Volume 2 | January, 2020

Welcome to the second edition of the Virginia SOR newsletter featuring important grant-related updates, program highlights, success stories, and CSBs featured in local news. Articles in this issue articles include:

1 : Our Stories are Everything 2 : Success Story: Valley CSB 3 : Program Highlight: Mobile MAT Clinic 4 : SAMHSA Visit Highlight 5 : Portsmouth Community Recovery Event 6 : OMNI Evaluation Updates 7 : Organization Highlight: VARR 8 : Horizon CSB Update: New Location! 9 : FQHC Funding Announcement 10 : Celebrations and Events 11 : CSB SUD Programs in the News 12 : Peer Support 13 : Share your News and Stories!

Our Stories Are Everything By Mike Zohab, SOR Grant Manager We all have a story…..Many of you know part of mine. I have two nephews who suffered from SUD. One is living an incredible life in his recovery and the other did not make it. My nephews both struggled and had their ups and downs trying to get healthy. Many elements fuel our passion to help those in need and this is but one of the many “stories” in my life that have made me the person I am today. Recently, I was contacted by one of the federal government’s assistant drug czars to help coordinate a remembrance event at the White House for families who have lost a loved one to the opioid epidemic. Three of the families I endorsed were chosen and I was fortunate enough to also be invited.  The event was intimate and incredibly impactful. In addition to meeting Vice President Mike Pence and several senior members of the Drug Policy Office, I listened to some incredibly impactful stories of loss shared by the families who attended. The feeling of helplessness while struggling alongside a loved one fighting a deadly and unpredictable disease has got to be one of the most gut wrenching things imaginable. I have been blessed with opportunities to help hundreds of families consumed in this battle. The souls who are currently struggling and those who have lost their battles have a permanent place in my heart. It’s these individuals who fuel our determination to eliminate barriers of any type that keep people from getting the help they need.  The recovery story below, shared with us by Valley CSB, is one of many that demonstrate why we’re doing the work we do. Thank you all for the lives you are saving daily. Keep these souls, their friends and family in your thoughts this new year.

Success Story: Valley CSB Valley CSB shares success story of client utilizing Office-Based Opioid Treatment (OBOT) Female client D presented to VCSB’s Open Access department February 2019 to inquire if she was a candidate for OBOT treatment. She had been receiving Suboxone treatment from another provider since 2016, having reached stabilization of her opiate withdrawal and cravings under that provider, but was traveling a significant distance for every follow-up appointment. The distance was becoming more of a time and financial hardship for her and her significant other. She also had a 5-week old infant who needed to be with her. D shared a family history significant for opiate addiction and death. Her mother was addicted to opiates and died of an overdose in 2014. Her brother was also in prison for opiate-related legal charges. D shared that she began using opiates at age 16, but was able to continue high school. D reported that when she was 18, she was sent to jail for 6 months and then to a diversion program for another 6 months due to substance possession charges. She has never married, but has been in her current significant relationship for the past several years. D successfully transitioned to the VCSB OBOT program in February 2019 and to date has remained in remission of opiate withdrawal and cravings. She endorses some cannabis use occasionally and continues working in her recovery program to continue to further diminish her use. She brings her little one with her to all of her appointments, demonstrating love and healthy bonding to this little one. She shares that she is thankful to be working with the VCSB OBOT program to maintain her freedom from opiate cravings and to be able to continue living her life.

