Tip 46 Administrative Issues In IOP

Dr. Dawn-Elise Snipes, PhD, LMHC, CRC, NCC

Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC

 Strategic planning
 Conducting a community needs assessment
 Identifying program strengths
 Clarifying program mission
 Developing and evaluating goals
 Identifying strategies to attain goals
 Communities that Care Planning System
https://preventionplatform.samhsa.gov/


 People who have knowledge of or experience
with SA
 Representatives from the:
 local community
 client population
 program’s referral sources
 Gender, racial, cultural diversity
 People with expertise in:
 state and local politics
 insurance & managed care
 financial management
 legal matters
 nonprofits and foundations


 Mission statement and philosophy
 Client care
 screening, assessment, treatment and discharge planning
 Recordkeeping
 security of clients’ records
 Organizational structure
 governance committees and staff positions
 Personnel
 hiring, evaluating, terminating
 Structure and staffing
 Clients’ rights and the program’s grievance process


 Comprehensive Accreditation Manual for
Behavioral Health Care (CAMBHC)
 Client-Focused Functions
 Ethics, Rights, and Responsibilities (RI)
 Provision of Care, Treatment, and Services (PC)
 Medication Management (MM)
 Surveillance, Prevention, and Control of Infection (IC)


 Organization Functions
 Improving Organization Performance (PI)
 Leadership (LD)
 Management of the Environment of Care (EC)
 Life Safety (LS)
 Management of Human Resources (HR)
 Management of Information (IM)
 Opioid Treatment Programs (OTP)
 Foster Care (FC)
 Performance Measurement and the ORYX
Initiative


 Core values and mission
 Input from persons served and stakeholders
 Individual-centered
planning, design, service delivery
 Organizational leadership
 Information management and performance
management
 Fiscal management
 risk management
 Human resources

 Communication
 Accessibility
 Health, safety, transportation
 Information analysis and outcomes
management
 Rights of the persons served
 Program structure and staffing
 Screening and access to services
 Transition/recovery support services


 Pharmacotherapy
 Seclusion and restraint
 Records of the persons served
 Quality Improvement


 FloridaRules Common Licensing Standards
 Standards for IOP
 Core services provided at least each 9
hours/week
 Individual, group, family counseling
 Psychiatric services
 Substance abuse education
 Relapse prevention skills
 Life skills
 Vocational Rehabilitation
 Referral to wrap-around services
 No more than 50 clients


 Managed care companies
 Vocational Rehabilitation & Employers
 Mental health treatment providers
 Employee assistance programs (EAPs)
 Schools
 Hospitals
 Welfare agencies
 Criminal justice agencies
 Religious leaders


 Food banks
 Recreational facilities and programs
 Credit Counseling
 Adult education
 Parent training
 Housing resources
 Childcare providers
 Self-help groups
 Legal assistance
 Transportation


 Eliminate non-core services
 Non-self-supporting after 6 months
 Evaluatestaffing and consolidate positions
 Reduce paperwork
 Implement time-saving EMR
 Automate repetitive activities
 Record and rebroadcast orientation
 Team with other agencies
 Increase buying power


 Recruitinterns and volunteers
 Write AmeriCorps and other grants
 Work with programs that refurbish computers


 Cultivate relationships with the money
people
 Invite officials and funders to program
functions
 Humanize the client population
 To funders and community-at-large
 Website updates
 Program achievements


 Lack of experienced staff
 High demand for counselors
 Low pay, long hours
 Stressful job
 Administrative demands
 Limited community resources


 Experienced clinician?
 Program’s modality
 With client population
 Clinician understand co-occurring disorders?
 Skills ability to perform all functions
effectively?
 Assessment
 Integrated summary
 Treatment planning
 Referral


 Staff interview candidates
 Before clinical director
 Candidates role-play counseling session
 Clinical director interviews
 Candidates recommended by staff


 New staff sign statement supporting:
 Addiction
 biopsychosocial
 spiritual disorder
 multidisciplinary approaches
 medication
 Recovery is possible
 Recovery support groups
 vital role in treatment and recovery


 Professional standards and reporting
requirements
 Supervision and peer assessments
 Gain insights into deficiencies
 Current on addiction research and trends
 Involvement in professional organizations
 Respect for clients’ diverse backgrounds
 Recognition of personal bias
 Effect on treatment
 Understanding of personal recovery
 Effect on treatment provision


 Capacity to conduct self-evaluation
 Participation in regular continuing education
 Emotional maturity
 Adaptability
 Creativity
 Ability to relate effectively
 Confront and resolve
 Internal personal difficulties
 Willingness to learn about and understand
 Diverse backgrounds


 Current screening and assessment instruments
 Cultural diversity
 Information gathering and client assessment
 Symptoms of intoxication, withdrawal, toxicity
 Psychoactive substances
 Physical, pharmacological, psychological
implications of substance abuse
 Mental status assessment criteria
 Treatment matching and placement criteria
 Confidentiality requirements
 Theories about how behavior changes
 Assessing clients’ readiness for change


 Communicate
 Clients and their significant others
 Define and prioritize needs
 Treatment modalities and community resources
 Individualized treatment plans with clients
 Establish a SPOC
 Marshall community resources
 Advocate for the client


 Engage clients and establish rapport
 Recognize intervention effectiveness
 Integrate therapy with real-time events
 Recognize when to seek consultation or refer
 Educate about addiction and recovery
 Help clients build and practice recovery skills
 Encourage strong sober support system


 Conflicts of interest
 Staff-client relationships
 Grievance procedures


 Core clinical staff
 Clinical management
 Case managers and clinical supervisors
 Specializedservices
 Administrative and support staff


 Medical services
 Counseling
 Case management
 Family services
 Social services
 Psychological services
 Psychiatric services
 Liaison with criminal justice, child welfare
and other agencies


 Vocational rehabilitation
 Recreational therapy
 Art, music, dance therapy
 Nutrition counseling
 HIV/AIDS counseling
 Spiritual counseling
 Literacy instruction
 General equivalency diploma preparation


 Policy on length of time in recovery
 Written job requirement specifying staff
abstinence
 ADA protects against discrimination in
employment
 Staff Relapse
 Legal vs. illegal drugs
 Incentives for relapsing employees to seek treatment
 job modifications, temporary transfers, etc.
 Duration of abstinence before returning to work
and/or client services


 Staffto client ratio 1:8-1:15
 Considerations
 State regulations
 Funder regulations
 Types of care provided
 Linkages to wrap-around services
 Realistic workload


 General staff meetings
 Weekly
 Address staff concerns
 Provide training
 Allow for case reviews
 Crisis meetings
 Sentinel events
 Client crisis


 Program performance/Utilization review
 Policymaking
 Competitive status
 Finances


 Essentialstep-down component
 Management involves outreach, advocacy,
planning, supervision
 Community partnerships
 Referrals and distribute workload
 Motivate and engage their staff through
bottom-up management
 Regularly assessed
 Cost-effectiveness and meeting patients’ needs


Tip 46 Administrative Issues In IOP

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