BH Residential Garden Gate Program Plans FY10

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					Residential Services: Garden Gate Program Plans, FY10                                 Page 1 of 6

                        Satilla Community Services
                                Program Plan
                                   FY 10
                            GARDEN GATE

Program Description

The Garden Gate Ready For Work (RFW) Residential Program provides 24 hour a day, 7 days
per week substance abuse treatment, residential services and holistic childcare for women and
their dependent children, age 13 and younger. Fifteen (15) residential gender specific treatment
slots are available, with priority status given to pregnant women. An average length of stay is
approximately seven (7) to twelve (12) months although some women may require longer
lengths of stay depending on their circumstances and the severity of their treatment needs.
When clinically appropriate, consumers are integrated back into the community. They
participate in job searches, and obtain employment or they may choose to continue their
education. Case managers may refer consumers to Supportive Employment with Satilla
Community Services, the Georgia Department of Labor, or Adult Literacy Programs as needed.

The program is located at:
Garden Gate Residential Services,
852 Tiffany Lane
Waycross, GA 31503

Program Philosophy

In line with national policy and best practice, Satilla Community Services is working towards
better-integrated behavioral health and substance abuse programs for the many consumers
with multiple disabilities. Our goal is an integrated set of behavioral health and community
support programs fully competent too provide services for all consumers with substance abuse,
developmental disability and / or mental health problems co-occurring in any combination. See
also agency Mission, Vision and Values statement.

Traditionally women have faced unique obstacles in seeking substance abuse treatment,
among the most powerful being lack of childcare. By admitting both the woman and her
dependent children as a viable family unit, we begin to break through the intergenerational cycle
of chemical dependency and associated family problems.

Garden Gate utilizes an eclectic theoretical approach to gender-specific substance abuse
treatment in a holistic environment. This approach allows for the utilization of a wide range of
therapeutic interventions. The models incorporated include Person-Centered Care, Systems
Model, Seeking Safety, and Matrix Model. The Person-Centered philosophy used recognizes
that all participants are unique individuals with unique needs, wants, goals and dreams.
The Person-Centered approach is designed to encourage staff to view the individual's needs
through their eyes, and to honor their preferences, choices and abilities. The benefits of a
Person-Centered Approach include individualized planning sessions, increased respect of
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cultural preferences, the gathering of a group of committed allies who support the individual,
and a focus on the individual‟s strengths, rather than weaknesses.

Garden Gate also utilizes the Systems Model. The individual has the opportunity to learn and
grow in a therapeutic setting. Consumers attend weekly individual counseling sessions, and
daily educational groups that treat „mind, body, and soul‟ with: Drug education, identifying and
coping with high- risk situations, anger and stress management, co-occurring education, trauma
classes, proper nutrition and exercise, job skills, meditation, and spirituality groups. Family
issues are addressed with parenting classes, codependency, family education groups and
individual family meetings (as requested), visitations and Family Days. Family involvement and
community support systems are important resources in achieving treatment goals.

Garden Gate also uses the Seeking Safety module to assist consumers with trauma issues.
Seeking Safety is designed to help clients and clinicians explore the link between trauma/PTSD
and substance abuse without delving into extensive details about the past that may be de-
stabilizing during early recovery. Its goal is to provide a present-focused, empathic approach
that “owns” and names the trauma experience, helps validate the connection to substance
abuse, and provides specific safe coping skills to manage the often-overwhelming emotions and
impulses of this dual diagnosis. This model incorporates four domains: cognitive, behavioral,
interpersonal, and/or a combination.

The last model utilized is the Matrix Model. The goal of the Matrix Model is to provide a
framework for substance abusers to accomplish the following: (a) cease drug use, (b) remain in
treatment, (c) learn about issues critical to addiction and relapse. (d) receive direction and
support, (e) receive education for family members affected by the addiction. (f) become familiar
with the self-help programs, and (g) receive monitoring by urine drug testing. The Matrix model
requires the clinician to function as teacher and coach simultaneously. The Matrix model
fosters a positive, encouraging relationship with the consumer, and uses that relationship to
reinforce positive behavior change. The interaction between the clinician and the consumer
promotes self-esteem, dignity, and self-worth.

