Addiction Education Advisory Group Meeting

10/21/2016

Minutes

Attendees:: Dennis Braun (Assumption), Bill Carlo (U Mass Boston), John Ciervo (Cambridge College SOPC),Amy Ford (Greenfield Community College), Joe Gardner (Middlesex Community College), Jim Gorske (AdCare Educational),Haner Hernandez (AdCare/Latinx BH Institute), Brian McKenna (Northern Essex Community College), Jen Parks (BSAS), Linda Mullis (Westfield State), Erica Piedade(BSAS), Barbara Reid (Cambridge College), Karen Shack (Commonwealth Corporation), Deborah Strod (DMA Health), Anne Zarlengo (High Point Treatment Center)

Action Items:

  1. Alex: clarification about when work experience can be used for the practicum. They are distinct for CADCII, but not for LADC? And are the 300 hours included in the 6000?
  2. Amy: complete AAEP application, follow up with Ian, Alex or Jen with any questions.
  3. Amy: follow up with Haner, Ann, Linda for exam preparation materials. Also look at readytotest.com.
  4. Ann: send the daylong curriculum and PowerPoint (or we can upload on the AEAG workspace)
  5. Brian: send the link to Debbie for the program manual that he included with his application.
  6. Erica: provide advice on CORI to AEAG members.
  7. Haner: Clarify whether the new requirements for 300 hours for certification are starting in January or July? And what about the exam? Programs should be careful with their advertising. The MBSACC will meet in December and Haner will share news.
  8. Haner: tell Jen when people call you looking to hire
  9. Jen/Deb (or AEAG members): request agencies’ internship manuals for comparison to the education program manuals.
  10. Jen/Deb Edit handbook outline
  11. Jen/Deb Edit survey (and ask for suggestions about what to ask related to programs who use their own forms/guidebook).
  12. Jen/Deb/New members: Get new members onto the AEAG workspace
  13. Jen/Deb: Add a Resource page on COS re: CARC (and CPS?)
  14. Jen/Deb: Check to see if there is any requirement for ongoing supervision for recovery coaches, particularly those starting independent recovery coaching businesses.
  15. Jen/Deb: find some advice on educational institutions and CORIs.
  16. Jen/Deb: follow up with Haner on the RC learning community and the COS workspace (which was for ATR and only two counties).
  17. Jen/Deb: follow-up on whether asking about recovery status is legal or not.
  18. Jen/Deb: Upload materials to the workspace (survey draft, internship manual outline draft).
  19. Jen: send email asking for aggregate student demographics from the last couple of years. Add the reason for collection, and description of usage expected.
  20. Jen: send out link to the survey so we can get feedback by next Wednesday
  21. John: follow up on materials for LMHC track
  1. Announcements
  2. BSAS has a new Tobacco Practice Guidance document at
  3. Residential RFR

i. Requires senior clinician in residential programs - was not requirement before.

ii. Medicaid and Medicare will be looking for clinical milestones, so will integrate ASAM criteria for funded programs.

iii. Whole system will be pushed toward using electronic medical record if you are involved with federal funding. Most residential programs are struggling with how to develop EMRs - medical record, billing process and interoperability (data sharing). Young professionals in the field have to be exposed.

Translate into medical records - what does Residential mean?

iv. The proposed Medicaid Waiver covers 30 days of the stay. A lot of how it will be operationalized is evolving, everyone at BSAS is in workgroupswith MassHealth. ATS, CSS, and outpatient are covered and now MassHealthis including TSS and Residential Staff had no requirements for credentialing, now there will be more of a push for credentialing and demonstrating clinical knowledge.

  1. Long term care facilities are struggling with SUD patients - in past didn’t deal with them. Baby boomers and short term rehab.
  2. Co-occurring disorders –this is an identified area for BSAS and DMH and the legislature - both fields have not done well around COD. BSAS looking to create another level of care for that –a huge area will boom.
  3. The workforce needs skills in telemedicine and telehealth - how to use the equipment to establish clinical engagement. MBHP already pays for telehealth, especially around psychiatry. There will be a need to get certified in telehealth.

