Access To Recovery (ATR)
WYOMING ACCESS TO RECOVERY PROGRAM
ATR Services and Application
What is Access to Recovery?
Access to Recovery (ATR) is President Bush’s initiative, in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Center for Substance Abuse Treatment (CSAT), to expand treatment opportunities for people in need of substance abuse treatment and recovery support services. ATR recognizes that people need choice and that recovery can take many pathways: physical, mental, emotional, or spiritual. ATR’s aim is to utilize a broad range of community approaches by inviting traditional substance abuse practitioners and non-traditional providers to create a range of treatment service options that give people a range of choices and service options.
Funding
Access to Recovery began a three year grant cycle on August 2, 2004. The last day of the current grant cycle is August 2, 2007. Every federally funded grantee must document how they will complete and close all activities on or before the ending date of the grant. Ninety days before the ending date of the grant, on May 2, 2007, Access to Recovery may request an extension to the normal end date of the grant in order to spend any funds not used during the normal grant cycle.
New funding for ATR VIP and ATR Meth have been requested by President Bush in the 2008 federal budget. At this time, Congress has not yet voted on the funding categories under which ATR is bundled. At such time as new funds become available, Access to Recovery anticipates applying for these funds.
Some operational modifications may be required as new funding becomes available. At this time we have no details of any changes that may be required internally, of our vendors, or for our clients.
New Clients:
The average ATR client uses services for approximately 90 days. In order to demonstrate that Access to Recovery can be concluded on August 2, 2007, No New Clients will be processed after May 2, 2007, 90 days prior to the end of the grant. If, on May 2, 2007, it appears that sufficient unspent funds are available to continue operations for an extended time, this deadline may be extended. If additional funds are secured prior to May 2, 2007, this deadline may also be extended.
What are the Goals of Access to Recovery?
The goals of ATR are to expand access to a comprehensive array of clinical treatment and recovery support options and increase substance abuse treatment capacity. ATR actively seeks the inclusion of "non-traditional" providers (such as faith-based providers or health professionals) in an attempt to increase substance abuse treatment capacity. Other important elements of the ATR program are monitoring outcomes, tracking costs, preventing waste, fraud and abuse, and to ensure accountability and effectiveness in the use of Federal funds.
The primary aim of Access to Recovery is to empower consumers by allowing them to choose who will provide their substance abuse treatment services. ATR utilizes treatment vouchers that are issued on behalf of a client and made available to the treatment provider of their choice. The key to successful implementation of the voucher program will be the ability of the State to insure that clients have a genuine, free, and independent choice among eligible providers.
The Goals of the Wyoming Access to Recovery Program
Wyoming’s response to this Federal Request for Proposal was the Wyoming Access to Recovery (WATR) project. Wyoming’s Department of Health, Substance Abuse Division (SAD) and Wyoming's Department of Family Services, Probation Services (DFS), worked cooperatively to present a response for funding ATR services in Wyoming. Wyoming was one of fourteen (14) states that was awarded funding. One of the primary aims of WATR is to assist the State in integrating our fragmented juvenile justice system and provide a treatment continuum of care that is available to all youth involved with the courts. One of the goals of the program is to reduce the number of youth involved with repeat offenses, requiring additional court resources and involvement with Law Enforcement.
Another goal of WATR is to expand the definition of adequate treatment to include quality after care support services, known as Recovery Support Services (RSS) in ATR, for every youth involved in substance abuse treatment services. It is also our goal to assess and evaluate all youth, 12-25 years of age, involved in the WATR program and to use this data to better inform our treatment providers, families and the courts as to the service needs of our clients.
Service needs will be funded through a voucher system where the youth and their families will choose, from the WATR provider referral list, who they want to receive treatment and/or recovery support services from. The WATR program will generate treatment vouchers that will be made available to the treatment providers and recovery support providers that have been chosen by the youth and their families. Once services are rendered the providers will submit these service voucher through our electronic voucher system where they will be redeemed from the ATR grant funds.
Target Population
Wyoming’s proposal is to target adolescent youth who are involved with the courts in Natrona County and, as indicated by assessments, require substance abuse services. Any youth referred from the Municipal, Circuit or District Court will be eligible for WATR services. Any adolescent referred by DFS’s Probation Services or juveniles on Adult Probation through the Circuit Court are also eligible for WATR services. The WATR program will also provide outpatient clinical services, limited inpatient clinical services when available, and recovery support services to the youth’s family members.
Referrals to WATR
One of the systemic goals of WATR is to create a single unified entry point for all juveniles regardless of the court system they are being referred from. To accomplish this goal we have implemented a Case Facilitator position to be that entry point. WATR will work with each court system to implement a referral process that incorporates each court unique requirements and streamline it into a single entry point for referring clients for substance abuse screenings. These screenings will determine if a client is in need of a more comprehensive substance abuse evaluation. The Case Facilitator will refer clients for more comprehensive evaluations.
A Case facilitator will be assigned to all WATR client and families to insure access to the treatment continuum and insure that clients complete their treatment. The Case Facilitator will track each client through the treatment continuum, advocate for services to support their stay in treatment and collect treatment outcome data (GPRA data) to be reported to the Federal ATR program. The Case Facilitator is responsible for managing referrals to the program, administering the substance abuse screening and making a referral for more comprehensive evaluations when indicated.
Admission into the WATR Program
All youth admitted to the WATR program will receive a comprehensive substance abuse evaluation and assessment to determine the extent of their needs. The process starts when the youth are referred for evaluation and assessment services and admission is granted if it is determined they are in need of treatment and/or recovery support services. Once a youth has completed their evaluation, they and their family members, will be provided with a counseling and consultation session to explain the outcome of the evaluation. They will also be educated about providers of substance abuse treatment services and recovery support services in Natrona County. Youth and their families will be provided with a list of these providers for them to make choices regarding who and where they will receive these services.