Program Highlight: Mobile MAT Clinic Virginia's First Mobile MAT Clinic Delivers Much-Needed Services to Eastern Shore Consumers In late October, the Eastern Shore Community Services Board (ESCSB) proudly introduced Virginia’s very first mobile outpatient services and medication assisted treatment (MAT) facility. Funded by the SOR grant, this traveling Office-Based Opioid Treatment (OBOT) sets up at multiple sites in Accomack and Northampton Counties each week, linking people in remote areas with services that, until now, haven’t been easily accessible.  The mobile unit, which is staffed with key treatment team members including a psychiatric nurse practitioner, substance abuse and mental health clinician, case manager, psychiatric nurse and peer recovery specialist, offers every service found at a traditional OBOT. Individuals can receive medication assessments and inductions as well as counseling and case management. And thanks to the accompaniment of other community providers, mobile MAT unit consumers also have access to local resources like employment counseling, food bank assistance, immunizations and housing applications.  According to Kelly Bulin, ESCSB director of program development, planning and prevention services, the goal is to make behavioral health services on the Shore not only more accessible, but comprehensive and person centered. To help accomplish this vision, partners such as incorporated towns, churches, healthcare facilities, the local community college and fire/rescue departments are providing host sites to offer additional space for SMART Recovery groups and REVIVE training. For more information on this innovative new service model, reach out to Kelly Bulin at 757-442-5388, ext. 501.

SAMHSA Visit Highlights SOR Funding Supports CSB/Community Coalition Partnerships and Strategies The fall brought several great opportunities to showcase opioid misuse prevention work happening around the state! During a three-day visit from SAMHSA in October, representatives from Hanover and Goochland-Powhatan visited the DBHDS Central Office and met with SAMHSA SOR Prevention Project Officer Sandra Adrovet. The Hanover team included: CSB Prevention Services Coordinator Martha Lambert, Hanover Cares Coalition Executive Director Octavia Marsh, and grant evaluator/VCU Senior Research Associate Mel Fearnow-Kenney. A few of the topics they discussed were: how they partner with local first responders and hospitals to access the most current data on emergency calls for opioid overdoses and emergency room visits, and how a survey of area young adults further informed their efforts. They also work with treatment and recovery partners to help ensure resource information is shared with those who are at-risk of overdose (and those closest to them). One of their key messages is “You Are Worthy. Treatment is Available. Recovery is Possible.” Of particular interest to SAMHSA’s Adrovet, was the breadth of local, and regional, collaborations they employ to reach community members across the lifespan. Some of the non-traditional partners include realtors, hospice care providers and funeral home directors. The Hanover delegation said bringing new partners to the effort is very rewarding. For example, funeral directors immediately understood how encouraging proper medication disposal promotes community safety and assists families in need of support and guidance while they grieve the loss of a loved one. Additionally, “non-traditional” partners bring an important fresh perspective. The Goochland-Powhatan visitors included: CSB Prevention Supervisor Robin Pentecost, Rural Substance Abuse Awareness Coalition (RSAAC) Chair Carolyn McKann and RSAAC Vice Chair Mike Caudill. They shared how RSAAC has grown considerably in the past few years and credited OPT-R and SOR funding with kick starting their expansion. Among the strategies they highlighted: Coalition members visited almost all of their local medical practices to discuss the opioid crisis, advocate for safe prescribing and hear about successes and challenges. The next phase of these visits will include dentists and veterinarians. RSAAC, in cooperation with the Sheriff’s Office, hosted “Hidden In Plain Sight” a series of informational events where parents and guardians were guided through a mock teen bedroom to learn about local trends, signs of drug and alcohol use, how to talk with children about substance use, and how to access resources. RSAAC partners used SOR funding to install the county’s first permanent drug disposal drop box. RSAAC and the CSB worked with Virginia TRIAD, local law enforcement and other partners to raise awareness about medication misuse and theft, and distributed medication lock boxes to older adults.You can learn more about Hanover Cares Coalition a t http://www.hanover-cares.org/ and RSAAC at http://rsaac.org/ . These are just a handful of the many strategies highlighted during the SAMHSA visit.If you have questions or would like contact information for the individuals referenced, please contact SOR Prevention Coordinator Jennifer Farinholt at: j ennifer.farinholt@dbhds.virginia.gov. Hanover Cares Coalition partners with the school system to distribute a calendar with monthly wellness messages to all families with students enrolled in the county schools. The calendar includes important school dates and other information helpful to parents—a high-priority audience that can be difficult to reach! Prescription medicine bags are another way that Hanover reaches the community to promote safe storage and disposal.

