Oregon Recovery Homes

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Oxford House statistics and growth

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Oregon Recovery Homes

  1. 1. A Program of The Recovery Association Project and Central City Concern Presented by Oregon Recovery Homes
  2. 2. Presentation Objectives <ul><li>Convey exactly what the Oregon Recovery Homes Program consists of </li></ul><ul><li>Demonstrate that Oregon Recovery Homes is a Proven, Successful and Cost-effective means to long-term recovery </li></ul><ul><li>Explain Program Expansion Goals to include House Monitoring, Systems Implementation and Rural Outreach Campaigns </li></ul><ul><li>Increase support and investment in Oregon Recovery Homes </li></ul>
  3. 3. Presentation Outline <ul><li>Background </li></ul><ul><li>Program Description </li></ul><ul><li>Revolving Loan Fund </li></ul><ul><li>Resident Profile </li></ul><ul><li>Program Success </li></ul><ul><li>Keys to Future Success </li></ul>
  4. 4. Background <ul><li>1988 Anti-Drug Abuse Act allows for States to establish Revolving Loan Fund pursuant to USC Title 42, Section 300x-25: Group Homes for Recovering Substance Abusers </li></ul><ul><li>1989 Oregon Offices of Alcohol and Drug Abuse Programs establishes Oregon Recovery Homes and $100,000 Revolving Loan Fund </li></ul><ul><li>1989-1994 ORH RLF administered by a variety of contractors </li></ul><ul><li>1994 ORH Contract awarded to Ecumenical Ministries of Oregon </li></ul>
  5. 5. Background (continued) <ul><li>2000 Outreach Coordinator position added to ORH contract and awarded to EMO </li></ul><ul><li>2003 Second Outreach position is added to OMHAS contract with OHCS funding and the original position assumed Program Manager duties. EMO receives Washington County Outreach Coordinator contract </li></ul><ul><li>2005 OHCS discontinues funding, but OMHAS funds to maintain position. All ORH contracts are awarded to Central City Concern and the Recovery Association Project </li></ul>
  6. 6. Program Description <ul><li>Oregon Recovery Homes provides Start-up Loans, Technical Assistance and Outreach Support to groups and communities throughout Oregon to help establish self-run and self-supporting Recovery Homes as a means to successfully and cost-effectively sustain long-term recovery </li></ul>
  7. 7. Outreach Coordination <ul><li>“ The Outreach Coordinator serves as the institutional memory for a population whose leadership is transitional in nature” </li></ul><ul><li>-Ken Guza, Washington State DASA </li></ul>
  8. 8. Technical Assistance and Outreach Support are provided by The Recovery Association Project and are delivered as two strategic functions <ul><li>Supporting Existing Recovery Home networks in regions with both community and membership support </li></ul><ul><li>Supporting Communities with little or no Recovery Home support </li></ul><ul><li>(Both strategies require extensive collaboration with existing Recovery Home networks) </li></ul>
  9. 9. Technical Assistance <ul><li>RLF Application Assistance and Approval </li></ul><ul><li>Lease Negotiation </li></ul><ul><li>Operational System Training </li></ul><ul><li>Volunteer Coordination </li></ul><ul><li>Leadership Development </li></ul><ul><li>Systems Implementation </li></ul><ul><li>Moderating Legal and Policy issues </li></ul><ul><li>Serving as Institutional Memory </li></ul>
  10. 10. Outreach Support <ul><li>Traveling to Communities throughout Oregon in need of recovery housing resources </li></ul><ul><li>Networking with local community members, organizations and agencies </li></ul><ul><li>Establishing new Recovery Homes as part of a community effort </li></ul><ul><li>Outreach Presentations </li></ul><ul><li>Connecting Recovery Homes to Support Networks </li></ul>