The WATR program is required to inform families that they have a right, and it is their choice, to determine if they want to receive services from a non-traditional provider such as Faith Based (FB) agencies. Native Americans families have the right to select their traditional medical approaches.
Continuum of Services
Because the WATR program is limited in funding it will only provide limited out-of-home treatment services, when available, and will help clients locate funding that they may be eligible for. WATR program will strive to provide a wide range of outpatient clinical substance abuse services and recovery support services. The following are examples of services that are currently being offered:
Clinical Services
1. Substance Abuse Evaluation services
2. Brief Intervention
3. Treatment Planning
4. Individual Counseling - Secular and Pastoral
5. Group Counseling - Secular and Pastoral
6. Family/Marriage Counseling - Secular and Pastoral
7. Co-occurring Treatment with Medication
8. Clinical Day Treatment or Evening Support
9. Adult Detox
10. Transitional Treatment Services
11. Limited Residential Treatment Services - Adult and Adolescent
Recovery Support Services (RSS) or Aftercare Services
1. Family Services (Parenting, Sexual and Marriage Education): Introduce the client to drug-free social activities and provide them with tools that promote a healthy lifestyle. Services should introduce and integrate the client into socially normal activties for which the client(s) has no experience, competency or exposure. Due to client’s full disclosure during a client’s choice of activities, providers may actively proselytize for their particular faith during sessions.
2. Child Care: Provides structured activities and supervision for children under the age of emancipation of persons who are participating in ATR programming. Separate DFS certification is required to provide this service.
3. Employment Coaching: Community-based employment service providing support to help the client gain and maintain employment, internship, or apprenticeship.
4. Transportation: Is reimbursed at predetermined rate per mile. Providers must be certified and must maintain extended liability insurance on all vehicles.
5. Supportive Transitional Drug-free Housing Services: Assist in the selection and placement of appropriate temporary housing for ATR clients. Emergency housing applies to clients who are temporarily displaced from their permanent housing. Separate DFS certification is required to provide this service.
6. Relapse Prevention: Relapse prevention is the implementation of a combination of best practice treatment modalities designed to keep an individual client clean and sober.
7. Spiritual Support: Includes activities that provide proactive interaction between the provider and client including, but not limited to, prayer, holy-book studies, instruction in religious rituals, and structured discussions about the philosophy of religion. Services can be provided on an individual basis or in a group.
8. HIV/AIDS Education: Focus on educating the client on the risks, statistics, transmission, legal, and financial aspects of the disease.
9. Other Educational Services – GED Preparation: Structured sessions focusing in increasing, expanding, or stabilizing the educational skills of a client. This code includes tutoring, parent education, and other structured classes designed to present information in a group setting.
10. Peer Coaching and/or Mentoring: Providers certified for peer coaching or mentoring use their personal experiences in overcoming an experience similar to those being experienced by the client to model successful behaviors. Activities include modeling of life-skills and the development of alternate lower-risk behaviors.
11. Alcohol and Drug-free Social Activities: Non-structured meetings exposing clients to environments on healthy peer interaction in an organized social activity.
This list of services will be expanded as more WATR providers are recruited.
Movement through the Service Continuum
The Case Facilitators will work in conjunction with provider agencies to insure clients are able to meet scheduled appointments, identify support services and obtain additional evaluations and assessments. The Case Facilitator is assigned when clients enter the program and tracks with them through the treatment continuum, into after care service and remains with the client until discharged from the ATR program. The Case Facilitator is responsible for advocating for client rights such as the ability to change treatment providers if the client is not satisfied with their service
The case facilitation provider is also responsible for collecting the Government Performance and Results Act (GPRA) outcome data, which is required by the federal ATR program. This data is collected on the client at admission, 30 days and then every 60 days until discharge. This data requires the client to meet face to face with the person administering the GPRA.
WATR Certification and Approval Process
To become eligible to provide services to the WATR program, Natrona County treatment providers will be required to submit an application for clinical certification and/or a WATR approval application to provide recovery support services. Theses applications will be reviewed by the Wyoming Department of Health’s Substance Abuse Division (SAD) and processed through the State’s certification process. If an application is determined to be eligible for clinical certification or approved to provide recovery support services, a provisional license will be issued. All providers with a provisional license will undergo a certification site visit before they are offered a permanent license or approval to provide WATR services.
All WATR providers will also be required to complete and sign a WATR service agreement with the Department of Health, Substance Abuse Division. The service agreement between the State and WATR provider’s allows providers to accept vouchers and provide treatment services, it also authorizes ATR funds to be drawned down for payment of services rendered.
WATR providers, like any other agent providing services to the state, are required to carry liability insurance, have professional certifications, meet program and service standards and have sound accounting and finance practices and standards. The signing of this agreement with the State requires the provider to use practices and methods that are evidenced based and represent best practices.
For those wishing to provide services in Natrona County under the ATR Grant, please fill out the following survey and return it to the Substance Abuse Division.
ATR Survey (Word)
ATR Survey (PDF)
Go here to see the requirements and applications for providing services under ATR
ATR Clinical Services Provider List (34k, PDF)
ATR Recovery Support Services Provider List (1.6mb, PDF)
ASAM Definitions (PDF)
For information or questions, please contact:
William D, Harms, DPhil
Wyoming Access to Recovery
Project Director
100 West B Street
Casper, WY 82601
Phone: 307-265-3482
Fax: 307-265-3020
william.harms@health.wyo.gov