MABPCB’S PLACE IN THE STATE

• PROVIDES THE STATE EXAM FOR THE BOARD OF PROFESSIONAL COUNSELORS & THERAPISTS’ (BOPC&T) ADDICTION CREDENTIALS: CAC-AD AND CSC-AD

• IS THE STATE BOARD FOR THE CERTIFIED PEER RECOVERY SPECIALIST (CPRS)

• PROVIDES PRIVATE CREDENTIALS FOR CHEMICAL DEPENDENCY, CRIMINAL JUSTICE, CO-OCCURRING DISORDERS, AND SUPERVISION.

• ALL CREDENTIALS ARE BACKED UP BY THE INTERNATIONAL CERTIFICATION & RECIPROCITY CONSORTIUM (IC&RC)

WHERE WE ARE NOW

• ONE APPLICANT JUST PASSED EXAM; 24 OTHERS HAVE JUST TAKEN PREP COURSE

• BOARD CONSIDERING ENDORSEMENTS TO PEER CREDENTIAL INCLUDING CRIMINAL JUSTICE, GERONTOLOGY, TRANSITIONAL AGE YOUTH, SOMATIC CARE, FAMILY, ETC

• BOARD INCORPORATES PEER INFORMATION/TRAINING IN CURRENT WORKSHOPS - STIGMA & CO-OCCURRING DISORDERS ON MARCH 27. MORE TO COME AS ENDORSEMENTS ARE APPROVED

• BOARD ON BHA WORKFORCE DEVELOPMENT & TRAINING COMMITTEE

• BOARD ON OCA’S MEDICAID REIMBURSEMENT AND STANDARDS COMMITTEE

• RECIPROCITY FROM OTHER STATES THAT ARE NOT IC&RC-APPROVED

THE CERTIFIED PEER RECOVERY SPECIALIST

IN THE CONTINUUM OF CARE

WHAT IS A CONTINUUM OF CARE?

• A CONTINUUM CAN BE SEEN AS HAVING NO BEGINNING AND NO END

• DEVELOPMENTALLY, A HUMAN EXISTS. SOMEWHERE ALONG THE LINE A PROBLEM DEVELOPS THAT NEED ADDRESSING AND ATTENTION IS GIVEN TO IT. DEPENDING ON CRITICALITY OF PROBLEM, AN INTERVENTION MAY BE MORE PRONOUNCED

• TREATMENT CONTINUUM USUALLY BEGINS WITH A CRISIS INTERVENTION, BE IT WITH AN ACT TEAM, IN AN EMERGENCY ROOM, WITH A POLICE OFFICER, WITHIN A FAMILY, OR IN A SCHOOL

CONTINUUM, CONT’D

• ONCE IN THE SYSTEM SEVERAL OPTIONS ARE OPEN

• AT A CRITICAL LEVEL A PERSON EXPERIENCING A SEVERE MENTAL HEALTH CHALLENGE MAY BE ADMITTED TO A PSYCHIATRIC WARD OF A GENERAL HOSPITAL, THEN TO RESIDENTIAL REHAB TO CONTINUED STABILITY

• AN ALCOHOLIC OR OTHER DRUG ADDICT MAY HAVE A SIMILAR EXPERIENCE, EXCEPT THEY ARE ADMITTED TO A DETOX THEN RESIDENTIAL REHAB

• MORE MODERATE CASES MAY BE REFERRED TO OUTPATIENT CARE OR TO A COMMUNITY SERVICE, SUCH AS MOBILE ACT

• OTHERS WILL RECEIVE SUPPORT SERVICES AS A REFERRAL

FILLING IN THE GAPS

• PEER WORK HAS BEEN IN EXISTENCE EVER SINCE PEOPLE HAVE HAD PROBLEMS

• WILLIAM WHITE’S AUTHORITATIVE WORK ON THE SUBJECT REMINDS US THAT PEER WORK DID NOT BEGIN JUST 20 OR 30 YEARS AGO, BUT ORGANIZATIONS, BOTH SECULAR AND RELIGIOUS, THAT DEVELOPED OVER THE LAST TWO CENTURIES TO HELP ALCOHOLICS AND OTHERS USED FELLOW SUFFERERS TO HELP THOSE WHO WERE STILL SUFFERING (OR CHALLENGED OR LIVE WITH)

• AS PHENOMENAL AS THESE ORGANIZATIONS HAVE BEEN OVER THE LAST 200 YEARS TO HELP THOSE IN NEED THERE WAS STILL SOMETHING LACKING

GAPS CONT’D

• NUMBER ONE – MOST OF THESE ORGANIZATIONS CENTERED ON ALCOHOLICS OR DRUG ADDICTS, WHILE THOSE WITH MENTAL HEALTH CHALLENGES WERE WITHOUT SUPPORTS

