Evaluation Services (2012-2014)


Evaluation of the BREAC Project for Women Probationers
Sub-contract with UCLA ISAP and HealthRight 360

Christine E. Grella, Ph.D., Principal Investigator (cgrella@mednet.ucla.edu)
Luz Rodriguez, Project Director

This study is conducting both process and outcome evaluations of a project entitled, Breaking Recidivism by Engaging and Changing (BREAC), which is being implemented by HealthRight 360. The BREAC project aims to establish an innovative gender-responsive and trauma-informed services delivery system for women probationers in the Los Angeles County jail who are identified as having substance abuse problems.  The project is guided by the Woman Offenders Case Management Model (WOCMM), which is based on gender-responsive principles and theory and was developed specifically for women offenders under an initiative of the National Institute of Corrections.  Case management services begin during the in-custody phase, and continue through 90 days of residential treatment at a community facility as well as during aftercare, for up to 12 months following intake.  Following residential treatment, participants are given the option to step down into outpatient treatment and will continue to receive ongoing assistance with family-related services, transitional housing, vocational training, mental health services, and recovery support.  The evaluation study will determine the degree to which the case management model is successfully implemented and the outcomes of participants (N=96) across the various components of the integrated services delivery system.  In addition, staff competencies and organizational development with regard to implementing the model of gender-responsive and trauma-informed service delivery will be assessed.

Evaluation of the BREAC Project for Women Probationers was funded by HealthRight 360, contract 20130759, through SAMHSA grant No. TI023936, from September 2012 to September 2015.

DOJ Second Chance Reentry Program for Adult Offenders
with Co-Occurring Substance Abuse and Mental Health Disorders

Nena Messina, Ph.D., Principal Investigator (nmessina@.ucla.edu)
Kira Jeter, MPH, Project Director

The Adult Reentry Comprehensive Services (ARCS) project aimed to expand pre- and post-release re-entry treatment services for medium to high risk adult offenders to support post-release re-integration. Performance objectives were to increase substance-abuse, mental, and behavioral-health treatment services for offenders with co-occurring disorders (COD) in jail and in the community and provide services to 120 participants over the 2-year grant period. The outcome objectives were to reduce symptoms of COD, increase long-term housing, increase employment, and reduce recidivism. Evaluation objectives were two-fold: (1) monitor the implementation of the planned intervention, and (2) measure observed changes in participants from before to after their participation in the project in the domains of COD symptoms, long-term housing, employment/volunteer status, program completion/termination, recidivism (i.e., re-arrest and/or return to custody), treatment adherence, and services received.

DOJ Second Chance Re-entry Program for Adult Offenders was funded by Los Angeles County, contract PH-001733, from January 2013 to September 2014.

Drug/Medi-Cal (DMC)

Desirée Crèvecoeur-MacPhail, Ph.D., Principal Investigator (desireec@.ucla.edu)
Richard Rawson, Ph.D., Co-Investigator
Sarah Cousins, M.P.H., Project Director

To assist the county in preparing for the Medi-Cal Waiver (which includes Drug Medi-Cal), the Los Angeles County Evaluation System (LACES) is to provide the county with an estimation of the number of clients who will utilize the substance use disorder treatment system by treatment modality (e.g., residential, outpatient, narcotic replacement treatment).  This client utilization estimation will be based on the estimate from the Los Angeles County Department of Substance Abuse Prevention and Control (SAPC) that an additional 360,000 individuals will be eligible for Medi-Cal in Los Angeles County.  In addition, UCLA will provide an estimate of the number of additional counselors that will be needed, based on the increased client flow.  Finally, UCLA will also provide an estimate of the cost (salary) of the additional counselors and other staff persons that may be required for this new system.  LACES will also help with development and implementation of a Quality Assurance/ Utilization Management (QA/UM) plan.  LACES will assist the county by gathering additional related information around areas such as performance measurement, outcomes, optimal quality assurance processes and utilization of resources, patient-centered treatment, and health care integration as requested.  Finally, LACES will conduct an item-by-item analysis of the current admission and discharge questions to determine which items should remain, which should be edited, and which can be deleted based on changes to the treatment system and to reduce redundancy.

Drug/Medi-Cal (DMC) was funded by Los Angeles County, contract PH-001733, from July 2014 to June 2015.

