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Sa umt meetingHPR I Substance Abuse Regional Access Team
February 9, 2011
Attending were: Nancy Haden, NWCSB; Christy Cacciapaglia, Alan Cale, WSH; Mary Montgomery, Jim Clark, Mary Schlimm, Region Ten; Tracy Koblish, HRCSB; Debra McPhee, RACSB; Jackie Dare, Jan Lizotte, RRCSB; and Paul Regan, HPR I. Review Agenda / Approve Minutes: No agenda change. The Minutes from the 12/08/10
Regional Utilization Data: Regional utilization data for January, 2011, were reviewed.
Utilization of all three Crisis Stabilization Programs exceeded 84%. New Hope utilization has increased in the past several weeks. It is unclear if this is a result of the recently announced policy to allow limited, outdoor smoking breaks. The WSH Admissions, TDO and Admissions with a Substance Abuse Diagnosis reports for January, 2011, were reviewed. There were 43 admissions; 31 from HPR I. There were 4 HPR I Civil TDOs. There was only 1 civil, primary SA admission. This was by TDO that was required for lack of a willing community facility. The person was discharged in less than 1 week. The 2/9/11 WSH census was 243; effectively full. All civil admissions beds were full. Discussion ensued regarding a person whose discharge from WSH to Boxwood was delayed due to being treated on Klonopin. Boxwood admission requires ten days free of benzodiazepines, although this may be shortened in the case of a direct admission from WSH or another hospital. SARAT recommends that WSH consider alternatives to Klonopin and other benzodiazepines for persons with co-occurring substance abuse. Alternatives such as Vistaril, Buspar, Celexa and other SSRI medications may be considered; along with concurrent psychosocial treatments for anxiety. This recommendation will be brought to Pat Higgins, WSH Director of Social Work. HPR I DETOX AND RESIDENTIAL PROGRAMS PRESCREENING FORM: The Team
reviewed the latest prescreening revision and reached the following decisions: To increase font size for Emergency Contact’s address on page 1. To provide space on page 4 to continue the list of medications, dosage, schedule, etc. To add Y/N drop down boxes where these are absent. To reduce the number of referrals in the REFFERRAL / CALL INFORMATION: section (page 4) to obtain sufficient space to continue the list of medications from page 2. To add a hyperlink to the HPR I website in the REFFERRAL / CALL INFORMATION: section (page 4) for additional information about HPR I and SARPOS funded facilities. To continue the use of current versions of the new prescreen until updates are available. Nancy will update and forward the form to Paul for posting and distribution of PDF and Page 1 of 3
Jackie will forward to Paul copies of documents with program specific information that comprise RRCSB’s Boxwood / New Hope Preadmission Screening packet. These may be posted on the HPR I website after review by programs and necessary updates. The form is specific to New Hope, Boxwood and Courtland Center Detox. Crisis Stabilization Units use the DBHDS Uniform Preadmission Screening Form for admission
Regional Program Billing: The topic of billing for the day of an unplanned discharge was
revisited. It appears that only one regional program bills in this manner. A preference for consistent billing practices across residential programs was voiced. This topic will be continued
Training / Grants Update: No updates.
Regional Website: The possible posting the Regional Program Utilization Report on the
website was discussed; as was a recommendation to post a year of program Minutes with older
FY 11 SARPOS Contracts: Paul reported mixed feedback on the Galax Treatment Center’s
proposed fee increase. He will bring this to the Executive Director Forum for decision. HPR I / SUD Services Delivery – Strategic Planning: Discussion resulted in identification of
Structured half-way housing that is affordable: incidents of persons returning to jail for Increased funding for intensive SA day treatment / habilitation. Ambulatory Detox programs. Community services, including intensively assisted housing, for persons with alcohol dementia. These are typically for persons 50 years and older. Expansion of drug courts / family courts. Programs to assist persons with felony convictions to obtain jobs: lack of work is a significant barrier to community based recovery. Tracy will convene a group to develop a proposal for review by the SARAT and submission, in final form, to the HPR I Executive Director Forum. SARAT volunteers for this group include:
Updates from standing representatives:
Boxwood: The new building should be completed in March with move in during the last week
of April or first week of May. Census will continue to be capped at 14 until the move. The milieu is working well. Fewer unplanned discharges are noted. Wellness Recovery Center: Medicaid billing is below the target of 2 of 11 beds. To avoid a
budget shortfall, the program will need to achieve Medicaid billing for 3 of 11 beds through the end of the year. Mary will work with referring CSBs to address this concern. Page 2 of 3
SARPOS End of Year Funding: The Department was unable to attend this meeting. It was
agreed to summarize in these Minutes instructions from Joe Stallings concerning CSB requests for additional SARPOS funding when such funding is depleted before the end of the fiscal year. …the request should be to (Joe Stallings) or the new (DBHDS) SA Director from either the (CSB) Executive Director or SA Director. There is no particular form or format. Email is adequate to get the process rolling. Basically it should state what the CSB is requesting and why. Typically we do not "advertise" these funds, as usually we do not know what if anything will be available until the last minute. If anyone has questions Paul will request a representative and designee from the Department for SARAT meetings.
Suboxone Tapers: Tracy advised that Willow Oaks provides Suboxone taper and induction
services. In addition, Willow Oaks is usually able to take clients quickly, needs a TB test and prefers their prescreening which can be found at their website. Meeting adjourned at 12.40 PM. Next meeting will be at the Region Ten’s Offices at 502-A Old Lynchburg Road on April 13, 2011 at 10.30 AM. Page 3 of 3
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