About Us

What is The Link?

The Link Halfway House is for men who have successfully completed short term residential treatment for chemical dependency, but have demonstrated a need for continued treatment in a structured environment for an additional 9 to 12 months.

The Link Recovery Houses

The Link Recovery Houses are for men completing The Link Halfway House who may still be in need of additional peer support, structured living, and access to counseling staff and house activities. Lincoln House is located at 521 Lincoln Avenue, and Truman House is located at 1003 W. Norfolk Avenue, next door to the halfway house.

Policies

Abuse and Neglect Policy

Resident Suggestions and Grievance Policy

Licensing and Funding

The Link is licensed by the Nebraska Department of Health and Human Services (HHS), Division of Alcoholism, Drug Abuse and Addiction Services and accredited by CARF.
Funding comes from the Nebraska Department of Health and Human Services (HHS), Nebraska Department of Corrections, client fees, The Link Alumni Association, and private donations.

Area Served

The Link gives first priority to individuals in the 22 county area of Northeast Nebraska known as Region IV. Although first priority is given to residents of Region IV, we accept clients from throughout Nebraska. Out-of-state clients are accepted whenever feasible.

Mission Statement

It is the mission of The Link to offer the recovering alcoholic or addict a safe environment in which to live and to offer assistance through professional counseling in the development of personal and social skills to ease the transition to healthy living in society.

Philosophy

The philosophy of The Link is to offer adult males who suffer from mental illness, alcoholism, and/or other drug addiction the opportunity to improve their lives to the fullest, within their capabilities and limitations. The philosophy is based on the "whole person" concept and the 12 Step model of treatment. The Link provides the setting for men in early recovery to be treated in a dignified and caring manner, with encouragement towards motivation, responsibility and productivity. The Link utilizes eclectic treatment approaches in providing the proper nurturing and treatment, which when used in conjunction with participation in self-help groups, such as AA, NA and DRA, help meet the individual needs of each Link resident desiring long term recovery.

Program Goals

1. Provide a continuum of care on an individual basis and in group settings, utilizing an individual treatment plan.
2. Provide a home-like, drug-free atmosphere.
3. Provide a comprehensive addiction treatment program which covers all facets of alcoholism and/or other drug addictions. This will include, but is not limited to Alcoholics Anonymous, Narcotics Anonymous, and other appropriate self- help groups for on-going support in his recovery efforts.
4. Provide trained, educated, competent staff for the implementation of the treatment program.
5. Utilize resources within the community and state for the benefits of residents and interests of the agency.
6. Provide resident assessments, evaluations, counseling and referrals for other health issues as needed.
7. Work with residents to secure employment utilizing job-counseling and motivational techniques.
8. Provide each resident an opportunity to initiate an on-going individual recovery.
9. Provide each Link graduate the opportunity to join and participate in the Link Alumni Association for ongoing support and activity in his recovery effort. Ongoing individual therapy will be provided for all graduates of the Link program at no charge.

The Level Treatment level of Care provided

Level of care/treatment provided:
• 3.1 Adult SA Substance Abuse Services

Basic Definition:
• Halfway House is a transitional, 24-hour structured supportive living/treatment/recovery facility located in the community for adults seeking reintegration into the community generally after primary treatment at a more intense level. This service provides safe housing, structure and support, affording individuals an opportunity to develop and practice their interpersonal and group living skills, strengthen recovery skills and reintegrate into their community, find/return to employment or enroll in school.

Population Served

The halfway house program serves the adult (19 years and older) male population who exhibit behavioral health problems due to chronic substance dependence and meet American Society of Addictions Medicine (ASAM) medical necessity criteria for halfway house level of care.

The Level Treatment level of Care provided

Hours and Days:
• The Link operates 24 hours a day, 365 days per year.

Frequency of Services:
• The frequency of services depends on the individual service being referred to and the assessed needs of the resident. Some services such as individual counseling and house meetings occur weekly, while group counseling and psycho-education classes occur several times per week. Family counseling occurs on an as needed bases. Addiction Support Peer services occur throughout Phase I.

