About the Study
In 2018, the Chief Evaluation Office (CEO) partnered with the Employment and Training Administration (ETA) to fund contractor Mathematica to conduct the National Health Emergency (NHE) Demonstration Grants to Address the Opioid Crisis: Implementation Evaluation. The literature review and implementation study aims to document all facets of the six NHE demonstration grants and identify challenges and promising practices to generate information that will better inform grantees, sub-grantees, providers and partners delivering workforce services to individuals and communities affected by opioid addiction. The evaluation has produced a literature review, resource guide, and final report.
This Department of Labor-funded study was a result of the annual process to determine the Department’s research priorities for the upcoming year. It contributes to the labor evidence-base to inform employment and training programs and policies and addresses Departmental strategic goals and priorities.
- National Health Emergency Demonstration Grants to Address the Opioid Crisis: Implementation Evaluation (Final Report, December 2021)
- Embedding employment services in an opioid treatment facility (Issue Brief, October 2021)
- Adapting work readiness training for people in recovery (Issue Brief, October 2021)
- Registered Apprenticeships for Community Health Workers and Dually Certified Peer Recovery Specialist-Community Health Workers (Issue Brief, October 2021)
- Supporting employers using the Project Extension for Community Healthcare Outcomes (ECHO) model (Issue Brief, October 2021)
- National Health Emergency Disaster and SUPPORT Act Grantee Briefing (Webinar, April 2021)
- The Role of the Workforce System in Addressing the Opioid Crisis (Literature Review, March 2020)
- The Role of the Workforce System in Addressing the Opioid Crisis (Resource Guide, March 2020)
From the literature review:
- What is currently known about the role of employment and training in addiction recovery and rehabilitation, both generally and with opioids, for different subpopulations? What services and factors appear to have been effective or promising in the past, with the different target groups? What models or approaches are currently being tested in the US and in other countries?
From the implementation study:
- How were the grants implemented? What factors influenced implementation? What challenges did grantees encounter in implementation and how were those addressed? Were there problems with outreach, service enrollment, retention, and completion? What factors affected job placement and job retention?
- Who were the major partners involved and what services did they provide? What are the variations in the model, structure, governance, partnerships, across grants and sites?
- Partnerships with the behavioral health system were reported as critical for grant implementation. Many of the relationships were new, and partners struggled at times to define the purpose of the partnerships. In some cases, behavioral health partners were viewed as sources for mutual referrals or “hosts” for workforce staff. In other cases, partners collaborated to co-create new programs such as a specialized work readiness training for individuals in recovery.
- Aligning the expectations of workforce development and behavioral health partners was challenging due to differences in culture and operations. In particular, the systems had different conceptions of “work readiness.” Behavioral health partners expected that anyone who wanted to work would be eligible for American Job Center (AJC) services, but AJCs turned down some potential clients with opioid use disorder whom they deemed not ready to take advantage of their services.
- Efforts to train AJC staff on how to interact with people in recovery appear potentially promising. Two of the grantees offered training for AJC staff on topics such as substance use disorders, what it means to be in recovery, and how to interact with people with opioid use disorder in a sensitive manner (such as by using person-first language) to help break down stigma around working with people in recovery and improve the experience of people in recovery who seek services at AJCs. Having trainers with lived experience seemed particularly impactful to interview respondents.
- Flexible grant eligibility requirements allowed states to take different approaches to participant recruitment, and the approaches were associated with differences in participant characteristics. Four grantees relied heavily on recruiting participants through behavioral health partner organizations and on-site outreach at treatment facilities and recovery organizations; the other two grantees primarily screened people already seeking AJC services. States with a targeted approach to recruiting participants impacted by the opioid crisis through behavioral health partnerships enrolled more participants with barriers to employment, including prior justice involvement, being homeless at enrollment, having a disability, and not being employed at the time of program entry.
- Frontline staff and administrators identified the need for intensive case management. People in recovery recruited through partnerships with behavioral health providers had complex needs and required more support than clients typically served at AJCs.
- Grantees reported substantial labor market demand and participants interested in peer recovery occupations, but labor market information about these careers is relatively limited. The Bureau of Labor Statistics does not track peer recovery specialists as a distinct occupation. To better understand the potential earnings of people entering these positions, more labor market information is needed, along with information on possible career paths and opportunities for advancement."
- The workforce system may be able to support a community’s recovery infrastructure by helping employers provide recovery-friendly workplaces. Providing technical assistance to employers through incumbent worker training, recovery-friendly workplace initiatives, and learning communities such as Project Extension for Community Healthcare Outcomes (ECHO) can magnify the workforce system’s impact on the outcomes of individuals in recovery.
Staatz, C., Berk, J., Blyler, C., Bodenlos, K., Mack, M., Gutierrez, I. (2021). Mathematica. National Health Emergency Grants to Address the Opioid Crisis: Implementation Study Final Report. Chief Evaluation Office, U.S. Department of Labor.
Staatz, C. (2021). Mathematica. Embedding employment services in an opioid treatment facility. Chief Evaluation Office, U.S. Department of Labor.
Staatz, C. (2021). Mathematica. Adapting work readiness training for people in recovery. Chief Evaluation Office, U.S. Department of Labor.
Staatz, C. (2021). Mathematica. Registered Apprenticeships for Community Health Workers and Dually Certified Peer Recovery Specialist-Community Health Workers. Chief Evaluation Office, U.S. Department of Labor.
Bodenlos, K. (2021). Mathematica. Supporting employers using the Project Extension for Community Healthcare Outcomes (ECHO) model. Chief Evaluation Office, U.S. Department of Labor.
Vine, M., Staatz, C., Blyler, C., Berk, J. (2020). Mathematica. The Role of the Workforce System in Addressing the Opioid Crisis: A Review of the Literature. Chief Evaluation Office, U.S. Department of Labor.
Vine, M., Staatz, C., Blyler, C., Berk, J. (2020). Mathematica. The Role of the Workforce System in Addressing the Opioid Crisis: A Resource Guide. Chief Evaluation Office, U.S. Department of Labor.
The Department of Labor’s (DOL) Chief Evaluation Office (CEO) sponsors independent evaluations and research, primarily conducted by external, third-party contractors in accordance with the Department of Labor Evaluation Policy. CEO’s research development process includes extensive technical review at the design, data collection and analysis stage, including: external contractor review and OMB review and approval of data collection methods and instruments per the Paperwork Reduction Act (PRA), Institutional Review Board (IRB) review to ensure studies adhere to the highest ethical standards, review by academic peers (e.g., Technical Working Groups), and inputs from relevant DOL agency and program officials and CEO technical staff. Final reports undergo an additional independent expert technical review and a review for Section 508 compliance prior to publication. The resulting reports represent findings from this independent research and do not represent DOL positions or policies.