A Program of The Recovery Association Project and Central City

Concern Presented by

Oregon Recovery Homes

Presentation Objectives

Convey exactly what the Oregon Recovery Homes Program consists of

Demonstrate that Oregon Recovery Homes is a Proven, Successful and Cost-effective means to long-term recovery

Explain Program Expansion Goals to include House Monitoring, Systems Implementation and Rural Outreach Campaigns

Increase support and investment in Oregon Recovery Homes

Presentation OutlineBackground Program DescriptionRevolving Loan FundResident ProfileProgram SuccessKeys to Future Success

Background

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

1989 Oregon Offices of Alcohol and Drug Abuse Programs establishes Oregon Recovery Homes and $100,000 Revolving Loan Fund

1989-1994 ORH RLF administered by a variety of contractors

1994 ORH Contract awarded to Ecumenical Ministries of Oregon

Background (continued)2000 Outreach Coordinator position added to

ORH contract and awarded to EMO2003 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

2005 OHCS discontinues funding, but OMHAS funds to maintain position. All ORH contracts are awarded to Central City Concern and the Recovery Association Project

Program DescriptionOregon 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

Outreach Coordination“The Outreach Coordinator serves as the

institutional memory for a population whose leadership is transitional in nature” -Ken Guza, Washington State DASA

Technical Assistance and Outreach Support are provided by The Recovery Association Project and are delivered as two strategic functions

Supporting Existing Recovery Home networks in regions with both community and membership support

Supporting Communities with little or no Recovery Home support

(Both strategies require extensive collaboration with existing Recovery

Home networks)

Technical AssistanceRLF Application Assistance and ApprovalLease NegotiationOperational System Training Volunteer Coordination Leadership DevelopmentSystems Implementation Moderating Legal and Policy issuesServing as Institutional Memory

Outreach SupportTraveling to Communities throughout

Oregon in need of recovery housing resources

Networking with local community members, organizations and agencies

Establishing new Recovery Homes as part of a community effort

Outreach PresentationsConnecting Recovery Homes to Support

Networks

The Revolving Loan Fund is administered by Central City Concern$100,000 RLF from initial federal allocation 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

Current RLF capacity is just under $168,000, $121,000 of which is currently outstanding

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 !!!

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

Each dollar of the fund has been used 4 to 5 times over to establish these homes

RLF Loan Application CriteriaIn accordance with USC Title 42, Section

300x-25Nonprofit EntityProvide System of OperationResidents must be in recovery from

alcoholism and/or drug addictionDemocratically self-runFinancially self-supportingMust expel any member who returns to using

alcohol or drugs

Approved Uses of RLF Loans:Must be used for associated start up costs of the home

First Months RentCleaning DepositsFurnishings and AppliancesOther Household WaresMinor Structural Modifications

Revolving Loan Fund (continued)

Oregon Recovery Home Resident Profile 2007 Random Cross-section

Survey(Based on a 10% representative sample of homes- 14 homes

with 88 residents from various regions of the state completing survey)

General DemographicsAverage age: 34 years 59% are male and 41% are femaleAverage length of abstinence is 17 monthsAverage length of residency is 8.5 months86% have been in treatment averaging 2.2 episodes73% have experienced homelessness averaging 15 months77% of have been incarcerated averaging 38.9 months

Ethnicity

Source of Referral

Source of Treatment Funding73% Publicly Funded

Source of Initial Rent

Marital Status

Recovery Resources

Community Resources

Income169% increase during average of 8.5 month residency

Unemployed Income Sources

Financial Financial SupportSupport

% of Residents% of Residents Monthly Monthly AmountAmount

Food StampsFood Stamps 89.2%89.2% $190.00$190.00

General Assistance/ General Assistance/ TANF/ Welfare TANF/ Welfare

30.8%30.8% $430.00$430.00

SSI/SSDSSI/SSD 10.8%10.8% $827.00$827.00

UnemploymentUnemployment 7.5%7.5% $763.00$763.00

Health Care Coverage

Incarceration

Of the 77% of residents who experienced incarceration the following circumstances were reported

Primary Recovery Method

Weekly Attendance of Recovery Program

Employment & Comparative Cost Burdens Employment rate: 70% Average monthly income: $1,590

Average Education: 10.9 years

Primary Drug Used

Secondary Drug Used

Prior Place of Residence

Another Way of Looking at itAbout 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.

11 Years of Oxford House Growth

ORH Support to Oxford Houses over the past 6 years60.7% of Oxford Houses opened receive

hands-on Outreach Support84.8% of Oxford Houses opened received

Technical Assistance91% of oxford Houses opened received Start-

up Loans

AMH 2007 Housing Survey

Actual capacity of Oxford Houses was approx. 1,000

Beds by CountyCounty M-Houses M-Beds W-Houses W-Beds Total Houses Total Beds

Benton 2 21 1 8 3 29

Clackamas 22 189 10 84 32 273

Clatsop 1 7 0 0 1 7

Columbia 2 14 0 0 2 14

Deschutes 4 28 2 14 6 42

Douglas 5 34 0 0 5 34

Jackson 8 61 2 15 10 76

Josephine 2 22 1 8 3 30

Lane 5 43 1 7 6 50

Linn 4 42 2 19 6 61

Marion 11 92 11 78 22 170

Multnomah 35 268 11 89 46 357

Umatilla 2 13 1 8 3 21

Washington 13 95 8 58 21 153

Yamhill 1 8 0 0 1 8

Total 117 937 50 388 167 1325

“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

Why do Oxford Houses work?