Enhancing Follow-up Rates Through a Rechargeable Incentive Card

David Farabee, Ph.D., Principal Investigator (dfarabee@ucla.edu)
Angela Hawken, Ph.D. (Pepperdine), Co-Investigator
Stacy Calhoun, M.A., Project Director

For longitudinal field studies involving substance abusers, successfully tracking, locating, and following-up with a representative sample of subjects is a challenge. One meta-analysis of 85 longitudinal studies of substance abuse clients found that nearly one-third of subjects were lost to attrition within 36 months (Hansen, Tobler, & Graham, 1990). This poses a significant threat to the validity of findings in the substance abuse (and related) fields, as follow-up rates below 80% have been shown to produce dramatically biased estimates of drug use and crime (Nemes et al., 2002). The purpose of this Phase II Small Business Technology Transfer (STTR) proposal is to conduct a randomized field test of the rechargeable incentive card (RIC) system developed in Phase I, and to execute a detailed plan to commercialize the finalized set of products and services. The RIC System involves an on-the-spot issued debit card linked to an account to which researchers can immediately transfer funds following a follow-up contact (whether this involves telephone or in-person interviews, mail-in surveys, or provision of biological samples). The card also contains a toll-free number that subjects can use to call (as often as once a month) to notify the researchers of changes in their locator/contact information. This, too, results in an automatic transfer of funds to the subjects’ RIC System account. This technology was developed though a close collaboration between the Calance Corporation and the UCLA Integrated Substance Abuse Programs (ISAP). In Phase II, this same collaborative will finalize the RIC System, commercialize it, and test its impact on follow-up rates and staff time devoted to tracking and locating subjects, using a sample of substance abusers (N=300) enrolled in three outpatient treatment programs in the Los Angeles area. The RIC System could be employed in studies involving medication, education, employment, and panel studies in many research areas, but the application holds particular promise in the field of substance abuse research, which often involves itinerant, hard-to-track subjects—many of whom have criminal justice histories.

Enhancing Follow-up Rates Through a Rechargeable Incentive Card was funded by the Calance Corporation, grant 2 R42 DA025387, from May 2012 to March 2014.

Evaluation of HealthRight 360 Pregnant and
Parenting Women’s Treatment Program

Christine E. Grella, Ph.D., Principal Investigator
(cgrella@mednet.ucla.edu)
Luz Rodriguez, Project Director

The Families Living our Recovery (FLOR) project provides comprehensive services to women offenders (N=114) who have transitioned to a residential drug treatment program following their release from prison or jail.  The program goals are to provide treatment for substance abuse, mental health, and trauma-related problems; to improve participants’ mental health, family functioning, employment status, and psychosocial functioning; and to assist participants in their reunification with children and other family members.  The FLOR project utilizes evidence-based substance abuse, parenting, and family-based interventions within the context of intensive case management services.  Participants also receive vocational training and training in life management skills.  Children of FLOR participants may reside in the residential treatment program and are provided with prevention, early intervention, and medical services through referral to community partners.  The program also aims to promote the development of a comprehensive, integrated service delivery system based on family-centered treatment planning. UCLA ISAP is conducting a process and outcome evaluation study of the FLOR project. The evaluation study is examining whether the project recruits the intended target population, the degree to which the program model is successfully implemented, and participant outcomes at follow-up, including substance use, mental health status, psychosocial functioning, family status, and employment and housing status.  Barriers in the delivery of addiction services, health services, and social services to women offenders will also be addressed.

Evaluation of Pregnant and Parenting Women’s (PPW) Program was funded by the Haight-Ashbury Free Clinic (now HealthRight 360), contract 20114625 to UCLA, through SAMHSA grant No. TI023652, from October 2011 to September 2014 (with a no-cost extension through September 2015).

Evaluation of Illness Management & Recovery (IMR) Project at
Substance Abuse Treatment Facility
at Corcoran State Prison

Christine E. Grella, Ph.D., Principal Investigator
(cgrella@mednet.ucla.edu)
Jerry Cartier, M.A., Project Director

This project conducted a formative evaluation of the Illness, Management and Recovery (IMR) Program at the Substance Abuse Treatment Facility in Corcoran State Prison. IMR is an evidence-based, behavioral self-management program for individuals with co-occurring substance use and mental health disorders.  The following methods were used: (1) participant case flow analysis of cumulative admissions (N = 241), treatment retention, and treatment referrals at parole; (2) annual surveys of treatment and custody staff who work on the IMR unit; (3) site visits that included interviews with staff and observations of IMR groups; (4) review of participant case files; and (5) analysis of program records.  The IMR Fidelity Scale was used to assess implementation of 13 core components and mixed-methods analyses were conducted with qualitative and quantitative data.  Findings were cross-checked across data sources within an integrative framework in order to validate common themes across the data sources.  Several barriers to program implementation were identified, including referral of inappropriate inmates to the program; differences in attitudes and perceptions between treatment and custody staff; and frequent staff turnover and lack of sustained training.  The evaluation also found strong support for implementation of several of the IMR program core components and associated staff competency, and observed a high level of participant engagement.  Study findings can be used to develop strategies to improve implementation of the IMR program within correctional settings.