Staffing and qualifications

• Clinical Director (APRN, RN, LMHP, LIMHP, or licensed psychologist) or LADC working with the program and responsible for all clinical decisions (i.e. admissions, assessment, treatment/discharge planning and review) and to provide consultation and support to care staff and the individuals they serve.
• Appropriately licensed and credentialed professionals working within their scope of practice to provide substance abuse treatment. LADC’s and PLADC’s are included and Behavioral Health Services funded programs must have a minimum of 50% licensed alcohol and drug counselors.
• Direct Care Staff, holding a bachelor’s degree or higher in psychology, sociology or a related human service field are preferred but two years of coursework in a human services field and/or two years’ experience/training or two years of lived recovery experience with demonstrated skills and competencies in treatment with individuals with a behavioral health diagnoses is acceptable.
• All staff should be educated/trained in rehabilitation and recovery principles

The Link Staff trainings

Leadership of The Link provides resources and education for personnel to stay current in the field, because this support is critical to the ability of the personnel to learn and implement current strategies and interventions.

Some of these resources include publications such as SAMHSA publications, National Institute on Drug Abuse (N.I.D.A.) Notes, Treatment Improvement Protocol (TIP) manuals, continuing education workshops, training during staff meetings, online training through Relias Learning Systems and unlimited access to Essential Learning website trainings through the Nebraska Magellan Website. Infosec trainings will be provided to staff who deliver services. Such training will include: features, setup, use, maintenance, safety considerations, infection control, and troubleshooting. Essential Learning has specific trainings that will meet the requirements of accreditation programs such as National Institute on Drug Abuse and Addiction (NADAA) as well as Commission on Accreditation of Rehabilitation Facilities (CARF).

The Link provides and or arranges competency-based training to personnel providing direct services specific to their position in:
• areas that reflect the specific needs of persons served
• clinical skills that are appropriate to the position
• individual plan development
• interviewing skills
• program-related research-based treatment approaches

The Link Admissions and Discharge procedures

Admissions Procedures:
• The information gathered is initially placed on a The Link Referral List. The next step in the screening process is to receive and review collateral information from the referral source. The referral source provides us with a referral packet that includes an assessment and treatment progress update. If the potential resident still appears eligible for admission after reviewing the collateral information, an interview/screening with the potential resident is scheduled. The Executive Director is required to keep this information on their person at all times when they are taking it with them to interview a potential intake. Sometimes the interview will be completed over the phone if the potential resident is a significant distance from Norfolk and a face-to-face interview is not feasible. The Executive Director will add his notes to the referral form that the potential resident completed, during and after the interview/screening.

Admission criteria:
• Primary diagnosis of substance use disorder according to the current edition of the Diagnostic and Statistical Manual.
• Maintenance of at least 30 days of sobriety.
• Willing and able to maintain at least forty hours per week of work, or if receiving disability compensation or retirement compensation 20 hours of volunteer work.
• A person who voluntarily enters the program and is willing to stay for a minimum of six months
• Individual capable of responsible self-administration of all prescribed medications
• Meets ASAM admission patient placement criteria for level III.I
• Ambulatory, capable of self-care, self-support, and not in need of acute medical care.
• Must be a male, 19 years of age or older.

After the interview/screening, the Director determines whether The Link is going to accept the potential Resident into the program. If the Director is unsure whether or not this person should be admitted here, he will consult with the referring agency about the appropriateness of the potential resident into our program. If the Director offers to admit the potential resident, a time and date will be set for his admission. If the resident is not able to come directly into the halfway house after his treatment completion, he will be placed on The Link Waiting List. There is occasionally an opportunity for referrals on the waiting list to temporarily reside in Truman House while waiting to admit to the halfway house.

Discharge Procedures:
• A treatment plan review is performed on a monthly basis for each Resident living at the halfway house. When that review identifies a substantial completion of the Resident’s treatment goals/objectives and the need for this level of care is no longer present, they are considered for graduation. Other discharge criteria include non-compliance with the treatment plan; persons served requests discontinuation of services or request a transfer/ referral to a different agency. A discharge may also happen in order to protect the therapeutic milieu of the halfway house. For example, if someone is caught stealing or physically threatens someone, they will be discharged. A Discharge Summary is prepared within 7 days of discharge.

The Link Ineligibility for services

Ineligible for services:
• If a person served is found to be ineligible for services he will be informed as to the reasons why in order to give him an opportunity to more effectively target a service delivery system that he is eligible for. If the ineligible person desires, and with the proper releases of information completed, we can inform the family/support system as to the reasons. The referring agency provides information for the screening and will be informed as to reasons for ineligibility without consent. If a person is found ineligible, The Link counselor will make recommendations for alternative sources that may better fit his needs. This above mentioned procedure is documented on the screening form we keep on potential Residents.

