Stabilization, Rehabilitation and Reintegration, under Managed Care and Medicaid Redesign

In 820 program, they provide comprehensive care for individuals seeking to stabilize, rehabilitate, and reintegrate into their communities. The journey towards recovery is guided by a well-structured continuum of care that encompasses three essential phases: Stabilization, Rehabilitation, and Reintegration.

Stabilization Element:

During the Stabilization element, our primary focus is to provide immediate relief to individuals grappling with withdrawal symptoms and substance cravings. Validated screening instruments such as the COWS (Clinical Opiate Withdrawal Scale), CIWA (Clinical Institute Withdrawal Assessment), and others help us assess the severity of withdrawal and mental health symptoms. Through a holistic approach, we gauge the person's readiness for change and progression through the stages of recovery.

Our metrics here are both behavioral and health-related, ensuring that each patient receives a comprehensive evaluation for medication-assisted treatment (MAT) needs, reports reduced cravings, undergoes safety assessments, and is connected with a discharge plan for a smooth transition to the next element.

Rehabilitation element:

In the Rehabilitation element, we empower individuals to regain control over their lives by achieving personalized goals and objectives. By utilizing evidenced-based practices, we work closely with patients to develop relapse prevention strategies and holistic wellness plans. Their progress is quantified by remission of substance use criteria, successful goal attainment, and advancements in their readiness for change. We gauge improvements in quality of life through pre, intermediate, and post-test evaluations using the Quality of Life Index (QOLI).

Our specific metrics for this element encompass a comprehensive approach. We assess the need for MAT, monitor cravings reduction, encourage active participation in evidenced-based group interventions, and ensure a solid discharge plan with the support of social workers. Our ultimate aim is to empower patients for successful reintegration while reducing hospital admissions and enhancing vocational and social outcomes.

Reintegration element:

In the Reintegration phase, the focus shifts towards guiding individuals to become self-reliant in their community settings. As they transition from residential care to independent or supportive living arrangements, we offer targeted support in establishing work and living supports. Our clinical services extend into an outpatient setting, allowing patients to apply their acquired skills and navigate the new care systems effectively.

Throughout this element , biometric measures and evidenced-based tools are used to assess progress and address ongoing needs. With a commitment to holistic well-being, we help patients transition successfully by collaborating with vocational and housing specialists, fostering social connectedness, and reducing emergency room visits.

In essence, our program's success lies in the seamless integration of the Stabilization, Rehabilitation, and Reintegration elements. By prioritizing personalized care plans, comprehensive assessments, and evidence-based practices, we empower individuals to embark on a transformative journey towards lasting recovery and a renewed sense of purpose within their communities.

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