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Session Title: Design, Cost, and Initial Program Model Findings From the Substance Abuse and Mental Health Services Administration (SAMHSA) Grants for the Benefit of Homeless Individuals National Cross-Site Evaluation
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Panel Session 869 to be held in Carmel on Saturday, Nov 5, 9:50 AM to 11:20 AM
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Sponsored by the Alcohol, Drug Abuse, and Mental Health TIG
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| Chair(s): |
| Nahama Broner, RTI International, nbroner@rti.org
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| Abstract:
SAMHSA's Grants for the Benefit of Homeless Individuals (GBHI) program funds grantees to provide services to expand and strengthen treatment to those with substance use and, or co-occurring mental disorders and link treatment services with housing with the goals of abstinence, housing stability and decreased homelessness. In operation since 2001, this U.S. federal program has not previously been evaluated. This panel presents the evaluation framework, a socioecological model, the design, and data collection and analysis methodology for each of the study's components-structure, process, outcome and cost--developed to address evaluation questions. We also present initial findings from the 25-site impact study regarding service models, intervention costs and leveraging of resources to develop integrative strategies for the provision of evidence-based treatment, wrap-around services, and housing. Implications for multi-site evaluation design of heterogeneous programs will be discussed in the context of assessing the effectiveness of interventions on abstinence, homelessness and housing.
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Grants for the Benefit of Homeless Individuals (GBHI) Cross-Site Evaluation Framework, Design and Methods
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| Jim Trudeau, RTI International, trudeau@rti.org
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| Nahama Broner, RTI International, nbroner@rti.org
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| Karl Maxwell, United States Department of Health and Human Services, maxwell@samhsa.hhs.gov,
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The SAMHSA GBHI cross-site evaluation framework assumes four interrelated propositions of a socioecological model in which first, clients are located within the local grantee project site, which is located within the local treatment system and the broader community context. Second, there are interactive relationships among these ecological levels. Third, each level contains appropriate evaluation components (i.e. structure, process, outcome, and cost elements). Fourth, grantees are located not only in their local communities but also in the "virtual community" of the federal program that directly influences grantees and indirectly influences their clients and treatment systems in which they are embedded. The cross-site evaluation includes 137 programs, with an impact study of 25 programs. The presentation describes the goals of the evaluation, research questions, cross-site design, and data collection and analysis methodology developed in consultation with a national expert panel.
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Services and Housing Model Approaches: A Cross-site Evaluation of the Grants for the Benefit of Homeless Individuals (GBHI)
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| Nahama Broner, RTI International, nbroner@rti.org
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| Jim Trudeau, RTI International, trudeau@rti.org
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| Alexander Cowell, RTI International, acowell@rti.org
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| Arnie Aldridge, RTI International, aaldridge@rti.org
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| Karl Maxwell, United States Department of Health and Human Services, maxwell@samhsa.hhs.gov,
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This presentation describes the approaches to integrating evidence-based treatment, wrap-around services and housing developed by 25 programs funded in 2009 through the SAMHSA GBHI program serving veterans, women and families, youth and those involved in the criminal justice system with substance use and, or co-occurring mental disorders. Based on structured interviews, document extraction, focus groups, site visit observation, and client self-report data, we will present the primary models that serve to organize grantee approaches to substance use, services and housing. We will describe a number of model elements including setting, clinical population characteristics, treatment and housing criteria, evidence-based practices, supports and financing that were used to develop these models across sites. Lessons learned and innovations with regard to differential implementation of evidence-based treatment and approaches by subpopulation will also be delineated. This presentation will conclude with the planned use of these models in analyses and the implications of this approach.
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Costs of Service Provision for Participants in Grants for the Benefit of Homeless Individuals Program: Approach and Preliminary Results
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| Arnie Aldridge, RTI International, aaldridge@rti.org
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| Alexander Cowell, RTI International, acowell@rti.org
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| Nahama Broner, RTI International, nbroner@rti.org
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| Carolina Barbosa, RTI International, cbarbosa@rti.org
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The presentation reports on the approach and preliminary findings of the economic component of the SAMHSA GBHI cross-site evaluation. We describe the methods of obtaining the costs of services directly covered by the grantee as well as the correlated services that the grantee leverages. These correlated services are from within the grantee agency, from partner providers and from the existing social support system. The costs of services provided under the grant are estimated using a protocol that includes a structured instrument completed by the evaluator and the grantee in tandem. That protocol also gathers qualitative data on key service areas to which clients are connected, in which clients may not have otherwise received services, but that are not covered directly by the SAMHSA grant. Emphasis is placed on the scope, challenges, and alternative approaches for collecting the data. Preliminary cost estimates are presented.
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Taxonomy of Approaches to Transportation for Grants for the Benefit of Homeless Individuals (GBHI) Program Participants
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| Arnie Aldridge, RTI International, aaldridge@rti.org
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| Alexander Cowell, RTI International, acowell@rti.org
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| Nahama Broner, RTI International, nbroner@rti.org
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In this presentation we focus on the role of transportation models in the 25 GBHI programs. Transportation is an oft-noted barrier for clients accessing substance abuse and mental health treatment. As emphasis on recovery support and wrap-around services grows, transportation emerges as an even more important factor in a program's success. Differences in a program's geographic location, its approach to integrating services and housing, its organizational structure, and its target population all can influence the program's ultimate transportation services, which can themselves influence the programs' service delivery models. In this study we provide a taxonomy of the approaches to transportation services and analyze why they were chosen. We describe the pros and cons for each approach in terms of service model integration, fidelity to evidence-based practices, program outputs, costs, efficiency and synergy within the program and the grantee organization, client experiences and outcomes, and implications for program sustainability.
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