1. Kristin Stainbrook, PhD
The Residential Substance Abuse Treatment (RSAT) Aftercare Study: Early Findings on RSAT funded Aftercare
Kristin Stainbrook, PhD
RSAT Training and Technical Assistance Workshop
New Orleans, LA ◊ July 16, 2015
This research is supported by NIJ grant #2013-MU-0057

2. Overview of Presentation
Provide a description of the RSAT Study
Describe the sample of RSAT funded aftercare programs and present preliminary data on services, challenges, and innovations
Describe next steps for the analysis
Open discussion about challenges to aftercare in your programs/communities

3. RSAT Study Research Aims
Understand how States/Territories and Subgrantees use BJA RSAT funds for treatment and aftercare for offenders transitioning to the community
Describe the specific substance abuse treatment and aftercare services that are supported with RSAT funds
Describe the challenges, facilitators, and lessons learned
11/23/2018

4. Study Design and Methods
The RSAT State Coordinator Program Inventory- focuses on understanding the role and responsibility of the RSAT Coordinator in funding and administering RSAT program funds.
Administered as a web-survey
The RSAT Subgrantee Program Inventory- focuses on Subgrantee facilities or agencies funded services with RSAT to understand: program setting and enrollment criteria; screening and assessment procedures; program staffing; the types of services and evidence based practices provided in RSAT programs, pre-release planning activities; aftercare related activities; exemplary practices; barriers and facilitators to aftercare; and lessons learned.
Administered as a telephone interview
11/23/2018

5. Study Sample
Coordinator Inventory- includes all 50 states and 5 territories, N=54 programs
Response rate: 87% (n=47)
Subgrantee Inventory- targeted all RSAT Subgrantees with active programs reporting PMT data in July-Sept 2014 quarter and serving at least 10 individuals during the period, N=77 programs
Response rate: 78% (n=60)
11/23/2018

6. RSAT funded aftercare programs
Includes all RSAT funded services and support provided in a community setting
A total of 12 programs interviewed spent 20% or more of their funds on post-facility (jail/prison) services
Two programs targeted females only & two males only
One program targeted juveniles
11/23/2018

7. Program Referral
Nine of the 12 programs provide a linkage from a correctional setting to community service providers
Five of these programs link directly from a RSAT prison/jail program
For the remaining 3 programs, participants are court mandated to participate
Only 9 programs represent “aftercare” that is services provided to support clients following discharge from jail/prison
11/23/2018

8. Aftercare Program Setting & Model
Two General Approaches:
Five programs provide RSAT services in a residential treatment facility
Two of these consider themselves halfway houses
Transitional case managers are the primary service model for the 7 community based programs
Average program length 6-months to year
Program capacity small
Transitional CM programs- average daily 20-50
Residential- average daily is 10-20
11/23/2018

9. Program Funding
Programs have been in operation approximately 2-6 years, through one has been in operation for 18 years (a residential program)
Average amount of RSAT funds for programming is 86K, three are below 50K
Majority of RSAT funds are spent on staff positions
All but one program spend funds on substance abuse counselors/clinicians; most also fund case managers and a small percentage of management/oversight (5-10% of funds)
Two programs used RSAT funds principally for non-staff expenses
11/23/2018

10. Funding (con’t)
All programs reported using other financial and in-kind staffing resources to support RSAT programs
Most of the funding came from state resources
About half use funds for non-staff expenses
Training materials, drug testing, etc.
Programs that included multi-service agency reported leveraging a broader range of services
11/23/2018

11. Program Services Main services provided by programs:
All programs provide case management
Substance abuse individual and group services provided by all but one program
Trauma services provided in nine programs
Peer support provided by six programs
Ten programs provided wrap-around support, and 7 reported linking clients to educational and vocational services
11/23/2018

12. Evidence Based Practices (EBP)
All twelve programs reported providing Motivational Interviewing (MI) and Cognitive Behavioral Therapy (CBT)
Two programs reported Thinking 4 Change and Moral Reconation Therapy (MRT)
Two identified a trauma specific EBP
11/23/2018

13. Innovations/Unique Features
Funding/leveraging
Use of RSAT funds to support Medication Assisted Therapy (MAT) by one site to fill an existing gap in the community
One program uses portion of RSAT funds like Access to Recovery (ATR) to support housing related needs (e.g. security deposit, utilities)
Juvenile program used to enrich aftercare program by providing supplemental resources
11/23/2018

14. Innovations/Strengths
Outreach/engagement
One program reported using peers to conduct in-reach to RSAT program to “sell” the aftercare program and promote the positive impact of the transitional support
Among programs focusing on transitional CM - reported that having the same case manager/clinician providing support both in the facility and in community helped with enrollment and retention
11/23/2018

15. Innovations/Strengths
Collaboration
Majority of programs report participation in multi-system community boards/committees focused on diversion, re-entry, offender issues
Regular opportunities for communication/ interactions around participant needs and progress between community corrections and RSAT case managers
One program co-locates staff
11/23/2018

16. Innovations/Strengths
Services
Several respondents reported that contracting with a provider for RSAT program helped capitalize on resources available within the organization and its connections to other community providers
Individualization of services to promote transition to community, including resources to support basic needs
Using peers for groups and mentoring
11/23/2018

17. Challenges Funding and Resources
RSAT funding decreases over the past few years, no longer adequate to support programming
Community resources for treatment supports major barrier to long term recovery, no resources to support medication assisted treatment
Majority of respondents identified housing and transportation as a barrier to participation in services
*One program no longer using RSAT funds for program- taken over with state funds
*Another program- used to be one of three in the state- not only one
11/23/2018

18. Challenges Services/Client Retention
For residential programs, having clients with sentences long enough to participate or unanticipated release is a challenge
For case manager programs, tracking clients and retaining them is challenging when it is voluntary
A few sites mentioned the tension between what in legal interest of participant and interest of recovery
11/23/2018

19. Next Steps for Study
Analyze the staffing, services and support funded by RSAT across all programs types
Explore the transitional and aftercare services available to RSAT jail and prison participants that are not funded by RSAT
Document the challenges and barriers to aftercare across programs
11/23/2018

20. Open Discussion
What aftercare is available for participants in your RSAT programs?
What are the biggest needs for participants transitioning from facility to community?
What are the issues/challenges with providing aftercare for RSAT participants?
11/23/2018