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Karen L. Coburn, Ed.D.

Outreach and Engagement Specialist

606-585-4713
kcoburn@fletchergroup.org

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ERNIE FLETCHER KEYNOTE PRESENTATION AT WEST VIRGINIA RECOVERY HOUSING CONFERENCE SEPTEMBER 28, 2020

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ERNIE FLETCHER KEYNOTE PRESENTATION AT WEST VIRGINIA RECOVERY HOUSING CONFERENCE SEPTEMBER 28, 2020

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Ernie Fletcher, Founder and Chief Medical Officer of the Fletcher Group Rural Center Of Excellence, addresses the 2020 West Virginia Recovery Housing Convention. Starting with an overview of substance use across the nation and specifically in West Virginia, Fletcher explains how the peer-supported “Recovery Ecosystem” model of Recovery Housing that he launched as governor of Kentucky succeeds in addressing the needs of those seeking long-term abstinence and return to health.

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ERNIE FLETCHER KEYNOTE PRESENTATION AT WEST VIRGINIA RECOVERY HOUSING CONFERENCE SEPTEMBER 28, 2020

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PRESENTATION BY THE FLETCHER GROUP'S KAREN COBURN AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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PRESENTATION BY THE FLETCHER GROUP'S KAREN COBURN AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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Karen Coburn, the West Virginia Outreach and Engagement Specialist for the Fletcher Group Rural Center Of Excellence, activities in West Virginia, addresses the 2020 West Virginia Recovery Housing Convention and the various presentations to be made during the conference by other Fletcher Group RCOE personnel.

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PRESENTATION BY THE FLETCHER GROUP'S KAREN COBURN AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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PRESENTATION BY THE FLETCHER GROUP'S TONY WHITE AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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PRESENTATION BY THE FLETCHER GROUP'S TONY WHITE AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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Tony White, National Outreach and Engagement Specialist for the Fletcher Group Rural Center Of Excellence, addresses the 2020 West Virginia Recovery Housing Convention.

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PRESENTATION BY THE FLETCHER GROUP'S TONY WHITE AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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PRESENTATION BY THE FLETCHER GROUPS JENNIFER WHITE AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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PRESENTATION BY THE FLETCHER GROUPS JENNIFER WHITE AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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Jennifer White, Director of Health Initiatives for the Fletcher Group Rural Center Of Excellence, discusses Recovery Housing for pregnant and parenting women at the 2020 West Virginia Recovery Housing Convention.

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PRESENTATION BY THE FLETCHER GROUPS JENNIFER WHITE AT THE WEST VIRGINIA RECOVERY HOUSING CONFERENCE

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Technical Assistance For Building Safe, Sustainable Recovery Housing

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Is your community overwhelmed by the opioid and substance use epidemic? The first step is safe, sustainable Recovery Housing. Here's how to do it debt-free.

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Fletcher Group Rural Center of Excellence

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Fletcher Group Rural Center of Excellence

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Our Target Counties

We partner with federal, state and local agencies as well as faith-based entities and the private sector to serve over 100 rural counties in ten states: Kentucky, West Virginia, Ohio, Georgia, Mississippi, Tennessee, Washington, Oregon, Montana and Idaho.

Our Success Stories

To see how our Rural Center of Excellence is helping communities across the country, take a look at a few of our Success Stories.

Our Logic Model

Are you interested in seeing the Goals, Team Members, Strategies, Activities, Outputs, and Impacts of the Fletcher Group Rural Center of Excellence? If so, just click Fletcher Group RCOE Logic Model.

Resources Available To You

Fulfilling RCORP's Mission

The Fletcher Group is one of three organizations chosen to receive the HHS grant of $6.6 million over the next three years. The other recipients are the University of Vermont and the University of Rochester, New York. Alone among the three, the Fletcher Group RCOE features a strong focus on Recovery Housing.

