Measuring Success in Substance Use Grant Programs Outcomes and Metrics for Improvement (2020) / Chapter Skim
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3 Treatment Programs
3 Treatment Programs
Pages 39-54
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and the State Pilot Grant Program for Treatment for Pregnant and Postpartum Women (PPW-PLT) -- are focused on substance use disorder (SUD)
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This could include a wide range of activities related to RSS, such as building connections between different recovery resources and networks, reducing stigma associated with drug and alcohol use, providing educational programming and outreach related to drug and alcohol use and recovery, providing peer mentorship and coaching, or linking to other service providers. Other allowable activities include building infrastructural connections between substance use treatment programs, primary care providers, the criminal legal system, employers, housing services, child welfare agencies, or other RSS that promote recovery from SUD; designing activities to reduce stigma; or conducting public education, training, and outreach on identifying SUD and promoting a culture of support and recovery.
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b quality of long-term recovery support from Building Communities of that are domestic private substance use and addiction: Recovery (BCOR) a nonprofit entities in 2018 Awarded: • Support the development, enhancement, states, territories, or tribes 18 (up to $200,000 each)
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promote a coordinated, effective and efficient state system managed by state substance abuse agencies by encouraging new approaches and models of service delivery.4 SAMHSA's overall goal with respect to the PPW-PLT program is to reduce use of alcohol and other drugs, increase engagement and retention in treatment, and increase access to and use of medications to treat substance use disorders. Of note, the PPW-PLT is distinct from another grant program offered by SAMHSA, the Services Grant Program for Residential Treatment for Pregnant and Postpartum Women, which focuses exclusively on residential treatment, prevention, and recovery services for women and their children.5 Grantees under the PPW-PLT program, on the other hand, may only use up to 15 percent of funds on residential-based services (though they are not required to provide residential-based services under the terms of the grant)
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These SSAs are required to partner with at least one direct service provider organization (e.g., a substance use treatment organization) that meets the following criteria: is appropriate to the grant and directly involved in the proposed project; has been providing relevant services for at least the past 2 years; and is in compliance with all local and state licensing, accreditation, and certification requirements.
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No cost sharing or matching was required for the PPWPLT grants.6 The required activities under PPW-PLT are to: • Facilitate the availability of family-based services for PPW, their minor children, and other family members as necessary, includ ing outreach, engagement, screening, assessment, wrap-around recovery services, family reunification programs, parenting inter ventions, treatment for SUD with medication, mental health care, and case management; • Promote the coordination of services across disparate systems (e.g., behavioral health, primary care, housing, child and family services) ; and • Identify gaps in service availability throughout the state and implement a state infrastructure development plan to ensure sustained partnerships between existing public health systems and other state systems that could provide services across the continuum of care for PPW.
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• Help state substance abuse agencies address the continuum of care, including services provided to women Up to 3 years in non-residential-based settings; and • Promote a coordinated, effective, and efficient state system managed by state substance abuse agencies by encouraging new approaches and models of service delivery. Through this program, the Substance Abuse and Mental Health Services Administration seeks to reduce the misuse of alcohol and other drugs, increase engagement in treatment services, increase retention in the appropriate level and duration of services, and increase access to the use of medications approved by the Food and Drug Administration in combination with counseling to treat drug addiction.
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. For those with a history of military deployment, there is a screening question BOX 3-2 State Pilot Grant Program for Treatment for Pregnant and Postpartum Women Grantees Fiscal Year 2017 • Massachusetts State Department of Public Health (Boston, MA)
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Grantees in both the State Pilot Grant Program for Treatment for Preg nant and Postpartum Women and Building Communities of Recovery programs are expected to achieve an 80 percent follow-up rate at 6 months. In summary, the CSAT GPRA tool aims to measure the following: • Services planned and actually delivered (e.g., screening, case manage ment, infectious disease counseling, employment coaching, other medical care, relapse prevention, education services, peer coaching, methadone, recovery support)
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, including medications for OUD.7 For patients with co-occurring SUD and another behavioral health diagnosis or infectious disease due to SUD, integrated services have been 7 The committee notes that in the final stages of preparing this report, the GPRA tool underwent an update. Now, the revised tool includes a question specifically about medications for OUD, including methadone, buprenorphine, and naltrexone.
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SAMHSA can use these data to elucidate best practices across programs and inform future grant program requirements. Recommendation 3-4: The Substance Abuse and Mental Health Ser vices Administration should implement a validated and psychometri cally sound tool for assessing recovery among clients of its grant programs, as the Center for Substance Abuse Treatment Government Performance Results and Modernization Act tool does not elicit ade quate data on the process of recovery.
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Measurement Effectiveness The CSAT GPRA questions assessing past 30-day use of drugs and alcohol may be limited because they provide a small window for assessing substance use and do not account for limited opportunities for use while in a restricted environment during the measurement period. For example, days in restriction environments (e.g., inpatient detoxification, residential treatment programs, correctional facilities or inpatient hospitalization)
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All such questions should be tested for reliability, particularly with respect to framing effects. Recommendation 3-7: The Substance Abuse and Mental Health Ser vices Administration should use or develop self-report measures for its grant programs that minimize confusion and risk of alienating patients and clients.
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Notably, one current BCOR grantee has instituted a goal to have participants complete 60 hours of skills training in a coffee shop or thrift shop. Recommendation 3-9: The Substance Abuse and Mental Health Ser vices Administration should support grantees in providing and mea suring the success of activities related to job skills and readiness in the Building Communities of Recovery and State Pilot Grant Program for Treatment for Pregnant and Postpartum Women programs.
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BCOR Recommendations BCOR grantees are required to use funds to develop and expand RSS, including peer RSS. However, the CSAT GPRA tool does not contain evaluation metrics for specifically assessing how peer recovery coaches, mentors, or support specialists are trained, how they are deemed eligible and certified, how they are integrated into the community, and how they impact the recovery journey of their clients.
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treatment programs in years prior to, during, and after implementation of the State Pilot Grant Program for Treatment for Pregnant and Postpartum Women (PPW-PLT) grant program and their referral sources.
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