• NUMBER TWO – NOT EVERY PATIENT WHO WENT THROUGH A REHAB OR REFERRAL ADHERED TO THESE VOLUNTEER SUPPORT ORGANIZATIONS

• NEW ORGANIZATIONS ARISE IN LATTER 20TH CENTURY IN RESPONSE TO NEED

• 1978 – NARPA, 1979 – NAMI, 1981 – ON OUR OWN/MD, 1988 – COPELAND CTR

• 2002 - SAMHSA PUBLISHES FIRST RFP FOR PEER RECOVERY CENTERS

HOW DO INDIVIDUAL PEER RECOVERY SPECIALISTS WORK IN THE CONTINUUM OF

CARE?• AS GREAT AS THE NEW ORGANIZATIONS AND DROP-IN CENTERS ARE, THEY

STILL HAVE THE SAME PROBLEM AS THOSE OLDER ORGANIZATIONS: PEOPLE COME TO THEM

• THE NEW PARADIGM IS INTEGRATION, OR TO USE ANOTHER TERM, EMBEDDED

• A COMMUNITY OUTREACH WORKER MAY WORK WITH A MOBILE ACT TEAM TO IDENTIFY THOSE IN NEED IN THE COMMUNITY AND WILL DEVELOP A RELATIONSHIP WITH THE INDIVIDUAL TO ENGAGE PERSON TO START ON THE ROAD TO RECOVERY

HOW DO THEY WORK, CONT’D

• DEPENDING ON NEED A PERSON MAY ENTER A MORE STABILIZED TREATMENT SETTING FOR A PERIOD OF STABILIZATION FOLLOWED BY OUTPATIENT, ETC.

• MORE OFTEN THAN NOT A PERSON BECOMES ENGAGED IN SUPPORT SERVICES IN A DROP- CENTER OR COMMUNITY RECOVERY CENTER

• THOSE WHO DO ENTER FORMALIZED CARE STILL HAVE THE RELATIONSHIP OF THE PEER WORKER. THAT WORKER FOLLOWS THEM THROUGH THE CONTINUUM OF CARE AND FOR SEVERAL YEARS THEREAFTER, AIDING IN THEIR RECOVERY

• THOSE WHO LACK A WORKER UPON ADMISSION, RECEIVE ONE WHO DOES THE SAME AS THE OTHER ABOVE, WORKING AS PART OF A TREATMENT TEAM

PEER RECOVERY SPECIALISTS BRING RESULTS

• THIS RESULTS IN LOWERED RECIDIVISM RATES, LOWER EMERGENCY DEPARTMENT & DOCTOR VISITS, LOWERED INSURANCE RATES, REDUCED ARRESTS AND INCARCERATIONS, SAVING THE STATE TAXPAYERS’ MONEY

• LONG TERM RECOVERY HAS GREATER BENEFITS IN THAT PRODUCTIVE, TALENTED WORKERS ADD TO THE TAX BASE

• CERTIFIED PEER RECOVERY SPECIALISTS MUST DEMONSTRATE THE ABILITY TO PROVIDE EFFECTIVE SERVICES INCLUDING ADVOCACY, MENTORING, EDUCATION, RECOVERY SUPPORT, AND ENGAGE IN ETHICAL RESPONSIBILITY.

COMBATING STIGMA

• THE FEDERAL PARITY ACT HELPS ENSURE THAT MENTAL HEALTH AND SUBSTANCE ABUSE INSUREES RECEIVE EQUAL TREATMENT. MARYLAND HAS EMBRACED THE SPIRIT OF THE ACT. THE STATE'S NEW ASO PROVIDES GENEROUS COVERAGE

• UNFORTUNATELY, PEER WORK IS NOT COVERED BY ANY PUBLIC OR PRIVATE INSURANCE PLANS. PEER WORKERS OFTEN ARE HIRED IN TO OTHER SLOTS AND ARE ASKED TO PERFORM DUTIES OUTSIDE OF THEIR SCOPE OF PRACTICE

• THE STATE HAS THE OPPORTUNITY TO CHANGE THAT VIA IMPLEMENTING STATE LAW FOR INSURANCE COVERAGE (MA, HOSPITALS, PRIVATE) AND COMAR INCLUSION

COMBATING STIGMA, CONT’D

• ACCREDITING BODIES CARF AND THE JOINT COMMISSION HAVE WRITTEN STANDARDS THAT GUIDE TREATMENT PROVIDERS IN HOW TO UTILIZE PEER WORKERS WITHIN THEIR ORGANIZATIONS. WITH MARYLAND TURNING ACCREDITING RESPONSIBILITIES OF PRIVATE PROVIDERS OVER TO THESE TWO ORGANIZATIONS, NEW AVENUES ARE OPEN FOR PEER WORK

• ENDORSEMENTS TO THE BASIC CREDENTIAL WILL BRING SPECIALIZED PEER WORK TO THE JUSTICE SYSTEM, PRIMARY CARE FACILITIES AND MEDICAL HEALTH HOMES, ELDER CARE, AND YOUTH PROGRAMS