CDS Family & Behavioral Health Services, Inc.
CO-OCCURRING DISORDERS CAPABILITY
SUMMARY REPORT
1. Types of provider involvement in state and local Co-Occurring planning processes.
a. May 19, 2009, Sam Clark, Chief Operations Officer (COO), Peggy Vickers, Quality Assurance Coordinator (QAC), and Cindy Starling, Regional Coordinator (RC), attended a training provided by DCF to introduce provider staff to the Kenneth Minkoff, MD, and Christie A. Cline, MD of Zia Logic on the Comprehensive, Continuous Integrated System of Care (CCISC).
b. February 8, 2010, participated with FADAA by providing feedback on the revisions, including co-occurring language added to 65D-30 Substance Abuse, Florida Administrative Code.
c. June 22 and 23, 2010, Sam Clark, COO, and Peggy Vickers, QAC participated in the Statewide Co-Occurring Initiative Meeting provided by DCF, FADAA, and FCCMH. The agency participated in the development of the Co-Occurring Regional Plan Review.
2. The number of times the COMPASS was used and the composition of the focus group(s) for each use.
a. June 15, 2009, Sam Clark, COO, Peggy Vickers, QAC, Leslie Frost, RC, Karen Baugh, Supervisor, Cindy Starling, RC, were trained on the COMPASS. Training was made available on the FADAA website.
b. June 23, 2009, Circuit 3 and 8 staff which included a Regional Coordinator, Supervisor, and four SAMH Counselor/Case Managers, two Family Action Counselor/Case Managers and two front desk staff completed the COMPASS.
c. July 27, 2009, Circuit 7 SAMH staff which included a Regional Coordinator, Supervisor/Counselor/Case Manager and Administrative Assistant completed the COMPASS. Due to a number of vacant positions and staff out on leave during this time, CDS plans to redo the COMPASS during the first quarter of FY 2010-2011.
d. On 2/15/2011, Circuit 3 & 8 and 7, two Substance Abuse Mental Health (SAMH) Regional Coordinators and 2 Supervisors and the Chief Operations Coordinator completed the COMPASS. The staff reviewed scores and analysis during the March SAMH monthly meeting.
3. Brief narrative detailing the findings from the COMPASS, the action steps developed, and the progress made for each action step.
a. SAMH staff completed the Co-Morbidity Program Audit and Self Survey (COMPASS) for Behavioral Health Services. This not only assessed the current level of knowledge and implementation in the programs, but we were able to identify specific educational needs. A staff interest in Motivational Interviewing and Motivational Enhancement was identified.
b. Some materials have already been obtained for training purposes: “Motivational Interviewing with Dr. William R. Miller” from psychotherapy. Net was purchased. We received the training by Addiction Professionals entitled “Integrating Treatment for Co-Occurring Disorders” this past March. In addition weekly group supervision has been used to discuss many participants that are being treated for their Co-Occurring Disorders.
c. General Staff Competencies and Training increased from 33 percent to 37 percent across all CDS programs and circuits.
4. The number of clinicians evaluated using the CODECAT.
a. During the first quarter of FY 2009-2010, Circuit 3, 8 and 7 Managers participated in FADAA Webinar Training on CODECAT.
b. A total of five Counselors/Case Managers completed the individual CODECAT. Four in Circuit 3 and 8 and one in Circuit 7.
c. In Circuit 7, due to turn over in staff and a number of staff out on leave, the CODECAT is being redone again with up to four staff and will be completed in the first quarter of FY 2010-2011.
d. During March and April 2011, a total of eight Counselors/Case Managers one completed the individual CODECAT. Five in Circuit 3 and 8 and three in Circuit 7. One SAMH Supervisor and one Regional Coordinator completed the Supervisory Evaluation (Group Evaluation) The analysis of the data will not be presented until the July 2011 SAMH meeting.
