2. 5/26/20161 NIATx ORP Change Project Enhanced Handoffs in Mi-LINC Gena de Sousa, Project Director Janet Fleege, WIser Choice Project Director Kit Van Stelle, ORP Evaluator Dr. Michael Nunley, Program Evaluator Milwaukee County Behavioral Health Division

3. Milwaukee Linking Individuals to a New Chance: Mi-LINC Target: Men and women returning to Milwaukee after prison release 6+ months prior to release: –Intake screen by Central Intake Unit (CIU) –Client chooses providers During 6 months prior to release: –Recovery Support Coordinator (RSC) reach-in visits –Single Coordinated Care Plan (SCCP) begun At release: –RSC contacts client, convenes Recovery Support Team (RST) –Clinical treatment begins immediately after release

4. Why Handoff Matters Mi-LINC builds onto WIser Choice, Milwaukee County’s recovery oriented system of care, which includes 70+ providers (Central Intake, Clinical, Recovery Support Coordination and Recovery Support Services) Over 80% of reentry clients who attend first appointment stay in treatment at least 30 days Reentry clients who complete an episode of treatment are half as likely to be reincarcerated A warm handoff communicates to the client a welcoming invitation to their recovery journey

5. 5/26/20164 PLAN Problem: Appointments were not made at time of intake screen, so many clients were released without a treatment appointment at the chosen provider Aim:  Scheduling of treatment appointments prior to release from prison Goal: Increase to 100% Baseline: 28% Change Cycles: Jan 1, 2012 – Aug 20, 2012 Total improvement: 76%

6. 5/26/20165 DO Appointment with treatment provider scheduled 45 days prior to release Included: –CIU staff –RSC staff –Provider Network –Better communication between CIU, RSC, RST, community providers (treatment, recovery support services), correctional institutions, and community corrections staff

7. STUDY Month#Released #With Treatment Appt ScheduledPercent Achieved BASELINE: Oct-Dec 20117228% Jan 20127686% Feb 20129889% Mar 2012400% Apr 20126467% May 201233100% June 20124125% July 201210 100% Aug 2012 (to 8-20)6583% Total for 2012493776%

8. STUDY

9. ACT Adopt!

10. LESSONS LEARNED COMMUNICATION! COMMUNICATION! COMMUNICATION! Enthusiasm wanes; procedural changes are needed for stable change. –Client status review (monthly) –CIU internal changes (process, tracking) Success achieved only with TEAM effort!