Oregon Problem Gambling Services

1. PGS Treatment Regional Trainings
Summer/Fall 2018

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

3. 3
This Afternoon’s Stuff!
• Getting You Full Credit (Maximize
Encountering)!!

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

5. 5
This Afternoon’s Stuff!
• Developing Quality Improvement
Processes!
This Photo by Unknown Author is licensed under CC BY

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

7. 7
This Afternoon’s Stuff!
• Integration & Diversification
This Photo by Unknown Author is licensed under CC BY-ND

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

9. 9
This Afternoon’s Stuff!
• Increasing Client Census in Your
Program
– GBIRT Train the Trainer
– In Reach and Referral Pathways
This Photo by Unknown Author is licensed under
CC BY-NC-SA

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

11. 11
This Afternoon’s Stuff!
• Create Community! (Dialogue with
the PGS System)
This Photo by Unknown Author is licensed under
CC BY-NC

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

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PGS System: Residential and Respite
Treatment
• Salem -- Bridgeway Residential
• Grants Pass -- Options Respite
• Baker City – New Directions Respite
This Photo by Unknown Author is
licensed under CC BY-NC-SA

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

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Billing and Initial
Engagement
• Screening and Outreach
– 50D
– T1023
PGS Rates Updated

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Non Client Billing
• Outreach Codes
• FLEX Codes
– Client FLEX
– Workforce FLEX
PGS Rates Updated

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New Co-Occurring Codes!
• Assessments
• Individual Sessions
• Group Sessions
• PGS Rates Updated

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Quality Improvement: Access
Wait Times
–First appointment offered within five business
days.
Appointment….
Offered…

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Quality Improvement:
Successful Completions
• “A successful problem gambling treatment completion is
defined as the Individuals: (a) who have achieved of at
least [75]% of short-term treatment goals; (b) who have
completed a continued wellness plan (i.e., relapse
prevention plan); and (c) who have lacked engagement
in problem gambling behaviors for at least [30]
consecutive days prior to successful completion of A&D
81 Services.”

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Quality Improvement:
Length of Stay Variances
• New Form and Process
– Stream line process
– Focus on treatment completion, engagement, risk acuity.
– Opportunity for reflection/pause.
• New LOS Variance Request

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Integration & Diversification
– Integrating with program staff in your agency
• Do staff in other agency programs know about gambling?
• Do staff in other agency programs know how to identify and
refer people dealing with gambling disorder?
– Integrating clinical services in your agency
• Do clients in other agency programs receive psychoeducation
about gambling disorder?
• Do clients in your gambling programming have access to
services “outside” of gambling programming?

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Integration & Diversification
– Diversifying services available
• Does your program have capacity to provide specialty services?
– recovery mentor,
– group therapy,
– couples and family therapy,
– SUD’s treatment,
– Mental Health Treatment (including medication),
– Medical Treatment,
– Case Management?
– Diversifying staff involvement
• Are staff in other programs ready to work with gamblers?

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Legs of your chair: Keys to stability!
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

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GBIRT Train the Trainer
• GBIRT

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GBIRT Trainthe Trainer
• History and Context of GBIRT
– Nationally
– Oregon State
– Program Implementations
• Purpose and Intent of GBIRT
– Training of staff
– Training of Community Gatekeepers
– Providing a bridge from education to referral

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GBIRT Trainthe Trainer
• Structure of THIS specific training
– “Behind the Scenes” look
– “Cliff Notes” on Screening and Brief Intervention

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Behind the Scenes of GBIRT Training
• Part I: Experiential Engagement
• Part II: Establishing Problem & Prevalence
• Part III: Establishing and defining how the
specific audience interfaces with Problem
Gambling.
• Part IV: Screening
• Parts V&VI: Brief Intervention and Referral to
Treatment

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Let’s Look at Some GBIRT Slides
• GBIRT Slides

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Referral Pathways: Principles of a Program
• Principle #1: At risk groups and
gatekeepers must be specifically
identified.
This Photo by Unknown Author is licensed under CC BY-SA

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Referral Pathways: Principles of a Program
• Principle #2: Outreach efforts to at risk
groups and gatekeepers must be regular.
This Photo by Unknown Author is licensed under CC BY-SA

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Referral Pathways: Principles of a Program
• Principle #3: Outreach efforts to at risk
groups and gatekeepers must be
repetitive.
This Photo by Unknown Author is licensed under CC BY-SA

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Referral Pathways: Principles of a Program
• Principle #4: Outreach efforts to at risk
groups is best done by peer mentors.
This Photo by Unknown Author is licensed under CC BY-SA

