Bringing comprehensive recovery to rural communities

Name a programmatic or clinical innovation in addiction treatment, and chances are that the California-based multi-service agency Community Recovery Resources (CoRR) has leveraged it. An agency merger, creative financing, integration of evidence-based and wellness practices—all have contributed to converting the 40-year-old agency from one formerly focused mainly on outpatient and criminal justice services to a full-continuum provider serving rural communities as a one-stop wellness center.

CEO Warren Daniels borrows from an expression frequently used to describe the downtrodden addict when recalling the forces that drove change in his organization beginning in the early 2000s. “We were sick and tired of being sick and tired of having the same results in our programming,” says Daniels.

A grand jury report had chronicled a methamphetamine epidemic in CoRR's rural service area; the agency serves Nevada County (a community of around 100,000 residents with no city larger than 12,000) and Placer County. The provider agency identified fragmented service delivery systems with gaps, including a dearth of residential and transitional-living services and a desperate need for detox services.

CORR's goal became one of increasing access and improving outcomes by reducing barriers to success through a complete array of services in a single, dignified setting. The vision was to staff this site with multidisciplinary professionals who were family-focused in their approach and who worked in a more integrated fashion with other health professionals.

A critical step in realizing this transformative vision occurred through the availability of funding from a state ballot issue to assist nonprofits in offering services to the homeless. “We set out to qualify transitional living as a homeless activity,” says Daniels.

The agency first identified a one-acre property in the community of Grass Valley to establish a campus-style facility that would allow for a major expansion of services. The size would expand to more than three acres when a neighboring property became available.

A true breakthrough came in 2010 when CoRR secured a loan of $9.3 million from the U.S. Department of Agriculture Rural Development (USDA RD) to finance construction—an unprecedented investment for the federal agency that would create the 37,000-square-foot facility called The Campus.

Shortly thereafter, a competitor agency, the Sierra Council on Alcoholism and Drug Dependence, approached CoRR in search of assistance. A merger of the two entities would be executed in a short five months. “We doubled in terms of our staff and revenue,” says Daniels.

The Campus opened as CoRR's rural wellness center in September 2012. CoRR describes it as a site combining “therapy, counseling, psychiatric, residential and medical services with programs that promote self-sufficiency—education, supportive transitional housing, employment and parenting/life-skill training.” Other family-focused services include a child development center, adolescent services, and brief residential programs for families with loved ones in treatment.

Whole-health approach

Observers have said that if the Affordable Care Act (ACA) is about treating the whole person and family and not just the episodic illness, CoRR should serve as a model for taking that approach in addressing substance abuse.

CoRR deputy director Ariel Lovett says the agency prioritizes robust services for individuals at all socioeconomic levels. At present, about 70% of the organization's revenues are from public-sector sources, with about 20% in commercial insurance and about 10% in private pay.

The program employs multiple evidence-based clinical practices, including cognitive-behavioral therapy (CBT), Motivational Interviewing (MI), Dialectical Behavior Therapy (DBT) and the Seeking Safety curriculum for trauma-based services. Wellness services also are defined as a high priority, with yoga, art therapy and fitness among the offerings that are integrated into the program.

CoRR's description of the program at The Campus states, “In this unique model, families can stay together, parents can secure safe housing for their children and people can renew active and supportive lives in their communities.”

Located just off Main Street in a rural community, The Campus offers a single point of access for individuals and families of all ages to promote recovery and wellness.

Says Daniels, “My belief is that every community in America needs a campus like this in order to get a handle on skyrocketing healthcare costs and to promote community wellness.”

Echoing this belief, the Obama administration late last year announced that $50 million will be made available through USDA Community Facilities to support the development of similar behavioral health services. CoRR executives have been asked to work with the USDA and the Office of National Drug Control Policy (ONDCP) to train loan officers and share their experiences.