The Link program admission, ongoing assessment and individualized service planning

Resident Orientation:
• Upon admission, a licensed alcohol and drug counselor will be performing the intake/orientation process with the new Resident. If a consumer has poor reading skills, the paperwork can be read aloud to them. During this session the counselor will also explain the purpose and process of the assessment, how the treatment plan is to be developed with their participation in goal development and achievement, as well as the transition criteria and procedures. Time is taken to answer questions throughout the process. Each Resident receives a Resident Handbook which includes copies of forms for them to re-read or review following admission.

Assessment:
• The assessment process is facilitated by a qualified professional, licensed alcohol and drug counselor, who is knowledgeable enough to assess the specific needs of the persons served and is trained in the use of applicable tools/tests/instruments prior to administration. This process includes information obtained from the person served and referral source, as well as family members/other collateral sources (probation, drug court, physicians) when applicable and/or permitted.

The purpose of the primary assessment process is to gather sufficient information to develop an individualized person-centered plan. The assessment will include an evaluation of the person at intake, additional clinical examinations as needed for the individual, collection of medical and psychological information, review of the referral information, the most recent discharge summary, and the most recent evaluation with bio-psycho-social data. The assessment, which includes information provided by the resident and any collateral information, will be used to formulate an individualized treatment plan.
The assessment process is to be completed within ten (10) days of admission.

Ongoing assessment:
• The ongoing assessment process focuses on the person’s specific needs, identifies expectations of person served, is responsive to the changing needs of the person served, includes provisions for communicating the results of the assessments to; personnel, the person served, and others as appropriate, and provides the basis for legally required notification when applicable (probation, parole, drug court).

Reassessments:
• Reassessments are obtained on all persons served every six months on the CDS form. Reassessments are also conducted following significant life or status changes of the person served and noted on the weekly progress note.

Individual Treatment Plan:
• Each person served is actively involved in and has a significant role in the individual planning process, as well as a major role in determining the direction of his individual plan. The plan is prepared using the information from the assessment process and interviews of the person served. It is based on the person’s strengths, assessed needs, abilities, and preferences. It also focused on inclusion into the local community, family when appropriate, natural support systems and other needed services. The plan involves the family of the person served when applicable or permitted. The plan specifies services to be provided by The Link to meet the needs of the person served. It will identify any needs beyond the scope of the program and make the necessary referrals for these services. It will include measurable goals to achieve all needed outcomes. The Plan will define therapeutic all therapeutic activity and frequency. The specific criteria for graduation will be explained and the estimated length of stay listed. The plan is communicated in an understandable manner and a copy is always offered to the individual served.

The Link Emergency Care and interventions

Emergency incident procedures:
Policy: The Link is committed to prevent, identify report, take remedial action, document, debrief, and make recommendations for improvement intending to promote safe environments for personnel and person served.
Procedure: The Link identifies incidents as:
• Violence / aggression
• Sexual assault
• Abuse and neglect
• Suicide or attempted suicide
• Emergency/911 contacts
• Infection control/communicable disease,
• Injury/medical
• Death
• Crime at facility
• Damage to property
• Motor vehicle accident
• Use or possession of weapons
• Resident elopement
• Biohazard accidents
• Unauthorized use or possession of legal or illegal substances (alcohol, abandoned prescription medication, illegal drugs, use or possession of any legal substance that is in violation of the organization’s policies and procedures, Ex. Xanax)
• All incidents listed above require the completion of an Incident Report form.
• The incident report form must be completed within 48 hours of the incident.
• Reports are reviewed by the immediate supervisor and then the Executive Director.
• The Executive Director will keep written documentation of incidents in his locked desk in a folder labeled “Incident Reports”.
• Debriefings are offered following traumatic emergencies to provide support to personnel and persons served. Documentation of these timely debriefings is required.
• Any immediate changes in policies or recommendations for improvement are discussed in board meetings and subsequent changes passed on to personnel at staff meetings.
• An annual written report presented to the Board of Directors is prepared by the Executive Director summarizing:
• Causes (a root cause analysis may be required in certain circumstances)
• Trends
• Actions for improvement
• Results of performance improvement plans
• Necessary education and training of personnel
• Prevention of recurrence
• Internal and External Reporting requirements

Seclusion/Restraint/Timeout:
• Link staff do not employ seclusion or restraint for any reason. Physically aggressive behavior may result in contacting law enforcement and removal from Link property. During periods of emotional distress, staff may utilize de-escalation techniques to calm the resident and/or the resident may be allowed to voluntarily take brief timeouts to de-stress in order to rejoin programming or other activities. All timeouts must be voluntary. The resident will be allowed to go to a private area or other residents may be asked to temporarily move to another area. The resident in timeout may be encouraged to utilize previously learned calming techniques while in timeout. In a case of imminent danger the least restrictive means needed to ensure safety of all those present may be utilized until law enforcement arrives.