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Referral Pathways: Principles of a Program
• Principle #5: Create a detailed plan and
stick to it.
This Photo by Unknown Author is licensed under CC BY-SA

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Referral Pathways: Phases of a Plan
• Phase I. Within the Agency
• Provide Gambling Informed Training to all staff – utilize
GBIRT model
– Front desk
– Physical Health Providers (if part of agency services)
– Mental Health Providers
– Addiction Treatment Providers
• Establish clear processes for screening and referral to
treatment

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Referral Pathways: Phases of a Plan
• Phase I. Within the Agency
• Conduct ongoing trainings on a regular schedule
– Refreshers
– New Employee Training
• Outreach Education presentations to at risk clients and
patients served by the agency
– Regularly scheduled
– Conducted by Peers if possible

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Referral Pathways: Phases of a Plan
• Phase II. Outside Healthcare, Addiction and Mental
Health Service Providers in the Community
• Provide Gambling Informed Training to all staff – utilize
GBIRT model
– Front desk
– Physical Health Providers (if part of agency services)
– Mental Health Providers
• Establish clear processes for screening and referral to
treatment

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Referral Pathways: Phases of a Plan
• Phase II. Outside Healthcare, Addiction and Mental Health
Service Providers in the Community
• Conduct ongoing trainings on a regular schedule
– Refreshers
– New Employee Training
• Outreach Education presentations to at risk clients and
patients served by the agency
– Regularly scheduled
– Conducted by Peers if possible

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Referral Pathways: Phases of a Plan
• Phase III. Criminal Justice System
• Identify available groups within community
– Judges and Courts – Including Treatment Courts
– District Attorneys
– Defense Attorneys
– Parole and Probation Officers
– Jails
• Provide Gambling Informed Training to all staff – utilize
GBIRT model

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Referral Pathways: Phases of a Plan
• Phase III. Criminal Justice System
• Establish clear processes for screening and referral to
treatment
• Conduct ongoing trainings on a regular schedule
– Refreshers
– New Employee Training
• Outreach Education presentations to at risk offenders at
P&P and Jails
– Regularly scheduled
– Conducted by Peers if possible

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Referral Pathways: Phases of a Plan
• Phase IV: Community Gatekeepers
(Potentially high frequency of contact with
Problem Gamblers)
• Identify non-clinical gatekeepers (examples)
– DHS case workers
– DV/IPV agencies
– Senior Services Agencies
– Veteran’s Services
– Who Else?

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Referral Pathways: Phases of a Plan
• Phase IV: Community Gatekeepers (Potentially high frequency of
contact with Problem Gamblers)
• Provide Gambling Informed Training to all staff – utilize
GBIRT model
• Establish clear processes for screening and referral to
treatment
• Conduct ongoing trainings on a regular schedule
– Refreshers
– New Employee Training
• Ongoing regular contact (eg. newsletter, electronic
newsletter)

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Create Community! (Dialogue with
the PGS System)
– Dialogue
– Program Development Opportunities
– Technical Assistance Pilot Project
– Monthly Meetings and Events
– Workforce Development
– Other ways to collaborate This Photo by Unknown Author is
licensed under CC BY-NC-SA

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Program Development Opportunities?!?
In Reach &
Referral
Pathways
Maximize
Encountering Integrate &
Diversify
Dialogue with
PGS system
Quality Improvement
Processes

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Program Development Opportunities?!?
• GBIRT Training (G)
• Referral Pathways Planning (R)
• Maximizing Your Encountering (E)
• Integration and Diversification (I)
• Quality Improvement (Q)
This Photo by Unknown Author is licensed under CC
BY-ND

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Technical Assistance Pilot Project
• Program Self Assessment
• Review with David
• Dialogue with staff
• Dialogue with clients
• Create Development Plan
• Follow Up Quarterly

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Meetings & Events
• Treatment Calls
• All Provider Webinars
• Case Consults
This Photo by Unknown Author is licensed under CC BY-NC

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Workforce Development: Notes from
Survey and Project
•Changing System
– Seasoned Gambling Counselors
– New Gambling Counselors
This Photo by Unknown Author is
licensed under CC BY
This Photo by Unknown Author is licensed
under CC BY-NC-ND

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Workforce Development: Notes from
Survey and Project
Priority Areas:
Recruit new talent into the field
Strengthen the core workforce
Broaden the concept of the workforce
Create structures to support the workforce

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Workforce Development: Notes from
Survey and Project

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Other Ways to Collaborate?!?

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