"Guiding Clients From the Darkness of Addiction Since 1990"
ORGANIZATIONAL  EXPERIENCE
Updated 1/20/09

Personalized Nursing LIGHT House, Inc. (PNLH) was founded in 1990 by a distinguished team of professionals who envisioned an innovative treatment modality (IOP with a domicile) that would fill a service need in the continuum of care for addiction.  This concept of a comprehensive holistic approach to treatment while providing independent housing in furnished apartments has seen dramatic growth in the number of referrals and treatment capacity.  Referral agents, funders, and consumers recognize the therapeutic value that an IOP with domiciliary care has to offer.

One distinguishing attribute about PNLH’s program structure is the combination of structure (4 1/2 hours of group counseling per day, Monday through Friday) and freedom (after groups, clients are free to obtain employment, visit family, attend 12-step meetings, etc.).  Clients often rave about how this combination of structure and freedom assisted them in internalizing their recovery.  Clients have the freedom to practice their recovery skills on a daily basis but have formal and informal support/structure to assist them.  Formal support includes:  a) counseling staff on call 24 hours a day, seven days a week, b) for clients in IOPD, apartment monitors (a male and a female) visit the apartments where clients live on random evenings/nights to ensure the healing environment in the apartments, and c) urine drug testing occurs on admission, on discharge day, and randomly during their treatment stay.  A breathalyzer test is conducted daily (Monday through Friday).  Any client found to be positive is discharged from the program with an opportunity to reapply.

While a formal case management program is new to PNLH, we have been performing case management services for the past 15 years.  A case manager assigned specifically to PNLH’s SEMCA clients would improve the efficiency in meeting the needs of these clients. 

PNLH originated in Plymouth; starting as a modest 10-bed treatment program.  Today the Plymouth program has grown to 36 beds serving adult men and women.  Since its inception, the Plymouth location has served over 2,900 clients.

In February 1995, PNLH expanded to Detroit to provide the Detroit location its unique program model to residents of the City of Detroit.  Since its inception, the Detroit location has serviced over 550 clients. During its federal CSAT Funded projects, the target population in Detroit’s program was addicted African American men who have sex with other men (MSMs) who also have with co-occurring HIV.  Note:  This was a free service offered appropriate tri-county clients.  The success of one of the projects was published in the The American Journal of Drug and Alcohol Abuse in 2003. (Andersen, M., Paliwoda, J., Kaczynski, R., Schoener, E., Harris, C., Madeja, C., Reid, H., Weber, C., & Trent, C. (2003).  Integrating Medical and Substance Abuse Treatment for Addicts Living with HIV/AIDS: Evidence-Based Nursing Practice Model. The American Journal of Drug and Alcohol Abuse.  Vol. 29, No. 4.  pp. 847-859)
 

In 1998, PNLH opened another location in Ann Arbor.  This facility, which offered IOP and OP, was very successful.  In a short period of time, the Ann Arbor office was consistently at or near full serving over 1,000 clients.  The Ann Arbor location was male only IOPD program.  This gender specific programming assisted consumers who struggled with sharing feelings in front of  female peers or are otherwise distracted from focusing on treatment by the inclusion of female peers.  This program closed in June of 2003 and re-opened one year later.  Currently, we have 24 beds serving both men and women.

In 2006, PNLH opened its Enhanced Outpatient with Domicile (EOPD) program in Ann Arbor which allows clients to remain in PNLH’s apartments while enrolled in outpatient services at PNLH.   The program provides housing and structure throughout the week, while providing clients much more free time to engage in work, recovery activities, etc.  The program has been very successful in terms of recovery and retention rates.

In 2007, the Ann Arbor program was certified by WCHO as a co-occurring enhanced program provider.  We demonstrated to WCHO that we have integrated the mental health assessment and treatment into our program services.  In addition, in April 2007, PNLH acquired licensing from the state of Michigan for Integrated Treatment for Persons with Mental Health and Substance Use Disorders.

Quality in behavioral health care has been a passion for PNLH founders.  The current CEO and co-founder participated in quality improvement initiatives since the early 1990s (peer quality review program in Michigan, WCHO’s Quality Improvement committee, SEMCA’s quality improvement committee (2006 – current), and various other short term improvement projects).  Most recently (2007) PNLH has been accepted as part of a quality improvement initiative created by NIATX.  In this process, PNLH will conduct various QI activities to enhance the accessibility, retention, and quality of services offered.  PNLH’s was selected for its success in NIATX as a feature story in NIATX’s publication circulated to 3 states (September 2008).