According to a 2018 GAO report, the Recovery Housing industry is unregulated and fraught with fraud, ineffectiveness and, occasionally, client abuse. While quality and effectiveness vary greatly, consumers have little information with which to choose providers. As a result, families often spend thousands of dollars with little result as loved ones continue to experience the results of Substance Use and Opioid Use Disorders. Unfortunately, Recovery Housing is limited in rural communities, in large part because of a lack of resources and technical assistance.

A Team Effort

The Fletcher Group is a uniquely purpose-driven and agile organization that leverages a wide range of partners. The company's RCOE evaluation team will draw on the expertise of the University of Kentucky College of Public Health and Kentucky Injury Prevention Research Center (KIPRC) as well as JBA, a leading program evaluation organization with over 40 years of multi-state experience.

Other partners will include the National Alliance for Recovery Residences (NARR), the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Hazelden Betty Ford Foundation.

An additional key role will be played by the Federation of Appalachian Housing Enterprises (FAHE), a financial intermediary with expertise in low-income housing tax credits, section-8 housing, and other financial resources needed to fund Recovery Housing.

Boots On The Ground

The Fletcher Group's expertise in prevention, intervention, Medication-Assisted Treatment (MAT), and Recovery Housing will be promoted locally by Outreach and Engagement Specialists residing in each rural region. To lower overdose fatalities, provide alternatives to jail for drug offenders, reduce recidivism, and promote health and well-being, the Specialists will identify needs and assist in tailoring the response most appropriate to each rural community.

This web page is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $10.4 million. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.

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Our Rural Center Of Excellence Is Facilitated By A Major HRSA Grant

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Our Target Counties We partner with federal, state and local agencies as well as faith-based entities and the private sector to serve over 100 rural counties in ten states: Kentucky, West Virginia, Ohio, Georgia, Mississippi, Tennessee, Washington, Oregon, Montana and Idaho.

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Staffed by financial, technical, business, and treatment experts, the Fletcher Group provides organizations, communities, counties, and states with unrivaled Technical Assistance. Our experience in building innovative Recovery Ecosystems can dramatically enhance your organization's effectiveness by improving collaboration, developing new partnerships, and blending otherwise fragmented funds and resources.

Key Benefits

A Wide Range Of Assistance
We provide Technical Assistance ranging from Blended Funding, Housing Credits, and innovative Payment Methodologies to Case Management, Harm Reduction, and Trauma-Informed Treatment. Descriptions of each appear under the Tabs below.

Customized Approach
No one size fits all. Our services respect local conditions, needs, and expectations. Our customized support may include evaluations, interviews, focus groups, external stakeholder engagement, and comprehensive reviews of data, policies, and procedures.

Best Practices
We apply the latest recovery science, epidemiological data, and Evidence-Based Practices to optimize all your prevention, treatment, and recovery efforts. To appreciate our guiding principles, check out our Best Practices Overview.

TA Categories

Blended Funding leverages a wide range of existing funds and resources to provide the long-term housing and wrap-around services needed for full, lasting recovery. Partners can include HUD, law enforcement, court systems, local health and social services, housing programs, faith-based organizations, for-profit and not-for-profit private organizations, and interested entities within the private sector. Such Blended Funding can, in many cases, cover virtually all expenses, including construction, start-up, and daily operating costs, thus enabling the creation of facilities that might otherwise be impossible to build and sustain.

The Fletcher Group has extensive experience leveraging Low-Income Housing Tax Credits (LIHTC) and other federal funding streams to build, support, and sustain recovery housing. Created through the federal Tax Reform Act of 1986 to encourage private equity investments in affordable rental housing, the Low-Income Housing Tax Credit can be used to construct new properties, acquire and renovate existing buildings, or refinance and renovate existing affordable housing properties financed through other federal housing programs. These investments reduce the need for costlier methods of financing, such as bank loans and mortgages, thus substantially lowering the cost of financing LIHTC properties. As such, LIHTC can play a crucial role in creating, preserving and expanding the supply of recovery housing, particularly in rural communities.