Portsmouth Community Recovery Event Recovery Rocks in Portsmouth! Back by popular demand, Portsmouth Department of Behavioral Health Service's Peer Recovery Specialists hosted a National Recovery Month Event at The Neighborhood Facility for the community. This annual event was designed to engage those affected by mental health and /or substance use challenges in the City of Portsmouth. The vendors included warm-line support, community resources, Ident-a-kid, in-home mental health agency and mobile veteran services.  Attendees enjoyed plenty of refreshments, music, face painting, balloon art and fun for the whole family. Portsmouth local businesses donated the prizes and raffles towards the activities. Throughout the event participants were encouraged to paint rocks to tell their recovery stories. These rocks will be placed in the community, to encourage and support those in need. Together we are stronger as a community and that was the focus of this well attended event.

OMNI Evaluation: Updates and What's to Come

Prevention  OMNI worked with CSB staff to review and finalize entry of all SOR implementation data from the fiscal year used for the SOR Annual Report. The report describes the breadth and depth of the excellent work that was completed in year one of the grant. The SOR evaluation plan has been finalized, and OMNI will continue working with DBHDS and CSB staff to plan and execute the prevention objectives that include: a continued focus on implementation of prevention strategies such as coalition development; supply reduction; and community education. Additionally, OMNI will continue ongoing data tracking and provision of technical assistance, as well as develop a qualitative study of SOR prevention efforts to better understand the successes, challenges, and broader impact of the work across the commonwealth. Treatment  Now that that GPRA administration is in full swing (572 total Intake GPRAs as of December 31 st, 2019), including discharge and 6-month follow-up surveys, the treatment team has been focusing efforts around supporting CSBs and FQHCs with specific implementation needs. The TA team has connected with each CSB and FQHC directly to work through the logistics of expanding GPRA eligibility criteria to help meet SAMHSA's reporting requirements. Expanded GPRA-eligible populations include, but are not limited to individuals receiving: Peer support services Wraparound services (childcare, transportation, etc.) Direct treatment services (case management, groups, IOP) During TA communications, one common barrier raised was GPRA engagement. In response, the treatment team developed an Engagement Information Sheet for individuals. Additionally, the team rolled out a new version of the online GPRA for year 2. The new version has been modified to support user experience and ensure accurate reporting.

Recovery: Virginia's Criminal Justice System Conference  Year 2 SOR recovery evaluation efforts will build on the work in year 1 to include:  A comprehensive literature review; Survey and focus groups with peer recovery specialists; Development of a best-practices and implementation recommendations document; and Support of implementation of SOR funded collegiate recovery efforts. Members of the OMNI team made a trip out to Virginia in early October to attend the "Addressing Opioid Use in Virginia's Criminal Justice System” conference hosted in Virginia Beach. Key stakeholders and representatives across systems shared their experiences and innovative approaches to support individuals in the criminal justice system needing opioid treatment. The following surfaced as crucial elements to creating effective programs: Finding a champion, Prioritizing reentry, Practicing patience Recovery: Virginia Site Visit  While in Virginia Beach for the conference, members of the OMNI SOR Recovery Team had opportunities to visit different organizations to learn more about the varied and innovative work of Peer Recovery Specialists. We're excited to share some highlights with you!  Norfolk CSB is developing and implementing events through their Recovery Drop-In Center. Portsmouth CSB is pioneering Medicaid billing to support peer-led groups, an active warm-line, and emergency department partnerships. Virginia Beach Human Services is providing community outreach and support through various groups with community members, hospitals, and local jails. Chesapeake Integrated Behavioral Healthcare is supporting patients in substance use and mental health crisis. The Up Center in Norfolk is on-boarding its first SUD peer. The Rams in Recovery program at VCU is expanding service offerings for its robust collegiate recovery community.