Evaluation of Illness Management & Recovery (IMR) Project at SATF was funded by the State of California Department of Corrections and Rehabilitation, contract 5600002110, from July 2012 to June 2014 (with a contract extension to June 2015).

Evaluation of the Bridges to Housing Project

Christine E. Grella, Ph.D., Principal Investigator
(cgrella@mednet.ucla.edu)
Kira Jeter, M.A., Project Director

The Bridges to Housing (B2H) Project was a community-based partnership with the goal of helping chronically homeless individuals with co-occurring disorders in West Los Angeles to access permanent housing, apply for MediCal and other public benefits, and obtain treatment and other services in the community.  The collaborative project was led by CLARE Foundation (substance abuse treatment), with St. Joseph Center (outreach, prevention, and case management services), Step Up on Second (psychosocial rehabilitation and support), Venice Community Housing Corporation (housing provider), New Directions (case management, treatment, and housing for veterans), Edelman Mental Health Center, and Venice Family Clinic (health care provider).  B2H utilized the Housing First intervention approach, motivational interviewing, and assertive case management.  Partner agencies referred participants (n=91) across agencies for needed services; provided linkage to transitional and permanent housing; provided comprehensive team-based case management to support recovery and housing retention; and assisted participants in applying for benefits.  An annual Community Consortium meeting was held to disseminate evaluation study findings and review policy developments regarding health care reform, housing strategies, and public benefits. The evaluation study assessed barriers to project implementation, characteristics of participants, and participant outcomes at a 6-month follow-up; staff completed annual evaluation surveys regarding the community partnership and intervention model.  Findings will be used to support continued program development for provision of comprehensive services to homeless individuals with co-occurring substance use and mental health disorders.

Evaluation of the Bridges to Housing Project was funded by the CLARE Foundation, contract no 20114621, through SAMHSA grant No. TI023570, from September 2011 to September 2014.


Evaluation of the Homeless
Co-Occurring Treatment Program

Christine E. Grella, Ph.D., Principal Investigator
(cgrella@mednet.ucla.edu)
Luz Rodriguez, Project Director

The Homeless Co-occurring Treatment Program (HCOTP) is a 4–6 month intensive outpatient treatment program that integrates substance abuse and mental health services for individuals who are in transition to permanent housing.  An Assertive Community Treatment (ACT) model is used to provide integrated and comprehensive services within the context of intensive case management, referral to wrap-around and recovery support services, and motivational interviewing to increase treatment engagement.  Targeted outcomes include reductions in substance use and mental health symptoms, increases in social support, and sustained residential stability.  The project will serve 38 individuals per year for 5 years, for a total of 190 individuals.  ISAP is conducting the process and outcome evaluation of this project, which includes client-level assessments at baseline, discharge, and 6-month follow-up; tracking of services provided to participants and their satisfaction with services; focus groups with staff and participants; and ongoing observations of the implementation process.   

Evaluation of the Homeless Co-Occurring Treatment Program was funded by a SAMHSA grant, T1021435, to Special Service for Groups, contract 20104695, from September 2010 to September 2015.

Evaluation, Training, and Technical Assistance for
Substance Use Disorder Services Integration

Darren Urada, Ph.D., Principal Investigator
(durada@ucla.edu)
Richard A. Rawson, Ph.D., Co-Investigator
Valerie Antonini, MPH, Project Director

The purpose of this project is to provide evaluation, training, and technical assistance (ETTA) for substance use service integration activities within the health care system of California. From 2012 to 2015, ISAP will provide the following:

  • Examine how ongoing policy changes are affecting who receives substance use disorder (SUD) treatment and how access, services, costs, and quality of care are being affected. Make recommendations to improve policies, practices, and data quality.
  • Refine program performance and patient outcome measures.
  • Collect and disseminate cutting-edge information on the integration of SUD services with mental health and primary care services.
  • Recommend strategic planning principles to guide the development of an integrated drug treatment delivery system in California in the context of health care reform.
  • Coordinate and facilitate an interactive forum (Learning Collaborative) with county administrators and other key stakeholders to discuss SUD integration.
  • Conduct case study/pilot evaluations.
  • Provide training at the county level on strategies to prepare for health care reform.
  • Provide technical assistance at the county level to facilitate integration following the implementation of major health care reforms in 2014.

For more information, please visit http://www.uclaisap.org/Integration/index.html

Evaluation, Training, and Technical Assistance for Substance Use Disorder Services Integration was funded by the California Department of Alcohol and Drug Programs, contract 12-00117, from July 2012 to June 2015.

