Indiana’s Certified Recovery Specialist Program

1. Indiana’s Certified Recovery Specialist Program

2. Overview Program Background and Purpose Role of the CRS Guidelines for Becoming a Certified Recovery Specialist Training Curriculum Questions and Answers September 2009

3. Program Background and Purpose September 2009

4. Why have Certified Recovery Specialists? The Indiana Division of Mental Health and Addiction wants to ensure that consumers of mental health services have the most effective treatment available in the least restrictive settings. Certified Recovery Specialists are a viable option to supplement treatment for consumers. CRS instill hope, choice, and empowerment for recovering individuals. September 2009

5. Theoretical Foundation’s Values • Recovery creates and supports services, practices and policies that facilitate safety, hope, choice and empowerment. • Partnership Building offers meaningful and sustained quality maximized through multiple stakeholder involvement. • Optimal Treatmentinvolves the implementation of evidence-based practices. • Client-Centered focuses on individualized needs.

6. Quality Practices Underlying Evidence-Based Practices • The nature and quality of the therapeutic relationship is critical. • Quality practices are inclusive and continuous. • Quality practices are individualized and match services to the needs, strengths, preferences, and values of the recipient. • Quality practices promote responsible partnerships via informed and shared decision-making. • Quality practices are dynamic. • Quality practices are outcome oriented and continuous. • Quality practices are culturally competent.

7. CMS Guidance • States utilizing peer support services must comply with all Federal Medicaid regulations and policy. • Peer support providers should be self-identified consumers who are in recovery from mental illness. • Supervision and care coordination are core components of peer support services. • Peer support providers must be sufficiently trained to deliver services.

8. CMS Guidance Continued • Supervision must be provided by a competent mental health professional (as defined by the State). • Amount, duration and scope of supervision will vary depending on State Practice Acts, demonstrated competency and experience of the peer support provider, as well as the service mix. • Supervision may range from direct oversight to periodic care consultation.

9. CMS Guidance Continued • Peer support services must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals. • States should use a person-centered planning process to help promote participant ownership of the plan of care. Such methods actively engage and empower the participant, and individuals selected by the participant, in leading and directing the design of the service plan to ensure that it reflects the needs and preferences of the participant in achieving the specific, individualized goals that have measurable results and are specified in the service plan.

10. CMS Guidance Continued • Peer support providers must complete training and certification as defined by the State. • Training must provide peer support providers with a basic set of competencies necessary to perform the peer support function. • Ongoing continuing educational requirements for peer support providers must be in place.

11. Where will Certified Recovery Specialists work? CRS will work with consumers within community mental health centers and state operated facilities. They will be employees of those organizations. The services that they provide within CMHCs will be reimbursed to the employer through Medicaid Rehab Option billing as of July 1, 2010. Completing the program does not guarantee employment. Conditions of employment will be negotiated individually by employing agency. September 2009

12. Earlier Programs • Depression Bi-Polar Support Alliance Peer Support Specialist Training • META Peer Employment Training Program (Arizona) • Certified Peer Support Specialist Training (South Carolina) • Certified Peer Specialist Training (Illinois) • The Georgia Model (Iowa) • Transformation Center (Massachusetts) • Peer Specialist Training Program in Michigan • Intentional Peer Support (New Hampshire) • Consumer Connections Peer to Peer Core Training (New Jersey)

13. First Group in Arizona - 2006 Participants experienced gains of perceived empowerment, attitudes toward recovery and self-concept. One hundred percent of the trainees went on to obtain positions within the mental health agency in which they received the training and 89 percent were still working 12 months after they were hired. • 29 percent of the jobs were full time • 52 percent part time • 19 percent were hourly • Findings suggest that a specific, manualized peer training program was able to improve participants’ recovery and employability. (Bill Anthony, Lori Ashcraft, Eugene Johnson, et.al.)

14. Arizona Program • One year after the Peer Support staff began working in the two hospital facilities, there was, according to hospital administration, a reduction of • 36% in the use of seclusion • 48% reduction in the use of restraint • 56% reduction in hospital readmission rates

15. Role of the CRS

16. What will Certified Recovery Specialists do? They will support recovery by talking, encouraging, being a role model, assisting in problem-solving, and motivating consumers to manage their own recovery effectively. September 2009

17. How have CRS fit into other programs? • in residential programs • mental health support services • partial hospital and partial care programs • screening centers • self help centers • peer counselors • outreach workers • job coaches • medication appointment advocates

18. Mass. Job Description (Excerpt) • Assist clinicians in evaluation and crisis intervention in various hospital and community based settings. • Assists with the high-volume flow of client care in the urgent care center and in the community; greets clients, provides support during the evaluation process, helps gather client information as part of the evaluation process. • Assists with follow-up client contact, referrals, and resource linkages. • Participates in Staff meetings and other program/systems meetings • Assist people with psychiatric disabilities to identify personal priorities, preferences, strengths, and interests in order to help them establish goals consistent with their worldview. • Promotes use of natural supports within the neighborhood and community of people with psychiatric disabilities. • Gather information about community agencies and families to assist staff in provision of services.