OMNI and the SOR grant management team at DBHDS recognize the incredible work being implemented and in developed across the commonwealth. The SOR Recovery team collects lessons learned to support others in bolstering peer recovery efforts within Virginia. If you have an experience you'd like to share, please feel free to reach out to the team to learn more at SORSupport@omni.org and ask specifically for Amber Murray or Jenna Lee Mathews.

Organization Highlight Virginia Association of Recovery Residences (VARR) Brings Quality Standards and Accreditation to Recovery Housing.  Thanks to Virginia’s HB 2045, the Voluntary Registration of Recovery Homes, consumers will have an online ally in their search for reliable recovery housing. Within the next few months, those looking for a safe place to live during early recovery will be able to check the DBHDS website to see which homes are recognized as meeting the quality standards set forth by Virginia Association of Recovery Residences. While VARR accreditation is not mandatory, it does assure the public that VARR member home operators take quality, ethics and their residents’ recovery very seriously. Implementation of the new certification is on track to be in place by July of 2020. We’ll provide progress updates frequently.  What VARR Does Create, monitor, evaluate, and continually improve recovery residence standards and measures of quality. Accredit recovery residences who meet criteria and standards of VARR. A voice for social model recovery programs in Virginia, which includes recovery treatment programs that provide housing to clients. Ensure ethical practices by members. Maintain a forum for exchanging ideas, lending support, problem solving, and developing new and existing residential programs. Provide community education and member training that enhances competency and individual growth of residents, their families, and peer recovery supports along with facility staff, volunteers and others in the recovery community. Promote recovery within the community. Ensure quality and safe recovery residences, through an annual re-accreditation processes. Learn more about what VARR does by visiting their website! Visit VARR website

Horizon CSB Update: New Location! Horizon Behavioral Health Expands SUD Services with New Appomattox Location  With help from SOR grant funding, Horizon Behavioral Health in Lynchburg has opened a 4,000 square foot outpatient facility in Appomattox, (an area which has seen high overdose rates in recent years). This new center provides the capacity to serve nearly 200 additional SUD consumers. In addition to adult SUD, psychiatric, case management and peer recovery services, Horizon’s Appomattox location offers intensive outpatient, child psychiatric services and a Supporting Families of Addiction and Mental Illness (SFAMI) community group. “It is always exciting to expand our mission of supporting and promoting the health, independence and self-worth of individuals and families in Central Virginia,” says Horizon CEO Damien Cabezas . “With this expansion in Appomattox we will be able to continue to keep individuals healthy and in their community.”

FQHC Funding Announcement Federally Qualified Health Centers Awarded $930,000 to Combat the Opioid Crisis  The Department of Behavioral Health and Developmental Services and Virginia Community Healthcare Association are pleased to announce that five Federally Qualified Health Centers (FQHC) were awarded Medication Assisted Treatment (MAT) grants in the amount of $930,000. The recipients are Central Virginia Health Services, Johnson Health Center, New Horizons Healthcare, Rockbridge Area Health Center (RAHC) and Southeastern Virginia Health Systems. This MAT grant will support the current state effort to combat the opioid epidemic. The five FQHCs will expand access to medication-assisted treatment for individuals with opioid use disorder and become a Preferred Office-based Opioid Treatment (OBOT) provider. Individuals in the local communities will have greater access to medical evaluation and a physical exam; prescription of buprenorphine or naltrexone; and other support services. These parts work together to help provide a whole-patient approach to the treatment of opioid use disorders. “As an integral part of Virginia’s Health Safety Net, our Community Health Centers have been addressing the needs of their communities for over forty years. We are delighted that these five Community Health Centers are the recipients of this important funding. The funding will allow them to expand their Medication Assisted Treatment programs in the communities they serve.” said Neal Graham, CEO, Virginia Community Health Center. According to Program Director Claire Capron, having peer recovery services has been especially beneficial to RAHC’s OBOT patients.  “On the first day that our OBOT program launched, in October, we had two patients in attendance. One of the patients has been in recovery for several years, but had only been seen for individual rather than group therapy. This patient shared very upsetting experiences while in treatment with other [Substance Use] programs and was very apprehensive about group sessions. During the patient’s first group, at RAHC, she became extremely overwhelmed emotionally, as our peer recovery specialist spoke about his experiences and why he was there. This session was so moving for her that she chose to continue receiving group counseling at our health center. The other patient was extremely hopeful for recovery because of the supportive environment that we provide, to include having a peer recovery specialist. We are very excited to offer this service to our OBOT patients but also to all other [Substance Use Disorder] patients here at RAHC.”