Developing cooperative agreements and contracting with corrections facilities, such as drug courts, jails and prisons, is another key to creating an effective "Recovery Ecosystem." According to Bureau Of Justice statistics, two-thirds of Federal and State prisoners and probationers could be characterized as drug-involved. Jail overcrowding, the high cost of prisoner care, the cost of prosecuting drug offenses, and the growing number of mentally ill in the prison system pose huge challenges to local governments. With research indicating that treatment can reduce substance use and substance-involved criminal activity, more and more drug courts are endorsing treatment alternatives. Because of our prior experience in the field, the Fletcher Group is uniquely qualified to help you develop rewarding, sustainable relationships with local courts and corrections facilities-the kind that can ensure your organization's sustainability, reputation, and good work.

All healthcare organizations, from health plans and hospitals to physicians and employers, are rapidly transitioning to Value-Based Care and alternative reimbursement models. This is particularly true of programs addressing addiction and homelessness. With years of experience on both the payer and provider sides of healthcare, the Fletcher Group is uniquely qualified to help you develop the governance and staffing needed for a new era of value-based reimbursement. We'll be happy to work with you as both a process strategy advisor and a hands-on, tactical resource, helping you embrace change and optimize workflow as you leverage the most advanced technology and payment methodologies.

To say that healthcare should be community-based goes without saying. It is from communities that those in recovery come and it is to those same communities that they later return in hopes of a better life. The Fletcher Group has long adopted a "Community As Method" approach to everything we do. As a result, we can much to help you make sure that genuine community input is reflected in all aspects of your program, from policy-making and staff training to planning and communications. We also believe that individual recovery relates directly to the patient's social environment-the community the patient comes from. Recovery can succeed only by recognizing all the direct and indirect relationships between that environment and the client's illness. The same can be said of community-based interventions. Because community buy-in is the fist step in developing the knowledge, attitudes, beliefs, and skills that influence community and individual health, we believe each project should include the development of an effective "Community Task Force" that can engage stakeholders in all stages of a program's development, from planning to execution.

Having succeeded in their own journey to recovery, Peer Support Workers often excel at helping others travel the same path. They can contribute inside the program by leading recovery groups, providing training and mentoring, administering programs and agencies, and supervising other peer workers. They can also work effectively outside the program by building community relationships, advocating for people in recovery, developing resources, and educating both policymakers and general public. Such work also helps the Peer Support Worker. By staying in close contact with those in recovery they're far less likely to relapse. At the same time, our long experience with a wide variety of Peer-Driven Programs indicates that Peer Support Workers, though highly qualified in many respects, can benefit significantly from training in other core competencies. In addition to explaining how Peer Support Specialists can add value to your program, we can also help supervisors understand how best to maximize their contribution.

The social enterprise model has a proven track record in providing mentorship and hope to those men and women who've served their time and are ready to start anew. By enabling support, structure, skill development, and paying jobs, Social Enterprise can do much to help people transform lives, reunite with their families, and help rebuild local communities. The return on Social Enterprise investments has also been well documented. According to researchers, society accrues a $2.23 benefit for every dollar spent. That return includes things like increased income, less reliance on government programs, and taxes paid when a person is given the chance to work. Beyond the numbers, there's also a powerful "ripple effect"-what happens to families, communities, workplaces, and ultimately to society when people's lives are so transformed that they can begin turning their focus to helping others. Just as your clients need effective support and coaching to fulfill their potential, your organization may need guidance when it comes to building bridges with the private sector. Our unique experience with employers and faith-based initiatives can be invaluable as you work to create the hands-on business training, employment, and leadership opportunities that are so crucial to complete and lasting recovery.

One of the key determinants of success is the ability of those in recovery to find meaningful employment. That, in turn, depends on the ability to accurately assess the vocational interests, passions, predispositions, knowledge, and skills of the potential employee. Without an accurate assessment, all parties involved-employer, employee, and those bringing the two together-run the risk not only of momentary disappointment but of a negative "Ripple Effect" that can damage the efforts of everyone involved, including those who follow. The numerous highly successful social enterprise programs facilitated by The Fletcher Group testify to our accuracy in assessing the skills and aptitude of those we've returned to the workforce. We can of course also help you with workforce training so that those you help to recovery can acquire the skills they need, set realistic goals, make wise career plans, and ultimately fulfill their potential as fully functional members of society.

