Addiction Recovery Mobile Outreach Team (ARMOT)
- Need: To reduce the number of overdoses and overdose-related deaths from opioids in rural Pennsylvania.
- Intervention: ARMOT provides 1) case management and recovery support services to individuals with substance use disorders and 2) education and support to rural hospital staff, patients, and their loved ones.
- Results: In the first 18 months of its grant cycle, ARMOT made 254 referrals.
Pennsylvania is 7th in the nation for drug overdose mortality rates: From 2009 to 2013, over 3,000 people died from heroin overdoses. The opioid crisis has grown so severe in this state that overdose deaths are outnumbering deaths from car accidents.
And overdoses weren't the only reason patients with opioid use disorder were going to the hospital. Some patients were looking for comfort medications, while others seeking detox or treatment didn't know where to go. The rural counties of Armstrong, Indiana, and Clarion developed a program that would provide these patients with treatment and support whether they entered a hospital or a treatment facility.
The Addiction Recovery Mobile Outreach Team (ARMOT) is a collaboration of:
- Armstrong-Indiana-Clarion Drug and Alcohol Commission (AICDAC)
- Armstrong County Memorial Hospital (ACMH)
- Clarion Hospital
- Indiana Regional Medical Center
ARMOT provides case management and recovery support services to adults and adolescents with substance use disorders. Program staff encourage patients to involve their families in the recovery process so that ARMOT staff can educate families on the types of support their loved ones will need at home.
This video highlights ARMOT's impact in its first 18 months through its case management and support services:
- Screen patients to determine type of substance use disorder
- Ask patients if they would like to be referred to the ARMOT program
- Refer patients to ARMOT if patients give written permission
The Mobile Case Manager (MCM):
- Meets with patients at their bedside
- Screens and assesses patients to determine type of treatment needed
- Discusses treatment options with patients and completes referral to treatment
- Coordinates with treatment agency to determine pickup time for patients
- Connects patients to community resources
- Educates hospital staff on substance use disorders and the recovery process
The peer Certified Recovery Specialist (CRS):
- Can share lived experience and knowledge of substance use disorder and the recovery process
- Can meet first with patients on request
- Educates patients' families on the recovery process
- Connects patients to natural community support, such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings
- Attends first AA/NA and other support group meetings with patients
ARMOT's goal in year one (May 1, 2015-April 30, 2016) was to refer at least 80 patients to the program. In year one, ARMOT had 88 referrals. Of those 88:
- 48 patients participated in a level-of-care assessment with the MCM and 37 were admitted into drug and alcohol treatment, thus a 77% access rate to treatment if they met with the MCM
- 22 patients accepted a referral to meet with a peer CRS
- 24 patients involved family members in their care
- 55 referrals reported dual diagnosis (mental health and substance use disorder)
ARMOT's goal in year two was to have 96 referrals. As of October 31, 2016, ARMOT already had 166 referrals. Of those 166:
- 86 patients participated in a level-of-care assessment with the MCM and 48 were admitted into drug and alcohol treatment, thus a 63.4% access rate to treatment if they met with the MCM
- 60 patients accepted a referral to meet with a peer CRS
- 46 patients involved family members in their care
- 69 referrals reported dual diagnosis
ARMOT is also featured in RHIhub's Prevention and Treatment of Substance Abuse Toolkit Program Clearinghouse.
You can read more about ARMOT in the Rural Monitor article Pennsylvania Mobile Team Addresses Substance Use Disorders.
Because of hospital staff turnover, educating line staff is an ongoing process. There's also the challenge of being a mobile unit working among three hospitals, especially in scheduling adequate coverage and transporting records. Currently, an ARMOT staff member is present in the hospital from 8:00 a.m. to 4:00 p.m. Patients entering the hospital at night might not be willing to wait until 8:00 a.m. the next day to speak with an ARMOT employee.
HIPAA regulations can make sharing patient information a challenge as well. Hospitals invited ARMOT staff to new employee orientations so that they could become familiar with confidentiality policies. ARMOT staff are considered sub-contracted volunteers with the three hospitals, thus giving them minimal but sufficient access to each hospital's electronic medical records.
Management staff at AICDAC met with interested partners at the very beginning of program implementation to establish the need for services and collaborate on a program that would meet identified needs. Local agency investment is key. This program would not be possible without FORHP funding and the support the agency receives as the ARMOT program progresses.
Mike Krafick, Certified Recovery Specialist Supervisor
Armstrong-Indiana-Clarion Drug and Alcohol Commission
724.354.2746 Ext. 315
Behavioral health workforce
December 16, 2016
December 5, 2017
Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.