BJA Peer Recovery Support Services Mentor Initiative: Mentor Application While there is no current data on opioid addiction among criminal justice involved individuals, it is estimated that two-thirds of persons in correctional settings have a substance use disorder, and that 9-13 percent were using opioids regularly before their incarceration (Krawczyk, Picher, Feder, and Saloner, 2017). Research suggests that incarcerated individuals are more than 100 times more likely to die of an overdose in the two weeks post-release than members of the general population and that use of opioids including prescription pain relievers, heroin, and synthetic opioids is linked with a higher rate of recidivism (Spaulding, Seals,et al., 2009). In the context of child welfare, increases in drug overdose deaths and drug-related hospitalizations are correlated with increasing the rates of child protective services reports, substantiated reports, and foster care placements, and with more complex and severe child welfare cases (Radel, Baldwin, Crouse, Ghertner, and Waters, 2018). Increasingly, peer recovery support services (PRSS) are an important and sometimes central part of efforts to effectively address these issues, as part of the continuum of care for substance use disorders. The Peer Recovery Support Services Mentoring Initiative (PRSSMI) supports jurisdictions interested in incorporating PRSS in their portfolio of substance abuse intervention and treatment strategies. The purpose of the initiative is to: Enhance the capacity of selected jurisdictions to develop a PRSS as a component of their diversion or alternatives to incarceration programs. Improve the jurisdiction s ability to successfully implement an PRSS program, in collaboration with community partners. PRSSMI is seeking jurisdictions that are experienced in implementing PRSS to be mentors to other jurisdictions that are early in the process of implementing PRSS. To be mentors, we seek programs that: Advocate the value peer support services within the larger context of behavioral health, recovery-oriented systems of care, criminal justice, and/or child welfare Leverage the uniqueness of peer status in program design Have clearly defined roles for peers and other staff Use sound evidence-supported practices and policies Engage in systematic recruitment, screening, and hiring of peer workers Provide (or require) training in core competencies (basic) and specialized skills (advanced) for peer staff Promote continuing education and development for peer staff Train non-peer staff in value and purpose of peer supports Provide appropriate supervision of peer workers Focus on outcomes; use data to assess program efficacy Demonstrate that their intervention leads to positive outcomes Demonstrate strong collaboration among the courts, child welfare, substance abuse treatment agencies and others This form is for jurisdictions to apply to be a mentor site that will host others. Please complete form and upload supporting documents. You may save and complete your application across several sessions. There are 22 questions in this survey Organization Information Please tell us a little bit about your organization. 1
What is your: Please write your answer(s) here: Organization name Mailing address City State Zip Code Website Congressional district Who is your organization's primary contact person? Please write your answer(s) here: First Name Last Name Email Address Phone in format xxx-xxx-xxxx Who is other contacts for your organization? Additional 1 Additional 2 Additional 3 Additional 4 Additional 5 Name Email Address 2
Which of the following best describes your organization? Please choose only one of the following: County Health Department Jail/ Detention Center Problem Solving Court Law Enforcement First Responder Healthcare Agency Treatment / Addiction Services Organization Recovery Service Organization SSA/ Behavioral Health Council Other Is your organization: Please choose all that apply: COAP grantee with at least two years of experience managing or coordinating a peer recovery support services program in a criminal justice setting. Grantee of BJA, SAMHSA, or other federal program with at least two years of experience in developing and running a PRSS program in a criminal justice setting. Established recovery community organization or PRSS program with at least two years experience in peer support for criminal justice-involved individuals Established recovery community organization or PRSS program with at least experience providing peer support with individuals involved with child welfare Other: 3
How long has your organization been providing peer recovery support services? Only numbers may be entered in this field. How did you learn about the mentorship program? 4
Program Information What is the title of your program? Describe the nature and scope of the opioid problem in your area of service. Please provide a brief description of your program. 5
On which intercept(s) does your PRSS program focus? [Check all that apply, and list what peer services you provide at that intercept.] Comment only when you choose an answer. Please choose all that apply and provide a comment: Intercept 0 - Community / Crisis Response Intercept 1 - Law Enforcement Intercept 2 - Initial Detention / Initial Court Hearings Intercept 3 - Jail / Courts Intercept 4 - Reentry Intercept 5 - Community Corrections Other: How many peers work in your program? Only numbers may be entered in this field. Are the peer workers employed by your agency, or by a collaborating organization? Please choose only one of the following: Our agency Collaborating organization Other 6
How many individuals (or families) served? Only numbers may be entered in this field. What are the anticipated outcomes for your program? What are the outcome measures? What performance data and/or outcomes data do you collect? Who are your key partners/ collaborating organizations for your project? 7
What connection does your program have with local recovery community organizations (RCOs), or other entities within the recovery community, beyond AA or NA? 8
Focus Questions Why are you interested in being a mentor site? What are your primary goals for the mentorship? What are the three key lessons learned that you think important to share? Given the qualities of a program that PRSSMI is seeking, what makes your organization exemplary? What are the evidence-supported practices or promising approaches that you use? What have been results to date? 9
Please tell us any additional information you would like staff to know about your program that has not been covered in the above questions. 10
Supporting Documents Please upload the following documents in support of your mentorship application: 1. One- to two-page program description 2. Program brochure, promotional materials, or media clippings 3. Program staffing chart 4. Program budget for previous 2 years 5. Reports on outcomes/ results 6. Any other documents that you'd like to submit in support of your application. PDF documents are preferred; MS Word documents are acceptable. Please upload at most 10 files Kindly attach the aforementioned documents along with the survey Please certify that if selected, your program agrees to the following: Please choose all that apply: Assist assigned mentee sites for a least one year, through regularly scheduled support calls for the first three months Be available as a mentor for at least one hour per week for months four through twelve Participate in mentor-site training Host one site visit 11