Roughly 68 percent of all overdose deaths in the U.S. involve a prescription or illicit opioid. Of particular concern is illicitly manufactured fentanyl, which is 50 to 100 times more potent than morphine. The prevalence of Opioid Use Disorders (OUDs) has also risen dramatically among pregnant and parenting women, more than quadrupling from 1999 to 2014. A contributing factor in pregnancy-associated deaths, opioid use among pregnant women has also generated a corresponding rise in neonatal abstinence syndrome (NAS) as well as a dramatic increase in children entering the child welfare system. Many states have identified pregnant and postpartum women as a priority population for SUD recovery efforts, yet gaps remain in care. The Fletcher Group has developed a wide range of tools, processes, and practices to help organizations like yours deliver effective SUD treatments. We are nationally recognized for developing highly effective, evidence-based prevention and recovery strategies and never stop working to better understand and identify effective ways of preventing opioid overdoses and opioid-related harm. Our extensive data acquisition skills can help you accurately assess your program's effectiveness and focus resources where they're needed most. Combined with our ability to form partnerships between disparate agencies and institutions, we can lend you a major hand in coping with the most significant epidemic of this century.

Medication-Assisted Treatment (MAT) is often misconstrued as nothing more than substituting one drug for another. The truth is that controlled levels of Methadone, Naltrexone, and Buprenorphine effectively complement counseling and behavioral therapies by relieving withdrawal symptoms and psychological cravings. The Fletcher Group partners with the Hazelden Betty Ford Foundation to provide training and technical assistance, including COR-12 Counseling, for recovery residents using MAT as part of the programming. This allows us to address any and all MAT issues you may have, including practice management, legal and regulatory requirements, patient screening and assessment, treatment protocols and planning, appropriate types of treatment (maintenance and/or detoxification), certification and licensing through SAMHSA, Continuing Medical Education (CME) Courses, opioid pharmacology, patient monitoring and strategies for managing challenging patient situations. To train the diverse behavioral health workforce needed to meet the nation's needs, we offer Best Practices webinars, online courses, and face-to-face workshops. We can also provide guidance on the use of Medication-Assisted Treatment for alcohol abuse.

Trauma impacts individuals, families, and communities by disrupting healthy development, adversely affecting relationships, and contributing to mental health issues, including substance use, domestic violence, and child abuse. Trauma Informed Care (TIC) recognizes, acknowledges, and promotes sensitivity to trauma's effects by applying a holistic, person-centered treatment approach that acknowledges all the biological, psychological, neurological, and social impacts of trauma. In other words, TIC treats the whole person, taking into account past trauma and the victim's resulting coping mechanisms. Psychologically Informed Environments (PIE) complements TIC in serving patients dealing with complex emotional and psychological needs. Being trauma-informed has numerous advantages. The creation of a safe physical and emotional environment can benefit clients and their families. It can also improve staff morale by setting the table for a pro-active approach that fosters understanding and empathy as well as professional competence and confidence.

Mental illness is treatable, help is available, and practical steps can be taken towards full recovery. The Fletcher Group Technical Assistance Center works with a wide variety of organizations and treatment practitioners to enhance their ability to deliver effective evidence-based mental health services, including both prevention and recovery. Our wide range of interactive tools, resources, and treatment options can play a critical role in helping those in need complete their journey to recovery. Our work also incorporates a keen appreciation for the families of those in recovery who, unfortunately, are prone to stress, guilt, shame, anger, fear, anxiety, grief, and isolation. Their health and wellbeing cannot be ignored nor can the importance of flexibility in assisting them. What works for adults may not work for younger or older patients. The Fletcher Group is always respectful of individual beliefs, local practices, cultural mores and linguistic needs as well as the historical healthcare disparities that can affect both access and outcome.