  11. 11. The Revolving Loan Fund is administered by Central City Concern <ul><li>$100,000 RLF from initial federal allocation </li></ul><ul><li>Additions to the RLF in supplements totaling $85,000 added by the State, late fees and account interest has extended the RLF beyond the original $100,000 </li></ul><ul><li>Current RLF capacity is just under $168,000, $121,000 of which is currently outstanding </li></ul><ul><li>Over the course of 19 years (1989 to 2008) approx. 230 loans have been made, averaging $4,000 each, and totaling $920,000…all from the same RLF !!! </li></ul><ul><li>230 recovery homes were established with the help of these loans, of which 167 are still in operation, and the RLF is still available to help open even more recovery homes </li></ul><ul><li>Each dollar of the fund has been used 4 to 5 times over to establish these homes </li></ul>
  12. 12. RLF Loan Application Criteria <ul><li>In accordance with USC Title 42, Section 300x-25 </li></ul><ul><li>Nonprofit Entity </li></ul><ul><li>Provide System of Operation </li></ul><ul><li>Residents must be in recovery from alcoholism and/or drug addiction </li></ul><ul><li>Democratically self-run </li></ul><ul><li>Financially self-supporting </li></ul><ul><li>Must expel any member who returns to using alcohol or drugs </li></ul>
  13. 13. Approved Uses of RLF Loans: M ust be used for associated start up costs of the home <ul><li>First Months Rent </li></ul><ul><li>Cleaning Deposits </li></ul><ul><li>Furnishings and Appliances </li></ul><ul><li>Other Household Wares </li></ul><ul><li>Minor Structural Modifications </li></ul>
  14. 14. Revolving Loan Fund (continued)
  15. 15. <ul><li>Oregon Recovery Home Resident Profile 2007 Random Cross-section Survey </li></ul><ul><li>(Based on a 10% representative sample of homes- 14 homes with 88 residents from various regions of the state completing survey) </li></ul>
  16. 16. General Demographics <ul><li>Average age: 34 years </li></ul><ul><li>59% are male and 41% are female </li></ul><ul><li>Average length of abstinence is 17 months </li></ul><ul><li>Average length of residency is 8.5 months </li></ul><ul><li>86% have been in treatment averaging 2.2 episodes </li></ul><ul><li>73% have experienced homelessness averaging 15 months </li></ul><ul><li>77% of have been incarcerated averaging 38.9 months </li></ul>
  17. 17. Ethnicity
  18. 18. Source of Referral
  19. 19. Source of Treatment Funding 73% Publicly Funded
  20. 20. Source of Initial Rent
  21. 21. Marital Status
  22. 22. Recovery Resources
  23. 23. Community Resources
  24. 24. Income 169% increase during average of 8.5 month residency
  25. 25. Unemployed Income Sources Financial Support % of Residents Monthly Amount Food Stamps 89.2% $190.00 General Assistance/ TANF/ Welfare 30.8% $430.00 SSI/SSD 10.8% $827.00 Unemployment 7.5% $763.00
  26. 26. Health Care Coverage
  27. 27. Incarceration Of the 77% of residents who experienced incarceration the following circumstances were reported
  28. 28. Primary Recovery Method
  29. 29. Weekly Attendance of Recovery Program
  30. 30. Employment & Comparative Cost Burdens Employment rate: 70% Average monthly income: $1,590
  31. 31. Average Education: 10.9 years
  32. 32. Primary Drug Used
  33. 33. Secondary Drug Used
  34. 34. Prior Place of Residence
  35. 35. Another Way of Looking at it About 34% of Residents move into Oxford Houses directly from other State or Federally funded Institutions, many of which would otherwise be potentially homeless. 15% live with family as an often temporary and last resort, and 7% rent rooms in often derogatory environments to avoid homelessness. Add that to the 24% entering directly from homelessness and you get roughly 80% of Residents in Oxford Houses at risk of homelessness upon entry… Oxford Houses are truly the LAST HOUSE ON THE BLOCK for many.
