Progress of Four Programs from the Comprehensive Addiction and Recovery Act (2021) / Chapter Skim
Currently Skimming:
2 PPW-PLT and BCOR Programs
2 PPW-PLT and BCOR Programs
Pages 17-44
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From page 17... ...
support family-based services for pregnant and postpartum women with a primary diagnosis of a SUD, including opioid disorders; 2) help state substance abuse agencies ad dress the continuum of care, including services provided to women in nonresidential-based settings; and 3)
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From page 18... ...
number of 6-month follow-up interviews conducted at each grantee site versus the grantee's goal for 6-month follow-up interviews. The GPRA data reports were received in several batches.
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toward substance abuse agencies • Develop and implement a state service by encouraging new strategic plan or enhance an existing provision; no approaches and models of plan to ensure sustained partnerships more than 25 service delivery." across public health and other percent may systems that will result in short go toward Through this program, and long-term strategies to support infrastructure SAMHSA seeks to "reduce the family-based treatment services or capacity misuse of alcohol and other along the continuum of care for building. drugs, increase engagement pregnant and postpartum women." in treatment services, increase retention in the appropriate Allowable Activities level and duration of services, • "Adopt and/or enhance computer and increase access to the system, management information use of medications approved system (MIS)
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. Utilizing both of these submissions, the committee prepared summary tables of the GPRA data for the PPWPLT and BCOR programs (available in Appendix B)
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The committee did rely on the GPRA data to describe the characteristics of program participants at program entry, discharge, and 6-month follow-up from intake. From reviewing the GPRA data for the PPW-PLT and BCOR programs, a number of possible confounds must be noted before making conclusions about program impact.
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The exact reporting periods covered by the individual grantee progress reports varied widely. The progress reports for PPW-PLT grantees were dated anywhere between October 2017 and June 2020, and those for the BCOR program were dated between September 2018 and December 2019.
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characteristics of patients with follow up data Data aggregated across Difficult to interpret effects of SAMHSA grantees (without pre– grant funding on client outcomes; redactions post data or comparison prevent interpretation of the context for groups) client outcomes, either in terms of program features or community/population context or data Grantee progress reports PPW-PLT, Not all grantees Results only speak to progress of reporting BCOR submitted (25/27 grantees BCOR grantees)
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. Information regarding this activity comes from both GPRA data reports and grantee progress reports.
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; • Mental health care that includes a trauma-informed system of assessments, interventions, and social emotional skill building services; and • Case management." Data reports provided to the committee by SAMHSA on services received by clients (from discharge forms) indicate the following as the most commonly received services: 57.9 percent "substance abuse education," 37.7 percent "information and referral," 28.5 percent "relapse prevention" (see Appendix B, Table PPW-PLT-6)
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. In summary, while a first-glance review of data from the GPRA data reports provided by SAMHSA would suggest that that the program had favorable effects on substance use and related factors, the limitations described above do not allow for confidence in this interpretation.11 Increased Engagement in Treatment Services Across the six PPW-PLT grantees, the program had the goal of recruiting 1,645 women into the PPW-PLT.
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From page 27... ...
Very little of the GPRA data can be used to assess progress toward this goal because there are no adequate baseline data on community-level access to MOUD with which to make a comparison. The committee reviewed the GPRA data reports to identify the number of clients (a)
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. The GPRA data provided to the committee only specified methadone and did not specify other medications used in MOUD treatment.15 Data from progress reports do not provide consistent reporting on the provision of MOUD.
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Administrative challenges. Grantee progress reports noted numerous administrative obstacles or challenges that impacted their progress toward achieving this required activity -- providing family-based services for PPW-PLT with a primary diagnosis of an SUD, including OUD.
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; It Should Identify Gaps in Services Furnished to Pregnant and Postpartum Women Along the Continuum of Care with a Primary Diagnosis of SUD, Including OUD GPRA data cannot be used to assess progress toward this goal because all data are focused on individual-level information. Grantee progress reports varied in reporting elements and/or grantees did not provide information for
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, the committee cannot comment on grantee progress toward this goal. Required Activity 3: Develop and Implement a State Strategic Plan or Enhance an Existing Plan to Ensure Sustained Partnerships Across Public Health and Other Systems That Will Result in Short- and Long-Term Strategies to Support Family-Based Treatment Services Along the Continuum of Care for Pregnant and Postpartum Women Progress reports and evaluation reports (when made available to the committee by some grantees)
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, Electronic Health Records (EHRs) , etc., to Document and Manage Client Needs, Care Process, Integration with Related Support Services, and Outcomes Only one of the grantee progress reports mentioned activities related to this allowable activity.
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GPRA data reports were relevant only to Required Activity 1, to facilitate availability of family-based treatment and RSS. Grantee progress reports also provided relevant information.
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This included leadership training for peers, community outreach and collaboration, and internal enhancements such as billing and the use of electronic health records. Specific activities described by the BCOR programs in response to this overall activity were provided in the progress reports and are summarized here.
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Some of this was linked to the allowable activities to conduct community education, address stigma, and conduct outreach, and activities described here may overlap with those. However, some also served the purpose of enabling the BCOR programs to provide RSS with the support of the broader community, opening ways for individuals in need of RSS to be referred to the BCOR programs, and allowing the grantees to support other programs and services in the community.
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From page 36... ...
delivered under the grant program and client-reported outcomes at intake and, where available, whether clients remained in the program, at 6 months and at discharge. The BCOR programs noted challenges in finding or interviewing clients for follow-up interviews both at discharge and 6 months, as indicated by the smaller numbers at those time periods (see Appendix B, Table BCOR-1)
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From page 37... ...
Thus, the GPRA data provide only a partial picture of the success of the BCOR program. The GPRA data indicate that more than 2,000 clients were directly served by BCOR programs, that these clients were of high need for a range of services that would support them in their recovery, and that the programs provided case management and RSS to these clients.
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The committee turned to the grantee progress reports for information on the success and progress on this allowable activity. Of the 25 grantees for which progress reports were available, 20 identified building connections between recovery networks, recovery community organizations (RCOs)
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Allowable Activity 2: Reduce the Stigma Associated with Drug and Alcohol Addiction Grantees in the BCOR program were allowed to create outreach and other programs that reduce discrimination and stigma, with an end goal of eradicating discrimination and stigma for people living with SUDs. Grantees have initiated multimodal programs with foundations committed to social justice, with the aim that people who live with the chronic illness of SUDs will be less likely to encounter stigma and discrimination.
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. Allowable Activity 3: Conduct Public Education and Outreach on Issues Relating to Drug and Alcohol Addiction and Recovery This activity relates directly to the FOA's objective to promote education about recovery from SUDs, which presumably enhances the programs' ability to develop, enhance, and expand the delivery of RSS to a community that is knowledgeable about the disease of SUDs, recovery, and the need for the recovery supports.
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The BCOR programs that engaged in this allowable activity, either fully or partly, identified a wide range of approaches. Generally these could be grouped into (1)
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Based on a review of redacted progress reports and GPRA data, which were not designed for activities beyond direct client service provision, 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 an assessment of how effective those services were.
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Many BCOR programs were part of, or were part of the development of, networks of other recovery care organizations. Furthermore, many RSS are provided by other types of organizations (e.g., housing, employment services)
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