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RecoveryNet Open Access Collaborative

Delphi Drug and Alcohol Council

RecoveryNet Open Access Collaborative Logo

Program Website
Year:
2018
State:
New York
Winner Status:
Applicant
Program Type:
Access to Care
Target Population:
Individuals with a Substance Use Disorder
Setting:
Clinic

Program Description

Open Access is a collaborative program of RecoveryNet, an eight agency collaborative of community-based substance use disorder programs in the Rochester, NY founded in 1998. Open Access was developed by the RecoveryNet partners as a response to the Opiate Epidemic and the need for more capacity and rapid access to treatment. While many of the RecoveryNet partners, and others in the community, offered some open access hours for walk-in evaluations and admission to treatment, the hours and the locations of such services was disjointed and confusing to the public. And, all of the open access options that existed in the community were only available during weekday business hours. The partners came together, and with support from the County Office of Mental Health and the NYS Office of Alcoholism and Substance Abuse Services, to build a shared open access office adjacent to the local in-patient detox program. The program launched in late summer 2017 and is ramping up to 24/7 operation. It is currently open weekday evenings and from 9:00 AM to 10:00 PM Saturday and Sunday. Approximately 50% of the clients are immediately admitted for in-patient care and the rest are scheduled for an appointment on the next business day.

Creativity

We are not aware of any other instance of a group of providers coming together to jointly operate an open access clinic. Because the collaborative includes virtually the full continuum of care and programs that specialize in serving a wide variety of target populations, we possess the expertise, the commitment and the credibility to effectively serve as a starting point a broad cross section of the community. In response to needs identified since opening, we have added a family education/support group twice a month and monthly Narcan training/distribution class. We also have incorporated translation capability for 240 languages and dialects, including American Sign Language. We are in the process of the bringing self-help on site and will begin distribution of a smart phone recovery support application next month. In response to transportation problems getting people to in-patient units up to 2 hours away, we began using Uber for such transportation.

Leadership

We are proud that after we brought the concept of a 24/7 open access clinic to the NYS Office of Alcoholism and Substance Abuse Services, they immediately embraced the idea and issued an RFP to replicate the program in every region of the State. Our design is also innovative in that the program is staffed by a Qualified Health Professional (QHP) and two credentialed Peer Advocates any time it is open. The QHP’s are drawn from the staff of the RecoveryNet partners and are paid time and a half for this work. This gives us access to a pool of very experienced professionals, something normally difficult in this labor market, and allows chronically underpaid staff members to supplement their income. We launched the program with a ribbon cutting attended by the State Commissioner, but it is the community support and use of social media that have spread the word.

Sustainability

We were able to build out the facility and launch the service largely due to financial support from the NYS Office of Alcoholism Services, but sustaining the program will rely much more heavily on using “in community billing,” a process that launched in NYS in 2016 that allows licensed clinics to bill Medicaid Managed Care for services provided in the community on the same rates and terms as services provided at their home sites. We are optimistic going forward that managed care and the regional performing provider system, the local DSRIP Medicaid redesign organization, will see 24/7 open access as a cost effective alternative to patients using emergency departments. We have begun discussion about enhanced funding from them both.

Replicability

The concept of open access has been around for some time now and is well understood by providers. The major innovation is making it even more accessible to potential patients by eliminating confusion about hours of operation and location with the creation of a shared site and 24/7 availability. The credibility of the program is also enhanced by its sponsorship by a longstanding collaborative of respected community-based organizations.

Results/Outcomes

Open Access only began operation in August of 2017, but since its first full month of operation in September, we have seen volume double in October and double yet again in November. While we were not able to sustain that rate of growth during the holidays, volume increased again in December. While not everyone who comes to Open Access either needs, or is ready to accept, admission for in-patent detox or rehabilitation, we have consistently been able to get immediate admission to in-patient services for approximately half of the people who walk through the door. Those not needing in-patient care, and those for whom immediate access is not possible given the limited capacity in the community, are connected with a Peer and are given an appointment are one of the partner agencies on the next business day.