Discussions:

  1. Welcome to new members Amy Ford from Greenfield Community College, and John Ciervo from Cambridge College; and to guest Karen Shack from the Commonwealth Corporation. Commonwealth Corporation manages workforce development funds for the state, and is interested in understanding the education and training needs of the addictions workforce.
  2. AAEP Renewal: Renewal went fine – no issues to report.
  3. Data on AAEP graduates’ exam pass and licensure rates
  4. Most schools are not tracking how many students go forward and complete licensure or certification. No resources to track; some students wait even up to a year to take exam; some take the exam and then can take wait three years to get the work hoursfor certification or licensure.
  5. HPTC does track, but it is a different situation because all students are employees. Anne reviews the completion document from the ICRC exam with students to assess areas where they might need additional work. Ann does track that.
  6. Karen from Commonwealth Corporation: understanding the pool of qualified workers who complete the education piece is important, in order to figure out what other strategies could be helpfulfrom the state’s perspective.
  7. Data on student demographics - This came up in relation to the start of the African-American Behavioral Health training program, to find out where African-American students are currently getting their education.
  8. Race/Ethnicity:
  9. Cambridge College keeps track of it in terms of who is going through the program - all state colleges keep track of ethnicity. Ann has access to that.
  10. UMass registrars don’t allow that kind of info to be released even if without identifiers.
  11. Linda tracks herself.
  12. Jen will send an email asking for aggregate data from the last couple of years: Black, Latinx, White, and Languages spoken. Maybe also includerecovery status if appropriate wording can be figured out. She will explain the “why” – workforce shortage and most workers do not reflect the people they are serving.
  13. There are nuances in the data which need to be reflected.
  1. Recovery status:

Lot of people who seek education in used to have experience, but many now do not. Some students need to get into recovery. For Linda about 80% are in recovery. Ateducational conferences by self-report it is 45%. The percentage is gradually dropping - the myth that it is the old 12-steppers is gone. In Lawrence and Haverhill the influx of Latinas and Latinos has decreased the number in recovery. As we get into the integrated care and more professionalized it would be useful to track the barometer - is it a field of peers or professionalized? Opioid crisis has brought it to the fore: John has people with MSWs who never took an addiction course, and came back to school to learn the material. Despite the trend of people in recovery not entering the field, we need to value them.

Viewpoints:

i. The question can be asked in relation to Time in Recovery, especially for those organizations that take interns and have criteria for that. The topic just comes up multiple ways. Most people share it freely when told the response is confidential. The rule of thumb has been 2 years in recovery to enter the program; but what if they are only in recovery for a year and yet are working at an agency -- then we feel responsibility to provide support. Last thing we want to do is contribute to relapse or misunderstanding. It also comes up that people have a criminal record and they have to explain it, and for many people that has to do with being in recovery. The recovery movement also encourages that the more people who disclose the less stigma there will be, although traditionally there is also anonymity in the 12 step programs, so there is a contradiction.

ii.At High Pointthe guidance is more that people can choose to self-disclose, but the organization is hesitant for them to do that.

iii. Differing opinions were expressed about whether it is legal to ask about recovery status.