19. Limitations 1      CRS do not work with consumers they have been with or are in treatment with as fellow patients. 2      CRS do not work with consumers who share staff with them, i.e. Psychiatrist, Nurses and so forth. 3      CRS do not work with consumers who are friends, or are who are persons they socialize with away from work settings.

20. How will working affect benefits? Earning income may affect entitlements and must be considered when applying for work. Applicants are encouraged to apply for Vocational Rehabilitation Assistance immediately to access maximum information and benefits. Providers planning to hire CRS will want to consult with VR to maximize hiring benefits. September 2009

21. Guidelines for Becoming a Certified Recovery Specialist September 2009

22. What are the qualifications? Must be at least 18 years old. Must be a resident of Indiana. Must have at least a high school diploma or GED. Must be willing to identify yourself as a person in recovery from mental illness. Must provide current or past treatment verification signed by providing office. Must attend training and pass the certification exam. September 2009

23. What is the training like? Five consecutive days of training Five locations in Indiana 20 modules Multiple instructors Tutoring opportunities Attendance is required. No cost to participants Trainings will take place beginning in January of 2010. September 2009

24. What if I need assistance in attending the training? Be detailed on the training application regarding the type of assistance needed. Check with Department of Vocational Rehabilitation to access possible training benefits. Lunch will be provided each day. A $25 card will be provided. September 2009

25. Daily Training Schedule 9:00 – 9:10 Opening and recap 9:10 –10:40 Session I 10:40–10:50 Break 10:50–12:20 Session II 12:20–1:35 Lunch and Break 1:35 – 3:05 Session III 3:05 – 3:15 Break 3:15 – 4:30 Session IV and close Each training will have a dedicated Trainer for the week as well as a resource person to assist with issues that may be uncovered in training. September 2009

26. Certification Requirements Attend (10 points/module = 200 points) Opportunity to make up missed sessions online; Must earn minimum of 90% of attendance points. Complete Module Evaluations Pass exam (80%) online in 2-hour block. Preparation support online, handouts, tutoring calls, additional special arrangements if needed. One retake allowed. September 2009

27. Training Curriculum September 2009

29. What does the curriculum include? 20 modules 4 modules per day Modules cover issues of recovery and how to facilitate them. September 2009

30. CRS Modules September 2009

31. Where will the trainings be? Indianapolis Ft. Wayne Richmond Evansville Merrillville September 2009

32. When will trainings take place? • Richmond – January 11 – 15, 2010 • Ft. Wayne – January 18 – 22, 2010 • Evansville – February 1 – 5, 2010 • Merrillville – March 15 – 19, 2010 • Indianapolis – March 29 – April 2, 2010

33. Evaluation Activities • Demographics of participants • A pre and post test over all curriculum content • The Empowerment Scale pre/post ratings • The Recovery Attitudes Questionnaire pre/post • An item analysis of final test scores as they related to content will be obtained. • Statistical associations among trainee characteristics, trainee satisfaction, and test scores can be examined using Pearson correlation. • Quarterly conference calls with facilitators • Module satisfaction ratings • Overall satisfaction ratings

34. How do individuals register for training? Visit the CRS website at www.certifiedrecoveryspecialist.org Watch for the posting of further details about training locations. Application may be made through any PC with Internet access and completed online. Applications may be downloaded, completed, faxed or mailed back to the address provided. Treatment Verification forms may be downloaded and mailed or faxed back. After completing the application, applicants will be invited to view a web-based module prior to attending the training. September 2009

35. What is asked on the application? Demographic and contact information Education attainment Previous job experience Indications of special accommodations needed for the training Written answers regarding personal recovery and what has been beneficial, motivation for becoming a CRS September 2009

36. What if applicant is already working as a Recovery Specialist? Must be employed as CRS for one year. Must have been trained through a Certified Peer Specialist National Training Program within last five years and show documentation of successful passing of exam. Must supply proof of employment, copy of job description. DMHA will review and determine status. September 2009

37. What if applicant has been trained somewhere else but has not yet worked in the field? Must verify Certified Peer Specialist National Training Program within last two years. DMHA will review and determine status. All questions regarding applicability of prior experience to this program should be directed to Bruce Van Dusen of the Indiana Division of Mental Health and Addiction. September 2009

38. QUESTIONS? Visit www.certifiedrecoveryspecialist.org Or call Tiffany Wicker or Martha Levey 317-471-0000 September 2009

39. Bruce Van Dusen, AAS Office of Family and Consumer Affairs Bureau Chief Bruce.VanDusen@fssa.in.gov 317-232-7912 Indiana Government Center South 402 West Washington Street, Room W353 Indianapolis, IN 46204