Program Goals

   To remove alcohol and drugs as a barrier to employment. This includes successful
    completion of treatment service program; improved consumer overall physical health,
    psychological functioning, and family life, abstinence from all addictive psychoactive
    substances in recovery, except when taken in accordance with a structured medications
    maintenance program; and consumer participation in aftercare.
   To have 95% to 100% of the pregnant women who enter the program before their third
    trimester to have a healthy and drug free child
   To help the women who bring their children with them to the program keep custody
    throughout the RFW Substance Abuse Treatment Program; and those women who do not
    have custody of their children to regain it while completing them program.
   To help the women to achieve self-sufficiency with empowerment of choices.

Service Modalities

   24 hour facility
   Services authorized by physician
   Individualized service plan for recovery
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   Individualized family and support system contacts
   Case coordination
   Staff person on call 24 hours a day, 7 days a week
   Treatment community as a therapeutic agent
   Personal responsibility and positive character change promoted
   Graduated responsibilities and earned privileges
   Primary medical care for women, including referral for prenatal care, while the women are
    receiving these services.
   Primary pediatric care, including initial screenings and child immunizations.
   Gender specific substance abuse treatment and other therapeutic interventions for women,
    addressing issues of relationships, sexual and physical abuse, parenting skills, and child
    care while the women receive these services.
   Therapeutic interventions for children in custody of women in treatment which may, among
    other things, address their developmental needs, including possible issues of neglect,
    sexual or physical abuse.
   Sufficient case management and transportation to ensure that the women and their children
    have access to services provided.
   Access to on-site or off-site detoxification services as clinically indicated.
   Abstinence orientation, group and individual therapy.
   Family involvement.
   Recovery group attendance, psycho-education (including appropriate medical therapies),
    relapse prevention, and aftercare services.

Children, housed on site, receive a parallel treatment component to the women‟s services.
Holistic Child Care Provides:
       A nurturing environment that addresses and resolves behavioral issues from a holistic
       A healing atmosphere where various traumatic issues can be surfaced, addressed and
        resolved resulting in healthier behavioral relationship patterns
       Constructive and proactive activities rather than punitive reactions to behavior
       An environment where women in recovery can learn to interact in a nurturing,
        constructive and healthy manner with their children, relearning or learning healthy
        parenting skills
       Appropriately trained skilled pediatric medical and mental health professionals are
        available either on-site or through a professional network, via contract
       All participants will have access to a comprehensive spectrum of mental health and
        ancillary services designed to meet the multiple and changing needs of each child
       Wrap-around issues will be addressed. These include academic issues, medical needs,
        age-diversity of children, safety issues, gender issues, and partnerships with substance
        abuse programs in the community.

Target Population

The Garden Gate Program has been designed specifically to provide long-term substance
abuse treatment as part of a continuum of care at a clinically managed, medium/high intensity
level (ASAM III.1 to III.5). The diagnosis of eligibility must be Substance Abuse or Substance
Dependence as indicated by DSM-IV criteria with a LOCUS screening indicating a need for that
level of service. Consideration will be given to both a history of poor response to traditional
treatment and access to resources necessary to maintain independent living. Residential
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Services‟ role in the treatment process begins with outreach networking, in a plan to identify
potential consumers in need and work with local community agencies in developing coordination
of services and cooperative case management during treatment.
Admission Criteria:
 Individuals with DSM-IV primary AD diagnosis
 Substance abuse should be a demonstrated barrier to employment
 Pregnant, post-partum women, or women who are attempting to regain custody of the
    dependent children.
 The service is primarily intended for the residents of the counties of Atkinson, Bacon,
    Brantley, Charlton, Clinch, Coffee, Pierce, Ware, Ben Hill, Berrien, Brooks, Cook, Echols,
    Irwin, Lanier, Lowndes, Tift and Turner. Persons from outside this area may be served in
    the program, however, if they meet the clinical criteria.
 Must meet most-in-need criteria as established by LOCUS screening tool and
    correspondingly appropriate ASAM jIII.5 initial level of treatment
 Functionally appropriate for services as indicated by GAF scores of 20 to 80
 Must be medically safe to treat, with proof of stabilization of any preexisting medical
    condition (cannot have severe “high-risk) problems
 At risk of harm to self or unborn child due to substance use/abuse
 Unable to access resources necessary to maintain independent living
 History of poor response to traditional treatment and/or history of non-compliance
 Documented psychological and physical exam, indicating appropriate for residential setting
 Background criminal clearance, indicating other consumers would not be placed at risk
    within the residential environment
 Current Tuberculosis screening and no apparent signs or symptoms of infectious disease
 Evidence of failure of less intensive treatment interventions(unable to maintain abstinence in
    a less restrictive environment
 Must have at least one authorized person for contact in case of emergency
 Compliance signature on Behavioral Contract
 Immediate detoxification needs are routinely to be met before admission to RFW Residential

