CABHI- Homeless Veterans

Abstract Project Title: Cooperative Agreement for the Benefit of Homeless Individuals (CABHI). The Evaluation Center has been asked to provide evaluation services on a SAMHSA grant (announcement TI-15-003) through a subcontract with the Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities (KDBHDID). Chronically homeless persons and homeless veterans roam the streets of most major cities, and Louisville, Lexington and the Cincinnati metro areas are no exception. Most of these persons are likely to have a severe mental illness or a substance use disorder. At the last homeless Point in Time survey 4,998 were counted on a single cold Kentucky day in 2014. The KDBHDID proposes to use a combination of evidence based practices: Pathways to Housing's Housing First model; Assertive Community Treatment; Screening, Brief Intervention, and Referral to Treatment (SBIRT) and SSI/SSDI Outreach, Access and Recovery (SOAR) to attain our goal of eliminating homelessness. Four community based teams, made up of a multi-disciplinary outreach crew will seek out the homeless wherever they might be. Two teams will be in Louisville and one each in Lexington and the northern Kentucky metropolitan counties adjoining Cincinnati. Working with the Kentucky Interagency Council on Homelessness (KICH) and community based care givers, homeless persons will be linked to housing, mental health and addiction treatment. The 470 of the most seriously in need persons are targeted by CABHI Kentucky. In order to engage the chronically homeless and homeless veterans the CABHI Kentucky teams will include peer counselors, nurses, social workers, employment counselors, case managers and recovery specialists. This diverse group will represent the cultures and sub populations they will serve. The CABHI Kentucky team will make special efforts to provide services in a culturally sensitive and competent manner. In order to document the activities and progress, an Evaluation team will provide performance, process and outcome data. The evaluation results will be provided to SAMHSA, the KDBHDID Steering Committee and KICH. CABHI Kentucky means a new life for those who have hit bottom and who are now most in need of a lift up. The Evaluation Center at the University of Kentucky provides independent evaluation services ranging from survey creation, data collection and analysis, interviews and focus groups, historical document review, statistical analysis, and grant writing support. The Center follows American Evaluation Associations' ethical guidelines for evaluation services, which include systematic inquiry, competence, integrity, honesty, respect for people, and responsibility for general and public welfare. The focus of the Center is to provide utilization-focused evaluations (UFE) where the information provided is useful to the intended users. This requires a dynamic, participatory approach working with stakeholders to facilitate decision making and promote sustainability. The Center is staffed by a Director, Assistant-Director, one staff evaluator, and 5 research assistants. The Center Director, Dr. Jessica Hearn has over 9 years of research and evaluation experience, including serving as the evaluator for Kentucky's currently funded State Adolescent Treatment-Enhancement and Dissemination cooperative agreement. Thus, Dr. Hearn is familiar with the GPRA reporting requirements, the submission of data via the Common Data Platform, and the analysis of data to inform decision making about adolescent substance use treatment policy and practice. Since the data collection requires face to face interviews for intake, follow-up and discharge, each of the three sub award regions will have an on staff Evaluation Associate whose job it is to collect the GPRA and all other evaluation instruments. In addition to the demographic data (gender, age, race, and ethnicity) on all clients served, Evaluation Associates will report on the performance measures including abstinence from use; housing status; employment status; criminal justice system involvement; access to services; retention in services; and social connectedness. All Evaluation Associates will be required to attend online or face to face GPRA Training. Additionally, the Evaluation Associates will participate in online training offered by the federal Office of Research Integrity known as "The Research Clinic." Data Collection procedures - The goal of the evaluation team is to collect data which will enable KDBHDID to report on key outcome measures relating to substance use and mental health. If necessary, the Evaluation Associates will collect the data face to face using pencil and paper instruments and interviews. If possible, the Evaluation team will use one of the online electronic data collection systems incorporated in to the agencies Electronic Health Records System. Data will also be collected and entered into the Kentucky Housing Corporation's HMIS. Whenever possible, data integration methods will be used to minimize the complexities of the Program Evaluation data collection system. Purchasing software to accomplish this end may be necessary. The SAMHSA Common Data Platform (CDP) web-based data collection and reporting tool will be used for data entry either in the field with mobile access or at another time within the seven day requirements. In all cases, the Evaluation Associates will be expected to handle the data with utmost security to avoid any unforeseen or unplanned access to the evaluation data. Data forms will be kept under lock and key, laptops will have layers of security to prevent access, and all computers will be kept secure. (See the attached Protection of Human Subjects and the Sample Consent Forms for details). Evaluation staff will be monitored so that they meet or exceed the 80% standard set by SAMHSA. The Project Evaluator will create monthly evaluation activity reports by implementation site to ensure that baseline and follow-up data are accurate and complete. The Evaluation Center will design the details of the data handling and storage and retrieval. The Evaluator will analyze the data for reporting to the Steering Committee, KDBHDID, KICH and the semiannual reports to SAMHSA. As part of the analysis subpopulations will be examined and compared to projected service levels shown elsewhere in this application. For each of the Evidence Based Practices the Evaluation Center will utilize the SAMHSA Toolkit to determine fidelity of implementation. The reason to use these fidelity measures is to assure that CABHI Kentucky achieves the best possible results through consistent implementation strategies across all sites. Fidelity measures will be sent to grant Principal Investigators to ensure appropriate implementation. Additional measures to be used in this program will include instruments selected from TIP 59: Improving Cultural Competence, such as the Multicultural Counseling Self Efficacy Scale, and Racial Diversity Form. This 60-item self-report instrument assesses perceived ability to perform various counselor behaviors in individual counseling with a racially diverse client population. Information will be gathered at baseline and follow-up.