PNLH has used the nursing intervention LIGHT Model to implement service to over 5,000 clients since its inception in 1990 at its three different locations (Plymouth, Detroit, & Ann Arbor).  Since it is the staff’s belief to learn from every client, collectively, very valuable knowledge and experience has accumulated.  Organizationally, much knowledge on how to help clients, approach sensitive client issues, demonstrate value for clients, etc. will continue to be implemented if PNLH is funded for services.  Furthermore, a vast and valuable network of human services agencies has been developed to serve the case management needs of clients.

PNLH has demonstrated its ability to implement successfully these proposed services, with over seventeen years of experience in this modality.  In fact, PNLH was one of the first programs to initiate an IOP with domiciliary care.  During this time, PNLH has enjoyed the working relationships established with its funders, especially SEMCA. PNLH has demonstrated its ability to manage the relationships between the funder, the client, and case manager effectively during all contract years.  In fact, PNLH has an internal goal to ensure that all contract requirements from its various funders and referral sources are met in a timely and appropriate manner.  This goal includes requested paperwork/forms, etc. are returned to all funders on time and correctly completed.

PNLH has created program evaluation system that has been referenced by CARF surveyors as a model for other behavioral healthcare providers.  During a recent (February 04) state licensing visit, the licensing consultant indicated that PNLH has one of the top 2 or 3 most sophisticated outcome management systems in the state.   This evaluation system ensures that PNLH is providing effective, efficient and consumer friendly services.  The evaluation system measures numerous variables both at program exit and 6 months post discharge.  PNLH has computerized its clinical database and therefore, various variables relating to outcomes can be reviewed with a click of a button. A sample of the demographic and outcome measures for IOP and OP services at PNLH from the October 2007 through September 2008 time period at our Plymouth location reveals:

Variable    Percentage or Number
Number of admissions    436
Gender    65% Men, 35% women
Average Age    38.9
Employed at admission    9.4%
Drug of choice   
   Alcohol    27.3%
   Crack    44%
   Heroin    19.0%
   Marijuana    3.4%
  Other     6.3%
Homeless at admission    55.5%
Dually Diagnosed    44%
Completed/Graduated from PNLH    61.7%
Six month Follow-ups    69.6% were in Recovery @ 6 months post treatment *

* 46, 6-month follow-ups

One of the factors that can be contributed to PNLH’s successful expansion is the continual input from the clients, referral agents, and other community shareholders in improving PNLH’s services.  PNLH uses a variety of mechanisms (focus groups, six-month follow-up surveys, etc) to achieve input into improving its programs.  A few of these mechanisms are described in more detail in the “Consumer Satisfaction” section.

Experience with Special Populations:
Homeless:
Since its inception, PNLH has provided its IOPD services primarily to the homeless substance abusing consumer.  Even with the various insurance agencies that refer to PNLH, 47% of all clients that enter the Plymouth office are homeless upon admission (71% of SEMCA clients).

Co-occurring Mental Illness and Substance Abuse:
Approximately, 45% of clients admitted last year had previous history of mental illness. We have developed systems and clinical protocols to deal with a variety of issues that accompany a person with co-occurring mental illness (medication management, medication adherence, etc).  Furthermore, PNLH has participated as a member of the Co-occurring Committee for the Washtenaw/Livingston Coordinating Agency. At this committee, we work to improve the services and service access for this special population.   PNLH is aware of and working on implementing Minkoff’s model for developing an enhanced program for the co-occurring consumer. Recently, we were certified by WCHO as a Co-occurring Enhanced provider.

HIV/AIDS:
Arguable one of PNLH’s greatest strength is its depth of knowledge and experience in dealing with the HIV+ substance abuser.  In 1995, PNLH opened its Detroit office as an exclusive program for HIV+ substance abusers.  The program was designed specifically for this special population.  In recent years, PNLH, in collaboration with The City of Detroit and Wayne State University, is a recipient of a CSAT funded project for substance abusers with co-occurring communicable diseases.  Of these clients, 95% are HIV positive.  In 2002, PNLH was directly awarded a 5-year CSAT grant to provide a specific IOPD program for HIV+ substance abusers.  An integrated model of care has been developed for this CSAT Project to incorporate the medical aspects of care into the clients treatment plan. 

African-American Males:
Through experience, PNLH has developed cultural competency in dealing with African American-Males.  In our Detroit office, approximately 95% of our consumers are African-American; 37% in Plymouth.