effectively integrating peers into the workforce dana foglesong, bs, crps, tts recovery and...
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Effectively Integrating Peers into the WorkforceDANA FOGLESONG, BS, CRPS, TTS
RECOVERY AND INTEGRATION SPECIALIST
OFFICE OF SUBSTANCE ABUSE AND MENTAL HEALTH
FADAA-FCCMH Annual Conference August 6, 2015
Trailblazers
Emerging Champions
Champions
Supporters
Who’s here?
Today’s Topics
Role Benefits
Barriers Preparation
Role of my peer specialistRole model of recovery and living well with a diagnosis
Assist in the development of strengths-based, individual, SMART, goals
Assist in the development of rehabilitation goals to get back to school and work
Serve as an mentor & advocate for resolution of issues I was unable to resolve on my own
Develop community support through encouragement of family communication and volunteering
Educate on ways to maintain my wellness and recovery through his lived experience
Provide education on navigation of community services and mental health recovery
ROLE
Meaningful Clear
Support
Affiliation
Information
Instrument
Emotion4 Types of Support:1. Emotional2. Informational3. Affiliational4. Instrumental
CENTER FOR SUBSTANCE ABUSE TREATMENT, WHAT ARE PEER RECOVERY SUPPORT SERVICES? HHS PUBLICATION NO. (SMA) 09-4454. ROCKVILLE, MD: SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, 2009.
IS PART OF THE ROLE NOT PART OF THE ROLE
Functions as an advocate for the person in recovery, both within and outside the program
Represent perspective of the program
Uses language based on common experiences Uses clinical language
Shares knowledge of local resources Provides case management services
Encourages, supports, praises Diagnoses, assesses, treats
Helps to set personal goals Mandates tasks and behaviors
A role model for positive recovery behaviors Tells person how to lead a life in recovery
Provides peer support services Does whatever the program requires
SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION (SAMHSA) (2012). EQUIPPING BEHAVIORAL HEALTH SYSTEMS AND AUTHORITIES TO PROMOTE PEER SPECIALIST/PEER RECOVERY COACHING SERVICES.
CONSISTENT WITH PEER ROLE NOT CONSISTENT WITH PEER ROLE
Medications
Supporting someone to evaluate andcommunicate their concerns and
desired changes regarding medications; Supporting someone to
come up with a plan toward independence with med
management, changes, etc.
Administer medications; Use your own lived experience to
encourage someone to comply with their medication orders; Report back as
to whether or not someone is taking their medications, etc.
Assessments
Support the person to collect theirthoughts and have their voice heard in
the process; Support the person to understand what is written about them;
To be present while the assessment is happening as a support person
Giving your opinion about how theperson is ‘functioning’; Completing
written assessment paperwork
NEXT THREE SLIDES LEGERE, L. THE PROVIDER’S HANDBOOK ON DEVELOPING AND IMPLEMENTING PEER ROLES. RETRIEVED FROM HTTP://WWW.PSRESOURCES.INFO/IMAGES/STORIES/A_PROVIDERS_HANDBOOK_ON_DEVELOPING__IMPLEMENTING_PEER_ROLES.PDF
CONSISTENT WITH THE PEER ROLE NOT CONSISTENT WITH PEER ROLE
TreatmentPlans
Supporting the person to get theirvoice heard during the treatment
planning process (by being present, helping them plan before the meeting, and/or advocacy); Advocating to keep
treatment goals that are not self-identified or are otherwise inconsistent with a recovery-oriented approach out
of the plan
Writing a treatment plan; Focusing 1:1interactions with the person around what
they’re supposed to be working on according to their treatment plan; Writing
routine progress reports on treatment goals
Meetings
Advocating to not talk about theperson without them; Supporting the
person to be present and heard at treatment team meetings that pertain
to them; Supporting the person to gather information and understand the content of meetings; Asking clarifying
questions at meetings to support understanding;
Routine attendance at meetings whereindividuals are being discussed without them being present; Giving your own
opinion about what should happen with someone (particularly where it is not
consistent with that person’s own desires)
CONSISTENT WITH PEER ROLE NOT CONSISTENT WITH PEER ROLE
Giving RidesBecause the person trusts you and
wants you to go with them; Because you’re going with the person to advocate/support them at an
appointment
Because everyone else has something more ‘important’ to do; Because they
hope you’ll convince the person to do/not do something on their way to an
appointment
FilingWhen you’re just occasionally helping
out around the office because you happen to be there; When it’s papers
from a project or training you are personally working on/organizing
When the papers contain personalinformation about particular people; When you’re routinely filing because
no one else wants to
What is MY role to ensure peer’s job duties are consistent with their role and
the unique gifts they bring?
Specific Roles Recovery Support Navigator or Recovery Support Bridger
Help individuals transitioning out of long and/or recurrent involvements with an institutional setting, such as a state hospital, Crisis Stabilization Unit, jail, prison, or the child welfare system.
Crisis Recovery Support Specialist
Provide immediate support to individuals in crisis in a variety of settings, including a CSU, mobile crisis unit, crisis telephone support, peer-run respite, and detox centers.
Whole Health Recovery Support Specialist or Peer Wellness Coach
Support individuals in identifying and achieving personal goals related to health, or the eights dimensions of wellness, through community based support programs and/or one on one support.
Specific Roles Employment Support Specialist/Coach
Assist individuals in transitioning back to meaningful work by linking them to existing supports, obtaining resources and advocating for reasonable accommodations.
Housing Support Specialist/Coach
Support individuals to successfully manage their recovery so that they can live independently and permanently in the community whether transitioning out of a homeless situation, group home or State Hospital.
Recovery Coach
Serve as mentors and role models and help connect individuals to recovery support services, formal and informal community supports.