  1. Exam Preparation: GCC would like to help students prepare. AdCare and HPTC will share materials (Ann will send her daylong curriculum and PowerPoint). See also readytotest.com. Haner has something old in Spanish but there are not a lot of materials for people who want to study in their primary language.
  2. Relationship with agencies providing internships:
  3. Hospitals are more likely to have more formalized relationships than AAEPs (e.g.Lahey and McLean’s with Middlesex Community College which has 6 contracts signed by the college president; St. Elizabeth’s with Cambridge College; Veteran’s Administration). Unlike social work programs, there are very few formal relationships for AAEPs. There is usually an agreement for individual students. Brian has a program manual and linked it on the application.
  4. CORI - there are different practices related to CORIthat need to be negotiated between agencies offering internships and schools. Students do ask how a CORI will affect their job choices; some programs have been sued in the past for matriculating a student who then could not find an internship due to a CORI. Many agencies say they can’t take an intern on probation or parole, and yet there are program directors with extensive CORIs. Each situation is individual. Need education about CORI for internships, CORI in educational setting, CORI in employment.
  5. Internship placements
  6. Lots of providers not taking interns.
  7. Provider can recruit from their intern pool so taking interns benefits them
  8. Get parallel manuals from agencies for comparison.
  9. Feedback for Alex on Self-Assessment Tools:
  10. We should put the self-assessment tools on COS.
  11. 3 people report they have been very useful, one has not used them.
  12. It is a little hard to find them on the BSAS website.
  13. There was traditionally more interest in the IIIs and IIs but High Point just had 3 pass at the Master’s level on the last test.
  14. CARC and CPS Courses
  15. Very important that most courses be geared for the specific certification – ethics for recovery are different from ethics for treatment; same for prevention. BSAS would love it if education programs wanted to offer the courses. We need a robust training calendar for this alone. So far no CARCs in the state yet.There might be a way to use some of the CARC requirements for an AAEP program or some of an AAEP program for CARC requirements, but still they are different audiences and mostly differently pitched content.
  16. We want to be sure people going for these CARC and CPS certifications know where to go to meet the education requirements. There is nothing to prevent AAEPs from offering the courses or allowing people to take the relevant existing courses.
  17. Can CCAR apply toward LADC (and CADC)? Depends on applicants calling and working with Jacquie or Bonnie in the certification office.

i. Recovery Coach Academy is 27.5 hours for some, 30 hours for others and the difference has to do withwhere it is offered: 27.5through AdCare, but30 through NEschool. For first 3 domains in CARC, inclass hours are 30. So if you have 27.5 it covers most, but you have to find additional 2.5 somewhere else.

Fourth domain is 16 hours on Ethics. The training we have on AdCare calendar is 11 hours - so people need an additional 5 hours. Have been accepting hours that many of the programs around the table offer, but have to have the 11 on the AdCare calendar which are specific for recovery coaching ethics (i.e. different from prevention).

  1. Right now the courses that are hard to find are: cultural competency, Motivational Interviewing, MH for recovery coaches.
  2. Agencies are starting to require CARC but there are not any CARCs in MA, even though there are people who have taken the Recovery Coach Academy. RC Academy is only half of the educationpiece for CARC and not the 500 hours of experience and the certification. To require CARC the Agencies have to have certified Recovery CoachSupervisors, for which a training is being offered. Some are saying they want people hired to have certification within a year of hire.
  3. Billable: Recovery Coaching can be a billable service without certification. Haner does monthly RC learning community for the state. Haner gets lots of calls from people looking to hire.
  4. Issue of people who become a recovery coach then starting their own business as recovery coaches. CARC has an initial supervision requirement, but not ongoing. There is a recovery coach code of ethics, which might require supervision at least.
  5. People outside are confused - using RC for clinical interdisciplinary teams - some believe appropriately but some just see cheap labor.
  1. Questions on Handbook Outline
  2. Clarify what background checks are done, exactly
  3. CACREP could be deleted. Mostly for masters programs, but only 2 in MA. NEASC would be the best to put down there - but that has to do with entire organization, maybe sub AAEP.
  4. Should be very simplified for the provider, with checklist. Handbook goes with student to agency and has all the forms in it.
  5. Not all students need the practicum
  6. Work vs. practicum – distinct for CADCII but is that the case for LADCII and I?
  7. The application form asks for start and end date, and number of hours in supervision. The 6000 is not necessarily 6000 hours of counseling (CADC and LADC are different) because of doing paperwork and supervision as part of your 40 hours per week.
  8. John - if you have an MSW and did your internship in an addictions facility and had the supervision you might not need the practicum, but you have to have the documentation about core functions etc. in the documentation of the work.
  9. MBSACC: change to 300 hours education requirement; and possibly a change in the exam. Programs should be careful with their advertising, that those with 270 hours will meet licensure but not certification requirements. The MBSACC will meet in December and Haner will share news. Haner said the change to education requirements is effective January 1, 2017, so students in school now might need more hours.
  10. Feedback on Survey of providers related to internships

Jen and Deb will review notes and make changes to survey based on feedback.

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