Accepting responsibility for operating the house instills a sense of esteem, confidence and accomplishment

No limitations on length of stayAllows fellowship with similar people,

stability in member’s lives, and sufficient time for change and personal growth

Strategically located in low-risk, low-crime environments

Affordable…average monthly rent, utilities and household supplies are under $400

Why do Oxford Houses work? (continued)Part of the surrounding community so residents

learn about and gain access to local resources and experience a sense of the larger community

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

Self-governed structure and stability make it desirable to residents

Encourages self-sufficiency through employment and post-secondary education

Encourages accountability to peers and communityEnforces abstinence and avoidance of substance

abuse

Evidence-based PracticeAMH 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

DePaul Research Findings Primary Reason for choosing Oxford House:

Fellowship provided and the existence of a structured setting where avoidance of substance use was enforced

Most Common reasons for entering Oxford House 34.6% Desire for Peer Social Support 30.7% Having nowhere to go 25% Seeking a Drug-Free environment

Most important Benefits of living in Oxford House: Sense of community with similar others Self-paced recovery option that gave sufficient time for

psychological growth while avoiding substance use Fellowship provided and the existence of a structured

setting where avoidance of substance use was enforced

DePaul Research Findings (continued)

28.8% attend some form of counseling outside of the Oxford House

A 6 month follow-up study showed a 69.2% overall success rate:50% were still residing in an OH32% had left on good terms18% had left on bad terms (relapse or

disruptive behavior)

DePaul Research Findings (continued) Psychiatric Diagnoses & Rates of Drug Dependence

Cocaine: 84.6%Alcohol: 71.2%Cannabis: 69.2%Amphetamines: 37%Opioids: 25%Sedative-Hypnotics: 23.1%Phencyclidine: 15.4%Hallucinogens: 15.4%Heroin: 13.7%Inhalants: 3.9%

DePaul Research Findings (continued) Substance Dependency

DePaul Research Findings (continued) Psychiatric DiagnosesOther Psychiatric Disorders

Anti-social Personality Disorder: 57.7%Any Affective (mood) Disorder: 38.5%Post-Traumatic Stress Disorder: 34.6%Major Depression: 26.9%Dysthymia: 19.2%Panic Disorder: 15.4%Generalized Anxiety Disorder: 13.5%No Psychiatric Co morbidity: 21.2%

DePaul Research Findings Psychiatric Diagnoses (continued)52% reported having 2 or more Psychiatric

Disorders25% were diagnosed with ASP and PTSD15.4% were diagnosed with ASP and Major

Depression11.5% were diagnosed with PTSD and Panic

Disorder

DePaul Research Findings (continued)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:87% were drug-free after one year and 65% after two years as compared to 31% of participants in other settings (more than double)Higher levels of monthly income: $989 vs. $440Lower incarceration rates: 3% vs. 9%Higher levels of optimism and confidenceThe Economic Benefits of this example, focusing on productivity and incarceration benefits are:An estimated $613,000 in savings accruing to the Oxford House participantsAn average of $8,173 per Oxford House member

DePaul Quotes“Oxford House could be a justifiable alternative to

inpatient treatment and incarceration”“Even we were amazed at the results” “These findings suggest tremendous public policy

benefits for these types of low cost, residential, non-medical care options for individuals with substance abuse problems”

“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”

“It’s time for creative, simple solutions that address our social agendas”

DePaul Quotes (continued)“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”

“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”

DePaul Quotes (continued)“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”

The Oxford House AdvantageOxford House takes on characteristics of three

proven recovery concepts

Therapeutic Community

Alternative Treatment

Self Help Group

Therapeutic CommunitiesTherapeutic Communities are residential settings where substance abusers learn social behavior and develop a sense of belonging and trust of others

The ideology of Therapeutic Communities embraces complete life-style change through supportive communal living

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

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

Alternative Treatment ModalitiesAlternative Treatment Modalities have been characterized as embracing values of affordability, volunteerism, genuine affection for clients, and equality in status for clients and providers

Research indicates that individuals respond more favorably to treatment when allowed to set their own goals for recovery

Programs that allow opportunities for autonomous work, particularly when that work involves helping others in recovery, have shown promising results

The Self-Help ConceptThe Ultimate goals of the Self-Help process are the provision of support for members, and the improvement of members’ psychological functioning

A common process characterizing these groups is the mutual support of members through verbal sharing of personal experience

Self-help peer-led therapy has been assessed as both more clinically effective and less expensive than therapy led solely by professional staff

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