RMC Research is providing process, product, and outcome evaluation services to the One Sky Center operated by Oregon Health and Science University. Formally known as the National Resource Center for Substance Abuse Prevention and Treatment for American Indians and Alaska Natives, One Sky Center is cofunded by the federal Centers for Substance Abuse Prevention (CSAP) and Substance Abuse Treatment (CSAT). One Sky Center facilitates best practices in addictions prevention and treatment services to American Indians and Alaska Natives, their families, and their communities by providing materials and guidance in comprehensive, culturally appropriate services that honor traditional ways of living and healing. One Sky Center is complemented by 4 centers of excellence across the country that provide workshops, consultations, and products to organizations and practitioners that serve American Indians and Alaska Natives.

RMC Research is providing evaluation services for Oregon Partnership’s Club Drugs Awareness Project funded by the federal Center for Substance Abuse Prevention. This 1-year, school-based pilot project involves youth in Grades 9 and 10 at Portland’s Jefferson High School in an innovative intervention that draws upon the expertise of Portland’s Northwest Film Center and prevention staff associated with Oregon Partnership's YouthLink program. Participating students will learn about the filmmaking process through a series of workshops and will produce a video about the harmful effects of club drug use. The goal of the Club Drugs Awareness Project is to prevent, reduce, or delay club drug use by enhancing individual protective factors among project participants and raising community awareness of club drug use among youth. The project also aims to foster youth connectivity to school and community and to link youth to Oregon Partnership’s advocacy programs, information resources, and bilingual prevention and treatment referral services.

RMC Research, in collaboration with the Oregon Health & Science University’s Department of Family Medicine, is identifying, refining, evaluating, and documenting integrated approaches to treating persons with mild to moderate co-occurring substance abuse and mental health disorders in outpatient substance abuse treatment settings. The study design comprises a process evaluation and a client outcome evaluation and involves both quantitative and qualitative research methodology and data. This study will provide key stakeholds with information on the procedures, professional qualifications, management approaches, intra- and interagency relationships, and administrative rules required to successfully treat co-occurring disorders with minimal burden on the client and the treatment system.

RMC Research studied the impact of managed care on the utilization, cost, and outcomes of chemical dependency services provided to Medicaid-eligible adults in Oregon. Washington State, which provides its publicly funded treatment through a fee-for-service system, served as a comparison group for purposes of the study. Through a retrospective study of Medicaid claims and treatment outcomes documented in state databases and a prospective study of a representative sample of clients interviewed at 3 time points during and after their treatment episode, RMC Research assessed these changes at the client, provider, and system levels. In addition, RMC Research conducted a qualitative study of the environment of treatment services under managed care through a series of site visits to a sample of treatment providers in both states.

RMC Research studied the impact of managed care on the use, cost, and outcomes of chemical dependency treatment for Medicaid-eligible adolescents in Oregon. Washington State, which provides its chemical dependency treatment services through a fee-for-service system, served as the comparison condition for purposes of the study. Through a retrospective study of Medicaid claims and treatment participation documented in state databases and a prospective study of a representative sample of clients interviewed at 3 time points during and after their treatment episodes, RMC Research assessed the impact of managed care at the client, provider, and system levels. A qualitative study of the provision and coordination of care across the areas of education, mental health, juvenile justice, child welfare, and chemical dependency treatment provided information about the implementation of the systems in both states.

RMC Research conducted an evaluation of the Dual Diagnosis Program operated by Unity West (formerly Mental Health Services West), a community mental health agency in Portland, Oregon. The Center for Mental Health Services and the Center for Substance Abuse Treatment jointly sponsored the evaluation as part of the Collaborative Demonstration Program for Homeless Individuals. Using a quasi-experimental research design, RMC Research conducted baseline interviews and 4 follow-up interviews with study participants to examine outcomes related to alcohol and other drug use and psychiatric and residential stability. Other quantitative data collected and analyzed by RMC Research included service utilization data and demographic data from the agency's management information system. RMC Research also collected qualitative data through interviews with agency case managers and staff of the Dual Diagnosis Program and through focus groups and interviews with study participants.