  36. 36. 11 Years of Oxford House Growth
  37. 37. ORH Support to Oxford Houses over the past 6 years <ul><li>60.7% of Oxford Houses opened receive hands-on Outreach Support </li></ul><ul><li>84.8% of Oxford Houses opened received Technical Assistance </li></ul><ul><li>91% of oxford Houses opened received Start-up Loans </li></ul>
  38. 38. AMH 2007 Housing Survey Actual capacity of Oxford Houses was approx. 1,000
  39. 39. Beds by County
  40. 40. “ The person who says it cannot be done should not interrupt the person doing it” --Chinese Proverb 2007 AMH Housing Survey identified a need for over 2,000 additional beds in recovery housing
  41. 41. Why do Oxford Houses work? <ul><li>Accepting responsibility for operating the house instills a sense of esteem, confidence and accomplishment </li></ul><ul><li>No limitations on length of stay </li></ul><ul><li>Allows fellowship with similar people, stability in member’s lives, and sufficient time for change and personal growth </li></ul><ul><li>Strategically located in low-risk, low-crime environments </li></ul><ul><li>Affordable…average monthly rent, utilities and household supplies are under $400 </li></ul>
  42. 42. Why do Oxford Houses work? (continued) <ul><li>Part of the surrounding community so residents learn about and gain access to local resources and experience a sense of the larger community </li></ul><ul><li>Provide an environment in which to raise children that is more stable and secure than shelters, halfway houses, public housing complexes or the homes of relatives who are not in recovery </li></ul><ul><li>Self-governed structure and stability make it desirable to residents </li></ul><ul><li>Encourages self-sufficiency through employment and post-secondary education </li></ul><ul><li>Encourages accountability to peers and community </li></ul><ul><li>Enforces abstinence and avoidance of substance abuse </li></ul>
  43. 43. Evidence-based Practice <ul><li>AMH has recently submitted an application for the Oxford House Model to be considered an evidence-based practice in accordance with Senate Bill 267, which requires that increasing amounts of state funds be focused on Evidence-Based Practices </li></ul>
  44. 44. DePaul Research Findings <ul><ul><li>Primary Reason for choosing Oxford House: </li></ul></ul><ul><ul><ul><li>Fellowship provided and the existence of a structured setting where avoidance of substance use was enforced </li></ul></ul></ul><ul><ul><li>Most Common reasons for entering Oxford House </li></ul></ul><ul><ul><ul><li>34.6% Desire for Peer Social Support </li></ul></ul></ul><ul><ul><ul><li>30.7% Having nowhere to go </li></ul></ul></ul><ul><ul><ul><li>25% Seeking a Drug-Free environment </li></ul></ul></ul><ul><ul><li>Most important Benefits of living in Oxford House: </li></ul></ul><ul><ul><ul><li>Sense of community with similar others </li></ul></ul></ul><ul><ul><ul><li>Self-paced recovery option that gave sufficient time for psychological growth while avoiding substance use </li></ul></ul></ul><ul><ul><ul><li>Fellowship provided and the existence of a structured setting where avoidance of substance use was enforced </li></ul></ul></ul>
  45. 45. DePaul Research Findings (continued) <ul><li>28.8% attend some form of counseling outside of the Oxford House </li></ul><ul><li>A 6 month follow-up study showed a 69.2% overall success rate: </li></ul><ul><ul><li>50% were still residing in an OH </li></ul></ul><ul><ul><li>32% had left on good terms </li></ul></ul><ul><ul><li>18% had left on bad terms (relapse or disruptive behavior) </li></ul></ul>
  46. 46. DePaul Research Findings (continued) Psychiatric Diagnoses & Rates of Drug Dependence <ul><ul><li>Cocaine: 84.6% </li></ul></ul><ul><ul><li>Alcohol: 71.2% </li></ul></ul><ul><ul><li>Cannabis: 69.2% </li></ul></ul><ul><ul><li>Amphetamines: 37% </li></ul></ul><ul><ul><li>Opioids: 25% </li></ul></ul><ul><ul><li>Sedative-Hypnotics: 23.1% </li></ul></ul><ul><ul><li>Phencyclidine: 15.4% </li></ul></ul><ul><ul><li>Hallucinogens: 15.4% </li></ul></ul><ul><ul><li>Heroin: 13.7% </li></ul></ul><ul><ul><li>Inhalants: 3.9% </li></ul></ul>
  47. 47. DePaul Research Findings (continued) Substance Dependency
  48. 48. DePaul Research Findings (continued) Psychiatric Diagnoses <ul><li>Other Psychiatric Disorders </li></ul><ul><ul><li>Anti-social Personality Disorder: 57.7% </li></ul></ul><ul><ul><li>Any Affective (mood) Disorder: 38.5% </li></ul></ul><ul><ul><li>Post-Traumatic Stress Disorder: 34.6% </li></ul></ul><ul><ul><li>Major Depression: 26.9% </li></ul></ul><ul><ul><li>Dysthymia: 19.2% </li></ul></ul><ul><ul><li>Panic Disorder: 15.4% </li></ul></ul><ul><ul><li>Generalized Anxiety Disorder: 13.5% </li></ul></ul><ul><ul><li>No Psychiatric Co morbidity: 21.2% </li></ul></ul>
  49. 49. DePaul Research Findings Psychiatric Diagnoses (continued) <ul><li>52% reported having 2 or more Psychiatric Disorders </li></ul><ul><ul><li>25% were diagnosed with ASP and PTSD </li></ul></ul><ul><ul><li>15.4% were diagnosed with ASP and Major Depression </li></ul></ul><ul><ul><li>11.5% were diagnosed with PTSD and Panic Disorder </li></ul></ul>