First 5 LA

Desirée Crèvecoeur-MacPhail, Ph.D., Principal Investigator (desireec@ucla.edu)
Nena Messina, Ph.D., Co-Investigator (nmessina@ucla.edu)
Kira Jeter, M.P.H., Project Director

The Access to Substance Abuse Service for High Risk Parents (SA Access) program provides screening, brief intervention, and referral to substance abuse treatment (SBIRT) to pregnant women and caregivers who have an open Los Angeles County Department of Children and Family Services (DCFS) case for a child aged up to 5 years old. Expected outcomes include: (1) increased access and utilization of substance use disorder (SUD) treatment services among parents/caregivers with open DCFS cases; (2) greater than 30-day retention in SUD treatment; (3) decreased substance use among caregivers with children; and (4) increased family well-being. Child social workers refer parents with newly opened DCFS and suspected SUD cases to a substance abuse navigator (co-located in DCFS offices) who then screens the parent/caregiver using the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) and motivational interviewing methods. Parents who screen as high risk are connected to a treatment provider for further assessment.  If the caregiver is moderately at-risk, the navigator will provide a brief intervention. Additionally, the navigator can provide a referral should the caregiver want additional screening and treatment. Low-risk clients are provided education on substance use risk and prevention.

First 5 LA was funded by Los Angeles County, contract PH-001733, from July 2011 to June 2015.


Los Angeles County Evaluation System (LACES):
An Outcomes Reporting Program

Desirée Crèvecoeur-MacPhail, Ph.D., Principal Investigator (desireec@ucla.edu)
Richard A. Rawson, Ph.D., Co-Principal Investigator
M. Douglas Anglin, Ph.D., Co-Investigator

The Los Angeles County Evaluation System (LACES) is designed to assess the overall effectiveness of the county’s alcohol and drug treatment/recovery system and measure the effectiveness of specific service modalities and service components. To accomplish this, LACES augmented the intake and discharge questions used by the county’s alcohol and drug treatment/recovery system. The information from the revised admission and discharge questions provide information that is used to evaluate the treatment system at the county level.  In addition, LACES works with the County of Los Angeles to examine its drug court, Women’s Re-entry, Driving Under the Influence (DUI), and medication-assisted treatment programs (MATs).  The information gained from these programs, as well as the continued review of annual admission and discharge data, provides client outcome and program performance information that can be used to improve the overall substance use disorder treatment system. In addition, LACES has implemented several pilot projects in order to improve treatment engagement and retention and to assess for the “optimal” level of care.  Future tasks for LACES include assisting the county in preparation for the Medi-Cal Waiver and continuing to work to improve treatment through training and data-based reporting.

Los Angeles County Evaluation System (LACES): An Outcomes Reporting Program was funded by the Los Angeles County Alcohol and Drug Program Administration, contract PH00173 (March 2004 through June 2015).


Kern County Project CARE Evaluation

Richard A. Rawson, Ph.D., Principal Investigator (rrawson@mednet.ucla.edu)
Darren Urada, Ph.D., Co-Investigator
Valerie Antonini, M.P.H., Project Director

In 2011, California’s Kern County contracted with UCLA ISAP to provide evaluation, training, and technical assistance services for Project Care, which aims to integrate substance use and mental health services into primary care settings.  UCLA’s work with Kern County’s Project Care fell into two broad categories: (1) general integration activities, training, and technical assistance, and (2) measures of integration.  After three years of implementation, ongoing technical assistance, and evaluation, UCLA and Project Care participants have identified some important lessons about the integration of behavioral health in primary care settings.  These may be useful to stakeholders at various levels (e.g., state, county, health centers, individual service providers) in planning, implementing, and evaluating integrated care.  In addition, participants in Project Care have improved or maintained their previous progress in developing and providing integrated behavioral health care.

Kern County Project CARE Evaluation was funded by Kern County, contracts 241-2011, 400-2011, 566-2012, 660-2014, from May 2011 to June 2015.

Time for Change Foundation’s Positive Futures

Nena Messina, Ph.D., Principal Investigator (nmessina@ucla.edu)
Kira Jeter, M.P.H., Project Director

Time for Change Foundation’s Positive Futures program aims to provide community-based SUD treatment and re-entry services to 135 adult female ex-offenders in order to reduce their prevalence of alcohol and other drug use, homelessness, unemployment, and recidivism. The project seeks to create a collaborative of agencies to provide wrap-around services to clients; incorporate evidenced-based practices to address substance abuse and mental health issues, including trauma symptoms; and provide supportive services (i.e., mentoring, transportation, education, and job training).  UCLA ISAP is conducting both the process and outcome evaluation components of the project.

Time for Change Foundation’s Positive Futures was funded by SAMHSA Center for Substance Abuse Treatment, grant 1H79T1024020, from November 2012 through August 2015.

 

Last Updated:  10/01/2015

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