Maintain a policy and procedure manual that contains the organization’s purpose and philosophy;
  • Establish a governing body (for all nonprofit agencies) (Board of Directors) that meets according to their by-laws to provide fiscal planning and oversight, ensures quality improvement in service delivery, establishes policies to guide the administrative operations of the organization, ensures responsiveness to the community and individuals being served, and delegates operational management to a program manager in order to effectively operate its services;
  • Develop a plan of action for continuity of services in the event that the organization can no longer perform services due to facility incapacitation or loss of key personnel;
  • Implement a policy to prevent conflict of interest which states that no employee or volunteer may use his or her position to secure privileges or advantages from any participant; and
  • Implement a policy to ensure the work environment must be free from sexual harassment and verbal abuse and intimidation.

Personnel