Improving Continuation from Detox into Treatment – Arapahoe House Tucson Learning Collaborative – July 2009 Arapahoe House is the largest provider of substance abuse treatment services in Colorado, offering outpatient, residential, and detoxification services. Arapahoe House operates three social model detoxification programs with a total of 98 beds. Together these three programs provide approximately 18,000 episodes of detoxification annually. The primary goals of these detoxification programs are to monitor clients to insure a safe withdrawal from alcohol and drugs; in addition these programs aim to motivate clients to seek further appropriate treatment. If the client is interested in further treatment, the staff will work with them to help facilitate linkage to ongoing care.

AIM (Plan) Problem is low rate of continuation from detox into treatment (Baseline rate of 4.9% of clients entering treatment within 30 days of discharge from detox) Goal is to increase continuation rate to 14.9% Current focus is on streamlining referrals to AH outpatient programs & increasing referrals and admissions to DUI education and treatment

CHANGE (Do) 1 st Set of Change Cycles Deputy Director does walk through; sees many problems; internal AH barriers change team created Internal change team gets to work! – Trained detox staff to schedule OP appointments – Waived fee for OP intake; coding as a transfer – Offers initial OP orientation at additional more convenient locations – Reduced paperwork duplication at OP 2 nd Set of Change Cycles Outside DUI providers invited to participate Staff trained in new referral process; new tracking processes started; clients given names of at least 3 DUI providers Staff starts trying to schedule intake appointments prior to discharge DUI providers make presentations to staff and clients

RESULTS (Study) Improved relationships with AH outpatient programs; referrals to AH OP increase by 18% Total continuation rate increases to 19.1% in January; goal is met for January, February, March But rate dips in April and May; change team is studying reasons

NEXT STEPS (Act) Expand successful linkage activities at the two other detox facilities in Commerce City and Wheat Ridge Increasing the linkage to ongoing care fits into the pay for performance and measureable outcome shifts from funding entities Broader Vision for Arapahoe House

IMPACT (Business Case, Lessons Learned) AH successfully increased referrals into our own programs; resulting increase in census and revenue led to adding OP staff at one location. Staff get a greater level of job satisfaction by linking clients to treatment and seeing the data of successful referrals. An outside point of view (walk through) helps point out how things can be done differently, peoples comfort with change is challenged – opens creative processes. Strong support from Executive Management is critical to successfully making procedure changes.