RMC Research is studying the impact of financing on the long-term outcomes of methadone maintenance programs serving adult heroin users in Oregon and Washington. This study, which is funded in part by the National Institute on Drug Abuse, will document the factors limiting access to methadone; provider practices that promote or restrict retention in methadone programs; and the impact on treatment outcomes of factors such as criminal history, health care costs, and reliance on public welfare. RMC Research, in collaboration with researchers at Oregon Health Sciences University and Washington’s Division of Alcohol and Drug Abuse, will assemble and link administrative data sets from various state agencies to retrospectively study a 10-year history of service utilization and outcomes across the 2 states. The research team will use sophisticated statistical methods to control for individual and state characteristics. Under an administrative supplement, RMC Research will study the short-term impacts of a legislative decision to drop the substance abuse and mental health benefit for the Medicaid expansion group. This group represents a significant proportion of the Medicaid-eligible population presenting for publicly funded outpatient methadone treatment.

RMC Research is conducting an expansion of its prior study of the impact of managed care on chemical dependency treatment for Medicaid-eligible adults and adolescents. This study continues the examination of chemical dependency treatment in Oregon under managed care and in Washington under a fee-for-service system through analysis of data from extant databases in both states and continues a qualitative study describing the implementation of both states' treatment systems. The study involves a 24-month follow-up interview with the more than 400 adult clients who participated the earlier study and who were interviewed at treatment entry and 6 and 12 months later. A validity study of the treatment services received by the prospective sample uses data from 4 independent sources and investigates the level of agreement among these sources.

RMC Research is evaluating the Drug-Free Communities Support Program conducted by the Lane County (Oregon) Coalition to Prevent Substance Abuse. This program funded by the federal Office of Juvenile Justice and Delinquency Prevention and the Office of National Drug Control Policy strives to establish and strengthen collaboration among organizations with an interest in reducing substance abuse among youth. Efforts will focus on developing community awareness initiatives and environmental strategies to reduce risk factors and enhance protective factors among youth.

RMC Research is evaluating the Lane County Heroin Treatment Capacity Expansion project, which aims to increase access to intensive outpatient treatment for heroin-using adolescents and adults in Lane County, Oregon. The federal Center for Substance Abuse Treatment is funding this project, which is part of the communitywide strategy of the Lane County Health and Human Services Department and a contracted panel of intensive outpatient treatment providers. The project will expand the capacity of the existing treatment system, improve outreach efforts, and expand education and linkages to medical intervention. RMC Research is evaluating both the processes and outcomes of the project and its impact on the community. The data sources for the evaluation include treatment provider quarterly reports, Oregon’s Client Process Monitoring System, Government Performance and Results Act core client outcome measures, focus groups with treatment providers, and interviews with key stakeholders.

This is a secondary data analysis project using information obtained in national studies including the Drug Abuse Treatment Outcome Study (DATOS), the Alcohol and Drug Services Study (ADSS), and the Substance Abuse and Mental Health Services Administration (SAMHSA) Managed Care and Vulnerable Populations Study. RMC Research was one of the grantees in the SAMHSA managed care studies and is working with the Oregon Health & Science University, the prime grantee on this project, contributing its expertise on the SAMHSA family of studies to the current research questions.

Public behavioral health care programs have undergone marked change over the last decade as Medicaid managed care has come to replace the previous fee-for-service organizational and financing arrangements. Yet there has been little research into the implications of managed care for Medicaid clients with "dual diagnoses" pertaining to both mental health and substance abuse disorders.

This project has 5 primary research aims. It will (a) describe the prevalence of mental health disorders among Medicaid clients presenting for treatment at public substance abuse agencies as well as the prevalence of substance abuse problems among clients of public mental health programs; (b) examine the impact of managed care on recognition by clinicians of clients' co-occurring mental health and chemical dependency problems; (c) study the impact of managed care on provision of mental health and substance abuse services for Medicaid clients with co-occurring disorders; (d) analyze the impact of managed care on retention of dually diagnosed clients in public substance abuse treatment plus the impact of managed care on the retention of clients with substance abuse problems in public mental health treatment programs; and (e) examine outcomes of treatment for dually diagnosed clients in fee for service versus managed care systems.