Case Managers must master a variety of disciplines ranging from collaborative assessments and care coordination to advocating and facilitating new services to meet complex patient needs. They must be ever mindful of patient safety, stigmatizing language, legal and regulatory changes, and quality of care as well as the bottom line-the cost-effectiveness of everything done in their name. The Fletcher Group can help you identify and address the knowledge, skills, and other key competencies needed to ensure that your Case Management processes are well-targeted, community-oriented, and seamlessly integrated within a wider strategy of integrated care. In doing so, we make sure our efforts complement yours through partnerships that are close, collaborative, and flexible. We support the principles of self-determination and self-care and adhere to a holistic approach that appreciates of all parties involved and considers all potential consequences. By letting the Fletcher Group help you prioritize, facilitate, and coordinate services, you'll find yourself better able to institute the kind of Best Practices that can efficiently and cost-effectively meet all the complex needs of your patients.

Traditionally used to treat patients in distant, inaccessible locations, TeleHealth is now practiced in a wide variety of healthcare settings. Its usage can help your practice lower costs, improve efficiency, provide patients with better access to services, and facilitate the continual contact that can keep patients plugged in. Although the benefits are significant, there can be administration challenges. What might be called "payment parity"-reimbursement for Telemedicine services comparable to those of in-person services-can be problematic. Misdiagnosis can be another problem, but with even more serious consequences. That's why teaming with the Fletcher Group to address some of the most challenging problems of our current healthcare system (access to care, cost-effective delivery, and distribution of limited providers) can be so valuable. We can help you introduce new efficiencies while preventing the kind of mistakes that can disrupt, impede, and even compromise the excellent service and outstanding reputation you have worked so hard to achieve.

Technological innovation has already helped reduce wait times, prolong life, and assist physicians in diagnosis. But that's just the beginning. The Fletcher Group is not only fully equipped with the latest prevention, treatment, and recovery technology. We can also assist you in adopting, adapting, and refining those technologies by helping you think clearly about where you want to go and how to get there, particularly in terms of safety, security, and regulation. As the pace of change accelerates, our expert guidance can make a real difference, particularly in regard to demographic data, medical histories, test results, insurance data, and other information used to identify a patient or provide healthcare services.

Why Invest In Technical Assistance?

Why the Fletcher Group?

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Technical Assistance To Fight The Opioid And Substance Use Epidemic

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Staffed by financial, technical, business, and treatment experts, the Fletcher Group provides organizations, communities, counties, and states with unrivaled Technical Assistance. Our experience in building innovative Recovery Ecosystems can dramatically enhance your organization's effectiveness by improving collaboration, developing new partnerships, and blending otherwise fragmented funds and resources.

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FLETCHER GROUP RCOE POWERPOINT PRESENTATION FOR WEST VIRGINIA - PDF

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FLETCHER GROUP RURAL CENTER OF EXCELLENCE FLYER

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Risks to those with SUD posed by Pandemic

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Risks to those with SUD posed by Pandemic

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"fletcher group" "recovery housing" "opioid epidemic" "substance use disorder" addiction homelessness

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The Fletcher Group is dedicated to bringing evidence-based, best-practice solutions- including sustainable Recovery Housing-to rural communities hit hard by ...

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Wow! Talk about busy! You'd think one national epidemic (the opioid crisis) was enough. Like you and everyone else, we're suddenly preoccupied with COVID-19 and how best to deal with it.

If you're involved in recovery or providing services for those who are, you'll find loads of helpful information on our website's "COVID-19 HELP" web page at https://www.fletchergroup.org/covid-19-help/

There's also guidance there for the general public as we all work and sacrifice to protect... each other's health and safety.

No one has a crystal ball to see how exactly this will all play out, but those interested in long-term social effects will find provocative information on our Policy page at https://www.fletchergroup.org/policy/

We'll keep you posted here of other activities as they develop. In the meantime, we pray that you and yours remain safe and healthy during this very challenging time.

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Wow! Talk about busy! You'd think one national epidemic (the opioid crisis) was enough. Like you and everyone else, we're suddenly preoccupied with COVID-19 and how best to deal with it.