Progress of Four Programs from the Comprehensive Addiction and Recovery Act (2021) / Chapter Skim
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.3 STATEMENT OF TASK AND REPORT METHODOLOGY The Statement of Task to the National Academies calls for an ad hoc committee to conduct a review of outcomes achieved by four specific programs funded by SAMHSA, as authorized in CARA. The specific CARA programs are Building Communities of Recovery (BCOR)
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SAMHSA explained that their agreements with grantees prohibited SAMHSA from sending the committee unredacted program progress reports. To fill in some of these gaps, the committee reached out to individual grantees to request additional information; a limited number of unredacted reports were received.
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grantees Results Act data reports Individual-level data Does not speak to community-level or systems level change Unclear whether clients Cannot isolate effect of SAMHSA grant funding were (a) enrolled in other on client outcomes programs simultaneously or (b)
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No explanations are provided Unclear whether unanswered questions indicated as to why some grantees left no progress, some progress, or simply a skipped questions blank question Some material in the two Unclear which is correct; cannot interpret these report types for OD Treatment data Access directly contradict one another SAMHSA Responses PPW-PLT, At times, the committee Did not always provide additional clarifications to National Academies BCOR, requested clarification on a Questions OD Treatment Access, point (e.g., reporting period FR-CARA for another reporting tool) , and gaps remained in SAMHSA's responses NOTE: BCOR = Building Communities of Recovery; CSAP = Center for Substance Abuse Prevention; CSAT = Center for Substance Abuse Treatment; FR-CARA = First Responders-Comprehensive Addiction and Recovery Act; PPW-PLT = State Pilot Grant Program for Treatment for Pregnant and Postpartum Women; SAMHSA = Substance Abuse and Mental Health Services Administration.
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TABLE S-2 Summary of the PPW-PLT and BCOR Programs Awards Eligible and Project Funding Program Applicants Period Restrictions Program Purpose Program Activities PPW-PLT Single state 2017 No more than The purpose of this program Required Activities agencies for awards: 15 percent of is to "enhance flexibility in • "Facilitate the availability of family substance 3 the federal the use of funds designed to based treatment and recovery support abuse ($1,100,000 funding may • support family-based services. each)
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, the committee finds that the BCOR programs as a whole made progress toward this goal. The progress reports indicate a wide range of ways in which RSS were developed, expanded, and enhanced, and the GPRA data indicate that many clients directly received RSS, although the data do not allow for assessment of how effective those services were.
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TABLE S-3 Summary of the OD Treatment Access and FR-CARA Programs Awards Eligible and Project Funding Program Applicants Period Restrictions Program Purpose Program Activities OD Federally 2017 No more The purpose of the Required Activities Treatment qualified awards: than 20 program is to "expand • "Establish a program for prescribing a drug or Access health 1 (up to percent of access to FDA- device approved by the FDA for treatment of centers $1,000,000 total award approved drugs or known or suspected opioid overdose.
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Allowable Activities • "Collaborate with health care providers to educate them on overdose dangers and recommend that they consider providing resources to overdose victimsb and families, including information on treatment and recovery. • Provide public education on any state ‘Good Samaritan' laws, such as those that permit bystanders to alert emergency responders to an overdose or to administer FDA-approved overdose reversal drugs without fear of civil or criminal penalties." See the toolkit at https://store.samhsa.gov/product/Opioid-Overdose-Prevention-Toolkit/SMA18-4742 (accessed March 13, 2020)
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Twenty grantees had held meetings with advisory councils that they had joined or that were newly established during the reporting period. Some, but not all, grantees engaged to varying degrees in the allowable activities to collaborate with health care professionals and to assist in the provision of public education about applicable Good Samaritan laws.
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The committee is concerned that its ability to draw firm conclusions on the specified CARA programs will likely continue to be limited. The committee uses these identified limitations, described in the previous sections of this chapter and throughout the report, to lay out a set of information needs that would allow it to design and perform a more rigorous evaluation of program effectiveness, recognizing that these programs are fully under way, and some are soon to be completed.
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