RMC Research is evaluating Oregon Partnership’s Methamphetamine Awareness Project funded by the federal Center for Substance Abuse Prevention in October 2003. The project involves students in Grades 9 and 10 at 3 Yamhill County high schools in an innovative intervention that utilizes the expertise of Portland’s Northwest Film Center and prevention staff associated with Oregon Partnership's YouthLink program. One school will participate in the project in each of 3 years. The goal is to prevent, reduce, or delay methamphetamine use by enhancing individual protective factors among project participants and raising community awareness of the harmful effects of methamphetamine use. Project participants will learn about the filmmaking process through workshops and skill-building activities and will produce a video. YouthLink staff will use proven prevention strategies to foster youth connectivity to school and community; enhance awareness of methamphetamine; and link youth to Oregon Partnership’s advocacy programs, information resources, and bilingual prevention and treatment referral services. RMC Research’s evaluation will examine the 3 cohorts and control groups to determine whether the project demonstrates persistent short-term effects, continued effects, and long-term effects.

RMC Research evaluated the efforts of the Northwest Frontiers Addiction Technology Transfer Center (NFATTC) and state alcohol and drug authorities to expand and improve the collaborative efforts, expertise, and standards of practice among diverse groups of addiction and allied practitioners in Alaska, Oregon, Washington, Idaho, Hawaii, and the Pacific territories through the provision of clear direction and support for the improvement of substance abuse training and service delivery systems. The evaluation spanned 3 levels of NFATTC activity: through observation and case reporting the evaluation documented the process of technology transfer; through surveys and interviews the evaluation assessed the immediate outcomes of NFATTC services; and through document review, archival analysis, and case study reporting the evaluation chronicled the long-term impact of NFATTC in the addictions field.

RMC Research is evaluating the efforts of the Northwest Frontiers Addiction Technology Transfer Center (NFATTC) and state alcohol and drug authorities to expand and improve the collaborative efforts, expertise, and standards of practice among diverse groups of addiction and allied practitioners in Alaska, Oregon, Washington, Idaho, Hawaii, and the Pacific territories through the provision of clear direction and support for the improvement of substance abuse training and service delivery systems. The evaluation spans 3 levels of NFATTC activity: through observation and case reporting the evaluation documents the process of technology transfer; through surveys and interviews the evaluation assesses the immediate outcomes of NFATTC services; and through document review, archival analysis, and case study reporting the evaluation chronicles the long-term impact of NFATTC in the addictions field. During the current grant period (expected to last through September 2006), the RMC Research evaluation team will replicate the regional substance abuse treatment workforce survey originally conducted in 1999-2000. The survey assesses the perceived competencies, training needs, and workforce recruitment and retention challenges of substance abuse treatment professionals across the region.

RMC Research serves as the external evaluator of the Northwest Urban American Practice Research Collaborative, which aspires to enhance the development and application of knowledge within a network of urban, community-based substance abuse treatment agencies and health care programs that are sensitive to the cultural needs of Native Americans. In response to the National Institute of Medicine report Bridging the Gap Between Practice and Research, Oregon Health and Science University linked these agencies and programs serving Native Americans in the Pacific Northwest with a university-based research program directed by a Cherokee psychiatrist. Treatment agency sites are located in Seattle, Washington; Portland, Oregon; and Salem, Oregon. Treatment counselors at these sites are actively engaged in adapting evidenced-based therapies to American Indian treatment. The project is producing the American Indian Counselors' Workbook in Motivational Interviewing/Stages of Change.

