C - Coordinating L - Linking A - Accessing M - Monitoring P - Planning. Care Coordination Overview for Service Providers.
C - Coordinating
L - Linking
A - Accessing
M - Monitoring
P - Planning
Care Coordination Overview for Service Providers
Four year Access to Recovery (ATR) grant, Maryland RecoveryNet – awarded by to the Maryland Alcohol and Drug Abuse Administration for approximately $3.2 million per year.
Meet with clients at their inpatient facility (or via phone if necessary) prior to their release from treatment for the Intake Interview.
Bi-weekly follow-up monitoring via telephone or at locations agreed upon by the Care Coordinator and client.
Review and monitor voucher usage and assist with plan for client accessing services.
Refer and/or schedule appointments for clients to receive primary medical care and mental health services if needed and requested.
Arrange transportation, if needed, in support of access to recovery services and activities.
Assess gaps in goods and services and utilize gap service voucher to meet needs in the recovery plan.
Maintain an ongoing relationship with the client
Administer and submit GPRA Discharge and 6-Month Follow-up Surveys and Client Satisfaction Survey.
Ability to build solid relationships based on trust
Understands recovery planning and resources needed/accessed that support the recovery plan
Aware of community resources and able to connect to community resources.
Knowledge of GPRA rules and implementation standards
Ability to encourage and empower individuals
Troubleshoot and problem solve
TRACK and locate ATR clients
A discharge and a 6 month GPRA are required (Care Coordinator function)
A minimum of 80% enrolled of ATR enrolled clients must complete the 6 month follow-up GPRA
Less than 90% follow-up rate = Technical Assistance and correction plan
6 month Follow-up GPRA must be given 5-8 months after initial enrollment
Discharge GPRA is due after 30 days of voucher inactivity. (Care Coordinator function can be via telephone and/or administrative is client is not located)
One time, face-to-face or telephone* interview with ATR client conducted prior to discharge from residential treatment program : (Requires 3-5 days notice from portal)
*More than 20 miles 0r 30 minutes travel time= Telephone intake with client while still in residential treatment.
Less then three -five (business) days notice of client discharge date.
Other: Requires RAC approval
Review and verification of:
Public transportation that supports client recovery activities. Passes are obtained by Care Coordination Provider agency and disseminated to clients. Providers are reimbursed through the SMART VMS. Includes administrative fee :Might be adjusted regionally
Email to RAC and inform of need
Document purchase with receipt
Document in the provider’s record
Obtain client signature of service/goods
Document in the SMART VMS
Goods or services paid for by the Care Coordination Provider and reimbursed at the rate below to the Provider. This is a fund used to supplement client identified needs to temporarily support recovery needs and fill service gaps. Items which are appropriate to voucher include:
Unit rate=$1.00 Max= 200
One time, face-to-face* meeting with client, conducted 5-8 months following admission to ATR, to assess satisfaction with ATR and to complete GPRA follow-up interview. Also includes obtaining client satisfaction information (Customer Satisfaction Survey mailed to ADAA – 55 Wade Ave. Catonsville, MD 21228) and issuing client $15 gift card. (must be completed within the 5-8 month required window)
Unit =1 session
Units = 1
Unit Rate =$160
*telephone GPRA Waiver can be requested through the Project Director
Regional Area Coordinators (RAC) –Manage on Regional level
Client utilizes RecoveryNet resources to enhance and stabilize recovery
Care Coordinators (CC) – Manage on the client level
What are we looking at?
Overseer of Recovery Resources
Community Resource Connection
System Changer, and
A GPRA Getter
Mother, or a
Contact Deborah Green, Maryland ATR III Project Director – 410,402,8592
Anita Ray- Regional Coordinator- Region III