  50. 50. DePaul Research Findings (continued) <ul><li>One study assessed 150 participants randomly assigned to either Oxford House or “usual care conditions” (friends, relative, half-way house, rented apt., etc.) after undergoing treatment. At 2 year follow-up, the participants using Oxford House for at least 6 months demonstrated: </li></ul><ul><li>87% were drug-free after one year and 65% after two years as compared to 31% of participants in other settings (more than double) </li></ul><ul><li>Higher levels of monthly income: $989 vs. $440 </li></ul><ul><li>Lower incarceration rates: 3% vs. 9% </li></ul><ul><li>Higher levels of optimism and confidence </li></ul><ul><li>The Economic Benefits of this example, focusing on productivity and incarceration benefits are: </li></ul><ul><li>An estimated $613,000 in savings accruing to the Oxford House participants </li></ul><ul><li>An average of $8,173 per Oxford House member </li></ul>
  51. 51. DePaul Quotes <ul><li>“ Oxford House could be a justifiable alternative to inpatient treatment and incarceration” </li></ul><ul><li>“ Even we were amazed at the results” </li></ul><ul><li>“ These findings suggest tremendous public policy benefits for these types of low cost, residential, non-medical care options for individuals with substance abuse problems” </li></ul><ul><li>“ Moreover, we are beginning to look at this model and how it can be applied to a number of different groups, such as ex-offenders with substance abuse problems where recidivism is extremely high, the mentally ill and people with chronic illnesses, to name a few” </li></ul><ul><li>“ It’s time for creative, simple solutions that address our social agendas” </li></ul>
  52. 52. DePaul Quotes (continued) <ul><li>“ Unfortunately, a review of the literature on the efficacy of traditional alcohol and drug treatment indicates high recidivism rates for men and women within one year of treatment that includes immediate detoxification with adjacent therapies” </li></ul><ul><li>“ Additionally, under modern managed care, private and public sector inpatient and outpatient substance treatment facilities have reduced their services significantly. Thus there is a need to expand and evaluate the possibilities for lower cost, non-professional, community-based intervention options for substance abusers” </li></ul>
  53. 53. DePaul Quotes (continued) <ul><li>“ Not only does it appear that Oxford House is at least effective as other more traditional treatment models in promoting recovery, but, in a world of rising healthcare costs and decreased support for personal healthcare, the self-governing and financially self-supporting nature of Oxford House makes this form of service delivery a feasible and attractive alternative for persons seeking to attain and maintain sobriety” </li></ul>
  54. 54. The Oxford House Advantage <ul><li>Oxford House takes on characteristics of three proven recovery concepts </li></ul><ul><li>Therapeutic Community </li></ul><ul><li>Alternative Treatment </li></ul><ul><li>Self Help Group </li></ul>
  55. 55. Therapeutic Communities <ul><li>Therapeutic Communities are residential settings where substance abusers learn social behavior and develop a sense of belonging and trust of others </li></ul><ul><li>The ideology of Therapeutic Communities embraces complete life-style change through supportive communal living </li></ul><ul><li>Evaluation studies have found that duration of time spent in therapeutic communities is related to treatment effectiveness, with longer length of stays associated with better outcomes </li></ul><ul><li>It is evident that therapeutic communities have created an alternative form of substance abuse treatment which stands in contrast to traditional group homes and detoxification units </li></ul>
  56. 56. Alternative Treatment Modalities <ul><li>Alternative Treatment Modalities have been characterized as embracing values of affordability, volunteerism, genuine affection for clients, and equality in status for clients and providers </li></ul><ul><li>Research indicates that individuals respond more favorably to treatment when allowed to set their own goals for recovery </li></ul><ul><li>Programs that allow opportunities for autonomous work, particularly when that work involves helping others in recovery, have shown promising results </li></ul>
  57. 57. The Self-Help Concept <ul><li>The Ultimate goals of the Self-Help process are the provision of support for members, and the improvement of members’ psychological functioning </li></ul><ul><li>A common process characterizing these groups is the mutual support of members through verbal sharing of personal experience </li></ul><ul><li>Self-help peer-led therapy has been assessed as both more clinically effective and less expensive than therapy led solely by professional staff </li></ul><ul><li>Additionally, therapeutic communities using social learning and self-help interventions have been reported to show long-term success for 75% of individuals who complete treatment </li></ul>

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