The Link Quality Assurance processes

The Quality Assurance Coordinator and Quality Assurance Committee reviews functions and identifies possible risks in the following areas; fiscal risks, human resources risks, counseling risks, health & safety risks, and legal risks. The team can utilize incident reports, accreditation/site visit reports, Region 4 audits, walkthroughs, or any other means necessary to identify potential risks. At least quarterly the Quality Assurance Coordinator will meet with the Board of Directors and will submit a report of monitoring processes.

Procedures:
• The quality and appropriateness of client care is monitored through two mechanisms: 1) regular monitoring according to policies appropriate to the program and 2) overall review by the Quality Assurance Committee. Monitoring of treatment planning and client progress occurs within the following time frames for all clients receiving treatment services, weekly. The Quality Assurance Committee is responsible for insuring quality care through adherence to the following procedures.
• The Executive Director, Business Manager, Quality Assurance Coordinator, Therapist/Counselors, and other staff as assigned serve as the Quality Assurance Committee. The committee meets quarterly to review results of ongoing review of active charts in treatment and after discharge. The Quality Assurance Coordinator reviews all resident charts weekly to ensure appropriate documentation is completed.

The Link Process of Reporting

Ethics Reporting:
Any knowledge of violations or suspicion of an infraction, of the Code should be reported immediately without fears of reprisal and without fear of negative consequences. Any knowledge of suspected cases of abuse, neglect, exploitation and misappropriation of any Link resident should be reported immediately without fear of reprisal and without fear of negative consequences.
Any Link resident or Link personnel who become aware of any ethical violation or abuse, neglect, exploitation or misappropriation must report such knowledge to the Executive Director (or Board President if the report involves the Executive Director) and Adult/Child Protective Services. If the Executive Director is not available, the On Call will be notified immediately. There will be an information loop back to the “reporter” of the incident that the report has been received. The “reporter” is protected from consequences (no reprisal) resulting from making the report. Investigative Process Following the initial report or allegation, the Executive Director (or Board President) makes a determination, whether there is a need for a formal investigation. If a formal investigation is needed, it shall begin within 48 hours of the report received. To minimize the possibility of further abuse/neglect, immediately upon determination that an investigation is warranted, the staff alleged to have committed the wrongdoing will have no unsupervised contact with the resident. The supervisor will be appointed by the Executive Director. The Executive Director has full access to the Board of Directors as well as pertinent reports, information, etc.
The Executive Director (or Board President) also decides if the allegation made warrants suspension -- with or without pay -- during the course of an investigation. Other personnel action, such as immediate termination, may be warranted. The Board of Directors will be informed of any disciplinary action taken. Any disciplinary action applied to the Executive Director must be voted on by the Board of Directors. The safety and care of Link residents is of the highest priority. If any personnel is under investigation, that personnel will be reassigned so as not to have direct care of any Link residents until the investigation is completed.
Suspected abuse or neglect by staff is to be reported to the Nebraska Department of Health and Human Services Adult/Child Protective Services and/or the proper law enforcement agency. When needed, proper authorities, such as regulatory agencies, funding agencies, Nebraska Department of Health and Human Services, credentialing/licensure bodies, police, courts, etc. will be notified within 24 hours. When reporting these infractions/allegations, all laws of federal confidentiality (42 C.F.R. Part II and HIPAA) will be adhered to.

Client rights

Policy: The Link values, respects and protects the dignity of consumers of our services. Suggestions, grievances and appeals will be fully examined and dealt with. If they are taken to the formal level, they will be reviewed annually to determine trends, areas needing performance improvement, and actions to be taken.
Procedures: The Link Suggestion, Grievance and Appeal policy and Resident Rights are reviewed with each Resident at admission. Each Resident is given copies of these documents in their Resident Handbook which they retain for their personal use. Any Resident may file a suggestion, grievance, and appeal. These forms are posted outside of the Business Office at the Link.

Resident Handbook