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CASA EVALUATION OF WELFARE DEMONSTRATION PROGRAM IN NEW JERSEY FINDS EFFECTIVE APPROACH TO ADDICTION RECOVERY AND EMPLOYMENT
CORRESPONDING AMERICAN JOURNAL OF PUBLIC HEALTH ARTICLE REVEALS INTENSIVE CASE MANAGEMENT HELPS SUBSTANCE ABUSING WOMEN-ON-WELFARE ACHIEVE GOALS OF WELFARE REFORM
NEW YORK, N.Y., January 29, 2009 – A new approach to helping drug-addicted women on welfare that treats substance abuse and addiction as a chronic disease promises better outcomes of sobriety and employment than current approaches that focus on employment first, according to CASASARDSM: Intensive Case Management for Substance-Dependent Women Receiving Temporary Assistance for Needy Families, a new White Paper by The National Center on Addiction and Substance Abuse (CASA) at Columbia University.
CASASARDSM [i], an ongoing welfare demonstration program for drug-addicted mothers conducted in Essex (including Newark) and Atlantic (including Atlantic City) Counties, New Jersey, was designed to get women engaged in treatment and employment services, help them become sober, and successfully move to stable employment. CASASARDSM uses an innovative intensive case management approach to providing services for these women and compares it to the standard care approach that focus on employment first, screening and referral. Three hundred two participants were randomly assigned to each model (161 to intensive case management and 141 to standard care).
The demonstration and its results are also documented in a corresponding article, “Improving 24-Month Abstinence and Employment Outcomes for Substance-Dependent Women Receiving Temporary Assistance for Needy Families With Intensive Case Management”, published in the February 2009 issue of the American Journal of Public Health (AJPH). The article finds that while women in the CASASARDSM demonstration program receiving standard care appeared to gain employment faster than those receiving intensive case management, they were not able to sustain these jobs over time.
The CASA report and AJPH article revealed that compared to women receiving standard care, the women receiving the intensive case management approach:
- Received more time and services from their caseworkers;
- Achieved rates three times as great of initiation, engagement, and retention in outpatient substance abuse treatment;
- Achieved significant reductions in substance use with women receiving intensive case management and were almost twice as likely to be completely abstinent at the 12 and 24 month follow-ups compared to standard care women; and
- Were more than twice as likely to be employed full-time at the end of two years.
“Risky substance use and addiction constitute this nation’s number one public health problem. Our failure to prevent and treat it costs society more than $600 billion each year. These striking outcomes suggest that a long term care strategy of treatment and abstinence first create the conditions where employment can better be achieved and sustained, even among this seriously disabled population,” said Joseph A. Califano, Jr., CASA’s chairman and president and former U.S. Secretary of Health, Education, and Welfare. “CASASARDSM offers a promising new approach to reduce the human and economic costs of addiction to our welfare system and to achieve the goals of welfare reform throughout the nation.”
Past CASA research has found that for each unemployed female welfare recipient with a substance use disorder who becomes substance-free and self-supporting, the economic benefit to society is about $48,000 annually in avoided welfare, health care and criminal justice costs, and contribution to the economy in employment. In New Jersey alone, this could amount to economic benefits of as much as $35 million per year.
“Due to the promising outcomes, the NJ Department of Human Services has expanded the CASASARDSM program to an additional 17 counties so we can serve even more mothers on welfare who have substance abuse problems. We hope our success can serve as a model to other states,” said New Jersey Human Services Commissioner Jennifer Velez.
CASASARDSM is the first major system level test of the chronic disease management approach to addiction. Based on its success, the CASA White Paper recommends that:
- All states adopt this intensive case management approach for women with substance use disorders.
- Local and state agencies increase efforts to collaborate and coordinate services that support intensive case management.
- The federal government support intensive case management through regulatory change and funding.
CASASARDSM represents the pioneering work of Jon Morgenstern, PhD., vice president and director of CASA’s division of Health and Treatment Research and Analysis, other CASA researchers and collaborators of the New Jersey Department of Human Services, Rutgers University and the National Council on Alcohol and Drug Dependence. It was supported by federal funding from the National Institute on Drug Abuse and the Administration for Children and Families.
“CASA’s evaluation reveals a finding of great importance to welfare administrators—the ability of intensive case management to increase participation in treatment and retention thereby achieving abstinence, a necessary precondition of achieving any other welfare related goals,” said Dr. Morgenstern.
The AJPH article was written by scientists from CASA and Rutgers University, Jon Morgenstern, Ph.D.; Charles Neighbors, Ph.D., M.B.A.; Alexis Kuerbis, MSW; Annette Riordan, Ph.D.; Kimberly Blanchard, Ph.D.; Katharine H. McVeigh, Ph.D.; Thomas J. Morgan, Psy.D.; and Barbara McCrady, Ph.D.
CASA is the only national organization that brings together under one roof all the professional disciplines needed to study and combat all types of substance abuse as they affect all aspects of society. CASA and its staff of more than 50 professionals has issued 67 reports and white papers, published one book, conducted demonstration programs focused on children, families and schools at 227 sites in 87 cities and counties in 34 states plus Washington, DC and two Native American tribal reservations, held 17 conferences attended by professionals and others from 49 states, and has been evaluating the effectiveness of drug and alcohol treatment in a variety of programs and drug courts. CASA is the creator of the nationwide initiative Family Day—A Day to Eat Dinner With Your Childrentm –the fourth Monday in September—the 28th in 2009—that promotes parental engagement as a simple and effective way to reduce children’s risk of smoking, drinking and using illegal drugs. In May 2007, CASA’s Chairman Joseph A. Califano, Jr., called for a fundamental shift in the nation’s attitude about substance abuse and addiction with publication of his book, HIGH SOCIETY: How Substance Abuse Ravages America and What To Do About It. For more information visit www.casacolumbia.org.
[i] CASA’s Substance Abuse Research Demonstration program.