Volunteers of America Oregon (VOAOR) serves as the lead agency for the VOA/Miracles Family Recovery Support Program, a partnership with the Oregon Department of Human Services – Children’s Services, the Multnomah County Mental Health and Addictions Services Division, The Miracles Club, and Portland State University Regional Research Institute for Human Services. This project intensifies its service delivery, expands data capability to inform/isolate best practices to achieve positive outcomes for children and families. The funded organization is the VOA/Miracles Family Recovery Support Program, which is housed in a dedicated site offering drop-in center services. All services are trauma-informed, culturally responsive, and strengths-based.
Parents in recovery from substance use who are involved with or at-risk of involvement with child welfare. Emphasis on reaching out to and engaging African American parents and families.
Major Program Goals
- Help parents and families sustain recovery
- Improve child well-being
- Improve parent well-being
- Improve permanency and safety
- Improve family functioning and stability
- Reduce the count of African American children entering or retuning to foster care
- Create an enhanced Recovery Oriented System of Care
- Develop a sustainable Recovery Oriented System of Care
Major Program Services
The evidence-based and promising practices that Volunteers of America Oregon incorporates is Nurturing Parenting. In addition, other program services include:
Recovery Oriented Systems of Care (including aftercare and family services)
- Trauma-informed, culturally responsive recovery support for families
- Culturally competent services for African Americans
- Family/parent counseling
- Parents Anonymous
- Mindfulness Based Relapse Prevention
- Drop-in center
- Transportation support
- Employment assistance
- Case management
- Housing assistance
- Relapse prevention
- Life skills development
- Peer-to-peer mentoring
- Self-help and support groups
- Life skills
- On-site meals
- On-site childcare
- Resource access
Certified Peer Recovery Mentors
- Staff trained in provision of trauma-informed care, including individual and family counseling
- Beyond Trauma
- All services are trauma-informed
Partner Agencies and Organizations
Volunteers of America Oregon (VOAOR); Miracles Club; Oregon Department of Human Services (DHS); Multnomah County Mental Health and Addiction Services Division (MHASD); Portland State University's Regional Research Institute for Human Services (RRI); FIT (Family Involvement Team) includes: Multnomah County Family Court, Oregon DHS, Multnomah County MHASD, five substance use treatment providers and Parents Anonymous.
Outcome Study Design
Matched comparison group design with 400 families (200 intervention and 200 comparison/services as usual), up to five families for each group selected randomly each month.
Comparison group – matched on key characteristics, not enrolled in VOA/Miracles Family Recovery Support Program due to distance, scheduling, or program capacity.
Parent interviews – conducted by PSU/RRI for Human Services Consumer Interviewers for VOA/Miracles Family Recovery Support Program and comparison group families. Gift card incentives for completing baseline interviews and 6 month follow up interviews.
- Addiction Severity Index (ASI)
- Trauma Symptom Checklist - 40 (TSC- 40)
- Parenting Stress Index - 4 (PSI - 4)
- Vineland-II, Socialization Subscale
- Trauma Symptom Checklist for Young Children (TSCYC)
- Assessment of Recovery Capital
- Protective Factors Survey (PFS)
Additional Data Components:
- Oregon MOTS – Measures and Outcomes Tracking System Database
- Oregon DHS OR-Kids Database
Process Evaluation Design:
Data gathered from multiple sources to evaluate the implementation of the project.
Process evaluation data collection includes:
- Parent interviews: program feedback and services received gathered in discharge interviews
- Parent focus groups
- Phone interviews with partners
- Check-ins with program staff
- Program service data
The VOA/Miracles Family Recovery Support Program collaboration examines the effects of the Recovery Oriented System of Care (ROSC) using a quasi-experimental, matched comparison group study. Through the VOA/Miracles Family Recovery Support Program, individuals in the program group have access to a therapist, resource specialist, and/or peer recovery mentor; a set of services specified in a recovery support plan (which draws on a menu of options that includes evidence-based practices); and the drop-in site, which offers additional supports for families. Comparison group members do not have access to this system of services through the VOA/Miracles Family Recovery Support Program, although they have access to business-as-usual services that in some cases may overlap with services program group members receive. The evaluation collects information about the implementation of the program and collaboration among partners.