Benefits: Your perspective• Trust and reliability• Quick rapport• Bridge between the staff and the clients• Navigating resources• Mutuality• Unique perspective• Ability to build relationships with clients• The knowledge peers bring• Flexibility
Benefit: Improved Outcomes Significant research shows that peer support is effective in: engaging and retaining people in mental health and addiction services, supporting individuals in playing active roles in their treatment through empowerment lowering re-hospitalization rates, reducing utilization of crisis and emergency room services.
NEXT TWO SLIDES: HENDRY, P., HILL, T., ROSENTHAL, H. PEER SERVICES TOOLKIT: A GUIDE TO ADVANCING AND IMPLEMENTING PEER-RUN BEHAVIORAL HEALTH SERVICES. ACMHA: THE COLLEGE FOR BEHAVIORAL HEALTH LEADERSHIP AND OPTUM, 2014
Outcomesincreasing overall satisfaction with services
providing knowledge about psychiatric disorder and addictions, and their management
assisting in connecting to communities
reducing symptoms and or substance use
improvements in practical outcomes e.g. employment, housing, and finances
increasing ability to cope with stress
increasing quality of life
increasing ability to communicate with mainstream providers
positive outcomes in chronic illness
significant reductions in inpatient days
significant increases in outpatient services
reducing relapse and initiating recovery engagement when relapse occurs
Benefit: Value of Experience “You don’t know what it’s like”
Role modeling how to overcome significant challenges and live well in recovery
Systems navigation-overcoming “wrong door”
Benefit: Systems Recovery
Peer Specialists are Change Agents
Living proof to staff
Natural shift to recovery-oriented care
Barriers: Your Perspective• Clarity on role and code of ethics• Staff culture• Criminal background
Barriers:
Level Two Background Screening*
Training & Certification for Ready to Work Peers
Organizational Culture
Certification Certification is through the Florida Certification Board, the state ethics board
Is a true peer; this means that the peer specialist must be in recovery from a mental health or substance use condition or family member/caregiver of individual in recovery
Individuals demonstrate competency in the field of peer recovery
Meet minimum standards for professional certification, including education, experience, training, and testing
Perform work according to a professional code of ethics
Maintain their knowledge and skill base by completing annual continuing education units
NEXT TWO SLIDES RETRIEVED FROM WWW.FLCERTIFICATIONBOARD.ORG
Changes in Policy Scholarship program for certification-related fees for persons seeking initial certification, reinstatement, or renewal is open now through June 30, 2016
Substance use recovery peers added
40 hours of training in the following four domains: Advocacy, Mentoring, Recovery Support, and Professional Responsibility
500 hours of supervised work and/or volunteer experience providing peer-to-peer recovery support services in any of the learning domains
2 letters of recommendation
Must have a clean criminal history for a minimum of 3-years prior to application for certification, including release from all sanctions.
CRPS Candidate Guide 2015
Barrier: Organizational CultureVideo Link on Eliminating Stigma Faced by Peer Support Staff https://www.youtube.com/watch?v=jZ08zCaKmlQ#t=120
Buy-In
Training
Policy
Hiring
Prep
arati
on
Buy-In and TrainingBuy-in for the ShiftRecovery principles into practiceRoles and Responsibilities of the peer workforce
Readiness AssessmentOrientation and Comprehensive Training
Policy Review and ReadinessOrganization’s mission/vision/values/policiesDo they reflect the principles of recovery? Ie. Self-determination Is documentation recovery-oriented?
Human resource policy and procedureHR clearly understands the role of a peer and interview questionsAwareness of social security benefits and how those affect workADA policy and accommodations
Hiring
Clear Job Descriptions
Hiring the right people (training/certification)
Not hiring to help someone in their recovery
Setting pay rates
Billing for Peer ServicesIn March 2014, the community behavioral health handbook was released allowing five, covered services to be provided by Certified Recovery Peer Specialists, including Psychosocial Rehabilitation Services and Clubhouse services. Managed Care Organizations could opt into using the substitution service code, HOO38. Magellan, Cenpatico, United, and Wellcare can utilize H0038.In mid 2014, the Department added a billable service for Recovery Support allowing providers to bill for services provided by Certified Recovery Peer Specialists. Peer Specialists are also used on FACT, FIT, CAT, CCST, PATH, Outreach, Clubhouse, Drop-In Center, ect.
Medicaid/HOO38: Self-Help/Peer Services
• Services may include: peer specialist activities, peer mentoring, peer education, recovery coach services and mental health services provided by peers.
• Must be Certified• Supervised by a Licensed Master's Level Clinician
SAMH/55: Recovery Support Services
• These services are designed to support and coach an adult or child and family to regain or develop skills to live, work and learn successfully in the community. Services include substance abuse or mental health education, assistance with coordination of services as needed, skills training, and coaching.
• Must be Certified• No requirements for Mental Health. For Substance Abuse, supervision must be by a Qualified Professional as defined in Rule 65D-30.002, F.A.C.
Often the most crucial factor for the success of a peer worker is
QUALITY SUPERVISION
Change Agent ChampionConsider peer supervisorCommit to concept and culture of recoveryUnderstand and value the philosophy of peer supportUnderstand and value the role of peer staffAware of stigma and discrimination within the agency and point out when appropriate
RETRIEVED FROM HTTP://WWW.NASMHPD.ORG/SITES/DEFAULT/FILES/STRATEGIES%20FOR%20EFFECTIVE%20SUPERVISION%20OF%20A%20GROWING%20PEER%20WORKFORCE.PDF
Supervision: BasicsExperiencedFlexibilitySame expectations and accountability; lowering expectations is subtle discriminationKnow the difference in ‘therapy’ and supervisionFocus on mental illness only as it negatively impacts a person’s workPromoting Wellness Recovery Action Plans (WRAP) Career Advancement