5. Brief narrative detailing the findings from the CODECAT and action steps developed to enhance clinicians’ Co-Occurring attitudes, knowledge, values and skills.
a. SAMH staff individually and corporately completed the Co-Occurring Disorders Educational Competency Assessment Tool (CODECAT). At that time, CDS was able to initially identify the strengths and weaknesses of individual staff. Information was ordered from SAMHSA including the Treatment Improvement Protocol: Substance Abuse Treatment for Persons with Co-Occurring Disorders.
b. Staff has been encouraged to participate in the many webinars being offered on Co-Occurring Disorders.
c. Annually each SAMH position includes an individualized training plan as apart of the employees’ annual evaluation. Weaknesses identified in the CODECAT, peer or supervisor record review, clinical supervision or other assessments used by the supervisor will be reflected in the persons training plan for improvement for the following year.
d. Circuit 3 & 8 and 7 staffs have participated in the Hazelton Co-Occurring Webinars. Circuit.
6. Overall progress toward Co-Occurring Disorder service capability.
a. Prior to the state initiative on Co-Occurring Disorder, CDS was working on all policies, procedures and forms to address both substance abuse and mental health issues in accordance with CARF accreditation for integrated service delivery. Since our agency uses a person centered approach, and training begins at New Employee Orientation, there should be no “wrong front door”.
b. CDS SAMH Adult and Adolescent Programs have been working hard to incorporate the Co-Occurring Treatment Model into our programs. Many staff was already familiar with the concept previously referred to as Dual Diagnosis. However, others have been trained to separate mental health issues from substance abuse. Beginning of 2009 summer, we have had several training/ learning opportunities on the topic.
c. Some of the training received by SAMH staff during the past 12 months include:
i. SA Treatment for people with Co-Occurring disorders
ii. The guide to clinical services 2005- MH and SA Conditions
iii. Bi-polar disorder and alcoholism
iv. SA treatment for persons with Co-Occurring Disorders
v. Screening/Assessing Adolescents for SA Disorders
vi. Comorbid psychiatric factors contribute to Adolescent SA Disorders
vii. Co-Occurring Disorder-which came first…
viii. Science of Addiction
ix. Integrating Treatment of Co-Occurring Disorders
x. Screening and Assessing Organizational Capabilities for Co-Occurring Participants.
xi. Stages of Change for Addictions.
xii. Trauma Informed Care
d. An effort has been made to improve identification of Co-Occurring Disorders in new and existing participants. Staff has been encouraged to always note these disorders on their interpretive summaries. It has also been noted that individual plans reflect the needs of those participants that have substance abuse and mental health problems.
e. SAMH Counselors/ Case Managers working with Adolescents began using the evidence based assessment tool, MINI International Neuropsychiatric Interview for Children and Adolescents with all new participants beginning 7/1/2009. This replaced previous screening tool that only assessed substance abuse risk. The MINI International Neuropsychiatric Interview is used to illicit specific drug use and mental health risk. Discharge forms have also been altered to specifically document substance abuse and mental health needs, aftercare and referrals.
f. While CDS does not offer psychopharmacology services, our Individual Plans reflect the mental health or medication management services being provided by for the participant by other community service providers.
g. FY 2010-2011 CDS contracted with a physician with the Alachua County Health Department and submitted a Medicaid Enrollment Application, the agency is in the pre-certification process with hopes of expanding our co-occurring services for youth and adults.
7. Overall progress towards Co-Occurring disorder service capability development in accordance with timeframes specified in the action plan.
a. CDS has made some significant gains in providing Co-Occurring Services to our participants by increasing staff’s awareness of the State goals.
b. CDS will continue to assess and evaluate our progress towards an Integrated Treatment Program for Co-Occurring Disorders as staff turn over occurs.
c. CDS will participate in the committee on Co-Occurring Regional Plan development.
d. CDS will research and implement appropriate materials and ideas that were shared during the Statewide Co-Occurring Initiative Meeting on June 22 and 23, 2010.
e. CDS will continue to evaluate our progress on the agency-wide Co-Occurring Plan.
6/2011 CDS Annual Summary Report Agency Co-Occurring Disorders CapabilitiesPage 3