Celebrations and Events Alexandria CSB Recovery Month Celebration On September 26, city of Alexandria Department of Community and Human Services staff, representatives from other city departments and community members gathered to celebrate those in recovery during a National Recovery Month event at the Lee Center. The annual event, which includes a BBQ and family friendly activities, spreads the positive message that behavioral health is essential to overall health, prevention works, treatment is effective and people can and do recover. At the event, Mayor Justin Wilson, read a proclamation recognizing International Overdose Awareness Day and touched on how city staff and community partners are working to address the opioid epidemic in Alexandria. Members of the recovery community also shared their addiction and recovery journeys during the event. Alexandria Opioid Work Group Community Event The city of Alexandria Opioid Work Group, comprised of representatives from a wide range of city services and partners, presented a draft of the city’s three year strategic plan to address the local effects of the national opioid crisis on November 18. The event included a short presentation followed by round-table style opportunities for community members to engage Work Group representatives, ask questions and share any items that were missing from the plan, which is in its final drafting stages.

CSB SUD Programs in the News! From Northwestern CSB: The Winchester Star: Mentors Offer Sobriety Help on Holidays and Year Round WINCHESTER — Northwestern Community Services’ Peer Resource Center is a refuge from stress and temptation for recovering addicts. Holidays like Thanksgiving can be a particularly stressful time with gatherings of family and friends sometimes involving alcohol or drug use. So the center, which opened in August of last year, held its first-ever pre-Thanksgiving dinner on Wednesday to offer a sober alternative. The center has 12 peer recovery specialists who each serve between eight and 10 clients. They typically meet with clients once or twice per week for about an hour. Peers, also known as peer support specialists, are people in long-term recovery mentoring people who recently achieved sobriety. Peers receive at least 72 hours of training overseen by the state Department of Behavioral Health and Services and must be sober for at least a year to be certified. Training includes improving communication skills, learning evidence-based best practices for recovery, exploring definitions of recovery and learning about trauma-informed care. Other training includes learning about advocacy, ethics and mentoring. Continue Reading From Rappahannock Area CSB: Fredericksburg News Star: Family Learns Too Late of the Benefit of Fighting Drug Use with Medicine The regret will haunt Michelle McGinnis the rest of her life. She wishes she’d known how to help her younger brother, Bryan, as he struggled with drugs. She saw how much he wanted to beat his need for heroin and be there for his five kids.  She researched rehabilitation programs and was repeatedly frustrated when insurance wouldn’t cover one aspect of his treatment or another, deeming it medically unnecessary. After he managed to get into, and finish, one such program, the facility offered to put him on suboxone, a drug that reduces a person’s cravings for opioids. It’s part of medication-assisted treatment, or MAT. Continue Reading

Peer Support

Rockbridge Area Health Center’s Certified Peer Recovery Specialist:

“ My passion is to be of service, in the form of Recovery Support, to those of us that are actively seeking it. [Through] Hope, Recovery and Advocacy of my own life I am able to present a therapeutic environment to our patients. The position of Peer Recovery Specialist at Mountain View Recovery does just that for me and the program” . –Lewis Johnston Peer Medicaid Billing   Hey, CSBs! You’ve got questions about Medicaid billing for peer recovery services? Virginia Department of Medical Assistance Services has answers! Send your inquiries to: csbhelp@dmas.virginia.gov and they’ll provide the direction you need to start billing for individual and group peer services .

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Got something you’d like us to include in the next SOR newsletter? Send it to angela.weight@dbhds.virginia.gov .