Exclusion Criteria:
 Women who are not pregnant and/or do not have minor children in their custody or in the
   custody of another adult (legal adoptions by another adult are not included in the
 Unavailability of funding slots; referrals will be made to appropriate services elsewhere in
   the program
 Failure to meet standards of admission criteria, as determined by Admission Screening
   Committee and physician recommendation
 Consumers who are not capable of active participation in the treatment process
 A consumer for whom substance abuse is not a presenting barrier to employment
 Heroin addiction: consumers will be referred to Licensed Methadone Clinic
 If a consumer has left treatment against medical advice (AMA) or has been administratively
   discharged in the past six months

Utilization / Continued Stay:
 The consumer continues to meet criteria for DSM-IV diagnosis and ASAM level of treatment
     provided through Residential Treatment Program
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   Treatment has not yet resulted in a level of functioning that allows for safe discharge to less
    intensive treatment
   Treatment goals have not yet been achieved
   The consumer has insufficient resources or skills to achieve or maintain an adequate level
    of functioning without the program
   A likelihood of benefit from continued treatment or treatment would prevent further

Discharge / Transfer Criteria:
 Begins with the intake process in establishing treatment designed to decrease the level of
   intensity of services necessary.
 An aftercare plan is developed for each woman defining appropriate community support
   systems, follow-up responsibility and where required drug screens will be done during the
   first three months in aftercare.
 A completed LOCUS discharge assessment indicates discharge to ASAM Level I or Level II
   RFW outpatient program in the consumer‟s home area.
 All appropriate referral sources for continued linkages to services will be invited to
   participate in the discharge treatment team process.

Mechanisms to Address the Needs of Special Population

Reasonable and appropriate accommodations are established within the program to assist all
consumers in receiving the services they need. Buildings are “ADA accessible”

Program Resources

Services are supervised and provided by a Licensed Professional, LPC, LMFT, and/or LCSW,
paraprofessionals, RN. Staffing includes a program manager, secretarial support, house-
parents, social service providers, substance abuse counselors, social service aides. Psychiatric
and physician services are made available as required.

The program is accommodated on its own campus in a quiet residential area just outside the
city limits of Waycross. The furnished accommodation for the women and children consists of
15 duplex apartments, each providing a minimum of two bedrooms, a living room, fully equipped
eat-in-kitchen and full bathroom. A separate administration building houses staff offices,
communal meeting and treatment rooms and other administrative functions. Another separate
building accommodates play areas and classrooms for the children‟s part of the program. The
entire site is gated and secured within a perimeter fence. Additional security measures include
video cameras and alarms on the doors to the apartments. A security guard is on duty
throughout the night and conducts regular patrols. The women are supplied with all the facilities
and equipment they need to care for them and their children (including cooking, cleaning and
laundry facilities). In addition to safe and heated / air conditioned premises, the program has
adequate network connections and hardware to allow all clinicians ready access to the agency‟s
computerized and integrated clinical care management system.

Dr. Glyn Thomas, Executive Director

Janett Carter, Director for Behavioral Health
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