RMC Research collaborated with Oregon Health Sciences University to study the impact of changes in the provision of drug abuse treatment services for Medicaid clients as the financing system transitioned from fee-for-service to capitated. The study addressed whether public or private sector agencies should deliver drug abuse treatment services for Medicaid clients and whether drug abuse treatment services should be integrated with physical health care services. The study also examined the impact of Medicaid clients' assignment to either integrated or carved-out drug abuse treatment and enrollment in either a for-profit or a nonprofit health maintenance organization. The project studied in detail people with comorbid mental health problems, pregnant women, and Native Americans. RMC Research utilized the Client Process Monitoring System (CPMS) database and other drug treatment data.

RMC Research is working with a partnership of federal, state, and local agencies to produce a plan for the development and implementation of an intergrated statewide data information and reporting system in Oregon. This system will be used to monitor progress toward specific targets related to the unlawful use of drugs, drug-related crime activity, and drug-related health and social consequences.

RMC Research conducted an evaluation of the program services of Oregon Partnership, which provides alcohol and other drug abuse prevention and treatment referral services to help Oregonians build safe and healthy communities. Oregon Partnership received funding from the federal Office of Juvenile Justice and Delinquency Prevention to implement strategies to reduce underage drinking and substance abuse through community engagement, training and technical assistance, information dissemination, problem identification, and assessment and referral services. RMC Research collaborated with Oregon Partnership to design an evaluation of the partnership’s core services, which included a resource library, HelpLine, YouthLine, and YouthLink. Oregon Partnership also engaged in a community-based planning process that served as the foundation for the design of a training and technical assistance center. RMC Research conducted interviews with key stakeholders throughout Oregon to assess their alcohol and other drug abuse prevention program and services needs, and Oregon Partnership used the resultant data to design a program plan for the training and technical assistance center, which helps Oregon communities enhance their efforts to reduce underage drinking and substance use and mobilize youth and community leaders.

RMC Research is part of the Oregon Practice Improvement Collaborative, a consortium of 4 research and training organizations, more than 30 collaborating investigators, the substance abuse treatment provider community, and state policy groups interested in promoting research activities that more closely meet the needs of the practitioners and consumers of substance abuse treatment. In response to the National Institute of Medicine report "Bridging the Gap Between Practice and Research," Oregon Health and Science University convened leading researchers, policymakers, and treatment providers across Oregon to address this serious issue in the field of substance abuse treatment. RMC Research is leading the "knowledge adoption study" component of the project, which involves researchers and practitioners working together to adopt and implement evidence-based practices in substance abuse treatment agencies. Evaluation of the project focuses on changes in researchers' and practitioners' behavior as they relate to successful implementation of these practices.

Strengthening Treatment Access and Retention (STAR) program is a unique collaborative effort between the Center for Substance Abuse Treatment (CSAT) and the Robert Wood Johnson Foundation (RWJF). The goal of the grant program is for substance abuse treatment agencies to implement clinical and administrative practice improvements and redesign their organizational systems and processes in order to improve client access and retention to their substance abuse treatment services. RMC Research staff is subcontracting its evaluation services to one of the STAR grantees, the Mid-Columbia Center for Living (MCCFL), helping them to assess progress toward meeting its process improvement goals over the 3-year grant period.

RMC Research is providing program evaluation services for the Tualatin Valley Centers (TVC) Recovery Mentor Project, which proposes to enhance services for offenders with substance abuse problems who are in the process of transitioning from state and county institutions back into their home communities in Washington and Clatsop Counties in Oregon. The Recovery Mentor Project will assign recovery mentors to meet frequently with all program participants and clinical staff to provide substance abuse treatment and aftercare services as determined by the program participants' treatment plans. The program evaluation will focus on the achievement of the project's goals and objectives and will use data supplied by the recovery mentors, the clinicians, and county justice agencies. The project's goals include successfully engaging program participants in services; helping program participants meet such transition goals as finding employment, housing, and physical and behavioral health services; reducing the recidivism rate among program participants; and increasing the percentage of positive case closures—that is, release from supervision based on the completion of sentencing and supervision requirements—in comparison to baseline data.