Outcome Study Design
To recruit families for the program group, project staff conduct outreach through and request referrals from multiple agencies and organizations (for example, substance use treatment providers, child welfare caseworkers, recovery support services, and community organizations). Project staff also rely on word of mouth. All parents from eligible families who enroll with the VOA/Miracles Family Recovery Support Program are asked if the evaluation team can contact them; those who grant permission for contact are recruited for the study. Comparison group families are recruited by working with substance use treatment providers. Case managers receive instructions about which clients are eligible for the comparison group (defined as parents in recovery from substance use disorders who are at the end of or near the end of their substance use treatment and who are either engaged with or at-risk of engagement with child welfare; the same definition applies to those in the program group). Case managers are asked to focus on those who are geographically distant from the VOA/Miracles Family Recovery Support Program site but are still within Multnomah County. They ask eligible clients to allow the evaluation team to contact them; those who grant permission are recruited for the study.
Outcomes will be collected in each of five domains for both groups: child well-being, permanency, safety, recovery, and family functioning. Data sources include administrative data and information collected by the local evaluator. Administrative data on safety and permanency are provided by the Oregon Department of Human Services child welfare database, the OR-Kids data system. The source for administrative data on treatment is provided by the Oregon Health Authority, Addictions, and Mental Health Division through the Measures and Outcomes Tracking System (MOTS) database. Data collection with all standardized instruments is conducted by data collectors hired and trained by the evaluation team. The data collectors hired have life experiences similar to those of the people being interviewed (that is, recovery from addiction and child welfare involvement). Data is collected twice for each program group family: (1) at the time they begin services (at or near the end of substance use treatment) and (2) approximately six months later. Data is collected on the same timeline for each comparison group family: (1) at or near the end of substance use treatment and (2) approximately six months later.
Additional Evaluation Components
In addition to the outcome study, the evaluation also includes an implementation evaluation that examines, among other topics, whether the project reaches the targeted population; what procedures, infrastructure, and supports are in place to facilitate implementation of the selected evidence-based practices; what services are ultimately provided; and the characteristics of enrolled participants. The evaluation will also assesses the collaboration process among RPG partners.
RPG National Cross-site Evaluation Participation
The grantee is participating in the RPG cross-site evaluation studies of family and child outcomes, program implementation, and collaboration among RPG grantees and partners.
Sustainability Strategies and Activities
The partnership for the VOA/Miracles Family Recovery Support Program has a thoughtful plan to sustain the project after the funding period. This includes private fundraising that builds on the success of the project, and developing infrastructure and systems to bill for appropriate services. It also includes the continued partnership with DHS and MHASD, the two current funding partners, as needed. First, the partners are developing a coordinated development plan to identify and pursue private funding through individual and foundation supports. Second, VOAOR is developing infrastructure to include an electronic health record and billing capacity. Much of VOAOR's past funding has been through government contracts, limiting the necessity of client based billing. The advent of the Affordable Care Act and integration of physical and behavioral health services supports VOAOR's step toward insurance funded activities.
Oregon entered into a new phase of peer recovery support services through standardizing the training and certification process for peer support specialists. Legislation related to Oregon’s efforts to implement the Affordable Care Act (ACA), directed the Oregon Health Authority (OHA) to establish a process to approve Peer Support Specialist (PSS) training programs and certify peer support specialists. Sixteen agencies are certified by OHA to provide peer support specialist training that lead to individual certifications, of which the Miracles Club is one. The Addiction Counselor Certification Board of Oregon (ACCBO) also certifies Recovery Mentors who serve as peer support specialists for addictions, assuring that they meet standards for training, confidentiality, reporting, and ethics. As a SAMHSA Access to Recovery (ATR) grantee, the state provides a testing ground for the Addictions and Mental Health Division (AMH) to sustain the service through Medicaid. The state received approval from Centers for Medicare and Medicaid Services (CMS) to bill Medicaid for recovery support services and that process continues with establishing rates. The service may be covered through managed care when contracts with Oregon’s Coordinated Care Organizations are amended and funding is built into their rates. Oregon has not established a firm timeline for when recovery support services will become billable, which allows VOAOR time to prepare to bill for some services as early as year three. It is projected that billing for these services is more likely in years four and five. As the project develops billable services for recovery support, the cash match is adjusted to reflect this new income, with the goal of full sustainability after the grant funding period ends.